Thymoma yog qog uas loj hlob hauv cov qog ua qog uas tuaj yeem ua tau zoo (tsis yog mob qog noj ntshav) lossis mob qog noj ntshav (mob qog noj ntshav). Thymoma qee zaum cuam tshuam nrog myasthenia gravis, tus kab mob paraneoplastic uas tus neeg mob ntsib cov leeg qaug zog thiab poob ntawm cov leeg tswj. Kev kho tus mob qog noj ntshav yuav nyob ntawm seb nws nyob hauv lub cev ntev npaum li cas. Hauv ntau qhov kev kho mob phais yog txaus, tab sis lwm qhov nws yuav koom nrog ntau txoj hauv kev: ua ke ntawm kev phais, kev kho hluav taws xob, thiab tshuaj kho mob.
Cov kauj ruam
Txoj Kev 1 ntawm 3: Tshem Tawm Thymoma phais
Kauj Ruam 1. Paub txog tias kev tshem tawm phais tuaj yeem ua tau thaum ntxov
Yog tias koj tus mob qog noj ntshav nyob rau theem pib thiab tseem tsis tau kis mus rau koj lub cev tas li, koj yog tus neeg xaiv tsa zoo tshaj plaws rau kev phais tshem tawm cov qog, cov qog qog, thiab qee cov nqaij nyob ib puag ncig. Cov txheej txheem no yog hu ua thymectomy. Kev phais yog qhov yuav tshwm sim tshaj plaws ntawm kev kho nyob rau theem I thiab II ntawm tus kab mob thiab tej zaum yuav siv tau me ntsis hauv theem III.
Feem ntau ntawm cov xwm txheej, kev phais mob los ntawm nws tus kheej yog txaus los kho tus mob thymoma tag nrho hauv nws cov theem pib. Txawm li cas los xij, kev phais tsuas tuaj yeem kho tau li 25 - 40% ntawm theem III thymomas
Kauj Ruam 2. Paub tias lig lig theem tuaj yeem raug phais me me tab sis tsis tshem tawm ib txwm
Yog tias thymoma tau nthuav dav heev, nws yuav tsis tuaj yeem tshem tawm cov thymoma tag nrho. Kev phais tuaj yeem siv tau, txawm li cas los xij, kom txo qis cov qog, yog li ua rau txo cov tsos mob. Qhov no hu ua debulking. Qhov kev phais no yuav suav nrog tshem ib feem ntawm lub ntsws lossis kab mob hauv lub ntsws thaum kis mob tau kis mus rau thaj chaw no.
Qee tus neeg mob yuav xav tau kev kho hluav taws xob tom qab kev phais debulking kom tua cov qog nqaij hlav qog nqaij hlav uas yuav raug tso tseg tom qab kev phais. Qhov no hu ua kev kho mob ntxiv
Kauj Ruam 3. Nrhiav tus kws phais mob thoracic
Feem ntau cov thymectomy yog ua los ntawm tus kws phais lub plab, lossis tus kws phais uas ua haujlwm feem ntau ntawm lub hauv siab. Koj tus kws phais lub plab yuav tsum tau ntawv pov thawj los ntawm pawg thawj coj saib, thiab koj yuav tsum tuaj yeem lees paub nws daim ntawv pov thawj online.
Kauj Ruam 4. Txheeb xyuas koj tus kws phais neeg lub peev xwm
Yog tias koj muaj qee qhov kev xaiv hauv qhov teeb meem no, sim nrhiav tus kws phais neeg uas tau ua ntau yam kev phais thymectomies yav dhau los. Xav tias dawb nug koj tus kws phais cov lus nug txog nws kev paub, suav nrog:
- Cov naj npawb ntawm kev phais tiav tau ua tiav
- Tus nqi hauv tsev kho mob
- Pawg thawj coj pov thawj
- Tsev kho mob zoo
Kauj Ruam 5. Nkag mus rau qhov nruab nrab sternotomy
Nov yog qhov kev phais feem ntau uas tau ua los tshem tawm theem I lossis II thymoma. Qhov no cuam tshuam txog kev faib lub pob txha ntawm lub mis thiab tshem cov thymoma thiab cov ntaub so ntswg ib puag ncig, xws li sab hauv lub ntsws thiab lub plawv. Nov yog kev phais qhib, uas txhais tau tias koj muaj feem yuav pheej hmoo ntshav poob thiab lub sijhawm rov zoo. Txawm li cas los xij, hom kev phais no ua haujlwm zoo heev ntawm kev tshem tawm cov qog nqaij hlav hauv nws tag nrho.
Hauv qee kis, koj yuav tsum tau siv tshuaj kho mob lossis hluav taws xob ua ntej phais. Kev siv tshuaj kho mob thiab hluav taws xob tuaj yeem ua rau cov qog ua kom yooj yim dua
Kauj Ruam 6. Tshawb nrhiav seb koj puas yog tus neeg sib tw rau lub tshuab thymectomy neeg hlau
Cov txheej txheem no cuam tshuam nrog kev txiav tawm ntawm tus neeg mob lub hauv siab thiab txuas cov neeg hlau caj npab ntawm ib sab ntawm chav hauv paus. Ntau qhov khoom siv kho mob tau txuas rau ntawm lwm sab, suav nrog lub koob yees duab endoscopic uas pab saib lub cev, cov cuab yeej ntse, cov cuab yeej xaws ntse, cov tawv taub hau me me, thiab lasers. Tus kws phais neeg ua haujlwm siv tus tswj hwm los tswj cov cuab yeej uas nyob hauv tus neeg mob lub cev. Cov cuab yeej muaj peev xwm zoo ib yam li tib neeg lub dab teg. Tus kws phais neeg ua haujlwm tshwj xeeb xaws thiab txiav cov lus tsa suab siv cov cuab yeej. Lub khoos phis tawj txhais cov kws phais neeg lub siab thiab ua rau lawv sab hauv lub cev.
Txoj hauv kev no tuaj yeem txo qis lub sijhawm rov zoo thiab poob ntshav, tab sis tsis tuaj yeem ua rau txhua tus neeg mob nyob ntawm qhov mob hnyav ntawm lawv cov qog ntshav
Kauj Ruam 7. Nug koj tus kws phais neeg txog qhov muaj peev xwm ua phais laparoscopic thoracic
Qhov kev phais no suav nrog ua peb qhov phais me me ntawm sab xis lossis sab laug ntawm lub hauv siab. Scopes thiab lwm yam twj paj nruag raug tso los ntawm qhov txhab kom cov qog tuaj yeem raug tshem tawm. Hom kev phais mob no txo qis koj lub sijhawm rov zoo, tab sis nws yuav tsis tuaj yeem ua rau txhua tus neeg mob.
Kauj Ruam 8. Tau debulking phais
Qhov kev phais no yog ua tiav rau thymomas uas nyob rau theem tom ntej thiab tau nce mus thoob plaws lub cev. Qhov no ua tiav thaum nws tsis tuaj yeem tshem tag nrho cov qog ntshav. Cov txheej txheem no sim tshem tawm cov qog feem ntau yog tias ua tau, thiab nws pab daws qee cov tsos mob. Qhov no kuj tseem yuav suav nrog tshem tawm cov ntaub so ntswg ib ncig ntawm lub hauv siab, lub plawv, thiab lub ntsws.
Kauj Ruam 9. Rov zoo li peb mus rau rau lub lim tiam tom qab thymectomy
Koj yuav tsis tuaj yeem rov qab mus ua haujlwm tam sim, tsev kawm ntawv, lossis tawm dag zog lub cev. Rau feem ntau cov neeg mob thymectomy, peb mus rau rau lub lis piam ntawm lub sijhawm rov zoo yog txaus ua ntej rov qab mus ua haujlwm ib txwm muaj. Txawm li cas los xij, cov kev mob tshwm sim ntawm thymectomy yog qhov tsawg: feem ntau cov neeg mob raug tso tawm hauv tsev kho mob tom qab ob peb hnub xwb, thiab feem ntau tsis xav tau tshuaj kho mob hnyav.
Nco ntsoov tias cov qog thymus tsis tsim nyog rau cov neeg laus kom muaj kev tiv thaiv kab mob zoo. Cov neeg mob feem ntau tsis muaj kev mob tshwm sim tom qab thymus tshem tawm cov qog
Txoj Kev 2 ntawm 3: Tshem Tawm Cov Thymoma Siv Kev Kho Hluav Taws Xob
Kauj Ruam 1. Paub txog tias hluav taws xob yuav tsis ua haujlwm ntawm nws tus kheej
Kev kho hluav taws xob tuaj yeem pab txo cov qog ua ntej raug tshem tawm phais. Cov hluav taws xob kuj tseem tuaj yeem pab ua kom cov qog nqaij hlav rov qab los tom qab phais. Ua ke nrog kev siv tshuaj kho mob, hluav taws xob tuaj yeem pab txo cov tsos mob thymoma hauv cov neeg mob qog nqaij hlav lig lig, xws li ua pa nyuaj lossis mob hauv siab. Txawm li cas los xij, hluav taws xob los ntawm nws tus kheej tsis yog qhov kev kho mob zoo tshaj plaws.
Kauj Ruam 2. Tshawb nrhiav seb txoj kev kho hluav taws xob ua haujlwm li cas
Kev siv hluav taws xob cuam tshuam nrog kev siv hluav taws xob pom lub zog loj los rhuav tshem cov qog nqaij hlav cancer. Qhov no pab nres lawv ntawm kev nce thiab sib ntxiv. Hom hluav taws xob siv nyob ntawm qhov muaj zog uas yuav tsum tau tshem tawm koj tus mob thymoma thiab ntxiv tias cov thymoma yuav kis mus deb npaum li cas.
Yog tias koj xaiv rau kev kho hluav taws xob, koj yuav ua haujlwm nrog kws kho mob uas hu ua hluav taws xob oncologist
Kauj Ruam 3. Tau txais Computerized Tomography (CT) scan
CT scan yog ib txoj hauv kev zoo los tsim cov duab ntawm koj lub cev. Nws cuam tshuam nrog kev siv tus lej X-duab hluav taws xob ntawm ntau lub ces kaum thiab tom qab ntawd sib txuas lawv kom pom kev hla ntu ntawm koj lub cev. CT scan tuaj yeem pab koj pab neeg oncology txiav txim siab qhov koob tshuaj thiab txoj haujlwm ntawm koj txoj kev kho hluav taws xob.
Kauj Ruam 4. Tshaj tawm txoj kev kho hluav taws xob sab nraud (EBRT) 5 hnub hauv ib lub lis piam
Hom hluav taws xob feem ntau uas siv yog kev kho hluav taws xob sab nraud. Nws siv xoo hluav taws xob los ntawm lub tshuab ib yam li cov txheej txheem x-ray ib txwm muaj, tsuas yog cov duab xoo hluav taws xob no muaj zog ntau dua.
- Cov txheej txheem tsis ua mob, tab sis nws yuav ua rau muaj kev phiv tom qab suav nrog: qaug zog, tawv nqaij liab, poob phaus, tsis qab los noj mov, xeev siab, thiab ntuav. Tag nrho cov no yog vim muaj cov hluav taws xob ntau heev, uas tuaj yeem ua rau lub cev ib txwm muaj nrog cov qog nqaij hlav cancer. Ntau cov kev mob tshwm sim yog ib ntus thiab tuaj yeem daws nrog tshuaj.
- Lwm hom EBRT uas tau siv yog kev kho hluav taws xob peb txheej txheem (3D-CRT). Cov txheej txheem no muaj peev xwm ua kom raug lub hom phiaj qog thaum tseem cuam tshuam tsawg dua ntawm cov ntaub so ntswg ib puag ncig. Qhov no txhais tau tias cov txheej txheem no muaj cov kev mob tshwm sim tsawg dua li kev kho hluav taws xob tas li.
- Kev kho hluav taws xob feem ntau tau ua tiav ob peb feeb ntawm ib lub sijhawm, rau ob peb hnub hauv ib lub lis piam, txuas ntxiv mus rau ntau lub lis piam.
Kauj Ruam 5. Kom ib tus kws kho mob ua qhov Kev Kho Kom Raug Mob-Kho Qhov Muag (IMRT)
IMRT yog daim ntawv qib siab ntawm 3D-CRT uas tseem tuaj yeem siv los tshem cov qog ntshav. Cov txheej txheem tso siab rau lub khoos phis tawj txhawm rau txheeb xyuas qhov tseeb ntawm cov ntaub so ntswg qog noj ntshav. Cov kab teeb thiab kev siv hluav taws xob tuaj yeem hloov kho kom tiv thaiv kev ua phem rau cov nqaij noj qab nyob zoo nyob ze.
Kauj Ruam 6. Tshaj tawm sab hauv hluav taws xob
Lub hauv paus ntawm cov hluav taws xob kuj tseem tuaj yeem yog kev cog qoob loo uas tau tso ncaj qha rau ntawm cov qog nqaij hlav uas siv rab koob lossis raj raj. Hom kev kho hluav taws xob no hu ua interstitial lossis sab hauv hluav taws xob. Cov hluav taws xob sab hauv feem ntau yog muab rau cov neeg mob sab nrauv tau ob peb lub lis piam. Koj tsis muaj xov tooj cua thaum lub sijhawm lossis tom qab kho.
Txoj Kev 3 ntawm 3: Tshem Tawm Thymoma Siv Tshuaj Kho Mob
Kauj Ruam 1. Nkag siab tias kev siv tshuaj kho mob thymoma kho li cas
Kev siv tshuaj tua kab mob yog txheej txheem kho mob siv los tua cov qog nqaij hlav cancer siv cov tshuaj. Cov tshuaj no yog txhaj tshuaj los yog qhov ncauj. Thaum cov tshuaj chemo nkag rau hauv koj cov ntshav, lawv kis mus rau lwm lub cev. Qhov no muaj txiaj ntsig thaum thymomas tau nkag mus rau cov ntaub so ntswg thiab cov nruab nrog cev.
- Kev siv tshuaj kho mob tuaj yeem siv ua ntej kev phais kom txo cov qog nqaij hlav uas tsis tuaj yeem tshem tawm tau los ntawm kev phais.
- Kws kho mob kuj tseem tuaj yeem ua tiav tom qab kev phais kom tua cov qog nqaij hlav cancer uas tseem tshuav lawm.
- Kev siv tshuaj khomob tuaj yeem siv nrog rau hluav taws xob rau cov neeg mob hnyav kom tau txais kev kho mob phais.
- Kws kho mob tsis pom zoo rau cov neeg mob uas cov qog nqaij hlav tuaj yeem raug phais tawm yooj yim.
Kauj Ruam 2. Tham nrog koj tus kws kho mob txog kev siv tshuaj kho mob
Cov tshuaj kws kho mob tuaj yeem siv los ntawm lub qhov ncauj lossis txhaj rau hauv cov leeg lossis leeg. Cov tshuaj tuaj yeem nkag mus rau hauv cov ntshav thiab mus txog cov qog nqaij hlav cancer thoob plaws lub cev. Txoj kev kho mob no hu ua kev siv tshuaj kho mob vim nws koom nrog txhua lub cev hauv lub cev.
Kauj Ruam 3. Tham nrog koj tus kws kho mob txog kev kho mob hauv cheeb tsam
Kev khomob kuj tseem tuaj yeem muab ncaj qha rau thaj chaw tshwj xeeb ntawm lub cev uas tau tsim cov thymoma. Hom kev kho mob no yog nyob hauv ib cheeb tsam. Kev siv tshuaj kho mob hauv ib cheeb tsam puas tsuaj cov qog nqaij hlav cancer uas nyob hauv thaj tsam ntawd.
Kauj Ruam 4. Paub seb yam tshuaj twg raug muab thaum kho tshuaj
Muaj ntau yam tshuaj kho kab mob uas tuaj yeem muab rau thaum kho. Lawv suav nrog: carboplatin, cisplatin, cyclophosphamide, doxorubicin, etoposide, ifosfamide, octreotide, paclitaxel thiab pemetrexed. Kev sib txuas ua ke uas nquag siv hauv kev kho tus mob thymoma suav nrog:
- Cyclophosphamide, cisplatin thiab doxorubicin.
- Paclitaxel thiab carboplatin.
- Cisplatin thiab etoposide.
Kauj Ruam 5. Mus rau plaub mus rau rau mus rau rau ntawm kev siv tshuaj kho mob
Kev khomob tau muab tshuaj rau hauv ntau qhov kev mus, txhua qhov uas kav ntev li peb txog tsib lub asthiv. Cov neeg mob so thiab rov zoo nyob nruab nrab ntawm cov kev mus los no. Kev pib ua tshuaj kho mob feem ntau yuav siv plaub mus rau rau mus ntxiv kom ua tau zoo.
Kauj Ruam 6. Paub txog cov kev phiv los ntawm kev siv tshuaj kho mob
Cov kev phiv los ntawm chemo uas koj tau ntsib yuav nyob ntawm qhov koob tshuaj thiab cov tshuaj muab. Ntau yam ntawm cov kev mob tshwm sim no yuav ploj mus tom qab kev siv tshuaj kho mob tau xaus. Txawm li cas los xij, cov kev mob tshwm sim muaj xws li:
- Xeev siab
- Ntuav
- Kab mob
- Raws plab
- Txo kev qab los noj mov
- Plaub hau poob
- Qaug zog
Kauj Ruam 7. Nug koj tus kws kho mob txog octreotide
Octreotide yog cov tshuaj tsim hluavtaws uas tuaj yeem ua rau txo qis thiab tua cov qog nqaij hlav hauv hlwb. Yog tias koj muaj tus mob qog noj ntshav lig lig uas tsis tuaj yeem raug phais tshem tawm tag nrho, nug koj tus kws kho mob seb qhov kev xaiv tshuaj hormonal puas tuaj yeem ua rau koj.
Lub tswv yim
- Robotic thymectomy tau qhia rau cov neeg mob rog rog vim tias nws tsis muaj kev cuam tshuam ntau.
- Tsis txhob ua siab deb nug cov neeg ua haujlwm kho mob.
- Nco ntsoov tias kev kwv yees rau cov neeg mob qog noj ntshav yog qhov zoo tshaj plaws, tshwj xeeb tshaj yog rau cov uas nyob rau theem pib ntawm kev mob.
Lus ceeb toom
- Ua koj qhov kev tshawb fawb ntawm kws phais neeg, kws kho plawv, thiab tsev kho mob thaum ua ke koj li phiaj xwm kev kho mob. Ua kom ntseeg tau tias txhua tus kws kho mob tau ntawv pov thawj thiab paub dhau los thiab tias koj lub tsev kho mob ua haujlwm tau zoo tshaj plaws.
- Qhia rau koj tus kws kho mob txog cov kev mob tshwm sim uas koj tau ntsib. Lawv yuav tuaj yeem pab koj daws cov teeb meem mob no.
