Xav txog seb, ib tug neeg tau mob heev rau ob peb hnub, lawv lub cim xeeb tsis meej, lawv cov pob qij txha qee zaum mob, thiab lawv daim tawv nqaij pib khaus. Yog li thaum koj mus ntsib kws kho mob rau ib yam dab tsi zoo li no, thiab lawv ua ntau yam kev kuaj mob, lawv pom tias lub hauv paus ntawm txhua yam no yog mob qog noj ntshav zais rau hauv lub cev. Nws puas tsis zoo kawg? Mob qog noj ntshav nyob hauv ib qho chaw, tab sis vim nws cov teebmeem, cov tsos mob uas zoo li tsis muaj feem cuam tshuam kiag li tshwm sim hauv ntau qhov ntawm lub cev. Qhov ntawd yog qhov peb hu ua Paraneoplastic Syndrome hauv kev kho mob.
Hais yooj yim xwb, Paraneoplastic Syndrome yog dab tsi?
Qhov no yuav zoo li nyuaj me ntsis rau kev nkag siab, tab sis cia peb ua kom yooj yim. Thaum muaj qog nqaij hlav loj hlob hauv koj lub cev, muaj cov teebmeem ncaj qha. Piv txwv li, yog tias koj muaj mob qog nqaij hlav ntsws, koj yuav hnoos. Yog tias koj muaj mob qog nqaij hlav plab hnyuv, koj yuav muaj ntshav hauv koj cov quav. Cov no yog cov tsos mob ncaj qha ntawm mob qog nqaij hlav.
Tiam sis Paraneoplastic Syndrome yog ib yam dab tsi txawv. Qhov tshwm sim ntawm no yog tias koj lub cev tsim ntau yam tsos mob los teb rau mob qog noj ntshav. Qhov ntawd yog, nws tsis yog ib yam dab tsi uas mob qog noj ntshav ua ncaj qha, tab sis vim tias mob qog noj ntshav nyob hauv lub cev, lwm yam kab ke hauv lub cev mus ua haujlwm tsis zoo li 'teb' rau nws.
Muaj ob txoj hauv kev tseem ceeb uas qhov no tuaj yeem tshwm sim:
1. Kev Tiv Thaiv Kab Mob Los Ntawm Tus Kheej: Xav txog peb lub cev tiv thaiv kab mob zoo li ib pab tub rog tiv thaiv lub teb chaws. Cov qe ntshav qog yog ib tug yeeb ncuab uas tau nkag mus rau hauv lub teb chaws. Yog li peb cov tub rog (lub cev tiv thaiv kab mob) pib tawm tsam tus yeeb ncuab no (mob qog). Rau qhov ntawd, lawv tsim cov riam phom tshwj xeeb, uas yog , cov tshuaj tiv thaiv kab mob . Tab sis qee zaum, thaum lub sijhawm sib ntaus sib tua no, peb cov tub rog ua yuam kev. Lawv pib tawm tsam tsis yog cov qe ntshav yeeb ncuab xwb, tab sis kuj tseem muaj cov qe ntshav zoo, noj qab haus huv hauv peb lub cev, xav tias lawv yog cov yeeb ncuab. Piv txwv li, lawv tuaj yeem tawm tsam cov qe ntshav hauv lub paj hlwb, cov qe ntshav tawv nqaij, lossis cov qe ntshav hauv cov pob qij txha. Thaum ntawd cov tsos mob ntsig txog cov kab mob ntawd tshwm sim.
2. Kev tsim cov tshuaj hormones los ntawm cov hlwb qog noj ntshav: Qee hom mob qog noj ntshav tuaj yeem tsim cov tshuaj ntau dhau, xws li cov tshuaj hormones, uas peb lub cev feem ntau tsis tsim, lossis tsim tsawg heev. Cov tshuaj hormones tsis zoo no sib sau ua ke hauv cov ntshav thiab mus ncig thoob plaws lub cev, cuam tshuam kev ua haujlwm ntawm ntau yam kabmob. Piv txwv li, cov tshuaj hormones no tuaj yeem ua rau cov ntshav siab nce siab, lossis cov calcium nce siab hauv cov ntshav.
Qhov tseem ceeb yog tias qee zaum, txawm tias ua ntej kuaj pom tias muaj mob qog noj ntshav, cov tsos mob ntsig txog Paraneoplastic Syndrome no tshwm sim ua ntej. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum paub txog cov tsos mob no.
Cov feem twg ntawm lub cev raug cuam tshuam los ntawm tus mob no?
Cov kab mob Paraneoplastic syndromes muaj peev xwm cuam tshuam rau yuav luag txhua lub cev hauv lub cev. Txawm li cas los xij, feem ntau pom lawv hauv cov kab mob no. Cia peb saib seb lawv yog dab tsi thiab cov mob twg tuaj yeem tshwm sim ntsig txog lawv.
| Lub cev system raug cuam tshuam | Tej yam mob uas yuav tshwm sim (piv txwv) |
|---|---|
| Lub paj hlwb (lub hlwb, tus txha caj qaum, cov hlab ntsha) | Cov mob xws li Cerebellar degeneration, Encephalitis, Lambert-Eaton myasthenic syndrome, Myasthenia gravis, Peripheral neuropathy, thiab Stiff person syndrome. |
| Cov kab mob endocrine (cov tshuaj hormones) | Cov mob xws li Cushing syndrome, Hypercalcemia (nce calcium hauv cov ntshav), thiab Carcinoid syndrome. |
| Cov ntaub so ntswg sib txuas (pob txha, pob qij txha, cov leeg) | Dermatomyositis, Paraneoplastic polyarthritis (mob pob qij txha), Hypertrophic osteoarthropathy. |
| Ntshav | Kab mob ntshav tsis txaus uas muaj mob ntev, Paraneoplastic erythrocytosis, Paraneoplastic thrombocytosis. |
| Tawv nqaij | Acanthosis nigricans (tuab tawv nqaij tuab thiab tuab rau qee qhov chaw xws li qhov tsoob thiab caj dab), Dermatomyositis, Sweet syndrome, Paraneoplastic pemphigus. |
Cov tsos mob uas pom ntau thiab tshwj xeeb yog dab tsi?
Muaj ntau yam tsos mob uas pom thawj zaug hauv tus kab mob paraneoplastic syndrome. Cov no kuj tuaj yeem pom hauv lwm yam kab mob, yog li nws tsis yog lub tswv yim zoo los ntshai tsuas yog pom cov no.
Cov tsos mob feem ntau:
- Kub taub hau tsis muaj laj thawj
- Kev ntshaw noj mov
- Tawm hws ntau dhau thaum hmo ntuj
- Kev poob phaus txawv txawv yam tsis muaj kev siv zog
Ntxiv rau cov tsos mob uas tshwm sim ntau no, raws li peb tau tham ua ntej, cov tsos mob tshwj xeeb tshwm sim nyob ntawm lub cev uas cuam tshuam.
| Lub kaw lus cuam tshuam | Cov tsos mob tshwj xeeb uas yuav pom tau |
|---|---|
| Lub paj hlwb | Nyuaj rau kev taug kev, tsis muaj zog sib npaug, kiv taub hau, pom ob sab, tsis nco qab, qaug zog, leeg tsis muaj zog, hais lus tsis tau. |
| Lub cev endocrine | Ntshav siab, hnyav nce tsis paub vim li cas, ntshav qab zib ntau, qaug zog heev. |
| Cov ntaub so ntswg sib txuas | Mob pob qij txha, o pob qij txha, mob nqaij thiab tsis muaj zog. |
| Ntshav | Ib hom qe ntshav uas txo qis lossis nce ntxiv tsis zoo li qub (piv txwv li, ntshav tsis txaus, lossis muaj feem yuav ntshav txhaws ntau ntxiv). |
| Tawv nqaij | Cov pob khaus uas tsis yog mob qog noj ntshav ntawm daim tawv nqaij, daim tawv nqaij liab, khaus ntau dhau, thiab kev hloov pauv ntawm xim tawv nqaij. |
Leej twg muaj feem yuav mob no ntau dua?
Cov kab mob Paraneoplastic syndromes feem ntau yuav tshwm sim rau txhua tus neeg uas muaj mob qog noj ntshav. Txawm li cas los xij, lawv yuav tshwm sim ntau dua nrog qee hom mob qog noj ntshav. Raws li cov ntaub ntawv txheeb cais, kwv yees li 8 ntawm 100 tus neeg mob qog noj ntshav (8%) muaj tus mob no.
Cov hom mob qog noj ntshav uas feem ntau cuam tshuam nrog tus mob no yog:
- Mob qog nqaij hlav ntsws (feem ntau pom nrog hom no)
- Mob qog noj ntshav hauv lub mis
- Cov mob qog nqaij hlav ntsig txog ntshav (xws li lymphoma, leukemia)
- Mob qog nqaij hlav zes qe menyuam
Tus kws kho mob nrhiav tau qhov no li cas?
Thaum koj mus ntsib kws kho mob uas muaj cov tsos mob no, thawj qhov uas nws yuav ua yog sau keeb kwm kom meej thiab kuaj lub cev. Tom qab ntawd, lawv yuav xaj ntau qhov kev kuaj mob kom paub seb cov tsos mob puas yog los ntawm mob qog noj ntshav lossis lwm yam mob.
- Kev kuaj ntshav: Kev kuaj ntshav niaj hnub tuaj yeem kuaj xyuas lwm yam ua rau koj cov tsos mob (piv txwv li, kev kis kab mob, kev tsis sib npaug ntawm cov tshuaj hormones). Tsis tas li ntawd, qee qhov kev kuaj ntshav tshwj xeeb tuaj yeem nrhiav cov tshuaj tiv thaiv lossis cov cim qog nqaij hlav uas cuam tshuam nrog paraneoplastic syndrome.
- Kev Thaij Duab: Cov kev kuaj xws li CT scan , MRI scan , lossis ultrasound yog siv los nrhiav seb puas muaj qog nqaij hlav hauv lub cev.
- Kev kuaj mob hlwb: Yog tias koj cov tsos mob raug xav tias muaj feem cuam tshuam nrog lub paj hlwb, koj tus kws kho mob yuav ua ntau yam kev ua ub no los sim koj lub zog, kev nco qab, kev sib npaug, thiab kev sib koom tes.
- Kev Siv Lub Qhov Ncauj/Kev Siv Lub Pob Txha: Qhov no suav nrog kev siv me me ntawm cov kua dej hauv lub hlwb, cov kua dej uas nyob ib puag ncig koj lub hlwb qaum, thiab kuaj nws kom pom tias puas muaj cov tshuaj tiv thaiv tsis zoo hauv cov kua dej no uas tab tom tawm tsam cov hlwb noj qab haus huv.
Yuav kho li cas?
Qhov tseem ceeb tshaj plaws thiab tseem ceeb tshaj plaws hauv kev kho tus kab mob paraneoplastic syndrome yog kho tus mob qog noj ntshav uas ua rau muaj txhua yam no. Thaum tus mob qog noj ntshav raug tswj lossis kho tau zoo lawm, cov tsos mob ntawm tus kab mob paraneoplastic syndrome feem ntau yuav ploj mus ntawm nws tus kheej.
Tib lub sijhawm ntawd, thaum lub sijhawm kho mob qog noj ntshav, kev kho mob kuj tseem muab los tswj cov tsos mob uas tau tshwm sim. Lub hom phiaj tseem ceeb ntawm cov kev kho mob no yog ua kom lub cev tiv thaiv kab mob tsis txhob ntxhov siab, uas ua yuam kev tawm tsam cov hlwb noj qab haus huv.
- Cov tshuaj Corticosteroids: Cov tshuaj zoo li Prednisolone. Cov no ua haujlwm los ntawm kev txo qhov o thiab o hauv lub cev.
- Cov tshuaj tiv thaiv kab mob:Cov tshuaj no txo qhov kev ua haujlwm ntawm lub cev tiv thaiv kab mob thiab tiv thaiv nws kom tsis txhob tawm tsam cov hlwb noj qab haus huv.
- Tshuaj tiv thaiv kab mob hauv cov hlab ntsha (IVIG): Qhov no suav nrog kev muab cov tshuaj uas muaj cov tshuaj tiv thaiv kab mob uas tau los ntawm cov neeg noj qab haus huv rau hauv cov hlab ntsha. Cov tshuaj tiv thaiv kab mob no pab rhuav tshem cov tshuaj tiv thaiv kab mob phem uas ua rau lub cev puas tsuaj.
- Plasmapheresis: Qhov no yog ib txoj kev ua zoo ib yam li kev ntxuav cov ntshav. Koj cov ntshav raug coj mus, cov kua dej (plasma) raug cais tawm, cov tshuaj tua kab mob phem raug lim tawm, thiab cov plasma uas tau ntxuav lawm raug muab rov qab rau hauv koj lub cev.
- Kev kho lub cev, kev ua haujlwm, thiab kev hais lus: Yog tias lub paj hlwb tau raug cuam tshuam thiab muaj teeb meem taug kev, hais lus, lossis ua haujlwm txhua hnub, cov kev kho mob no tuaj yeem pab rov tsim cov peev xwm ntawd.
Thaum twg koj yuav tsum mus ntsib kws kho mob?
Yog tias koj muaj cov tsos mob txawv txawv zoo li cov uas tau hais hauv tsab xov xwm no, tshwj xeeb tshaj yog tias lawv hnyav lossis kav ntev tshaj ob lub lis piam, koj yuav tsum mus ntsib kws kho mob.
Nco ntsoov tias, tsis yog txhua tus neeg uas muaj cov tsos mob no muaj mob qog noj ntshav. Ntau yam ntawm cov tsos mob no kuj tuaj yeem tshwm sim los ntawm lwm yam mob uas tsis loj npaum li mob qog noj ntshav. Yog li ntawd, tsis txhob xav tias qhov phem tshaj plaws thiab ntshai. Txawm li cas los xij, nws yog ib qho tseem ceeb kom nrhiav seb dab tsi ua rau nws. Yog li ntawd, nco ntsoov nrhiav kev pab kho mob.
Yog tias koj tau kho mob qog noj ntshav yav dhau los, piv txwv li hauv tsib xyoos dhau los, thiab tam sim no muaj cov tsos mob zoo li no, nws yog ib qho tseem ceeb heev uas yuav tsum tau mus kuaj dua. Qhov no tuaj yeem pab txiav txim siab seb puas tau rov qab los dua.
Thaum koj nyob nrog mob qog noj ntshav, nws yog ib qho ib txwm muaj kev xav tias ntxhov siab thaum koj muaj cov tsos mob zoo li no. Tab sis nws yog ib qho tseem ceeb kom nkag siab tias kev kho mob zoo tshaj plaws rau tus kab mob paraneoplastic no zoo ib yam li kev kho mob rau tus mob qog noj ntshav. Kev ua raws li koj txoj kev npaj kho mob qog noj ntshav ze ze yuav pab tau koj tswj cov tsos mob no. Muaj ntau txoj kev kho mob uas tuaj yeem pab koj. Tham nrog koj tus kws kho mob txog lawv.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Paraneoplastic syndrome tsis yog qhov cuam tshuam ncaj qha los ntawm mob qog noj ntshav, tab sis yog qhov cuam tshuam tsis ncaj qha los ntawm lub cev lub cev tiv thaiv kab mob lossis cov tshuaj hormones los teb rau mob qog noj ntshav.
- Muaj tej lub sij hawm, cov tsos mob uas cuam tshuam nrog tus mob no tshwm sim ua ntej , txawm tias ua ntej kuaj pom tias muaj mob qog noj ntshav los xij.
- Txoj kev kho mob tseem ceeb tshaj plaws yog kho tus mob qog noj ntshav hauv qab.
- Yog tias koj muaj cov tsos mob txawv txawv (piv txwv li poob phaus, cov leeg tsis muaj zog, hloov pauv ntawm daim tawv nqaij) uas tshwm sim yam tsis muaj laj thawj thiab kav ntev tshaj ob lub lis piam, mus ntsib kws kho mob yam tsis muaj kev ncua.
- Vim tias cov tsos mob no tuaj yeem tshwm sim los ntawm ntau lwm yam mob, nws yog ib qho tseem ceeb kom tsis txhob ntshai thiab nrhiav kev kuaj mob kom zoo .
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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