Thaum koj pom tias koj lossis ib tus neeg koj hlub muaj mob qog noj ntshav, nws nyuaj rau piav qhia rau hauv cov lus. Nws yog ib qho ib txwm muaj kev ntshai thiab xav paub thaum koj tus kws kho mob qhia koj txog kev kho mob tshiab, xws li PRRT, uas yog ib lo lus tsis paub. Tab sis tsis txhob txhawj. Txawm hais tias qhov no yog ib qho kev kawm nyuaj me ntsis, hnub no peb yuav tham txog PRRT yog dab tsi, nws ua dab tsi, thiab nws qhov zoo thiab qhov tsis zoo yog dab tsi, hauv txoj kev yooj yim heev uas koj tuaj yeem nkag siab.
PRRT txhais li cas?
Hais yooj yim xwb, PRRT yog ib txoj kev kho mob siab heev uas tsom mus rau, nrhiav, thiab rhuav tshem cov hlwb qog noj ntshav, zoo li 'lub foob pob hluav taws coj' . Nws yog siv tshwj xeeb los kho ib hom qog noj ntshav hu ua 'Neuroendocrine Tumors (NETs).'
Qhov tshwj xeeb ntawm kev kho mob no yog tias cov khoom siv radioactive (radioactivity) uas nws tso tawm mus ncaj qha rau hauv cov hlwb qog noj ntshav thiab rhuav tshem lawv. Yog li ntawd, kev puas tsuaj rau cov hlwb noj qab haus huv tsawg dua li kev kho mob hluav taws xob ib txwm muaj.
Txoj kev kho mob no ua haujlwm li cas hauv lub cev?
Yuav kom nkag siab qhov no, cia peb siv ib qho piv txwv yooj yim. Xav txog tias koj cov qog nqaij hlav yog cov qhov rooj uas muaj ntau lub 'keyholes' tshwj xeeb ('receptors'). Txhua lub qhov rooj tsuas yog haum rau tus yuam sij nrog ib lub duab tshwj xeeb.
Cov tshuaj no, hu ua PRRT, yog ua los ntawm kev sib txuas ob yam khoom:
1. Tus Yuam Sij: Qhov no yog ib qho protein. Tus yuam sij no tsuas yog haum rau hauv 'lub qhov tseem ceeb' ntawm cov hlwb qog noj ntshav xwb. Nws tsis haum rau hauv cov hlwb noj qab nyob zoo.
2. Tus Neeg Caij Tsheb Uas Muaj Cov Khoom Siv Hluav Taws Xob: Tus yuam sij no muaj ib qho khoom me me uas muaj cov khoom siv hluav taws xob ('radionuclide') txuas rau nws.
Yog li ntawd, thaum koj muab cov tshuaj no rau koj lub cev, tus 'yuam sij' no mus ncig thoob plaws lub cev, nrhiav cov 'qhov tseem ceeb' hauv cov hlwb qog noj ntshav, thiab txuas nws tus kheej rau lawv. Tom qab ntawd, 'tus neeg caij tsheb radioactive' ntawm tus yuam sij mus rau hauv lub hlwb qog noj ntshav, ua puas rau DNA ntawm lub hlwb ntawd, thiab rhuav tshem lub hlwb los ntawm sab hauv.
Txoj kev no tsuas yog xaiv tau kev tua cov hlwb qog noj ntshav xwb, yam tsis ua rau cov hlwb noj qab nyob zoo puas tsuaj loj heev. Qhov no yog qhov zoo tshaj plaws ntawm kev kho mob no.
Cov tshuaj PRRT uas siv ntau tshaj plaws niaj hnub no yog 'lutetium Lu 177 dotatate (LUTATHERA®)'.
Kev kho mob PRRT raug pom zoo rau leej twg?
Txoj kev kho mob no tsis haum rau txhua tus neeg mob qog noj ntshav. Tam sim no, feem ntau pom zoo rau cov qog noj ntshav hu ua 'gastroenteropancreatic NETs', uas yog qog noj ntshav ntawm txoj hnyuv (hnyuv, plab, qhov quav) thiab pancreas. Muaj ntau qhov xwm txheej uas txoj kev kho mob no yuav haum rau koj.
| Xwm txheej | Kev piav qhia |
|---|---|
| Tsis haum rau kev phais | Yog tias tus mob qog nqaij hlav tau kis mus rau ntau qhov chaw ntawm lub cev, kev phais ib leeg xwb yuav tsis kho tau tag nrho. Ntau tus neeg uas muaj NETs tej zaum yuav tau kis tus mob qog nqaij hlav lawm thaum lawv kuaj pom tias muaj mob. |
| Lwm yam kev kho mob tsis tau ua tiav | Yog tias phais tsis tau, yuav muab kev kho mob xws li kev kho mob hormone. Tab sis qee zaum, cov kev kho mob ntawd ua rau cov hlwb qog nqaij hlav loj hlob tsis tuaj yeem tswj tau. Rau cov neeg ntawd, PRRT yog ib qho kev xaiv zoo. |
| Cov qog nqaij hlav muaj qhov 'keyhole' ntawd | Qhov no yog qhov tseem ceeb tshaj plaws. Yuav kom cov tshuaj PRRT mus txog qhov 'key' thiab txuas, yuav tsum muaj 'keyholes' hu ua somatostatin receptors ntawm qhov chaw ntawm cov hlwb qog nqaij hlav. Koj tus kws kho mob yuav ua qhov kev luam theej tshwj xeeb, xws li kev luam theej octreotide lossis PET scan , kom pom tias koj cov hlwb qog nqaij hlav puas muaj cov no. |
Ua ntej thiab thaum lub sijhawm kho mob muaj dab tsi tshwm sim?
Ua ntej kev kho mob
Yog tias koj noj lwm yam tshuaj rau NETs (tshwj xeeb tshaj yog somatostatin analogs), koj tus kws kho mob yuav qhia koj kom tsis txhob noj lawv ob peb lub lis piam ua ntej PRRT. Koj tus kws kho mob kuj yuav kuaj ntshav li ib lub lis piam ua ntej koj txoj kev kho mob los xyuas koj lub raum ua haujlwm thiab suav cov qe ntshav kom paub tseeb tias koj lub cev nyob rau hauv lub xeev zoo kom tau txais kev kho mob.
Nyob rau hnub kho mob
Feem ntau kev kho mob no yuav muab txhua ob lub hlis rau 4 zaug rau lub sijhawm 8 lub hlis. Qhov no yog kev kho mob sab nraud, tsis tas yuav nyob hauv tsev kho mob. Tag nrho cov txheej txheem yuav siv sijhawm li 5-6 teev.
- Ua ntej, ib lub raj me me (cannula) raug ntxig rau hauv cov leeg ntshav hauv koj txhais caj npab thiab ib txoj kab saline raug tsim.
- Kwv yees li ib teev ua ntej kev kho mob pib, yuav muab tshuaj rau kom tsis txhob xeev siab thiab ntuav.
- Tom qab ntawd, koj yuav tau txais cov kua ntsev uas muaj cov amino acids los tiv thaiv koj lub raum li ntawm 4 teev. Qhov no tseem ceeb heev.
- Kwv yees li 30 feeb tom qab cov amino acids pib muab tshuaj, cov tshuaj PRRT raug muab rau lub cev los ntawm cov saline dhau sijhawm 30-45 feeb.
- Thaum twg muab cov tshuaj saline tag lawm, ces muab lub raj mis tso rau hauv caj npab tshem tawm.
Hnub tom qab kev kho mob, koj yuav muaj kev kuaj xyuas dua ib zaug ntxiv los xyuas seb cov tshuaj radioactive tau mus qhov twg hauv koj lub cev, tshwj xeeb tshaj yog qhov twg cov qog nqaij hlav cancer nyob.
Cov kev mob tshwm sim thiab kev pheej hmoo yog dab tsi?
Ib yam li kev kho mob twg los xij, tej zaum yuav muaj qee qhov kev phiv.
Cov kev mob tshwm sim feem ntau:
Cov kev mob tshwm sim feem ntau yog xeev siab thiab ntuav , tab sis cov no feem ntau tuaj yeem tswj tau los ntawm kev kho mob thaum ntxov.
Lwm yam teeb meem uas yuav tshwm sim tau:
- Txhua yam cuam tshuam rau kev ua haujlwm ntawm lub raum lossis daim siab.
- Cov qe ntshav tsawg zuj zus (cov qe ntshav dawb, cov qe ntshav liab, thiab cov platelets). Qhov no ua rau ua pa nyuaj, ua rau muaj kev kis kab mob ntau ntxiv, thiab ua rau muaj kev pheej hmoo ntawm kev los ntshav lossis kev raug mob.
- Tsis tshua muaj feem yuav muaj lwm yam mob qog ntshav xws li myelodysplastic syndrome lossis leukemia.
Koj tus kws kho mob yuav saib xyuas koj cov ntshav tsis tu ncua thoob plaws koj txoj kev kho mob. Yog tias muaj teeb meem tshwm sim, lawv yuav txiav txim siab hloov cov koob tshuaj lossis tsum koj txoj kev kho mob.
Ib qho xwm txheej loj heev uas yuav tsum tau kev saib xyuas tam sim ntawd!
Kev mob qog nqaij hlav yog ib qho mob uas tsis tshua muaj tab sis muaj peev xwm ua rau tuag taus uas tuaj yeem tshwm sim thaum lub sijhawm kho mob no. Nws yog tshwm sim los ntawm kev tso tawm ntau cov tshuaj hormones los ntawm cov hlwb qog nqaij hlav mus rau hauv cov ntshav. Cov tsos mob tuaj yeem tshwm sim hauv 48 teev thawj zaug ntawm kev kho mob.
Yog koj muaj ib qho ntawm cov tsos mob no, mus rau chav kho mob ceev (ETU) ze tshaj plaws tam sim ntawd lossis hu rau 1990:
* Ua pa nyuaj
* Lub ntsej muag lossis caj dab liab, xav tias kub lossis kub hnyiab hauv lub cev (Flushing)
* Ntshav siab poob qis tam sim ntawd (mob taub hau)
* Lub plawv dhia ceev ceev
* Raws plab hnyav heev
Lub neej txhua hnub tom qab kev kho mob
Feem ntau cov neeg zam tau qhov kev kho mob no zoo thiab rov zoo sai.
Kev ua haujlwm ntawm radioactivity thiab kev nyab xeeb:
Kev kho mob siv cov tshuaj hluav taws xob me me xwb. Qhov no yuav raug tso tawm ntawm koj lub cev hauv koj cov zis thiab quav rau ob peb hnub tom ntej. Thaum lub sijhawm no, koj tus kws kho mob yuav muab cov lus qhia rau koj kom tiv thaiv lwm tus kom tsis txhob raug cov tshuaj hluav taws xob.
- Nws yog ib qho tseem ceeb heev uas yuav tsum nyob deb ntawm cov poj niam cev xeeb tub thiab cov menyuam yaus ob peb hnub.
- Ntxuav koj txhais tes kom huv si nrog xab npum tom qab siv chav dej.
Mus ncig teb chaws:
Tej zaum yuav muaj me ntsis hluav taws xob nyob hauv koj lub cev txog li 3 lub hlis tom qab koj kho mob. Qhov no yuav ua rau cov cuab yeej ntes hluav taws xob tawm ntawm tshav dav hlau lossis ciam teb. Yog li ntawd, ib txwm khaws daim npav tshwj xeeb uas koj tau txais los ntawm tsev kho mob thiab koj cov ntaub ntawv kho mob nrog koj. Qhov no tseem ceeb heev kom tsis txhob muaj kev tsis yooj yim thaum mus ncig.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- PRRT yog ib txoj kev kho mob siab heev uas xa cov hluav taws xob uas tsom mus rau cov hlwb qog noj ntshav. Nws yog siv tshwj xeeb rau Neuroendocrine Tumors (NETs).
- Txawm hais tias qhov no tsis yog kev kho mob uas kho tau mob qog noj ntshav tag nrho los xij, nws pab ua kom cov qog nqaij hlav me dua lossis tiv thaiv kev loj hlob, tswj cov tsos mob, thiab txhim kho lub neej zoo los ntawm kev ua kom lub sijhawm muaj sia nyob ntev dua.
- Ob peb hnub tom qab kho mob, ua raws li cov lus qhia kom tiv thaiv lwm tus ntawm kev siv hluav taws xob (tshwj xeeb tshaj yog nyob deb ntawm cov menyuam yaus thiab cov poj niam cev xeeb tub).
- Yuav tsum paub txog cov tsos mob ntawm tus kab mob carcinoid (ua pa nyuaj, ntsej muag liab, raws plab hnyav, lub plawv dhia ceev). Yog tias koj muaj cov tsos mob no, mus rau ETU ntawm tsev kho mob tam sim ntawd.
- Tsis txhob yig nrog koj tus kws kho mob tham txog tej yam kev mob tshwm sim lossis teeb meem uas koj yuav ntsib.
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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