종양환자의 응급상황

목차

1.Structural-Obstructive Oncologic Emergencies
(1)Superior Vena Cava Syndrome
(2)심낭압전(Pericardial Tamponade)
(3)장폐색증(Intestinal Obstruction)
(4)요로폐색증(Urinary Obstruction)
(5)담도폐색증(Biliary obstruction)
(6)척추압박증후군(Spinal Cord Compression Syndrome)
(7)뇌압증가(Increased Intracranial Pressure)
(8)암성뇌막염(Neoplastic Meningitis)
(9)백혈구울체(Leukostasis)

2.Metabolic Emergencies(hormonal problems, paraneoplastic syndromes)

3.Treatment-Related Emergencies
(1)종양용해증후군(Tumor Lysis Syndrome)
(2)Human Antibody Infusion Reaction
(3)용혈성요독증후군(Hemolytic Uremic Syndrome)
(4)호중구감소성열(Febrile Neutropenia)
(5)Typhlitis(Neutropenic enterocolitis)
(6)출혈성방광염

본문내용

➀원인
-Lung cancer(mc),lymphoma,metastatic tumor(testicular & breast carcinoma)
-other cause ; benign tumor, aortic aneurysm, fibrosing mediastinitis, thyroid enlargement, thrombosis, long term central catheter.
➁증상
-neck & facial swelling, dyspnea, cough, hoarseness, tongue swelling, headache, nasal congestion, epistaxis, hemoptysis, dysphagia, pain, dizziness, syncope, lethargy.
➂이학적 소견
-dilated neck veins, collateral veins(+), cyanosis and edema of the face, arm, and chest, proptosis, glossal & laryngeal edema
➃진단
-Chest X-ray ; widening of the superior mediastinum(Rt), pleural effusion(25%)
-CT ; most reliable view of mediastinum
➄치료
-조직 진단 후 치료
-Radiation treatment; NSCLC, metastatic solid cancer
-Chemotherapy ; SCLC, GCT, lymphoma(steroid)
-Conservative treatment
;diuretics, low salt diet, head elevation, oxygen
;intravascular self-expanding stents
-surgery; benign cause
-mortality ; associated with underlying cause
(2)심낭압전(Pericardial Tamponade)
➀원인
-cancer ; lung cancer, breast cancer, leukemia, lymphoma
-benign ; irradiation, drug-induced pericarditis, hypothyroidism

참고 자료

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