20.500.12556/DiRROS-9136
Kompresija hrbtenjače
Spynal Cord Compession
Kompresija hrbtenjače je zaplet rakave bolezni, ki redko ogroža bolnikovo življenje, če pa je ne odkrijemo, lahko že v nekaj urah vodi do nepopravljive okvare hrbtenjače s trajno paralizo. Do kompresije hrbtenjače največkrat pride pri bolnikih z zasevki v hrbtenici, redkeje je posledica neposrednega vraščanja mehkotkivne tumorske mase v hrbtenični kanal. Do tega zapleta najpogosteje pride pri bolnikih z rakom pljuč, dojke, prostate, ščitnice, ledvice in s plazmocitomom. Bolnik kot prve težave navaja bolečine v hrbtenici, temu se pridružijo nevrološki izpadi. Nivo kompresije hrbtenjače določimo z nevrološkim pregledom. Od diagnostičnih metod je na prvem mestu rentgensko slikanje, ki pa nam pokaže le skeletne nepravilnosti, zato je za opredelitev kompresije hrbtenjače nujna MRI. Pri grozeči kompresiji hrbtenjače moramo ukrepati takoj. Bolniku svetujemo mirovanje, predpišemo mu analgetike in glukokortikoide. Izbira zdravljenja je odvisna od narave bolezni, obsega prizadetosti hrbteničnega kanala in bolnikovega splošnega stanja. Obsega kirurško zdravljenje v kombinaciji z obsevanjem in sistemskim zdravljenjem ali pa le obsevanje skupaj s sistemskim zdravljenjem ali brez njega. V vsakem primeru je pri sumu, da gre za kompresijo hrbtenjače, pomembno, da zdravljenje začnemo čim prej.
Spinal cord compression is a complication of cancer that is usually not immediately life-threatening, but can lead to significant morbidity in a different way. The mechanisms by which tumors can compress the spinal cord are hematogenous spread of tumor cells to the vertebra, or rarely, by direct extension of paraspinal tumors into the spine. Such compression is predominantly due to metastatic spread of the lung, breast, prostate, thyroid, kidney cancer or multiple myeloma. The most common presentation of spinal cord compression is back pain that is followed by neurological impairment. The level of compression should be determined by physical examination. A standard x-ray is generally ordered first, but it shows only bony lesions. However, MRI is the imaging technique of choice for suspected spinal cord compression. Spinal cord compression needs urgent treatment. Patient has to be prescribed analgetics and glucocorticoids and rest is advised. The choice of treatment depends on primary cancer type, degree of spinal cord damage and general performance status of the patient. Surgery in combination with radiotherapy and systemic therapy is treatment of choice in some cases, but radiotherapy alone or in combination with systemic therapy is sometimes an option. In any case, it is important to start the treatment as soon as possible.
true
false
true
Slovenski jezik
Ni določen
by Authors
Neznano
2018-08-31 13:37:31
2018-08-31 13:37:31
2022-08-24 18:00:35
0000-00-00 00:00:00
2009
0
0
BSDOCID145259;
str. 43-44
št. 1
Letn. 13
2009
0000-00-00
Zaloznikova
Objavljeno
NiDoloceno
0000-00-00
0000-00-00
0000-00-00
616-006
1408-1741
URN:NBN:SI:doc-QVH7ZT37
25709529
65324032
RAZ_Matos_Erika_i2009.pdf
RAZ_Matos_Erika_i2009.pdf
1
CA29DCB925C1A103E6A20E35DD232E37
0f773de981e4d77cc3d85c97d8088194e5186aebaed9c1f11bb2bbd3c26ffbb7
754e5255-17b5-11ed-b6b8-001a4af901a5
20.500.12556/dirros/e89fb135-1491-479d-85f9-529b700133d3
https://dirros.openscience.si/Dokument.php?lang=slv&id=10917
Onkološki inštitut Ljubljana
Onkologija : strokovni časopis za zdravnike
0
0
0