Ngati mwauzidwa kuti muli ndi mitsempha yamapapu kapena mapapu pa x-ray, mwina mukuwopa kwambiri. Kodi zifukwa zina ndi ziti? Ndi kangati anthu omwe ali ndi mitsempha yamapapu? Ndipo mwayi wotani ndi khansara yamapapo ?
Ndikofunika kufotokoza nthawi yomweyo kuti ambiri -mapapo 60 peresenti ya m'mapapo aliwonse- alibe khansa. Tidzakambirana za izi zowonongeka, koma ndizofunikira kudziwa kuti ngati nthendayi ndi khansara yamapapo pali mwayi wochuluka kuti ikhoza kuchiritsidwa.
Nkhono, mwakutanthauzira, ndi yosakwana masentimita atatu, ndipo pa kukula kwake, khansa zambiri zamapapu zimachiritsidwa kwambiri. Ngakhale ngakhale khansa ya m'mapapo yomwe ili yaikulu, chithandizo ndi kupulumuka kwa khansa ya m'mapapo zakula bwino kwambiri m'zaka zingapo zapitazo.
Cholinga chomaliza musanayambe ndikuzindikira kuti kupyolera pakudziwa ndikofunikira ngakhale simunasute fodya. Pakalipano, palinso anthu ambiri omwe amasuta fodya komanso osuta fodya omwe amakhala ndi khansa ya m'mapapo , kuposa anthu omwe amasuta.
Kodi Makhalidwe Abwino Ndi Otani?
Mphungu yamapapu imatchedwa "malo" pamapapo omwe ali masentimita atatu (pafupifupi 1.5 mainchesi) m'mimba mwake kapena osachepera. Mitsempha imeneyi imatchulidwa kuti "zilonda zam'kati" zikafotokozedwa pa mayesero. Ngati kusadziwika kumawonekera pa x-ray ya mapapo ndi yaikulu kuposa masentimita atatu, iyo imatengedwa ngati " mapapo " osati mmimba ndipo imakhala yochuluka kwambiri.
Mankhwalawa amatha kukhala osachepera sentimita imodzi musanayambe kuwoneka pa chifuwa cha x-ray, pomwe mitsempha yazing'ono ngati imodzi kapena milimita imodzi nthawi zina imatha kuwonedwa pa CT.
Kukula
Mitsempha yamimba ndi yowoneka bwino ndipo imapezeka pamtundu umodzi wa ma x-ray, ndipo imodzi mwa ma 100 a CT omwe amapezeka pachifuwa.
Pafupifupi 150,000 mafupa a mapapu amapezeka kwa anthu ku United States chaka chilichonse. Pafupifupi theka la anthu opitirira 50 omwe amasuta amatha kugwedeza pamatenda awo a CT.
Ngati kachilombo kameneka kamapezeka pa chifuwa cha x-ray, nkofunika kukhala ndi kanema wa CT. Mankhwala a khansa ang'onoang'ono amatha kuphonyedwa m'chifuwa cha x-ray .
Zizindikiro
Mafupa ambiri ammapiko sapangitsa zizindikiro zilizonse ndipo amapezeka "mwangozi" kapena "mwangozi" pamene chifuwa cha X-ray chachitika chifukwa china. Ngati zizindikiro zilipo, zikhoza kuphatikizapo chifuwa, kukhetsa magazi, kupuma, kupuma pang'ono, kapena matenda opuma ngati ma nodule ali pafupi ndi msewu waukulu.
Zimayambitsa
Mitsempha ya mapuloteni ikhoza kukhala yowopsa (osati ya khansa) kapena yoipa (khansara). Zomwe zimayambitsa zonsezi zimaphatikizapo ma granulomas (mapira a matenda omwe amatha chifukwa cha matenda kapena kutupa) ndi matenda a hamartomas (zotupa zamapapu zowononga). Chifukwa chofala kwambiri cha mitsempha yamapapu yoipa imaphatikizapo khansara yamapapo kapena khansa kuchokera m'madera ena a thupi lomwe lafalitsidwa m'mapapo ( kansa ya metastatic ).
Mankhwala amatha kusweka m'magulu akuluakulu.
- Matendawa - Matenda opatsirana omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tingaphatikizepo matenda opatsirana monga mabakiteriya monga matenda a chifuwa chachikulu komanso matenda enaake omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda, tizilombo toyambitsa matenda monga astoplasmosis, blastomycosis, aspergillosis, and coccidiomycosis, matenda a parasitic monga ascariasis (nsomba zam'mimba), etikucoccus (hydatid cysts) Zikasokonezeka.) Pamene chitetezo cha mthupi "chikuzungulira" malo opatsirana nthawi zambiri chimapanga granulomas.
- Kutupa - Zinthu monga nyamakazi ya nyamakazi , sarcoidosis , ndi Wegener's granulomatosis, komanso pneumoconioses monga silicosis ingathenso kumayambitsa granulomas.
- Matenda a Benign - zotupa za Benign monga matenda a nyamakazi (omwe amafala kwambiri ammimba a m'mapapo,) amadzimadzi amtundu wotchedwa acenomas, fibromas, blastomas, neurofibromas, ndi hemangiomas. Amatha kusonyeza ngati mphutsi m'mapapu pa x-ray.
- Matenda opweteka - Khansa yomwe ingawoneke ngati khansa yamapapu imaphatikizapo khansa ya m'mapapo, ma lymphomas , mitsempha, ndi zotupa za carcinoid.
- Metastases - Mitsempha yamapangidwe imatha kukhalanso ndi mitsempha ya khansa zina monga khansa ya m'mawere, khansara yamtundu, khansara ya chikhodzodzo, ndi khansara ya prostate.
- Mitsempha yowonongeka yowonjezereka - Kuika magazi m'magazi (m'magazi amagazi omwe ataya magazi awo,) Zida zamagazi zoopsa (AV malformation,) atelectasis (kugwa kwa gawo la mapapo,) mapapo a pulmonary fibrosis , ndi amyloidosis ndi zina zomwe zimayambitsa mapapo mimba.
Kudziwa
Chinthu choyamba chomwe adokotala akufuna kuchita ngati awona chifuwa cha mapapu pa x-ray ndikupeza ma x-rays omwe mwakhala nawo kale ndi kuwafanizira. Ngati nkhono kapena mitsempha yakhalapo kwa nthawi yayitali, mayesero ena sangafunike. Ngati nkhonoyi ndi yatsopano kapena mulibe ma-x-ray yosiyana, mungawonongeke kwambiri.
Ngati nthendayi ikupezeka pa chifuwa cha x-ray, sitepe yoyamba kawirikawiri iyenera kuti ikhale ndi kanema ka TB. Mayesero ena monga MRI angafunike.
Panthawi imeneyi, dokotala wanu akufuna kudziwa mbiri yanu komanso zifukwa zilizonse zomwe zingakhale zoopsa zomwe mumakhala nazo m'magazi amtundu uliwonse (onani m'munsimu.) Mwachitsanzo, ngati mwangoyenda kumene, matenda opatsirana angakhale ochepa koma ngati akusuta, chotupa chowopsya chingakhale chotheka. Zizindikiro za chotupa monga momwe tawonera pa CT yanu ikuyendanso.
Nthawi zina kujambulira PET kumathandiza popitiriza kufotokozera nkhono. Mosiyana ndi CT scans ndi MRI ndi "mayendedwe" mayesero. Amatha kupeza zilonda m'mapapo koma samapereka zenizeni za zomwe zikuchitika mumphuno. Ndikulandira PET, shuga pang'ono ya radioactive imalowetsedwa m'magazi anu. Matendawa amayamba kukula kwambiri ndi shuga yomwe imayambira pamayeso. Izi zingakhale zothandiza posiyanitsa chiwopsezo chochuluka kuchokera ku minofu yowopsya ngati chifuwa chokula chidzatenga shuga zambiri. Izi ndi zothandiza makamaka kwa omwe adayika kale matenda a mfupa, matenda a m'mapapo kapena opaleshoni zomwe zingabweretse minofu yambiri.
Ngati nthendayi ikuoneka kuti ikukula kapena ili ndi zizindikiro za matenda oopsa, (ali ndi "mwayi wochepa" wa khansara) "kuyembekezera ndi kuyang'ana" njira zina zingatengedwe ndi CT scan mobwerezabwereza pakapita nthawi. Mankhwala okhaokha omwe sakhala osinthika kwa zaka ziŵiri kapena kupitilira safunikira kuwonjezereka.
Chidutswa cha Mankhwala Osokoneza Bongo
Mwamwayi, chiwindi cha mapapu kawirikawiri chimafunika kuti mudziwe motsimikiza chomwe chikuchititsa nodule. Mwamwayi, njira zatsopano zowonongeka zowonongeka zimapezeka nthawi zambiri. Izi zikhoza kukhala zofunika ngakhale dokotala wanu atatsimikizira kuti n'chiyani chikuchititsa nodule kapena mitsempha.
Chitsanzo ndi pamene mitsempha imaganiziridwa kuti ndi khansara yamtundu wina monga khansa ya m'mawere. Kafukufuku waposachedwapa amasonyeza kuti ngakhale pamene phokoso lamapapu limapezeka mwa munthu yemwe angayembekezere kukhala ndi mapangidwe a mapapu, theka la mitsempha yonseyo ndi metastases pamene imapangidwira. Mpaka 25 peresenti, kani, anali khansara yachiwiri yamapapu yoyamba.
Malingana ndi malo a nodule, chida chabwino cha singano chikhoza kuchitika. Nthaŵi zina chimbudzi chowombera chimatha kuchita monga mbali ya bronchoscopy. Nthaŵi zina chiwonetsero chotsegula chingakhale chofunika. Ngakhale zili choncho, njira zatsopano, monga opaleshoni yamagetsi yothandizira mavidiyo (VATS) ikhoza kuchitidwa m'malo mwa thoracotomy.
Benign vs. Malignant Nodules
Zonsezi, nthenda yoti mapapu ali ndi khansa ndi 40 peresenti, koma chiopsezo chokhala ndi mapapu kukhala khansa chimasiyana kwambiri ndi zifukwa zingapo. Kwa anthu osakwana zaka 35, mwayi wokhala ndi mapapu ndi khansa ndi osachepera 1 peresenti, pamene nthenda ya mafupa a m'mapapo mwa anthu oposa 50 ali oopsa .
Zina zomwe zimapangitsa kapena kuchepetsa chiopsezo cha mapapu ndi khansa ndizo:
- Kukula - Manyowa akuluakulu amakhala odwala khansa kusiyana ndi ang'onoang'ono.
- Kusuta - Omwe akusuta komanso omwe kale anali osuta amakhala odwala matenda a khansa kusiyana ndi osuta fodya. Phunzirani kuchuluka kwa osuta omwe ali ndi khansa ya m'mapapo.
- Ntchito - Ntchito zina zowonjezera ntchito zimapangitsa kuti phokoso likhale ndi khansa.
- Mbiri yachipatala - Kukhala ndi mbiri ya khansa kumapangitsa mwayi kuti mimba ingakhale yowopsya.
- Mbiri ya Banja y - Anthu omwe ali ndi matenda a khansa komanso mbiri ya banja la khansara yamapapo ndi ovuta kwambiri kukhala ndi mitsempha ya khansa kusiyana ndi omwe alibe mbiri ya banja.
- Zizindikiro - Mpata kuti kachilombo ka kansa ndi kansa ya m'mapapo kwambiri ngati zizindikiro zina za khansa ya m'mapapo zilipo.
- Maonekedwe / maonekedwe a nkhono - Zovuta, zozungulira zimakhala zosaopsa, pamene "mitsempha" yamphongo, kapena ndi malire osayenerera kapena osowa kwambiri amakhala odwala khansa.
- Zolimba / zosalimba - Mankhwala omwe ali olimba m'malo molimba amakhala odwala khansa
- Kukula - Khansa ya khansa imakhala ikukula mofulumira ndi nthawi yowerengeka yowerengeka ya miyezi inayi, pamene mitsempha yowopsa imakhalabe yofanana kukula nthawi.
- Kuwerengera - Mitsempha yowonongeka yomwe imawerengedwera ndi yowonongeka.
- Cavitation - Manodoma omwe amatchulidwa kuti "ophika," kutanthawuza kuti mkati mwa dothili mumakhala mdima pa x-ray, ndizosawoneka kuti ndizosautsa.
- Galasi ya pansiyi imayambitsa mitsempha - Mankhwala omwe amafotokozedwa kuti ali ndi galasi yamaonekedwe nthawi zambiri amakhala ovuta ndipo akhoza kukhala oopsa kapena ovuta. Chifukwa cha vutoli, chidziwitso cha zilonda izi nthawi zambiri zimafunikira.
- Chiwerengero cha mitsempha - Amene ali ndi mitsempha yambiri amakhala ndi khansara kuposa omwe ali ndi mitsempha yokha kapena yochepa yokha.
- Malo a mitsempha - Lobules yomwe ili mu lobes lamanja kapena lamanzere m'munsikati kapena m'mapakati apakatikati a mapapo ndi ochepa kwambiri omwe amakhala odwala khansa kuposa omwe ali kumanzere kapena kumtunda wapamwamba kwambiri.
- Mitundu ndi malo - Ngati mwatuluka panja ku United States, chifuwa cha mapapo ndi chotheka. Mwachitsanzo, kafukufuku wamaphunziro apeza kuti mitsempha yamapapu chifukwa cha matenda a schistosomiasis, matenda opatsirana, amakhala ofala kwambiri m'mayiko a ku Africa. Momwemonso, mitsempha yokhudzana ndi matenda a fungalomu, monga coccidiomycosis amapezeka kumwera chakumadzulo.
Manodoma Okhazikika Okhazikika
Chiwerengero cha mafupa ammapiko omwe amawerengedwa ndi radiologists monga "indeterminate" chawonjezeka ndi kudza kwa kansa ya m'mapapo. Kumva kuti mimba yanu kapena mitsempha yanu imatha kukhala yosokoneza. Kodi sizomveka? Mwamwayi, nthawi zina simungathe kuyeza mayesero okha kuti mudziwe ngati nkhwangwa ndi yosautsa-ngakhale mutaganizira zinthu zonse pamwambapa. Kuti muyankhe funso ili, biopsy iyenera kuchitidwa. Mwamwayi, akatswiri a radiologists, opaleshoni, ndi odwala omwe ali pamodzi akupeza njira zochepa zowonongeka za minofu. Kuti mumvetse bwino chifukwa chake funsoli ndi lovuta kwambiri, mungafune kudziwa zambiri za kusiyana pakati pa zotupa zowononga komanso zoopsa .
Kuwongolera Khansa Yam'mimba
Kuyezetsa khansa ya m'magazi kwa anthu oyenerera kwapezeka kuti kuchepetsa chiwerengero cha kufa kwa khansa ya m'mapapo ndi 20 peresenti. Koma monga ndi mayesero aliwonse owonetsetsa, pali chiopsezo cha chinyengo, ndipo zimakhala zachilendo kupeza minofu pa kuyang'ana kwa CT. Koma kupeza mitsempha sikutanthauza khansa. Ndipotu, maphunziro mpaka pano akuganiza kuti kokha pafupi asanu mwa magawo asanu a mitsempha yomwe imapezeka pa mapulogalamu oyambirira a CT mapaipi ndi khansa.
Chithandizo
Mankhwala a mapapu amapapu amasiyana kwambiri malinga ndi chifukwa, kaya ali okhudzana ndi matenda, kutupa, khansa, kapena zina. Amapapu ochulukirapo amavutitsa, makamaka omwe alipo komanso osasintha kwazaka zingapo, akhoza kusiya okha.
Mawu Ochokera
Ngati mwamvapo kuti inu kapena wokondedwa wanu muli ndi chifuwa cha mapapu mumakhala wamantha komanso osokonezeka. Pali njira zambiri zosiyana ndipo zina mwaziwopsya. Zingakuthandizeni pang'ono kuganizira kuti minofu yambiri si khansara, ndipo ngakhale yomwe ingathe kuchiritsidwa ndi opaleshoni.
Ngati mwasankha kufufuza chidziwitso chanu mu mzere ndikofunikira kuzindikira kuti sayansi ikusintha mofulumira. Njira zatsopano zogwiritsira ntchito zizindikiro zikupezeka komanso mankhwala atsopano pachaka. Popeza mankhwala akusintha mofulumira kwambiri, Ndikofunika kukhala wothandizira pazochipatala. Ngati simukupeza mayankho, funsani mafunso ambiri. Taganizirani kupeza lingaliro lachiwiri mosasamala zomwe mumamva. Potsirizira pake, yesetsani kwa abwenzi ndi abwenzi. Ngati khansa yanu imakhala khansara yamapapu pali gulu la khansa yamapapu yogwira ntchito yomwe ingakulandireni.
> Zotsatira:
> Gould, M., Donington, J., Lynch, W. et al. Kuwunika kwa Anthu Omwe Ali ndi Mankhwala Osokoneza Bongo: Kodi ndi liti la khansa? . Chifuwa. 2013. 143 (S Suppl): e93S-e120S.
> McWilliams, A., Tammemagi, M., Mayo, J. et al. Mpata wa Khansa mu Mitsempha Yowonongeka Yoyang'aniridwa pa Kuyang'ana Koyamba CT. The New England Journal of Medicine. 2013. 369: 910-919S.
> Wang, Y., Gong, J., Suzuki, K., ndi S. Morcos. Njira Zogwiritsira Ntchito Zojambula Zogwiritsa Ntchito Zokonzeka Zokha. Journal of Thoracic Disease. 2014. 6 (7): 872-87.
> Yang, W., Jiang, H., Khan, A. ndi al. Transthoracic Needle Aspiration mu Solitary Pulmonary Nodule. Kafukufuku Wofufuza za Khansa Yamasulidwe. 2017. 6 (1): 76-85.
> Yao, Y., Lv, T., ndi Y. Nyimbo. Mmene Mungayambitsire Kugwiritsa Ntchito Mankhwala Osokoneza Bongo: Kuchokera Powonongeka Kuchipatala. Kafukufuku Wofufuza za Khansa Yamasulidwe. 2017. 6 (1): 3-5.