Oncological pathologies nyob hauv ib qho ntawm thawj qhov chaw hais txog cov neeg tuag thoob ntiaj teb. Hmoov tsis zoo, qhov tshwm sim ntawm mob qog noj ntshav tsis yog txo qis, tab sis tsuas yog nce ntxiv. Cov kws tshawb fawb tab tom sim nrhiav txoj hauv kev los kho cov kab mob oncological uas yuav daws tau tus kab mob tag nrho. Txog niaj hnub no, 3 txoj hauv kev tiv thaiv kab mob qog noj ntshav tau ua tiav: kev phais, kws khomob thiab kev kho hluav taws xob. Tag nrho cov ntawm lawv yog tsom rau tshem tawm cov qog nws tus kheej thiab txo qhov kev pheej hmoo ntawm kev rov tshwm sim. Adjuvant thiab neoadjuvant chemotherapy yog siv los nres kev loj hlob ntawm cov hlwb txawv txav. Cov txheej txheem no yog siv ob qho tib si raws li kev kho mob nyuaj thiab ntawm nws tus kheej (rau qee cov kab mob oncological).
Adjuvant chemotherapy - txhais li cas?
Tshuaj khomob yog ib txoj kev kho mob ntawm kev kho mob. Rau nws txoj kev siv, cov tshuaj cytostatic yog siv los tua cov qog hlwb. Cov neeg mob feem ntau nug cov lus nug: adjuvant chemotherapy - yog dab tsi? Lo lus no qhia txog kev coj ua ntawm kev kho mob tom qab phais. Raws li qhov noadjuvant chemotherapy yog ib qho kev ntsuas tsim nyog kom tsis txhob muaj mob qog noj ntshav ntxiv. Hom kev kho no yog siv rau yuav luag tag nrho cov qog. Nws yog siv rau mob qog noj ntshav ntawm lub ntsws, lub mis, plab, hnyuv thiab lwm yam kabmob. Chemotherapy yog muab ua ntej thiab tom qab phais. Rau qee hom mob qog noj ntshav (Hodgkin tus kab mob, qog liab ntawm daim di ncauj, tawv nqaij), nws tsuas yog kho.
Ntau hom tshuaj khomob
Txhua cov tshuaj khomob tau muab cais ua cytostatics. Lawv qhov kev txiav txim yog tsom mus rau qhov tsis muaj kev tuag ntawm cov qog cell. Qhov no yog ua nyob rau hauv ntau txoj kev. Feem ntau, cov tshuaj cuam tshuam nrog cell DNA synthesis. Yog li ntawd, nws poob lub peev xwm los faib. Kev ua txhaum ntawm kev sib txuas lossis kev ua haujlwm ntawm DNA yog ua los ntawm embedding nyob rau hauv cov saw, tawg bonds ntawm nucleotides.
Tshuaj khomob muaj cov qauv sib txawv. Ib txhia ntawm lawv yog cov nroj tsuag (tshuaj "Vincristine"), lwm tus yog cais raws li alkylating agents (txoj kev los yog ntsiav tshuaj "Cyclophosphamide"). Tsis tas li ntawd, cov pab pawg kws kho mob muaj xws li tshuaj tua kab mob tshwj xeeb, anthracyclines thiab platinum npaj. Cov neeg sawv cev ntawm cov pab pawg no yog cov tshuaj "Rubomycin", "Adriamycin". Adjuvant chemotherapy yog muab los ntawm kev tso dej tso rau hauv. Cov tshuaj pleev thiab cov ntsiav tshuaj cov ntaub ntawv suav hais tias tsis tshua muaj txiaj ntsig, yog li lawv siv tsis tshua muaj. Hauv qee kis, cov tshuaj tau muab tshuaj intraperitoneally, uas yog, rau hauvplab kab noj hniav. Qee zaum kev nkag mus rau hauv cov hlab ntsha yog siv rau kev txhaj tshuaj.
tshuaj kho mob ua dab tsi?
Zoo li lwm yam kev kho mob, cov tshuaj kho mob ntxiv muaj qee yam qhia. Ua ntej pib kho nrog cov tshuaj cytostatic, nws yog ib qho tsim nyog yuav tsum ua kom tiav kev kuaj mob ntawm tus neeg mob. Tom qab ntawd, tus kws kho mob soj ntsuam tag nrho cov kev pheej hmoo thiab txiav txim siab txog kev kho mob. Cov lus qhia hauv qab no rau kev kho mob nrog cytostatics yog qhov txawv:
- Cov qog ntawm lub hematopoietic system (leukemia). Nrog rau hom mob qog noj ntshav no, kev kho tshuaj khomob yog tib txoj hauv kev los daws cov hlwb atypical.
- Cov qog nqaij hlav - rhabdomyosarcoma.
- Chorioncarcinoma.
- Wilms thiab Burkitt qog.
- Malignant neoplasms ntawm lub mis, uterus thiab appendages, digestive ib ntsuj av, genitourinary system, ntsws, thiab lwm yam. Nyob rau hauv cov ntaub ntawv no, adjuvant chemotherapy yog ib tug ntxiv txoj kev kho. Nws yog ua tom qab tshem tawm cov qog.
- Nrog mob qog noj ntshav tsis ua haujlwm. Qee zaum, kev kho mob nrog cov tshuaj cytostatic tuaj yeem txo qhov loj ntawm cov qog. Qhov no yog qhov tsim nyog rau kev kho mob phais (piv txwv li, mob qog noj ntshav ntawm zes qe menyuam). Tsis tas li ntawd, txoj kev no tuaj yeem siv txhawm rau txhawm rau txo qhov ntsuas ntawm kev phais (rau cov qog mis). Nyob rau hauv cov ntaub ntawv no, neoadjuvant chemotherapy yog siv.
- Kev kho mob tsis zoo. Nrog rau cov hom mob qog noj ntshav siab, cov tshuaj khomob yog siv los txo tus neeg mob tus mob. Feem ntau nws yog siv rau cov menyuam yaus. Nws kuj tseem siv tau los ua kev kho mob palliative rau mob qog noj ntshav, hlwb lossis caj dab.
Tshuaj khomob
Raws li koj paub, tshuaj khomob tsis yog ib txwm yooj yim zam los ntawm cov neeg mob. Feem ntau, cov neeg mob muaj ntau yam kev phiv tshwm sim uas tshwm sim los ntawm kev qhia txog cov tshuaj cytostatic. Qee tus neeg mob tsis kam kho.
Adjuvant chemotherapy yog muab rau hauv cov voj voog. Lub sijhawm kho yog los ntawm 3 mus rau 6 lub hlis (qee zaum ntau dua). Kev xaiv ntawm chav kawm yog txiav txim los ntawm tus kws kho mob, coj mus rau hauv tus account tus neeg mob tus mob. Feem ntau, txog 6-7 chav kawm ntawm kws khomob yog nqa tawm hauv rau lub hlis. Nws ntseeg tau tias ntau zaus tus neeg mob tau txais kev kho mob, qhov txiaj ntsig zoo dua. Piv txwv li, ib chav kawm ntawm cov kws khomob tuaj yeem siv sijhawm 3 hnub txhua 2-4 lub lis piam. Thaum lub sijhawm kho, nws yuav tsum ua tib zoo saib xyuas tus neeg mob tus mob. Tsis tas li ntawd, cov ntshav suav nrog hauv kev so ntawm cov chav kawm.
Contraindications rau kev kho mob chemotherapy
Txawm tias muaj txiaj ntsig ntawm kev kho mob nrog cov neeg ua haujlwm cytostatic, lawv tsis tau sau ib txwm. Txhua tus kws kho mob paub tias kev siv tshuaj kho mob adjuvant tsis yog tsuas yog cov txheej txheem qog nqaij hlav xwb, tab sis kuj muaj cov hlwb noj qab haus huv. Hauv particular, qhov no siv rau leukocytes. Qee cov tshuaj muaj kev phom sij rau cov hlab plawv thiab lub ntsws. Mob raum thiab kab mob siab yog suav tias yog contraindications rau chemotherapy. Qhov no yog vim qhov tseeb tias qhov kev pheej hmoo ntawm kev tsim tsis txaus ntawm cov kabmob no loj heev. Tsis tas li ntawd, chemotherapy yuav tsum tsis txhob muab rau cov neeg mobkeeb kwm ntawm calculous cholecystitis (gallstones). Contraindications rau kev kho nrog tshuaj cytostatic yog hloov pauv hauv kev kuaj ntshav dav dav. Tshwj xeeb tsis tau tsim nyob rau hauv uas kev kho mob yog tsis yooj yim sua. Cov no suav nrog: platelet suav tsawg dua 10010⁹, txo qis hauv hematocrit thiab hemoglobin. Nws tseem tsis tuaj yeem ua cov tshuaj khomob rau cov neeg mob uas muaj mob asthenia hnyav. Ib lub cev hnyav ntawm 40 kg lossis ntau dua yog suav tias tsim nyog rau kev kho mob.
Kev mob tshwm sim ntawm cov tshuaj kws khomob
Qhov hnyav ntawm kev kho mob chemotherapy yog nyob rau hauv nws cov kev mob tshwm sim. Ntxiv nrog rau qhov tshwm sim sab nraud ntawm qhov tsis zoo ntawm cov tshuaj, muaj kev hloov pauv hauv kev tshuaj ntsuam. Qhov tshwm sim tseem ceeb yog kev tawm tsam ntawm hematopoietic system. Qhov no feem ntau cuam tshuam cov kab mob leukocyte. Raws li qhov tshwm sim ntawm kev puas tsuaj rau cov qe ntshav dawb, lub cev tiv thaiv kab mob raug kev txom nyem. Qhov no yog tshwm sim los ntawm kev tsis muaj zog, qhov sib ntxiv ntawm ntau yam kab mob. Lwm qhov tshwm sim yog cov teebmeem neurotoxic ntawm cov tshuaj. Qee cov neeg mob muaj kev nyuaj siab, kua muag, pw tsaug zog. Cov neeg mob kuj qhia xeev siab, ntuav, thiab raws plab. Cov kev mob tshwm sim ntawm cov tshuaj cytostatic kuj cuam tshuam rau cov tsos mob ntawm tus neeg mob. Ntawm kev kuaj xyuas, muaj alopecia (cov plaub hau poob) thiab pallor ntawm daim tawv nqaij.
Gastric Cancer: Tshuaj Khomob
cov txheej txheem Oncological hauv plab feem ntau pom. Lawv feem ntau tsim los ntawm polyposis lossis peptic ulcer. Mainmanifestations ntawm plab mob cancer yog mob nyob rau hauv lub epigastric cheeb tsam, aversion rau nqaij cov zaub mov, belching. Hauv thawj theem ntawm cov txheej txheem oncological, kev kho phais yog tsim nyog. Nws muaj nyob rau hauv resection ntawm lub cev thiab tsim ib qho anastomosis ntawm txoj hlab pas thiab txoj hnyuv. Adjuvant chemotherapy rau gastric mob cancer yog ua nyob rau hauv tsis muaj contraindications. Nws tso cai rau koj kom ncua lub sij hawm ntawm kev zam txim, thiab tseem slows down lub metastasis ntawm cov qog. Hmoov tsis zoo, cov tshuaj cytotoxic tsis zoo rau txhua hom mob qog noj ntshav. Nws cov txiaj ntsig zoo ntawm adenocarcinoma tau raug pov thawj. Nws kuj tau ua raws li kev ntsuas ntawm kev kho mob palliative.
Kev Kho Mob Kho Mob rau Mob Cancer
Kev kho tshuaj khomob ntxiv rau kev mob qog noj ntshav mis yog qhov tsim nyog rau txhua hom histological ntawm cov txheej txheem oncological. Nws tau ua tom qab kev phais mob, tsis hais qhov twg ntawm kev phais mob (mastectomy lossis sectoral mis resection). Qhov no yog qhov tsim nyog kom tsis txhob muaj cov kab mob metastasis ntawm cov hlwb atypical rau cov qog nqaij hlav thiab cov kabmob nyob deb. Muaj tsawg zaus, chemotherapy tsis yog yuav tsum tau kho mob cancer mis. Piv txwv li, yog tias cov qog loj dua 1 cm loj thiab tsis kis mus rau cov qog nqaij hlav. Nws kuj yuav tsum tau siv nrog ceev faj hauv cov neeg mob hluas. Thaum lub sij hawm premenopausal, kev kho mob nrog tshuaj cytostatic yog nqa tawm rau txhua tus neeg mob, tshwj tsis yog cov neeg uas muaj contraindications.
Puas yog cov kws khomob khomob muaj nyob rau ciam teb cystadenoma?
NtauCov poj niam paub txog qhov kev kuaj mob xws li cyst (cystadenoma) ntawm zes qe menyuam. Feem ntau, qhov tsim yog benign thiab tsis tshua hloov mus rau hauv cov txheej txheem qog nqaij hlav. Txawm li cas los xij, muaj qee hom cystadenomas uas ua rau mob malignancy. Cov no suav nrog cov qog nqaij hlav serous thiab papillary ciam teb. Cov tsos mob ntawm cov kev tsim no tuaj yeem yog mob hauv plab plab, kev coj khaub ncaws tsis xwm yeem. Lawv raug kuaj los ntawm ultrasound ntawm lub plab hnyuv siab raum. Kev kuaj mob kom raug tsuas yog ua tau nrog cystadenoma biopsy. Nrog ciam teb formations, kev kho mob phais yog tsim nyog, qhov ntim ntawm uas nyob ntawm lub hnub nyoog ntawm tus neeg mob. Adjuvant chemotherapy yog ua nyob rau hauv tsawg zaus thaum muaj kev pheej hmoo ntawm qog metastasis siab. Nws kuj tau qhia txog kev rov tshwm sim ntawm cov txheej txheem oncological ntawm lwm lub zes qe menyuam.
Tshuaj kho mob ntsws cancer
mob qog noj ntshav ntau tshaj yog mob ntsws cancer. Nws yuav siv ntau lab lub neej thoob ntiaj teb. Adjuvant chemotherapy rau mob ntsws cancer yuav luag ib txwm qhia. Nws yog ib qho tsim nyog tsis tsuas yog tom qab kev phais mob, tab sis kuj yog ib txoj kev ywj pheej rau diffuse me me cell hlav. Ntau yam tshuaj siv. Ntawm lawv yog cov tshuaj "Cisplastin", "Vinorelbin", "Gemcitabine" thiab lwm yam. Lub ntsiab lus qhia rau kev siv tshuaj khomob yog peripheral thiab hauv nruab nrab lub ntsws mob qog noj ntshav nrog rau cov qog ntshav qog ntshav. Kev kho mob nrog cov tshuaj cytostatic tsis yog ua tiav tsuas yog thaum tus neeg mob tsis kam lees, muaj cov kab mob decompensated, senile.hnub nyoog thiab nyob rau theem 4 ntawm cov txheej txheem oncological.
Kev sib txuas lus ntawm kws khomob nrog kev txhim kho metastases
Ib lub hom phiaj tseem ceeb ntawm kev kho mob yog tshem tawm cov metastases nrog kev kho tshuaj kho mob ntxiv. Nws ntseeg tau tias vim qhov kev ua ntawm cov tshuaj cytostatic, qhov kev pheej hmoo ntawm kev rov ua dua ntawm cov txheej txheem qog yog txo qis. Ua tsaug rau chemotherapy nyob rau hauv lub postoperative lub sij hawm nrog mob qog noj ntshav ntawm lub mis, ntsws, uterus thiab appendages, metastases nyob rau hauv lub regional lymph nodes raug tshem tawm tag nrho. Nws kuj txo qhov kev pheej hmoo ntawm lawv cov tsos ntawm cov kab mob nyob deb. Raws li qhov no, tshuaj kho mob qog noj ntshav pab ua kom qeeb ntawm cov txheej txheem oncological, thiab qee zaum - kho kom tiav.
Kev tshuaj xyuas ntawm cov kws kho mob tshwj xeeb thiab cov neeg mob txog kev kho tshuaj kho mob ntxiv
Raws li tus kws kho mob oncologist, kws khomob yog ib txoj hauv kev ua rau muaj kev cuam tshuam rau lub cev. Nws tsis tsuas yog suppresses tus neeg mob lub cev tiv thaiv kab mob, tab sis kuj yog ib qho nyuaj rau zam los ntawm cov neeg mob. Txawm li cas los xij, rau hnub tim, kev kho mob nrog cov tshuaj cytostatic muaj ntau qhov zoo dua li qhov tsis zoo. Nws raug sau tseg tias nrog kev sib koom ua ke rau kev tawm tsam oncology, txoj hauv kev muaj sia nyob nce.
