Uma udokotela ekutshela noma othile omaziyo ukuthi unomdlavuza wesibindi futhi ethi ukuhlinzwa akunakwenzeka, kuyinto evamile ukuzizwa ukwesaba okukhulu nokukhathazeka. Ungase uzibuze, "Ngenzenjani manje?" Kodwa-ke, ngentuthuko kwezokwelapha zanamuhla, kunezindlela zokwelapha ezingasilethela impumuzo enkulu nethemba ngisho nasezimweni ezinjalo. Namuhla, sizokhuluma ngokwelashwa okukhethekile, okuthuthukile. Lokho ukwelashwa kwe-Y-90.
Kulungile, pho-ke luyini lolu hlobo lokwelashwa lwe-Y-90?
Kalula nje, ukwelashwa nge-Y-90 uhlobo lokwelashwa ngemisebe oluqondiswe ngqo kumdlavuza wesibindi. Igama elithi "Y-90" nansi igama elifushane lento ekhipha imisebe ethi "Yttrium-90".
Cabanga ngesimila somdlavuza njengekamu lesitha esibi. Imithambo yegazi ehambisa igazi kulelo kamu ifana nemigwaqo ethwala ukudla neziphuzo kulelo kamu. Kulokhu kwelashwa, odokotela bafaka izigidi zama-microscopic beads aqukethe into ekhipha imisebe ebizwa ngokuthi i-Y-90, emincane kangangokuthi ayikwazi ngisho nokubonakala ngamehlo enyama, emthanjeni wegazi oyinhloko ohambisa igazi ku-cancer tumour.
Lezi zinhlayiya ezincane zihamba ngegazi futhi zihlale emithanjeni yegazi emincane ngaphakathi kwesimila. Uma sezihlale lapho, ziletha umthamo omkhulu wemisebe ngqo emangqamuzaneni omdlavuza. Ingxenye engcono kakhulu ukuthi lemisebe igxile endaweni encane kakhulu, ngakho-ke akukho monakalo omkhulu noma akukho nhlobo ezicutshini zesibindi ezinempilo ezizungezile isimila.
Into ebalulekile ukuthi ukwelashwa kwe-Y-90 kungase kungayiqedi ngokuphelele umdlavuza wesibindi. Kodwa-ke, kunganciphisa amathumba , kulawule lesi sifo, futhi kunikeze isiguli ithuba elingcono lokuphila isikhathi eside ngaphandle kwezimpawu kanye nekhwalithi yokuphila enhle.
Lokhu kwelashwa kwaziwa ngamanye amagama amaningana, isibonelo, i-"Transarterial Radioembolization - TARE" kanye ne-"Selective Internal Radiation Therapy - SIRT", okungasetshenziswa udokotela wakho.
Ubani lokwelashwa okufanelekela kangcono?
Udokotela wakho uzonquma ukuthi lokhu kwelashwa kulungile yini kuwe. Ngokuvamile, ukwelashwa kwe-Y-90 kuyanconywa ezimweni ezilandelayo:
- Kulabo abanomdlavuza oyinhloko osuka esibindini.
- Kubantu abanomdlavuza osakazekele esibindini (umdlavuza osakazekile) usuka kwenye indawo.
- Iphinde isetshenziswe kwezinye izinhlobo zomdlavuza we-bile duct.
Lokhu kwelashwa kuvame ukucatshangelwa lapho ukuhlinzwa kungenzeki ukususa isimila somdlavuza.Kwezinye izimo, umdlavuza useduze kakhulu nemithambo yegazi emikhulu, futhi ukuhlinzwa kungabangela umonakalo omkhulu esibindini. Ezimweni ezinjalo, ukwelashwa kwe-Y-90 kungalawula ukukhula komdlavuza futhi kulondoloze ukusebenza kwesibindi.
Enye into ebalulekile ukuthi kwabanye abantu, ngemva kokwelashwa kokuqala kwe-Y-90 kunciphisa isimila, bangase bakwazi ukuhlinzwa noma ukufakelwa isibindi kamuva. Lokhu kungaba yisinyathelo esibalulekile endleleni yokululama.
Uzilungiselela kanjani ngaphambi kokwelashwa?
Ngaphambi kokwelashwa, udokotela wakho uzokuxilonga ngokucophelela ukuqinisekisa ukuthi uphilile ngokomzimba. Lokhu kuvame ukufaka:
- Ukuhlolwa ngokomzimba
- Ukuhlolwa kwegazi
- Ukuhlolwa kokusebenza kwesibindi
Ngaphezu kwalokho, udokotela wakho uzoxoxa nawe ngalezi zinto ngokucacile ngaphambi kokwelashwa:
- Umlando wakho ophelele wezokwelapha, noma yikuphi ukungezwani komzimba onakho, nokuthi ukhulelwe yini.
- Imiphi imithi oyithathayo njengamanje nokuthi imiphi imithi okudingeka uyeke ukuyisebenzisa ngaphambi kokwelashwa.
- Udinga ukuhlela ukuthi othile akuyise ekhaya ngemva kokwelashwa.
- Ngaphambi kokwelashwa, sekuyisikhathi sokuyeka ukudla nokuphuza.
- Mayelana nenqubo yonke yokwelashwa.
Lesi yisikhathi esihle kakhulu sokubuza udokotela noma yimiphi imibuzo noma ukungabaza ongase ube nakho.
Sizoxoxa ngendlela ukwelashwa okusebenza ngayo?
Ukwelashwa kwe-Y-90 kuqukethe izinyathelo ezimbili eziyinhloko. Lezi ezimbili zivame ukwenziwa zishiyane cishe ngamasonto amabili. Le nqubo iholwa udokotela ochwepheshe.
| Izinyathelo | Kwenzekani? |
|---|---|
| Isinyathelo 1: Ukumaka i-Angiogram | Lokhu kufana nokuzijwayeza ukwelashwa kwangempela. Lapha, kwenziwa ukusikwa okuncane kakhulu esithweni sakho sangasese noma esihlakaleni, bese kufakwa ipayipi elincane kakhulu (i-catheter) ngalo emithanjeni yegazi ehambisa igazi kumdlavuza. Bese kufakwa idayi ekhethekile .Imithambo yegazi ethwala umdlavuza ihlelwe kahle. Lokhu kusetshenziselwa ukukhetha indlela eqondile yokuletha izinhlayiya ze-Y-90. Lokhu kungathatha cishe amahora ama-2-4. |
| Isinyathelo 2: Ukumnika i-Y-90 | Lokhu ukwelashwa kwangempela. Njengakuqala, kufakwa i-catheter, bese kufakwa izigidi zezinhlayiya ze-Y-90 ezinemisebe endleleni ehlelwe kahle. Lezi zinhlayiya zibhajwa ngaphakathi kwesimila bese ziqala ukukhipha imisebe. Le nqubo ivame ukuthatha ihora noma amabili. Ama-90% emisebe evela kulezi zinhlayiya akhishwa zingakapheli izinsuku eziyi-10. Lezi zinhlayiya zibe sezihlala zingenangozi emzimbeni. |
Yiziphi izinzuzo zokwelashwa nge-Y-90?
Ukwelashwa nge-Y-90 kunezinzuzo eziningana ngaphezu kokwelashwa ngemisebe yendabuko (i-EBRT).
- Ukwelashwa okuqondiwe: Ngenxa yokuthi imisebe iya ngqo kumdlavuza, kunomonakalo omncane kakhulu ezicutshini ezinempilo. Ngakho-ke, kunemiphumela emibi embalwa.
- Okungahlaseli kakhulu: Azikho izimbobo ezinkulu zokuhlinzwa. Kwenziwa ngokusika okuncane kakhulu, njengokufaka inalithi. Ngakho-ke, isikhathi sokuphulukiswa sifushane futhi cishe azikho izibazi.
- Ukululama okusheshayo: Ungabuyela empilweni evamile ngokushesha kunokuhlinzwa okukhulu.
Ingabe ikhona imiphumela emibi noma izingozi?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunamathuba okuba nemiphumela emibi emincane kanye nezinkinga ezingavamile kakhulu.
Izimo ezivame ukubonakala
Kuvamile ukuzizwa ukhathele isonto elilodwa noma amabili ngemva kokwelashwa. Abanye abantu bangase babe nesimo esibizwa ngokuthi i-post-embolization syndrome (PES) . Lokhu kufaka phakathi:
- Isicanucanu nokuhlanza
- Isifiso sokudla
- Ubuhlungu besisu
- Ukuzizwa ushisa
Lezi zimpawu zivame ukuqala ngemva kwezinsuku ezintathu bese ziphela phakathi nesonto. Uma uhlangabezana nalezi zimpawu, tshela udokotela wakho ukuze akunike imithi edingekayo.
Izinkinga ezingavamile
- Ukutheleleka: Ukutheleleka kungase kuvele endaweni yokufakwa kwe-catheter. Lokhu kungadinga ama-antibiotic.
- Ukungezwani komzimba: Kungenzeka ukuthi ube nokungezwani komzimba nento efana nodayi osetshenzisiwe. Yingakho udokotela ezobuza nge-allergies yakho kusengaphambili.
- Izilonda zesisu: Akuvamile kakhulu, lokhu kungenzeka uma izinhlayiya ze-Y-90 zingena esiswini noma emathunjini amancane. Kodwa-ke, le ngozi iphansi kakhulu ngoba udokotela uvimba imithambo yegazi kulezo zindawo ngesikhathi sokuhlolwa kwe-angiogram.
Yini okufanele ngiyiqaphele ngemva kokwelashwa?
Phumula kahle izinsuku ezimbalwa ngemva kokwelashwa. Landela imiyalelo kadokotela wakho ngokucophelela, ikakhulukazi noma yimiphi imikhawulo yokushayela nokuzivocavoca.
Enye into ebalulekile imayelana ne-radioactivity. Ngisho nangemva kokubuyela ekhaya usuka esibhedlela, inani elincane lemisebe evela ezinhlayiyeni ze-Y-90 lizokhishwa izinsuku ezimbalwa. Ngakho udokotela wakho angakunikeza iseluleko esinjengalesi:
- Gwema ukulala embhedeni ofanayo nomlingani wakho izinsuku ezimbalwa.
- Gwema ukuhlala eduze nomuntu isikhathi eside.
- Nciphisa ukusondelana eduze nabesifazane abakhulelwe kanye nalabo abanezivikelo zomzimba ezibuthakathaka.
Kodwa ungakhathazeki. Ngenxa yokuthi i-Y-90 iyindlela yokwelapha eqondiwe, iningi lemisebe limuncwa umdlavuza uqobo. Ngakho-ke ingozi kwabanye evela kuwe iphansi kakhulu.
Uma unomkhuhlane, uzizwa ubanda, uvuvukile, ubomvu, noma ufudumele lapho kufakwe khona i-catheter, unesihlungu esiswini esinzima, noma ukungabi namizwa emilenzeni yakho, yazisa udokotela wakho ngokushesha .
Kuvamile ukuzizwa wesaba uma ucabanga ngokufaka into ekhipha imisebe emzimbeni wakho. Kodwa-ke, ukwelashwa kwe-Y-90 kuyindlela yokwelapha ephephile futhi ephumelelayo yomdlavuza wesibindi. Kungakunikeza namandla okuphila isikhathi eside ngaphandle kwezimpawu zomdlavuza. Ngakho-ke, uma udokotela wakho ekuncoma lokhu kwelashwa, khuluma naye ngokucophelela bese ubuza yonke imibuzo yakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Y-90 iyindlela yokwelapha ekhethekile ethumela izinhlayiya ezinemisebe ngqo ukuze zihlasele izimila zesibindi.
- Nakuba lokhu kungelaphi ngokuphelele umdlavuza, kunganciphisa isimila, kulawule lesi sifo, kwandise isikhathi sokuphila, futhi kuthuthukise ikhwalithi yokuphila.
- Lokhu akusilo ukuhlinzwa okukhulu. Njengoba kwenziwa ngokusikwa okuncane, isikhathi sokululama sifushane futhi imiphumela emibi mincane.
- Kubalulekile ukulandela imiyalelo enikeziwe ukuze uzivikele emisebeni izinsuku ezimbalwa ngemva kokwelashwa.
- Uma unemibuzo mayelana nalokhu kwelashwa, ungesabi ukubuza udokotela wakho.
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