mob qog noj ntshav Pancoast yog kab mob oncological uas nyob hauv thaj chaw sab saud ntawm lub ntsws. Nyob rau hauv nws cov tsos mob, nws zoo ib yam li tuberculosis, abscess, echinococcus, mob ntsws, benign qog thiab lwm yam pathologies.
Pancoast's qog tau txais nws lub npe los ntawm kws kho hluav taws xob Henry C. Pancoast. Nws yog thawj tus ntawm nws cov npoj yaig los piav qhia txog tus kab mob no. Qhov no tshwm sim xyoo 1924.
Ntxiv rau cov kab mob malignant, qee cov kab mob inflammatory thiab oncological, kuj nyob rau sab sauv ntawm lub ntsws, tuaj yeem ua rau cov tsos mob zoo sib xws. Qhov tshwm sim no hu ua Pancoast syndrome.
Qhov ceev ntawm qhov teeb meem ntawm Pancoast mob qog noj ntshav nyob hauv qhov nyuaj ntawm nws qhov kev kuaj mob ntxov vim qhov chaw tshwj xeeb ntawm cov qog, kaw los ntawm cov pob txha pob txha. Txawm tias muaj kev pab los ntawm fluorography, tau ua nyob rau hauv cov chaw kho mob oncological niaj hnub no, nws yog deb ntawm ib txwm muaj peev xwm txheeb xyuas tus kab mob sai sai thaum ntxov.
Ua rau mob ntsws cancer sab sauv
Feem ntau, qhov ua rau mob qog noj ntshav Pancoast cuam tshuam los ntawm tib yam ua rau lwm hom mob ntsws cancer. Qhov no yog dab tsi? Lub ntsiab yog vim li cas rau nws manifestation yog haus luam yeeb: nquag los yog passive. Lub luag haujlwm tseem ceeb yog ua los ntawm tus naj npawb ntawm cov luam yeeb haus luam yeebhnub, kev haus luam yeeb zoo, thiab tag nrho cov keeb kwm kev haus luam yeeb. Nws yog ib qho tsim nyog sau cia tias thaum muab kev quav yeeb quav tshuaj, ib tus neeg tawm ntawm qhov kev pheej hmoo tsuas yog tom qab kaum xyoo.
Cov neeg uas tsis muaj kev mob siab rau kev haus luam yeeb tuaj yeem raug tus kab mob no. Qhov feem pua ntawm Pancoast cancer hauv cov neeg haus luam yeeb tau nce 1.7-2 zaug. Cov menyuam yaus thiab cov tub ntxhais hluas uas nws niam nws txiv tsis tu ncua haus luam yeeb nyob rau hauv lawv lub xub ntiag kuj poob rau hauv pab pawg uas muaj kev pheej hmoo. Kev haus luam yeeb hauv 85% ntawm cov neeg mob ua rau mob qog noj ntshav ntawm lub ntsws.
Ntxiv rau kev haus luam yeeb, ib puag ncig thiab kev lag luam tuaj yeem ua rau Pancoast cancer. Kev sib cuag nrog cov tshuaj xws li tshuaj tua kab, asbestos, hlau hnyav, arsenic, npib tsib xee lossis chromium kuj ua rau muaj mob qog noj ntshav Pancoast.
Lub luag haujlwm ntawm ntau yam kab mob ntsws hauv keeb kwm kuj tseem zoo: tuberculosis, mob ntsws yav dhau los thiab bronchiectasis - tag nrho cov no ua rau muaj kev pheej hmoo ntawm tus neeg mob qog nqaij hlav Pancoast.
Tus kab mob no cuam tshuam rau txiv neej tsib zaug ntau dua li poj niam, thiab nws tshwm sim tom qab hnub nyoog 50 xyoo. Nws tau raug pov thawj tias qhov ua rau mob qog noj ntshav Pancoast kuj kis tau ntawm qib noob.
Feem ntau, muaj ntau yam tseem ceeb cuam tshuam rau qhov tshwm sim ntawm Pancoast cancer:
- hnub;
- smoking;
- ib puag ncig xwm txheej hauv cheeb tsam;
- kev ua haujlwm hauv kev tsim kho lossis kev lag luam tshuaj;
Cov tsos mob Cancer
Ntau tus neeg mob nrhiav kev pab nrogtheem ntawm tus kab mob. Qhov teeb meem no yog txuam nrog qhov tsis muaj cov tsos mob nyob rau hauv thaum ntxov: tus neeg mob tsis muaj hnoos, hemoptysis thiab, qhov tseem ceeb tshaj plaws, pom lub cev tsis xws luag nyob rau hauv daim ntawv ntawm pob ntawm lub cev. Mob hauv oncology ntawm cov theem pib, raws li txoj cai, tsis tshwm sim.
Tsuas ceeb toom cov tsos mob nyob rau theem 1 thiab theem 2 ntawm mob qog noj ntshav yog qhov tsis muaj zog, qaug zog tas li, poob phaus.
Pancoast thiab Horner syndromes
Nrog rau chav kawm ntxiv ntawm tus kabmob, muaj qhov tshwm sim ntawm Pancoast thiab Horner syndromes, ob leeg ib leeg thiab ua ke nrog ib leeg. Koj yuav tsum paub txog qhov no.
Pancoast Syndrome yog tshwm sim los ntawm ntau yam tsos mob hauv qab no:
- mob hnyav rau ntawm sab ntawm cov qog hauv zos - hauv lub xub pwg nyom, raws cov hlab ntsha ulnar thiab hauv qab scapula;
- qaug zog ntawm cov leeg ntawm caj npab ntawm lub cev cuam tshuam ntawm lub cev, paresthesia, loog ntawm cov ntiv tes, atrophy ntawm cov leeg ntawm limb;
- suab hloov - hoarseness, hnoos.
Thaum ib lub qog cuam tshuam rau lub siab lub ntsws, Horner's syndrome tshwm:
- drooping ntawm daim tawv muag sab sauv (ptosis);
- anhidrosis ntawm sab sauv qaum thiab ib feem ntawm lub ntsej muag nrog cov qog nqaij hlav sab;
- menyuam kawm ntawv constriction (miosis) thiab retraction ntawm lub qhov muag (ethnophthalmos).
Ntau zaus, Pancoast cancer yog nrog los ntawm superior vena cava syndrome nrog qog siab rau nws. Tus mob no yog nrog los ntawm cov tsos mob hauv qab no:
- mob plab;
- hnoos;
- ua pa nyuaj;
- mob taub hau thiab tsaug zog ntxiv;
- ntxhi thaum ua pa.
Kev kuaj mob ntsws cancer apical
Raws li tau hais los saum toj no, kev kuaj mob ntawm tus kab mob yog qhov nyuaj heev, vim tias nyob rau theem pib ntawm Pancoast cancer, txawm tias kev kuaj X-ray ib txwm tsis tuaj yeem kuaj pom vim qhov tseeb tias cov qog tsis pom ntawm lub site ntawm nws localization.
Raws li txoj cai, cov neeg mob ua ntej txhua tus tig mus rau tus kws kho mob hlwb lossis tus kws phais mob nrog kev tsis txaus siab ntawm qhov mob ntawm ceg ceg, thiab tsuas yog tom qab ntawd lawv tau teem sijhawm nrog tus kws kho mob oncologist.
Muab Pancoast cov qog zoo ib yam hauv nws cov tsos mob rau lwm yam kab mob ntawm cov kab mob bronchopulmonary, nws qhov kev kuaj mob yuav tsum ua kom tiav thiab suav nrog cov kev kuaj hauv qab no:
- X-ray - txiav txim siab pom muaj qog nyob rau theem tom qab vim qhov tuab ntawm pleura thiab cov tsos ntawm blackouts.
- xam tomography thiab MRI - txiav txim siab txog qib kev koom tes ntawm cov hlab ntsha, tav, qog nqaij hlav, vertebrae hauv cov txheej txheem. Cov txiaj ntsig ntawm cov kev tshawb fawb no yog qhov tseem ceeb tshaj plaws. Lawv qhia txog qhov ua tau.
- Biopsy ntawm lymph nodes - tso cai rau koj los txiav txim siab theem ntawm kev loj hlob ntawm pathology.
- ntshav kuaj - txiav txim lub xeev ntawm lub cev tag nrho.
Tsis tas li, raws li kev tshuaj xyuas ntxiv, bronchoscopy tau ua (txiav txim siab qhov xwm txheej ntawm bronchi thiab trachea ze rau thaj tsam cuam tshuam), arteriogram thiab phlebogram (xws li cov hlab ntsha thiab cov hlab ntsha hauv cheeb tsam clavicle).
kev kho mob ntsws cancer
Kev kho mob qog noj ntshav Pancoast tsuas yog tshwm sim hauv cov chaw kho mob tshwj xeeb, thaum lub hauv paus tseem ceeb yog qhov nyuaj ntawm txoj kev kho. Raws li kev txheeb cais qhia, Pancoast cancer feem ntau kuaj pom nyob rau theem 3, thaum qhov mob ntawm oncology ntawm hom no dhau los ua tsis tau. Kev kho mob nyob rau hauv rooj plaub no yuav tsum pib nrog kev noj cov tshuaj tua kab mob, mus txog rau kev noj tshuaj narcotic.
Cov kev kho mob tseem ceeb rau Pancoast qog yog:
- chemotherapy;
- xov tooj cua;
- kev cuam tshuam kev phais.
Kev Kho Mob Ua Ntej
Kev kho tus kab mob tshwm sim hauv ntau theem: kev kho ua ntej thiab tom qab phais, phais.
Kev kho ua ntej yog kev sib xyaw ua ke ntawm cov tshuaj khomob thiab hluav taws xob tsim nyog los txo cov qog thiab tiv thaiv kev kis tus kabmob mus rau cov qog ntshav. Qhov no tso cai rau koj ua haujlwm uas ua tsis tau ua ntej kev kho mob.
Radiotherapy kuj tuaj yeem siv los ua txoj kev ywj pheej ntawm kev kho mob thaum tsis tuaj yeem phais. Irradiation nyob rau hauv cov ntaub ntawv no txo qhov mob ntawm tus neeg mob, tab sis tsis cuam tshuam rau lub neej expectancy.
Ob qho tib si hluav taws xob thiab tshuaj khomob tau ua nyob rau hauv cov chav kawm hauv ntau theem, nrog kev so ntawm lawv 2-3 lub lis piam. Tom qab kev kho mob hluav taws xob thiab kws khomob, tus neeg mob tau teem sijhawm rau kev kuaj thib ob, cov txiaj ntsig ntawm qhov kev txiav txim siab txog qhov ua tau ntawm kev phais.kev cuam tshuam.
Kev cuam tshuam ntawm kev phais hauv kev kho mob ntsws cancer
Kev phais phais yog nyob deb ntawm kev ua tiav hauv txhua kis: yog tias tsis muaj kev lees paub tag nrho tias tus neeg mob lub peev xwm yuav tso cai rau nws mus rau kev phais, lossis yog tias ntau qhov chaw ntawm lub cev, thaj chaw deb ntawm qhov txhab, twb raug cuam tshuam., kev cuam tshuam tsis muaj ntsiab lus. Qhov feem pua ntawm cov ciaj sia nyob rau hauv xws li ib tug tsis saib xyuas ntawm tus neeg mob yog tsawg.
Hauv lwm qhov xwm txheej, thaum ua haujlwm tau, muaj ntau txoj kev xaiv rau nws siv:
- Pneumoectomy - tshem tawm tag nrho cov ntim ntawm lub ntsws cuam tshuam.
- Resection ntawm ib feem ntawm lub ntsws.
Nrog rau qhov loj hlob ntawm cov qog, nws muaj peev xwm tshem tawm ob peb tav thiab vertebrae, hlab ntsha, hauv siab phab ntsa, brachial plexus. Muaj tsawg zaus, tus neeg mob yuav tsum tau txiav caj dab sab sauv.
Tom qab ua haujlwm, hluav taws xob thiab tshuaj khomob kuj tau ua "tiav" cov qog hlwb kom tsis txhob rov muaj dua.
Kev mob ntsws cancer sab sauv
Kev ciaj sia ntawm cov neeg mob uas tau mob qog noj ntshav Pancoast ncaj qha nyob ntawm theem uas tau kuaj pom tus kab mob.
Nyob rau hauv cov neeg mob kuaj mob nyob rau theem 1 ntawm tus kab mob, qhov ciaj sia taus yog kwv yees li 60%, nyob rau theem 2 - tsis ntau tshaj 40%, thiab thaum kuaj mob cancer theem 3, lub tseem ceeb tsib xyoos. tsuas yog kov yeej 20% ntawm cov neeg mob.
Ntawm theem 4, Pancoast cancer yog qhov kho tsis tau: hauv 98% ntawm cov neeg mob, kev tuag tshwm sim hauv 6-7 lub hlis tom qabkev kho mob.
