Izinhlobo / inhliziyo / ukwelashwa kwengane-inhliziyo-ukwelashwa-pdq

Ukwelashwa Kwe-Cardiac Cardiac (Heart) Tumors Treatment (®) –Patient Version

Imininingwane ejwayelekile Mayelana Nezimila Zenhliziyo Yenhliziyo (Inhliziyo)

AMAPHUZU ASEMQOKA

• Izimila zenhliziyo yengane, ezingaba yingozi noma zibe yimbi, zakheke enhliziyweni.

• Izimpawu nezimpawu zesimila senhliziyo zifaka phakathi ushintsho kwisigqi esijwayelekile senhliziyo nenkinga yokuphefumula.

• Ukuhlolwa okuhlola inhliziyo kusetshenziselwa ukuthola (ukuthola) nokuxilonga isimila senhliziyo.

Izimila zenhliziyo yengane, ezingaba yingozi noma zibe yimbi, zakheke enhliziyweni.

Izicubu eziningi ezakha enhliziyweni ziyingozi (hhayi umdlavuza). Izicubu zenhliziyo ezingabonakala ezinganeni zifaka okulandelayo:

• I-Rhabdomyoma: Isigaxa esakha imisipha esakhiwa yimicu emide.

• I-Myxoma: Isigaxa esingaba yingxenye yesifo esizuzwe njengefa esibizwa ngeCarney complex. Bona isifinyezo se- ku-Childhood Multiple Endocrine Neoplasia Syndromes ukuthola eminye imininingwane.

• I-Teratomas: Uhlobo lwesimila segciwane leseli. Enhliziyweni, lezi zicubu zenzeka kakhulu ku-pericardium (isaka elihlanganisa inhliziyo).

• Amanye ama-teratomas ayingozi (umdlavuza).

• I-Fibroma: Isigaxa esakha izicubu ezinjenge-fiber ezigcina amathambo, imisipha nezinye izitho endaweni.

• Isimila se-Histiocytoid cardiomyopathy: Isigaxa esakha amangqamuzana enhliziyo alawula isigqi senhliziyo.

• I-Hemangiomas: Isigaxa esakha amangqamuzana alayini imithambo yegazi.

• I-Neurofibroma: Isigaxa esakha amaseli nezicubu ezihlanganisa izinzwa.

Ngaphambi kokuzalwa kanye nasezinganeni ezisanda kuzalwa, izicubu zenhliziyo ezivame kakhulu i-teratomas. Isimo esizuzwe njengefa esibizwa nge-tuberous sclerosis singadala isimila senhliziyo enganeni engakazalwa (umbungu) noma esanda kuzalwa.

Izimila ezimbi eziqala enhliziyweni zivame kakhulu ukwedlula izicubu zenhliziyo ezinobungozi ezinganeni. Izicubu zenhliziyo ezimbi zifaka:

• I-teratoma enobungozi.

• I-Lymphoma.

• I-Rhabdomyosarcoma: Umdlavuza owakhiwa yimisipha owenziwe ngemicu emide.

• I-Angiosarcoma: Umdlavuza owakhiwa kumaseli alayini imithambo yegazi noma imithambo yegazi.

• I-sarcoma engafani nhlobo ye-pleomorphic: Umdlavuza ovame ukwakheka kuzicubu ezithambile, kepha nawo ungakha ithambo.

• I-Leiomyosarcoma: Umdlavuza owakheka kumaseli wemisipha abushelelezi.

• I-Chondrosarcoma: Umdlavuza ovame ukwakheka kuqwanga lwamathambo, kepha kuyaqabukela ungaqala enhliziyweni.

• I-Synovial sarcoma: Umdlavuza ovame ukwakheka uzungeze amalunga, kepha kungenzeka ukuthi kuyaqabukela ukwakheka enhliziyweni noma esikhwameni esizungeze inhliziyo.

• I-Infantile fibrosarcoma: Umdlavuza owakha izicubu ezinjenge-fiber ezigcina amathambo, imisipha nezinye izitho endaweni.

Lapho umdlavuza uqala kwenye ingxenye yomzimba futhi usakazekele enhliziyweni, ubizwa ngokuthi yi-metastatic cancer. Ezinye izinhlobo zomdlavuza, njenge-sarcoma, i-melanoma, ne-leukemia, ziqala kwezinye izingxenye zomzimba bese zisabalala ziye enhliziyweni. Lesi sifinyezo siphathelene nomdlavuza oqala ukwakheka enhliziyweni, hhayi umdlavuza we-metastatic.

Izimpawu nezimpawu zesimila senhliziyo zifaka phakathi ushintsho kwisigqi esijwayelekile senhliziyo nenkinga yokuphefumula.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa izicubu zenhliziyo noma ezinye izimo.

Buza kudokotela wengane yakho uma ingane yakho inokunye kwalokhu okulandelayo:

• Shintsha ngesigqi esivamile senhliziyo.

• Inkinga yokuphefumula, ikakhulukazi lapho ingane ilele phansi.

• Ubuhlungu noma ukuqina maphakathi nesifuba okuzwa kangcono lapho ingane ihleli.

• Ukukhwehlela.

• Ukuquleka.

• Uzizwa unesiyezi, ukhathele, noma ubuthakathaka.

• Ukushaya kwenhliziyo okusheshayo.

• Ukuvuvukala emilenzeni, emaqakaleni noma esiswini.

• Ukuzizwa ngikhathazekile.

• Izimpawu zesifo sohlangothi.

• Ukuba ndikindiki okungazelelwe noma ukubuthakathaka kobuso, ingalo, noma umlenze (ikakhulukazi ohlangothini olulodwa lomzimba).

• Ukudideka okungazelelwe noma inkinga yokukhuluma noma ukuqonda.

• Inkinga engazelelwe yokubona ngamehlo noma womabili.

• Inkinga engazelelwe ukuhamba noma ukuzizwa unesiyezi.

• Ukulahlekelwa okungazelelwe kokulingana noma kokuxhumanisa.

• Ikhanda elibuhlungu ngokuzumayo ngaphandle kwesizathu esaziwayo.

Kwesinye isikhathi izicubu zenhliziyo azibangeli zimpawu noma zimpawu.

Ukuhlolwa okuhlola inhliziyo kusetshenziselwa ukuthola (ukuthola) nokuxilonga isimila senhliziyo.

Lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa:

• Ukuhlolwa komzimba kanye nomlando wezempilo: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• I-x-ray yesifuba: I-x-ray yezitho namathambo ngaphakathi kwesifuba. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. Idayi ingajovwa emthanjeni noma igwinywe ukusiza izitho noma izicubu zivele kahle. Le nqubo ibizwa nangokuthi i-computed tomography, i-computerized tomography, noma i-computer axial tomography.

• I-MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane yezindawo ezingaphakathi komzimba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• I-Echocardiogram: Inqubo lapho amagagasi omsindo wamandla aphezulu (i-ultrasound) ehlaselwa enhliziyweni nezicubu noma izitho eziseduze bese enza ama-echoes. Isithombe esinyakazayo senziwa ngama-valve enhliziyo nawenhliziyo njengoba igazi lifakwa enhliziyweni.

• I-Electrocardiogram (EKG): Ukuqoshwa komsebenzi kagesi wenhliziyo ukuhlola izinga nesigqi sayo. Inani lama-pads amancane (ama-electrode) abekwa esifubeni sesiguli, ezingalweni nasemilenzeni, futhi axhunywe ngezintambo emshinini we-EKG. Umsebenzi wenhliziyo bese uqoshwa njengegrafu elayini ephepheni. Umsebenzi kagesi oshesha noma ohamba kancane kunokujwayelekile kungaba uphawu lwesifo senhliziyo noma ukulimala.

• I-catheterization yenhliziyo: Inqubo yokubheka ngaphakathi kwemithambo yegazi nenhliziyo ngezindawo ezingajwayelekile noma umdlavuza. I-catheter ende, ezacile, ifakwa emthanjeni noma emthanjeni emgodini, entanyeni, noma engalweni bese kufakwa emithanjeni yegazi kuye enhliziyweni. Isampula lezicubu lingasuswa kusetshenziswa ithuluzi elikhethekile. Isazi sezifo sibheka izicubu ngaphansi kwesibonakhulu ukubheka amangqamuzana omdlavuza.

Izigaba Zezimila Zenhliziyo

Inqubo esetshenzisiwe ukuthola ukuthi izicubu zenhliziyo (umdlavuza) ezibulalayo zisabalale zisuka enhliziyweni ziye ezindaweni eziseduze noma kwezinye izingxenye zomzimba zibizwa nge-staging. Alukho uhlelo olujwayelekile lokubeka izicubu zenhliziyo ebuntwaneni eziyingozi. Imiphumela yokuhlolwa nezinqubo ezenziwayo zokuthola izicubu zenhliziyo ezimbi zisetshenziselwa ukusiza ukwenza izinqumo mayelana nokwelashwa.

Izicubu zenhliziyo eziphindaphindayo eziphindayo zibuyele emuva (zibuya) ngemuva kokwelashwa.

Uhlolojikelele lwenketho yokwelashwa

AMAPHUZU ASEMQOKA

• Kunezinhlobo ezahlukahlukene zokwelashwa kwezingane ezinamathumba enhliziyo.

• Izingane ezinezimila zenhliziyo kufanele zihlelelwe ukwelashwa kwazo yiqembu lodokotela abangochwepheshe ekwelapheni umdlavuza wezingane.

• Izinhlobo ezinhlanu zokwelashwa zisetshenzisiwe:

• Ukulinda okulindile

• Ukwelashwa ngamakhemikhali

• Ukuhlinzwa

• Ukwelashwa ngemisebe

• Ukwelashwa okuhlosiwe

• Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

• Ukwelashwa kwezimila zenhliziyo ebuntwaneni kungadala imiphumela emibi.

• Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

• Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

• Ukuhlolwa kokulandelela kungadingeka.

Kunezinhlobo ezahlukahlukene zokwelashwa kwezingane ezinamathumba enhliziyo.

Ezinye izindlela zokwelapha zijwayelekile (indlela esetshenziswa njengamanje), kanti ezinye ziyahlolwa ezivivinyweni zokwelashwa. Isivivinyo somtholampilo wokwelashwa isifundo socwaningo esihloselwe ukusiza ukuthuthukisa ukwelashwa kwamanje noma ukuthola ulwazi ngezindlela zokwelashwa ezintsha zeziguli ezinomdlavuza. Lapho izivivinyo zokwelashwa zibonisa ukuthi ukwelashwa okusha kungcono kunokwelashwa okujwayelekile, ukwelashwa okusha kungaba ukwelashwa okujwayelekile.

Ngoba umdlavuza ezinganeni uyivelakancane, ukubamba iqhaza esivivinyweni somtholampilo kufanele kubhekwe. Ezinye izivivinyo zokwelashwa zivulekele kuphela iziguli ezingakaqali ukwelashwa.

Izingane ezinezimila zenhliziyo kufanele zihlelelwe ukwelashwa kwazo yiqembu lodokotela abangochwepheshe ekwelapheni umdlavuza wezingane.

Ukwelashwa kwezimila zenhliziyo ezimbi kuzobhekwa ngudokotela oncologist, udokotela ogxile ekwelapheni izingane ezinomdlavuza. Udokotela we-oncologist usebenza nabanye ochwepheshe bezempilo yezingane abangochwepheshe ekwelapheni izingane ezinomdlavuza futhi abagxile ezindaweni ezithile zemithi. Lokhu kungafaka ongoti abalandelayo nabanye:

• Udokotela wezingane.

• Udokotela ohlinzayo wenhliziyo.

• Udokotela wenhliziyo wezingane.

• I-radiation oncologist.

• Udokotela wezifo zengqondo.

• Umhlengikazi ongumhlengikazi.

• Usonhlala kahle.

• Uchwepheshe wokuvuselelwa.

• Isazi sokusebenza kwengqondo.

• Ingcweti kwezempilo yengane.

Izinhlobo ezinhlanu zokwelashwa zisetshenzisiwe:

Ukulinda okulindile

Ukulinda ngokuqapha kusibhekisisa isimo sesiguli ngaphandle kokunikeza ukwelashwa kuze kuvele izimpawu noma izimpawu. Lokhu kwelashwa kungasetshenziselwa i-rhabdomyoma.

Ukwelashwa ngamakhemikhali

I-Chemotherapy yindlela yokwelapha umdlavuza esebenzisa izidakamizwa ukuvimba ukukhula kwamangqamuzana omdlavuza, kungaba ngokubulala amaseli noma ngokuwavimba ekuhlukaniseni. Lapho i-chemotherapy ithathwa ngomlomo noma ifakwa emthanjeni noma emisipheni, izidakamizwa zingena egazini futhi zingafinyelela kumaseli womdlavuza emzimbeni wonke (systemic chemotherapy).

Ukuhlinzwa

Uma kungenzeka, umdlavuza ususwa ngokuhlinzwa. Izinhlobo zokuhlinzwa ezingenziwa zifaka okulandelayo:

• Ukuhlinzwa ukukhipha isimila nezinye izicubu ezinempilo ezizungezile.

• Ukufakelwa kwenhliziyo. Uma isiguli silinde inhliziyo enikelwe, olunye unyango luyanikezwa lapho kudingeka.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe ukwelashwa komdlavuza okusebenzisa amandla amakhulu ama-x-ray noma ezinye izinhlobo zemisebe ukubulala amangqamuzana omdlavuza noma ukuwagcina ekukhuleni. Ukwelashwa kwemisebe kwangaphandle kusebenzisa umshini ongaphandle komzimba ukuthumela imisebe ebheke emdlavuzeni.

Ukwelashwa okuhlosiwe

Ukwelashwa okuhlosiwe uhlobo lokwelashwa olusebenzisa izidakamizwa noma ezinye izinto ukuhlasela amangqamuzana omdlavuza. Izindlela zokwelashwa ezihlosiwe zivame ukudala ukulimala okuncane kumaseli ajwayelekile kunokwelashwa ngamakhemikhali noma ukwelashwa ngemisebe.

• I-mTOR inhibitors imisa amaseli ekuhlukaniseni futhi ingavimbela ukukhula kwemithambo yegazi emisha okudingeka ukuthi izimila zikhule. I-Everolimus isetshenziselwa ukwelapha izingane ezine-rhabdomyoma ne-tuberous sclerosis.

Ukwelashwa okuhlosiwe nakho kuyacutshungulwa ekwelapheni izicubu zenhliziyo ebuntwaneni ezimbi ezibuye zabuya (zabuya).

Izinhlobo ezintsha zokwelashwa ziyahlolwa ezivivinyweni zokwelashwa.

Imininingwane mayelana nokuhlolwa kwemitholampilo iyatholakala kuwebhusayithi ye-NCI.

Ukwelashwa kwezimila zenhliziyo ebuntwaneni kungadala imiphumela emibi.

Ngemininingwane ngemiphumela emibi eqala ukwelashwa komdlavuza, bheka ikhasi lethu le-Side Effects.

Imiphumela emibi yokwelashwa komdlavuza eqala ngemuva kokwelashwa futhi iqhubeke izinyanga noma iminyaka ibizwa ngemiphumela ephuzile. Imiphumela yamuva yokwelashwa komdlavuza ingafaka:

• Izinkinga zomzimba.

• Izinguquko zemizwa, imizwa, ukucabanga, ukufunda, noma inkumbulo.

• Umdlavuza wesibili (izinhlobo ezintsha zomdlavuza) noma ezinye izimo.

Eminye imiphumela yesikhashana ingalashwa noma ilawulwe. Kubalulekile ukukhuluma nodokotela bengane yakho ngemiphumela engaba khona sekwephuzile ebangelwe ukwelashwa okuthile. Bona isifinyezo se- ngemiphumela yamuva yokwelashwa komdlavuza wezingane ukuthola eminye imininingwane.

Iziguli zingafuna ukucabanga ngokubamba iqhaza esivivinyweni somtholampilo.

Kwezinye iziguli, ukubamba iqhaza esivivinyweni somtholampilo kungaba yindlela engcono kakhulu yokwelashwa. Ukuhlolwa kwemitholampilo kuyingxenye yenqubo yocwaningo lomdlavuza. Ukuhlolwa komtholampilo kuyenziwa ukuthola ukuthi ngabe ukwelashwa komdlavuza okusha kuphephile futhi kuyasebenza yini noma kungcono kunokwelashwa okujwayelekile.

Eziningi zezindlela zokwelashwa ezijwayelekile zomdlavuza zisuselwa ekuhlolweni kokuqala komtholampilo. Iziguli ezibamba iqhaza esivivinyweni somtholampilo zingathola ukwelashwa okujwayelekile noma zibe phakathi kwabokuqala ukuthola ukwelashwa okusha.

Iziguli ezibamba iqhaza ezivivinyweni zokwelashwa zisiza nokwenza ngcono indlela umdlavuza ozophathwa ngayo ngokuzayo. Noma izilingo zomtholampilo zingaholeli ekwelashweni okusha okusebenzayo, zivame ukuphendula imibuzo ebalulekile futhi zisize ukuqhubela phambili ucwaningo.

Iziguli zingangena ezivivinyweni zokwelashwa ngaphambi, ngesikhathi, noma ngemuva kokuqala ukwelashwa kwazo komdlavuza.

Ezinye izivivinyo zokwelashwa zifaka kuphela iziguli ezingakatholi ukwelashwa. Ezinye izilingo zivivinya ukwelashwa kweziguli ezinomdlavuza ongakabi ngcono. Kukhona nokuhlolwa komtholampilo okuhlola izindlela ezintsha zokunqanda umdlavuza ukuthi ungaphindi (ubuye) noma kunciphise imiphumela emibi yokwelashwa komdlavuza.

Ukuhlolwa kwemitholampilo kuyenzeka ezingxenyeni eziningi zezwe. Imininingwane mayelana nokuhlolwa kwemitholampilo esekelwa yi-NCI ingatholakala ekhasini lewebhu le-NCI lokuhlolwa kokuhlolwa kwemitholampilo. Izivivinyo zomtholampilo ezisekelwa ezinye izinhlangano zingatholakala kuwebhusayithi yeClinicalTrials.gov.

Ukuhlolwa kokulandelela kungadingeka.

Olunye uvivinyo olwenziwe ukuxilonga umdlavuza noma ukuthola isigaba somdlavuza lungaphindwa. Olunye uvivinyo luzophindwa ukuze kubonakale ukuthi umuthi usebenza kanjani. Izinqumo mayelana nokuthi uqhubeke, ushintshe, noma umise ukwelashwa zingasuselwa emiphumeleni yalezi zivivinyo.

Ezinye zezivivinyo zizoqhubeka ukwenziwa ngezikhathi ezithile ngemuva kokuphela kokwelashwa. Imiphumela yalezi zivivinyo ingakhombisa ukuthi ngabe isimo sengane yakho sishintshile noma uma umdlavuza ubuyile (buyela emuva). Lezi zivivinyo kwesinye isikhathi zibizwa ngokuthi izivivinyo zokulandelela noma ukuhlolwa.

Ukwelashwa Kwezimila Zenhliziyo Yezingane

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Ukwelashwa kwezimila zenhliziyo ebuntwaneni kungafaka okulandelayo:

• Ukulinda ngokuqapha, i-rhabdomyoma, kwesinye isikhathi eyehlayo bese ihamba yodwa.

• Ukwelashwa okuhlosiwe (i-everolimus) yeziguli ezine-rhabdomyoma ne-tuberous sclerosis.

• I-Chemotherapy elandelwa ukuhlinzwa (okungafaka phakathi ukukhipha okuthile noma sonke isimila noma ukufakelwa inhliziyo), kuma-sarcomas.

• Ukuhlinzwa wedwa, kwezinye izinhlobo zesimila.

• Ukwelashwa ngemisebe yamathumba angenakususwa ngokuhlinzwa.

Ukwelashwa Kwezimila Zenhliziyo Eziphindaphindayo Zengane

Ngemininingwane mayelana nokwelashwa okubalwe ngezansi, bheka isigaba se-Treatment Option Overview section.

Ukwelashwa kwezimila zesifo esibuhlungu esivela njalo ebuntwaneni kungafaka okulandelayo:

• Isivivinyo somtholampilo esihlola isampula lesimila sesiguli ukuthola izinguquko ezithile zofuzo. Uhlobo lokwelashwa okuqondisiwe oluzonikezwa isiguli kuncike ohlotsheni lokushintsha kofuzo.

Ukufunda Okwengeziwe Ngamathumba Wenhliziyo Yezingane

Ngemininingwane engaphezulu evela kuNational Cancer Institute mayelana nezimila zenhliziyo ebuntwaneni, bheka okulandelayo:

• Ikhasi Lasekhaya Lomdlavuza Wezimila Zenhliziyo

• I-Computed Tomography (CT) Iskena Nomdlavuza

• Izindlela Zokwelapha Zomdlavuza

Ngemininingwane eminingi yomdlavuza wezingane nezinye izinsiza zomdlavuza ezijwayelekile, bheka okulandelayo:

• Mayelana Nomdlavuza

• Umdlavuza Wezingane

• I-CureSearch ye-Cancer YezinganePhuma Ukuzikhulula

• Imiphumela Emuva Yokwelapha Yomdlavuza Wezingane

• Intsha kanye nabantu abadala abancane abaneCancer

• Izingane Ezinomdlavuza: Umhlahlandlela Wabazali

• Umdlavuza Ezinganeni Nasebusheni

• Isiteji

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho mayelana Nomdlavuza

• Kwabasindile Nabanakekeli

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