Kunzima ukusho ngamazwi ukwesaba nokushaqeka okuzwayo lapho wena noma umuntu omthandayo etholakala enomdlavuza. Kodwa ngenxa yentuthuko kwezokwelapha namuhla, kunezindlela eziningi zokwelapha ezisebenzayo ezihlose amangqamuzana omdlavuza kuphela futhi zinciphise umonakalo emzimbeni. Enye indlela yokwelapha enjalo, ikakhulukazi yomdlavuza wesibindi, yi-TACE. Ake sixoxe ngalokhu ngamazwi alula namuhla.
Kalula nje, kuyini ukwelashwa kwe-TACE?
Igama eliphelele le-TACE yi -Transarterial Chemoembolization . Nakuba igama liyinkimbinkimbi kancane, okwenzekayo kulokhu kulula kakhulu. Cabanga ngomdlavuza njengendawo lapho abantu ababi becasha khona. Badinga ukudla namanzi (okungukuthi igazi) ukuze baphile. Kulokhu kwelashwa, uthola umthambo wegazi oyinhloko ohlinzeka ngegazi kumdlavuza, bese ufaka eminye imithi yokulwa nomdlavuza ( i-chemo ) ngqo kumdlavuza ngalowo mthambo. Ngemuva kwalokho, umthambo wegazi uvalwa yisinhlayiya esincane.
Kalula nje, lokhu kwenza izinto ezimbili ngesikhathi esisodwa:
1. Umuthi obulala amangqamuzana omdlavuza ulethwa ngqo esimila .
2. Lapho isimila siyeka ukwamukela igazi, silahlekelwa umoya-mpilo nezakhamzimba esizidingayo, bese isimila siba buthaka bese siqala ukufa, njengokungathi “sibanjwe yi-coma.”
Ingabe lokhu kuhlukile kunokwelashwa ngamakhemikhali okuvamile?
Yebo, lokhu kuhluke kakhulu ku-chemotherapy esivame ukuyazi. Ake sibone ukuthi umehluko omkhulu uyini.
| Isici | Ukwelashwa kwe-TACE | Ukwelashwa Nge-Chemotherapy Okuhlelekile |
|---|---|---|
| Indlela yokuphatha | Umuthi unikezwa ngqo ku-tumor yomdlavuza uqobo. | Umuthi uhamba egazini emzimbeni wonke. |
| Isilinganiso | Imithi eningi kakhulu inikezwa kuphela esimila. | Kunikezwa umthamo ohambisana nokubekezelelwa komzimba. |
| Okuqhamuka uma udla imishanguzo | Ngenxa yokuthi umuthi awuhambi emzimbeni wonke, imiphumela emibi efana nokulahlekelwa izinwele nokuhlanza ngokweqile ayivamile kakhulu. | Ngenxa yokuthi kuthinta umzimba wonke, imiphumela emibi efana nokulahlekelwa izinwele, ukuhlanza, nokulahlekelwa ukwazi kuvamile. |
Ubani ofanelekela lolu hlobo lokwelashwa lwe-TACE?
Lokhu kwelashwa kusetshenziselwa kakhulu abantu abanomdlavuza wesibindi (i-hepatocellular carcinoma) , ikakhulukazi labo abanezimila ezinkulu kakhulu ukuthi zingasuswa ngokuhlinzwa.
Futhi, lokhu kwelashwa kusetshenziselwa izinhlobo eziningana zomdlavuza ezisakazekele esibindini (esisabalaliswe yi-metastasized) zivela kwezinye izindawo.
- Umdlavuza webele
- Umdlavuza wamathumbu amakhulu
- Izimila ze-neuroendocrine (umdlavuza ohlobene nesimiso sezinzwa)
- I-Sarcoma (` i -Sarcoma` )
- I-melanoma yeso
Ingabe lokhu kuzolimaza isibindi?
Lokhu kuyikwesaba okunengqondo kubantu abaningi. Kodwa ngokumangalisayo, kunezindlela ezimbili eziyinhloko zokuhambisa igazi esibindini sethu.
1. Umthambo wesibindi: Lo mthambo unikeza isibindi inani elincane legazi. Kodwa-ke, izimila ezinomdlavuza esibindini zithola cishe lonke igazi lazo kulo mthambo.
2. Umthambo we-Portal: Yilapho isibindi sithola khona ingxenye enkulu yegazi laso.
Ekwelashweni kwe-TACE, umthambo wesibindi kuphela ohlinzeka ngegazi kumdlavuza ovinjiwe. Njengoba izingxenye eziphilile zesibindi ziqhubeka nokuthola igazi elivela emthanjeni we-portal, akukho monakalo omkhulu ekusebenzeni kwesibindi.
Kalula nje, sivimba kuphela "umbhobho wokudla" womdlavuza. Izingxenye ezinhle zesibindi ziyaqhubeka nokuthola izakhamzimba ezizidingayo.
Ingabe bakhona abantu okungafanele bathole ukwelashwa nge-TACE?
Yebo, lokhu kwelashwa akufanele wonke umuntu. Udokotela wakho uzokuxilonga bese enquma ukuthi lokhu kufanele yini kuwe. Ngokuvamile akufaneleki kubantu abanezimo ezilandelayo:
- Uma imisele yenyongo ivaliwe
- Uma unezinkinga zokujiya kwegazi
- Uma unesifo sezinso
- Uma umdlavuza ususakazekele ezithweni eziningi zomzimba
- Uma unezinye izifo zesibindi ezingathi sína (i-hepatic encephalopathy, i-portal vein thrombosis)
- Uma une-allergies enzima kumadayi athile asetshenziswa ekwelapheni
Kulungile, manje ake sibone ukuthi lokhu kwelashwa kwe-TACE kusebenza kanjani.
Lokhu kwelashwa kwenziwa yi- Interventional Radiologist . Okusho ukuthi, udokotela osebenzisa imishini ekhethekile efana ne-X-ray ukuze abuke umzimba bese efaka amashubhu amancane (ama-catheter) kuwo.
Wenzani ngaphambi kokwelashwa?
Udokotela wakho uzokwenza izivivinyo eziningana ukuze ahlele ukwelashwa kwakho.
- I-CT scan noma i-MRI scan
- Ukuhlolwa kwegazi ukuhlola ukusebenza kwezinso kanye nokujiya kwegazi
Futhi, ngaphambi kokwelashwa, unganikezwa ama-antibiotic ukuvimbela ukutheleleka, imithi yokunciphisa isicanucanu, kanye nemithi yokuvikela izinso zakho ezintweni ezikhishwa lapho amangqamuzana omdlavuza efa.
Kwenzekani ngesikhathi sokwelashwa?
Lokhu akuyona into enkulu. Nakhu okwenzekayo:
1. Izingane ezincane zinikezwa umuthi wokubulala izinzwa ojwayelekile . Lokhu kusho ukuthi zilele ngokuphelele. Abantu abadala banikezwa umuthi wokudambisa kuphela, okwenza zilale kancane .
2. Udokotela uzosika kancane kakhulu umthambo wegazi eduze kwembobo noma esihlakaleni sakho.
3. Kufakwa ipayipi elincane elibizwa ngokuthi i-catheter ngaleyo ndawo.
4. Ngemuva kwalokho, ngenkathi ubheka umshini okhethekile ofana ne-X-ray (`fluoroscopy`), ithubhu idluliselwa ngokucophelela emthanjeni ohlinzeka ngegazi esimila somdlavuza wesibindi.
5. Okulandelayo, kufakwa udayi okhethekile ngepayipi. Umdlavuza kanye nemithambo yegazi ezungezile bese kubonakala ngokucacile.
6. Uma indawo eqondile isitholakele, udokotela ufaka ingxube yemithi yokwelapha ngamakhemikhali kanye nezinhlayiya ezincane (ama-embolic agents) ezivimba umthambo wegazi ungene emthanjeni.
7. Uma inqubo isiqediwe, i-catheter iyasuswa bese kufakwa ibhandishi endaweni encane eqoshiwe. Njengoba kungekho ndawo enkulu eqoshiwe, asikho isidingo sokuthungwa.
Yiziphi izinzuzo nezingozi zalokhu kwelashwa?
Njenganoma yiluphi uhlobo lokwelashwa, i-TACE inezinzuzo kanye nezingozi.
| Izinzuzo | Izingozi Nemiphumela Engemihle |
|---|---|
| Izinga lempumelelo eliphezulu: Ukukhula komdlavuza kungamiswa noma kulawulwe cishe kuma-70% eziguli. | Ukutheleleka: Njenganoma yikuphi ukwelashwa, kunengozi encane yokutheleleka. |
| Kuvikela ukusebenza kwesibindi: Izingxenye ezinempilo zesibindi azilimali kangako. | Ukulimala kwezinso: Ingozi iphakeme kancane, ikakhulukazi kubantu abanesifo sikashukela. |
| Ukululama okusheshayo: Ungalulama futhi ubuyele empilweni ejwayelekile ngokushesha kunokwelashwa njalo komdlavuza. | Ukulimala kwesibindi: Akuvamile kakhulu ukuthi kwenzeke ukulimala kwesibindi uma umuthi uye endaweni engafanele. |
| Imiphumela emibi embalwa: Kunemiphumela emibi embalwa ngoba kunomthelela omncane emzimbeni wonke. | I-Postembolization Syndrome: Umkhuhlane, isicanucanu, kanye nobuhlungu ngemva kokwelashwa. (Lokhu kuvamile). |
Kwenzekani ngemva kokwelashwa? Kuthatha isikhathi esingakanani ukululama?
Ngemva kokwelashwa, abantu abaningi baba nomkhuhlane, isicanucanu, ukuhlanza, kanye nobuhlungu. Lokhu kubizwa ngokuthi i-postembolization syndrome . Lokhu kuvamile. Kuzodingeka uhlale esibhedlela usuku olulodwa noma ezimbili kuze kube yilapho lezi zimpawu ziphela.
Udinga ukuphumula kancane ngemva kokubuyela ekhaya.
- Thatha umuthi udokotela wakho akunika wona wobuhlungu kanye nesicanucanu.
- Kungase kube nomkhuhlane omncane cishe isonto lonke.
- Ungase uzizwe ukhathele futhi uphelelwe yisifiso sokudla amasonto amaningana.
Konke lokhu kuyaphela kancane kancane. Iningi labantu liyalulama ngokuphelele phakathi namasonto ambalwa futhi liphile impilo enhle. Kodwa-ke, kuzodingeka uqhubeke nokuhlolwa ukuze ubone ukuthi izimila ezintsha ziyavela yini.
Uma unalezi zimpawu, xhumana nodokotela ngokushesha!
Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ngemva kokuya ekhaya ngemva kokwelashwa, shayela udokotela wakho ngokushesha noma uye esibhedlela lapho uthole khona ukwelashwa.
- Uma ungakwazi ukulawula ukuhlanza kanye nesicanucanu naphezu kokuthatha imithi.
- Uma unenkinga yokugxilisa ingqondo, uzizwa udidekile, noma unenkinga yokuhamba.
- Uma unomkhuhlane ongapheli futhi umzimba wakho ubanda futhi ujuluka.
- Uma amehlo noma isikhumba siphenduka siphuzi (i-jaundice) - lokhu kungaba uphawu lokulimala kwesibindi.
Umlayezo Wokuya Nawe Ekhaya
- I-TACE iyindlela yokwelapha ephumelela kakhulu ehlasela ngqo umdlavuza wesibindi futhi iwulethele imithi, inqande ukutholakala kwegazi.
- Lokhu akulimazi kakhulu umzimba futhi kunemiphumela emibi embalwa kakhulu kune-chemotherapy ejwayelekile.
- Ukwelashwa kwenziwa ngaphandle kokusikwa okukhulu, kusetshenziswa ipayipi elincane elifakwe emzimbeni. Ngakho-ke, isikhathi sokululama sifushane.
- Kuvamile ukuzwa izimpawu ezifana nomkhuhlane kanye nesicanucanu ngemva kokwelashwa, kodwa kubaluleke kakhulu ukuqaphela izimpawu ezingathi sína.
- Udokotela wakho ungumuntu ongcono kakhulu ukunquma ukuthi lokhu kwelashwa kukufanele yini, ngakho khuluma naye ngokukhululekile ngakho.
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