Isizathu Sokuba Kungenzeka Noma Kungabi Yindlela
Ngesikhathi esesimweni somdlavuza wamaphaphu esidlule kwakubhekwa "ukuphikisana" ngokuphelele kokufakelwa kwamaphaphu (ukuphikisana ngokuphelele kusho ukuthi inqubo kufanele igwenywe ngokuphelele) impendulo ayisoloko "cha."
Kunezikhathi, nakuba zingavamile, lapho ukufakelwa kwamaphaphu kungasetshenziswa njengendlela yokwelapha abantu abanezinhlobo ezithile zomdlavuza wamaphaphu. Eqinisweni, ukusetshenziswa kweziphazamisi zamaphaphu emdlavuza wamaphaphu kuye kwanda kancane eminyakeni yamuva.
Ukuphakanyiswa kwamaphaphu kunganconywa nini, ucwaningo lukusho ukuthini, futhi kungani kungenakuphakanyiswa iningi labantu abaphila nomdlavuza wamaphaphu?
Ngesikhathi futhi kungani ukuguqulwa kungavamile ukusetshenziswa
Kubantu abaningi abanomdlavuza wamaphaphu, ukufakelwa kwamaphaphu (single noma kabili) akuyona inketho. Esinye sezizathu ukuthi ukuguqulwa kwamaphaphu kuthathwa njengokwelashwa kwendawo. Izindlela zokwelapha zendawo ezifana nokufakelwa kwamaphaphu, ukuhlinzwa komdlavuza wamaphaphu , kanye nokwelapha imishanguzo yomdlavuza wamaphaphu kuphela ukwelapha amangqamuzana omdlavuza ovalwe emaphashini. Ngeshwa, ngenxa yabantu abaningi abanomdlavuza wamaphaphu, umdlavuza usakaze ngaphesheya kwamapayipi kuya kuma-lymph nodes futhi ngokuvamile ezindaweni ezikude zomzimba. Uma lokhu kwenzeka, ukwelashwa okuhlelekile (ukwelashwa okusebenza kumangqamuzana omdlavuza kuwo wonke umzimba) njengekhemotherapy, ukwelashwa okuhlosiwe , kanye ne-immunotherapy kungcono ukukhetha.
Esinye isizathu esiyinhloko ingozi yokuguqulwa komdlavuza wamaphaphu epulazini elifakelwe kabusha.
Eqinisweni, ngisho nalabo bantu abangavamile lapho ukuguqulwa kwamaphaphu kungasetshenziswa njengokwelashwa, umdlavuza wamaphaphu uvame ukuphindaphinda ekufakweni (okunikeziwe) emaphashini.
Lapho Ukutshala Kungase Kusetshenziswe
Kunezimo ezintathu eziyinhloko lapho ukufakelwa kwamaphaphu kungacatshangelwa khona umuntu onomdlavuza wamaphaphu. Lokhu kubandakanya abantu abane:
- I-Bronchioloalveolar carcinoma yamaphaphu (i-BAC) ehamba phambili ne-multifocal (engaphezu kwendawo eyodwa yomdlavuza emaphashini noma emaphashini.) I-BAC, engasabizwa nge-BAC futhi kunalokho i-subtype ye-lung adenocarcinoma, ama-akhawunti amaphesenti angu-5 ama-cancer wamaphaphu noma angaphansi, avame kakhulu kubantu abangabhemi, kubantu besifazane, nabantu base-East-Asian heritage.
- Umdlavuza wamaphaphu oqala ekuqaleni uhlangene nesifo sokuphela kwesigaba samaphaphu afana neCOPD.
- Umdlavuza we-Metastatic emaphashini avela kwenye isifunda somzimba, okuwukuphela kwemitha emaphashini, futhi uma umdlavuza oyinhloko ( umdlavuza "wokuqala") ulawulwa kahle. Lesi simo asivamile kakhulu.
Kulezi zilungiselelo, ukufakelwa kwamaphaphu kungacatshangwa lapho izindlela ezingezona zokuhlinzwa zingakwazi ukunikeza ukulawula okufanele umdlavuza. Ukuze uphumelele, odokotela kudingeka baqoke ngokucophelela abantu abangase bazuze ekufakweni kwamaphaphu futhi baqiniseke ukuthi umdlavuza uhlelwe ngokucophelela, isibonelo, ukuthi ukuhlolwa okufana ne- PET scan kanye ne- endobronchial ultrasound akubonisi noma yibuphi ubufakazi bomdlavuza isakaze ngaphesheya kwamaphaphu.
Injongo Yokufakelwa Kwemungulu Ye-Cancer Cancer
Ukufakelwa kwamaphaphu kungasetshenziswa kokubili njengendlela yokwelashwa (ngenhloso yokuphulukisa lesi sifo) futhi njengokwelashwa okunomsoco (ngenhloso yokukhulisa impilo kodwa hhayi ukuphilisa lesi sifo).
Okushiwo Ucwaningo
Kuze kube manje, ukufakelwa kwamaphaphu kuye kwaba yindlela yokwelashwa engavamile yomdlavuza wamaphaphu, kodwa ukubuyekezwa kweDiski ye-United Network for Organ Sharing (UNOS) yembula lokhu okulandelayo:
Kusukela ngo-1987 kuya ku-2010 kunamacala angaphansi kuka-50 aqoshiwe (angaphansi kuka-0.1 amaphesenti amacala okufakelwa kwamaphaphu) wokufakelwa kwamaphaphu asetshenziselwa umdlavuza wamaphaphu. Kulaba bantu, iziguli ezingu-29 zinezici eziningi ze-BAC (manje ziphinde zafakwa njengehlobo le-lung adenocarcinoma).
Ngaphandle kokufakelwa kwamaphaphu, futhi ngezokwelapha zendabuko, isilinganiso sokusinda esiphakathi kwabantu abane-BAC esithuthukile singu-1 unyaka. Kubantu abathola ukufakelwa kwamaphaphu, isilinganiso sokusinda seminyaka emihlanu sasingamaphesenti angama-50 futhi sifana nesilinganiso sokusinda kubantu abathola ukufakelwa kwamaphaphu kwezinye izizathu, njenge-COPD.
Lokhu kungcono kunokusinda okubikezelwe nge-chemotherapy, kodwa ngezokwelapha ezintsha ezinjengezokwelapha ezithintekayo kanye ne-immunotherapy, lokhu akuyazi.
Ukuvumelana kubonakala sengathi lokho kubantu abakhethiwe ngokucophelela, ukufakelwa kwamaphaphu kungabangela ukuhlala isikhathi eside kwabanye abantu abane-BAC.
Isibonelo Sokuphila Kwangempela
Uma uhlala nomdlavuza, akukho lutho olufana nokuzwa ngabantu "ababekhona." Abaningi emphakathini womdlavuza wamaphaphu baye baphefumulelwa ngumdlali webhola lebhola ekolishi, uJerrold Dash, oye wahlanganyela nohambo lwakhe ekutholeni ukufakelwa kwamapayipi amabili phakathi kwesigaba 4 BAC.
Kubhulogi yakhe, uhlanganyela ngokuwina umdlavuza wakhe wemdlavuza wamaphaphu nge-transplant yamaphaphu. Nasi umugqa wesikhathi sokufakelwa kwakhe, nombono wesiguli sakhe ku-BAC nokufakelwa kwamaphaphu.
Izifo Zengculazi Yikuphi Ukuguqulwa Kungase Kucatshangelwe
Ukufakelwa kwamaphaphu kungacatshangelwa abantu abanezifo zamaphaphu ekupheleni, lapho kungekho okunye okukhethwa kukho ukwelashwa okukhona, futhi lapho umuntu engenakwenzeka ukuba aphile okungaphezu konyaka kodwa kungenjalo impilo enhle. Ezinye zalezi zifo zifaka:
- Izifo Eziphuthumayo Zokuvimbela Izifo (COPD) njenge- emphysema
- I-Cystic Fibrosis
- I-Pulmonary Fibrosis
- Bronchiectasis
- Ukulimala emiphakathini yamapayipi ngenxa yesici senhliziyo esiswini
- Dysplasia ye-Bronchopulmonary
- Ukuntuleka kwe-Alpha-1-Antitrypsin
- I-Sarcoidosis
- Izifo Zengculaza Zomzimba
- Ukucindezeleka komfutho wegazi
Ingabe Ukuguquka Kwemangalisa Kuphakamisa Ingozi Ye-Cancer Lung?
Yebo, ngezizathu eziningana abantu abaye bathola ukufakelwa kwamaphaphu basengozini enkulu yokwenza umdlavuza wamaphaphu esikhathini esizayo, nezinombolo ezibeka ingozi zizungeze amaphesenti angu-2.5 kuye ngokucwaninga.
Ngaphansi
Ukufakelwa kwamaphaphu ngokuvamile akuyona inketho kubantu abaphila nomdlavuza wamaphaphu. Ngaphandle kokuba umdlavuza omncane futhi ungasondeli emaphashini owodwa, akunakwenzeka ukuthi ukufakelwa kwamaphaphu kuzokwenza noma yini kodwa kubangele ukukhubazeka nokuhlupheka okukhulu. Ngisho nekansana encane, ithuba lokuphindaphinda linciphisa ithuba lokuthi ukufakelwa kwamaphaphu kuzosebenza kahle.
Lokho kusho ukuthi kubantu abathile abane-lung adenocarcinoma (uhlobo olubizwa ngokuthi i-BAC), ukufakelwa kwamaphaphu kungaba yindlela enamandla. Ngisho nakule nkinga izingozi zalokhu kuhlinzeka, okuyiziningi, zidinga ukulingwa ngokucophelela ngokumelene nanoma iyiphi inzuzo okulindelekile. Ezimweni ezingavamile, ukufakelwa kwamaphaphu kungase kube ukwelashwa okuphumelelayo. Ngenhlanhla, njengoba izindlela ezintsha zokwelapha umdlavuza wamaphaphu njengezinhlobonhlobo zokwelapha kanye nokuzivikela ekutholeni zikhona, kunezinto eziningi, kanti nakanjani izindlela ezincane zokwelapha lezi zomshukela.
Uma ucabanga ukuthi ukufakelwa kwamaphaphu kungaba yindlela yokukhetha, ungafunda kabanzi. Hlola umhlahlandlela wokudlulisa amaphaphu we-COPD . Nakuba kunemifikiswano eminingi phakathi kokudluliselwa komdlavuza wamaphaphu ne-COPD, izinto eziyisisekelo zokuhlinzwa zifana kakhulu.
> Imithombo:
> Ahmad, U. et al. Imiphumela ye-transplantation yamaphaphu yomdlavuza wamaphaphu ku-United Network for Registry Sharing Registry. Ama-Annal of Surgery Thoracic . 2012. 94 (3): 935-40.
> Brand, T., no B. Haithcock. I-Cancer Lung ne-Lung Transplantation. Imitholampilo yezokwelapha . 2018. 2 (1): 15-18.
> de Perrot, M. et al. Umsebenzi we-transplantation wamaphaphu ekwelapheni i-bronchogenic carcinomas ezigulini ezinezifo zokuphefumula. I-Journal ye-Clinical Oncology . 2004. 22 (21): 4351-6.
> Garver, R. et al. Ukuphindaphindiwe kwe-caronoma ye-bronchioloalveolar kumaphaphu asetshenziswe. I-New England Journal of Medicine . 1999. 340 (14): 1071-4.
> Machuca, T., no-S. Keshavjee. Ukutshalaliswa komdlavuza wamaphaphu. Umbono wamanje kwi-Organ Transplantation . 2012. 17 (5): 479-84.
> Mathew, J., noRk Kratzke. Umdlavuza we-Lung nokufakelwa kwesiphuphu: ukubuyekezwa. I-Journal ye-Thoracic Oncology . 2009. 4 (6): 753-60.
> Raviv, Y. et al. Umdlavuza we-Lung ekufakweni kwamaphaphu okuthutha: isipiliyoni esibhedlela esiphakeme kanye nokubuyekezwa kwezincwadi. I-Cancer Lung . 74 (2): 280-3.
> Zorn, G. et al. Ukufakelwa kwepulmonary ye-bronchioloalveolar carcinoma. I-Journal ye-Thoracic and Surgery Cardiovascular . 2003. 125 (1): 45-8.