Ngabe Ukwelashwa Kwemdlavuza Kungalimaza Amaphiko Futhi Kuphathwa kanjani?
Kusho ukuthini umonakalo wamaphaphu (uketshezi wamapulmoni) kusuka ekwelapheni komdlavuza, ngingazi kanjani ukuthi nginakho, futhi uphathwa kanjani?
Ukwelapha I-Cancer Kwangcolisa Ukwelashwa Kwamapuloni (Ukulimala Kwemungulu)
Omunye wemiphumela emibi engaziwa kakhulu yokwelashwa kwegazi kanye nomorsa isifo somonakalo wamaphaphu. Lolu hlobo lomonakalo wamaphaphu lungabuye lubizwa ngokuthi i-pulmonary toxicity noma i-lung toxicity.
Ubuthi obuphambanisayo bungabuka ukuvuvukala kwendwangu yamapayipi kuya ekuqothulweni okungapheli kwamathambo ephaphu. Kulinganiselwa ukuthi iziguli ezingu- 10% ezithola imithi ye-chemotherapy - okungenani izinhlobo ze-chemotherapy ezisebenziselwa i-blood cancers - ziyoba nemiphumela emibi ye-pulmonary.
Yini Ebangelwa Ubuthi Obuthakathaka?
Ubuthi obuphambene nomzimba luwumphumela ongase ube nomphumela wokubili we-chemotherapy kanye ne-radiotherapy. Okubangela ubuthi be-pulmonary akuqondakali kahle. Kodwa-ke, ososayensi bathole izici eziningana abazizwa bazidlale indima endleleni ukuphathwa kwe-pulmonary toxicity eqala ngayo.
- Ukusebenzisana phakathi kwe-chemotherapy ne-radiotherapy ene-molecule ye-oxygen
- Umphumela onobuthi oqondile kwi-DNA yamaseli wamaphaphu
- Ukusabela okuvuthayo kwamathishu amaphaphu ngemva kokudonswa kwamakhemikhali noma imisebe
Izimpawu Zobuthi Bokudakwa
Izimpawu zokwelapha ezihlobene ne-pulmonary toxicity ezihlobene nezokwelapha zifanelekile futhi zingangqubuzana kalula nezinye izimo zamaphaphu .
Izimpawu ezijwayelekile zokwelashwa ezihlobene nomuthi zihlanganisa:
- Ukukhwehlela okumile
- Ukuphelelwa umoya
- Ubuhlungu besifuba
- Ukuphefumula ngokushesha
- Ubunzima bokubamba umoya wakho
- Fever
Kwezinye izimo, izibonakaliso ze-pulmonary toxicity zingabonakala ngesikhathi sokwelashwa, noma kungathatha izinyanga ezimbalwa ukuze izimpawu ziqale. Ngokwesilinganiso, izimpawu ezihlobene nomonakalo wamaphaphu ziqala amasonto ayisithupha kuya kwangu-8 emva kokuqala kokwelashwa.
Ngenxa yokuthi lezi zimpawu zifana nezinye izimo ezingase zihlangane neziguli zomdlavuza ezifana ne-pneumonia noma ukusabalalisa kwamangqamuzana amabi emaphashini, izazi kufanele zilawule ngaphambi kokuba zithole ukuxilongwa kwezokwelapha ezihlobene ne-pulmonary toxicity. Ngamanye amazwi, ubuthi be-lung lung "ukuxilongwa kokukhipha."
Yiziphi izinyathelo ezithinta kakhulu ukwelashwa kwezidakamizwa?
Izinhlobo eziningi zemithi ye-chemotherapy ziye zahlotshaniswa ne-pulmonary toxicity. Eminye yezinto ezivame kakhulu ezisetshenziselwa ukwelashwa kwegazi kanye nomdlavuza wamarrow yilokhu:
- Bleomycin
- I-Idarubicin
- I-Methotrexate
- Cyclophosphamide
- Busulfan
- Arsenic trioxide
Ukwelashwa kwezidakamizwa endaweni yesifuba kungase kubangele ubuthi be-pulmonary . Lo mphumela ungahle ukhulume uma uthola i-radiotherapy ngokuhambisana ne-chemo.
Izici zengozi Ekuthuthukiseni I-Pulmonary Toxicity
Izinto ezibeka iziguli ezithile engozini ephakeme yokuthuthukisa ubuthi be-pulmonary akucaci futhi zivame ukuphikisana ngazo. Noma kunjalo, okulandelayo kuphakanyisiwe njengezici eziyingozi:
- Ukukhula kweminyaka
- I-chemotherapy yokuhlanganiswa
- Umzila we-chemotherapy administration
- Ukwelashwa kwezidakamizwa kuhlanganiswe ne-chemotherapy
- Izinkinga zezinso
- Isifo sesifo sephaphu esingaphansi
- Umlando wokubhema
- Ukuchayeka kwangaphambili ku-asbestos
- Amanani aphezulu we-chemotherapy
- I-Colony stimulating factor (G-CSF) njengemithi yokweseka e-bleomycin regimens (imithi efana Neupogen neNeulasta ephakamisa inani lakho legazi elimhlophe)
- Ukusebenzisa ukwelapha oksijini ngesikhathi semjikelezo ye-chemotherapy
Ukuqaphela Ukwelashwa Okuhlobene Nezokwelapha Ezihlobene Nezokwelapha
Ukuthola iziguli ezinobuthi be-pulmonary kungaba nzima kakhulu ngenxa yezibonakaliso nezimpawu ezingezona ezithile kanye nokuntuleka kwezinketho zokuhlola ezicacile. Ngokuyinhloko, izazi zifika ekuxilongweni kwezokwelapha ezihlobene ne-pulmonary toxicity emva kokuba zonke ezinye izimbangela, njenge- pneumonia , zikhishiwe.
Abahlengikazi bazosebenzisa ukuhlolwa kwegazi njengokwezibalo eziphelele zegazi ngokuhlukana, esifubeni se-X-rays noma nge- CT , ukuhlolwa komsebenzi we-pulmonary (PFT) futhi ngezinye izikhathi i- bronchoscopy ukulawula ukutheleleka noma ukusakazwa kwamangqamuzana omdlavuza emaphashini njengesizathu sezimpawu. Uma kungekho esinye isizathu esingabonakala, futhi usanda kuba nokwelashwa okukhulu okwedlule, isazi sakho singanquma ukuthi izinkinga zakho zamaphaphu zibangelwa ukwelashwa kwakho komdlavuza.
Ukwelashwa Kokudakwa Kwe-Pulmonary
Uma udokotela wakho osolwa kakhulu ukuthi umonakalo wakho wamaphaphu uhlobene nenye yezokwelapha noma imithi oyitholayo, cishe izoyeka leyo agent. Kwezinye izimo, bangashintsha imithi ngesinye esinobuthakathaka noma nje basuse isidakamizwa. Nakuba kungase kube nzima ukushintsha ukwelashwa kwakho, udokotela wakho ngeke athathe leso sinqumo kalula.
Ayikho ukwelashwa okuqondile komonakalo wamaphaphu obangwa yimithi yokwelashwa, kunezinto ezimbalwa ezingasiza ngezibonakaliso ongase uzibonele:
- I-Steroids ukunciphisa ukuvuvukala emaphashini akho
- Ukusebenzisa ngokucophelela ukwelapha oksijini
- Ama-Narcotics ukusiza ukukhulula ukukhululeka nokusiza ekunciphiseni ukuphefumula
- Ukuzivocavoca umzimba
- I-physiotherapy yokuphefumula (ukuvuselelwa kwe-pulmonary)
- Ukuyeka ukubhema
- Umsebenzi womzimba nokuzivocavoca
Ukuphila Emva Kokudakwa Kwemfuyo
Amacala amakhulu we-pulmonary toxicity angaba yingozi. Kwezinye izimo, umonakalo wamaphaphu obangelwa ukwelashwa komdlavuza ungahlala unomphela. Kodwa-ke, ezimweni eziningi, lapho iziguli ziphila ngalezi zindlela ezinzima zokuphazamisa amaphaphu, ziyabuyiselwa ngokuphelele ngaphandle kwemiphumela ehleliyo esele.
Iyifinyelela phezulu
Umonakalo wamangwenya ungabangela ukuthi i-chemotherapy noma i-radiotherapy ekwelapheni umdlavuza. Njengoba izindlela zethu zokwelashwa kwegazi kanye nomrhodlavuza seziphumelela kakhulu, abantu baphila isikhathi eside kunanini ngaphambili ngaphambi kokwelashwa. Ngakho-ke, izinhlelo zokunakekelwa zidinga ukucabangela umthelela wesikhathi eside wesikhumba sokuphefumula ngaphezu kokukwazi ukuphulukisa le mibandela.
Imithombo
Maldonado, F., Limper, A., noJ. Jett. Ubuthi obuphambanisayo obuhlobene nokuphathwa kwe-antinoplastic: ama-cytotoxic agents. Kusesikhathini. Kubuyekezwe 09/28/15. http://www.uptodate.com/contents/pulmonary-toxicity-associated-with-antineoplastic-therapy-cytotoxic-agents
Pal, S. Bleomycin Yenza Ukulimala Kwemungulu. Kusesikhathini. Kubuyekezwe 09/14/15. http://www.uptodate.com/contents/bleomycin-induced-lung-injury
Shippee, B., Bates, J., noK. Richards. Indima yokuhlola kanye nokuqapha i-bleomycin pulmonary toxicity. Umbhalo we-Oncology Pharmacy Practice . 2015 Mar 2. (Epub ngaphambi kokuphrinta).