Chemotherapy, Deep Venous Thrombosis, uye Pulmonary Embolism
Ropa rakasangana nekemotherapy rinotaurwa zvishoma kudarika, kureva, kusuruvara uye kurutsira, asi izvozvo hazvirevi kuti hazvina matambudziko. Zvechokwadi, achienzaniswa neanozivikanwa zviratidzo zvekutsvaga, kuneta, nekushaiwa bvudzi, zvinogona kuva zvinotyisa zvikuru. Zvakati, kunzwisisa nzira dzekuisa njodzi, kuziva nzira dzokuderedza ngozi yako, nekuziva zviratidzo, zvese zvinogona kukubatsira iwe kuderedza ngozi yako panguva yekurapa kenza.
Overview
Ropa rinoputika - zvichida rinozivikanwa mune zvechiremba rinoreva se "thongsis yevamwe" -kuri kunyanya kunetseka kune vanhu vane kenza.Takaziva kwekanguva kuti vanhu vane kenza kazhinji-kwete avo vanogamuchira chemotherapy - vane ngozi yakawanda ye ropa .) Pavanhu voga, ropa rinoputika mumakumbo rinogona kurwadza, asi chinonyanya kukosha ndechokuti mavhare acho achapura uye oenda kumapapu.Zinoitika izvi - chimwe chinhu chinonzi semaprommoni embolism - ndiyo chirwere chekurapa.
Kana iwe uchifamba munyika yose, unogona kunge uchiziva mavhidhiyo epamberi epamusoro-soro ayo ose kukosha kwemakumbo maitiro ekudzivirira kuvhara ropa, asi hatiwanzozvinzwa nezvengozi iyi nemabasa akasiyana-siyana ekugadzirisa-zvakadai sekuenda nechikwereti chemotherapy. Munyaya iyi, izvo zvausina kumbonzwa zvingakukuvadza. Zvechokwadi, iyi ndiyo imwe nzira iyo iyo iwe uri mumutsigiri wako mukuchengetedzwa kwekenza - kudzidza pamusoro pechinhu ichi chinetso, nekukurukura nachiremba wako kana iwe uri nehanya - zvinogona kuita kuti musiyano huve hupenyu hwako uye zvichida kunyange mugumisiro wako.
Risk Factors
Zvinogara zvichifungidzirwa kuti vanhu vanoenda kuburikidza nechemotherapy vane ngozi yakawedzerwa yeropa, asi harina kusvika muna 2013 kuti izvi zvinokonzerwa nekenza yakaongororwa chete. Muchidzidzo chikuru, zvakawanikwa kuti chiitiko chekuvhara ropa chinokwira chemotherapy chaive che12,6 kubva muzana, zvichienzanisa nehutano hwe4,4 muzana kune vanorwara nekenza vasina kuwana chemotherapy.
Dambudziko racho raive rakanyanya mune mamwe kanzira kupfuura vamwe, nekenza sepancreatic nekenza yemapapu ine ngozi huru. Mukuwedzera, mamwe chemotherapy nemishonga inoshandiswa kurwisana nemigumisiro yemakemikari yakasanganiswawo nehuwandu hwehutano. Muchidzidzo ichi, zvinodhaka izvo zvakanyanya kuiswa pangozi zvaisanganisira Platinol (cisplatin), Avastin (bevacizumab), uye Epogen kana Chirongwa (red red stimulator erythropoietin.)
Mukuwedzera kune chemotherapy, ndeapi mamwe marapirwo uye mamiriro ezvinhu angasimudza ngozi yevanhu vanogara nekenza? Zvimwe zvinokonzera ngozi zvinosanganisira:
- Kuvhiya - Mune zvimwe zvidzidzo, dambudziko rekuvhara ropa mumakirini evechirwere kwave kuri kusvika makumi mashanu kubva muzana mushure mekuvhiyiwa
- Hospitalization, kunyanya kugara kunopfuura zuva rimwe chete
- Kurara kwenguva refu
- Pakati pekusvikirira kwemafuro (zvakadai sekuva nechipatro chemotherapy)
- Mishonga inonzi angiogenesis inhibitors (yakadai seAvastin)
Zviratidzo
Kuti uzive zviratidzo zvinogona kuitika, zvinogona kubatsira kuputsa izvi muzviratidzo zvinowanzoonekwa neropa rekuvhara mumakumbo (venous thrombosis) uye zviratidzo zvine chokuita neropa rinoputika ndokuenda kumapapu (pulmonary embolism .)
Zviratidzo zveveous thrombosis (blood clots muhudyu) zvinosanganisira zviratidzo mumhuru kana pamakumbo makuru kunosanganisira:
- Rufu
- Tenderness
- Kuzvimba
- Wakanaka
Zviratidzo zvinokonzerwa nepatmonary embolism zvinogona kusanganisira:
- Kurwadziwa kwechifukidzo chechipfuva-kazhinji kunorwadza kwakanyanya. Ramba uchiyeuka kuti dzimwe nguva inovhara kufamba kuenda kune dzakasiyana munzvimbo mumapapu, uye kurwadziwa kunogona kusava munzvimbo imwe chete
- Kupfupika kwemhepo
- Kushungurudza kana kukonzera ropa
- Lightheadedness
- Kusanzwisisa
- Cyanosis - a blue discoloration yeganda nemiromo
- Moyo arrhythmias - asina njere mwoyo rhythms
- Yakapfurikidza kuputika kwepamusoro uye kutengesa kwomwoyo pamwe nekuderera kweropa
Kudzivirira
Mishonga
Mishonga-anticoagulants-iri kushandiswa kakawanda mumakore achangopfuura kuderedza dambudziko rekuvhara ropa mune varwere vekenza.
Izvi zvinotaurwa kune "prophylactic anticoagulation" iyo, inoshandurwa, zvinoreva kudzivirira ropa-kuponda.
Kune mishonga yakawanda yemishonga inogona kukurudzira prophylactically. Zvidzidzo zvemazuva ano zvinoratidza kuti mishonga yakadai se heparin inoshanda zvakanaka kune vanhu vane kenza kupfuura mishonga inopindira vitamini K-yakadai seCoumadin (warfarin), asi mishonga yakasiyana inogona kukurudzirwa zvichienderana nemamiriro ako ezvinhu. Mimwe yemishonga iyi (iyo yamunonzwa inonzi yakaderera mashekeri inorema heparin) inosanganisira:
- Lovenox (enoxaparin)
- Fragmin (dalteparin)
- Innohep (tinzaparin)
- Arixtra (fondaparinux) - ichi chitsva "heparin-like" mishonga
Kuzvitarisira
Mukurapa, tinowanzotaura pamusoro pezvinodhaka kana zvasvika pakudzivirira, asi pane zvinhu zvakawanda zvaunogona kuzviita iwe kuderedza dambudziko rako. Danho rokutanga uye rinokosha nderekuti uzvidzidzise pachako uye mubvunze mibvunzo. Iva neruzivo nezviratidzo zveropa clots uye pulmonary embolism. Kana iwe uine hanya nezvose, usamirira, asi taura nachiremba wako pakarepo. Kumbira oncologist yako kana pane chimwe chinhu chaunogona kuita kuti uderedze njodzi yako, kana kuti angakurudzira mishonga kuderedza ngozi. Mukuwedzera, iwe unogona kuda:
- Famba-svetuka zvakakwana sezvinobvira, mukati memiganhu yako. Kana iwe usingazivi kuti basa rakakura rinokurudzirwa, bvunza chiremba wako. Kakawanda nguva pfupi yekubata muviri kunobatsira pane zvisingasvikiki mabasa akawanda
- Kunyange kana iwe uri pamubhedha, shandisa maitiro ako. Chiremba wako kana mukoti anokwanisa kubatsira kuratidzira maitiro aya awa. Iwe unogona kuedza kuisa zvigunwe zvako kumusoro wako uye ipapo pasi kakawanda (zvakare, taura nachiremba wako senzira dzakanakisisa dzinogona kusiyana zvichienderana nehutano hwako chaihwo)
- Dzivisa kutengesa kwenguva refu. Kana iwe uchifanira kunge uri mumotokari kwenguva yakareba, purogiramu kazhinji inomira-nguva yega yoga-wobuda mumotokari uye famba-famba
- Mukuwedzera kune dzimwe nzira dzekubhururuka nekenza , edza kumuka kweawa imwe neimwe, uye zvichida pamaminitsi makumi matatu nemasere uye famba-famba. Iwe unogona kuita gumbo kudzidzira kunyange kana wakagara. Zvichienderana nemamiriro ako ezvinhu, oncologist yako inogona kufunga kukubata iwe ne anticoagulant (somuenzaniso, pasi maserosiyo uremu heparin) usati waenda. Ita chokwadi chekubvunza. DVT nekuda kwekufambisa ndege kunowanikwa zvakakwana zvokuti vakagadzirirwa "uwandu hwemakondomu ehurumende."
- Usasvuta
- Kana chiremba wako anokurudzira kudzvinyirira mashizha, iva nechokwadi chekutevera mazano ake
- Usatambuka makumbo ako
- Dzivisa zvipfeko zvakaoma zvakasimba, kunyanya zvipfeko zvakasimba zvakapoteredza mabvi ako kana munzvimbo yako yekumera
- Bvisa marumbo ako kana zvichibvira
- Dzivisa caffeine uye doro. Zvose caffeine uye doro zvinogona kutungamirira kukudzikisa mvura, uye kupera simba kwemvura kunomutsa dambudziko rekuvhara ropa
> Sources:
> American Society of Clinical Oncology. Cancer.Net Kudzivirira uye Kurapa Zvivharo Zveropa. Updated 01/20/15.
> Garcia Escobar, I., Antonio Rebollo, M., Garcia Adrian, S. et al. Kuchengetedza uye Kubudirira kweKunokosha Thromboprophylaxis muVarwere veCarcer. Clinical and Translational Oncology . 2016 May 4. (Epub mberi kwekudhinda).
> Khorana, A., Dalal, M., Lin, J., naG. Connolly. Nharaunda uye kufungidzira kweveous thromboembolism (VTE) pakati pevarume vane chirwere chepachirwere chepachivande chinopinda chemotherapy muUnited States. Cancer . 2013. 119 (3): 648-55.
> Posch, F., Konigsbrugge, O., Zielinski, C., Pabinger, I., uye C. Ay. Kurapa kweveous thromboembolism kune varwere vane kenza: A network meta-analysis kuenzanisa kushanda uye kuchengeteka kweanticoagulants. Thrombosis Research . 2015. 136 (3): 582-9.
> Vitale, C., D'Amato, Venous thromboembolism nekenza yemapapu: kuongorora. Multidisciplinary Respiratory Medicine . 2015. 10 (1): 28.