Matenda a chilengedwe amachititsa mbali yaikulu ya nthenda zonse. Zaka zoposa 10 miliyoni zatsopano pachaka zimapezeka padziko lonse lapansi. Mayiko onse akudikirira nkhani kuchokera kwa asayansi za kukhazikitsidwa kwa mankhwala ozizwitsa a khansa. Ndipo panthawiyi, chiwerengero cha imfa kuchokera ku oncology chikupitiriza kukula. Nanga mankhwalawa ndi chiyani?
Mankhwala osokoneza bongo a khansa
Pali njira zingapo zothandizira ovomerezeka. Izi ndi chemotherapy, radiation, hormonal, chithandizo chamakono, opaleshoni intervention. Njirayo imasankhidwa malinga ndi mtundu, siteji ya matenda, malo a chotupa, boma la thanzi la wodwala, ndi zina zotero. Kodi pali mankhwala a khansa? Matenda a metabolites amagwiritsidwa ntchito pofuna mankhwala a chemotherapy. Cholinga chachikulu pakugwiritsira ntchito ndiko kukula kwa maselo a khansa kumatha, chotupa sichitha, ndipo metastases sichiwoneka. Izi ndi mankhwala monga:
- Ftorafur;
- Methotrexate;
- Hydroxyurea;
- Xeloda.
Anesthetics kwa oncology
Mankhwala omwe amathetsa ululu, ali ndi khansara, amagwiritsidwa ntchito popewera mavuto omwe ali nawo pamthupi ndi m'maganizo. Ululu wa oncology umagawidwa mu mitundu iwiri: nthenda ndi ubongo. Mankhwala opweteka amaperekedwa malinga ndi mtundu wa ululu. Choncho, zimadziwika kuti kupweteka kwa nociceptive kumatha ndi kugwiritsa ntchito mankhwala a analgesics, mankhwala osagwiritsidwa ntchito poletsa kutupa, opioids. Kuti athetse ululu wamagazi, mankhwala ophera tizilombo toyambitsa matenda komanso tricyclic mankhwala olepheretsa kugwiritsidwa ntchito.
Mankhwala osokoneza bongo amphamvu a oncology amalembedwa ndi dokotala, pamene ofookawo sakhalanso ofunika. Izi zimachitika chifukwa cha kusintha kwa thupi mwamsanga kumagwiritsidwe ntchito. Zikatero, njira yowonjezera itatu imagwiritsidwa ntchito, yochokera ku bungwe la WHO. Pa nthawi yomweyo, kukonzekera kwa adjuvant kumatengedwa. Chigamulochi chimapereka zotsatira zowonongeka m'mabuku 90%
- osati mankhwala osokoneza bongo ;
- mankhwala osokoneza bongo komanso mankhwala osokoneza bongo;
- Opiates a gulu la morphine komanso osagwiritsa ntchito mankhwala osokoneza bongo.
Kupulumutsidwa ku ululu kumayamba ndi kugwiritsa ntchito mankhwala osokoneza bongo. Izi ndi izi:
- Paracetamol;
- Aspirin;
- Metamizole sodium;
- Diclofenac;
- Ndi ethanol;
- Ibuprofen;
- Naproxen;
- Ketorolac;
- Piroxicam;
- Meloksikam;
- Xsefokam;
- Mefenamic acid.
Mankhwala osokoneza bongo ndi mankhwala osokoneza bongo omwe:
- perekani zotsatira zake (antidepressants, glucocorticoids, mankhwala odana ndi kutupa);
- Kuthandizani zotsatira zoyipa za mankhwala osokoneza bongo (antipsychotics);
- kulimbitsa mphamvu zawo zowopsa (Clonidine, otsutsa calcium).
Kwa opiates ofooka amanyamula:
- Codeine;
- Tramadol.
Kuwonjezera pa mankhwala amphamvu a mankhwala osokoneza bongo amachititsa kuti:
- Propionylphenylethoxyethylpiperidine hydrochloride;
- Morphine;
- Buprenorphine;
- Fentanyl.
Mankhwala osokoneza bongo a oncology
Kuwombera sikungokhala ndi khalidwe losasangalatsa, komanso kumatulutsa thupi kuti lichepetse madzi, ndipo timapepala ta m'mimba timatha kuwonongeka. Kuwonetsa mseru ndi kusanza ndi khansara ndizochitika zachizoloŵezi. Zifukwa zingakhale zosiyana:
- mankhwala;
- mankhwala;
- chotupa ndi metastases mu ubongo;
- mavuto a chifuwa cha m'mimba;
- impso kulephera;
- metastases pachiwindi;
- kuledzera;
- matenda opatsirana ndi opweteka.
Musanayambe kuthetsa chizindikiro chosasangalatsa ndi mankhwala osokoneza bongo, nkofunika kukhazikitsa zifukwa. Pachifukwachi, mankhwala omwe wodwalayo amalandira ndi data ya laboratory imaphunziridwa. Zomwe zimayambitsa chizindikiro ichi zingakhale zofunikira komanso zapadera. Pamene akusanza pakati, zida zotsatirazi zimagwiritsidwa ntchito:
- oteteza serotonin (blockers ya 5 NTZ-receptors - Ondansetron, Tropisetron, Granisetron, etc.), amatha kumwa mowa kwambiri;
- corticosteroids (Dexamethasone, Methylprednisolone, Solumedrol);
- Benzodiazepines (diazepam, lorazepam).
Ntchito yothandizira mankhwala osokoneza bongo:
- atropine ndi mankhwala ena oletsa anticholinergic (Platyphylline ndi Metacin);
- antihistamines (Diphenhydramine, Suprastin);
- Otsutsana ndi Dopamine ndiwo phenothiazines (Etaperazine, Torekan, Aminazine) ndi butyrophenones (Droperidol, Haloperidol), Metoclopramide (Cerucal).
Mankhwala owopsa ndi khansa
Thandizo lachidule ndilo luso lolimbana ndi oncology. Apo ayi, mankhwalawa amatchedwa "anzeru". Dzina limeneli analandira kuti athe kugwira ntchito pa maselo osinthasintha, pamene ziwalo ndi ziwalo zathanzi zimakhalabe zosasintha. Mankhwala oterewa amaperekedwa kuti athetse kukula kwa zotupa, kuchepetsa mlingo wa mankhwala a chemotherapy komanso odwala kwambiri. Pakadali pano, pafupifupi 10 mankhwala osokoneza bongo akhala akuyesedwa ndikugwiritsidwa ntchito, pafupifupi mazana akuyesedwa ndipo mwinamwake posachedwapa adzagwiritsidwa ntchito pochiza khansa.
Kusamalitsa mankhwala osokoneza bongo
Pali malingaliro ambiri ponena za kugwiritsa ntchito ma immunomodulators mu matenda a khansa. Iwo anayamba kugwiritsidwa ntchito m'ma 70. Kuchita kumasonyeza kuti njira zoterezi sizipereka zotsatira zosasangalatsa. Zingakhale zabwino komanso zoipa. Mankhwala opatsirana pogonana ali ndi zizindikiro zingapo:
- Pambuyo pa chemotherapy ndi majekesi ndi matenda a immuno- ndi hematological (Tamerite, Polyoxidonium, Glutoxim, Galavit, Neovir, Cycloferon, Roncoleukin, Leukinferon, Lycopid, Decaris, Timalin, Timogen, Milife);
- pambuyo zovuta zochitika (Polyoxidonium, Leukinferon, Galavit, Imunofan, Roncoleukin Myelopid, Lycopid);
- kukonza kusokonezeka kwa chitetezo cha m'thupi (Polyoxidonium, Glutoxim, Leukinferon, Imunofan, Galavit);
- kuchitapo kanthu pa neoplasm yokha (Roferon, Reaferon-EU, Intron-A, interferon ya Leukocyte kwa jekeseni);
- chifukwa choletsa metastases (Leukinferon, Neovir, Roncoleukin ndi Galavit), kuti ntchitoyi isagwire ntchito.
Kukonzekera kwa hemoglobini yowonjezereka mu mapulaneti
Malinga ndi chiwerengero cha maselo ofiira a magazi, kusiyanitsa pakati pa microcytic, macrocytic ndi yachibadwa magazi. Kukonzekera kwachitsulo kwa atcology kumayendetsedwa mwa intravenously mwa jekeseni pamodzi ndi kukonzekera kwa erythropoietin, zomwe zimayambitsa kupanga erythrocytes. Kuonjezera apo, kuonjezera hemoglobini mu odwala khansa, njira yowonjezera ya erythrocytes imagwiritsidwa ntchito, pamene maselo ofiira ofiira operekedwa kuchokera ku magazi opereka amaloledwa mkati mwake. Motero, hemoglobin imatuluka mwamsanga.
Mankhwala atsopano mu kansa
Kusintha kwa chithandizo cha oncology, monga njira ina iliyonse yamankhwala, imachitika pafupifupi zaka 10 zilizonse. Zomwe zachitika posachedwa, biotherapy ya zotupa, zowonongeka za immunotherapy, kuyambitsidwa kwa njira zatsopano zopangira opaleshoni, komanso makina opepesa ndi opatsirana. Kupanga mankhwala atsopano a khansa, zimatenga nthawi yochuluka. Pambuyo poyambitsa, mankhwalawa amapita magawo angapo a kuyesedwa.
Mankhwala osokoneza khansa
Pa maphunziro atsopano - mankhwala atsopano a ku Russia otsutsana ndi khansa, yotengedwa ndi kampani ya mankhwala BIOCAD, PD-1. Kuchokera mu 2015 mpaka 2016, kuyesedwa kwa nyama kunkachitika. Zotsatira zinasonyeza kwambiri zonse zomwe zinapangidwa poyamba. Ichi ndi chofanana chomwe chimatchedwa "point" mankhwala, omwe amaletsa kukula kwa chotupacho. Tsopano gawo lachiwiri la mayesero likuchitika. Zimakonzedwa kuti mankhwalawa akhalepo kuti agwiritsidwe ntchito kuyambira 2018-2019.
Ndi mitundu yanji ya khansa yomwe ikulimbana ndi mankhwala atsopano?
Mankhwala atsopano oletsa khansa, malinga ndi akatswiri, amagwira ntchito ngati khansa ya m'mapapo , impso, mutu ndi khosi, chikhodzodzo, khansa ya khansa. Ogulitsa amalonjeza kuti ngakhale phwando likaima, zotsatira za mankhwala atsopano zidzapitirira, zomwe zidzapatse mpata wochiritsa ngakhale odwala kwambiri. Ndipo chofunikira kwambiri, chidachi chidzapezeka kwa a Russia. Anthu awiri ogwiritsira ntchito mankhwalawa amagwiritsidwa ntchito kunja ndipo ali ndi mtengo wapatali kwambiri.
Ndi mankhwala ati omwe sungakhoze kuthandizidwa ndi oncology?
Poyankha funsoli, ndi mankhwala ati omwe sangathe kuwonetsa, ndibwino kukumbukira kuti mankhwala ena samangoteteza chithandizo kuchokera kuchilombo, koma zimapangitsanso kuti zikhale zovuta kwambiri. Mwachitsanzo, mankhwala osokoneza bongo, mavitamini ndi anticoagulants angayambitse kukula kwa mimba ndi metastases. Pansi pa chiletso ndi mahomoni. funso lidalipobe ndi kudya kwazitsulo zopangidwa ndi chitsulo. Iwo amafupa mosavuta ndipo sagwiritsidwa ntchito ndi thupi. Choncho, akhoza kuchita zoipa kuposa zabwino.