Types/gestational-trophoblastic/patient/gtd-treatment-pdq

Chithandizo cha Matenda a Gestational Trophoblastic (®) -Patient Version

Zambiri Zokhudza Matenda a Gestational Trophoblastic

MFUNDO ZOFUNIKA

• Matenda a Gestational trophoblastic (GTD) ndi gulu la matenda osowa omwe m'maselo achilengedwe amakula mkati mwa chiberekero atatenga pathupi.

• Hydatidiform mole (HM) ndi mtundu wofala kwambiri wa GTD.

• Gestational trophoblastic neoplasia (GTN) ndi mtundu wa matenda opatsirana pogonana (GTD) omwe nthawi zambiri amakhala owopsa.

• Timadontho tating'onoting'ono tambiri

• Choriocarcinomas

• Zotupa za Placental-site trophoblastic

• Zotupa za Epithelioid trophoblastic

• Zaka zakubadwa komanso mimba yam'mbuyomu zimakhudza chiopsezo cha GTD.

• Zizindikiro za GTD zimaphatikizapo kutuluka magazi kwachilendo komanso chiberekero chomwe chimakhala chachikulu kuposa zachibadwa.

• Kuyesa komwe kumayang'ana chiberekero kumagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira matenda a gestational trophoblastic.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Matenda a Gestational trophoblastic (GTD) ndi gulu la matenda osowa omwe m'maselo achilengedwe amakula mkati mwa chiberekero atatenga pathupi.

Mu matenda a gestational trophoblastic (GTD), chotupa chimayamba mkati mwa chiberekero kuchokera minyewa yomwe imapangidwa pambuyo pathupi (kulumikizana kwa umuna ndi dzira). Minofu imeneyi imapangidwa ndi ma trophoblast cell ndipo nthawi zambiri imazungulira dzira lomwe limakumana ndi chiberekero. Maselo a Trophoblast amathandizira kulumikiza dzira la umuna ndi khoma la chiberekero ndikupanga gawo la placenta (chiwalo chomwe chimapereka michere kuchokera kwa mayi kupita kwa mwana wosabadwa).

Nthawi zina pamakhala vuto ndi dzira la umuna ndi maselo a trophoblast. M'malo mwa mwana wosabadwa bwino, chotupa chimayamba. Mpaka pomwe padzakhala zizindikilo za chotupacho, mimba idzawoneka ngati mimba yabwinobwino.

Ambiri a GTD ndi owopsa (osati khansa) ndipo samafalikira, koma mitundu ina imakhala yoyipa (khansa) ndipo imafalikira kumatenda oyandikira kapena mbali zakuthupi za thupi.

Matenda a Gestational trophoblastic (GTD) ndi mawu wamba omwe amaphatikizapo mitundu yosiyanasiyana ya matenda:

• Magulu a Hydatidiform (HM)

• HM yonse.

• HM yochepa.

• Gestational Trophoblastic Neoplasia (GTN)

• Timadontho tating'onoting'ono tambiri.

• Choriocarcinomas.

• Zotupa za Placental-site trophoblastic (PSTT; ndizosowa kwambiri).

• Zotupa za Epithelioid trophoblastic (ETT; zosowa kwambiri).

Hydatidiform mole (HM) ndi mtundu wofala kwambiri wa GTD.

Ma HM ndi zotupa zokula pang'onopang'ono zomwe zimawoneka ngati matumba amadzimadzi. HM amatchedwanso kuti mimba yam'mimba. Zomwe zimayambitsa ma hydatidiform moles sizikudziwika.

Ma HM atha kukhala okwanira kapena opanda tsankho:

• HM yathunthu imapangidwa umuna ukamadzipiritsa dzira lomwe mulibe DNA ya amayi. Dzira lili ndi DNA yochokera kwa bambo ake ndipo maselo omwe amayenera kuti azikhala placenta siachilendo.

• HM imapangika pang'ono pomwe umuna umapereka dzira labwinobwino ndipo pamakhala magawo awiri a DNA kuchokera kwa abambo omwe ali mu dzira la umuna. Gawo lokha la mwana wosabadwayo ndi maselo omwe amayenera kukhala nsengwa ndizachilendo.

Ma moles ambiri a hydatidiform amakhala owopsa, koma nthawi zina amakhala khansa. Kukhala ndi chimodzi kapena zingapo mwaziwopsezo zotsatirazi kumawonjezera chiopsezo kuti mole ya hydatidiform idzakhala khansa:

• Mimba isanakwane 20 kapena pambuyo pa zaka 35.

• Mulingo wokwera kwambiri wa beta chorionic gonadotropin (β-hCG), mahomoni opangidwa ndi thupi nthawi yapakati.

• Chotupa chachikulu m'chiberekero.

• Chotupa cha ovarian chachikulu kuposa masentimita 6.

• Kuthamanga kwa magazi nthawi yapakati.

• Chithokomiro chopitilira muyeso (mahomoni owonjezera a chithokomiro amapangidwa).

• Kunyansidwa kwambiri ndikusanza nthawi yapakati.

• Maselo otchedwa trophoblastic m'magazi, omwe amatha kutseka mitsempha yaying'ono yamagazi.

• Mavuto akulu otseka magazi obwera chifukwa cha HM.

Gestational trophoblastic neoplasia (GTN) ndi mtundu wa matenda opatsirana pogonana (GTD) omwe nthawi zambiri amakhala owopsa.

Gestational trophoblastic neoplasia (GTN) imaphatikizapo izi:

Timadontho tating'onoting'ono tambiri

Tizilombo tomwe timayambitsa matendawa timapangidwa ndi timadzi timene timatulutsa chiberekero. Timadontho tating'onoting'ono tambiri timatha kukula ndikufalikira kuposa mole ya hydatidiform. Nthawi zambiri, HM yathunthu kapena yaying'ono imatha kukhala mole yolakwika. Nthawi zina mole yolusa imatha popanda chithandizo.

Choriocarcinomas

Choriocarcinoma ndi chotupa choyipa chomwe chimachokera m'maselo a trophoblast ndikufalikira mpaka kumtunda kwa chiberekero ndi mitsempha yamagazi yapafupi. Itha kufalikira mbali zina za thupi, monga ubongo, mapapo, chiwindi, impso, ndulu, matumbo, mafupa a chiuno, kapena nyini. Choriocarcinoma imatha kupanga amayi omwe adakhala ndi izi:

• Mimba yokhala ndi molar, makamaka ndi mole yathunthu ya hydatidiform.

• Mimba yachibadwa.

• Mimba ya Tubal (zomwe zimayikitsidwa ndi dzira mumachubu osati pachiberekero).

• Kupita padera.

Zotupa za Placental-site trophoblastic

Chotupa cha malo otchedwa trophoblastic (PSTT) ndi mtundu wosowa wa matenda opatsirana pogonana omwe amachititsa kuti placenta igwirizane ndi chiberekero. Chotupacho chimapangidwa kuchokera kuma cell trophoblast ndikufalikira muminyewa ya chiberekero komanso mumitsempha yamagazi. Ikhozanso kufalikira kumapapu, m'chiuno, kapena ma lymph node. PSTT imakula pang'onopang'ono ndipo zizindikilo kapena zizindikilo zitha kuwoneka miyezi kapena zaka pambuyo pathupi labwinobwino.

Zotupa za Epithelioid trophoblastic

Chotupa cha epithelioid trophoblastic (ETT) ndi mtundu wosowa kwambiri wa gestational trophoblastic neoplasia yomwe imatha kukhala yoyipa kapena yoyipa. Chotupacho chikakhala choyipa, chimatha kufalikira mpaka m'mapapu.

Zaka zakubadwa komanso mimba yam'mbuyomu zimakhudza chiopsezo cha GTD.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala wanu ngati mukuganiza kuti mutha kukhala pachiwopsezo. Zowopsa za GTD ndi izi:

• Kukhala ndi pakati usanakwanitse zaka 20 kapena kupitirira zaka 35.

• Kukhala ndi mbiri ya hydatidiform mole.

Zizindikiro za GTD zimaphatikizapo kutuluka magazi kwachilendo komanso chiberekero chomwe chimakhala chachikulu kuposa zachibadwa.

Zizindikiro ndi zizindikilozi zimatha kubwera chifukwa chodwala matenda opatsirana pogonana kapena matenda ena. Funsani dokotala ngati muli ndi izi:

• Kutaya magazi kumaliseche sikugwirizana ndi kusamba.

• Chiberekero chomwe chimakhala chachikulu kuposa momwe amayembekezera panthawi yapakati.

• Kupweteka kapena kupanikizika m'chiuno.

• Kunyansidwa kwambiri ndikusanza nthawi yapakati.

• Kuthamanga kwa magazi ndi mutu komanso kutupa kwa mapazi ndi manja koyambirira kwa mimba.

• Kutaya magazi kumaliseche komwe kumapitilira kwakanthawi kotalikirapo kuposa nthawi zonse mukabereka.

• Kutopa, kupuma movutikira, chizungulire, komanso kugunda kwamtima kosachedwa kapena kosafunikira komwe kumayambitsidwa ndi kuchepa kwa magazi m'thupi.

GTD nthawi zina imayambitsa chithokomiro chopitilira muyeso. Zizindikiro za chithokomiro chopitilira muyeso ndi izi:

• Mofulumira kapena osasinthasintha kugunda kwa mtima.

• Kugwedezeka.

• Kutuluka thukuta.

• Kuyenda pafupipafupi.

• Kuvuta kugona.

• Kukhala ndi nkhawa kapena kukwiya.

• Kuchepetsa thupi.

Kuyesa komwe kumayang'ana chiberekero kumagwiritsidwa ntchito kuti apeze (kupeza) ndikuzindikira matenda a gestational trophoblastic.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuwunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza kuyang'ana ngati pali matenda, monga zotupa kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• Kuyezetsa magazi: Kuyesa kumaliseche, khomo pachibelekeropo, chiberekero, machubu, mazira, ndi thumbo. A speculum amalowetsedwa mumaliseche ndipo dokotala kapena namwino amayang'ana kumaliseche ndi chiberekero ngati ali ndi matenda. Kuyezetsa magazi kwa khomo pachibelekeropo kumachitika nthawi zambiri. Dotolo kapena namwino amalowetsanso chala chimodzi kapena ziwiri zopaka mafuta, zokutira zanja lamanja kumaliseche ndikuyika dzanja linalo pamimba pamunsi kuti mumve kukula, mawonekedwe, ndi malo oberekera komanso thumba losunga mazira. Dotolo kapena namwino amalowetsanso chala chopaka mafuta, chopukutira mu rectum kuti amve ziphuphu kapena malo abwinobwino.

Kuyesa kwapelvic. Dokotala kapena namwino amalowetsa chala chimodzi kapena ziwiri zopaka mafuta, zokutidwa ndi dzanja limodzi kumaliseche ndikudina pamimba pamunsi ndi dzanja linalo. Izi zachitika kuti mumve kukula, mawonekedwe, ndi mawonekedwe a chiberekero ndi thumba losunga mazira. Nyini, khomo pachibelekeropo, machubu opatsira mazira oyenda, ndi thumbo timayang'ananso.

• Kuyesa kwa ultrasound pamimba: Njira yomwe mafunde amphamvu kwambiri (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati mwa chiuno ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Nthawi zina transvaginal ultrasound (TVUS) idzachitika. Kwa TVUS, ultrasound transducer (kafukufuku) imayikidwa mu chikazi kuti ipange sonogram.

• Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zapamwamba kapena zotsika kuposa zachilendo) zitha kukhala chizindikiro cha matenda. Magazi amayesedwanso kuti aone chiwindi, impso, ndi mafupa.

• Chiyeso cha serum tumor marker: Njira yomwe magazi amayang'aniridwa kuti athe kuyeza kuchuluka kwa zinthu zina zopangidwa ndi ziwalo, zotupa, kapena zotupa mthupi. Zinthu zina zimalumikizidwa ndi mitundu ina ya khansa ikapezeka m'magulu owonjezeka mthupi. Izi zimatchedwa zolembera zotupa. Kwa GTD, magazi amafufuzidwa ngati ali ndi beta chorionic gonadotropin (β-hCG), mahomoni omwe amapangidwa ndi thupi nthawi yapakati. β-hCG m'magazi a mayi yemwe satenga pakati atha kukhala chizindikiro cha GTD.

• Urinalysis: Kuyesa kofufuza mtundu wa mkodzo ndi zomwe zili mkatimo, monga shuga, mapuloteni, magazi, mabakiteriya, ndi mulingo wa β-hCG.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Matenda a Gestational trophoblastic nthawi zambiri amatha kuchiritsidwa. Chithandizo ndi madandaulo zimadalira izi:

• Mtundu wa GTD.

• Kaya chotupacho chafalikira m'chiberekero, ma lymph node, kapena mbali zakutali za thupi.

• Chiwerengero cha zotupa komanso komwe ali mthupi.

• Kukula kwa chotupa chachikulu kwambiri.

• Mulingo wa β-hCG m'magazi.

• Posakhalitsa chotupacho chidapezeka mayi atatenga mimba.

• Kaya GTD idachitika pambuyo pokhala ndi pakati, kupita padera, kapena kutenga pakati.

• Chithandizo cham'mbuyomu cha trophoblastic neoplasia.

Njira zamankhwala zimadaliranso ngati mkaziyo akufuna kudzakhala ndi pakati mtsogolo.

Magawo a Gestational Trophoblastic Tumors ndi Neoplasia

MFUNDO ZOFUNIKA

• Pambuyo pa matenda opatsirana pogonana apezeka, amayesedwa kuti apeze ngati khansa yafalikira kuchokera pomwe idayambira kupita mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

• Palibe njira yokhazikika yama hydatidiform moles.

• Magawo otsatirawa amagwiritsidwa ntchito pa GTN:

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

• Chithandizo cha gestational trophoblastic neoplasia chimachokera ku mtundu wa matenda, gawo, kapena gulu lowopsa.

Pambuyo pa matenda opatsirana pogonana apezeka, amayesedwa kuti apeze ngati khansa yafalikira kuchokera pomwe idayambira kupita mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza kukula kapena kufalikira kwa khansa imatchedwa staging, Zomwe zimasonkhanitsidwa kuchokera pakukonzekera zimathandiza kudziwa gawo la matenda. Kwa GTN, siteji ndichimodzi mwazinthu zomwe amagwiritsidwa ntchito pokonzekera chithandizo.

Mayesero ndi njira zotsatirazi zitha kuchitidwa kuti zithandizire kudziwa matendawa:

• X-ray pachifuwa : X-ray ya ziwalo ndi mafupa mkati mwa chifuwa. X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi kupita mufilimu, ndikupanga zithunzi zamkati mwa thupi.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamatupi amthupi, zojambulidwa mosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

• MRI (magnetic resonance imaging) yokhala ndi gadolinium: Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, komanso kompyuta kuti ipange zithunzi zingapo zazomwe zili mkati mwa thupi, monga ubongo ndi msana. Chinthu chotchedwa gadolinium chimalowetsedwa mumtsempha. Gadolinium imasonkhanitsa mozungulira maselo a khansa kuti athe kuwonekera pachithunzichi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

• Lumbar puncture: Njira yogwiritsira ntchito cerebrospinal fluid (CSF) kuchokera pamtsempha. Izi zimachitika poika singano pakati pa mafupa awiri mumsana ndi CSF mozungulira msana ndikuchotsa madzi. Chitsanzo cha CSF chimayang'aniridwa ndi microscope ngati pali zisonyezo kuti khansara yafalikira kuubongo ndi msana. Njirayi imatchedwanso LP kapena tapu ya msana.

Pali njira zitatu zomwe khansa imafalikira mthupi.

Khansa imatha kufalikira kudzera mu minofu, ma lymph system, ndi magazi:

• Minofu. Khansara imafalikira kuchokera pomwe idayamba ndikukula kupita kumadera oyandikana nawo.

• Lymph dongosolo. Khansara imafalikira kuchokera pomwe idayamba polowa m'mitsempha. Khansara imadutsa m'mitsempha yamafuta kupita mbali zina za thupi.

• Magazi. Khansara imafalikira kuchokera pomwe idayamba ndikulowa m'magazi. Khansara imadutsa m'mitsempha yamagazi kupita mbali zina za thupi.

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa ikafalikira mbali ina ya thupi, imatchedwa metastasis. Maselo a khansa amachoka pomwe adayamba (chotupa choyambirira) ndikuyenda mumitsempha kapena magazi.

• Lymph dongosolo. Khansara imalowa mumitsempha, imadutsa m'mitsempha yamafuta, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

• Magazi. Khansara imalowa m'magazi, imadutsa m'mitsempha yamagazi, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

Chotupa cha metastatic ndi khansa yofanana ndi chotupa chachikulu. Mwachitsanzo, ngati choriocarcinoma imafalikira m'mapapu, maselo a khansa m'mapapo ndiye ma choriocarcinoma. Matendawa ndi metastatic choriocarcinoma, osati khansa yamapapo.

Palibe njira yokhazikika yama hydatidiform moles.

Mpweya wa Hydatidiform (HM) umapezeka mchiberekero kokha ndipo sukufalikira mbali zina za thupi.

Magawo otsatirawa amagwiritsidwa ntchito pa GTN:

Gawo I

Pa gawo loyamba, chotupacho chili mchiberekero mokha.

Gawo II

Gawo lachiwiri, khansa yafalikira kunja kwa chiberekero kupita ku ovary, fallopian chubu, nyini, ndi / kapena mitsempha yomwe imathandizira chiberekero.

Gawo III

Gawo lachitatu, khansa yafalikira m'mapapu.

Gawo IV

Mu gawo IV, khansa yafalikira kumadera akutali a thupi kupatula mapapu.

Chithandizo cha gestational trophoblastic neoplasia chimachokera ku mtundu wa matenda, gawo, kapena gulu lowopsa.

Ma moles owopsa ndi choriocarcinomas amathandizidwa kutengera magulu omwe ali pachiwopsezo. Gawo la mole yolimbana kapena choriocarcinoma ndi chinthu chimodzi chomwe chimagwiritsidwa ntchito kudziwa gulu lomwe lili pachiwopsezo. Zina ndi monga izi:

• Zaka za wodwalayo matendawa akapangidwa.

• Kaya GTN idachitika pambuyo pokhala ndi pakati, kupita padera, kapena kukhala ndi pakati.

• Posakhalitsa chotupacho chidapezeka mayi atatenga mimba.

• Mulingo wa beta chorionic gonadotropin (β-hCG) m'magazi.

• Kukula kwa chotupa chachikulu kwambiri.

• Komwe chotupacho chafalikira komanso kuchuluka kwa zotupa m'thupi.

• Ndi mankhwala angati a chemotherapy chotupacho chomwe amathandizidwapo (cha zotupa zobwerezabwereza kapena zosagwira).

Pali magulu awiri omwe ali pachiwopsezo cha ma moles ndi choriocarcinomas: chiopsezo chochepa komanso chiopsezo chachikulu. Odwala omwe ali ndi matenda oopsa nthawi zambiri samalandira chithandizo choopsa kuposa odwala omwe ali ndi matenda oopsa.

Chotupa cha Placental-site trophoblastic (PSTT) ndi epithelioid trophoblastic tumor (ETT) zimadalira gawo la matenda.

Kubwezeretsa Kwatsopano ndi Kotsutsa Gopational Trophoblastic Neoplasia

Matenda a trophoblastic neoplasia (GTN) omwe amapezeka mobwerezabwereza ndi khansa yomwe yabwereranso (ibwerera) itachiritsidwa. Khansara imatha kubwerera mchiberekero kapena mbali zina za thupi.

Gestational trophoblastic neoplasia yomwe sichiyankha mankhwala amatchedwa kugonjetsedwa kwa GTN.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi matenda opatsirana pogonana.

• Mitundu itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito:

• Opaleshoni

• Chemotherapy

• Thandizo la radiation

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Kuchiza matenda opatsirana pogonana kungayambitse mavuto.

• Odwala angaganize zopita nawo kukayezetsa.

• Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala omwe ali ndi matenda opatsirana pogonana.

Pali mitundu yosiyanasiyana ya chithandizo kwa odwala omwe ali ndi matenda opatsirana pogonana. Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Asanayambe chithandizo chamankhwala, odwala angaganize zopita kukayesedwa kuchipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayesero azachipatala omwe akupitilira amapezeka patsamba la NCI. Kusankha chithandizo choyenera kwambiri cha khansa ndichisankho chomwe chimakhudza gulu la odwala, banja, komanso zamankhwala.

Mitundu itatu yamankhwala ogwiritsidwa ntchito imagwiritsidwa ntchito:

Opaleshoni

Dokotala akhoza kuchotsa khansara pogwiritsa ntchito izi:

• Kuchepetsa ndi kuchiritsa (D&C) ndikutulutsa koyamwa: Njira yochitira opaleshoni yochotsa minofu yosazolowereka ndi ziwalo zamkati mwa chiberekero. Khomo lachiberekero limakwezedwa ndipo zinthu zomwe zili mkati mwa chiberekero zimachotsedwa ndi kachipangizo kocheperako. Makoma a chiberekero amapukutidwa mokoma mtima ndi chida (chooneka ngati supuni) kuchotsa chilichonse chomwe chingatsalire m'chiberekero. Njirayi itha kugwiritsidwa ntchito ngati mayi ali ndi pakati.

Kuchulukana ndi machiritso (D ndi C). A speculum amalowetsedwa mumaliseche kuti afutukule kuti ayang'ane khomo lachiberekero (gulu loyamba). Chopukutira chimagwiritsidwa ntchito kukulitsa chiberekero (chapakati). Therttte imayikidwa kudzera pachibelekeropo kulowa m'chiberekero kuti muchotse minofu yachilendo (gawo lomaliza).

• Hysterectomy: Kuchita opaleshoni kuchotsa chiberekero, ndipo nthawi zina khomo pachibelekeropo. Ngati chiberekero ndi khomo lachiberekero atulutsidwa kudzera mu nyini, opaleshoniyi amatchedwa kachilombo ka nyini. Ngati chiberekero ndi khomo pachibelekeropo atulutsidwa kudzera pachobvala chachikulu pamimba, opaleshoniyi amatchedwa kuti kutsekeka m'mimba kwathunthu. Ngati chiberekero ndi khomo lachiberekero amatulutsidwa kudzera pang'amba pang'ono pamimba pogwiritsa ntchito laparoscope, opaleshoniyi amatchedwa laparoscopic hysterectomy.

Kutsekemera. Chiberekero chimachotsedwa mwa opaleshoni kapena popanda ziwalo zina kapena zotupa. Chiberekero chonse, chiberekero ndi khomo pachibelekeropo zimachotsedwa. Mchiberekero chonse chokhala ndi salpingo-oophorectomy, (a) chiberekero kuphatikiza chubu chimodzi (chimodzi) chokhala ndi mazira ndi mazira chimachotsedwa; kapena (b) chiberekero kuphatikiza tinthu tambirimbiri tating'onoting'ono tating'onoting'ono tating'onoting'ono tating'onoting'ono tating'onoting'ono tating'onoting'ono timatulutsidwa. Mu hysterectomy yowopsa, chiberekero, khomo pachibelekeropo, mazira onse awiri, machubu, komanso minofu yoyandikana nayo imachotsedwa. Njirazi zimagwiritsidwa ntchito podula pang'ono kapena kuwongolera mozungulira.

Dokotala atachotsa khansa yonse yomwe imawonekera panthawi yochitidwa opaleshoniyi, odwala ena amatha kupatsidwa chemotherapy atachitidwa opareshoni kuti aphe maselo aliwonse a khansa omwe atsala. Chithandizo chomwe chimaperekedwa pambuyo pa opareshoni, kuti muchepetse chiopsezo kuti khansa ibwererenso, amatchedwa adjuvant therapy.

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika m'matumbo a cerebrospinal, chiwalo, kapena thupi ngati pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera). Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa, kapena ngati chotupacho chili pachiwopsezo chochepa kapena chowopsa.

Kuphatikiza kwa chemotherapy ndi chithandizo chogwiritsa ntchito mankhwala opatsirana ambiri opatsirana khansa.

Onani Mankhwala Ovomerezeka a Gestational Trophoblastic Disease kuti mumve zambiri.

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Momwe mankhwalawa amaperekera zimadalira mtundu wa matenda opatsirana pogonana omwe akuchiritsidwa. Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza matenda opatsirana pogonana.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Zambiri zamayesero azachipatala omwe akupitilira amapezeka patsamba la NCI.

Kuchiza matenda opatsirana pogonana kungayambitse mavuto.

Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Odwala angaganize zopita nawo kukayezetsa.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.

Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.

Mayeso otsatirawa angafunike.

Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Magazi a beta a chorionic gonadotropin (β-hCG) amawerengedwa kwa miyezi isanu ndi umodzi chithandizo chitatha. Izi ndichifukwa choti mulingo wa β-hCG womwe ndi wapamwamba kuposa wabwinobwino ungatanthauze kuti chotupacho sichinayankhe mankhwala kapena chakhala khansa.

Njira Zothandizira Kuchiza Matenda a Gestational Trophoblastic

M'chigawo chino

• Zilonda za Hydatidiform

• Gestational Trophoblastic Neoplasia

• Gestational Trophoblastic Neoplasia yoopsa kwambiri

• Kuopsa koopsa kwa Metastatic Gestational Trophoblastic Neoplasia

• Placental-Site Gestational Trophoblastic Tumors ndi Epithelioid Trophoblastic Tumors

• Kubwezeretsa kapena Kukaniza Gestational Trophoblastic Neoplasia

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Zilonda za Hydatidiform

Chithandizo cha mole ya hydatidiform chingaphatikizepo izi:

• Opaleshoni (Dilatation and curettage with suction evacuation) kuchotsa chotupacho.

Pambuyo pa opaleshoni, kuyezetsa magazi kwa beta chorionic gonadotropin (β-hCG) kumachitika sabata iliyonse mpaka mulingo wa β-hCG ubwerera mwakale. Odwala amapitanso kukaonana ndi azachipatala mwezi uliwonse kwa miyezi isanu ndi umodzi. Ngati kuchuluka kwa β-hCG sikubwerera mwakale kapena kuwonjezeka, kungatanthauze kuti mole ya hydatidiform sinachotsedwe kwathunthu ndipo yasanduka khansa. Mimba imapangitsa kuti ma β-hCG achuluke, chifukwa chake dokotala akukufunsani kuti musakhale ndi pakati mpaka kutsata kukamaliza.

Kwa matenda omwe atsalira pambuyo pa opareshoni, chithandizo nthawi zambiri chimakhala chemotherapy.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

' Gestational Trophoblastic Neoplasia.'

Gestational Trophoblastic Neoplasia yoopsa kwambiri

Chithandizo cha chiopsezo choterechi chotchedwa trophoblastic neoplasia (GTN) (mole invasive mole kapena choriocarcinoma) chingaphatikizepo izi:

• Chemotherapy ndi mankhwala amodzi kapena angapo a anticancer. Chithandizochi chimaperekedwa mpaka pomwe beta ya chorionic gonadotropin (β-hCG) ndiyabwino pamasabata atatu mankhwala atatha.

Ngati kuchuluka kwa β-hCG m'magazi sikubwerera mwakale kapena chotupacho chimafalikira kumadera akutali a thupi, mankhwala a chemotherapy omwe amagwiritsidwa ntchito pangozi ya metastatic GTN amaperekedwa.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuopsa koopsa kwa Metastatic Gestational Trophoblastic Neoplasia

Chithandizo cha chiopsezo cha metastatic gestational trophoblastic neoplasia (invasive mole kapena choriocarcinoma) chingaphatikizepo izi:

• Kuphatikiza chemotherapy.

• Intrathecal chemotherapy ndi mankhwala a radiation kuubongo (khansa yomwe yafalikira m'mapapu, kuti isafalikire kuubongo).

• Mankhwala a chemotherapy kapena intrathecal chemotherapy ndi / kapena radiation pamaubongo (a khansa yomwe yafalikira ku ubongo).

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Placental-Site Gestational Trophoblastic Tumors ndi Epithelioid Trophoblastic Tumors

Chithandizo cha malo otsekemera otsekemera a trophoblastic and epithelioid trophoblastic tumors atha kuphatikizira izi:

• Opaleshoni yochotsa chiberekero.

Chithandizo cha gawo lachiwiri la malo otsekemera otsekemera kwambiri ndi zotupa za epithelioid trophoblastic zitha kukhala izi:

• Kuchita opaleshoni kuchotsa chotupacho, chomwe chingatsatidwe ndi kuphatikiza chemotherapy.

Kuchiza kwa gawo lachitatu ndi lachitatu la malo otsekemera otsekemera ndi epithelioid trophoblastic zotupa zitha kuphatikizira izi:

• Kuphatikiza chemotherapy.

• Kuchita opaleshoni kuti muchotse khansa yomwe yafalikira m'malo ena, monga mapapo kapena pamimba.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kubwezeretsa kapena Kukaniza Gestational Trophoblastic Neoplasia

Chithandizo cha zotupa zobwerezabwereza kapena zosagwira zomwe zingaphatikizepo izi ndi izi:

• Chemotherapy ndi mankhwala amodzi kapena angapo a anticancer a zotupa zomwe zidachitidwa kale ndi opaleshoni.

• Kuphatikiza kwa chemotherapy kwa zotupa zomwe zimathandizidwa kale ndi chemotherapy.

• Kuchita opaleshoni ya zotupa zomwe sizimayankha chemotherapy.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe zambiri Zokhudza Matenda a Gestational Trophoblastic

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudzana ndi zotupa za m'mimba zomwe zimayambitsa matenda opatsirana pogonana komanso neoplasia, onani izi:

• Gestational Trophoblastic Tsamba Latsamba

• Mankhwala Ovomerezeka a Gestational Trophoblastic Disease

• Khansa ya Metastatic

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa

• Kusinthana

• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa

• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira

Za Chidule cha

Za

Physician Data Query () ndi nkhokwe ya National Cancer Institute's (NCI's) yokhudza zambiri za khansa. Database ya ili ndi chidule cha zomwe zatulutsidwa posachedwa popewa khansa, kuzindikira, ma genetics, chithandizo, chisamaliro chothandizira, komanso mankhwala othandizira komanso othandizira. Zambiri mwachidule zimabwera m'mitundu iwiri. Omasulira akatswiriwa ali ndi zambiri zolembedwa mchilankhulo chaukadaulo. Mitundu ya odwala imalembedwa m'njira yosavuta kumva, yopanda ukadaulo. Mabaibulo onsewa ali ndi chidziwitso cha khansa chomwe ndicholondola komanso chaposachedwa ndipo matembenuzidwe ambiri amapezekanso m'Chisipanishi.

ndi ntchito ya NCI. NCI ndi gawo la National Institutes of Health (NIH). NIH ndiye likulu la kafukufuku waboma. Zidule za zimakhazikitsidwa pakuwunika kodziyimira pawokha zolemba zamankhwala. Sindiwo malingaliro a NCI kapena NIH.

Cholinga cha Chidule ichi

Chidule cha chidziwitso cha khansa ya chili ndi zambiri pakadali pano za chithandizo cha matenda opatsirana pogonana. Zimatanthauza kudziwitsa ndi kuthandiza odwala, mabanja, ndi osamalira. Sichipereka malangizo kapena malingaliro apadera popanga zisankho pazokhudzaumoyo.

Owunikanso ndi Zosintha

Mamembala Olemba amalemba zidule za khansa ya ndikuziwongolera. Ma board awa amapangidwa ndi akatswiri azithandizo zamatenda a khansa ndi zina zapadera zokhudzana ndi khansa. Zowombazi zimawunikiridwa pafupipafupi ndipo amasintha pakakhala zatsopano. Deti pachidule chilichonse ("Kusinthidwa") ndi tsiku losintha posachedwa kwambiri.

Zomwe zili pachidule ichi zidatengedwa kuchokera ku mtundu wa akatswiri azaumoyo, womwe umawunikidwa pafupipafupi ndikusinthidwa momwe zingafunikire, ndi Adult Treatment Editorial Board.

Zambiri Zoyesa Zachipatala

Kuyesedwa kwachipatala ndi kafukufuku woti ayankhe funso lasayansi, monga ngati mankhwala amodzi aposa ena. Mayesero amatengera maphunziro am'mbuyomu ndi zomwe taphunzira mu labotale. Chiyeso chilichonse chimayankha mafunso ena asayansi kuti apeze njira zatsopano komanso zabwino zothandiza odwala khansa. Mukamayesedwa azachipatala, zambiri zimasonkhanitsidwa pazokhudza chithandizo chatsopano ndi momwe chimagwirira ntchito. Ngati kuyesa kwachipatala kukuwonetsa kuti chithandizo chatsopano ndichabwino kuposa chomwe chikugwiritsidwa ntchito pano, chithandizo chatsopano chitha kukhala "chovomerezeka". Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Mayesero azachipatala amapezeka pa intaneti patsamba la NCI. Kuti mumve zambiri, imbani Cancer Information Service (CIS), malo olumikizirana ndi NCI, ku 1-800-4-CANCER (1-800-422-6237).

Chilolezo Chogwiritsa Ntchito Chidule Ichi

ndi dzina lolembedwa. Zomwe zili mu zikalata za zitha kugwiritsidwa ntchito momasuka ngati zolemba. Sizingadziwike kuti ndi chidule cha khansa ya NCI pokhapokha chidule chonse chikuwonetsedwa ndikusinthidwa pafupipafupi. Komabe, wogwiritsa akhoza kuloledwa kulemba chiganizo monga "Chidule cha chidziwitso cha khansa ya PDI ya NCI chokhudza kupewa khansa ya m'mawere chimanena zoopsa zake motere: [onaninso mwachidule mwachidule]."

Njira yabwino yolongosola chidule cha ndi:

Zithunzi pazidulezi zimagwiritsidwa ntchito ndi chilolezo cha wolemba, wojambula, ndi / kapena wofalitsa kuti azigwiritsidwa ntchito pazidule za zokha. Ngati mukufuna kugwiritsa ntchito chithunzi kuchokera pachidule cha ndipo simukugwiritsa ntchito chidule chonse, muyenera kupeza chilolezo kuchokera kwa mwininyumba. Sizingaperekedwe ndi National Cancer Institute. Zambiri zogwiritsa ntchito zithunzizi mwachidule, komanso zithunzi zina zambiri zokhudzana ndi khansa zitha kupezeka mu Visuals Online. Zowoneka paintaneti ndi zithunzi zoposa 3,000 zasayansi.

Chodzikanira

Zomwe zidafotokozedwazi siziyenera kugwiritsidwa ntchito popanga chisankho chobwezera inshuwaransi. Zambiri pazokhudza inshuwaransi zikupezeka ku Cancer.gov patsamba la Managing Care Care.

Lumikizanani nafe

Zambiri zokhudzana ndi kulumikizana nafe kapena kulandira thandizo patsamba la Cancer.gov zitha kupezeka patsamba Lumikizanani nafe kuti tithandizidwe. Mafunso amathanso kuperekedwa ku Cancer.gov kudzera pa Tsamba Lakutumiza la Imelo

Sanjani malinga ndi tsiku Sanjani ndi zigoli

Thandizani kutsitsimutsa kwama ndemanga

Onjezani ndemanga yanu

love.co ilandila ndemanga zonse . Ngati simukufuna kudziwika, lembetsani kapena lowetsani . Ndi yaulere.