Kungenzeka yini ukuthi i-Pulmonary Nodule ibe Ngculaza?
Yini ngempela i-nodule yodwa yamapulmoni, futhi yiziphi amathuba ukuthi umdlavuza?
Njalo ngonyaka e-US, abantu abangaphezu kuka-150 000 bazokwaziswa ukuthi bane-nodule yodwa yamapulmonary, futhi lokhu kulindeleke ukuba kwandiswe njengoba abantu abaningi behlola ukuhlolwa komdlavuza wamaphaphu . Kusho ukuthini uma uthola ukuthi une-nodule yangasese yodwa?
I-Solitary Pulmonary Nodule: Incazelo
I-nodule yodwa yamapulmoni ichazwa njenge-nodule eyodwa (okungavamile) ebonwe kwi-x ray noma CT, engaphansi noma elingana no-3 cm (1½ amasentimitha ububanzi) ububanzi.
Uma "ibala" emaphashini likhulu kunama-3 cm libhekwa njengamaphaphu amaningi . I-nodule ifakwe izicubu ezivamile, futhi akukho nezinye izimpawu ezingase ziphakamise umdlavuza (njengezigqila ezikhulisiwe noma i-pleural effusion) ezikhona. Ama-nodules we-solitary yamapulangwe ngokuvamile atholakala ngengozi uma i-x-ray isenzelwa esinye isizathu. Zivamile, zitholakala cishe ku-1 kuwo wonke ama-x-rays angu-500.
Uma kunezingqimba ezingaphezu kweyodwa, izimbangela ezikhona kanye nokuhlolwa okuphakanyisiwe kungase kube okuhlukile. Funda kabanzi ngezimbangela nokuhlaziywa kwama -nodules amaningi wamapulmoni .
Yini Engenzeka Yimbangela Yendlela Yokuziphendulela Yesizungu?
Kunezimbangela eziningi ze-nodules yamapululini yodwa (SPN), ezinye zivame ngokwengeziwe kuncike eminyakeni yobudala kanye nendawo. Ezinye zazo zihlanganisa:
- Umdlavuza we-Lung: Umdlavuza wamaphaphu omusha ungabonisa njenge-SPN. Lapho umdlavuza wemaphaphu utholakala ngalesi sigaba , amathuba okuphulukiswa aphakeme kakhulu kunezigaba ezilandelayo.
- Amanye amakhemikhali: Umdlavuza we-Metastatic kusuka kumdlavuza kwezinye izingxenye zomzimba, noma i- lymphomas ingabonakala njenge-solule yamapululini yodwa, nakuba ngokuvamile imithinastase yamaphaphu ihlanganisa ama-nodules amaningi e-pulmonary.
- Izifo (ezintsha nezindala): Ukutheleleka kwamabhaktheriya njengesifo sofuba, izifo ezifungayo ezifana ne-blastomycosis, i-histoplasmosis, i-coccidiomycosis, ne-cryptococcosis, kanye nezifo ezinama-parasitic ezifana ne-dirofilariasis ne-ascariasis zingabangela i-SPN.
- Izimo ze-rumatoid: Izifo ezinjenge- rheumatoid arthritis , sarcoidosis , ne-Wegener granulomatosis zingabangela i-SPN.
- Izimo ezibandayo: Ama-Cysts, nokuthuthukiswa okungavamile kwemithambo yegazi kanye nemisipha emaphashini (i-AV malformations) ingabangela ama-nodules yamapululini yedwa.
Lezi zimbalwa kuphela zezimo ezingase zidale u-nodule wodwa wamapulmoni. Funda kabanzi mayelana nezimbangela zamapulisi wamaphaphu .
Yiziphi Izindlela Ukuthi I-Pulmonary Nodule Yona Yodwa Yingqikithi?
Ngokuvamile, ithuba lokuthi udonsa wodwa we-pulmonary umdlavuza ungamaphesenti angama-40, kodwa lokhu kuhluka kakhulu kubantu ngabanye kuye ngokuthi kunezici eziningana. Lokhu kufaka:
- Ubudala: Kubantu abasha, i-SPN cishe inobungozi , kanti, kubantu abaneminyaka engaphezu kwengu-50, kungenzeka ukuthi bayingozi (umdlavuza).
- Ukusetshenziswa kotshwala: Umlando wokubhema uphakamisa amathuba okuthi i-SPN iyingozi.
- Umlando womdlavuza: Ukuba nomlando cishe noma yiluphi uhlobo lomdlavuza kwenza kube lula ukuthi i-SPN ingumdlavuza.
- Indawo yendawo / ukuhamba kwamanye amazwe: Ezindaweni zomhlaba lapho izifo ezingenhla zivamile, i-SNP cishe ingenxa yokutheleleka.
- Usayizi: Okukhulu ngobukhulu be-SPN, cishe kunomdlavuza.
- Ukubukeka kwe-SPN kuma-ray-ray: Ama-nodules e-pulmonary ebonakala nxazonke futhi abushelelezi kuma-x-ray cishe amathuba okuba ayinhlonipho, kanti labo abonakala bengavamile bangase babe yingozi. Kukhona okunye okutholakala kwe-radiological ukuthi ama-radiologists afuna ukubikezela ukuthi kungenzeka ukuthi i-SPN iyingozi noma cha.
Kwenzekani Ngemuva kokuthi Udokotela Wami Uthole I-Solitary Pulmonary Nodule?
Ngemuva kokuthola i-SPN, into yokuqala okuzokwenza ukuthi udokotela wakho afune ukuyenza, hlola ukubona ukuthi unayo yini i-x-rays endala noma ama-CT angakwazi ukuqhathanisa nezivivinyo zakho zamanje. I-SPN engazange ishintshe ngosayizi weminyaka emibili ibhekwa njengobuningi futhi ngokuvamile ayidingi ukulandelwa okulandelayo.
Uma ungenayo i-x-rays yangaphambili, noma uma i-nodule ibonakala ikhula, kunezinketho eziningi ezingabhekwa ngazo. Ezinye zazo zihlanganisa:
- Ukuqaphela: Uma i-SNP ingabhekana kahle, ukulandela ngokuphindaphindiwe kwama-x-ray / CT scan kunganconywa.
- Phinda ukuhlola: Noma nini lapho ukuhlolwa kwezokwelapha kwenziwa, kukhona ithuba lokuthi imiphumela iphutha. Ngezinye izikhathi isithunzi, noma ukuthi ubeke kanjani uma i-x-ray isenziwa, yenza kube sengathi kukhona into lapho lapho engekho. Ukuphindaphinda ukuhlolwa ukuqinisekisa ukuthi i-nodule ekhona ngempela inganconywa.
- Ukuhlolwa okuqhubekayo: Ukuhlanganisa imiphumela yesifo se-x-ray noma ukuhlolwa kwe-CT ngesinye isilingo, njengokuhlola kwe- PET , kungasiza udokotela wakho ukuba aqonde ukuthi ngabe isigunci siyinto yokukhathazeka. Kubalulekile ukuqaphela ukuthi ama- x-rays esifubeni angahle akhohlwe amakhemikhali , futhi uma kukhona ithuba lokuthi i-SPN iyingozi, udokotela wakho uzoyala i-CT scan (noma ungacela eyodwa uma ingalawulwa.)
- I-Biopsy: Indlela kuphela yokukwazi ngokucacile ukuthi i-SNP iyinhlamba noma iyingozi yini ukuthola isampula yamathishu engabonwa ngaphansi kwe-microscope. Kuye ngokuthi indawo ye-SNP, izinketho ezingahle zinconywe zihlanganisa i- bronchoscopy , i- fine fancy aspiration biopsy (FNA) , ukuhlinzeka nge-thoracoscopic (VATS) noma i-pulp biopsy evulekile ngevidiyo nge-thoracotomy. Funda kabanzi mayelana nokuqonda amaphaphu akho wephuphu .
Amakhemikhali Amapulmonary Solitary on Screening Lung Cancer
Ngokuvunyelwa nokwandisa ukutholakala komdlavuza we-CT wamaphaphu, kungenzeka ukuthi ama-nodules yamapululini ayodwa ayotholakala. Lokhu kubangela inkinga yokuhlonza ngezikhathi ezithile, kanti ucwaningo lwamuva lubonisa ukuthi izinyathelo ezincane ezingenasisindo zokuxilongwa, njengezinhle ze-needle biopsies, zingase zibe nenzuzo ngaphezulu kokubili i-PET ihlola (engakwazi ukunikeza ukuxilongwa kwezicubu) nezinqubo eziningi ezingenayo.
Uma i-SPN yakho itholakale ekuhloleni komdlavuza wamaphaphu, funda kabanzi mayelana nokubikezela ukuthi ngabe i-nodule etholakala ekuhlolweni kungumdlavuza noma cha.
> Imithombo:
> Bai, C., Choi, C., Chu, C. et al. Ukuhlolwa Kwezimpawu Zama-Pulmonary: Ama-Clinical Practice Consensus Guidelines e-Asia. Isifuba . 2016. 150 (4): 877-893.
> I-National Institute of Health. I-Medline Plus. I-Solitary Pulmonary Nodule. Kubuyekezwe 08/1/17. https://medlineplus.gov/ency/article/000071.htm
> Yang, W., Jiang, H., Khan, A. et al. I-Transthoracic Isinxephezelo Isaluka ku-Solitary Pulmonary Nodule. Ucwaningo lwe-Cancer Research . 2017. 6 (1): 76-85.