Zonse Zokhudza Khansa ya Gallbladder

Zamkati

• Chidule
• Zimayambitsa khansa ya ndulu
• Zowopsa
• Zizindikiro za khansa ya ndulu
• Kuzindikira ndi kukhazikitsa khansa ya ndulu
• Chithandizo cha khansa ya ndulu
• Maganizo ake
• Kupewa khansa ya ndulu

Chidule

Ndulu yanu ndi chiwalo chaching'ono chokhala ngati thumba pafupifupi mainchesi atatu m'litali ndi mainchesi 1 mainchesi omwe amakhala pansi pa chiwindi chanu. Ntchito yake ndikusunga bile, yomwe ndi madzimadzi opangidwa ndi chiwindi chanu. Mukasungidwa mu ndulu yanu, bile imatulutsidwa m'matumbo anu ang'ono kuti muthandize kugaya chakudya.

Khansara ya gallbladder ndiyosowa. Malinga ndi American Cancer Society (ACS):

• Opitilira 12,000 ku United States adzalandira matenda awo mu 2019.
• Nthawi zambiri amakhala adenocarcinoma, mtundu wa khansa womwe umayambira m'maselo am'matumbo m'mbali mwa ziwalo zanu.

Zimayambitsa khansa ya ndulu

Madokotala sakudziwa chomwe chimayambitsa khansa ya ndulu. Amadziwa kuti, monga khansa yonse, cholakwika, chotchedwa mutation, mu DNA ya munthu chimayambitsa kukula kwama cell kosalamulirika.

Maselo akuchulukirachulukira, kukula, kapena chotupa chimayamba. Ngati sanalandire chithandizo, maselowa amatha kufalikira m'minyewa yoyandikira komanso mbali zina zakuthupi.

Pali zifukwa zoopsa zomwe zimakulitsa zovuta za khansa ya ndulu. Ambiri mwa iwo ndi ofanana ndi kutupa kwa ndulu kwa nthawi yayitali.

Kukhala ndi zoopsa izi sikukutanthauza kuti mudzakhala ndi khansa. Zimangotanthauza kuti mwayi wanu wowupeza utha kukhala wapamwamba kuposa wina wopanda chiopsezo.

Zowopsa

Miyala yamiyala ndizinthu zazing'ono zolimba zomwe zimapangidwa mu ndulu yanu pamene ndulu yanu ili ndi cholesterol yambiri kapena bilirubin - pigment yomwe imapangidwa maselo ofiira amwazi akawonongeka.

Pamene ma gallstones amatseka njira - yotchedwa bile ducts - kuchokera mu ndulu kapena chiwindi, ndulu yanu imawotcha. Izi zimatchedwa cholecystitis, ndipo zimatha kukhala vuto lalikulu kapena lanthawi yayitali.

Kutupa kwanthawi yayitali kuchokera ku cholecystitis ndiye chiopsezo chachikulu cha khansa ya ndulu. Malinga ndi American Society of Clinical Oncology (ASCO), ma gallstones amapezeka mwa 75 mpaka 90% ya anthu omwe ali ndi khansa ya ndulu.

Koma ndikofunika kukumbukira kuti miyala yamtengo wapatali ndiyofala kwambiri ndipo kukhala nayo sikutanthauza kuti mudzakhala ndi khansa. Malinga ndi ASCO, anthu 99 pa anthu 100 aliwonse omwe ali ndi ndulu samapeza khansa ya ndulu.

Zina mwazomwe zimayenderana ndi chiopsezo cha khansa ya ndulu ndi izi:

• Ndulu ya porcelain. Apa ndipamene ndulu yanu imawoneka yoyera, ngati dongo, chifukwa makoma ake amawerengedwa. Izi zitha kuchitika pambuyo pa cholecystitis yanthawi yayitali, ndipo imalumikizidwa ndi kutupa.
• Tizilombo toyambitsa matenda. Pafupifupi 5% yazing'onozing'ono zazing'ono zomwe zili mu ndulu yanu ndizo khansa.
• Kugonana. Malinga ndi ACS, azimayi amatenga khansa ya ndulu mpaka kanayi kuposa amuna.
• Zaka. Khansara ya gallbladder imakhudza anthu azaka zopitilira 65. Pafupipafupi, anthu amakhala ndi zaka 72 akapeza kuti ali nawo.
• Gulu. Ku United States, Latin America, Amwenye Achimereka, ndi Mexico ali pachiwopsezo chachikulu cha khansa ya ndulu.
• Mavuto amiseche. Zomwe zili m'mabande am'mabande zomwe zimalepheretsa kutuluka kwa bile zimatha kuyipangitsa kuti ibwererenso mu ndulu. Izi zimayambitsa kutupa, komwe kumawonjezera chiopsezo cha khansa ya ndulu.
• Pulayimale sclerosing cholangitis. Kuthyoka komwe kumachitika chifukwa cha kutukusira kwa ma ducts kumawonjezera chiopsezo chanu cha khansa ya ndulu ndi khansa ya ndulu.
• Mkuntho.Salmonella mabakiteriya amayambitsa typhoid. Anthu omwe ali ndi matenda osachiritsika, okhalitsa kapena opanda zizindikiro ali ndi chiopsezo chachikulu cha khansa ya ndulu.
• Achibale omwe ali ndi khansa ya ndulu. Chiwopsezo chanu chimakwera pang'ono ngati muli ndi mbiri yokhudza banja lanu.

Zizindikiro za khansa ya ndulu

Zizindikiro zowonekera za khansa ya ndulu nthawi zambiri sizimawoneka mpaka matenda atakula kwambiri. Ndicho chifukwa chake, kawirikawiri, imafalikira kale ku ziwalo zapafupi ndi ma lymph node kapena kupita kumadera ena a thupi lanu ikapezeka.

Zikachitika, zizindikilo zimatha kukhala:

• kupweteka m'mimba, nthawi zambiri kumtunda chakumanja kwa mimba yanu
• jaundice, yomwe khungu lanu limakhala lachikasu komanso loyera chifukwa cha kuchuluka kwa bilirubin chifukwa chotsekeka
• Mimba yam'mimba, yomwe imachitika ndulu yanu ikakulirakulira chifukwa chotsekedwa ndi ndulu kapena khansa imafalikira pachiwindi ndipo zotupa zimapangidwa m'mimba mwanu chakumanja
• nseru ndi kusanza
• kuonda
• malungo
• Kutupa m'mimba
• mkodzo wakuda

Kuzindikira ndi kukhazikitsa khansa ya ndulu

Nthawi zina, khansa ya ndulu imapezeka mwangozi mu ndulu yomwe idachotsedwa chifukwa cha cholecystitis kapena chifukwa china. Koma nthawi zambiri, dokotala wanu amayesa kuyesa matenda chifukwa munali ndi zizindikilo.

Mayesero omwe angagwiritsidwe ntchito pozindikira, siteji, ndikukonzekera chithandizo cha khansa ya ndulu ndi awa:

• Kuyesa magazi. Kuyezetsa kwa chiwindi kumawonetsa momwe chiwindi, ndulu, ndi mitsempha ya ndulu ikugwirira ntchito ndipo zimapereka chidziwitso pazomwe zimayambitsa matenda anu.
• Ultrasound. Zithunzi za ndulu yanu ndi chiwindi zimapangidwa kuchokera kumafunde amawu. Ndi mayeso osavuta, osavuta kuchita omwe nthawi zambiri amachitidwa pamaso pa ena.
• Kujambula kwa CT. Zithunzizo zikuwonetsa ndulu yanu ndi ziwalo zozungulira.
• Kujambula kwa MRI. Zithunzizo zikuwonetsa zambiri kuposa mayeso ena.
• Percutaneous transhepatic cholangiography (PTC). Iyi ndi X-ray yotengedwa utoto wabayidwa womwe umawonetsa zotsekeka m'matope anu kapena chiwindi.
• Endoscopic retrograde cholangiopancreatography (ERCP). Pachiyesochi, chubu chowala ndi kamera, yotchedwa endoscope, imalowetsedwa mkamwa mwanu ndikupita m'matumbo anu ang'onoang'ono. Kenako utoto umabayidwa kudzera m'kachubu kakang'ono kamene kamaikidwa mu ndulu yanu ya ndulu ndipo X-ray imatengedwa kuti ifunafuna timitsempha ta ndulu totseka.
• Chisokonezo. Chotupa chaching'ono chimachotsedwa ndikuyang'aniridwa pa microscope kutsimikizira kuti ali ndi khansa.

Kuwonetsa khansa kumakuwuzani ngati khansara yafalikira kunja kwa ndulu yanu. Amagwiritsidwa ntchito ndi madokotala kusankha njira yabwino kwambiri yothandizira ndikuzindikira zotsatira zake.

Khansara ya gallbladder imagwiritsidwa ntchito pogwiritsa ntchito American Joint Committee on Cancer TNM system. Mulingo umachokera ku 0 kupita ku 4 kutengera momwe khansara yakulira mpaka pakhoma la ndulu komanso kufalikira kwake.

Gawo 0 limatanthauza kuti maselo abwinobwino sanafalikire kuchokera pomwe amapangidwira - wotchedwa carcinoma in situ. Zotupa zazikulu zomwe zimafalikira ku ziwalo zapafupi ndi chotupa chilichonse chomwe chafalikira, kapena kupaka metastasized, kumadera akutali a thupi lanu ndi gawo 4.

Zambiri pazakufalikira kwa khansa zimaperekedwa ndi TNM:

• T (chotupa) - chikuwonetsa kutalika kwa khansara mpaka khoma la ndulu
• N (mfundo): imafalitsa kufalikira ku ma lymph node pafupi ndi ndulu yanu
• M (metastasis): imafalikira kumadera akutali a thupi

Chithandizo cha khansa ya ndulu

Opaleshoni imatha kuchiza khansa ya ndulu, koma khansa yonse iyenera kuchotsedwa. Izi ndi njira yokhayo khansa ikapezeka msanga, isanafalikire ziwalo zapafupi ndi ziwalo zina za thupi.

Tsoka ilo, ziwerengero zochokera ku ACS zimangowonetsa kuti munthu m'modzi mwa anthu asanu aliwonse amapeza matendawa khansa isanafalikire.

Chemotherapy ndi radiation nthawi zambiri amagwiritsidwa ntchito kuwonetsetsa kuti khansa yonse yatha atachitidwa opaleshoni. Amagwiritsidwanso ntchito pochiza khansa ya ndulu yomwe singathe kuchotsedwa. Sichitha kuchiza khansa koma imatha kutalikitsa moyo ndikuchiza zisonyezo.

Khansara ya ndulu ikapita patsogolo, opaleshoni imatha kuchitidwa kuti muchepetse zizindikilo. Izi zimatchedwa chisamaliro chothandizira. Mitundu ina yosamalira odwala ingaphatikizepo:

• mankhwala opweteka
• nseru mankhwala
• mpweya
• kuyika chubu, kapena stent, mu chotengera cha bile kuti chikhale chotseguka kuti chizitha

Kusamalira odwala kumagwiritsidwanso ntchito ngati opareshoni sangachitike chifukwa munthu alibe thanzi lokwanira.

Maganizo ake

Maganizo a khansa ya ndulu amadalira siteji. Khansa yoyambirira ili ndi malingaliro abwino kuposa khansa yapitayi.

Kuchuluka kwa zaka zisanu kupulumuka kumatanthauza kuchuluka kwa anthu omwe ali ndi matenda omwe ali ndi moyo zaka zisanu atazindikira. Pafupifupi, zaka zisanu zapulumuka magawo onse a khansa ya ndulu ndi 19 peresenti.

Malinga ndi ASCO, zaka zisanu zapulumuka khansa ya ndulu ndi gawo ndi:

• 80% ya carcinoma in situ (gawo 0)
• 50% ya khansa yomwe imangokhala ndulu (gawo 1)
• 8% ya khansa yomwe imafalikira kumatenda am'mimba (gawo lachitatu)
• ochepera 4 peresenti ya khansa yomwe yasintha (gawo 4)

Kupewa khansa ya ndulu

Chifukwa zifukwa zambiri zowopsa, monga zaka ndi mafuko, sizingasinthidwe, khansa ya ndulu siyingapewere. Komabe, kukhala ndi moyo wathanzi kungathandize kuchepetsa chiopsezo chanu. Malangizo ena okhalira ndi moyo wathanzi angaphatikizepo:

• Kukhala wathanzi labwino. Ichi ndi gawo lalikulu la moyo wathanzi ndipo njira imodzi yochepetsera chiopsezo chanu chotenga mitundu yambiri ya khansa, kuphatikiza khansa ya ndulu.
• Kudya chakudya chopatsa thanzi. Kudya zipatso ndi ndiwo zamasamba kungakuthandizeni kulimbitsa chitetezo cha mthupi lanu komanso kukutetezani kuti musadwale. Kudya tirigu mmalo mwa mbewu zoyengedwa ndikuchepetsa zakudya zomwe zakonzedwa kungakuthandizeninso kukhala ndi thanzi labwino.
• Kuchita masewera olimbitsa thupi. Ubwino wochita masewera olimbitsa thupi umaphatikizapo kufikira ndikulemera kwakanthawi ndikulimbitsa chitetezo chamthupi.