Recent progress in the diagonsis and treatment of superior vena cava syndrome

doi:10.3877/cma.j.issn.2095-5782.2022.01.013

Abstract

Abstract:

Superior vena cava syndrome (SVCS) is a group of clinical symptoms caused by complete or incomplete obstruction of superior vena cava and its main branches. SVCS is a common tumor emergency. When the patient has acute or subacute dyspnea, face and neck swelling, if not timely intervention, can lead to hypoxia, increased intracranial pressure, and even death. With the change of the times, the etiologies of SVCS have changed greatly, and its diagnosis and treatment methods have also developed with the progress of medical technology. This article reviews the etiologies, clinical manifestations, diagnosis and treatments of SVCS to provide a better understanding.

Key words: Superior vena cava syndrome, Tumor, Chemoradiotherapy, Endovascular therapy

Chao Liu, Pengxu Ding, Pengli Zhou, Xinwei Han. Recent progress in the diagonsis and treatment of superior vena cava syndrome[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2022, 10(01): 70-74,87.

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References 39

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分型	SVC阻塞程度	奇静脉血流流向
Ⅰ	部分	前向
Ⅱ	近似完全	前向
Ⅲ	完全	逆向
Ⅳ	完全	无血流

分型	SVC阻塞程度	奇静脉血流流向
Ⅰ	部分	前向
Ⅱ	近似完全	前向
Ⅲ	完全	逆向
Ⅳ	完全	无血流

神经	咽喉	颜面部	胸壁及上肢
头痛	咳嗽	鼻塞	颈部及胸壁静脉扩张
视力模糊	舌肿胀	结膜水肿、眶周水肿	颈部及胸壁静脉扩张
视乳头水肿	呼吸困难	面部肿胀	上肢肿胀
意识障碍	喘鸣/喉水肿	突眼	上肢肿胀

神经	咽喉	颜面部	胸壁及上肢
头痛	咳嗽	鼻塞	颈部及胸壁静脉扩张
视力模糊	舌肿胀	结膜水肿、眶周水肿	颈部及胸壁静脉扩张
视乳头水肿	呼吸困难	面部肿胀	上肢肿胀
意识障碍	喘鸣/喉水肿	突眼	上肢肿胀

分级	类别	发生率（%）	定义
0	无症状	10	影像提示SCVS，无临床症状
1	轻度	25	头颈部水肿，紫绀
2	中度	50	头颈部水肿合并功能障碍（轻度吞咽困难，咳嗽，头部、下巴或眼睑运动轻中度障碍，眼水肿致视力障碍）
3	重度	10	轻/中度脑水肿（头痛、头晕）或轻/中度喉水肿或心脏储备功能下降（弯腰后晕厥）
4	危及生命	5	严重脑水肿（精神错乱、迟钝）或重度喉水肿（喘鸣）或显著血流动力学损害（无诱因的晕厥、低血压、肾功能不全）
5	致命	< 1	死亡

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