Nharaunda yehutano inokosha pakusarudza mishonga yekurapa
Chii chinonzi chiitiko chekuita uye nei zvichikosha kune vanhu vane kenza? Matanho mazhinji emakiriniki anoda chimwe chiitiko chekushanda kwehutano asati aona kana vanhu vakakodzera. Sei izvi zvichiitwa?
Tsanangudzo: Chiitiko Chekuita
Nharaunda yehutano ndiyo chiyero chekuti munhu anokwanisa sei kutakura mabasa ezuva nezuva kana achigara nekenza.
Kunzwisisa kuti mumwe munhu achaita sei nekurapa kunoenderana nerudzi rwekenza, danho rekenza, uyewo hutano hwehutano hwevanhu uye kukwanisa kutarisira kuchengeta kwavo.
Kukosha kwekuenzanisa Chimiro Chekuita
Iwe unogona kushamisika kuti nei oncologist yako kana muchechi wekutsvaga mutsva arikubvunza mibvunzo iyo yese pamusoro pehupenyu hwezuva nezuva. Iyi mibvunzo inobvunzwa senzira yekuziva kuti uri kuita sei nemabasa ako ezuva nezuva , kana "ADLs". Nokuongorora mabasa aya chiremba wako anogona kuverenga "chimiro chako" uye chiyero chekushanda chiitiko chinogona kubatsira nenzira dzakawanda:
- Kuti uone kana mumwe munhu ane hutano hunonzwisisika kubvumira kurapwa kwakadai sechemotherapy , chirwere , kana kuti remishonga inonzi radiation . Nezvose zvinorapwa zvekenza, zvakakosha kuongorora njodzi dzinobata mararamiro ekurapa. Somuenzaniso, pangave pane nguva apo chemotherapy inogona kuderedza panzvimbo yekuwedzera hupenyu hwekutarisira.
- Sezvo sarudzo yekutsvaga yemakiriniki miedzo . Mune mimwe miedzo yekurapa inoda varwere kuti vave nehutano hwakanaka vasati vamboedza kurapwa kwekuedza.
- Kuongorora mhinduro yomumwe munhu kumushonga.
- Kuona kana / kana chirwere chiri kufambira mberi sei.
- Kuti uenzanise kufungidzira .
Performance Scales
Zvinyorwa zviviri zvinotanga kushandiswa zvinoshandiswa kuenzanisa nharaunda yehutano kune avo vanorarama nekenza: EEastern Co-operative Oncology Group (ECOG) / WHO system, uye chikwata cheKanofsky chekuita.
Yokutanga pane izvi inoshandisa chimiro chekuita pachiyero che-0 kusvika ku5, uye yechipiri pane chiyero che 0 kusvika ku100. Cherechedza kuti zviyero izvi zvinopesana kana nhamba yakaderera kana nhamba yepamusoro inoreva kushanda zvakanaka. Nekuita kweEECOG / WHO, nhamba yakanaka kwazvo, asi nehutano hweKalofsky inhamba yakanaka ndeye 100.
ECOG / WHO Performance Status
- 0: Kushanda nesimba, hapana zvipingamupinyi pamabasa. Chiitiko chekuita che 0 chinoreva kusagadzikana mupfungwa yokuti mumwe munhu anokwanisa kuita zvose zvavaikwanisa kuita vasati vaona.
- 1: Haikwanise kuita zvinhu zvinonetsa, asi anokwanisa kuita mabasa epamba uye mabasa ekugara. Izvi zvinoreva kuti iwe haugoni kuita basa rakaoma asi unogona kuita chero chimwe chinhu.
- 2: Anokwanisa kufamba uye kuzvitarisira kuzvitarisira, asi asingakwanisi kushanda. Kubva pamubhedha zvinopfuura 50% zvekumuka kwamaawa. Muchikamu ichi, vanhu vanowanzokwanisa kutakura chero basa rekushanda, kusanganisira chiedza chehofisi.
- 3: Yakagadzirirwa pamubhedha kana chigaro chinopfuura 50 muzana yekumuka kwemaawa.
- 4: Akaremara zvakakwana.Iye akavharirwa kumubhedha kana chigaro. Asingakwanisi kuita chero kuzvitarisira.
- 5: Rufu
Karnofsky Performance Status
- 100: Kazhinji, hapana zviratidzo, kana uchapupu hwehosha
- 90: Zviratidzo zviduku, asi zvinokwanisa kutakura zvinhu zvakajairika
- 80: Zvimwe zviratidzo, basa rinowanzofanira kushanda nesimba
- 70: Haakwanisi kuita mabasa ezvakanaka, asi anokwanisa kuzvitarisira
- 60: Zvinowanzodiwa kuchengetedza zvido zvizhinji, dzimwe nguva rubatsiro rwekuzvitarisira
- 50: Unoda rubatsiro rukuru nekuzvitarisira, kugara uchirapa
- 40: Akaremara; inoda kuchengetwa kwakakwana uye rubatsiro
- 30: Akaremara kwazvo; hospitalized
- 20: Kurwara kukuru; kuchengetedza kwakanyanya kunotsigira kunodiwa
- 10: Kuramba uchifa
- 0: Rufu
Maitiro ekugadzirisa muMitambo Yezvipatara
Vanhu vazhinji vanovhiringidzika nehutano hwemamiriro ekuda mumakiriniki ekuedzwa.
Sei izvi zvichikosha? Hazvirevi here vanhu vanogona kubatsirwa?
Pane zvikonzero zvishomanana vatsvakurudzi vanoshandisa maitiro ehutano hwekushandira kuti vaone kukodzera kwekupinda kliniki yekuedzwa.
Imwe ndeyekuti migumisiro yavo ndeye "kuzviratidza." Mune mamwe mazwi, kana mumwe muongorori aizoita dambudziko rakafanana, zvinokosha kutanga nevanhu vane hutano hwakafanana.
Chimwe chikonzero, zvisinei, chinokosha kwauri iwe pachako. Nokunyora kushanda kwenyaya, vanachiremba vanokwanisa kutarisa mishonga mitsva kuti vaone kana vane mamiriro akaipa ekushanda kwehutano. Semuenzaniso, kana vanhu vakapindura kune zvinodhaka asi vakatanga nehutano hwema 0, iyo yakaderera kusvika 2, vanachiremba vanozofanira kufunga kuti kana kwete here migumisiro yemutachiona yakaratidza kuti zviitiko zvakanaka zvavakawana mukurapa kenza.
Kunzwisisa Zvakawanda NezveMitambo Muchipatara
Pane nhema dzakawanda pamusoro pekuongororwa kwechipatara . Mashoko anonyanya kutaurwa pamusoro pe "kuva guinea yenguruve" inowanzotaurwa mukunyomba, asi vanhu vazhinji havanzwisisi kuti zvii zvinokonzerwa nekliniki zvinosanganisira kana kukosha kwavo mukutsvakurudza kwekenza. Zvinogona kubatsira kuona kuti mushonga wose wekenza unowanikwa-mishonga yose uye mararamiro ose-akamboshandiswa chete mumakiriniki, uye panguva iyoyo, vanhu chete vanogona kumira kuti vabatsirwe nemuedzo uyu ndivo avo vakapinda mumatambudziko.
Kutsvaga kenza kunochinja. Kwemakore mazhinji zvakaratidzika sehuwandu hwekutsvakurudza kwakaiswa pachitatu chechitatu . Iyi miedzo inokosha apo inopindura mubvunzo uyu, "Chirwere ichi chinoshanda here kupfuura chimwe chirwere," asi panguva imwe chete, zvakawanda zvekuvandudzika zvakaonekwa zvakanga zviduku. Imwe mishonga inogona kuwedzera kupona ne10 muzana. Miedzo yakawanda iri kuitika ikozvino ichitsauko I miedzo . Iyi miedzo mune imwe pfungwa inotakura njodzi yakawanda sezvavanenge vachida kupindura mubvunzo uyu, "Izvozvo zvinodhaka zvakachengeteka," asi panguva imwechete vari kuedza zvinodhaka zvinogona kupa kuwedzera kwakanyanya mukurarama nekushandisa nzira dzokurapa kenza iyo itsva. Zvinodhaka zvakadai se immunotherapy nemishonga inorapwa inowanzowira munharaunda iyi.
Pasi Pano paItsika Chiitiko
Vanhu vazhinji vanovhiringidzika nehutano hwehutano sezvo hutsika hunoita zvishoma hunogona kugadzirisa avo vanogona kunge vachibatanidzwa mumuedzo wekliniki. Panguva imwe chete, ichi chiyero chinobatsira zvikuru kuvanhu vanorarama nekenza. Mushure mezvose, chii chinowanzokosha kune vanhu kurarama nechirwere chipi nechipi chekurapa ndechokuti mamiriro ezvinhu aya anokonzera kukwanisa kwavo kurarama, kushanda, uye kunakidzwa noupenyu.
> Sources:
> West, H., naJJ Jin. Maitiro Ehutano Muvarwere Nekenza. JAMA Oncology . 2015. 1 (7): 998.