Koj puas tau txais kev kho mob hluav taws xob rau mob qog noj ntshav taub hau thiab caj dab? Nws puas cuam tshuam rau koj cov pob txha? Cia peb kawm txog (Osteoraradionecrosis - ORN)!

Koj puas tau muaj mob, o, lossis mob hauv koj lub qhov ncauj lossis lub puab tsaig tom qab tau txais kev kho mob hluav taws xob rau mob qog noj ntshav taub hau lossis caj dab? Tej zaum yuav yog lub sijhawm rau koj kawm txog tus mob hu ua osteoradionecrosis. Tsis txhob txhawj, peb yuav tham txog nws kom meej thiab yooj yim heev.

Osteoradionecrosis (ORN) yog dab tsi?

Hais yooj yim xwb, osteoradionecrosis (ORN) yog kev tuag ntawm cov hlwb pob txha vim raug hluav taws xob. Nws yog ib qho mob uas tuaj yeem tshwm sim ua ib qho kev phiv ntawm kev kho mob hluav taws xob rau mob qog noj ntshav, tshwj xeeb tshaj yog mob qog noj ntshav taub hau thiab caj dab. Nco ntsoov tias, cov hluav taws xob siv los tua cov hlwb pob txha qee zaum tuaj yeem ua rau cov hlwb pob txha noj qab haus huv puas tsuaj thiab. Nws tuaj yeem tshwm sim ntau lub hlis lossis txawm tias ntau xyoo tom qab tau txais kev kho mob hluav taws xob.

Feem ntau tus mob no cuam tshuam rau pob txha qais qis (mandibular osteoradionecrosis). Txawm li cas los xij, nws tuaj yeem tshwm sim rau txhua tus pob txha uas tau raug hluav taws xob, xws li pob txha qais sab saud (maxillary osteoradionecrosis) lossis sab xub ntiag ntawm tus txha nqaj qaum (vertebral osteoradionecrosis). Tsis tshua muaj, tus mob no kuj tuaj yeem cuam tshuam rau lub taub hau, tab sis nws tuaj yeem loj dua me ntsis.

Kev kho mob hluav taws xob thiab kev noj qab haus huv ntawm pob txha - vim li cas qhov no thiaj tshwm sim?

Tam sim no, cia peb saib seb vim li cas qhov no thiaj tshwm sim. Kev siv hluav taws xob ua rau cov hlab ntsha uas muab ntshav rau cov pob txha puas tsuaj. Ib yam li lwm qhov ntawm peb lub cev, cov pob txha xav tau cov ntshav zoo kom noj qab nyob zoo thiab kho sai yog tias lawv puas tsuaj.

Xav txog seb, ib yam li tsob ntoo qhuav tsis muaj dej, yog tias pob txha tsis tau ntshav txaus, nws kuj yuav poob nws lub neej thiab pib tuag.

Yuav ua li cas thaum cov ntshav no raug cuam tshuam?

• Cov pob txha thiab cov nqaij nyob ib puag ncig yooj yim raug kab mob.
• Nws tsis yooj yim kho kom zoo.
• Nws pib tuag me ntsis.

Peb thaj chaw ntawm peb lub puab tsaig muaj kev phom sij tshwj xeeb rau qhov no. Qhov no yog vim nws nyuaj rau tiv thaiv kom tsis txhob muaj hluav taws xob mus txog rau ntawm lub puab tsaig thaum lub sijhawm kho mob hluav taws xob rau mob qog noj ntshav taub hau thiab caj dab. Tsis tas li ntawd, qhov kev pheej hmoo ntawm qhov '(ORN)' no ntxiv rau los ntawm cov kab mob uas nyob hauv peb lub qhov ncauj.

Kev puas tsuaj los ntawm hluav taws xob hauv qhov ncauj tuaj yeem ua rau muaj tej yam xws li:

• Kev raug mob ntawm pob txha (txhais tau tias pob txha raug mob los ntawm cov pos hniav).
• Qee zaum mob thiab o ntawm lub puab tsaig .
• Muaj ib qho qhov txhab uas tsis kho tau .

Tus mob no feem ntau tshwm sim li cas?

Raws li American Head & Neck Cancer Society, osteoradionecrosis yuav tshwm sim ntawm 4% thiab 8% ntawm cov neeg uas muaj mob qog noj ntshav taub hau thiab caj dab.

Cov tsos mob ntawm osteoradionecrosis (ORN) yog dab tsi?

Tam sim no cia peb saib seb koj yuav muaj cov tsos mob dab tsi hauv qhov xwm txheej no. Yog tias koj muaj ib lossis ntau yam ntawm cov no, nws yog qhov zoo tshaj plaws los nrhiav kev pab kho mob.

• Mob los yog mob qog rau sab nraud ntawm cov pos hniav, caj dab, lossis lub puab tsaig.
• Mob.
• O.
• Kev kis kab mob (zoo li kua qaub ncaug).
• Cov hniav tsis sib haum zoo (malocclusion).
• Ib qho kev xav tingling lossis tickling .
• Cov pob txha tawg tawm hauv qhov ncauj.
• Qee zaum, hauv qab lub puab tsaig, daim tawv nqaij tawg thiab pob txha tawm los (qhov no kuj hu ua "fistula").
• Pob txha puab tsaig tawg.
• Kev nruj ntawm cov leeg nqaij ntawm lub puab tsaig uas ua rau lub qhov ncauj tsis qhib zoo (trismus).

Vim li cas osteoradionecrosis (ORN) thiaj tshwm sim?

Qhov ua rau mob yog kev siv tshuaj tua hluav taws xob rau lub taub hau thiab caj dab. Qhov mob no feem ntau tshwm sim rau cov neeg uas tau txais cov tshuaj tua hluav taws xob ntau dua 60 Gray (Gy) units. (Gy yog ib chav ntsuas rau kev tua hluav taws xob).

Cov Yam Uas Ua Rau Mob Osteoradionecrosis (ORN) - Leej twg yuav muaj feem ntau dua?

Muaj ib txhia neeg muaj feem yuav mob no ntau dua li lwm tus. Saib seb cov lus qhia no puas siv tau rau koj:

• Kev tu cev qhov ncauj tsis zoo (tsis txhuam koj cov hniav kom zoo, tsis saib xyuas koj qhov kev tu cev qhov ncauj).
• Yog tias cov teeb meem hniav (xws li cov kab noj hniav thiab cov kab mob ntawm cov pos hniav) tsis tau raug daws kom zoo ua ntej pib kho mob hluav taws xob.
• Yog tias koj lub qhov ncauj qhuav (xerostomia) tom qab kev kho mob hluav taws xob.
• Yog tias muaj xwm txheej lossis raug mob rau lub puab tsaig tom qab kev kho mob hluav taws xob, tshwj xeeb tshaj yog nyob rau hauv thawj xyoo.
• Yog tias ib tug hniav raug rho tawm ntawm thaj chaw uas tau raug irradiated ua ntej.

Nco ntsoov, qhov mob osteoradionecrosis no tuaj yeem tshwm sim txawm tias ntau xyoo tom qab tau txais kev kho mob hluav taws xob rau mob qog noj ntshav taub hau thiab caj dab.

Yuav kuaj mob li cas?

Feem ntau Osteoradionecrosis (ORN) tshwm sim ob peb xyoos tom qab kev kho mob hluav taws xob. Yog tias koj tus kws kho mob xav tias qhov no, nws yuav ua qhov kev kuaj xyuas koj lub taub hau thiab caj dab kom zoo. Nws kuj tseem yuav tiv tauj tus kws kho mob hluav taws xob uas tau muab kev kho mob hluav taws xob rau koj kom paub tag nrho cov tshuaj hluav taws xob uas koj tau txais.

Cov kev kuaj mob twg pab tau rau kev kuaj mob?

Yuav kom paub tseeb tias koj tus mob yog dab tsi, koj tus kws kho mob yuav pom zoo kom kuaj xws li:

• Cov duab X-ray ntawm cov hniav.
• Ib qho kev luam theej duab CT ntawm lub puab tsaig (CT - computed tomography scan).
• Yuav ua ib qho biopsy los xyuas seb puas muaj mob qog noj ntshav rov qab los dua.

Cov kev kho mob rau qhov no yog dab tsi?

Kev kho mob rau osteoradionecrosis (ORN) nyob ntawm seb koj tus mob hnyav npaum li cas thiab hnyav npaum li cas. Qhov tseem ceeb tshaj plaws yog pib kho sai li sai tau.Thaum koj pib kho mob sai npaum li cas, koj yuav muaj feem zoo dua. Muaj ob qho kev phais thiab kev kho mob uas tsis yog phais rau qhov no.

Kev tswj hwm kev phais

Muaj ntau txoj kev phais mob rau qhov mob no:

• Kev phais tshem cov pob txha thiab cov nqaij mos: Qhov no yog thaum tus kws phais tshem cov pob txha thiab cov nqaij mos uas tuag los yog muaj kab mob tawm, zoo li kev ntxuav qhov chaw phem.
• Kev phais kho dua daim tawv nqaij dawb: Qhov no yog ib qho kev phais mob nyuaj me ntsis. Nws suav nrog kev siv cov hlab ntsha, cov nqaij, thiab tej zaum ib daim pob txha los ntawm lwm qhov ntawm koj lub cev (piv txwv li, ib ceg lossis caj npab) thiab hloov mus rau hauv thaj chaw lub puab tsaig uas puas lawm.
• ALTFL (Anterolateral Thigh Fascia Lata Rescue Flap): Qhov no kuj yog ib hom ntawm daim tawv nqaij dawb. Hauv cov txheej txheem no, ib daim ntaub txuas (fascia) raug coj los ntawm sab nraub qaum ntawm lub duav thiab hloov mus rau lwm qhov. Cov ntaub so ntswg no muaj cov hlab ntsha ntau heev, ua rau thaj chaw puas tsuaj tau txais cov pa oxygen thiab cov as-ham. Cov kev tshawb fawb tsis ntev los no tau qhia tias txoj kev no zoo heev rau cov neeg uas muaj ORN.
• Kev txiav pob txha tag nrho: Cov txheej txheem phais mob ib txwm no yog siv thaum muaj pob txha tuag ntau heev, tshwj xeeb tshaj yog nyob rau hauv lub puab tsaig qis. Hauv cov txheej txheem no, cov pob txha puas tsuaj raug tshem tawm tag nrho thiab daim tawv nqaij dawb uas muaj pob txha raug txiav rau hauv nws qhov chaw. Txawm hais tias qhov no yog ib qho txheej txheem ua tiav, nws yog ib qho kev phais loj. Nws tuaj yeem ua rau nyob hauv tsev kho mob ntev dua thiab lub sijhawm rov zoo ntev dua. Yog li ntawd, cov kws kho mob sim kuaj mob thiab kho qhov mob no sai li sai tau.

Kev tswj hwm tsis yog phais

Kuj tseem muaj kev kho mob uas tsis yog phais:

• Tshuaj tua kab mob: Yog tias muaj kev kis kab mob hauv pob txha lossis cov nqaij nyob ib puag ncig, koj tus kws kho mob yuav sau ntawv kom noj tshuaj tua kab mob.
• PENTOCLO: Qhov no yog kev sib xyaw ua ke ntawm ntau yam tshuaj: pentoxifylline, tocopherol (vitamin E), thiab clodronate. Pentoxifylline ua haujlwm los ntawm kev ua kom cov ntshav ntws mus rau cov pob txha uas puas lawm. Tocopherol (vitamin E) pab txhawb kom lub cev tiv thaiv kab mob muaj zog thiab tiv thaiv cov ntshav txhaws. Clodronate pab tiv thaiv kom tsis txhob poob pob txha ntxiv. Qee zaum pentoxifylline thiab tocopherol raug muab yam tsis muaj clodronate (qhov no hu ua PENTO).
• Kev kho mob oxygen hyperbaric (Kev kho mob oxygen hyperbaric - HBO):Muaj ib txhia kws kho mob siv txoj kev kho mob no los pab kom lub cev kho tau sai dua. Hauv qhov no, koj raug muab tso rau hauv ib chav tshwj xeeb thiab ua kom koj ua pa tau cov pa oxygen ntshiab. Cov pa oxygen hauv chav no siab dua li peb npaug ntawm qhov chaw ib txwm muaj. Lub hom phiaj tseem ceeb yog ntxiv cov pa oxygen txaus rau hauv cov ntshav kom kho cov nqaij uas puas lawm. Txawm li cas los xij, muaj ntau lub tswv yim sib txawv ntawm cov zej zog kho mob txog txoj kev kho mob "Hyperbaric oxygen" no. Txawm hais tias nws yog siv ua kev kho mob tus qauv hauv qee lub chaw, tseem tsis muaj kev tshawb fawb tswj hwm uas tau lees paub nws txoj kev vam meej.

Puas tiv thaiv tau osteoradionecrosis (ORN)?

Tej zaum qhov mob no yuav tsis tiv thaiv tau tas li, tab sis ua ntej koj pib kho mob hluav taws xob rau koj lub taub hau lossis caj dab, koj tus kws kho mob yuav nrog koj tham txog cov hau kev los txo qhov kev pheej hmoo no.

Ua ntej pib kho mob hluav taws xob, koj yuav tsum ua cov hauv qab no:

• Mus ntsib kws kho hniav , ntxuav koj lub qhov ncauj kom huv si, thiab kuaj xyuas tag nrho .
• Mus kho hniav txhua yam (xws li kev txhaws hniav, rho hniav).
• Pib kho cov tshuaj fluoride txhua hnub.

Koj yuav tsum ua cov no thaum lub sijhawm kho mob hluav taws xob thiab tom qab kho mob:

• Ua kom huv si qhov ncauj (txhuam koj cov hniav ob zaug ib hnub, ntxuav cov hniav ntawm ob sab).
• Txo cov khoom noj thiab dej haus uas muaj suab thaj .
• Mus ntsib koj tus kws kho hniav tsis tu ncua kom tau kev kuaj mob thiab ntxuav koj lub qhov ncauj.
• Tau txais kev kho mob rau txhua yam teeb meem hniav tshiab sai li sai tau .
• Txuas ntxiv kho cov tshuaj fluoride txhua hnub.

Kab mob osteoradionecrosis (ORN) kis tau sai npaum li cas?

Feem ntau, osteoradionecrosis (ORN) qeeb qeeb tshwm sim. Nws yuav siv sijhawm ntau xyoo rau koj kom muaj cov tsos mob.

Puas kho tau osteoradionecrosis (ORN)?

Txawm hais tias cov kws phais tsis tuaj yeem ua rau cov pob txha tuag rov qab muaj sia nyob, kev kho mob kom zoo tuaj yeem tiv thaiv kev loj hlob ntawm osteoradionecrosis (ORN). Lawv hais tias yog tias pib kho mob thaum ntxov, tus mob no tuaj yeem raug nres hauv 96% ntawm cov neeg mob .

Yog li ntawd, yog tias koj muaj osteoradionecrosis (ORN), kev pib kho mob thaum ntxov yog koj lub sijhawm zoo tshaj plaws rau kev vam meej. Koj qhov kev phais yuav luv dua, thiab koj yuav rov zoo sai dua. Thaum koj kho sai dua (ORN), qhov zoo dua.

Kev Kwv Yees Txog Kab Mob Osteoradionecrosis (ORN)

Kab mob Osteoradionecrosis (ORN) yog ib yam mob uas kho tau yooj yim heev. Hom kev kho mob uas xav tau nyob ntawm qhov chaw ntawm cov pob txha puas tsuaj, qhov loj ntawm cov pob txha tuag, thiab cov kev kho mob uas koj tau sim ua ntej.

Feem ntau, qhov me dua ntawm thaj chaw ntawm pob txha puas tsuaj, qhov zoo dua qhov muaj feem rov zoo yam tsis tas phais loj. Qee kis ntawm ORN yuav tsis teb rau kev kho mob me me thiab tej zaum yuav nce mus rau kev kis kab mob pob txha (osteomyelitis) lossis pob txha tawg. Hauv cov xwm txheej zoo li no, cov kws phais yuav tsum tau ua qhov phais loj (dawb flap).

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog tias koj tau txais kev kho mob hluav taws xob rau koj lub taub hau lossis caj dab ua ntej thiab koj pib muaj cov tsos mob xws li mob, o, lossis mob nqaij, mus ntsib koj tus kws kho mob tam sim ntawd. Lawv tuaj yeem lees paub tias koj muaj osteoradionecrosis (ORN) thiab pib kho mob sai sai.

Kuv yuav tsum nug kuv tus kws kho mob li cas?

Yog tias koj lossis ib tus neeg koj hlub tau kuaj pom tias muaj osteoradionecrosis (ORN), tej zaum koj yuav xav nug koj tus kheej cov lus nug no:

• Cov pob txha necrosis no tau kis mus deb npaum li cas lawm?
• Kuv muaj cov kev kho mob twg?
• Kuv puas yuav tsum tau phais?
• Kuv txoj kev xav (kev kho tau) yog dab tsi?

Thaum kawg, nco ntsoov (Cov Lus Coj Mus Tsev)

Kab mob Osteoradionecrosis (ORN) yog ib qho teeb meem loj heev ntawm kev siv hluav taws xob los kho lub taub hau thiab caj dab. Nws yuav siv sijhawm ntau xyoo kom cov tsos mob tshwm sim. Txawm hais tias ORN tsis tuaj yeem "kho tau tag nrho," nws tuaj yeem tswj tau nrog kev kho mob. Cov txiaj ntsig nyob ntawm qhov chaw ntawm pob txha puas tsuaj, qhov dav ntawm pob txha tuag, thiab qhov hnyav.

Yog tias koj muaj mob, o, pob txha raug mob, lossis lwm yam tsos mob ntawm osteoradionecrosis, mus ntsib kws kho mob tam sim ntawd. Lawv tuaj yeem pom zoo kev kho mob kom zoo thiab pab koj tswj koj tus mob. Kev tu cev qhov ncauj kom huv si thiab mus ntsib koj tus kws kho hniav tsis tu ncua yog qhov tseem ceeb rau kev tiv thaiv thiab kuaj pom tus mob no thaum ntxov.

` Osteoradionecrosis, ORN, cov kev mob tshwm sim los ntawm kev siv hluav taws xob, kab mob pob txha puab tsaig, kev kho mob qog noj ntshav, kev tuag pob txha, kev noj qab haus huv ntawm qhov ncauj