Cory lived in an old man. According to his son’s report of his medical history, he had been suffering from mild Alzheimer’s for many years. Fortunately, there was no serious progress, and he could take care of himself. This time I was admitted to our respiratory department mainly because of asthma. I used to be able to climb stairs, but now I can only walk 100 meters on the ground before taking a break.
We quickly checked him and found that there were effusions in the pleural cavity and pericardium, and we immediately arranged for him to have a puncture. Since he has been taking anticoagulants to prevent another myocardial infarction, he was afraid The anticoagulant caused bleeding from the puncture, so I stopped the medication and waited for two days before the puncture was done. After the puncture was done, a tube was put in, and blood was drawn out. The moment the blood flowed out, I knew in my heart that he had lung cancer.
Lung cancer often metastasizes to the whole body when it is advanced, sometimes to the brain, sometimes to the bones. The chest cavity and the pericardium are also frequently metastasized. The pericardium is the two layers of skin outside the heart. If When cancer cells metastasize here, there will be effusion, sometimes yellow, sometimes blood red. Generally, the red color indicates the possibility of lung cancer metastasis.
Alzheimer’s disease may be slower to respond. The elderly seem to have a lower perception of pain caused by tumors than normal people. After the water in the pleural effusion and pericardium is drained, the elderly basically no longer complain about pain. Lie in bed every day like a healthy person. So why do patients have symptoms before pumping? This is mainly related to the characteristics of the thoracic cavity.
Our thoracic cavity is surrounded by the ribs and muscle skin of the chest wall. There are various organs and tissues in it, the most important ones are the lungs, the heart and the esophagus. On the surface of the lungs and the heart There are two layers of envelopes on the surface to protect the two organs, and the two layers of envelopes are closed, which means that the two layers of envelopes are actually like a skin water sac that has been drained. The layers are tightly pressed together and wrapped around the surface of the lung. When the inside is invaded by bacteria or tumor cells, it will produce effusion to protect itself, which will result in pleural effusion. If the pericardium is invaded, it will lead to pericardial effusion. liquid.
What are the symptoms of pleural and pericardial effusions?
The early symptoms of pleural effusion may have transient pain manifestations. As we all know, the lungs have no pain nerves. Unless the lung cancer grows to a large size, it will not Pain occurs, but the two layers of skin on the outside of the lungs are different. Although they are about the same thickness as paper, there are a lot of nerves on the top, and the sensitivity is similar to that of fingers. A little stimulation will cause pain, and the two layers of pleura stick together. , it will slide relative to each other when breathing, which is equivalent to the injury of the palm of the hand, but it will stick to each other and rub against each other. The pain is often unbearable, and the pain will be rhythmic with breathing. The same is true for the pericardium. Pain occurs when transferring.
But this pain is mostly temporary, because soon these invading bacteria or tumor cells quickly produce a lot of fluid, which accumulates in the chest cavity or in the pericardium, which can cause The two layers of thoracic cavity and the pericardium are separated, which is equivalent to separating the two injured palms, so there will be no pain. But this time, it is not that the condition is relieved, but the condition is more serious.
This is the characteristic of pleural effusion and pericardial effusion. It is painful at first, but then it is different. At this time, there is often a certain degree of cough, but it is usually not serious. Compression of the lungs will cause a decline in respiratory function and cause asthma. Our lungs are similar to sponges and are composed of countless small air bubbles, while the volume of our chest cavity is relatively fixed. If there is too much water, The lungs will be compressed and the volume will shrink, resulting in the symptoms of chest tightness and asthma.
And the heart can’t stand the pressure of the fluid in the pericardium. The heart must first dilate to suck the blood into the heart chamber, and then the blood can be pumped into the arteries. If the pericardium is full of Water may compress the heart and cause severe cardiac tamponade, making the heart lose its pumping function, and people will suddenly die suddenly.
Everything has two sides. If suffering from a tumor is a misfortune, then relatively speaking, patients with pleural effusion or pericardial effusion have one more way to diagnose the disease than other patients. Ordinary patients may need to perform lung puncture and bronchoscopy to confirm the diagnosis, but patients with pleural effusion and/or pericardial effusion can diagnose the disease by examining cancer cells in pleural effusion or pericardial effusion. The pain of pericardiocentesis is relatively small.
Lung cancer can be diagnosed when cancer cells are found in pleural effusion or pericardial effusion, and it can be confirmed that they have the same characteristics as lung cancer cells, and these cells can be used after the diagnosis of cancer cells The purpose of genetic testing is to see if you can take targeted drugs. If you can take targeted drugs, you can choose targeted drugs for treatment. If you have pleural effusion or pericardial effusion, the use of targeted drugs can be reimbursed by medical insurance.Yes, because as long as cancer cells are found in the two, it is the most advanced stage of lung cancer, and targeted drugs for advanced lung cancer can be covered by medical insurance.
In addition, for lung cancer patients with effusion, the more suitable drugs are vasopressin drugs, which mainly inhibit the growth of blood vessels in the tumor, and the pleural and pericardial effusions mainly come from the pleura And the proliferating blood vessels in the pericardium, inhibiting the growth of these blood vessels can reduce the number of cancer cells and reduce the production of pleural effusion.