Zifukwa Zogwiritsira Ntchito ndi Zovuta Zotsatira za Corticosteroids ndi Khansa
Steroids amagwiritsidwa ntchito kwambiri kwa anthu omwe ali ndi khansa chifukwa cha zifukwa zambiri. Kodi ndendende ndi corticosteroids? Kodi amagwira ntchito yanji pa chithandizo cha khansa? Kodi ndi zina zotani zomwe zimakhalapo kwa nthawi yayitali, komanso zingakhudze bwanji maganizo anu?
Kodi Steroids (Corticosteroids) ndi chiyani?
Steroids ndi mankhwala omwe amapangidwa mthupi mwathu ndi mapuloteni a endocrine, omwe amathandiza kwambiri poyendetsa ntchito za thupi.
Ena mwa awa ndi awa:
- Kugwiritsa ntchito madzi ndi mchere wokhutira thupi
- Ulamuliro wa kutentha kwa thupi
- Kuteteza magazi
- Metabolism wa mafuta, chakudya, ndi mapuloteni
- Kulamulira "kupanikizika maganizo" kwa thupi
- Ulamuliro wa kutupa
- Kuyankha ku matenda
- Kupanikizika (onani m'munsimu)
Ndi Steroids Yotani Amene Amagwiritsidwa Ntchito M'kudwala Mankhwala a Khansa?
Tikamaganizira za wina amene amatenga steroids, nthawi zambiri timaganizira za othamanga osamva kapena olemera. Masewera olimbitsa thupi, monga omwe atchulidwa pamwambapa, amatchedwa anabolic steroids ndipo samakonda kugwiritsa ntchito khansa yosamalira.
Nthaŵi zambiri, steroids amagwiritsidwa ntchito kwa anthu omwe ali ndi khansa amatchedwa corticosteroids . Corticosteroids ndi mankhwala mwachibadwa opangidwa ndi adrenal glands, tizilombo toyambitsa matenda omwe amakhala pamwamba pa impso. Zitsanzo za mitundu iyi ya steroid ndi:
- Cortef (hydrocortisone)
- Deltasone (prednisone)
- Kutaya (prednisolone)
- Decadron (dexamethasone)
- Medrol (methylprednisolone)
Pogwiritsidwa ntchito kwa khansa, mankhwalawa amaperekedwa pamlomo kapena mujambulidwa mwakabisira (chifukwa cha zovuta zina iwo angakhale mbali yowonongeka, jekeseni m'magulu, kapena kupumidwa kudzera m'mphuno kapena m'mimba mwachangu).
(Corticosteroid converter ingagwiritsidwe ntchito poyerekeza mlingo wa imodzi mwa mankhwala awa kupita kwa wina.)
Chifukwa Chogwiritsa Ntchito Steroids mu Chithandizo cha Khansa
Steroids (corticosteroids) ingagwiritsidwe ntchito pa zifukwa zosiyanasiyana pa matenda a khansa. Izi zingakhale zosokoneza, ndipo nkofunika kufunsa wanu oncologist za cholinga chenicheni cha mankhwala omwe mwauzidwa.
Njira zotheka kugwiritsa ntchito corticosteroids ndi khansa ndizo:
- Pofuna kupewa kuthamangitsidwa kwa magazi kapena mankhwala - Steroids amagwiritsidwa ntchito nthawi zambiri (kuphatikizapo antihistamines ndi mankhwala ena) kuti athetse vutoli. Mankhwala enaake monga mankhwala a Taxol (paclitaxel) amachititsa kuti anthu asamaganize. Mankhwala othamangitsidwa ku rituximab , mtundu wa mankhwala omwe akugwiritsidwa ntchito omwe amagwiritsidwa ntchito ndi khansa yokhudzana ndi magazi ndi yofala kwambiri. Nthawi zambiri steroids amaperekedwa nthawi imodzimodzi monga mankhwalawa ngati njira yowonetsera.
- Pofuna kuthandizira kuchepetsa mankhwala osokoneza bongo komanso kusanza - Monga momwe zimayendera, steroid imagwiritsidwa ntchito limodzi ndi mankhwala ena kuti athetse kapena kusamalira nthenda.
- Kuwonjezera njala - Mu chikhalidwe chathu chodziletsa, nthawi zambiri timayang'ana kulemera kwa thupi ngati kuphatikiza. Komabe khansa ya kachesi -magulu a zizindikiro kuphatikizapo kutaya kwadzidzidzi ndi kuwonongeka kwa minofu-imayambitsa pafupifupi 20 peresenti ya imfa za khansa, zomwe zimachititsa kuti zikhale zovuta kuthetsa mavuto monga kusowa kwa njala kwa anthu omwe ali ndi khansa .
- Monga gawo la chemotherapy regimen.
- Kuchepetsa kutupa.
- Kuchiza ululu.
- Kuti muzitha kuchitapo kanthu khungu.
- Kuchepetsa mpweya wochepa mu khansa yapamwamba.
- Kuchepetsa kutupa pamene khansara imafalikira ku ubongo (ndi ubongo metastases ).
- Kuchepetsa kutupa m'mimba ya msana - Kupsyinjika kwa msana ndi vuto lomwe nthawi zambiri limawoneka ndi myeloma komanso khansa zina zomwe zafalikira mafupa (metastases).
- Kuchepetsa kupopera kwa vena cava (vuto la khansa).
- Pofuna kuthandizira kuchepetsa matumbo (monga vuto la khansa).
- Kuchiza matenda ophatikizidwa (GVHD) pambuyo pa kusinthitsa maselo .
Kumvetsa Cortisol ndi Kupanikizika Kwambiri
Pofuna kumvetsetsa momwe steroids angagwiritsire ntchito kwa anthu omwe ali ndi khansa, ndizothandiza kuganizira momwe steroids "zachirengedwe" zimagwirira ntchito m'thupi ndi kufunika kogwiritsira ntchito mankhwalawa monga momwe adayankhulira.
Pamene matupi athu alimbikitsidwa-kaya mwakuthupi kapena m'maganizo-chizindikiro chimatumizidwa ku gland, kachilombo kakang'ono ka ubongo mu ubongo. Mtundu wa pituitary umatulutsa hormone yotchedwa adrenocorticotropic hormone (ACTH). ACTH, imalangizanso zizindikiro za adrenal (zochepa zazing'ono za endocrine zomwe zimakhala pamwamba pa impso) kumasula cortisol, "steroid zachilengedwe."
Cortisol imakhala ndi mbali yofunika kwambiri yothetsera vutoli, mwa kusintha kutentha, kuyankha matenda, ndi ntchito zina zambiri. Kuchokera ku mphamvu ya kuthamanga kwa magazi mpaka ku shuga ya magazi.
Mankhwala opangidwa ndi mankhwala opangidwa ndi steroids amagwira ntchito ngati cortisol. Mankhwala amphamvuwa amagwiritsidwa ntchito kwambiri mu mankhwala ndipo ndizofunikira kwambiri pa chithandizo cha khansa zokhudzana ndi magazi, monga khansa ya m'magazi, lymphoma, ndi myeloma, komanso khansa yamphamvu.
Zotsatira Zotsatira za Steroid Ntchito
Zotsatira za steroid zimakhala zoipitsitsa pamene zimatengedwa pa mlingo waukulu komanso nthawi yaitali. Ngati mukuphunzira za zotsatira zake, mukhoza kupeza zosokoneza, chifukwa zotsatira zake zimakhala zosiyana kwambiri ndi zotsatira za mankhwalawa. Kumayambiriro kwa inu mukhoza kuzindikira mphamvu yowonjezera pa steroids, koma pa nthawi yayitali, mungaone zofooka.
Kumvetsetsa "malingaliro okhudzidwa" pakupanga mahomoni achilengedwe m'thupi kungathandize kufotokoza izi. Kudziwa "malingaliro a malingaliro" kungakuthandizeninso kumvetsetsa chifukwa chake simuyenera kusiya mankhwalawa mwamsanga kapena kuchepetsa mlingo wanu ngati mwakhala mukuwatenga kwa nthawi yaitali.
Poyambirira mukamamwa mankhwala awa, mumatha kuganiza mozama za mankhwala monga "kuwonjezera" thupi lanu la corticosteroids. Pakapita nthawi, thupi lanu likuzindikira kuti mukupeza ma corillosteroids omwe mukufunikira piritsi kapena mawonekedwe osakanikirana, ndipo thupi lanu limatumiza uthenga kuti asiye kupanga corticosteroids yanuyo. Ngati mankhwalawa akuwoneka mwadzidzidzi, sikuti mukupeza mankhwala okhaokha, koma zingatengere nthawi yambiri kuti thupi lanu lizindikire kuti likufunikira kupanga corticosteroids kachiwiri.
Zotsatira zazing'ono (zotsatira zoyipa zomwe zimachitika msanga kapena pamene steroid zimagwiritsidwa ntchito kwa kanthawi kochepa) zikuphatikizapo:
- Kugonana - Pali zifukwa zambiri zomwe zimayambitsa kugona ndi khansa, koma zomwe zimagwirizana ndi steroids, makamaka zomwe zimaperekedwa pa mankhwala a chemotherapy, zingakhale zovuta.
- Zomwe zimayambitsa matendawa - Kawirikawiri, ngakhale kuti steroid imagwiritsidwa ntchito molakwika, anthu ena amatha kusokonezeka ndi steroids .
- Delirium - Chisokonezo, ndi delirium zimachitika, makamaka pamene zikuphatikizapo mankhwala opweteka a narcotic mwa anthu omwe ali ndi khansa yapamwamba.
Zotsatira za nthawi yaitali za mankhwalawa ndizofala ndipo zingaphatikizepo:
- Kugonjetsa kwa thupi ndi matenda - Steroids yokha amatha kuteteza ku chitetezo cha mthupi chomwe, powonjezeredwa kupweteka kwa mafupa chifukwa cha khansa mumtambo kapena chemotherapy, ikhoza kukhala yamphamvu. Izi zikhoza kuonjezera chiwopsezo chanu chotenga kachilombo ka HIV kapena zimayambitsa matendawa.
- Phindu lolemera - Anthu amene amatenga steroids kwa nthawi yaitali amatsirizira ndi zomwe zimatchedwa "moon facies" zomwe mafuta owonjezera amamanga pambali pa nkhope.
- Kufooka (makamaka kulemera kwa minofu yofooka).
- Kusintha maganizo kapena kusintha maganizo (onani m'munsimu).
- Zilonda za m'mimba ndi gastritis - Nthawi zina anthu pa steroid amapatsidwa mankhwala ochiritsira kuti athe kuchepetsa zilonda zam'mimba.
- Kuthamanga kwa magazi.
- Kusokoneza tulo.
- Zowonjezera shuga wagazi (makamaka ngati mukudwala matenda a shuga) - Si zachilendo pamene mankhwala apamwamba a steroid amagwiritsidwa ntchito kuti munthu akhale "kwa kanthawi" akudwala matenda a shuga ndipo amafuna mankhwala a shuga (shuga ya steroid ).
- Osteoporosis (mafupa osweka) - Ngakhale kugwiritsidwa ntchito kwafupipafupi kwa steroids kungabweretse mitsempha yambiri ya mafupa, zomwe zingathe kuonjezera chiopsezo cha ziphuphu.
- Kutupa manja kapena mapazi chifukwa cha madzi ndi kusungidwa kwa mchere.
- Zozizira.
- Zikodzo.
Zotsatira zina zingakhale zabwino kapena zoipa malingana ndi matenda a munthu. Mwachitsanzo, kuwonjezeka kwa njala ndi kulemera kwa thupi kungakhale kopindulitsa kwa anthu ochepa kwambiri omwe ali ndi khansa.
Kutenga mankhwala anu ndi zakudya kungathandize pa mavuto ena omwe steroid angayambitse matenda anu. Mungasankhenso kutenga mitundu iyi ya mankhwala kumayambiriro kwa tsiku kuti asakhale ndi vuto la kugona usiku.
Mofanana ndi zotsatira zambiri za mankhwala, odwala, odwala, kapena madokotala amatha kukupatsani njira zothandizira kuwongolera kapena kuchepetsa. Onetsetsani kuti dokotala wanu adziwe ngati mukukumana ndi zizindikiro kapena zotsatira zake.
Zotsatira za Steroids pa Mood
Ngakhale kuti mwinamva mawu akuti "kukwiya koopsa," omwe amagwiritsidwa ntchito pofotokoza khalidwe laukali ndi kutuluka kwa anthu omwe amatenga anabolic steroids, nkofunika kudziwa kuti corticosteroids ikhoza kukhala ndi zotsatirapo pamtima.
Zotsatira za m'maganizo za corticosteroids zimatha kuchoka ku mkwiyo, kupuma, ndi kupsa mtima mpaka ku paranoia, chisokonezo, ndi mania. Mosiyana ndi zimenezi, si zachilendo kukhala ndi maganizo ochepa kapena ovutika maganizo mutasiya mankhwalawa.
Tsoka ilo, ndi zonse zomwe zikuchitika m'moyo wanu ndi khansara, zingakhale zovuta kudziwa momwe zimakhalira. Inde, muli pa steroids, koma mukupangidwanso matenda a khansa ndikuyesera kukhala ndi moyo wamba. Ndi zachilendo kuti mukumva zowawa zambiri mukamakumana ndi khansa .
Lamulo lachidziwitso ndi lakuti ngati maganizo anu akusintha amakhudza umoyo wanu kapena thanzi la ubale wanu, muyenera kulankhula ndi timu yanu ya oncology. Ngati malingaliro anu ndi ovuta, mungafunike kupeza thandizo mwamsanga.
Mfundo Zofunika Ponena za Kutenga Steroids
Mofanana ndi mankhwala ambiri ochiza khansa, nkofunika kutenga steroid monga adokotala akufotokozera. Nazi mafunso ena abwino omwe mungawafunse gulu lanu la thanzi la mankhwala anu asanayambe:
- Ndidzatenga nthawi yanji kumwa mankhwalawa?
- Ndi ndani amene ndingamuuze ngati ndikumva mankhwalawa?
- Bwanji ngati ndiphonya mlingo? (Osangotenga mlingo wambiri wa mankhwala).
- Bwanji ngati ndasanza mankhwala anga?
- Ndi zotsatira zotani zomwe mumakonda kuziwona ndi mankhwala enawa ndi nthawi yayitali komanso kugwiritsa ntchito nthawi yaitali?
Pewani Kuthamangitsidwa Kowonongeka kwa Steroids
Monga tanenera kale, kumwa mankhwala a steroid kumakhudza momwe thupi limapangidwira thupi. Pachifukwachi, pamene mankhwala anu asagwiritsidwe ntchito ngati mbali ya mankhwala anu, dokotala wanu nthawi zambiri amatha kupatsa mlingoyo m'malo mowasiya mwadzidzidzi. Ndikofunika kwambiri kuti musaleke kumwa mankhwalawa pokhapokha mutauzidwa ndi dokotala wanu. Nthawi zambiri, kuimitsa steroids mosavuta kungabweretse mavuto oopsa a moyo.
Ngakhale ngati mukutsatira ndandanda, dokotala wanu adziwe ngati zizindikiro zanu zikuvutitsa. Anthu ena amayenera kumwa mankhwalawa pang'onopang'ono kwa milungu ingapo kapena miyezi.
Zofunika pa Steroids mu Chithandizo cha Khansa
Steroids ndi masewera olimbitsa mtima omwe ali ndi khansa. Ngakhale mankhwala a chemotherapy, mankhwala opatsirana pogwiritsa ntchito mankhwala, komanso makamaka mankhwala atsopano ochiritsidwa ndi chithandizo cha immunotherapy amatamandidwa chifukwa cha khansa yowononga, steroid imagwira ntchito mwakachetechete, kuteteza ndi kuchepetsa mavuto komanso ngakhale kupanga mankhwala ena bwino. Ndicho chifukwa chake amathandiza kwambiri pochiza khansa zokhudzana ndi magazi ndi ziwalo zolimba.
Izi zinati, mankhwalawa ali ndi zotsatira zochepa komanso zazing'ono, zina zomwe zingakhale zovuta. Onetsetsani kuti mufunse mafunso ndikuyankhula za zizindikiro zirizonse zomwe mukukumana nazo, ngakhale kuti ndizo "zokha" zokha. Khalani wovomerezeka wanu mu chisamaliro chanu cha khansa .
Zotsatira
- Kasper, Dennis L .., Anthony S. Fauci, ndi Stephen L .. Hauser. Mfundo za Harrison za Mankhwala a M'kati. New York: Mc Graw Hill Education, 2015. Print.
- Leppert, W., ndi T. Buss. Ntchito ya Corticosteroids mu Chithandizo cha Mavuto Odwala Odwala Khansa. Zochitika Zamakono ndi Zolemba M'mutu . 2012. 16 (4): 307-13.
- Matsuo, N., Morita, T., Matsuda, Y. et al. Otsutsa a Mayankho ku Corticosteroids kwa Anorexia mu Matenda Apamwamba a Khansa: A Multicenter Akuyembekezera Observational Phunziro. Thandizo Lothandiza ku Khansa . 2017. 25 (1): 41-50.
- Matsuo, N., Morita, T., Matsuda, Y. et al. Otsatira a Deliriamu mu Corticosteroid-Odwala Ochiritsidwa ndi Khansa Yapamwamba: Zofufuza, Zopindulitsa, Zopindulitsa, Zophunzira. Journal of Medicine Palliative
- Mori, M., Shirado, A., Morita, T. et al. Zotsatila za Kuyankha kwa Corticosteroids kwa Dyspnea mu Matenda Apamwamba a Khansa: Choyamba Chodziwikiratu Cholinga Choyang'ana Phunziro. Thandizo Lothandiza ku Khansa . 2017. 25 (4): 1169-1181.