Yuav kuaj thiab kho tus mob qog noj ntshav li cas (nrog duab)

Cov txheej txheem:

Yuav kuaj thiab kho tus mob qog noj ntshav li cas (nrog duab)
Yuav kuaj thiab kho tus mob qog noj ntshav li cas (nrog duab)

Video: Yuav kuaj thiab kho tus mob qog noj ntshav li cas (nrog duab)

Video: Yuav kuaj thiab kho tus mob qog noj ntshav li cas (nrog duab)
Video: tuav wb lub neej kom ruaj khov - Mang Vang ft. Christina Xyooj [Official Audio] 2021-22 2024, Lub peb hlis ntuj
Anonim

Txawm hais tias kev kis tus mob qog noj ntshav tsawg tsawg, nws muaj cov neeg tuag ntau dua. Raws li National Cancer Institute, kev pheej hmoo ntawm mob qog noj ntshav yog 4 ntawm 100, 000 tus neeg nyob rau ib xyoos hauv xyoo 2012 nrog rau 5 xyoos kev muaj sia nyob ntawm 18%. Ob hom kab mob qog noj ntshav tau lees paub: adenocarcinoma thiab squamous cell carcinoma. Lub sijhawm rov zoo los ntawm mob qog noj ntshav txoj hlab ntshav tuaj yeem txhim kho tau yog tias nws tau kuaj pom ntxov, yog li paub cov cim thiab tsos mob yog qhov tseem ceeb rau kev kuaj mob thiab kho kom raug.

Cov kauj ruam

Ntu 1 ntawm 4: Paub txog Cov tsos mob ntawm mob qog noj ntshav

Ntsuam xyuas thiab kho Kab Mob Kheesxaws Kauj Ruam 1
Ntsuam xyuas thiab kho Kab Mob Kheesxaws Kauj Ruam 1

Kauj Ruam 1. Ua tib zoo saib qhov nyuaj ntawm kev nqos

Nyuaj nyuaj ntawm nqos (tseem hu ua dysphagia) yog ib qho ntawm cov tsos mob tshwm sim tshaj plaws ntawm mob qog noj ntshav.

  • Thaum lub sijhawm ntxov, koj yuav hnov qee zaus "ua kom khov," tshwj xeeb yog cov zaub mov nyuaj (xws li nqaij, mov ci, thiab txiv apples) thaum koj nqos. Yog tias qhov no tshwm sim, mus ntsib kws kho mob.
  • Tus mob no yuav mob zuj zus ntxiv thaum mob qog noj ntshav nce mus. Thaum kawg, nws tuaj yeem nce mus rau qhov chaw uas koj tsis tuaj yeem nqos tau cov zaub mov khov.
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 2
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 2

Kauj Ruam 2. Saib xyuas koj qhov hnyav

Kev poob phaus yam tsis tau xav txog, tshwj xeeb yog kaum phaus hauv ib hlis lossis ntau dua, tuaj yeem yog lub cim qhia tias mob qog noj ntshav.

  • Ntau yam mob qog noj ntshav sib txawv tuaj yeem ua rau poob phaus, tab sis mob qog noj ntshav esophageal, tshwj xeeb, cov tsos mob no tuaj yeem ua rau hnyav dua los ntawm kev nqos nyuaj.
  • Kev ntuav tsis pub dhau ob peb teev ntawm kev noj mov yog lwm qhov tsos mob ntawm mob qog noj ntshav; ntuav thiab lwm yam teeb meem ntsig txog GI, xws li mob raws plab raws li mob qog noj ntshav kis mus rau txoj hnyuv.
  • Txawm hais tias qhov teeb meem hloov pauv mus rau mob qog noj ntshav lossis tsis yog, nws yog qhov zoo tshaj mus ntsib kws kho mob yog tias koj pom qhov hloov pauv tsis tau piav qhia hauv koj qhov hnyav.
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 3
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 3

Kauj Ruam 3. Siv mob hauv siab tiag

Kev hnov mob ntawm ib puag ncig lossis tom qab koj lub pob txha tuaj yeem qhia pom mob qog noj ntshav. Mus ntsib koj tus kws kho mob yog tias koj tab tom muaj mob hauv siab ntawm ib yam twg, thiab yog tias qhov mob hnyav, nrhiav kev pab tam sim ntawd.

Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 4
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 4

Kauj Ruam 4. Saib rau qhov kub hnyiab hauv siab

Qee tus neeg uas muaj mob qog noj ntshav esophageal muaj cov tsos mob ntawm plab zom mov lossis kub cev, ua rau muaj qhov tsis xis nyob hlawv hauv siab. Yog tias koj pom cov tsos mob no, teem caij nrog koj tus kws kho mob.

Kev kub siab yog tshwm sim los ntawm cov kua qaub hauv lub plab ua rau lub plab zom mov tom qab noj mov, tshwj xeeb yog nrog cov zaub mov ntsim lossis dhau sijhawm. Yog tias kub siab tsis lees paub thiab kho, nws tuaj yeem ua rau qee tus neeg muaj kev pheej hmoo rau Barrett's, uas yog mob qog noj ntshav ua ntej uas yuav tsum tau saib xyuas ze

Kuaj thiab kho Kab mob qog noj ntshav Kauj Ruam 5
Kuaj thiab kho Kab mob qog noj ntshav Kauj Ruam 5

Kauj Ruam 5. Ceev faj txog qhov hnoos qeev

Yog tias koj lub suab nrov nrov tsis pom qhov laj thawj, mus ntsib kws kho mob. Hnov zoo ib yam kuj tseem tuaj yeem yog ib qho qhia tias mob qog noj ntshav.

Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 6
Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 6

Kauj Ruam 6. Paub txog koj qhov kev pheej hmoo

Koj tsev neeg keeb kwm (keeb kwm caj ces) nrog rau kev mob yav dhau los muab cov ntsiab lus tseem ceeb txog koj txoj kev pheej hmoo ntawm kev mob qog noj ntshav.

  • Yog tias koj muaj keeb kwm ntawm Barrett txoj hlab pas lossis qib qis dysplasia, koj muaj kev pheej hmoo nce ntxiv ntawm kev mob qog noj ntshav. Tsis yog ib qho ntawm cov xwm txheej no yog cov tsos mob ntawm mob qog noj ntshav, tab sis lawv yuav tsum tau ceev faj ntxiv thiab saib xyuas tas li.
  • Cancer esophageal feem ntau yog txiv neej ntau dua li poj niam.
  • Kev rog tuaj yeem ua rau koj muaj kev pheej hmoo ntawm txoj hlab pas adenocarcinoma.
  • Squamous cell carcinoma zoo li tshwm sim ntau zaus hauv cov neeg haus dej, haus luam yeeb, lossis raug rau ib puag ncig ib puag ncig uas ua rau mob ntev thiab ua rau mob ntawm txoj hlab pas.
  • Kev sib tw kuj ua lub luag haujlwm: adenocarcinoma ntau dua rau cov neeg dawb, thiab squamous cell carcinoma ntau dua rau cov neeg dub.

Ntu 2 ntawm 4: Txheeb Xyuas Kab Mob Kheesxaws

Kuaj thiab kho Kab mob qog noj ntshav Kauj Ruam 7
Kuaj thiab kho Kab mob qog noj ntshav Kauj Ruam 7

Kauj Ruam 1. Teem caij nrog koj tus kws kho mob

Yog tias koj muaj cov tsos mob ntawm mob qog noj ntshav, hu rau koj tus kws kho mob kom teem sijhawm. Nws lossis nws yuav nug koj txog koj cov tsos mob thiab xaj kom kuaj zoo.

Kuaj thiab kho Kab Mob Khees Kaws Kauj Ruam 8
Kuaj thiab kho Kab Mob Khees Kaws Kauj Ruam 8

Kauj Ruam 2. Teem sij hawm nqos barium

Hauv kev sab laj nrog koj tus kws kho mob, koj tuaj yeem txiav txim siab teem sijhawm nqos barium. Thaum lub sijhawm ntsuas no, koj yuav nqos cov kua dej ua kua, hu ua barium, tom qab ntawv xoo hluav taws xob.

  • Kev ntsuas nqos barium qhia tawm cov qauv sab hauv ntawm txoj hlab pas, thiab nrog nws, ib qho pob me me lossis thaj chaw uas tau tsa hauv qhov ob sab phlu.
  • Thov nco ntsoov tias txawm hais tias kev nqos barium tuaj yeem qhia pom tias muaj kev cuam tshuam, nws tsis txaus ib leeg los kuaj mob qog noj ntshav. Kev tshuaj xyuas ntxiv, xws li kuaj nqaij, yuav tsum tau ua los ua qhov kev kuaj mob ntawd.
Kuaj thiab kho Kab Mob Hlwb Kab Mob Kauj Ruam 9
Kuaj thiab kho Kab Mob Hlwb Kab Mob Kauj Ruam 9

Kauj Ruam 3. Muaj lub tshuab kuaj kab mob endoscopic nrog lub koob txhaj tshuaj zoo

Yog tias koj cov tsos mob thiab/lossis cov txiaj ntsig ntawm barium nqos tau nws, koj tus kws kho mob kuj tseem tuaj yeem ua lub tshuab kuaj kab mob endoscopic (EUS) nrog lub koob txhaj tshuaj zoo.

  • Thaum lub sijhawm kuaj no, koj tus kws kho mob yuav tshuaj xyuas koj txoj hlab pas siv qhov uas tau qhia los ntawm kev ntsuas ultrasound. Nws lossis nws yuav saib rau cov quav hniav, nodules, ulcerations, lossis pawg uas yog tus yam ntxwv mob qog noj ntshav.
  • Ib qho ntxiv, nws lossis nws yuav ua qhov kev kuaj nqaij los ntawm kev siv cov ntaub so ntswg los ntawm koj txoj hlab pas kom kuaj. Kev kuaj lub cev no yuav qhia seb koj puas muaj mob qog noj ntshav esophageal thiab yog tias muaj, yam twg.
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 10
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 10

Kauj Ruam 4. Teem Sijhawm Tso Positron Emission Tomography - Xeem Tomography Scan (PET/CT)

Yog tias koj muaj mob qog noj ntshav, koj tus kws kho mob tuaj yeem xaj tus tsiaj PET/CT, uas yog qhov kev kuaj pom zoo uas suav nrog PET scan nrog CT scan.

  • Thaum lub sijhawm kuaj mob no, koj yuav haus cov kua hu ua 18-F fluorodeoxyglucose (FDG), tos 30 feeb rau koj lub hlwb kom nqus tau cov tshuaj, thiab tom qab ntawd pw ntawm lub rooj raws li cov duab raug coj los ntawm koj lub cev, los ntawm koj lub taub hau mus rau koj lub hauv caug.
  • Cov qog nqaij hlav, zoo li cov cell ib txwm muaj, xav tau cov piam thaj kom muaj sia nyob, thiab lawv muaj cov metabolism hauv siab; Raws li qhov tshwm sim, thaj chaw uas "teeb pom kev" ntawm kev tshuaj ntsuam muab cov ntaub ntawv hais txog kev mob qog noj ntshav thiab seb koj cov qog nqaij hlav loj npaum li cas.
Kuaj thiab kho Kab Mob Hlwb Kab Mob Kauj Ruam 11
Kuaj thiab kho Kab Mob Hlwb Kab Mob Kauj Ruam 11

Kauj Ruam 5. Nkag siab koj cov txiaj ntsig kev xeem

Tham nrog koj tus kws kho mob txog koj qhov xwm txheej tshwj xeeb. Muaj ob hom mob qog noj ntshav tseem ceeb: adenocarcinoma thiab squamous cell carcinoma. Ntxiv mus, hauv Tebchaws Meskas thiab Europe, "TNM" txheej txheem txheej txheem siv los piav qhia kev mob qog noj ntshav.

  • Tus "T" qhia pom tias cov qog tau nkag mus tob hauv koj txoj hlab pas.
  • Tus “N” qhia seb cov qog ntshav nyob ib ncig ntawm txoj hlab pas puas muaj cov qog nqaij hlav cancer hauv lawv.
  • Tus "M" qhia txog metastasis (mob qog noj ntshav uas tau kis mus rau lwm qhov ntawm koj lub cev).

Ntu 3 ntawm 4: Kho Tus Mob Cancer Esophageal

Kuaj thiab kho Kab Mob Hlwb Kab Mob Kauj Ruam 12
Kuaj thiab kho Kab Mob Hlwb Kab Mob Kauj Ruam 12

Kauj Ruam 1. Tham nrog koj tus kws kho mob txog kev kho mob

Koj tus kws kho mob tuaj yeem piav qhia qhov kev xaiv kho mob sib txawv thiab xav tau dab tsi.

Cov kev kho mob feem ntau suav nrog kev phais, tshuaj kho mob thiab hluav taws xob

Kuaj thiab kho Kab Mob Kheesxaws Kauj Ruam 13
Kuaj thiab kho Kab Mob Kheesxaws Kauj Ruam 13

Kauj Ruam 2. Nkag siab txog koj cov kev phais

Txoj hlab pas yog ib txoj kev kho mob qog noj ntshav tau. Txawm hais tias muaj ntau qhov kev hloov pauv ntawm kev ua haujlwm, cov hauv paus ntsiab lus zoo ib yam - tus kws phais neeg tshem tawm ib feem ntawm txoj hlab pas nrog cov qog.

  • Txoj haujlwm no yuav ua thawj zaug hauv koj lub plab (kom tso lub plab tawm) thiab tom qab ntawd hauv koj lub hauv siab kom tshem tawm ib feem ntawm txoj hlab pas nrog mob qog noj ntshav. Qhov no yog ua raws los ntawm kev rov txuas lub plab mus rau txoj hlab pas ntxiv.
  • Ib qho kev sib txawv ntawm txoj hlab pas yog Ivor-Lewis txoj hlab pas. Nws tuaj yeem ua tiav ob qho tib si transthoracic (nrog lub qhov txhab qhib loj hauv lub hauv siab) lossis qhov tsawg tshaj plaws-cuam tshuam (siv cov cuab yeej tshwj xeeb thiab tshuab thev naus laus zis).
  • Yog ua tiav hauv txoj hauv kev tsawg tshaj plaws, koj yuav muaj qhov txhab me me, tsis muaj ntshav poob, tsawg dua qhov teeb meem tom qab ua haujlwm, pw hauv tsev kho mob luv dua, thiab khaws cia zoo dua ntawm kev ua haujlwm ntsws tom qab ua haujlwm.
Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 14
Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 14

Kauj Ruam 3. Nug txog kev khomob

Koj tus kws kho mob yuav txiav txim siab tias yuav tsum siv tshuaj kho tus kheej kom tswj tau cov tsos mob lossis ua ke nrog lwm yam kev kho mob. Tshuaj kho mob suav nrog tau txais tshuaj tua kab mob qog noj ntshav los ntawm IV lossis tshuaj hauv qhov ncauj.

  • Kev khomob yuav raug tswj ua ntej kev phais kom txo cov qog nqaij hlav, lossis tom qab phais kom tua cov qog nqaij hlav cancer uas tau tso tseg.
  • Yog tias koj muaj kev noj qab haus huv tsis zoo thiab tsis tuaj yeem tswj kev phais, kev siv tshuaj kho mob yuav yog koj li kev kho mob tseem ceeb.
  • Hmoov tsis zoo tshuaj kho kab mob muaj ntau yam tshwm sim, suav nrog xeev siab, ntuav, thiab plaub hau poob. Nws yog ib qho tseem ceeb uas koj nkag siab txog qhov tshwm sim tsis zoo ua ntej kho yog li koj tuaj yeem npaj rau lawv kom tsim nyog.
  • Kev khomob kuj tseem tuaj yeem ua ke nrog kev kho hluav taws xob, uas yog hu ua chemoradiation.
Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 15
Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 15

Kauj Ruam 4. Nug txog kev kho hluav taws xob

Lwm qhov kev xaiv kho mob qog noj ntshav yog kev kho hluav taws xob. Kev kho hluav taws xob siv hluav taws xob hluav taws xob siab kom ua rau cov nqaij mob qog noj ntshav. Kev kho hluav taws xob tuaj yeem tswj tau los ntawm sab nraum lub cev lossis los ntawm lub raj hauv lub caj pas kom sib txuas ncaj qha nrog cov nqaij.

  • Koj tus kws kho mob tuaj yeem xaiv txoj kev kho hluav taws xob los ua lwm txoj hauv kev phais yog tias koj tsis noj qab nyob zoo txaus los mus phais.
  • Cov kev mob tshwm sim ntawm kev kho hluav taws xob suav nrog khaus tawv nqaij, xeev siab, thiab qaug zog, thiab lwm yam.
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 16
Ntsuam xyuas thiab Kho Kab Mob Kheesxaws Kauj Ruam 16

Kauj Ruam 5. Tham nrog koj tus kws kho mob thiab nug seb koj puas xav tau lub raj mis pub mis

Qee cov neeg mob uas mob qog noj ntshav esophageal xav tau jejunostomy tubes (pub raj), txawm nyob rau lub sijhawm tom qab ua haujlwm tam sim lossis ntev dua.

  • Yog tias koj tsis tuaj yeem nqos zaub mov lossis tsis tuaj yeem tau txais zaub mov txaus los ntawm koj lub qhov ncauj, j-raj yuav muab tso rau hauv koj lub plab mus rau hauv jejunum (ntu thib ob ntawm koj txoj hnyuv me).
  • Cov kua dej muaj peev xwm muab tau los ntawm lub raj no. Nug koj tus kws kho mob txog ntev npaum li cas koj yuav tau noj koj cov khoom noj los ntawm lub raj pub mis.

Ntu 4 ntawm 4: Rov Qab Los Ntawm Kev phais

Kuaj thiab kho Kab Mob Kheesxaws Kauj Ruam 17
Kuaj thiab kho Kab Mob Kheesxaws Kauj Ruam 17

Kauj Ruam 1. Npaj rau lub sijhawm rov qab ua haujlwm

Qee tus kws phais neeg xa lawv cov neeg mob txoj hlab pas mus rau chav kho mob luv luv tom qab phais, thaum lwm tus lees paub cov neeg mob ncaj qha mus rau lawv chav tsev kho mob.

  • Thaum kawg, koj yuav tsum qhia koj lub cev tias yuav noj dab tsi ntxiv, uas tuaj yeem yog txheej txheem qeeb. Cov neeg mob feem ntau tuaj yeem mus tsev tau xya mus rau kaum hnub tom qab phais tas.
  • Thaum lub sijhawm phais, ib lub raj yas yuav muab tso rau hauv koj txoj hnyuv. Qhov no yuav tso cai rau koj kom tau txais kev pub nkag mus rau hauv lub cev (lub raj pub mis) thaum lub sijhawm kho kom zoo. Lawv yuav pib qeeb ib hnub lossis ob hnub tom qab koj phais thiab maj mam nce ntxiv.
  • Txog xya hnub tom qab koj phais, lwm qhov kev nqos barium yuav ua kom ntseeg tau tias tsis muaj qhov xau nyob ib puag ncig anastomosis (thaj av uas koj cov hlab pas tseem tshuav tau xaws rau hauv koj lub plab).
  • Tom qab ntawd koj yuav pib haus dej thiab lwm yam kua, tom qab ntawd nce mus rau cov zaub mov muag.
Txheeb Xyuas thiab Kho Kab Mob Khees Xaws Kauj Ruam 18
Txheeb Xyuas thiab Kho Kab Mob Khees Xaws Kauj Ruam 18

Kauj Ruam 2. Nkag siab koj qhov kev saib xyuas tom tsev

Ua ntej xa koj mus tsev, cov kws saib xyuas mob thiab kws kho mob yuav muab cov ntaub ntawv qhia rau koj txog kev saib xyuas koj li cas thiab tswj koj li kev noj zaub mov zoo. Tus kws saib xyuas kev noj qab haus huv hauv tsev tseem tuaj yeem raug xaiv los pab koj thaum thawj lub lim tiam tom qab koj phais.

Txheeb Xyuas thiab Kho Kab Mob Khees Mees Kauj Ruam 19
Txheeb Xyuas thiab Kho Kab Mob Khees Mees Kauj Ruam 19

Kauj Ruam 3. Paub tias koj qhov kev phais phais yuav cuam tshuam rau koj lub neej zoo li cas

Hauv lub hlis tom qab kev phais, koj yuav ntsib teeb meem nqos tau, rov ua dua, mob, thiab qaug zog. Koj kuj tseem yuav ntsib qhov hu ua "dumping syndrome" - teeb meem tshwm sim thaum zaub mov nkag mus rau hauv lub plab me sai heev thiab tsis tuaj yeem zom tau zoo.

Cov cim ntawm "pov tseg cov tsos mob" suav nrog yaug, xeev siab, ntuav, thiab ntuav. Tham nrog koj tus kws kho mob, tab sis paub tias nws feem ntau daws nws tus kheej hauv lub sijhawm luv

Txheeb Xyuas thiab Kho Kab Mob Hlwb Kab Mob Kauj Ruam 20
Txheeb Xyuas thiab Kho Kab Mob Hlwb Kab Mob Kauj Ruam 20

Kauj Ruam 4. Nkag siab koj li kev rov zoo mus sij hawm ntev

Qee tus neeg mob ntsib teeb meem tom qab ua haujlwm txawm tias peb lossis ntau xyoo tom qab phais. Cov teeb meem no tuaj yeem suav nrog ua tsis taus pa, teeb meem nrog kev noj mov, rov ua dua, raws plab, thiab qaug zog.

Koj tus kws kho mob yuav pom zoo kom koj noj tshuaj antacids lossis cov tshuaj tua kab mob kom txo qee cov tsos mob no

Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 21
Kuaj thiab Kho Kab Mob Kheesxaws Kauj Ruam 21

Kauj Ruam 5. Ua raws koj tus kws kho mob qog noj ntshav

Koj tus kws kho mob oncologist tuaj yeem lees paub tias koj tsis xav tau kev kho ntxiv. Nws lossis nws yuav xav pom koj nyob rau niaj hnub rau yav tom ntej yav tom ntej, ib yam, txhawm rau tshuaj xyuas koj tus mob thiab xyuas kom tseeb tias mob qog noj ntshav tsis rov tshwm sim.

Lub tswv yim

  • Vim tias rog dhau thiab kev noj qab haus huv tsis zoo ua rau koj pheej hmoo mob qog noj ntshav, txo koj txoj kev pheej hmoo los ntawm kev tawm dag zog ib txwm muaj, txiav luam yeeb, txwv koj kev haus cawv, thiab tham nrog koj tus kws kho mob yog tias koj xav tias koj tau raug rau ib puag ncig ib puag ncig uas ua rau koj txoj hlab pas mob.
  • Nco ntsoov tias txawm hais tias mob qog noj ntshav esophageal tau txiav txim siab tshwj xeeb tshaj yog tuag nyob rau yav dhau los, kev nce qib hauv kev kho mob tau ua qhov kev kwv yees tau zoo dua rau ntau tus neeg mob. Nyob twj ywm, thiab tham nrog koj tus kws kho mob txog txhua yam ntawm koj cov kev xaiv.

Pom zoo: