Medulloblastoma ndi mtundu wa khansa ya ubongo. Khansara ya ubongo ndi chotupa mu ubongo. Kawirikawiri, zotupa mu ubongo zingayambike mu ubongo, kapena zimachokera kumalo osiyana ndi kusokoneza (kufalikira) ku ubongo. Medulloblastoma ndi imodzi mwa ziphuphu za ubongo zomwe zimayambira mu ubongo, m'dera lotchedwa brainstem.
Zizindikiro
Pali zizindikiro zosiyanasiyana za medulloblastoma. Izi zikuphatikizapo:
- Mutu
- Chizungulire
- Kusalongosoka kolakwika ndi kugwirizana
- Kulimbitsa
- Kusuntha kwa diso kosadziwika
- Masomphenya obisika kapena masomphenya awiri
- Kufooka kwa nkhope kapena kutayika kwa nkhope kapena maso
- Kufooka kapena kupweteka kwa mbali imodzi ya thupi
- Kutaya chidziwitso
Zizindikiro za medulloblastoma zikhoza kuchitika chifukwa cha kuwonongeka kwa cerebellum kapena kuponderezedwa kwa ubongo, monga ubongo, kapena chifukwa cha hydrocephalus (kupitirira kwa madzi m'thupi).
Chiyambi
Medulloblastoma imayambira mu cerebellum, yomwe ili m'chigawo cha chigaza chomwe chimatchedwa posterior fossa. Dera ili siliphatikizapo cerebellum koma komanso ubongo.
Mphunoyi imayendetsa bwino ndikugwirizanitsa ndipo ili kumbuyo kwa ubongo. Ubongowu umaphatikizapo midbrain, pons, ndi medulla ndipo amalola kulankhulana pakati pa ubongo ndi thupi lonse komanso kuyang'anira ntchito zofunika monga kupuma, kumeza, kuthamanga kwa mtima ndi kuthamanga kwa magazi.
Pamene medulloblastoma ikukula mkati mwa cerebellum, ikhoza kupondereza pons ndi / kapena medulla kupangitsa zizindikiro zokhudzana ndi ubongo, kuphatikizapo masomphenya awiri, kufooka kwa nkhope, ndi kudzichepetsa. Mitsempha yoyandikana nayo imatha kupangidwanso ndi medulloblastoma.
Hydrocephalus
Madzi otentha omwe amachititsa kuti ubongo ukhale wovuta ndi imodzi mwa zomwe zimapangitsa medulloblastoma, ngakhale kuti onse omwe ali ndi medulloblastoma amapanga hydrocephalus.
Malo otchedwa posterior fossa, omwe ndi malo omwe ubongo ndi ubongo ulipo, amadyetsedwa ndi mtundu wamadzi wapadera wotchedwa CSF (cerebrospinal fluid), monga ubongo wonse. Madzi oterewa amayendayenda mu malo omwe amamanga ndi kuzungulira ubongo ndi msana. Muzochitika zachilendo, palibe zotchinga zilizonse mu malo awa.
Kawirikawiri, medulloblastoma imalepheretsa kutuluka kwa madzi m'thupi mwachangu, kumayambitsa madzi ambiri m'kati mwa ubongo. Izi zimatchedwa hydrocephalus. Hydrocephalus amachititsa ululu pamutu, zizindikiro za ubongo ndi zamatsenga. Kuwonongeka kwa ubongo kungapangitse kukhumudwa kosatha ndi kuthupi.
Kuchotsa madzi owonjezera nthawi zambiri kumafunika. Ngati madziwa akuyenera kuchotsedwa mobwerezabwereza, VP (ventriculoperitoneal) shunt ingafunike. VP shunt ndi chubu yomwe ingakhoze kuikidwa opaleshoni mu ubongo kuti ichepetse kuthamanga kwambiri kwa madzi.
Kudziwa
Matenda a medulloblastoma amadalira njira zingapo, zomwe zimagwiritsidwa ntchito pamodzi.
Ngakhale mutakhala ndi zizindikiro zomwe zimagwirizanitsidwa ndi medulloblastoma, ndizotheka kuti mulibe medulloblastoma - chifukwa ndi matenda osadziwika bwino.
Komabe, ngati muli ndi zizindikiro zilizonse za medulloblastoma, ndikofunikira kuti muwone dokotala wanu mwamsanga chifukwa chomwe chikhoza kukhala medulloblastoma kapena vuto lina lakumaganizo.
- Mbiri ndi kuunika kwa thupi: Dokotala wanu angakufunseni mafunso ofotokoza za madandaulo anu. Paulendo wanu wachipatala, dokotala wanu nayenso adzafufuza bwinobwino, komanso kufufuzidwa mwatsatanetsatane. Zotsatira za mbiri yanu ya zamankhwala ndi kuunika kwa thupi kungathandize kuthandizira ndondomeko yotsatira yomwe mungayang'anire vuto lanu.
- Kujambula kwa ubongo : Ngati mbiri yanu ndi thupi lanu likutsutsa medulloblastoma, dokotala wanu akhoza kuitanitsa kafukufuku wa ubongo, monga MRI ya ubongo. Ubongo wa MRI ungapereke chithunzi chabwino cha posterior fossa ya ubongo, komwe ndi kumene medulloblastoma ikuyamba kukula.
- Chiwopsezo: Chidziwitso ndi chodabwitsa kwambiri chokhudzana ndi kukula kapena chotupa pofuna cholinga choyang'ana minofu yomwe yachotsedwa pansi pa microscope. Zotsatira za biopsy zimagwiritsidwa ntchito kuti zithetse masitepe otsatirawa. Kawirikawiri, ngati mutapezeka kuti muli ndi chotupa chomwe chiri ndi matenda a medulloblastoma, mukhoza kuyesedwa kuti muchotseretu chotupacho, osati chifukwa chotsitsa. Chiwopsezo chimangotanthawuza kuchotsedwa kwa minofu yochepa. Kawirikawiri, ngati mungathe kuchitidwa opaleshoni, kuchotsedwa kwa chotupa chochuluka monga momwe zingathere kukulimbikitsidwa.
Zimene muyenera kuyembekezera
Medulloblastoma imaonedwa kuti ndi khansa yowopsya, yomwe imatanthawuza kuti imafalitsa. Kawirikawiri, medulloblastoma imafalikira mu ubongo ndi msana wonse, kuchititsa zizindikiro za ubongo. Kawirikawiri imafalikira kumadera ena a thupi kunja kwa dongosolo la manjenje.
Chithandizo
Pali njira zambiri zomwe zimagwiritsidwa ntchito pochiza medulloblastoma, ndipo zimagwiritsidwa ntchito pamodzi.
- Opaleshoni : Ngati inu kapena wokondedwa wanu muli medulloblastoma, kuchotsa kwathunthu kwa chotupacho kukulimbikitsidwa. Muyenera kukhala ndi mayesero ojambula ubongo ndi kuyesa kutsogolo musanathe opaleshoni.
- Chemotherapy : Chemotherapy ili ndi mankhwala amphamvu owononga maselo a kansa. Izi cholinga chake kuti athetse kapena kuthetsa chifuwa chachikulu monga momwe zingathere, kuphatikizapo malo a chotupa chomwe chikhoza kufalikira ku chotupa choyambirira. Pali mitundu yambiri ya mankhwala a chemotherapeutic, ndipo dokotala wanu adzakuyanjanitsani bwino kuti muwoneke pang'onopang'ono ndi chiwombankhanga, kukula kwa chotupa, kutalika kwake, ndi msinkhu wanu. Chemotherapy ikhoza kutengedwa pakamwa, IV (intravenously) kapena intrathecally (injected mwachangu dongosolo la mitsempha.)
- Mafunde : Mankhwalawa amagwiritsidwa ntchito pochiza khansa, kuphatikizapo medulloblastoma. Miyezi yowonongeka ikhoza kupita kumalo a chotupa kuti itithandize kuchepetsa kukula ndikupewa kubwereza.
Kuthamangitsani
Ndi mankhwala, kupulumuka kwa zaka zisanu kwa anthu omwe amapezeka ndi medulloblastoma kumasiyana malinga ndi zinthu zingapo kuphatikizapo:
- Zaka : Achinyamata osakwana zaka zoposa 1 ali ndi zaka makumi asanu ndi atatu (30%) omwe amakhalapo, pamene ana ali ndi zaka 60 mpaka 80 pazaka zisanu. Akuluakulu amakhala ndi pafupifupi 50 mpaka 60 peresenti kupulumuka zaka zisanu, ndipo achikulire ambiri akuchira bwino ndi kupulumuka kusiyana ndi akuluakulu.
- Kukula kwa chotupa : Zilonda zazing'ono zimagwirizanitsidwa ndi zotsatira zabwino kusiyana ndi zotupa zazikulu.
- Kupweteka kwa mimba: Kutupa komwe sikufalitsidwa kupitirira malo oyambirira kumagwirizana ndi zotsatira zabwino kuposa matenda omwe afalikira.
- Kaya chotupa chonsecho chikhoza kuchotsedwa pa opaleshoni: Ngati chotupa chonsecho chichotsedwa, pali mwayi wapang'ono wobwereza ndi mwayi wochuluka wopulumuka kusiyana ndi zomwe zikuwonedwa pakadalibe chotupa chotsalira chitatha pambuyo pa opaleshoni. Chifukwa chomwe chotupacho sichingachotsedwe kwathunthu ndi chakuti chikhoza kukhala chogwirizana kwambiri kapena chophatikizidwa ndi dera la ubongo lomwe liri lofunika kwambiri kuti lipulumutsidwe.
- Kuwopsa kwa chifuwa chochokera ku matenda (kuyang'aniridwa ndi microscope): Ngakhale kuti chiwerengero sichinali choyamba choyamba pamene medulloblastoma imachotsedwera, ikhoza kuyankhidwa ndi microscope kuti ipeze zofunikira, zomwe zingathandize kutsogolera chisankho ndi chemotherapy.
Mtundu wa Zaka ndi Zochitika
Medulloblastoma ndilo vuto lofala kwambiri la ubongo m'mabwana, komabe ilo silolendo, ngakhale kwa ana.
- Ana : Zomwe zimakhalapo zaka za zaka zisanu ndi zisanu ndi zisanu ndi ziwiri, koma zimatha kupezeka kwa ana ndi achinyamata. Kwachidziwikire, medulloblastoma imakhudzidwa ndi ana 4-6 miliyoni ku United States ndi Canada, ndipo ana pafupifupi 500 omwe amapezeka ndi medulloblastoma ku United States chaka chilichonse.
- Akuluakulu : Medulloblastoma ndi chotupa chochepa pakati pa anthu achikulire omwe ali ndi zaka zoposa 45, ndipo sichidziwika kwambiri pambuyo pake. Pafupifupi 1 peresenti ya zotupa za ubongo mwa anthu akuluakulu ndi medulloblastoma.
Genetics
Nthaŵi zambiri, medulloblastoma sichikugwirizana ndi zifukwa zilizonse zoopsa, kuphatikizapo majini. Komabe, pali mitundu yochepa yambiri yomwe imayambitsa matenda a medulloblastoma, kuphatikizapo matenda a Gorlin ndi matenda a Turcot.
Mawu Ochokera
Ngati inu kapena wokondedwa wanu mwapezeka kapena mukuchiritsidwa kuti mugwiritse ntchito medulloblastoma, zingakhale zovuta kwambiri. Zingasokonezenso ntchito zachizoloŵezi monga sukulu ndi ntchito. Ngati mukumva kupwetekedwa kwa chifuwa, muyenera kupeza chithandizo cha chotupa kachiwiri. Njira yochira ikhoza kutenga zaka zingapo ndipo nthawi zambiri imaphatikizapo mankhwala opangira thupi ndi ntchito.
Ana ambiri ndi akuluakulu amachira kuchokera ku medulloblastoma ndikupeza mwayi wokhala ndi moyo wabwino komanso wopindulitsa. Matenda a khansa amtundu wambiri akukula bwino, kupanga zotsatira zake bwino komanso mankhwala amalekerera.
> Zotsatira:
> Kramer K, Pandit-taskar N, Humm JL, et al. Phunziro lachiwiri la radioimmunotherapy ndi intraventricularI-3F8 ya medulloblastoma. Mankhwala a khansa ya magazi. 2018; 65 (1)
> Johnston DL, Keene D, Kostova M, ndi al. Chikoka cha medulloblastoma ku Canada ana. J Neurooncol. 2014; 120 (3): 575-9.
> Atalar B, Ozsahin M, Fuzani J, n. Al. Chithandizo cha mankhwala ndi zizindikiro zokhudzana ndi odwala akulu omwe ali ndi medulloblastoma: Zomwe zimachitikira Cancer Network (RCN). Onkolo Wotentha. 2018;