Ukuba uye watshelwa ukuba unamaqanda emiphunga okanye imiphunga yamaphaphu kwi-x-ray, mhlawumbi uyothuswa. Ziziphi ezinye ezibangela Ngamaxesha amaninzi abantu baneengqungquthela zamaphaphu? Yaye yintoni na amathuba okuba ngumhlaza wemiphunga ?
Kubalulekile ukuthetha ngokukhawuleza ukuba uninzi- ubuncinci beepesenti ezingama-60 zeemiphunga-miphunga jikelele-azinomdlavuza. Siza kuthetha ngalezi zizathu, kodwa kubalulekile ukuba uqaphele ukuba ukuba i-nodule ngumdlavuza wamaphaphu kusekhona ithuba elihle lokuba unako ukuphiliswa.
I-nodule, ngencazelo, ingaphantsi kweesentimitha ezintathu ububanzi, kwaye ngeli nani, amaninzi emdlavuza wamaphaphu aphilisa kakhulu. Nangona kunjalo nangomdlavuza wamaphaphu omkhulu, unyango kunye namazinga okusinda komhlaza wemiphunga uye waphucula kakhulu kwiminyaka embalwa edlulileyo.
Inqaku lokugqibela ngaphambi kokuqala kukuba uqaphele ukuba ukulandela ukufumana ukuxilongwa kubalulekile nokuba awuzange uphuze. Ngexesha langoku, kukho abaninzi abantu ababeshushu nabangabhemi abaphucula umdlavuza wamaphaphu , kunabantu abavuthayo.
Ziziphi iiNodules eziLungile?
Umkhonto wamaphaphu uchazwa ngokuthi "indawo" kwimpompo engama-centimeters amathathu (malunga ne-1.5 intshi) ububanzi okanye ngaphantsi. Ezi ngqungquthela zihlala zibizwa ngokuthi "izilonda zemali" xa zichazwe kwi-test imaging. Ukuba ukungaqhelekanga kubonakala kwi-x-ray yemiphunga kukukhulu kunama-centimitha amathathu, kuthathwa ngokuba "ngumzimba wamaphaphu " endaweni yesigxina kwaye kunokwenzeka ukuba unomdlavuza.
Iigununu ze-Lung zifuna ukuba ubuncinane ubuncinane bentimitha kwisayizi ngaphambi kokuba zibonwe kwi-x-ray esifubeni, kanti iinqununu zibe ziincinci enye ukuya kweyimilimitha ezimbini ngamanye amaxesha zingabonwa kwi-CT scan.
Ukukhula
Izigulane ze-Lung ziqhelekileyo kwaye ziyafumaneka kwi-500 ye-chest x-rays, kunye neyodwa kwi-CT scan scans.
Phantse iifomula eziyi-150,000 zamaphaphu zifunyanwa kubantu baseMelika ngamnye ngonyaka. Phantse isiqingatha sabantu abangaphezu kweminyaka engama-50 abatshitshiyo baya kugubha kwi-CT scan yabo esifubeni.
Ukuba i-nodule enokuthi ibonakala kwi-x-ray yesifuba, kubalulekile ukuba ne-CT scan. Amancinci amancinci angaphoswa kwi-x-ray yesifuba .
Iimpawu
Amanqamzana amaninzi emiphunga awabangeli naziphi iimpawu kwaye atholakala "ngengozi" okanye "ngephutha" xa i-x-ray isifuba senzelwa esinye isizathu. Ukuba iimpawu zikhona, zingabandakanya ukukhwehlela, ukukhwehlela igazi, ukuphefumula, ukuphefumula okufutshane, okanye izifo zokuphefumula ukuba i-nodule (s) ifumaneka kwindawo ehamba phambili.
Izizathu
Izigulane ze-Lung zinokuba zizibilini (ezingenomdlavuza) okanye ezibi (umhlaza). Izizathu eziqhelekileyo ngokubanzi ziquka i- granulomas (iziqu zeethambo ezivuthayo ngenxa yentsholongwane okanye ukuvuvukala) kunye ne-hamartomas (izifo zesifo se-lung cancer). Isizathu esona siqhelo sesigxina samaphaphu emiphunga sifaka umdlavuza wamaphaphu okanye iisifo somdlavuza ukusuka kwezinye iindawo zomzimba eziye zasasazeka kwimiphunga ( umhlaza wesifo se-metastatic ).
Ama-Nodules angaphulwa phantsi kwiindidi ezimbalwa.
- Izifo - Izifo ezithintekayo zezigulane zingabandakanya izifo ezinjengegciwane lesifo sesifo sofuba kunye nezinye izifo ezithintekayo kwi-mycobacterial, izifo ezinjenge-histoplasmosis, i-blastomycosis, i-aspergillosis, kunye ne-coccidiomycosis, kunye nezifo ezinama-parasitic ezifana ne-ascariasis (i-roundworms), i-echinococcus (i-hydatid cysts) kunye ne-paragonimous ukukhukhula.) Xa i-immune system "iindonga" kwiindawo zokusuleleka ihlala idala i-granulomas.
- Ukuvuvukala - Iimeko ezinjenge- rheumatoid arthritis , i- sarcoidosis , ne-wegener's granulomatosis, kwakunye ne-pneumoconiosis ezifana ne-silicosis inokukhokelela kwi-granulomas.
- Izilonda ze-Benign - Izifo ezinomdlavuza ezinjenge- hamartomas (i-tumart tummine), i-fibromas, i-blastomas, i-neurofibromas kunye ne-hemangiomas. Unokubonisa njengengqungquthela kwimiphunga kwi-x ray.
- Izidumbu ezinobungozi - Iidumbu ezinokuthi zibonakaliswe njenge-nodule ziquka umdlavuza wamaphaphu, i- lymphomas , i-sarcomas, kunye nezicubu ze-carcinino.
- I-Metastases - Iimvundulwazi zengqumbo zingakho ngenxa yeemitha zesifo ezivela kwamanye amagciwane anesifo somhlaza wesifuba, umhlaza wesibeletho, umhlaza womhlaza, kunye nomhlaza wesibeletho.
- Ezinye izigulane ezinobungozi - Iziphene zamapulmonary (indawo yeengxube zamaphaphu ezilahlekelwe yigazi,) izitya zegazi ezingabonakaliyo (i-AV malformations,) i- atelectasis (ukuwa kwesahluko,) i- pulmonary fibrosis , kunye ne- amyloidosis nazo zonke ezinye izinto ezibangelwa imiphunga ngqungquthela.
Ukuxilongwa
Into yokuqala ogqirha uya kufuna ukuyenza xa ebona isigxina somphunga kwi x-ray yakho ukufumana nayiphi na i-x-rays oye waba nayo kwaye uyayithelekisa. Ukuba i-nodule okanye iingqungquthela ziye zaba khona ixesha elide, iimvavanyo ezingaphezulu azidingeki. Ukuba i-nodule yintsha okanye awunayo i-x-rays ngaphambi kokuthelekisa, ukuqhubela phambili kungadinga.
Ukuba i-nodule ifunyenwe kwi-x-ray yesifuba, isinyathelo sokuqala siza kuba senze i-CT scan yakho esifubeni. Ezinye iimvavanyo ezinjengeMRI ziyimfuneko.
Kule nkalo, ugqirha uya kufuna ukwazi imbali yakho kunye nayiphi na ingozi enayo nayiphi na uhlobo lweengqungquthela zamaphaphu (jonga ngezantsi.) Ngokomzekelo, ukuba usandula ukuhamba, isifo sofayo singasenokwenzeka xa baye bavutha, i-tumor ebulalayo inokuba nzima. Iimpawu zesifo esibuhlungu njengoko siboniswe kwi-CT scan iya kuhlolwa.
Ngamanye amaxesha ukukhangela kwe-PET kunceda xa ufuna ukuchaza ngokugqithisileyo. Ngokungafani neempendulo ze-CT kunye nee-MRI ziyi "mvavanyo". Banokufumana izilonda kwimiphunga kodwa benganikeli ngokwenene into eyenzekayo kwi -nodule. Nge-PET scan, inani elincinci lomshukela omshubileyo lijojowe kwigazi lakho. Ukukhula ngokugqithisileyo kwezicubu kuthatha ngaphezulu kweso ishukela ekhanyisa ukuhlolwa. Oku kunokuba luncedo ekuhlukaniseni i-tumor ekhulayo kwiisisundu ezinobumba njengoko isisu esandayo siya kuthatha ininzi yeswekile. Oku kunceda kakhulu kulabo abaye baqala ukukhanya kwemifuba yesifuba, izifo zamaphaphu okanye utyando olunokubangela ukuba izikhwebu ezinqabileyo.
Ukuba i-nodule engabonakali iyakhula okanye ineziganeko zesifo se-tumor, ("sinako ukuhlaselwa") "indlela yokulinda nokubukela" ngamanye amaxesha inokuthi ithathwe nge-CT scan kwakhona emva kwexesha elithile. Iigununu ezizimeleyo zodwa eziye zatshintshana kwixesha leminyaka emibini okanye ngaphezulu ayidingi naluphi na olunye uphuculo.
I-Biopsy ye-Pulmonary Nodules
Ngelishwa, i- biopsy imphunga idla ngokufunekayo ukuze ukwazi ngokuqinisekileyo oko kubangela i-nodule. Ngombulelo, iindlela zokusasaza ezitsha kunye nezincinci ezincinci zifumaneka ngoku. Oku kubalulekile nokuba ugqirha wakho uyaqiniseka ukuba yintoni eyenza i-nodule okanye iigununu.
Umzekelo xa amaxilongo acingelwa ukuba ngumhlaza wesi-metastatic ukusuka kwesinye isifo esinomdlavuza wesifuba. Uphando olutsha lubonisa ukuba nangona xa isigulane samaphaphu sifumaneka kumntu onokulindelwa ukuba abe nemitha yesifo semiphunga, isigamu sezigulane kuphela zi-metastase xa zenziwe. Ukufikelela kuma-25 ekhulwini, kunoko, yayisomdlavuza wesibini wamaphaphu oyintloko.
Ngokuxhomekeke kwindawo ekuqhutywe kuyo, i- biopsy inaliti yenziwe yenziwe kakuhle. Ngamanye amaxesha i-endobronchial ultrasound kunye ne-biopsy inokwenziwa njengenxalenye ye-bronchoscopy. Ngamanye amaxesha i-biopsy evulekile ingafuneka. Nangona kunjalo, iindlela ezintsha, ezifana ne-VATS) ezinokuncediswa ngevidiyo ziyakwenziwa rhoqo endaweni ye-thoracotomy.
Benign vs. Malignant Nodules
Ngokubanzi, amathuba okuba isigulane semiphunga ngumhlaza ngowama-40 ekhulwini, kodwa umngcipheko wesiginci somphunga unomdlavuza uyahluka ngokuxhomekeke kwizinto ezininzi. Kubantu abangaphantsi kweminyaka engama-35 ubudala, ithuba lokuba umgudu wamaphaphu ngumhlaza ungaphantsi kwepesenti enye, kanti i-half-lung yamapululune kubantu abangaphezu kweminyaka engama-50 ababi (umdlavuza).
Ezinye izinto eziphakamisa okanye ezinciphisa umngcipheko wokuthi umkhonto wamaphaphu ngumhlaza kubandakanya:
- Ubukhulu - iigununu ezinkulu kakhulu zinomdlavuza kuncinci.
- Ukutshaya - Abangoku kunye nabokuqala ukutshaya banakho amathuba okuba nomdlavuza wamaphaphu kunomdla wokutshaya. Funda ipesenti yabantu ababhemayo abanomdlavuza wamaphaphu.
- Umsebenzi - Olunye utyalo lwezemisebenzi luphakamisa amathuba okuba isigulane ngumhlaza.
- Imbali yezonyango - Ukuba nomlando womhlaza kwandisa ithuba lokuba i-nodule ingaba yingozi.
- Imbali yentsapho y - Abo baxhambileyo kunye nembali yentsapho yomdlavuza wamaphaphu banakho amathuba okuba neengqungquthela zomhlaza kunezo ezingenayo imbali yentsapho.
- Iimpawu - Ixesha lokuba umkhonto unomdlavuza wamaphaphu mkhulu xa kukho ezinye iimpawu okanye iimpawu zomhlaza wemiphunga .
- Uhlobo / imbonakalo ye-nodule - I- nodle , ejikelezileyo i-nodules inokuba yinto enobungozi, kanti i-nodules "ezinemibala", okanye imida engavumelekanga okanye i-lobular inokuthi ibe nomdlavuza.
- Eziqinileyo / ezingagxininisi - Iimodyuli eziyingxenye eqinile kunokuba zomelele zinokwenzeka ukuba zibe nomhlaza
- Ukukhula - I-Cancerous nodules yamathambo ikhula ngokukhawuleza ngexesha elinokuphindwa kabini leenyanga ezine, ngelixa iinqununu ezinobunzima zihlala zifana nobukhulu bexesha.
- Ukulinganisa - Izigulane ze-Lung ezibalwe ziyakwazi ukuba zilungele.
- I-Cavitation - i-Nodules echazwe ngokuthi "i-cavitary," nto leyo ichaza ukuba inxalenye yangaphakathi yombhobho ibonakala mnyama kwi-x-ray, inokuthi ibe yinto enobungozi.
- Iingqungquthela zeglasi zeplastiki - Iimododo ezichazwe njengento yokubonakalisa igrlasi yomhlaba zisoloko zicelomngeni kwaye zi nokuba zinobungozi okanye zibi. Ngenxa yolu bunzima, i-biopsy yezi zilonda zidla ngokufunekayo.
- Inani lezigulane - Abo abanamaxilongo amaninzi banomdla wokuba nomhlaza kunabo abanesigxina samanye ama-pulmonary.
- Indawo yezigulane - I-Lobules ekhoyo kwi-lobes ephantsi okanye ekhohlo okanye e-right lobe yomphunga ayinakwenzeka ukuba ibe nomhlaza kunezo zikho ekhohlo okanye ngasekunene kwi-lobes.
- Uhlanga kunye nendawo yokuhlala - Ukuba uye wahamba ngaphandle kweUnited States, i-nodule yamapapu inokuba yinto enobungakanani. Ngokomzekelo, uphando lwe-eccent luye lwafumanisa ukuba izigulane zamaphaphu ngenxa ye-scytosomiasis, ukusuleleka kwe-parasitic, ziqhelekile kubantu abafudukela e-Afrika. Ngokufanayo, iigununu ezinxulumene nokusuleleka kwefungal, ezifana ne-coccidiomycosis ziqhelekileyo kuMzantsi-ntshona.
Iimodyuli ze-Lung ezizimeleyo
Inani leenqununu zamaphaphu ezifundwa ngama-radiologicalist "njenge-indeterminate" landisiwe kunye nokufika komhlaza wesifo somhlaza. Ukuva ukuba i-nodule yakho okanye iigununu ziyakundibanisa. Akunjalo? Ngelishwa, kukho amaxesha apho akunakwenzeka kwimifanekiso yokucinga kuphela ukuba ukwazi ukuba i-nodule iyingozi-nangemva kokuqwalasela yonke into engentla. Ukuze uphendule lo mbuzo, kufuneka kwenziwe i-biopsy. Ngombulelo, ii-radiologists, oogqirha, kunye ne-pathologists ndawonye bafumana iindlela ezincinci zokusampula izicubu. Ukuqonda kakuhle ukuba kutheni le mbuzo inzima kangaka, unokuba unqwenela ukufunda kabanzi malunga neentlukwano phakathi kwezibilini ezinobungozi nezibi .
Ukuhlolwa kweCarcer Lung
Ukuhlolwa kwesifo somhlaza kubantu abalungileyo kuye kwafunyanwa ukunciphisa izinga lokufa komdlavuza wamaphaphu ngama-20 ekhulwini. Kodwa njengoko kukho naluphi na uvavanyo lokuhlola, kukho umngcipheko weempembelelo zobuxoki, kwaye kuyaqhelekileyo ukufumana iigununu kwi-CT yokuhlola. Kodwa ukufumana iigununu akusoloko kuthetha umhlaza. Enyanisweni, uphando olude luqikelela ukuba kuphela iipesenti ezintlanu zeendununu ezifunyenwe kwi-CT yokuqala yokuhlola i-lung cancer.
Unyango
Unyango lwee-nodules zamaphaphu luhluka kakhulu kuxhomekeke kwisizathu, nokuba zihlobene nezifo, ukuvuvukala, umhlaza okanye ezinye iimeko. Uninzi lwamapulisi aluhlaza, ngakumbi abo abakhoyo kwaye abangazange batshintshe kwixesha leminyaka embalwa, banokushiywa bodwa.
ILizwi
Ukuba uvile ukuba wena okanye umthandayo unomkhuhlane wamapapu mhlawumbi unobungozi obunxunguphako kwaye uphazamisekile. Kukho amathuba amaninzi amaninzi kwaye ezinye zazo ziloyiko. Kunokukunceda ukuba uqikelele ukuba uninzi lweengqungquthela alunomhlaza, kwaye kunye nazo ezinokuphulukiswa nokuhlinzwa.
Ukuba ugqiba ukuphanda i-nodule yakho kumgca kubalulekile ukuqaphela ukuba isayensi iyatshintsha ngokukhawuleza. Amasu okuxilonga amasha ayafumaneka kunye nokunyanga amatsha ngonyaka. Ekubeni iyeza litshintsha ngokukhawuleza, Kubalulekile ukuba ube ngummeli wakho kwonyango lwakho. Ukuba awufumani iimpendulo, cela imibuzo eminye. Cinga ukufumana umbono wesibini kungakhathaliseki ukuba uva ntoni. Ekugqibeleni, fi kelela kwiintsapho kunye nabahlobo. Ukuba i-nodule yakho iya kuba ngumdlavuza wamaphaphu kunomdla wesifo somdlavuza wamaphaphu oza kuwamkela.
> Imithombo:
> Gould, M., Donington, J., Lynch, W. et al. Uvavanyo lwaBantu ngabanye abaneeNodules zePulmonary: Ixesha loMhlaza weLung? . Esifubeni. 2013. 143 (S Suppl): e93S-e120S.
> McWilliams, A., Tammemagi, M., Mayo, J. et al. Ubunokwenzeka beCarcer kwi-Pulmonary Nodules Efunyenwe kwi-Screening CT yokuqala. I-New England Journal of Medicine. 2013. 369: 910-919S.
> Wang, Y., Gong, J., Suzuki, K., noS S. Morcos. Iingqinisiso eziSekelwe kwiSicwangciso seSigcawu sokuCwangcisa iSolomon Pulmonary Nodule. Umbhalo Wezifo Zesifo. 2014. 6 (7): 872-87.
> Yang, W., Jiang, H., Khan, A. et al. I-Transthoracic Needle Impumulo kwi-Solitary Pulmonary Nodule. Uphando lweLung Cancer Research. 2017. 6 (1): 76-85.
> Yao, Y., Lv, T., no-Y. Ingoma. Indlela yokuchonga i-Nodules yePulmonary: Ukususela kwi-Screening kuya kwiNyango. Uphando lweLung Cancer Research. 2017. 6 (1): 3-5.