Mesothelioma Pleural: Iimpawu, Oonobangela, uthintelo

mesothelioma Pleural - isifo somhlaza eyingozi kakhulu, nto leyo sikhatshwa ukuvela nophuhliso yamathumba amabi, kwi kwemiphunga ndizayo pleural. Ngokuqhelekileyo, isifo ayide ikwazi kuchaphazela imeko imiphunga kunye umzimba uphela. Kungenxa yoko le nto kubaluleke kangaka ukufunda oonobangela ezisisiseko kunye iimpawu zesi sifo. I ngaphambili ukuxilongwa echanekileyo uthomalaliso kuyaqalwa, kokukhona ukuphumeza uxolelo nokulondoloza ubomi babantu.

Yintoni mesothelioma pleural? Amafoto kunye nenkcazo emfutshane

Umhlaza pleura - nomhlaza esinqabileyo. Nangona kokuba uxilongiwe nanini na ubudala, uninzi lwezigulane kunye lokufunyaniswa ilungu oqolileyo oyindoda, ngendlela ethile inxaxheba kwimisebenzi ezinobungozi. Kananjalo kubalulekile ukuba siqaphele ukuba inani labantu nokubandezeleka kulo sifo siya sisanda nyaka ngamnye.

Mesothelioma - Ithumba oluthi luqokelelane kwinkqubo yotshintsho amabi of epithelial iiseli pleura. Okokuqala, it has uhlobo maqhuqhuva ezincinane okanye kukubola, onombolo yakhe kwandisa njengokuba isifo siqhubeka, ekusekeni uhlobo ukukhanya emhlabeni iqokobhe.

Iintlobo yamathumba amabi

Xa yesilungu, kukho iinkqubo zokuhlela eziliqela. Ngokuxhomekeka kuhlobo iiseli mesothelioma pleural ingaba:

• epithelioid (uhlobo olunjalo ithumba kwenzeka ngo-50-60% yamatyala);
• ezinezikhondo okanye sarcomatoid (efumaneka-10% amatyala);
• 30-40% yazo zonke iimeko Ithumba sisigaba ezimbini-okanye oxutyiweyo (eyenziwa zombini iindidi cell).

Kuxhomekeka isakhiwo acinar ekwanti, iseli amancinane, kwaye tubopapillyarnye ezinezigulo iseli ecacileyo.

Le Pathogenesis kwesifo

mesothelioma Pleural - isiphumo wenguqu amabi weeseli pleural umgangatho epithelium (mesothelium). Xa Lendawo amiliswe ifomu ithumba kuyo nayiphi na inxalenye Parietal okanye pleura visceral. Kodwa rhoqo kukho uhlobo ehlasela ngayo esi sifo apho iiseli amabi diffusely isasazwe phezu pleura, ityala ukukhanya inwenwa. Xa kunjalo, ukuba kwisisu pleural kuhlala ezamahala, ngaphakathi nokwanda bokugcinwa ukopha (ngegazi) okanye exudate seroplastic.

Ekubeni pleura ngokusondeleyo nabo ke pericardium (imvulophu inwenwa imisipha intliziyo), ngoko ke iiseli amabi, kwi zigaba kamva nako isicelo esicwangciswe ngayo pericardium. Kwakhona ithumba nabakwaziyo iyakhula ku ezalathelwe nkovu.

Eyona eziphambili ezibangela izifo

An mbuzo umdla, kwaye oonobangela kwesi sifo. Kakade ke, ukuze bafunde ngokupheleleyo indlela wenguqu amabi weeseli akufuneki waphumelela ngokupheleleyo. Nakuba kunjalo, abaphandi mihla baye bafumanisa ukuba kukho ubungozi ezininzi bandiqumbisayo isifo embi:

• Phephezela inguqu ebulalayo weeseli ekunokuqhagamshelwana nazo nge-asbestos. Ngokutsho izifundo izibalo,-9 kwabali-10 abaye kubonakele mesothelioma pleural, ngaphambili wasebenza nalo mbandela. Hi ndlela leyi, asbestos liye lasetyenziswa ngokubanzi kushishino ukuya malunga 1970.
• Imiba yomngcipheko zibandakanya ukusulelwa SV40 intsholongwane zabantu, nto leyo eyaziwa amayeza phantsi elinye igama, umzekelo intsholongwane simian. Ukususela ngowe-1955 ukuya 1963, wazithwala phandle i ugonyo kwihlabathi labantu ipoliyo. Ngelishwa, lokugonya yayixubana kunye amasuntswana entsholongwane. Indlela kanye lo ubunzima libandakanyeka ukusekwa kunye nophuhliso mesothelioma, kude kube sekupheleni ayaziwa, kodwa uqhagamshelwano kwasuka.
• Unobangela kwesifo kunokuba iziphumo umzimba radiation. Umzekelo, mesothelioma lisenokuba wadibana emzimbeni thorium dioxide. Hi ndlela leyi, eli ingxam 1950, yasetyenziselwa ngethuba leemviwo radiology. Kunye nokuzibandakanya pleural esinxulunyaniswa kunye radiotherapy transferred ngaphambili.
• Iinkcukacha ngamachiza athile unako bandiqumbise izifo. Umzekelo, umsebenzi eqhubekayo kunye neentlobo ezithile inks, izinyibilikisi, imichiza bako ekuqaleni kukhokelela ngokuma sisilonda esidumbileyoesingaphakathi, uze emva koko uye inguqu elinobuhlungu of iiseli.

Yintoni iimpawu zesi sifo ukuba kwenzeka ngasemva?

Ngoko nangoko ke paha ukuba mesothelioma singanyangekiyo pleural uvela kakhulu ngokukhawuleza. Ngaphandle diagnosis ngexesha kwiinyanga nje ezimbalwa kamva isifo kunokukhokelela ekufeni komntu.

Ngokuqhelekileyo, uphawu lokuqala intlungu inxalenye esezantsi esifubeni, yaye ngamanye amaxesha ngasemva. Ukongeza, izigulane ezikhala ukhohlokhohlo rhoqo ezomileyo, nto leyo nayo sikhatshwe yi ngesisa. Ngophuhliso sifo kuvandlakanywa ubunzima yokuginya, hoarseness.

Kukho nezinye iimpawu ezihambisana mesothelioma le pleura. Iimpawu zihlanganisa ukubila enzima kunye nomkhuhlane. Amaxesha amaninzi, izigulane zifumana anemia. Kungenzeka kwakhona ukuba umzimba, ngaphandle itye okanye naluphi na utshintsho ubonelelo.

Ekubeni kwisisu pleural oqokelela fluid, omnye neziphithiphithi, kwaye dyspnea na, hayi kuphela ngexesha umsebenzi umzimba, kodwa urhulumente ukuphumla. Zokuhlatywa kunye nokususwa exudate uncedo ngexesha ukuququzelela imeko yesigulane. Noko ke, ukuqina pleural ndingungelwe amalungu mediastinal, esoloko ibangela ukuphazamiseka kwi inxalenye yegazi.

lokufunyaniswa kwesifo

Xa usibona i kugqirha onamava Basenokukrokrela ukuba isiguli mesothelioma pleural. Uxilongo zincediswe esifubeni X-ray. Kodwa nje imiqondiso ezimbalwa ungabona kule mifanekiso. Ngoko ke, kuyimfuneko kunye nezinye izifundo:

• Indlela ephambili uphethwe a CT scan. Ngethuba loviwo, uya kuqaphela ubukho effusion pleural, pleural ukuqina node, inyambalala ithumba angqonge kwaye compress kwemiphunga, shift mediastinal.
• Magnetic intlokoma umfanekiso inika umfanekiso echanileyo ngakumbi nobungakanani ithumba kwasasazeka. Unakho ukubona iqondo umonakalo uvalo, kwaye ukusasazeka kwesifo ezingqongileyo inyama ithambile.
• Apho kuboniswe yaye wenza i ungcoliseko Itomography, nto leyo evumela ukufumanisa ubukho metastases ezikude kunye nobungakanani inxaxheba nkovu node.

Ezinye iinkqubo eyenziwa ukuqinisekisa lokufunyaniswa morphological

Emva kwezi nkqubo ifuna kunye nokuqinisekisa morphological kwesifo. Oku kuthetha ukuba kufuneka ukufumanisa ukuba ingaba nangezilonda bakufumanisayo eneneni mesothelioma amabi.

Okokuqala lwalugxile kuhlalutyo athathe exudation ukusuka kwisisu pleural, nto leyo ke ngoko wathumela ukuba kubizwe cytology. Ngelishwa, uvakalelo kule nqubo 25-50% kuphela, kwaye ngoko ke kufuna nezinye cazululo. Maxa wambi wenza kunye nesifundo histologic, ukuchaneka apho, ngelishwa, hayi ziphezulu kakhulu kwaye malunga ne-60%. Nangona kunjalo, le nkqubo kuyafikeleleka kwaye kuyafikeleleka ngokwasezimalini, kodwa ngenxa yokuba ziqhutywa kwindawo yokuqala.

ubuchule Okuninzi ngqo ezi yeli lizwe, ingakumbi Mediastinoscopy thoracoscopy (kuquka ukuvulwa diagnostic esifubeni).

Yintoni inkqubo unyango?

Ngelishwa, ifuthe amayeza asetyenziswa amayeza mihla ngenxa ichemotherapy, yi-20% kuphela. Ukusetyenziswa "Cisplatin", "Mitomycin", "Etoposide", "Gemzar" kunye namanye amayeza ezithile ukunciphisa ubungakanani thumba kunye ukufikelela injongo yokuphucula imeko yomguli. Kodwa ke, umgangatho igolide a ichemotherapy udibaniso. Umzekelo, i-scheme onokukwazi ukujonga ngolu hlobo lulandelayo: "Gemcitabine" + "Alimta" okanye "Gemcitabine" + "Cisplatin".

Ukuba kukho effusion pleural, isigulane unokunikwa cytostatics alawula ngqo kwi ndawo ibinomthwebeba pleural. Ngamanye amaxesha injongo efanayo wasebenzisa interferon. Inceda ukwehlisa okanye ukunqanda ukuqokelela exudate yaye ngaloo ndlela kube lula kakhulu eliphefumla yesigulane.

Ngokuqhelekileyo, uphando esebenzayo iindidi zamachiza anti-umhlaza yenziwa ukuza kuthi ga ngoku. Izincomo iziyobisi ezithembisayo - inhibitors yegazi endothelial factor ukukhula. Ngelishwa, izinga ukusinda phakathi izigulane ulihlwempu.

neenkqubo eziyimfuneko zotyando

Esi sifo kushiya na igumbi kakhulu ukuba kushenxa, ingakumbi xa kuziwa kwi zigaba ezithile zesi sifo. Ngoko ke ingaba uqhaqho kunokwenzeka ukuba umntu ukuba unesifo mesothelioma pleural? unyango Surgical, ngokuqhelekileyo luqhutywa kuphela xa nethumba yenzelwe kwindawo enye. Kwiimeko ezinjalo, ukususwa lwenziwa pleura, ngamanye amaxesha kunye inxalenye kwemiphunga. Ezi nkqubo ziqhutywa malunga 11-15% amatyala. Ubude bobomi kwanasemva unyango elinjalo ezinkulu na iinyanga 9-22, ngexesha ezininzi kwiminyaka embalwa. Isiphumo kakhulu ngempumelelo unika uthomalaliso indibanisela, apho umsebenzi kudityaniswe ichemotherapy.

mesothelioma Pleural: sase-

Zomhlaza kunjalo yingozi. Ngoko ke yintoni na ukuba isigulane othe wafunyaniswa "mesothelioma pleural"? Wezulu, yeha, ayikhuthazi kakhulu. Kakade ke, konke kuxhomekeke kanye oko sigaba isifo eso. Akhawunti kufuneka sithathe ubudala nempilo jikelele yomguli, ukusebenza amachiza asetyenziswa, njalo njalo. D. Ngokubanzi, ilungelo nothomalaliso kwi zigaba zokuqala zesi sifo kungenziwa uxolelo, maxa wambi ukulondoloza ubomi yomguli ngeminyaka 5-6.

Ngelishwa, ngokufuthi kwizigulane unesifo isebenzisa mesothelioma pleural (inyathelo 4). Bangaphi abantu abaphila nesi sifo? Ngelishwa, nkqu ukusetyenziswa zonke iindlela zezonyango namhlanje kunqabile ukusindisa ubomi yomguli ngaphezulu kweenyanga 2-8.

Ingaba kukho amanyathelo okuthintela esi sifo?

Pleural mesothelioma lung - sisifo emangalisayo eziyingozi kaninzi ebangela ukufa komntu. Ngelishwa, i-arhente esebenzayo umbala ayikho. Kunjalo, kuba ukufunda ngenyameko izinto ezinkulu engabangela inguqu onobungozi eziseleni, kwaye ukuba kunokwenzeka azame ukuziphepha. Umzekelo, iingcali umphunga Siyaleza ngamandla ukusebenza asbestos, bahlala kwiimeko ezinzima, njalo-njalo. D.

Ngokuqhelekileyo, kuyimfuneko ukuba ukuyeka ukutshaya, njengoko lo mkhwa kungabangela ezininzi izifo isixokelelwano sokuphefumla, kuquka oku. Kwaye minyaka yonke kubalulekile ukuba othintelo iimviwo X-reyi yemiphunga (esifubeni-X ray), kuba kungekudala uza unesifo sisifo esithile, kokukhona ithuba lokuphumelela zonyango. ingqalelo ekhethekileyo kuyimfuneko ukuba ahlawule abasebenzi zamashishini eziyingozi, abaneemfuno zempilo usengozini enkulu.