Chotupa cham'mimba

Chotupa cham'mimba ndimtundu wa khansa yomwe imafalikira kuchokera ku chiwalo china kupita kukakhungu kochepa (pleura) kozungulira mapapo.

Magazi ndi ma lymph system amatha kunyamula ma cell a khansa kupita ku ziwalo zina m'thupi. Kumeneko, amatha kupanga zophuka kapena zotupa zatsopano.

Pafupifupi mtundu uliwonse wa khansa imatha kufalikira m'mapapu ndikuphatikizira pleura.

Zizindikiro zimatha kuphatikizira izi:

• Kupweteka pachifuwa, makamaka mukamapuma kwambiri
• Tsokomola
• Kutentha
• Kutsokomola magazi (hemoptysis)
• Kusapeza bwino, kusakhazikika, kapena kudwala (malaise)
• Kupuma pang'ono
• Kuchepetsa thupi
• Kutaya njala

Wothandizira zaumoyo adzakufunsani ndikufunsani za mbiri yanu yamankhwala ndi zomwe mukudziwa. Mayeso omwe angachitike ndi awa:

• X-ray pachifuwa
• Kufufuza kwa CT kapena MRI pachifuwa
• Ndondomeko yochotsera ndikuwunika pleura (open pleural biopsy)
• Yesani yomwe imayesa mtundu wa madzi amadzi omwe asonkhana m'malo opembedzera (kuwunika kwamadzi)
• Ndondomeko yomwe imagwiritsa ntchito singano kuchotsa zitsanzo za pleura (pleural singano biopsy)
• Kuchotsa madzi am'mapapo (thoracentesis)

Zotupa zamagulu nthawi zambiri sizingachotsedwe ndi opaleshoni. Khansa yoyamba (yoyambirira) iyenera kuthandizidwa. Chemotherapy ndi radiation radiation itha kugwiritsidwa ntchito, kutengera mtundu wa khansa yoyamba.

Wopereka wanu atha kulangiza thoracentesis ngati muli ndi madzi ambiri osonkhanitsa m'mapapu anu ndipo mumakhala ndi mpweya wochepa kapena mpweya wochepa wama oxygen. Madzi atachotsedwa, mapapu anu azitha kukulirakulira. Izi zimakuthandizani kupuma mosavuta.

Pofuna kupewa kuti madzimadzi asadzasonkhanenso, mankhwala akhoza kuikidwa molunjika pachifuwa panu kudzera mu chubu, chotchedwa catheter. Kapenanso, dotolo wanu amatha kupopera mankhwala kapena talc m'mapapo panthawiyi. Izi zimathandiza kusindikiza malo ozungulira mapapu anu kuti madziwo asabwerere.

Mutha kuchepetsa nkhawa zakudwala polowa nawo gulu lothandizira pomwe mamembala amagawana zomwe akumana nazo pamavuto.

Kuchuluka kwa zaka zisanu (kuchuluka kwa anthu omwe amakhala zaka zopitilira 5 atawazindikira) ndi ochepera 25% kwa anthu omwe ali ndi zotupa zopempha zomwe zafalikira kuchokera mbali zina za thupi.

Mavuto omwe angabwere chifukwa chake ndi awa:

• Zotsatira zoyipa za chemotherapy kapena radiation radiation
• Kupitilira kufalikira kwa khansa

Kuzindikira koyambirira ndi chithandizo cha khansa yoyambirira kumatha kuteteza zotupa m'matumbo mwa anthu ena.

Chotupa - metastatic pleural

• Malo osangalatsa

Arenberg DA, Pickens A. Metastatic zilonda zotupa. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 55.

Broaddus VC, Robinson BWS. Zotupa zamagulu. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 82.

Putnam JB. Mapapu, khoma pachifuwa, pleura, ndi mediastinum. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 57.