Chifukwa chiyani khansa ya kapamba 4 ya kapamba imachitika ndipo imachitika bwanji?

Khansa 4 yamatumbo a pancreatic ndizovuta kuchiza ndipo imadziwika ndi metastatic foci yakutali. Ngakhale kugwira ntchito mopitirira muyeso sikulola kuchiritsa odwala ndikubwezeretsa ntchito za chiwalo.

Pancreas yaumunthu imakhala m'matumbo oyandikira m'mimba. Amapanga mahomoni ndipo amapanga madzi a pancreatic, omwe amathandizira pakuwonongeka kwa michere. Chiwalochi chimapangidwa ndi mutu, thupi ndi mchira.

Mawonekedwe

Khansa ya pancreatic ndi matenda a oncological omwe amapezeka mwa anthu omwe ali ndi vuto lobadwa nalo kapena matenda opatsirana osakhazikika. Nthawi zambiri amuna amadwala. Izi ndichifukwa chosuta komanso kumwa mowa. Milandu yoposa 50%, khansa imayamba mwa anthu achikulire (pambuyo pa zaka 70).

Nthawi zambiri, mutu wa chiwalo umakhudzidwa, nthawi zambiri mchira ndi thupi.

Kukula kwa matenda amtundu wa oncological kumakhazikitsidwa ndi kusintha kwa maselo. Chofunikira kwambiri cha matendawa ndi kusowa kwa mgwirizano wabwino ndi chilichonse chokhudza thupi.

Khansa nthawi zambiri imapezeka m'magawo anayi. Izi zimachitika chifukwa cha chithunzi cholakwika cha chipatala chaching'ono ndi chotupa chachikulu. Khansa yomwe imapezeka kwambiri ndi adenocarcinoma.

Kwa matenda oipawa, mapangidwe a metastases amadziwika. Awa ndi gawo la maselo atypical omwe amapanga ziwalo zina zamkati kapena ma lymph node. Mu khansa ya pancreatic, maselo a atypical amafalikira kudzera mthupi kudzera m'magazi kapena m'mimba. M'malo omaliza, ma lymph node omwe ali pafupi ndi mutu wa gland amayamba kukhudzidwa.

Kenako, ma node m'chigawo cha kusintha kwa m'mimba kulowa duodenum amatenga nawo mbali. Ngati sanachitepo kanthu, maselo atypical amalowa m'matumbo aang'ono. Pomaliza, khansa imayerekezera ku ma backmpitoneal lymph node.

Ndi kufalikira kwa hemato native, maselo atypical amapezeka mu ziwalo zotsatirazi:

chiwindi
impso
mapapu
thumba losunga mazira
bongo
m'mimba
mafupa
matumbo.

Nthawi zambiri, peritoneum imakhudzidwa ndi njirayi. Khansa nthawi zambiri imapereka metastases kuzinthu zam'mapapu.

Mawonetseredwe azachipatala a kansa 4 yemwe alibe khansa ndi osadziwika. Zizindikiro zazikulu za matendawa ndi:

kupweteka kwapakati ndi m'mimba,
kuwonda
kufooka
kuchepa kwa magwiridwe
kutentha thupi kotsika
kuchuluka kwam'mimba,
kulemera mu hypochondrium kumanja kapena kumanzere,
Kapangidwe ka timabowo tofewa,
Zowawa m'mitsempha,
kuteteza khungu,
Khungu
mkodzo wakuda
kumveketsa ndowe,
nseru
kusanza

Anthu otere amatha kukhala ndi cholecystitis ndi matenda ashuga owonjezera. Potsirizira pake, kumva ludzu ndi kusokonekera kwamkodzo. Pamaso pa kupweteka kwapafupipafupi kwa gawo 4, ululu umachitika. The chachikulu chotupa, kulimba. Ululu umatulukira kumbuyo ndikuwonjezeka ndi munthu yemwe amatsamira patsogolo.

Ndi khansa yam'mutu, kupweteka kumakhalapo nthawi zambiri. Chizindikiro ichi chimatha kumveka mu hypochondrium kumanja. Cholinga chake ndi chiwindi cholakulitsidwa.

Maonekedwe a ululu kumanzere kwa hypochondrium akuwonetsa splenomegaly (ndulu yolumikizidwa). Chotupa chachikulu chimatha kupondereza duct ya bile. Pankhaniyi, chimbudzi cha bile chimasokonekera ndipo jaundice amakula.

Mwa anthu oterowo, khungu la pakhungu ndi ma membala am'mimba owoneka amasintha. Khungu limakhala ngati mtundu wachikasu. Kuwonjezeka kwa milingo ya bile m'magazi kumayambitsa kuyabwa. Zizindikiro zodziwika bwino za khansa ya kapamba ndizovuta zam'mimba, kusanza, ndi kusokonezeka kwa tulo. Tizilomboto timakhala mushy ndi kaphatikizidwe wamafuta.

Izi ndichifukwa chosowa ma enzyme. Pa gawo 4 la khansa, kuledzera kwambiri kwa thupi kumawonedwa. Amawonetsedwa ndi kufooka, kuchepa kwa ntchito komanso kuchepa thupi. Zizindikiro zowonjezera za matendawa ndi:

chotupa pa thupi
kutupa
kusamba kwa msambo,
zilonda zam'mimba
kukokana m'miyendo.

Mu khansa yokhala ndi metastases muubongo, zizindikiro monga mawonekedwe a mawonekedwe a nkhope, kusakhazikika, kupweteka mutu, kuwonongeka kwa mawonekedwe, kuyankhula kokhazikika komanso kusintha kwa mawonekedwe kumawonekera. Maonekedwe a chifuwa, kufupika ndi hemoptysis amawonetsa kulowa kwa maselo a chotupa m'mapapu.

Zomwe zimayambitsa kukula kwa oncological matenda awa sizinakhazikitsidwe. Zotheka kukhala pangozi ndi izi:

kutupa kosatha kwa kapamba,
kupezeka kwa matenda ashuga
kusuta
uchidakwa
onenepa kwambiri
matenda a chiwindi
olemedwa ndi chibadwa,
zilonda zam'mimba.

Zilonda za tumor nthawi zambiri zimapezeka mwa anthu omwe akuperewera. Choyambitsa chiopsezo ndikugwiritsa ntchito nyama zosuta, soseji, khofi, zakudya yokazinga, confectionery ndi ophika buledi, ndi sopo.

Kuzindikira kwa khansa ya kapamba 4 kapamba

Kuti mupange kuzindikira koyenera muyenera:

kafukufuku
kuyang'anira
palpation pamimba
kuyezetsa magazi komanso kopitilira muyeso,
urinalysis
pulogalamu
Ultrasound yam'mimba,
FEGDS,
CT kapena MRI
positron emission tomography,
cholangiopancreatography,
makulidwe
kusanthula kwa cytological
laparoscopy
kusanthula kwa zotupa.

Mukafuna kuyesa zasayansi ya khansa, zosintha zotsatirazi zapezeka:

kuchuluka kwa bilirubin m'mwazi,
kuchuluka kwa phosphatase wamchere,
kutsika kwa hemoglobin,
Kupititsa patsogolo kwa ESR
kukhalapo kwa embryonic antigen.

Palpation ndi lothandiza. Dokotala amatha kudziwa komwe amapangidwira ndipo amamva chotupacho kudzera khoma lamkati lakumbuyo.

Momwe mungachiritsire

Ndi khansa yachiphamaso 4, mankhwala othandizira ndi othandizira. Zolinga zazikulu zamankhwala nthawi imeneyi ndi:

kupatsa moyo wodwala,
Kuchotsa Zizindikiro
kukonza chimbudzi.

Ngakhale madotolo odziwa ntchito sangathe kuchotsera odwala matenda awa. Ndi khansa ya kalasi yachinayi, kulandira kuchipatala ku chipatala cha oncology kumafunika.

Chemotherapy

Chithandizo chachikulu kwa odwala chotere ndi chemotherapy. Zimakhazikitsidwa ndikugwiritsa ntchito poizoni osiyanasiyana omwe amapha ma cell a khansa. Chithandizo chotere chimakhudza mkhalidwe wa thupi lonse. Polychemotherapy nthawi zambiri amachitidwa. Zimaphatikizapo kugwiritsa ntchito mankhwala angapo nthawi imodzi.

Mankhwala odziwika bwino ndi Ongecin, Gemcitabine, Gemcitar ndi Hemitis. Fluorouracil nthawi zambiri imaphatikizidwa mu regimen yothandizira odwala omwe ali ndi khansa. Pa chemotherapy, muyenera kusiya kugwiritsa ntchito mankhwalawa komanso zakudya zamagulu ena.

Poletsa chotupa kukula ndikuchepetsa mkhalidwe wa odwala, poizoniyu ukhoza kuchitika. Chithandizo chotere sichothandiza kwenikweni kuposa chemotherapy. Ma radiation ya Ionizing imayambitsa kuchepa kwakukulu kwa chitetezo chokwanira komanso zotsatira zina. Pochiza khansa, masewera a gamma, kuwonetsa ma electrodes othamanga ndi bremsstrahlung amagwiritsidwa ntchito.

Chithandizo chotsimikizika ndi chithandizo chothandiza ku khansa ya pancreatic. Umu ndi mtundu wa chemotherapy pomwe mankhwala omwe adalowetsedwa alibe mphamvu pakhungu maselo athanzi, ndikupha okhawo omwe ali ndi khansa. Erlotinib amapereka zotsatira zabwino. Awa ndi mankhwala a mzere woyamba wa khansa ya pancreatic yosagwira ntchito. Mankhwalawa nthawi zambiri amaphatikizidwa ndi gemcitabine.

Ophera

Ndi ululu waukulu, izi zitha kutumikiridwa:

analcics-noncotic analgesics,
NSAIDs
opioid receptor agonists.

Poyamba, mankhwala monga Analgin, Diclofenac ndi Naproxen amagwiritsidwa ntchito. Ndi kusagwira kwawo, analcics ya narcotic imalembedwa (Promedol, Fentanyl, Tramadol, Prosidol). Opaleshoni amatha kulowetsedwa.

Mankhwala othandizira odwala khansa omwe ali ndi metastases ndi osathandiza. Pankhaniyi, opaleshoni yachifundo imagwira ntchito. Mwa odwala, gawo la chotupa limatha kuchotsedwa kapena kutsekeka kwa ducts ya bile kungathetsedwe. Cholinga chachikulu cha opareshoni ndikuthandizira moyo wa wodwala.

Zakudya zoyenera zimathandiza kulimbana ndi khansa. Zakudya zimatha kukulitsa chilimbikitso, kuchepetsa matenda, kusintha kugaya chakudya komanso kuchepetsa kuledzera. Odwala amafunika:

idyani 5-6 patsiku,
kumwa malita 1.5-2 amadzimadzi,
Zakudya zotentha
Kanani zakudya zamafuta ndi zonunkhira,
kupatula mowa ndi madzi owala kuchokera menyu.

Ndikulimbikitsidwa kuti muphatikize mbewu monga chimanga, nsomba, zipatso, ndiwo zamasamba, mbewu monga chimanga ndi mkaka mu zakudya. Zakudya zoyenera zimapewa kuchepa thupi.

Khansa ya kapamba ya kapamba 4 imapezeka liti?

Gawo lachinayi la khansa ya pancreatic imadziwika ndi mawonekedwe amodzi - kukhalapo kwa metastases yakutali. Poterepa, zilibe kanthu kuti chotupa chachikulu chili ndi kukula kotani, kaya chakula m'matupi oyandikana, kapena ngati maselo a khansa amapezeka mwa omwe ali pafupi (wamba) zamitsempha.

Nthawi zambiri, khansa ya pancreatic imagwira ziwalo zotsatirazi:

chiwindi
peritoneum ndi filimu yopyapyala ya minyewa yolumikizana yomwe imaloza mkati mwa khoma lamkati pamimba ndikuyika ziwalo zina zamkati,
mapapu
mafupa
bongo.

Wodwala akapezeka kuti ali ndi khansa ya kapamba 4 ya kapamba, nthawi zambiri sizotheka kuchotsa chotupacho. Mankhwalawa ndi osangalatsa. Cholinga chake ndikuthandizira kuchepetsa zizolowezi ndikuwongolera mkhalidwe wa wodwalayo, madokotala amayesa kukulitsa moyo wa wodwalayo.

Zizindikiro za matendawa

Poyambirira, chotupacho sichidziwonetsa, motero nkovuta kwambiri kuzindikira. Zizindikiro sizakhazikika, nthawi zambiri zimawonetsa matenda ena.

Chizindikiro ichi chimapezeka pawiri:

Kupsyinjika kwa ndulu ya danc mu khansa ya pancreatic.
Kufalikira kwa maselo a khansa m'chiwindi komanso matenda operewera.

Nthawi zambiri, chiwindi chimagwira ndipo chimachoka m'matumbo a lumen bilirubin - poizoni kuwonongeka mankhwala a hemoglobin. Ngati pali kuphwanya kwa mapangidwe a bile ndi ntchito yama cell a chiwindi - hepatocytes - bilirubin imalowa m'magazi, chifukwa cha izi khungu ndi loyera m'maso limasanduka chikasu, mkodzo umayamba kuda, chopondacho chimayamba imvi, chosasuluka. Kuphatikiza apo, kudziunjikira pakhungu, bilirubin imayambitsa kuyabwa. Zizindikiro zofananazi zimatha kudwala nthenda ya ndulu, hepatitis, cirrhosis.

Kuchulukitsa kwa magazi

Mu gawo 4 la khansa ya kapamba, ma magazi amatha kupanga mitsempha yayikulu, nthawi zambiri m'miyendo. Mkhalidwe uwu umatchedwa mitsempha yakuya. Imadziwoneka ngati edema, redness, kumva kutentha mu mwendo. Kugundika kwamwazi ndi kowopsa chifukwa nthawi zina amachoka ndikuyenda m'mitsempha yamapapu. Pali kupuma pang'ono, kupweteka pachifuwa. Mkhalidwe uwu umatchedwa pulmonary embolism.

Mitsempha yakuya kwambiri imachitika m'matenda ena. Ngati munthu wapezeka ndi matendawa, izi sizitanthauza kuti ali ndi khansa.

Matenda a shuga

Mu kapamba, mumakhala malo ena apadera a minofu - ma islets - omwe amapanga insulin. Ali ndi udindo wochepetsa magazi. Nthawi zina, khansa ya kapamba, kupanga insulin kumachepa. Ngati kuchuluka kwa shuga m'magazi kukwera pang'ono, wodwalayo sakumananso ndi vuto lililonse (shuga yayikulu ikhoza kuwoneka pongoyesa magazi). Ndi zovuta zazikulu, Zizindikiro zamatenda a shuga zimatulukira: ludzu, mkodzo wowonjezera, kamwa yowuma.

Zizindikiro zokhudzana ndi metastases

Metastase yamafupa ikakhudzidwa, kupweteka kwa mafupa, kufooka kwa pathological komwe kumatuluka pang'ono pamakina ogwiritsa ntchito kumakhala kosokoneza. Ma metastases m'mapapo amawoneka ngati chifuwa chosatha, kupuma movutikira, kupweteka pachifuwa, kusayera kwa magazi mu sputum. Pamene peritoneum ikukhudzidwa, imatha kukhazikika ascites - kudzikundikira kwa madzi am'mimba chifukwa cha kusokonezeka kwamadzi.

Njira Zodziwitsira

Popeza palibe zoyeserera zomwe anthu ambiri amavomereza zomwe zitha kuzindikira khansa ya kapamba m'magawo a asymptomatic, kuyezetsa kumayamba nthawi zambiri pomwe dokotala apeza wodwala yemwe angasonyeze matenda. Amayamba ndi njira zosavuta komanso zotsika mtengo zodziwira matenda omwe amathandizira kuzindikira chotupa. Zikapezeka, maphunziro owonjezera amalembedwa kuti amveketse bwino matendawa.

Nthawi zambiri, mayeso amayamba ndi Makina a Ultrasound. Pamodzi ndi classical ultrasound, endoscopic ultrasound imagwiritsidwa ntchito pamene sensor ili kumapeto kwa catheter yomwe imayikidwa mu duodenum. Ngati chotupa chapezeka, singano ingayikidwe kudzera mu catheter ndipo biopsy ikhoza kuchitika.

MSCT - zowonjezera zowerengeka zowerengera makanema - ikuchitika pambuyo mtsempha wa magazi mwapadera kusiyana njira. Phunziroli limathandizira kuzindikira khansa ya pancreatic ndi kufalikira kwa ziwalo zoyandikana, kuti izoloze moyenera singano panthawi ya biopsy.

MRI - kulingalira kwa maginito - Imagwiritsidwa ntchito pafupipafupi kuposa CT, chifukwa izi ndizophunzira zovuta kwambiri zomwe zimafunikira zida zapadera, zomwe siziri m'chipatala chilichonse. Ngati chotupa cha pancreatic chikuwoneka, zosintha zingapo za MRI zimagwiritsidwa ntchito:

MRI cholangiopancreatography limakupatsani mwayi wophunzira kapamba ndi minofu yoyandikana nayo.
MRI angiography ndi kuphunzira zamitsempha yamagazi.

PET - positron emission tomography - Chida choyenera chopezera metastases. Pulogalamu yotetezeka ya radioactive, yomwe imapezeka m'maselo a khansa, imalowetsedwa m'thupi la wodwalayo. Chifukwa cha izi, amawonekera pazithunzi zapadera. Nthawi zina PET imagwiritsidwa ntchito limodzi ndi CT kuti mumvetsetse bwino komwe kuli metastases.

Endoscopic retrograde cholangiopancreatography (ERCP) - njira yomwe imathandizira kuphunzira ma ducts a bile ndi pancreatic duct, kuti azindikire kuchepa kwa iwo. Denga la radiopaque limalowetsedwa mumkamwa pogwiritsa ntchito endoscope yomwe imalowetsedwa mkamwa, pambuyo pake imachitika. Mukamachita izi, mutha kuchita zina:

Tengani chidutswa cha minofu ya biopsy.
Ikani stent kuti mubwezeretse kutuluka kwa bile.

Percutaneous transhepatic cholangiography ikuchitika ngati nkosatheka kuchita ERCP. Poterepa, mankhwala a radiopaque amalowetsedwa kudzera mu singano yolowetsedwa pakhungu. Mukamayendetsa, mutha kuyambitsa biopsy, kukhazikitsa stent.

Kuyesedwa kwa magazi kwa Bilirubin ndimakonda kudziwa zomwe zimayambitsa jaundice. Zimathandizira kudziwa zomwe zidayambitsa chizindikirocho: chotupa cha chiwindi kapena chipika cha m'mimba.

Kuyesa kwa magazi kwa zotupa - zinthu zomwe milingo yake imachuluka m'magazi ndi zotupa za pancreatic. Nthawi zambiri zimazindikira kuchuluka kwa chikhomo CA 19-9pafupipafupi - REA (anticinoembryonic antigen) Pozindikira, mayeserowa ndi osadalirika. Nthawi zina ndimakhala ndi khansa ya kapamba 4 ya kapamba, milingo yam'mimba imakhala yachilendo, ndipo mwa anthu athanzi amakhala okwera. Komabe, iyi ndi njira yothandiza yofufuzira momwe wodwalayo alili pakapita nthawi ndikuwunika momwe mankhwalawo alili.

Biopsy - Njira yolondola kwambiri yodziwira khansa. Itha kuchitika ndi singano kudzera pakhungu, endoscopically, pa ERCP kapena percutaneous transhepatic cholangiography.

Chithandizo cha khansa ya kapamba 4 kapamba

Dokotala akakulemberani mankhwala othandizira khansa ya kapamba 4, samayembekezera kuti chotupacho chiwonongeka ndipo chikhululukiro. Chithandizo cha opaleshoni nthawi zambiri chimakhala chosatheka. Ngakhale metastasis imodzi yokha ikapezeka, ndizotheka kwambiri kuti alipo kale ambiri, amangokhala ndi ma microscopic ndipo sangathe kuwazindikira pogwiritsa ntchito njira zowunikira.

Kulongosola Matenda

Khansa ya pancreatic ngati matenda siyikupereka zizindikiro zolimba komanso zotchulidwa poyambira mawonekedwe kapena kukula. Zonsezi zimadzetsa kuti anthu omwe akumukhudza sakudziwa za matenda omwe adapha kale. Chifukwa chake, ndikuwonetsa kochepa kwa boma lopweteka, amayamba kudzipanga okha mankhwala a kapamba, amagwiritsa ntchito zakudya podya, osaganizira kuti ndi oncology. Monga lamulo, pokhapokha ngati chiwonjezerocho chikukula, chitachitika khansa 4, khansa yapezeka, yomwe, ndi matenda amtundu wa kapamba, sitha kuthandizidwa.

Gawo lachinayi la khansa ya pancreatic organic imapezeka pokhapokha ngati ma cell omwe ali ndi kachilombo komanso osinthika alowa m'magazi am'magazi ndi dongosolo la munthu. Nthawi yomweyo, amafalikira thupi lonse ndipo amakhudza mbali zatsopano za thupi. Izi matenda akuda a matendawa, amakula makamaka mwa anthu opitilira 50, koma nthawi zina amakhala opanda chitetezo chokwanira komanso asanakwanitse zaka 40. Muimfa, matendawa amakhala malo achinayi pakati pa odwala khansa.

Kodi munthu azikhala nthawi yayitali bwanji atazindikira kuti ali ndi khansa ya kapamba 4 ya kapamba? Mu gawo lachinayi la khansa ya kapamba, mankhwalawa samabweretsa machiritso osaneneka ndipo samatha kuthandizidwa mosamala, popeza kufalikira kwamphamvu kwa metastases mthupi kukukula kwambiri pakupanga ziwalo zonse zamkati mwa munthu.

Ndizosatheka kuchira ku matendawa, koma mutha kuyimitsa khansa, zomwe zimapangitsa kukhala ndi moyo wopitilira chaka chimodzi chamoyo. Zonse zomwe zimayambitsidwa mu mankhwala athu: chemotherapy, kuwonetsa ma radiation pazomwe zimayambitsa khansa, kungaletse kukula kwa njira za oncological, koma osawachiritsa. Zowona, ali ndi zomwe amabweza - zotsatira zoyipa za thupi, zomwe sizitha kuthana nazo chifukwa cha chitetezo chamthupi "chosweka".

Kupita patsogolo kwakukulu kwa kupulumuka, kutsimikiziridwa muzochita - odwala omwe ali ndi matenda a khansa ya kapamba a digiri ya 4 ndi metastases yomwe yachitika m'thupi lonse la munthu salola wodwalayo kukhala ndi moyo zaka zopitilira 4-5. Pali milandu yomwe imadutsapo, koma amapanga 2% ya odwala onse. Kuchotsa kufinya, pakadali pano pa chitukuko cha khansa, sikubweretsa zotsatira, chifukwa nthawi zambiri odwala sangathe kulolera opareshoniyi chifukwa cha ziwalo zomwe zimakhudzidwa ndi thupi.

Kodi zingatheke bwanji kuti ambiri asamangokhalira kufunikira kuzizindikiro zoyambirira za khansa ya kapamba? Zizindikiro zofooka za oncology pamlingo woyamba ndi wachiwiri wa chitukuko chake ndizongoyambitsa izi. Mawonekedwe ang'onoang'ono amatanthauziridwa ndi anthu ngati kulephera kwamphamvu kapena poyizoni wochepa.

Nthawi zambiri, malingaliro ongokhala moyo, mowa, kusuta kumawonjezeredwa kwa izi, zomwe zimayambitsa kusakhazikika mu sternum ndi m'mimba. Pokhazikitsa gawo lachitatu, zizindikiro zowoneka bwino zimayamba kuwonekera ndipo ndalama zomwe zimagwiritsidwa ntchito podzipaka nokha sizimabweretsa kubwezeretsedwa kwa boma lopweteka, koma kuwonongeka kokha.

Khansa ya pancreatic ndi gawo lake la 4, ili ndi mawonekedwe komanso chithunzi cholimba cha maphunzirowa. Nthawi yomweyo, pali matenda am'mimba komanso njira zosiyanasiyana za ziwalo zoyandikana, zomwe zimakhudzidwa ndi metastases ya khansa. Ma metastases pamlingo wachitukuko amakhudza izi:

zimakhudza ziwalo zoyandikana ndi munthu (matumbo, ndulu, zilonda 12 zam'mimba, m'mimba),
kudzera m'magazi, maselo opatsirana amalowa m'mapapu, chiwindi, ndi ubongo wa munthu.

Zambiri zimatengera kuyang'ana kwa maziko a oncological. Mwachitsanzo, pakuwonongeka kwa thupi la kapamba, mtundu waukulu wa zotupa zimakhala m'chiwindi. Chifukwa cha metastasis m'chiwindi imakhudza minofu yonse, yomwe imapangitsa mkhalidwe wa wodwalayo. Nthawi yomweyo, chinthu chofunikira mu zotupa ndi kuyandikira kwa chiwindi kwa kapamba.

Nthawi yomweyo, chiwindi chimafalitsa matenda kuchokera ku ma ducts a bile, omwe amakhumudwitsa kupezeka kwa hepatitis yamakina. Ichi chikuyamba kukhala chizindikiro chomaliza cha kukula kwa pancreatic oncology ya 4th degree.

Komanso pali kuwonjezeka kwamphamvu kwa ma lymph node pa thupi la munthu. Malinga ndi zisonyezo ndi zizindikiro zawo, amakhala:

zopweteka
owoneka bwino komanso osavuta kutulutsa.

Ndiponso matenda amapita m'matumbo, popeza kachiwiri, amakhudzana mwachindunji ndi kapamba, ndipo izi zimayambitsa kusokonekera kwa chiwalo.

Matenda a kapamba omwe adapezeka kale amapanga zovuta zina, chifukwa chake, munthu saona Zizindikiro ndi khansa ya kapamba, ndipo ali pa gawo 4;

kupweteka kwambiri kusanza ndi kusanza,
ululu umakulirakulira ukagona,
khungu limasinthira chikaso,
kutopa ndi nkhawa zazing'ono,
kugona kosalekeza
kuchepa kwakanthawi m'masiku ochepa,
kusowa kwa chakudya.

Pa magawo 4 a khansa, kukula kwa kapamba owopsa, kumafika pachimake pa chitukuko ndi zizindikiro zamphamvu zomwe sizimachepetsa ndikupitilizabe kudzikumbutsa zowawa zowonjezereka. Kupezeka kwa chotupa mu gawo la 4 la khansa ya kapamba kumayambitsa kusagwira bwino ntchito kwa chimbudzi cha anthu. Pamakhala matumbo m'matumbo, ma dermts amtundu wa choleretic amatsekeka, matumbo onse amayamba kukhala osatheka. Kukanika kwa pancreatic kumaleka kupanga ma enzymes ofunikira, omwe amachititsa kuti pakhale pancreatitis pamaziko a khansa matenda ndi necrosis ya minofu ndi ziwalo. Vutoli limakulitsa thanzi lathu lonse komanso limathandizira njira yowononga thupi lonse.

Chithandizo chitha

Kwa odwala khansa ya kapamba, khansa ya digiri ya 4 imasiya mwayi kwa moyo wautali, koma ndi njira yoyenera yothandizira ndi thanzi lanu, mutha kuwonjezera kwambiri zaka, kusiya kuyimitsidwa kwa matenda. Popanda kuchitapo kanthu kuti aletse kufalikira, kulosera kwa moyo kuli pafupifupi zaka ziwiri.

Zoyenera kuchita ndi chitukuko cha khansa ya kapamba 4 ya pancreatic kukulitsa moyo wa wodwala? Vuto lalikulu ndikuti kulowererapo kwa opaleshoni sikungakhale ndi zotsatira zabwino, chifukwa kuyang'ana kwa minofu yowonongeka ndikosatheka chifukwa cha kuchuluka kwawo. Kukula kwakumapeto kwa chiphunzitsochi ndi pafupifupi 12% ya kuchuluka kwa odwala, pomwe ena onse amaliza njira zawo mpaka zaka ziwiri, kuchokera pa degree iyi ya oncology.

Mankhwala, radiation ndi chemotherapeutic zimapangitsa m'thupi. Izi zimapangitsa kukhala kwakanthawi kuti ayimitse kukula kwa machitidwe a pathological ndi oncological mthupi la munthu. Zowona, njira izi sizipereka nthawi zonse ndipo zimapindula, chifukwa chitetezo chofooka cha thupi nthawi zina chimalephera kusamutsa izi. Pambuyo pakuwonjezera zolakwika ndi njira zodziwira, dokotala amasankha ngati achite njira zoyenera kapena ayi. Nthawi zina, ngati ma metastases a 3 ndi 4th asadathe kuwononga ziwalo zamkati za wodwalayo, amachitidwa opareshoni. Opaleshoniyo imatchedwa Whipple. Kodi opareshoniyi amachitika bwanji?

Kuchita opareshoni kumachitika ndikuchotsa mutu wa kapamba ndi kuyanika kunja kwa minofu yowonongeka ndi metastases. Kodi opaleshoni yotere imatha kuwonjezera mwayi wopatsa nthawi wodwala? Zonse zimatengera mtundu wamanambala awa komanso kuthekera kwa thupi kupulumuka katundu wolemera pagome la opareshoni. Ambiri mwa mwayi woti opaleshoniyo ndi yomaliza kwa munthu.

Ngati opaleshoniyo idachita bwino, ndiye kuti pali zovuta zina zomwe zingachitike panthawi yakukonzanso. Pambuyo pa izi, wodwalayo amapatsidwa chemotherapy, yomwe imapangitsa kuti ziwonongeke kwathunthu maselo a khansa, omwe sangalole kuti ayambirenso kufalikira mthupi la munthu.

Chithandizo cha poizoniyu

Nthawi zina, chithandizo cha mankhwala a radiation chimaperekedwa limodzi ndi chemotherapy yochizira khansa ya kapamba ya kapamba 4. Mankhwalawa amatchedwa chemoradiation. Ndiwothandiza, koma yodzala ndi zovuta zina.

Kulimbana ndi Zizindikiro ndi Zovuta

Mankhwalawa Palliative zotupa za kapamba wachinayi akhoza kukhala zotsatirazi:

Kulimbana ndi ululu ndi ma noncotic kapena narcotic analgesics.
Chithandizo chothandizira chimathandiza kuthana ndi mavuto komanso kulekerera bwino ma chemotherapy.
Kulimbana ndi kutopa. Dokotala amawunika momwe wodwalayo alili, ndipo amapereka zakudya zoyenera. Ngati wodwalayo sangathe kudya pawokha, yambitsani chakudya kudzera pa chubu kapena kulowetsedwa kwamatenda a michere.
Kutuluka kwa bile kumabwezeretsedwanso stent - chimango cholimba ndi khoma lamiyala yachitsulo. Itha kuyikika nthawi ya ERCP, percutaneous transhepatic cholangiography.
Kubwezeretsani patency pamimba polenga anastomosis: gawo la matumbo limakhazikika kukhoma kwamimba ndipo dzenje limapangidwa pakati pawo.
Kulimbana ascites chokhumudwitsayabwino (kudzikundikira kwamadzi m'chifuwa chapakati pakati pa ma sheet a pleura).

Pancreatic khansa kupulumuka mlingo 4

Matenda a khansa amayesedwa ndi kuchuluka kwa zaka zisanu. Zimawonetsa kuchuluka kwa odwala omwe anapulumuka zaka 5 atapezeka. Gawo lachinayi la khansa ya kapamba, kuchuluka kwa zaka zisanu ndi 16%. Koma kuchuluka kotsika kotere si chifukwa chololera. Palibe odwala khansa opanda chiyembekezo, mutha kuthandiza. Ngakhale zitakhala zotheka kuwonjezera moyo pang'ono - ichi ndi chigonjetso chomwe tiyenera kuchita nacho nkhondo.

Zizindikiro za matenda

Chifukwa chiyani zimachitika kuti anthu samalabadira zizindikiro za khansa ya kapamba? Vutoli ndikuchepa kwa chithunzi cha chipatala. Ngati neclasm ya oncological ili m'magawo oyamba (1 kapena 2), munthu akhoza kukhala ndi mawonekedwe ochepa a matendawa, koma ochepa amawalabadira.

Izi zimachitika chifukwa chokhala moyo wosalira zambiri, mowa, kusuta, kusowa zakudya m'thupi, chifukwa kupweteka kwakanthawi komwe kumachitika m'mimba kumadabwitsa anthu ochepa ndipo sikumakupangitsani kusamala. Khansa ya pancreatic ya digiri yachitatu - kudziwikiratu kale, komwe kumadziwika ndi chithunzithunzi cha chizindikiro, komabe akumalandira chithandizo komanso kutalikitsa moyo wa munthu - kumayambitsa kupweteka kwambiri.

Milandu yomwe munthu adapezeka kuti ali ndi chifuwa cham'mimba, zizindikiro za khansa zimasiyidwa osayang'aniridwa, wodwalayo amaganiza kuti izi zachulukitsa chiwindi. Zizindikiro za kansa 4 ya kapamba:

kupweteka kwambiri
pafupipafupi
kuchuluka kwa ululu usiku
kukula kwa chizindikirocho kumawonjezereka ngati munthu wasintha maonekedwe a thupi.
khungu lachikaso ndi zimagwira pakhungu,
kuwonda mwadzidzidzi
kukana kudya,
kufooka kwakukulu ndi kugona,
kutopa,
pafupipafupi kusanza ndi kusanza.

Pomaliza, gawo 4 lachitukuko cha khansa, chotupacho chimafika pakakulidwe kakakulu. Amayamba kupanikizika ndi ma ducts a bile, chifukwa chake amasiya kugwira ntchito mwachizolowezi, kusayenda kwa chakudya kumachitika, chakudya sichingagwidwe mwakudya, ndipo ntchito ya ziwalo zonse zam'mimba imasokonekera.

Thupi, podziwa kuti silitha kuthana ndi chakudya, limayamba kuyankha pazinthu zilizonse ndikusanza ndi mseru, motero munthu amadana ndi chakudya. Kuchepetsa thupi mwachangu kumachitika chifukwa cha kukanika kwa pancreatic, komwe sikungapangitse zinthu za enzyme zomwe zimathandizira pakukonza chakudya, mapuloteni ndi mafuta.

Nthawi zambiri mumamva nkhani yokhudza momwe mnzake, wachibale, anamwalira mwadzidzidzi ndi khansa ya kapamba, koma sichoncho. Oncology ya chiwalochi imayamba pang'onopang'ono, ndipo mwadzidzidzi sadzafa ndi matenda otere. Ndizoti anthu samalabadira zoyamba za matenda ndipo amapita kuchipatala makamaka pokhapokha madokotala sangathe kuchita chilichonse.

Kodi wodwala angatani

Khansa yapakansa, matendawo omwe ndi osauka, ndizovuta kwambiri, ndipo wodwalayo ayenera kukhala okonzekera kuti moyo wake udzasintha kwambiri. Ngakhale pali zosiyasiyana pomwe anthu omwe ali ndi matenda otere amakhala ndi moyo wotakataka, iwonso amatha kuyendayenda ndi kudya. Koma izi ndizosowa kwambiri. Zonse zimatengera momwe thupi liyenera kukhalira, makamaka chitetezo cha m'thupi, komanso momwe wodwala amakhalira.

Kodi munthu angatani? Choyamba, kukula kwa matendawa kumatha kupewedwa. Kuti muchite izi, muyenera kuyang'anitsitsa thanzi lanu, osachepera 1 pachaka kukaona chipatala kuti mukamam'peze.

Ngati pakhala pali khansa m'mbiri ya banja, makamaka, abale ake apamtima anali ndi khansa ya kapamba, ndikofunikira kuyesedwa magazi kamodzi pachaka kuti mudziwe zotupa. Pancreatic oncology, yomwe imapezeka koyambirira kwa chitukuko, iyenera kuchiritsidwa. Ngakhale pali zoopsa zobwereranso, mutha kuzithana nawo, mosiyana ndi khansa yachiwiri.

Kutalika kwa moyo wa munthu yemwe wapezeka ndi khansa ya pancreatic ya gawo 4 komanso zimatengera momwe wodwalayo akumvera.

Osakana thandizo la akatswiri amisala omwe akuchita nawo zothandiza pakukonzanso mtima kwa anthu omwe ali ndi matendawa. Ndi khansa ya kapamba, mungapulumuke bwanji ndi funso lomwe limafunsidwa pafupipafupi kwa odwala omwe akumana ndi matenda osachiritsika awa. Ngakhale adotolo sangayankhe funsoli: zinthu zochulukirapo zimakhudza muyezo wokhala ndi nthawi yake.

Ubwino wa chithandizo ndi zakudya

Wodwala sayenera kutaya mtima. Zachidziwikire kuti, matendawa ndi opha, ndi okhawo omwe mungakhale nawo miyezi iwiri ndi isanu. Nchiyani chomwe chikufunika kuchitidwa kuti nthawi yayitali ikhale moyo komanso kuti ibwerere bwino? Osasiya kulandira chithandizo. Odwala ena amapilira ndi chemotherapy chifukwa cha kukulitsa zotsatira zoyipa - kufooka kwambiri, kuwonjezeka kwakanthawi kwa ululu, kusanza pang'ono komanso kusanza. Ndikofunikira kumvetsetsa kuti zovuta ndizosakhalitsa, ngakhale zitakhala zovuta motani, chithandizo chotere chimapatsa munthu mwayi wa kutalikitsa moyo.

Zakudya zikusintha kwambiri, tsopano wodwalayo amangodya zomwe dokotala wanena. Njira yogaya chakudya siyenera kukhala yodzaza ndi zinthu zolemera, ziwalo zamkati motero gwiritsani ntchito kuvala. Ma metastases, kufalikira m'mateni oyandikana nawo, amakhudza chiwindi, zomwe zimatsogolera pakupanga carcinoma. Mutha kudziteteza ku zovuta, muyenera kusiya zizolowezi zoyipa, kudya moyenera, kukayezetsa kuchipatala pafupipafupi ndipo, koposa zonse, musataye mtima.

Odwala khansa yapakansa amakhala kwanthawi yayitali bwanji? Zonse zimatengera momwe chithandizo chamanthawi chinayambira. Ndi matenda awa, kuchedwetsa chemotherapy tsiku lililonse kungayambitse kufalikira kwapadera kwa metastases.Anthu omwe adachitapo chemotherapy amakhala moyo wozindikira khansa yachinayi ya kapamba wamtundu wautali kuposa odwala omwe amawopa zovuta ndipo amakana kulandira chithandizo.

Thanzi ndi moyo wa wodwala zili m'manja mwake mokha.

Malamulo oti ayesedwe pafupipafupi kuchipatala si achabe. Kuzindikira kwakanthawi kwamatendawa, pomwe matenda adakali pachiwopsezo cha chitukuko, apulumutsa miyoyo ya anthu oposa m'modzi.

Ngati pali kupweteka kwapafupipafupi pamimba, mavuto am'mimba aonekera, ichi ndi chizindikiro cha gastritis, komanso pathologies akulu kwambiri. Kunyalanyaza zizindikiritsozo, kudzipatsa tokha mankhwala nkoletsedwa. Choyamba, anthu omwe ali ndi vuto la chibadwa cha ziwonetsero zam'mimba zimayenera kuchita mantha ndikuthamangira kukayezetsa.

Kodi amathandizidwa?

Khansa ya digiri iyi nthawi zambiri imachiritsidwa, ngakhale nthawi zina, kawirikawiri, milandu yochira imalemba. Madokotala ena amawona kuchiritsa kumeneku ngati chiwonetsero cha mphamvu yopanda mphamvu ya thupi, pomwe ena amakhulupirira kuti gawo la matendawo silinadziwike molondola. Mulimonsemo, chithandizo sichingakanidwe. Ndikofunikira kuti muchepetse kuvutika kwa wodwala ndi vuto lakelo, kwakanthawi kwakanthawi.

Kuphatikiza apo, ndikofunikira kuchita osati mankhwala okha, komanso thandizo la malingaliro. Mkhalidwe wopsinjika udzabweretsadi chimaliziro, koma chiyembekezo chenicheni chidzatipatsa mwayi wokhala ndi moyo wautali.

Tsoka ilo mtengo wa chithandizo chotere ndi chofunikira kwambiri. Muzipatala ku USA ndi Israel, mutha kuwonjezera moyo wa wodwalayo motalikirapo, mpaka 15%, koma chithandizo choterocho chimawononga madola 70-100 miliyoni ndi zina.

Mankhwala

Pa gawo lotsiriza la khansa ya kapamba, madokotala ali ndi zolinga zazikulu 3:

kukula kwa chotupa,
Kuchepetsa kukula kwake ndi kufalikira kwa metastase,
mpumulo wa zowawa.

Kuti mukwaniritse cholinga chomaliza, mankhwala osiyanasiyana amagwiritsidwa ntchito.:

Choyamba, akatswiri opweteka pa gulu la NSAID amalembedwa, nthawi zambiri awa ndi Ibuprofen, Ketanov, Naproxen,
ngati mankhwala othandizira sagwiritsidwa ntchito, omwe amatchedwa opiates amagwiritsidwa ntchito: Tramal, Tramadol, Promedol, amagwira ntchito, koma ali kale osokoneza bongo, omwe amakakamiza nthawi yayitali kuchuluka kwa mankhwalawa.
ndi zowawa zoopsa, pa gawo la IV la matendawa, iwo amasintha pang'onopang'ono kupita ku mankhwala osokoneza bongo, amakhala m'gulu la owerengera okhwima ndipo nthawi zambiri amathandizidwa ndi ogwira ntchito yazaumoyo.

Kuwonetsedwa pangozi

Nthawi zambiri, kukhudzana ndi maselo a khansa omwe amagwiritsa ntchito poizoni ya x-ray amagwiritsidwa ntchito limodzi ndi chemotherapy. Chithandizo cha radiation chimakupatsani mwayi wowononga gawo lawo lomwe limagwira ntchito kwambiri, koma, mwatsoka, chotupacho sichimapha kwathunthu.

Zikuwonekeratu kuti mu gawo lomaliza la matenda a njala nthawi zambiri odwala samayang'ana, koma zakudya zinazake zikulimbikitsidwa.

Izi zimachepetsa katundu pa zikondamoyo zomwe zakhudzidwa (mukukumbukira mbiri yakale ya kapamba?) Ndipo imagwiranso ntchito yotupa yonse yam'mimba, yomwe mwina imakhudzidwa kale ndi metastases.

Mfundo zachakudya zopatsa thanzi ndi madigiri 4 a matenda ndizotsatirazi:

chizikhala chambiri komanso chamtundu umodzi, ndibwino kudyetsa wodwalayo magawo 6 pa tsiku,
makonda ayenera kuperekedwa kwa mbewu monga chimanga ndi broth,
Nyama siyenera kuphatikizidwa kwathunthu kuchokera kuzakudya za wodwalayo, koma ndi bwino ngati ili nyama yankhumba kapena nkhuku,
Zakudya zokazinga ziyenera kuchotsedwa kwathunthu, yesani kuphika chakudya cha wodwalayo mu boiler kapena chophika chambiri,
ndikofunika kudya zakudya zamkaka zopatsa mphamvu tsiku lililonse,
Zakumwa, zakumwa zosaphatikizidwa ndi asidi kapena msuzi wa rosehip ndizothandiza kwambiri.

Zotsatirazi ndizoletsedwa:

mafuta amitundu yam'madzi ndi nyama,
nyemba, zimalepheretsa ntchito yamatumbo,
shuga ndi mchere wambiri
popeza khansa ya kapamba nthawi zambiri imakhudza anthu okalamba, thupi lawo silikugwiranso mkaka wonse.

Zithandizo za anthu

Pali njira zingapo zodziwika bwino komanso njira zothanirana ndi khansa, zomwe zimagwiritsidwa ntchito ngati mankhwala achikhalidwe. Mankhwalawa ndi ASD, komanso osakaniza malinga ndi njira ya Shevchenko, komanso chithandizo chamankhwala chomera.

Palibe njira yeniyeni yothandiza anthu yothana ndi khansa, makamaka pagawo IV.

Mankhwala oterewa amatha kuthandizira kuphatikiza ndi chithandizo chamankhwala., komanso kumayambiriro kwa matendawo.

Ndi angati akukhala ndi digirii iyi ya matenda?

Zakhala zikunenedwa kuti ngakhale mankhwala apamwamba kwambiri, kudya komanso kutsatira boma kungakulitse moyo wa wodwala mu gawo lachinayi la khansa mpaka zaka 5. Komabe, kupezeka kwa mitundu yopanga metastatic kumachepetsa nthawi imeneyi. Nthawi zambiri, odwala omwe ali ndi metastasis mu ziwalo zina zoyandikana amakhala ndi miyezi ingapo kuti akhale nthawi imeneyi.

Ndipo komabe chiyembekezo chimwalira chomaliza, muyenera kumenya nkhondo. Osachepera Kuchepetsa kuvutika kwa odwala omwe akudwala matenda osachiritsika ndikumazungulira pomusamalira kumapeto kwake.

Zizindikiro za matendawa

Khansa 4 yamatumbo a chibelekero imadziwika ndi kufalikira kwamphamvu kwa matenda a metabolism osati mu gland, koma m'thupi lonse la munthu. Mwa ziwalo zapafupi, m'mimba, ndulu, chiwindi ndi mbali zina zamatumbo zimakhudzidwa kwambiri. Maonekedwe a metastases m'mapapo ndipo ngakhale ubongo sunatsutsidwe.

Gawo lachinayi la khansa limadziwika ndi mawonetseredwe azachipatala. Zimatengera komwe kuli metastases.

Zizindikiro zikuluzikulu za m'mimba ndikutulutsa mseru pafupipafupi, komwe nthawi zina kumayendetsedwa ndi kusanza. Odwala nthawi zambiri amafotokoza kuponderezana pansi: nthawi ya matenda am'mimba osinthika ndi kudzimbidwa.

Chifukwa chotenga nawo gawo pazochitika za ndulu, zizindikiro za jaundice zimawonekera: ziphuphu za khungu zimapeza kuwala.

Kuwonongeka kwa khansa ya pancreatic kumabweretsa kuchepa kwa ntchito yake yachinsinsi. Pa gawo lachinayi la matendawa, chiwonetsero chachikulu ndikuwonongeka kwa chimbudzi, zomwe zimachitika chifukwa chophwanya kupanga ma enzyme. Kuphatikiza apo, kaphatikizidwe ka madzi a m'mimba amatsitsidwa. Odwala adazindikira kuwonongeka kwakukuru mukulakalaka. Izi zikuwonetsa chifukwa chachikulu chomwe munthu amathandizira kuchepetsa thupi.

Chotupa cha khansa chimayambitsa poizoni wakuthupi, chifukwa cha zomwe zimachitika kuledzera - kufooka kwambiri, thukuta, kuwonongeka kwathunthu kwa thanzi, kutopa ndi kutopa. Osati pafupi pokhapokha, komanso zotumphukira zamitsempha zimatulutsa.

Chifukwa cha kuwonongeka kwa kapamba, kukula kwa matenda ashuga ndi kapamba wachiwiri sikumatsutsidwa. Zizindikiro zokhudzana ndi matenda a m'matumbo amatha kusiyanasiyana, owopsa kwambiri ndikukula kwam'mimba, ndipo amafunika opaleshoni yomweyo.

Mwa zisonyezo zina, zizindikiro za kudzikundikira kwamadzi m'mimba zimatha kuwoneka. Nthawi zambiri izi zimabweretsa chitukuko cha ascites, chomwe chimawonedwa kumapeto kwa chotupa. Zomwezi zimachitikanso pomwe ma cell atypical amafalikira ku mesentery.

Mfundo zakuchiritsa matenda

Khansa chotupa 4 magawo a kapamba sangachotsedwe. Izi ndichifukwa choti ma cell atypical samangokhala mu endocrine organ, komanso ena ambiri. Komabe, nthawi zina, ngakhale 2 kapena 3 ya kukula kwa mawonekedwe owonongeka sichitha kugwira ntchito. Choyamba, izi zimakhudzidwa ndi kutengera kwawo. Kuphatikiza apo, kapamba ndizakuya komanso kolumikizana kwambiri ndi mitsempha yayikulu ya magazi ndi mitsempha ya mitsempha.

Chithandizo chikufuna kupondereza kukula kwa maselo a khansa. Izi zimapangitsa kupitilira kwa matendawa ndikuchepetsa zovuta zowonekera pakuchipatala. Pachifukwa ichi, chemotherapy imagwiritsidwa ntchito mwachangu: ndi gawo lachinayi la khansa lomwe limathandizidwa ndi njirayi, pomwe sizingatheke kuchotsa chotupacho pochita opareshoni.

Kwambiri chithandizo cha matendawa kumakhala ndi chithandizo chamankhwala. Cholinga chake chachikulu ndikuchotsera zomwe zikupezeka kale. Izi zipangitsa kuti wodwalayo akhale bwino, chifukwa matendawa sakukhalanso moyo, koma amangopulumuka. Pachifukwa ichi, detoxification mankhwala ndi analgesics amagwiritsidwa ntchito.

Zochita za opaleshoni ndizotheka kubwezeretsa patency yamatumbo, ma ducts a bile, etc. Komabe, kuchotsedwa kwa kapamba sikumachitika, chifukwa kuchuluka kwa kuwonongeka kwa thupi ndi maselo a khansa ndikofunikira kwambiri kotero kuti palibe zotsatira.

Chemotherapy

Chemotherapy yokhala ndi kansa ya kapamba 4 ya chikhodzodzo ndiyo njira yokhayo yovomerezeka pazochitika izi: zimakupatsani mwayi woletsa kapena kuchepetsa kukula kwa chotupa ndi metastases ku ziwalo zina. Izi ndizotheka chifukwa cha kuchepa kwa ntchito yama cell atypical, omwe amakwaniritsidwa mothandizidwa ndi mankhwala apadera, omwe amaphatikizapo ziphe ndi poizoni.

Komabe, chithandizo cha chemotherapy sichimangokhudza maselo a khansa okha, koma chamoyo chonse. Izi zimabweretsa kuwonongeka kwakukulu mu thanzi la anthu. Mlingo wofunikira wa mankhwalawa amasankhidwa payekhapayekha: zizindikiro zazikulu, kuchuluka kwa kuwonongeka kwa kapamba, komanso ziwalo zina zimatengedwa. Kupezeka kwa matenda opatsirana kumathandizanso kwambiri.

Kugwiritsa ntchito chemotherapy kungakulitse nthawi yotalikirana ndi miyezi ingapo, mpaka kufikira 9-10. Zimatengera momwe maselo a khansa amawonera mankhwala omwe apatsidwa. Pambuyo pa chithandizo chamankhwala, munthu akhoza kumva kusintha pang'ono - kuchepa kwa ululu, kulakalaka kudya komanso kuchuluka kwa thupi.

Mukamachiza ndi chemotherapy, mavuto angachitike. Zovuta zazikulu:

kuthamanga ndi kuthothoka kwa tsitsi mpaka pamadazi,
kukula kwa matenda otsegula m'mimba,
kuwopsa kwa mapangidwe a magazi,
kuwonongeka kwa chapakati mantha dongosolo.

Malangizo a chemotherapy

Khansa ya pancreatic imathandizidwa ndi 1 chemotherapy mankhwala kapena kuphatikiza angapo. Pa monotherapy, gemcitabine kapena docetaxel imagwiritsidwa ntchito. Chithandizo chokwanira chimaphatikizapo kugwiritsa ntchito fluorouracil ndi cisplatin, kapena gemcitabine ndi fluorouracil. Chosankha chabwino nthawi zambiri chimasankhidwa mwayeserera, popeza ndizosatheka kulosera momwe thupi liyenera kuchitira chithandizo isanakwane.

Kuti muthane ndi zomwe zimachitika chifukwa cha chemotherapy, muyenera kutsatira malingaliro ena:

Onani mosamalitsa kusankhidwa kwa katswiri. Osamamwa othandizira pazakudya ndi mankhwala ena. Izi zimatha kupangitsa kuti thupi lizigwirizana komanso kuti lipweteke.
Njira yakumwa. Wodwala amayenera kumwa osachepera 2 malita a madzi oyera tsiku lililonse. Izi zimayambitsa kwamikodzo, kuti zinthu zapoizoni zisiye thupi mwachangu.
Pankhani ya zovuta, monga nseru, ndikofunikira kudziwitsa katswiri. Dokotala amawunika momwe mankhwalawo amathandizira, ndipo ngati kuli koyenera, asinthe mlingo wa chemotherapy.
Onjezerani zolimbitsa thupi. Ngakhale atafooka, wodwalayo amayenera kupita kunja kwa nthawi yayitali. Izi zikuthandizira kubwezeretsa kamvekedwe ka minofu ndikusintha momwe mukumvera
Funsani wamisala. Sikuwonetsedwa osati kwa wodwala, komanso kwa abale.

Mankhwala opweteka

Maziko a chithandizo chamankhwala ndikugwiritsa ntchito analgesics. Izi ndichifukwa choti mu magawo apamwamba a khansa ya kapamba, amamva ululu wolimba.

Pachigawo choyambirira cha chotupa cha khansa, ndizotheka kuthana ndi zosasangalatsa zomverera pogwiritsa ntchito mankhwala osagwirizana ndi anti-yotupa: Paracetamol, Ibuprofen, Naproxen ndi mankhwala ena. Muyenera kumwa mankhwala piritsi limodzi ndi 1 mapiritsi 1 kamodzi patsiku, ndi mphamvu zowawa - mpaka ma PC atatu. patsiku.

Pokhapokha pakuchitika zabwino kuchokera ku kugwiritsa ntchito mankhwala olimbana ndi zotumphukira, adokotala atha kusankha pakufunika kophatikizira opiates ofooka mu mankhwala othandizira. Awa ndi a Tramadol, Dihydrocoden ndi a Promedol, omwe amapezeka mu mitundu ingapo ya mapiritsi: mapiritsi ndi njira zovomerezeka, zina mwazomwe zimayambitsa zovuta izi. .

Pa gawo lomaliza la matendawa, ululu ukakhala wamphamvu kwambiri kuti munthu sangakhale, kugona komanso kugona, zimasonyezedwa kugwiritsa ntchito ma opiates amphamvu (Prosidol, Fentanyl). Nthawi zambiri amagwiritsidwa ntchito kuchipatala ngati chithandizo chamankhwala. Nthawi zina, wodwala akakhala kunyumba, jakisoni amapangidwa ndi katswiri wazachipatala, chifukwa mankhwalawa amaphatikizidwa pagulu la mankhwala osokoneza bongo omwe amayang'aniridwa mwamphamvu.

Udindo wazakudya

Zakudya zamafuta a khansa ya pancreatic ziyenera kulimbikitsidwa ndikwanira kuti thupi lilandire kuchuluka kofunikira, michere ndi michere. Zowonadi, chifukwa cha kufalikira kwa matendawa, munthu amayamba kufooka, kukonda kwambiri kudya, komanso kuwonda kwambiri kumawonedwa. Nthawi yomweyo, chikhalidwe cha zakudya zoyenera kudya chimayenera kuganiziridwa m'njira yochepetsera kudya mafuta, chifukwa izi zimakwiyitsa chida champhamvu pa chiwalo ndipo chimathandizira kaphatikizidwe ka michere. Ngati kapamba wakhudzidwa, izi ziyenera kupewedwa nthawi zonse ngati zingatheke.

Wodwala ayenera kudya pafupipafupi, koma pang'ono. Ndikofunika kupera chakudya kuti muchepetse kuyamwa kwa m'mimba. Palibe chifukwa muyenera kudya zakudya zotentha kwambiri kapena kuzizira.

Zakudya za khansa ya pancreatic zimaphatikizapo kuwotcha, komanso kuphika, kutsitsa kapena kuphika. Izi zimakulitsa zinthu zofunikira pazogulitsa ndipo nthawi yomweyo zimalepheretsa zovuta pamimba ndi kapamba.

Kuchokera pachakudya ziyenera kupatula kuti zikhale zokazinga, zonunkhira, zamchere, zosuta komanso zosemedwa. Choletsedwa chimaphatikizapo mowa, tiyi wamphamvu, khofi, chokoleti, maswiti, mazira, nyama yofiira, etc. Ndikofunikira kuchepetsa mchere, shuga ndi zonunkhira zina pophika.

Mukamadya, menyu amayenera kukhala ndi mbale zochokera ku nsomba zamafuta ochepa kapena nyama yazakudya. Tsiku lililonse, wodwalayo ayenera kudya msuzi, makamaka wokometsedwa. Phula lothandiza kuchokera ku buckwheat, mpunga, oatmeal, komanso mafuta amkaka ochepa. Kugwiritsa ntchito zipatso kapena ndiwo zamasamba ndikuwonetsedwa, koma ndikosayenera kudya muzakaphika, ndibwino kuphika mu uvuni.

Khansa ya kapamba ndimatenda oopsa kwambiri. Kuti muchotse chikhululukiro kapena kuti muchepetse kukula kwa chotupacho, munthu ayenera kutsatira mosamalitsa malangizo a katswiri.

Ubwino wa chithandizo ndi zakudya

Matendawa ndi owopsa, koma wodwalayo amasankha kuchuluka kwa momwe angakhalire ndi malingaliro ake pochira. Ambiri amakana njira za chemotherapeutic chifukwa cha zotsatira zoyipa za mwambowu. Tiyenera kumvetsetsa kuti mavuto omwe abwera mthupi ndi osakhalitsa, amachoka, muyenera kungodikirira.

Osachulukitsa chakudya chamafuta ndi zinthu zolemera, chifukwa izi zimapangitsa kufooka kwa chitetezo chathupi komanso kuwonjezereka kwa matenda a khansa.

Kukula kwa metastases ya chiwindi kumayambitsa carcinomas, chifukwa chake ndikofunikira kusiya zizolowezi zoyipa, kugwiritsira ntchito chakudya chokha, ndikuthamangitsa kufufuza kwamthupi kosalekeza.
Kuchedwa kugwiritsa ntchito chemotherapy kumathandizira kuti metastases iwonjezere dera la chotupa, ndikuchepetsa mwayi wamankhwala ndikuletsa kufalikira