Matenda a manja pa nthawi ya chemotherapy
Matenda a manja (foot-foot syndrome) (HFS), omwe amadziwikanso kuti erythrodysesthesia wam'maluwa a kanjedza, ndi mankhwala a dermatological omwe amachititsa mankhwala enaake a mankhwala ndi mankhwala. Zimakhudza makamaka manja a m'manja ndi zidutswa za mapazi. HFS imapezeka pamene mankhwala ochepa amatha kutuluka kunja kwa ma capillaries ndipo amachititsa kuwonongeka kwa minofu. Anthu ambiri omwe ali ndi HFS amakhala ndi zotsatira zochepa, koma ena akhoza kuvutika kwambiri, kupanga zochitika za tsiku ndi tsiku sikungatheke.
Chemotherapy ndi Targeted Mankhwala Ochepetsa Mankhwala Omwe Angayambitse Mankhwala Othandiza
Matenda a miyendo yamagulu amayamba kugwirizanitsidwa ndi mankhwala a Xeloda (capecitabine) *. Mankhwala ena omwe amadziwika kuti amachititsa matenda a manja-mapazi ndi awa:
- 5-FU (fluorouracil) *
- Cytosar-U (cytarabine)
- Adriamycin (doxorubicin) - kupatsirana kosalekeza
- FUDR (floxuridine)
- Doxil (liposomal doxorubicin)
- Idamycin (idarubicin)
- Nexavar (Sorafenib)
- Sutent (Sunitinib)
Kumbukirani kuti si anthu onse omwe amatenga mankhwalawa a khansa omwe angapangitse matenda a miyendo.
* Kulephera kwa Dihydroprimidine dehydrogenase (DPD) - kukhala ndi mitundu yosiyanasiyana ya michere yambiri yamagetsi kuposa yachizolowezi - ndi wochimwa wamba wa HFS woopsa kwambiri omwe amapezeka ndi kugwiritsa ntchito mankhwalawa. Nthawi zambiri amatsatizana ndi kutsekula m'mimba. Pafupifupi anthu asanu aliwonse a ku America ali ndi vutoli. Kuyesera sikozoloŵera, koma dokotala wanu akhoza kuchita chotero ngati mukufuna kutenga imodzi mwa mankhwalawa.
Zizindikiro za Mankhwala Otsatira Manja
Zizindikiro zodziwika zomwe zimaphatikizapo matenda a miyendo ndi awa:
- Kusinkhasinkha kapena kutaya
- Kupsa
- Kufiira
- Kutupa
- Chifundo
Pa milandu yoopsa ya matenda a dzanja, phazi likhoza kuyamba kutentha kapena kukhala ndi zilonda kapena zilonda. Zowuma, khungu losakanika lomwe lingathe kapena silingathe kupezeka. Izi zingakhudze kwambiri khalidwe la munthu, makamaka kuthekera kwake kuyenda ndi kugwiritsa ntchito manja ake.
M'mayesero am'chipatala, pafupifupi 5% mpaka 10 peresenti ya anthu adakumana ndi zotsatirazi za matenda a manja.
Kuwonongeka kwa Mankhwala Osindikizira Manambala ndi Mapiri a Manja
Kutaya manotsi kumagwirizanitsa ndi kugwiritsa ntchito mankhwala osokoneza bongo omwe amachititsa matenda a miyendo . Izi zimakhala zosavuta kugwiritsidwa ntchito poyerekezera ndi kutalika kwa nthawi yomwe mankhwalawa amatengedwa. Kusungunuka ndi kusungunuka kwa khungu pa nthawi kungayambitse zolemba zala. Matenda a miyendo ya manja anandiuza kwambiri nkhani mu 2009 pamene munthu wina wa ku Singapore anamangidwa ku US Customs chifukwa chosakhala ndi zolemba zala. Chikhalidwe chake chinali chogwirizana ndi kutenga Xeloda (capecitabine) kwa zaka zitatu.
Kulepheretsa ndi Kusamalira Mankhwala a Pachimake
Kupewa ndikofunikira ndi HFS. Kutentha ndi kukangana ndi zinthu ziwiri zomwe zimapweteka kwambiri capillary kuvulala. Kwa mlungu umodzi mutapatsidwa mankhwala achinayi, kapena kwa nthawi yonse yomwe mukugwiritsa ntchito mankhwala osokoneza bongo, palinso zinthu zambiri zomwe mungachite kuti muteteze ndi kusamalira HFS:
Pewani Madzi Otentha - Kuwonetsa khungu kumadzi otentha kwa nthawi yaitali (kutengera kusamba ndi kusamba) Mwachitsanzo, kusamba m'manja, ndi kusangalala mumoto wotentha sikuvomerezedwa. Kutenga madzi ozizira bwino kapena ochepa amatha sabata imodzi mutatha kumwa mankhwala a IV kapena nthawi yomwe mumamwa mankhwala.
Magolovesi a mabulosi samapereka chitetezo - amawotcha manja. Dokotala wanu angalimbikitsenso kuti musatenge kapena kusamba maola 24 musanayambe kuchipatala.
Pewani Kuchita Zochita Zolimbitsa Thupi ndi Ntchito Yamanja - Kuchita zinthu zolimbitsa thupi zomwe zimayambitsa kupanikizika kwambiri ndi kupsinjika pamanja ndi mapazi, monga aerobics, kuyenda kwautali, kuthamanga, ndi kulemera (ngakhale ndi magolovesi), ziyenera kupeŵedwanso. Ntchito yamanja ngati munda ndi ntchito ya yard iyenera kupeŵedwanso.
Valani Zovala Zovala Zovala - Zovala zoyenera ndi nsapato zingayambitse kusokoneza, motero zimapangitsa kuti nyanjayi iwonjezeke. Valani nsapato zabwino zowonongeka.
Musayende mu mapazi opanda kanthu; Masokiti a thonje kapena zofewa zabwino ndi zabwino.
Musamang'ambe mphete - Kuti musamathetse mkangano, pewani kuvala mphete pa zala zanu. Mapuloto omwe sanachotsedwe, monga mphete za ukwati, akhoza kukhala magwero a mabakiteriya. Mabakiteriya akhoza kugwedezeka pakati pa mphete ndi chala. Kupewa kuteteza ndi kuteteza ndi kofunika kwambiri ndi HFS chifukwa cha kukhudzidwa kwa khungu.
Sungani Manja ndi Mapazi Kokongola - Tsiku lonse, gwiritsani ntchito madzi oundana kapena ozizira kumangiriza manja ndi mapazi. Kuwawaza m'madzi kangapo patsiku kumathandizanso.
Gwiritsani Ntchito Zam'madzi - Zam'madzi ndizozitsulo zokhazokha zomwe zimapangitsa khungu louma, losweka, ndi lopsa mtima. Madokotala ambiri amalimbikitsa zinthu zamakono monga Aveeno ndi lanolin, Lubriderm, Udder Cream, Bag Balm, ndi Aquaphor. Mungagwiritse ntchito maola ambiri patsiku, koma onetsetsani kuti musakanize khungu ndi kuthamanga kwakukulu. Kuvala masokosi ndi magolovesi atatha kugwiritsa ntchito kumathandiza kusunga chinyezi.
Khalani Osungunuka bwino - Kutaya madzi m'thupi ndi chifukwa cha khungu louma, choncho ndikofunika kuti musunge madzi ambiri. Caffeine ndi chifukwa chodziwikiratu cha kuchepa kwa madzi m'thupi ndipo ayenera kupeŵa.
Mmene Dokotala Wanu Angagwiritsire Ntchito Mankhwala Othandiza Amanja
Matenda ochepa a HFS sangapange thandizo lachipatala, kuyang'anitsitsa mosamala ndi inu ndi namwino wanu ndi dokotala. Ngati mutayamba kuzindikira zizindikiro za HFS, funsani namwino kapena adokotala anu oncology . Ngati mukuvutika ndi HFS ndikuwona kuti chikuipiraipira, nkofunika kuti mutchule dokotala wanu nthawi yomweyo.
Matenda osapitirira mpaka aakulu a matenda a dzanja-foot omwe amalepheretsa ntchito za tsiku ndi tsiku amawonedwa kuti ndi vuto lalikulu la chithandizo, ndipo amachiritsidwa. Kupewera mankhwala kapena kuchepetsa mlingo kungakhale kofunikira. Mankhwala opweteka a OTC monga ibuprofen angalimbikitsidwe kuti athetse ululu. Mlomo kapena zam'mimba corticosteroids zingathandize ena ndi kutupa. Celebrex (celecoxib) yosakanizidwa ndi mankhwala osagwiritsidwa ntchito poyesa mankhwala osokoneza bongo imawoneka kuti ikugwira bwino ntchito pogwiritsa ntchito kafukufuku wa maphunziro.
Mavitamini apamwamba a vitamini B6 nthawi zambiri amalimbikitsidwa kwa anthu omwe angathe kukhala ndi HFS kapena akuvutika nazo kale. Othandiza anthu ambiri kumaphatikizapo kugwiritsira ntchito nthawi yayitali 50 mpaka 150 mg ya B6, yomwe ndi yayikulu kwambiri kuposa ndondomeko ya tsiku ndi tsiku. Kufufuza kwa meta 2015 - kupenda kafukufuku wofalitsidwa mpaka lero - sanathe kupeza kuti vitamini B6 kwenikweni yathandizira ndi matenda a manja, koma anthu sali owerengeka ndipo mwina anthu ena ali ndi kusintha kwa zizindikiro. Nthawi zonse funsani dokotala wanu asanayambe kumwa vitamini B6 kwa HFS. Mavitamini ena amchere amatha kuchepetsa mphamvu ya mankhwala a chemotherapy .
Maphunziro ambiri akuchitidwa za kupewa ndi kusamalira matenda a manja. Udindo wamagawo a nicotine, henna, ndi vitamini E ndi zina mwa zinthu zambiri zomwe zimaphunziridwa pofuna kuthandizidwa kwa HFS.
Zotsatira:
Hoesly, F., Baker, S., Gunawardane, N., ndi J. Cotliar. Matenda opangidwa ndi manja a Capecitabine ovuta kwambiri chifukwa cha pseudomonal superinfection yomwe imayambitsa matenda a bakiteriya ndi imfa. Archives of Dermatology . 2011. 147 (12): 1418-23.
Jo, S., Shin, H., Jo, S. ndi al. Mankhwala othandizira odwala matenda a pyridoxine othandizira pa matenda a manja pa nthawi ya chemotherapy: meta-analysis. Dermatology Yachipatala . 2015. 40 (3): 260-70.
Makedo, L., Lima, J., dos Santos, L., ndi A. Sasse. Njira zothandizira matenda opatsirana pogwiritsira ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala omwe amachititsa kuti munthu asatengedwe. Thandizo Lothandiza ku Khansa . 2014. 22 (6): 1585-93.
McLellan, B., Ciardiello, F., Lacouture, M. et al. Regorafenib-yogwirizanitsa ndi manja a mapazi a m'mapazi: malangizo othandiza pa matenda, kupewera, ndi kasamalidwe. Annals of Oncology . 2015. 26 (10: 2017-26.