Isikhungo Sezokwelapha saseRambam

Buyekeza:Ukwelashwa kweBongo aneurysm inqubo yokuhlinzwa eyenziwa lapho ubungozi bokuqothuka kwe-aneurysm buye buphakeme impela. Isilinganiso sobude bokuhlala phesheya: amavikiIsikhathi esichithwe emtholampilo kuya ngohlobo lwe-aneurysm. Ngama-aneurysm angenayo i-plug, isikhathi sokululama ngemuva kokwelashwa sivame ukufushane kunokuba kuqhume ukukhipha.

Into yokuqala iziguli nawo wonke umuntu wesifazane okudingeka ayazi ngomdlavuza webele (njengoba, ngempela, noma uluphi uhlobo lomdlavuza): namuhla lesi akusona isigwebo, isigaba sangaphambi kwesifo, amathuba aphezulu wokuhlula umdlavuza ngokuphelele. Futhi ezigabeni zakamuva, kunamathuba amaningi futhi amaningi okulwa ngempumelelo nesifo sibonga ukuqala kwezindlela zanamuhla zokuguqula izindlela zokwelapha (bheka ngezansi).Ubani osengozini? Umdlavuza webele yi-neoplasm ebabayo eyenzeka cishe koyedwa kwabesifazane abayishumi. Umdlavuza webele ungatholakala kunoma yimuphi ubudala, kepha ngemuva kweminyaka engama-65 yobudala, ubungoziUkwakheka kwesimila kukhuphuke amahlandla ayi-6 kunangaphambilini. Abaphenyi bakhomba izimbangela ezilandelayo zokukhula kwalesi sifo:1) ifa elisindayo: uma izihlobo, ikakhulukazi ohlangothini lukamama, zitholakale zinomdlavuza webele, izitho zangasese zowesifazane, nezinye izifo ze-oncological, khona-ke ingozi yokuthola umdlavuza webele iyanda;2) ukuqala kokuqala kokuya esikhathini (kuze kube yiminyaka eyi-12) kanye nokuqala kwesikhathi kokuya esikhathini (ngemuva kweminyaka engama-55);I-3) ukungazali inzalo, ukuzalwa kokufika sekwedlule isikhathi (ngemuva kweminyaka engama-30), ukuntuleka kokuqunjelwa yisisu noma isikhathi esifushane sokuncelisa ibele, i-postitis ye-mastitis;4) impilo yobulili engajwayelekile;5) ukulimala kwe-gland ye-mammary;6) ukuxilongwa kwe "dishormonalmammary gland hyperplasia ”;7) ukukhuluphala;8) ukungasebenzi kwegilo;9) ukwelashwa esikhundleni se-hormone.Izimpawu zomdlavuza webele Kwezokwelapha, isimila esiswini sezilwane ezincelisayo ezimweni eziningi sitholwa ngowesifazane noma oshade naye, okwenzeka futhi. Isimila singatholakala lapho kuhlolwa udokotela wezifo ezincelisayo, udokotela wezifo zamehlo, udokotela ohlinzayo, noma ukutholakala ngengozi ngesikhathi sokuhlolwa kwesibalo.Yiziphi izimpawu okufanele ziqwashise:    ngaphezu kokuzizwa ngemfundo ebeleni, owesifazane angabona izinguquko ezingalweni: ulceration, retraction, ubona kusukela ingono. Lesi yisikhathi sokubonana nodokotela ngokushesha!     ezigabeni zakamuva umakiubuthakathaka obukhulayo, ukuwohloka kwempilo, ukukhwehlela, ukuphefumula kanzima, ubuhlungu bethambo kungenzeka.Ukwelashwa Komdlavuza Webele Ukwelashwa umdlavuza webele kwenziwa ngezigaba eziningana kusetshenziswa izindlela ezahlukahlukene. Izindlela ezintathu eziphambili zisetshenziswa namuhla:Umuthi wokwelapha antitumor.Kunezinhlobo eziningi zokwelapha okunjalo, okungukuthi:* i-chemotherapy: kulokhu, izidakamizwa ezihlose ekubhujisweni kwamaseli e-tumor ziyasetshenziswa;* Ukwelashwa kwama-hormone, okungukuthi, ukusetshenziswa kwezidakamizwa ezicindezela ukusebenza kwe-hormonal kwesimila kanye nomzimba;* Ukwelapha okuqondisiwe kuyinkomba entsha, indlela lapho izidakamizwa “zibukhali” ngomphumela oqondiwe kumaseli we-tumor futhi kakhulu kuthinta abaphilileizicubu zomuntu;* I-Immunotherapy iyinkomba entsha kakhulu, namuhla ezinhlanganweni zamazwe omhlaba ze-oncologists ibizwa ngokuthi enye yezindlela eziphambili kakhulu nezikhuthazayo zokulwa nezinhlobo ezahlukene zomdlavuza. Umongo we-immunotherapy usezinhlelweni ezikhethekile zamaseli omzimba eziguli. Ngenxa yobuchwepheshe babo obuhlukile, baphenduka isikhali esinamandla esingabona futhi sibhubhise ngokunembile amaseli womdlavuza.Ngokuxilongwa komdlavuza webele, ukwelashwa okuhlinzwa nokwelashwa ngemisebe nakho kuyasetshenziswa.Shiya isicelo kuwebhusayithi yethu futhi ongoti bethu bazokuthinta bakusize ukhethe umtholampilo ohamba phambili ngokuhambisana necala lakho mahhala.

nullizidakamizwa kanye nokwelashwa ngemisebe kuxhunyiwe ekusebenzeni. Ukuzikhethela kwendlela eholayo yokwelashwa kuchazwa ngosayizi nendawo yesimila, isimo sesiguli nezifo ezihlangene.Njengoba kunesimila esincane kakhulu esingamanyanisi i-mucosa, kuphela i-mucosa enesendlalelo engaphansi yahlanganiswa nge-gastroscope, futhi imiphumela yokwelashwa mihle kakhulu.Esiteji I - II somdlavuza, ingxenye ye-esophagus iyasuswa, isiphuzo sigcwele ingxenye yesisu noma isigaxa sakhiwa esiswini. Namuhla kungenzeka ukusebenzisa imishini ye-endoscopic yale misebenzi.Ngokusakazeka kwesimila engxenyeni yemisipha futhi, kubuye kwenziwe umsebenzi, kepha lokhunullKwesinye isikhathi i-chemoradiotherapy yenziwa ngokuhlinzwa okunganele kokuhlinzwa. I-Chemotherapy ingenziwa uma ukuhlinzwa kungeke kwenzeke, lapho isimila sikhulu kakhulu, noma ngesisu esincane, kepha ngokubhekelwa okujwayelekile kokuhlinzwa. Kulesi sinqumo sokugcina, ukusinda kuqhathaniswa nokwelashwa okuhlinzwa. Lapho kukhona i-fistulas, i-chemoradiotherapy ayinakwenzeka. I-Chemotherapy ingahle ibe yinkimbinkimbi ngokuvuvukala okukhulu kwe-mucous membrane ye-esophagus, ezodinga isidlo ngokusebenzisa i-dropper.Shiya isicelo kuwebhusayithi yethu futhi ongoti bethu bazokuthinta bakusize ukhethe umtholampilo ohamba phambili ngokuhambisana necala lakho mahhala.

Umdlavuza wamalunga Ngokwesilinganiso, kunabantu abathola umdlavuza wamaphaphu abangama-40 kubantu abangu-100 000 emhlabeni, ngaphezu kwalokho, amadoda atholakala nalesi sifo amahlandla aphindwe ka-10 kunabesifazane, kanti inani lezakhamizi zasemadolobheni kuzo zonke izimo liphindwe kaningi kunabantu bendawo. Noma kunjalo, umuthi wanamuhla unesikhali esinamandla sokwelapha lolu hlobo lwe-oncology: ngokufinyelela ngesikhathi okusiza, kungenzeka kakhulu ukuthi ungagcini nje ngokuvimba ukuthuthukiswa kwalesi sifo, kodwa futhi ukhohlwe ngakho kuze kube phakade.Umdlavuzaamaphaphu: iphrofayli lesifo kanye nokuqashelwa kwelashwaCishe abantu abayizigidi ezi-5 babulawa umdlavuza wamaphaphu minyaka yonke emhlabeni. Lolu hlobo lokulimala kwezifo lubizwa nangokuthi yi-bronchogenic carcinoma, noma umdlavuza we-bronchogenic. Isigaxa sivela ku-epithelium eqine ye-mucous membrane ye-bronchi, alveoli ne-epithelium ye-bronchial gland. Naphezu kweqiniso lokuthi i-etiology yalesi sifo ayikacaci, izizathu eziyinhloko zokuvela kwayo zibandakanya: ukubhema; ukuchayeka kwi-radon kanye nama-carcinogens athile (amaminerali we-asbestos ayingozi kakhulu emaphashini); izinhlobo ezithile zamagciwane; ukukhuphuka kwenqwaba yezinhlayiya zothuli emoyeni. I-pathogenesis yomdlavuza wamaphaphu ivuliwenullnullamaphaphu.Umdlavuza wamaphaphu wesigaba 1 ubonakala nge-tumor efinyelela kubukhulu obungu-3 cm, ongakangeni manje. I-neoplasm itholakala engxenyeni eyodwa yamaphaphu noma ngaphakathi kwe-bronchus yesigaba.Isigaba 2 - isimila esifinyelela ku-6 cm sitholakala engxenyeni eyodwa yamaphaphu noma ngaphakathi kwe-bronchus engxenyeni ethile. Ama-metastases awodwa kuma-pulmonary kanye ne-bronchopulmonary lymph node ayaqapheleka.Isigaba 3 - isimila esikhudlwana kune-6 cm ngokushintshwa kwe-lobe eseduze yamaphaphu noma ukuhluma kwe-bronchus eseduze noma i-bronchus enkulu. Ama-metastases atholakala ku-bifurcation, tracheobronchial, paratracheal lymph node.4isigaba somdlavuza wamaphaphu saziwa nge-metastases ezinhlelweni ezikude nezitho zomzimba, i-pleurisy kanye / noma i-pericarditis ejoyina. Lokhu kuhlukaniswa kusebenza kuphela nge-squamous cell carcinoma. Endabeni yomdlavuza omncane weseli, oqala ukukhula ngokushesha, izigaba ezi-2 kuphela ezihlukaniswa. Isigaba sokuqala - isigaba esinqunyelwe - sihambisana nokwenziwa kwamaseli we-pathogenic emaphashini owodwa nezicubu eziseduze. Esigabeni sesibili, isimila sihlangana endaweni engaphandle kwamaphaphu nasezitho ezikude.Ukwelashwa umdlavuza we-lungUkuxilongwa okuhle kwe-pulmonary oncology kubaluleke kakhulu, ngoba ukukhethwa kwezindlela zokwelashwa ezifanele kuncike kuyo. Izindlela eziphambiliukungenelela kokuhlinzwa, i-chemo kanye nokwelashwa ngemisebe. Ngenxa yentuthuko esheshayo yobuchwepheshe bezokwelapha, lezi zindlela seziphephe futhi zisebenza ngempumelelo.1. Ukwelashwa kusetshenziselwa i-squamous cell carcinoma. Ngesikhathi sokuhlinzwa, kususwa lonke ithumbu elinomdlavuza noma ingxenye yalo ehlukile. Umthamo wezicubu osusiwe uncike kuhlobo lwesimila nendawo okuyo. Umkhuba wamanje ekwelashweni komdlavuza wamaphaphu ukusetshenziswa kwezindlela ezingekho mthethweni, ezikhiqizwa kusetshenziswa ikhamera yevidiyo encane. Le ndlela ibizwa nge-Video-assisted Thoracoscopic Surgery (VATS). Ukusebenza okunjalo kuhambisana nobuhlungu obukhulu, futhi inqubo yokuvuselela ngemuva kwabo iqhubeka ngokushesha.2. Chemotherapy- Ukwelashwa okuyinhloko kweziguli eziningi ezinomdlavuza wamaphaphu. Umnyombo wayo ulele ekuphuzeni imithi ebhubhisa amaseli womdlavuza.3. Okuhlosiwe (okuhlosiwe) ukwelashwa komdlavuza wamaphaphu. Izidakamizwa ezinjalo zibona amangqamuzana amabi ngezimpawu zawo ezithile futhi azonakalise, zithinta imisebenzi ebalulekile (ukukhula, ukuhlukaniswa). Ngaphezu kwalokho, izidakamizwa ezinjalo ziphazamisa ukunikezwa kwegazi esiswini. Ukwelapha okuhlosiwe (okuhlosiwe) kungabekwa njengendlela yokuzimele yokwelashwa noma ngokuhlanganiswa ne-chemotherapy ukuze kwandiswe ukusebenza kahle kokwelashwa.4. Ukwelashwa nge-immunological ekwelapheni umdlavuza wamaphaphu kuyisiqondiso esisha nesethembisayo ngaphakathii-oncology yokulondolozeka. Ukwelashwa okunjalo kukuvumela ukusetha amaseli amasosha amasosha omzimba wakho ngokumelene namaseli womdlavuza futhi “okubhekiswe” kuthinta kuphela amangqamuzana e-tumor.5. I-Radiotherapy. Ukufakelwa kwesimila ngensimbi enamandla yemisebe ye-gamma, ngenxa yokuthi amangqamuzana omdlavuza afa (amisa ukukhula nokukhiqiza kabusha). Kwenziwe ngendlela eyihlane noma ephezulu. Ngokulashwa ngemisebe ecijile, zombili isimila uqobo kanye nezifunda ze-metastasis zezifunda kuvezwa ngemisebe. Ukwelashwa ngemisebe kusetshenziselwa nomdlavuza omncane weseli.Shiya isicelo kuwebhusayithi yethu futhi ongoti bethu bazokuthinta bakusize ukhethe umtholampilo ohamba phambili ngokuhambisana necala lakho mahhala.

I-acute lymphoblastic leukemia, ebuye ifushaniswe ngokuthi YONKE (ngezinhlamvu zokuqala zesifo), futhi kwesinye isikhathi ungathola igama le-acute lymphocytic leukemia - isifo esibuhlungu sohlelo lwe-hematopoietic. Lesi sifo siqala kumnkantsha wethambo. Umongo wethu wethambo uyimboni yamaseli egazi ahlukahlukene. Lapho umugqa wethambo ugula, khona-ke le fektri, esikhundleni seyenempilo (odokotela bakhuluma ngamangqamuzana avuthiwe), iqala ukukhiqiza inani elikhulu lamaseli egazi amhlophe angakafiki.Lapho umuntu egula, khona-ke wonke amaseli egazi akhula futhi avuselelwa ngokuvumelanayo, konke kwenzeka ngendlela elinganiselayo. Amaseli wegazi avuthwa kancane kancane, futhi inqubo yokuvuthwa iyinkimbinkimbi impela. Kepha niniingane iyagula ine-lymphoblastic leukemia, i.e.BONKE, inqubo yokuvuthwa iphula ngokuphelele.Amangqamuzana amhlophe egazi, okungukuthi, amangqamuzana amhlophe egazi, avele avele angavuthi ngokuphelele futhi angakhuli abe amaseli okusebenza agcwele. Esikhundleni salokho, baqala ukuhlanganyela ngokushesha nangokungalawuleki. Umsebenzi wohlelo lwe-hematopoietic uyaqhubeka nokusebenza ngokungafanele: amangqamuzana agulayo afaka amanye aphilile futhi abambelele endaweni yomongo. Ingane egulayo ayinawo amangqamuzana egazi amhlophe anempilo, amangqamuzana abomvu egazi (amaseli abomvu egazi), noma amaplatelet egazi (amaplatelet).Kungaleso sizathu izingane zingakha i-anemia (anemia), izinkinga ezithathelwanayo ezahlukahlukene (ukutheleleka), kanye nokuphuma kwegazi kaningi. Futhi lokhulezo yizimpawu zokuqala ezingakhuluma nge-leukemia ebukhali enganeni. Kepha lesi sifo uqobo, SONKE, kusukela ekuqaleni asitholakali kunoma iyiphi ingxenye yomzimba. Ukusuka emqubeni wethambo, ungena ungene egazini, ungene ezicutshini ze-lymphoid (uhlelo lwe-lymphatic) nakuzo zonke ezinye izitho zomzimba. Umsebenzi wohlelo lonke lwezitho, okungukuthi, umzimba wonke, uqala ukuphazamiseka. Kungakho ZONKE, njengazo zonke ezinye izinhlobo ze-leukemia, zibizwa ngokuthi isifo esibuhlungu esise-systemic, okungukuthi, lesi sifo sibulala wonke umzimba njengohlelo.KONKE kusakazeka emzimbeni wonke ngokushesha okukhulu. Ngaphandle kokwelashwa, amaseli we-leukemia aphambukeka yonke indawo, hhayiizithiyo zomhlangano. Izitho zomzimba lapho ziyeke khona ukusebenza ngokujwayelekile kanti nezifo ezintsha ezinkulu ziqala kuzo. Uma i-leukemia ingelashwa, khona-ke ukufa kwenzeka ezinyangeni ezimbalwa.Shiya isicelo samahhala kwiwebhusayithi yethu futhi ochwepheshe bethu bazokuthinta bakusize ukhethe umtholampilo ohamba phambili ngokulandela icala lakho. Indlela yokwelashwa yokwelapha i-leukemia ebukhali incike eminyakeni yobudala kanye nesiguli, uhlobo nesigaba sokuthuthuka kwalesi sifo, futhi kubalwa ngaso sonke isikhathi ngokwahlukana ngakunye esimweni ngasinye.Kunezinhlobo ezimbili eziyinhloko zokwelashwa kwe-leukemia ebukhali - ukwelashwa ngamakhemikhali nokwelashwa kokuhlinzwa - ukufakelwa kwamathambo.I-Chemotherapy yakhiwaizinyathelo ezimbili ezilandelanayo:• Inhloso yesigaba sokuqala ukutholwa kokuxolelwa. Ngama-chemotherapy, ama-oncologists athola ukwehla kwezinga lamaseli wokuqhuma• Isinyathelo sokuhlanganisa esidingekayo ukubhubhisa amaseli womdlavuza asele• Ukungenisa kabusha, njengomthetho, ukuphinda ngokuphelele uhlelo (izidakamizwa, imithamo, imvamisa yokuphatha) yesigaba sokuqala• Ngaphezu kwezidakamizwa ze-chemotherapeutic, ama-cytostatics akhona ohlelweni olujwayelekile lokwelashwa.Ngokwezibalo, ubude besikhathi sokwelashwa kwamakhemikhali kwe-leukemia acute cishe iminyaka emi-2.I-Chemotherapy ehlanganiswe ne-cytostatics iyiindlela enolaka yokuvezwa, okudala imiphumela emibi eminingana (isicanucanu, ukuhlanza, impilo engeyinhle, ukulahlekelwa izinwele, njll.). Ukuze kuncishiswe isimo sesiguli, kunqunywa ukwelashwa okufana. Ngaphezu kwalokho, kuya ngesimo, ama-antibiotics, ama-detoxification agents, ama-platelet ne-erythrocyte mass, nokunconywa kwegazi kunganconywa.Ukufakelwa kwamathamboUkufakelwa kwamathambo kunikeza isiguli amaseli anempilo we-stem, athi kamuva abe ngokhokho bamaseli egazi ajwayelekile.Isimo esibaluleke kakhulu sokudluliswa kwezidalwa kuyinto yokuxolelwa ngokuphelele kwesifo. Kubalulekile ukuthi umongo wethambo ohlanziwe kusuka kumaseli aqhuma ugcwaliswe ngamaseli anempilo.Ukuze ulungiselele isiguli ukuhlinzwa,Ukwelashwa okukhethekile kwe-immunosuppressive kuyenziwa. Lokhu kuyadingeka ukubhubhisa amaseli we-leukemia futhi kucindezele ukuzivikela komzimba ukuze kunciphise ingozi yokwenqatshwa.Ukuxhumana kokuthathwa kokufakelwa kwamathambo:• Ukwephulwa kokusebenza kwezitho zangaphakathi• Izifo ezithathelanayo ezingapheli• Ukubuyela emuva kwe-leukemia ebusayo, hhayi ukuhumushela ekuxolelweni• ukugugaShiya isicelo kuwebhusayithi yethu futhi ongoti bethu bazokuthinta bakusize ukhethe umtholampilo ohamba phambili ngokuhambisana necala lakho mahhala.

Ngokwesilinganiso, ukuguqulwa kusuka ku-precancer kuya ekubeni isimila esinomdlavuza kuthatha iminyaka emi-2 kuye kweli-15. Ukuguqulwa okwalandela kusuka esigabeni sokuqala somdlavuza kuye kokugcina kuthatha iminyaka eyi-1-2.Umdlavuza womlomo wesibeletho ngukuthuka okulimazayo, okuthi ngokwezibalo zezokwelapha phakathi kwezifo ze-oncological ezenzeka ebulilini obulungile, kuthathe indawo yesine (ngemuva komdlavuza wesisu, isikhumba kanye nezindlala zezinso).Umthombo womdlavuza womlomo wesibeletho amangqamuzana ajwayelekile amboza wesibeletho. Zingaphezu kwezinkulungwane ezingama-600 zalezi zithumba ezitholwa minyaka yonke.iziguli. Yize umdlavuza wesibeletho uvame ukwenzeka phakathi kweminyaka engama-40-60, kodwa, ngeshwa, muva nje usencane kakhulu.Ukwelashwa komdlavuza womlomo wesibeletho kuhlangene futhi kufaka phakathi ukuhlinzwa, ukwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe. Esimweni ngasinye, ukwelashwa kunqunywa ngakunye, kuya esigabeni salesi sifo, izifo ezikhona, isimo somlomo wesibeletho, kanye nokuba khona kwezifo ezithathelanayo njengamanje.Ngesikhathi sokuhlinzwa, isimila singasuswa nengxenye yomlomo wesibeletho, kususwe isimila kanyeisibeletho, futhi kwesinye isikhathi ngesibeletho uqobo. Imvamisa, ukuhlinzwa kuhlanganiswa ngokususwa kwama-lymph node we-pelvis (uma amaseli womdlavuza ekwazi ukujwayela). Udaba lokususwa kwe-ovarian luvame ukunqunywa ngokuhlukile (ezigabeni zokuqala zomdlavuza kwabesifazane abasebasha, ama-ovari angagcinwa).Ngemuva kokuhlinzwa, uma kunesidingo, iziguli zinqunyelwe ukwelashwa ngemisebe. Ukwelashwa ngemisebe ye-ionizing kungaqedela ukwelashwa kokuhlinzwa, futhi kungabekwa ngokuhlukile. Ekwelapheni umdlavuza wesibeletho, i-chemotherapy, izidakamizwa ezikhethekile eziqeda ukukhula zingasetshenziswa.kanye nokuhlukaniswa kwamangqamuzana omdlavuza. Ngeshwa, amathuba we-chemotherapy yalesi sifo alinganiselwe.Impumelelo yokwelashwa komdlavuza womlomo wesibeletho ixhomeke eminyakeni yesiguli, ukunemba kokukhethwa kwezokwelapha, futhi, okubaluleke kakhulu, ekutholakalweni kwesifo ekuqaleni. Lapho umdlavuza womlomo wesibeletho utholwa esencane, i-diagnostosis iyathandeka futhi lesi sifo singalashwa ngezindlela zokuhlinzwa zodwa.Shiya isicelo kuwebhusayithi yethu futhi ongoti bethu bazokuthinta bakusize ukhethe umtholampilo ohamba phambili ngokuhambisana necala lakho mahhala.