Wierecky J, Bokemeyer C
Abteilung für Hämatologie, Onkologie, Immunologie und Rheumatologie, Medizinische Klinik II, Universitätsklinikum Tübingen.
Internist (Berl). 2005 Jan;46(1):9-18. doi: 10.1007/s00108-004-1318-0.
Superior vena cava syndrome is a medical condition determined by the mechanisms of extrinsic compression, invasion or thrombosis of the superior vena cava. The most common underlying cause is a malignant process, especially lung cancer and lymphoma. Typical symptoms include progressive dyspnea, head and upper body edema and cyanosis. Most patients can be treated with appropriately directed chemotherapy or radiotherapy. Accurate diagnosis of the underlying etiology needs to be established before treatment. Only under extreme emergency conditions such as laryngeal or cerebral edema irradiation should be initiated without a histological diagnosis. With the refinement of endovascular stents, percutaneous stenting is being increasingly used as primary treatment modality. Metastatic spinal cord compression is one of the most dreadful complications of cancer. In most patients the initial symptom is progressive back pain with an axial or radicular distribution. MRI should be preferred in the diagnostic work-up, corticosteroids be administered promptly after biopsy. Radiation therapy or surgical treatment should be started as soon as possible.
上腔静脉综合征是一种由上腔静脉外部压迫、侵犯或血栓形成机制所决定的病症。最常见的潜在病因是恶性病变,尤其是肺癌和淋巴瘤。典型症状包括进行性呼吸困难、头部和上身水肿及发绀。大多数患者可通过适当的定向化疗或放疗进行治疗。在治疗前需要明确潜在病因的准确诊断。只有在诸如喉水肿或脑水肿等极端紧急情况下,才应在未进行组织学诊断的情况下开始放疗。随着血管内支架技术的完善,经皮支架置入术正越来越多地被用作主要治疗方式。转移性脊髓压迫是癌症最可怕的并发症之一。在大多数患者中,初始症状是呈轴向或神经根分布的进行性背痛。在诊断检查中应首选磁共振成像(MRI),活检后应立即给予皮质类固醇。应尽快开始放疗或手术治疗。