Khansa yapakansa yokhala ndi metastases ya chiwindi: chithandizo, kuneneratu, kuchuluka kwa anthu

Khansa ya pancreatic ndi gulu la ma oncological pathologies omwe ali ndi zotsatira zosasangalatsa. Kuopseza kwa chifuwa cha pancreatic ndikuti koyambirira koyambirira, ngati zingatheke kupewa kupangika kwa zinthu zovulaza mu chiwalo, matendawa sadziwonetsa. Chifukwa chake, chitukuko cha khansa ya kapamba mu 90% imapezeka pamalo pomwe madokotala akulephera kuthandiza wodwalayo.

Kupezeka kwa khansa mu kapamba asanachitike metastasis, ndipo kuli kovuta kudziwa. Komanso, ngati mumayang'anitsitsa thanzi lanu ndikulemba zofunikira zamthupi, ndiye kuti ndizotheka kuneneratu za khansa. Chifukwa chake, odwala atazindikira kuti ali ndi chidwi, ngati khansa ya pancreatic yokhala ndi metastases ya chiwindi yapezeka, ndi angati akukhala.

Khansa yapakansa

Khansa ya pancreatic imayamba m'magawo anayi:

  • Gawo 1. chotupa ndi chaching'ono, sichidutsa 2 cm, mkati mwa kapamba. Opaleshoni yamtundu uliwonse imapezeka kuti ichiritse. Zoneneratu kuti wodwalayo achira ndizokwera.
  • Gawo 2. Gawo la lesion limakula, limafalikira kumalire a pafupi, ma lymph node. Chithandizo cha opaleshoni sichimaperekedwa kwa wodwala aliyense; chifukwa, izi zimafunikira. Rediation kapena chemotherapy ndikofunikira.
  • Gawo 3. Lotupacho sichinafikirebe ziwalo kwathunthu, koma zotengera ndi mitsempha zimakhudzidwa kale. Kukula kwa metastases ndikuyang'ana matendawa pawokha kumapanikizidwa ndi chithandizo chokha. Kuphatikiza pa chemotherapy kapena radiotherapy, zovuta zimaphatikizapo opaleshoni ya bile duct bypass. Cytokine therapy imachitidwanso kuti poizoni wamphamvu m'thupi asakhale wamphamvu. Gene amakonzekera IFN, TNF-T ndi ena amalola maselo athanzi kukhala olimba, ndipo maselo a khansa kuti adziwononge. Gawoli silikugwira ntchito.
  • Gawo 4. Gawo lokhazikitsidwa, malo ogwiritsira ntchito. Maselo a khansa sangathe kuyimitsidwa, amachulukana mosalamulirika, amanyamula thupi lonse. Wodwala sagwiridwapo ntchito, mankhwalawo omwe amwedwa amachepetsa ululu. Mwayi wopulumuka zaka zoposa 5 pakadali pano ndi 4% yokha ya odwala.

Nthawi zambiri, matendawa amapezeka m'magawo awiri a 2-3, ndikupeza chithandizo chamankhwala kwa dokotala ndikuwazindikira. Zowonadi, nthawi zina, chifukwa cha mawonekedwe awonetserako, khansa siyikulangizidwa pa malo oyamba.

Pancreatic khansa metastasis limagwirira

Chiwalo chimagawika m'magawo atatu - mutu, thupi ndi mchira. Mutu uli pafupi ndi duodenum, ndipo mchirawo uli pafupi kwambiri ndi ndulu. Chifukwa cha zoterezi zimachitika m'matumbo, m'magulu amitsempha yamavuto, zimakhala zovuta kuchita diagnostics kapena kulowererapo kulikonse. Nthawi zambiri imakumana ndi khansa ya mutu wa kapamba, kawirikawiri mchira - mu 5% yokha.

Choyamba, mathero a mitsempha ya kapamba amakhudzidwa, chifukwa chake kupweteka kumawonekera. Chifukwa cha izi, kunyowa kwa chakudya kumavulala, zomwe zimapangitsa kuti muchepetse thupi. Pambuyo kuwonekera kwa jaundice, chifukwa ndulu imayamba kugwira ntchito molakwika.

Pambuyo pake, maselo a khansa amasunthira m'njira zitatu zosiyanasiyana:

  • Ndi magazi.
  • Ndili ndi zamakono.
  • Kudzera pakuwonongeka kwa chotupa, pomwe ziwalo zake zimatuluka kumimba ndipo zimagwirizika ndi ziwalo zina.

Ndi matendawa, metastases imasunthira ku zamitsempha, mapapo, chiwindi, m'mimba, matumbo.

Zizindikiro za matendawa

Zina mwazizindikiro ndi:

  • Kuchepetsa mwadzidzidzi komwe sikuchira.
  • Ululu mbali yakumanja, kumva ziwalo zokulitsidwa mkati.
  • Mavuto am'mimba am'mimba, nthawi zambiri amasanza mseru, kuchepa kwa njala.
  • Thupi.
  • Jaundice

Nthawi zambiri, dokotala amafunsidwa ngati zizindikiro zapadera zimawonekera - zimaphatikizapo jaundice komanso kuchepa thupi kwambiri. Kuwoneka kwa zizindikiro zazikulu kumachitika chifukwa chakuti metastases ikufalikira kale, iyi ndi gawo la 3-4 la matendawa.

Zizindikiro

Kuphatikizika kwa njira zodziwira matenda osiyanasiyana kumasiyananso mbali iliyonse yamatendawa, chifukwa m'mene imayamba kukula, zomwe zimakhala ndi ziwalo zina, mitsempha yamagazi, ndi ma lymph node. Kuti muwone malo omwe metastases idawonekera kale, kusanthula kowonjezera ndikofunikira.

  1. Kuyesedwa kwa magazi konse. Ndi kuchepa kwa hemoglobin, matenda a oncological angakayikiridwe.
  2. Kuyesa kwamwazi wamagazi. Hepatic michere ndi zamchere phosphatase kuchuluka.
  3. Ogulitsa. Afunika kutsimikiza kuti atsimikizadi khansa ndikufufuza momwe angathandizire. Nthawi zambiri, malinga ndi zotupa, zimadziwika ngati chotupacho chikugwirika kapena ayi.
  4. Kuti mumvetsetse bwino vutoli, ultrasound yam'mimba imapangidwa kuti ipende metastase pazinthu.
  5. CT ndi MRI ithandizanso kuyambiranso chithunzi cha minofu ya pancreatic ndikumvetsetsa malo enieni a metastases.
  6. PET imathandizanso kudziwa kuchuluka, malo a metastases, gawo la matendawa.
  7. Kuzindikira laparoscopy ndi biopsy.

Pamapeto pake, kuyesa konse komwe kukuchitika kudzakuthandizani kuti mupange chithunzi chonse cha matendawa kuchokera pazotsatira zotsatirazi:

  1. Chiwerengero cha metastase, kukula kwawo.
  2. Chitukuko cha metastases.
  3. Kukula kwa ziwalo.
  4. Mlingo wa kuledzera kwamthupi.

Kuyesedwa komweku kumachitika nthawi ya chithandizo, ndipo ena atatha, kuonetsetsa kuti mankhwalawo akuyenda bwino ndipo palibe chotupa chikukula.

Chithandizo cha khansa ya pancreatic ndi metastases nthawi zambiri chimachitika ndi opareshoni. Nthawi yomweyo, ma metastases ena ndi chotupa amachotsedwa, ndipo ngati chotupa ndichachikulu kwambiri - kapamba ndi gawo la chiwindi momwe ndingathere.

Kuchepetsa kufalikira kwa matendawa, zomwe zimayambitsa matupi athu ndi chemotherapy. Chifukwa chake, zochitika za maselo owopsa amachepa, ndipo zotsalazo zimawonjezera kukana kuwonongeka.

Chithandizo cha poizoniyu. Nthawi zina amalembedwa pamaso pa opaleshoni kuti muchepetse chotupacho ndi metastases, zomwe zimathandizira ntchito ya adotolo kuti awachotsere pa nthawi ya opareshoni. Chithandizo cha radiation chimayambitsa kuwonongeka kwa gawo limodzi la maselo a khansa, komabe, zizindikirazi zimakhalabe zolimba.

Pa magawo 3 ndi 4, ntchito sizinachitike. Chemotherapy ndi radiation chithandizo chovomerezeka pa 3, ngati mkhalidwe waumoyo walola. Pazigawo zinayi za khansa, chithandizo chimalimbikitsa thanzi la wodwalayo komanso kuchepetsa ululu.

Zakudyazi zimaperekedwa pa gawo lomaliza la khansa ya kapamba, komanso musanayambe chithandizo nthawi iliyonse. Izi ndizofunikira kuti zowunikira zikhale zodalirika komanso kuthandizira thupi lofooka kuti lizitha kukonzanso mphamvu. Chifukwa chake, zakudya za khansa ya pancreatic yokhala ndi metastases zizigwiritsidwa ntchito pamagulu otsatirawa:

  • Thupi limafunikira mapuloteni. Chifukwa chake, nyama imagwiritsidwa ntchito, koma mafuta ochepa - ng'ombe, kalulu, bere la nkhuku kapena nsomba.
  • Masamba ambiri, zipatso, zitsamba, zipatso.
  • Zopangira mkaka wowonda wokhala ndi mafuta ochepa.
  • Porridge pamadzi.
  • Mutha kuphika mbewu zilizonse, kupatula barele ndi mapira.
  • Mazira amtundu wa mafupa opanda ma yolks.
  • Zakumwa zamphesa, timadziti tating'onoting'ono tatsopano, zodzikongoletsera zamasamba, tiyi wopanda mphamvu wakadali madzi.

  • Mafuta onenepa, zakudya zina zamafuta.
  • Zakudya zamatenda.
  • Zakudya zonunkhira, zonunkhira, zamchere.
  • Soseji, masoseji.
  • Mazira owiritsa kwambiri.
  • Zinthu zamafuta mkaka, kuphatikiza batala.
  • Kuphika batala.
  • Shuga, uchi, chokoleti, confectionery.
  • Zipatso zokoma, zowawasa (maapulo, mapeyala).
  • Masamba, jamu, mphesa ndi zipatso zina zokoma kapena zowawasa.
  • Anyezi, adyo.
  • Zakumwa za kaboni, kuphatikizapo madzi.
  • Kofi, tiyi, koko, mowa.
  • Mpiru, horseradish, mayonesi, ketchup, zonunkhira zotentha.

Anthu omwe ali ndi oncology nthawi zina amakana malonda, chifukwa makomedwe amatsenga amatayika ndipo chakudya chimawoneka chatsopano. Chifukwa chake, chakudya chimaloledwa kukola ndi basil, thyme, timbewu, rosemary ndi zitsamba zina zatsopano kapena zouma. Zipatso zouma kapena zipatso zimaphatikizidwa ndi njere.

Ndi angati omwe akukhala ndi khansa ya pancreatic ndi metastases ya chiwindi?

Khansa ya pancreatic imakula msanga, ndipo imatha kupezeka pokhapokha pagawo la 2 kapena 3, lomwe limasokoneza mankhwalawo ndikupangitsa zolosera kukhumudwitsa. Ngati metastases siinafalikire ku ziwalo zofunika, ndipo matendawa adachitika nthawi ya 1 kapena koyambirira kwa gawo lachiwiri la chithandizo, ndiye kuti pali mwayi waukulu wochira.

Chiyembekezo chamoyo ndi mtundu uwu wa oncology zimatengera kufalikira kwa matendawa, kuchuluka kwa metastase. Zomwe zimachitika mu zaka, jenda, komanso mkhalidwe wamunthu thupi lisanayambike matendawa limakhudzanso. Matenda oyipa, zovuta zapambuyo, chifuwa, ndi zina zonse ndizofunikira.

Ngati metastases yasunthira kale ku chiwindi, imanena pafupifupi nyengo ya miyezi 4-6. Ngati chotupa chachikulu, ndiye kuti wodwalayo sangakhale ndi moyo kwa miyezi itatu. Pali nthawi zina pomwe odwala adakwanitsa chaka chimodzi, koma izi ndizosowa.

Khansa ya pancreatic ndimatenda oopsa, omwe ndi amodzi mwa mitundu yoyipa kwambiri ya oncology, yomwe imapangitsa wodwalayo kuti afe, osasiya nthawi yamankhwala. Zimakhala zovuta ndi zovuta ndi matenda, chifukwa matendawa samadziwonetsa kwa nthawi yayitali. Chifukwa chake, chinthu chokhacho chomwe madokotala amalangizira ndikuchiza thanzi ndi chisamaliro. Kuwoneka kwa zizindikiro zosamveka kuyenera kuyambitsa ulendo wopita kwa dokotala.

Zida zazikulu za metastasis

Khansa ya pancreatic metastasize kuti akupanga zida ndi ziwalo.

Ma metastases ali ndi njira zitatu zogawirira:

  1. Hemato native - kulekanitsa kwa zotupa maselo kuchokera ku cholinga chachikulu ndikuyenda kwawo kwa chiwindi kapena chiwalo china kudzera m'magazi.
  2. Lymphogenic - maselo owononga amalowa ndikamayendedwe a lymphatic ndikulowerera ma lymph node.
  3. Ikani - neoplasm imakula kukhala chiwalo chapafupi.

Ndi pancreatic oncology, neoplasm metastasize kwenikweni, chifukwa nthawi yokhayo ndiyofunikira. Nthawi zambiri, neoplasms yachiwiri imachitika m'mitsempha, m'mapapo, m'mimba, komanso m'chiwindi. Khansa ya pancreatic imawoneka molawirira kwambiri, ndipo nthawi zina zizindikiro za metastase zimachitika kale kuposa zizindikiro za chotupa chachikulu. Metastases ya chiwindi imachitika mu gawo lililonse lachitatu, chifukwa chiwalochi chimakhala ndi magazi abwino.

Zomwe zimakhudza kudalirika kwa khansa ya chiwindi

  • Yuri Pavlovich Danilov
  • Julayi 9, 2019

Nthawi zambiri imakhudzidwa ndi khansa yam'mimba, chifuwa, kapamba. Minofu ya chiwindi imaperekedwa bwino ndi magazi: miniti iliyonse imasefa malita ndi theka a magazi. Kuvulala kwa chiwindi kumayendera limodzi ndi zizindikiro zofanana ndi hepatocellular carcinoma:

  • kukana kulemera (ndi kuwonongeka kwa mchira wa kapamba),
  • kutaya kulakalaka
  • malungo
  • kuchuluka kukula kwa chiwindi
  • kuchuluka chiwindi michere
  • kuchuluka pazambiri zotupa
  • kutsegula m'mimba kukhalapo kwa mafuta mu chopondapo (chamkansa yam'mutu).

Metastasis ikhoza kukhala asymptomatic. Potere, wodwalayo amwalira pasanathe miyezi isanu ndi umodzi. Ndi khansa ya kapamba, wodwalayo amadandaula za kufooka, kumva kutopa, kusasangalala m'mbali. Makina a jaundice amatha. Zizindikiro zimatengera malo a metastases.

Chithandizo chapadera chimaphatikizira njira yophatikiza, kuphatikizapo:

  • zokoma opaleshoni
  • chemotherapy
  • poizoniyu mankhwala
  • phwando ma pinkiller
  • zakudya mankhwala.

Kusankhidwa kwa njira zamankhwala kumadalira momwe wodwalayo alili, kukula kwa zotupa. Ndi zotsatirapo zabwino, wodwalayo amachitidwa opaleshoni pa bile duct. Zikondwerero ndi gawo la chiwindi chimachotsedwa kwathunthu. Odwala ambiri omwe ali ndi khansa amabwera kudzafunafuna mochedwa akapezeka mtundu wa chotupacho.

Ndi vuto la chiwindi, munthu amakumana ndi zovuta pakudya chimbudzi. Muzovuta kwambiri, kuperewera kwa zakudya m'thupi kumabweretsa matumbo. Mankhwala othandizira pakudya ndi njira yothandiza kuchepetsa mkhalidwe wa wodwala.

Ma analgesics ndi mankhwala a narcotic ndi anzawo okhazikika a wodwala mu magawo anayi a khansa. Asayansi ena amakhulupirira kuti kumwa mankhwala opha ululu ayenera kuikidwa posachedwa. Mankhwala osokoneza bongo samathandizira chithandizo, koma kukonza zomwe zili ponseponse.

Kusiyana pakati pa cirrhosis ndi khansa ya chiwindi

  • Victoria Navrotskaya
  • Julayi 9, 2019

Chithandizo cha radiation chimakulolani kuwonjezera moyo wa munthu mpaka kalekale. Ma x-ray omwe amagwira ntchito kwambiri amadzaza madera omwe akhudzidwa. Njirayi imagwiritsidwa ntchito kuyimitsa kanthawi kovulaza.

Maselo a khansa amafalikira ndi magazi. Munthawi imeneyi, wodwalayo amamulembera maphunziro a chemotherapy kuti atalitse moyo.

Kupambana kwamankhwala kumatsimikiziridwa ndi zifukwa zingapo:

  • kuchuluka ma metastases (zingapo kapena zingapo),
  • mtundu khansa
  • digiri ya kusokonezeka kwa chiwindi.

Metastase amodzi amachotsedwa ndi lobar, segmental, kapena atypical resection. Kwina konse, njira yokhotakhota ya transhepatic radiofrequency ablation ikuyamba kutchuka. Ili ndi zabwino zambiri:

  • ntchito milandu maphunziro metastases yatsopano
  • minofu yathanzi ayi zowonongeka
  • chizindikiro chawonjezeka kuchuluka kwa kupulumuka odwala.

Njirayi imakhala ndikulowetsa ma elekitirodi singano m'thupi lomwe lakhudzidwalo lomwe mafunde a wailesi amadyetsedwa. Ku Russia, opaleshoni yotere imachitika m'makliniki angapo aku Moscow. Choyipa chake ndiye mtengo wokwera kwambiri wa njirayi.

Embolization ndi njira yamakono yochizira ma metastases. Mchiwiya chogwiriridwa, mankhwala omwe amaphwanya mtsempha wamagazi amaponyedwa. Njira yogawa maselo a khansa imachepa poti zakudya zamagulu ochepa zimatha.

Gawo lotsika la khansa ya pancreatic yokhala ndi metastases ya chiwindi imasonyeza zosavomerezeka kuneneratu. Chiyembekezo cha moyo chimadalira malo omwe chotupacho, kuchuluka kwake kufalikira, kuchuluka kwa metastase. Adenocarcinoma ndiye mtundu woipa kwambiri wamatenda a chamba. Ndi zowonongeka kwathunthu kwa minyewa ya chiwindi, zimaganiziridwa kuti munthu adzakhala ndi moyo wa miyezi 4.5.

Ndani ali pachiwopsezo

Chotupa choyipa chimakonda kupita patsogolo mwachangu, sichitha anthu pazaka zilizonse. Kuchepa kumapezeka kawirikawiri pokhudzana ndi mawonekedwe a moyo wa wodwalayo, momwe angagwirire ntchito zomwe zingayambitse kudwala. Ali pachiwopsezo chotenga khansa yapancreatic:

  • osuta
  • oledzera
  • odwala matenda ashuga
  • wokhala ndi matenda osachiritsika: kapamba, chifuwa, kupezeka kwa chotupa kapena chotupa mu
  • anthu omwe samatsata zakudya, amadya zakudya zamafuta ambiri
  • wogwira ntchito m'makampani ogulitsa mafakitale, nthawi zonse amakumana ndi mankhwala: mafuta, ma sol sol,
  • atamuchita opareshoni yapitayi kuti ayanjenso m'mimba kapena cholecystectomy.

Chimbudzi ndi gawo lofunikira mu chakudya chamagaya, chimalimbikitsa kupanga ma enzymes, makamaka insulin ndi glucagon, ndikuwongolera shuga. Ngati siteji ya chitukuko cha chotupa imapangika patatu kokha, ndiye kuti gawo lachinayi metastases yafalikira kale ku impso, mapapu, mafupa ndi chiwindi.

Kodi khansa yachigawo 4 imawoneka bwanji?

Gawo lomaliza kapena lothana ndi vuto la chotupa, monga lamulo, latchulapo komanso kulekerera kwambiri ndi zizindikiro za odwala. Kuledzera kwamphamvu kwambiri kwa thupi kumawonedwa chifukwa cha kutulutsa kwakukulu kwa zinthu za m'magazi a ma cell a khansa. Pa gawo la 4 la kupanga poizoni, zizindikilo ndizodziwikiratu:

  • kufooka
  • kutayika kwa magwiridwe
  • kusowa kwa chakudya
  • kuwonda msanga
  • zilonda za epigastric zone ndikubwerera mapewa, m'munsi kumbuyo, kumbuyo, miyendo yakumtunda,
  • kuphwanya kwam'mimba chifukwa chofinya ndi chotupa chokulirapo cha dera lakumalo,
  • kuyamwa michere pakumeza,
  • kuwoneka mseru, kusanza, kupindika komanso kutulutsa magazi,
  • kuchepa kwa magazi m'thupi, kuchepa kwa vitamini,
  • chikaso cha khungu ndi mucous nembanemba wamaso.

Kuzindikira kuwonjezeka kwa chiwindi, ndulu ndi zamitsempha. Pansi pa khungu, mumatha kumva kupendekera kwawo kofewa. Odwala ambiri amakhala ndi chifuwa cham'mimba ngati chotupa chikufika kumapapu.

Nthawi zambiri odwala omwe ali pa gawo 4 la khansa samatulukiranso. Zofooka zimakhala zamphamvu kwambiri kotero zimapangitsa kuti zisathe kuyenda payekha. Mchitidwe wamanjenje umasinthidwa kwambiri ndi pathological. Monga lamulo, onse odwala kwambiri omwe ali ndi khansa yachinayi amadwala:

  • kukhumudwa
  • mantha ambiri ndi mkwiyo,
  • kusakhazikika
  • kugona kusokonezedwa.

Chotupa cha pancreatic chikukula mwachangu, ndikupereka ma metastases ku ziwalo zosiyanasiyana: zam'mimba, chiwindi, zimbudzi, ma duodenum awiri, ndulu.

Chithunzi cha chipatala cha matendawa sichikuwoneka bwino. Zizindikiro zake ndizofanana ndi khansa ya m'matumbo, ndipo pokhapokha ngati madokotala atulukiratu, madokotala amawululira malo enieni komanso kukula kwa chotupa mu kapamba.

Magawo otukuka

Monga matenda ena a oncological, khansa ya kapamba imakhala ndi magawo anayi a chitukuko chake:

  1. Neoplasm akuyamba kumene kupanga ndipo sapitirira masentimita awiri. Chotupacho chili mkati mwa kapamba, motero ndichosavuta kuchichotsa. Zambiri mwatsatanetsatane ndizabwino.
  2. Mu gawo lachiwiri, maphunziro amapita kumadera a lymph node ndikulowa m'malo oyandikira. Pakadali pano, theka la odwala okha ndi omwe angapange opaleshoni yotsatiridwa ndi chemotherapy ndi radiation therapy.
  3. Amati gawo lachitatu ngati kuwonongeka kwa mitsempha ndi mitsempha yamagazi kwachitika. Mothandizidwa ndi chithandizo chophatikizidwa, kukula kwa neoplasm komanso kukwiya kwake kungathe kuchepetsedwa. Chemotherapy yodziwika imasinthidwa ndi cytokine mankhwala, omwe amakhala oopsa kwa maselo athanzi. Kuchita opaleshoni ya biliary bypass ndikofunikira. Masewera olimbitsa thupi a gawo lachitatu sagwiranso ntchito.
  4. Pomaliza, maselo a chotupa amagawanika mosasamala komanso mwachangu, metastase imapezeka mwa odwala ambiri. Momwe chithandizo cha sitejiyi chimakhalira chosangalatsa, chifukwa matendawa amakhumudwitsa kwambiri (kutalika kwa nthawi yayitali kuyambira miyezi ingapo mpaka chaka chimodzi).

Wodwalayo akangotembenukira kuchipatala, amakhala ndi mwayi wopulumuka.

Kuti muzindikire pakapita nthawi, muyenera kudziwa zizindikiro za matendawa ndipo ngati pali zizindikiro, pitani kuchipatala. Koma ngati tikulankhula za oncopathology ndi metastasis ya chiwindi, ndiye kuti odwala amadziwa kale za matenda awo kapena akuwakayikira kuti alipo.

Kodi chithandizo chake ndi chiani?

Ndi khansa 4, khansa yowonjezera ya chemo ndi radiation ikuwonetsedwa. Opaleshoni, opaleshoni, komanso kupereka mankhwala kwa ululu waukulu ndizotheka. Onetsetsani kuti odwala amatsata zakudya kuti azitha kukhala ndi moyo.

Masiku ano, madokotala akuti ngakhale khansa 4, kanthawi kochulukirachulukira. Koma ndikofunikira kumvetsetsa kuti popanda kulandira chithandizo chokwanira, njira ya khansa imatha kutenga miyezi yochepa. Palibe chifukwa chomwe muyenera kukanira chithandizo chamankhwala chomwe madokotala amapereka. Khansa imayamba msanga ndipo zizindikiro za chotupa cha 4th zikuwonetsedwa bwino. Chithandizo chokwanira chokha chokwanira chimalimbikitsa moyo wa khansa ya England.

Ngati metastases sanapezeke, ndiye kuti ntchito yokhazikika imakhazikitsidwa. Kuchiritsa matendawa kwathunthu kumatengera kupezeka kwa chotupacho, kuzindikira. Chofunikira ndi mkhalidwe wamaganiza a wodwala. Monga lamulo, psychotherapists amagwira ntchito ndi odwala omwe ali m'makiriniki. Kusintha kwachidwi ndikofunikira kwambiri.

Kunyumba, odwala amalangizidwa kuchitira khansa ya pancreatic ndi mankhwala azitsamba:

  • geranium-wofiira wamagazi (rhizome) popanga madzi otentha ndikumwa 1-2 tbsp. l musanadye
  • hemlock (tincture),
  • Buliki yakuda pakulimbikira kwa masiku 14 m'malo amdima ndi kutenga 3 akutsikira kanayi pa tsiku,
  • mphesa monga chinthu chofunikira kwambiri pakufewa kwamphamvu kwa thupi.

Ndi zitsamba zachilengedwe zomwe zimathandizira kusunga thupi (makamaka chitetezo chokwanira) mwa chizolowezi pambuyo pa maphunziro a chemotherapy.

Zikondazo zimayandikana kwambiri ndi ziwalo zofunika kwambiri (chiwindi ndi matumbo), kotero kuyeretsa thupi ndi kapamba sikulowa m'malo ngakhale kwa odwala omwe ali ndi khansa ya 4th.

Zambiri zomwe zatsalira kuti zikhale ndi moyo

Odwala ambiri ali ndi chidwi chofuna kudziwa ngati khansa ya kapamba yokhala ndi metastases ya chiwindi ikupezeka, anthu angati amakhala? Gawo la khansa ya pancreatic ndikuti limachitika popanda pafupifupi zizindikiro. Matendawa amatizindikira pokhapokha ngati mwayesedwa ndipo nthawi zambiri amakhala omaliza. Masiku ano, mankhwala obwera kumene mu mankhwala opangira mankhwala amatha kupititsa patsogolo moyo wa odwala komanso kukulitsa thanzi lawo, kuyimitsa chitukuko ndi kufalikira kwa ma neoplasms ndi metastases thupi lonse. Koma kuyankha funsoli mosasamala: kodi ndizotheka kuchiritsa khansa pagawo 4 ndikovuta.

Mankhwalawa ndiwotalikirapo ndipo ngakhale ndi njira zaposachedwa ndizovuta kukwaniritsa chikhululukiro chokhazikika komanso kwanthawi yayitali. Gawo 4 zilonda zam'mimba zimafalikira thupi lonse, zimayambitsa kuwonongeka osati mutu wapa khunyu, komanso chiwindi, ndulu, matumbo, mapapu komanso ubongo. Ma metastases ambiri pamaso pa chiwindi amapereka chidziwitso chokhumudwitsa.

Mukadwala MRI, yachiwiri ya khansa imayamba kupezeka ndipo kufa kumatha kupezeka mkati mwa miyezi iwiri. Zinthu zikuipiraipira, chotupacho chikukula motsutsana ndi maziko a matenda a shuga.

Odwala akuwonetsedwa njira yovuta kwambiri ya chemotherapy kuti atalike ndi moyo komanso kuti athetse zowawa. Komanso, njira ya radiation chithandizo, radiotherapy pochotsa chotupa pamodzi ndi zimakhala zowazungulira kuti abwezeretsere patency ndi kutuluka kwa ducts ya bile.

Kudyetsa chakudya ndikofunikira

Pafupifupi, chiyembekezo cha moyo wa odwala omwe ali ndi gawo la 4 la khansa ndi zaka 0.5. Ngati odwala akukana kupita kuchipatala kwambiri, ndiye kuti nthawi yotalikirapo siyidutsa miyezi iwiri. 5% yokha ya odwala omwe ali pa siteji 4 amapulumuka chaka chimodzi. Zonse zimatengera kukula kwa chotupa, kuchuluka kwa metastase, komanso zaka za wodwalayo. Pokhala ndikuyang'ana koyambirira kwa madokotala pa magawo a 1-2, kuchuluka kwa kupulumuka kumakhala kwakukulu kwambiri - mpaka zaka 5.

Pa gawo 4 la khansa ya kapamba, madokotala sangathenso kuunikira zabwino. 2% yokha ya odwala amakhala ndi moyo wopitilira zaka 3 ali ndi matenda oterewa ndipo amangomvera zonse zomwe dokotala amupatsa, komanso zakudya, komanso moyo wabwino. Inde, zamankhwala masiku ano zimatha kuthana ndi vuto la wodwalayo, koma pazigawo 4, monga lamulo, zizindikiro zake ndizowala ndipo mankhwala ambiri sangathe kuthetsa vutoli.

Khansa ya pancreatic komanso ndi metastases ya chiwindi ndizovuta kuzichita pakokha pa gawo la 4, imadziwika ndi kukhalapo kwa metastases, kufalikira kwawo mthupi lonse. Tsoka ilo, madokotala mpaka pano sangathe kuthana ndi khansa ya pancreatic.

Ngakhale kuchotsa kwathunthu kwa neoplasm kumatheka pokhapokha 20% yamilandu. Kuyambitsanso kwa pancreatic kumawonjezera kupulumuka mpaka zaka 5, ngakhale kuchuluka kwa anthu kuli kochepa kwambiri, 8% yokha ya anthu. Zotsatira zoyipa pambuyo pakuchita opaleshoni yayikulu zimawonedwa mu 15% ya milandu, chifukwa zimayambiranso pambuyo pochita opareshoni pambuyo pa wodwala aliyense wachiwiri. Imfa mu 90% ya odwala imawonedwa pakatha zaka ziwiri. Koma zimatengera gawo la khansa, kukhazikitsidwa kwa maphunziro a madokotala.

Odwala amalangizidwa:

  • osazengereza kulandira chithandizo msanga ngati khansa ikukayikiridwa,
  • Musachite mantha kapena kukana njira zomwe madokotala amakupatsani,
  • kukayezetsa mokwanira komanso njira zonse zodziwikira.

Khansa si sentensi. Komabe, ndikofunikira kukhala olimba mu chikhalidwe komanso mphamvu ya chidwi kuti mukhale ndi moyo. Iyi ndi njira yokhayo yomwe ingathandize kwambiri kuti moyo ukhale wabwino komanso osaganizira za matendawa.

Kutalika kwa moyo

Odwala ambiri ali ndi nkhawa ndi funso, ali ndi khansa ya 4th degree ndi metastases kuti amakhala ndi ndalama zingati? Zotsatira za odwala oterewa zimakhala zomvetsa chisoni. Nthawi yayitali imakhala mpaka miyezi isanu ndi umodzi. Akakana mankhwala a pancreatic chemotherapy, sakhala oposa miyezi 2. Mlingo wopulumuka chotupa chosagwira ntchito ndi 1%.

Madokotala amatsimikizira kupulumuka kwa miyezi itatu chiwindi chikuwonongeka, ndipo osapitirira miyezi isanu ndi umodzi ngati chotupa chaphimba ziwalo zina. Chilichonse chidzatsimikizidwa ndi kukula kwa mapangidwe, msambo wa wozunzidwayo, kuchuluka kwa zotupa.

Kutalika kwa moyo wopeza khansa m'mapapo kumakhala kochepa kwambiri, ndi 5% yokha ya omwe akuvutika ndi moyo chaka chimodzi, ngakhale atachitapo kanthu. Ngati wodwalayo adalumikizidwa koyambirira kwa siteji ya 1-2, ndiye kuti ndi zaka 5.

Zizindikiro za zotupa

Pa gawo lomaliza la khansa ya kapamba, pakakhala metastasis yogwira, pali zizindikiro za matendawa.

  • kufooka kukukula
  • kugwira ntchito kumachepa
  • kusowa kwa chakudya
  • kulemera kwa thupi kukuchepa kwambiri
  • kupweteka kwambiri pamimba,
  • m'mimba chimasokonekera,
  • kusokonezeka kwa metabolic kumachitika,
  • kuchepa magazi kwambiri
  • jaundice amachitika.

Kulemera kumakhala kotsika kwambiri, kumayambitsa matenda a anorexia, pomwe m'mimba umakula chifukwa cha kuchuluka kwa madzi mkati mwake (ascites). Odwala ambiri amafufuza kale gawo lachitatu kapena lachinayi, pamene zizindikiro za metastasis zimatchulidwa.

Chithandizo chitha

Therapy wa oncology amalembedwa kutengera kukula kwa mapangidwe ndi gawo la matendawa. Tsoka ilo, kuchitira khansa ya pancreatic ndi metastases ya chiwindi kumatha kungochotsa zisonyezo ndikukulitsa moyo wa wodwalayo pang'ono.

Njira zazikulu zothandizira palliative:

  • kulowererapo kwa radiosuction - ndi mpeni wa cyber, adotolo amachotsa zoyipazi, koma sangathe kuchotsa ma metastases,
  • chemotherapy - ndi njira yothandizira mankhwalawa mutha kuchepetsa kukula kwa chotupa ndikuyimitsa kukula kwake,
  • poizoniyu - mothandizidwa ndi mankhwala a radiation, kukula ndi kuchuluka kwa ma metastase kumachepetsedwa, ndipo zizindikiro za khansa zimayimitsidwa.

Nthawi zina, ndizotheka kuchita opaleshoni yoyipa kuchotsa zikondamoyo, koma gawo 4, opaleshoni imangokhala yothandiza.

Pamaso pa chotupa cha khansa mu kapamba, ndikofunikira kutsatira zakudya, makamaka ngati metastases kwa chiwindi itapita. Chamoyo chazimiririka sichitha kudzipatula pawokha podzigawanitsa chakudya. Kulephera kwakudya kumawonjezera kusowa kwa chilimbikitso mwa wodwala. Maziko omwe wodwalayo amadya ndi chakudya No. 5.

Mbale zonse zimayenera kukhala zamadzimadzi ndi theka, zimagwiritsidwa ntchito pamafuta aliwonse sizimachotsedwa, chifukwa thupi lomwe lili mgawo lachinayi silingathe kuwabaya. Ndizosavomerezeka kuwonjezera zonunkhira komanso mchere wambiri m'mbale. Kutumikirako kumayenera kukhala kochepa, koma muyenera kudyetsa wodwalayo pafupipafupi, mwina theka lililonse la supuni imodzi.

Ndi khansa ya kapamba ya digiri ya 4, matulukidwewo amakhumudwitsa. Pakusowa chithandizo, wodwalayo amakhala osaposa miyezi isanu. Ngati chithandizo chinayambika atangopezeka ndi matendawa, ambiri amakhala ndi moyo mpaka chaka chimodzi. Chiwopsezo chonse cha zaka zisanu chopulumuka mgawo lachinayi la khansa ya kapamba chimachokera ku magawo awiri mpaka asanu.

Kusiya Ndemanga Yanu