Koj puas mob hauv siab tas li lossis ua pa nyuaj? Tej zaum koj tau raug asbestos thaum koj ua haujlwm thaum koj tseem hluas. Niaj hnub no peb tab tom tham txog ib hom mob qog noj ntshav uas tsis tshua muaj tab sis loj heev uas tuaj yeem tshwm sim ntau xyoo tom qab los ntawm kev raug li ntawd. Qhov no hu ua Pleural Mesothelioma hauv cov lus kho mob. Txawm hais tias lub npe yuav zoo li nyuaj, cia peb ua kom yooj yim.
Pleural Mesothelioma yog dab tsi tiag?
Hais yooj yim xwb, muaj ib daim nyias nyias, zoo li ib daim npog, nyob ib ncig ntawm phab ntsa sab hauv ntawm peb lub ntsws thiab lub hauv siab. Qhov no yog qhov peb hu ua pleura hauv kev kho mob. Daim nyias nyias no yog ua los ntawm ib hom cell tshwj xeeb hu ua mesothelium . Yog li thaum mob qog noj ntshav tshwm sim hauv cov cell mesothelium no, nws hu ua Pleural Mesothelioma (lossis malignant pleural mesothelioma).
Qhov ua rau qhov no yog kev raug cov pob zeb hu ua asbestos . Tej zaum koj yuav paub tias yav dhau los, cov ntawv asbestos tau siv los ua cov khoom siv hauv tsev, tshwj xeeb tshaj yog rau cov ru tsev. Thaum cov asbestos no lwj, tawg, lossis ua haujlwm rau, cov khoom me me, tsis pom tau raug tso tawm mus rau hauv huab cua. Thaum cov no raug nqus pa, lawv mus rau hauv lub ntsws thiab poob. Qhov txaus ntshai tshaj plaws yog tias peb lub cev tsis tuaj yeem yaj lossis tshem tawm cov khoom me me no. Yog li ntau xyoo, lawv ua rau cov daim nyias nyias nyob ib puag ncig lub ntsws puas tsuaj, ua rau o, thiab thaum kawg hloov pauv cov hlwb thiab hloov lawv mus ua mob qog noj ntshav.
Puas muaj cov hom mob qog noj ntshav no tseem ceeb?
Yog lawm, Lub Koom Haum Kev Noj Qab Haus Huv Ntiaj Teb (WHO) tau faib cov mob qog noj ntshav no ua peb hom loj raws li qhov xwm txheej ntawm cov hlwb qog noj ntshav. Qee hom kis tau sai, thaum lwm hom loj hlob qeeb dua. Kev kho mob kuj txawv nyob ntawm hom.
| Hom mob qog noj ntshav | Piav qhia yooj yim |
|---|---|
| Epithelioid Mesothelioma | Qhov no yog hom mob uas feem ntau pom muaj (kwv yees li 60% - 80%). Nws yooj yim kho dua li lwm hom mob. |
| Sarcomatoid Mesothelioma | Qhov no yog hom kab mob tsawg tshaj plaws (kwv yees li 10%). Nws loj hlob sai heev thiab nyuaj kho. |
| Biphasic Mesothelioma | Qhov no kuj yog ib hom tsis tshua muaj (kwv yees li 10% - 15%). Nws muaj cov hlwb sib xyaw los ntawm ob hom saum toj no. |
Thaum koj tus kws kho mob tau txiav txim siab meej tias koj muaj hom mob dab tsi, lawv yuav muab lub tswv yim zoo rau koj txog kev kho mob twg zoo tshaj plaws rau koj thiab yav tom ntej yuav zoo li cas.
Cov tsos mob ntawm tus kab mob no yog dab tsi?
Ib qho teeb meem nrog qhov no yog tias cov tsos mob tshwm sim qeeb heev . Nws yuav siv sijhawm 20, 30, lossis txawm tias 50 xyoo tom qab raug asbestos kom cov tsos mob tshwm sim. Cov tsos mob thawj zaug zoo ib yam li cov mob khaub thuas lossis lwm yam mob me, yog li ntau tus neeg tsis quav ntsej txog lawv. Tsuas yog thaum tus kab mob hnyav dua me ntsis lawv thiaj li mus ntsib kws kho mob.
Ob qho tsos mob tseem ceeb yog:
- Mob hauv siab tas li
- Ua pa nyuaj (ua pa luv luv)
Tsis tas li ntawd xwb, koj kuj tuaj yeem pom cov tsos mob no:
- Hnoos tas li thiab suab nrov nrov
- Nyuaj nqos (dysphagia)
- Mob nraub qaum qis
- Kev o ntawm lub ntsej muag thiab tes
- Kev poob phaus tsis muaj laj thawj
- Kev hws hmo ntuj
- Kev qaug zog
- Kub taub hau ua rau koj tsis muaj zog
Puas muaj lwm yam ua rau tsis yog asbestos?
Kev raug tshuaj asbestos yog qhov ua rau 70% ntawm cov neeg mob uas kuaj pom tias muaj mob qog noj ntshav no. Txawm li cas los xij, qee zaum, cov neeg uas tsis raug tshuaj asbestos kuj tuaj yeem mob qog noj ntshav no. Cov kws tshawb fawb tseem tab tom tshawb nrhiav qhov no. Qee qhov ua rau muaj mob qog noj ntshav yog:
- Tau txais kev kho mob hluav taws xob rau thaj tsam hauv siab ua ntej lawm.
- Kev hloov pauv caj ces uas tau txais los ntawm noob caj ces (piv txwv li, qhov tsis muaj cov noob caj ces BAP1).
- Kev raug rau cov khoom siv hu ua carbon nanotubes (uas tam sim no siv los ua kom cov khoom xws li tsheb thiab cov khoom siv kis las muaj zog).
Qhov tseem ceeb tshaj plaws yog tias tsis muaj kev pheej hmoo los ntawm cov ntawv asbestos raug ntsia rau ntawm lub ru tsev. Qhov kev pheej hmoo tsuas yog tshwm sim thaum cov khoom tawg, lwj, lossis raug tshem tawm, tso cov khoom me me rau hauv huab cua.
Leej twg muaj kev pheej hmoo tshaj plaws?
Kab mob no feem ntau tshwm sim rau cov neeg uas tau raug asbestos ntau xyoo los ntawm lawv txoj haujlwm. Coob leej ntawm cov neeg no tam sim no so haujlwm lawm (hnub nyoog tshaj 65 xyoo). Lawv tau ua haujlwm hauv cov haujlwm ntsig txog asbestos thaum lawv tseem hluas, ua ntej cov cai lij choj tau siv txog kev phom sij ntawm asbestos.
Txawm tias nyob hauv Sri Lanka, cov neeg uas ua haujlwm zoo li no muaj kev pheej hmoo ntau dua:
- Cov neeg ua haujlwm hauv kev tsim kho vaj tse thiab kev rhuav tshem
- Cov neeg ua haujlwm hauv cov chaw tsim khoom nkoj
- Cov neeg ua haujlwm hauv cov chaw nres tsheb thiab cov chaw tsim khoom
- Cov chaw tsim khoom thiab cov neeg teeb tsa cov ntaub ntawv rwb thaiv tsev
- Cov neeg tua hluav taws
- Cov kws kho dej
- Cov neeg khawb av
Tsis tas li ntawd,
- Cov neeg uas nyob hauv tib lub tsev nrog ib tus neeg ua haujlwm nrog asbestos kuj muaj kev pheej hmoo, vim tias cov khoom me me ntawd tuaj yeem nkag mus rau hauv tsev los ntawm lawv cov khaub ncaws thiab khau.
- Cov neeg uas nyob ze ntawm lub qhov av asbestos lossis qhov chaw uas cov tsev qub uas muaj asbestos raug rhuav tshem kuj muaj kev pheej hmoo.
Yuav kuaj mob li cas?
Thaum koj mus ntsib kws kho mob, nws yuav xub nug txog koj cov tsos mob, keeb kwm kev kho mob, thiab tshwj xeeb tshaj yog txog koj txoj haujlwm thiab tej zaum yuav raug asbestos. Tom qab ntawd, lawv yuav pom zoo kom kuaj qee yam, xws li:
- Kev kuaj duab: Kev siv tshuab xoo hluav taws xob hauv siab tuaj yeem nrhiav kev hloov pauv hauv lub ntsws, qhov tuab ntawm lub ntsws, lossis cov kua dej nyob ib puag ncig lub ntsws (pleural effusion). Tsis tas li ntawd, kev kuaj MRI, CT scan, lossis PET scan yuav raug txib kom pom qhov twg ntawm qhov mob qog noj ntshav thiab seb qhov mob qog noj ntshav puas tau kis mus rau lwm qhov.
- Kev kuaj ntshav: Qee qhov kev kuaj ntshav nrhiav cov qib siab ntawm qee yam tshuaj uas cuam tshuam nrog tus mob qog noj ntshav no (xws li fibulin-3 thiab cov peptides uas yaj tau hauv mesothelin) hauv cov ntshav.
- Kev kuaj lub hauv siab: Qhov no suav nrog kev rho tawm ib qho me me ntawm cov kua dej los ntawm ib puag ncig lub ntsws thiab kuaj nws seb puas muaj cov qog nqaij hlav. Qhov no tuaj yeem pab txo qhov mob hauv siab thiab ua pa nyuaj.
- Kev kuaj mob biopsy:
Qhov no yog qhov kev kuaj mob tseem ceeb tshaj plaws. Tib txoj kev kom paub tseeb 100% seb koj puas muaj mob mesothelioma yog mus kuaj mob qog nqaij hlav. Qhov no suav nrog kev rho ib daim nqaij me me los ntawm ib puag ncig lub ntsws thiab kuaj nws hauv qab lub tshuab kuaj mob kom pom tias puas muaj cov qog nqaij hlav thiab, yog tias muaj, hom qog nqaij hlav twg.
Cov theem ntawm mob qog noj ntshav yog dab tsi?
Ib yam li lwm yam mob qog noj ntshav, nws raug muab faib ua theem 1 txog 4 nyob ntawm seb tus kab mob kis mus rau lwm qhov. Kev kho mob yog npaj raws li theem no.
| Theem | Xwm txheej |
|---|---|
| Theem 1 | Tus mob qog no tsuas yog nyob rau ntawm daim nyias nyias uas nyob ib puag ncig lub ntsws (pleura). Thaum lub sijhawm no, tej zaum yuav muaj kev phais kom tshem tawm tag nrho cov mob qog no. |
| Theem 2 | Tus mob qog noj ntshav tau kis mus dhau lub pleura me ntsis lawm, tab sis nws tseem nyob ze rau qhov chaw uas nws pib. |
| Theem 3 | Tus mob qog noj ntshav tau kis mus rau cov kabmob ze thiab cov qog ntshav hauv lub cev. |
| Theem 4 | Tus mob qog nqaij hlav tau kis mus rau lwm qhov chaw (xws li lub siab, pob txha). |
Cov kev kho mob rau qhov no yog dab tsi?
Mob qog nqaij hlav hauv lub ntsws (pleural mesothelioma) yog ib yam mob qog nqaij hlav uas nyuaj kho vim nws kis tau yooj yim los ntawm cov hlab ntsha, cov hlab ntsha, thiab cov nqaij mos. Yog li ntawd, cov kws kho mob qog nqaij hlav feem ntau npaj kev kho mob siv ntau yam kev kho mob sib xyaw ua ke.
- Kev Phais Mob: Kev phais mob yuav ua tau thaum pib mob. Qhov no yuav suav nrog kev tshem tawm tag nrho lub ntsws uas muaj mob qog noj ntshav (extrapleural pneumonectomy - EPP) lossis tshem tawm tsuas yog cov nqaij mob qog noj ntshav thiab pleura (pleurectomy with decortication - P/D).
- Kev Kho Mob Hluav Taws Xob: Qhov no yog kev siv cov hluav taws xob muaj zog heev los tua cov hlwb qog noj ntshav. Kev kho mob no yog siv los tua cov hlwb uas tseem tshuav tom qab phais lossis txo cov tsos mob (xws li mob hauv siab).
- Kev kho mob qog noj ntshav: Qhov no suav nrog kev muab cov tshuaj rau lub cev uas tua cov hlwb qog noj ntshav lossis tiv thaiv lawv kom tsis txhob loj hlob. Pemetrexed, carboplatin, thiab cisplatin yog cov tshuaj uas siv ntau tshaj plaws.
- Kev Kho Mob Tiv Thaiv Kab Mob: Qhov no yog ib txoj kev kho mob tshiab uas txhawb peb lub cev tiv thaiv kab mob kom paub thiab rhuav tshem cov hlwb qog noj ntshav.
- Kev Kho Mob Rau Lub Sijhawm Ntev: Lub hom phiaj tsis yog kho tus mob qog noj ntshav. Hloov chaw, nws yog los tswj tus neeg mob cov tsos mob (mob, ua pa luv luv) thiab ua kom lub neej txhua hnub xis nyob thiab tsis mob li sai tau.
- Kev Sim Tshuaj: Cov no yog cov kev tshawb fawb uas sim qhov kev nyab xeeb thiab kev ua tau zoo ntawm cov kev kho mob tshiab. Cov no yog siv los sim cov kev kho mob tshiab, xws li kev kho mob gene. Koj tuaj yeem tham nrog koj tus kws kho mob txog seb koj puas tuaj yeem koom nrog ib qho ntawm cov kev sim no.
Puas muaj ib txoj kev los zam tau tus kab mob no?
Txoj kev zoo tshaj plaws thiab tib txoj kev los tiv thaiv pleural mesothelioma yog tsis txhob nqus cov asbestos. Txawm hais tias feem ntau lub tebchaws tau txwv tsis pub siv asbestos, nws tseem yuav muaj nyob rau hauv cov tsev qub thiab cov tsheb uas tsim ua ntej xyoo 1980. Koj tuaj yeem ua cov hauv qab no kom txo koj qhov kev pheej hmoo:
- Yog tias koj muaj cov asbestos qub hauv koj lub tsev, kom ib tus kws tshaj lij tshuaj xyuas nws ua ntej kho.
- Yog koj tab tom tshem tawm cov asbestos, muab txoj haujlwm rau ib lub tuam txhab uas tau kawm tiav. Tsis txhob sim ua koj tus kheej.
- Yog tias koj raug cov asbestos thaum koj ua haujlwm, nco ntsoov hnav khaub ncaws tiv thaiv thiab lub ntsej muag kom zoo. Ceev faj tsis txhob nqa cov khoom me me mus tsev rau ntawm koj cov khaub ncaws lossis khau thaum koj mus tsev tom qab ua haujlwm tas.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Pleural mesothelioma yog ib hom mob qog nqaij hlav uas tsis tshua muaj tab sis loj heev ntawm lub ntsws, feem ntau yog los ntawm kev ua pa ntawm cov asbestos me me.
- Cov tsos mob (mob hauv siab, ua pa nyuaj) tshwm sim ntau xyoo tom qab raug tshuaj.
- Yog tias koj muaj keeb kwm raug tshuaj asbestos thiab muaj cov tsos mob saum toj no, mus ntsib kws kho mob tam sim ntawd yam tsis muaj kev ncua.
- Txawm hais tias tus kab mob no tsis tuaj yeem kho tau tag nrho los xij, kev phais mob, kev siv tshuaj kho mob qog noj ntshav, kev siv hluav taws xob kho, thiab kev kho mob niaj hnub no tuaj yeem tswj cov tsos mob, ua kom lub neej muaj sia nyob ntev dua, thiab txhim kho lub neej zoo dua.
- Txoj kev zoo tshaj plaws los zam qhov no yog tiv thaiv koj tus kheej ntawm cov hmoov av asbestos.
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