Izimpawu nezimpawu zomdlavuza wezinso eziqaphelisa abantu nodokotela bazo ukuba zikhona ziye zashintsha ngokuphawulekayo eminyakeni yamuva. Esikhathini esedlule, i-classic triad ye-flank ubuhlungu, igazi emcimbini, kanye nobuningi ebantwini kwakuvame kakhulu. Namuhla, izimpawu ezivame kakhulu ziyi-anemia, ukukhathala, ukulahlekelwa isisindo, ukulahlekelwa ukudla, kanye nomkhuhlane.
Ngaphezu kwalokho, ukusabalalisa komdlavuza wezinso kwezinye izingxenye zomzimba (isifo semetastatic) kunika izibonakaliso zokuqala eziyisixwayiso zesifo (njengokukhwehlela noma ubuhlungu besifo) ngamaphesenti angu-20 kuya kumaphesenti angu-30 abantu.
Izimpawu Ezivamile
Ezimweni zokuqala zomdlavuza wezinso, kuvame ukuba nezimpawu ezimbalwa, futhi ukuxilongwa okuningi okwenziwe manje kusekelwe ekuhloleni kwelabhu nokucabanga ngaphambi kokuba kuvele izimpawu.
I-anemia
I-anemia njengamanje isibonakaliso esivela kakhulu sesethulo somdlavuza wezinso, futhi sikhona ngamaphesenti angama-20 kuya kwangu-40 abantu abathintekayo. Izinso zenza iphrotheni ebizwa ngokuthi i-erythropoietin, evuselela ukukhiqizwa kwamaseli abomvu ebomneni (ekusebenzeni okuthiwa i-erythropoiesis). Ngomdlavuza wezinso, ukukhiqizwa kwehla kwamaprotheni kunciphise inani eliphansi lamaseli abomvu obomvu (i-anemia).
Ngokuphambene nalokho, abanye abantu bangase babe nesibalo segazi elibomvu eliphakeme kakhulu (i-erythrocytosis) ngenxa yokukhiqizwa kwe-erythropoietin ngamaseli omdlavuza wezinso. Lokhu kubizwa ngokuthi i-paraneoplastic syndrome-izimpawu ezenzeka ngenxa yezinto noma amahomoni akhiqizwa ngamangqamuzana omdlavuza (okuxoxwe ngezansi).
Igazi ku-Urine
Igazi emcimbini (i-hematuria) liyisifo esivamile somdlavuza wezinso, okwenzeka okungenani isigamu sabantu abatholakala ngesikhathi esithile. Lokho kusho ukuthi abantu abangamaphesenti angu-10 kuphela manje abanezimpawu zakudala zegazi emcimbini, ubuhlungu be-flank, nomswakama ngesikhathi sokuxilongwa, futhi uma sezikhona, lesi sifo sesivele sisakazekile (sesisetshenzisiwe).
I-urine ingase ibonakale igazini (ebizwa ngokuthi "i-hematuria ephelele"), ilinganise, futhi ibangele i-pink tinge emcinini, noma ingaba yinkimbinkimbi kangangokuthi ibonakala kuphela e- urinalysis .
I-Flank Pain
Ubuhlungu bungase buvele ngemuva, eceleni, noma esiswini, futhi kungahluka emanzini afihlakeleyo ebuhlungu obuhlungu obuhlabayo. Ubuhlungu obusenkundleni obwenzeka ngaphandle kokulimala okusobala kufanele kwenziwe njalo uphenyo. Abantu abangamaphesenti angu-40 abanomdlavuza wezinso babhekana nobuhlungu ngesikhathi esifanayo ngesikhathi sesifo sabo, kodwa ubuhlungu be-flank buba yinto engavamile njengezibonakaliso zesifo.
I-Flank Mass (Emuva, eceleni, noma kwesisu)
I-flank mass (ihlumela ohlangothini, emuva, noma esiswini) kuye kwaphawulwa ngamaphesenti angama-45 abantu abanomdlavuza wezinso kwezinye izifundo, nakuba kungatholakali nje njengesibonakaliso sokuqala kunesikhathi esidlule. Noma yiziphi izibungu kule ndawo, ngisho noma ucabanga ukuthi ingenye yezinhlamba ezivuthiwe ezivame ukukhula, kufanele zibukwe udokotela wakho.
Ukulahlekelwa kwesisindo okungenasisekelo
Ukulahleka kwesisindo okungenhloso kungumuthi ovamile wesifo somdlavuza wezinso, okwenzeka cishe kubantu besithathu ngesikhathi sokuxilongwa. Kuchazwa njengokulahlekelwa kwamaphesenti angu-5 noma ngaphezulu kwesisindo somzimba ngaphezu kwenyanga enyanga eziyisithupha kuya kweziyi-12.
Isibonelo, ukulahleka kwamakhilogremu angu-10 kumakhilogremu angu-200 umuntu esikhathini esingangezinyanga eziyisithupha, okwenzeka ngaphandle kokushintsha kokudla noma ukuzivocavoca, kungabhekwa njengokulahlekelwa kwesisindo esingalindelekile noma esingenhloso.
Ngaphezu komdlavuza wezinso, kunezimo ezinzima ezihambisana nalesi sibonakaliso, futhi abantu kufanele bahlale bebona udokotela wabo uma belahlekelwa isisindo ngaphandle kokuzama.
Ukukhathala
Ukukhathala nakho kwenzeka ku-around one-third of people abathintekayo abanomdlavuza wezinso. Ukukhathala komdlavuza , ngokungafani nokukhathala okuvamile, kungaba okujulile, futhi kuvame ukubola ngokuhamba kwesikhathi. Akusilo uhlobo lokukhathala oluthuthukisa ubusuku obuhle bokulala noma indebe enhle yekhofi.
I-Cachexia
I-cachexia yisifo esibhekene nokulahlekelwa isisindo, ukulahlekelwa ukudla, nokulahleka kwesisindo somzimba. Kucatshangwa ukuthi i-cachexia ikhona emazungeze amaphesenti angama-30 abantu ababhekene nomdlavuza wezinso. Ngaphandle kokuba uphawu lokuveza, kukholelwa ukuthi yiyona imbangela eqondile yokufa kubantu abangamaphesenti angama-20 abantu abanomdlavuza futhi kufanele bakukhathalele wena nodokotela bakho uma bekhona.
Ukulahlekelwa Ukudla
Ukulahlekelwa isifiso, noma ngaphandle kwe-cachexia noma ukulahlekelwa isisindo, kuyisifo esivamile somdlavuza wezinso. Abantu bangaqaphela ukuthi abalambile nje, noma kunalokho, bangase bazizwe begcwele ngokugcwele ngenkathi bedla.
Fever
Umkhuhlane (izinga lokushisa elingaphezu kuka-100.4 degrees F) yisifo esivamile somdlavuza wezinso, esivela kubantu abangaba yingxenye yabantu besithathu ngesikhathi sokuxilongwa. Umkhuhlane ungase uqhubeke, noma kunalokho, ungase ufike futhi uhambe, kodwa kwenzeka ngaphandle kwempawu ebonakalayo yokutheleleka. Umkhuhlane ongenayo incazelo ( umkhuhlane wemvelaphi engaziwa ) kufanele uvakashele udokotela wakho njalo.
Ukucindezelwa Kwegazi Eliphakeme
Izinso zikhiqiza ama-hormone adlala indima ebalulekile ekulawuleni ukucindezeleka kwegazi. Ukucindezela okukhulu kwegazi kungase kube uphawu lomdlavuza wezinso. Ngokuqhubekayo, ukuphikelela kwengcindezi ephakeme yegazi kungaholela ekulimaleni kwezinso zezinso.
Ukuvuvukala ema-Ankles naseLegs
Izinso nazo zidlala indima ebalulekile ekulawuleni ukulinganisa kwamanzi (kanye nama-electrolytes) emzimbeni. Umdlavuza wezinso (nezinye izifo zezinso) zingaphazamisa lo mthethonqubo, okuholela ekutheni ukugcinwa kwamanzi okugcoba okubhekwa njengokukhukhumeza ezinyaweni, ezinyaweni nasemilenzeni.
Ukuqhuma
Ukuqhuma, noma iziqephu lapho isikhumba siba bomvu, kanye nomzwelo wokufudumala (noma ngisho nokushisa) kobuso, intamo, noma imikhawulo, kuyisimo esingaba khona. Kunezimbangela eziningana ezibangelwa umdlavuza (ezimbi) ezibangelwa ukuqhuma okuncane, okunye okungumdlavuza wezinso. Qaphela uma lesi sibonakaliso senzeka ngaphezu kwamanye.
Izimpawu zeMetastases
Kubaluleke kakhulu ukukhuluma ngezibonakaliso ezikhona zomdlavuza wezinso eziye zasakazeka ( ezifakwe emzimbeni ) kwezinye izifunda zomzimba, njengoba izimpawu ezihlobene nalezi zimpawu ezibonisa ukuthi yizimpawu ezingamaphesenti angama-20 kuya kwangu-30 abantu abatholakala benesifo.
Abantu abangaphezu kwamaphesenti angama-30 banemitha yokushisa ngesikhathi sokuxilongwa. Umdlavuza wezinso uvame ukusabalala emaphashini, amathambo, kanye nobuchopho, futhi kungaholela ezimbonini ezilandelayo.
Isikhukhula
Ukukhwehlela okuqhubekayo yilona uphawu oluvame kakhulu lomdlavuza lusakazeka emaphashini . Ezinye izimpawu ezingase zenzeke zihlanganisa ukushaya, ukukhwehlela igazi , noma ubuhlungu esifubeni, ehlombe, noma emuva.
Ukuphelelwa umoya
Ukuphefumula kungumuthi ojwayelekile wesifo somdlavuza wezinso, kokubili njengesibonakaliso somdlavuza osakaze emaphashini nangenxa ye-anemia. Ekuqaleni, ukuphefumula kungase kwenzeke kuphela ngomsebenzi, futhi kungaxoshwa kalula ngenxa yokungasebenzi, ukuzuza isisindo noma ukuguga.
I-Bone Pain
Amathambo yindawo yesibili yomdlavuza wezinso (emva kwemaphaphu). Ubuhlungu be-bone obuvela emathini e-metastase bungaba nzima, futhi ngokuvamile abuhlobene nanoma yiluphi uhlobo lokulimala. Ngesinye isikhathi isibonakaliso sokuqala somdlavuza siyiphundu endaweni yethambo elibuthakathaka.
Izimpawu ezijwayelekile
Kunezinto ezimbalwa ezingavamile kepha izimpawu eziyingqayizivele ezihlobene nomdlavuza wezinso.
I-Varicocele
I-varicocele yi-vein evulekile (i-varicose vein) eyenzeka ku-scrotum noma i-testicle. Izimpawu zingase zihlanganise ukuvuvukala, ubuhlungu, nokukhwabanisa kwethempulethi. Ngokuvame ukuvela ngakwesokudla, i-varicocele ehlobene nomdlavuza wezinso ayihambi uma umuntu elele.
Izimpawu ze-paraneoplastic
I-paraneoplastic syndromes yizigaba zezimpawu ezenzeka ngenxa yokukhiqizwa kwamahomoni noma ezinye izinto ngamaseli amathumba. Ngomdlavuza wezinso, lawa ma-syndromes angaholela ezingeni eliphakeme le-calcium egazini ngezimpawu ezinjengokuzihlambalaza nokuhlanza, ubuthakathaka nokudideka, isibalo esiphezulu se-cell cell (i-erythrocytosis), nokwanda kwezivivinyo zokusebenza kwesibindi ngisho nalapho isisu ayisakaze esibindi (Stauffer syndrome).
Izinkinga
Kunezinkinga eziningi ezingase zenzeke ngenxa yomdlavuza wezinso. Ngezinye izikhathi, lezi zingase zenzeke ngisho nangaphambi kokuxilongwa, kepha ngokuvamile zitholakala lapho isisu sifinyelele phambili. Kungenzeka ngenxa yesisu ngokwayo, ngenxa yokwelashwa kwesisu, noma ngenxa yesifo se-metastatic.
Khumbula ukuthi abantu abaningi abahlangabezane nazo zonke lezi zinkinga, futhi abantu abaningi abatholi noma yikuphi kwalokhu. Zixoxwa lapha ukuze abantu bakwazi ukutholakala amandla ekunakekelweni kwabo kwezempilo futhi baqonde ukuthi kungenzeka yini ukukhathazeka.
Hross Hematuria
I-urine egazini elingenangqondo ivela kancane kancane njengesibonakaliso sokuqala somdlavuza wezinso, kodwa kwenzeka ekugcineni cishe isigamu sabantu. Kungaba ukwesaba okukhulu ukuzulazula igazi elikhulu ngokuzumayo, kodwa ukwelashwa okusheshayo kungavame ukulawula ukuphuma kwegazi.
I-Pleural Effusion
Lapho umdlavuza wezinso usakazeka emaphashini noma emgodini wamapayipi, kungabangela ukwakheka kwamanzi emkhatsini wezingqimba ezifaka amaphaphu ( pleura ). Lapho amangqamuzana omdlavuza ekhona, lokhu kubhekiselwa njengokwenyusa okubi kabi kwezwi . Ngezinye izikhathi inqwaba yamanzi (amalitha amaningana) iqoqa, okwenza kube nokuphefumula okukhulu.
Inqubo ebizwa ngokuthi i-thoracentesis ihilela ukubeka inaliti enhle ngesikhumba esikhwameni sesifuba nangaphakathi emgodini wokugodla ukuhoxisa uketshezi. Ama-pleural effusions aphinde abuye futhi angaphathwa nge-catheter ehlala ngaphakathi (i-shunt evumela ukugeleza okuqhubekayo ketshezi) noma inqubo lapho kutholakala khona into ecasulayo (i-talc) phakathi kwezingqimba ezibangela ukuba bahlukane ndawonye ukuze kube khona uketshezi asikwazi ukuqoqa ( pleurodesis ).
I-Fractures ye-Pathological
Ubuhlungu be-bone bungaba yisifo sokuqala somdlavuza wezinso uma kutholakala izidakamizwa. Uma umdlavuza ungena emthanjeni, ubuthakathaka ithambo futhi kungabangela ukuqhuma okuncane noma okungabikho ukuhlukumezeka. Lezi zibhekwa njengezingcingo ze- pathologic .
Lapho umdlavuza wezinso usakazeka emgodleni ophansi, ama-microfractures emgodleni angabangela ukuwa kwe-vertebrae bese ucindezela ezimpandeni zezinzwa, okubangela ukucindezela komgogodla. Lokhu kungaholela ekubuthakathaka kwemilenze kanye nokulahlekelwa kwesigungu nesiguli, futhi yisimo esiphuthumayo sezokwelapha.
I-bone metastases evela emdlalweni wezinso zivame ukubhubhisa kakhulu, zidinga ukunakekelwa ngokucophelela ebuhlungu, ukuhlukunyezwa okungahle kwenzeke kanye nokucindezelwa kwesisindo, i-hypercalcemia (i-high blood calcium ngenxa yokwehla kwethambo) nokuningi. Ngenhlanhla, kunezinhlobo ezihlukahlukene zokwelashwa ezitholakalayo namuhla ezinganciphisa lezi zinkinga.
Ukucindezelwa Kwegazi Eliphakeme
Njengoba kuxoxwe ngaphambili, izinso zidlala indima ebalulekile ekulawuleni ukucindezeleka kwegazi. Umdlavuza wezinso ungabangela ukucindezela kwegazi okuqhubekayo, futhi ngezinye izikhathi ukucindezeleka kwegazi okulukhuni kakhulu ukulawula ( isifo somfutho wegazi obizayo ).
I-Hypercalcemia
Izinga eliphakeme le-calcium lingaba khona egazini, kokubili ngenxa ye-paraneoplastic syndrome futhi ngenxa yokuphuka kwethambo ngamathambo ayisisindo. Izinga eliphezulu le-calcium legazi nomdlavuza ( hypercalcemia ) angeke liholele kuphela ezimpawu ezifana ne-nausea, kodwa ubuthakathaka obunzima bomzimba, ukudideka, i-coma, ngisho nokufa. Lokho kusho ukuthi kuyaphathwa uma nje kutholakala.
I-High Red Cell Cell Count
Inani elibomvu lamasosha egazi (i- erythrocytosis ) lingahle lenzeke, yize i-anemia ivamile ngaphambi kwesikhathi ngomdlavuza wezinso. Lokhu kwenzeka ngenxa yokukhiqizwa ngamangqamuzana omdlavuza weprotheyini evuselela umongo we-bone ukukhiqiza amangqamuzana abomvu egazi. Amangqamuzana egazi obomvu okwedlulele, angakwandisa ingozi yezindwangu zegazi, ukuhlaselwa yinhliziyo, nokushaya, ngenxa yokuthi igazi "likhulu kakhulu" (i-viscous more).
Ukungakwazi ukusebenza kwesibindi
Umdlavuza wezinso ungathinta isibindi kokubili ngokusakaza komdlavuza kanye nengxenye ye-paraneoplastic syndrome. Njengoba isibindi sihlunga igazi, njengezinso, inhlanganisela yesifo sebindi nesifo sezinso kungabangela ukuqoqwa kwezidakamizwa egazini, okuholela ekudidekeni, izinguquko zobuntu, izinguquko zemizwelo, nokuningi.
Izinkinga zokwelapha
Ukwelashwa komdlavuza wezinso kungabandakanya ukukhipha ingxenye noma zonke izinso. Lena inqubo enkulu yokuhlinzeka futhi ingabangela izenzakalo zenhliziyo, isifo sokushaya isisu, i-embolism ye-pulmonary (i-clot ephuka emlenzeni futhi iya emaphashini), i-pneumonia, noma ukulimala ngesikhathi sokuhlinzwa, njengesibindi, i-spleen, i-pancreas, noma isiguli. Ukwelashwa kwesisu nesisu kuyenzeka futhi.
Ukwelashwa kuyinselele kakhulu uma lesi sifo sifinyelela ngaphakathi kwe-vein ye-renal, futhi ngokuvamile sidinga udokotela ohlinzayo ogxile ezifweni ezinesifo somzimba (njengesifo sokuhlinza inhliziyo) ukususa umdlavuza. Ukuhlinzwa kuye kwaphuthuka, futhi izinkinga zimbalwa kunezikhathi ezedlule, ikakhulukazi ngezinketho zokuhlinzwa ezingenasidingo ezitholakalayo manje, njenge-nephrectomy ye-laparoscopic (ukususwa kwezinso ngokubambisana okuncane emathunjini nasezintweni ezikhethekile). Uma uthola lokhu kuhlinzwa, themba ithimba lakho lokunakekelwa kwezempilo kanye nezwi noma yikuphi ukukhathazeka okungenzeka ube nakho.
Ukuhluleka kwe-Renal
Njengoba ukuhlinzeka ngokuvamile kuvame ukususa izinso, noma okungenani ingxenye yezinso, lokhu kushiya izinso ezilodwa kuphela ezisebenzayo ngemuva. Ngaphezu kwalokho, ezinye zezokwelapha ezisetshenziselwa umdlavuza wezinso, kanye nemithi, zingabeka ukucindezeleka ezintsheni ezisele, okuholela ekuhlulekeni kwezinso . Uma ukwehluleka kwezinso kwenzeka, i-dialysis ingadingeka (noma ukufakelwa kwezinso uma isifo somdlavuza wezinso ekuqaleni).
Nini Ukubona Udokotela Wakho
Uma unezinkinga ezibalwe ngenhla, kubalulekile ukubona udokotela wakho. Eziningi zezimpawu zomdlavuza wezinso zinezimbangela eziningi, kepha kunezinye izizathu ezinzima ukuthi ungaba nalezi zimpawu.
Izimpawu yindlela yethu yomzimba yokufakazela ukuthi kukhona okungalungile. Esikhundleni sokwesaba nokungazinaki, thatha isinyathelo ukuze uthole ukuthi kungani kwenzeka khona ukuze uthole ukwelashwa okufanele futhi okufika ngesikhathi. Khuluma nodokotela wakho bese ubuza imibuzo. Uma ungenayo izimpendulo, cabanga ukuthola umbono wesibili.
> Imithombo:
> Society of American of Clinical Oncology. I-Cancer.Net. I-Cancer Cancer: Izimpawu Nezimpawu. Kubuyekeziwe ngo-08/2017. https://www.cancer.net/cancer-types/kidney-cancer/symptoms-and-signs
> Lara, Primo N., no-Eric Jonasch. Izimiso Nezenzo Zomdlavuza Wezinso . I-Springer International Publishing, 2015.
> Sadeghian, A., Rouhana, H., Oswald-Stumpf, B., no E. Boh. I-Etiologies kanye nokuphathwa kwe-Cutaneous Flusihng: Izimbangela ezimbi. Umagazini we-American Academy of Dermatology . 2017. 77 (3): 405-414.
> Umer, M., Mohib, Y., Atif, M., noMnu Nazim. I-Skeletal Metastasis e-Renal Cell Carcinoma: Ukubuyekezwa. Ama-Annal of Medicine and Surgery (eLondon) . 2018. 27: 9-16.