Zizindikiro za khansa ya m'magazi ndi zina za khansa ya magazi zikhoza kukhala zosavuta ndipo zingakhale zofanana ndi zikhalidwe zina zochepa kwambiri. Ndikofunika kuti dokotala akhale ndi matenda oyenerera kuti:
- Lembani momwe matendawa angapitirire
- Dziwani mankhwala othandiza kwambiri
Kawirikawiri, munthu akamasonyeza zizindikiro za khansa ya m'magazi amatumizidwa kwa katswiri mu hematology / oncology .
Ameneyu ndiye dokotala yemwe angasankhe matenda, komanso akukonzekera mankhwala omwe angafunike. Mitundu ina ya khansa ya m'magazi imachedwa kuchepa ndipo imatha kuyang'aniridwa, pamene ena amafunika kuchiza mwamsanga. Zina mwa mafunso ofunikira omwe mungafune kufunsa dokotala wanu zidzakuthandizani kumvetsa zomwe zikubwera motsatira, mwachitsanzo: Kodi mtundu wanga wa khansa ya m'magazi ikhoza kupita patsogolo posachedwa? Kodi ndimamva bwanji ngati ndili ndi khansa ya m'magazi ? Kodi ndine wotsatila mayesero a zachipatala, ndipo kodi mungandipatsireko china chilichonse? Chifukwa chiyani?
Kuzindikira khansa ya m'magazi
Kuyeza thupi ndi mbiri ya zachipatala: Mbiri ndi zakuthupi ndizo zoyambira pa matenda a khansa ya m'magazi. Pamene ogwira ntchito zachipatala akuwona wodwala yemwe potsiriza amapezeka ndi khansa ya m'magazi, nthawi zonse amayamba ndi kufufuza kwathunthu ndi mbiri yachipatala. Adzakhala ndi chidwi chodziŵa zambiri za zizindikiro zilizonse zomwe mukukumana nazo ndipo adzachita zolemba zonse za mutu uliwonse.
Mitundu yosiyanasiyana ya khansa ya m'magazi ingagwirizane ndi zotsatira zosiyana pa kuunika kwa thupi. Nthawi zina pangakhale zizindikiro za kutuluka mwadzidzidzi kapena kupweteka. Nthawi zina pangakhale kuwonjezeka kwa ziwalo zina monga chiwindi kapena ntchentche. Nthawi zina sipangakhale zizindikiro za kunja kwa khansa yomwe dokotala amatha kuzindikira pa kuunika kwa thupi.
Mulimonsemo, matenda ambiri angawoneke ngati khansa ya m'magazi, kotero kuti matenda a khansa ya m'magazi amafunika kuyesedwa kwina.
Ntchito yamagazi: Magazi amatha kutengedwa kuchokera mumsana mdzanja lanu ndikukutumiza ku labotale mumachubu yoyesera. Zitsanzozo zimayesedwa ndipo maselo amafufuzidwa pansi pa microscope. Kuyezetsa magazi kwa khansa ya m'magazi kumaphatikizapo:
- Complete Blood Count (CBC): Mayesero kuti ayese maselo ofiira ofiira, maselo oyera, ndi mapuloletiti m'thupi komanso mmene maselo amawonera.
- Mankhwala Omwe Amagazi Amagazi: Maselo amagazi amawotedwa ndipo amawoneka pansi pa makina oonera masikweya kuti akhalepo "maselo" aang'ono.
Chidule cha Basic Leukemia Magazi Ntchito Zotsatira : Mthemphayoyayi yemweyo ingayambitse kupeza zosiyana mu kuyesa magazi kwakukulu pazigawo zosiyana pa matendawa, koma pano pali zotsatira zowonjezereka za CBC kwa mitundu ikuluikulu yambiri ya khansa ya m'magazi .
Matenda | Zotsatira za CBC | Zotsatira za Magazi a Magazi |
Zovuta Myelogenous Leukemia (AML) | • Maselo ofiira ndi mapiritsi ofiira ochepa kuposa omwe amapezeka | • Maselo oyera oyera kwambiri |
Pachimake Lymphocytic Khansa ya m'magazi (YONSE) | • Maselo ofiira ndi mapiritsi ofiira ochepa kuposa omwe amapezeka | • Maselo oyera oyera kwambiri |
Matenda a Myelogenous Leukemia (CML) | • Kuchuluka kwa maselo a magazi kumachepetsedwa ndipo chiwerengero choyera cha selo nthawi zambiri chimakhala chokwanira | • Pitirizani kusonyeza maselo oyera oyera |
Chronic Lymphocytic Leukemia (CLL) | • Maselo ofiira ndi mapiritsi amatha kapena sangachepetse | • Maselo oyera oyera kapena osakhala oyera |
Mayendedwe a Marrow Bone : Kawirikawiri, zomwe zimaperekedwa ndi magazi omwe akupezeka m'thupi lanu sizingokwanira kupititsa patsogolo matendawa komanso zochiritsira. Maselo a m'magazi mumagawidwe anu onse anali opangidwa kamodzi mu thupi lanu la "magazi cell factor," fupa la fupa. Dokotala wanu angakulimbikitseni ndondomeko kuti mutenge msupa wa fupa. Izi zimadziwika ngati mafupa a mafupa, ndipo mafupa amachotsedwa pogwiritsa ntchito singano yaitali. Mu mafupa a mafupa, pangakhale maselo abwino opanga magazi ndi maselo a khansa ya m'magazi, omwe nthawi zambiri amakhala osiyana siyana omwe angakhale ofunika.
Mayesero apadera a maselo a khansa ya m'magazi angasonyeze makhalidwe ena omwe amagwiritsidwa ntchito pofuna kudziwa momwe mungasankhire mankhwala.
Kuyeza kwa Mitsempha Yam'mimba (Lumbar Puncture): Dokotala angasankhe kuyesa madzi omwe ali pafupi ndi chingwe cha msana kuti aone ngati pali maselo a khansa ya m'magazi omwe alipo. Mayesowa, omwe amatchedwa "lumbar puncture" kapena "matepi a msana") akhoza kuchitidwa ku ofesi kapena kuchipatala.
Potsatira njirayi, dokotala adzagonjetsa wodwalayo kumbali yake, kapena kuika patsogolo kuti agone patsogolo pa tebulo kotero kuti "amazingidwa". Dokotala amatha kuyeretsa dera kumtunda, ndipo agwiritseni ntchito singano yaing'ono kuti apereke mankhwala kuti asokoneze malowa. Kenaka, singano yochuluka imalowetsedwa kumbuyo, pakati pa vertebrae, ndi malo ozungulira msana. Madzi ena amachotsedwa ndi kutumizidwa ku labu kuti apitirize kusanthula.
Kawirikawiri, dokotala adzapuma wodwalayo pamalo omwewo kwa kanthawi kochepa potsatira njirayi.
Katemera wa m'magazi
Kukhazikitsa malo kumatanthauza dongosolo limene madotolo ndi akatswiri a labotale amayesera kupanga magulu anu a khansa. Kawirikawiri khansara imawongolera, pali kuchuluka kwa momwe matendawa afalikira, komabe khansa ya m'magazi imayandikira pang'ono mosiyana. Mitundu yosiyanasiyana ya khansa ya m'magazi imagawidwa, kapena imaikidwa, mosiyana, komanso.
Mwinamwake mwamvapo machitidwe omwe amagwiritsidwa ntchito popanga mitundu ina ya khansa-mwachitsanzo, "ali ndi khansa ya m'kati mwa IV," kapena "ali ndi kansa ya m'mawere ya m'ma III," etc. za khansa ndi momwe zimafalikira thupi lonse, koma zingakhale zosafunikira kwenikweni pa matenda a khansa ya m'magazi yomwe siimapanga zilonda zolimba.
Kwa matenda aakulu a khansa ya m'magazi , kapena CLL , madokotala ambiri amagwiritsa ntchito njira ya Rai. Mchitidwewu ukhoza kukhala wosiyana, chifukwa zikuwoneka kuti uli moyandikana ndi zomwe zimachitika pa mitundu ina ya khansa. Miyeso imadalira mbali ina kufalikira kwa ziwalo zina, chiwindi, ndi nthata. Maphunzilo a Rai awerengeka 0 mpaka IV ndipo akhoza kupatulidwa m'magulu otsika, apakati komanso omwe ali oopsa.
Kwa acute lymphocytic khansa ya m'magazi , kapena ONSE, komabe, sikuti njirayi imayendetsedwa mwanjira iyi, ndipo matendawa kawirikawiri sakhala ndi ziphuphu zomwe zimakula mopitirira malire. Zonsezi zikhoza kufalikira kwa ziwalo zina ngakhale zisanadziwike, kotero m'malo mogwiritsa ntchito njira zamakolo, madokotala nthawi zambiri amagwiritsa ntchito gawo la ALL ndi m'badwo wa wodwalayo. Izi kawirikawiri zimaphatikizapo mayesero a cytology, cytometry yothamanga ndi mayesero ena a labu kuti azindikire subtype ya ALL.
Mofananamo, matenda oopsa a khansa ya m'magazi kapena AML matendawa samapezeka mpaka atafalikira kwa ziwalo zina. Gulu la AML likugwiritsidwa ntchito pogwiritsa ntchito njira yamagetsi. Pali mitundu yosiyanasiyana ya ma stage yogwiritsidwa ntchito. Chikhalidwe cha French-American-British (FAB), AML amagawidwa m'magawo asanu ndi atatu, M0 kupyolera M7. Bungwe la World Health Organization (WHO) linapanga dongosolo losiyana la AML staging kuyesa kufotokozera momveka bwino malingaliro awo (mawonekedwe).
Kwa matenda aakulu a myeloid (CML), dokotala wanu adzafufuza mayeso a magazi ndi mafupa a mafupa kuti azindikire kuchuluka kwa maselo odwala. Pali magawo atatu a CML: aakulu, othamanga ndi osindikizira . Nthawi yayitali ndi CML. Ambiri mwa odwala CML amapezeka mu CML osakayika pakakhala zizindikiro zofatsa, makamaka kumva wotopa kapena wofooka. Ngati CML imakhala yochepa pakulandila kuchipatala panthawi yachilendo, ikhoza kukhala yowopsya, yomwe ingayambitse nthawi yowonjezereka. Pamene khansa ya munthu imayamba kupita patsogolo, zizindikiro zingakhale zofala kwambiri. Gawo lachiwawa kwambiri limatchulidwa ngati kusinthitsa CML, kapena kuphulika kwa mavuto. Gawoli likupezeka ndi kukhalapo kwa maselo ambiri omwe amakhala ndi magazi-20 peresenti kapena kuposerapo ndi myeloblasts kapena ma-lymphoblasts-m'mafupa kapena mwazi, ndipo zizindikiro zimakhala zofanana ndi za myeloid yodwala matenda a m'magazi.
Mafunso Ofunsa Dokotala Wanu
Mayeso ndi ndondomeko zingakhale zoopsa ngati simukudziwa zomwe muyenera kuyembekezera. Mungathe kulemba mafunso ena omwe angapemphe kuti akuthandizeni kukonzekera. Zitsanzo zina za mafunso omwe mungafune kufunsa wothandizira zaumoyo wanu ndi awa:
- Kodi mayeso awa adzachitidwa kuti?
- Kodi ndondomeko yowunikirayi ndi iti?
- Kodi ndikufunika kubweretsa wina ndi ine?
- Kodi ndiyenera kusala?
- Kodi ndingathe kubwerera kuntchito pambuyo poyesedwa?
- Ndizitenga nthawi yayitali kuti zotsatira zibwererenso?
- Ndingapeze bwanji zotsatira?
- Kodi ndikuyembekezerapo zotsatira zina za mayesowa?
- Kodi mayeserowa adzaphimbidwa ndi dongosolo langa la thanzi?
Khalani omasuka kulemba zolemba pamene wothandizira zaumoyo wanu akuyankha mafunso anu. Awuzeni mafunso anu mwanjira ina ngati simukumvetsa. Gulu lanu lifuna kuti mudziwitse bwino njira iliyonse.
Kudzisamalira Nokha
Ngati inu kapena mwana wanu mukuyesedwa ndi khansa ya m'magazi, iyi mwina nthawi yoopsya komanso yovuta pamoyo wanu. Mwina simukudziwa za tsogolo lanu, mukudandaula za momwe matenda a khansa ya m'magazi angakhudzira banja lanu. Kuphatikizanso apo, mukhoza kumverera bwino.
Ngakhale kuti n'kosatheka kuiwala mavuto onse omwe muli nawo, ndikofunika kuti mudzipatse nthawi yamtendere, yosinkhasinkha tsiku ndi nthawi kuchita zinthu zomwe zimakupatsani chimwemwe. Mwinamwake kuyenda mu dzuwa, kukambirana ndi bwenzi lakale pa khofi. Chilichonse chomwe chingakuthandizeni kuti mupumule ndikugwirizananso ndi "wakale". Mwina mudzadabwa kuona momwe thupi lanu limakhalira bwino pamene maganizo anu ali omasuka.
Mawu Ochokera
Ngati mwakhala mukudziŵa kale njira yothetsera khansa ina yomwe ilibe khansa ya khansa, khansa ya m'mawere kapena kansa ya prostate, magawo a khansa ya m'magazi sangathe kumasulira bwino poyamba. Matenda a khansa ya m'magazi amasiyana chifukwa cha mtundu wina wa khansa ya m'magazi. Selo loyera la magazi nthawi yomwe limagwiritsidwa ntchito nthawi zina limagwiritsidwa ntchito kuthandizira pakadwala la khansa. Zida zina, monga polemba CML ndi AML, zimaphatikizapo kuwerengera myeloblasts, kapena maselo oyera a magazi oyera, omwe amapezeka m'magazi kapena mafupa.
Chinthu chimodzi chofunika kwambiri kuti mutchere khutu kumayambiriro ndi chakuti khansa yanu imakhala ndi khansa ya m'magazi kapena khansa ya m'magazi. Mitundu yambiri ya khansa ya m'magazi ikhoza kumakula ndikukhala yochuluka, komabe, mawu achilendo nthawi zambiri amatanthawuza kukula ndi kuchepa pang'onopang'ono kusiyana ndi mawu ovuta.
Kuwonjezera pa chigawo chachikulu cha khansa ya m'magazi, ma tags ang'onoang'ono kwambiri kapena "zizindikiro" kunja kwa maselo a khansa ya m'magazi amatha kudziwika ndi mayesero a ma laboni ndipo nthawi zambiri amafunika kuwonetsetsa ndipo akukonzekera kupita patsogolo. Odwala awiri omwe ali ndi matenda ofanana ndi khansa ya m'magazi angakhale ndi zosiyana zosiyana ndi matendawa, mayankho osiyanasiyana ochizira, komanso osiyana siyana.
Pamapeto pake, khansa ya m'magazi ndi yofala kwambiri mu ubwana, ndipo nthawi zambiri ubongo wa mwana umakhala ngati wosiyana kwambiri ndi khansa ya m'magazi. Ngati mukufunafuna kudziwa chifukwa cha mwana yemwe ali ndi khansa ya m'magazi, dziwani kuti nthawi zina mankhwala ndi majekesi amasiyana pakati pa magulu awiriwa, ngakhale kuti khansa ya m'magazi imakhala ndi dzina lomwelo.
> Zotsatira:
> American Cancer Society. Kodi matenda a khansa ya m'magazi amatani? 2017
> Caldwell, B. (2007). Zovuta za leukemias. Ku Ciesla >, B >. (Mkonzi.) Hematology mu Practice (pp. 159-185). Philadelphia, Pennsylvania: FA Davis Company.
> Finnegan >, K. > (2007). Matenda a myeloproliferative. Ku Ciesla, B. (Mkonzi) Hematology mu Kuchita (pp.187-203). Philadelphia, Pennsylvania: FA Davis Company.
> Leukemia & Lymphoma Society. Mayeso a magazi. 2017.