Seoul National University Hospital

Buyekeza:Ukwengezwa kwesifuba kuyinqubo yokuhlinzwa yokushintsha usayizi nokwakheka kwezinduna ezincelisayo. Imvamisa yenziwa kusetshenziswa ukufakelwa okufakwe ebeleni, kepha isithako sokufaka izicubu ze-adipose siyasetshenziswa. Esimweni sesibili, ngosizo lwe-liposuction, amafutha atholakala esiswini nasezinkalweni, bese ethulwa emithanjeni yezilwane ezincelisayo. Njengomthetho, ukufakelwa kwezicubu ze-adipose kukuvumela ukuthi ukhuphule usayizi webele ngesilinganiso esingamasentimitha ayi-200 (cishe usayizi owodwa). Isilinganiso sobude bokuhlala phesheya: 1 amasonto

Buyekeza:I-electrocardiogram (ECG) iqoshwa kusetshenziswa ama-electrodes abekwe esikhunjeni. Babamba imibhobho kagesi yemisipha yenhliziyo, ekuvumela ukuthi usethe usayizi wamakamelo ezinhliziyo, imvamisa yezivumelwano zenhliziyo namanye amapharamitha. I-electrocardiogram ingabona ukuphazamiseka kwenhliziyo okuhlukahlukene, kufaka phakathi isifo senhliziyo, ukuhluleka kwenhliziyo, inhliziyo, ukukhubazeka kwenhliziyo, ama-inhliziyo valve, noma i-pericarditis. Isilinganiso sobude bokuhlala phesheya: 1 - 2 izinsukuUma i-electrocardiogram ingazivezi izifo zenhliziyo ezinkulu, isiguli singandiza ngokushesha ngemuva kwenqubo.

IBrachytherapy, ebizwa nangokuthi i-radiation yangaphakathi yangaphakathi, iyindlela yokwelapha umdlavuza lapho kufakwa khona amaphilisi enziwe ngemisebe emzimbeni. Le ndlela yokwelashwa inciphisa umphumela wemisebe kwezicubu eziseduze nezitho zomzimba, ngokungafani nemisebe yangaphandle, lapho kungewona kuphela kuphela isimila esivezwa emisebeni.I-brachytherapy yenziwa ekubuseni kwemithamo ephezulu noma ephansi, lapho imisakazo iphathwa okwesikhashana noma ngokuqhubekayo (endabeni yokugcina, izinto ezinomsakazo zilahlekelwa umsebenzi wazo ngokwazo). Uhlobo lokwelashwa olusetshenziswayo luncike ohlotsheni lomdlavuza kanye nezimpawu zesiguli ngasinye. Kwasetshenziswa imithamo emikhulu nokufakwa okungapheli kwezinto ezinemisebe, njengomthetho, womdlavuza wendlala yesinye.Inconyelwe- Umdlavuza we-Lung - umdlavuza we-Prostate - umdlavuza webele - umdlavuza we-Esophageal - umdlavuza wesitho sangasese sowesifazane - umdlavuza waseColorectal - umdlavuza wesikhumba

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.

ICyberKnife iyindlela engalashwa yokwelapha umdlavuza kanye nama-benign tumors. Ngosizo lwe-software ne-video diagnostics, izimila zenziwa endaweni ngokunemba ngangokunokwenzeka futhi zifakwa ngokuqondile ngemithamo ephezulu yemisebe.

Ngemuva kokuthi isiguli sitholwe sinesimila somdlavuza bese sitholakala, sidluliselwa ukuba siyobonisana nge-oncological. Le yingxoxo nodokotela lapho kuzoxoxwa ngohlelo lokwelashwa.Ngemuva kokuthi isiguli sitholwe sinesimila somdlavuza bese sitholakala, sidluliselwa ukuba siyobonisana nge-oncological. Le yingxoxo nodokotela lapho kuzoxoxwa ngohlelo lokwelashwa. Isazi se-oncologist sizoyenza. Uzokutshela konke okudingeka ukwazi ngesifo sakho nangendlela yaso yokwelashwa. Isikhathi, imiphumela emibi, imiphumela elindelekile, kanye namathemba akho. Ngokwemvelo, ungabuza udokotela oncologist yonke imibuzo yakho.Ngesikhathi sokwelashwa, uzobonisana nodokotela wakho we-oncologist, ozoqikelela inqubekela phambili yokwelashwa.Inconyelwe    Umdlavuza

nullziveze ezigabeni zokuqala zesifo (ngaphandle kwesifo sokuwa).Izici ezibalulekile zobungozi zibandakanya:     ukukhula ngeminyaka - njengomthetho, lesi sifo sikhula kubantu besifazane ngemuva kokunqamuka kokuya esikhathini, iminyaka yobudala engama-50 kuye kwayi-60 (amacala ayi-8 kwangu-10);      abesifazane abaqala ukuya esikhathini (ukuya kufinyelela eminyakeni eyi-12) kanye nokuya esikhathini (ngemuva kweminyaka engama-52);      ukubhema      ukukhuluphala      ukuthatha izidakamizwa zokulimaza inzalo kanye nokwelashwa esikhundleni se-hormone;      i-polycystic;      i-endometriosis (ukunwetshwa okungajwayelekile kokufakwa kwangaphakathi kwesibeletho);i-herederals factor (genetic predisposition) - ukuba khona kwezihlobo eziseduze zomdlavuza we-ovarian, ibele noma umdlavuza we-colorectal.Abesifazane abangenazo izingane futhi abangakaze bancelise amabele nabo basengozini.Izigaba kanye nezinhlobo zomdlavuza we-ovarianKunezigaba ezi-4:    Esigabeni 1, i-lesion itholakala endaweni eyodwa noma kuwo wonke amaqanda. Isifo sokuqaqamba kwesifo siyabonakala, ikhambi likhona, iziguli eziningi ziya ekuxolelweni okuzinzile ngaphandle kokubuyisa lesi sifo.    Esigabeni sesibili, i-neoplasm isakazeka kwezinye izingxenye zomgogodla we-pelvic. Ngokuvamile, nakulesi sigaba, isibikezelo sinhle, ngokwezibalo ezisebangeni leminyaka emihlanunullngokuya ngezinga lokulimala:    isigaba A (ukulimala okuphansi) - isimila esikhula kancane, amaseli ane-anomalies amancane (ahlukaniswe kakhulu);     isigaba B (ukulimala okulinganiselwe) - izinguquko ezishiwo ngokwengeziwe zokuziphatha kumaseli wesimila kuqhathaniswa nokwehlukaniswe kakhulu;     iklasi C (ukulimala okuphezulu) - isimila esikhula ngokushesha, amangqamuzana aphansi.Ukwelashwa Komdlavuza OvarianUkwelapha okuhlanganisa kuvame ukufaka inhlanganisela yendlela yokuhlinzwa (ukuhlinzwa) kanye ne-chemotherapy.UkuhlinzwaNjengomthetho, ngesikhathi sokuhlinzwa komdlavuza we-ovary, zombili izitho ezigoqiwe, amashubhu we-fallopian nesibeletho, ama-lymph node asondele kanye namaqhubu izicubu ze-adipose emgodini wesisu asuswe,umdlavuza usakazekele kuwo.Uma intokazi ingasithola lesi sifo ekuqaleni (esiteji 1), kwezinye izimo ukungenelela okumnene kwenziwa ngokususa ishubhu le-ovari ne-fallopian ohlangothini olulodwa. Ngaphezu kweqiniso lokuthi i-prognosis yokwelapha kuleli cala lihle, lokhu kukuvumela ukuthi ugcine ithemba lokukhulelwa.Ukwehlisa ubunzima kanye nobunzima bezinkinga, kanye nezinhloso zokugcoba, ukuhlinzwa komdlavuza wamathambo kungenziwa kusetshenziswa uhlelo lweRobot da Vinci oluhlelekile.I-ChemotherapyI-Chemotherapy yomdlavuza we-ovary ivame ukubekwa ngemuva kokuhlinzwa njengengxenye yokwelashwa okuyinkimbinkimbi. Izidakamizwa zivame ukuphathwaemthanjeni noma ngqo emgodini wesisu, inhlanganisela yalezi zindlela nayo iyasetshenziswa.Ezigabeni zakamuva, i-chemotherapy ingakhethwa njengeyona ndlela eyinhloko yokwelapha.Ukwelashwa ngemisebeEzimweni ezingavamile (ezinobuhlungu obukhulu, ukopha okuvela esiswini), ukwelashwa ngemisebe yangaphandle noma i-brachytherapy (imisebe yokuxhumana) kufakwa ohlelweni lokwelapha umdlavuza we-ovary.Ukubuyiselwa emuva kokulashwaNgenkambo ejwayelekile yokuvuselela umzimba, ukululama okugcwele ngemuva kokwelashwa komdlavuza we-ovary kwabesifazane kuthatha amasonto angama-6. Uma isibeletho sikhishiwe, kungakapheli amasonto angama-3-4 kuyadingeka ukushiya ucansi. Kwezinye izimo, udokotela wakho angakunquma ama-hormone namavithamini D.

Umdlavuza wesikhumba uyinkinga evame kakhulu. Emhlabeni, i-Australia, New Zealand ne-USA zihola inani lamacala amasha we-melanoma abikwa ngonyaka. E-Russia, njengakwezinye izindawo emhlabeni, izibalo zokungasebenzi kahle ziyakhula.Ngokusho kweWorld Health Organisation, zingu-132,000 izigameko ezintsha ze-melanoma ezibikwa minyaka yonke emhlabeni. Iningi leziguli lingabantu asebekhulile, ngemuva kweminyaka engama-50 inani labesilisa abagulayo liphakeme izikhathi eziphindwe kabili kunabesifazane. Kepha emadodeni nakwabesifazane abasebasha, umdlavuza wesikhumba ukhula kaningi. Ngokusho kwesazi se-epidemiologists, lokhuUmdlavuza eRussia ungowesibili kuphela umdlavuza wamaphaphu, umdlavuza webele nomdlavuza wendlala. Ngamanye amagama, lokhu akuphathelene nesifo esithile esiyindida, kodwa mayelana nokusongela kwangempela empilweni.Izinhlobo zesikhumba oncologyImikhakha yesikhumba ejwayelekile ifaka:I-Basal cell carcinoma - lesi simila sitholakala ezimweni ezi-7 zomdlavuza wesikhumba kwezingu-10. IBasalioma ibukeka njenge-nodule noma isikhafu sombala obomvu onsundu noma opinki, ovame ukubonakala ebusweni. I-neoplasm ngesinye isikhathi ingaluma, ilimaze noma iphume igazi - ikhuphuka ngosayizi kancane,ngaphandle kokubangela umuntu azwakalise ukungakhululeki, yingakho ukuhambela udokotela kungabambezeleka. Ngenhlanhla, leli thumba liyaqabukela lisakazeka emzimbeni wonke (linikeza ama-metastases), ngakho-ke, i-prognosis yeziguli imvamisa iyathandeka.I-squamous cell carcinoma yesikhumba (i-squamous cell carcinoma) imvamisa ifana ne-mushroom esesimweni: umzimba oyindilinga onomlenze omncane. Lesi simila sifana ne-wart: ezimeni eziningi sitholakala ngaphezulu kobuso, esifundeni sezindebe eziphansi. Kwezinye izinhlobo ze-squamous cell carcinoma, i-neoplasm ingaqashelwa kuphela ngokushintsha kombala wesikhumba: endaweni ye-pathologicalubukeka emile noma ebuhlungu. Ezigabeni zakamuva, i-carcinoma iholela ekwakhekeni kwama-metastases futhi kwesinye isikhathi ayinakuphulukiswa.IMelanoma uhlobo oluyingozi kakhulu lwesimila esidala ukubulawa kwabantu abaningi umdlavuza wesikhumba. Ikhula kaningi kusuka emabhuntshwini - ukunqwabelana kwamangqamuzana e-pigment, ama-melanocyte, kepha hhayi kuphela: i-melanoma ingathinta ne-retina, i-membrane ye-mucous (umgogodla womlomo, isitho sangasese sangasese somlomo wesibeletho). Le neoplasm ibonakala ngokukhula okusheshayo futhi ithambekele ekwakhekeni kwama-metastases amaningi akude - emathanjeni, ebuchosheni, emaphashini, esibindini. Nomangokwelashwa okufika ngesikhathi, iziguli ezinesifo se-melanoma zivame ukubuyela emuva - ukukhula okuphindaphindekile kwethumbu ngemuva kweminyaka eminingana.Kunezindlela eziningana eziyisisekelo zokulwa nomdlavuza wesikhumba.Ukuhlinzwa kuyindlela engabizi kakhulu yokususa isimila. Ukusebenza okuhle kakhulu kokuhlinzwa kuqashelwa ezigabeni zokuqala, lapho i-neoplasm ingathinti ama-lymph node nezinye izitho nezicubu. Ngemuva kokususa isimila, udokotela ohlinzayo wenza i-cauterization (i-electrocoagulation) kanye ne-curettage (i-curettage) yendawo yenxeba ukuze abhubhise amaseli womdlavuza asele. Njengoba umdlavuza wesikhumba uvama ukukhula ebusweni, kukhona ukungenelela okumnene,anciphisa amaphutha obuhle. Lokhu kufaka phakathi i-cryodestruction, lapho khona isimila siqandisiwe yi-nitrogen ewuketshezi futhi sikhishwe ngaphandle kokulimala kwezicubu ezinzima. Kodwa-ke, kufanele kuqondwe ukuthi ezimweni ezinobunzima obunomdlavuza - i-squamous cell carcinoma kanye ne-melanoma - akunakwenzeka ukwenza ukhetho ngokuvumela umthamo omncane wokuhlinzwa. Ukuhlinzwa kwe-Micrographic, ngokwendlela ye-MOHS (Mohsa), kubhekwa njengendlela ephephile futhi ephumelela kunazo zonke yokungenelela kokuhlinzwa komdlavuza wesikhumba. Ngalo, isikhumba esinamaseli we-tumor sisuswa ezingqimbeni, ngaphansi kokulawulwa kwesibonakhulu, futhi ungqimba ngalunye luku ngqongesikhathi sokuhlinzwa kuthunyelwa ukuyohlolwa okwengeziwe elabhoratri. Udokotela ohlinzayo unqanda ukungenelela kuphela ngesikhathi lapho ama-histologists eqinisekisa ukuthi inxeba alinawo amangqamuzana amabi.I-Radiotherapy isetshenziswa njengesijobelelo sendlela yokuhlinzwa. Imisebe iyingozi kumaseli athambekele ekukhuleni ngokushesha, ngakho-ke, imishayo eqondisiwe yemisebe ye-ionizing inganciphisa usayizi wesimila, futhi ichithe lawo maseli ayingozi asinde ngemuva kokuhlinzwa. Isikhathi samaseshini we-radiotherapy kanye nethamo lemisebe kungumuntu ngamunye esigulini ngasinye.I-Chemotherapy ihlelekile futhi yendawo. Ngokuqokwa kwale nqubo, i-cytotoxic (elimazayo kuamaseli) amakhemikhali afakwa ngaphakathi emzimbeni noma asetshenziswe ngqo ku-tumor. Indlela enjalo ibaluleke kakhulu ekuboneni ama-metastases lapho ukugxilwa komdlavuza kutholakala ngaphandle kokufinyelela kodokotela abahlinzayo.Ukwelashwa nge-Photodynamic kufaka phakathi ukubhujiswa kwesimila ngogongolo lwe-laser ngemuva kokuthathwa kokuqala kwezithombe (okwandisa ukuzwela kwamangqamuzana kukhanye). Le ndlela yinto entsha, futhi ukusetshenziswa kwayo ngaphandle kokuhlinzwa kungaphansi kwengxoxo. Kodwa-ke, ukuthuthukiswa kwezobuchwepheshe kunomthelela wokuthi ukwelashwa kwe-Photodynamic kancane kancane kungeniswa emkhakheni wezokwelapha wezikhungo zezokwelapha.Ukwelashwa kwe-immune kanye nokuhlosiwe - amasu asemqoka futhi athembisayo abandakanya ukuqondiswa okuqondiwe.isimila ngokuvuselela amasosha omzimba noma ukwethulwa kwezidakamizwa okwenzelwe uhlobo oluthile lomdlavuza ngokusekelwe ezimweni zofuzo zomuntu ngamunye. Abanye ochwepheshe banesiqiniseko sokuthi ngokuhamba kwesikhathi le ndawo eku-oncology izothatha indawo yazo zonke ezinye izindlela zokwelapha i-neoplasms, kepha kuze kube manje, ukwelashwa okuvikela umzimba nokuhlosiwe kuyasetshenziswa ngokuhambisana nezinye izinqubo futhi - ukuvimbela ukubuyela emuva.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.

Buyekeza:Ukwengezwa kwesifuba kuyinqubo yokuhlinzwa yokushintsha usayizi nokwakheka kwezinduna ezincelisayo. Imvamisa yenziwa kusetshenziswa ukufakelwa okufakwe ebeleni, kepha isithako sokufaka izicubu ze-adipose siyasetshenziswa. Esimweni sesibili, ngosizo lwe-liposuction, amafutha atholakala esiswini nasezinkalweni, bese ethulwa emithanjeni yezilwane ezincelisayo. Njengomthetho, ukufakelwa kwezicubu ze-adipose kukuvumela ukuthi ukhuphule usayizi webele ngesilinganiso esingamasentimitha ayi-200 (cishe usayizi owodwa). Isilinganiso sobude bokuhlala phesheya: 1 amasonto