Malinga ndi deta yofunikira ya International Agency for Research on Cancer (IARC) ya World Health Organization (WHO), khansa ya m'mapapo yakhala imodzi mwa zotupa zoopsa kwambiri, ndipo kupewa ndi kuchiza khansa ya m'mapapo kwakhala chinthu chofunika kwambiri popewa ndi kuchiza khansa.
Malinga ndi ziwerengero zoyenera, zokwana20% ya odwala khansa ya m'mapapo omwe si ang'onoang'ono amatha kuchitidwa opaleshoni yochiritsiraAmbiri mwa odwala khansa ya m'mapapo ali kale m'chipatala.magawo apamwambaakapezeka ndi matendawa, ndipo angapeze phindu lochepa kuchokera ku chithandizo chamankhwala cha radiotherapy ndi chemotherapy. Ndi kupita patsogolo kosalekeza ndi chitukuko cha sayansi ya zamankhwala, kubuka kwachithandizo cha ablativeM'malo mwa opaleshoni, chithandizo chatsopano chabweretsa chiyembekezo kwa odwala khansa ya m'mapapo.
1. Kodi mukudziwa zambiri zokhudza chithandizo cha khansa ya m'mapapo chotchedwa ablative therapy?
Chithandizo cha khansa ya m'mapapo chimaphatikizapokuchotsedwa kwa ma microwave ndi kuchotsedwa kwa ma radiofrequencyMfundo yochizira imaphatikizapo kuyika electrode yotulutsa mpweya, yomwe imadziwikanso kuti“kafukufuku,”kulowa mu chotupa m'mapapo. Electrode ingayambitsekuyenda mofulumiraza tinthu monga ma ayoni kapena mamolekyu amadzi mkati mwa chotupacho, zomwe zimapangitsa kutentha chifukwa cha kukangana, zomwe zimapangitsa kutikuwonongeka kosasinthika monga coagulative necrosis ya maselo otupa.Nthawi yomweyo, liwiro la kusamutsa kutentha limachepa mofulumira m'maselo abwinobwino a m'mapapo ozungulira, zomwe zimasunga kutentha mkati mwa chotupacho, ndikupanga"Zotsatira za kutenthetsa kutentha."Chithandizo cha ablative chingaphe chotupacho bwino pamenekukulitsa chitetezo cha minofu ya m'mapapo yabwinobwino.
Chithandizo cha Ablative chimadziwika ndikubwerezabwereza, kuchepetsa kusasangalala kwa wodwala, kuvulala pang'ono, komanso kuchira mwachangu,ndipo yadziwika kwambiri ndipo imagwiritsidwa ntchito m'machitidwe azachipatala. Komabe, poganizira kuti chithandizo cha ablative chimaphatikizapo magawo osiyanasiyana monga radiology, oncology, interventional radiology, ndi anatomy ya opaleshoni, imafuna luso lapamwamba la opaleshoni komanso makhalidwe abwino kuchokera kwa dokotala wochita opaleshoni.
Lero, tikufuna kukudziwitsani katswiri wodziwika bwino pankhani ya chithandizo chamankhwala,Dr. Liu Chen, yemwe wakhala akugwira ntchito m'mundawu kwa zaka zambiri ndipo wadzipereka ku kafukufuku womasulira matenda ndi kufalitsa bwino njira zodziwira matenda ndi njira zochiritsira zosafunikira monga kusanthula kwa chotupa komwe kumakhala kovuta komanso koopsa, kuchotsedwa kwa kutentha, ndi kuyika tinthu tating'onoting'ono m'thupi.Dr. Liu amadziwika kuti ndi "ngwazi yodziwika bwino" ndipo watenga nawo mbali popanga mgwirizano ndi malangizo a akatswiri pa njira zosiyanasiyana zochiritsira khansa ya m'mapapo ku China. Iye wayambitsa lingaliro la kasamalidwe kathunthu ka matenda a khansa ya m'mapapo ndipo wakhazikitsa njira zodziwika bwino zochitira opaleshoni kuti akonze chisankho cha chithandizo chamankhwala cham'deralo cha khansa ya m'mapapo yoyambirira, zomwe zikulimbikitsa chitukuko chonse cha njira yodziwira ndi kuchiza khansa ya m'mapapo ku China.
"Ngwazi pa Nsonga ya Singano" - Dokotala Liu Chen
Amadziwika bwino ndi njira zodziwira matenda ndi njira zochiritsira zotupa motsogozedwa ndi zithunzi
1. Kuchotsa kwa microwave/Radiofrequency
2. Kufufuza kwa percutaneous biopsy
3. Kuyika tinthu ta radioactive
4. Kusamalira ululu wopweteka
2. Cholinga ndi zizindikiro za chithandizo cha khansa ya m'mapapo
"Mgwirizano wa Akatswiri pa Chithandizo cha Ablative cha Matenda Oyamba ndi Omwe Amafalikira M'mapapo"(kope la 2014) limagawa chithandizo cha ablative cha khansa ya m'mapapo m'magulu awiri: chochiritsa ndi chochepetsa ululu.
Kuchotsa mankhwala ochiritsiraCholinga chake ndi kupha minofu yonse ya chotupa chapafupi ndipo chingathandize kuchiritsa.Khansa ya m'mapapo yoyambirira ndi chizindikiro chenicheni cha chithandizo chochotsa kutupa,makamaka kwa odwala omwe ali ndi vuto la mtima ndi mapapo, okalamba, osatha kuvomereza opaleshoni, okana kuchitidwa opaleshoni, kapena omwe ali ndi chotupa chimodzi chomwe chikubwereranso pambuyo pa chithandizo cha radiotherapy, komanso odwala ena omwe ali ndi zilonda zingapo zoyambirira za khansa ya m'mapapo omwe amafunika kusunga ntchito ya mapapo.
Kuchotsa kwa palliativecholinga chake ndiKuletsa kwambiri chotupa chachikulu mwa odwala omwe ali ndi khansa ya m'mapapo yomwe yakula, kuchepetsa kuchuluka kwa chotupa, kuchepetsa zizindikiro zoyambitsidwa ndi chotupacho, ndikukweza moyo wa wodwalayo.Kwa odwala omwe ali ndi khansa ya m'mapapo yokwera kwambiri, zotupa zomwe zili ndi mainchesi oposa 5 kapena zotupa zingapo zimatha kuchiritsidwa ndi singano zambiri, ma point ambiri, kapena njira zina zochiritsira, kapena kuphatikizidwa ndi njira zina zochiritsira kuti apulumuke nthawi yayitali. Pa matenda a khansa ya m'mapapo omwe ali ndi ma step stage, ngati kuwongolera zotupa zakunja kwa mapapo kuli bwino ndipo pali zotupa zochepa zokha zomwe zili m'mapapo, chithandizo cha ablative chingathandize bwino kuwongolera matendawa ndikukweza moyo wa wodwalayo.
3. Ubwino wa chithandizo cha ablative
Opaleshoni yochepa kwambiri, kuchira mwachangu: Chithandizo cha ablative chimaonedwa kuti ndi opaleshoni yochepetsera kulowererapo. Singano ya ablative electrode yomwe imagwiritsidwa ntchito nthawi zambiri imakhala ndi mainchesi a1-2mm, zomwe zimapangitsa kuti opaleshoni icheke pang'ono kukula kwa dzenje la singano. Njira imeneyi imapereka ubwino mongakuvulala kochepa, kupweteka kochepa, komanso kuchira mwachangu.
Nthawi yochepa yochita opaleshoni, komanso nthawi yabwino yochitira opaleshoni:Chithandizo cha ablative nthawi zambiri chimachitidwa pansi pa mankhwala oletsa ululu am'deralo kapena kuphatikiza ndi mankhwala oletsa ululu m'mitsempha, zomwe zimathandiza kuti munthu asafunike kulowetsa m'mimba. Odwala ali ndi tulo tochepa ndipo amatha kudzutsidwa mosavuta powagwira pang'ono. Odwala ena angamve ngati opaleshoniyo yatha atatha.kugona pang'ono.
Kuyeza magazi nthawi imodzi kuti mupeze matenda molondola:Pa chithandizo cha ablative, chida chowongolera coaxial kapena choboola chogwirizana chingagwiritsidwe ntchito kuti mupeze biopsy ya chotupacho.kuzindikira matenda ndi kuyezetsa majiniperekani chidziwitso chofunikira pa zisankho za chithandizo pambuyo pake.
Njira yobwerezabwereza: Kafukufuku wambiri wochokera m'magwero akunja ndi akunja asonyeza kuti kuchuluka kwa odwala khansa ya m'mapapo omwe ali pachiwopsezo choyambira omwe akulandira chithandizo cha ablative kuli kofanana ndi kwa opaleshoni yochotsa kapena stereotactic radiation therapy. Pankhani ya kubwereranso kwa matendawa m'deralo, chithandizo cha ablative therapy chimagwiritsidwa ntchito pochiza khansa ya m'mapapo.ikhoza kubwerezedwa kangapokuti ayambenso kulamulira matendawa pamenekukulitsa moyo wa wodwalayo.
Kuyambitsa kapena kukulitsa ntchito ya chitetezo chamthupi: Chithandizo cha Ablative cholinga chake ndikupha maselo a chotupa m'thupi, ndipo nthawi zina, zimatha kuyambitsa kapena kukulitsa chitetezo cha mthupi cha wodwalayo, zomwe zimapangitsa kuti kumene zotupa zomwe sizinachiritsidwe m'zigawo zina za thupi zimasonyeza kubwerera m'mbuyo. Kuphatikiza apo, chithandizo chochepetsa kutupa chingaphatikizidwe ndi mankhwala ochizira matenda kuti apangemphamvu yogwirizana.
Chithandizo cha ablative ndi choyenera makamaka kwa odwala omwe sangathe kulekerera opaleshoni yochotsa opaleshoni kapena opaleshoni yonse chifukwa chaKusagwira bwino ntchito kwa mtima, ukalamba, kapena matenda ena ambiri omwe amayambitsa matendaNdi mankhwala omwe amakondedwa kwambiri kwa odwala omwe ali nditimibulu tambirimbiri tomwe timayamba msanga (monga timibulu tambirimbiri tomwe timapangidwa ndi magalasi).
Nthawi yotumizira: Ogasiti-23-2023