Mirayiridzo uye Kuraira
Kuvhiya hakuiti sekuwanzana kwekenza yemukenza kadiki shoma semukenza usina chediki wekenza yemapapu, uye vanhu vazhinji vanobvunza kuti nei. Ngatitaurirei pazvinenge zvichiita, uye zvikonzero nei chiropotherapy uye remishonga inonzi radiation kazhinji ndiyo nzira dzakanakisisa dzokurapa.
Inogona Kuitwa Here?
Munguva yakapfuura, kuvhiyiwa kwekenza yemukirini yemapapu yakanga isina kunyatsoonekwa sarudzo.
Kazhinji kacho, apo kenza kadiki kadiki yemapapu inowanika, yakatozopararira kune dzimwe nzvimbo dziri pamapapu ((metastasized) kana iripo mumapapu maviri. Mune izvo zvirongwa, chemotherapy uye remishonga inonzi radiation ndiyo nzira dzakanakisisa dzokurapa.
Asi vanachiremba varizve kutarisa chiduku chiduku chevanhu vanogona kubatsirwa, uye kurarama kwemazuva mazhinji, vachitsvakurudza zvakabudirira chekenza yemukemukari kadiki.
Apo Kuvhiya Hakunorumbidzwa
Muchechi muduku wekenza yemapapu ane nhoroondo yepamapfumbamwe 15 muzana yemakenza emapapu. Inoputsika muzvikamu zviviri: chikamu chiduku uye nzvimbo yakakura. Kana mumwe munhu ane mukana wakazara wekenza yemapapu yemapapu (inowanikwa munharaunda makumi manomwe kubva muzana yevanhu panguva yekuongororwa), kuvhiyiwa hakunatsiri kutarisira upenyu. Nechitsepa chakakura chekenza yemapapu memapapu, kusanganiswa kwemakemikrasi uye remishonga inonzi radiation inogona kushanda zvakanaka, pakutanga pakutanga. Kana kuvhiyiwa kwaifanira kuitika hakungogone kuve kusina maturo asi kunogona kukanganisa kurapwa kunobatsira.
Apo Kuvhiya Kwingave Ichishanda
Kuvhiya kunogona kupa mukana wekugara kwenguva yakareba kune vamwe vanhu vane kamukira kadiki kadiki kemukirini yemapapu mukati:
- Kenza iripo mune rimwe chete mapapu.
- Kenza haina kusanganisira lymph nodes kana iripo chete mumakirini emakiromita ari pedyo. (Mune mamwe mazwi, kuvhiyiwa haisi chakanaka chevanhu vane chirwere cheN2 paTMM yemapapiro emukenza , iyo inoreva lymph nodes ine kenza munzvimbo iri pakati pemapapu (mediastinal lymph nodes).
- Kuvhiya kunowanzova yekusarudza kana kenza iri mumativi ekunze emapapu.
Mhando dzeUkuvhiya
Pane 4 mhando mikuru yekuvhiya iyo inoitwa nemukenza wemapapu:
- Pneumonectomy. Pneumonectomy chirwere chinosanganisira kubviswa kwemapapu ose. Vamwe vanhu vanoshamisika kuti kuvhiyiwa uku kunobvira, asi kune vanhu vane mamwe mabasa akanaka, vanhu vazhinji vakabvumira nzira yacho zvakanaka chaizvo.
- Lobectomy. A lobectomy ndiyo nzira inoshandiswa kureba kwemapapu. Mapapu akanaka ane 3 lobes uye mapapu ari kuruboshwe ane 2.
- Wedzera resection kana segmentectomy. A wedge resection inoburitsa umo chiremara pamwe nechepamusoro-soro yezvisikwa zvakapoteredza zvinobviswa. Izvi zvinoita kuti zviduku zvishoma zvive zvakarashika kunze kweiyo inonzi lobectomy, asi inogonawo kutakura ngozi yakawanda yekudzokorora.
- Sleeve resection.
Pakati peizvi, lobectomy inoratidzika kuva nemigumisiro yakanakisisa yevanhu vose vane kenza yemukirini yemapapu.
Usati Uchivhiya
Kana kuvhiyiwa kunofungidzirwa, kuongorora kwakanyatsonaka kuchadikanwa kuitwa, kusanganisira mediastinoscopy (chirongwa chinotarisa kenza mumharapakati pemapapu), kuve nechokwadi kuti kenza haina kupararira kune lymph nodes munzvimbo ino (n2 lymph nodes). PET / CT inogona kunge iri imwe nzira yemasikirinoscopy kune vamwe vanhu.
Pulmonary function test ichaitwawo kuti ave nechokwadi chokuti munhu achabvumira kuvhiyiwa uye ave nemapapu akakwana mushure mekuvhiyiwa.
Sezvo kupona kubva pakuvhiyiwa kwekenza yemukirini yemapapu kunoratidzika kuva nani mumakirini emukenza unoita zvizhinji zvekuvhiya uku, zvakakosha kutsvakurudza kenza yako isati yavhiyiwa uye funga kuwana pfungwa yechipiri pane imwe kenza yakakura .
Mushure mekuvhiya
Kana kuvhiyiwa kuchiitwa, zvinokosha kuti chemotherapy uye kazhinji kacho kurapa kwemaawa kunoshandiswa mushure mekuvhiyiwa, sezvo izvi zvinovandudza kupona.
Prophylactic cranial irradiation (PCI) , rudzi rwemazuva ano rakagadzirirwa kubatsira kudzivirira kupararira kwekenza kuuropi, inogona kushandiswa kuderedza dambudziko rekenza rinopararira kuuropi mushure mekuvhiyiwa.
Dambudziko rehutachiona hwemagetsi hunowanikwa makore matatu mushure mekuvhiyiwa kuwedzera pamwe nechetatu rechirwere, uye kumwe kuongorora kwakawana ngozi iyi kuva 9,7 muzana yepatanhi 1, 18.5 muzana yegadziriro yechipiri, uye 35.4 muzana yepakati chetatu zvirwere.
Prognosis
Zvidzidzo zvinoratidza kuti kune vanhu vane danga rekutanga (zvishoma zvishoma) kemukirini kadiki emapapu emapapu (T1 kana T2), kuvhiyiwa kunowedzera kuponeswa kwehupenyu. Mukuongorora kukuru, zvakawanikwa kuti kuponesa kwevanhu vane zvirwere zvepanyika uye zvepamatunhu kwakagadziridzwa nekuvhiyiwa.
Kune avo vane chirwere chinowanikwa munzvimbo iyo vaiva ne lobectomy, kuponeswa kwemazuva mashoma kwaive nemwedzi 65 uye iyo yega yega yegore yekupera makore 5 yaiva yepamusoro makumi mashanu nezana. Iyi nhamba inogona kutinhira inotyisa kusvikira iwe uchivaenzanisa nemararamiro evanhu vasingagoni kuvhiyiwa izvo zvaisanganisira kuponeswa kwemazana emwedzi gumi nemashanu uye yehupenyu hwemakore mashanu ehupenyu hwe 31.8 muzana.
Chinyorwa ndechokuti kurapwa kweuropi metastases nekuda kwekenza yemapapu kuri kuchinja, uye dzimwe mamiriro ezvinhu vanhu vane zvishoma chete masastases ("oligometastases") anogona kubatwa nechinangwa chokurapa neine stereotactic body body radiotherapy (SBRT) kana kuti proton beam therapy .
Pasi Pasi
Munguva yakapfuura, kuvhiyiwa kwaiwanzoonekwa sechisarudzo chekurapa kenza yemukirini yemapapu. Izvi zvinoita sezviri kuchinja seongororo idzva dzakawana rubatsiro rwekupona kune vamwe vanhu vane chirwere. Kunyanya, vanhu vane chirwere chepenza chepapu zvisinganyanyove nani zviri nani zvikuru makore mashanu ekupukunyuka nekuvhiyiwa kupfuura nekemotherapy uye remishonga yemaawa chete. Pamitemo yakasiyana-siyana iripo, lobectomy yakave nemigumisiro yakaisvonaka.
Zvakakosha kuchengeta mupfungwa kuti munhu wose akasiyana. Mamwe mavambo ekutanga (chirwere chisinganyanyi) kemukirini kadiki yemapapu mapepa angave akaoma kana asingakwanisi kurapa nekuvhiyiwa nekuda kwekugara kwechirwere. Kuvapo kwemamwe mararamiro kunogona kutungamirirawo kune ngozi yekuvhiya kupfuura kupfuura zvingave zvingabatsira.
Kana uri kurarama nemukenza wemapapu zvakakosha kuva iwe mutauriri wako pamuri kutarisira. Mikana yekurapa kwekamudiki yemukenza yemapapu irikuvandudza uye mushonga mutsva uri kuongororwa mumakiriniki ekuedzwa. Zvimwe zvezvirapa izvi, zvakadai savanoshandisa idzva remunodhakirwo mishonga zvinopa chivimbiso chekuwedzerwa kwezvinhu zvakanyanya mune ramangwana. Kunyange zvazvo vanhu vakawanda vanotya makiriniki, zvinokosha kuyeuka kuti mushonga wose watinayo iye zvino waimbova chikamu chekuongorora kliniki.
> Sources:
> Zvakanaka, C. Chiitiko chechiremba wechiremba wepamusoro pakugadziriswa kwenzira mucheche musana kadiki rekuvhiyiwa kwekenza yemapapu. Zvinyorwa zveTrracic uye Mwoyo Mushonga . 2016. 151 (4): 1219.
> Koletsis, E., Prokakis, C., Karanikolas, M., Apostolakis, E., uye D. Dougenis. Ikozvino basa rekuvhiyiwa iduku duku remapapu carcinoma. Nyaya yeCardiothoracic Surgery . 2009. 4:30.
> National Cancer Institute. Small Cell Lung Cancer Treatment (PDQ) - Mwoyo Murefu. Updated 11/09/17.
> Schreiber, D., Rineer, J., Weedon, J. et al. Kubudirira kwezviitiko pamwe nekushandiswa kwekuvhiyiwa muchengeti-mutsara wechidiki chemukati wemapapu emapapu: inofanirwa here kuti basa racho riongororwe? Cancer . 116 (5): 1350-7.
> Zhu, J., Bi. Y., Han A. et al. Zvinokonzerwa nehutachiona hwehutachiona hwehupombwe zvakagadziriswa zvachose nekenza yemukiramu kadiki yemapapu: kuongorora zvekare kuti vaone varwere vanowanzobatsirwa neprophylactic iraniation. Radiation Oncology . 2014. 9: 216.