Sonke siyakwazi ukwesaba nokushaqeka okuvela ekuzwa kudokotela ukuthi othandekayo wakho unomdlavuza osakazeke kuwo wonke umgodi wesisu, okungukuthi, ngaphakathi esiswini. Kodwa-ke, ngokuthuthuka kwesayensi yezokwelapha, manje sekukhona ukwelashwa okunganikeza ithemba ngisho nasezimweni ezinzima kangaka. Namuhla, sizokhuluma ngokwelashwa okukhethekile nokuthuthukisiwe. Lokhu kubizwa ngokuthi i-HIPEC.
Kalula nje, iyini i-HIPEC?
Igama elithi HIPEC limele i -Hyperthermic Intraperitoneal Chemotherapy . Nakuba leli gama lizwakala liyinkimbinkimbi kancane, okwenzekayo kulokhu kulula kakhulu. Ake sihlukanise la magama futhi siwaqonde.
- I-Hyperthermic - isho "ukushiswa" .
- I-Intraperitoneal - isho ukuthi "ngaphakathi komgodi wesisu." Kalula nje, umgodi we-peritoneal yisikhala esingenalutho ngaphakathi kwesisu sethu lapho kutholakala khona izitho ezifana nesibindi, isisu, namathumbu.
- Ukwelashwa ngamakhemikhali - kubhekisela emithini enikezwa ukubhubhisa amangqamuzana omdlavuza, njengoba sonke sazi, "i-chemo".
I-HIPEC iyindlela yokwelapha lapho imithi ye-chemo eshisayo ifakwa khona ngqo esiswini sesiguli ngemva kokuhlinzwa, bese ingaphakathi lihlanzwa kahle, kubhujiswe amangqamuzana omdlavuza. Njengoba nje sigeza isinki ngensipho, le ndlela isebenzisa i-chemo efudumele ukubhubhisa ngisho namangqamuzana amancane omdlavuza angase ashiywe esiswini.
Yiziphi izinhlobo zomdlavuza ezifanelekela lolu hlobo lokwelashwa?
Ukwelashwa kwe-HIPEC kuvame ukusetshenziselwa umdlavuza osakazeke (osuvele ususakazeke) esiswini usuka kwenye indawo emzimbeni. Kusetshenziswa futhi nakweminye imidlavuza eqala esiswini uqobo.
| Izinhlobo zomdlavuza ezicatshangelwa ukwelashwa kwe-HIPEC | |
|---|---|
| Umdlavuza osusakazekele esiswini usuka kwezinye izitho zomzimba: | |
| Umdlavuza we-adrenal | Umdlavuza wesithasiselo |
| Umdlavuza we-Colorectal | Umdlavuza wesibindi |
| Umdlavuza wesibeletho | Umdlavuza wesisu |
| Umdlavuza okhula ngaphakathi kwesisu: | |
| Umdlavuza oyinhloko we-peritoneal | I-mesothelioma ye-Peritoneal |
| I-Pseudomyxoma peritonei | |
Okubalulekile: Ukwelashwa kwe-HIPEC akuwuqedi ngokuphelele umdlavuza. Kodwa-ke, kungasiza iziguli ziphile isikhathi eside, kunciphise izimpawu, futhi ziphile impilo engcono . Udokotela wakho uzokuchazela ngokuningiliziwe ukuthi lokhu kwelashwa kukufanele yini nokuthi yiziphi izinzuzo nezingozi.
Ulungiselela kanjani lokhu kuhlinzwa okukhulu?
Lokhu ukwelashwa okunamandla kakhulu nokuyinkimbinkimbi. Ngakho-ke, kubaluleke kakhulu ukuzilungiselela ngangokunokwenzeka, kokubili ngokomzimba nangokwengqondo, ngaphambi kokuba kwenzeke. Ithimba lakho lezokwelapha lizokusiza ngalokhu. Izinto ezilandelayo zingaba zibalulekile ekulungiseleleni:
- Uma ubhema, yeka ngokuphelele .
- Ukuyeka ukusebenzisa utshwala.
- Ukuzivocavoca kokuphefumula kusetshenziswa idivayisi ekhethekile (i-incentive spirometer) ukuqinisa amaphaphu.
- Joyina iqembu lokusekela iziguli ezinomdlavuza noma ucele usizo kudokotela wengqondo.
Injani yonke inqubo yokwelashwa?
I-HIPEC yingxenye yesibili yenqubo enezingxenye ezimbili. Yonke inqubo ingathatha phakathi kwamahora ama-5 kuya kwayi-10.
Isinyathelo sokuqala: Ukuhlinzwa Kwe-Cytoreductive (CRS)
Isinyathelo sokuqala ukuhlinzwa. Uhlinzwa nge-anesthesia, okusho ukuthi ulele ngokuphelele. Odokotela abahlinzayo bavula isisu sakho basuse zonke izimila zomdlavuza ezibonakalayo kanye nezicubu ezigulayo .
Isinyathelo Sesibili: Ukwelashwa kwe-HIPEC
Ukwelashwa kwe-HIPEC kusetshenziselwa ukubhubhisa amangqamuzana amancane kakhulu omdlavuza angabonakali ngeso lenyama ngemva kokuba izimila zomdlavuza sezisusiwe ngokuhlinzwa.
1. Ukufaka i-catheter: Odokotela abahlinzayo bafaka amapayipi amaningana (ama-catheter) esiswini sakho. Lawa mapayipi axhunywe emshinini ofudumeza imithi ye-chemotherapy.
2. Ukunikeza i-chemo efudumele: Umshini ufudumeza imithi ye-chemo cishe kuma-degree Celsius angu-41-42 (108°F) bese uyipompa ingene esiswini ngepayipi.
3. Ukulethwa kwe-Chemo: Ithimba lezokwelapha lizojikeleza umzimba wakho kancane kancane kusukela kolunye uhlangothi kuya kolunye, liqinisekise ukuthi isixazululo se-chemo esishisayo sifinyelela kuwo wonke amakhona esiswini sakho. Lokhu kuzothatha noma yikuphi kusukela kumaminithi angu-30 kuya emahoreni ama-2.
4. Ukususwa kwe-Chemo: Ngemva kwesikhathi esibekiwe, uketshezi lwe-chemo olupompelwa emgodini wesisu luyasuswa ngokuphelele. Indawo bese ihlanzwa futhi nge-saline ukuze ihlanzwe.
5. Ukuthungwa kwamanxeba: Ekugcineni, yonke imicu eyenziwe ngenxa yokuhlinzwa ithungwa ivaliwe.
Yiziphi izinzuzo ezikhethekile zokwelashwa kwe-HIPEC?
Uma i-chemotherapy esetshenziswa emzimbeni inikezwa ngemithambo yegazi, ihamba emzimbeni wonke negazi. Kodwa-ke, ngenxa yesithiyo se-membrane esibizwa ngokuthi i-peritoneum esizungeze umgodi wesisu, kunzima ukuthi imithi ye-chemotherapy ingene kahle emgodini wesisu.
Kodwa ekwelashweni kwe-HIPEC, ngoba sihlinzeka nge-chemo ngqo emgodini wesisu, ingadlula lowo mgoqo iye lapho kukhona khona amangqamuzana omdlavuza bese iwabhubhisa.
Ezinye izinzuzo:
- Ukwelashwa ngamakhemikhali okunamandla kakhulu: Ngenxa yokuthi imithi iyashiswa, inethonya elikhulu kumaseli omdlavuza. Futhi, ngenxa yokuthi ishaya ngqo kumaseli omdlavuza, iphumelela kakhulu ekubulaleni amaseli omdlavuza.
- Izikhathi ezimbalwa zokwelapha: Asikho isidingo sokunikeza izigaba eziningi ze-chemotherapy njenge-chemotherapy ejwayelekile. Lokhu kwelashwa kungaqedwa ngokuhlinzwa okukodwa.
- Imiphumela emibi encishisiwe: Njengoba imithi ye-chemo igcina kakhulu esiswini, imiphumela emibi ethinta umzimba wonke (ukulahlekelwa izinwele, ukuhlanza ngokweqile) eyenzeka ngokwelashwa njalo ngamakhemikhali ingancishiswa.
Kwenzekani ngemva kokwelashwa? Kuthatha isikhathi esingakanani ukululama?
Kuye ngesimo sakho ngemva kokwelashwa kwe-HIPEC, kungadingeka uhlale egunjini lokunakekelwa okujulile (ICU) izinsuku ezimbalwa. Ungase futhi uxhunywe emshinini "wokuphefumula" ukuze ukusize uphefumule.
Ngenxa yokuthi lokhu kwelashwa kusebenzisa imithi enamandla ye-chemotherapy, ungase unikezwe ukudla okunempilo ngepayipi lokuncelisa kuze kube yilapho ukusebenza kwamathumbu akho kubuyela esimweni esijwayelekile.
Imiphumela emibi elandelayo ingase ivele ngesikhathi sokululama:
- Ukugcwalisa isisu
- Ukuqunjelwa noma isifo sohudo
- Ukukhathala
- Isicanucanu nokuhlanza
- Ubuhlungu endaweni yokuhlinzwa
- Ukuvuvukala komzimba (ngenxa yosawoti osetshenziswa ekwelapheni)
Kungathatha cishe amasonto amane kuya kwayi-12 ukululama ngokuphelele. Lokhu kuhlanganisa isonto elilodwa kuya kwamabili esibhedlela.
Uma udinga ukukhuluma nodokotela ngokushesha
Uma uba nanoma yiziphi zalezi zimpawu ngemva kokubuyela ekhaya, kufanele ushayele udokotela wakho ucingo ngokushesha .
- Uma umkhuhlane ungaphezu kuka-38.3°C (101°F)
- Isicanucanu nokuhlanza okungapheli
- Ukuvuvukala okukhulu, ukubomvu, noma ubomvu obuzungeze inxeba lokuhlinzwa
- Uma ubuhlungu buba bubi kakhulu
Lokhu kungaba izimpawu zokutheleleka noma isilonda esingapholi kahle, ngakho-ke kubalulekile ukufuna ukwelashwa ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- I-HIPEC iyindlela ekhethekile yokwelapha umdlavuza osusakazekele esiswini.
- Lapha, amangqamuzana omdlavuza abonakalayo aqala ngokususwa ngokuhlinzwa, bese kusetshenziswa imithi yokwelapha ngamakhemikhali eshisayo ukubhubhisa amangqamuzana omdlavuza angabonakali.
- Nakuba lokhu kungesona ukwelashwa okwelapha umdlavuza ngokuphelele, kusiza kakhulu ekwandiseni impilo yesiguli nokunciphisa izimpawu.
- Lokhu ukuhlinzwa okuyinkimbinkimbi kakhulu, futhi ukululama kuthatha amasonto amaningana.
- Uma lokhu kwelashwa kuphakanyiswa kuwe noma kothandekayo wakho, kubaluleke kakhulu ukuba nengxoxo evulekile nejulile nodokotela wakho mayelana nezinzuzo, izingozi, kanye nemiphumela.
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