Tikudziwa momwe zimakhalira zovuta kulimbana ndi khansa. Mankhwala omwe mumalandira, monga chemotherapy ndi radiation, nthawi zina angayambitse mavuto ena azaumoyo. Kodi mudaganizapo kuti mankhwala a khansa angakhudze mtima wanu? Ndicho chimene madokotala amati Cardiotoxicity . Musachite mantha mukamva dzinali. Izi sizinthu zomwe zimachitikira aliyense. Koma ndikofunikira kwambiri kudziwa izi. Chifukwa chake lero tikambirana izi mosavuta, m'njira yomwe mungamvetse.
Mwachidule, kodi Cardiotoxicity ndi chiyani?
Kuopsa kwa mtima ndi kuwonongeka komwe kumachitika mumtima mwathu chifukwa cha mankhwala ena a khansa kapena mankhwala ena. Taganizirani za mankhwala omwe amapha maselo a khansa ngati msilikali wamphamvu kwambiri. Msilikali uyu akamamenyana ndi maselo a khansa, nthawi zina maselo athanzi omwe ali pafupi nawo amathanso kuwonongeka pang'ono. Ndicho chimene kuopsa kwa mtima kuli.
Chinthu chachikulu chomwe chingachitike ndichakuti mtima umavutika kupopa magazi m'thupi lonse. Minofu ya mtima imatha kufooka. Nthawi zina, izi zimatha kubweretsa matenda otchedwa Cardiomyopathy . Izi zikutanthauza kuti mphamvu ya minofu ya mtima kupopa magazi imachepa kwambiri.
Chinthu chimodzi chapadera pa vutoli ndichakuti nthawi zina limatha kuchitika patatha zaka zambiri chithandizo cha khansa chitatha. Chiwopsezochi chimakhala chachikulu makamaka kwa akuluakulu omwe adalandira chithandizo cha khansa ali ana.
Ndani amene ali pachiwopsezo chachikulu?
Ngakhale kuti aliyense amene walandira chithandizo cha khansa ali ndi mwayi wopeza vutoli, si aliyense amene ali nalo. Komabe, anthu ena ali pachiwopsezo chachikulu.
- Anthu omwe akumwa mankhwala ena: Mankhwala ena a chemotherapy ndi mankhwala ena amatha kukhudza mtima. Tikambirana za izi posachedwa.
- Anthu omwe adalandira chithandizo cha radiation kudera la pachifuwa: Ngati chithandizo cha radiation chaperekedwa chifukwa cha khansa ya pachifuwa, mwachitsanzo, khansa ya m'mawere, radiation ingakhudzenso mtima pang'ono.
- Anthu omwe adalandira chithandizo cha khansa ali aang'ono: Chiwopsezochi ndi chachikulu pang'ono kwa akuluakulu omwe adalandira chithandizo ali aang'ono.
Kafukufuku wina akusonyeza kuti mpaka 20% ya akuluakulu omwe akulandira chithandizo cha khansa angakumane ndi matenda a mtima, ndipo pakati pa 7% ndi 10% mwa awa akhoza kukhala ndi matenda a mtima kapena kulephera kwa mtima.
Kodi zotsatirapo za matenda a mtima ndi ziti pa mtima?
Matendawa angayambitse mavuto osiyanasiyana a mtima. Sizinthu zonsezi zomwe zimachitika kwa aliyense, koma ndikofunikira kudziwa zomwe zimayambitsa. Onani tebulo ili m'munsimu.
| Matenda a mtima omwe angakhalepo | Mwachidule... |
|---|---|
| Matenda a mtima | Minofu ya mtima imafooka ndipo singathe kupopa magazi bwino. |
| Matenda a Mtima / Kutsekeka kwa Mtima | Kutsekeka kwa mtsempha womwe umapatsa magazi kumtima. |
| Kulephera kwa Mtima | Mtima ndi wofooka ndipo sungathe kupopa magazi kuti ukwaniritse zosowa za thupi. |
| Kugunda kwa mtima kosakhazikika (Arrhythmia) | Kugunda kwa mtima mofulumira kwambiri, kugunda mopitirira muyeso, kapena kosasinthasintha. |
| Matenda a Mtima | Ma valve omwe amagwira ntchito ngati zipata mkati mwa mtima sagwira ntchito bwino. |
| Kuthamanga kwa Magazi Kwambiri/Kotsika | Kuthamanga kwa magazi anu kumakhala kokwera kwambiri kapena kotsika kwambiri. |
| Madzi ozungulira mtima | Kuchulukana kwa madzi mu nembanemba yopyapyala yomwe imaphimba mtima, zomwe zimapangitsa kuti mtima ukhale wopanikizika. |
Kodi ndi zizindikiro ziti zomwe mungakumane nazo?
Zizindikiro za mtima zokhudzana ndi poizoni wa mtima zimatha kuonekera mwadzidzidzi kapena kukula pang'onopang'ono. Ngati mukulandira kapena mwangomaliza kumene chithandizo cha khansa, ndikofunikira kudziwa zizindikiro izi.
Kumbukirani kuti zizindikiro izi zingayambitsidwe ndi zinthu zina, koma ngati muli ndi chimodzi kapena zingapo mwa izi, lankhulani ndi dokotala wanu.
| Chizindikiro | Mungamve motere. |
|---|---|
| Kuvuta kupuma (Dyspnea) | Ndimamva kupuma movutikira komanso kupuma pang'ono ndikayenda pang'ono, kukwera masitepe, kapena kungoyima. |
| Kupweteka pachifuwa kapena kusasangalala | Zikumveka ngati chifuwa chanu chikufinyidwa, chikufinyidwa, kapena chikungomva kupweteka. |
| Kutupa kwa miyendo (Edema) | Malo monga miyendo, akakolo, ndi mapazi amatupa ndi kupweteka akamakanikiza ndi chala. |
| Kugunda kwa mtima | Mukumva ngati mtima wanu ukugunda mofulumira, kapena ngati ukudumphadumpha. |
| Chizungulire ndi kukomoka | Kuzungulira ndi kuzungulira . Kuzungulira ndi kuzungulira . |
| Kutupa kwa Mimba | Malo am'mimba amaoneka otupa komanso okulirakulira chifukwa cha madzimadzi omwe amasonkhana m'thupi. |
Kodi zifukwa zazikulu zomwe zimayambitsa matenda a mtima ndi ziti?
Ngakhale kuti pali mitundu yambirimbiri ya mankhwala a khansa, mitundu ikuluikulu yochepa imathandiza kwambiri pa vutoli.
1. Mankhwala ena a chemotherapy
Mankhwala otchedwa anthracyclines ndi gulu la mankhwala a chemotherapy omwe amadziwika bwino ndi izi. Chitsanzo ndi Doxorubicin (Adriamycin®) . Mankhwalawa nthawi zambiri amagwiritsidwa ntchito pochiza khansa monga khansa ya m'magazi, khansa ya m'mawere, khansa ya m'mawere, ndi myeloma yambiri.
2. Mankhwala Ochiritsira Omwe Amagwiritsidwa Ntchito
Trastuzumab (Herceptin®) ndi chitsanzo cha mankhwala otere. Amagwiritsidwa ntchito pochiza khansa ya m'mawere ndi khansa ya m'mimba. Pali chiopsezo chowonjezeka cha matenda a mtima, makamaka ngati mankhwalawa aperekedwa pamodzi ndi anthracycline.
3. Chithandizo cha radiation pachifuwa
Pamene kuwala kwa dzuwa kuperekedwa pachifuwa chifukwa cha khansa, monga khansa ya m'mawere kapena Hodgkin's Lymphoma, kuwalako kumatha kuyenda mumtima. Pakapita nthawi, izi zitha kuwononga mitsempha yamagazi ndi minofu ya mtima.
Kodi madokotala amazindikira bwanji vutoli?
Ngati muli ndi zizindikiro zomwe zatchulidwa pamwambapa, kapena ngati muli m'gulu la anthu omwe ali pachiwopsezo chachikulu, dokotala wanu mwina angakupatseni mayeso a mtima. Mayeso akulu ndikuwunika momwe mtima umapopera. Izi zimachitika pogwiritsa ntchito muyeso wotchedwa Left Ventricular Ejection Fraction (LVEF) . Mwachidule, iyi ndi kuchuluka kwa magazi omwe mtima umapopera m'thupi nthawi iliyonse ukagunda.
Pansipa pali mayeso ena omwe amagwiritsidwa ntchito poyesa zinthu izi.
| Mayeso | Mumachita chiyani ndi izi? |
|---|---|
| Echocardiogram (Echo) | Iyi ndiyo njira yomwe imagwiritsidwa ntchito kwambiri. Mafunde a ultrasound (monga ma scan omwe timapeza kuti tiwone ana) amagwiritsidwa ntchito poona kugunda kwa mtima, kukula kwake, mawonekedwe ake, ndi momwe umapopera magazi. |
| MRI ya mtima | Kugwiritsa ntchito maginito ndi mafunde a wailesiImatenga zithunzi zomveka bwino komanso zatsatanetsatane za mtima. Iyi imaonedwa kuti ndiyo njira yabwino kwambiri yodziwira poizoni wa mtima. |
| Mayeso a Kupsinjika kwa Mtima | Amayesa momwe mtima wanu umayankhira kuchita masewera olimbitsa thupi pokuyendetsani pa treadmill kapena kukwera njinga. |
| Kujambula kwa Multigated Acquisition (MUGA) | Kuchuluka kwa LVEF kumayesedwa poika mankhwala ochepa a radioactive omwe alibe vuto lililonse m'thupi ndikugwiritsa ntchito kamera kuti muwone akuyenda mumtima ndi magazi. |
| Kujambula kwa Mtima kwa CT | Chithunzi cha mtima cha 3D chimapangidwa pogwiritsa ntchito ma X-ray angapo. Izi zitha kukhala zothandiza kwambiri kwa anthu omwe adalandira chithandizo cha radiation. |
Kodi vutoli limachiritsidwa bwanji?
Njira yochiritsira imadalira kuchuluka kwa kuwonongeka kwa mtima wanu ndi chomwe chimayambitsa.
- Kusintha mankhwala: Ngati zatsimikizika kuti chithandizo cha khansa chomwe mukugwiritsa ntchito chikukhudza mtima wanu, dokotala wanu angasankhe kusiya kumwa mankhwalawo, kuchepetsa mlingo, kapena kukusinthani ndi mankhwala ena.
- Mankhwala a mtima: Dokotala wanu angakulembereni mankhwala atsopano kuti athandize kusintha ntchito ya mtima ndikuwongolera zizindikiro. Mwachitsanzo:
- ACE Inhibitors: Izi zimakulitsa mitsempha yamagazi ndikuwonjezera kuyenda kwa magazi.
- Beta-blockers: Izi zimalamulira kugunda kwa mtima ndikuchepetsa kuthamanga kwa magazi pamtima.
- Mankhwala ochepetsa kutupa: Amathandiza kuchotsa madzi ochulukirapo m'thupi kudzera mu mkodzo, zomwe zimachepetsa kutupa.
- Digoxin: Imachepetsa kugunda kwa mtima ndipo imapangitsa mtima kupompa magazi bwino.
Kodi vutoli lingachiritsidwe kwathunthu?
Funso limene anthu ambiri amakhala nalo ndi ili, "Nthawi zina mungathe, nthawi zina simungathe."
- Kuopsa kwa mtima komwe kumachitika chifukwa cha mankhwala monga Trastuzumab (Herceptin®) nthawi zambiri kumatheka . Izi zikutanthauza kuti ntchito ya mtima ikhoza kubwerera mwakale chithandizo chikatha kapena mankhwala ena akayamba kugwiritsidwa ntchito.
- Anthracyclines kapena Chithandizo cha RadiationKuwonongeka komwe kumachitika nthawi zambiri sikungasinthe . Pazochitika zotere, mungafunike kumwa mankhwala othandizira mtima ndikusintha moyo wanu wonse.
Kodi chingachitike n’chiyani kuti tichepetse chiopsezochi?
Kunena zoona, palibe njira yodzitetezera 100% ku matenda a mtima. Chifukwa chithandizo chimenecho n'chofunikira kwambiri pochiza khansa. Koma chofunika kwambiri chomwe mungachite ndikuzindikira vutoli mwachangu momwe mungathere.
- Lankhulani ndi dokotala wanu: Musanayambe kulandira chithandizo cha khansa, kambiranani momasuka ndi dokotala wanu za ubwino wa chithandizocho, komanso zotsatira zake, monga zotsatira zake pa mtima.
- Kuyezetsa mtima nthawi zonse: Mukakhala ndi chithandizo cha khansa komanso mukatha kulandira chithandizo, fufuzani mtima wanu nthawi zonse (monga echo scan) monga momwe dokotala wanu wanenera. Izi zithandiza kuzindikira mavuto aliwonse msanga ndikuyamba kulandira chithandizo.
Nthawi yoti mupemphe upangiri wa dokotala nthawi yomweyo!
Ngati mukulandira kapena mwalandira chithandizo cha khansa, ndipo mukukumana ndi zizindikiro zoopsa zotsatirazi, pitani ku Dipatimenti Yothandiza Pangozi (ETU) yapafupi nthawi yomweyo.
- Kugunda kwa mtima kosalekeza kapena kowonjezeka.
- Chizungulire, kusawona bwino, kapena kukomoka.
- Kupweteka pachifuwa kapena kupuma movutikira kumawonjezeka mwadzidzidzi.
- Kutupa kwa milomo kapena pakhosi.
- Kutupa kosazolowereka kwa miyendo kapena mapazi.
- Kulemera kumawonjezeka ndi makilogalamu oposa 1.5 (mapaundi atatu) mkati mwa sabata imodzi.
Zizindikiro zimenezi zingakhale chizindikiro cha matenda aakulu a mtima, choncho musazengereze.
Uthenga Wopita Nawo Kunyumba
- Kuopsa kwa mtima ndi kuwonongeka kwa mtima komwe kumachitika chifukwa cha mankhwala a khansa. Izi sizichitika kwa aliyense, koma pali chiopsezo.
- Nthawi zonse dziwani zizindikiro monga kupuma movutikira, kupweteka pachifuwa, ndi kutupa kwa miyendo.
- Musanayambe chithandizo cha khansa, kambiranani ndi dokotala wanu za ubwino ndi kuipa kwake komanso zotsatira zake pa mtima wanu.
- Ndikofunikira kwambiri kuyezetsa mtima nthawi zonse (monga kubwerezabwereza) monga momwe dokotala wanu akulangizira, panthawi ya chithandizo komanso pambuyo pake.
- Vuto likadziwika msanga, m'pamenenso limakhala ndi mwayi waukulu woti lichiritsidwe bwino. Musachite mantha, dziwani, ndipo gwirani ntchito limodzi ndi dokotala wanu.
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