Kodi tiyenera kuphunzira za zilonda zam'kamwa/m'mimba (mucositis) zomwe zimabwera ndi chithandizo cha khansa?

Mukalandira chithandizo cha khansa, nthawi zina mumapeza zilonda zopweteka kwambiri mkamwa ndi pakhosi panu, sichoncho? Pali nthawi zina zomwe simungathe kudya kapena kumwa, ndipo zimakhala zovuta kulankhula. Umenewo ndi vuto lomwe tikambirane lero, lotchedwa mucositis . Musadandaule, izi zimachitika kwa anthu ambiri, ndipo pali njira zothetsera vutoli. Tiyeni tiwone bwino.

Kodi matenda a Mucositis ndi chiyani? Mwachidule...

Matenda a mucositis ndi kutupa ndi kuvulala kwa mucous membrane wa m'mimba mwathu (GI tract) , kapena mucosa . Taganizirani izi ngati mucous membrane wa pakamwa pathu wonyowa, wosalala, komanso wa pinki. Umenewo ndi mucous membrane womwe umaphimba kugaya kwathu konse. Ndiwo womwe umatiteteza ku majeremusi ndi mankhwala oopsa omwe amapezeka muzakudya zathu.

Komabe, njira zina zothandizira khansa, makamaka chemotherapy , radiation therapy , kapena stem cell transplantation , monga bone morrow transplantation , zimatha kuwononga membrane wofewa uwu. Apa ndi pamene mucositis imachitika. Matendawa nthawi zambiri amawoneka mkamwa ngati oral mucositis .

Kodi matenda a mucositis amenewa amakhudza bwanji thupi lathu?

Tsopano, onani, maselo a khansa ndi mtundu wa selo lomwe limagawikana mwachangu kwambiri. Chifukwa chake, mankhwala operekedwa a khansa adapangidwa kuti awononge maselo omwe amagawikana mwachangu. Koma vuto ndilakuti, maselo omwe ali mu nembanemba yathu ya mucous ndi mtundu wa selo lomwe limagawikana ndikusinthidwa mwachangu kwambiri. Chifukwa chake, mankhwala a khansa sangasiyanitse pakati pa awiriwa. Chifukwa chake, pamodzi ndi maselo a khansa, maselo omwe ali mu nembanemba yathu yoteteza nawonso amawonongeka.

Kawirikawiri, nembanemba ya mucous iyi imatiteteza chifukwa imabwereranso msanga. Ngakhale bala laling'ono limachira msanga. Koma mu mucositis, maselo omwe ali mu nembanemba iyi amawonongeka, komanso kuthekera kwa maselo amenewo kukonzanso ndikuchiritsa mabala kumachepa. Kenako chimachitika ndi chiyani? Nembanemba iyi imayamba kuwonongeka kwambiri ndi zochita wamba monga kudya ndi kulankhula. Sikuti zokhazo, komanso chiopsezo cha matenda chimawonjezeka kwambiri.

Mu matenda a mkamwa, mkati mwa pakamwa mumakhala ofiira, owala, otupa, ndipo zilonda zimaonekera. Nthawi zina , mafinya oyera amatha kuwoneka mkamwa. Anthu ena angamve kupweteka pang'ono, koma ena angamve kupweteka kosapiririka. Madokotala agaŵa ululu uwu m'milingo. Milingo 1 ndi 2 ndi yofatsa, koma milingo 3 ndi 4 ndi ululu waukulu. Mu milandu yovuta iyi, simungathe kudya kapena kumwa, ndipo ngakhale chithandizo cha khansa chingafunike kuchepetsedwa.

Anthu ena amatha kukhala ndi matenda a m'mimba, osati mkamwa mokha, komanso m'matumbo. Izi zingayambitse zizindikiro monga kupweteka m'mimba, nseru, ndi kusanza . Ngati ili pafupi ndi m'mimba, zizindikirozi zingachitike. Ngati pali kutupa m'matumbo, mutha kutsegula m'mimba kapena kupweteka mukamayenda m'matumbo.

Ndani amene ali ndi mwayi waukulu wopeza matenda a mucositis?

Matenda a mucositis amayamba mwa anthu pafupifupi 50% omwe amalandira mankhwala a chemotherapy, ndipo pakati pa 80% ndi 100% omwe amalandira chithandizo cha radiation kapena transplantation stem cell. Izi zikutanthauza kuti ndi ofala kwambiri.

Komanso, mutha kukhala pachiwopsezo chachikulu chotenga kapena kukulitsa vutoli pazifukwa monga:

• Ngati mukusuta kapena kutafuna fodya .
• Ngati mumwa mowa mopitirira muyeso.
• Ngati thupi lasowa madzi m'thupi .
• Ngati pali kusowa kwa mapuloteni m'thupi .
• Ngati index yanu ya kulemera kwa thupi (BMI) ndi yotsika .
• Ngati muli ndi zoikamo mano kapena mukugwiritsa ntchito mano opangidwa ndi mano .
• Ngati muli ndi matenda a chiseyeye .
• Ngati muli ndi matenda a impso .
• Ngati muli ndi matenda a shuga .
• Ngati muli ndi kachilombo ka HIV .

Kodi zizindikiro za Mucositis ndi ziti?

Kutupa kukachitika, nthawi zambiri kumayambitsa kufiira, kupweteka, kutentha, ndi kutupa . Kuphatikiza apo, kumatha kuwonetsanso zizindikiro zomwe zimakhala zapadera m'dera lililonse.

Zizindikiro za mucositis ya m'kamwa:

• Mkati mwa pakamwa ndi mkamwa mumakhala ofiira, owala, komanso otupa .
• Pakamwa pouma .
• Malovu okhuthala kwambiri .
• Zilonda pakamwa .
• Madontho oyera ofewa a mafinya .
• Kuvuta kumeza, kulankhula, kudya, ndi kumwa .
• Kutuluka magazi .
• Kuphimba kwa mucous koyera pakamwa koyera .

Zizindikiro za matenda a mucosa m'mimba:

• Kufiira kwa nembanemba ya mucous (erythematous mucosa) .
• Kupweteka m'mimba .
• Kusanza ndi kusanza .
• Kutsegula m'mimba .
• Magazi kapena ntchofu m'chimbudzi chanu .
• Kuyenda m'mimba mopweteka .

Kodi zifukwa zazikulu za mucositis ndi ziti?

Madokotala akamalankhula za matenda a mucositis, nthawi zambiri amanena za kutupa kwa mkamwa ndi m'mimba komwe kumachitika chifukwa cha mankhwala a khansa. Monga tafotokozera, mankhwala amenewa amawononga maselo omwe amagawikana mofulumira, kuphatikizapo maselo omwe ali mu nembanemba zathu za mucous. Pakamwa kapena m'mimba zimatha kukhudzidwa mwanjira imeneyi ndi radiation yambiri kapena chemotherapy yomwe imaperekedwa ku thupi lonse, kapena ndi mankhwala ochepa omwe amaperekedwa kudera linalake lokha.

Nthawi zina, kutupa kwa nembanemba ya mucous kumatha kuchitika ndi matenda ena, monga matenda. Koma kenako amatchedwanso mayina ena enieni. Mwachitsanzo, kutupa mkamwa kumatchedwa stomatitis , ndipo kutupa mkamwa chifukwa cha matenda kumatchedwa gingivostomatitis .

Kodi mavuto omwe angakhalepo chifukwa cha Mucositis ndi ati?

Ichi ndi chinthu choyenera kusamala nacho pang'ono.

• Kusadya mokwanira: Kupweteka pakamwa, pakhosi, m'mero, kapena m'mimba kungapangitse kuti zikhale zovuta kudya kapena kumwa. Izi zitha kukhala zovuta kwambiri kwa anthu omwe ali ndi khansa, omwe ali kale ndi vuto la njala komanso kuchepa thupi. Ndikofunikira kuwapatsa zakudya zabwino. Pafupifupi 70% ya anthu angafunike kugonekedwa m'chipatala kuti akadyetsedwe ndi machubu.
• Kutsegula m'mimba kosatha: Ngati mukutsegula m'mimba kosatha, kapena ngati muli ndi magazi m'chimbudzi chanu, mungafunike kupita kuchipatala ndikuyang'aniridwa kuti mupewe kutaya madzi m'thupi kapena kuchepa kwa magazi m'thupi.
• Matenda: Pamene nembanemba ya mucous yawonongeka, chimodzi mwa zinthu zofunika kwambiri zoteteza thupi lathu chimatayika. Anthu omwe ali ndi khansa amakhala ndi maselo oyera ochepa m'magazi, zomwe zikutanthauza kuti chitetezo chawo cha mthupi chimafookanso. Mabala akayamba chifukwa cha mucositis, majeremusi amatha kulowa m'magazi. Anthu omwe ali ndi mucositis, omwe akulandira mankhwala a chemotherapy, komanso omwe ali ndi maselo oyera ochepa m'magazi (neutropenia) ali pachiwopsezo chachikulu chotenga matenda oopsa m'magazi (septicemia).
• Kuchepetsa chithandizo cha khansa: Pankhani ya matenda aakulu a mucositis, odwala ena a khansa ayenera kuchedwetsa kapena kuchepetsa chithandizo chawo. Ichi ndi chiopsezo china pa thanzi lawo. Akuti odwala oposa 30% amasiya kulandira chithandizo chifukwa cha vutoli.

Kodi matenda a Mucositis amachiritsidwa bwanji?

Matenda a mucositis ndi zotsatira zoyipa zomwe zimachitika chifukwa cha chithandizo cha khansa . Angathe kuzindikirika mosavuta poyang'ana zizindikiro zanu, mbiri yanu yachipatala, ndi madera omwe kutupa kumachitika. Ngati muli ndi matenda a mucositis m'mimba, yang'anani mayeso ojambulira.Muyenera kutenga imodzi. Komanso, dokotala wanu angafune kuwona ngati muli ndi matenda aliwonse a bakiteriya kapena bowa. Izi zitha kuchitika poyesa magazi mosavuta.

Kodi mankhwala a Mucositis ndi ati?

Matenda a mucositis nthawi zambiri amatha okha chithandizo chanu cha khansa chitatha. Ngati mukulandira chithandizo cha chemotherapy, mucositis idzaonekera mkati mwa sabata imodzi kapena ziwiri mutayamba kulandira chithandizo ndipo idzatha mkati mwa sabata imodzi kapena zisanu ndi chimodzi. Ngati mukulandira chithandizo cha radiation, mucositis idzaonekera mkati mwa milungu iwiri kapena itatu mutayamba kulandira chithandizo ndipo idzatha mkati mwa milungu iwiri kapena inayi mutamaliza kulandira chithandizo. Nthawi yomwe imatenga kuti mupeze bwino imatha kusiyana kutengera momwe ilili yoopsa komanso momwe mumasamalira bwino kuti isakule kwambiri. Pamene mukuchira, muyenera izi:

Kusamalira ululu

Ululu ndi vuto lalikulu kwambiri la mucositis, makamaka likachitika mkamwa. Mankhwala ophera ululu sangakhale nthawi yayitali kapena sangafike m'malo onse. Mungafunike kugwiritsa ntchito njira zosiyanasiyana kuti muchepetse ululu wanu. Mungafunike mankhwala otsukira pakamwa, mankhwala ochepetsa ululu omwe amaperekedwa ndi dokotala, komanso mankhwala oletsa ululu omwe amaperekedwa ndi dokotala. Musalole ululuwo. Muyenera kudya ndi kumwa bwino kuti mupeze bwino. Lankhulani ndi dokotala wanu za momwe mungachepetse ululu mukalandira chithandizo cha khansa.

Mankhwala ena ochepetsa ululu wa mucositis:

• Mankhwala oletsa ululu pakhungu: Izi zikuphatikizapo zinthu monga `lidocaine`, `benzocaine`, `dyclonine hydrochloride (HCl)` ndi `Ulcerease® (0.6% phenol)`.
• "Magic mouthwash": Ichi ndi chisakanizo cha `lidocaine`, `diphenhydramine`, ndi `Maalox®`.
• Mankhwala oletsa kutupa: Mwachitsanzo, prednisone.
• "GI cocktail": Ichi ndi chisakanizo cha `Maalox®`, `Nystatin®` ndi `Hurricane Liquid®`.
• Acetaminophen: Yofanana ndi `Tylenol®`.
• Mankhwala oletsa ululu omwe amaperekedwa ndi dokotala: Izi ziyenera kumwedwa ndi mankhwala ofewetsa ndowe kuti mupewe kudzimbidwa.

Kusamalira pakamwa

Mukakhala ndi matenda a mucositis mkamwa, muyenera kusamala kwambiri pakamwa panu. Izi sizingochepetsa ululu, komanso zimateteza ku kuwonongeka kwina ndi matenda ena. Ngakhale zinthu zosavuta monga kudya, kulankhula, ndi kumeza zimatha kuwononga ma mucous nembanemba anu ofooka. Izi zikutanthauza kusankha zakudya zofewa ndi zinthu zomwe zingasunge pakamwa panu ndi pakhosi panu kukhala ndi chinyezi komanso chitetezo. Popeza ma mucous nembanemba anu ofooka amakhala osavuta kutenga matenda, ukhondo nawonso ndi wofunikira kwambiri .

Chithandizo cha mucositis ya m'kamwa:

• Pakani mano anu kwambiri - koma pang'onopang'ono: Osachepera katatu kapena kanayi patsiku. Gwiritsani ntchito burashi ya mano yofewa komanso mankhwala otsukira mano okhala ndi fluoride. Pewani mankhwala oyeretsa mano. Ngati mano otsukira mano akukwiyitsani pakamwa panu, gwiritsani ntchito phala la mchere ndi soda. Sakanizani pang'onopang'ono . Tsukani mano otsukira mano tsiku lililonse.
• Kutsuka pakamwa: Tsukani pakamwa panu ndi madzi amchere kapena madzi amchere ndi soda kasanu kapena kasanu ndi kamodzi patsiku. Iyi ndiyo njira yofatsa komanso yothandiza kwambiri yotsukira zilonda pakamwa ndikupha majeremusi. Muthanso kugwiritsa ntchito mankhwala otsukira pakamwa opanda mowa.
• Zakudya: Zakudya zanu ziyenera kukhala zopanda mafuta ambiri komanso zosapsa kwambiri . Pewani zakudya zokhala ndi asidi, zokometsera komanso zophwanyika. Pewani shuga ndi mowa. Izi zitha kuwononga nembanemba ndikulimbikitsa kukula kwa mabakiteriya ndi bowa. Ma protein shakes ndi lingaliro labwino lowonjezera zakudya komanso madzi.
• Kuthira madzi m'thupi: Mungafunike kumwa madzi ambiri kuti muchepetse kuuma kwa pakamwa panu komanso kuchepa kwa chinyezi m'mimba mwanu. Mungafune kuyesa mankhwala opangira malovu okhala ndi ma enzyme monga Oral Balance®. Anthu ena amaona kuti kuyamwa ayezi kumathandizira kunyowetsa komanso kutonthoza pakamwa pawo. Mungafunenso kuteteza milomo yanu popaka mafuta odzola pamilomo.

Kuchiza mavuto

Ngati mwataya madzi ambiri m'thupi, mulibe zakudya zokwanira, kapena muli ndi kachilomboka, mungafunike:

• Zakudya zopatsa thanzi
• Kupereka mankhwala a saline (IV fluids)
• Mankhwala opha tizilombo

Kodi ndiyenera kudya ndi kumwa chiyani mpaka mucositis itatha?

Zakudya zabwino:

• Zakudya zokhala ndi mapuloteni ambiri
• Zakudya zopatsa thanzi
• Zakudya zofewa
• Ma popsicles opanda shuga

Zinthu zomwe siziyenera kudyedwa:

• Zakudya zokometsera
• Zakudya zokhala ndi asidi
• Zakudya zokazinga kapena mafuta
• Zakudya zokhala ndi shuga wambiri

Zakudya zabwino:

• Tiyi wa Chamomile
• Madzi ambiri

Zinthu zomwe sizili bwino kumwa:

• Zakumwa zokhala ndi kaboni
• Mowa

Kodi matenda a Mucositis angapewedwe?

Pakadali pano palibe zambiri zomwe tingachite kuti tipewe matenda a mucositis ku chithandizo cha khansa, koma madokotala akufufuza izi. Mankhwala angapo akuyesedwa pano omwe angathandize kuchepetsa kuopsa ndi nthawi ya matendawa mwa anthu ena. Ena mwa iwo ndi awa:

• Cryotherapy: Kuyamwa madzi oundana musanayambe komanso panthawi ya chithandizo cha chemotherapy kungathandize kuteteza ku mucositis ya m'kamwa.
• Palifermin: Iyi ndi njira yopangidwa ndi chinthu chopangidwa ndi matupi athu chotchedwa keratinocyte growth factor (KGF). KGF imagwira ntchito yoteteza ndikukonzanso maselo mkamwa ndi m'mimba. Zawonetsedwa kuti zimathandiza kuchepetsa kuopsa ndi nthawi ya mucositis mwa anthu omwe ali ndi khansa ya m'magazi komanso omwe adasinthidwa mafupa kapena maselo oyambira.
• Mankhwala ophera tizilombo: Gelclair® ndi Zilactin® zawonetsedwa kuti zimachepetsa kutupa kwa mucosa mkamwa mwa kuphimba ndi kuteteza mucosa musanalandire chithandizo cha radiation.
• Amifostine: Mankhwalawa amatha kuchepetsa kuopsa kwa mucositis ya m'kamwa mwa anthu omwe akulandira chithandizo cha radiation kumutu ndi pakhosi. Komabe, nseru ikhoza kukhala zotsatirapo zina.

Ngati ndili ndi vutoli, ndiyenera kuyembekezera chiyani?

Izi nthawi zambiri zimatha zokha mukamaliza chithandizo cha khansa, koma zingatenge milungu iwiri kapena isanu ndi umodzi. Mungafunike kumwa mankhwala ochepetsa ululu omwe dokotala wanu wakupatsani kuti akuthandizeni kuthana ndi vutoli panthawiyi. Kusamalira pakamwa panu kwambiri ndikusunga paukhondo kuti mupewe matenda kungathandize kuti muchire mwachangu. Ngati mukuyamba matenda kapena mukuvutika kudya kapena kumwa, onetsetsani kuti mwapeza upangiri wa dokotala.

Ndiyenera kupita kwa dokotala liti?

Ngati muwona zizindikiro izi, funsani upangiri wa dokotala nthawi yomweyo:

• Pamene zizindikiro zoyamba za mucositis zikuwonekera.
• Ngati muli ndi zizindikiro za matenda, monga malungo .
• Ngati mukuvutika kudya ndi kumwa .
• Ngati muchepetsa thupi .
• Ngati muli ndi kutsegula m'mimba kosalekeza .
• Ngati mumatuluka magazi pafupipafupi pakamwa panu kapena ndi ndowe zanu.

Matenda a mucositis ndi amodzi mwa zotsatira zoyipa komanso zovuta kwambiri za chithandizo cha khansa. Kuopsa kwake kumadalira zinthu zambiri, kuphatikizapo thanzi lanu lonse, mtundu wa chithandizo chomwe mumalandira, komanso momwe mumasamalirira bwino mutatha kulandira chithandizo.

Pomaliza, kumbukirani izi (Uthenga Wopita Nawo Kunyumba)

Matenda a Mucositis ndi akanthawi kochepa, koma sikuyenera kukhala vuto lalikulu, ndipo pali thandizo lomwe likupezeka. Masabata angapo oyamba mutalandira chithandizo cha khansa ndi ofunikira kwambiri kuti muchiritse. Pali chiopsezo chenicheni cha kusowa zakudya m'thupi kapena matenda panthawiyi. Kudzisamalira nokha komanso chisamaliro chamankhwala ndizofunikira kwambiri mukakhala ndi matenda a mucositis. Musaope kulankhula ndi dokotala wanu kuti mupeze thandizo lomwe mukufuna. Simuli nokha!

Mucositis , chithandizo cha khansa, zilonda pakamwa, kutupa m'mimba, zotsatira zoyipa za chemotherapy, zotsatira zoyipa za chithandizo cha radiation, chisamaliro cha pakamwa