Cia peb kawm txhua yam txog kev hloov Stem Cell hauv txoj kev yooj yim.

Tej zaum koj twb tau hnov ​​txog kev hloov noob hlwb (stem cell transplants). Qhov tseeb, lawv yog ib qho kev kho mob uas muaj txiaj ntsig zoo heev, thiab cawm tau qee yam kab mob. Tab sis lawv siv sijhawm ntev heev kom rov zoo tag nrho. Peb puas yuav tham txog qhov no kom ntxaws me ntsis, zoo li peb tab tom tham nrog ib tug phooj ywg?

Cov Stem Cells yog dab tsi?

Hais yooj yim xwb, cov hlwb noob yog ib hom hlwb tshwj xeeb heev hauv peb lub cev. Cov hlwb no muaj peev xwm zoo kawg nkaus los tsim ntau hom hlwb sib txawv. Cov hlwb noob uas peb tab tom tham txog hauv kev hloov hlwb noob no yog cov uas ua rau muaj cov hlwb tseem ceeb hauv peb cov ntshav. Ntawd yog:

• Cov qe ntshav liab: Cov no yog cov uas nqa cov pa oxygen thoob plaws lub cev.
• Cov qe ntshav dawb: Cov qe ntshav no tiv thaiv peb los ntawm kev tawm tsam cov kab mob thiab cov kab mob uas nkag mus rau hauv peb lub cev.
• Platelets: Cov no yog cov uas pab cov ntshav txhaws thaum muaj kev raug mob.

Xav txog nws zoo li cov noob hlwb no zoo li ib lub pob av nplaum uas tuaj yeem ua rau txhua yam. Nyob ntawm qhov xav tau, nws tuaj yeem siv los ua cov qe ntshav liab, cov qe ntshav dawb, lossis cov qe ntshav dawb.

Vim li cas cov kev hloov pauv ntawm cov hlwb no thiaj ua?

Tam sim no, cia peb saib seb cov kev hloov noob hlwb no yuav pab tau li cas. Qhov no tsis yog ib yam dab tsi uas ua rau txhua yam kab mob, tab sis qee zaum mob hnyav, qhov no yog qhov kev daws teeb meem zoo tshaj plaws.

• Rau cov neeg uas muaj cov kab mob ntshav loj heev: Piv txwv li, qee hom kab mob leukemia, uas tshwm sim thaum cov pob txha tsis ua haujlwm zoo.
• Rau cov neeg uas muaj qee hom mob qog noj ntshav: Mob qog noj ntshav xws li lymphoma lossis multiple myeloma.
• Rau cov neeg uas muaj lub cev tiv thaiv kab mob tsis zoo: Lawv lub cev tiv thaiv kab mob tsis muaj zog heev ua rau lawv lub cev tsis tuaj yeem tawm tsam cov kab mob.
• Rau cov neeg uas muaj qee yam kab mob autoimmune: Piv txwv li, hauv cov kab mob zoo li lupus, thaum lub cev cov hlwb tawm tsam lub cev.
• Txoj kev kho mob no kuj tseem zoo heev rau lwm yam kab mob ntshav uas tau txais los ntawm noob caj noob ces: Thalassemia lossis Sickle Cell Disease.

Peb tau cov stem cell no qhov twg los?

Zoo, tam sim no tej zaum koj yuav xav paub tias peb tau cov stem cell no los qhov twg. Muaj peb qhov chaw tseem ceeb uas cov kws kho mob tuaj yeem tau cov cell no:

1. Pob Txha: Qhov no yog txoj kev nrov tshaj plaws. Qhov no feem ntau hu ua 'Kev Hloov Pob Txha'. Pob txha yog qhov mos mos, zoo li daim ntaub hauv peb cov pob txha loj. Nws yog qhov chaw uas cov qe ntshav raug tsim.

2. Los ntawm Cov Ntshav: Los ntawm kev muab cov tshuaj tshwj xeeb, cov hlwb ntawm cov pob txha tuaj yeem tso tawm mus rau hauv cov ntshav, thiab tom qab ntawd cov hlwb no tuaj yeem sau los ntawm lub tshuab zoo ib yam li kev pub ntshav ib txwm muaj. Qhov no hu ua Peripheral Blood Stem Cell (PBSC) sau.

3.Ntshav Ntawm Txoj Hlab Ntsws: Tom qab tus menyuam yug los, thaum txoj hlab ntaws raug tshem tawm, cov ntshav uas tseem tshuav muaj cov hlwb tseem ceeb no. Cov no tuaj yeem sau thiab siv los ntawm ib tus neeg xav tau.

Ua li no, peb hu tus neeg uas muab cov noob hlwb ua 'tus pub' . Qhov tseem ceeb heev yog tias hauv qee yam kab mob, tus neeg uas muaj kab mob kuj tuaj yeem yog nws tus kheej pub. Ntawd yog, nws cov noob hlwb raug coj ua ntej kev kho mob pib, khov, thiab tom qab ntawd hloov rov qab rau nws thaum xav tau. Qhov no hu ua 'Autologous Transplant' .

Tiam sis feem ntau, lwm tus pub cov hlwb no. Qhov no hu ua 'Allogeneic Transplant' . Yog tias cov hlwb noob raug coj los ntawm lwm tus, cov qauv caj ces ntawm cov hlwb ntawd, tshwj xeeb tshaj yog cov cim HLA (Human Leukocyte Antigen), yuav tsum zoo sib xws heev. Hais yooj yim, txhua lub hlwb hauv peb lub cev muaj daim npav ID me me. Ob daim npav ID no yuav tsum zoo sib xws heev, txwv tsis pub lub cev yuav tsis lees txais cov hlwb tshiab. Feem ntau, tus kwv tij ntawm tus menyuam yog qhov sib phim zoo tshaj plaws. Qee zaum, qhov sib phim tuaj yeem pom los ntawm niam txiv lossis tus neeg pub dawb tsis muaj feem cuam tshuam. Muaj cov ntaub ntawv loj (registries) rau qhov no kom nrhiav tau cov neeg pub dawb sib xws.

Yog tias tsis pom tus neeg pub nyiaj uas phim ces yuav ua li cas?

Xav txog seb, yog tias cov noob hlwb los ntawm tus neeg pub tsis sib phim zoo (qee zaum txawm tias lawv sib phim zoo tag nrho los xij, cov teeb meem no tuaj yeem tshwm sim ntau dua lossis tsawg dua), ob qho teeb meem tseem ceeb tuaj yeem tshwm sim:

1. Kev Tsis Lees Txais: Qhov no yog thaum tus neeg mob lub cev tiv thaiv kab mob tawm tsam cov qe ntshav dawb uas tau hloov tshiab. Nws xav tias, "Cov no tsis yog peb cov qe ntshav dawb, lawv zoo li cov neeg txawv teb chaws tuaj txeeb lawv," thiab sim rhuav tshem lawv. Qhov no raug tiv thaiv los ntawm cov tshuaj tiv thaiv kab mob.

2. Kab Mob Graft-versus-Host (GVHD): Qhov no yog qhov txawv. Cov qe ntshav dawb ntawm tus neeg pub tshiab uas tau hloov pauv (tshwj xeeb yog T-lymphocytes) pib tawm tsam cov qe ntshav dawb hauv tus neeg mob lub cev, xav tias, "Lub cev no tsis yog peb li." Qhov no tuaj yeem cuam tshuam rau thaj chaw xws li daim tawv nqaij, siab, thiab txoj hnyuv. Kuj muaj tshuaj los tswj qhov no thiab.

Cov txheej txheem hloov hlwb no tshwm sim li cas?

Zoo, cia peb saib seb cov txheej txheem hloov pauv no ua haujlwm li cas. Nws yog ib qho txheej txheem ntau kauj ruam.

1. Kev Npaj:

Ua ntej yuav hloov cov hlwb noob (stem cell transplant), cov kws kho mob yuav muab ib yam dab tsi hu ua 'central line', lossis 'central venous catheter' . Qhov no zoo li ib txoj kab loj, tshwj xeeb IV (intravenous). Nws raug muab tso rau hauv ib txoj hlab ntsha loj ze ntawm lub plawv, hauv qab daim tawv nqaij ntawm lub caj dab, hauv siab, lossis qhov chaw mos. Txoj kab nruab nrab no tuaj yeem tso rau hauv qhov chaw ntev dua li IV ib txwm muaj. Qhov no ua rau nws yooj yim dua rau cov kws kho mob thiab cov kws tu mob muab tshuaj rau koj, coj cov qauv ntshav, thiab muab cov hlwb hloov rau koj. Koj tsis tas yuav tau koob tshuaj ntau zaus.

2. Kev kho mob kom zoo:

Kev hloov cov noob hlwb (stem cell transplants) yog ua nyob rau hauv ib chav tshwj xeeb hauv tsev kho mob. Ua ntej, tus neeg uas yuav tau txais cov noob hlwb pub dawb (tus neeg tau txais) yuav tau txais cov tshuaj chemotherapy thiab/lossis kev siv tshuaj tua kab mob ntau heev rau ob peb hnub. Qhov no hu ua kev kho mob conditioning. Qhov no ua rau ob qho laj thawj tseem ceeb:

• Tua cov hlwb phem, cov hlwb puas tsuaj (piv txwv li cov hlwb mob qog noj ntshav, cov hlwb pob txha uas tsis ua haujlwm zoo) uas ua rau muaj kab mob.
• Ua kom nws lub cev tiv thaiv kab mob tsis muaj zog kom cov hlwb tshiab pub dawb thiaj li tau cog rau hauv lub cev yam tsis raug tso tseg.

3. Kev hloov noob hlwb:

Tom qab kev kho mob tiav lawm, tom qab ib lossis ob hnub so, cov noob hlwb los ntawm tus neeg pub dawb raug txhaj rau hauv tus neeg mob los ntawm txoj kab hauv nruab nrab (ib yam li kev muab ntshav). Qhov no yog ib qho txheej txheem uas siv sijhawm ntau teev. Cov noob hlwb no mus ncig los ntawm cov ntshav thiab nyob hauv cov pob txha pob txha, qhov chaw uas lawv pib tsim cov noob hlwb tshiab, noj qab haus huv.

Tom qab hloov chaw lawm, muaj dab tsi tshwm sim?

Tom qab ib tug neeg tau txais kev hloov noob hlwb (stem cell transplant), nws yuav siv sijhawm ntev rau lawv lub cev los tsim cov qe ntshav liab tshiab, cov qe ntshav dawb, thiab cov qe ntshav dawb. Feem ntau nws yuav siv sijhawm li 2-4 lub lis piam rau cov qe ntshav tshiab no pib ua haujlwm. Thaum lub sijhawm no, qhov kev pheej hmoo ntawm kev kis kab mob, kev los ntshav, thiab lwm yam teeb meem yog siab heev. Qhov no yog vim tias tus lej ntawm cov qe ntshav tsawg heev thaum cov qe ntshav qub raug rhuav tshem thiab cov tshiab raug tsim.

Feem ntau cov neeg nyob hauv ib chav tshwj xeeb hauv tsev kho mob li 3 txog 5 lub lis piam (lossis ntev dua) tom qab lawv hloov pauv. Thaum lub sijhawm no, pab pawg kho mob ceev faj heev txog cov hauv qab no:

• Yuav kuaj ntshav txhua hnub kom paub seb puas muaj cov qe ntshav tshiab los ntawm cov qe ntshav uas tau cog rau hauv cov nroj tsuag.
• Muaj tshuaj muab rau kom tiv thaiv kev tsis lees txais thiab kab mob Graft-versus-Host (GVHD).
• Cov tshuaj xws li tshuaj tua kab mob, tshuaj tua kab mob fungal, thiab tshuaj tua kab mob antiviral raug muab rau kom tiv thaiv kev kis kab mob.
• Yog tias tsim nyog, cov qe ntshav liab thiab cov platelets raug muab rau sab nraud (kev txhaj ntshav).
• Nws xyuas seb cov kabmob xws li lub siab thiab lub raum puas ua haujlwm zoo.
• Tej teeb meem xws li mob qhov ncauj, ntuav, raws plab, kis kab mob, los ntshav, tsis kam lees, lossis GVHD yuav tsum tau kho sai sai.
• Xyuas kom tus neeg mob tau txais kev noj haus txaus. Qhov no yuav suav nrog kev pub mis rau hauv lub raj lossis kev noj zaub mov tag nrho los ntawm kev txhaj tshuaj (TPN).
• Txhua tus neeg uas tuaj rau tsev kho mob raug kuaj xyuas kom paub tseeb tias lawv ua raws li cov cai tiv thaiv kev kis kab mob. Qhov ntawd txhais tau tias:
• Tsis muaj leej twg uas muaj mob dab tsi (txawm tias mob khaub thuas) tuaj yeem tuaj ntsib tus neeg mob.
• Txhua tus neeg yuav tsum ntxuav lawv txhais tes kom huv si ua ntej nkag mus hauv chav.
• Txhua tus neeg yuav tsum hnav lub npog ntsej muag, hnab looj tes, thiab lub tsho loj.

Cov niam txiv (yog tias yog menyuam yaus) yuav pab tau li cas?

Tom qab ib tug me nyuam tau txais kev hloov pauv stem cell, nws tusYuav siv sijhawm li 6 txog 12 lub hlis, lossis ntev dua, rau lub cev tiv thaiv kab mob kom rov zoo tag nrho. Txog thaum ntawd, txawm tias cov kab mob me me kuj tuaj yeem nyuaj rau cov menyuam yaus. Txawm tias mob khaub thuas tuaj yeem ua rau muaj kev phom sij. Nov yog qee yam uas koj tuaj yeem ua tau los pab tiv thaiv koj tus menyuam ntawm cov kab mob:

• Koj tus menyuam, cov tswv cuab hauv tsev neeg, thiab cov qhua (uas raug tso cai tuaj xyuas) yuav tsum ntxuav lawv txhais tes kom huv si thiab nquag siv xab npum tua kab mob thiab/lossis tshuaj ntxuav tes. Qhov no yog qhov tseem ceeb tshaj plaws.
• Tsis txhob coj leej twg mob los ze tus me nyuam.
• Da dej rau koj tus menyuam txhua hnub nrog tshuaj zawv plaub hau thiab xab npum mos mos. Ua kom daim tawv nqaij huv si.
• Ua raws li cov lus qhia ntawm tus kws kho mob kom meej:
• Thaum twg tus menyuam thiaj mus tau tsev kawm ntawv lossis lwm qhov chaw pej xeem (chaw muaj neeg coob coob, xinesmas, khw loj).
• Thaum twg ib tug me nyuam yuav tsum hnav lub npog ntsej muag thaum tawm mus sab nraud?
• Cov khoom noj twg zoo rau tus menyuam noj thiab cov khoom noj twg tsis zoo rau tus menyuam noj (piv txwv li, zaub xam lav nyoos, nqaij thiab ntses tsis tau siav).
• Tus me nyuam puas nyob ze cov tsiaj thiab kov tau lawv?

Peb yuav tsum paub dab tsi ntxiv?

Muaj ntau tus menyuam yaus (thiab cov neeg laus) rov zoo tom qab tau txais kev hloov noob hlwb. Txawm li cas los xij, lub sijhawm siv nyob hauv tsev kho mob thiab lub sijhawm siv rov zoo nyob hauv tsev tuaj yeem yog qhov nyuaj rau tus neeg mob thiab lawv tsev neeg, ob qho tib si ntawm lub hlwb thiab lub cev.

Tsis txhob sim mus ncig ua si no ib leeg xwb. Thov kev pab.

Nrhiav kev pab los ntawm lwm tus neeg hauv tsev neeg, cov phooj ywg, koj pab neeg kho mob, tus kws pab tswv yim, lossis tus neeg ua haujlwm pabcuam zej zog. Koj tsuas tuaj yeem saib xyuas koj tus neeg mob (lossis tus menyuam, yog tias nws yog menyuam yaus) yog tias koj saib xyuas koj tus kheej zoo.

Yuav kom pab tau koj tus neeg mob kom rov zoo thiab noj qab nyob zoo, ua cov no:

• Mus ntsib kws kho mob tas li thiab muab tshuaj rau koj raws sijhawm.
• Txhawb nqa thiab txhawb tus neeg mob thaum lub sijhawm muaj kev hloov pauv ntawm lub cev (piv txwv li, plaub hau poob, qaug zog, tawv nqaij hloov pauv) uas yuav tshwm sim vim yog kev kho mob chemotherapy thiab/lossis kev kho mob hluav taws xob.
• Pab lawv daws qhov kev kho siab thiab kev sib cais uas los ntawm kev nyob deb ntawm cov phooj ywg thiab tsev neeg thaum lawv rov zoo. Muab sijhawm los tham, txawm tias los ntawm kev hu video.
• Nug tus neeg mob seb lawv puas xav nrog tus kws pab tswv yim lossis tus neeg ua haujlwm pabcuam tham kom pab lawv daws cov kev xav xws li kev tu siab, kev ntshai, thiab kev npau taws uas yuav tshwm sim thaum lub sijhawm rov zoo.
• Pab tus neeg mob (tshwj xeeb yog ib tug menyuam yaus) tsim kom muaj ib txoj kev ua neej yooj yim txhua hnub uas suav nrog kev tawm dag zog me me (yog tias tus kws kho mob pom zoo), noj mov raws sijhawm, thiab cov dej num uas lawv nyiam, xws li ua si, nyeem ntawv, thiab kos duab.

Thaum twg peb yuav tsum mus ntsib kws kho mob sai sai?

Muaj qee qhov kev pheej hmoo thaum koj rov qab los tsev tom qab koj hloov pauv koj lub cev. Yog tias koj muaj ib qho ntawm cov tsos mob hauv qab no:Koj yuav tsum hu rau kws kho mob tam sim ntawd, tsis txhob ncua ib pliag, lossis koj yuav tsum raug coj mus rau tsev kho mob:

• Yog tias qhov kub yog 38.0°C (100.4°F) lossis siab dua thaum saib ntawm lub qhov ncauj (qhov no yog lub cim txaus ntshai tshaj plaws).
• Yog koj lub qhov ntswg ntws, hnoos, hauv siab nruj, lossis ua pa nyuaj.
• Yog tias tseem ntuav lossis raws plab.
• Yog koj tso zis dub thiab muaj cov quav xim av (qhov no yuav yog ib qho cim qhia tias koj los ntshav hauv txoj hnyuv).
• Yog tias koj mob qhov ncauj yooj yim los yog los ntshav tsis tu ncua (piv txwv li los ntawm lub qhov ntswg lossis cov pos hniav).
• Yog tias muaj ntshav nyob rau hauv cov zis, lossis yog tias cov xim ntawm cov zis tau hloov pauv.
• Yog koj mob taub hau heev, kiv taub hau, lossis pom kev tsis meej.
• Tsis ua li cas yog koj hnoos ntshav, tab sis yog koj tswj tsis tau qhov ntswg los ntshav hauv ob peb feeb xwb,
• Yog tias muaj ib yam dab tsi tshiab tshwm sim rau ntawm lub cev, xws li pob khaus.

Thaum kawg, qee yam tseem ceeb uas yuav tsum nco ntsoov

Yog li ntawd, kev hloov noob hlwb tuaj yeem yog kev kho mob zoo heev, hloov pauv lub neej rau qee yam kab mob loj. Tab sis nws yog ib qho kev kho mob loj, thiab kev rov zoo yuav tsum siv sijhawm, ua siab ntev, thiab mob siab rau. Qhov tseem ceeb tshaj plaws yog ua raws li tus kws kho mob cov lus qhia kom meej, muab kev hlub, kev khuv leej, thiab kev txhawb nqa rau tus neeg mob (yog tias yog menyuam yaus, tus menyuam) thiab tshwj xeeb tshaj yog tiv thaiv lawv ntawm kev kis kab mob.

Nco ntsoov tias, koj thiab koj tus neeg mob tsis yog tib tug xwb hauv txoj kev nyuaj no! Pab neeg kho mob, tsev neeg, thiab cov phooj ywg puav leej nrog koj nyob. Yog tias koj muaj lus nug lossis kev tsis ntseeg, txawm tias me me li cas los xij, tsis txhob ntshai nug pab neeg kho mob. Lawv nyob ntawd los pab koj.

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