Ukujonga ukuhlinzwa, ukufakelwa kwesibindi, kunye neziyobisi zamagunya
Ukonyangwa komhlaza wesibindi kuxhomekeke kwinqanaba lomhlaza, kunye nomsebenzi wesibindi somntu.
Ngelixa unyango olukhethiweyo lukhutshwa ngokukhangela komhlaza, abantu abaninzi abavumi ukuhlinzwa ngenxa yengxaki yesifo sabo kunye / okanye impilo engasweleyo yesibindi sempilo. Ngaphandle kokuhlinzwa, ezinye iindlela zonyango ziquka ukufakelwa kwesibindi, unyango lokuphulukana nokunyanga, unyango lwe-embolization, kunye nemishanguzo yemithi njengonyango olujoliswe kuyo, i-chemotherapy, kunye ne-immunotherapy.
Ukuhlinzwa
Ukutshatyalaliswa kokutshatyalaliswa komhlaza wesibindi yonyango olukhethiweyo. Nangona kunjalo, umngeni kunye nokuhlinzwa, kukuba abantu abaninzi abanomhlaza wesibindi banesifo se- cirrhosis kwisifo sesibindi eside.
Ngomsebenzi ongenalutho lwesibindi ukusuka kwisibindi (isibindi sinqabileyo), ukususa inxalenye encinci yesisu sesibindi kunye nomhlaza kunokunikela ngesibindi ngendlela engasebenzi. Ngaphezu koko, ezininzi iintsholongwane zeesibindi azikwazi ukususwa kakuhle ngenxa yokuba zinkulu kwaye / okanye zisasaze ngaphandle kwesibindi.
Vavanyo
Ukuze ufikelele ukuba ingaba umntu ungumgqatswa ogqityiweyo, ugqirha uya kuyala uvavanyo lokucinga (njenge-CT scan okanye i-MRI) ukuvavanya umlinganiselo womhlaza, kunye nokuhlolwa kwegazi emsebenzini . Umgqatswa ongcono kunomntu onesisu esisodwa (esingabininzi) kwaye ulondoloze umsebenzi wesibindi.
Ukuba wena okanye othandekayo unomdlavuza wesifo sesibindi, kuyimfuneko uhlolisise yonke ingozi kunye nemiphumo engabonakaliyo kunye nodokotela wakho ogqirha.
Ukongezelela, ungesabi ukubuza imibuzo uze ubuze malunga namava akho ogqirha.
Iimiphumo zangaphandle
Ukutshatyalaliswa kokutshatyalaliswa komdlavuza wesibindi kukuhlinzwa okukhulu, ngakumbi ekubeni isibindi sineemithwalo yegazi. Oku kwenza igazi ngexesha lotyando lugxininiso olukhulu.
Ezinye iziphumo ezichaphazelekayo zonyango ziquka:
- Sulelo
- Amacwecwe egazi
- Iingxaki ezinxulumene ne-anesthesia
- Pneumonia
Iqela lakho lezonyango liya kukubeka iliso ukuze unciphise le mngcipheko, kwaye unikele imiyalelo ngeendlela onganciphisa umngcipheko weengxaki.
Ukutshintsha izityalo
Ngaphandle kokuhlinzwa, ukunyatheliswa kwesibindi yindlela enye yokunyanga yokunyanga, kunye nenzuzo eyongeziweyo yokunyanga ingomdla kuphela kodwa i-cirrhosis, nayo. Ngethuba lokufakelwa kwesibindi, ugqirha othayathelisayo ususa isibindi esinesifo aze asuse endaweni enomnye umntu ophilileyo.
Ugqirha unokuncoma ukutshintshwa kwesibindi ukuba i-tumor (s) yesibindi sincinci okanye ukuba utyando alukho ngenxa yeso sibindi esingasimpilo.
Isithintelo esikhulu sokuguquka kwesibindi kukufumaneka okukhawulezileyo kwezibindi. Ngokwe-American Cancer Society, kuphela ama-6,500 angama-liver afumaneka ukutshintshwa kunyaka ngamnye, kwaye ezininzi zazo zisetyenziselwa abantu abaneengxaki zesibindi ngaphandle komhlaza.
Iimiphumo zangaphandle
Ukongezelela kwimiphumo echaphazelekayo enxulumene nokuhlinzwa kwesibindi (ukuphuma kwegazi, ukusuleleka, ugalelo lwegazi, iingxaki ze-anesthesia, kunye ne-pneumonia), kukho imiphumo emihle enokuthi ifakwe kumachiza umntu kufuneka athathe emva kokutshintshwa.
La mayeza anqanda ukukhusela umkhuhlane angamthintela umntu ukuba angalahla isibindi esitsha.
Ngenxa yokuba banqanda i-immune system yakho, nangona kunjalo, abantu banokutheleleka kwiintsholongwane.
Ezinye iziphumo ezichaphazelekayo zamachiza okuxhatshazwa ngumzimba ziquka:
- Igazi elonyukayo
- Cholesterol ephezulu
- Iingxaki zeengso
- Sikashukela
- I-Bone ithathaka (ebizwa ngokuba yi-osteoporosis)
Iinkqubo ezingenziNzululwazi
Kubantu abanomdlavuza wesibindi abangabagqatshi, abaphululiweyo kunye / okanye ukunyangwa kwamathambo kungabonwa yonyango. Ezi zonyango ziyancipha kwaye mhlawumbi zibhubhise izibilini zesibindi.
Ablation Therapy
Ukwelashwa kwe-Ablation yindlela engeyiyo yokuhlinzwa yokubulala iiseli zomhlaza kwaye iyona ndlela isetyenziswe rhoqo kwisifo somhlaza wesibindi. Le nkqubo ibandakanya ukubeka inaliti okanye iphenyi ngqo kwi-tumor yesibindi kunye nokusebenzisa iindlela ezahlukeneyo zokubulala iiseli.
Iindidi zonyango lokuqhelisa zibizwa ngokuba zisekelwe kwiindlela ezisetyenziselwa ukutshabalalisa iiseli zomhlaza:
- I-Rafiofrequency ablation (RFA): Amagagasi omsakazo ophezulu aphezulu atshisa abulale amaseli omhlaza
- I-ethanol ye-percutaneous (utshwala): Ukusela utywala kumaseli omhlaza
- I-Cryotherapy : Iigesi ezibandayo kakhulu ziyadluliselwa kwi-tumor ukuze zifakela iiseli zomhlaza
- I-microwave ablation: Ukufudumala kwii-microwaves kudluliselwa kumaseli omhlaza
Njengoko nayiphi nayiphi na inkqubo, kukho iingozi kunye nemiphumo engase ibe yinkcitho ekungenisweni kwe-ablation. Ezinye zezi ziquka:
- Ukuhlamba kunye nokulimaza kwindawo yesikhumba apho inaliti okanye iphenyo ifakwe
- Ukulimala kwimithambo yegazi kwisibindi okanye iisundu zesibindi ezijikelezayo xa inaliti okanye ipererelo ingeniswa ngokungafanelekanga
- Usuleleko, kubandakanya ukungena kwesibindi
- Ukulimala kwi-bile duct okanye ezinye izitho
- Ukulimala (ubunzima obunqabileyo apho amangqamuzana omhlaza ahlakazeka kwiphepha lenaliti)
Ulwabiwo lweMpilo
Ngexesha lokubambisa, ukunikezelwa kwegazi kumdlavuza wesibindi kuvinjelwe ukuze umhlaza "ulambile" kwaye awukwazi ukukhula. Le ndlela yokonyango ingasetyenziselwa izibilini zesibindi ezinkulu kunye / okanye ezingenakususwa.
Ngamanye amaxesha ukuhlanganiswa kuhlanganiswe ne-chemotherapy (ebizwa ngokuba yi-chemoembolization) okanye i-radiation (i-radioembolization).
Imigaqo
Amachiza enesigqirha asetyenziswa ukuphatha umhlaza wesibeleko esiphezulu okanye sexesha elide.
Ulwaphulo olulindelekileyo luyonyango lokuqala lokunyanga umhlaza wesibindi, olandelwa yi-chemotherapy okanye i-immunotherapy njengokhetho lwesibini.
Iipilithi ezijoliswe
Iziyobisi ezijolisweyo zisebenza ngokuphazamisa izinto ezifunekayo ngomhlaza ukuba zikhule. Iyeza lokuqala elivunyiweyo lokwelapha umdlavuza wesibindi esingenasisombululo (isifo somhlaza wesibindi esingasinakususwa) sisisifo se- Nexavar (sorafenib), esilujoliswe kwisigxina sesibindi ekwenzeni imithwalo yegazi entsha.
Iziphumo eziqhelekileyo zemiphumo ye-Nexavar ziquka:
- Ukukhathala
- Rash
- Ukuphelelwa kwesidlo
- Uhudo
- Igazi elonyukayo
- Ukuphendula ngonyawo
Kubantu abangenako ukunyamezela i-Nexavar, okanye njengenye indlela yokwelashwa kwelayini lokuqala, isilwanyana esifanayo esibizwa ngokuthi nguLenvima ( lenvatinib ) sinokuqwalaselwa.
Esi sifundo sesigaba se-III, uLenvima (xa kuthelekiswa neNexavar) unomvuzo ophezulu ophezulu wokusinda (iinyanga ezili-13,6 ngokubhekiselele kwi-12.3), izinga lokuphendula eliphezulu (iipesenti ezingama-24 kunye neepesenti ezili-9), kunye nexesha eliphakamileyo ekuqhubekeni kwezifo (7.4 iinyanga ukuya kwezi-3.7 iinyanga ).
Imiphumo emibi kakhulu yeLenvima yile:
- Igazi elonyukayo
- Uhudo
- Ukunciphisa ukutya
- Ukuhla ukusinda
- Ukukhathala
Esinye isilwanyana esijoliswe kuso iStivarga (regorafenib) ibimbela amaprotheni anceda umdlavuza wesibindi. Eli liza lisebenzisa nje njengonyango lwesibini (ithetha ukuba iNexavar okanye uLenvima bayeka ukusebenza).
Iziphumo eziqhelekileyo ziquka:
- Ukukhathala
- Ukulahlekelwa ngumdla kunye nokulahleka kwesisindo
- Rash ezandleni nasezinyaweni
- Igazi elonyukayo
- Umkhuhlane kunye nezifo
- Uhudo
- Ubuhlungu beBelly
Chemotherapy
I-Chemotherapies yiziyobisi ezibulala amangqamuzana omhlaza. Nangona "i-chemo" ngokuqhelekileyo ithathwa ngomlomo okanye ngesisu, xa isifo somhlaza wesibindi, sinokulawulwa ngokuthe ngqo kwisibindi ngetyitha ye-hepatic (ebizwa ngokuba yi-hepatic infusion infusion).
Ngokuxhomekeke kumhlobo kunye nomthamo we-chemotherapy owanikezelweyo, umntu unokufumana uluhlu lweemiphumo ezinokuthi:
- Ukulahlekelwa kweenwele
- Izilonda zomlomo
- Ukuxuba, ukuhlanza, kunye / okanye urhudo
- Ukunyuka kwesisindo ukusuka ekunciphiseni kwesondlo
Ekubeni izilwanyana ze-chemo zijolise ngokuhlukana kweeseli (iiseli zomhlaza zikhula ngokukhawuleza), iiseli zomnatha womntu zihlala zibhujiswa. Oku kunokukhokelela kwiimpawu ezinjenge-bruising elula kunye negazi, kunye nokukhathala kunye nomngcipheko omkhulu wokusuleleka.
Immunotherapy
I-Immunotherapy yinto enomdla kakhulu, inkqubela yokwelapha eguqukayo eguqule ubuso bomdlavuza. Isisiseko emva kwe-immunotherapy kukuba ivuselela umzimba womntu ukuhlasela iintsholongwane zomhlaza.
Ngomdlavuza wesibindi, i- immdiotherapy ye-immdiotherapy i-Opdivo (nivolumab) isebenza ngokukhusela iproteinyini yokuhlola i-immune ebizwa ngokuthi i-programmed death 1 (PD-1). Le prothini yenziwe ngokunyanga ngamaseli omhlaza ukukhusela isistim somzimba somntu ekuqapheliseni njengento yangaphandle. Ngoko, ngokuthintela iP-1, umhlaza ungabonwa kwaye uhlaselwe.
I-Opdivo inikezwa nge-vein, nganye iveki ezimbini. Iziphumo ezichaphazelekayo zibandakanya:
- Ukukhathala okanye ubuthathaka
- Fever
- Isiqhamo
- Isisindo kunye nokulahleka kwesidlo
- Ukutshiza kunye nokugqithisa kwesikhumba
- Intlungu okanye isiswini
- Ukutyunjwa okanye urhudo
Iziphumo ezibi kakhulu zibandakanya impendulo ekungeneni (okufana neempembelelo ezithintekayo) okanye ukuphendula ngokuzenzekelayo, apho umzimba womntu uqala ukuhlasela izitho zempilo (umzekelo, imiphunga).
I-Medicine Complementary (CAM)
Ngaphambi kokusebenzisa nayiphi na imifuno okanye ukutya, qiniseka ukuba ugqirha ugqirha wakho. Oku kuya kunceda ukukhusela nayiphina imiphumo engafanelekanga kunye nokusebenzisana.
Sho-saiko-to
Esinye isidakamizwa semithi esibizwa ngokuba yiSho-saiko-to (esibizwa nangokuthi yi-Xiao Chai Hu Tang), esiyimxube yezinto eziyisixhenxe ze-botanicals, kubandakanya i-ginseng, i-ginger kunye ne-licorice, isetyenziselwe ukuphatha i- hepatitis and cirrhosis.
Olunye uphando lubonisa ukuba leziyobisi ezinokuthi zinokunceda ukunqanda ukukhula komhlaza wesibindi kubantu abane-cirrhosis, nangona indlela echanekileyo yokuthatha isenzo ayifani ngokucacileyo. Nangona i-Sho-saiko-kukholelwa ukuba iyaxhomekeka kakuhle, ingabangela ukulimala kwamaphaphu kunye nesibindi, ngoko kufuneka kuthathwe kuphela phantsi kolawulo lugqirha.
Basil oyiNgcwele
Enye imifuno ebizwa ngokuthi i- Ocimum sanctum L okanye "i-Holy Basil" isityalo esiqulethe iiprotochemicals ezikhuthaza impilo yesibindi. Kwakhona kuneendawo ezichasene nomhlaza. Ngamanye amaxesha imifuno eluhlaza isetyenziswa kwii-Thai cuisine. Ayikho imiphumo emibi eyaziwayo.
Ingxube Yamanzi
U-Silymarin ( Silybum marianum ), obizwa nangokuthi i- milk thistle , isetyenziswe kwamanye amazwe (njengesiJamani) njengonyango oluxhasayo lwezifo ezingapheliyo zesibindi. Kukholelwa ukuba unendawo yokuchasana nomhlaza kwaye unesiprofayili esihle senkonzo, nangona kungabangela ukuphendulwa komzimba okanye iimpawu zokunciphisa umzimba.
Ukutya kweNdalo
Ngaphandle kwemifuno, ukutya kwendalo kunokukunceda nokukhusela umdlavuza wesibindi. Ikhofi iyisityebi esisisityebi se-antioxidants kwaye idibene nomngcipheko omncinci we-cirrhosis kunye nomhlaza wesibindi. Nangona kunjalo, akukho bungqina bobunzululwazi bokuthi ukwandisa ukusetyenziswa kwekhofi yakho yangoku (okanye ukuqala ukusela ikofi ukuba awunakho) kuyinzuzo.
Olunye ukutya kwendalo, i-resveratrol, efumaneka kwi-mulberries, izidiliya ezibomvu, kunye namanqwanqatha, unokuba nemiphumo yokuchasana nomhlaza ngaphezu kokukhusela isifo sesibindi esingasinxilisayo .
> Imithombo:
> I-American Cancer Society. (nd). Ukunyangwa kweNtsholongwane yoMhlaza
> Umcebisi A, uReig M, uBruix J. Hepatocellular carcinoma. Lancet. Ngo-2018 uMar 31; 391 (10127): 1301-14.
> Kim JW et al. Ukukhishwa kweengxubevange zesibindi nge-ultrasound ehamba nge-ultrasound: Indlela esiyenza ngayo ngokukhuselekileyo kwaye ngokupheleleyo. Korean J Radiol . 2015 uNgo-Dec; 16 (6): 1226-39.
> Kudo M et al. ULenvatinib ngokubhekiselele kwi-sorafenib kwindlela yokuqala yokufumana unyango lwezigulane ezine-hepatocellular carcinoma ezingenakuphuphuma. Lancet. 2018 uMar 24; 391 (10126): 1163-73.
> Waghray A, AR ARali, Menon KVN. I-hepatocellular carcinoma: Ukususela kwi-diagnostic ukuya kunyango. Hlabathi J Hepatol. 2015 Meyi 18; 7 (8): 1020-29.