He aha te matepukupuku o te whēkau iti?
Ki te whakarapopoto, ko te Matepukupuku o te Pīkau Iti te tipu o ngā pūtau matepukupuku i roto i tō whekau iti, arā, ko te " whekau iti ". I mōhio koe he wāhanga tino nui te whekau iti o tā tātou pūnaha nakunaku ? Kei roto hoki i tēnei pūnaha he maha atu ngā whekau, pērā i te ate me te repeure . Kei roto te whekau iti i tō tātou ara gastrointestinal (GI) . Arā, kei te ara mai i te waha, mā te esophagus, ki te puku, kātahi ki te whekau iti, ā, mai i reira ki te whekau nui (colon). Hei whakamārama, ko te puku me te whekau nui e honoa ana e tēnei whekau iti. E toru ngā wāhanga matua o te whekau iti:- Duodenum : Koinei te wāhanga tuatahi e tata ana ki te puku.
- Jejunum: Koinei te wāhanga waenga o te whekau iti.
- Ileum: Koinei te wāhanga whakamutunga me te wāhanga roa rawa atu o te whekau iti.
He pēhea te noa o tēnei mate pukupuku?
Ina hoki, he tino onge te mate pukupuku o te whekau iti . E ai ki ngā raraunga o Amerika, tata ki te 3% o ngā mate pukupuku katoa o te ara nakunaku ka pāngia e tēnei momo mate pukupuku. Ko te mate pukupuku koroni , te mate pukupuku rectum, te mate pukupuku esophageal, me te mate pukupuku puku he mea noa ake. Nō reira, ka taea e koe te whakaaro he iti noa iho tēnei.He aha ngā momo matepukupuku o te whekau iti ?
He maha ngā momo mate pukupuku e puta ana i roto i te whekau iti. Ka whakarōpūhia ēnei i runga i te momo pūtau e tīmata ai te mate pukupuku.- Ngā pukupuku carcinoid: Ka tīmata ēnei i roto i ō pūtau neuroendocrine . Ka āwhina ēnei pūtau i tō tinana ki te whakaputa homoni me te whakahaere i te tukunga o ngā wai nakunaku i roto i te whekau iti. Tata ki te haurua o ngā mate pukupuku whekau iti katoa e pā ana ki ngā pukupuku carcinoid.
- Adenocarcinomas: Ka tīmata ēnei i roto i ngā pūtau repe e whakarārangi ana i te arai o te whekau iti. Tata ki te hautoru o ngā matepukupuku whekau iti katoa.
- Sarcomas: Ka tīmata ēnei i roto i te kiriuhi wheua.te kiko honohono rānei pērā i te uaua. Ko te momo sarcoma tino noa e pā ana ki te whekau iti ko te pukupuku stromal gastrointestinal (GIST) . I mua ko te leiomyosarcoma tōna ingoa.
- Lymphoma: Ka tīmata ēnei i roto i ngā pūtau e kiia nei ko ngā lymphocytes . Ko ngā lymphocytes he momo toto mā e kitea ana i roto i tō pūnaha lymphatic . He wāhanga tino nui te pūnaha lymphatic o tō tātou pūnaha ārai mate. Ka āwhina i te tinana ki te whawhai ki ngā pūtau kino me ngā huakita e puta ai te mate.
He aha ngā tohu o tēnei mate pukupuku?
Ka rerekē pea ngā tohu o te mate pukupuku o te whekau iti. Kei runga i te momo pukupuku me tōna wāhi. I ētahi wā, ka kitea pea ngā pukupuku engari kāore he tohu (kāore he tohu) . Hei tauira, he maha ngā wā kāore he tohu o ngā pukupuku carcinoid. I ētahi wā ka kitea noa iho i te wā o ngā whakamātautau whakaahua mō tētahi atu mate. Ko ngā tohu noa ko:- Te mamae o te puku, te kōpiri rānei.
- He puku i roto i te puku e rite ana ki te mea e mau ana i te ringa.
- Whakapairuaki, ruaki, me te korere.
- Te ngaronga taumaha mō te kore take.
- Te kore toto ( anemia).
- Te kōwhai o ngā kanohi, o te kiri rānei (te makuku , te whero rānei).
- Ngā tūtae toto (tērā pea ka whero, ka mangu rānei i roto i te wharepaku).
- Te whero o te kiri, inā koa ngā ringaringa me te tinana o runga, ka huri hei papura.
He aha ngā take o te mate pukupuku o te whekau iti?
Ka puta ngā pukupuku kino o te whekau iti ina tere te wehewehe o ngā pūtau matepukupuku, ā, ka tipu ngātahi hei puranga. I roto i te wā, ka taea e ēnei pūtau matepukupuku te wehe atu i te pukupuku taketake, ka haere mā roto i ngā pona lymph, i te toto rānei ki ētahi atu wāhanga o te tinana, ka taea ai e rātou te hanga i tētahi pukupuku hou (pukupuku tuarua). Ka kiia tēnei tukanga he metastasis . Ka puta ngā pūtau matepukupuku nā ngā whakarerekētanga ira . Ko te tikanga tēnei ka puta ngā huringa i roto i te DNA o tētahi pūtau, ka wehewehe te pūtau me te kore e taea te whakahaere. Kāore anō kia mōhiotia e ngā kairangahau he aha te take o ēnei huringa.He aha ngā āhuatanga mōrearea mō tēnei mate pukupuku?
Ko te take mōrearea he mea e whakanui ake ai te tūponotanga o te whakawhanake i tētahi mate. Heoi, ko te whai take mōrearea ehara i te mea ka pāngia koe e te mate pukupuku. Waihoki, ko te korenga o ngā take mōrearea ehara i te mea kāore koe e pāngia e te mate pukupuku. He maha ngā take mōrearea ka pā ki te mate pukupuku o te whekau iti:- Tau: Ka piki ake te mōrearea o te nuinga o ngā momo mate pukupuku o te whekau iti i te pakeketanga. Ko te tau toharite mō te tautuhi mate he 65 tau te pakeke.
- Ira Tangata: He nui ake te tūponotanga ka pāngia ngā tāne e tēnei mate pukupuku.
- Iwi: E ai ki ngā raraunga mai i te Hononga o Amerika, he nui ake te kitea o tēnei mate i waenga i te hunga mangu, engari he nui ake te kitea o te lymphoma i waenga i te hunga mā.
- Ngā āhuatanga ira: Mena he āhuatanga tō ō mātua, ō tuākana, tuākana rānei, ō tamariki rānei, tera pea ka nui ake tō mōrearea. Ko ētahi tauira ko te (Familial Adenomatous Polyposis - FAP) , te (Peutz-Jeghers syndrome) , te (Hereditary Nonpolyposis Colorectal Cancer - HNPCC) , me te (Lynch syndrome) .
- Ngā āhuatanga mumura: Ka taea e ngā mate e puta ai te mumura roa o ngā whekau, pērā i te mate a Crohn me te mate Celiac , te whakanui ake i te mōrearea.
- Ngā mate pūnaha ārai mate, te ngoikore rānei o te pūnaha ārai mate: Ka taea e ngā mate e ngoikore ai te pūnaha ārai mate, pērā i te HIV/AIDS , te mate a Crohn , me te mate Celiac, te whakanui ake i tō mōrearea. Waihoki, ka taea e ngā maimoatanga pērā i te radiotherapy te whakaiti i te pūnaha ārai mate, ka whakanui ake i tō mōrearea ki te mate pukupuku o te whekau iti. Ka taea hoki e ngā rongoā e pehi ana i te pūnaha ārai mate i muri i te whakawhitinga okana te whakanui ake i tō mōrearea.
Ki te whakaaro koe kei a koe tētahi o ēnei āhuatanga mōrearea, he pai ake te kōrero ki tētahi tākuta .
Me pēhea te tātaritanga o te mate pukupuku o te whekau iti?
He uaua pea te tautuhi i te mate pukupuku o te whekau iti nā te mea he tino onge. Waihoki, he rerekē ngā tohu i runga i te momo pukupuku. Me whai whakamātautau me ngā tikanga whānui pea koe i mua i te whiwhinga o te tautuhi.Te whakamātautau tinana me te hītori hauora
Ka tirotirohia koe e te tākuta, ka tirohia tō hauora whānui, ka tirohia mēnā he tohu o te mate, ā, ka pātai atu hoki mō ō mate o mua, ō maimoatanga me ō whanonga hauora.Ngā whakamātautau toto
- Ngā rangahau matū toto: Ka ine ēnei i te nui o ētahi matū ka tukuna ki roto i te toto mai i ngā whekau me ngā kiko. Mena he nui rawa (teitei, iti rānei) te nui o tētahi matū, tera pea he tohu kei roto i te whekau, i te kiko rānei e whakaputa ana i taua matū. Hei tauira, ka taea te whakahaere i tētahi whakamātautau mahi ate hei tirotiro mēnā kua horapa te mate pukupuku ki te ate.
- Te tatau toto katoa (CBC): Mā tēnei whakamātautau ka hoatu he mōhiohio ki tō tākuta mō ngā pūtau i roto i tō toto. Ka taea e ngā pukupuku o te whekau iti te whakaheke toto, ka heke ai te maha o ngā pūtau toto whero, ka puta ai te anemia.
Whakaahua
- Endoscopy: Ko te tirotiro i roto i te ara gastrointestinal (GI) mā te whakamahi i tētahi taputapu angiangi, rite ki te ngongo (endoscope). He rama me he kāmera kei runga i tēnei ngongo.I te wā o te endoscopy o runga, ka whakaurua e te tākuta he endoscope mā roto i te waha, ka tirohia te esophagus, te puku, me te wāhanga tuatahi o te whekau iti (duodenum). Ka taea e te endoscope motuhake e kiia nei ko te double-balloon enteroscopy te tirotiro hohonu ake ki roto i te whekau iti. I te wā o te endoscopy, ka tangohia pea e te tākuta ngā tauira kiko ( biopsies ) ka tukuna atu hei whakamātautau. Kātahi ka tirohia i raro i te karuārai hei tirotiro mēnā he tohu mate.
- Te tirotiro pūrua (kāmera pire): Ko te horomitanga o tētahi pūrua kei roto he kāmera iti. I a te pūrua e haere ana i roto i te tinana, ka tangohia ngā whakaahua o te ara GI. Ka taea te tango i ēnei whakaahua ki te rorohiko, ā, ka taea te tiro e te tākuta. Ahakoa he āhua pōhēhē te ingoa, kāore tēnei tikanga e whakamahi i tētahi endoscope.
- Matawai CT (matawai CT - matawai CAT): He tikanga tēnei e tango ana i tētahi raupapa o ngā pikitia taipitopito o roto o te tinana mai i ngā koki rerekē. Ka whakaaturia ēnei pikitia ki tētahi rorohiko e hono ana ki tētahi mīhini hihi-X. I ētahi wā ka werohia he tae ki roto i tētahi uaua, ka hoatu rānei hei inu. Mā tēnei ka kitea mārama ngā whekau, ngā kiko rānei.
- MRI (whakaahua aukume): Ka whakamahia he aukume, he ngaru reo irirangi, me te rorohiko hei hanga i tētahi raupapa pikitia taipitopito o roto o te tinana. Ahakoa he rite tonu ngā mōhiohio e tukuna ana e te MRI me te CT scan mō te pānga o te pukupuku ki ngā kiko ngohengohe, ko te CT scan te mea e whakamahia ana hei kite i te mate pukupuku o te whekau iti.
- Hiko-X o te puku: He hihi-X o ngā whekau o te puku. Ko te hihi-X he hihi pūngao e tika ana mā roto i te tinana, ā, ka whakaatahia ki runga i te kiriata, ka hanga he pikitia o roto o te tinana.
- Te hihi-X o te Barium: Ko te paninga o tō ara GI ki tētahi matū kirikiri e kiia nei ko te barium. Mā te barium ka kitea te ara GI i runga i te hihi-X. I roto i tētahi raupapa GI o runga , ka tangohia he raupapa whakaahua hihi-X i te wā e haere ana te barium mā te ara GI (esophagus, puku, whekau iti). I roto i tētahi raupapa GI o raro (barium enema) , ka whakaurua he barium wai ki roto i te rectum. Ka tangohia ngā whakaahua hihi-X i te wā e pania ana e te barium te ara GI o raro.
Pokanga
Mena kāore e ranea ngā mōhiohio e tukuna ana e ētahi atu whakamātautau hei whakatau i te mate, ka whakatau pea tō tākuta ki te mahi pokanga. Mā ēnei tikanga ka taea e tō tākuta te tirotiro tika i ō whekau. Mena he kiko whakapae, ka mahia he koiora hei tirotiro i ngā tohu o te mate pukupuku. Ka taea te mahi pokanga hei:- Laparoscopy: I roto i tēnei tikanga, ka whakauruhia he ngongo angiangi, rite ki te karu tirotiro (laparoscope) mā roto i tētahi, i ētahi rānei tapahi iti i roto i te puku. Mā te laparoscopy ka taea e te tākuta te kite i ngā whekau puku mō ngā tohu o te mate pukupuku.
- Te pokanga puku:I roto i tēnei, ka tapahia e te tākuta te pakitara o te puku, ka tirohia hoki ngā whekau o te puku mō ngā tohu o te mate pukupuku.
He aha ngā wāhanga o te mate pukupuku o te whekau iti?
Mā te wāhanga o te mate pukupuku ka mōhio koe ki te rahi o te pukupuku, kei hea, me te mea kua horapa (metastasized). Ko ngā whakamātautau me ngā tikanga e whakatau ana i te wāhanga o te mate pukupuku whekau iti ka mahia i te wā e tātaritatia ai. Ko te momo mate pukupuku whekau iti kei a koe (tumor carcinoid, adenocarcinoma, sarcoma, lymphoma rānei) ka whakatau i te pūnaha wāhanga e whakamahia ana e tō tākuta.He aha ngā maimoatanga mō tēnei?
Ko te maimoatanga ka whiwhi koe ka whakawhirinaki ki te momo mate pukupuku kei a koe, tōna wāhanga, te wāhi o te pukupuku, me ngā āhuatanga o ngā pūtau i roto i te pukupuku. Ka pā anō hoki ō manakohanga ki ngā whakatau maimoatanga.Pokanga
Ko te pokanga te maimoatanga tino noa mō te mate pukupuku o te whekau iti. Tērā pea ko te pokanga:- Tangohanga: Te pokanga hei tango i te katoa, i tetahi wāhanga rānei o te okana kei reira te mate pukupuku. Mena kua horapa te mate pukupuku, ka tangohia pea e te tākuta ētahi wāhanga o te whekau iti me ngā okana tata. Kātahi ka mahia he anastomosis (te hono anō i ngā pito kua tapahia o te whekau). Ka tangohia pea ngā pona lymph e tata ana ki te whekau iti, ā, ka tirohia kia kitea ai kua horapa te mate pukupuku.
- Karo: Mena he pukupuku e aukati ana i te whekau engari kāore e taea te tango, ka mahia he pokanga hei tuku i te kai i roto i te whekau iti kia karo i te pukupuku.
Te rongoā matū
Ko te chemotherapy te whakamahinga o ngā rongoā hei aukati i te tipu o ngā pūtau matepukupuku. Ka patua e rātou ngā pūtau, ka aukati rānei i te wehewehe. I runga i te maimoatanga chemotherapy, ka aro pea ngā rongoā ki ngā pūtau matepukupuku i tētahi wāhanga motuhake o te tinana (chemotherapy ā-rohe) ka patua rānei ngā pūtau matepukupuku puta noa i te tinana (chemotherapy pūnaha). Ka tohua pea e tō tākuta he chemotherapy hei patu i ngā pūtau matepukupuku e toe ana i muri i te pokanga (te rongoā tāpiri) . Mena kua horapa tō matepukupuku (kua horapa), ka tukuna pea he chemotherapy pūnaha ki a koe.Te rongoā irahiko
Ko te rongoā irahiko he whakamahinga o ngā hihi-X kaha-teitei, o ētahi atu momo irahiko rānei hei patu i ngā pūtau matepukupuku, hei aukati rānei i te tipu o aua pūtau. Tērā pea ka tūtohu tō tākuta i te rongoā irahiko mēnā kāore e taea te tango i tō matepukupuku mā te pokanga. Tērā pea ka hoatu te rongoā irahiko hei wāhanga o te tiaki mamae hei āwhina i te whakamama i ngā tohu. I ētahi wā, ka hoatu tahitia te rongoā irahiko me te chemotherapy (rongoā chemoradiation) hei patu i ngā pūtau matepukupuku e toe ana i muri i te pokanga.Ngā momo rite o te Somatostatin
Ka rongoatia e te tākuta ngā pukupuku carcinoid o te whekau iti me ngā rongoā rite ki te somatostatin.Ka aukati ēnei rongoā i te hanga nui rawa o ngā homoni i tō tinana. Ka āwhina tēnei ki te whakaiti i ngā tohu me te whakahaere i te mate. Ko ētahi tauira o ēnei rongoā ko te lanreotide me te octreotide.Me nui ake ngā rangahau mō ngā painga o te whakakotahi i te rongoā irahiko me te rongoā matū i muri i te pokanga mō te mate pukupuku o te whekau iti.
Te rongoā arotahi
Ko te mahi a ngā rongoā arotahi mā te tautuhi i ngā ngoikoretanga o ngā pūtau matepukupuku me te whakamahi i aua ngoikoretanga hei whakangaro i a rātou. Kei te ako ngā kairangahau i ngā rongoā arotahi hei āwhina i te rongoā i ngā adenocarcinomas, ngā GIST, me ngā lymphomas.Te rongoā ārai mate
Ko te mahi a te immunotherapy mā te whakapakari i tō pūnaha ārai mate me te whakanui ake i tōna kaha ki te whawhai ki ngā pūtau matepukupuku. Ka whawhai noa tō pūnaha ārai mate ki ngā pūtau rerekē me ngā whakaeke kino pērā i ngā iroriki. Heoi, i ētahi wā ka taea e ngā pūtau matepukupuku te hipa i ngā parepare a te pūnaha ārai mate. Mā te immunotherapy ka māmā ake te kite me te whakangaro i ngā pūtau matepukupuku mā te pūnaha ārai mate. I runga i te momo whakarerekētanga ira i roto i tō pukupuku, ka tūtohu pea tō tākuta i te immunotherapy.Ngā whakamātautau haumanu
He rangahau ngā whakamātautau haumanu hei whakatau mēnā he haumaru, he whai hua, he pai ake rānei ngā maimoatanga matepukupuku hou i ngā maimoatanga paerewa. I tēnei wā, kei te rangahauhia te chemotherapy adjuvant, ngā maimoatanga arotahi, me te immunotherapy i roto i ngā whakamātautau haumanu. Pātai atu ki tō tākuta mēnā he kaitono pai koe mō tētahi whakamātautau haumanu.He aha te auau whakaora mō te mate pukupuku o te whekau iti?
Ka rerekē ngā reiti oranga i runga i te momo mate pukupuku o te whekau iti, tōna taumata, me te wāhi i tīmata ai te mate pukupuku i roto i te whekau iti. Hei tauira, 65% o te hunga kua kitea he adenocarcinomas i te wā tōmua ka ora i muri i ngā tau e rima. He iti iho tēnei reiti, arā, 4%, mō ngā mate pukupuku i te wā tōmuri. Ko te reiti oranga mō ngā tau e rima mō ngā pukupuku carcinoid i te wā tōmua he 95%, ko ngā mate pukupuku i te wā tōmuri he 42%.Pātai atu ki tō tākuta me pēhea te pānga o ngā tohu o tō matepukupuku ki tō āhua o mua.
He aha ngā pātai me pātai atu e au ki taku tākuta?
I tēnei wā, tera pea he maha ngā pātai kei roto i tō hinengaro. Kaua e mataku. Kōrero mārire ki tō tākuta. Anei ētahi pātai nui ka taea e koe te pātai:- He aha te momo pukupuku kei a au?
- Kei tehea wāhanga o taku mate pukupuku?
- He aha ngā āhuatanga e pā ana ki te tūponotanga o taku whakaoranga?
- He aha te maimoatanga e taunaki ana koe?
- He aha ngā mōrearea me ngā painga o ēnei maimoatanga?
- Kia pēhea te roa ka ora ake ahau i taku mahere maimoatanga?
- He aha ngā hua e tika ana kia tumanakohia e au i runga i taku mate pukupuku, tōku hauora whānui, me te urupare ki te maimoatanga?
Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)
Ko te mate pukupuku o te whēkau iti he mate kāore i te tino rangona, engari he mea tika kia arohia.- He tino onge tēnei, engari he mea nui kia rapu tohutohu hauora tonu atu mēnā ka puta ngā tohu.
- Kia tūpato ki ngā tohu pēnei i te mamae o te puku, te ngaronga taumaha kāore i te mārama, me ngā tūtae toto.
- Mena kei a koe ngā āhuatanga mōrearea , kōrero ki te tākuta, ā, me whakahaere ngā whakamātautau e tika ana.
- He maha ngā whakamātautau hei tautuhi i tō mate . Kaua e manukanuka, mā ngā tākuta koe e āwhina.
- He maha ngā kōwhiringa maimoatanga , kei runga i tō āhua.
- Ki te kitea wawe, he nui te tūponotanga ka ora ake.
Ko te mea nui, ki te mea he ruarua, he mataku rānei ōu mō tēnei mea, kaua e mamae ko koe anake, engari me kōrero ki tētahi tākuta pono . Mā rātou koe e ārahi me te tautoko e hiahiatia ana e koe. Kia ora tonu!
Matepukupuku o te whēkau iti, matepukupuku, pūnaha nakunaku, tohu, maimoatanga matepukupuku, whēkau, matepukupuku o te whēkau iti
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