Peb paub tias nws nyuaj npaum li cas los tawm tsam mob qog noj ntshav. Cov kev kho mob uas koj tau txais, xws li chemotherapy thiab radiation, qee zaum tuaj yeem ua rau muaj lwm yam teeb meem kev noj qab haus huv. Koj puas tau xav tias kev kho mob qog noj ntshav tuaj yeem muaj kev cuam tshuam rau koj lub plawv? Qhov ntawd yog qhov peb hu ua Cardiotoxicity hauv kev kho mob. Tsis txhob ntshai thaum koj hnov lub npe no. Qhov no tsis yog ib yam dab tsi uas tshwm sim rau txhua tus. Tab sis nws yog ib qho tseem ceeb heev uas yuav tsum paub txog qhov no. Yog li hnub no peb yuav tham txog qhov no yooj yim heev, hauv txoj kev uas koj tuaj yeem nkag siab.
Hauv lwm lo lus, Cardiotoxicity yog dab tsi?
Kev ua rau lub plawv puas tsuaj yog qhov kev puas tsuaj rau peb lub plawv los ntawm qee yam kev kho mob qog noj ntshav lossis tshuaj. Xav txog cov tshuaj uas tua cov hlwb qog noj ntshav zoo li tus tub rog muaj zog heev. Thaum tus tub rog no tawm tsam cov hlwb qog noj ntshav, qee zaum cov hlwb noj qab haus huv hauv peb lub plawv uas nyob ze kuj tseem yuav raug puas tsuaj me ntsis. Qhov ntawd yog qhov kev ua rau lub plawv puas tsuaj.
Qhov tseem ceeb tshaj plaws uas yuav tshwm sim tau yog lub plawv nyuaj rau nqus ntshav thoob plaws lub cev. Cov leeg plawv tuaj yeem qaug zog. Hauv qee kis mob hnyav, qhov no tuaj yeem ua rau muaj mob hu ua Cardiomyopathy . Qhov no txhais tau tias cov leeg plawv lub peev xwm nqus ntshav tau txo qis heev.
Ib qho tshwj xeeb txog tus mob no yog tias nws qee zaum tuaj yeem tshwm sim ntau xyoo tom qab kev kho mob qog noj ntshav tas lawm. Qhov kev pheej hmoo no muaj ntau heev rau cov neeg laus uas tau kho mob qog noj ntshav thaum lawv tseem yog menyuam yaus.
Leej twg muaj kev pheej hmoo tshaj plaws?
Txawm hais tias leej twg uas tau kho mob qog noj ntshav muaj feem yuav mob no los xij, tsis yog txhua tus neeg yuav mob. Txawm li cas los xij, qee tus neeg muaj feem yuav mob ntau dua me ntsis.
- Cov neeg noj qee yam tshuaj: Qee cov tshuaj chemotherapy thiab lwm yam kev kho mob tuaj yeem cuam tshuam rau lub plawv. Peb yuav tham txog qhov ntawd me ntsis.
- Cov neeg uas tau txais kev kho mob hluav taws xob rau thaj tsam hauv siab: Thaum muab kev kho mob hluav taws xob rau mob qog noj ntshav hauv siab, piv txwv li, mob qog noj ntshav hauv mis, cov hluav taws xob kuj tseem tuaj yeem cuam tshuam rau lub plawv rau qee qhov.
- Cov neeg uas tau txais kev kho mob qog noj ntshav thaum lawv tseem hluas: Qhov kev pheej hmoo no siab dua me ntsis rau cov neeg laus uas tau txais kev kho mob thaum lawv tseem hluas.
Qee qhov kev tshawb fawb qhia tias txog li 20% ntawm cov neeg laus uas tau txais kev kho mob qog noj ntshav yuav muaj qee yam kab mob plawv, thiab ntawm 7% thiab 10% ntawm cov no yuav muaj mob plawv lossis mob plawv tsis ua haujlwm.
Cardiotoxicity muaj cov teebmeem dab tsi rau lub plawv?
Qhov mob no ua rau muaj ntau yam teeb meem plawv. Tsis yog txhua yam no tshwm sim rau txhua tus, tab sis nws yog ib qho tseem ceeb uas yuav tsum paub txog cov ua rau muaj. Saib daim ntawv hauv qab no.
| Tej zaum yuav muaj mob plawv | Hais yooj yim xwb... |
|---|---|
| Kab mob plawv | Cov leeg nqaij plawv yuav qaug zog thiab tsis tuaj yeem tso ntshav tau zoo. |
| Mob Plawv Nres / Mob Myocardial Infarction | Kev txhaws ntawm cov hlab ntsha uas xa ntshav mus rau lub plawv. |
| Lub plawv tsis ua haujlwm | Lub plawv tsis muaj zog thiab tsis muaj peev xwm tso ntshav kom txaus rau lub cev xav tau. |
| Lub plawv dhia tsis xwm yeem (Arrhythmia) | Lub plawv dhia ceev, dhia nrawm, lossis tsis xwm yeem. |
| Kab mob plawv | Cov qhov dej uas ua haujlwm zoo li lub rooj vag hauv lub plawv tsis ua haujlwm zoo. |
| Ntshav Siab/Qis | Koj cov ntshav siab siab lossis qis tsis zoo li qub. |
| Cov kua dej sib sau ua ke nyob ib puag ncig lub plawv | Cov kua dej sib sau ua ke hauv daim nyias nyias uas npog lub plawv, ua rau muaj kev nyuaj rau lub plawv. |
Tej zaum koj yuav muaj cov tsos mob dab tsi?
Cov tsos mob ntawm lub plawv uas cuam tshuam nrog kev ua rau lub plawv tsis ua haujlwm zoo tuaj yeem tshwm sim sai sai lossis maj mam tshwm sim. Yog tias koj tab tom kho lossis nyuam qhuav kho mob qog noj ntshav tas, nws yog ib qho tseem ceeb uas yuav tsum paub txog cov tsos mob no.
Nco ntsoov tias, cov tsos mob no tuaj yeem tshwm sim los ntawm lwm yam, tab sis yog tias koj muaj ib lossis ntau yam ntawm cov no, nco ntsoov tham nrog koj tus kws kho mob.
| Cov tsos mob | Tej zaum koj yuav xav li no. |
|---|---|
| Ua pa nyuaj (Dyspnea) | Kuv ua tsis taus pa thiab ua pa nrov thaum kuv taug kev me ntsis, nce ntaiv, lossis sawv ntsug twj ywm. |
| Mob hauv siab los yog tsis xis nyob | Zoo li koj lub hauv siab raug zawm, raug nias, lossis tsuas yog mob xwb. |
| Ceg o (Edema) | Cov cheeb tsam xws li ob txhais ceg, pob luj taws, thiab ko taw yuav o thiab mob thaum nias nrog tus ntiv tes. |
| Kev mob plawv dhia | Zoo li koj lub plawv dhia ceev thiab dhia ceev, lossis zoo li nws dhia tsis tu ncua. |
| Kiv taub hau thiab tsaus muag | Tig thiab tig . Tig thiab tig . |
| Kev Ntsws Plab | Thaj chaw plab zoo li o thiab loj dua vim muaj dej ntau hauv lub cev. |
Dab tsi yog cov ua rau mob plawv (cardiotoxicity) tseem ceeb?
Txawm hais tias muaj ntau txhiab hom kev kho mob qog noj ntshav, ob peb hom tseem ceeb ua rau muaj tus mob no ntau tshaj plaws.
1. Qee cov tshuaj kho mob qog noj ntshav
Cov tshuaj Anthracyclines yog ib hom tshuaj kho mob qog noj ntshav uas paub zoo txog qhov no. Piv txwv li, Doxorubicin (Adriamycin®) . Cov no feem ntau siv los kho cov mob qog noj ntshav xws li mob ntshav dawb (leukemia), mob lymphoma, mob qog noj ntshav hauv lub mis, thiab mob multiple myeloma.
2. Cov Tshuaj Kho Mob Rau Lub Hom Phiaj
Trastuzumab (Herceptin®) yog ib qho piv txwv ntawm cov tshuaj zoo li no. Nws yog siv los kho mob qog noj ntshav hauv lub mis thiab mob qog noj ntshav hauv plab. Muaj kev pheej hmoo ntxiv ntawm kev mob plawv, tshwj xeeb tshaj yog thaum cov tshuaj no raug muab ua ke nrog anthracycline.
3. Kev kho mob hluav taws xob rau thaj tsam hauv siab
Thaum muab hluav taws xob rau hauv siab rau mob qog noj ntshav, xws li mob qog noj ntshav hauv lub mis lossis Hodgkin's Lymphoma, cov hluav taws xob tuaj yeem hla lub plawv. Raws li lub sijhawm dhau mus, qhov no tuaj yeem ua rau cov hlab ntsha thiab cov leeg ntawm lub plawv puas tsuaj.
Cov kws kho mob kuaj mob li cas?
Yog tias koj muaj cov tsos mob uas tau hais los saum toj no, lossis yog tias koj nyob hauv pawg neeg muaj kev pheej hmoo siab, koj tus kws kho mob yuav xaj kom kuaj lub plawv ua haujlwm. Qhov kev kuaj tseem ceeb yog xyuas seb lub plawv puas muaj peev xwm nqus tau. Qhov no ua tiav los ntawm kev siv kev ntsuas hu ua Left Ventricular Ejection Fraction (LVEF) . Hais yooj yim, qhov no yog feem pua ntawm cov ntshav uas lub plawv nqus tawm mus rau hauv lub cev txhua zaus nws dhia.
Hauv qab no yog qee qhov kev sim uas siv los ntsuas cov no.
| Kev Ntsuas | Koj ua li cas rau qhov no? |
|---|---|
| Kev kuaj lub plawv (Echocardiogram) | Qhov no yog qhov siv ntau tshaj plaws. Cov nthwv dej ultrasound (zoo li cov scans uas peb tau txais thaum peb pom cov menyuam mos) yog siv los saib lub plawv dhia, qhov loj me, cov duab, thiab nws nqus cov ntshav li cas. |
| Kev kuaj mob plawv MRI | Siv cov hlau nplaum thiab cov xov tooj cuaNws thaij tau cov duab ntawm lub plawv kom meej thiab ntxaws ntxaws. Qhov no suav tias yog txoj hauv kev zoo tshaj plaws los kuaj pom kev lom ntawm lub plawv. |
| Kev Ntsuas Kev Nyuaj Siab ntawm Lub Plawv | Lawv ntsuas seb koj lub plawv teb li cas rau kev tawm dag zog los ntawm kev cia koj taug kev ntawm lub treadmill lossis caij tsheb kauj vab. |
| Kev Ntsuas Multigated Acquisition (MUGA) | Tus nqi LVEF yog ntsuas los ntawm kev txhaj me me ntawm cov tshuaj radioactive uas tsis muaj teeb meem rau lub cev thiab siv lub koob yees duab los saib nws mus ncig hauv lub plawv nrog cov ntshav. |
| Kev Ntsuas CT ntawm Lub Plawv | Ib daim duab 3D ntawm lub plawv yog tsim los ntawm kev siv ntau daim duab X-ray. Qhov no tuaj yeem pab tau zoo rau cov neeg uas tau kho mob hluav taws xob. |
Yuav kho tus mob no li cas?
Txoj kev kho mob nyob ntawm seb koj lub plawv puas tsuaj npaum li cas thiab ua rau nws mob.
- Hloov cov tshuaj: Yog tias paub tseeb tias kev kho mob qog noj ntshav uas koj tab tom noj tam sim no cuam tshuam rau koj lub plawv, koj tus kws kho mob yuav txiav txim siab tso tseg cov tshuaj, txo qhov ntau npaum li cas, lossis hloov koj mus rau lwm yam tshuaj.
- Cov tshuaj kho mob plawv: Koj tus kws kho mob yuav sau ntawv kom muab cov tshuaj tshiab los pab txhim kho kev ua haujlwm ntawm lub plawv thiab tswj cov tsos mob. Piv txwv li:
- ACE Inhibitors: Cov no ua rau cov hlab ntsha dav dua thiab txhim kho cov ntshav ntws.
- Beta-blockers: Cov no tswj lub plawv dhia thiab txo qhov siab rau ntawm lub plawv.
- Cov tshuaj diuretics: Lawv pab tshem tawm cov kua dej ntau dhau ntawm lub cev los ntawm cov zis, uas txo qhov o.
- Digoxin: Nws tswj lub plawv dhia thiab ua rau lub plawv nqus ntshav tau zoo dua.
Tus mob no puas kho tau tag nrho?
Nov yog ib lo lus nug uas ntau tus neeg muaj. Cov lus teb yog, "Qee zaum koj ua tau, qee zaum koj ua tsis tau."
- Kev ua xua rau lub plawv los ntawm cov tshuaj xws li Trastuzumab (Herceptin®) feem ntau yog kho tau . Qhov no txhais tau tias lub plawv ua haujlwm tau zoo tuaj yeem rov qab mus rau qhov qub thaum kev kho mob raug tso tseg lossis lwm yam tshuaj pib.
- Kev Kho Mob Anthracyclines lossis Kev Kho Mob Hluav Taws XobQhov kev puas tsuaj uas ua rau feem ntau tsis rov qab zoo li qub . Hauv cov xwm txheej zoo li no, koj yuav tsum tau noj tshuaj pab txhawb lub plawv thiab hloov pauv koj txoj kev ua neej mus tas koj lub neej.
Yuav ua li cas thiaj li txo tau qhov kev pheej hmoo?
Yog hais qhov tseeb, tsis muaj ib txoj kev twg los tiv thaiv tau 100% kev mob plawv. Vim tias kev kho mob ntawd yog qhov tseem ceeb rau kev kho mob qog noj ntshav. Tab sis qhov tseem ceeb tshaj plaws uas koj ua tau yog paub txog qhov mob no sai li sai tau.
- Tham nrog koj tus kws kho mob: Ua ntej pib kho mob qog noj ntshav, tham nrog koj tus kws kho mob txog cov txiaj ntsig ntawm kev kho mob, nrog rau cov kev mob tshwm sim, xws li cov teebmeem rau lub plawv.
- Kev kuaj xyuas tsis tu ncua: Thaum lub sijhawm thiab tom qab kev kho mob qog noj ntshav, kuaj xyuas koj lub plawv tsis tu ncua (piv txwv li, echo scan) raws li koj tus kws kho mob qhia. Qhov no yuav pab nrhiav pom txhua yam teeb meem thaum ntxov thiab pib kho.
Thaum twg yuav tsum nrhiav kev pab kho mob tam sim ntawd!
Yog tias koj tab tom txais lossis tau txais kev kho mob qog noj ntshav, thiab koj muaj ib qho ntawm cov tsos mob hnyav hauv qab no, mus rau chav kho mob ceev (ETU) ze tshaj plaws tam sim ntawd.
- Lub plawv dhia ceev ceev lossis nce ntxiv.
- Kiv taub hau, pom kev tsis meej, lossis tsaus muag.
- Ua tsis taus pa lossis mob hauv siab sai sai.
- O ntawm daim di ncauj lossis caj pas.
- Ob txhais ceg lossis ko taw o txawv txawv.
- Qhov hnyav nce ntau tshaj 1.5 kg (3 phaus) hauv ib lub lim tiam.
Cov tsos mob no yuav yog ib qho cim qhia tias muaj mob plawv loj heev, yog li ntawd tsis txhob ncua sijhawm.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev ua rau lub plawv puas tsuaj yog kev puas tsuaj rau lub plawv los ntawm kev kho mob qog noj ntshav. Qhov no tsis tshwm sim rau txhua tus, tab sis muaj kev pheej hmoo.
- Nco ntsoov paub txog cov tsos mob xws li ua pa nyuaj, mob hauv siab, thiab o ntawm ob txhais ceg.
- Ua ntej pib kho mob qog noj ntshav, nrog koj tus kws kho mob tham txog qhov zoo thiab qhov tsis zoo thiab tej yam uas yuav tshwm sim rau koj lub plawv.
- Nws yog ib qho tseem ceeb heev uas yuav tsum tau kuaj lub plawv tsis tu ncua (xws li echo) raws li koj tus kws kho mob pom zoo, thaum lub sijhawm kho mob thiab tom qab kho mob.
- Yog tias pom teeb meem sai sai, ces yuav kho tau zoo dua. Tsis txhob ntshai, paub txog qhov teeb meem ntawd, thiab nrog koj tus kws kho mob tham.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus