Ukubheka ukuhlinzeka, ukufakelwa kwesibindi, kanye nemithi kadokotela
Ukwelashwa kwesifo somdlavuza wesibindi kuxhomeke esiteji somdlavuza, kanye nomsebenzi womuntu ongaphansi kwesibindi.
Ngenkathi ukwelashwa okuthandwayo kukhishwa ukwelashwa, abantu abaningi abavunyelwe ukuhlinzwa ngenxa yesifo sabo kanye / noma impilo embi yesibindi sesibindi. Ngaphandle kokuhlinzwa, ezinye izinketho zokwelashwa zihlanganisa ukufakelwa kwesibindi, ukwelashwa kwe-ablation, ukwelapha okuqinisekisiwe, nemishanguzo kadokotela njengokwelapha okuhlosiwe, i-chemotherapy, ne-immunotherapy.
Ukuhlinzwa
Ukususwa kwesifo somdlavuza wesibindi kuyindlela yokwelapha. Kodwa inselele ngokuhlinzwa, ukuthi abantu abaningi abanesifo somdlavuza wesibindi banesifo se-cirrhosis esesifo eside sesibindi eside.
Ngomsebenzi ongenalutho wesibindi kusuka ku-cirrhosis (isibindi sinzima kakhulu), ukususa ngisho nengxenye encane yezincubu zesibindi kanye nomdlavuza kungenza ukuthi isibindi singasebenzi ngokwanele. Ngaphezu kwalokho, i-cancer eminingi yesibindi ayikwazi ukususwa kahle ngoba ikhulu kakhulu futhi / noma isakaze ngaphandle kwesibindi.
Ukuhlola
Ukuze uthole ukuthi ngabe umuntu ungumuntu ohlinzekwa kahle yini noma cha, udokotela uzoyilungisa ukuhlolwa kwe-imaging (njenge-CT scan noma i-MRI) ukuze kuhlolwe izinga lomdlavuza, kanye nokuhlolwa kwegazi emsebenzini . I-candidate engcono kunazo zonke umuntu ophethe isisu esisodwa esisodwa (hhayi esiningi) nokulondoloza umsebenzi wesibindi.
Uma wena noma othandekayo enesifo somdlavuza wesibindi, kubalulekile ukuthi ubuyekeze zonke izingozi kanye nemiphumela emibi engaba khona nodokotela wakho ohlinzayo.
Ngaphezu kwalokho, ungesabi ukubuza imibuzo futhi ubuze ngokuhlangenwe nakho kwakho ohlinzayo.
Imiphumela Ezingenakwenzeka
Ukususwa kwesifo somdlavuza wesibindi kuyindlela enkulu yokuhlinza, ikakhulukazi njengoba isibindi sinesithambile segazi. Lokhu kwenza ukuphuma kwegazi ngesikhathi sokuhlinzwa kunendaba enkulu.
Ezinye imiphumela emibi engaba khona yokuhlinzekwa zihlanganisa:
- Ukutheleleka
- Ama-clots egazi
- Izinkinga ezihlobene ne-anesthesia
- I-pneumonia
Ithimba lakho lezokwelapha lizokuqapha ukuze unciphise lezi zingozi, futhi unikeze imiyalelo yezindlela onganciphisa ingozi yokucindezeleka kanye.
Ukufakelwa kwesibindi
Ngaphandle kokuhlinzwa, ukuguqulwa kwesibindi kungenye indlela yokwelapheka okunokuphulukiswa, kanye nenzuzo eyengeziwe yokwelapha hhayi kuphela umdlavuza kodwa ne-cirrhosis, futhi. Ngesikhathi sokufakelwa kwesibindi, udokotela wesigqila sokufakelwa ususa isibindi esiphelele futhi asithathe indawo enempilo komunye umuntu.
Udokotela angase ancoma ukufakelwa kwesibindi uma isiguli sesibindi sincane noma uma ukuhlinzwa kungenakwenzeka ngenxa yesibindi esingenampilo.
Isithiyo esikhulu sokufakelwa kwesibindi ukutholakala okulinganiselwe kwama-livers. Ngokusho kwe-American Cancer Society, kuphela ama-liver angu-6 500 kuphela atholakalayo ukufakelwa ngonyaka, futhi iningi lawo lisetshenziselwa abantu abanezinkinga zesibindi ngaphandle komdlavuza.
Imiphumela Ezingenakwenzeka
Ngaphandle kwemiphumela emibi ehambisana nokuhlinzwa kwesibindi (ukuphuma, ukutheleleka, ama-blood clots, izinkinga ze-anesthesia, ne-pneumonia), kunezimo ezimbi ezingase zihlanganiswe nemithi umuntu adinga ukuthatha emva kokufakelwa.
Le mithi yokuvimbela ukuzivikela ivimbela umuntu ukuba enqabe isibindi sakhe esisha.
Ngenxa yokuthi banqanda isimiso somzimba wakho wamasosha omzimba, noma kunjalo, abantu bajwayele ukutheleleka.
Eminye imiphumela emibi engaba khona yemithi yokuvimbela ukuzivikela ihlanganisa:
- Umfutho wegazi ophezulu
- I-cholesterol ephakeme
- Izinkinga zezinso
- Isifo sikashukela
- I-bone egudlulayo (okuthiwa i-osteoporosis)
Izinqubo ezingezona zokuhlinzwa
Kubantu abanesifo somdlavuza wesibindi abangewona ukhetho oluhlinzekwayo, ukwelashwa kwe-ablation kanye / noma ukwelapha okumele kube yindlela yokwelashwa. Lezi zindlela zokwelapha zinciphisa futhi mhlawumbe zibhubhise izicubu zesibindi.
I-Ablation Therapy
Ukwelashwa kwe-Ablation kuyindlela engeyona yokuhlinzwa yokubulala amangqamuzana omdlavuza futhi iyindlela yokwelashwa yesibindi esetshenziswa njalo njalo. Le nqubo ihlanganisa ukubeka inaliti noma ipulazi ngqo kwisisu senhliziyo futhi isebenzisa izindlela ezahlukene zokubulala amaseli.
Izinhlobo ze-ablation therapy zibizwa ngegama elisetshenziselwa ukubhubhisa amaseli omdlavuza:
- Ama-radiation frequency (RFA): Amagagasi omsakazo we-High-energy ashisa futhi abulale amangqamuzana omdlavuza
- I-ethanol yangaphutha (alcohol) ablation: Utshwala lujojowe emangqamuzaneni omdlavuza
- I-Cryotherapy : Igezi ezibandayo kakhulu zidluliselwa phakathi kwe-tumor ukuze zifakwe kumaseli omdlavuza
- I-microwave ablation: Ukushisa kusuka kuma-microwaves kudluliselwa emangqamuzaneni omdlavuza
Njenganoma yikuphi inqubo, kunezingozi kanye nemiphumela emibi engaba khona ekubhekaneni ne-ablation. Ezinye zazo zihlanganisa:
- Ukuqhaqhazela nokulimaza esikhungweni sesikhumba lapho inaliti noma ipulazi efakwe khona
- Ukulimala emithanjeni yegazi esibindi noma izicubu zesibindi ezizungezile uma inaliti noma ipulazi isetshenziswa ngokungalungile
- Ukutheleleka, okufaka i-abscess yesibindi
- Ukulimala kwe-bile duct noma ezinye izitho
- Ukuhluma kwe-tumor (ingxube engavamile lapho amangqamuzana omdlavuza ahlakazeka khona emkhakheni wenaliti)
Ukwelapha Embolization
Ngesikhathi sokumiswa, igazi elihlinzekwa umdlavuza wesibindi livinjiwe ngakho umdlavuza "ulambile" futhi awukwazi ukukhula. Le ndlela yokwelashwa ingasetshenziselwa izicubu zesibindi ezinkulu futhi / noma azikwazi ukususwa ngokuhlinzwa.
Ngezinye izikhathi ukuhlanganiswa kuhlanganiswe ne-chemotherapy (okuthiwa i-chemoembolization) noma i-radiation (radioembolization).
Imigomo
Imithi yokwelashwa isetshenziselwa ukwelapha umdlavuza wesibindi esiphezulu noma sekwephuzile.
Imithi yokwelashwa ehlosiwe yindlela yokwelashwa yokuqala yokuphatha umdlavuza ophezulu we-fover, olandelwa yi-chemotherapy noma i-immunotherapy njengendlela yokukhetha yesibili.
Imithi ehlosiwe
Izidakamizwa ezihlosiwe zisebenza ngokuphazamisa izinto ezidingekayo ukuze umdlavuza ukhule. Imithi yokwelashwa yokuqala eyamukelekile yokwelapha umdlavuza wesibindi ongasenakunyakazeka (isifo somdlavuza wesibindi ongasakwazi ukususwa ngokuhlinzwa) yi- Nexavar (sorafenib), okuyisidakamizwa esihlosiwe esivimbela isifo senhliziyo ekuvimbeleni imithwalo yegazi entsha.
Imiphumela emibi evamile ye-Nexavar ihlanganisa:
- Ukukhathala
- Rash
- Ukulahlekelwa kwesifiso
- Uhudo
- Umfutho wegazi ophezulu
- Ukuphendula ngezandla
Kubantu abangakwazi ukubekezelela i-Nexavar, noma njengenye indlela yokwelashwa kwemigqa yokuqala, imithi efanayo ebizwa ngokuthi i- Lenvima ( lenvatinib ) ingacatshangwa.
Esifundweni sesigaba III, uLenvima (uma kuqhathaniswa neNexavar) wayenenzuzo ephakeme yokuphila okusinda (izinyanga ezingu-13.6 kuya ku-12.3), izinga lokuphendula eliphakeme (amaphesenti angu-24 kuya ku-9 amaphesenti), kanye nesikhathi esiphezulu ekuthuthukisweni kwesifo (izinyanga ezingu-7.4 kuya kwezi-3.7 izinyanga ).
Imiphumela emibi kakhulu kaLenvima yilezi:
- Umfutho wegazi ophezulu
- Uhudo
- Ukunciphisa ukudla
- Ukulahlekelwa kwesisindo
- Ukukhathala
Omunye umuthi ohlosiwe u- Stivarga (regorafenib) uvimbela amaprotheni asiza amangqamuzana omdlavuza wesibindi. Lesi sidakamizwa okwamanje sisetshenziselwa ukwelashwa kwemigqa yesibili (okusho ukuthi uNexavar noma uLenvima ayeke ukusebenza).
Imiphumela emibi evamile ihlanganisa:
- Ukukhathala
- Ukulahlekelwa kwesifiso nokulahlekelwa isisindo
- Rash ezandleni nasezinyaweni
- Umfutho wegazi ophezulu
- Umkhuhlane kanye nezifo
- Uhudo
- Ubuhlungu beBelly
I-Chemotherapy
I-Chemotherapies yizidakamizwa ezibulala amangqamuzana omdlavuza. Nakuba "i-chemo" ivame ukuthathwa ngomlomo noma nge-vein, uma isifo somdlavuza wesibindi, singasetshenziswa ngqo esibindi nge-artic hepatic (okuthiwa i-hepatic artery infusion).
Ngokuya ngohlobo kanye nomthamo we-chemotherapy enikeziwe, umuntu angase ahlangabezane nemiphumela emibi efana nalokhu:
- Ukulahlekelwa kwezinwele
- Izilonda zomlomo
- Ukudabuka, ukuhlanza, kanye / noma isifo sohudo
- Ukulahlekelwa kwesisindo kusuka ekunciphiseni kwesifiso
Njengoba izidakamizwa ze-chemo zihlose ukuhlukanisa amangqamuzana ngokushesha (amangqamuzana omdlavuza akhula masinyane), amangqamuzana omnkantsha womuntu avame ukubhujiswa. Lokhu kungabangela izimpawu ezifana nokuchoboza futhi ukuphuza kalula, kanye nokukhathala kanye nengozi enkulu yokutheleleka.
Immunotherapy
I-Immunotherapy iyindlela ekhethayo yokwelashwa eguqukayo eyashintsha ubuso bomdlavuza. Isisekelo se-immunotherapy siwukuthi ivuselela amasosha omzimba omuntu ukuhlasela amangqamuzana omdlavuza.
Ngomdlavuza wesibindi, imithi ye-immunotherapy Opdivo (nivolumab) isebenza ngokuvimbela amaprotheni omzimba wokuzivikela omzimba okuthiwa ukufa okuhleliwe 1 (PD-1). Le phrotheni yenza ngenkohliso ngamangqamuzana omdlavuza ukuvimbela isimiso somzimba sokuzivikela somuntu ukuba singakuqapheli njengangaphandle. Ngakho, ngokuvimba i-PD-1, umdlavuza ungabonakala futhi uhlaselwe.
I-Opdivo inikezwa nge-vein, njalo ngemva kwamasonto amabili. Imiphumela emibi engaba khona ihlanganisa:
- Ukukhathala noma ubuthakathaka
- Fever
- Isikhukhula
- I-nausea nokulahlekelwa kwesifiso
- Ukuqubuka nokukhwabanisa isikhumba
- Ubuhlungu be-muscle noma obuhlangene
- Ukuqokwa noma isifo sohudo
Imiphumela emibi kakhulu ihlanganisa ukusabela ekumpomeni (okufana nokuphendula okwehliswayo) noma ukusabela okuzenzakalelayo, lapho isimiso somzimba somuntu siqu siqala ukuhlasela izitho ezinempilo (isibonelo, amaphaphu).
Imithi Ephelele (CAM)
Ngaphambi kokusebenzisa noma iyiphi imifino noma ukudla, qiniseka ukuthi uvumele udokotela wakho azi. Lokhu kuzokusiza ukuvimbela noma yimiphi imiphumela emibi engadingeki kanye nokusebenzisana.
Sho-saiko-kuya
Esinye isidakamizwa semithi okuthiwa i-Sho-saiko-to (ebizwa nangokuthi i-Xiao Chai Hu Tang), okuyingxube ye-botanicals eyisikhombisa, kuhlanganise ne-ginseng, i-ginger, ne-licorice, isetshenziselwe ukwelapha isifo sofuba esingapheli nesifo esiwumshayabhuqe.
Olunye ucwaningo lubonisa ukuthi lesi sidakamizwa semithi singasiza ekunciphiseni ukuthuthukiswa kwesifo somdlavuza wesibindi kubantu abane-cirrhosis, nakuba isenzo esicacile sesenzo singacacile. Ngenkathi uSho-saiko-kukholelwa ukuthi ngokuvamile uvunyelwe kahle, kungabangela ukulimala kwamaphaphu nesibindi, ngakho kufanele kuthathwe kuphela ngaphansi kokuqondiswa udokotela.
I-Basil Engcwele
Enye imifino ebizwa ngo- Ocimum sanctum L noma "Holy Basil" isitshalo equkethe ama-phytochemicals agqugquzela impilo yesibindi. Ibuye ibe nezindawo zokulwa nomdlavuza. Ngesinye isikhathi imifino eluhlaza isetshenziselwa ukudla kwama-Thai. Ayikho imiphumela emibi eyaziwayo.
I-Milk Thistle
U-Silymarin ( Silybum marianum ), obizwa ngokuthi i- milk thistle , usetshenziswe emazweni athile (njengeJalimane) njengokwelashwa okusekela isifo esingenasifo sesibindi. Kukholelwa ukuthi kunezindawo zokulwa nomdlavuza futhi unesiprofayili esihle sokuphepha, nakuba kungabangela ukusabela okweqile noma izimpawu zokugaya kancane.
Ukudla Kwemvelo
Ngaphandle kwamakhambi, ukudla okungokwemvelo kungasiza ekuvikeleni umdlavuza wesibindi. Ikhofi iyimithombo ecebile yama-antioxidants futhi ihlobene nengozi enciphisa kokubili umdlavuza we-cirrhosis nesifo sesibindi. Kodwa-ke, abukho ubufakazi besayensi ukuthi ukwandisa ikhofi yakho yamanje (noma ukuqala ukuphuza ikhofi uma ungenayo) inenzuzo.
Okunye ukudla okuvela emvelo, i-resveratrol, etholakala kuma-mulberries, amagilebhisi abomvu, namanqamu, angase abe nomthelela wokulwa nomdlavuza ngaphezu kokuvikela ekubhekaneni nesifo esingenaso utshwala esinamafutha .
> Imithombo:
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> Kim JW et al. I-ultrasound eqondiswa yi-radius frequencyback ablation ye-tumor tumps: Indlela esiyenza ngayo ngokuphepha nangokuphelele. I-Korean J Radiol . 2015 Nov-Dec; 16 (6): 1226-39.
> Kudo M et al. I-Lenvatinib ne-sorafenib ekwelapheni kokuqala komugudu weziguli ezine-hepatocellular carcinoma engenakuphulukiswa: isigaba esingahleliwe > isigaba sesibili sokungabi ngaphansi kocansi. I-Lancet. 2018 Mar 24; 391 (10126): 1163-73.
> Waghray A, AR Murali, Menon KVN. I-hepatocellular carcinoma: Ukusuka ekuxilongweni kuya kokwelashwa. Izwe J Hepatol. 2015 Meyi 18; 7 (8): 1020-29.