Yintoni umhlaza womqala, iimpawu eziphambili kunye nonyango

Umxholo

• Iimpawu eziphambili zomhlaza wokuqaqamba kwengqondo
• Uxilongo lwenziwa njani
• Izizathu eziphambili
• Unjani unyango
• Ukutya komhlaza wokuqina

Umhlaza wesifo sokudumba ngumhlaza luhlobo olomeleleyo lomhlaza olwenzeka ngenxa yotshintsho kwiiseli zomqala, ezithi zibe mandundu, zikhokelele ekubonakaleni kweempawu ezithile kunye neempawu ezinjengobunzima bokuginya, ukubonakala kwesigaqa kwinxalenye ephezulu yomzimba. isisu kunye nelindle elimnyama, nangona kunjalo iimpawu zomhlaza kwi-esophagus zibonakala kuphela xa isifo sele sikwizigaba eziphambili ngakumbi kunye ne-metastases, sinamathuba ambalwa okunyanga.

Ngokutsho kwendawo yeeseli ezichaphazelekayo, umhlaza wesifo sokuqaqamba unokuhlelwa ngokweendidi ezimbini eziphambili:

• I-squamous cell carcinoma, lolona hlobo luqhelekileyo lomhlaza kwi-esophagus kwaye ichaphazela indawo ephezulu yomqala kwaye, ke, kuqhelekile ukuba kwenzeke kubantu abatshayayo kunye / okanye kwiziselo ezinxilisayo;
• Adenocarcinoma, edla ngokubonakala kwicandelo elijoyina umqala esiswini kwaye lixhaphake kakhulu kubantu abane-gastric reflux engapheliyo, umqala kaBarrett naxa umntu etyebe kakhulu.

Olu hlobo lomhlaza luxhaphake kubantu abangaphezulu kwama-50 kwaye abanezinto ezinobungozi njengokutyeba, i-reflux, i-gastritis okanye abatshayayo. Ke ngoko, ukuba umntu unalo naluphi na uphawu okanye uphawu olunxulumene nomhlaza kwi-esophagus kwaye unazo naziphi na izinto ezinobungozi ezinxulumene nesifo, kuyacetyiswa ukuba ubonane nogqirha wezamazinyo ukuze ufumanise isifo kwaye unyango lunokumiselwa, uku uninzi luhlala lucetyiswa ukuba lwenziwe utyando ukususa isuntswana lomqala, kunye ne-chemo kunye nemitha yokuphelisa iiseli zomhlaza ezinokuthi zingasuswa ngexesha lotyando.

Iimpawu eziphambili zomhlaza wokuqaqamba kwengqondo

Ezinye iimpawu kunye neempawu ezinokubonisa ukukhula komhlaza kwi-esophagus zezi:

• Ubunzima kunye nentlungu yokuginya, ekuqaleni ukutya okuqinileyo kunye nolwelo;
• Ukudumba nokukhohlela rhoqo;
• Ukuphelelwa ngumdla wokutya kunye nobunzima;
• Ukudinwa xa usenza umthambo olula, njengokulalisa ibhedi okanye ukunyuka izitepsi;
• Ukuziva kwesisu esipheleleyo;
• Ukugabha ngegazi kunye isicaphucaphu;
• Ubumnyama, ipasti, ivumba elinamandla okanye ilindle eligazi;
• Ukuphazamiseka esiswini okungadluliyo;
• Iqhuma esiswini, elinokucofa;
• Ukudumba iilwimi kwicala lasekhohlo lentamo;
• Amaqhuqhuva ajikeleze inkaba.

Ngokwesiqhelo, umhlaza we-esophageal awubangi naziphi na iimpawu okanye iimpawu, nangona kunjalo njengoko isifo siqhubeka, iimpawu ezinokuthi ziqale ukuqaphela. Ke, ukuqala kweempawu kubonisa ukuba isifo sele sele sikwinqanaba elihambele phambili, kwaye ukuxilongwa ngokukhawuleza kunye nonyango kubalulekile.

Uxilongo lwenziwa njani

Ukuxilongwa komhlaza wesifo esophageal kwenziwa nge-endoscopy, eluvavanyo olwenziwa ngenjongo yokujonga ngaphakathi ingaphakathi kwesisu kunye nesisu kunye nokujonga naziphi na iimpawu zotshintsho. Ukuba iqhuma okanye naluphi na utshintsho olufunyenweyo ngexesha loviwo, kuyacetyiswa ukuba kwenziwe isampuli yesampulu yesisu esophageal ukujonga iimpawu zeeseli, ukongeza kwi-X-ray yomqala, ngakumbi ukuba umntu unobunzima ukuginya.

Ukongeza, ugqirha unokubonisa uvavanyo lwegazi olubandakanya ukubalwa kwegazi ukukhangela i-anemia kunye novavanyo lwe-stool ukujonga igazi esitulweni.

Ngexesha lovavanyo lwe-endoscopic, kunokwenzeka ukuba ugqirha ujonge inqanaba lesi sifo ngokweempawu eziqwalaselweyo:

• Inqanaba I - Ukudumba eludongeni lwe-esophagus malunga ne-3 ukuya kwi-5 mm kwaye ngaphandle kwemetastases, ngamathuba amakhulu onyango;
• Inqanaba II -Ukwandiswa kodonga lokuxinwa okungaphezulu kwe-5 mm kwaye ngaphandle kweemastastase ezinamathuba athile onyango;
• Inqanaba III - Ukuqina kodonga lokuqina lokuchama oluchaphazela izicwili ezijikeleze umqala ngethuba elincinci lokunyanga;
• Ibala IV -Ubukho beemastastase ngumzimba, ngamathuba amancinci kakhulu onyango.

Nangona kunjalo, la manqanaba anokuchazwa ngokweenkcukacha ngohlobo lomhlaza womqala ofunyaniswe ngugqirha.

Izizathu eziphambili

Ukubonakala komhlaza wokudumba kunxulunyaniswa nemingcipheko ethile, enje:

• Ukusela kakhulu iziselo ezinxilisayo kunye neecuba;
• Ukungenisa iziselo ezishushu ngaphezu kwe-65º C, ezifana nekofu, iti okanye i-chimarrão, umzekelo;
• Ukungenisa izinto zealkaline, ezinje ngechlorine esetyenziselwa ukucoca ekhokelela ekunciphiseni komqala;
• Imbali yomhlaza wentloko okanye wentamo.

Ukongeza, olu hlobo lomhlaza luxhaphake kakhulu kwizigulana ezinesifo njenge-gastritis, gastroesophageal reflux okanye isifo sePlummer-Vinson, i-achalasia okanye i-esophagus ka-Barrett, umzekelo, ukucaphukisa komqala kudla ngenxa ye-Reflux esiswini se-bile.

Unjani unyango

Unyango lomhlaza wokuqhinwa luthathela ingqalelo indawo yethumba kunye nenqanaba lesi sifo, ukongeza kwimbali yezonyango yomntu, ubudala kunye neempawu zakhe. Ke, unyango lolu hlobo lomhlaza oluboniswe yi-oncologist kunye ne-gastroenterologist lunokubandakanya:

• Utyando lokususa umqala: isahlulo esinethumba siyasuswa kwaye sonke sidityaniswe nesisu. Nangona kunjalo, xa umqala kufuneka ususwe ngokupheleleyo, kuyimfuneko ukubeka indawo yokufakelwa yokufakelwa okanye ususe inxenye yamathumbu ukubuyisela umqala, umzekelo;
• Unyango ngonyango: kwenziwa ukuthintela ukukhula kweeseli zethumba kwindawo yomqala;
• Unyango ngamayeza: ngokusebenzisa inaliti emthanjeni okanye kwimisipha kwaye kwezinye iimeko ngeepilisi ukukhuthaza ukupheliswa kweeseli zomhlaza ezinokubakho.

Kwiimeko ezininzi olu nyango aluwunyangi ngokupheleleyo umhlaza, lunceda kuphela ukunciphisa iimpawu zomhlaza kunye nokwandisa ubomi besigulana. Ukuxelwa kwangaphambili kobomi kolu hlobo lomhlaza kuyahluka ngohlobo lomhlaza, ukubekwa esiteji, unyango olwenziwe kunye nempendulo yesigulana kunyango, kodwa njengoko esi sifo sikwimeko ezininzi sifunyenwe kwinqanaba eliphambili kwaye, ke ngoko, ixesha lokuphila lesigulana limalunga ne-5 iminyaka ubudala.

Ukongeza, isigxina sobomi besigulana esinomhlaza kwi-esophagus sikhulu ngakumbi xa ithumba likhona kuphela kwindawo yomqala kwaye akukho metastases.

Ukutya komhlaza wokuqina

Kwimeko yomhlaza wokuqaqamba kwemiphunga, kunokuba yimfuneko ukwenza utshintsho kwindlela otya ngayo, ngenxa yobunzima bokuginya kunye neziphumo ebezingalindelekanga kunyango, ngakumbi ichemotherapy ebangela isicaphucaphu kunye nokungonwabi esiswini.

Ke, kunokuba yimfuneko ukulungiselela ukutya kwe-pastry, okunje ngesidudu kunye nesuphu kwi-blender, okanye ukongeza ii-thickeners kukutya okungamanzi. Ukongeza, kunokuba yimfuneko ukufumana izondlo ngqo ngokusebenzisa umthambo okanye usebenzise ityhubhu ye-nasogastric, eyityhubhu ebaleka isuka empumlweni iye esiswini, ukunceda ukufumana ukutya okufanelekileyo. Jonga ezinye iindlela zokutya xa ungakwazi ukuhlafuna.