Ese wahawe ubuvuzi bwa radiation kuri kanseri yo mu mutwe no mu ijosi? Ese igira ingaruka ku magufwa yawe? Reka twige kuri (Osteoradionecrosis - ORN)!

Ese wigeze ugira ububabare, kubyimba, cyangwa igisebe mu kanwa cyangwa mu rwasaya nyuma yo kuvurwa kanseri yo mu mutwe cyangwa mu ijosi hakoreshejwe imirasire? Igihe gishobora kuba kigeze ngo umenye indwara yitwa osteoradionecrosis. Ntugahangayike, tuzabivugaho birambuye kandi mu buryo bworoshye cyane.

Osteoradionecrosis (ORN) ni iki?

Muri make, osteoradionecrosis (ORN) ni urupfu rw'uturemangingo tw'amagufwa bitewe no guhura n'imirasire. Ni indwara ishobora kubaho nk'ingaruka mbi zo kuvura kanseri hakoreshejwe imirasire, cyane cyane kanseri yo mu mutwe no mu ijosi. Wibuke ko imirasire ikoreshwa mu kwica uturemangingo twa kanseri rimwe na rimwe ishobora kwangiza uturemangingo tw'amagufwa tuzima. Ishobora kubaho amezi cyangwa imyaka nyuma yo guhabwa imiti ikoresha imirasire.

Iyi ndwara ikunze kugira ingaruka ku igufwa ry'umusaya wo hasi (mandibular osteoradionecrosis). Ariko, ishobora kugaragara ku igufwa iryo ari ryo ryose ryahuye n'imirasire, nko ku igufwa ry'umusaya wo hejuru (maxillary osteoradionecrosis) cyangwa igice cy'imbere cy'umugongo (vertebral osteoradionecrosis). Ni gake cyane, iyi ndwara ishobora no kugira ingaruka ku gahanga, ariko ishobora kuba ikomeye gato.

Ubuvuzi bushingiye ku mirasire n'ubuzima bw'amagufwa - kuki ibi bibaho?

Noneho, reka turebe impamvu ibi bibaho. Imirasire yangiza imiyoboro y'amaraso yoroshye itanga amaraso mu magufwa. Kimwe n'ibindi bice by'umubiri wacu, amagufwa akeneye amaraso meza kugira ngo akomeze kugira ubuzima bwiza kandi akire vuba iyo yangiritse.

Tekereza gato, nk'uko igiti cyumye kidafite amazi, iyo igufwa ritabonye amaraso ahagije, na ryo rizatakaza ubuzima bwaryo rigatangira gupfa.

Bigenda bite iyo amaraso ahagaze nabi?

• Amagufwa n'ingingo zikikije byoroshye kwandura indwara.
• Ntibishoboka gukira neza.
• Bitangiye gupfa buhoro buhoro.

Agace k'urwasaya rwacu gakunze kwibasirwa n'iki kibazo. Ibi biterwa nuko bigoye gukumira imirasire kugera ku rwasaya mu gihe cyo kuvura kanseri yo mu mutwe no mu ijosi hakoreshejwe imirasire. Nanone, ibyago byo kurwara iyi "(ORN)" byiyongera bitewe na bagiteri ziba mu kanwa kacu mu buryo busanzwe.

Kwangirika kw'imirasire mu kanwa bishobora gutera ibintu nk'ibi:

• Kugaragara kw'amagufwa (bivuze ko igufwa rigaragara binyuze mu ishinya).
• Hari ubwo umuntu agira ububabare no kubyimba mu rwasaya .
• Kugira igikomere kidakira .

Iyi ndwara ikunze kugaragara gute?

Nk’uko bivugwa n’Umuryango w’Abanyamerika ushinzwe kurwanya kanseri y’umutwe n’ijosi, osteoradionecrosis ishobora kugaragara hagati ya 4% na 8% by’abantu bafite kanseri y’umutwe n’ijosi.

Ni ibihe bimenyetso bya osteoradionecrosis (ORN)?

Noneho reka turebe ibimenyetso ushobora kugira muri iki kibazo. Niba ufite kimwe cyangwa byinshi muri ibi, ni byiza gushaka inama kwa muganga.

• Igisebe cyangwa igisebe kiri inyuma y'ishinya, ijosi, cyangwa urwasaya.
• Ububabare.
• Kubyimba.
• Kwandura (nk'amashyira).
• Amenyo adahuye neza (malocclusion).
• Kumva urimo gukurura cyangwa gushyuha .
• Uduce tw'amagufwa tuva imbere mu kanwa.
• Hari igihe, munsi y'agakanu, uruhu ruravunika maze igufwa rikavamo (ibi byitwa kandi "fistula").
• Gucika kw'umusaya.
• Gukomera kw'imitsi y'umusaya bituma umunwa udafunguka neza (trismus).

Kuki osteoradionecrosis (ORN) ibaho?

Impamvu nyamukuru ni ubuvuzi bushingiye ku mirasire ku mutwe no mu ijosi. Iyi ndwara ikunze kugaragara cyane cyane ku bantu bahawe dose y'imirasire irenga unite 60 z'ibara ry'umukara (Gy). (Gy ni igipimo cy'imirasire).

Ibintu bishobora gutera Osteoradionecrosis `(ORN)` - Ni nde ufite amahirwe menshi yo kuyirwara?

Hari abantu bafite ibyago byinshi byo kurwara iyi ndwara kurusha abandi. Reba niba ibi bintu bikureba:

• Isuku nke yo mu kanwa (kudasukura amenyo neza, kutita ku isuku yo mu kanwa).
• Niba ibibazo by'amenyo (nk'ibihoho n'indwara z'ishinya) bitarakemuwe neza mbere yuko ubuvuzi bw'imirasire butangira.
• Niba urwaye umunwa wumye (xerostomia) nyuma yo kuvurwa hakoreshejwe imirasire.
• Iyo habayeho impanuka cyangwa imvune ku ruhu nyuma yo kuvurwa hakoreshejwe imirasire, cyane cyane mu mwaka wa mbere.
• Iyo iryinyo rikuwe mu gace kari karashweho imirasire mbere.

Wibuke ko iyi ndwara ya osteoradionecrosis ishobora kubaho ndetse n'imyaka myinshi nyuma yo kuvurwa kanseri yo mu mutwe no mu ijosi hakoreshejwe imirasire.

Ibi bipimwa gute?

Osteoradionecrosis (ORN) ikunze kubaho imyaka myinshi nyuma yo kuvurwa hakoreshejwe imirasire. Niba muganga wawe abikeka ko ibi ari ukuri, azagusuzuma neza umutwe wawe n'ijosi. Azahamagara kandi umuganga w'indwara zo mu bwoko bwa radiation oncologist waguhaye iyo radiation therapy kugira ngo amenye ingano y'imirasire wahawe.

Ni ibihe bipimo bifasha mu gusuzuma indwara?

Kugira ngo yemeze ko indwara isanzwe ihari, muganga wawe ashobora kukugira inama yo gupima indwara nka:

• Imirasire ya X-ray y'amenyo.
• Hakorwa isuzuma rya CT ku ruhu rw'umusaya (CT - computed tomography scan).
• Hashobora gukorwa isuzuma rya biopsy kugira ngo harebwe niba kanseri yongeye kugaruka.

Ni ubuhe buryo bwo kuvura ibi?

Uburyo bwo kuvura indwara ya osteoradionecrosis (ORN) buterwa n'ingano n'uburemere bw'indwara yawe. Ikintu cy'ingenzi ni ugutangira kuvurwa vuba bishoboka.Uko utangira kuvurwa vuba, niko amahirwe yawe yo gukira aba menshi. Hariho uburyo bwo kuvura bwaba ubwo kubaga n'ubwo kubaga.

Ubuyobozi bw'ubuvuzi

Hariho uburyo butandukanye bwo kubaga iyi ndwara:

• Gukuraho igufwa ryapfuye cyangwa ryanduye: Ibi bibaho igihe umuganga ubaga akuyemo igufwa n'ingingo byapfuye cyangwa byanduye, kimwe no gusukura ahantu habi.
• Kubaga ku buntu: Ubu ni ukubaga kugoye gato. Bikubiyemo gufata imiyoboro y'amaraso, ingingo, ndetse wenda n'igice cy'igufwa mu kindi gice cy'umubiri wawe (urugero, ukuguru cyangwa ukuboko) ukabishyira mu gace k'umusaya kangiritse.
• ALTFL (Anterolateral Thigh Fascia Lata Rescue Flap): Ubu buryo nabwo ni ubwoko bw'uruti rw'umugongo. Muri ubu buryo, agace k'uruti rw'umugongo (fascia) gakurwa inyuma y'itako kagaterwa. Uru rugingo ruhinduka cyane, bigatuma agace kangiritse gahabwa ogisijeni n'intungamubiri. Ubushakashatsi buherutse bwerekanye ko ubu buryo bugira akamaro cyane ku bantu barwaye ORN.
• Guteranya amagufwa burundu: Ubu buryo busanzwe bwo kubaga bukoreshwa iyo hari amagufwa menshi yapfuye, cyane cyane mu ruhaya rwo hasi. Muri ubu buryo, igufwa ryangiritse rirakurwaho burundu hanyuma agace k'amagufwa gashyirwamo agace gato. Nubwo ubu buryo bugira ingaruka nziza, ni igikorwa gikomeye. Bushobora gutuma umuntu amara igihe kirekire mu bitaro kandi agakira igihe kirekire. Kubwibyo, abaganga bagerageza gusuzuma no kuvura iyi ndwara hakiri kare.

Uburyo bwo kuvura abaganga batari ababaga

Hariho kandi uburyo bwo kuvura butari ubwo kubaga:

• Antibiyotike: Iyo hari ubwandu mu igufwa cyangwa mu ngingo zikikije, muganga wawe azakwandikira imiti igabanya ubukana bw'indwara.
• PENTOCLO: Iyi ni imiti itandukanye: pentoxifylline, tocopherol (vitamine E), na clodronate. Pentoxifylline ikora mu kongera amaraso ajya mu igufwa ryangiritse. Tocopherol (vitamine E) ifasha gukomeza ubudahangarwa bw'umubiri no gukumira kubyimba kw'amaraso. Clodronate ifasha mu gukumira gutakaza amagufwa. Hari igihe pentoxifylline na tocopherol bitangwa nta clodronate (ibi byitwa PENTO).
• Ubuvuzi bwa ogisijeni ikabije (Ogisijeni ikabije - HBO - ubuvuzi):Abaganga bamwe bakoresha ubu buryo bwo kuvura kugira ngo bihutishe gukira k'umubiri. Muri ibi, ushyirwa mu cyumba cyihariye kandi uhumeka ogisijeni yuzuye. Urugero rwa ogisijeni mu cyumba ruri hejuru inshuro eshatu ugereranyije n'aho bisanzwe. Intego nyamukuru ni ukongera ogisijeni ihagije mu maraso kugira ngo usane ingirangingo zangiritse. Ariko, hari ibitekerezo bitandukanye mu baganga kuri ubu buryo bwo kuvura "ogisijeni ya hyperbaric". Nubwo bukoreshwa nk'ubuvuzi busanzwe mu bigo bimwe na bimwe, nta bushakashatsi bugenzuwe bwemeje ko bwagize icyo bugeraho.

Ese indwara ya osteoradionecrosis (ORN) ishobora kwirindwa?

Iyi ndwara ishobora kutazigera ikumirwa buri gihe, ariko mbere yuko utangira kuvurwa hakoreshejwe imirasire ku mutwe cyangwa mu ijosi, muganga wawe azakubwira uburyo bwo kugabanya iyi ngaruka.

Mbere yo gutangira kuvurwa hakoreshejwe imirasire, ugomba gukora ibi bikurikira:

• Jya kwa muganga w'amenyo , usukure umunwa wawe neza, kandi wisuzumishe neza .
• Kora ubuvuzi ubwo aribwo bwose bw'amenyo (nk'ubwo kuyashyiramo, kuyakuramo amenyo).
• Tangira kuvurwa buri munsi hakoreshejwe fluoride .

Ugomba gukora ibi bikurikira mu gihe cyo kuvurwa hakoreshejwe imirasire na nyuma yayo:

• Komeza kugira isuku mu kanwa (koza amenyo yawe kabiri ku munsi, sukura hagati y'amenyo yawe).
• Gabanya ibiryo n'ibinyobwa birimo isukari .
• Jyana na muganga w'amenyo buri gihe kugira ngo agusuzumishe kandi usukure umunwa wawe.
• Shaka ubuvuzi bw'ibibazo byose bishya by'amenyo vuba .
• Komeza kuvurwa na fluoride buri munsi.

Indwara ya osteoradionecrosis (ORN) ikwirakwira vuba gute?

Kenshi na kenshi, osteoradionecrosis (ORN) ikura buhoro buhoro. Bishobora gufata imyaka myinshi kugira ngo ugire ibimenyetso.

Ese indwara ya osteoradionecrosis (ORN) ishobora kuvurwa?

Nubwo abaganga babaga badashobora kongera kuvura igufwa ryapfuye, ubuvuzi bukwiye bushobora guhagarika iterambere rya osteoradionecrosis (ORN). Bivugwa ko iyo ubuvuzi butangiye hakiri kare, iyi ndwara ishobora guhagarikwa muri 96% by'abarwayi .

Rero, niba ufite indwara ya osteoradionecrosis (ORN), gutangira kuvurwa hakiri kare ni yo mahirwe meza yo gutsinda. Kubagwa kwawe gushobora kuba gugufi, kandi ushobora gukira vuba. Uko uvurwa vuba (ORN), ni ko birushaho kuba byiza.

Isuzuma ry'indwara ya Osteoradionecrosis (ORN)

Osteoradionecrosis (ORN) ni indwara ivurwa cyane. Ubwoko bw'ubuvuzi bukenewe buterwa n'aho igufwa ryangiritse riri, ingano y'urupfu rw'amagufwa, n'uburyo bwo kuvura wagerageje mbere.

Muri rusange, uko agace k'amagufwa kangiritse gato, ni ko amahirwe yo gukira adakozwe cyane. Hari abarwayi ba ORN bashobora kudakira ubuvuzi buto kandi bashobora kwandura amagufwa (osteomyelitis) cyangwa kuvunika amagufwa. Muri ibyo bihe, abaganga babaga bashobora gukenera kubagwa mu buryo bukomeye (free flap).

Ni ryari ngomba kujya kwa muganga?

Niba wigeze kuvura umutwe cyangwa ijosi hakoreshejwe imirasire, ugatangira kugira ibimenyetso nko kubabara, kubyimba, cyangwa gukomereka, hita ubonana na muganga wawe. Bashobora kwemeza ko ufite indwara ya osteoradionecrosis (ORN) kandi bagatangira kuvurwa vuba.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Niba wowe cyangwa uwo ukunda yarasanzwemo indwara ya osteoradionecrosis (ORN), ushobora kwibaza ibi bibazo:

• Iyi ndwara y’amagufwa yakwirakwiriye igeze he?
• Ni ubuhe buryo bwo kuvura mfite?
• Ese nkeneye kubagwa?
• Ni iki mbona (uburyo bwo kuvura)?

Amaherezo, ibuka (Ubutumwa bwo kujyana mu rugo)

Osteoradionecrosis (ORN) ni ingaruka mbi cyane zo kuvurwa hakoreshejwe imirasire ku mutwe no mu ijosi. Bishobora gufata imyaka myinshi kugira ngo ibimenyetso bigaragare. Nubwo ORN idashobora "gukira burundu," ishobora gukemurwa no kuvurwa. Ingaruka ziterwa n'aho igufwa ryangiritse riherereye, ingano y'urupfu rw'igufwa, n'ubukana bwaryo.

Niba ufite ububabare, kubyimba, amagufwa yawe, cyangwa ibindi bimenyetso bya osteoradionecrosis, jya kwa muganga ako kanya. Bashobora kukugira inama yo kuvurwa neza no kugufasha gucunga ikibazo cyawe. Kugira isuku yo mu kanwa no kujya kwa muganga w'amenyo buri gihe ni ingenzi mu gukumira no gutahura iki kibazo hakiri kare.

Osteoradionecrosis , ORN, ingaruka mbi ku buvuzi bushingiye ku mirasire, indwara y'amagufwa yo mu rwasaya, kuvura kanseri, gupfa kw'amagufwa, ubuzima bw'amenyo