Chotupa chaubongo - chachikulu - achikulire

Chotupa choyambirira chaubongo ndi gulu (misa) la maselo osadziwika omwe amayamba muubongo.

Zotupa zam'mutu zoyambirira zimaphatikizapo chotupa chilichonse chomwe chimayamba muubongo. Zotupa zoyambirira zaubongo zimatha kuyambira m'maselo aubongo, nembanemba mozungulira ubongo (meninges), misempha, kapena glands.

Zotupa zitha kuwononga mwachindunji ma cell aubongo. Zitha kuwononganso maselo ndikupanga kutupa, kuyika magawo ena aubongo, ndikuwonjezera kukakamiza mkati mwa chigaza.

Zomwe zimayambitsa zotupa muubongo sizidziwika. Pali zifukwa zambiri zoopsa zomwe zingathandize:

• Chithandizo cha radiation chomwe chimagwiritsidwa ntchito pochizira khansa ya muubongo chimawonjezera chiopsezo cha zotupa zamaubongo mpaka zaka 20 kapena 30 pambuyo pake.
• Zina mwazotengera zimawonjezera ziwopsezo zotupa muubongo, kuphatikiza neurofibromatosis, Von Hippel-Lindau syndrome, Li-Fraumeni syndrome, ndi Turcot.
• Ma lymphoma omwe amayamba muubongo mwa anthu omwe ali ndi chitetezo chamthupi chofooka nthawi zina amalumikizidwa ndi matenda a Epstein-Barr virus.

Izi sizinatsimikizire kuti ndizoopsa:

• Kuwonetsedwa ndi ma radiation kuntchito, kapena pamagetsi, mafoni am'manja, mafoni opanda zingwe, kapena zida zopanda zingwe
• Kuvulala kumutu
• Kusuta
• Thandizo la mahomoni

MITUNDU YOPHUNZITSA MAUMBWE

Zotupa zamaubongo zimasankhidwa kutengera:

• Kumene kuli chotupacho
• Mtundu wa minofu yomwe ikukhudzidwa
• Kaya alibe khansa (ovuta) kapena khansa (yoyipa)
• Zinthu zina

Nthawi zina, zotupa zomwe zimayamba kukhala zankhanza zimatha kusintha machitidwe awo ndikukhala okwiya kwambiri.

Zotupa zimatha kuchitika msinkhu uliwonse, koma mitundu yambiri imafala kwambiri m'badwo wina. Akuluakulu, ma gliomas ndi meningiomas ndi omwe amapezeka kwambiri.

Gliomas amachokera ku maselo am'magazi monga ma astrocyte, oligodendrocyte, ndi ma ependymal cell. Gliomas agawika mitundu itatu:

• Zotupa za Astrocytic zimaphatikizaponso astrocytomas (mwina sizotheka khansa), anaplastic astrocytomas, ndi glioblastomas.
• Zotupa za Oligodendroglial. Zotupa zina zoyambirira zamaubongo zimapangidwa ndi zotupa zonse za astrocytic ndi oligodendrocytic. Izi zimatchedwa gliomas wosakanikirana.
• Glioblastomas ndi mtundu wankhanza kwambiri wa chotupa chachikulu muubongo.

Meningiomas ndi schwannomas ndi mitundu ina iwiri ya zotupa zamaubongo. Zotupa izi:

• Zimapezeka nthawi zambiri pakati pa 40 ndi 70.
• Nthawi zambiri samakhala ndi khansa, komabe amatha kuyambitsa mavuto akulu ndi imfa kuchokera kukula kwake kapena komwe amakhala. Ena ali ndi khansa komanso ndewu.

Zotupa zina zoyambirira zamaubongo mwa akulu ndizosowa. Izi zikuphatikiza:

• Ependymomas
• Craniopharyngiomas
• Zotupa za pituitary
• Pulayimale (chapakati mantha dongosolo - CNS) lymphoma
• Zotupa zaminyewa zapineal
• Zotupa zoyambirira za majeremusi a ubongo

Zotupa zina sizimayambitsa zizindikiro mpaka zitakhala zazikulu kwambiri. Zotupa zina zimakhala ndi zizindikilo zomwe zimayamba pang'onopang'ono.

Zizindikiro zimadalira kukula kwa chotupacho, malo, kutalika kwake, komanso ngati pali kutupa kwa ubongo. Zizindikiro zofala kwambiri ndi izi:

• Kusintha kwa magwiridwe antchito amunthu
• Kupweteka mutu
• Khunyu (makamaka okalamba)
• Kufooka kwa gawo limodzi la thupi

Mutu wopangidwa ndi zotupa zamaubongo atha:

• Khalani oipitsitsa munthuyo akadzuka m'mawa, ndikudzuka m'maola ochepa
• Zimapezeka panthawi yogona
• Zimapezeka ndi kusanza, kusokonezeka, kusawona bwino, kufooka, kapena kufooka
• Pitirizani kukula ndi chifuwa kapena kuchita masewera olimbitsa thupi, kapena kusintha kwa thupi

Zizindikiro zina zitha kuphatikiza:

• Sinthani kukhala tcheru (kuphatikiza kugona, chikomokere, ndi chikomokere)
• Kusintha pakumva, kulawa, kapena kununkhiza
• Zosintha zomwe zimakhudza kukhudza komanso kumva kupweteka, kupanikizika, kutentha kosiyanasiyana, kapena zina zoyambitsa
• Kusokonezeka kapena kuiwalaiwala
• Zovuta kumeza
• Zovuta kulemba kapena kuwerenga
• Chizungulire kapena kuyenda kosazolowereka (vertigo)
• Mavuto amaso monga kukopeka kwa chikope, ophunzira amitundu yosiyana, kuyenda kosalamulirika, kuyenda kwamaso (kuphatikiza kuchepa kwa masomphenya, kuwonera kawiri, kapena kutayika kwathunthu)
• Kugwedeza kwamanja
• Kulephera kulamulira chikhodzodzo kapena matumbo
• Kutayika bwino kapena kulumikizana, kusakhazikika, kuyenda movutikira
• Kufooka kwa minofu pamaso, mkono, kapena mwendo (nthawi zambiri mbali imodzi)
• Dzanzi kapena kumva kulasalasa mbali imodzi ya thupi
• Umunthu, malingaliro, machitidwe, kapena kusintha kwamaganizidwe
• Kulephera kulankhula kapena kumvetsetsa ena omwe akuyankhula

Zizindikiro zina zomwe zimatha kuchitika ndi chotupa cha pituitary:

• Kutulutsa kwachilendo kwamabele
• Kusamba (kusamba)
• Kukula kwa m'mawere mwa amuna
• Kukulitsa manja, mapazi
• Tsitsi lokwanira kwambiri
• Kusintha kwa nkhope
• Kuthamanga kwa magazi
• Kunenepa kwambiri
• Kuzindikira kutentha kapena kuzizira

Mayesero otsatirawa angatsimikizire kupezeka kwa chotupa muubongo ndikupeza komwe ili:

• Kujambula kwa CT pamutu
• EEG (kuyeza zamagetsi zamaubongo)
• Kufufuza kwa minofu yomwe imachotsedwa pachotupa panthawi yochita opaleshoni kapena biopsy yoyendetsedwa ndi CT (itha kutsimikizira mtundu wa chotupacho)
• Kuyesedwa kwa ubongo wamtsempha wamtsempha (CSF) (kumatha kuwonetsa maselo a khansa)
• MRI ya mutu

Chithandizochi chingaphatikizepo kuchitidwa maopaleshoni, ma radiation, komanso chemotherapy. Zotupa zamaubongo zimachiritsidwa bwino ndi gulu lomwe limaphatikizapo:

• Dokotala wa neuro-oncologist
• Neurosurgeon
• Katswiri wazachipatala
• Wofufuza oncologist
• Ena othandizira zaumoyo, monga ma neurologist ndi ogwira nawo ntchito

Kuchiza mwachangu nthawi zambiri kumawongolera mwayi wazabwino. Chithandizo chimadalira kukula ndi mtundu wa chotupacho komanso thanzi lanu. Zolinga zamankhwala zitha kukhala kuchiritsa chotupacho, kuchepetsa zisonyezo, komanso kukonza magwiridwe antchito aubongo kapena kutonthoza.

Nthawi zambiri pamafunika opaleshoni yopanga zotupa zambiri zamaubongo. Zotupa zina zimatha kuchotsedwa kwathunthu. Zomwe zili mkatikati mwa ubongo kapena zomwe zimalowa mu ubongo zimatha kuchotsedwa m'malo mochotsedwa. Debulking ndi njira yochepetsera kukula kwa chotupacho.

Zotupa zimakhala zovuta kuzichotsa kwathunthu ndi opaleshoni yokha. Izi ndichifukwa choti chotupacho chimalowerera muubongo wozungulira ngati mizu ya chomera yomwe imafalikira m'nthaka. Ngati chotupacho sichingachotsedwe, opaleshoni imathandizabe kuchepetsa kupanikizika ndikuchotsa zizindikilo.

Thandizo la radiation limagwiritsidwa ntchito pazotupa zina.

Chemotherapy itha kugwiritsidwa ntchito ndi opaleshoni kapena chithandizo chama radiation.

Mankhwala ena omwe amagwiritsidwa ntchito pochizira zotupa zoyambira mu ana atha kukhala:

• Mankhwala ochepetsa kutupa kwa ubongo ndi kukakamizidwa
• Anticonvulsants kuti achepetse kugwidwa
• Mankhwala opweteka

Njira zachitonthozo, njira zachitetezo, kulimbitsa thupi, komanso chithandizo chantchito zitha kufunikira kuti mukhale ndi moyo wabwino. Uphungu, magulu othandizira, ndi njira zina zofananira zitha kuthandiza anthu kuthana ndi vutoli.

Mutha kulingalira zolembetsa mayeso azachipatala mutalankhula ndi gulu lanu lazachipatala.

Zovuta zomwe zingachitike chifukwa cha zotupa zamaubongo zimaphatikizapo:

• Herniation yaubongo (nthawi zambiri imapha)
• Kutaya kulumikizana kapena kugwira ntchito
• Kukhazikika, kukulirakulira, komanso kutayika kwakukulu kwa ubongo
• Kubwerera kwa kukula kwa chotupa
• Zotsatira zoyipa za mankhwala, kuphatikizapo chemotherapy
• Zotsatira zoyipa za mankhwala a radiation

Itanani omwe akukuthandizani ngati mungakhale ndi mutu watsopano, wopitilira kapena zisonyezo zina za chotupa muubongo.

Itanani omwe akukuthandizani kapena pitani kuchipinda chodzidzimutsa ngati mungayambe kugwidwa, kapena mwadzidzidzi kukhala wopusa (kuchepa kukhala tcheru), kusintha kwa masomphenya, kapena kusintha kwa malankhulidwe.

Multifune ya Glioblastoma - akulu; Ependymoma - achikulire; Glioma - achikulire; Astrocytoma - achikulire; Medulloblastoma - achikulire; Neuroglioma - achikulire; Oligodendroglioma - achikulire; Lymphoma - achikulire; Vestibular schwannoma (acoustic neuroma) - achikulire; Meningioma - achikulire; Khansa - chotupa chaubongo (akulu)

• Kutulutsa kwa ubongo - kutulutsa
• Opaleshoni ya ubongo - kutulutsa
• Chemotherapy - zomwe mungafunse dokotala wanu
• Thandizo la radiation - mafunso omwe mungafunse dokotala wanu
• Ma stereosactic radiosurgery - kutulutsa

• Chotupa chaubongo

Dorsey JF, Salinas RD, Dang M, ndi al. Khansa yapakati yamanjenje. Mu: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 63.

> Michaud DS. Epidemiology ya zotupa zamaubongo. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 71.

Tsamba la National Cancer Institute. Chithandizo cha akulu chotupa chotupa chotupa (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/brain/hp/adult-brain-kuchiza-pdq. Idasinthidwa pa Januware 22, 2020. Idapezeka pa Meyi 12, 2020.

Tsamba la National Comprehensive Cancer Network. Maupangiri a NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): khansa yapakatikati yamanjenje. Mtundu wa 2.2020. www.nccn.org/professionals/physician_gls/pdf/cns.pdf. Idasinthidwa pa Epulo 30, 2020. Idapezeka pa Meyi 12, 2020.