Izifo ezingokwemvelo zithatha ingxenye enkulu yezo zonke izifo. Amacala angaphezu kwezigidi ezingu-10 ngonyaka atholakala emhlabeni jikelele. Wonke amazwe alindele izindaba ezivela ososayensi mayelana nokusungulwa kokwelashwa okumangalisayo komdlavuza. Futhi okwamanje, izinga lokufa kusuka kwi-oncology liqhubeka likhula. Ngakho yimuphi ukwelashwa kwalesi sifo?
Izidakamizwa ze-Antineoplastic yomdlavuza
Kunezindlela eziningana zokuphatha i-oncology. Lokhu yi-chemotherapy, imisebe, i-hormonal, ukwelashwa okuhlosiwe, ukungenelela kokuhlinzwa. Indlela ikhethwa kuye ngokuthi uhlobo, isigaba sesifo, indawo yesisu, isimo sempilo yesiguli, njll. Ingabe kukhona isidakamizwa somdlavuza? I-metabolites ye-Antineoplastiki isetshenziselwa ukwelashwa kwamakhemikhali. Umgomo oyinhloko wokuwasebenzisa ukukwenza ukukhula kwamangqamuzana omdlavuza kuphelile, isisu asikhulumi, futhi ama-metastases awaveli. Lezi yizidakamizwa ezifana nalezi:
- I-Ftorafur;
- I-Methotrexate;
- I-Hydroxyurea;
- Xeloda.
I-anesthetics ye-oncology
Izidakamizwa eziqeda ubuhlungu, nomdlavuza, zisetshenziselwa ukuvimbela imiphumela emibi esimweni somzimba nesengqondo yesiguli. Ubuhlungu ku-oncology buhlukaniswe izinhlobo ezimbili: i-neuropathic ne-nociceptive. Imithi yokwelashwa inqunywe ngokusho kohlobo lobuhlungu. Ngakho-ke, kwaziwa ukuthi ubuhlungu be-nociceptive buphela ekusetshenzisweni kwe-analgesics, izidakamizwa ezingekho-steroidal eziphikisayo, ama-opioids. Ukuqeda ubuhlungu be-neuropathic, izidakamizwa zokulwa nezifo kanye ne-tricyclic anti-depressants zibekiwe.
Ama-painkillers anamandla okwe-oncology anqunywe udokotela, lapho labo ababuthakathaka bengasenalo umphumela oyifunayo. Lokhu kwenzeka ngenxa yokujwayela okusheshayo komzimba ezindleleni ezisetshenzisiwe. Ezimweni ezinjalo, inqubo yesinyathelo esithathu isetshenziselwa, ngokusekelwe kuzincomo ze-WHO. Ngesikhathi esifanayo, kwenziwa amalungiselelo adjuvant. Lolu hlelo lunikeza umphumela we-analgesic kuma-90% wamacala:
- i-analgesic engeyona yezokwelapha ;
- isidakamizwa esibuthakathaka sama-narcotic kanye ne-analgesic engezona-narcotic;
- ama-opiates eqembu le-morphine kanye ne-analgesic engeyona ye-narcotic.
Ukukhululeka ebuhlungu buqala ngokusetshenziswa kwama-analgesics angewona ama-narcotic. Lezi yizi:
- I-Paracetamol;
- I-Aspirin;
- Metamizole sodium;
- Diclofenac;
- Kuyinto ethanol;
- Ibuprofen;
- I-Naproxen;
- Ketorolac;
- I-Piroxicam;
- Meloksikam;
- Xsefokam;
- I-mefenamic acid.
Imithi ye-adjuvant yizidakamizwa ezilandelayo:
- banike amandla (ama-antidepressants, glucocorticoids, izidakamizwa eziphikisayo);
- babe nomphumela wokulungisa emiphumeleni emibi ye-analgesics yama-narcotic (antipsychotics);
- ukuqinisa umphumela wabo we-analgesic (iClonidine, abaphikisi be-calcium).
Ama-opiate abuthakathaka athwala:
- I-Codeine;
- I-Tramadol.
Ukusetshenziswa kwezidakamizwa ezinamandla kakhulu ze-anesthesia kungathiwa:
- Propionylphenylethoxyethylpiperidine hydrochloride;
- Morphine;
- Buprenorphine;
- Fentanyl.
Imithi ye-antiemétique ye-oncology
Ukuvuthwa akuyona nje uhlamvu olungathandeki, kodwa futhi ngokushesha kuholela umzimba ukuba uphelelwe amanzi, futhi izibungu ezinomuncu emaphethweni omathunjini zithola umonakalo owenziwe ngomshini. Ukubonakaliswa kwezinambuzane nokuhlanza emdlalweni yisenzakalo esivamile. Izizathu zingahluka:
- ukwelashwa kwemisebe;
- i-chemotherapy;
- i-tumor ne-metastase ebuchosheni;
- izinkinga zesisu somuthi wamathunjini;
- ukuhluleka kwezinso;
- izidakamizwa zesibindi;
- ukudakwa;
- izifo ezithathelwanayo nezivuthayo.
Ngaphambi kokuqeda isibonakaliso esingajabulisi nezidakamizwa, kubalulekile ukubeka izizathu. Ngenxa yalokhu, izidakamizwa isiguli esitholayo futhi idatha ye-laboratory ifundiswa. Izimbangela zalesi sibonakaliso zingase zibe phakathi nendawo. Uma uhlanza indlela ephakathi, amathuluzi alandelayo asetshenziswa:
- abaphikisi be-serotonin (ama-blockers ka-5 NTZ-receptors - i-Ondansetron, iTropisetron, i-Granisetron, njll), ayaphumelela kakhulu ekudakwa;
- corticosteroids (Dexamethasone, Methylprednisolone, Solumedrol);
- Benzodiazepines (diazepam, lorazepam).
Isenzo sokusebenza kwezidakamizwa ze-antiemetic ku-oncology:
- i-atropine nezinye izidakamizwa ze-anticholinergic (i-Platyphylline ne-Metacin);
- antihistamines (i-Diphenhydramine, i-Suprastin);
- Abaphikisi be-Dopamine yi-phenothiazines (Etaperazine, Torekan, Aminazine) ne-butyrophenones (i-Droperidol, i-Haloperidol), i-Metoclopramide (Cerucal).
Izidakamizwa ezibhekwe nomdlavuza
Ukwelapha okubhekiswe kuyindlela emisha ekulweni ne-oncology. Ngaphandle kwalokho, lezi zidakamizwa zibizwa ngokuthi "zihlakaniphile". Leli gama lazitholayo ngenxa yokwazi ukwenza kuphela kuma-cell cell, kuyilapho izicubu ezinempilo nezitho zomzimba zihlala zingashintshi. Imithi enjalo ye-oncology inqunyelwe ukuyeka ukukhula kwezidumbu, ukunciphisa ukulinganisa kwamakhemikhali kanye nezimo ezinzima zeziguli. Kuze kube manje, izidakamizwa ezingaba ngu-10 ziye zahlolelwa ngomzimba futhi zasetshenziswa, cishe amanye amahlanu ahlolwe futhi, mhlawumbe, maduzane azosetshenziselwa ukwelapha umdlavuza.
Ukungafaki izidakamizwa ekuvuthweni kwe-oncology
Kunemibono eminingi mayelana nokusetshenziswa kwama-immunomodulators ezinkingeni zomdlavuza. Baqala ukusetshenziswa ema-70. Ukuzivocavoca kubonise ukuthi izindlela ezinjalo azibaniki umphumela ongahle. Kungaba kuhle futhi kungalungile. I-immunotherapy ne-oncology isetshenziselwa izinkomba eziningana:
- emva kwe-chemotherapy ne-irradiation nge-immuno- ne-hematological disorders (iTamerite, Polyoxidonium, Glutoxim, Galavit, Neovir, Cycloferon, Roncoleukin, Leukinferon, Lycopid, Decaris, Timalin, Timogen, Milife);
- emva kokusebenza okunzima (i-Polyoxidonium, iLeukinferon, i-Galavit, i-Imunofan, i-Roncoleukin Myelopid, i-Lycopid);
- ukulungisa ukuphazanyiswa emasimini omzimba (Polyoxidonium, Glutoxim, Leukinferon, Imunofan, Galavit);
- ukuze kwenziwe isenzo se-neoplasm ngokwayo (i-Roferon, i-Reaferon-EU, i-Intron-A, i-interferon ye-Leukocyte yezijovo);
- ukuze kuvikelwe imithi (i-Leukinferon, i-Neovir, i-Roncoleukin ne-Galavit), ukusebenza kahle kule ndlela akuboniswa.
Ukulungiselela ukwandisa i-hemoglobin ku-oncology
Kuye ngenani lamaseli abomvu egazi, ukuhlukanisa phakathi kwe-microcytic, i-macrocytic ne-normalcy anemia. Amalungiselelo ensimbi ye-oncology ahlinzekwa nge-intravenously ngokujova kanye namalungiselelo e-erythropoietin, okukhuthaza ukukhiqizwa kwama-erythrocytes. Ngaphezu kwalokho, ukwandisa i-hemoglobin ezigulini zomdlavuza, indlela yokumpontshelwa kwe-erythrocytes isetshenziswa, lapho amaseli abomvu egazi atholakele ku-donor igazi ajowelwa ngaphakathi. Ngakho, izinga le-hemoglobin liphuma ngokushesha.
Imithi emisha ekwelapheni komdlavuza
Izinguquko ekwelapheni kwe-oncology, njengezinye iziqondiso emithi, zenzeka cishe njalo eminyakeni eyishumi. Kokuthuthukiswa kwamuva, i-biotherapy yezifo ezifuywayo, i-immunotherapy ehlosiwe, ukwethulwa kwezindlela ezintsha zokuhlinzwa, kanye nemishini yokwelapha kanye nokwelashwa okuhlosiwe. Ukwakha isidakamizwa esisha somdlavuza, kuthatha isikhathi esiningi. Ngemva kokusungulwa, isidakamizwa sidlula izigaba eziningana zokuhlola.
Umdlavuza womuthi we-Spot
Ezifundweni zakamuva - imithi entsha yaseRashiya elwa nomdlavuza, eyakhiwe yinkampani yezokwelapha i-BIOCAD, PD-1. Ukusuka ngo-2015 kuya ku-2016, izivivinyo zezilwane zenziwa. Imiphumela iboniswe ngaphezu kwakho konke okwakhiwe ekuqaleni. Lokhu kuyimithi ehlosiwe noma ebizwa ngokuthi "iphuzu", elivimba ukuthuthukiswa kwesisu. Manje isigaba sesibili sokuhlolwa siyaqhubeka. Kuhlelwe ukuthi lesi sidakamizwa sizotholakala ukuze sisetshenziswe kusukela ngo-2018-2019.
Yiziphi izinhlobo zomdlavuza ezilwa nomuthi omusha?
Umuthi omusha wokulwa nomdlavuza, ngokusho kochwepheshe, usebenza ezinhlotsheni ezinjalo ze-oncology njengomdlavuza wamaphaphu , izinso, ikhanda nentamo, isisu, i-melanoma. Abakhiqizi bathembisa ukuthi ngisho nangabe izamukeli zizoyeka, umphumela womuthi omusha uzoqhubeka, okuzokwenza kube nethuba lokululama ngisho neziguli ezinzima kakhulu. Futhi okubaluleke kakhulu, ithuluzi lizotholakala kumaRussia. Izidakamizwa ezimbili ezisetshenzisiwe kakade zikhiqizwa phesheya futhi zinezindleko eziphezulu kakhulu.
Yiziphi izidakamizwa ezingenakuthathwa nge-oncology?
Ukuphendula umbuzo, yikuphi imithi engenakwenzeka kwi-oncology, kubalulekile ukukhumbula ukuthi imithi ethile ayikwazi nje ukuvimbela ukwelashwa kusuka kwi-oncology, kodwa futhi igxilise isimo nakakhulu. Isibonelo, izidakamizwa ezikhuthaza umzimba, amavithamini kanye nama-anticoagulants angabangela ukukhula kwe-tumor kanye nama-metastases. Ngaphansi kokuvinjelwa namahomoni. umbuzo uhlala futhi mayelana nokudla kwamalungiselelo ensimbi. Zilawa kalula futhi azilawulwa ngumzimba. Ngakho-ke, bangenza umonakalo omkhulu kunokuhle.