Uma sizwa igama elithi "umdlavuza," sonke siyasaba kancane, akunjalo? Lokho kuvamile. Kodwa ngokuthuthuka kwesayensi yezokwelapha, manje sekukhona ukwelashwa okuphumelelayo kakhulu nokuthuthukile komdlavuza. Namuhla, sizokhuluma ngokwelashwa okukhethekile okuhlose ngqo izimila zesibindi futhi okunemiphumela emibi embalwa kune-chemotherapy ejwayelekile. Lokhu kubizwa ngokuthi i-TACE. Ake sibheke imininingwane.
Kusho ukuthini nje i-TACE?
Igama eliphelele le-TACE yi -Transarterial Chemoembolization . Nakuba igama lizwakala liyinkimbinkimbi kancane, okwenzekayo kule nqubo kulula kakhulu. Kalula nje, kuyindlela yokwelapha evimba imithambo yegazi ehlinzeka ngesimila somdlavuza, inqamule ukuhlinzekwa kwegazi kwaso.
Cabanga ngokhula olungafunwa engadini. Bekungenzekani uma sinqamula ukuphakelwa kwamanzi kuleso sitshalo? Ngaphandle kwamanzi, isitshalo besizofa ezinsukwini ezimbalwa. Yilokho okwenzekayo ngalolu hlobo lokwelashwa kwe-TACE. Isimila somdlavuza naso siyisisu esingafunwa, esikhula ngokushesha. Sidinga igazi eliningi ukuze sikhule. Kulolu hlobo lokwelashwa, odokotela bathola umthambo wegazi ohlinzeka ngegazi esimila ngokwaso, bafake into ekhethekile kuso, bese bewuvimba. Kulokhu, izinto ezimbili eziyinhloko zihlanganiswa ukuze ziwuthumele emthanjeni:
- Imithi yokwelapha ngamakhemikhali: Lena imithi ebulala amangqamuzana omdlavuza.
- Ama-embolic agents: Lawa afana nezinhlayiya ezincane zepulasitiki. Asiza ukugcina imithi ye-chemo ngaphakathi kwesimila. Lokhu kuvumela imithi ukuthi ihlasele umdlavuza ngqo, kunokuba iye kwezinye izingxenye zomzimba.
Lokhu kuhluke kanjani ku-chemotherapy ejwayelekile (Systemic Chemotherapy)?
Uma uzwa i-chemotherapy, cishe uzwa ngohlobo lokwelashwa oluhilela ukujova izidakamizwa emzimbeni. Lokho sikubiza ngokuthi 'i-Systemic Chemotherapy'. I-TACE iyindlela yokwelapha ehlukile kancane, eqondiswe ngqo. Ake sibone ukuthi umehluko omkhulu uyini phakathi kwalokhu okubili.
| Okukhethekile | Ukwelashwa kwe-TACE | Ukwelashwa ngamakhemikhali okuvamile |
|---|---|---|
| Indlela yokunikeza umuthi | Umuthi unikezwa ngqo esimila somdlavuza. | Umuthi uhamba emzimbeni wonke ngegazi. |
| Isilinganiso | Umdlavuza ngokwawo unganikezwa imithi eminingi kakhulu. | Kusetshenziswa umthamo ophansi kakhulu ngoba uthinta umzimba wonke. |
| Okuqhamuka uma udla imishanguzo | Ngenxa yokuthi umuthi awuhambi emzimbeni wonke, kunemiphumela emibi embalwa efana nokulahlekelwa izinwele nokuhlanza ngokweqile. | Ngenxa yokuthi kuthinta umzimba wonke, amathuba okuba nemiphumela emibi aphezulu. |
Ubani ofanelekela ukwelashwa kwe-TACE?
Lokhu kwelashwa kusetshenziswa kokubili kubantu abadala kanye nezingane. Kusetshenziswa kakhulu umdlavuza wesibindi (`i-Hepatocellular carcinoma`) . Ikakhulukazi, i-TACE ivame ukunconywa njengokwelashwa kokuqala kweziguli ezinezimila ezinkulu kakhulu ukuba zingasuswa ngokuhlinzwa.
Akukhona lokho kuphela, lokhu kwelashwa kusetshenziselwa nomdlavuza osakazeke (osuvele usudlulele) esibindini usuka kwezinye izindawo. Isibonelo:
- Umdlavuza webele
- Umdlavuza wamathumbu amakhulu
- `Izimila ze-carcinoid`
- `Izimila ze-Neuroendocrine`
- I-melanoma yeso (umdlavuza weso)
- `I-Sarcoma`
Kodwa khumbula, isinqumo sokugcina sokuthi lokhu kwelashwa kuyakufanelekela yini sizokwenziwa udokotela ohlola isimo sakho.
Ingabe i-TACE izolimaza ukusebenza kwesibindi?
Lena inkinga abantu abaningi abanayo. Kunengqondo ukuzibuza ukuthi ukunqamula ukugeleza kwegazi esibindini kuzosilimaza yini. Kodwa akukho okufanele sikhathazeke ngakho. Isizathu ukuthi kunemithambo yegazi emibili eyinhloko ehlinzeka ngegazi esibindini sethu.
1. Umthambo wesibindi: Lo mthambo unikeza ingxenye encane kuphela yegazi eliphelele lesibindi. Okumangalisayo ukuthi izimila ezinomdlavuza esibindini zithola cishe lonke igazi lazo kulo mthambo.
2. Umthambo we-Portal: Lo mthambo oyinhloko uhlinzeka ngegazi eliningi elidingwa yisibindi.
Ku-TACE, odokotela bavimba kuphela lowo mthambo omncane, umthambo wesibindi . Ngisho noma ukuphakelwa kwegazi kumdlavuza kunqanyuliwe, amangqamuzana esibindi aphilile ayaqhubeka nokuthola lonke igazi alidingayo emthanjeni oyinhloko, umthambo we-portal . Ngakho-ke, ukusebenza okuvamile kwesibindi akuthinteki kakhulu.
Indlela yokwelashwa eyenziwa ngayo
Lokhu kwelashwa kwenziwa yi- Interventional Radiologist . Okusho ukuthi, uchwepheshe osebenzisa ubuchwepheshe bokuthwebula izithombe njenge-X-ray futhi asebenzise amashubhu amancane (ama-catheter) ukwelapha ngaphakathi emzimbeni ngaphandle kokwenza imivimbo emikhulu emzimbeni.
Nansi inqubo yesinyathelo ngesinyathelo yokuthi ukwelashwa kusebenza kanjani:
1. Ukulungiselela: Izingane zinikezwa umuthi wokubulala izinzwa ojwayelekile. Abantu abadala banikezwa umuthi wokudambisa ubuhlungu ukuze bazizwe belele kancane futhi bekhululekile.
2. Ukufaka i-catheter: Udokotela wenza isilonda esincane kakhulu esikhumbeni eduze kwe-groin noma esihlakaleni sakho bese efaka ipayipi elincane (i-catheter) ngalo liye emthanjeni wegazi.
3. Ukuthola indlela: Bese kuthi, kusetshenziswa inqubo ekhethekile ye-X-ray ebukhoma (i-fluoroscopy), ithubhu iqondiswa ngokucophelela emthanjeni ohlinzeka ngegazi esimila somdlavuza esibindini.
4. Ukujova ngedayi: Ukuze kubonakale kahle isimila kanye nemithambo ezungezile, kufakwa idayi ekhethekile (`idayi ephikisanayo`) ngepayipi.
5. Ukunikeza ukwelashwa: Ngemuva kwalokho, ingxube yemithi ye-chemo kanye ne-'embolic agent' esikhulume ngayo ngaphambilini ifakwa ngepayipi ngqo emthanjeni oholela esimila somdlavuza.
6. Ukuqeda: Uma ukwelashwa sekuqediwe, udokotela uzosusa ipayipi bese efaka iplasta encane phezu kwesibazi. Lokhu ngeke kudinge ukuthungwa.
Yini ongayilindela ngemva kokwelashwa?
Ngemva kokwelashwa nge-TACE, abantu abaningi bangase babe nobuhlungu, isicanucanu, ukuhlanza, kanye nomkhuhlane omncane . Lesi simo sibizwa ngokuthi 'i-postembolization syndrome'. Lokhu kuyinto evamile futhi akukho okufanele ukhathazeke ngakho. Ngokuvamile kuzodingeka uhlale esibhedlela usuku olulodwa noma ezimbili kuze kube yilapho lezi zimpawu ziphela.
Kubalulekile ukuphumula amasonto ambalwa ngemva kokubuyela ekhaya.
- Sebenzisa umuthi wobuhlungu kanye nesicanucanu njengoba nje udokotela wakho ekuyalele.
- Ungase ube nomkhuhlane omncane cishe isonto lonke.
- Ungase uzizwe ukhathele futhi uphelelwe yisifiso sokudla amasonto amaningana.
Izimo lapho kufanele wazise udokotela wakho ngokushesha
Uma uhlangabezana nezimpawu ezilandelayo, yazisa udokotela noma isibhedlela esikwelaphe ngokushesha.
- Uma ungakwazi ukulawula ukuhlanza kanye nesicanucanu naphezu kokuthatha imithi.
- Uma uzizwa udidekile noma ungasakwazi ukuzibamba ngokuzumayo.
- Uma unezimpawu ezifana nomkhuhlane oqhubekayo, ukubanda, kanye nokujuluka .
- Uma unesikhumba noma amehlo aphuzi (i-jaundice), uphawu lokwehluleka kwesibindi.
Umlayezo Wokuya Nawe Ekhaya
- I-TACE iyindlela yokwelapha umdlavuza wesibindi engahlinzwa, eqondiwe, futhi engangenisi kakhulu.
- Lokhu kuvimbela ukuphakelwa kwegazi kumdlavuza futhi kubhubhise amangqamuzana omdlavuza.
- Kunemiphumela emibi embalwa emzimbeni wonke uma kuqhathaniswa nokwelashwa ngamakhemikhali okuvamile.
- Ukululama kuyashesha ngemva kokwelashwa, futhi abantu abaningi bangabuyela empilweni evamile ngokushesha.
- Khuluma nodokotela wakho wezifo zomdlavuza mayelana nokuthi lolu hlobo lokwelashwa lukulungele yini futhi wenze isinqumo esifanele.
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