Ndibwino Kuti Mupeze Matenda a Khansa Kumayambiriro
Mwachidule
Mwamwayi, zipsinjo zakupha, kapena zotupa za khansa, za mimba zamphongo ndi machimo a paranasal ndi osowa.
Pafupifupi 3 peresenti ya khansa yowopsya ya mutu ndi khosi imakhudza mitsempha yamphongo ndi sinama ya paranasal. Zonsezi, khansa imeneyi imakhala pafupifupi 0,5 peresenti ya khansa yonse yoopsa. Kuwonjezera apo, amuna amayamba kudwala ndi khansa, ndipo anthu 4 mwa anthu asanu aliwonse omwe ali ndi vutoli ali ndi zaka 55 kapena kuposa.
Chifukwa chakuti chinachake ndi chosowa, komabe sikutanthauza kuti sikofunikira. Kwa omwe ali ndi mitsempha yoipa ya minofu ndi sinthana za paranasal - pafupifupi 2000 Amerika amapezeka kumene chaka chilichonse - komanso onse okondedwa awo, zotupa za khansa ndizovuta kwambiri.
Mwapadera malinga ndi American Cancer Society, zaka zisanu zapakati pa moyo, kapena chiwerengero cha anthu omwe ali ndi moyo zaka zisanu pambuyo pozindikira kuti poyamba, khansa ya nasal kapena paranasal sinus imafika pa 35 mpaka 63 peresenti poyambira pa sitepe kapena mwamphamvu.
Kodi Mng'oma Ndi Chiyani?
Mphuno yanu imagwirizanitsidwa pakamwa panu kupyolera pamphuno .
Kodi Zithunzi za Paranasal Ndi Ziti?
Ziphuphu ndi malo kapena malo osadziwika m'thupi lathu. Mulu wamphongo umatsegukira ku machimo ena awiri a paranasal, omwe amamanga phokoso la m'mphuno.
Machimo ochulukirapo ambiri ndi machimo akuluakulu omwe amakhala pamasaya. Chilichonse cha maxillary sinus chimagwedeza mphuno palokha ndikugona pansi pa maso.
Zomwe zimayambira kutsogolo zili pamwamba pa nsidze.
Machimo a mtundu wa ethmoid ndiwo magulu ang'onoang'ono omwe amathana ndi ziphuphu zochepa zomwe zimakhala ndi minofu ndi mafupa oonda. Machimo awa amakhala pakati pa maso anu.
Zowonongeka za sphenoid zimakhala mkati mwa mphuno ndipo ziri kumbuyo kwa maso.
Machimo amachititsa zinthu zambiri kuphatikizapo zotsatirazi:
- fyuluta ndi mpweya wotentha
- perekani thandizo la fuga
- yambani chigaza
- thandizani kutulutsa mawu anu
Kawirikawiri, uchimo wa paranasal umadzazidwa ndi mpweya. Komabe akakhala ndi kachilomboka ndi kutentha, machimo amenewa akhoza kudzaza ndi magazi, mafinya, ndi ntchentche - zonse zomwe zimapweteka komanso zopweteka.
Kodi Mankhwala Osokoneza Bongo Amakhala Otani?
Makungwa ambiri amphongo ndi sinthana za paranasal zimachitika pa mlingo wa maxillary sinus. Nthawi zambiri, khansa izi zimagunda pamphuno, pamphuno (yomwe imakhala pakhomo la mphuno) ndi machimo amtundu. Kawirikawiri khansa imeneyi imakhudza uchimo wamkati kapena sphenoid.
Kodi Maselo Amene Amachokera Kumtundu Wambiri Wosakanizidwa ndi Khansa ya Paranasal?
Zachimake ndi ngalande zamphongo zimayikidwa ndi mitundu yosiyanasiyana ya maselo ndi makompyuta kuphatikizapo zotsatirazi:
- maselo ophwanya
- maselo osakanikirana ndi madontho aang'ono ochepa
- maselo osayanjanitsika
- melanocytes
- ma lymphocytes (maselo a chitetezo cha m'thupi)
- maselo a mitsempha
- maselo a mafupa
- maselo a minofu
Mmodzi mwa maselowa angayambe khansa, zomwe zimapangitsa kuti khansa komanso penalaal khansa ikhale ndi mitundu yosiyanasiyana ya khansa, kapangidwe ka makina, ndi mankhwala.
Mwachitsanzo, khansa ya khansa (mtundu wa khansa ya khungu); sarcoma (fupa, minofu kapena kansa ya khungu); Lymphoma (khansa ya magazi yomwe imakhudza lymphocyte); ndi esthesioneuroblastoma (kapena khansara yochokera ku mitsempha yambiri) ingathe kuchititsa khansa ya nasal ndi paranasal.
Komabe, ambiri mwa mitundu yosiyanasiyana ya khansa sizimachitika. M'malo mwake, khansa yapakhungu yambiri ndi imene imayambitsa khansa ya nasal ndi paranasal. Pafupifupi 50 peresenti ya khansa imeneyi imachokera ku maselo osakanikirana. Mtundu wachiwiri wambiri wamphongo kapena khansa ya paranasal sinus ndi adenocarcinoma, yomwe imachokera ku maselo osasangalatsa.
Zizindikiro
Khansa ya minofu yamphongo ndi sinthana ya paranasal imakhala yosiyana kwambiri ndi zovuta zogwira mtima zomwe zimakhudza dera lino (ganizirani matenda opuma opuma monga chimfine kapena chimfine kapena sinusitis). Komabe, pamapeto pake, zotupazo zimakula, ndipo zimakhala zovuta kwambiri , kumangoyang'ana kumayambiriro a maatomu monga pafupi ndi maso ndi ubongo.
Nazi zizindikiro zoyambirira za minofu ndi minofu ya paranasal sinus:
- mphuno yothamanga
- kusokonezeka
- kudziletsa
- chidzalo cha sinus
- chifundo chauchimo
Pambuyo pa chotupa chimakula ndikudyera m'zinthu zozungulira, zotsatirazi zikhoza kuchitika:
- kutuluka m'mphuno;
- kupweteka kwa nkhope;
- kupweteka kwa dzino (ngati chotupa chimakula chachikulu chokwanira kumenyana ndi mkamwa, mano opweteka amatha kuvulaza);
- mavuto a maso (mwachitsanzo, masomphenya awiri, osayang'ana maso ndi maso) /
Tsoka ilo, anthu ambiri amene amapezeka kapena potsirizira pake amatchulidwa ndi katswiri wa ENT (khutu, mphuno ndi khosi) ndi mitsempha ya nasal ndi khansa ya paranasal sinus imachita patapita nthawi, atayamba kuwona zizindikiro kuti mwina iwo kapena madokotala awo osamalidwa sangathe kutero chimfine, chimfine, sinusitis (matenda a sinus) kapena zina zotero.
Ndipotu nthawi zambiri anthuwa ayesa ma antibiotic angapo. Pamapeto pake, panthaŵi yomwe anthu ambiri ali ndi khansa, kuwonjezeka kwake kumawonjezeka ndipo zizindikiro, kapena maganizo, zimakhala zowonongeka.
Zimayambitsa
Khansa ya ziphuphu zamphongo ndi uchimo wa paranasal zimayambitsidwa ndi kuphatikiza kwa chibadwa (kuganizira kusintha kwa chilengedwe) ndi kuwonetsa zachilengedwe.
Zowonjezera zingapo zomwe zimayambitsa khansa ya mutu ndi ya mitsempha, kuphatikizapo minofu yamphongo ndi khansa ya paranasal sinus, yatsimikiziridwa. Zowopsazi zimapangitsa munthu kukhala ndi matendawa.
Nazi zifukwa zina zoopsa za khansa izi:
- kusuta;
- kugwiritsa ntchito mowa;
- Phulusa (inyalala, zikopa, nsalu, maluwa ndi matabwa);
- ma radiation (monga radium omwe amawoneka pazithunzi zojambula kapena pa radon);
- zosokoneza;
- formaldehyde;
- mpweya wa mpiru;
- kudula mafuta;
- mafuta amchere;
- chromium;
- zakudya zosungidwa;
- HPV (kachilombo ka papilloma kamene kamayambitsa ziwalo zogonana);
- Vuto la Epstein-Barr;
- Kupweteka (mtundu wa mphamvu yofewa yomwe imapezeka ku India);
- matenda ochepa a m'kamwa (zofooka zoopsa);
- Makolo a ku Asia.
Zambiri mwazifukwazi zimachitika chifukwa cha ntchito. Mwachitsanzo, anthu omwe amagwira ntchito m'mafakitale omwe amabweretsa zikopa, zitsulo, mafuta ndi zina zotere amakhala pachiopsezo chachikulu poyerekeza ndi chiwonongeko chifukwa cha kuphulika.
Ndipotu, zomwe zimachititsa kuti pakhale mitsempha yam'mimba ndi khansa ya paranasal sinus ndi kusuta komanso kumwa mowa kwambiri makamaka makamaka palimodzi.
Kudziwa
Chifukwa chakuti zizindikiro za minofu yamphongo ndi khansa ya paranasal sinus ikhoza kukhala yabwino kwambiri - makamaka oyambirira - dokotala wa ENT (mphuno, mphuno ndi khosi), kapena otolaryngologist, adzafunika kuwonetsera mwachindunji ndi chidziwitso, kapena chitsanzo, chotupa, kapena misa, kuti mudziwe chomwe chiri.
Asanachite kapena kulamula mayesero a chidziwitso, dokotala adzayamba kuyeza mutu ndi khosi. Ngati mukuganiza kuti chotupacho chikugwiritsidwa ntchito, zimaperekedwa mwapadera ku zotsatira za kuyesedwa kwa diso, monga kusuntha kwa diso.
Kuwonjezera pamenepo, ziphuphu ndi minofu zimayang'aniridwa mosamala, zonse pogwiritsa ntchito kuyang'ana ndi kulumikiza kapena kukhudza. Mwachindunji, kukanikiza pambali za machimo kungathe kupweteka ngati mukudwala kapena matenda.
Pano pali mayesero osiyanasiyana omwe angapangidwe kuti athe kuthandizira ma khansawa ndikukonza chithandizo choyenera:
- phokoso losungunuka (phukusi losakaniza lokhala ndi kamera ndi kuwala komwe kumagwiritsidwa ntchito kuyang'ana mkati mwa chingwe cha m'mphuno)
- CT
- MRI
- X-ray
- PET kuyesa
Pa mayeserowa, ma X-ray ndi CT amawunika kudziwa ngati khansara yayamba kufalikira ku malo omwe ali pafupi ndi chisa. Ngakhale, PET yowunikira imagwiritsidwa ntchito kuti aone ngati khansa izi zafalikira kapena zowonongeka. Mwachiwonekere, ndizovuta kwambiri kwa wodwalayo pamene khansa izi zimafalikira ku ziwalo zina za thupi.
Kusinthana
Kawirikawiri, khansa ya mimba yamphongo ndi sinthana ya paranasal ndi mitundu ya khansa ya mutu ndi khosi. Mofanana ndi mitundu ina ya khansara, khansa yamutu ndi ya pakhosi imapezeka ndikugwiritsa ntchito magawo: Gawo 0, I, II, III ndi IV. Zigawo izi zimagawidwa motengera momwe zimakhalira. Pakati pa siteji, khansara yowopsa kwambiri. Kuwonjezera pamenepo, magawowa akutsatiridwa pogwiritsa ntchito TNM staging .
T mu TNM imayimira chotupa chachikulu ndipo imatanthauza kukula kwa chotupacho.
N ku TNM imayimira kutenga nawo mbali.
M M TNM amaimira metastase kapena kufalikira kwina.
Sikokwanira kwa khansa ya m'mphuno yamphongo kapena sinthana za paranasal kufalitsa m'magazi kapena kuchepetsa mphamvu ndi kufalikira ku malo ena akutali. Komabe, zotupazi zingathe kufalikira kumalo oyandikana nawo, ndipo ngati zimalowa mu ubongo, imfa imatha.
Tiyeni tione bwinobwino magawo osiyanasiyana a khansara ya mutu ndi khosi.
- Gawo 0 Khansa ndi carcinoma in situ ndipo ilipo pomwe idayambira. Ngati agwidwa oyambirira, Gawo 0 khansa nthawi zambiri imachiritsidwa.
- Gawo 1 khansara yayamba kufalikira mu mucosa, kapena kunja kwa nsalu zamphongo kapena uchimo, koma sichidutsamo fupa. Kuwonjezera pamenepo, palibe mankhwala opatsirana pogonana kapena metastases omwe alipo. Malingana ndi American Cancer Society pakati pa 1998 ndi 1999, chiwerengero cha zaka zisanu zapakati pa anthu omwe ali ndi ndondomeko yoyamba ya nasal ndi kansa ya paranasal sinus inali 63 peresenti.
- Gawo 2 khansara yalowa mu fupa. Komabe, khansa ya Stage 2 siinayambe kufalikira ku maselo a mitsempha kapena m'magazi akutali. Zomwe zimakhalapo kwa zaka zisanu za anthu omwe ali ndi ndondomeko ya ndondomeko yachiwiri ya mitsempha ndi khansa ya paranasal sinus ndi 61 peresenti.
- Gawo lachitatu khansara ikhoza kutanthauza chotupa chomwe chaphulika kukhala fupa ndi zina zowonongeka kwambiri ndipo chimagunda minofu. Zomwe zimakhalapo zaka zisanu zapakati pazitsamba 3 zamphongo ndi khansa ya paranasal sinus ndi 50 peresenti
- Khwerero 4 kansa ikhoza kutanthauza chotupa chomwe chafalikira kwambiri m'magulu oyandikana ndi ma lymph nodes komanso kuponyedwa ku metastases. Zomwe zimakhalapo zaka zisanu zapakati pazitsamba 4 zamphongo ndi khansa ya paranasal sinus ndi 35 peresenti.
Kawirikawiri mapiritsi a mutu ndi khosi - kuphatikizapo mthunzi wamphongo ndi zotupa za paranasal sinus - zimaphatikizapo mitsempha yam'mimba kapena kutaya mitsempha yayitali. Komabe, 20 mpaka 40 peresenti ya anthu omwe ali ndi khansa imeneyi ndipo samayankha kuchitidwa mankhwala ochiritsira.
Zindikirani, khansa ya maxillary sinus - mitundu yambiri ya misomali ndi khansa ya paranasal sinus - ali ndi ma stage enieni. Khansa ya khansa ya maxillas ikhoza kukhala chete kwa nthawi ndithu chifukwa maxillary sinus ndi yaikulu, ndipo zimatengera nthawi kuti khansara ikhoze kuchoka mu malo aakulu.
Kuphatikiza pa kupangidwanso, zotupa zimagwiritsidwanso ntchito, kapena kugawidwa mwachibadwa, pogwiritsira ntchito minofu ndi zitsanzo za selo. Matenda a m'munsi amasiyanitsa bwino kwambiri ndipo matenda oposa amasiyanitsa kapena osayanjanitsika. Matenda osadziwika amakhala ndi majekesi oopsa chifukwa amagawana ndi kufalikira mofulumira kusiyana ndi matenda osiyana bwino.
Chithandizo
Mankhwala a minofu ndi khansa ya paranasal sinus imadalira pa sitepe kapena kukula kwa khansa ndi matenda anu onse.
Mwachitsanzo, munthu wathanzi wodwala khansa ya Stage 1 akhoza kuchiritsidwa ndi opaleshoni yekha. Komabe, munthu amene ali ndi matenda apamwamba kwambiri angafunikire opaleshoni, chemo, ndi mankhwala odzola. Potsiriza, mwa anthu omwe ali ndi matenda apamwamba kwambiri omwe sangathe kuchiritsidwa, opaleshoni ikhoza kuchepetsa kukula kwa chifuwa ndi kupitiriza kupulumuka. Mwa kuyankhula kwina, kusamalira anthu omwe ali ndi matenda owopsya akhoza kukhala ochepa.
Nazi njira zina zothandizira anthu omwe ali ndi khansa iyi:
- opaleshoni
- chemotherapy
- chithandizo cha ma radiation
- mankhwala othandizira
- kusamalira bwino
Anthu omwe ali ndi matenda apamwamba angafunike mitundu yambiri ya akatswiri omwe ali pa bolodi kuti apereke mankhwala, monga ENT, neurosurgeon, odwala oncologist ndi radiation oncologist.
Ngati inu kapena wokondedwa wanu mukukayikira khansara ya minofu yamphongo kapena sinama ya paranasal, nkofunika kuti mupite kwa dokotala ndikukambirana za nkhawa zanu. Kumayambiriro kwa nthawi ya khansayi, pamene zizindikiro siziri zofunikira, dokotala wanu akhoza kusonyeza chiwerengero chochepa cha khansa yotereyi - makamaka chifukwa khansa ndizosowa.
Komabe, ngati muli ndi mbiri ya banja la khansara yotereyi, mwakhala mukukumana ndi zoopsa, mumakhala ndi zizindikiro monga mphuno kapena mphuno yomwe imachoka ngakhale zitatha mankhwala osokoneza bongo kapena akuwona kusintha kwa maonekedwe kapena mavuto ena omwe amasonyeza kuti chifuwa chikufalikira , nkofunika kuti muwone ENT kapena muwuze dokotala wanu wamkulu kuti mukufuna kuwona ENT.
Zotsatira
Fischman ML, Rugo HS. Khansa yapamwamba. Mu: LaDou J, Harrison RJ. eds. Kufufuza Koyamba ndi Kuchiza: Ntchito Yopangira Ntchito & Mazingira, 5e . New York, NY: Hill ya McGraw; 2013.
Mandpe AH. Chaputala 17. Paranasal Sinus Neoplasms. Mu: Lalwani AK. eds. Kufufuza Koyamba ndi Kuchiritsidwa mu Otolaryngology-Mutu ndi Kuchita Opaleshoni, 3e . New York, NY: Hill ya McGraw; 2012.