I-Chemotherapy, i-Deeplyous Thrombosis, ne-Pulmonary Embolism
Amacwecwe egazi anxulumene ne-chemotherapy akhulunywa ngaphantsi koko, athi, isisulu sokubamba isantya kunye nokuhlanza, kodwa oko akuthethi ukuba bangaphantsi kwengxaki. Enyanisweni, xa kuthelekiswa neempawu eziqhelekileyo zezibilini, ukukhathala, kunye neentlungu zokulahleka, zinokuba yingozi kakhulu. Oko kuthetha, ukuqonda ingozi, ukwazi iindlela zokunciphisa umngcipheko, kwaye ukuqonda iimpawu, unokukunceda ukunciphisa umngcipheko wakho ngexesha lotyando lomhlaza.
Sibanzi
Amacwecwe egazi - okunye okubizwa ngokuba ngongoma lwezokwelapha njenge "thrombosis" engumdlavuza-ngokwenene kunenkxalabo ebalulekileyo kubantu abanomdlavuza. Siyazi ixesha elithile ukuba abantu abanomdlavuza ngokubanzi - kungekhona nje abo bafumana i-chemotherapy - banomngcipheko ophezulu Iingcango zegazi . Ngokwabo, ama-blood clots kwimilenze ingaba bubuhlungu, kodwa inkxalabo enkulu kukuba la maqhekeza aya kuphuma aze ahambe emiphakeni. Oku kwenzeka - into ebizwa ngokuba yi-pulmonary embolism-yingozi yonyango.
Ukuba uhamba ngamazwe ngamazwe, unokuqhelana namavidiyo angaphambi kokuhamba okubalulekayo okuthintela umlenze ukukhusela ama-clots egazi, kodwa asivumi ukuva malunga nale mngcipheko ngemisebenzi eminye eyenziwa ngaphambili - njengokwenza i-chemotherapy. Kule meko, into ongazange uyive ingakulimaza. Enyanisweni, le nto yinto ebonisa ngayo ukuba ngummeli wakho ekunakekeleni umdlavuza wakho - ukufunda malunga nale nkxalabo, kunye nokuqhagamshelana nogqirha wakho ukuba unenkxalabo - inokwenene impahluko kwimpilo yakho kwaye mhlawumbi nesiphumo sakho.
Izinto zobungozi
Kusoloko ikhunjulwa ukuba abantu abahamba nge-chemotherapy banomngcipheko wokwanda kwegazi, kodwa bekude kube ngo-2013 ukuba le nkalo yomhlaza wonyango ihlolwe yodwa. Kwisifundo esiphezulu, kwafunyanwa ukuba iziganeko zamacandelo egazi ziyeza kwi-chemotherapy zaziyi-12,6 ekhulwini, xa kuthelekiswa nomngcipheko we-1.4 ekhulwini kwizigulane zomhlaza ezingenayo i-chemotherapy.
Umngcipheko wawukhudlwana kwezinye iisomhlaza kunezinye, kunye neengcingo ezifana nomdlavuza we-pancreatic nomdlavuza wamaphaphu unomngcipheko omkhulu. Ukongezelela, ezinye iziyobisi zonyango kunye neyeza ezazisetyenziswa ukulwa nemiphumo emibi yechemotherapy nazo zidibaniswe nobungozi obandayo. Kule sifundo, iziyobisi ezandisa ingozi ziquka iPlatinol (cisplatin), i-Avastin (bevacizumab), kunye ne-Epogen okanye i-Program (i-red-stimulator erythropoietin.)
Ukongeza kwi-chemotherapy, yiyiphi enye imithi kunye neemeko ezinokuphakamisa umngcipheko wegazi lamalungu kubantu abaphila nomhlaza? Ezinye izinto ezinobungozi ziquka:
- Ugqirha - Kweminye uphando, umngcipheko wamacwecwe egazi kwizigulane zomhlaza uye wafikelela kuma-50 ekhulwini emva kokuhlinzwa
- Izibhedlele, ngokukodwa zihlala zingaphezu kweentsuku enye
- Ukuphumla kwebhedi elide
- Ufikelelo oluphambili lwentambo (njengokwamachiza e-chemotherapy)
- Imithi ebizwa ngokuba yi-angiogenesis inhibitors (njenge-Avastin)
Iimpawu
Ukuze uqaphele iimpawu ezinokwenzeka, kunokukunceda ukuphule ezi zibonakaliso zibonwa nge-clot yegazi emilenzeni (i-thrombosis ene-venous) kunye neempawu ezinxulumene ne-clot yegazi eye yaphuka yaya emiphakeni (i-pulmonary embolism .)
Iimpawu ze-thrombosis ye-venous (i-blood clots emlenzeni) ifaka iimpawu kumathole okanye emlenzeni ophezulu kuquka:
- Ubomvu
- Ukunyamezela
- Ukuvuvukala
- Ukufudumala
Izibonakaliso ngenxa yokugqithiswa kwamapulmoni zingabandakanya:
- Iintlungu zesifuba ngokukhawuleza - ngokuqhelekileyo intlungu ebuhlungu. Hlalani nikhumbule ukuba ngamanye amaxesha ivula iindawo ezahlukahlukeneyo kwimiphunga, kwaye intlungu ayikwazi ukuba yindawo enye
- Ukuqhawukelwa ngumphefumlo
- Ukukhupha okanye ukukhwehlela igazi
- Lightheadedness
- Ukungaqondi
- I-Cyanosis - ukuguqulwa okwesibhakabhaka kwesikhumba nemilomo
- I-arrhythmias yenhliziyo - izitho zentliziyo ezingavamile
- Ukuphakanyiswa kwezinga lokuphefumula nentlawulo yenhliziyo ngexinzelelo lwegazi eliphantsi
Thintelo
Amachiza
Amagciwane-anticoagulants-asetyenziswa ngokuphindaphindiweyo kwiminyaka yakutshanje ukunciphisa ingozi yamacandelo egazi kwizigulane zomhlaza.
Oku kubhekiselwa kwi-"prophylactic antiticoagulation", eguqulelwe, ithetha ukuthintela igazi.
Kukho amayeza amaninzi anganconywa ukuba angaphakanyiswa. Uphando olutshanje lubonisa ukuba imithi efana ne-heparin isebenza ngcono kubantu abanomdla kunemithi ephazamisa i-vitamin K-njenge-Coumadin (warfarin), kodwa amayeza ahlukeneyo anganconywa kuxhomekeke kwimeko ethile. Ezinye zezi ziyobisi (apho unokuva ngokubhekiselwe kuyo njenge-heparin yesisindo esiphantsi) ziquka:
- Lovenox (enoxaparin)
- Fragmin (dalteparin)
- Innohep (tinzaparin)
- Arixtra (fondaparinux) - le entsha "ye-heparin-like"
Ukuzinakekela
Kwiyeza, sivame ukuthetha ngamachiza xa kuziwa ekukhuseleni, kodwa kukho izinto ezininzi onokuzenza ukuze unciphise umngcipheko wakho. Isinyathelo sokuqala nesona sibalulekileyo sizenzele ukuba uzifundise kwaye ubuze imibuzo. Yazi kakuhle iimpawu zegazi kunye ne-pulmonary embolism. Ukuba unomdla kuzo zonke, ungalindi, kodwa qha ga mshelana nogqirha wakho. Buza i-oncologist yakho ukuba kukho nayiphi na into ekhethekileyo ongayenza ukuze unciphise umngcipheko wakho, okanye ukuba unokucebisa amayeza ukuba abe ngumngcipheko ophantsi. Ukongeza, ungathanda uku:
- Hambisa ngokubanzi kunokwenzeka, ngaphakathi kwemida yakho. Ukuba awuqinisekanga ukuba ukhuthazwa kangakanani umsebenzi, buza ugqirha wakho. Ixesha elifutshane ixesha elifutshane lohambo lomzimba lungcono kunezinto ezingapheliyo
- Nangona ulala, usebenzise imilenze yakho. Ugqirha wakho okanye umongikazi unokukunceda ukubonisa le mi sebenzi. Unokuzama ukukhomba iinzwane zakho kwintloko yakho kwaye umgangatho amaninzi ngamaxesha (kwakhona, uthetha ugqirha wakho njengendlela enyathelo elungileyo lingahluka ngokuxhomekeka kwimeko ethile yezokwelapha)
- Gweba uhambo olude. Ukuba kufuneka ube semotweni ixesha elide, qwa lasela rhoqo-nganye ubuncinane kwiyure-uze uphume emotweni uze uhambe
- Ukongezelela kwezinye izilwanyana zokubhabha nomhlaza , zama ukunyuka ubuncinane kwiiyure nganye, kwaye mhlawumbi yonke imizuzu engama-30 uze ujikeleze. Unokwenza imilenze xa uhleli. Ngokuxhomekeke kwimeko yakho, i-oncologist yakho inokuqwalasela ukuphatha nge-anticoagulant (umzekelo, i-heparin yesistim ephantsi) ngaphambi kokuba ubalekele. Qinisekisa ukubuza. I-DVT ngenxa yokuhamba ngeendiza ziqhelekile ukuba zenziwe "uqoqosho lweklasi yezoqoqosho."
- Musa ukutshaya
- Ukuba ugqirha wakho ukhuthaza ukugcinwa kwesitokisi, qiniseka ukuba ulandele umyalelo wakhe
- Gwema ukuwela imilenze yakho
- Gwema izambatho eziqinileyo, ingakumbi izambatho eziqinileyo ngamadolo okanye kwindawo yakho yokulima
- Ukuphakamisa imilenze xa kunokwenzeka
- Gwema i-caffeine notywala. Bobabini i-caffeine kunye notywala kunokukhokelela ekudambiseni amanzi, kwaye ukuphelelwa amandla kwamanzi kuphakamisa umngcipheko wegazi
> Imithombo:
> I-American Society of Clinic Oncology. I-Cancer.Net Ukukhusela nokuPhatha iIngubo zeGazi. Ukuhlaziywa 01/20/15.
> UGarcia Escobar, I., uAlexandre Rebollo, M., Garcia Adrian, S. et al. Ukhuseleko kunye noPhulo lwe-Primary Thromboprophylaxis kwizigulane zeCarcer. I-Clinical and Translational Oncology . 2016 Meyi 4. (Epub ngaphambi kokuprinta).
> Khorana, A., Dalal, M., Lin, J., kunye noG. Connolly. Isiganeko kunye neengqungquthela ze-thromboembolism ye-venous (VTE) phakathi kwezigulane ezingumngcipheko onobungozi obuphezulu obunomdlavuza we-chemotherapy e-United States. Cancer . 2013. 119 (3): 648-55.
> Posch, F., Konigsbrugge, O., Zielinski, C., Pabinger, I., kunye noC. Unyango lwe-thromboembolism engumdlavuza kwizigulane ezinomdlavuza: I-networking meta-analysis ngokumalunga nokusebenza nokukhuselwa kwe-anticoagulants. UPhando lweThrombosis . 2015. 136 (3): 582-9.
> Vitale, C., D'Amato, i-Venous thromboembolism nomdlavuza wamaphaphu: ukuhlaziywa. Imithi yokuphefumula emininzi . 2015. 10 (1): 28.