Ziyiphi Ionyango Zonyango Zingalimaza Amangxuma kwaye Yenzelwa Njani?
Kuthetha ntoni umonakalo wamaphaphu (unyango lwe-pulmonary) ukusuka kwonyango lomhlaza, ndingayazi njani ukuba ndibenalo, kwaye njani uphathwa ngayo?
Ukunyanga kweMhlaza yeCreater (Pung Damage)
Omnye wemiphumo engaphantsi eyaziwayo yonyango lwegazi kunye nomnayile weengcingo ngumonakalo wemiphunga. Olu hlobo lomonakalo lomphunga lungabizwa ngokuba yi-pulmonary toxicity okanye utyhefu.
Inetyhefu yepulmonary ingabelana nokuvuvukala kwimbumba yemiphunga ukuya ekutyaleni okusisigxina kwamathambo ephaphu. Kuqikelelwa ukuba ezininzi ezili-10% zezigulane ezithobela i-chemotherapy - ubuncinane iintlobo ze-chemotherapy ezisetyenziselwa i-cancer yegazi-ziya kuba nemiphumo emibi yecala.
Yintoni Eyibangela Ukutyhefuza Kwempawu?
Inetyhefu yepulmonary yindlela echaphazelekayo yamacrotherapy and radiotherapy. Yintoni ebangela ukuba i-pulmonary toxicity ingacaciswanga ngokucacileyo. Nangona kunjalo, izazinzulu ziye zafumanisa inani lezinto eziziva zidlala indima kwindlela utywala lwe-pulmonary eqala ngayo.
- Ukusebenzisana phakathi kwe-chemotherapy kunye ne-radiotherapy eneamoleksi ye-oxygen
- Isiphumo esichazayo ngqo kwi-DNA yamaseli emiphunga
- Impendulo evuthayo yamathumbu omphunga emva kokuchaphazela kwi-chemotherapy okanye i-radiation
Iimpawu zoTywala
Iimpawu zonyango ezinxulumene ne-pulmonary toxicity azibonakali zodwa kwaye zidibanisa kalula nezinye iimeko zemiphunga .
Impawu eziqhelekileyo zonyango olunxulumene nomonakalo wamaphaphu ziquka:
- Umkhuhlane omile
- Ukuqhawukelwa ngumphefumlo
- Iintlungu zesifuba
- Ukuphefumula ngokukhawuleza
- Ubunzima bokubamba umoya wakho
- Fever
Kwezinye iimeko, iimpawu zesifo sobutyhefu zingabonakala ngexesha lotyando, okanye kuthatha inyanga eziliqela ukuba iimpawu ziqale. Ngokomyinge, iimpawu ezinxulumene nomonakalo wamaphaphu ziqala iiveki ezi-6 ukuya kwezi-8 emva kokuqala kokonyango.
Ngenxa yokuba ezi zimpawu zifana nezinye iimeko ezinokufumana izigulane zomhlaza ezifana ne-pneumonia okanye ukusasazeka kweeseli ezibi emiphakeni, iingcali kufuneka zilawule ezi zinto ngaphambi kokuba zifumanise ukuxilongwa kwezonyango ezinxulumene ne-pulmonary toxicity. Ngamanye amazwi, inetyhefu yamaphaphu "ukuxilongwa kokungabikho."
Ziziphi iindlela zonyango ezinokuthi zenze i-Pulmonary Toxicity?
Zininzi iintlobo zamachiza e-chemotherapy eziye zadibaniswa ne-pulmonary toxicity. Ezinye zezona ziqhelekileyo ezisetyenziselwa unyango lwegazi kunye nomdlavuza wemrola zi:
- Bleomycin
- Idarubicin
- Methotrexate
- Cyclophosphamide
- Busulfan
- Arsenic trioxide
Ukunyanga kwamayeza kwimeko yesifuba kungabangela ukuba i-pulmonary toxicity . Esi siphumo sinokuthi sichazwe ngakumbi xa ufumene i-radiotherapy enxulumene ne-chemo.
Izinto ezinobungozi ekuphuhliseni utywala lwePulmonary
Imiba eyenza izigulane ezithile kwiingozi eziphezulu zokuphuza i-pulmonary toxicity zicaca kwaye zihlala zixutyushwa. Nangona kunjalo, oku kulandelayo kucetywayo njengemingcipheko:
- Ukukhula kweminyaka
- Ikhemotherapy
- Indlela yokulawula i-chemotherapy
- Ulwaphulo lwe-radiation kunye ne-chemotherapy
- Iingxaki zeengso
- Isifo sesifo sengqondo samaphaphu
- Imbali yokutshaya
- Ukudlulela kwangaphambili kwi-asbestos
- Amanqanaba aphezulu okhemotherapy
- I-Colony yokukhuthaza (G-CSF) njengamachiza axhasayo kwi-bleomycin regimens (amayeza anjengeNeupogen neNeulasta aphakamisa inani lakho legazi elimhlophe)
- Ukusetyenziswa konyango lwe-oksijini ngexesha lemizimba ye-chemotherapy
Ukuchonga i-Treatment Related Related to Pulmonary Toxicity
Ukuchonga izigulane ezinetyhefu ye-pulmonary kungaba nzima kakhulu ngenxa yeempawu kunye neempawu ezingezizo kunye nokungabikho kokukhethwa kovavanyo oluchanekileyo. Ngokona nxalenye, iingcali zifika kwi-diagnostic ye-pulmonary toxicity ehlobene nonyango emva kokuba zonke ezinye izizathu, ezifana ne- pneumonia , zikhutshwe.
Oogqirha baya kusebenzisa iimvavanyo zegazi njengento epheleleyo yegazi ngokuhlukileyo, esifubeni se-X ray okanye kwi- CT , i- pulmary testing test (PFT) kunye ngamanye amaxesha i- bronchoscopy ukulawula ukusuleleka okanye ukusasazeka kweeseli zamangqamuzana kwimiphunga njengesizathu sempawu. Ukuba akukho nanye isizathu esinokuqatshelwa, kwaye unokunyango olusenyongweni oluphambili, ingcali yakho inganquma ukuba iingxaki zakho zemiphunga zibangelwa unyango lwakho lomhlaza.
Unyango lweTyxicity
Ukuba ugqirha wakho uyakrokrela ukuba umonakalo wakho wemiphunga uhambelana nolunye unyango okanye unyango olulwamkelayo, luyakuthi luyeke loo arhente. Kwezinye iimeko, zingaphinde zithathele iyeza zonyango enye enye inetyhefu okanye ziphelise kuphela iziyobisi. Nangona kunokuba kunzima ukuba utshintshe kunyango lwakho, ugqirha wakho akayi kuthatha eso sigqibo ngokulula.
Akukho nonyango oluthile lomonakalo wamaphaphu obangelwa yimithi yokwelapha, kukho izinto ezimbalwa ezinokukunceda ngeempawu ozifumanayo:
- I-Steroids ukunciphisa ukuvuvukala emiphakeni yakho
- Ukulumkisa ukhathalelo lwe-oxygen
- Narcotics ukukunceda ukukhululeka nokuncedisa ukuphefumula okufutshane
- Ukuphucula umzimba
- Isifo sokuphefumula (physiotherapy)
- Ukuyeka ukutshaya
- Umsebenzi womzimba kunye nokuzilolonga
Ubomi Emva kokutywala i-Pulmonary Toxicity
Iimeko ezinzulu zesifo se-pulmonary canxicity. Kwezinye iimeko, umonakalo wamaphaphu obangelwa unyango lomhlaza ungasigxina. Nangona kunjalo, kwiimeko ezininzi, xa izigulane zisinda ezi mpahla eziphambene nompompo, ziyabuya ngokupheleleyo ngaphandle kweempembelelo eziseleyo.
Ukuyifumanisa
Umonakalo womngcipheko unokubangelwa kwi-chemotherapy okanye i-radiotherapy ekhatyweni komhlaza. Njengoko iindlela zethu zokwelapha ngegazi kunye nomnayile we-khansa ziye zasebenza ngokugqithiseleyo, abantu baphila ixesha elide kunanini ngaphambili emva kokunyanga. Ngoko ke, izicwangciso zokunyamekela kufuneka ziqwalasele igalelo lexesha elide lobutyhefu bokuphefumula ngaphezu kwendlela yokunyanga le miqathango.
Imithombo
Maldonado, F., Limper, A., noJ. Jett. Inetyhefu ye-pulmonary echaphazelekayo yonyango ye-antinoplastic: i-cytotoxic agents. Isemgangathweno. Ukuhlaziywa 09/28/15. http://www.uptodate.com/contents/pulmonary-toxicity-sociation-with-in-antinoplastic-therapy-cytotoxic-agents
Pal, S. Bleomycin Yenzelwe ukulimala kweLung. Isemgangathweno. Ukuhlaziywa 09/14/15. http://www.uptodate.com/contents/bleomycin-induced-lung-injury
Shippee, B., Bates, J., noK. Richards. Indima yokuhlola kunye nokubeka iliso kwi-bleomycin ye-pulmonary toxicity. Umbhalo we-Oncology Pharmacy Practice . 2015 uMatshi 2. (Epub ngaphambi kokuprinta).