Uyini umdlavuza we-esophageal, izimpawu eziyinhloko nokwelashwa

-Delile

• Izimpawu eziyinhloko zomdlavuza we-esophageal
• Ukuxilongwa kwenziwa kanjani
• Izimbangela eziyinhloko
• Injani impatho
• Ukudla komdlavuza we-esophageal

Umdlavuza we-Esophageal wuhlobo lomdlavuza olubucayi olwenzeka ngenxa yezinguquko kumaseli we-esophagus, eziba yingozi, okuholele ekubonakaleni kwezimpawu nezimpawu ezinjengobunzima bokugwinya, ukuvela kwesigaxa engxenyeni engenhla indle yesisu nesimnyama, kepha izimpawu zomdlavuza emqaleni zivele kuphela lapho lesi sifo sesivele sisezigabeni ezithuthuke kakhulu futhi sine-metastases, sinamathuba amancane okwelashwa.

Ngokuya ngamaseli athintekile, umdlavuza we-esophageal ungahlukaniswa ngezinhlobo ezimbili eziyinhloko:

• I-squamous cell carcinoma, okuluhlobo oluvame kakhulu lomdlavuza emqulwini futhi oluthinta ingxenye engenhla yomhosha futhi, ngakho-ke, kuvame ukwenzeka kubantu ababhemayo kanye / noma ezidakweni zotshwala;
• I-Adenocarcinoma, evame ukuvela engxenyeni ejoyina isisu esiswini futhi evame kakhulu kubantu abane-reflux engapheli yesisu, isisu sikaBarrett nalapho umuntu ekhuluphele ngokweqile.

Lolu hlobo lomdlavuza luvame kakhulu kubantu abaneminyaka engaphezu kwengu-50 futhi abanezinto ezinobungozi njengokukhuluphala, i-reflux, i-gastritis noma ababhemayo. Ngakho-ke, uma umuntu enanoma iluphi uphawu noma uphawu oluhlobene nomdlavuza endaweni yomzimba futhi enezici ezithile zobungozi ezihambisana nalesi sifo, kunconywa ukuthi ubonane nodokotela wezifo zesisu ukuze kutholakale ukuxilongwa nokwelashwa kungatholakala. iningi livame ukunconywa ukuthi lenze ukuhlinza ukususa ingxenye yomzimba, kanye ne-chemo nemisebe yokuqeda amangqamuzana omdlavuza okungenzeka ukuthi awazange aqedwe ngesikhathi sokuhlinzwa.

Izimpawu eziyinhloko zomdlavuza we-esophageal

Ezinye izimpawu nezimpawu ezingakhombisa ukukhula komdlavuza ku-esophagus yilezi:

• Ubunzima nobuhlungu ukukugwinya, ekuqaleni ukudla okuqinile bese kuba uketshezi;
• Ukubola nokukhwehlela okungapheli;
• Ukulahlekelwa isifiso sokudla nesisindo;
• Ukukhathala lapho wenza izivivinyo ezilula, njengokubeka umbhede noma izitebhisi zokukhuphuka;
• Ukuzwa kwesisu esigcwele;
• Ukuhlanza ngegazi nesicanucanu;
• Izitokisi ezimnyama, eziyipasta, ezinuka kabi noma ezinegazi;
• Ukungakhululeki esiswini okungadluli;
• Isigaxa esiswini, esingathambeka kalula;
• Izilimi ezivuvukele ohlangothini lwesobunxele lwentamo;
• Amaqhuqhuva azungeze inkaba.

Imvamisa, umdlavuza we-esophageal awubangeli zimpawu noma zimpawu, kepha njengoba isifo siqhubeka, izimpawu zesici zingaqala ukuqashelwa. Ngakho-ke, ukuqala kwezimpawu kubonisa ukuthi lesi sifo sesivele sisesigabeni esithuthuke kakhulu, futhi ukuxilongwa nokwelashwa okusheshayo kubalulekile.

Ukuxilongwa kwenziwa kanjani

Ukuxilongwa komdlavuza we-esophageal kwenziwa nge-endoscopy, okuwukuhlolwa okwenziwa ngenhloso yokubona ingaphakathi lesisu nesisu nokubheka noma yiziphi izimpawu zokushintsha. Uma kutholakala isigaxa noma yikuphi okunye ukuguqulwa ngesikhathi sokuhlolwa, kunconywa ukwenza i-biopsy yesampula yezicubu zomzimba ukuhlola izici zamaseli, ngaphezu kwe-X-ray yomlomo, ikakhulukazi uma umuntu enenkinga ukugwinya.

Ngaphezu kwalokho, udokotela angakhombisa ukuhlolwa kwegazi okubandakanya ukubalwa kwegazi ukuhlola i-anemia kanye nokuhlolwa kwendle ukuhlola igazi esitokisini.

Ngesikhathi sokuhlolwa kwe-endoscopic, kungenzeka futhi ukuthi udokotela ahlole isigaba sesifo ngokusho kwezici ezibonwe:

• Isiteji I - Isigaxa odongeni lomhosha cishe nge-3 kuye ku-5 mm futhi ngaphandle kwe-metastases, ngamathuba amakhulu okwelashwa;
• Isigaba II - Ukunwetshwa kodonga lokuqinela okungaphezulu kuka-5 mm nangaphandle kwemetastase enamathuba athile okwelashwa;
• Isigaba III - Ukuqina kodonga lokucinana oluthinta izicubu ezizungeze umqala ngamathuba amancane okwelashwa;
• Inkundla IV - Ubukhona bama-metastases ngumzimba, onamathuba amancane kakhulu okwelashwa.

Kodwa-ke, lezi zigaba zingachazwa ngokuningiliziwe ngokusho kohlobo lomdlavuza wokuqunjelwa okutholwe ngudokotela.

Izimbangela eziyinhloko

Ukubonakala komdlavuza we-esophageal kuhlotshaniswa nezici ezithile zobungozi, njenge:

• Ukuphuza ngokweqile iziphuzo ezidakayo nogwayi;
• Ukungeniswa kweziphuzo ezishisayo ezingaphezu kuka-65º C, njengekhofi, itiye noma i-chimarrão, isibonelo;
• Ukungeniswa kwezinto ezinama-alkaline, njenge-chlorine esetshenziselwa ukuhlanza okuholela ekunciphiseni i-esophagus;
• Umlando womdlavuza wekhanda noma wentamo.

Ngaphezu kwalokho, lolu hlobo lomdlavuza luvame kakhulu ezigulini ezinezifo ezifana ne-gastritis, i-reflux yegastroesophageal noma iPlummer-Vinson syndrome, i-achalasia noma i-esophagus kaBarrett ngokwesibonelo, ngokucasulwa kwesisu ngokuvamile ngenxa ye-reflux esiswini senyongo.

Injani impatho

Ukwelashwa komdlavuza wokucinana kwengqondo kubheka indawo yesimila nesigaba sesifo, ngaphezu komlando womtholampilo womuntu, iminyaka nezimpawu zakhe. Ngakho-ke, ukwelashwa kwalolu hlobo lomdlavuza okukhonjiswe yi-oncologist kanye ne-gastroenterologist kungafaka:

• Ukuhlinzwa ukukhipha i-esophagus: ingxenye enesigaxa iyasuswa bese kuthi konke kuhlanganiswe nesisu. Kodwa-ke, lapho kufanele kususwe ngokuphelele i-esophagus, kuyadingeka ukubeka okufakelwayo kokufakelwa kokuqina noma kususwe ingxenye yamathumbu ukufaka indawo, isibonelo;
• I-Radiotherapy: kwenziwa ukuvimbela ukukhula kwamangqamuzana e-tumor endaweni yomzimba;
• Ukwelashwa ngamakhemikhali: ngemijovo emthanjeni noma kwemisipha futhi kokunye ngamaphilisi ukukhuthaza ukuqedwa kwamangqamuzana omdlavuza okungenzeka asekhona.

Ezimweni eziningi lezi zindlela zokwelapha aziwelaphi ngokuphelele umdlavuza, zisiza kuphela ekunciphiseni izimpawu zomdlavuza futhi zelule nempilo yesiguli. Isibikezelo sempilo yalolu hlobo lomdlavuza siyahluka ngohlobo lomdlavuza, isiteji, izindlela zokwelashwa ezenziwayo kanye nempendulo yesiguli ekwelashweni, kepha njengoba lesi sifo sitholakala ezimeni eziningi, ngakho-ke, isikhathi sokuphila sesiguli cishe singu-5 ubudala.

Ngaphezu kwalokho, isibikezelo sempilo yesiguli esinomdlavuza esikhumulweni sikhulu kakhulu lapho isimila sitholakala kuphela endaweni futhi akukho metastases.

Ukudla komdlavuza we-esophageal

Endabeni yomdlavuza wokuqopha, kungadingeka ukwenza izinguquko ezithile ekudleni, ngenxa yobunzima bokugwinya kanye nemiphumela emibi yokwelashwa, ikakhulukazi i-chemotherapy ebanga isicanucanu nokuphatheka kabi esiswini.

Ngakho-ke, kungadingeka ukulungisa ukudla kwamakhekhe, njengephalishi nesobho ku-blender, noma ukufaka izikhukhuzuku ekudleni okumanzi. Ngaphezu kwalokho, kungadingeka ukuthola izakhamzimba ngqo ngomthambo noma usebenzise ithubhu le-nasogastric, eliyishubhu eligijima lisuka ekhaleni liye esiswini, ukusiza ukuthola ukudla okufanele. Bheka ezinye izinketho zokudla lapho ungeke ukwazi ukuhlafuna.