Kumvetsetsa Zizindikiro ndi Zowopsa
Khansara ya Larynge ndi mtundu wa khansara umene umakhudza khungu, limba lomwe timadziwa kuti ndilo bokosi la mawu. Anthu pafupifupi 13,000 a ku America amapezeka kuti ali ndi khansa yapakhungu chaka chilichonse, ndipo pafupifupi 3,500 amafa ndi matendawa.
Anatomy
Mphunoyi imakhala ndi zingwe zamagulu ndipo imagawidwa m'magulu atatu:
- glottis, mawu owona amamveka, pafupi ndi 60 peresenti ya khansa
- supraglotis, yomwe ili pamwamba pa glottis, kumene 35 peresenti ya khansa imapezeka
- subglottis, yomwe ili pafupi ndi glottis
Malo a chotupa akhoza kupanga zizindikiro zosiyana ndikusowa njira zosiyana zothandizira.
Zowopsa
Ngakhale sitikudziŵa chifukwa chenicheni cha khansa yowopsa, timadziwa zomwe zimawopsa kwambiri. Khansara ya Larynge ndi imodzi mwa mitundu yambiri ya khansa yokhudzana ndi kusuta .
Ngakhale izo zikhoza kuchitika mwa osasuta, umboni ukuika kwambiri ndudu kukhala chinthu chimodzi, chowopsa kwambiri pa matenda. Kusuta ndi kumwa mowa kwambiri kumapangitsa kuti pakhale ngozi.
Zina mwa zifukwa zina zofunika:
- okalamba (45 ndi pamwamba)
- Amuna (chifukwa cha magawo apamwamba a kusuta mwa amuna)
- mbiri ya khansara yamutu ndi ya khosi (kuphatikizapo kuyang'ana kumutu kapena kumutu kwa miyendo)
- kumwa mowa kwambiri
- ntchito yokhudzana ndi asibesitosi, malasha, kapena formaldehyde
- zakudya zamakono komanso / kapena nyama
- zobadwa ndi mbiri ya banja
- kuteteza thupi, kuphatikizapo anthu omwe ali ndi kachilombo ka HIV
- mpikisano (ndi anthu ambiri a ku America akupeza khansara yambiri kuposa azungu)
GERD, HPV, ndi Laryngeal Cancer ngozi
Kafukufuku wina wathandizira khansa yambiri ya m'mimba ndi matenda a m'mimba (GERD) . Ngakhale kuti mgwirizanowu ukupitirirabe kukhala wotsutsana, ngakhale American Cancer Society yathawa kuti pakhale zotsatira za chikhalire cha asidi chosaganizira pa khansa ya laryat.
Mofananamo, papillomavirus ya munthu (HPV) , kachilombo kamene kamagwirizanitsidwa ndi 95 peresenti ya khansa ya pachibelekero, ikhoza kuonjezeranso chiopsezo cha khansa yowopsa. Ngakhale magulu ena akuwona kuti chiwopsezo chili chochepa, kafukufuku wina wasonyeza kuti 25 peresenti ya matenda opatsirana a HPV omwe ali ndi kachilombo ka HIV (kuphatikizapo HPV zapakati pa 16 ndi 18).
Zizindikiro
Chimodzi mwa zizindikiro zofala kwambiri za khansara yowonongeka ndi mawu osasunthika a mawu . Kuwopsya komwe sikupita pambuyo pa masabata awiri ayenera kuuzidwa kwa dokotala wanu. Ngakhale vutoli likhoza kuyambitsidwa ndi chirichonse kuchokera ku zowawa za nyengo mpaka ku laryngitis, kulimbikira kwa mantha kumakhala kofunika nthawi zonse kulikonse komwe kumayambitsa.
Zizindikiro zina zingaphatikizepo:
- vuto lomeza (dysphagia)
- ululu kapena kuyaka pamene akumeza
- kumverera kwa chakudya kumakanizika mmero pako
- chifuwa chosasunthika chosagwirizana ndi chimfine kapena chiwopsezo ndipo chimatha milungu yoposa eyiti
- mtanda pa khosi pozungulira bokosi la mawu
- chikhure
- makutu
- kumangodya chakudya
- mpweya woipa wopitirira (halitosis)
- Kuwonongeka kwadzidzidzi kwaposa asanu pa zana mkati mwa miyezi 12
Kukula kwa chilakolako ndi malo ndizo zikuluzikulu pakuzindikiritsa zizindikiro zomwe munthu angakhale nacho. Ngati chotupa chimayamba mu zingwe za mawu, kusintha kwa mawu ndi mantha kumakhala kofala.
Pamene zotupa zimakhala pamwamba kapena pansi pa zingwe zamagulu, zizindikiro zosiyana monga vuto la khutu kapena kupuma zingathe kuchitika.
Kudziwa
Khansara ya Larynge imapezeka poyesa kuyeza thupi kuti imveke ndi zisolo kapena zopweteka pamtima. Kuti adziyang'ane bwino, adokotala angapangitse kuti asamayang'ane kapena akuwongolera mwachindunji:
- An Kujambula kwachinsinsi kophatikizirapo kumaphatikizapo chida cholumikizidwa nthawi yayitali ndi galasi yomwe imayikidwa mkamwa mwako kuti muyang'ane mwachindunji phokoso lanu.
- Pogwiritsa ntchito mankhwala osokoneza bongo, utsi umagwiritsidwa ntchito kuti ugwedeze pamtima, kenako umatha kudyetsa mkati kuti uwone bwino kumbuyo kwa khosi, makola, ndi zingwe. Chitsanzo chamatope (biopsy) chingatengedwe ngati chiri chonse chokayikira chikupezeka.
Njira zina zofufuzira zimaphatikizapo kujambula kwa maginito (MRI), computerize tomography (CT scan), X-ray barium swallow, kapena positron emission tomography (PET kufufuza).
Kusinthana
Ngati khansa imapezeka, dokotala wanu adzalinga kukula ndi kukula kwake kwa khansara. Iyi ndi njira yotchedwa staging. Gawo la kansa ya larynge lidzakuthandizani kudziwa momwe chithandizocho chiliri choyenera kwambiri kwa inu nokha.
Madokotala amachita izi poyamba kugwiritsa ntchito njira ya TNM. M'dongosolo lino:
- T imaimira chotupa ndipo imayimira kukula kwa chotupa chanu chochokera ku T1 (kumakhudza gawo laling'ono la larynx) kufika ku T4 (kufalikira kupyola pa larynx).
- N imaimira nthendayi ndipo imaimira kuchuluka kwa khansa m'matumbo anu kuyambira ku N0 (palibe khansara) ku N3 (kufalikira kupyola minofu).
- M imayimira metastasis ndipo imaimira momwe khansara yafalikira ( kuchepetsedwa) ku ziwalo zakutali zochokera M0 (palibe metastasis) mpaka M1 (metastasis).
Malinga ndi kafukufukuyu, khansara yanu idzaperekedwe siteji:
- Gawo 0 (kapena carcinoma in situ ) ndi khansa akuganiza kuti sizowonongeka.
- Gawo I ndi khansa ili pambali imodzi ya thupi.
- Gawo lachiwiri ndi khansa yomwe ili mderalo koma ikupita patsogolo.
- Gawo lachitatu ndi khansa yomwe ili ndi malo apamwamba komanso apamwamba koma amalingalira kwambiri.
- Gawo lachinayi ndi khansa zomwe zasintha.
Chithandizo
Mankhwala opanga opaleshoni ndi ma radiation ndi njira zochiritsira zothandizira khansa yapakhungu. Izi zikuphatikizapo njira zotsatirazi:
- kuchuluka kwa mankhwala osokoneza bongo, kuchotsa opaleshoni yonse ya larynx (zomwe zingamusiye munthuyo kuti asalankhule popanda chipangizo chopangira makina)
- kupweteka kwapadera komwe kumatanthawuza kuchotsedwa kwa malo okhudzidwa ndi larynx
- Mphuno yotchedwa laryngectomy yomwe imaphatikizapo kuchotsa opaleshoni ya larynx pansi pa zingwe za mawu
- cordectomy yokhudza kuchotsa opaleshoni imodzi kapena onse awiri
Njira zina ndizo:
- Thandizo la ma radiation limaperekedwa ngati mankhwala oyambirira kapena amagwiritsidwa ntchito pambuyo pochita opaleshoni kuti athetse maselo otsala a khansa
- Mitsempha yotchedwa lymph node dissection yokhudza opaleshoni yotulutsa opaleshoni pafupi ndi malo a malignancy
- mankhwala a chemotherapy omwe amagwiritsidwa ntchito monga mankhwala a neoadjuvant (kuti asweke chotupa pamaso pa opaleshoni) kapena mankhwala adjuvant (kuti athetse maselo otsala a khansa pambuyo pa opaleshoni)
Zotsatira zingasinthe munthu ndi munthu. Chidziwitso chachikulu ndi chakuti poyamba mumapezeka ndi kuchiritsidwa, mwayi wochuluka mukhala nawo. Matenda oyambirira ali ndi magawo 1, 2, ndi 3 khansa.
Mawu Ochokera
Kupezeka ndi matenda a khansa kungachititse kuti moyo wanu usasokonezeke ngakhale m'zaka zapakati pa matendawa. Funsani thandizo, ndipo lolani anthu kuti akuthandizeni. Yesetsani kwa ena. Ganizirani kulowetsa gulu lothandizira khansa kaya pagulu lapafupi kapena pa intaneti.
Mankhwala akusintha mofulumira ndipo kukhala woimira wanu kumangokuthandizani kuti muzimva bwino, kungakuthandizeni kupanga zisankho zabwino za thanzi lanu. Izi zikuphatikizapo mitundu yamankhwala omwe mumasankha.
Kusankha ngati kuchitidwa opaleshoni - kapena ngakhale kukula kwa opaleshoni yanu - ndi kusankha nokha. Mtengo wa moyo ukhoza kukhudzidwa, choncho ndi bwino kupatula nthaŵi yambiri ndikuphunzira za matenda anu ndi zomwe zimafunika kuchiza. Chinthu chofunika kwambiri ndi kusankha mwanzeru kuchokera kumvetsetsa bwino zomwe mungachite.
Zotsatira
- Blanchard, P., Volk, R., Ringash, J., Peterson, S., Hutcheson, K., ndi S. Frank. "Kuyeza Mutu ndi Khansa Yamphasa Zosangalatsa ndi Zoyembekeza Zoleza Mtima: Kukonzekera Kwambiri." Oncology Yamlomo . 2016. 62: 44-53.
- National Cancer Institute. "PDQ Cancer Information Summarie s." Laryngeal Cancer Treatment (PDQ): Health Professional Version. Bethesda, Maryland: 2002 (yasinthidwa December 2016).
- Salvador-Coloma, C., ndi Cohen, E. "Chisamaliro cha mitundu yambiri ya khansa ya Laryngeal." Journal of Practice Oncology . 2016; 12 (8): 717-24.