Kenza Yechiropa

"Dzidza zvimwe kubva kuna chiremba wechiropa Sean Cleary, M.D.\n\nAni anozviwana?\n\nKazhinji kenza yechiropa inoitika kune vanhu vane chirwere chechiropa. Asi dzimwe nguva kenza yechiropa inoitika kune vanhu vasina chirwere chechiropa uye hazvina kujeka kuti nei. Chirwere chechiropa chinogona kukonzera kuzvimba kwenguva refu muchiropa uye kuunganidza mutations inogona kukonzera kenza. Imwe yematambudziko makuru ndeyekuti vanhu vazhinji vanogona kuva nechirwere chechiropa uye vasina kuziva kusvikira chiropa chavo chakuvadzwa zvakanyanya kana kenza ikaunda. Heano mamwe mazano atinoziva anowedzera njodzi yako yekuwana kenza yechiropa: Kana uine hutachiona hwehepatitis B kana C, cirrhosis, zvimwe zvirwere zvechiropa zvakaita se hemochromatosis uye Wilson's disease, chirwere cheshuga, non-alcoholic fatty liver disease, kana kuiswa kweaflatoxins, une mukana mukuru wekuwana kenza yechiropa. Kunwa doro zvakanyanya kwemakore mazhinji kunogona zvakare kukonzera kukuvara kwechiropa kunogara kwenguva refu uye kukonzera kenza yechiropa.\n\nZviratidzo zvei?\n\nVanhu vazhinji havawani zviratidzo mumavambo ekutanga ekukura kwenza yechiropa. Kana zviratidzo zvikaonekwa, zvinogona kusanganisira kurasikirwa uremu pasina chikonzero, kurasikirwa chido chekudya, kurwadziwa mudumbu repamusoro, kusvotwa uye kurutsa, kushaya simba uye kuneta, kuzvimba mudumbu, jaundice uko maziso ako neganda rinotendeuka yero, uye matumbu machena, ane chalky. Zvimwe zviratidzo zvinogona kusanganisira fivha, tsinga dzakakura mudumbu dzinogona kuonekwa kuburikidza neganda, uye kuvhunduka kana kubuda ropa. Zvirongwa zvekuongorora uchishandisa ultrasound zvinobudirira kwazvo pakutsvaga kenza yechiropa usati wazviratidza. Uye tinokurudzira munhu wese ane matambudziko echiropa anozivikanwa kuti ataure nachiremba wavo kuti kuongororwa kuri kukodzera kwauri here.\n\nInoongororwa sei?\n\nKuongororwa uye maitiro anoshandiswa kuongorora kenza yechiropa anosanganisira bvunzo yeropa. Izvi zvinogona kuratidza kusakwana kwechiropa. Kuongororwa kwemafomu senge ultrasound, CT, uye MRI. Uye kana wakazivikanwa, nhanho inotevera ndeyekutsanangura huwandu hwekenza yechiropa kana nhanho. Chiremba wako anozobva akumbira bvunzo dzekuongorora kuti abatsire kuona saizi uye nzvimbo yekenza uye kana yakapararira. Kuongororwa kwemafomu kunoshandiswa kuongorora kenza yechiropa kunosanganisira CT scans, MRI, uye bone scans. Kune nzira dzakasiyana dzekuongorora kenza yechiropa. Semuenzaniso, imwe nzira inoshandisa nhamba dzeRoma kubva ku1 kusvika ku4, uye imwe inoshandisa mavara A kusvika kuD. Chiremba wako anoongorora nhanho yako yekenza kuti aone sarudzo dzako dzekurapa uye prognosis yako.\n\nInorapwa sei?\n\nKune nzira dzakawanda dzinogona kukubatsira chiremba wako kuti agadzire hurongwa hwekurwisa kenza yechiropa. Kuvhiya kunogona kurongwa kubvisa tumor kana kubvisa chiropa chose kuti uite kuisirwa kwechiropa. Kurapa kwako kunogona kusanganisira radiation therapy, iyo inoshandisa simba rakasimba kubva kunzvimbo dzakadai se-X-rays uye protons, kuparadza masero ekenza uye kudzikisa tumors. Madokota anotarisa simba iri muchiropa nepo achichengetedza tishu dzakapoteredza dzakapfava. Chemotherapy kurapa kwakajairika uye kushandiswa kwemakemikari ane simba kurwisa uye ndinokutendera kuti uuraye kenza. Targeted drug therapy inotarisa pane zvikanganiso zvakakosha zviripo mukati memasero ekenza. Nekuvhara zvikanganiso izvi, kurapwa kwezvinodhaka zvinangwa kunogona kukonzera masero ekenza kuti afe.\n\nZvino chii?\n\nKenza yechiropa inotanga mune masero echiropa. Rudzi rwakajairika rwekenza yechiropa runotanga mune masero anonzi hepatocytes uye rinonzi hepatocellular carcinoma.\n\nKenza yechiropa ndiro kenza rinotanga mune masero echiropa rako. Chiropa chako chimiro chakaita sebhora refutbhoru chinogara muchikamu chepamusoro chekurudyi chemudumbu rako, pasi pe diaphragm yako uye pamusoro pemudumbu rako.\n\nMarudzi akawanda ekenza anogona kuumbwa muchiropa. Rudzi rwakajairika rwekenza yechiropa ndiro hepatocellular carcinoma, iyo inotanga murudzi rukuru rwechiropa sero (hepatocyte). Mamwe marudzi ekensa yechiropa, akadai se intrahepatic cholangiocarcinoma uye hepatoblastoma, haawanzoitiki.\n\nKenza inopararira kuenda kuchiropa inowanzoitika kupfuura kenza inotanga mune masero echiropa. Kenza inotanga kune imwe nzvimbo yemuviri - senge colon, mapapu kana chifuva - uye wobva wapararira kuenda kuchiropa inonzi metastatic cancer panzvimbo pekunge iri kenza yechiropa. Rudzi urwu rwekenza runonzi zita rechikamu chemuviri chakatanga - senge metastatic colon cancer kurondedzera kenza inotanga mucolon uye inopararira kuenda kuchiropa."

Chiropa ndicho chikamu chikuru mukati memumuviri. Chikuru sezvibhakera. Chinowanikwa kunyanya kurutivi rwerudyi rwemusoro, pamusoro pemudumbu.

Vanhu vazhinji havaone zviratidzo uye zviratidzo pakutanga kwekenza yechiropa. Kana zviratidzo nezviratidzo zvikaonekwa, zvinogona kusanganisira:

• Kurasikirwa nehuremu pasina kuedza
• Kushaya chido chekudya
• Kurwadziwa kwemudumbu
• Kuita tsamwa nekurutsa
• Kushaya simba uye kuneta
• Kuchema kwemudumbu
• Kuonekwa kwechiedza cheyero paganda rako nepachena meziso ako (jaundice)
• Matumbu machena, akafanana nechakwi

Enda kunachiremba kana uine zviratidzo kana zvimwe zvinhu zvinokunetsa.

Kenza retsinga inoitika kana masero etsinga akaita shanduko (mutations) muDNA yavo. DNA yesero ndiro zvinhu zvinopa mirairo yezvese zvinhu zvinoitika mumuviri mako. Shanduko dzeDNA dzinokonzera shanduko mune idzi mirairo. Chimwe chezvibereko ndechekuti masero angatanga kukura asingadzoreki uye pakupedzisira akagadzira tumor — boka remasero ane kenza.

Dzimwe nguva chikonzero chekenza retsinga chinozivikanwa, sekune hutachiona hwehepatitis husingaperi. Asi dzimwe nguva kenza retsinga rinoitika kune vanhu vasina zvirwere zviripo uye hazvizivikanwi kuti chii chinorikonzeresa.

Zvinhu zvinowedzera njodzi yegomarara rechitokisi zvinosanganisira: Kutapukirwa kusingaperi neHBV kana HCV. Kutapukirwa kusingaperi nehutachiona hwehepatitis B (HBV) kana hepatitis C (HCV) kunowedzera njodzi yako yegomarara rechitokisi. Cirrhosis. Iyi mamiriro anofambira mberi uye asingadzoreki anokonzera kuti maronda aumbe muchitokisi chako uye anowedzera mikana yako yekuve negomarara rechitokisi. Zvimwe zvirwere zvechitokisi zvinogarwa nhaka. Zvirwere zvechitokisi zvinogona kuwedzera njodzi yegomarara rechitokisi zvinosanganisira hemochromatosis uye chirwere chaWilson. Chirwere cheshuga. Vanhu vane chirwere ichi cheshuga vane njodzi huru yegomarara rechitokisi kupfuura avo vasina chirwere cheshuga. Chirwere cheshuga chisiri chekudhakwa. Kuunganidzwa kwemafuta muchitokisi kunowedzera njodzi yegomarara rechitokisi. Kuratidzwa kune aflatoxins. Aflatoxins muchetura unogadzirwa nehutachiona hunokura pazvirimwa zvakachengetwa zvisina kunaka. Zvirimwa, zvakaita sezviyo nenzungu, zvinogona kusvibiswa neaflatoxins, izvo zvinogona kupedzisira zvave muzvikafu zvakagadzirwa nezvinhu izvi. Kunwa doro zvakanyanyisa. Kunwa doro rinopfuura mwero wezuva nezuva kwemakore mazhinji kunogona kutungamirira kukuvadzwa kusingadzoreki kwechitokisi uye kuwedzera njodzi yako yegomarara rechitokisi.

Cirrhosis chirwere chekuoma kwechiropa, uye inowedzera njodzi yekenza yechiropa. Unogona kuderedza njodzi yako ye cirrhosis kana iwe:

• Inwa doro zvine mwero, kana zvakadaro. Kana iwe uchida kunwa doro, deredza huwandu hwawunwa. Kune vakadzi, izvi zvinoreva kwete kupfuura chimwe chinwiwa pazuva. Kune varume, izvi zvinoreva kwete kupfuura zvinwiwa zviviri pazuva.
• Chengeta uremu hwakanaka. Kana uremu hwako hwazvino hwakanaka, shanda kuti uchengetedze nekusarudza kudya kwakanaka uye kurovedza muviri mazuva mazhinji evhiki. Kana uchida kuderedza uremu, deredza nhamba yemakorari aunodya zuva nezuva uye wedzera huwandu hwekurovedza muviri hwawunoita. Chinangwa chekuderedza uremu zvishoma nezvishoma - 1 kana 2 mapaundi (0.5 kusvika ku1 makirogiramu) vhiki imwe neimwe. Unogona kuderedza njodzi yako yehepatitis B nekugamuchira jekiseni rehepatitis B. Jekiseni rinogona kupiwa kune chero munhu, kusanganisira vacheche, vakuru vakwegura uye avo vane matambudziko emuviri. Hapana jekiseni rehepatitis C riripo, asi unogona kuderedza njodzi yako yekutapukirwa.
• Ziwa mamiriro ezveutano emumwe wako wepabonde. Usaita bonde risina kuchengetedzwa kunze kwekunge uine chokwadi chekuti mumwe wako haana kutapukirwa neHBV, HCV kana chero imwe chirwere chinopfuudzwa nepabonde. Kana usingazive mamiriro ezveutano emumwe wako, shandisa kondomu nguva dzose paunoita zvepabonde.
• Usashandise mishonga inopinda mutsinga (IV), asi kana ukaita, shandisa tsono yakachena. Dzikisa njodzi yako yeHCV nekusaisa mishonga isina kunyorerwa. Asi kana izvozvo zvisiri sarudzo kwauri, ita shuwa kuti chero tsono yaunoshandisa yakachena, uye usagovana nayo. Zvishandiso zvekushandisa zvinodhaka zvakasvibiswa ndicho chikonzero chakajairika chekutapukirwa nehepatitis C. Shandisa mapurogiramu ekutsinhanisa tsono munharaunda yako uye funga kutsvaga rubatsiro rwekushandisa kwako zvinodhaka.
• Tsvaga zvitoro zvakachengeteka, zvakachena paunowana kupiercing kana tattoo. Tsono dzisingagone kucheneswa zvakakwana dzinogona kuparadzira hutachiona hwehepatitis C. Usati waita kupiercing kana tattoo, tarisa zvitoro munharaunda yako uye bvunza vashandi nezvemabatiro avo ekudzivirira. Kana vashandi muzvitoro vakaramba kupindura mibvunzo yako kana vasina kutora mibvunzo yako zvakakomba, tora izvozvo semuenzaniso wekuti chitoro hachina kukodzera iwe. Kurapwa kuripo kwehepatitis B nehepatitis C zvirwere. Kutsvagisa kunoratidza kuti kurapwa kunogona kuderedza njodzi yekenza yechiropa. Kune vanhu vose, kuongororwa kwekukenza kwechiropa hakuna kuratidzwa kuti kunoderedza njodzi yekufa nekukenza kwechiropa, uye hazvikurudzirwi kazhinji. Vanhu vane mamiriro anoowedzera njodzi yekenza yechiropa vangafunga kuongororwa, senge vanhu vane:
• Hepatitis B kutapukirwa
• Hepatitis C kutapukirwa
• Cirrhosis yechiropa Kurukurai zvakanaka nezvakaipa zvekuongororwa nachiremba wako. Pamwe chete munogona kusarudza kana kuongororwa kuri kukodzera iwe zvichienderana nenjodzi yako. Kuongororwa kazhinji kunosanganisira bvunzo yeropa uye bvunzo ye ultrasound yepakati pemwedzi mitanhatu.

Nyanzvi yezvipembenene zvechiropa, Sean Cleary, M.D., inopindura mibvunzo inonyanya kubvunzwa nezvekenza yechiropa.

Ndapinzwa chirwere, ndofanira kusarudza sei timu yekurapa?

Paunofunga nezvekusarudza nzvimbo yekurapa kenza yechiropa, unoda kufunga nezvenzvimbo inorapira kenza yechiropa yakawanda uye ine nhengo dzese dzetimu inodiwa kurapa chirwere chako. Izvi zvinogona kusanganisira vanachiremba vezvipembenene zvechiropa kana vanachiremba vezvipembenene zvechiropa, vanachiremba vezvipembenene zvechiropa nevanachiremba vekusimudzira, uye vanachiremba vezvipembenene zvechiropa nevanachiremba vekurapa.

Ndingava sei shamwari yakanaka kune timu yangu yezvokurapa?

Imwe yenzira dzakanaka dzekubatana netimu yako yekurapa ndeyekubatanidzwa. Bvunza mibvunzo. Vabvunze nezve nzira dzekurapa dziripo. Kurukurai zvakanaka nezvakaipa uye zvakanakira kurapwa chero kupi kwakapiwa. Uye pamwe chete sarudzai zviri nani kwauri. Kuva neruzivo kunoita musiyano wose.

Chirwere changu chichakanganisa sei kudya kwangu nemararamiro angu?

Kana wapinzwa chirwere chekenza yechiropa, tinoda kuedza kudzivisa zvinhu zvinogona kukuvadza zvakanyanya chiropa. Uye izvi zvinogona kusanganisira doro nekusvuta. Zvimwe, tinoda kuedza kuva vane utano sezvinobvira nekuramba tiine kudya kwakanaka uye kurovedza muviri nguva dzose.

Ndinoda biopsy here?

Kenza yechiropa imwe yekenza umo tingasada biopsy kuita sarudzo nezve kurapwa kwako. Dzimwe nguva, kenza yechiropa inogona kuongororwa zvakavimbika pane zvidzidzo zvekuongorora senge CT scans kana MRIs. Zvakakosha kutaura nachiremba wako uye timu yako yezvokurapa kuti uone kana biopsy iri inodiwa sechikamu chechirongwa chako chekurapa.

Chemotherapy kana immunotherapy inokodzera here kwandiri?

Tave tichiva nezviitiko zvinofadza munyika ye chemotherapy ne immunotherapy ye kenza yechiropa. Zvakakosha kutaura nachiremba wako uye timu yako yezvokurapa kuti uone kana chemotherapy kana immunotherapy ingave yakakodzera sechikamu chechirongwa chako chekurapa. Tinokutendai nekanguva kwenyu. Uye tinokushuvira zvakanaka.

Biopsy yechiropa ndiyo nzira yekubvisa sampuli diki yetsvina yechiropa yekuongororwa kwelabhoritari. Biopsy yechiropa kazhinji inoitirwa nekupinza tsono yakatetepa kuburikidza neganda uye mukati mechiropa.

Kuongororwa nemazano anoshandiswa kuongorora kenza yechiropa anosanganisira:

• Kuongororwa kweropa. Kuongororwa kweropa kunogona kuratidza kusagadzikana kwechiropa.
• Kuongororwa kwemafirimu. Chiremba wako anogona kukurudzira kuongororwa kwemafirimu, senge ultrasound, CT ne MRI.

Kubvisa sampuli yetsvina yechiropa yekuongororwa. Dzimwe nguva zvinodikanwa kubvisa chidimbu chetsvina yechiropa yekuongororwa kwelabhoritari kuti uite kuongororwa kwakajeka kwekenza yechiropa.

Panguva yebiopsy yechiropa, chiremba wako anopinda tsono yakatetepa kuburikidza neganda rako uye mukati mechiropa rako kuti awane sampuli yetsvina. Mu laboratori, vanachiremba vanoongorora tishu pasi pe microscope kuti vatsvage masero ekenza. Biopsy yechiropa ine njodzi yekubuda ropa, kuvhunduka nehutachiona.

Kana kenza yechiropa yaongororwa, chiremba wako achaita basa rekuona huwandu (danho) rekenza. Kuongororwa kwekuisa danho kunobatsira kuona saizi nekwakabva kenza uye kana yakapararira. Kuongororwa kwemafirimu anoshandiswa kuisa danho rekenza yechiropa anosanganisira CTs, MRIs nebone scans.

Kune nzira dzakasiyana dzekuisa danho rekenza yechiropa. Semuenzaniso, imwe nzira inoshandisa nhamba dzeRoma I kusvika IV, uye imwe inoshandisa mavara A kusvika D. Chiremba wako anoshandisa danho rekenza yako kuti aone sarudzo dzako dzekurapa uye kufanotaura kwako.