Ke haʻi aku ke kauka iā ʻoe a i ʻole kekahi āu i ʻike ai he maʻi ʻaʻai akepaʻa a ʻōlelo ʻaʻole hiki ke hana ʻoki kino, he mea maʻamau ke manaʻo nui i ka makaʻu a me ka hopohopo. Ke noʻonoʻo nei paha ʻoe, "He aha kaʻu e hana ai i kēia manawa?" Eia naʻe, me nā holomua o ka lāʻau lapaʻau hou, aia nā lāʻau lapaʻau e hiki ke lawe mai iā mākou i ka hōʻoluʻolu nui a me ka manaʻolana i kēlā mau hihia. I kēia lā, e kamaʻilio mākou e pili ana i kekahi o ia ʻano lāʻau lapaʻau kūikawā a holomua. ʻO ia ka lāʻau lapaʻau Y-90.
ʻAe, he aha kēia lāʻau lapaʻau Y-90?
I ka ʻōlelo maʻalahi, ʻo ka lāʻau lapaʻau Y-90 kahi ʻano lāʻau lapaʻau radiation i kuhikuhi pono ʻia no ka maʻi kanesa o ke ake. ʻO "Y-90" eia ka inoa pōkole no ka mea radioactive "Yttrium-90".
E noʻonoʻo i kahi puʻupuʻu kanesa e like me kahi kahua hoʻomoana no kahi ʻenemi ʻino. ʻO nā kīʻaha koko e hoʻolako ana i ke koko i kēlā kahua hoʻomoana ua like ia me nā alanui e lawe ana i ka meaʻai a me ka mea inu i kēlā kahua hoʻomoana. Ma kēia lāʻau lapaʻau, hoʻokomo nā kauka i nā miliona o nā momi microscopic i loaʻa kahi mea radioactive i kapa ʻia ʻo Y-90, he liʻiliʻi loa ia ʻaʻole hiki ke ʻike ʻia me ka maka ʻōlohelohe, i loko o ke kīʻaha koko nui e hoʻolako ana i ke koko i ka puʻupuʻu kanesa.
Hele kēia mau ʻāpana liʻiliʻi ma ke kahe koko a noho i loko o nā kīʻaha koko liʻiliʻi i loko o ka puʻupuʻu. Ke noho lākou ma laila, hāʻawi lākou i kahi nui o ka radiation pololei i nā hunaola kanesa. ʻO ka mea maikaʻi loa, ua kau ʻia kēia radiation ma kahi liʻiliʻi loa, no laila he liʻiliʻi a ʻaʻohe pōʻino paha i nā ʻiʻo ate olakino e hoʻopuni ana i ka puʻupuʻu.
ʻO ka mea nui, ʻaʻole paha e ho'ōla loa ka lāʻau Y-90 i ke kanesa o ke akepaʻa. Eia nō naʻe, hiki iā ia ke hoʻēmi i nā puʻupuʻu , kaohi i ka maʻi, a hāʻawi i ka mea maʻi i kahi manawa kūpono e ola lōʻihi me ka ʻole o nā hōʻailona a me ke ʻano maikaʻi o ke ola.
Ua ʻike ʻia kēia lāʻau lapaʻau ma kekahi mau inoa ʻē aʻe, no ka laʻana, "Transarterial Radioembolization - TARE" a me "Selective Internal Radiation Therapy - SIRT", a kāu kauka paha e hoʻohana ai.
No wai kēia lāʻau lapaʻau kūpono loa?
Na kāu kauka e hoʻoholo inā kūpono kēia lāʻau lapaʻau iā ʻoe. ʻO ka maʻamau, ua ʻōlelo ʻia ka lāʻau lapaʻau Y-90 i nā hihia aʻe:
- No ka poʻe me ke kanesa i hoʻomaka i loko o ke akepaʻa (ka maʻi kanesa mua).
- No ka poʻe i loaʻa i ka maʻi kanesa i pālahalaha i ke akepaʻa (kane kanesa metastatic) mai kahi ʻē aʻe.
- Hoʻohana ʻia nō hoʻi ia no kekahi ʻano maʻi ʻaʻai bile duct.
Hoʻomanaʻo pinepine ʻia kēia lāʻau lapaʻau ke hiki ʻole ke ʻoki kino e wehe i ka puʻupuʻu kanesa.I kekahi mau hihia, aia ke kanesa ma kahi kokoke loa i nā kīʻaha koko nui, a hiki i ke ʻoki ʻana ke hōʻino nui i ke akepaʻa. I ia mau hihia, hiki i ka lāʻau lapaʻau Y-90 ke kāohi i ka ulu ʻana o ke kanesa a mālama i ka hana o ke akepaʻa.
ʻO kekahi mea nui ʻē aʻe, no kekahi poʻe, ma hope o ka hoʻēmi ʻana o ka lāʻau Y-90 mua i ka puʻupuʻu, hiki paha iā lākou ke hana ʻoki kino a i ʻole ka hoʻoili ʻana i ke akepaʻa ma hope. Hiki i kēia ke lilo i ʻanuʻu koʻikoʻi ma ke ala e hoʻōla ai.
Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?
Ma mua o ka mālama ʻana, e nānā pono kāu kauka iā ʻoe e hōʻoia i kou olakino kino. ʻO ka maʻamau, e komo pū kēia me:
- He hoʻokolokolo kino
- Nā hoʻāʻo koko
- Nā hoʻāʻo hana ate
Eia kekahi, e kūkākūkā pono kāu kauka i kēia mau mea me ʻoe ma mua o ka mālama ʻana:
- ʻO kou mōʻaukala olakino piha, nā maʻi allergies āu e loaʻa ai, a inā paha ʻoe e hāpai ana.
- He aha nā lāʻau lapaʻau āu e lawe nei a me nā lāʻau lapaʻau āu e pono ai e hoʻōki i ka lawe ʻana ma mua o ka mālama ʻana.
- Pono ʻoe e hoʻonohonoho i kekahi e lawe iā ʻoe i ka home ma hope o ka lāʻau lapaʻau.
- Ma mua o ka mālama ʻana, ʻo ka manawa kēia e hoʻōki ai i ka ʻai ʻana a me ka inu ʻana.
- E pili ana i ke kaʻina holoʻokoʻa o ka lāʻau lapaʻau.
ʻO kēia ka manawa kūpono loa e nīnau aku ai i ke kauka i nā nīnau a kānalua paha āu e loaʻa ai.
E kamaʻilio kākou e pili ana i ke ʻano o ka hana ʻana o ka lāʻau lapaʻau?
ʻElua mau hana nui o ka lāʻau Y-90. Hana pinepine ʻia kēia mau mea ʻelua ma kahi o ʻelua pule ka mamao. Alakaʻi ʻia kēia kaʻina hana e ke kauka loea.
| Nā ʻanuʻu | He aha ka mea e hana nei? |
|---|---|
| KaʻAnuʻu Hana 1: Ke Palapala ʻĀina ʻana i ka Angiogram | Ua like kēia me kahi hoʻomaʻamaʻa no ka mālama maoli. Maanei, hana ʻia kahi ʻoki liʻiliʻi loa ma kou ʻūhā a i ʻole ka pulima lima, a hoʻokomo ʻia kahi ʻōmole lahilahi loa (catheter) ma o ia mea ma nā kīʻaha koko e hoʻolako ana i ke koko i ke kanesa. A laila hoʻokomo ʻia kahi kala kūikawā .Ua palapala ʻia nā kīʻaha koko e lawe ana i ke kanesa me ka pololei. Hoʻohana ʻia kēia e koho i ke ala pololei e lawe ai i nā ʻāpana Y-90. Hiki i kēia ke hala ma kahi o 2-4 mau hola. |
| KaʻAnuʻu Hana 2: Hoʻokomo ʻana o Y-90 | ʻO kēia ka lāʻau lapaʻau maoli. E like me ma mua, hoʻokomo ʻia ke catheter, a hoʻokomo ʻia nā miliona o nā ʻāpana radioactive Y-90 ma ke ala i palapala ʻia. Hoʻopaʻa ʻia kēia mau ʻāpana i loko o ka puʻupuʻu a hoʻomaka e hoʻopuka i ka radiation. ʻO ka maʻamau, hoʻokahi a ʻelua paha hola o kēia kaʻina hana. Hoʻokuʻu ʻia he 90% o ka radiation mai kēia mau ʻāpana i loko o 10 mau lā. A laila noho nā ʻāpana me ka ʻino ʻole i loko o ke kino. |
He aha nā pono o ka lāʻau Y-90?
He nui nā pono o ka lāʻau lapaʻau Y-90 ma mua o ka lāʻau lapaʻau radiation kuʻuna (EBRT).
- Lapaʻau i kuhikuhi ʻia: Ma muli o ka hele pololei ʻana o ka radiation i ke kanesa, he liʻiliʻi loa ka pōʻino i nā ʻiʻo olakino. No laila, he emi nā hopena ʻaoʻao.
- ʻO ka hoʻokomo iki ʻana: ʻAʻohe ʻoki nui. Hana ʻia ia ma o kahi ʻoki liʻiliʻi loa, e like me ke komo ʻana i kahi nila. No laila, pōkole ka manawa ho'ōla a ʻaneʻane ʻaʻohe ʻeha.
- Hoʻōla wikiwiki: Hiki iā ʻoe ke hoʻi koke i ke ola maʻamau ma mua o ke ʻoki kino nui.
Aia kekahi mau hopena ʻaoʻao a i ʻole nā pilikia?
E like me nā lāʻau lapaʻau a pau, aia ka hiki ke loaʻa nā hopena ʻaoʻao liʻiliʻi a me nā pilikia kakaikahi loa.
Nā kūlana i ʻike pinepine ʻia
He mea maʻamau ka luhi no hoʻokahi a ʻelua paha pule ma hope o ka mālama ʻana. Hiki i kekahi poʻe ke loaʻa i kahi maʻi i kapa ʻia ʻo post-embolization syndrome (PES) . ʻO kēia kekahi:
- Ka luaʻi a me ka luaʻi
- Makemake nui
- ʻEha ʻōpū
- Manaʻo kuni
Hoʻomaka pinepine kēia mau hōʻailona ma hope o ʻekolu lā a nalowale i loko o hoʻokahi pule. Inā ʻike ʻoe i kēia mau hōʻailona, e haʻi i kāu kauka i hiki iā ia ke kuhikuhi i ka lāʻau lapaʻau e pono ai.
Nā pilikia kakaikahi
- Maʻi: Hiki ke ulu mai kahi maʻi ma kahi i hoʻokomo ʻia ai ke catheter. Pono paha kēia i nā lāʻau antibiotic.
- Nā maʻi ʻaleka: Hiki ke loaʻa kahi maʻi ʻaleka i kahi mea e like me ka mea hoʻoluʻu i hoʻohana ʻia. ʻO ia ke kumu e nīnau ai ke kauka e pili ana i kāu mau maʻi ʻaleka ma mua.
- ʻŌpū ʻōpū: He mea kākaʻikahi loa kēia, hiki ke hana inā komo nā ʻāpana Y-90 i loko o ka ʻōpū a i ʻole ka ʻōpū liʻiliʻi. Eia nō naʻe, haʻahaʻa loa kēia pilikia no ka mea ua ālai ke kauka i nā kīʻaha koko ma kēlā mau wahi i ka wā o ka mapping angiogram.
He aha kaʻu e pono ai e makaʻala ma hope o ka mālama ʻana?
E hoʻomaha maikaʻi no kekahi mau lā ma hope o ka lāʻau lapaʻau. E hahai pono i nā ʻōlelo a kāu kauka, ʻoiai kekahi mau kapu i ka hoʻokele kaʻa a me ka hoʻoikaika kino.
ʻO kekahi mea nui e pili ana i ka radioactivity. ʻOiai ma hope o kou hoʻi ʻana mai ka haukapila mai, e hoʻokuʻu ʻia kahi liʻiliʻi o ka radiation mai nā ʻāpana Y-90 no kekahi mau lā. No laila e hāʻawi paha kāu kauka iā ʻoe i kekahi mau ʻōlelo aʻoaʻo e like me kēia:
- Mai hiamoe ma ka moena hoʻokahi me kāu hoa no kekahi mau lā.
- Mai noho kokoke i kekahi no ka manawa lōʻihi.
- E kaupalena i ka pilina kokoke me nā wahine hāpai a me ka poʻe me nā ʻōnaehana pale kino nāwaliwali.
Akā, mai hopohopo. No ka mea, he lāʻau lapaʻau i kuhikuhi ʻia ʻo Y-90, ua omo ʻia ka hapa nui o ka radiation e ke kanesa ponoʻī. No laila, haʻahaʻa loa ka pilikia i nā poʻe ʻē aʻe mai ou aku.
Inā loaʻa iā ʻoe ke kuni, manaʻo i ke anu, pehu, ʻulaʻula, a mehana paha ma kahi i hoʻokomo ʻia ai ke catheter, ʻeha nui ka ʻōpū, a i ʻole ka mae ʻana o kou mau wāwae, e hoʻomaopopo koke i kāu kauka .
He mea maʻamau ka makaʻu i ka wā e noʻonoʻo ai ʻoe e pili ana i ke kau ʻana i kahi mea radioactive i loko o kou kino. Eia nō naʻe, he lāʻau palekana a maikaʻi loa ka lāʻau lapaʻau Y-90 no ka maʻi kanesa o ke akepaʻa. Hiki iā ia ke hāʻawi iā ʻoe i ka ikaika e ola lōʻihi me ka ʻole o nā hōʻailona o ka maʻi kanesa. No laila, inā ʻōlelo kāu kauka i kēia lāʻau lapaʻau nou, e kamaʻilio pono me ia a nīnau i kāu mau nīnau a pau.
Leka Lawe-Home
- He ʻano lapaʻau kūikawā ʻo Y-90 e hoʻouna pololei ana i nā ʻāpana radioactive i nā puʻupuʻu akepaʻa i kuhikuhi ʻia.
- ʻOiai ʻaʻole kēia e ho'ōla loa i ke kanesa, hiki iā ia ke hoʻēmi i ka puʻupuʻu, kaohi i ka maʻi, hoʻolōʻihi i ke ola, a hoʻomaikaʻi i ke ʻano o ke ola.
- ʻAʻole kēia he ʻoki kino nui. Ma muli o ka hana ʻia ʻana ma o kahi ʻoki liʻiliʻi, he pōkole ka manawa hoʻōla a he liʻiliʻi nā hopena ʻaoʻao.
- He mea nui e hahai i nā ʻōlelo kuhikuhi i hāʻawi ʻia e pale iā ʻoe iho mai ka radiation no kekahi mau lā ma hope o ka lāʻau lapaʻau.
- Inā he mau nīnau kāu e pili ana i kēia lāʻau lapaʻau, mai makaʻu e nīnau i kāu kauka.
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