Umngane wethu othandekayo wekati angaphinde abe yisisulu somdlavuza, isifo esingaba yingozi uma singatholakali futhi selashwe ngesikhathi. Nakuba kunezinhlobo eziningana zomdlavuza futhi zonke ziyimbangela yokukhathazeka, I-carcinoma yokuphefumula ingenye yezimila ezibaluleke kakhulu futhi ezivame kakhulu emakati, njengoba kuthinta ngqo amaphaphu kanye nekhono lokuphefumula ngendlela evamile.
Amakati angochwepheshe fihla ubuhlungu nokungakhululekiNgakho-ke, kukithi ukuqaphela kakhulu noma yiziphi izinguquko ekuziphatheni kwabo noma emisebenzini yabo yansuku zonke. Imininingwane ebonakala ingabalulekile, njengokukhwehlela okuncane noma ukulahlekelwa kancane kancane yisifiso sokudla, ingabonisa ukuthi impilo yabo iyawohloka. Ukuze sikusize, sizokuchaza lokhu ngokuningiliziwe. Iyini i-respiratory carcinoma emakati, ziyini izimpawu zayo, itholakala kanjani, futhi ingelashwa kanjani?kanye nezinkinga ezingaba khona kanye nesibikezelo.
Iyini i-carcinoma yokuphefumula?
I-carcinoma yokuphefumula, eyaziwa kakhulu ngokuthi umdlavuza wamaphaphu noma umdlavuza wohlelo lokuphefumulaKuyisifo lapho amangqamuzana angavamile futhi anobungozi akheka khona ezicutshini zendlela yomoya. Kungathinta amaphaphu, e- amakhala futhi imbala ama-sinuses e-paranasalukwehlisa izinga lokungenisa umoya kanye nokushintshana kwe-oxygen ngendlela efanele.
Emaphashini, la maseli akhula ngendlela engalawuleki, akheke isimila okungavimba i-bronchi, kungene izicubu zamaphaphu ezinempilo, futhi kusakazekele kwezinye izingxenye zomzimba ngegazi noma i-lymph, inqubo eyaziwa ngokuthi i-metastasisUma isimila siqala ngqo emaphashini, sibizwa ngokuthi isimila samaphaphu esiyinhlokoUma kuvela kwesinye isitho somzimba, kubizwa ngokuthi isimila samaphaphu esisakazekile noma sesibili.
Kungavela ezinhlotsheni ezahlukene zamaseli, ngakho-ke kunezinhlobo eziningana eziyinhloko ze-respiratory carcinoma emakati:
- I-squcinous cell carcinomaIbizwa nangokuthi i-squamous cell carcinoma, ivela emangqamuzaneni amancane, ayisicaba azungeze imigudu yomoya noma i-mucosa yamakhala. Inolaka futhi inamandla aphezulu okuhlasela izicubu eziseduze.
- Iseli carcinoma enkulu engafaniIkhula ezindaweni ezingaphandle kwamaphaphu, emaphethelweni angaphandle, futhi ngokuvamile inokuziphatha okubi kakhulu.
- I-AdenocarcinomaIvela emangqamuzaneni ezindlala zamaphaphu nangaphansi kolwelwesi lwe-bronchi. uhlobo oluvame kakhulu lwesimila samaphaphu esiyinhloko emakati futhi kungasakazekela emathanjeni nakwezinye izitho zomzimba.
Ngaphezu kwalokho, zingase zivele amathumba emaphashini asakazekile Lokhu kukhula kwezicubu kuvela kwezinye izinhlobo zomdlavuza wekati (njengezimila zebele, amathambo, noma isikhumba). Emakati amaningi, lokhu kukhula kwezicubu kumelela ingxenye enkulu yezimila ezibonakala emaphashini.
Izimbangela kanye nezici eziyingozi zomdlavuza wokuphefumula emakati
Izimbangela eziqondile zokuthi kungani ikati liba nomdlavuza wokuphefumula azicaci kahle, kodwa ezinye sezitholiwe. izinto ezandisa ingozi ngokuhlupheka ngakho:
- Ubudala obuthuthukisiweIningi lamakati anezimila zamaphaphu likhulile, lapho umzimba usuqongelele umonakalo omkhulu wamaseli futhi isimiso somzimba sokuzivikela singasebenzi kahle.
- Isakhi sofuzoNoma yiliphi ikati lingathuthuka umdlavuza, kodwa ngokuqinisekile izinhlobo ezithile zibonakala zinomkhuba ongcono, njengamawele ahlangene noma amaPheresiya, kanye nalabo abanomlando womndeni wezimila.
- Ukuchayeka ebuthi bemvelo: the intuthu yegwayi (kufaka phakathi ugwayi kagesi), amakhemikhali okuhlanza aqinile noma ukungcola komoya wasekhaya kungacasula uhlelo lokuphefumula futhi kukhuthaze ukubonakala kwamangqamuzana anomdlavuza.
- Izifo ezingamahlalakhonaIzimo zokuphefumula zesikhathi eside noma izinkinga zesistimu (inhliziyo, izinso, i-endocrine) zingaba buthaka isimiso somzimba sokuzivikela futhi zinciphise ikhono lomzimba lokulawula ukubonakala kwamaseli esimila.
- Ukunciphisa ukuzivikelaIsimiso somzimba esibuthakathaka, kungakhathaliseki ukuthi sibangelwa ukuguga, ukucindezeleka okuqhubekayo, noma ukugula, kwenza kube lula ukuthi amangqamuzana angavamile aphunyuke ekulawulweni okuvamile komzimba futhi akhe isimila.
Lezi zici azitholakali njalo emlandweni wekati, kodwa ukunciphisa ukuchayeka entuthwini namakhemikhaliUkuhlinzeka ngokudla okunekhwalithi ephezulu kanye nokuhlolwa njalo nodokotela wezilwane kusiza ekunakekeleni uhlelo lwabo lokuphefumula kanye nempilo yabo iyonke.
Yiziphi izimpawu?
I-carcinoma yokuphefumula emakatini inokuziphatha okukhohlisayo: ezigabeni zokuqala ingaba okucashile noma ngisho nokungabonakaliEqinisweni, izimila zamaphaphu emakati amaningi zitholakala ngengozi uma kuthathwa ama-X-ray ngezinye izizathu. Noma kunjalo, kunezimpawu okufanele zisixwayise.
Njengoba lesi sifo siqhubeka, ikati lingase lihlupheke kakhulu ukukhwehlela okuqhubekayo kanye nobunzima bokuphefumulaUngase uqaphele ukuthi baphefumula ngokushesha ngisho noma bephumule, ukuthi bayaphefumula ngaphandle kwesizathu esibonakalayo, noma ukuthi bakhathala kalula ngaphandle komzamo omkhulu, njengokukhwela izitebhisi noma ukudlala isikhashana.
Futhi akufanele silahle ezinye izimpawu ezijwayelekile, njenge ukulahleka kwesifiso, lo ukwehla kwesisindo okuqhubekayo, lo ukunganaki, usizi, malaise kanye nokucindezeleka. Ezimweni eziningi, lezi zinguquko zokuziphatha zenzeka ngaphambi kwezimpawu zokuphefumula ezisobala.
I-Adenocarcinoma kanye nezinye izinhlobo zomdlavuza wamaphaphu zingasakazekela ku- amathambo emilenze kanye nama-phalanges ezinzwaneokubangela ukukhubazeka, ubuhlungu obukhulu, kanye nokubhujiswa kwamathambo, okwaziwa ngokuthi i-feline digitalopulmonary syndromeKulezi zimo, ukuxhuga noma izilonda ezinzwaneni kungaba uphawu lokuqala lwesimila samaphaphu esifihliwe.
Ezinye izimpawu ezingase zivele emakati ane-carcinoma yokuphefumula zifaka:
- Ukuphefumula okusheshayo (i-tachypnea) noma ukuphefumula ngomzamo obonakalayo esiswini.
- Ukuhamba ngesondo noma imisindo yokuphefumula engavamile, efana nokushaya ikhwela.
- Ukuthimula noma impumulo egobhozayoikakhulukazi uma kukhona ukubandakanyeka kwezindlela zamakhala noma ama-sinuses e-paranasal.
- Umkhuhlane omncane uma kukhona ukutheleleka kwesibili noma ukuvuvukala okukhulu kwezicubu zamaphaphu.
- Ukuchithwa kwe-PleuralOkusho ukuthi, ukunqwabelana koketshezi oluzungeze amaphaphu, okubangela ukuphelelwa umoya okuphawulekayo kanye nokuma okungajwayelekile ukuze uzame ukuphefumula kangcono.
Uma ikati lethu libonisa noma yiziphi zalezi zimpawu, noma ngabe zibonakala zincane noma zihlukanisiwe, kufanele simyise kudokotela wezilwane ngokusheshaImpilo yesilwane kanye nekhwalithi yempilo yesikhathi esizayo kungancika ekuxilongweni kwasekuqaleni.
Ukuxilongwa kwe-carcinoma yokuphefumula emakati
Ukuqinisekisa ukuba khona kwe-respiratory carcinoma, kubalulekile ukwenza i-a inqubo ephelele yokuxilongaUdokotela wezilwane uzoqala ngokuhlolwa ngokomzimba kanye nomlando wezokwelapha onemininingwane, ebuza isikhathi sezimpawu, izinguquko zesisindo, isifiso sokudla, kanye nezinga lomsebenzi.
I-Las ama-x-ray esifuba Ziphakathi kokuhlolwa kokuqala kwezithombe ezisetshenzisiwe. Zivumela ukubona ngeso lengqondo izixuku zamaphaphu, izinguquko endleleni yezicubu zamaphaphu, futhi, ezimweni eziningi, ukutholakala kwezimila ezilodwa noma izilonda eziningi ezisakazeke kuzo zonke izingqimba eziningana. Zingabonisa nezimpawu zokuphuma kwe-pleural.
Ezimweni lapho kudingeka khona ukunemba okukhulu, okulandelayo kuyasetshenziswa: i-computed tomography (CT)enikeza izithombe ezinemininingwane zengaphakathi lesifuba. Le ndlela iwusizo kakhulu ekuhloleni ubukhulu obuqondile besimila, uma ihlasela izakhiwo eziseduze futhi uma kukhona ama-metastases emaphashini noma ama-metastases kwezinye izicubu zesifuba.
La i-ultrasound yamaphaphu Futhi sekuyindlela ewusizo kakhulu yokuhlonza izindawo zokuhlanganiswa kwamaphaphu, amaqhubu, kanye noketshezi lwe-pleuralngaphezu kokuvumela ukubhoboza inaliti encane ukuthi kuqondiswe ukuthola amasampula ezicubu noma amaseli.
Ukuqinisekisa ukuthi yi-respiratory carcinoma nokwazi uhlobo oluqondile lwesimila, isampula idinga ukuhlaziywa kusetshenziswa i-cytology noma i-biopsyLokhu kungatholakala ngokufuthwa kwenaliti encane okuqondiswa yi-ultrasound, i-thoracoscopy, noma ukuhlinzwa. Ukuhlolwa kwe-histopathological kunquma ukuthi ngabe yi-adenocarcinoma, i-squamous cell carcinoma, noma olunye uhlobo, futhi kuhlola ukuthi inolaka kangakanani.
Kanye nalezi zivivinyo, okulandelayo kuvame ukwenziwa ukuhlolwa kwegazi okuphelele Ukuhlola impilo yekati iyonke, kanye ne-ultrasound yesisu noma amanye amasu okuthwebula izithombe, ukubheka ama-metastases kwezinye izitho zomzimba. Konke lokhu kusenza sikwazi ukunquma isigaba sesifo bese sikhetha ukwelashwa okufanele kakhulu.
Iyini ukwelashwa?
Ukwelashwa kwe-carcinoma yokuphefumula emakati kuzoncika ku- uhlobo lwesimila, ubukhulu baso, indawo, ubudala bekati, kanye nokuba khona kwe-metastasisNoma nini lapho kungenzeka futhi isimila sichazwe kahle, inketho yokukhetha iwukuthi ukususwa ngokuhlinzwa kwe-mass, ngokuvamile ngokusikwa kabusha kwe-lobe yamaphaphu ethintekile (i-pulmonary lobectomy).
Ezimila eziyinhloko ezilodwa, ngaphandle kobufakazi bokuthi zisakazekele kwezinye izitho zomzimba, ukuhlinzwa kunganikeza ukuthuthuka okuphawulekayo kwekhwalithi kanye nobude besikhathi sokuphilaKodwa-ke, kuyinqubo eyinkimbinkimbi edinga i-anesthesia ejwayelekile kanye nesikhathi sokulaliswa esibhedlela kanye nokuphathwa kobuhlungu esikhathini sangemva kokuhlinzwa.
Uma isifo sesiqhubeke kakhulu, isimila sinama-multifocal, noma kukhona ama-metastases, ukuhlinzwa kungase kungenzeki. Kulezi zimo, udokotela wezilwane angancoma i-chemotherapy kanye/noma i-radiotherapy ukuzama ukumisa noma ukwehlisa ukukhula kwesimila. Ukwelashwa ngamakhemikhali kusebenzisa imithi yokulwa nomdlavuza esebenza kumaseli omdlavuza, kuyilapho ukwelashwa ngemisebe kusebenzisa imisebe enamandla aphezulu eqondiswe ezinqwabeni zesimila.
Kwamanye amakati, izinqubo zisetshenziselwa ukwelashwa ngamakhemikhali kwe-metronomic, ngemithamo ephansi neqhubekayo yemithi ethile, enhloso yayo iwukunciphisa ukwakheka kwemithambo yegazi emisha eyondla isimila futhi ilawule ukuqhubeka kwaso ngemiphumela emibi embalwa.
Ngaphezu kwalokho, indlela yokwenza ukunakekelwa okusekelayo: isiqeda-zinhlungu esanele sokulawula ubuhlungu, ukwelashwa nge-oxygen uma ikati linobunzima bokuphefumula, imithi yokunciphisa i-bronchodilator uma likhwehlela noma liba ne-bronchoconstriction, ukwelashwa kokuphuma kwe-pleural uma kukhona, kanye nokusekelwa kokudla okunempilo ukuvimbela isisindo esiningi kanye nokulahlekelwa yimisipha.
Umdlavuza akusona isifo okufanele sithathwe kalula. Kumelwe sikhumbule ukuthi Uma kutholakala ukuthi ikati linesifo ngokushesha futhi ukwelashwa kuqala, kulapho singaba khona neminyaka eminingi yokuba nekati lethu.Futhi uma izinketho zizoba ngcono zokugcina impilo yazo isezingeni eliphezulu.
Ukubikezela kanye nokuvimbela
Isibikezelo somdlavuza wokuphefumula emakatini yilesi ligodliwe futhi kuyahlukahluka kakhulu kuye ngohlobo lwesimila, ukuthi sisheshe sitholakale kanjani, kungenzeka ukuthi kuhlinzwe, kanye nokuba khona noma ukungabikho kwe-metastasis. Amakati lapho kungenziwa khona ukususwa okuphelele kwesimila esisodwa ngaphandle kokusabalala ngokuvamile anayo isikhathi eside sokuphila kunalabo abanesifo esithuthukile kanye ne-pleural effusion.
Nakuba kungenzeki njalo ukuvimbela lo mdlavuza, singakwazi nciphisa izici ezithile zengoziUkugwema intuthu kagwayi ekhaya, ukunciphisa ukuchayeka kumakhemikhali acasulayo, ukunikeza ukudla okunempilo, nokugcina isisindo esinempilo kuyizinyathelo ezisekela isimiso somzimba sokuzivikela kanye nempilo yokuphefumula.
I-Las ukuhlolwa kwezilwane ngezikhathi ezithileIkakhulukazi emakatini amadala, lokhu kuhlolwa kuyisihluthulelo sokuthola noma yikuphi ukukhubazeka kusenesikhathi. Ukufuna ukunakekelwa kwezilwane ngokukhwehlela okuqhubekayo, izinguquko ekuphefumuleni, ukwehla kwesisindo, noma ukukhubazeka okungachazeki kungavumela ukutholakala kwezimila ezigabeni ezingelapheka kakhulu.
Ukunakekela ikati elinomdlavuza wokuphefumula kuhilela ukuhlanganisa ukunakekelwa kwezilwane okungcono kakhulu nendawo ezolile, uthando, kanye nokuqapha isimo salo nsuku zonke. Ukuthola izinguquko ezincane nokwenza ngokushesha kungenza umehluko omkhulu enhlalakahleni yalo kanye nesikhathi esingaqhubeka nokujabulela ukuba nalo.