Kuteteza Mtima Wanu Kuchokera Kumagetsi Ndi Khansa Yam'manja Yamanzere
Mankhwalawa amathandiza kuti anthu ena azidwala khansa ya m'mawere koma akhoza kuwononga mtima wanu ngati mwasiya khansa ya m'mawere. Kuchiza mankhwala kwa mtima wanu kungakhalenso kuchulukana ndi kuwonongeka kwa mankhwala ena a khansa monga chemotherapy ndi mankhwala othandizira. Phunzirani momwe njira yopuma yopuma yopuma ndi mpweya ingagwiritse ntchito kuchepetsa kuchuluka kwa mankhwala omwe amawopsya mtima wanu, ndipo potero mumachepetsa chiopsezo cha matenda a mtima.
Mankhwala othandizira ma ARV chifukwa cha khansa ya m'mawere
Amayi ambiri amapita kuchipatala cha m'mawere , ndipo pakali pano, pafupifupi 50 peresenti ya anthu omwe ali ndi kansa ya m'mawere oyambirira ali ndi mankhwalawa. Mankhwala othandizira pafupipafupi angagwiritsidwe ntchito kuchepetsa chiopsezo cha kubwereranso m'mimba mukamaliza khungu. Imathandizanso kuchepetsa kufala kwa khansa ya m'mawere ndi chimodzi mwachisanu ndi chimodzi.
Mankhwalawa angagwiritsidwenso ntchito pambuyo poyambitsa matenda, makamaka kwa amayi omwe ali ndi ma lymph node zabwino pa matendawa. Nthenda yonse ya m'mawere imaperekedwa pa ndondomeko zosiyanasiyana malinga ndi malo a khansa koma nthawi zambiri imachitika tsiku ndi tsiku sabata zisanu ndi zisanu ndi chimodzi. Njira zatsopano zowonjezera mazira zimaperekanso mlingo waukulu wa ma radiation ndi maulendo ocheperapo ku malo ena.
Mankhwala Opatsirana ndi Mafupa ndi Matenda a Mtima
Chifukwa cha kupatsirana kwa khansa ya m'mawere chifukwa cha kuwonjezereka kwa mankhwala a chemotherapy, kupititsa patsogolo mankhwala a mahomoni kwa zaka zisanu ndi zisanu, komanso njira zochiritsira za matenda a HER2, chiopsezo chokhala ndi moyo wautali ndi khansara chiyenera kuthandizidwa.
M'mbuyomu, sitinali okhudzidwa ndi zotsatira za nthawi yaitali za mankhwala a radiation monga ife lero. Anthu ambiri angathe kuyembekezera kukhala ndi moyo zaka makumi angapo pambuyo pa mankhwalawa kutipangitsa kuti tione bwinobwino mavuto omwe angakhalepo zaka zambiri pamsewu.
Thandizo la ma ARV likuphatikizidwa mu mitundu yosiyanasiyana ya matenda a mtima.
Izi zikuphatikizapo:
- Matenda a mitsempha ya Coronary
- Kusamalira mtima / kusweka mtima kwa mtima, kufooka kwa minofu ya mtima yomwe imachepetsa mphamvu ya mtima kupopera magazi kwa thupi lonse
- Matenda omwe amagwiritsa ntchito valve ya mtima (valvular heart disease)
- Mitima yosadziwika (arrhythmias)
- Zochitika zapericardial: Kuwonongeka kwa chikhomo cha mtima (pericardium) kungachititse kuti madzi azikhala ndi madzi pakati pa minofu yotchedwa pericardial effusion . Kuwonongeka kwa thupi kumapangitsa kuti zikhale zovuta kwambiri kuti minofu ya mtima ipope ndipo nthawi zina ingakhale yachangu mwachipatala.
- Imfa ya mtima wa mwadzidzidzi
Kafukufuku apeza kuti kuchepetsa kuwala kwa dzuwa komwe kumafika pamtima pamene mankhwala akuwoneka amachepetsa chiopsezo cha mtima wa mtima (kuwonongeka kwa mtima), koma izi ndi zofunika bwanji?
Kuwunika kwakukulu kwa 2017 kunayang'ana kuopsa kwa imfa zokhudzana ndi mtima pakati pa amayi omwe amapezeka ndi khansa ya m'mawere pakati pa 2010 ndi 2015. Kuchokera ku deta komanso maphunziro ena, ofufuza anayesera kulingalira za momwe mankhwalawa amathandizira pa matenda a mtima amtsogolo ndikuyerekezera izi ndi phindu la ma radiation pofuna kuchepetsa kufala kwa khansa.
Apeza kuti phindu la mankhwala opatsirana pogwiritsa ntchito khansa ya m'mawere liposa chiwopsezo cha matenda a mtima chokhudzana ndi mazira.
Komabe, pali anthu amodzi omwe amasuta chiopsezo cha matenda a mtima wodwala poizonika. Zonsezi, kuyerekeza kwa ma radiation kunkawonjezera chiopsezo cha matenda a mtima pafupifupi 30 peresenti.
Kupewa Kupuma: Kodi Zimagwira Ntchito?
Kupewa kupuma ndi njira yosinthira mawonekedwe a chifuwa pofuna kuchepetsa kuwonetsa mtima kwa miyezi. Kupewa kupuma ndi kupuma kumapangitsa kuti ma ARV azitha kutulutsa mpweya wabwino ndipo amachigwira pamene phokoso likutchulidwa pa bere. Kugwira mkaka uku kumafunika kwa masekondi pafupifupi 20 mpaka 30, mobwerezabwereza pafupipafupi.
Malinga ndi kafukufuku wa 2016, mphamvu yopuma yozizira imachepetsa kuchuluka kwa mphamvu ya mtima yomwe imalandira (kutentha kwa mtima) pafupifupi 50 mpaka 60 peresenti yokhudzana ndi mtima wa miyezi ya anthu omwe amapuma mwachizolowezi komanso mwachangu panthawi yonseyi. Anthu ena adatha kupuma mpweya wokwanira moti panalibe ma radiation omwe amafika pamtima pawo. Pali mitundu yosiyanasiyana ya njirayi kuphatikizapo Active Breathing Control kapena ABC dongosolo.
Njira zina zayesedwa kuchepetsa mlingo wa miyendo yomwe imaperekedwa pamtima, koma nthawi zambiri imakhala ndi mphamvu yazitali (komanso yotetezedwa) yomwe imaperekedwa ku minofu ndi pachifuwa. Ndi kupuma kupuma ndi kupuma, ma radiation oncologists amatha kuchepetsa mphamvu pamtima popanda kuchepetsa mlingo wa ma radiation.
Kodi Mungayang'ane Chiyani Pachipatala Chanu?
Njira yoyamba yopuma kupuma ndiyo njira yokonzekera chithandizo ndi ma radiation oncologist kuti mudziwe komwe kudzapatsidwa ma radiation komanso pa mlingo (wotchedwa plansimistric plan). Pakati pa malo okonza mapulanetiwa, mawotchi anu amatha kuyesa ndi kuyesa mphamvu ya kupuma kupatsirana kuchuluka kwa mankhwala omwe amaperekedwa pamtima mwanu.
Ndondomekoyi imalekerera bwino ndipo pafupifupi 80 peresenti ya anthu amatha kuyendetsa mpweya wawo ndi kupuma mpweya wawo nthawi yochuluka. Anthu ena adziwonetsera okha kusambira lapu mu dziwe pansi pa madzi pamene akupuma. Pakati pa gawo lanu, ndondomeko yowonjezera monga mawonekedwe a biofeedback nthawi zambiri amaikidwa kuti akuuzeni nthawi yomwe mupuma nthawi ndi nthawi kuti mupume.
Zoperewera za Kupewa Kupuma ndi Kutentha Kwambiri
Monga tanenera kale, kupuma mpweya nthawi zambiri kumalekerera ndipo anthu ambiri amatha kupuma kwa nthawi yaitali. Komabe pali zofooka, komabe, ndipo anapeza kuti anthu ena (osachepera 20 peresenti) amavutika kuti asunge utsogoleri wawo mwasankhidwe.
Matenda Ena a Khansa Yophatikizidwa ndi Matenda a Mtima
Kachilombo ka khansa kwa khansa ya m'magazi yotsalira kungapangitse chiopsezo cha matenda a mtima, koma zina zowononga khansa ya m'mawere zingapangitse ngozi.
Mankhwala a khemotherapy a khansa ya m'mawere angakulepheretseni kudwala matenda a mtima, makamaka mtima wamtima komanso kulephera kwa mtima, ndipo ovomerezeka anu angakhale atayesedwa pamtima (monga MUGA scan) musanayambe mankhwala a chemotherapy. Adriamycin (doxorubicin) ndidzidzidzi wotchuka wa mtima wosagwiritsidwa ntchito ndipo amagwiritsidwa ntchito m'magulu ambiri a mankhwala a khansa ya m'mawere oyambirira. Cytoxan (cyclophosphamide) ingakhalenso ndi zotsatira zokhudzana ndi mtima.
Azimayi omwe ali ndi mankhwala osokoneza bongo omwe amachititsa khansa ya HER2 yabwino monga Herceptin (trastuzumab) ndi mankhwala oyenera angagwiritsidwe ntchito. Pafupifupi anthu asanu pa anthu 100 aliwonse omwe amachitilidwa ndi mankhwala ochiritsidwa ndi HER2 adzakhala ndi vuto linalake la mtima. Zimakhala zovuta kuti zichitike pamodzi ndi Adriamycin ndipo zikhoza kuwonjezera kuopsa kwa mtima chifukwa cha mankhwala opatsirana. Cardiotoxicity yochepa imakhala yochepa ndipo imakhala yochepa kuchokera pa 0,6 mpaka 4 peresenti.
Kwa amayi omwe ali ndi zotupa zotenga estrogen, mankhwala opatsirana kwa khansa ya m'mawere angayambitsenso matenda a mtima. Mankhwala otchedwa aromatase inhibitors, kuphatikizapo Aromasin (exemestane), Arimidex (anastrozole), ndi Femara (letrozole), amagwiritsidwa ntchito kwa amayi omwe ali ndi khansa ya m'mawere ya postmenopausal pambuyo chemotherapy ndi amayi omwe ali ndi khansa ya m'mawere ya premenopausal omwe athandizidwa ndi ovarian.
Kuchita opaleshoni ya khansa ya m'mawere sikuwoneka kuti kumawonjezera chiopsezo cha matenda a mtima, koma kupweteka kapena kupweteka kwamtundu wokhudzana ndi opaleshoni kungachepetse mphamvu yanu kuzindikira zizindikiro za matenda a mtima.
Kulankhulana ndi Dokotala Wanu Za Zinthu Zowopsa za Matenda a Mtima
Pamene mukudutsa khansa ya m'mawere malingaliro anu amawoneka pa khansa ya m'mawere yokha. Komabe matenda a mtima ndi omwe amachititsa kuti amayi azifa, komanso matenda a mtima, matenda a mitsempha amayamba kwambiri.
Ndikofunika kulankhula ndi adokotala za chiopsezo cha matenda a mtima okhudzana ndi khansa ya m'mawere. Kuphatikiza pa chithandizo cha khansa ya m'mawere, zifukwa zina zoopsa za matenda a mtima mwazimayi zingakhalepo:
- Mbiri yaumwini kapena banja la matenda a mtima
- Kusuta
- Kuthamanga kwa magazi
- Cholesterol (kapena otsika HDL)
- Kunenepa kwambiri kapena kunenepa kwambiri
- Matenda a shuga kapena matenda opatsirana
Dokotala wanu angafunenso kuyesa magazi monga C-reactive protein (CRP) . Malingana ndi mbiri yanu, zoopsa, ndi mankhwala a khansa, kuyesedwa kwina kungapangidwe.
Dziwani Zisonyezo Zochenjeza za Matenda a Mtima-Ali Osiyana ndi Akazi!
Zaka zaposachedwapa, taphunzira kuti zizindikiro za mtima mwa amayi nthawi zambiri zimasiyana ndi za amuna. Izi ndizoona kufooka kwa mtima komanso matenda a mitsempha yamakono ndipo amalingalira kuti ndi chimodzi mwa zifukwa zomwe matenda operekera mitsempha amatha kukhala ovuta kwambiri kwa amayi. Azimayi omwe ali ndi matenda a mtima amakhala ndi chipatala chakumapeto kwa matenda onse a mtima ndipo amatha kufa asanachoke kuchipatala. Ndikofunika kumvetsetsa zifukwa zomveka izi.
Kulephera kwa mtima kumakhudzana ndi matenda a mtima m'thupi nthawi zambiri kumaphatikizapo kupuma pang'ono ndikukakamira kutuluka kwapopu kumapapo. Zizindikiro za kulephera kwa mtima kwa amayi
akhoza kukhala wochenjera kwambiri. Zizindikiro zingakhale monga kutopa, kupuma pang'ono komwe kungafotokozedwe ngati kusagwirizanitsa, komanso kutupa kwa mapazi ndi mabotolo.
N'chimodzimodzinso ndi matenda a angina ndi mtima. Amuna amakonda kukhala ndi zizindikiro zapamwamba zowononga kupweteka kwa chifuwa monga njovu atakhala pachifuwa chawo. Angina mwa amayi nthawi zambiri amakhala ndi zizindikiro za kunyoza ndi kusanza, kunyalanyaza, kupuma pang'ono, kapena kutopa kwambiri. Ngakhale kuti amayi ena ali ndi "zizindikiro" za matenda a mtima, zizindikiro za matenda a mtima mwa amayi nthawi zambiri zimasiyana ndi amuna. Akazi akhoza kukhala ndi kutentha ndi kutentha m'mtima mwawo, kapena ngakhale chikondi chokhudza. Zizindikiro zazing'ono zimakhalapo kwa masabata atatu kapena anayi asanayambe kugwidwa mtima. Akazi sangakhale ndi ululu pachifuwa pomwe ali ndi vuto la mtima! Popeza kuvutika kwapakhomo kunyumba kumakhala kofala kwambiri kwa amayi, chiopsezo cha imfa mwadzidzidzi ndi chapamwamba.
"Kukhala chete" mtima kumatanthauzidwa ngati omwe amapezeka poyesedwa (monga electrocardiogram) koma zimachitika popanda zizindikiro. Zochitika zamtenderezi zikufala kwambiri kwa amayi.
Kuti amvetsetse nkhani, amayi onse omwe ali ndi khansa ya m'mawere ndi madokotala awo amatha kuganiza za vuto la khansa ya m'mawere kusiyana ndi kuthekera kuti zizindikirozi zikhoza kuimira matenda a mtima. Zambiri mwa zizindikirozi zimayamba chifukwa cha khansara ndipo kenako zimapezeka kuti zikugwirizana ndi matenda a mtima.
Mfundo Yofunika Kwambiri Yotsutsana ndi Kutupa Kwambiri Kuchepetsa Matenda a Mtima Kuchokera ku Mankhwala Opatsirana Madzi
Pambuyo pophunzira za matenda a mtima mwa amayi, komanso matenda ena a khansa omwe angapangitse chiopsezo, zimakhala zosavuta kumvetsa chifukwa chake kuchepetsa kutentha kwa mtima wako pa khansa ya m'mawere kungakhale kofunika.
Kupewa kupuma kumathandiza kuchepetsa kuchuluka kwa ma radiation pamtima koma 50 mpaka 60 peresenti, ndipo nthawi zina kuthetsa kuwonetsetsa kumeneku. Kawirikawiri njira zopumazi zimaloledwa bwino ndipo zingakupatseni "chinachake choti muchite" panthawi yanu yopuma.
Osati malo onse opangira ma radiation omwe amapereka mankhwalawa amapereka njirayi, koma imakhala yofala kwambiri kuzungulira dziko. Chifukwa cha zotsatira zokhudzana ndi chithandizo, zimatsitsimula kukhala ndi njira yomwe ilibe chiopsezo chachikulu.
Pomaliza, ngakhale kuti khansa ya m'mawere imatsogola m'maganizo mwanu, ndi matenda a mtima omwe amapha amayi ochuluka, kuphatikizapo amayi ambiri omwe amachizidwa khansa ya m'mawere. Lankhulani ndi dokotala wanu za zinthu zomwe zingakuchititseni chiopsezo komanso mayesero ena omwe angakulimbikitseni. Ndipo onetsetsani kuti mukudziŵa bwino zizindikiro za "mtima" zomwe zimapezeka kwa amayi. Azimayi amatha kuvutika mwadzidzidzi imfa, amathera nthawi yochuluka kuchipatala, ndi kufa asanachoke kuchipatala kusiyana ndi amuna omwe ali ndi matenda a mtima, chifukwa chimodzi chomwe sichikwera pazithunzi za radar kwa amayi kapena madokotala.
> Zotsatira:
> Boda-Heggermann, J., Knopf, A., Simeonova-Chergou, A. et al. Kuthandizira Kwambiri Kuzizira Kwambiri Kuchokera M'thupi: A Clinical Review. International Journal of Radiation Oncology, Biology, ndi Physics . 2016. 94 (3): 478-92.
> Schonecker, S., Walter, F., Freislederer, P. et al. Kukonza Chithandizo ndi Kufufuza kwa Gated Radiotherapy M'magulu Otsala a Khansa Yamtundu Woteteza M'thupi Pogwiritsa ntchito njira yotchedwa Catalyst / Sentinel ya Deep Inspiration Breath-Hold (DIBH). Mafilimu a Oncology . 2016. 11: 143.
> Taylor, C., Correa, C., Duane, F. et al. Kuwonetsa Ngozi za Khansa ya M'thupi Radiotherapy: Umboni Wochokera Kumayendedwe Amakono Mankhwala ku Mapula ndi Mtima ndi Kuchokera M'mbuyomu Randomize Mayesero. Journal of Clinical Oncology . 2017. 35 (15): 1641-1649.