Ngā mea e hiahia ana koe ki te mōhio mō ngā pukupuku carcinoid o te pūkahukahu

Kua pāngia koe e te maremare mō tētahi wā? Tērā pea kei te haere tahi mai me te huware? He poto rānei tō manawa? He maha ngā wā ka wareware tātou ki ēnei mea, me te whakaaro he makariri noa iho. Engari he tino onge, tera pea he mea kē atu kei muri i tētahi tohu iti nei me aro atu tātou. I tēnei rā ka kōrero tātou mō tētahi mate pukupuku onge engari he tino nui o ngā pukahukahu. Koia ēnei ko ngā Puku Carcinoid o te Puku.

Hei whakarāpopototanga, he aha ēnei pukupuku carcinoid o te pūkahukahu?

Me whakamārama ake tēnei. He momo pūtau motuhake kei roto i tō tātou tinana, nō te pūnaha io me te pūnaha homoni. Ka kiia ēnei he pūtau neuroendocrine. Whakaarohia ēnei pūtau hei kaiwhakarite i roto i tō tātou tinana. Ina tae mai he karere mai i te pūnaha io, ko tā rātou mahi he whakaputa homoni hei whakautu ki a ia, me te whakahaere i ngā mahi rerekē i roto i te tinana. Hei tauira, ka āwhina ēnei pūtau ki te whakahaere i te huarahi e tomo ai tō tātou manawa ki roto i ngā pukahukahu me te huarahi e neke ai te kai i roto i te ara nakunaku.

Nō reira, mō tētahi take, ina tīmata te wehewehe me te whakanui kore e taea te whakahaere i ēnei pūtau neuroendocrine, ka puta he pukupuku i aua wāhi. Ka kiia e mātou he pukupuku carcinoid pūkahukahu ngā pukupuku matepukupuku e tīmata ana i roto i ēnei pūtau neuroendocrine i roto i ngā pūkahukahu.

Kaua e wehi ina rongo koe i te kupu "matepukupuku." Nā te mea e rua ngā momo o ēnei pukupuku carcinoid. He rerekē rawa te whanonga o ngā mea e rua.

Ngā momo matua e rua o ngā kiore cassinoid

E rua ngā momo matua o ēnei tipu, i runga i te tere o te tipu me te kaha ki te horapa.

He aha ngā tohu o tēnei mate?

I te nuinga o te wā, inā koa mō te hunga he pukupuku noa iho ō rātou, kāore he tohu . Ka kitea noa iho ēnei tohu, me te mea kei roto i te hihi-X o te uma mō tētahi atu take. Heoi, ka pā pea ēnei tohu ki ētahi tāngata:

• Te maremare tonu (i ētahi wā he toto, he hūpē rānei)
• Mamae o te uma
• Te uaua ki te manawa (dyspnea)
• Te rongonga i te tangi 'whiowhio' ngoikore i te wā e manawa ana (wheezing)

He āhuatanga motuhake e kiia nei ko te Carcinoid Syndrome

He tino onge te tīmatanga o te whakaputa nui rawa o te homoni serotonin i roto i ēnei pukupuku. Ka puta pea he kore taurite o ngā homoni i roto i te tinana, ka puta ai ngā momo tohu. Ka kiia tēnei ko te mate carcinoid . Ko ōna tohu ko:

• Mate korere nui
• Te whero, te māhana rānei o te mata me te kaki (te whero)
• Te pikinga o te taumaha me te kore take
• Te uaua ki te manawa, ngā tohumate rite ki te mate huango rānei

Mena ka puta mai ēnei tohu, he mea nui kia rapu tohutohu hauora tonu.

He aha i pēnei ai te āhua o ngā pukupuku? He āhuatanga mōrearea kei reira?

Ina hoki, kāore anō kia kitea te tino take e tīmata whakarere ai te wehewehe o ēnei pūtau neuroendocrine me te kore e taea te whakahaere .

Heoi anō, kua kitea he nui ake te tūponotanga o ētahi tāngata ki te whakawhanake i tēnei mate. Ko ēnei āhuatanga ko:

• He mate ira tuku iho, he onge kei a au, e kiia nei ko te Multiple Endocrine Neoplasia momo 1 (MEN1) .
• Te kai hikareti (ina koa mō te momo kai hikareti rerekē)
• He wahine (he nui ake te tūponotanga o ngā wāhine ki te pāngia e tēnei mate)
• Kei waenganui i te 45 me te 55 tau te pakeke. Ahakoa ko te nuinga o te wā ka kitea te mate i roto i te hunga o tēnei reanga tau, ka taea e tēnei mate te pā ki ngā tau katoa, ahakoa he tamariki nohinohi.

Me pēhea te mohio ki tēnei āhuatanga?

Mena kei a koe tētahi o ngā tohu kua whakahuatia ake nei, me toro atu koe ki tō tākuta i te tuatahi. Ka pātai atu ia ki a koe mō ō tohu, ka whakarongo ki tō uma me te stethoscope, ā, ki te ruarua koe, ka tūtohu i ētahi whakamātautau hei whakaū i te mate.

1. Whakaahua: Ko te taahiraa tuatahi ko te tango i te hihi-X o te uma . Mena ka kitea he hapa, ka tonoa pea he matawai CT (matawai Tomography Rorohiko) . Ka taea e te matawai CT te whakaputa i ngā whakaahua tino mārama, whakawhiti-wāhanga o ngā pukahukahu, ka taea ai te whakatau i te rahi me te taunga o te puku.

2. Ngā whakamātautau toto me te mimi: Ka mahia ēnei whakamātautau hei tirotiro mēnā kei roto i te toto, i te mimi rānei ētahi homoni i hangaia e ēnei pukupuku.

3. Ko te koiora: Koinei te whakamātautau tino nui hei whakaū i te mate 100%. I konei, ka tangohia he wahi kiko iti rawa mai i te puku ka tirohia i raro i te karu hiko. Mā tēnei ka taea te whakatau tika mēnā he puku carcinoid te puku, he āhua noa, he āhua rerekē rānei. Ko te tikanga tino noa hei tiki i tēnei tauira kiko ko te bronchoscopy . I konei, ka tukuna he ngongo angiangi me te kāmera iti mā roto i ngā ara manawa hei tirotiro i te puku, ā, ka tangohia he wahi iti.

He aha ngā kōwhiringa maimoatanga?

Ko te maimoatanga pai rawa atu māu ka whakawhirinaki ki te momo, te rahi, te wāhi o te puku, me tō hauora whānui. Ko te rongo pai ko te nuinga o ngā puku carcinoid o te pūkahukahu ka taea te whakaora katoa mā te pokanga anake.

He maha ngā kōwhiringa maimoatanga matua:

• Pokanga:
• Lobectomy: Te tango katoa i te pūkahukahu kei reira te pukupuku.
• Te Tangohanga Wedge: Te tango i te pukupuku me te iti o te kiko e karapoti ana.
• Te tango i te pūkahukahu: He tino onge, ka hiahiatia pea te tango i te pukahukahu katoa.
• Te tango i ngā kōpū lymph: Ka whakatau pea te taote pokanga ki te tango i ngā kōpū lymph tata kia kite ai mēnā kua horapa te mate pukupuku, kia kore ai hoki e horapa atu.

• Whakaora Irahiko: Ka hoatu tēnei maimoatanga mēnā kāore e taea e te pokanga te tango katoa i te pukupuku, mēnā rānei kei roto te tūroro i tētahi āhuatanga hauora e kore ai e taea te pokanga. Kei roto ko te irahiko hihi-waho, te whakatakotoranga rānei i ngā rauemi irahiko iti ki te taha o te pukupuku (brachytherapy).

• Te rongoā matū:Nā te puhoi o te tipu o ēnei pukupuku, kāore i te tino whai hua te rongoā chemotherapy tikanga, e aro ana ki ngā pūtau tere tipu. Nō reira, he onge te hoatutanga o tēnei maimoatanga ki ngā momo noa. Heoi, tera pea e tika ana tēnei maimoatanga mō ngā momo tere tipu kāore i te ōrite, ina horapa rānei ki ētahi atu okana.

• Ētahi atu rongoā:
• Octreotide: Ka hoatu tēnei rongoā homoni hei whakahaere i ngā tohumate e puta mai ana i te mate carcinoid.
• Ngā aukati MTOR (hei tauira, Everolimus): He momo rongoā e aukati ana i te tipu o te pukupuku.

He aha te auau whakaora me te tirohanga?

He raruraru tēnei mō te tini o te tangata.

He uaua ake te rongoā i ngā pukupuku carcinoid rerekē. He paku teitei ake te mōrearea o te hokinga mai. Heoi, ka taea hoki te whakahaere angitu i tēnei āhuatanga mā te whakamahi i te huinga o ngā maimoatanga rerekē.

I te katoa, ko te reiti oranga mō ngā momo pukupuku carcinoid katoa i roto i ngā tau e rima he tino teitei, arā, 89% . Ko te tikanga o tēnei, i roto i te 100 tāngata i tāpaetia ki tēnei mate, e 89 kei te ora tonu i muri i te 5 tau.

Āhea koe me toro atu ki te tākuta?

Ki te pāngia koe e ngā tohu hou, e kino haere ana rānei, inā koa te poto o te manawa, te korere, te ngaronga taumaha rānei kāore i te mārama, me whakamōhio atu ki tō tākuta. Kaua e mangere ki te kōrero mō ngā pātai, ngā āwangawanga rānei.

Āhea te wā tika ki te haere ki te ETU (Emergency Treatment Unit) tonu atu?

Mena kei a koe ēnei tohu kino e whai ake nei, haere tonu ki te Tari Whawhati Tata (ETU) o te hōhipera tata:

• Te poto o te manawa (ahakoa kei te okioki koe).
• Te maremare toto.
• Te mamae o te uma hou, te mamae kino rānei.
• Te pōhēhē, te whakarerekētanga rānei o te hinengaro.
• Te tae kikorangi o te kiri, o ngā ngutu, o ngā maikuku rānei (cyanosis).

Ngā pātai hei pātai atu ki tō tākuta

He mea noa te pātai ina whiwhi koe i tētahi tātaritanga pēnei. Tērā pea he pai ki te pātai atu ki tō tākuta i ēnei pātai:

• He mea noa tēnei, he mea rerekē rānei?
• Kua horapa atu tēnei ki ētahi atu wāhi?
• He aha te maimoatanga e taunaki ana koe?
• He aha te tirohanga mō tēnei momo pukupuku?
• Me pēhea te whakahaere i ngā tohu i te kāinga?

He wheako uaua te whiwhi tātaritanga mō tētahi mate pukupuku. Engari kia maumahara, he tino ngāwari te rongoā i te nuinga o ngā carcinoids o te pūkahukahu, ā, he iti te tūponotanga o te hokinga mai anō. Kōrerohia mā te mahorahora ki tō rōpū hauora mō ngā mea hei tumanakohia mō tō mate. Mā rātou e whakamārama ngā kōwhiringa maimoatanga pai rawa atu ki a koe, ā, ka whakautua hoki ō pātai katoa.