Mesothelioma Pleural: Izimpawu, Izimbangela, zokuvimbela

mesothelioma Pleural - isifo umdlavuza kuyingozi kakhulu, okuyinto kuhambisana ukuvela nokuthuthukiswa izimila ebulalayo kule wamaphaphu ulwelwesi pleural. Ngokwemvelo, leso sifo awukwazi kuthinte isimo emaphashini umzimba wonke. Yingakho kubalulekile kakhulu ukufunda izimbangela eziyisisekelo futhi izimpawu zesifo. Uma isheshe ithole ukuxilongwa okufanele kanye therapy isiqalisile, kunamathuba amaningi okuthi ukufeza ukuthethelelwa nokulondoloza ukuphila komuntu.

Kuyini mesothelioma pleural? Izithombe kanye nencazelo emfushane

Umdlavuza wamaphaphu pleura - umdlavuza ezingavamile. Naphezu kweqiniso lokuthi kungaba ihlonzwe ngasiphi yobudala, iningi iziguli sitholakele ilungu Eyeduna esikhulile, e ehilelekile imisebenzi enobungozi ngandlela-thile. Kubalulekile ukuphawula ukuthi isibalo sabantu abaphethwe yilesi sifo ukhula minyaka yonke.

Mesothelioma - isimila kwakhiwa okuyinto e inqubo ukuguqulwa ebulalayo of EPITHELIAL amaseli pleura. Okokuqala, it has ifomu ngamaqhubu encane noma ishq, ogama inombolo kwandisa njengoba isifo siqhubeka, ukwakha uhlobo ukukhanya emhlabeni igobolondo.

Izinhlobonhlobo izimila ebulalayo

Ngo inqubo yokwelapha yesimanje, zikhona izinhlelo eziningana ngezigaba. Kuye uhlobo pleural mesothelioma amaseli kungaba:

• epithelioid (uhlobo ezinjalo isimila kwenzeka 50-60% of amacala);
• fibrous noma sarcomatoid (atholakala ku-10% amacala);
• 30-40% azo zonke izimo isimila kuyinto okhombisa ezimbili noma okuxubile (ehlanganisa zombili izinhlobo cell).

Kuye isakhiwo acinar elingalodwa, iseli encane, futhi tubopapillyarnye ecacile iseli komdlavuza.

I pathogenesis lesi sifo

mesothelioma Pleural - ngenxa ukuguqulwa abulalayo amaseli we epithelium kobuso pleura (the mesothelium). Lapho kwakheka engeyokuqala ifomu isimila kunoma iyiphi ingxenye ye-parietal noma pleura visceral. Nokho ngokuvamile kukhona uhlobo ehlasela umzimba lesi sifo lapho amaseli abulalayo diffusely basakaza on the pleura, esigubuzele ukukhanya icala. Kuleso simo, uma ingaphakathi pleural uhlala free, ngaphakathi ekuqongeleleni waphawula ka oluhambisana (ngegazi) noma exudate seroplastic.

Njengoba pleura eduze noxhumana pericardium (imvilophi esigubuzele imisipha yenhliziyo), khona-ke amaseli abulalayo emabangeni kamuva uyezwakala izingqimba we pericardium. Futhi isimila efanela iyakhula ukuba izindlala zamanzi.

Ziyini izimbangela eziyinhloko zalokhu yesifo

Umbuzo othakazelisayo lowo, futhi izimbangela yalesi sifo. Yiqiniso, ukufunda ngokugcwele indlela yoguquko abulalayo lamaseli is bengaphumelelanga ngokugcwele. Nokho, abacwaningi banamuhla baye wathola ukuthi kukhona izinto ingozi eziningana ukuthi kumkhathaze nobulwelwe ezifana:

• Imbangela ukuguqulwa abulalayo lamaseli kungaxhunywana nge asbestos. Ngokocwaningo olwenziwa kwezibalo, 9 aphume amadoda 10 owayekade kutholakele mesothelioma pleural, ngaphambili wasebenza le nto. By the way, asbestos iye kabanzi embonini kuya cishe 1970.
• Izinto eziyingozi ezingabangela i zihlanganisa isifo womuntu SV40 igciwane, okuyinto kwezokwelapha eyaziwa ngaphansi elinye igama, okungukuthi igciwane simian. Kusukela ngo-1955 kuya 1963, kwenziwe umgomo global sabantu uvendle. Ngeshwa, umgomo unendle nge virus izinhlayiya. Kanjani ncamashi lolu hlobo ehilelekile ukubunjwa nokuthuthukiswa kwezinhlangano mesothelioma, kuze kube sekupheleni ayaziwa, kodwa uxhumano usukela.
• Imbangela lesi sifo kungase kube nemiphumela emzimbeni yokukhishwa kwemisebe. Ngokwesibonelo, mesothelioma angagcina nabo emzimbeni cindezela dioxide. By endleleni, lokhu kuqinisa lokho 1950s, yasetshenziselwa ngesikhathi Luhlolo radiology. Futhi kungenzeka ukuzibandakanya pleural elihlobene ne-radiotherapy ngaphambilini adlulisiwe.
• Imininingwane ngamakhemikhali athile unamandla avuse isifo. Ngokwesibonelo, umsebenzi okuqhubekayo nezinhlobo ezithile uyinki, izihlanzi, amakhemikhali ezonakalisayo ekuqaleni kuholela umgudu lesion, bese ekutjhugulukeni abulalayo amaseli.

Ayini izimpawu zesifo zenzeka ngemuva?

Ngokushesha kuwufanele bethi abulalayo mesothelioma pleural eba emangalisayo okusheshayo. Ngaphandle uphethwe ngesikhathi esifanele nje kwezinyanga ezimbalwa Ngokuhamba kwesikhathi lesi sifo kungaholela ekufeni komuntu.

Ngokuvamile, uphawu lokuqala ubuhlungu engxenyeni engezansi kwesifuba, futhi ngezinye izikhathi ngemuva. Ngaphezu kwalokho, iziguli esekhala ukukhwehlela njalo ezomile, okuyinto futhi ephelezelwa ngesisa. With ukuthuthukiswa sifo kuyagcinwa ukugwinya hoarseness.

Zikhona nezinye izimpawu ezihambisana mesothelioma we pleura. Izimpawu zihlanganisa ukujuluka esindayo nomkhuhlane. Ngokuvamile, iziguli ukuzwa igazi. Kungenzeka futhi ukuba isisindo ukulahleka, ngaphandle ukuzincisha ukudla noma noma yiluphi ushintsho supply.

Kusukela ngalo ingaphakathi pleural aqoqana uketshezi, omunye thuthuva, futhi dyspnea, hhayi kuphela ngesikhathi umsebenzi ngokomzimba, kodwa isimo ukuphumula. Wokubhoboza nokususwa exudate usizo ngesikhathi lula isimo lesiguli. Nokho, ukuqina pleural ngazo ezithweni mediastinal, ngokuvamile abangela thuthuva phezu ingxenye uhlelo senhliziyo nemithambo yegazi.

sitholakele isifo

Uma kubhekwa i udokotela abanolwazi Bangase basole ukuthi isiguli has mesothelioma pleural. Sifo kwahambisana esifubeni X-ray. Kodwa kuphela izimpawu ezimbalwa ubona izithombe. Ngakho-ke, kudingeka nezinye izifundo:

• Indlela eyinhloko uphethwe scan CT. Phakathi luhlolo, uzophawula khona effusion pleural, pleural ukuqina node, isimila uquqaba ezungezile cindezela wamaphaphu, shift mediastinal.
• Magnetic resonance imaging inikeza isithombe esinembile yezinga isimila ukusabalala. Ungase futhi ukunquma izinga lomonakalo ukuba diaphragm, futhi ukusabalala kwezifo ukuba ezungeze izicubu zomzimba ezithambile.
• Lapho kuboniswe futhi ngacula positron ekushayweni tomography, okuvumela ukuba sithole khona metastases ezikude nezinga lymph node ukuzibandakanya.

Ezinye izinqubo kwenziwe ukuqinisekisa sitholakele morphological

Ngemva kwalezi izinqubo ezidinga kanye isiqinisekiso morphological uphethwe. Lokhu kusho ukuthi kudingeka sithole ukuthi izimila Kutholwe ngempela mesothelioma ebulalayo.

Ngokuyinhloko ukuhlaziywa ukuthatha exudation kusuka ngaphakathi komgodi pleural, okuyinto ke wathumela ukuba kulandwe Cytology. Ngeshwa, ukuzwela kwalesi nqubo% 25-50 kuphela, futhi ngenxa yalokho edinga amanye cwaningo. Ngezinye izikhathi kwenziwe futhi cwaningo histologic, ukunemba okuyinto, ngeshwa, akuzona eliphezulu kakhulu futhi imayelana 60%. Nokho, lezi izinqubo kufinyeleleke kakhudlwana futhi ezingabizi, kodwa ngoba iqondiswa kwasekuqaleni.

amasu Okuningi eqondile kukhona koda, futhi ikakhulukazi Mediastinoscopy thoracoscopy (kuhlanganisa ukuvulwa zokuxilonga esifubeni).

Iyini inqubo yokwelapha?

Ngeshwa, umphumela imithi ukuthi kusetshenziswa imithi yesimanje nokwelashwa ngamakhemikhali, kuyinto% 20 kuphela. Ukusetshenziswa "Cisplatin", "Mitomycin", "Etoposide", "Gemzar" nezinye nemithi ethile ungakwazi ukunqinda isimila nendlala okuthiwa i ekutheni siphumelele ekufezeni inhloso yokwenza ngcono isimo isiguli. Nokho, indinganiso igolide kuyinto nokwelashwa ngamakhemikhali inhlanganisela. Ngokwesibonelo, uhlelo babekwazi ukubheka ngale ndlela: "Gemcitabine" + "Alimta" noma "Gemcitabine" + "Cisplatin".

Uma kukhona effusion pleural, isiguli zinganikwa cytostatics esasikhipha ngqo ngaphakathi komgodi pleural. Ngezinye izikhathi inhloso efanayo esetshenziswa interferon. Kuyasiza ukuba banciphise ijubane noma ngisho ukuyeka ekuqongeleleni exudate futhi ngaleyo ndlela lula kakhulu ukuphefumula lesiguli.

Ngokwemvelo, ucwaningo asebenzayo ezihlukahlukene izidakamizwa anti-umdlavuza abazenzi kuze kube manje. Kubhekwe izidakamizwa ethembisa - inhibitor ka semithambo endothelial ukukhula isici. Ngeshwa, izinga sokusinda iziguli ayiyinhle.

izinqubo ezidingekayo kuhlinzwa

Lesi sifo eshiya hhayi ikamelo kakhulu iqhinga, ikakhulukazi uma kuziwa ezigabeni kamuva lesi sifo. Ngakho kungakhathaliseki ukuthi ukuhlinzwa kungenzeka uma isiguli sekutholakele ukuthi sine- mesothelioma pleural? ukwelashwa Steel, ngokuvamile eyenziwa kuphela uma isimila itholakala endaweni eyodwa. Ezimweni ezinjalo, ukususwa wenziwa pleura, ngezinye izikhathi kanye ingxenye wamaphaphu. Lezi zindlela kwenziwe mayelana 11-15% of amacala. Isikhathi ukuphila ngisho nangemva ukwelashwa olukhulu ezinjalo izinyanga 9-22, lapho eneminyaka engu kakhulu embalwa. Umphumela ephumelela kunazo unikeza ukwelashwa, lapho kusebenza kuhlangene ngamakhemikhali.

mesothelioma Pleural: umhlahlo

Umdlavuza noma kunjalo yingozi. Ngakho yini okumele uyilindele nesineke okwatholakala ukuthi une-"mesothelioma pleural"? Isibikezelo, maye, Akududuzi kakhulu. Yiqiniso, konke kuncike ncamashi ukuthi sigaba sini lesi sifo sitholakale. I-Akhawunti makamthathe ubudala noma impilo yabo jikelele isiguli, ukuphumelela izidakamizwa esetshenziswa, nokunye. D. Ngokuvamile, ilungelo yokwelapha kusaqalwa zesifo bungatholakala ukuthethelelwa, ngezinye izikhathi ngokusindisa ukuphila sesiguli iminyaka 5-6.

Ngeshwa, kaningi iziguli unesifo egijima mesothelioma pleural (isinyathelo 4). Bangaki siphila nalesi sifo? Ngeshwa, ngisho nokusetshenziswa zonke izindlela wokuphila emkhakheni wamuva wezokwelapha akuvamile ukusindisa ukuphila lesiguli izinyanga ezingaphezu kuka 2-8.

Zikhona izinyathelo zokuvimbela ukuba ukuba isifo?

Pleural mesothelioma wamaphaphu - isifo emangalisayo kuyingozi ukuthi ngokuvamile kubangela ukufa lomuntu. Ngeshwa, i-ejenti ngempumelelo prophylactic alikho. Noma kunjalo, ukufunda ngokucophelela izici eziyinhloko engabangela ukuguqulwa abulalayo amaseli, futhi uma kungenzeka bazame ukugwema kubo. Ngokwesibonelo, iphaphu Ochwepheshe batusa kakhulu ukusebenza asbestos, bahlala izimo ezingezinhle, nokunye. D.

Ngokwemvelo, kubalulekile ukuba ayeke ukubhema, njengoba lo mkhuba kungabangela eziningi izifo umgudu wokuphefumula, kuhlanganise lokhu. Futhi minyaka yonke kubalulekile ukuthatha zokuvimbela -X-ray luhlolo yamaphaphu (esifubeni X-ray), ngoba ngokushesha uzobe unesifo esithile, aba maningi amathuba okuba impumelelo ukwelashwa. Ngokukhethekile kuyadingeka ukukhokhela abasebenzi izimboni enobungozi, onempilo usengozini enkulu.