Kodi munalandira chithandizo cha radiation cha khansa ya mutu ndi khosi? Kodi imakhudza mafupa anu? Tiyeni tiphunzire za (Osteoradionecrosis - ORN)!

Kodi munayamba mwamvapo ululu, kutupa, kapena zilonda mkamwa mwanu kapena m'nsagwada mutalandira chithandizo cha radiation cha khansa ya mutu kapena khosi? Mwina nthawi yakwana yoti mudziwe za matenda otchedwa osteoradionecrosis. Musadandaule, tidzakambirana mwatsatanetsatane komanso m'njira yosavuta.

Kodi Osteoradionecrosis (ORN) ndi chiyani?

Mwachidule, osteoradionecrosis (ORN) ndi imfa ya maselo a mafupa chifukwa cha kuwala kwa dzuwa. Ndi vuto lomwe limatha kuchitika ngati zotsatirapo za chithandizo cha radiation cha khansa, makamaka khansa ya mutu ndi khosi. Kumbukirani, kuwala komwe kumagwiritsidwa ntchito kupha maselo a khansa nthawi zina kumatha kuwononganso maselo a mafupa athanzi. Kungachitike miyezi ingapo kapena zaka mutalandira chithandizo cha radiation.

Matendawa nthawi zambiri amakhudza fupa la nsagwada ya m'munsi (mandibular osteoradionecrosis). Komabe, amatha kuchitika m'fupa lililonse lomwe lakhudzidwa ndi kuwala kwa dzuwa, monga fupa la nsagwada ya pamwamba (maxillary osteoradionecrosis) kapena mbali yakutsogolo ya msana (vertebral osteoradionecrosis). Kawirikawiri, vutoli lingakhudzenso chigaza, koma lingakhale lalikulu pang'ono.

Chithandizo cha radiation ndi thanzi la mafupa - chifukwa chiyani izi zimachitika?

Tsopano, tiyeni tiwone chifukwa chake izi zimachitika. Kuwala kwa dzuwa kumawononga mitsempha yofewa yamagazi yomwe imapereka magazi ku mafupa. Monga mbali ina iliyonse ya thupi lathu, mafupa amafunikira magazi abwino kuti akhale athanzi komanso kuti achire mwachangu ngati awonongeka.

Tangoganizani, monga momwe mtengo umafota popanda madzi, ngati fupa sililandira magazi okwanira, nalonso lidzataya moyo wake ndikuyamba kufa.

Kodi chimachitika n’chiyani magazi akasokonekera?

• Mafupa ndi minofu yozungulira zimakhala zosavuta kutenga matenda.
• N'zosatheka kuchira bwino.
• Ikuyamba kufa pang'onopang'ono.

Nsagwada zathu zimakhala pachiwopsezo chachikulu cha izi. Izi zili choncho chifukwa zimakhala zovuta kuletsa kuwala kwa dzuwa kufika pa fupa la nsagwada panthawi yolandira chithandizo cha khansa ya mutu ndi khosi. Komanso, chiopsezo cha `(ORN)` ichi chimawonjezeka chifukwa cha mabakiteriya omwe amakhala mkamwa mwathu mwachibadwa.

Kuwonongeka kwa radiation mkamwa kungayambitse zinthu monga:

• Kupezeka kwa mafupa (kutanthauza kuti mafupa amaonekera kudzera m'kamwa).
• Kupweteka ndi kutupa kwa nsagwada nthawi zina.
• Kukhala ndi bala losachiritsa .

Kodi vutoli ndi lofala bwanji?

Malinga ndi bungwe la American Head & Neck Cancer Society, osteoradionecrosis imatha kuchitika pakati pa 4% ndi 8% ya anthu omwe ali ndi khansa ya mutu ndi khosi.

Kodi zizindikiro za osteoradionecrosis (ORN) ndi ziti?

Tsopano tiyeni tiwone zizindikiro zomwe mungakumane nazo pankhaniyi. Ngati muli ndi chimodzi kapena zingapo mwa izi, ndi bwino kufunsa upangiri kwa dokotala.

• Chilonda kapena chilonda chakunja kwa mkamwa, khosi, kapena nsagwada.
• Ululu.
• Kutupa.
• Matenda (monga mafinya).
• Mano osagwirizana bwino (malocclusion).
• Kumva kunjenjemera kapena kunjenjemera .
• Zidutswa za mafupa zomwe zimatuluka mkati mwa pakamwa.
• Nthawi zina, pansi pa chibwano, khungu limasweka ndipo fupa limatuluka (izi zimatchedwanso "fistula").
• Kusweka kwa fupa la nsagwada.
• Kulimba kwa minofu ya nsagwada komwe kumalepheretsa pakamwa kutsegula bwino (trismus).

Chifukwa chiyani osteoradionecrosis (ORN) imachitika?

Choyambitsa chachikulu ndi chithandizo cha radiation kumutu ndi pakhosi. Vutoli limapezeka kwambiri kwa anthu omwe adalandira mlingo wa radiation woposa mayunitsi 60 a Imvi (Gy). (Gy ndi gawo loyezera radiation).

Zinthu Zoopsa za Osteoradionecrosis `(ORN)` - Ndani ali ndi mwayi waukulu woti adwale matendawa?

Anthu ena ali pachiwopsezo chachikulu chotenga matendawa kuposa ena. Onani ngati izi zikukukhudzani:

• Kusasamalira bwino mano (kusatsuka mano anu bwino, kusasamalira bwino ukhondo wa mano anu).
• Ngati mavuto a mano (monga mabowo ndi matenda a chingamu) sanathetsedwe bwino chithandizo cha radiation chisanayambe.
• Ngati mukumva kuuma pakamwa (xerostomia) mutatha kulandira chithandizo cha radiation.
• Ngati pali ngozi kapena kuvulala kwa nsagwada pambuyo pa chithandizo cha radiation, makamaka mkati mwa chaka choyamba.
• Ngati dzino lachotsedwa pamalo omwe adayatsidwapo kale.

Kumbukirani, vuto la osteoradionecrosis lingachitike ngakhale patatha zaka zambiri mutalandira chithandizo cha radiation cha khansa ya mutu ndi khosi.

Kodi izi zimazindikirika bwanji?

Osteoradionecrosis (ORN) nthawi zambiri imachitika patatha zaka zingapo kuchokera pamene mwalandira chithandizo cha radiation. Ngati dokotala wanu akukayikira izi, adzakuyang'anirani bwino mutu ndi khosi lanu. Adzalankhulanso ndi katswiri wa khansa ya radiation yemwe anakupatsani chithandizo cha radiation kuti adziwe mlingo wonse wa radiation yomwe munalandira.

Ndi mayeso ati omwe amathandiza kupeza matenda?

Kuti atsimikizire matendawa, dokotala wanu angakulangizeni mayeso monga:

• Ma X-ray a mano.
• Kujambula nsagwada pogwiritsa ntchito CT scan (CT - computed tomography scan).
• Kuyezetsa khansa kungachitike kuti muwone ngati khansayo yabwereranso.

Kodi mankhwala ochizira izi ndi otani?

Chithandizo cha osteoradionecrosis (ORN) chimadalira kukula ndi kuopsa kwa vuto lanu. Chofunika kwambiri ndikuyamba chithandizo mwamsanga momwe mungathere.Mukayamba chithandizo msanga, mwayi wanu wochira umakhala wabwino. Pali njira zonse ziwiri zochizira opaleshoni ndi zina zomwe sizimachizira opaleshoni.

Kasamalidwe ka opaleshoni

Pali maopaleshoni angapo omwe amachitidwa pa vutoli:

• Kuchotsa mafupa ovulala pa opaleshoni: Izi zimachitika pamene dokotala wa opaleshoni amachotsa mafupa ndi minofu yakufa kapena yodwala, monga momwe zimakhalira poyeretsa malo oipa.
• Opaleshoni yokonzanso chibwano cha fupa la fupa la pulasitiki: Iyi ndi opaleshoni yovuta pang'ono. Imafuna kutenga mitsempha yamagazi, minofu, komanso fupa kuchokera mbali ina ya thupi lanu (monga mwendo kapena mkono) ndikuyiyika m'dera lowonongeka la nsagwada.
• ALTFL (Anterolateral Thigh Fascia Lata Rescue Flap): Iyi ndi mtundu wa free flap. Mu njirayi, chidutswa cha minofu yolumikizirana (fascia) chimatengedwa kumbuyo kwa ntchafu ndikuchiyikanso. Minofu iyi imakhala ndi mitsempha yambiri, zomwe zimathandiza kuti malo owonongekawo alandire mpweya ndi michere. Kafukufuku waposachedwapa wasonyeza kuti njira iyi ndi yothandiza kwambiri kwa anthu omwe ali ndi ORN.
• Kulumikiza mafupa kwathunthu: Njira yachikhalidwe yochitira opaleshoniyi imagwiritsidwa ntchito pamene pali mafupa ambiri akufa, makamaka m'nsagwada yapansi. Mu njira iyi, fupa lowonongeka limachotsedwa kwathunthu ndipo chotupa chokhala ndi fupa chimalumikizidwa m'malo mwake. Ngakhale kuti njira iyi ndi yopambana, ndi opaleshoni yayikulu. Imatha kubweretsa nthawi yayitali kuchipatala komanso nthawi yayitali yochira. Chifukwa chake, madokotala amayesetsa kuzindikira ndikuchiza vutoli mwachangu momwe angathere.

Kusamalira popanda opaleshoni

Palinso mankhwala osagwiritsa ntchito opaleshoni:

• Mankhwala Opha Utoto: Ngati pali matenda m'fupa kapena minofu yozungulira, dokotala wanu adzakupatsani mankhwala opha utoto.
• PENTOCLO: Iyi ndi mankhwala osakaniza angapo: pentoxifylline, tocopherol (vitamini E), ndi clodronate. Pentoxifylline imagwira ntchito powonjezera kuyenda kwa magazi kupita ku fupa lowonongeka. Tocopherol (vitamini E) imathandiza kulimbitsa chitetezo cha mthupi ndikuletsa magazi kuundana. Clodronate imathandiza kupewa kutayika kwa mafupa ena. Nthawi zina pentoxifylline ndi tocopherol zimaperekedwa popanda clodronate (izi zimatchedwa PENTO).
• Chithandizo cha okosijeni ya hyperbaric (Oksijeni ya hyperbaric - HBO - chithandizo):Madokotala ena amagwiritsa ntchito mankhwalawa kuti athandize thupi kuchira msanga. Mu izi, mumayikidwa m'chipinda chapadera ndipo mumapangidwa kuti mupume mpweya wabwino. Mpweya wa okosijeni mkati mwa chipindacho ndi wokwera katatu kuposa momwe ulili nthawi zonse. Cholinga chachikulu ndikuwonjezera mpweya wokwanira m'magazi kuti akonze minofu yowonongeka. Komabe, pali malingaliro osiyanasiyana pakati pa azachipatala pankhani ya chithandizo cha "Hyperbaric oxygen" ichi. Ngakhale chimagwiritsidwa ntchito ngati chithandizo chokhazikika m'malo ena, palibe maphunziro olamulidwa omwe atsimikizira kuti chapambana.

Kodi osteoradionecrosis (ORN) ingapewedwe?

Vutoli silingathe kupewedwa nthawi zonse, koma musanayambe kulandira chithandizo cha radiation kumutu kapena pakhosi panu, dokotala wanu adzakambirana nanu njira zochepetsera chiopsezochi.

Musanayambe chithandizo cha radiation, muyenera kuchita izi:

• Pitani kwa dokotala wa mano , tsukani pakamwa panu bwino, ndipo kayezetseni bwino .
• Pezani chithandizo chilichonse cha mano (monga kudzaza mano, kuchotsa mano).
• Yambani chithandizo cha fluoride tsiku lililonse.

Muyenera kuchita zinthu izi panthawi ya chithandizo cha radiation komanso pambuyo pake:

• Sungani bwino pakamwa (tsukani mano anu kawiri patsiku, tsukani pakati pa mano anu).
• Chepetsani zakudya ndi zakumwa zomwe zili ndi shuga .
• Pitani kwa dokotala wa mano nthawi zonse kuti mukayezedwe ndipo yeretsani pakamwa panu.
• Pezani chithandizo cha matenda atsopano a mano mwamsanga .
• Pitirizani kuchiza ndi fluoride tsiku lililonse.

Kodi osteoradionecrosis (ORN) imafalikira mofulumira bwanji?

Nthawi zambiri, osteoradionecrosis (ORN) imayamba pang'onopang'ono. Zingatenge zaka zingapo kuti muyambe kukhala ndi zizindikiro.

Kodi osteoradionecrosis (ORN) ingachiritsidwe?

Ngakhale madokotala opaleshoni sangathe kubwezeretsa fupa lakufa, chithandizo choyenera chingalepheretse kupita patsogolo kwa osteoradionecrosis (ORN). Akuti ngati chithandizo chiyamba msanga, vutoli lingathe kuimitsidwa mu 96% ya milandu .

Choncho, ngati muli ndi osteoradionecrosis (ORN), kuyamba chithandizo msanga ndiye mwayi wanu wabwino kwambiri wopambana. Opaleshoni yanu ikhoza kukhala yochepa, ndipo mungachire mwachangu. Mukalandira chithandizo mwachangu (ORN), zimakhala bwino.

Kuzindikira Matenda a Osteoradionecrosis (ORN)

Matenda a Osteoradionecrosis (ORN) ndi matenda ochiritsika kwambiri. Mtundu wa chithandizo chomwe chikufunika chimadalira komwe fupa lowonongeka lili, kuchuluka kwa kufa kwa fupa, komanso mankhwala omwe mudayesapo kale.

Kawirikawiri, malo owonongeka mafupa akakhala ochepa, mwayi wochira umakhala wabwino popanda opaleshoni yayikulu. Milandu ina ya ORN singayankhe chithandizo chaching'ono ndipo ingapitirire kukhala matenda a mafupa (osteomyelitis) kapena kusweka kwa mafupa. Zikatero, madokotala opaleshoni angafunike kuchita opaleshoni yayikulu (free flap).

Kodi ndiyenera kupita kwa dokotala liti?

Ngati mudalandirapo chithandizo cha radiation kumutu kapena pakhosi panu ndipo mukuyamba kumva zizindikiro monga kupweteka, kutupa, kapena kuvulala, pitani kwa dokotala nthawi yomweyo. Angatsimikizire kuti muli ndi osteoradionecrosis (ORN) ndikuyamba chithandizo chilichonse chofunikira mwachangu.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Ngati inu kapena wokondedwa wanu mwapezeka ndi matenda a osteoradionecrosis (ORN), mungafune kudzifunsa mafunso awa:

• Kodi kufalikira kwa mafupa kumeneku kwafalikira mpaka pati?
• Kodi ndi njira ziti zochiritsira zomwe ndili nazo?
• Kodi ndikufunika opaleshoni?
• Kodi malingaliro anga ndi otani (kuchira)?

Pomaliza, kumbukirani (Uthenga Wopita Nawo Kunyumba)

Osteoradionecrosis (ORN) ndi zotsatira zoyipa kwambiri za chithandizo cha radiation kumutu ndi pakhosi. Zingatenge zaka kuti zizindikiro ziwonekere. Ngakhale kuti ORN singachiritsidwe kwathunthu, imatha kuthandizidwa ndi chithandizo. Zotsatira zake zimadalira komwe fupa lowonongeka lili, kuchuluka kwa imfa ya fupa, komanso kuopsa kwake.

Ngati muli ndi ululu, kutupa, mafupa, kapena zizindikiro zina za osteoradionecrosis, pitani kwa dokotala nthawi yomweyo. Angakulimbikitseni chithandizo choyenera ndikukuthandizani kusamalira vuto lanu. Kusunga ukhondo wabwino wa pakamwa ndikuwona dokotala wa mano nthawi zonse ndikofunikira kuti mupewe ndikuzindikira vutoli msanga.

Osteoradionecrosis , ORN, zotsatira zoyipa za chithandizo cha radiation, matenda a mafupa a nsagwada, chithandizo cha khansa, imfa ya mafupa, thanzi la pakamwa