Izifo ze-oncological zithatha inxalenye enkulu yenani lazo zonke izifo. Iziganeko ezingaphezu kwezigidi ezili-10 ngonyaka zifunyaniswa kwihlabathi jikelele. Wonke amazwe alindele iindaba ezivela kwizinzululwazi malunga nokuveliswa konyango lokumangalisa umdlavuza. Kwaye kwangoku, amazinga okufa kwi-oncology aqhubeka ekhula. Ngoko ke unyango lwesi sifo?
Iziyobisi ze-Antineoplastic yomhlaza
Kukho iindlela ezininzi zokuphatha i-oncology. Le yi-chemotherapy, i-radiation, i-hormonal, ithagethi ejoliswe kuyo, ukungenelela okutyathwayo. Le ndlela ikhethiweyo kuxhomekeke kuhlobo, isigaba sesi sifo, indawo yecala, imeko yempilo yesigulane, njl. Ingaba kukho iziyobisi zomhlaza? I-antineoplastic metabolites isetyenziselwa i-chemotherapy. Injongo ephambili ekuzisetyenziseni kukukwenza ukukhula kweeseli zomhlaza kuphelile, i-tumor ayinyuli, kwaye i-metastases ayibonakali. Ezi zezi zi yobisi njenge:
- Ftorafur;
- Methotrexate;
- Hydroxyurea;
- Xeloda.
I-Anesthetics ye-oncology
Iziyobisi eziphelisa intlungu, nomhlaza, zisetyenziselwa ukuthintela iziphumo ezimbi kwisimo sengqondo somzimba nesengqondo. Ubuhlungu kwi-oncology budibene ngeentlobo ezimbini: i-neuropathic ne-nociceptive. Iyeza zonyango zimiselwe ngohlobo lwentlungu. Ngoko ke, kwaziwa ukuba intlungu ye-nociceptive iphela kunye nokusetyenziswa kwezi-analgesics, iziyobisi ezingekho-steroidal ezichasayo, i-opioids. Ukususa ubuhlungu be-neuropathic, izidakamizwa zokulwa ne-antiepileptic kunye ne-tricyclic antidepressants.
Ama-painkillers anamandla malunga ne-oncology anqunywe ngugqirha, xa ababuthathaka bengasenaso impembelelo. Oku kwenzeka ngenxa yokulungiswa ngokukhawuleza komzimba kwiindlela ezisetyenziswayo. Kwiimeko ezinjalo, i-regimen yesinyathelo esithathu isetyenziswe, ngokusekelwe kwiingcebiso ze-WHO. Ngelo xesha, amalungiselelo adjuvant athatyathwa. Eli cwangciso linika impembelelo ye-analgesic kwi-90% yamatyala:
- i-narcotic analgesic ;
- izidakamizwa ezinobuthakathaka kunye ne-narcotic analgesic;
- i-opiates yeqela le-morphine kunye ne-narcotic analgesic.
Ukukhululwa entlungu kuqala ngokusetyenziswa kwee-analgesics ezingafaniyo. Ezi zi:
- Paracetamol;
- Aspirin;
- Metamizole sodium;
- Diclofenac;
- I-ethanol;
- Ibuprofen;
- Naproxen;
- Ketorolac;
- Piroxicam;
- Meloksikam;
- Xsefokam;
- Mefenamic acid.
Iziyobisi ezinobungozi ziyingozi:
- banike umphumo (positive anti-depressants, glucocorticoids, izidakamizwa ezichasayo);
- unempembelelo yokulungiswa kwimiphumo emibi yeengxaki ze-narcotic (antipsychotics);
- ukuqinisa isiphumo sabo sengqondo (iClonidine, i-calcium antagonists).
I-opiates ebuthathakayo ithwala:
- Codeine;
- Tramadol.
Ukusetyenziswa kwezidakamizwa ezinamandla kunama-anesthesia kunokuthi:
- Propionylphenylethoxyethylpiperidine hydrochloride;
- Morphine;
- Buprenorphine;
- Fentanyl.
Iziyobisi ze-Antiemetic ze-oncology
Ukutshabalalisa kungekhona nje umntu onomdla ongathandekiyo, kodwa ngokukhawuleza ukhokelela umzimba ukuba ungcolise amanzi, kwaye iimbumba zamathumbu ezinambuzane zesisu zisenokulimala. Ukubonakaliswa kwesisulu sokubamba isantya kunye nokuhlanza emdlalweni ngumonakalo oqhelekileyo. Izizathu zingahluka:
- yonyango;
- chemotherapy;
- i-tumor kunye ne-metastase engqondweni;
- iingxaki zesisu segciwane lesisu;
- ukuhluleka kwezintso;
- iisitastase esibindi;
- utywala;
- izifo ezithintekayo nezivuzayo.
Ngaphambi kokuba uqalise ukupheliswa kwesigqirha esingathandekiyo kunye neziyobisi, kuyimfuneko ukuseka izizathu. Kule nto, iziyobisi ezifumana isigulane kwaye i-laboratory data ifundiswa. Izizathu zoluphawu lungundoqo kunye nendawo. Xa uhlamba umgangatho ophakathi, izixhobo ezilandelayo zisetyenziswa:
- abaphikisayo be-serotonin (i-blockers ye-NTZ-receptors-Ondansetron, iTropisetron, iGranisetron, njl.
- i-corticosteroids (Dexamethasone, i-Methylprednisolone, i-Solumedrol);
- Benzodiazepines (diazepam, lorazepam).
I-antiemetic yobuthakathaka kwindlela yokwenziwa kwimizimba ye-oncology:
- i-atropine kunye nezinye izidakamizwa ze-anticholinergic (i-Platyphylline ne-Metacin);
- i-antihistamines (i-Diphenhydramine, i-Suprastin);
- Iintsholongwane zeDopamine zi-phenothiazines (Etaperazine, Torekan, Aminazine) kunye ne-butyrophenones (Droperidol, Haloperidol), i-Metoclopramide (Cerucal).
Iziyobisi ezijoliswe ngumhlaza
Ulwaphulo olujoliswe kuko luyilo olutsha ekulwa ne-oncology. Ngaphandle koko, ezi zi yobisi zibizwa ngokuba "zihlakaniphile". Eli gama bafumene ngenxa yokukwazi ukwenza kuphela kwiiseli zokutshintsha, ngelixa izicubu ezinempilo kunye nezitho zihlala zingatshintshi. Eli hlobo lonyango lwe-oncology lugqityiwe ukuyeka ukukhula kwezidumbu, ukunciphisa amanani e-chemotherapy kunye nezimo ezinzima zezigulane. Okwangoku, amayeza angama-10 sele ahlolwa iiklinikhi kwaye ayisebenzise, malunga nezinye ikhulu zivavanywa kwaye, mhlawumbi, ziya kusetyenziswa ngokukhawuleza kunyango lomhlaza.
Ukuxhatshazwa kwezidakamizwa kwi-oncology
Kukho iingcamango ezininzi malunga nokusetyenziswa kwabaxhomekeke kwiimpawu zesifo somhlaza. Baqala ukusetyenziswa kuma-70. Ukuziqhelanisa kubonise ukuba iindlela ezinjalo aziboneli ngempumelelo. Ingaba yinto enhle kwaye ingalunganga. I-immunotherapy ne-oncology isetyenziselwa izibonakaliso eziliqela:
- emva kwe-chemotherapy kunye ne-irradiation nge-immuno-and hematological disorders (iTamerite, Polyoxidonium, Glutoxim, Galavit, Neovir, Cycloferon, Roncoleukin, Leukinferon, Lycopid, Decaris, Timalin, Timogen, Milife);
- emva kwemisebenzi eqinile (Polyoxidonium, Leukinferon, Galavit, Imunofan, Roncoleukin Myelopid, Lycopid);
- ukulungisa ukuphazamiseka kwi-immune system (Polyoxidonium, Glutoxim, Leukinferon, Imunofan, Galavit);
- isenzo kwi-neoplasm ngokwayo (iRoferon, iReaferon-EU, i-Intron-A, i-interferon yeLeukocyte yeenjini);
- ukwenzela ukuthintelwa kweemastastases (Leukinferon, Neovir, Roncoleukin kunye neGalavit), ukuphumelela kwesi sikhokelo akubonakali.
Ukulungiselela ukwandisa i-hemoglobin kwi-oncology
Ngokuxhomekeke kwinani lamaseli obomvu, bahlule phakathi kwe-microcytic, macrocytic ne-normal anemia. Ukulungiselela i-iron ye-oncology ilawulwa nge-intravenously nge-injection kunye nokulungiselela i-erythropoietin, ekhuthaza ukuveliswa kwe-erythrocytes. Ukongezelela, ukwandisa i-hemoglobin kwizigulane zomhlaza, indlela yokuxilongwa kwe-erythrocyte isetyenziswa, xa iiselom zegazi ezibomvu ezitholakala kwigazi lomnikelo zijojowe ngaphakathi. Ngaloo ndlela, izinga le-hemoglobin liphuma ngokukhawuleza.
Amachiza amatsha ekwenzeni unyango lomhlaza
Utshintsho kunyango lwe-oncology, njengawo nawuphi na ulwalathiso lwamayeza, lwenzeka malunga neminyaka eyi-10. Kwimveliso yakutsha nje, i-biotherapy yezifo, i-immunotherapy ekujoliswe kuyo, ukuqaliswa kweendlela ezintsha zokugqirha, kunye nokuchaneka koomatshini kunye nokunyanga. Ukuphuhlisa isilwanyana esitsha somhlaza, kuthatha ixesha elininzi. Emva kokusungulwa, isilwanyana sidlula amanqanaba amaninzi ovavanyo.
Isiza somhlaza wesiza
Kule zifundo zakutshanje - isicatshulwa esitsha saseRashiya esichasene nomhlaza, ephuhliswe yinkampani yezobisi i-BIOCAD, iP-PD-1. Ukususela ngo-2015 ukuya ku-2016, iimvavanyo zezilwanyana zaqhutywa. Iziphumo zibonise ngaphezu kwazo zonke izinto ezenziwe ngaphambili. Le yinto ejoliswe kuyo okanye ebizwa ngokuthi "iphuzu", eliye layeka ukuphuhliswa kwesisu. Ngoku isigaba sesibini semvavanyo siyaqhubeka. Kucetywayo ukuba le nkunkuma iya kufumaneka ukusetyenziswa kusekuqaleni kuka-2018-2019.
Ziziphi iintlobo zomhlaza ezilwa nesilwanyana esitsha?
Iingqungquthela ezintsha zokulwa nomhlaza, ngokutsho kweengcali, ziyasebenza kwiintlobo ze-oncology njengomdlavuza wamaphaphu , intliziyo, intloko nentamo, isisu, i-melanoma. Abavelisi bathembisa ukuba nangona xa ukumkela kuyaphela, umphumo wonyango olutsha luya kuqhubeka, oluya kunika ithuba lokufumana kwakhona izigulane ezigqithiseleyo. Kwaye ngokubaluleke kakhulu, isixhobo siya kufumaneka kumaRashiya. Amabini asele asetshenzisile asetyenziswayo ngaphandle kwaye anento ephezulu kakhulu.
Ziziphi iziyobisi ezingenakuthathwa nge-oncology?
Ukuphendula umbuzo, yiyiphi imithi ayinakwenzeka kwi-oncology, kukufanelekile ukukhumbula ukuba amanye amayeza ayinakukukhusela kuphela unyango olusuka kwi-oncology, kodwa luyakwandisa ngakumbi imeko. Ngokomzekelo, iziyobisi ezikhuthaza imetabolism, iivithamini kunye ne-anticoagulants zingabangela ukukhula kwe-tumor kunye ne-metastases. Ngaphantsi kokuvalwa kunye namahomoni. umbuzo uhlala uphathelene nokuthathwa kwamalungiselelo ensimbi. Zigcinwa lula kwaye azilawulwa ngumzimba. Ngoko ke, banokwenza okubi ngaphezu kokulungileyo.