kab mob Oncological hauv ntiaj teb niaj hnub no tau dhau los ua ntau dua. Qhov no yog vim qhov peculiarities ntawm ib puag ncig, ntau yam kab mob tshiab, nrog rau ntau cov carcinogens. Txhua xyoo, cov kws tshawb fawb qhia txog txoj hauv kev tshiab los tawm tsam mob qog noj ntshav. Txawm li cas los xij, cov txheej txheem qub ntawm kev kho mob tseem siv. Ib tug ntawm lawv yog PCT. Deciphering no abbreviation yog polychemotherapy. Kev tswj hwm ntawm cov tshuaj cytotoxic pab tshem tawm cov hlwb atypical uas ua rau cov qog. Txawm hais tias hom kev kho no tsis yooj yim zam los ntawm cov neeg mob, nws yog ib txoj hauv kev zoo tshaj plaws.
PCT hauv oncology: deciphering tus tsiaj ntawv
Hauv cov ntaub ntawv kho mob ntawm cov neeg mob qog noj ntshav, feem ntau muaj xws li tshuaj kho mob. Nws yog abbreviated li PCT. Hauv oncology, kev txiav txim siab ntawm cov ntawv luv no yog polychemotherapy, uas txhais tau hais tias kev sib xyaw ua ke ntawm ntau tus neeg ua haujlwm cytostatic ib zaug. Hom kev kho no yog tsom rau kev tshem tawm tag nrho cov qog lossis nws qhov txo qis.
Feem ntau, PCT ua ke nrog lwm yam kev kho mob. Ntawm lawv yog kev phais tshem tawm ntawm ib qho kev tsim pathological thiab kev kho hluav taws xob. Qee zaum polychemotherapy yog ib txoj kev ywj pheej ntawm kev kho mob. Kev xaiv ntawm PCT nyob ntawm qhov chaw thiab theem ntawm kev mob qog noj ntshav, nrog rau cov mob ntawm tus neeg mob. Tsuas yog tus kws kho mob oncologist tuaj yeem sau tshuaj cytotoxic.
Hom tshuaj kho mob hauv oncology
Thaum muab tshuaj cytostatic cov neeg ua haujlwm, cov kws kho mob raug coj los ntawm ob lub ntsiab lus. Cov no suav nrog: adjuvant thiab neoadjuvant chemotherapy. Nws yooj yim heev kom cais lawv. Yog li, dab tsi yog neoadjuvant PCT hauv oncology? Kev txiav txim siab tsuas yog yuav tsum tau rau cov neeg uas tsis nkag siab txog kev kho mob qog noj ntshav. Lub tswv yim ntawm "NPCT" txhais tau hais tias ib tug neeg tau txais kev kho mob ua ntej kev phais. Ntawd yog, cov qog tsis tuaj yeem raug tshem tawm tam sim no, tab sis tom qab noj cov tshuaj cytostatic, cov kab mob pathological yuav tsum txo qis.
Lub tswvyim rov qab yog adjuvant PCT hauv oncology. Deciphering lub abbreviation yog yooj yim. APCT yog kev kho mob qog noj ntshav tom qab phais. Qhov no txhais tau hais tias cov qog nws tus kheej tau raug tshem tawm tag nrho, tab sis kev kho cytostatic yuav tsum tau ua kom tsis txhob rov tshwm sim dua. Cov npe ntawm PCT hais txog kev kho mob ua ke lossis kev kho mob ntawm cov qog nqaij hlav malignant. Ntawd yog, ntxiv rau kev sau tshuaj, tus neeg mob tau txais kev phais, thiab qee zaum hluav taws xob.
Ib hom kev kho cais yog kev ywj pheej (kev kho mob) ntawm PCT hauv oncology. Kev txiav txim siabCov lus kho mob zoo li no tsis meej rau txhua tus kws kho mob. Feem ntau, tsuas yog tus kws kho mob oncologist tuaj yeem paub qhov txawv ntawm kev kho mob los ntawm kev tiv thaiv kev kho mob. Kev ywj pheej PCT yog ua nyob rau hauv rooj plaub uas lwm txoj kev rov qab tsis tau qhia. Piv txwv li, nrog mob qog noj ntshav me me lossis muaj cov metastases mus rau cov kabmob nyob deb.
Cov lus qhia rau kev kho
Nws tsim nyog sau cia tias txhua tus qog nqaij hlav raug kho txawv. Qee zaum tsuas yog kev phais lossis hluav taws xob txaus, hauv lwm qhov kev kho mob yuav tsum tau ua. PCT tsuas yog muab rau cov laj thawj kho mob tshwj xeeb, thaum tsim nyog. Yog tias tsis muaj kev kho mob zoo li no tom qab kev ua haujlwm los ntawm kws kho mob, cov txheej txheem malignant tau txwv rau thaj tsam me me thiab tsis cuam tshuam rau cov txheej txheem sib sib zog nqus ntawm lub cev. Tsis tas li ntawd, qee hom qog nqaij hlav tsis teb rau kev siv tshuaj khomob. Muaj cov lus qhia hauv qab no rau PCT hauv oncology:
- Malignant formations ntawm lymphoid ntaub so ntswg.
- ntshav qog noj ntshav.
- Cov qog nqaij hlav hauv plab.
- Small and large cell lung cancer.
- Neoplasms ntawm lub taub hau thiab caj dab.
Nws yuav tsum tau muab sau tseg tias qhov ua tau zoo ntawm kev kho mob yog nyob ntawm seb hom qog nqaij hlav. Piv txwv li, qog nqaij hlav qog ua haujlwm zoo dua rau kev kho cytotoxic dua li squamous cell carcinoma lossis sarcoma. Feem ntau, PCT tsis raug tshuaj rau thaum ntxov ntawm tus kab mob, yog tias cov qog tuaj yeem raug tshem tawm los ntawm kev phais. Adjuvant therapy yog qhia rau cov neeg mob uas muaj theem 2 lossis 3 tom qab phaismob qog noj ntshav. Yog tias cov qog loj thiab tau loj hlob mus rau hauv cov kabmob uas nyob sib ze, ib qho kev ywj pheej ntawm PCT raug sau tseg. Qee lub sij hawm hom kev kho mob no yog siv rau theem ntawm kev mob qog noj ntshav, thaum lwm txoj kev tsis muaj zog.
Yuav ua li cas kho tshuaj khomob?
Cov neeg feem coob paub tias kev kho mob feem ntau yog muab rau hauv cov voj voog. Qhov no txhais tau hais tias cov tshuaj cytostatic tau nkag mus rau hauv lub cev ntau zaus, thiab rau lub sijhawm ntev - ntawm qee lub sijhawm. Qhov kev kho mob zoo li no yog qhov tsim nyog vim tias cov tshuaj ua kom tsis yog tsuas yog cov qog xwb, tab sis kuj tseem muaj lwm cov hlwb ntawm lub cev. Kev taw qhia ntawm koob tshuaj loj ib zaug yog tsis yooj yim sua, vim cytostatics muaj cardio-, nephro- thiab hepatotoxic teebmeem. Nws yuav siv sij hawm rau lub cev kom rov zoo los ntawm PCT. Qhov nruab nrab, nws yuav siv li 2-4 lub lis piam. Lub sijhawm no, cov qe ntshav muaj sijhawm rov ua dua lawv tus kheej, thiab tus neeg mob txoj kev noj qab haus huv tau rov zoo li qub.
Tus naj npawb ntawm PCT cov kev kawm hauv oncology yuav txawv. Nws nyob ntawm qhov tolerability ntawm cov tshuaj, tus neeg mob tus mob thiab cov hauj lwm zoo ntawm kev kho mob. Tom qab 3 chav kawm, kev ntsuam xyuas yog ua, ua tsaug uas tus kws kho mob ua qhov kev txiav txim siab tsim nyog. Yog hais tias cov qog tau ploj tag los yog ib feem tsawg, cov tshuaj kho mob txuas ntxiv mus. Nyob rau hauv cov ntaub ntawv uas muaj ib tug zuj zus ntawm cov txheej txheem malignant, tus txheej txheem PCT hloov. Hauv qhov no, kev suav rov qab ntawm cov chav kawm pib dua.
Npaj thiab nrog kev kho mob
Cytotoxic tshuaj yog ib qho nyuaj rau zam cov tshuaj. Txawm tias lawv cov hauj lwm zoo, lawvyog sib npaug nrog tshuaj lom thiab ua mob rau lub cev. Txhua yam tshuaj siv rau kev kho mob muaj tshuaj lom. Ua ntej tshaj plaws, cytostatics ua rau cov hlwb ntawm daim siab, lub plawv thiab ob lub raum. Txhawm rau ua kom tsis muaj zog ntawm lawv cov teebmeem, kev kho mob nrog rau yuav tsum tau ua. Ua ntej kev taw qhia ntawm cov tshuaj, ib qho intravenous infusion ntawm hormonal thiab antiemetic tus neeg sawv cev yog yuav tsum tau. Cov tshuaj feem ntau siv rau kev kho mob premedication yog Dexamethasone, Ondansetron thiab Sodium Chloride. Lawv pab npaj lub cev rau chemotherapy. Ua tsaug rau cov tshuaj no, emetogenic thiab intoxication syndrome raug txo.
Cov kev kho mob nrog xws li tshuaj xws li tshuaj "Potassium chloride", "Magnesium sulfate", "Mannitol". Lawv pab kom tsis txhob muaj teeb meem ntawm lub plawv, lub ntsws thiab lub hlwb. Qee zaum, yuav tsum tau siv cov tshuaj tiv thaiv kab mob.
Contraindications rau kev sau tshuaj khomob
Txawm tias qhov tseeb tias tshuaj khomob yog ib txoj kev kho mob zoo tshaj plaws rau kev mob qog noj ntshav, nws tsis yog ib txwm tsim nyog. Qee zaum, cytostatic cov neeg ua haujlwm ua rau muaj kev phom sij ntau dua li qhov zoo. PCT yog contraindicated nyob rau hauv cov ntaub ntawv hauv qab no:
- Laus (los ntawm 70 xyoo).
- Intolerance rau cytostatic agents.
- Kev muaj mob hnyav ntawm lub siab.
- rau lub raum thiab lub siab tsis ua haujlwm.
- Kev mob kis tau txawm tias kho tsis tu ncua.
- Kev muaj ntau yam metastases.
- Cachexia.
Ua ntej yuav tshuaj PCT, txheej txheem kev xeem raug ua tiav. Cov no suav nrog: kev kuaj ntshav dav dav thiab biochemical, ECG, OAM, coagulogram, ultrasound ntawm lub plawv. Thaum kuaj pom cov kab mob decompensated, kev kho mob nrog cytostatics yog qhov tsis tsim nyog.
Cov txiaj ntsig tau ntawm kws khomob
Txhawm rau tswj cov txiaj ntsig ntawm PCT, kev tshuaj xyuas thib ob tau ua tiav. Ua tsaug rau qhov no, qhov txiaj ntsig ntawm kev kho yog ntsuas. Cov txiaj ntsig zoo ntawm kev kho mob muaj xws li: ua kom tiav thiab ib nrab regression ntawm cov qog, nrog rau stabilization. Hauv thawj kis, neoplasm ploj lossis txo qhov loj ntawm 2 zaug lossis ntau dua. Stabilization ntawm cov txheej txheem txhais tau hais tias cov qog tau nyob zoo li qub. Txawm li cas los xij, qhov no suav tias yog qhov txiaj ntsig zoo, vim tias tsis muaj kev kho mob, mob qog noj ntshav sai sai.
Yog tias qhov kev ntsuam xyuas pom tau tias qhov kev loj hlob ntawm malignant loj hlob tuaj, lossis metastases tau tshwm sim, cov kev kho mob tau hloov pauv. Yog tias tus neeg mob qhov mob txaus siab, cov chav kawm kws khomob tsis txwv. Txawm li cas los xij, qhov kev nce mus tas li yog qhov qhia tau tias kev kho mob tsis tuaj yeem tshwm sim, tab sis tsuas yog ua mob rau lub cev. Qhov no yog ib qho contraindication rau kev sau tshuaj PCT.
Drug list
Muaj ntau pawg kws tshuaj ntawm cov tshuaj cytostatic. Cov tshuaj feem ntau muaj xws li: tshuaj tua kab mob tshuaj tua kab mob, tshuaj ntsuab tshuaj ntsuab, cov khoom uas muaj platinum. Piv txwv li cov tshuaj "Doxorubicin", "Paclitaxel",Docetaxel, Cisplatin, Gemcitabine, thiab lwm yam.
