Sibutsetelo
I-radiation pneumonitis ukuvuvukala kwamapayipi ngenxa yokwelashwa kwemisebe noma radiotherapy yomzimba we-stereotactic ( SBRT ) yomdlavuza. Lo mphumela ohlangothini wokwelashwa kwemishanguzo kwenzeka cishe cishe kwesine kwabantu abahamba ngemithi yokwelapha emaphashini emaphaphu kodwa futhi bangabangela ukuphuma emisebeni kuya esifubeni somdlavuza webele , i-lymphomas, noma ezinye umdlavuza
Izimpawu zivame ukwenzeka phakathi kwesinye kanye nezinyanga eziyisithupha emva kokuqeda ukwelashwa kwemisebe. Ngokwelashwa (futhi lokhu kubalulekile), iningi labantu lilahla ngaphandle kwemiphumela ehlala njalo.
Izimpawu
Kubalulekile ukuqaphela imishanguzo ye-pneumonitis, ngoba izimpawu zingalingana kakhulu nalabo abangelwa umdlavuza wamaphaphu kuphela, noma bangaphutha ngokutheleleka okunjenge-pneumonia. Abantu abaningi bamane bebekezelela lezi zimpawu njengoba kulindeleke, kodwa i-pneumonitis ye-radiation iyisikhumbuzo esihle sokuthi kufanele ukhulume ne-oncologist yakho nganoma yiziphi izimpawu ozibonayo: Izimpawu ezivamile zihlanganisa:
- Ukuphefumula okuvame ukuphawuleka kakhulu ngokuzivocavoca.
- Ubuhlungu besifuba, ikakhulukazi ubuhlungu besifuba obubuhlungu ngokuphefumula ( ubuhlungu besifuba se-pleuritic .)
- Isikhukhula esingase somile noma sikhiqize i-mucus. Njengoba abantu abaningi abanomdlavuza wamaphaphu bekhwehlela ngezinye izikhathi, kubalulekile ukuqaphela noma yikuphi ukuguqulwa kokukhwehlela kwakho, kungakhathaliseki ukuthi kuvame kakhulu, kunzima noma kungakhululekile.
- I-low-grade fever.
Kwezinye izimo, azikho izimpawu, futhi ukuxilongwa kwenziwa ngokubonakala kwesibindi ku-x-ray kuphela.
Ubani Osesengozini?
Abanye abantu basengozini kakhulu kunezinye ze-radiation pneumonitis. Imibandela eyandisa ingozi ihlanganisa:
- Ngokufanayo (okusho ngesikhathi esifanayo) ukwelashwa kwemisebe kanye ne-chemotherapy. I-radiation pneumonitis (RP) ivame kakhulu kubantu abathola imisebe kanye namakhemikhali asemkhatsini kunabo abathola ama-radiation kanye nama- chemotherapy (ngezikhathi ezahlukene). Uma lokhu kuphazamisa kubalulekile ukubuka ezinye izici ngaphandle kwalesi sici. Esicwaningweni sika-2009, abacwaningi bathola ukuthi abantu abanomdlavuza wamaphasethi wesigaba 3 abathola imisebe efanayo kanye ne-chemotherapy babeneminyaka emibili yokuphila ngemva kweminyaka emihlanu. Ezinye izifundo ziye zaphakamisa nokusinda okuthuthukile lapho ukwelashwa kusetshenziswa ndawonye.
- Abantu abanezinye izifo zamaphaphu, njenge-COPD, basengozini enkulu.
- Iziguli ezindala ziyakwazi ukuthuthukisa i-pneumonitis emisebeni kuneziguli ezincane.
- Inani lamathambo aphathwayo. Ingozi ye-radiation pneumonitis iyanda nendawo yesifuba esiphathwayo. Kubuye kuvame kakhulu uma ama-lobes aphakathi namaphesenti aphansi aphathwa ngaphandle kokwelashwa kwamagciwane angaphezulu kwe-lobe yamaphaphu.
- Abantu abathola imithi ye-chemotherapy i-Paraplatin (i-carboplatin) ne-Taxol (paclitaxel.)
Isizathu
I-radiation ibangela ukuthi amaphaphu akhiqize ubuncane be-substancefactant. I-surfactant isebenza ukugcina amaphaphu ethuthuka lapho siphumelela futhi sandisa indawo yamaphaphu atholakalayo ekushintsheni oksijini ne-carbon dioxide. Kuyinto yokuntuleka kwe-surfactant ezinganeni ezingakabiphi lapho ngokuvamile ziholela ekucindezelekeni kokuphefumula.
Ukuxilongwa
Ukuhlolwa kwelabhu kungabonisa izimpawu zokuvuvukala, njengokwanda kwamaseli egazi elimhlophe. Imiphumela ye-test ebuka ukuvuvukala, okuthiwa yi-sed-rate, ingabonisa ukuphakama okungekho okwehlukile kunokwejwayelekile. I-x-ray yesifuba ingabonisa ukubonakala komzimba we-radiation pneumonitis futhi ingase isikisele ukuthi udinga ukuphathwa, ngisho noma ungenayo izimpawu.
Ukwelapha
Ukwelashwa kuhloswe ukunciphisa ukuvuvukala. Ama-corticosteroids, afana ne-prednisone, anikezwa kuze kufike ukuvuvukala bese kancane kancane kwehla ngokuhamba kwesikhathi. Ezinye izindlela zokwelashwa zingasetshenziswa kuye ngokuthi indawo. Isibonelo, nge-radiation esophagitis, imithi efana ne- proton pump inhibitors , izinguquko ekudleni, kanye nama-anesthetics wendawo ukusiza ngobuhlungu ingasetshenziswa.
Isibikezelo
I-radiation pneumonitis ivame ukuxazulula ukwelashwa futhi ayifuni neze ukubulala. Uma ingaphathwa kabi noma iphikelela, ingabangela i -fibrosis ye-pulmonary (ukunqanda kwamapayipi), enye yemiphumela emibi yesikhathi eside yocwaningo lwe-radiation .
Ukuvimbela
Ucwaningo luqhubeka lufuna izindlela zokunciphisa ingozi ye-radiation pneumonitis phakathi kwabantu abahamba ngemisebe yomdlavuza wamaphaphu. Kuze kube manje kubonakala ukuthi ukungena kwe-soy isoflavone (ukudla ukudla okunama-soy efana ne-tofu) kunganciphisa ingozi ye-radiation pneumonitis. Indlela lokhu kwenzeka ngokunciphisa ukuvuvukala, ngakho-ke akunakwenzeka ukuthi ukungena kokudla okunama-soy kungaphazamisa inhloso yokwelashwa kwemisebe-ukuqeda amangqamuzana omdlavuza-kodwa kubalulekile ukukhuluma ne-oncologist yakho yemisebe mayelana nalokhu, nanoma yiziphi ezinye iziphakamiso yena Kungase kube nokunciphisa ingozi yakho.
Ngaphansi
I-radiation pneumonitis ivame kakhulu kubantu abaphathwa ngemishanguzo efana nomdlavuza wamaphaphu nomdlavuza webele. Ngokujabulisayo, ngokuphulukiswa, lesi simo ngokuvamile sixazululwa ngaphandle kokuqhubeka senza i-radiation fibrosis. Into ebaluleke kakhulu ongayenza ukuthi uqaphele izimpawu ezingenzeka, bese ukhuluma nodokotela wakho uma uthola noma yikuphi kwalokhu. Njengombhalo wokugcina, izimpawu eziningi zingase zibe nezibonakaliso zomdlavuza wakho noma imiphumela emibi yezinye izifo. Khuluma njalo nodokotela wakho mayelana nanoma yiziphi izimpawu futhi ube ngummeli wakho siqu ukunakekelwa komdlavuza wakho . Awunayo i-whiner noma inkinga yesiguli ukuveza lokhu okukhathazayo, kanti udokotela wakho uzobona, esikhundleni salokho, ukuthi uyasebenza futhi uhileleke ekuhlanganyele ekunakekeleni kwakho.
> Imithombo:
> Abernathy, L. et al. I-Soy Isoflavones Yakha Ukuvuselelwa Kwe-Radioprotection Ye-Tungue Ejwayelekile Ye-Lung Ngokuvinjelwa Kwemisebe Yomlilo-Ukuvuselelwa Okukwenziwe Kwe-Macrophages Neutrophils. I-Journal ye-Thoracic Oncology . 2015. 10 (12): 1703-12.
> Hillman, G. et al. Ukukhishwa kwe-radioprotection yamathishu emaphaphu ngama-soy isoflavones. I-Journal ye-Thoracic Oncology . 2013. 8 (11): 1356-64.
> Kong, F. et al. I-non-encane yomdlavuza wamaphaphu wamaphaphu ahlobene nokusetshenziswa kwe-pulmonary toxicity: i-update on radiation pneumonitis kanye ne-fibrosis yamaphaphu. Ama-Seminar ku-Oncology . 2005. 32 (2 Suppl 3): S42-54.
> Okubo, M., Itonaga, T., Saito, T. et al. Ukubikezela Izingozi Ze-Radiation Pneumonitis emva kwe-Stereotactic Body Body Radiation Therapy for Izimbungulu Zomzimba Eziyinhloko noma ZeMetastatic. I-British Journal ye-Radiology . 2017 Feb 14. (Epub ngaphambi kokuphrinta).
> Palma, D. et al. Ukubikezela isifo sengculaza emva kokukhipha imithi yesifo somdlavuza ongasona omncane wesifo samaphaphu: ukuhlolwa kwe-patient meta-patient. I-International Journal ye-Radiation Oncology, i-Biology, ne-Physics . 2013. 87 (4): 690-6.
> Palma, D. et al. Ukubikezela i-pneumonitis emisebeni emva kwe-chemoradiation therapy yomdlavuza wamaphaphu: i-meta-analysis analysis yomuntu ngamunye emhlabeni wonke. I-International Journal ye-Radiation Oncology, i-Biology, ne-Physics . 2013. 85 (2): 444-50.
> Yazbeck, V. et al. Ukuphathwa kwezidakamizwa ezivamile zezicubu ezihlotshaniswa ne-chemoradiation (isikhumba esiyisisekelo, isisindo kanye nephuphu). Cancer Journal (Sudbury, Mass) . 2013. 19 (3): 231-7.