Umdlavuza wamaphaphu: izindlela zokwelapha nezokwelapha

-Delile

• Izinhlobo eziyinhloko zokwelashwa
• 1. Ukuhlinzwa
• 2. Ukwelashwa ngamakhemikhali
• 3. Ukwelashwa komzimba
• 4. I-Radiotherapy
• 5. Ukwelashwa kwe-Photodynamic
• 6. Ukwelashwa nge-Laser
• 7. Ukwehliswa kwemvamisa yomsakazo
• Siyini isikhathi sokuphila esilinganiselwayo?

Umdlavuza wamaphaphu yisifo esibi esibonakala ngokuba khona kwezimpawu ezinjengokukhwehlela, ukushesha, ubunzima bokuphefumula nokwehlisa isisindo.

Yize ubucayi bawo, umdlavuza wamaphaphu uyelapheka lapho ukhonjwa kusenesikhathi, kanye nokwelashwa kwawo, okungenziwa ngokuhlinzwa, ngemisebe noma ngamakhemikhali, futhi kungahlala izinyanga noma iminyaka. Kodwa-ke, okuvame kakhulu ukuthi umdlavuza wamaphaphu utholakala esigabeni esithuthukile sesifo, esikhula ngokushesha okukhulu, sinamathuba amancane okwelashwa.

Izinhlobo eziyinhloko zokwelashwa

Ukwelashwa komdlavuza wamaphaphu ngokuvamile kuyahluka ngokuya ngohlobo lomdlavuza, ukuhlukaniswa kwawo, usayizi wesimila, ubukhona bama-metastases nempilo ejwayelekile. Kodwa-ke, izinhlobo zokwelashwa ezisetshenziswa kakhulu yilezi:

1. Ukuhlinzwa

Ukuhlinzwa kwenziwa ngenhloso yokususa isimila kanye nama-lymph node athintwe ngumdlavuza, ngenhloso yokuvimbela amangqamuzana omdlavuza ukuthi angasakazeki aye kwezinye izingxenye zomzimba.

Ngokuya ngezimpawu zomdlavuza, odokotela abahlinzayo be-thoracic bangenza lokhu kuhlinza okulandelayo ukwelapha umdlavuza wamaphaphu:

• I-Lobectomy: kulapho kukhishwa lonke ulaka lwamaphaphu, futhi luhlobo olufanele kakhulu lokuhlinzwa lomdlavuza wamaphaphu, noma ngabe izimila zincane;
• I-pneumectomy: lwenziwa lapho kukhishwa lonke iphaphu futhi likhonjiswa lapho isimila sikhulu futhi sitholakala eduze nendawo;
• I-segmentectomy: ingxenye encane ye-lobe yamaphaphu enomdlavuza iyasuswa. Kuboniswa ezigulini ezinamathumba amancane noma ezisesimeni esibucayi sempilo;
• Ukuthola kabusha umkhono: akuvamile kakhulu futhi kwenzelwa ukususa isimila esithinta isifunda se-bronchi, okuyizibhubhu ezifaka umoya emaphashini.

Ngokuvamile, ukuhlinzwa kwenziwa ngokuvula isifuba, esibizwa ngokuthi ama-thoracotomies, kepha singenziwa ngosizo lwevidiyo, ebizwa nge-video-assisted thoracic. Ukuhlinzwa ngevidiyo akuhlaseli kakhulu, kunesikhathi esifushane sokululama futhi kubangela izinhlungu ezingemuva kokuhlinzwa kunokuhlinzwa okuvulekile, kepha akuboniswa kuzo zonke izinhlobo zomdlavuza wamaphaphu.

Isikhathi sokululama kusuka ekuhlinzeni sincike ohlotsheni lokuhlinzwa okwenziwe, kepha imvamisa ukukhishwa esibhedlela ngemuva kwezinsuku eziyi-7 futhi ukululama nokubuyela emisebenzini ejwayelekile kungahlala kusuka kumaviki ayisithupha kuye kwayi-12. Udokotela ohlinzayo uzokunika imithi edambisa izinhlungu futhi angancoma i-physiotherapy yokuphefumula ukusiza ukuthuthukisa ukuphefumula kwakho.

Ngemuva kokuhlinzwa kungenzeka ukuthi kuvele izinkinga ezifana nobunzima bokuphefumula, ukopha noma ukutheleleka yingakho kubalulekile njalo ukulandela izincomo zikadokotela futhi uthathe imishanguzo ekhonjisiwe.

Ngaphezu kwalokho, ngemuva kokuhlinzwa kubekwa idreyini yokukhipha igazi neziphuzo eziqoqiwe lapho kwenziwa ukuhlinzwa, kuyadingeka ukugcina ukunakekelwa ekugqokeni idreyini futhi njalo kwazise isici sokuqukethwe ngaphakathi komsele. Bheka konke mayelana nomsele ngemuva kokuhlinzwa.

2. Ukwelashwa ngamakhemikhali

I-Chemotherapy iyindlela yokwelapha ejwayelekile yezinhlobo ezahlukahlukene zomdlavuza wamaphaphu futhi ihlose ukubhubhisa amangqamuzana omdlavuza, atholakala emaphashini noma asakazeke emzimbeni wonke. Lolu hlobo lokwelashwa lwenziwa ngokusetshenziswa kwemithi ngomthambo noma ngemijovo, kokunye kucaciswa kakhulu ukuthi kufanele kube kumathebulethi. Izidakamizwa ezisetshenziswe ekhemotherapy zenzelwe ukubhubhisa nokumisa ukukhula kwamangqamuzana omdlavuza.

Isikhathi sokwelashwa ngamakhemikhali sincike ohlotsheni, kubukhulu nasekuqiniseni komdlavuza wamaphaphu, kepha ngokwesilinganiso uhlala unyaka owodwa. Amaseshini weChemotherapy abizwa ngemijikelezo, futhi umjikelezo ngamunye wenziwa njalo emavikini amathathu kuya kwamane. Isikhathi sokuphumula siyadingeka phakathi komjikelezo ngamunye ngoba i-chemotherapy ibuye ibulale amaseli anempilo adinga ukululama.

Izidakamizwa ezisetshenziswa kakhulu ekhemotherapy yokwelashwa komdlavuza wamaphaphu yi-Cisplatin, Etoposide, Gefitinib, Paclitaxel, Vinorelbine noma i-Vinblastine futhi kuya ngenkambiso yokwelashwa ekhonjiswa ngudokotela, ingasetshenziswa inhlanganisela phakathi kwabo nakwezinye izinhlobo zokwelashwa , isibonelo. isibonelo, kungenziwa ngaphambi noma ngemuva kokuhlinzwa.

Kodwa-ke, kuvamile ukuthi kube nemiphumela engemihle ehlobene nokusetshenziswa kwalezi zidakamizwa, njengokulahleka kwezinwele, ukuvuvukala komlomo, ukulahlekelwa isifiso sokudla, isicanucanu nokuhlanza, isifo sohudo noma ukuqunjelwa, ukutheleleka, ukuphazamiseka kwegazi nokukhathala okukhulu, ngokwesibonelo . Qondisisa okufanele ukwenze ukunciphisa imiphumela emibi yokwelashwa ngamakhemikhali.

Imiphumela emibi eminingi iyanyamalala ngemuva kokuqeda ukwelashwa, kepha kwezinye izimo kudambisa izinhlungu noma amakhambi esicanucanu angasetshenziswa ukudambisa izimpawu nokwenza ukwelashwa kube lula ukulandela. Bheka amathiphu alula okuthi ungayikhulula kanjani imiphumela emibi emibi ye-chemotherapy:

3. Ukwelashwa komzimba

Ezinye izinhlobo zomdlavuza wamaphaphu zikhiqiza amaprotheni athile avimbela amangqamuzana omzimba okuvikela ekubhubhiseni amangqamuzana omdlavuza. Ngakho-ke, eminye imithi iye yathuthukiswa ukuvimba ukusebenza kwala maprotheni okwenza umzimba ulwe nomdlavuza.

Le mithi iyingxenye ye-immunotherapy, njengoba isiza ukuzivikela komzimba ekwelapheni umdlavuza wamaphaphu. Eminye yezidakamizwa ezisetshenziselwa umdlavuza wamaphaphu yi-atezolizumab, i-durvalumab, i-nivolumab ne-pembrolizumab. Njengamanje, eminye imithi efanayo efanayo iyenziwa futhi ihlolwe ukwelapha zonke izinhlobo zomdlavuza wamaphaphu.

Izidakamizwa ze-Immunotherapy zinemiphumela engemihle ngaphandle kwe-chemotherapy, futhi ngokuvamile le miphumela ibuthakathaka, noma kunjalo, ingadala ukukhathala, ukuphelelwa umoya kanye nohudo.

4. I-Radiotherapy

I-Radiotherapy iyindlela yokwelapha umdlavuza wamaphaphu lapho imisebe isetshenziselwa ukuqeda amangqamuzana omdlavuza, futhi imisebe yangaphandle ingasetshenziswa ngomshini okhipha imishayo yemisebe, noma nge-brachytherapy, lapho okubekwa khona imisebe ye-radio eceleni kwesimila.

Ngaphambi kokuqala amaseshini e-radiotherapy, kwenziwa uhlelo futhi kumakwa esikhumbeni, okukhombisa ukubekwa okufanele emshinini we-radiotherapy, futhi ngenxa yalokho, zonke izikhathi zihlala zisendaweni emakiwe.

Ukwelashwa ngemisebe, njenge-chemotherapy, nakho kungenziwa ngokuhlangana nezinye izinhlobo zokwelashwa, njengaphambi kokuhlinzwa, ukunciphisa ubukhulu besimila, noma ngemuva kwalokho, ukubhubhisa amangqamuzana omdlavuza okungenzeka asesephashini. Kodwa-ke, lolu hlobo lwezokwelapha lungaholela nasemiphumeleni emibi, njengokukhathala, ukulahlekelwa isifiso sokudla, umphimbo obuhlungu, ukuvuvukala lapho kusetshenziswa khona imisebe, umkhuhlane, ukukhwehlela nokuphefumula, isibonelo.

Ngokuvamile, imiphumela emibi iyanyamalala ekugcineni kokwelashwa, kepha ezinye izimpawu, njengokukhwehlela, ukuphefumula okuncane kanye nomkhuhlane, okukhombisa ukuvuvukala kwamaphaphu, kungaqhubeka izinyanga ezimbalwa. Yazi ongakudla ukunciphisa imiphumela yokwelashwa ngemisebe.

5. Ukwelashwa kwe-Photodynamic

Ukwelashwa nge-Photodynamic komdlavuza wamaphaphu kusetshenziswa ezigabeni zokuqala zesifo lapho kunesidingo sokuvula imigwaqo yomoya evinjelwe isimila. Le ndlela yokwelapha iqukethe ukusetshenziswa komuthi okhethekile, ofakwa egazini ukuze unqwabelane kumaseli womdlavuza.

Ngemuva kokuthi isidakamizwa sesiqoqekile ku-tumor, kusetshenziswa i-laser beam endaweni ukubulala amangqamuzana omdlavuza, asuswe yi-bronchoscopy. Ukwelashwa kwe-Photodynamic kungadala ukuvuvukala komoya izinsuku ezimbalwa, kubangele ukuphefumula okuncane, ukukhwehlela okunegazi kanye ne-phlegm, okungalashwa esibhedlela.

6. Ukwelashwa nge-Laser

Ukwelashwa nge-Laser kuyindlela yokwelashwa esetshenziswa kwezinye izimo zomdlavuza wamaphaphu, ikakhulukazi uma isimila sincane. Kulolu hlobo lokwelashwa, i-laser isetshenziswa nge-endoscopy, ngokusebenzisa ithubhu eliguquguqukayo elifakwa ngomlomo liye emaphashini, elibizwa nge-bronchoscope, ukuze kubhubhise amangqamuzana omdlavuza.

Inqubo yokusebenzisa i-laser iyefana nokwenza i-endoscopy, ihlala isilinganiso semizuzu engama-30, edinga ukuzila kwamahora ayi-6 bese kusetshenzwa ukulala ngesikhathi sokuhlolwa hhayi ukuzwa ubuhlungu.

7. Ukwehliswa kwemvamisa yomsakazo

Ezimweni lapho umdlavuza wamaphaphu usesigabeni sokuqala, ukukhishwa kwe-radiofrequency kuboniswa esikhundleni sokuhlinzwa. Isebenzisa ukushisa okukhiqizwa amagagasi omsakazo ukubulala amangqamuzana omdlavuza emaphashini, isebenzisa izinaliti noma amashubhu ashisayo abhubhise isimila. Lezi zinaliti ziqondiswa yi-computed tomography ukwazi indawo ngqo yesimila.

Le nqubo yenziwa ngaphansi kokudotshwa futhi ihlala cishe imizuzu engama-30. Ngemuva kokwenza lokhu kwelashwa, isiza singaba buhlungu, ngakho-ke udokotela unquma ukusetshenziswa kwemithi yezinhlungu, njengokunciphisa izinhlungu.

Siyini isikhathi sokuphila esilinganiselwayo?

Isikhathi sokuphila ngemuva kokutholakala komdlavuza wamaphaphu sihluka kusuka ezinyangeni eziyi-7 kuye eminyakeni eyi-5, kuya ngezici ezithile, njengezempilo ejwayelekile, uhlobo lomdlavuza wamaphaphu nokuqala kokwelashwa. Ngisho noma lolu hlobo lomdlavuza lutholakala kusenesikhathi, amathuba okwelashwa awekho kakhulu, ngoba anethuba elihle lokubuya, okwenzeka cishe engxenyeni yamacala.