Iziko lezonyango lase-Sheba

Uphengululo:Unyango lwe-aneurysm yengqondo yinkqubo yoqhaqho eyenziwa apho umngcipheko wokuqhekeka kwe-aneurysm uphakamileyo. Ububanzi obumiselweyo bokuhlala kwelinye ilizwe: iivekiIxesha elichithwe ekliniki lixhomekeka kuhlobo lwe-aneurysm. Nge-aneurysm engafakwanga mntu, ixesha lokubuyisela emva konyango lihlala lifutshane kunasemva kokuqhekeka.

Into yokuqala ekufuneka beyazi abaguli kunye nawo wonke umntu obhinqileyo malunga nomhlaza wamabele (njengoko, eneneni, malunga naluphi na uhlobo lomhlaza): namhlanje esi ayisosigwebo, isigaba sangaphambi sesi sifo, ayanda amathuba wokoyisa umhlaza ngokupheleleyo. Kwaye kwizigaba ezilandelayo, kukho amathuba ngakumbi okulwa nesi sifo ngokubulela kweendlela zonyango zangoku (jonga ngezantsi).Ngubani osengozini? Umhlaza webele sisifo esingalunganga esibi esenzeka phantse kumfazi omnye kwabalishumi. Umhlaza wesifuba unokufunyaniswa nangaliphi na ixesha, kodwa emva kweminyaka engama-65 ubudala, umngciphekoUkwenziwa kwethumba kukuphindwe kasi-6 kunangaphambili. Abaphandi bafumanisa ezona zinto zibangela ukukhula kwesi sifo:1) Ukufumana inzala: ukuba izalamane, ngakumbi kwicala loomama, ziye zafunyaniswa ukuba zinomhlaza webele, izitho zangasese zabasetyhini, kunye nezinye izifo ze-oncological, ke umngcipheko wokukhula komhlaza webele unyuke;2) ukuqala kokuqala kokuya esikhathini (ukuya kuthi ga kwiminyaka eli-12) kunye nokuqala kade kokuyeka ukuya esikhathini (emva kweminyaka engama-55);I-3) ukungabikho komntwana, ukuzala kade emva kwexesha (emva kweminyaka engama-30), ukunqongophala kokuzala okanye ixesha elifutshane lokuncancisa, isifo sokudumba kwasemva kokubeletha;4) ubomi besondo ngokungaqhelekanga;5) ukulimala kwe-mammary gland;I-6) Ukuchongwa kwe-"dishormonali-mammary gland hyperplasia ”;7) ukukhuluphala;8) ukungasebenzi kwe-thyroid;9) Unyango olungena endaweni yehomoni.Iimpawu zomhlaza wamabele Kwinkqubo yezonyango, ithumba elikwi-gland ye-mammary kwiimeko ezininzi lifunyaniswa ngumfazi okanye iqabane, okwenzekileyo. Isimila sinokufunyanwa xa kubhalwa uviwo lwe-mammologist, ugqirha wezifo zengqondo, okanye ugqirha ofumaneke ngengozi ngexesha lovavanyo.Zeziphi iimpawu ekufuneka ulumkise:    Ukongeza kwimvakalelo kwimfundo ebeleni, umfazi unokujonga utshintsho kwi-nipple: ulceration, retraction, spoting from the nipple. Eli lithuba lokudibana nodokotela kwangoko!     kumanqanaba kamva uphawuukukhula kobuthathaka, ukonakala kwempilo, ukukhohlela, ukuphefumla okunzima, iintlungu zamathambo zinokwenzeka.Unyango lomhlaza webele Unyango lomhlaza webele lwenziwa ngamanqanaba aliqela kusetyenziswa iindlela ezahlukeneyo. Iindlela ezintathu eziphambili zisetyenziswa namhlanje:Unyango lwe-antitumor yamayeza.Kukho iindlela ezahlukeneyo zonyango olunje, ezizezi:* ichemotherapy: kule meko, iziyobisi ezijolise ekutshatyalalisweni kweeseli ze-tumor zisetyenzisiwe;* Unyango lwehomoni, oko kukuthi, ukusetyenziswa kweziyobisi ezixinzelela umsebenzi wehomoni wesisu kunye nomzimba;* Unyango olujolisiweyo luhambo olutsha, indlela apho amachiza “abukhali” kwiziphumo ekujolise kuzo kwiseli yesisu kwaye enze ngokungacacanga kwimpiloizicubu zomntu;* I-Immunotherapy lulwalona lwalathiso lutsha, abathi namhlanje kwiingqungquthela zamazwe amaninzi ze-oncologists babizwe yenye yeendlela eziphambili nezikhuthazayo zokulwa iintlobo ezahlukeneyo zomhlaza. Umxholo we-immunotherapy ukwinkqubo ekhethekileyo yeeseli zomzimba zokuzikhusela. Ngenxa yetekhnoloji yabo eyahlukileyo, bajika baba sisixhobo esinamandla esikwaziyo nokutshabalalisa ngokuchanekileyo iiseli zomhlaza.Ngokuxilongwa komhlaza wamabele, unyango lokuhlinzwa kunye nonyango lweradiation luyasetyenziswa.Shiya isicelo kwiwebhusayithi yethu kwaye iingcali zethu ziya kunxibelelana nawe kwaye zikuncede ukhethe ezona klinikhi zibalaseleyo ngokubhekisele kwimeko yakho yasimahla.

nullUnyango ngamachiza kunye nonyango oluhambelana nemitha. Ukukhethwa kwendlela ekhokelela kunyango kuchazwe ngokobungakanani kunye nendawo esikuyo isifo, imeko yesigulana kunye nezifo ezihamba nazo.Isisu esincinci kakhulu esingamiseli i-mucosa, kuphela i-mucosa enomaleko ophantsi kwaye iphinde yenziwa nge-gastroscope, kwaye iziphumo zonyango zilungile kakhulu.Kwinqanaba I-II lomhlaza, inxenye yesophagus iyasuswa, isiphene sizaliswe yinxalenye yesisu okanye ityhubhu yenziwe kwisisu. Namhlanje kunokwenzeka ukuba usebenzise izixhobo ze-endoscopic kule misebenzi.Ngokusasazeka kwethumba kuludwe lwezihlunu kunye nokuqhubeka, kwenziwa umsebenzi, kodwa okunullNgamanye amaxesha i-chemoradiotherapy yenziwa ngoxinzelelo olungonelanga. Chemotherapy inokwenziwa ukuba utyando alunakwenzeka, xa ithumba likhulu kakhulu, okanye linethumba elincinci, kodwa ngokuchasene ngokubanzi nokuhlinzwa. Kule ndlela yokulondolozwa, ukusinda kuthelekiswa nonyango lokuhlinzwa. Ubukho be-fistulas, ichemoradiotherapy ayinakwenzeka. I-Chemotherapy inokuba nzima kunye nokuvuvukala okukhulu kwe-membrane ye-mucous yesophagus, eya kufuna isidlo ngokuthoba.Shiya isicelo kwiwebhusayithi yethu kwaye iingcali zethu ziya kunxibelelana nawe kwaye zikuncede ukhethe ezona klinikhi zibalaseleyo ngokubhekisele kwimeko yakho yasimahla.

I-acute lymphoblastic leukemia, ekwabizwa ngokuba yi-BONKE (ngokwamagama okuqala esi sifo), kwaye ngamanye amaxesha igama elinesi sifo esibuhlungu kakhulu sisifo esibuhlungu kakhulu kwinkqubo yehematopoietic. Isifo siqala kumongo wethambo. Umongo wethu wethambo ngumzi-mveliso weeseli zegazi ezahlukeneyo. Xa umongo wamathambo ugula, lo mzi-mveliso, endaweni yezempilo (ogqirha bathetha malunga neeseli ezivuthiweyo), uqalisa ukuvelisa inani elikhulu leeseli ezimhlophe zegazi ezingafakwanga.Xa umntu engaguli, ke zonke iiseli zegazi zikhula kwaye zihlaziywe ngokuvisisanayo, yonke into yenzeka ngendlela elungeleleneyo. Iiseli zegazi zivuthwa ngokuthe ngcembe, kwaye inkqubo yokuvuthwa intsokothile. Kodwa niniumntwana ugula sisifo se-lymphoblastic leukemia, i.e.BONKE, inkqubo yokuvuthwa iqhekeza ngokupheleleyo.Iiseli ezimhlophe zegazi, oko kukuthi, iiseli ezimhlophe zegazi, ziye ziyeke ukuvuthwa ngokupheleleyo kwaye zingakhuli zibe ziiseli ezisebenza ngokupheleleyo. Endaweni yoko, baqala ngokukhawuleza nokwabelana ngokungalawuleki. Umsebenzi wenkqubo ye-hematopoietic uyanda ukungasebenzi kakuhle: iiseli ezigulayo zigxotha ezi zisempilweni kwaye zithathe indawo yazo kumongo. Umntwana ogulayo akanazo iiseli ezimhlophe zegazi, iiseli ezibomvu zegazi (iiseli ezibomvu zegazi), okanye iiplatelets zegazi (iiplatelets).Yiyo loo nto abantwana bekhula ukuba ne-anemia (anemia), iingxaki ezahlukeneyo zosulelo (usulelo), kunye nokukopha rhoqo. Kwaye okuEzi ziimpawu zokuqala ezinokuthi zithethe malunga ne-leukemia ebukhali emntwaneni. Kodwa esi sifo ngokwaso, YONKE, ukusukela ekuqaleni asikho kwilungu elinye lomzimba. Ukusuka kumongo wethambo, ungena ungene egazini, ungene kwii-lymphoid tishu (inkqubo ye-lymphatic) kuwo onke amanye amalungu. Umsebenzi wayo yonke inkqubo yezitho, oko kukuthi, umzimba uphela, uqala ukuphazamiseka. Kungenxa yeso sizathu le nto, njengazo zonke ezinye iintlobo zesifo sokuvuvukala, sibizwa ngokuba sisifo esibuhlungu isifo, oko kukuthi, isifo sitshabalalisa umzimba wonke njengenkqubo.ZONKE zisasazeka emzimbeni wonke ngokukhawuleza. Ngaphandle konyango, iiseli ze-leukemia ziyahluka naphi na, hayiimiqobo yokuhlangana. Amalungu apho kuyekwe ukuba asebenze ngokuqhelekileyo kwaye izifo ezinkulu ezikhulu ziqala kuwo. Ukuba i-leukemia ayinyangwa, ke ukufa kwenzeka kwiinyanga ezimbalwa.Shiya isicelo sasimahla kwiwebhusayithi yethu kwaye iingcali zethu ziya kunxibelelana nawe kwaye zikuncede ukhethe ezona klinikhi zibalaseleyo kwimeko yakho. Indlela yokunyanga isifo se-leukemia esibuhlungu ixhomekeka kubudala nakwimeko yesigulana, uhlobo kunye nenqanaba lokuphuhliswa kwesi sifo, kwaye kuhlala kubalwa ngokukodwa kwimeko nganye.Zimbini iintlobo eziphambili zonyango lwe-leukemia ebukhali - ichemotherapy kunye nonyango lokunyanga - ukuhambisa umongo kumathambo.Chemotherapy yenziweamanyathelo amabini ngokulandelelana:Iinjongo zenqanaba lokuqala kukwenziwa koxolelo. Nge-chemotherapy, i-oncologists ifezekisa ukuncipha kwinqanaba leeseli eziqhumayo• Inqanaba lokudibanisa eliyimfuneko ukutshabalalisa iiseli zomhlaza eziseleUkuphinda ungeniswe, njengomthetho, ukuphindaphinda ngokupheleleyo inkqubo (iziyobisi, iidosi, frequency yezolawulo) zenqanaba lokuqalaUkongeza kumachiza e-chemotherapeutic, ii-cytostatics zikhona kwirejimeni yonyango ngokubanzi.Ngokwezibalo, ixesha elipheleleyo lonyango lwe-chemotherapy ye-leukemia ye-acute yiminyaka emi-2.Chemotherapy edityaniswa yi-cytostatics yiindlela yokubonakalisa ubukrakra, obangela inani leziphumo (isicaphucaphu, ukugabha, impilo enkenenkene, ukulahleka kweenwele, njl. njl.). Ukunciphisa imeko yesigulana, unyango oluhambelana nalo lumiselweyo. Ukongeza, kuxhomekeke kwimeko, amayeza okubulala iintsholongwane, i-detoxification agents, iplatelet kunye ne-erythrocyte ubunzima, kunye nokukhutshelwa kwegazi kunokucetyiswa.Ukufakelwa kwamathamboUkuhanjiswa kwamathambo kunika isigulana iiseli ezisempilweni, ezithi kamva zibe ngookhokho beeseli eziqhelekileyo zegazi.Eyona meko ibaluleke kakhulu yokufakelwa komnye umntu kukuxolelwa ngokupheleleyo kwesi sifo. Kubalulekile ukuba umongo wethambo ococwe kwiiseli eziqhekezayo ugcwaliswe kwakhona ziiseli ezisempilweni.Ukulungiselela isigulana utyando,Unyango lwe-immunosuppression olukhethekileyo lwenziwa. Oku kuyimfuneko ukutshabalalisa iiseli ze-leukemia kwaye kucinezele ukhuselo lomzimba ukunciphisa umngcipheko wokwaliwa.Unxibelelwano malunga nokutshintshwa komongo wamathambo:Ukwaphulwa kokusebenza kwamalungu angaphakathi• Izifo ezosulelayo ezingapheliyoUkuphinda uqalise kwi-leukemia ebukhali, engaguqukiyo ekuxolelweni• ukwaluphalaShiya isicelo kwiwebhusayithi yethu kwaye iingcali zethu ziya kunxibelelana nawe kwaye zikuncede ukhethe ezona klinikhi zibalaseleyo ngokubhekisele kwimeko yakho yasimahla.

Umhlaza wamalaphu namhlanje yenye yeentlobo eziqhelekileyo ze-neoplasms ezibi. Ngokomndilili, kukho abantu abangama-40 abanomhlaza wemiphunga kubantu abangama-100,000 kwihlabathi, ngaphezu koko, amadoda afunyaniswa enesifo izihlandlo ezili-10 ngaphezulu kwabafazi, kwaye umda wabahlali basezidolophini kuzo zonke iimeko uphinda-phindeka kunabantu belali. Nangona kunjalo, amayeza okunyanga anamhlanje angamandla okunyanga olu hlobo lwe-oncology: ngokufika ngexesha lokunceda, kuyenzeka ukuba ungapheleli ekuphelisweni kwesi sifo, kodwa uphinde ulibale ngalo ngonaphakade.UmhlazaImiphunga: isifo sesifo kunye nokunyanga isifoMalunga nezigidi ezintlanu zabantu babulawa ngumhlaza wemiphunga minyaka le emhlabeni. Olu hlobo lomhlaza lukwabizwa ngokuba yi-bronchogenic carcinoma, okanye umhlaza we-bronchogenic. I-tumor ikhula kwi-epithelium eqingqiweyo ye-mucous membrane ye-bronchi, alveoli kunye ne-epithelium ye-bronchial gland. Ngaphandle kwento yokuba i-etiology yesifo ayikacaci, ezona zizathu ziphambili zokwenzeka kwayo kubandakanya: ukutshaya; ukubonakaliswa kwi-radon kunye ne-carcinogens ethile (i-asbestos mineral yeyona ngozi kakhulu kwimiphunga); iintlobo ezithile zentsholongwane; ukunyuka kokuxinana kwamasuntswana othuli emoyeni. I-pathogenesis yomhlaza wemiphunga ivuliwenullnullimiphunga.Inqanaba 1 lomhlaza wemiphunga libonakaliswa sisisu ukuya kuthi ga kubukhulu obuyi-3 cm, engekabikho metastasize. I-neoplasm ikwisigaba esinye semiphunga okanye ngaphakathi kwe-bronchus.Inqanaba lesi-2 - ithumba ukuya kuthi ga kwi-6 cm ikwindawo enye yemiphunga okanye ngaphakathi kwebronchus. I-metastases eyodwa kwi-pulmonary kunye ne-bronchopulmonary lymph node ziyaqwalaselwa.Inqanaba lesi-3-lithumba elikhulu kune-6 cm ngokutshintsha libe kukudibana kwemiphunga okanye ukumila kwebronchus esondeleneyo okanye i-bronchus ephambili. I-metastases ifumaneka kwi-bifurcation, tracheobronchial, paratracheal lymph node.4Inqanaba lomhlaza wemiphunga libonakaliswa nge-metastases kwiinkqubo ezikude kunye namalungu, i-pleurisy kunye / okanye i-pericarditis eqhotyoshelweyo. Olu hluko lusebenza kuphela kwi-squamous cell carcinoma. Kwimeko yomhlaza weseli omncinci, okhula ngokukhawuleza okukhulu, ngamanqanaba amabini kuphela ahlukileyo. Inqanaba lokuqala - inqanaba eliqingqiweyo - lihamba kunye nokwenziwa kweeseli zemithambo-luvo kwimiphunga enye kunye nezicubu ezikufutshane. Kwinqanaba lesibini, i-tumor metastasesa kwindawo engaphandle kwemiphunga kunye nakwizitho ezikude.Unyango lomhlaza wamalusuUkuchongwa kakuhle kwe-oncology ye-pulmonary kubaluleke kakhulu, kuba ukhetho lweendlela ezifanelekileyo zonyango luxhomekeke kuzo. Iindlela eziphambili zeziUngenelelo lokuhlinzwa, unyango lwe-chemo kunye nonyango lwe-radiation. Ngombulelo kuphuhliso olukhawulezileyo lwetekhnoloji yezonyango, ezi ndlela ziya zikhuselekile kwaye zisebenze.1. Unyango lonyango lusetyenziselwa i-squamous cell carcinoma. Ngexesha lotyando, ithumba elipheleleyo elinomhlaza okanye icandelo elisecaleni liyasuswa. Umthamo weethishu ezisuswe uxhomekeke kuhlobo lwesitshisi kunye nendawo akuyo. Imeko yangoku kunyango lomhlaza wemiphunga kukusetyenziswa kweendlela ezinqabileyo, eziveliswa kusetyenziswa ikhamera yevidiyo encinci. Obu buchule babizwa ngokuba yiVidiyo-encedisiweyo yeToracoscopic Surgery (VATS). Ukusebenza okunje kuhamba kunye nentlungu engachazwanga, kwaye inkqubo yokuvuselela emva kwabo iqhubeke ngokukhawuleza.2. Ukunyanga ngamayezaOlona nyango luphambili kwizigulana ezinomhlaza wemiphunga. Isiseko sayo silele ekuthatheni amayeza atshabalalisa iiseli zomhlaza.3. Ujoliso (ekujoliswe kulo) unyango lomhlaza wemiphunga. Amachiza anjalo aqaphela iiseli ezingalunganga ngeempawu zazo kwaye azitshabalalise, ezichaphazela imisebenzi ebalulekileyo (ukukhula, ukwahlula). Ukongeza, iziyobisi ziphazamisa ukubonelelwa kwegazi kwisisu. Unyango ekujolise kulo (ekujoliswe kulo) lunokuchazwa njengendlela yokuzimeleyo yonyango okanye ngokudibana ne-chemotherapy ukwenzela ukwandisa ukusebenza kakuhle konyango.4. Unyango lwe-immunological kunyango lomhlaza wemiphunga luyinto entsha kwaye luyathembisa kakhuluI-oncology yolondolozo. Unyango olunje lukuvumela ukuba usete iiseli zomzimba wakho wokuzikhusela kwiiseli zomhlaza kwaye "ujoliso" luchaphazela kuphela iiseli zesisu.5. I-Radiotherapy. Ukucaphukiswa kwethumba ngentsimbi enamandla emisebe ye-gamma, ngenxa yokuba iiseli zomhlaza ziyafa (bayayeka ukukhula kunye nokuzala). Iqhutywa yindlela ekude okanye ephezulu yedosi. Unyango lwe-radical radiation, zombini i-tumor ngokwayo kunye nemimandla ye-metastasis yommandla ivulelekile kwimisebe. Unyango lwe-radiation lukwasetyenziswa kumhlaza weseli omncinci.Shiya isicelo kwiwebhusayithi yethu kwaye iingcali zethu ziya kunxibelelana nawe kwaye zikuncede ukhethe ezona klinikhi zibalaseleyo ngokubhekisele kwimeko yakho yasimahla.

Ngokomyinge, utshintsho olusuka kwi-precancer luye kwi-tumor enomhlaza lithatha ukusuka kwi-2 ukuya kwi-15 iminyaka. Utshintsho olulandelayo ukusuka kwinqanaba lokuqala lomhlaza liye kwelokugqibela lihlala iminyaka emi-1-2.Umhlaza womlomo wesibeleko sisisu esibuhlungu, ethi ngokwezibalo zonyango phakathi kwezifo zesifo se-oncological ezenzeka ngesondo elifanelekileyo, sithatha indawo yesine (emva komhlaza wesisu, ulusu kunye ne-mammary gland).Umthombo womhlaza womlomo wesibeleko ziiseli eziqhelekileyo ezigubungela umntwana wesibeleko. Ngaphezulu kwe-600 amawaka ezi tumor zifunyanwayo minyaka le.abaguli. Nangona umhlaza womlomo wesibeleko uhlala ufumaneka phakathi kweminyaka engama-40-60 yeminyaka, kodwa, ngelishwa, kutsha kakhulu.Unyango lomhlaza womlomo wesibeleko luhlanganisiwe kwaye lubandakanya utyando, ichemotherapy kunye nonyango lwemitha. Kwimeko nganye nganye, unyango lumiselwe ngokukodwa, luxhomekeka kwinqanaba lesifo, izifo ezihamba kunye, imeko yomlomo wesibeleko, kunye nobukho bezifo ezosulelayo okwangoku.Ngexesha lokuhlinzwa, ithumba lingasuswa nenxalenye yomlomo wesibeleko, ukususwa kwethumba kunyeisibeleko, kwaye ngamanye amaxesha ngesibeleko ngokwayo. Rhoqo, utyando luxhaswe ngokususa ii-lymph node ze-pelvis (ukuba iiseli zomhlaza zikwazile ukuyiqhela). Umcimbi wokususa i-ovarian ihlala igqitywe ngokukodwa (kwinqanaba lokuqala lomhlaza kubafazi abancinci, ama-ovari angagcinwa).Emva kotyando, ukuba kunyanzelekile, izigulana zimiselwe unyango lwe-radiation. Unyango ngonyango lwe-ionizing radiation zombini lunokuncedisa unyango lokuhlinzwa, kwaye lunokumiselwa ngokwahlukeneyo. Unyango lomhlaza womlomo wesibeleko, ichemotherapy, iziyobisi ezizodwa ezinqumamisa ukukhula zingasetyenziswa.kunye nolwahlulo lweseli yomhlaza. Ngelishwa, amathuba e-chemotherapy kwesi sifo anqongophele.Impumelelo yonyango lomhlaza womlomo wesibeleko ixhomekeka kubudala besi sigulana, ukuchaneka kokukhethwa kwonyango, kwaye, okubaluleke ngakumbi, kuqhaqho lwesifo. Xa umhlaza womlomo wesibeleko ufunyaniswa kwinqanaba lokuqala, ugqirha uthandeka kwaye isifo sinokunyangwa ngeendlela zoqhaqho.Shiya isicelo kwiwebhusayithi yethu kwaye iingcali zethu ziya kunxibelelana nawe kwaye zikuncede ukhethe ezona klinikhi zibalaseleyo ngokubhekisele kwimeko yakho yasimahla.