Pancoast Cancer: Zoyambitsa, Zizindikiro, Matendawa ndi Chithandizo

Pancoast khansa - khansa kuti isanafalikire mu poyambira chapamwamba phapo. Ndi zizindikiro zake ofanana ndi TB, abscess, echinococcus, chibayo, chosaopsa zotupa ndi pathologies ena.

Dzina la Pancoast zotupa analandira m'malo mwa radiologist Henry K. Pancoast. Iye anali woyamba wa anzake anafotokoza matenda mwatsatanetsatane. Izi zinachitika mu 1924.

Kuwonjezera matenda oopsa, ndi zizindikiro zofanana angachititse matenda ena yotupa ndi khansa, komanso isanafalikire pamwamba pa phapo. zodabwitsazi amatchedwa Pancoast syndrome.

Kufunika kwa vuto Pancoast khansa ndi vuto la matenda oyambirira mu malingaliro ake malo enieni a chotupa cha, anatseka dongosolo fupa. Ngakhale mothandizidwa ndi x-ray ikuchitika zipatala za zotsogola Oncology mu magawo oyambirira izo Sizotheka kuti mwamsanga kuti matenda.

Zifukwa pamwamba pa khansa ya m'mapapo

Ambiri, pakutchulidwa khansa Pancoast anakhudzidwa ndi zifukwa zofanana monga mwa mitundu ina khansa ya m'mapapo. Ichi nchiyani? Chifukwa chachikulu mawonetseredwe ake ndi kosasuta: yogwira kapena kungokhala chete. The yofunika ankaimba ndi chiwerengero cha ndudu kusuta patsiku, khalidwe la fodya ntchito, ndipo zinachitikira wonse wa fodya. Tikumbukenso kuti zaka ngati kulephera kwa khalidweli anthu akutuluka zone ngozi pokhapokha khumi.

Kukayezetsa matenda Mwinanso anthu amene alibe amadwala kumulakalaka kusuta. Kuchuluka kugonjetsedwa khansa Pancoast chabe osuta kumawonjezera mu nthawi 1,7-2. Gulu chiopsezo mulinso ana ndi achinyamata amene makolo zonse kusuta pamaso pawo. Mukusuta 85% milandu chifukwa cha zochita pamwamba pa khansa ya m'mapapo.

Kuwonjezera fodya akhoza kuyambitsa khansa Pancoast zinthu zachilengedwe ndi mafakitale. Pokhudzana ndi zipangizo monga mankhwala, asibesitosi, zitsulo, Arsenic, faifi tambala kapena chromium Komanso kumawonjezera kuchuluka kwa odwala khansa Pancoast.

Great ndi udindo wa matenda osiyanasiyana m'mapapo m'mbiri TB, kunyamula-patsogolo chibayo ndi bronchiectasis, - zonsezi kumawonjezera mwayi wa munthu Pancoast chotupa.

matenda amakhudza anthu kasanu kambirimbiri kuposa akazi, pamene kumaonekera patapita zaka 50. Iwo imatsimikizirika kuti ndi kutengera za khansa Pancoast wadutsa pa chibadwa.

Ambiri, pali zinthu zingapo zimene zimakhudza pakutchulidwa wa Pancoast khansa:

• wamsinkhu;
• kusuta;
• mmene chilengedwe m'deralo;
• ntchito akatswiri pa ntchito yomanga ndi mankhwala mafakitale;
• chibadwa.

zizindikiro khansa

Nthawi zambiri, odwala kupempha thandizo kuchokera magawo zapamwamba za matendawa. Vuto limeneli chikugwirizana ndi kupanda zizindikiro mu magawo oyambirira: wodwalayo si chifuwa, hemoptysis, ndipo ambiri Chofunika - ndi zilema kuonekera thupi mu mawonekedwe a tokhala pa thupi. Ululu magawo oyambirira a khansa zambiri siziwoneka.

The machenjezo yekha pa magawo 1 ndi 2 a khansa ndi kufooka, kutopa nthawi zonse, imfa ya thupi.

Syndromes ndi Pancoast Horner

Mu njira zina za matendawa pali chiwonetsero cha syndromes ndi Pancoast Horner, onse mosiyana ndi osakaniza ndi mzake. Kufunika kudziwa.

Pancoast matenda akuwonetseredwa zambiri zizindikiro zotsatirazi:

• aakulu osautsa ululu kumbali ya chotupa kutanthauzira - m'dera phewa, m'kupita kwa mitsempha ulnar ndi pansi tsamba phewa;
• minofu ofooka dzanja pa mbali zinkakhala za thupi, paresthesia, dzanzi chala, manja a minofu ya nthambi;
• kusintha mawu - zikamera wa hoarseness, chifuwa.

Atadziŵa chotupa ulusi wachifundo kuwawonetsera syndrome Horner akuti:

• kuŵeramitsa wa chikope chapamwamba (ptosis);
• anhidrosis miyendo kumtunda ndi nkhope ndi maphwando akhudzidwa chotupa;
• constriction kwa mwana (miosis) ndi Anabweza wa diso (etnoftalm).

Nthawi zambiri, khansa limodzi ndi Pancoast kuposa vena cava syndrome chotupa pa kuthamanga pa izo. syndrome Izi limodzi ndi zizindikiro zotsatirazi:

• ululu pachifuwa;
• kutsokomola;
• kufupika kwa mpweya;
• mutu, ndi kuchuluka tulo;
• wenzulo pamene kupuma.

Matenda a nsonga khansa ya m'mapapo

Monga tanenera kale pamwambapa, matenda a matenda ndi zovuta zokwanira, chifukwa mu magawo oyambirira a khansa Pancoast sangathe nthawi zonse kudziwa ngakhale x-ray chifukwa chakuti chotupa pa malo kutanthauzira kwake ndi zosaoneka.

Monga ulamuliro, odwala ankapatsidwa mu malo oyamba ndi matenda okhudza ubongo, kapena dokotala madandaulo a ululu miyendo chapamwamba, ndipo patapita kuti alowe yokumana ndi oncologists katswiri.

Popeza kuti Pancoast chotupa zizindikiro zake zimafanana ndi matenda ena a dongosolo bronchopulmonary, matenda ake ayenera kukhala wopambana ndipo zikuphatikiza mitundu zotsatirazi Kafukufuku:

1. Radiography - detects kukhalapo kwa chotupa mu magawo pambuyo chifukwa cha thickening wa pleura ndi maonekedwe a midima.
2. Yopangidwa tomography ndi Kujambula - kudziwa mmene zokhudza mtima, nthiti, mfundo, vertebrae mu ndondomekoyi. Zotsatira za maphunziro awa ali pakati zofunika kwambiri. Iwo amasonyeza kuti n'zotheka opaleshoni.
3. Lymph mfundo biopsy - kudziwa siteji ya chitukuko matenda.
4. A magazi - ndiyo chikhalidwe cha m'thupi lonse.

Komanso, monga Kafukufuku zambiri imachitika bronchoscopy (Mzimuyo boma la bronchi ndi trachea, nkhani pafupi ndi dera lomwe linakhudzidwa), ndipo arteriogram phlebogram (ganizilani mmene mitsempha ndi mitsempha m'dera phewa).

Cancer m'mapapo Chithandizo

Chithandizo cha Pancoast khansa kumachitika kokha mu zipatala apadera khansa, chinthu lofunika kwambiri ndi zovuta za chithandizocho. Kafukufuku amasonyeza kuti khansa Pancoast ndi wapezeka zambiri mu gawo lachitatu, pamene ululu khansa ya mtundu uwu akukhala kuwapirira. Chithandizo Pankhaniyi m'pofunika kuyamba ndi phwando mankhwala ululu, mpaka analgesics chomwa mankhwalawa.

Njira yaikulu ya mankhwala ndi chotupa Pancoast:

• Morning;
• cheza mankhwala;
• opaleshoni.

mankhwala preoperative

Disease mankhwala kumachitika panthawi zingapo: preoperative ndi postoperative chithandizo opaleshoni.

Pre-mankhwala ndi zovuta mankhwala amphamvu ndi walitsa zofunika kuchepa zotupa ndi kuchepetsa kufala kwa metastases mu mwanabele. Izi zimathandiza kuti achite opareshoni kuti pamaso zimenezi zinali zosatheka.

mankhwala cheza Angagwiritsidwenso ntchito ngati njira palokha mankhwala pamene opaleshoni sizingatheke. Walitsa mu nkhani iyi, amachepetsa ululu mu mtima, koma sikumangotikhudza moyo zaka zambiri.

Ndipo dzuwa, ndi mankhwala amphamvu maphunziro imachitika mu magawo angapo, ndi yopuma pakati 2-3 masabata. Pambuyo radiotherapy ndi mankhwala amphamvu wodwala amagwira ntchito yotsatira bwinobwino zotsatira za zimene tinganene kuti n'zotheka opaleshoni.

Kufunika ntchito pa matenda a khansa ya m'mapapo

Opaleshoni mankhwala si milandu onse: ngati palibe chitsimikizo kuti mphamvu wodwalayo kumulola kuti opaleshoni kapena kale chidwi ambiri, chosonyeza chotupa, ndi ziwalo za thupi - kuchita alowererepo ndi zokhumudwitsa. Chiwerengero cha kupulumuka mu chikhalidwe ngati cha kunyalanyaza wodwalayo kochepa.

Nthawi zina, pamene ntchito ndi zotheka, pali mitundu ingapo ya kukwaniritsidwa kwake:

1. Pulmonectomy - kuchotsa buku lonse la m'mapapo anakhudzidwa.
2. Resection ya phapo.

Ndi chidwi chotupa overgrowth akhoza kuchotsa nthiti angapo ndipo vertebrae, mtima, thoracic mpanda wa brachial plexus. Nthawi zina, wodwala ayenera kugwira amputation wa miyendo chapamwamba.

Pambuyo opaleshoni radiotherapy ndi mankhwala amphamvu umachitika chifukwa "anawatha" maselo chotupa kupewa pakutchulidwa wa musabise.

Kuti madokotala ananena zawo khansa pamwamba mapapo

Kupulumuka odwala amene akukonza khansa Pancoast, zimadalira siteji imene matenda wakhala wapezeka.

Odwala matenda omwe adaperekedwa kwa gawo 1 matenda, pakhomo kupulumuka kuzungulira 60%, sitepe 2 - zosaposa 40%, ndi matenda a siteji 3 khansa asanu mzere kugonjetsa 20% odwala.

Pa siteji 4 khansa Pancoast pafupifupi osachiritsika: mu 98% milandu, munthu amafa pasanathe miyezi 6-7 pambuyo mankhwala maphunziro.