Rambam Medical Center

Ndemanga:Kuthandizira kwa bongo Kutalika kwakukulu kukakhala kunja: milunguNthawi yomwe amagwiritsidwa ntchito kuchipatala imatengera mtundu wa aneurysm. Ndi aneurysm wosakhazikika, nthawi yochira pambuyo poti chithandizo imakhala yofupikirapo kuposa kupukuta.

Chinthu choyamba chomwe odwala ndi mayi aliyense ayenera kudziwa pokhudzana ndi khansa ya m'mawere (monga, momwe ziliri ndi mtundu uliwonse wa khansa): lero lino si chiganizo, gawo loyambirira la matendawa, limwopseza mwayi wogonjetsa khansa kwathunthu. Ngakhale m'magawo apambuyo pake, pali mipata yambiri komanso yambiri yolimbana ndi matendawa chifukwa cha njira zamakono zosinthira chithandizo (onani pansipa).Ndani ali pachiwopsezo? Khansa ya m'mawere ndi vuto loipitsitsa lomwe limapezeka pafupifupi mwa akazi khumi. Khansa ya m'mawere imatha kupezeka ali ndi zaka zilizonse, koma zikafika zaka 65, ndiye kuti chiwopsezochochotupa mapangidwe ndi 6 kuchulukirapo kuposa kale. Ofufuzawo anazindikira izi zomwe zimayambitsa matendawa:1) cholowa cholemetsa: ngati achibale, makamaka akakhala ndi amayi, apezeka ndi khansa ya m'mawere, ziwalo zoberekera za amayi, komanso matenda ena a oncological, ndiye kuti chiopsezo chokhala ndi khansa ya m'mawere chikuwonjezeka;2) kumayambiriro kwa kusamba (mpaka zaka 12) komanso kutha kwa msambo (pambuyo pa zaka 55);3) osabereka, nthawi yoyamba kubadwa (pambuyo pa zaka 30), kuchepa kwa mkaka kapena nthawi yochepa yoyamwitsa, pambuyo pake;4) moyo wosagonana wogonana;5) kuvulala kwa gland;6) matenda a "dishormonalmammary gland hyperplasia ”;7) kunenepa kwambiri;8) kukanika kwa chithokomiro;9) kusintha kwa mahomoni.Zizindikiro za Khansa ya M'mawere Muzochitika zachipatala, chotupa mu chithokomiro cha mammary nthawi zambiri chimapezeka ndi mzimayi kapena mkazi, zomwe zimachitikanso. Chotupa chija chitha kuwoneka pakufufuzidwa ndi a mammologist, gynecologist, opaleshoni, kapena kungakhale mwangozi pofufuza mayeso.Zizindikiro ziti    kuphatikiza pakumvetsetsa kwamaphunziro m'mawere, mayi amatha kuwona kusintha kwa nsonga zake: zilonda zam'mimba, kuzimiririka, kuwona kuchokera ku nsonga zamabele. Uwu ndi nthawi yolankhula ndi dokotala nthawi yomweyo!     pambuyo pake magawo angapokufooka okulira, kuwonongeka kwa thanzi, kutsokomola, kupuma movutikira, kupweteka kwa mafupa kumatha kuchitika.Chithandizo cha Khansa ya M'mawere Chithandizo cha khansa ya m'mawere chimachitika m'magawo angapo pogwiritsa ntchito njira zosiyanasiyana. Njira zitatu zazikulu zomwe zikugwiritsidwa ntchito masiku ano:Mankhwala antitumor mankhwala.Pali mitundu ingapo ya mankhwalawa, yomwe ndi:* chemotherapy: Pankhaniyi, mankhwala omwe cholinga chake ndi kuwononga maselo a chotupa amagwiritsidwa ntchito;* mankhwala a mahomoni, ndiye kuti, kugwiritsa ntchito mankhwala osokoneza bongo omwe amachitika mu chotupa ndi m'thupi;* Chithandizo cholunjika ndi njira yatsopano, njira yomwe mankhwala "amawongolera" pazomwe zimapangitsa maselo a chotupa ndikuchita mosamalitsa wathanziminofu yaumunthu;* Immunotherapy ndiye njira yatsopano kwambiri, yomwe masiku ano pamakamponi apadziko lonse a oncologists amatchedwa imodzi mwanjira zapamwamba komanso zolimbikitsira zolimbana ndi khansa zamitundu mitundu. Chinsinsi cha immunotherapy ndichopangira mwapadera maselo chitetezo cha wodwalayo. Chifukwa cha ukadaulo wawo wapadera, amasintha kukhala chida champhamvu chomwe chimatha kuzindikira ndikuwonongeratu maselo a khansa.Pozindikira khansa ya m'mawere, chithandizo chamankhwala othandizira ndi chithandizo cha radiation imagwiritsidwanso ntchito.Siyani pempho patsamba lathu ndipo akatswiri athu adzakupezani ndi kukuthandizani kusankha chipatala chabwino kwambiri malinga ndi vuto lanu.

nullmankhwala ndi mankhwala a radiation chikugwirizana ndi opareshoni. Kusankha kwa chitsogozo chotsogola kumayendetsedwa ndi kukula ndi komwe chotupacho, mkhalidwe wa wodwalayo komanso matenda oyanjana nawo.Ndi chotupa chochepa kwambiri chomwe sichimamera mucosa, ndiye kuti mucosa yokhayo yomwe imapangidwa ndi gastroscope, ndipo zotsatira zake zimakhala bwino.Pa siteji I - II ya khansa, gawo lina lam'mphepete limachotsedwa, chilema chimadzaza gawo lamatumbo kapena chubu chimapangidwa kuchokera m'mimba. Masiku ano ndizotheka kugwiritsa ntchito zida za endoscopic pantchito izi.Ndi kufalikira kwa chotupacho m'matumbo a minofu ndikuwonjezerapo, opareshoni imachitidwanso, koma izinullNthawi zina chemoradiotherapy amachitika ndi osakwanira opaleshoni. Chemotherapy ikhoza kuchitika ngati opaleshoni singatheke, pamene chotupa ndi chachikulu kwambiri, kapena ndi chotupa chochepa, koma ndi contraindication wamba opaleshoni. Munjira yosasamala iyi, kupulumuka kumafanana ndi chithandizo cha opaleshoni. Pamaso pa fistulas, chemoradiotherapy siyotheka. Chemotherapy ikhoza kukhala yovuta chifukwa cha kutupa kwamphamvu kwa mucous membrane wa esophagus, komwe kumafunikira chakudya kudzera ndi dontho.Siyani pempho patsamba lathu ndipo akatswiri athu adzakupezani ndi kukuthandizani kusankha chipatala chabwino kwambiri malinga ndi vuto lanu.

Khansa ya lung lero ndi imodzi mwazinthu zodziwika bwino kwambiri za neoplasms. Pa avareji, pali anthu 40 odwala matenda a khansa m'mapapo anthu 100,000 padziko lonse lapansi, kuposa apo, amuna amapezeka ndi matendawa maulendo 10 kuposa azimayi, ndipo kuchuluka kwa okhala m'mizinda nthawi zonse kumakhala kochulukirapo kuposa kuchuluka kwa anthu akumudzi. Komabe, mankhwala amakono ali ndi zida zamphamvu zochizira matenda a oncology awa: kugwiritsa ntchito panthawi yake thandizo, ndizotheka kuti sikuti kungoletsa chitukuko, komanso kuiwalako za nthawi yonseyi.Khansamapapu: Mbiri ya matenda ndi kudalirika kwa machiritsoPafupifupi anthu 5 miliyoni amafa ndi khansa ya m'mapapo chaka chilichonse padziko lapansi. Matenda a mtunduwu amatchedwanso bronchogenic carcinoma, kapena khansa ya bronchogenic. Chotupacho chimayamba kuchokera ku epithelium ya mucous ya bronchi, alveoli ndi epithelium ya bronchial gland. Ngakhale kuti etiology yamatendawa sichikudziwikabe, zifukwa zazikulu zomwe zimachitikira zimaphatikizapo: kusuta; kukhudzana ndi radon ndi ma carcinogens ena (mchere wa asbestos ndiowopsa kwambiri pamapapu); mitundu ina ya ma virus; kuchuluka kwa kuchuluka kwa fumbi mlengalenga. Pathogenesis wa khansa ya m'mapaponullnullmapapu.Khansa ya m'mapapo 1 ya 1 imadziwika ndi chotupa mpaka kukula kwakukulu kwa 3 cm, komwe sikunachitikebe. Neoplasm imakhala mu gawo limodzi la mapapu kapena mkati mwa bronchus.Gawo lachiwiri - chotupa mpaka 6 cm chimakhala gawo limodzi la mapapu kapena mkati mwa bronchus. Metastases amodzi mu pulmonary ndi bronchopulmonary lymph node amawonedwa.Gawo lachitatu - chotupa chachikulu kuposa 6 cm chomwe chimasandulika kukhala pafupi ndi mapapo kapena kumera kwa bronchus yoyandikira kapena bronchus. Ma metastases amapezeka mu bifurcation, tracheobronchial, paratracheal lymph node.4gawo la khansa ya m'mapapo limadziwika ndi metastases m'magulu akutali ndi ziwalo, pleurisy ndi / kapena pericarditis imagwira. Kugawikaku kumagwira ntchito pokhapokha patakhala cell carcinoma. Pankhani ya khansa yaying'ono yamaselo, yomwe imayamba msanga, magawo awiri okha ndiomwe amadziwika. Yoyamba - gawo lochepera - imayendera limodzi ndi kufalikira kwa maselo amtundu umodzi m'mapapu amodzi ndi pafupi. Mu gawo lachiwiri, chotupacho chimakumana ndi gawo lakunja kwa mapapu komanso ziwalo zakutali.Mankhwala othandizira khansaKudziwitsa bwino matenda a pulmonary oncology ndikofunikira kwambiri, chifukwa kusankha njira zoyenera zamankhwala kumadalira. Njira zazikulu ndiopaleshoni othandizira, chemo ndi radiation chithandizo. Chifukwa cha kukula kwatsopano kwaukadaulo wazachipatala, njira izi zikuyamba kukhala zotetezeka komanso zothandiza.1. Mankhwala othandizira opaleshoni amagwiritsidwa ntchito ngati squamous cell carcinoma. Pa opaleshoni, chotupa chonse cha khansa kapena gawo lake limachotsedwa. Kuchuluka kwa minofu yomwe imachotsedwa kumadalira mtundu wa chotupacho ndi malo ake. Zochitika pakalipano pochiza khansa yamapapu ndikugwiritsa ntchito njira zowononga zachilengedwe, zomwe zimapangidwa pogwiritsa ntchito kamera ya kanema yaying'ono. Njirayi imatchedwa Video-Anathandiza Thoracoscopic Surgery (VATS). Kuchita koteroko kumayendetsedwa ndi ululu wocheperako, ndipo njira yokonzanso pambuyo pawo imatha mofulumira.2. Chemotherapy- Chithandizo chachikulu cha odwala ambiri omwe ali ndi khansa ya m'mapapo. Chinsinsi chake chagona pa kumwa mankhwala omwe amawononga ma cell a khansa.3. Chithandizo (chotsimikizika) cha khansa yam'mapapo. Mankhwalawa amazindikira maselo owopsa ndi machitidwe awo ndikuwawononga, amakhudza ntchito zofunika (kukula, kugawa). Kuphatikiza apo, mankhwalawa amasokoneza magazi m'magazi. Chithandizo chowongoleredwa (cholozera) chitha kutumikiridwa monga njira yodziyimira payokha kapena kuphatikiza ndi chemotherapy kuti uthandize kuwonjezera chithandizo.4. Katemera wa immunological pothana ndi khansa yamapapu ndi njira yatsopano komanso yolimbikitsa kwambirioncology yolimbikitsa. Chithandizo choterechi chimakupatsani mwayi wokhazikitsa maselo a chitetezo chathu mthupi kuphatikiza ma cell a khansa ndipo "chandamale" chimakhudza maselo a chotupa.5. Radiotherapy. Kuwotcha kwa chotupacho ndi mtanda wokulirapo wa ma gamma misewu, chifukwa chomwe maselo a khansa amwalira (amaletsa kukula ndi kubereka). Kuchitika ndi njira yakutali kapena yayikulu. Ndi chithandizo chowopsa cha radiation, chotupa chokha komanso zigawo za metastasis yam'madera zimayatsidwa ndi radiation. Radiation therapy imagwiritsidwanso ntchito ngati khansa yaing'ono ya cell.Siyani pempho patsamba lathu ndipo akatswiri athu adzakupezani ndi kukuthandizani kusankha chipatala chabwino kwambiri malinga ndi vuto lanu.

Acute lymphoblastic leukemia, yemwenso imafupikitsidwa monga ONSE (ndi zilembo zoyambirira za matendawa), ndipo nthawi zina mumatha kupeza dzina la pachimake lymphocytic leukemia - matenda oopsa a hematopoietic system. Matendawa amayambira m'mongo. Mafuta athu akumafupa ndi fakitale yamagazi osiyana. Mafuta a m'mafupa akadwala, ndiye kuti fakitoli, m'malo mwa athanzi (madokotala amalankhula za maselo okhwima), imayamba kupanga maselo oyera amisempha yambiri.Munthu akadwala, ndiye kuti maselo onse am'magazi amakula ndikusinthidwa bwino, zonse zimachitika mosamala. Maselo a m'magazi amakula pang'onopang'ono, ndipo kusinthaku kumakhala kovuta kwambiri. Koma litimwana amadwala ndi pachimake lymphoblastic leukemia, i.e. ZONSE, njira yokhwima imasinthiratu.Maselo oyera, ndiye kuti leukocytes, mwadzidzidzi amasiya kukhwima kwathunthu ndipo sakhala ndi magulu onse ogwira ntchito. M'malo mwake, amayamba kugawana mwachangu komanso mosalamulirika. Ntchito ya hematopoietic dongosolo ikusokonekera bwino: maselo odwala amatenga maselo athanzi ndikukhala mulufupa. Mwana wodwala amakhala wopanda maselo oyera am'magazi, maselo ofiira a m'magazi (maselo ofiira), kapena mapulateleti am magazi.Ichi ndichifukwa chake ana amatha kukhala ndi magazi m'thupi (anemia), matenda osiyanasiyana opatsirana (matenda), komanso magazi pafupipafupi. Ndipo iziAwo ndi zizindikiro zoyambirira zomwe zimatha kulankhula za khansa ya m'mimba mwa mwana. Koma nthendayo yokha, ZONSE, kuyambira pa chiyambi siziri m'chigawo chilichonse cha thupi. Kuchokera m'mphepete mwa mafupa, imalowa m'magazi, kulowa m'matumbo a lymphatid ndi ziwalo zina zonse. Ntchito yamakina onse a ziwalo, ndiye kuti, ziwalo zonse, zimayamba kusokonekera. Ndiye chifukwa chake ONSE, monga mitundu ina yonse ya khansa, amatchedwa matenda oopsa, ndiye kuti, matendawa amawononga thupi lonse ngati dongosolo.ZONSE zimafalikira m'thupi lonse mwachangu. Popanda chithandizo, maselo a leukemia amasowa kulikonse, ayizopinga misonkhano. Ziwalo komwe adasiya kugwira ntchito moyenera ndipo nthenda zazikulu zatsopano zimayamba mwa iwo. Ngati khansa ya m'magazi singalandire, ndiye kuti imfa imachitika m'miyezi ingapo.Siyani pulogalamu yaulere patsamba lathu ndipo akatswiri athu adzakupezani ndi kukuthandizani kusankha chipatala chabwino kwambiri malinga ndi mlandu wanu. Njira zochizira matendawa zimatengera zaka komanso momwe wodwalayo alili, mtundu ndi gawo la kukula kwa matendawa, ndipo nthawi zonse amawerengedwa payekhapayekha payekhapayekha.Pali mitundu iwiri yayikulu yamankhwala othandizira khansa ya m'mimba - chemotherapy ndi chithandizo cha opaleshoni - kuphatikizira kwa m'mafupa.Chemotherapy amapangidwa ndinjira ziwiri zotsatizana:• Cholinga cha gawo loyamba ndikupereka chikhululukiro. Ndi chemotherapy, oncologists amakwaniritsa kuchepa kwamitundu yama cell a blast• Kuphatikiza kofunikira kuti muwononge maselo otsala a khansaKubwezeretsanso, monga lamulo, kubwereza kwathunthu chiwembu (mankhwala, ma dosages, pafupipafupi oyang'anira) oyambira• Kuphatikiza pa mankhwala a chemotherapeutic, cytostatics amakhalapo pamalamulo azonse othandizira.Malinga ndi ziwerengero, kutalika konse kwa mankhwala a chemotherapy a leukemia pachimake ndi pafupifupi zaka ziwiri.Chemotherapy yophatikizidwa ndi cytostatics ndinjira yankhanza yowonetsera, kuyambitsa zotsatira zingapo zoyipa (nseru, kusanza, kudwala, kusowa tsitsi, ndi zina zambiri). Pofuna kuchepetsa vuto la wodwalayo, chithandizo chogwirizana chimayikidwa. Kuphatikiza apo, kutengera ndi momwe zinthu zilili, maantibayotiki, othandizira ma detoxization, maselo ophatikizika ndi erythrocyte, ndikuwonjezereka magazi.Kufupika kwa mafupaKuphatikizika kwa mafupa kumapereka wodwalayo maselo abwino olimbitsa, omwe pambuyo pake amakhala makolo a maselo abwinobwino a magazi.Chofunika kwambiri pakuzika ndikuchotsa kwathunthu matendawa. Ndikofunikira kuti marongo oyeretsedwa kuchokera ku maselo a kuphulika amadzazidwanso ndi maselo athanzi.Pofuna kukonzekeretsa wodwalayo opaleshoni,mankhwala apadera a immunosuppressive amachitika. Izi ndizofunikira kuwononga maselo a leukemia ndikupondera chitetezo cha mthupi kuti muchepetse chiopsezo chokana kupatsirana.Contraindication kuti kufalikira kwa mafupa:• Kuphwanya kachitidwe ka ziwalo zamkati• Matenda opatsirana pachimake• Kubwezeretsanso kwamatenda a leukemia, osamasulira ngati chikhululukiro• ukalambaSiyani pempho patsamba lathu ndipo akatswiri athu adzakupezani ndi kukuthandizani kusankha chipatala chabwino kwambiri malinga ndi vuto lanu.

Pafupifupi, kusintha kwa precancer kukhala chotupa cha khansa kumatenga zaka ziwiri mpaka 15. Kusintha kwotsatira kuyambira gawo loyambirira la khansa kupita komaliza kumatha zaka 1-2.Khansa ya khomo lachiberekero ndi chotupa chowopsa, chomwe malinga ndi ziwerengero zamankhwala pakati pa matenda a oncological omwe amapezeka pakati pa kugonana koyenera, chimatenga malo achinayi (pambuyo pa khansa yam'mimba, khungu ndi ma gonia a mammary).Gwero la khansa ya khomo pachibelekeropo ndi maselo abwinobwino omwe amaphimba khomo pachibelekeropo. Zoposa 600,000 zotupa izi zimapezeka pachaka.odwala. Ngakhale khansa yamchiberekero imakonda kupezeka pakati pa zaka 40-60, koma, mwatsoka, posachedwa idakula kwambiri.Chithandizo cha khansa ya khomo lachiberekero chimaphatikizidwa ndikuphatikiza opaleshoni, chemotherapy ndi radiation. Munthawi zonsezi, chithandizo chimagwiritsidwa ntchito payekhapayekha, zimatengera gawo la matendawa, matenda oyanjana, momwe khomo lachiberekero limakhalira, komanso kukhalapo kwa matenda opatsirana pakalipano.Pakupanga opaleshoni, chotupa chimatha kuchotsedwa ndi mbali ina ya khomo pachibelekeropo, kuchotsa chotupa chijakhomo pachibelekeropo, ndipo nthawi zina ndi chiberekero lokha. Nthawi zambiri, opareshoni imathandizidwa ndi kuchotsedwa kwa ma lymph node a pelvis (ngati maselo a khansa atha kuzolowera). Nkhani yakuchotsa kwamchiberekero nthawi zambiri imasankhidwa payekhapayekha (kumayambiriro kwa khansa m'mayi achichepere, thumba losunga mazira limatha kusungidwa).Pambuyo pa opaleshoni, ngati kuli kotheka, odwala amapatsidwa mankhwala a radiation. Kuchiza ndi ionizing radiation kumatha kuphatikiza chithandizo cha opaleshoni, ndipo amatha kuperekedwa padera. Pochiza khansa ya khomo lachiberekero, chemotherapy, mankhwala apadera omwe amaletsa kukula angagwiritsidwe ntchito.ndi khansa kugawanika. Tsoka ilo, kuthekera kwa chemotherapy kwa matendawa ndizochepa.Kupambana kwamankhwala othandizira khansa ya khomo pachifuwa kumadalira msinkhu wa wodwalayo, kulondola kwa kusankha kwa mankhwalawo, ndipo koposa zonse, pakudziwitsa matendawo. Khansa ya khomo lachiberekero ikapezeka kumayambiriro kwake, matendawa ndi abwino kwambiri ndipo matendawa amatha kuchiritsidwa ndi njira zopangira opaleshoni yokha.Siyani pempho patsamba lathu ndipo akatswiri athu adzakupezani ndi kukuthandizani kusankha chipatala chabwino kwambiri malinga ndi vuto lanu.