Types/childhood-cancers/late-effects-pdq

Imiphumela Emuva Yokwelapha Yomdlavuza Wezingane (®) -Patient Version

Imininingwane ejwayelekile mayelana nemiphumela yamuva

AMAPHUZU ASEMQOKA

• Imiphumela engemuva kwesikhathi yizinkinga zempilo ezenzeka izinyanga noma iminyaka ukwelashwa kuphelile.

• Imiphumela engemuva kwabasindile bomdlavuza wezingane ithinta umzimba nengqondo.

• Kunezici ezintathu ezibalulekile ezithinta ubungozi bemiphumela yangemva kwesikhathi.

• Ithuba lokuthola imiphumela yangemva kwesikhathi landa ngokuhamba kwesikhathi.

• Ukunakekelwa okulandelwayo njalo kubaluleke kakhulu kwabasindile bomdlavuza wezingane.

• Imikhuba emihle yezempilo nayo ibalulekile kulabo abasinda emdlavuzeni wezingane.

Imiphumela engemuva kwesikhathi yizinkinga zempilo ezenzeka izinyanga noma iminyaka ukwelashwa kuphelile.

Ukwelashwa komdlavuza kungadala izinkinga zempilo kulabo abasinde kumdlavuza wezingane izinyanga noma iminyaka ngemuva kokuphela kokwelashwa okuphumelelayo. Ukwelashwa ngomdlavuza kungalimaza izitho zomzimba, izicubu, noma amathambo futhi kudale izinkinga zempilo kamuva empilweni. Lezi zinkinga zezempilo zibizwa ngemiphumela ephuzile.

Ukwelashwa okungadala imiphumela emuva kwesikhathi kufaka okulandelayo:

• Ukuhlinzwa.

• Ukwelashwa ngamakhemikhali.

• Ukwelashwa ngemisebe.

• Ukufakelwa kwe-stem cell.

Odokotela bacwaninga ngemiphumela yesikhashana ebangelwe ukwelashwa komdlavuza. Basebenza ukuthuthukisa ukwelashwa komdlavuza nokuyeka noma ukunciphisa imiphumela esekugcineni. Yize imiphumela eminingi sekwedlule isikhathi ingasongeli impilo, ingadala izinkinga ezinkulu ezithinta impilo nekhwalithi yempilo.

Imiphumela engemuva kwabasindile bomdlavuza wezingane ithinta umzimba nengqondo.

Imiphumela engemuva kwabasindile bomdlavuza wezingane ingathinta okulandelayo:

• Izitho, izicubu, nokusebenza komzimba.

• Ukukhula nentuthuko.

• Isimo, imizwa, nezenzo.

• Ukucabanga, ukufunda nokukhumbula.

• Ukulungiswa kwezenhlalo nezingokwengqondo.

• Ingozi yomdlavuza wesibili.

Kunezici ezintathu ezibalulekile ezithinta ubungozi bemiphumela yangemva kwesikhathi.

Abaningi abasinda emdlalweni womdlavuza bayoba nemiphumela sekwephuzile. Ubungozi bemiphumela yesikhashana buxhomeke ezicini ezihlobene nesimila, ukwelashwa nesiguli. Lokhu kufaka phakathi okulandelayo:

• Izici ezihlobene nesimila

• Uhlobo lomdlavuza.

• Lapho isimila sikhona emzimbeni.

• Ukuthi isimila siyithinta kanjani indlela izicubu nezitho ezisebenza ngayo.

• Izici ezihlobene nokwelashwa

• Uhlobo lokuhlinzwa.

• Uhlobo lwe-Chemotherapy, umthamo, kanye nohlelo.

• Uhlobo lokwelashwa ngemisebe, ingxenye yomzimba elashwa, kanye nomthamo.

• Ukufakelwa kwe-stem cell.

• Ukusetshenziswa kwezinhlobo ezimbili noma ngaphezulu zokwelashwa ngasikhathi sinye.

• Ukufakwa komkhiqizo wegazi.

• Isifo esingelapheki sokuqhathanisa okususelwa ekusingatheni.

• Izici ezihlobene neziguli

• Ubulili bengane.

• Izinkinga zempilo ingane ebinazo ngaphambi kokutholakala ukuthi inomdlavuza.

• Isikhathi sengane nokukhula kwengane lapho kutholakala ukuthi yelashwa futhi yelashwa.

• Ubude besikhathi selokhu kutholakala ukuxilongwa nokwelashwa.

• Izinguquko emazingeni ama-hormone.

• Ikhono lezicubu ezinempilo ezithintekile ukwelashwa komdlavuza ukuzilungisa.

• Izinguquko ezithile kuzakhi zofuzo zengane.

• Umlando womndeni womdlavuza noma ezinye izimo.

• Imikhuba yezempilo.

Ithuba lokuthola imiphumela yangemva kwesikhathi landa ngokuhamba kwesikhathi.

Imithi emisha yokwelashwa komdlavuza wezingane inciphise inani lokufa komdlavuza oyinhloko. Ngoba abasindile bomdlavuza wezingane baphila isikhathi eside, banemiphumela ebambezeleka kakhulu ngemuva kokwelashwa komdlavuza. Abasindile kungenzeka bangaphili isikhathi eside njengabantu ababengenawo umdlavuza. Izimbangela ezivame kakhulu zokufa kwabasindile kumdlavuza wezingane yilezi:

• Umdlavuza oyinhloko uyabuya.

• Izinhlobo zesibili (ezihlukile) zomdlavuza oyinhloko.

• Ukulimala kwenhliziyo namaphaphu.

Ukufundwa kwezimbangela zemiphumela sekwedlule isikhathi kuholele kuzinguquko ekwelashweni. Lokhu kuthuthukise ikhwalithi yempilo yabasinde kumdlavuza futhi kusiza ukuvikela ukugula nokufa emiphumeleni yamuva.

Ukunakekelwa okulandelwayo njalo kubaluleke kakhulu kwabasindile bomdlavuza wezingane.

Ukulandelwa njalo kochwepheshe bezempilo abaqeqeshelwe ukuthola nokwelashwa ngemiphumela emuva kwesikhathi kubalulekile empilweni yesikhathi eside yabasindile bomdlavuza wezingane. Ukunakekelwa kokulandelela kuzohluka kumuntu ngamunye owelashelwe umdlavuza. Uhlobo lokunakekelwa luzoya ngohlobo lomdlavuza, uhlobo lokwelashwa, izici zofuzo, nemikhuba yempilo nempilo yomuntu jikelele. Ukunakekelwa kokulandelela kufaka phakathi ukuhlola izimpawu nezimpawu zemiphumela yangemva kwesikhathi kanye nemfundo yezempilo yokuthi ungavimbela kanjani noma unciphise imiphumela yangemva kwesikhathi.

Kubalulekile ukuthi abasinde kumdlavuza wezingane bahlolwe okungenani kanye ngonyaka. Izivivinyo kufanele zenziwe ngungoti wezempilo owaziyo ubungozi besisulu semiphumela yesikhathi esedlule futhi abone izimpawu zokuqala zemiphumela yesikhathi esedlule. Ukuhlolwa kwegazi nemifanekiso nakho kungenziwa.

Ukulandelwa kwesikhathi eside kungahle kuthuthukise impilo nekhwalithi yempilo yabasindile bomdlavuza. Kuyasiza nodokotela ukuthi bafunde ngemiphumela sekwephuzile yokwelashwa komdlavuza ukuze kuthuthukiswe izindlela eziphephile zezingane ezisanda kutholakala.

Imikhuba emihle yezempilo nayo ibalulekile kulabo abasinda emdlavuzeni wezingane.

Izinga lempilo labasindile kumdlavuza lingathuthukiswa ngokuziphatha okukhuthaza impilo nenhlalakahle. Lokhu kufaka phakathi ukudla okunempilo, ukuvivinya umzimba, nokuhlolwa njalo kwezokwelapha nokwamazinyo. Lezi zindlela zokuzinakekela zibaluleke kakhulu kwabasinde emdlavweni ngenxa yengozi yabo yezinkinga zempilo ezihlobene nokwelashwa. Ukuziphatha okunempilo kungenza imiphumela yesikhashana ibe nzima kakhulu futhi yehlise ubungozi bezinye izifo.

Ukugwema izindlela zokuziphatha ezilimaza impilo nakho kubalulekile. Ukubhema, ukusebenzisa ngokweqile utshwala, ukusetshenziswa kwezidakamizwa ngokungemthetho, ukuvezwa yilanga, noma ukungasebenzi ngokweqile kungadala ukulimala komzimba okuhlobene nokwelashwa futhi kungakhuphula ingozi yomdlavuza wesibili.

Umdlavuza Wesibili

AMAPHUZU ASEMQOKA

• Abasinde kumdlavuza wezingane banengozi eyengeziwe yomdlavuza wesibili kamuva empilweni.

• Izinhlobo ezithile zofuzo noma ama-syndromes angandisa ingozi yomdlavuza wesibili.

• Iziguli ezelashelwe umdlavuza zidinga ukuhlolwa njalo ukuze zihlolwe umdlavuza wesibili.

• Uhlobo lokuhlola olusetshenziselwa ukuhlola umdlavuza wesibili kuncike engxenyeni yohlobo lomuthi wokwelapha umdlavuza obekukhona isiguli phambilini.

Abasinde kumdlavuza wezingane banengozi eyengeziwe yomdlavuza wesibili kamuva empilweni.

Umdlavuza ohlukile oyinhloko owenzeka okungenani izinyanga ezimbili ngemuva kokuphela kokwelashwa komdlavuza ubizwa ngokuthi ngumdlavuza wesibili. Umdlavuza wesibili kungenzeka izinyanga noma iminyaka ukwelashwa kuqediwe. Uhlobo lomdlavuza wesibili olwenzeka lincike ngokwengxenye kuhlobo lokuqala lomdlavuza kanye nokwelashwa komdlavuza. Izicubu ze-Benign (hhayi umdlavuza) nazo zingavela.

Umdlavuza wesibili owenzeka ngemuva kokwelashwa komdlavuza ufaka okulandelayo:

• Izicubu eziqinile.

• I-Myelodysplastic syndrome kanye ne-leukemia ebukhali ye-myeloid.

Izicubu eziqinile ezingabonakala ngaphezulu kweminyaka eyi-10 ngemuva kokuxilongwa nokwelashwa komdlavuza okuyinhloko zifaka okulandelayo:

• Umdlavuza webele. Kukhona ingozi eyengeziwe yomdlavuza webele ngemuva kokwelashwa kwesisindo somuthi ophezulu weHodgkin lymphoma. Iziguli ezelashwa ngemisebe engaphezulu kwe-diaphragm engafaki ama-lymph node ekhwapheni zisengozini ephansi yomdlavuza webele.

Ukwelashwa komdlavuza osakaze esifubeni noma emaphashini ngemisebe yesifuba nakho kungandisa ubungozi besifo somdlavuza webele.

Kukhona nengozi eyengeziwe yomdlavuza webele ezigulini ezelashwa ngama-alkylating agents kanye nama-anthracyclines kodwa hhayi ngemisebe yesifuba. Ingozi iphezulu kakhulu kwabasindile be-sarcoma kanye ne-leukemia.

• Umdlavuza wegilo. Umdlavuza wegilo kungenzeka ngemuva kokwelashwa kwemisebe yentamo yeHodgkin lymphoma, i-acute lymphocytic leukemia, noma izicubu zobuchopho; ngemuva kokwelashwa kwe-iodine enemisebe ye-neuroblastoma; noma ngemuva kwenani eliphelele le-irradiation yomzimba (i-TBI) njengengxenye yokufakelwa kwe-stem cell.

• Izicubu zobuchopho. Izicubu zobuchopho zingenzeka ngemuva kokwelashwa ngemisebe ekhanda kanye / noma kwi-chemotherapy ye-intrathecal kusetshenziswa i-methotrexate yesimila esiyinhloko sobuchopho noma umdlavuza osakaze ebuchosheni noma emgogodleni, njenge-acute lymphocytic leukemia noma i-non-Hodgkin lymphoma. Lapho i-intrathecal chemotherapy esebenzisa i-methotrexate kanye nokwelashwa ngemisebe kunikezwa ndawonye, ​​ingozi yesimila ebuchosheni iba nkulu kakhulu.

• Izicubu zamathambo nezithambile. Kukhona ingozi eyengeziwe yamathambo nezicubu ezithambile ngemuva kokwelashwa ngemisebe ye-retinoblastoma, i-Ewing sarcoma, neminye imidlavuza yethambo.

Ukwelashwa ngamakhemikhali ngama-anthracyclines noma ama-alkylating agents nakho kwandisa ingozi yamathumba nezicubu ezithambile.

• Umdlavuza wamaphaphu. Kukhona ingozi eyengeziwe yomdlavuza wamaphaphu ngemuva kokwelashwa ngemisebe esifubeni seHodgkin lymphoma, ikakhulukazi ezigulini ezibhemayo.

• Isisu, umdlavuza wesibindi, noma umdlavuza obomvu. Umdlavuza wesisu, wesibindi noma we-colorectal kungenzeka ngemuva kokwelashwa ngemisebe esiswini noma okhalweni. Ingozi iyanda ngamanani aphezulu emisebe. Kukhona ingozi eyengeziwe yama-polyps angama-colorectal.

Ukwelashwa nge-chemotherapy kuphela noma ukwelashwa ngamakhemikhali kanye nokwelashwa ngemisebe kuhlanganisiwe futhi kwandisa ingozi yesifo somdlavuza wesisu, wesibindi noma wombala.

• Umdlavuza wesikhumba we-Nonmelanoma (i-basal cell carcinoma noma i-squamous cell carcinoma). Kunengozi eyengeziwe yomdlavuza wesikhumba we-nonmelanoma ngemuva kokwelashwa ngemisebe; imvamisa ivela endaweni lapho kunikezwe khona imisebe. Ukuvezwa emisebeni ye-UV kungakhuphula le ngozi. Iziguli ezakha umdlavuza wesikhumba we-nonmelanoma ngemuva kokwelashwa ngemisebe zinamathuba andile okuthuthukisa ezinye izinhlobo zomdlavuza esikhathini esizayo. Ingozi ye-basal cell carcinoma nayo inyuka ngemuva kokwelashwa ngemithi yokwelapha ngamakhemikhali, ebizwa nge-vinca alkaloids, efana ne-vincristine ne-vinblastine.

• I-melanoma ebulalayo. I-malignant melanoma ingenzeka ngemuva kwemisebe noma i-chemotherapy ehlanganisiwe nama-alkylating agents kanye nemithi elwa namagciwane (njenge-vincristine ne-vinblastine). Abasindile ku-Hodgkin lymphoma, i-retinoblastoma yefa, izicubu ezithambile ze-sarcoma, kanye nezicubu ze-gonadal kungenzeka babe sengozini enkulu yokuba ne-melanoma emibi. I-malignant melanoma njengomdlavuza wesibili ayijwayelekile kakhulu kunomdlavuza wesikhumba we-nonmelanoma.

• Umdlavuza womlomo womlomo. Umdlavuza womlomo womlomo kungenzeka ngemuva kokufakwa kwesitokisi kanye nomlando wesifo esingapheli se-graft-versus-host.

Umdlavuza wezinso. Kukhona ingozi eyengeziwe yomdlavuza wezinso ngemuva kokwelashwa kwe-neuroblastoma, ukwelashwa ngemisebe kuya maphakathi nomhlane, noma i-chemotherapy efana ne-cisplatin noma i-carboplatin.

• Umdlavuza wesinye. Umdlavuza wesinye kungenzeka ngemuva kwe-chemotherapy nge-cyclophosphamide.

I-Myelodysplastic syndrome kanye ne-acute myeloid leukemia kungavela eminyakeni engaphansi kwengu-10 ngemuva kokutholakala komdlavuza oyinhloko we-Hodgkin lymphoma, i-acute lymphoblastic leukemia, noma i-sarcoma kanye nokwelashwa ngamakhemikhali afaka okulandelayo:

• Umenzeli we-alkylating njenge-cyclophosphamide, ifosfamide, mechlorethamine, melphalan, busulfan, carmustine, lomustine, chlorambucil, noma i-dacarbazine.

• Umenzeli we-II inhibitor njenge-etoposide noma i-teniposide.

Izinhlobo ezithile zofuzo noma ama-syndromes angandisa ingozi yomdlavuza wesibili.

Abanye abasinde emdlavuzweni wobuntwana bangaba nengozi eyengeziwe yokuthola umdlavuza wesibili ngoba banomlando womndeni womdlavuza noma isifo somdlavuza esizuzwe njengeLi-Fraumeni syndrome. Izinkinga ngendlela i-DNA elungiswa ngayo kumaseli nendlela izidakamizwa ze-anticancer ezisetshenziswa ngayo ngumzimba nazo zingaphazamisa ingozi yomdlavuza wesibili.

Iziguli ezelashelwe umdlavuza zidinga ukuhlolwa njalo ukuze zihlolwe umdlavuza wesibili.

Kubalulekile ezigulini ezelashelwe umdlavuza ukuthi zihlolwe umdlavuza wesibili ngaphambi kokuba kuvele izimpawu. Lokhu kubizwa ngokuthi ukuhlolwa komdlavuza wesibili futhi kungasiza ekutholeni umdlavuza wesibili zisencane. Lapho izicubu noma umdlavuza ongajwayelekile utholakala kusenesikhathi, kungaba lula ukuselapha. Ngesikhathi kuvela izimpawu, umdlavuza kungenzeka ukuthi usuqale ukusabalala.

Kubalulekile ukukhumbula ukuthi udokotela wengane yakho akacabangi ukuthi ingane yakho inomdlavuza uma ephakamisa ukuhlolwa kokuhlolwa. Ukuhlolwa kokuhlolwa kunikezwa lapho ingane yakho ingenazo izimpawu zomdlavuza. Uma umphumela wokuhlolwa kokuhlola ungajwayelekile, ingane yakho ingadinga ukuthi kwenziwe ukuhlolwa okwengeziwe ukuthola ukuthi inomdlavuza wesibili yini. Lokhu kubizwa ngokuthi izivivinyo zokuxilonga.

Uhlobo lokuhlola olusetshenziselwa ukuhlola umdlavuza wesibili kuncike engxenyeni yohlobo lomuthi wokwelapha umdlavuza obekukhona isiguli phambilini.

Zonke iziguli ezelashelwe umdlavuza kufanele zihlolwe ngokomzimba kanye nomlando wezokwelapha kwenziwe kanye ngonyaka. Ukuhlolwa komzimba kwenziwa ukuze kubhekwe izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa, izinguquko esikhunjeni, noma yini enye ebonakala ingajwayelekile. Kuthathwa umlando wezokwelapha ukuze kufundwe ngemikhuba yezempilo yesiguli kanye nokugula okwedlule kanye nokwelashwa.

Uma isiguli sithole ukwelashwa ngemisebe, lezi zivivinyo nezinqubo ezilandelayo zingasetshenziswa ukuhlola umdlavuza wesikhumba, webele, noma wombala:

• Ukuhlolwa kwesikhumba: Udokotela noma umhlengikazi ubheka izigaxa esikhunjeni noma amabala abukeka angajwayelekile ngombala, usayizi, ukwakheka, noma ukuthungwa, ikakhulukazi endaweni lapho kunikezwe khona imisebe. Kunconywa ukuthi kuhlolwe isikhumba kanye ngonyaka ukubheka izimpawu zomdlavuza wesikhumba.

• Ukuzihlola kwamabele : Ukuhlolwa kwesifuba yisiguli. Isiguli sizwa ngokucophelela amabele nangaphansi kwezingalo ukuthola izigaxa noma yini enye ebonakala ingajwayelekile. Kuphakanyiswa ukuthi abesifazane abaphathwe ngomthamo ophakeme wemithi yokwelapha ngemisebe esifubeni benze ukuzihlola kwebele nyangazonke okuqala ngesikhathi sokuthomba kuze kube yiminyaka engama-25. Abesifazane abelashwa ngomthamo omncane wemisebe esifubeni kungenzeka bangadingi ukuqala ukuhlola umdlavuza webele ngesikhathi sokuthomba. Khuluma nodokotela wakho mayelana nokuthi kufanele uqale nini ukuzihlola amabele.

• Ukuhlolwa kwebele lomtholampilo (i-CBE): Ukuhlolwa kwesifuba ngudokotela noma omunye uchwepheshe wezempilo. Udokotela uzokuzwa ngokucophelela amabele nangaphansi kwezingalo ukuthola izigaxa noma yini enye ebonakala ingajwayelekile. Kuphakanyiswa ukuthi abesifazane abaphathwa ngomuthi ophakeme wemithi yokwelapha ngemisebe esifubeni bahlolwe imitholampilo minyaka yonke kusukela ekuthomba kuze kube yiminyaka engama-25. Ngemuva kweminyaka yobudala engama-25 noma engu-8 ngemuva kokuphela kokwelashwa ngemisebe (noma yikuphi okukuqala), izivivinyo zamabele zokwelashwa zenziwa njalo ezinyangeni eziyisithupha. Abesifazane abelashwa ngomthamo omncane wemisebe esifubeni kungenzeka bangadingi ukuqala ukuhlola umdlavuza webele ngesikhathi sokuthomba. Khuluma nodokotela wakho mayelana nokuthi kufanele uqale nini ukuhlolwa kwebele lomtholampilo.

• I-Mammogram: I-x-ray yebele. I-mammogram ingenziwa kwabesifazane ababenomthamo ophakeme wemisebe esifubeni futhi abangenawo amabele aminyene. Kuphakanyiswa ukuthi laba besifazane bane-mammogram kanye ngonyaka eqala eminyakeni engu-8 ngemuva kokwelashwa noma eneminyaka engama-25, noma ikuphi kamuva. Khuluma nodokotela wakho mayelana nokuthi kufanele uqale nini ukuba nama-mammograms ukuhlola umdlavuza webele.

• I-Breast MRI (imaging resonance imaging): Inqubo esebenzisa uzibuthe, amagagasi omsakazo, nekhompyutha ukwenza uchungechunge lwezithombe ezinemininingwane zesifuba. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI). I-MRI ingenziwa kwabesifazane ababenomthamo ophakeme wemisebe esifubeni futhi abanamabele aminyene. Kuphakanyiswa ukuthi laba besifazane bane-MRI kanye ngonyaka eqala eminyakeni eyi-8 ngemuva kokwelashwa noma eneminyaka engama-25, noma ikuphi kamuva. Uma unemisebe esifubeni, khuluma nodokotela wakho mayelana nokuthi uyayidinga yini iMRI yesifuba ukuze uhlole umdlavuza webele.

• I-Colonoscopy: Inqubo yokubheka ngaphakathi kwe-rectum ne-colon yama-polyps, izindawo ezingavamile, noma umdlavuza. I-colonoscope ifakwa nge-rectum kukholoni. I-colonoscope iyinsimbi encane, efana nethubhu enokukhanya nelensi yokubuka. Kungaba futhi nethuluzi lokususa ama-polyps noma amasampuli wezicubu, ahlolwe ngaphansi kwesibonakhulu ukuthola izimpawu zomdlavuza. Kuphakanyiswa ukuthi abasindile bomdlavuza wezingane ababenomthamo ophakeme wemisebe esiswini, okhalweni, noma emgogodleni bane-colonoscopy njalo eminyakeni emihlanu. Lokhu kuqala eneminyaka engama-35 noma iminyaka eyi-10 ngemuva kokuphela kokwelashwa, noma yikuphi kamuva. Uma unemisebe esiswini, okhalweni, noma emgogodleni, khuluma nodokotela wakho mayelana nokuthi kufanele uqale nini ukuba nama-colonoscopies wokuhlola umdlavuza obala.

Isistimu Yezinhliziyo

AMAPHUZU ASEMQOKA

• Imiphumela yesikebhe senhliziyo negazi sekwephuzile kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Imisebe esifubeni kanye nezinhlobo ezithile ze-chemotherapy inyusa ingozi yenhliziyo nemithambo yegazi.

• Imiphumela engemuva kwesikhathi ethinta inhliziyo nemithambo yegazi ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zenhliziyo nemithambo yegazi ngemuva kwesikhathi zibandakanya ukuphefumula kanzima nobuhlungu besifuba.

• Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo enhliziyweni nasemithanjeni yegazi.

• Imikhuba yezempilo ekhuthaza inhliziyo nemithambo yegazi enempilo ibalulekile kulabo abasinda emdlavuzeni wezingane.

Imiphumela yesikebhe senhliziyo negazi sekwephuzile kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana. Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala imiphumela yesikhathi senhliziyo neyegazi:

• I-leukemia ye-lymphoblastic acute (BONKE).

• I-leukemia enamandla kakhulu (AML).

• Izicubu zobuchopho nomgogodla.

• Umdlavuza wekhanda nentamo.

• IHodgkin lymphoma.

• I-non-Hodgkin lymphoma.

• Isimila seWilms.

• Umdlavuza welashwa ngokufakwa kwe-stem cell.

Imisebe esifubeni kanye nezinhlobo ezithile ze-chemotherapy inyusa ingozi yenhliziyo nemithambo yegazi.

Ingozi yezinkinga zempilo ezibandakanya inhliziyo nemithambo yegazi iyanda ngemuva kokwelashwa ngalokhu okulandelayo:

• Imisebe esifubeni, emgogodleni, ebuchosheni, entanyeni, ezinsweni, noma emisebeni yomzimba ephelele (i-TBI) njengengxenye yokufakelwa kwe-stem cell. Ubungozi bezinkinga buncike endaweni yomzimba ebichayeka emisebeni, inani lemisebe enikeziwe, nokuthi imisebe yanikezwa ngemithamo emincane noma emikhulu.

• Izinhlobo ezithile ze-chemotherapy kanye nomthamo ophelele we-anthracycline onikeziwe. I-Chemotherapy ene-anthracyclines efana ne-doxorubicin, i-daunorubicin, i-idarubicin, ne-epirubicin, kanye ne-anthraquinones efana ne-mitoxantrone yandisa ubungozi bezinkinga zenhliziyo nemithambo yegazi. Ubungozi bezinkinga buncike kumthamo ophelele we-chemotherapy onikiwe kanye nohlobo lwesidakamizwa esisetshenzisiwe. Kuya futhi ngokuthi ngabe ukwelashwa ngama-anthracyclines kwanikezwa ingane engaphansi kweminyaka eyi-13 nokuthi ngabe umuthi obizwa nge-dexrazoxane wanikezwa yini ngesikhathi sokwelashwa nge-anthracyclines. IDexrazoxane inganciphisa ukulimala kwenhliziyo nomthambo wegazi kuze kube yiminyaka emihlanu ukwelashwa. I-ifosfamide, i-methotrexate, ne-chemotherapy ene-platinum, efana ne-carboplatin ne-cisplatin, nayo ingadala imiphumela yesikhashana yenhliziyo negazi.

• Ukufakelwa kwe-stem cell.

• I-Nephrectomy (ukuhlinzwa ukususa konke noma ingxenye yezinso).

Abasindile bomdlavuza wezingane abaphathwa ngemisebe enhliziyweni noma emithanjeni yegazi nezinhlobo ezithile ze-chemotherapy zisengozini enkulu.

Izindlela zokwelapha ezintsha ezinciphisa inani lemisebe enikeziwe futhi zisebenzise imithamo ephansi yamakhemikhali noma imithi yamakhemikhali engeyona ingozi kangako inganciphisa ubungozi benhliziyo nemithambo yegazi emuva kwesikhathi uma kuqhathaniswa nokwelashwa okudala.

Okulandelayo kungakhuphula nobungozi benhliziyo nemithambo yegazi yemiphumela engemuva kwesikhathi:

• Isikhathi eside selokhu kwelashwa.

• Ukuba nomfutho wegazi ophakeme noma ezinye izinto ezinobungozi zesifo senhliziyo, njengomlando womndeni wesifo senhliziyo, ukukhuluphala ngokweqile, ukubhema, i-cholesterol ephezulu noma isifo sikashukela. Lapho lezi zinto zobungozi zihlanganiswa, ubungozi bemiphumela yesikhashana buphakama kakhulu.

• Ukuba namanani aphansi kunokujwayelekile we-thyroid, ukukhula, noma ama-hormone ocansi.

Imiphumela engemuva kwesikhathi ethinta inhliziyo nemithambo yegazi ingadala izinkinga ezithile zempilo.

Abasindile bomdlavuza wezingane abathole imisebe noma izinhlobo ezithile ze-chemotherapy banengozi eyengeziwe yemiphumela ephuzile enhliziyweni nasemithanjeni yegazi nezinkinga ezihlobene nempilo. Lokhu kufaka phakathi okulandelayo:

• Ukushaya kwenhliziyo okungavamile.

• Imisipha yenhliziyo ebuthakathaka.

• Inhliziyo eshisayo noma isaka elizungeze inhliziyo.

• Ukulimala kwama-valve enhliziyo.

• Isifo semithambo yegazi (ukuqina kwemithambo yenhliziyo).

• Ukwehluleka kwenhliziyo yokubopha.

• Ubuhlungu besifuba noma isifo senhliziyo.

• Amahlule egazi noma unhlangothi owodwa noma ngaphezulu.

• Isifo semithambo yeCarotid.

Izimpawu nezimpawu ezingaba khona zenhliziyo nemithambo yegazi ngemuva kwesikhathi zibandakanya ukuphefumula kanzima nobuhlungu besifuba.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yimiphumela yesikhathi senhliziyo neyegazi noma ngezinye izimo:

• Inkinga yokuphefumula, ikakhulukazi lapho ulele phansi.

• Ukushaya kwenhliziyo okuhamba kancane, okushesha kakhulu, noma okungafani nesigqi esivamile senhliziyo.

• Ubuhlungu besifuba noma ubuhlungu engalweni noma emlenzeni.

• Ukuvuvukala kwezinyawo, amaqakala, imilenze, noma isisu.

• Lapho kuvezwa amakhaza noma imizwa enamandla, iminwe, izinzwane, izindlebe, noma ikhala kuba mhlophe bese kuba luhlaza okwesibhakabhaka. Lapho lokhu kwenzeka

• eminweni, kungahle kube khona nobuhlungu nokuhayiza.

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

• Ukudideka okungazelelwe noma inkinga yokukhuluma noma ukuqonda inkulumo.

• Inkinga engazelelwe yokubona ngamehlo noma womabili.

• Inkinga engazelelwe ukuhamba noma ukuzizwa unesiyezi.

• Ukulahlekelwa okungazelelwe kokulingana noma kokuxhumanisa.

• Ikhanda elibuhlungu ngokuzumayo ngaphandle kwesizathu esaziwayo.

• Ubuhlungu, imfudumalo, noma ubomvu endaweni eyodwa yengalo noma yomlenze, ikakhulukazi emuva komlenze ongezansi.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo enhliziyweni nasemithanjeni yegazi.

Lokhu nezinye izivivinyo nezinqubo zingasetshenziswa ukuthola noma ukuthola imiphumela yesikebhe senhliziyo negazi:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukubheka izimpawu ezijwayelekile zempilo, kufaka phakathi ukuhlola inhliziyo ukuthola izimpawu zesifo, njengokushaya kwenhliziyo okungajwayelekile, umfutho wegazi ophakeme, noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini.

• 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-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.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho ezinjengenhliziyo futhi zenze ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

• 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. Le nqubo yenziwa ukuhlola amahlule egazi.

• Izifundo zephrofayili ye-Lipid: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani le-triglycerides, i-cholesterol, ne-low-and high-density lipoprotein cholesterol egazini.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zesifo senhliziyo nesokungena kwegazi ngemuva kwesikhathi. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Imikhuba yezempilo ekhuthaza inhliziyo nemithambo yegazi enempilo ibalulekile kulabo abasinda emdlavuzeni wezingane.

Abasinde kumdlavuza wezingane bangase banciphise ingozi yenhliziyo nemithambo yegazi ngemuva kwesikhathi ngokuba nokuphila ngendlela enempilo, okubandakanya:

• Isisindo esinempilo.

• Ukudla okunempilo enhliziyweni.

• Ukuvivinya umzimba njalo.

• Ukungabhemi.

Isistimu Yezinzwa Ephakathi

AMAPHUZU ASEMQOKA

• Imiphumela yobuchopho nentambo yomgogodla kungenzeka kakhulu ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Imisebe ebuchosheni inyusa ubungozi bobuchopho nomgogodla imiphumela esekugcineni.

• Imiphumela engemuva kwesikhathi ethinta ubuchopho nomgogodla ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zobuchopho kanye nomgogodla imiphumela engemuva kokufaka ikhanda, ukulahleka kokuxhumana, nokuquleka.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo ebuchosheni nakumgogodla.

• Abasindile emdlalweni womdlavuza wezingane bangaba nokukhathazeka nokudangala okuhlobene nomdlavuza wabo.

• Abanye abasinde emdlavuzeni wobuntwana bane-post-traumatic stress disorder.

• Intsha etholakala inomdlavuza ingaba nezinkinga zomphakathi kamuva empilweni.

Imiphumela yobuchopho nentambo yomgogodla kungenzeka kakhulu ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala ubuchopho nomgogodla imiphumela yesikhashana:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izicubu zobuchopho nomgogodla.

• Umdlavuza wekhanda nentamo, kufaka phakathi i-retinoblastoma.

• I-non-Hodgkin lymphoma.

• Osteosarcoma.

Imisebe ebuchosheni inyusa ubungozi bobuchopho nomgogodla imiphumela esekugcineni.

Ingozi yezinkinga zempilo ezithinta ubuchopho noma umgogodla iyanda ngemuva kokwelashwa ngalokhu okulandelayo:

• Imisebe ebuchosheni noma emgogodleni, ikakhulukazi imithamo ephezulu yemisebe. Lokhu kufaka phakathi imisebe yomzimba ephelele enikezwe njengengxenye yokufakelwa kwe-stem cell.

• I-Intrathecal noma i-intraventricular chemotherapy.

• I-Chemotherapy ene-high-dose methotrexate noma i-cytarabine enganqamula isithiyo segazi nobuchopho (ulwelwesi oluvikelayo oluzungeze ubuchopho).

Lokhu kufaka phakathi i-chemotherapy ephezulu enikezwa njengengxenye yokufakelwa kwe-stem cell.

• Ukuhlinzwa ukususa isimila ebuchosheni noma emgogodleni.

Lapho kunikezwa imisebe ebuchosheni nase-intrathecal chemotherapy ngasikhathi sinye, ubungozi bemiphumela yesikhashana buphakeme.

Lokhu okulandelayo kungakhuphula nobungozi bengqondo kanye nomgogodla imiphumela sekwedlule isikhathi kwabasinda ebuchosheni bobuchopho bengane

• Ukuba neminyaka eyi-5 ubudala noma ngaphansi ngesikhathi sokwelashwa.

• Ukuba ngowesifazane.

• Ukuba ne-hydrocephalus kanye ne-shunt ebekiwe ukukhipha uketshezi olungeziwe kuma-ventricles.

• Ukulahlekelwa ukuzwa.

• Ukuba ne-cerebellar mutism kulandela ukuhlinzwa ukususa isimila sobuchopho. I-Cerebellar mutism ifaka ukungakwazi ukukhuluma, ukulahlekelwa yi

• ukusebenzisana nokulinganisela, ukuguquguquka kwemizwelo, ukucasuka, nokuba nokukhala okuphezulu.

• Ukuba nomlando womuntu siqu wohlangothi.

• Ukuquleka.

Imiphumela yezinzwa ezenzekile emaphakathi nayo iyathinteka lapho isimila sakhe khona ebuchosheni nasentanyeni yomgogodla.

Imiphumela engemuva kwesikhathi ethinta ubuchopho nomgogodla ingadala izinkinga ezithile zempilo.

Abasinde kumdlavuza wezingane abathola imisebe, izinhlobo ezithile ze-chemotherapy, noma ukuhlinzwa ebuchosheni noma emgogodleni banengozi eyengeziwe yemiphumela sekwephuzile ebuchosheni nasentanjeni yomgogodla kanye nezinkinga ezihlobene nempilo. Lokhu kufaka phakathi okulandelayo:

• Ukuphathwa ikhanda.

• Ukulahlekelwa kokuxhumanisa nokulinganisela.

• Isiyezi.

• Ukuquleka.

• Ukulahleka komgodla we-myelin ohlanganisa imicu yezinzwa ebuchosheni.

• Ukuphazamiseka kokuhamba okuthinta imilenze namehlo noma ikhono lokukhuluma nokugwinya.

• Ukulimala kwemizwa ezandleni noma ezinyaweni.

• Unhlangothi. Ukushaywa unhlangothi kwesibili kungenzeka kakhulu kulabo abasindile abathole imisebe ebuchosheni, babe nomlando wokucindezela kwegazi,

• noma babeneminyaka engaphezu kwengu-40 ngenkathi bethola unhlangothi wokuqala.

• Ukulala kwasemini.

• IHydrocephalus.

• Ukulahleka kwesinye kanye / noma ukulawula amathumbu.

• AmaCavernomas (amaqoqo emithambo yegazi engajwayelekile).

• Ukuhlungu obusemhlane.

Abasindile futhi bangaba nemiphumela yesikhathi esedlule ethinta ukucabanga, ukufunda, inkumbulo, imizwa nokuziphatha.

Izindlela ezintsha zokusebenzisa imithamo ebhekiswe kakhulu futhi ephansi yemisebe ebuchosheni ingahle inciphise ubungozi bemiphumela yobuchopho nomgogodla.

Izimpawu nezimpawu ezingaba khona zobuchopho kanye nomgogodla imiphumela engemuva kokufaka ikhanda, ukulahleka kokuxhumana, nokuquleka.

Lezi zimpawu nezimpawu zingabangelwa ubuchopho kanye nomgogodla imiphumela yesikhashana noma ngezinye izimo:

• Ubuhlungu bekhanda obungaphela ngemuva kokuhlanza.

• Ukuquleka.

• Ukulahlekelwa ibhalansi, ukuntuleka kokuxhumanisa, noma ukuhamba kanzima.

• Inkinga yokukhuluma noma ukugwinya.

• Inkinga yokuthi amehlo asebenze ndawonye.

• Ubuntofontofo, ukuncinza, noma ubuthakathaka ezandleni noma ezinyaweni.

• Ukungakwazi ukugoba iqakala ukuphakamisa unyawo phezulu.

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

• Ukulala okungavamile noma ushintsho ezingeni lomsebenzi.

• Izinguquko ezingajwayelekile ebuntwini noma ekuziphatheni.

• Ukushintsha kwemikhuba yamathumbu noma inkinga yokuchama.

• Khulisa usayizi wekhanda (ezinganeni).

• Ukudideka okungazelelwe noma inkinga yokukhuluma noma ukuqonda inkulumo.

• Inkinga engazelelwe yokubona ngamehlo noma womabili.

• Ikhanda elibuhlungu ngokuzumayo ngaphandle kwesizathu esaziwayo.

Ezinye izimpawu nezimpawu zifaka okulandelayo:

• Izinkinga ngememori.

• Izinkinga ngokunaka.

• Inkinga ngokuxazulula izinkinga.

• Inkinga yokuhlela imicabango nemisebenzi.

• Ikhono elincane lokufunda nokusebenzisa imininingwane emisha.

• Unenkinga yokufunda ukufunda, ukubhala, noma ukwenza izibalo.

• Inkinga yokuxhumanisa ukunyakaza phakathi kwamehlo, izandla, neminye imisipha.

• Ukubambezeleka kokuthuthuka okujwayelekile.

• Ukuhoxa komphakathi noma unenkinga yokuzwana nabanye.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo ebuchosheni nakumgogodla.

Lokhu nezinye izivivinyo nezinqubo kungasetshenziswa ukuthola noma ukuxilonga imiphumela yobuchopho nomgogodla emuva kwesikhathi:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Ukuhlolwa kwe-Neurological: Uchungechunge lwemibuzo novivinyo lokuhlola ubuchopho, umgogodla nokusebenza kwe-nerve. Isivivinyo sihlola isimo somuntu somqondo, ukusebenzisana, kanye nekhono lokuhamba ngokujwayelekile, nokuthi izicubu, izinzwa, nokucabanga kusebenza kahle kangakanani. Lokhu kungabizwa nangokuthi ukuhlolwa kwe-neuro noma ukuhlolwa kwe-neurologic. Kwezinye izimo, ukuhlolwa okuphelele kungenziwa ngudokotela wezinzwa noma we-neurosurgeon.

• Ukuhlolwa kwe-Neuropsychological: Uchungechunge lwezivivinyo zokuhlola izinqubo nokuziphatha kwesiguli. Izindawo ezihloliwe zivame ukufaka:

• Ukwazi ukuthi ungubani nokuthi ukuphi nokuthi usuku luni.

• Amandla wokufunda nokukhumbula imininingwane emisha.

• Ubuhlakani.

• Amandla wokuxazulula izinkinga.

• Ukusetshenziswa kolimi olukhulunywayo nolubhalwayo.

• Ukubambisana kwesandla.

• Amandla wokuhlela imininingwane nemisebenzi.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zengqondo nobuchopho bomgogodla. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Abasindile emdlalweni womdlavuza wezingane bangaba nokukhathazeka nokudangala okuhlobene nomdlavuza wabo.

Abasindile emdlalweni womdlavuza wezingane bangaba nokukhathazeka nokudangala okuhlobene nezinguquko zomzimba, ukuba nezinhlungu, indlela ababukeka ngayo, noma ukwesaba umdlavuza ukubuya. Lezi nezinye izinto zingadala izinkinga ngobudlelwano bomuntu siqu, imfundo, umsebenzi, kanye nempilo, futhi kudale nemicabango yokuzibulala. Abasindile abanezinkinga bangase babe mancane amathuba okuthi bazihlalele bodwa sebebadala.

Izivivinyo ezilandelwayo zabasindile bomdlavuza wezingane kufanele zifake ukuhlolwa kanye nokwelashwa kokucindezeleka kwengqondo okungaba khona, njengokukhathazeka, ukudangala, nemicabango yokuzibulala.

Abanye abasinde emdlavuzeni wobuntwana bane-post-traumatic stress disorder.

Ukutholakala nokwelashwa kwesifo esisongela impilo kungaba yinto ebuhlungu. Lokhu kuhlukumezeka kungadala ukucindezeleka kwangemva kokuhlukumezeka (PTSD). I-PTSD ichazwa njengokuziphatha okuthile kulandela umcimbi ocindezelayo obandakanya ukufa noma usongo lokufa, ukulimala kanzima, noma ukuzisongela wena noma abanye.

I-PTSD ingathinta abasindile bomdlavuza ngezindlela ezilandelayo:

• Ukukhumbula isikhathi lapho betholakala futhi belashelwa umdlavuza, emaphusheni amabi noma emuva, futhi becabanga ngaso sonke isikhathi.

• Ukugwema izindawo, imicimbi, nabantu okubakhumbuza ngomdlavuza.

Ngokuvamile, abasindile bomdlavuza wezingane babonisa amazinga aphansi e-PTSD, ngokuya ngengxenye yesitayela sokubhekana neziguli nabazali bazo. Abasindile abathole ukwelashwa ngemisebe ekhanda lapho bengaphansi kweminyaka engu-4 noma abasindile abathole ukwelashwa okunamandla bangaba sengozini enkulu ye-PTSD. Izinkinga zomndeni, ukusekelwa okuncane noma okungekho nhlobo kwezenhlalo okuvela emndenini noma kubangani, kanye nengcindezi engahlobene nomdlavuza kungandisa amathuba okuba ne-PTSD.

Ngoba ukugwema izindawo nabantu abaxhumene nomdlavuza kungaba yingxenye ye-PTSD, abasindile abane-PTSD kungenzeka bangatholi ukwelashwa abakudingayo.

Intsha etholakala inomdlavuza ingaba nezinkinga zomphakathi kamuva empilweni.

Intsha etholwa ukuthi inomdlavuza ingafinyelela ezinqolobaneni ezimbalwa zomphakathi noma ifinyelele kuyo kamuva empilweni kunentsha engatholakali inomdlavuza. Izinyathelo zomphakathi zibandakanya ukuba nesoka noma intombi yokuqala, ukushada nokuba nengane. Bangase babe nenkinga yokuhlangana nabanye abantu noma bazizwe sengathi abathandwa abanye abangontanga yabo.

Abasinde kumdlavuza abakule minyaka yobudala babike ukuthi abanelisekile kangako ngempilo yabo nangempilo yabo jikelele uma kuqhathaniswa nabanye abalingana nabo abebengenawo umdlavuza. Intsha kanye nabantu abadala asebesindile kumdlavuza badinga izinhlelo ezikhethekile ezinikeza ukwesekwa ngokwengqondo, ukufundisa kanye nomsebenzi.

Uhlelo lokugaya ukudla

AMAPHUZU ASEMQOKA

• Amazinyo nemihlathi

• Izinkinga ngamazinyo nemihlathi ziyimiphumela sekwephuzile engahle yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Imisebe ekhanda nasentanyeni nezinhlobo ezithile ze-chemotherapy inyusa ingozi yemiphumela sekwephuzile emazinyweni nasemihlathini.

• Imiphumela engemuva kwesikhathi ethinta amazinyo nemihlathi ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zemiphumela yamazinyo nemihlathi zifaka phakathi ukubola kwamazinyo (izimbotshana) nobuhlungu bomhlathi.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo emlonyeni nasemhlathini.

• Ukunakekelwa kwamazinyo njalo kubaluleke kakhulu kwabasindile bomdlavuza wezingane.

• Ipheshana lokugaya ukudla

• Imiphumela yokuhamba kwesikhathi kokugaya ukudla kungenzeka kakhulu ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Imisebe yesinye, yesinye, noma yamasende kanye nezinhlobo ezithile zokwelashwa ngamakhemikhali kwandisa ubungozi bokugaya ukudla emuva kwesikhathi.

• Imiphumela engemuva kwesikhathi ethinta umgudu wokugaya ukudla ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu zomgudu wokugaya ukudla ngemuva kwesikhathi zibandakanya ubuhlungu besisu nohudo.

• Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo endaweni yokugaya ukudla.

• Amapayipi wesibindi nenyongo

• Imiphumela yesikhathi esizayo yesibindi nenyongo kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Izinhlobo ezithile ze-chemotherapy kanye nemisebe esibindini noma emathangeni e-bile kwandisa ubungozi bemiphumela yesikhashana.

• Imiphumela engemuva kwesikhathi ethinta isibindi kanye nemigwaqo yenyongo ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zesibindi nemiphumela yomgudu wephutha zifaka phakathi ubuhlungu besisu kanye ne-jaundice.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo esibindini nasesigaxeni se-bile.

• Imikhuba yezempilo egqugquzela isibindi esinempilo ibalulekile kulabo abasinda emdlavuzeni wezingane.

• Amapancreas

• Ukwelashwa ngemisebe kwandisa ingozi yemiphumela yepancreatic late.

• Imiphumela engemuva kwesikhathi ethinta amanyikwe ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zemiphumela yepancreatic late zifaka phakathi ukuchama kaningi nokoma.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zezempilo kumanyikwe.

Amazinyo nemihlathi

Izinkinga ngamazinyo nemihlathi ziyimiphumela sekwephuzile engahle yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala umphumela wezinkinga zamazinyo nemihlathi.

• Umdlavuza wekhanda nentamo.

• IHodgkin lymphoma.

• I-Neuroblastoma.

• I-leukemia esakazekela ebuchosheni nakumgogodla.

• Umdlavuza weNasopharyngeal.

• Izicubu zobuchopho.

• Umdlavuza welashwa ngokufakwa kwe-stem cell.

Imisebe ekhanda nasentanyeni nezinhlobo ezithile ze-chemotherapy inyusa ingozi yemiphumela sekwephuzile emazinyweni nasemihlathini.

Ingozi yezinkinga zempilo ezithinta amazinyo nemihlathi iyanda ngemuva kokwelashwa ngalokhu okulandelayo:

• Ukwelashwa ngemisebe ekhanda nasentanyeni.

• Ingqikithi yemisebe yomzimba (i-TBI) njengengxenye yokufakelwa kabusha kwe-stem cell.

• I-Chemotherapy, ikakhulukazi ngamanani aphezulu ama-alkylating agents njenge-cyclophosphamide.

• Ukuhlinzwa endaweni yekhanda nentamo.

Ingozi iyakhuphuka nakubasindile abebengaphansi kweminyaka engu-5 ngesikhathi sokwelashwa ngoba amazinyo abo angapheli abengakakheki ngokuphelele.

Imiphumela engemuva kwesikhathi ethinta amazinyo nemihlathi ingadala izinkinga ezithile zempilo.

Imiphumela yamazinyo kanye nemihlathi kanye nezinkinga ezihlobene nempilo zifaka okulandelayo:

• Amazinyo angajwayelekile.

• Ukubola kwamazinyo (kufaka phakathi izimbotshana) kanye nesifo sezinsini.

• Izindlala ezakha amathe azenzi amathe anele.

• Ukufa kwamangqamuzana emathambo emhlathini.

• Izinguquko endleleni obukeka ngayo ubuso, umhlathi, noma ugebhezi.

Izimpawu nezimpawu ezingaba khona zemiphumela yamazinyo nemihlathi zifaka phakathi ukubola kwamazinyo (izimbotshana) nobuhlungu bomhlathi.

Lezi kanye nezinye izimpawu nezimpawu zingadalwa yimiphumela yamazinyo emihlathini noma yezimo ezithile:

• Amazinyo mancane noma awanawo umumo ojwayelekile.

• Amazinyo ahlala njalo.

• Amazinyo angapheli afika esikhathini esingaphansi kweminyaka ejwayelekile.

• Amazinyo ane-koqweqwe lwawo oluncane kunokujwayelekile.

• Ukubola kwamazinyo okuningi (izimbotshana) nesifo sezinsini kunokujwayelekile.

• Umlomo owomile.

• Inkinga yokuhlafuna, ukugwinya nokukhuluma.

• Ubuhlungu bomhlathi.

• Imihlathi ayivuli futhi ivale indlela obekufanele.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo emlonyeni nasemhlathini.

Lokhu nezinye izivivinyo nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yamazinyo nemihlathi sekwephuzile:

• Ukuhlolwa kwamazinyo nomlando: Ukuhlolwa kwamazinyo, umlomo, nemihlathi ukubheka izimpawu ezijwayelekile zempilo yamazinyo, kufaka phakathi ukuhlola izimpawu zesifo, njengezimbotshana noma yini ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli kanye nokugula nokwelashwa kwangaphambilini. Lokhu kungabizwa nangokuthi ukuhlolwa kwamazinyo.

• IPanorex x-ray: I-x-ray yawo wonke amazinyo nezimpande zawo. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.

• I-X-ray yemihlathi: I-x-ray yemihlathi. I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni nasefilimini, lwenze isithombe sezindawo ezingaphakathi komzimba.

• I-CT scan (i-CAT scan): Inqubo eyenza uchungechunge lwezithombe eziningiliziwe zezindawo ezingaphakathi komzimba, njengekhanda nentamo, ezithathwe ezinhlangothini ezahlukene. Izithombe zenziwa yikhompyutha exhunywe kumshini we-x-ray. 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, ezinjengekhanda nentamo. Le nqubo ibizwa nangokuthi i-nuclear magnetic resonance imaging (i-NMRI).

• I-Biopsy: Ukususwa kwamangqamuzana amathambo emhlathini ukuze abukwe ngaphansi kwesibonakhulu ukuhlola izimpawu zokufa kwethambo ngemuva kokwelapha ngemisebe.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zamazinyo nemiphumela yomhlathi. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Ukunakekelwa kwamazinyo njalo kubaluleke kakhulu kwabasindile bomdlavuza wezingane.

Odokotela basikisela ukuthi abasinda emdlavuzeni wezingane bahlolelwe amazinyo futhi bahlanzwe nemithi ye-fluoride njalo ezinyangeni eziyisithupha. Izingane ezazinokwelashwa ngemisebe emgodini womlomo nazo zingabona i-orthodontist noma i-otolaryngologist. Uma izilonda zikhona emlonyeni, i-biopsy ingadingeka.

Ipheshana lokugaya ukudla

Imiphumela yokuhamba kwesikhathi kokugaya ukudla kungenzeka kakhulu ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwale mdlavuza neminye ebuntwaneni kungadala imiphumela yesikhashana yokugaya ukudla (isisu, isisu, amathumbu amancane namakhulu, i-rectum ne-anus):

• IRhabdomyosarcoma yesinye noma yesinye, noma eduze kwamasende.

• I-non-Hodgkin lymphoma.

• Izimila zamangqamuzana egciwane.

• I-Neuroblastoma.

• Isimila seWilms.

Imisebe yesinye, yesinye, noma yamasende kanye nezinhlobo ezithile zokwelashwa ngamakhemikhali kwandisa ubungozi bokugaya ukudla emuva kwesikhathi.

Ingozi yezinkinga zempilo ezithinta umgudu wokugaya ukudla inyuka ngemuva kokwelashwa ngalokhu okulandelayo:

• Ukwelashwa ngemisebe esiswini noma ezindaweni eziseduze nesisu, njenge-esophagus, isinye, i-prostate, noma amasende, kungadala izinkinga zomgudu wokugaya ukudla oqala ngokushesha futhi uhlale isikhathi esifushane. Kwezinye iziguli, noma kunjalo, izinkinga zomgudu wokugaya ukudla ziyabambezeleka futhi zihlala isikhathi eside. Le miphumela sekwephuzile ibangelwa ukwelashwa ngemisebe okulimaza imithambo yegazi. Ukuthola imithamo ephezulu yokwelashwa ngemisebe noma ukuthola i-chemotherapy efana ne-dactinomycin noma i-anthracyclines kanye ne-radiation therapy kungakhuphula le ngozi.

• Ukuhlinzwa kwesisu noma ukuhlinzwa okhalo ukukhipha isinye.

• I-Chemotherapy enama-alkylating agents afana ne-cyclophosphamide, i-procarbazine, ne-ifosfamide, noma ngama-platinum agents afana ne-cisplatin noma i-carboplatin, noma ngama-anthracyclines afana ne-doxorubicin, i-daunorubicin, i-idarubicin ne-epirubicin.

• Ukufakelwa kwe-stem cell.

Okulandelayo kungakhuphula nobungozi bendlela yokugaya ukudla ngemuva kwesikhathi:

• Ukuguga lapho kutholakala ukuxilongwa noma lapho kuqala ukwelashwa.

• Ukwelashwa ngakho konke ukwelashwa ngemisebe nokwelashwa ngamakhemikhali.

• Umlando wesifo esingelapheki sokuxhunyelelwa.

Imiphumela engemuva kwesikhathi ethinta umgudu wokugaya ukudla ingadala izinkinga ezithile zempilo.

Imiphumela yokuhamba kwesikhathi yokugaya ukudla nezinkinga zempilo ezihlobene nazo kufaka lokhu okulandelayo:

• Ukuncipha komphimbo noma ithumbu.

• Imisipha yomhosha ayisebenzi kahle.

• I-Reflux

• Isifo sohudo, ukuqunjelwa, ukungasebenzi kwe-fecal, noma ukuvinjelwa kwamathumbu.

• Ukugcotshwa kwamathumbu (imbobo emathunjini).

• Ukuvuvukala kwamathumbu.

• Ukufa kwengxenye yamathumbu.

• Amathumbu awakwazi ukuncela izakhamzimba ekudleni.

Izimpawu nezimpawu zomgudu wokugaya ukudla ngemuva kwesikhathi zibandakanya ubuhlungu besisu nohudo.

Lezi kanye nezinye izimpawu nezimpawu zingadalwa yimiphumela yokwenziwa kokugaya ukudla emuva kwesikhathi noma ngezinye izimo:

• Inkinga yokugwinya noma ukuzwa sengathi ukudla kunamathele emphinjeni.

• Isilungulela.

• Umkhuhlane onobuhlungu obukhulu esiswini kanye nesicanucanu.

• Ubuhlungu esiswini.

• Ukushintsha kwemikhuba yamathumbu (ukuqunjelwa noma uhudo).

• Isicanucanu nokuhlanza.

• Izinhlungu ezivamile zerhasi, ukuqunjelwa, ukugcwala, noma amajaqamba.

• Ama-hemorrhoids.

• I-Reflux.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo endaweni yokugaya ukudla.

Lokhu nokunye ukuhlolwa nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yokugaya ukudla ngemuva kwesikhathi:

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

• Ukuhlolwa kwe-rectal yedijithali: Ukuhlolwa kwe-rectum. Udokotela noma umhlengikazi ufaka umunwe othanjisiwe, ofakwe igilavu ​​ku-rectum ukuzwa izigaxa noma yini enye ebonakala ingajwayelekile.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• I-X-ray: I-x-ray uhlobo lomsebe wamandla ongangena emzimbeni ungene kwifilimu, wenze isithombe sezindawo ezingaphakathi komzimba. I-x-ray ingathathwa esiswini, ezinso, e-ureter, noma esinyeni ukuze kubhekwe izimpawu zesifo.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokuhlola izimpawu zomgudu wokugaya ukudla ngemuva kwesikhathi. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Amapayipi wesibindi nenyongo

Imiphumela yesikhathi esizayo yesibindi nenyongo kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala imiphumela yesibindi noma ye-bile duct:

• Umdlavuza wesibindi.

• Isimila seWilms.

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umdlavuza welashwa ngokufakwa kwe-stem cell.

Izinhlobo ezithile ze-chemotherapy kanye nemisebe esibindini noma emathangeni e-bile kwandisa ubungozi bemiphumela yesikhashana.

Ingcuphe yesibindi noma ye-bile duct imiphumela yamuva ingakhuphuka kwabasindile bomdlavuza wezingane abaphathwa ngokulandelayo:

• Ukuhlinzwa ukususa ingxenye yesibindi noma ukufakelwa kwesibindi.

• I-Chemotherapy efaka i-high-dose cyclophosphamide njengengxenye yokufakelwa kwe-stem cell.

• I-Chemotherapy efana ne-6-mercaptopurine, 6-thioguanine, ne-methotrexate.

• Ukwelashwa kwemisebe esibindini nakwimibhobho yenyongo. Ubungozi buxhomeke kulokhu okulandelayo:

• Umthamo wemisebe nokuthi isibindi siphathwa kanjani.

• Ubudala lapho belashwa (iminyaka emincane, inkulu ingozi).

• Ukuthi bekunokuhlinzwa yini okususwe ingxenye yesibindi.

• Noma ngabe i-chemotherapy, efana ne-doxorubicin noma i-dactinomycin, yanikezwa kanye nokwelashwa ngemisebe.

Ukufakelwa kwe-stem cell (kanye nomlando wesifo esingelapheki se-graft-versus-host).

Imiphumela engemuva kwesikhathi ethinta isibindi kanye nemigwaqo yenyongo ingadala izinkinga ezithile zempilo.

Imiphumela yesibindi ne-bile ephuzile nemiphumela yezempilo ehlobene ifaka okulandelayo:

• Isibindi asisebenzi ngendlela okufanele noma siyeke ukusebenza ngayo.

• Amatshe amatshe amade.

• Izilonda zesibindi seBenign.

• Ukutheleleka kwe-Hepatitis B noma C.

• Ukulimala kwesibindi okubangelwa yisifo se-veno-occlusive disease / sinusoidal obstruction syndrome (i-VOD / SOS).

• Isibindi fibrosis (ukugcwala kwezicubu ezixhumanayo esibindi) noma i-cirrhosis.

• Isibindi esinamafutha esinokumelana ne-insulin (isimo lapho umzimba wenza i-insulin kepha ungakwazi ukusisebenzisa kahle).

• Ukulimala kwezicubu nezitho zomzimba kusuka ku-iron eyengeziwe ngemuva kokumpontshelwa igazi okuningi.

Izimpawu nezimpawu ezingaba khona zesibindi nemiphumela yomgudu wephutha zifaka phakathi ubuhlungu besisu kanye ne-jaundice.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa imiphumela yesibindi neye-bile ngemuva kwesikhathi noma ngezinye izimo:

• Ukuzuza kwesisindo noma ukunciphisa umzimba.

• Ukuvuvukala kwesisu.

• Isicanucanu nokuhlanza.

• Ubuhlungu esiswini. Ubuhlungu bungavela eduze kwezimbambo, imvamisa ohlangothini lwesokunene, noma ngemuva kokudla ukudla okunamafutha.

• I-jaundice (kuphuzi kwesikhumba nabamhlophe bamehlo).

• Ukuhamba kwamathumbu okukhanyayo.

• Umchamo onombala omnyama.

• Igesi eningi.

• Ukungabi nesifiso sokudla.

• Ukuzizwa ukhathele noma ubuthakathaka.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Kwesinye isikhathi azikho izimpawu noma izinkomba zemiphumela yesibindi noma ye-bile kanti ukwelashwa kungenzeka kungadingeki.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo esibindini nasesigaxeni se-bile.

Lezi nezinye izivivinyo nezinqubo zingasetshenziswa ukuthola noma ukuthola imiphumela yesibindi noma ye-bile duct:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile ezikhishwe egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwesifo Isibonelo, kungahle kube nezinga eliphakeme le-bilirubin, i-alanine aminotransferase (ALT), ne-aspartate aminotransferase (AST) emzimbeni uma isibindi sine konakele.

• Izinga le-Ferritin: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani le-ferritin. I-Ferritin yiprotheni ebopha i-ayoni bese iyigcina ukuze isetshenziswe umzimba. Ngemuva kokufakelwa kwe-stem cell, izinga eliphezulu le-ferritin lingaba uphawu lwesifo sesibindi.

• Ucwaningo lwegazi ukuhlola ukuthi igazi ligcina kanjani ligaqele: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lamaplatelets emzimbeni noma ukuthi kuthatha isikhathi esingakanani ukuthi igazi livale.

• Ukuhlolwa kwe-hepatitis: Inqubo lapho kuhlolwe khona isampula segazi ukuthola izingcezu zegciwane le-hepatitis. Isampula yegazi nayo ingasetshenziselwa ukukala ukuthi lingakanani igciwane le-hepatitis elisegazini. Zonke iziguli ezampontshelwa igazi ngaphambi kuka-1972 kufanele zihlolwe ukuhlolwa kwesifo sokusha kwesibindi kohlobo B. Iziguli ezazimpontshelwe igazi ngaphambi kuka-1993 kufanele zihlolwe ukuhlolwa kwesifo sokusha kwesibindi kohlobo C.

Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu noma izitho zangaphakathi, njenge-gall bladder, bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

• I-Biopsy: Ukususwa kwamaseli noma izicubu esibindini ukuze zibukwe ngaphansi kwesibonakhulu ukubheka izimpawu zesibindi esinamafutha.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukuhlolwa kanye nezinqubo zokubheka izimpawu zesibindi noma i-bile duct. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Imikhuba yezempilo egqugquzela isibindi esinempilo ibalulekile kulabo abasinda emdlavuzeni wezingane.

Abasinde kumdlavuza wezingane abanemiphumela yesibindi sekwephuzile kufanele banakekele ukuvikela impilo yabo, kufaka phakathi:

• Ukuba nesisindo esinempilo.

• Ukungaphuzi utshwala.

• Ukuthola imishanguzo yamagciwane e-hepatitis A ne-hepatitis B.

Amapancreas

Ukwelashwa ngemisebe kwandisa ingozi yemiphumela yepancreatic late.

Ingozi yemiphumela yepancreatic sekwephuzile ingakhuphuka kwabasindile bomdlavuza wezingane ngemuva kokwelashwa kokulandelayo:

• Ukwelashwa ngemisebe esiswini.

• Ingqikithi yemisebe yomzimba (i-TBI) njengengxenye yokufakelwa kabusha kwe-stem cell.

Imiphumela engemuva kwesikhathi ethinta amanyikwe ingadala izinkinga ezithile zempilo.

Imiphumela ye-Pancreatic sekwephuzile nezinkinga ezihlobene nezempilo zifaka okulandelayo:

• Ukumelana ne-insulin: Isimo lapho umzimba ungasebenzisi i-insulin ngendlela efanele. I-insulin iyadingeka ukusiza ukulawula inani le-glucose (uhlobo lukashukela) emzimbeni. Ngenxa yokuthi i-insulin ayisebenzi ngendlela obekufanele isebenze ngayo, amazinga eglucose namafutha ayenyuka.

• Isifo sikashukela: Isifo lapho umzimba ungenzi i-insulin eyanele noma ungasisebenzisi ngendlela okufanele usisebenzise ngayo. Uma ingekho i-insulin eyanele, inani le-glucose egazini liyakhula futhi izinso zenza umchamo omkhulu.

Izimpawu nezimpawu ezingaba khona zemiphumela yepancreatic late zifaka phakathi ukuchama kaningi nokoma.

Lezi kanye nezinye izimpawu nezimpawu zingadalwa yimiphumela ye-pancreatic late noma ezinye izimo:

• Ukuchama njalo.

• Ukuzizwa womile kakhulu.

• Ukuzizwa ngilambile kakhulu.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukuzizwa ngikhathele kakhulu.

• Ukutheleleka njalo, ikakhulukazi kwesikhumba, izinsini, noma isinye.

• Ukubona okufiphele.

• Ukusikeka noma imihuzuko ephuza ukwelashwa.

• Ukuba ndikindiki noma ukuncinza ezandleni noma ezinyaweni.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zezempilo kumanyikwe.

Lokhu nezinye izivivinyo nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yepancreatic late:

• Isivivinyo se-Glycated hemoglobin (A1C): Inqubo lapho kukhishwa khona isampula yegazi nenani le-glucose enamathiselwe kumaseli abomvu egazi kulinganiswa. Inani eliphakeme kunelejwayelekile le-glucose elifakwe kumaseli abomvu egazi kungaba uphawu lwesifo sikashukela.

• Ukuzila ukudla ushukela wegazi: Isivivinyo lapho kuhlolwe khona isampula segazi ukukala inani le-glucose egazini. Lokhu kuhlolwa kwenziwa ngemuva kokuthi isiguli singakutholi ukudla ubusuku bonke. Inani eliphakeme kunokujwayelekile le-glucose egazini kungaba uphawu lwesifo sikashukela.

Uhlelo lwe-Endocrine

AMAPHUZU ASEMQOKA

• Indlala yegilo

• Imiphumela yekwephuzile yegilozi kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukwelashwa ngemisebe ekhanda nasentanyeni kwandisa ingozi yemiphumela ye-thyroid emuva kwesikhathi.

• Imiphumela engemuva kwesikhathi ethinta indlala yegilo ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu zemiphumela ye-thyroid sekwephuzile zixhomeke ekutheni ngabe incane kakhulu noma i-hormone yegilo emzimbeni.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo ku-thyroid.

• Indlala yamapayipi

• Imiphumela yangemuva kwesikhathi ye-Neuroendocrine ingabangelwa ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukwelashwa okuthinta i-hypothalamus noma i-pituitary gland kwandisa ubungozi besistimu ye-neuroendocrine.

• Imiphumela yamuva ethinta i-hypothalamus ingadala izinkinga ezithile zempilo.

• Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zezempilo ohlelweni lwe-neuroendocrine.

• Amasende namaqanda

• I-Metabolic syndrome

• I-Metabolic syndrome kungenzeka ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukwelashwa ngemisebe kwandisa ingozi yesifo se-metabolic syndrome.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola isifo se-metabolic syndrome.

• I-Metabolic syndrome ingadala isifo senhliziyo negazi nesifo sikashukela.

• Isisindo

• Ukukhuluphala ngokweqile, ukukhuluphala ngokweqile, noma ukukhuluphela kungumphumela wephuzile ongahle uvele ngemuva kokwelashwa komdlavuza othile wezingane.

• Ukwelashwa ngemisebe kwandisa ubungozi bokukhuluphala, ukukhuluphala ngokweqile noma ukukhuluphala.

• Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola ushintsho kusisindo.

Indlala yegilo

Imiphumela yekwephuzile yegilozi kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala imiphumela ye-thyroid sekwephuzile:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izicubu zobuchopho.

• Umdlavuza wekhanda nentamo.

• IHodgkin lymphoma.

• I-Neuroblastoma.

• Umdlavuza welashwa ngokufakwa kwe-stem cell.

Ukwelashwa ngemisebe ekhanda nasentanyeni kwandisa ingozi yemiphumela ye-thyroid emuva kwesikhathi.

Ingozi yemiphumela ye-thyroid emuva kwesikhathi ingakhuphuka kwabasindile bomdlavuza wezingane ngemuva kokwelashwa nganoma yikuphi okulandelayo:

• Ukwelapha ngemisebe yegilo njengengxenye yokwelashwa ngemisebe ekhanda nasentanyeni noma endlaleni yebuchopho ebuchosheni.

• Ingqikithi yemisebe yomzimba (i-TBI) njengengxenye yokufakelwa kabusha kwe-stem cell.

• Ukwelashwa kwe-MIBG (iodine enemisebe) ye-neuroblastoma.

Ingozi iyakhuphuka nakwabesifazane, kulabo abasindile ababesebancane ngesikhathi sokwelashwa, kwabasindile ababenomthamo wemisebe ophakeme, futhi njengoba isikhathi selokhu kutholakala ukuxilongwa nokwelashwa kukhula.

Imiphumela engemuva kwesikhathi ethinta indlala yegilo ingadala izinkinga ezithile zempilo.

Imiphumela yekwephuzile yegilo nezinkinga zempilo ezihlobene nazo zifaka okulandelayo:

• I-Hypothyroidism (ayanele i-hormone yegilo): Lona umphumela ovame kakhulu we-thyroid sekwephuzile. Imvamisa kwenzeka eminyakeni emi-2 kuye kwengu-5 ngemuva kokuphela kokwelashwa kepha kungenzeka ngemuva kwesikhathi. Kuvame kakhulu emantombazaneni kunabafana.

• I-Hyperthyroidism (i-hormone yegilo eningi kakhulu): Imvamisa kwenzeka eminyakeni emi-3 kuye kwengu-5 ngemuva kokuphela kokwelashwa.

I-Goiter (i-thyroid ekhulisiwe).

• Izigaxa ku-thyroid: Imvamisa zenzeka eminyakeni eyi-10 noma ngaphezulu ngemuva kokuphela kokwelashwa. Kuvame kakhulu emantombazaneni kunabafana. Lokhu kukhula kungaba yinto enobungozi (hhayi umdlavuza) noma ebulalayo (umdlavuza).

Izimpawu nezimpawu zemiphumela ye-thyroid sekwephuzile zixhomeke ekutheni ngabe incane kakhulu noma i-hormone yegilo emzimbeni.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa imiphumela ye-thyroid sekwephuzile noma ezinye izimo:

I-Hypothyroidism (incane kakhulu i-hormone yegilo)

• Ukuzizwa ukhathele noma ubuthakathaka.

• Ukuzwela kakhudlwana emakhazeni.

• Isikhumba esiphaphathekile, esomile.

• Izinwele ezimangelengele nezinciphileyo.

• Izinzipho zeBrittle.

• Izwi elihoshozelayo.

• Ubuso obukhukhumele.

• Imisipha namalunga okuqina nokuqina.

• Ukuqunjelwa.

• Izikhathi zokuya esikhathini ezisinda kunokujwayelekile.

• Ukuzuza kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukudangala noma inkinga ngememori noma ukwazi ukugxila.

Imvamisa, i-hypothyroidism ayibangeli zimpawu.

I-Hyperthyroidism (i-hormone yegilo eningi kakhulu)

• Uzizwa unovalo, ukhathazekile noma unemizwa.

• Inkinga yokulala.

• Ukuzizwa ukhathele noma ubuthakathaka.

• Ukuba nezandla ezinyakazayo.

• Ukushaya kwenhliziyo okusheshayo.

• Ukuba nesikhumba esibomvu, esifudumele esingahle silume.

• Ukuba nezinwele ezinhle, ezithambile eziwayo.

• Ukuba nokunyakaza kwamathumbu kaningi noma okuxekethile.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo ku-thyroid.

Lezi nezinye izivivinyo nezinqubo zingasetshenziswa ukuthola noma ukuthola imiphumela ye-thyroid sekwephuzile:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Izifundo zehomoni yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lamahomoni athile akhishwe egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwesifo esithweni noma esikhunjeni esisenzayo. Igazi lingahlolwa amazinga angajwayelekile wehomoni ekhuthaza i-thyroid (TSH) noma i-thyroxine yamahhala (T4).

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu zangaphakathi noma izitho bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi. Le nqubo ingakhombisa ubukhulu bendlala yegilo nokuthi ngabe kukhona amaqhubu (izigaxa) ku-thyroid.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukuhlolwa nokulandelwa kwezinqubo zokubheka izimpawu zemiphumela ye-thyroid emuva kwesikhathi. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Indlala yamapayipi

Imiphumela yangemuva kwesikhathi ye-Neuroendocrine ingabangelwa ngemuva kokwelashwa komdlavuza othile wobuntwana.

Uhlelo lwe-neuroendocrine uhlelo lwezinzwa nohlelo lwe-endocrine olusebenzisanayo.

Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala imiphumela ye-neuroendocrine emuva kwesikhathi:

• Izicubu zobuchopho nomgogodla.

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umdlavuza weNasopharyngeal.

• Umdlavuza welashwa nge-total-body irradiation (TBI) ngaphambi kokufakelwa kwe-stem cell.

Ukwelashwa okuthinta i-hypothalamus noma i-pituitary gland kwandisa ubungozi besistimu ye-neuroendocrine.

Abasinde kumdlavuza wezingane banengozi eyengeziwe yemiphumela yekwephuzile ye-neuroendocrine. Le miphumela idalwa ukwelashwa ngemisebe ebuchosheni endaweni ye-hypothalamus. I-hypothalamus ilawula indlela ama-hormone akhiwa ngayo futhi adedelwe angene egazini yindlala ye-pituitary. Ukwelashwa ngemisebe kunganikezwa ukwelapha umdlavuza eduze kwe-hypothalamus noma njenge-total-body irradiation (TBI) ngaphambi kokufakelwa kwe-stem cell. Le miphumela ibuye ibangelwe ukuhlinzwa endaweni ye-hypothalamus, i-pituitary gland, noma i-optic pathways.

Abasindile bomdlavuza wezingane abanemiphumela yangemva kwesikhathi ye-neuroendocrine bangaba namazinga aphansi wanoma yimaphi ama-hormone alandelayo enziwe endlaleni yebhinqa futhi akhishwe egazini:

• I-hormone yokukhula (GH; isiza ukukhuthaza ukukhula nokulawula imetabolism).

• Ihomoni ye-Adrenocorticotropic (ACTH; ilawula ukwenziwa kwama-glucocorticoids).

• Iprolactin (ilawula ukwenziwa kobisi lwebele).

• Ihomoni evuselela indlala yegilo (TSH; ilawula ukwenziwa kwamahomoni wegilo).

• I-Luteinizing hormone (LH; ilawula ukukhiqizwa kabusha).

• I-hormone evuselela i-follicle (FSH; ilawula ukukhiqizwa kabusha).

Imiphumela yamuva ethinta i-hypothalamus ingadala izinkinga ezithile zempilo.

Imiphumela yangemuva kwesikhathi yeNeuroendocrine nezinkinga ezihlobene nezempilo zifaka okulandelayo:

• Ukuntuleka kwehomoni yokukhula: Izinga eliphansi le-hormone yokukhula liwumphumela ovamile wokufika kwemisebe ebuchosheni kwabasindile bomdlavuza wezingane. Ukuphakama komthamo wemisebe futhi isikhathi eside kusukela ekwelashweni, iba sengozini enkulu yalo mphumela wephuzile. Izinga eliphansi le-hormone yokukhula nayo ingenzeka ebuntwaneni BONKE kanye nabasindile ekufakeleni ama-stem cell abathole ukwelashwa ngemisebe ebuchosheni nakumgogodla kanye / noma ekhemotherapy.

Izinga eliphansi le-hormone yokukhula ebuntwaneni liholela ekuphakameni kwabantu abadala okufushane kunokujwayelekile. Uma amathambo engane engakakhuli ngokugcwele, amazinga aphansi ama-hormone okukhula angalashwa nge-hormone ekhulayo yokwelashwa esikhundleni sokuqala ngonyaka owodwa ngemuva kokuphela kokwelashwa.

Ukushoda kwe-Adrenocorticotropin: Izinga eliphansi le-hormone ye-adrenocorticotropic liwumphumela wephutha ongajwayelekile. Kungenzeka kwabasindile besimila ebuchosheni bobuntwana, abasindile abanamazinga ama-hormone akhula kancane noma i-central hypothyroidism, noma ngemuva kokwelapha ngemisebe ebuchosheni.

Izimpawu zokushoda kungenzeka zingabi nzima futhi kungenzeka zinganakwa. Izimpawu nezimpawu zokushoda kwe-adrenocorticotropin zifaka okulandelayo:

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukungazizwa ngilambile.

• Isicanucanu.

• Ukuhlanza.

• Umfutho wegazi ophansi.

• Ukuzizwa ngikhathele.

Amazinga aphansi e-adrenocorticotropin angalashwa nge-hydrocortisone therapy.

• I-Hyperprolactinemia: Izinga eliphakeme le-hormone prolactin kungenzeka ngemuva komthamo omkhulu wemisebe ebuchosheni noma ekuhlinzweni okuthinta ingxenye yendlala yesibeletho. Izinga eliphezulu le-prolactin lingadala okulandelayo:

• Ukuthomba lapho usukhulile kuneminyaka ejwayelekile.

• Ukugeleza kobisi lwebele kowesifazane ongakhulelwe noma oncelisa ibele.

• Isikhathi esincane sokuya esikhathini noma cha noma izikhathi zokuya esikhathini ngokuhamba okulula kakhulu.

• Ukushisa okushisayo (kwabesifazane).

• Ukungakwazi ukukhulelwa.

• Ukungakwazi ukuthola ukwakhiwa okudingekayo kocansi.

• Idrayivu yocansi ephansi (kwabesilisa nabesifazane).

• I-Osteopenia (ubuncane bamaminerali amathambo).

Kwesinye isikhathi azikho izimpawu nezimpawu. Ukwelashwa akuvamile ukudingeka.

• Ukushoda kwehomoni ekhuthaza i-thyroid (central hypothyroidism): Izinga eliphansi lehomoni yegilo kungenzeka kancane kancane ngokuhamba kwesikhathi ngemuva kokwelashwa ngemisebe ebuchosheni.

Kwesinye isikhathi izimpawu zokushoda kwehomoni evuselela i-thyroid azibonwa. Izinga eliphansi le-thyroid le-thyroid lingadala ukukhula kancane nokubambezeleka kokuthomba, kanye nezinye izimpawu. Izinga eliphansi le-hormone yegilo lingelashwa ngelashwa lokushintsha i-hormone.

• I-Luteinizing hormone noma i-follicle-stimulating hormone deficiency: Amazinga aphansi ala mahomoni angadala izinkinga zempilo ezahlukahlukene. Uhlobo lwenkinga luxhomeke kumthamo wemisebe.

Abasindile bomdlavuza wezingane abaphathwa ngamazinga aphansi emisebe ebuchosheni bangakhulela ebusheni obuphakathi nendawo (isimo esibangela ukuthomba kuqale ngaphambi kweminyaka yobudala eyi-8 emantombazaneni neminyaka engu-9 kubafana). Lesi simo singelashwa nge-gonadotropin-releasing hormone (GnRH) agonist therapy ukubambezela ukuthomba nokusiza ukukhula kwengane. IHydrocephalus nayo ingakhuphula ubungozi balo mphumela wephuzile.

Abasindile bomdlavuza wezingane abaphathwa ngamanani aphezulu emisebe ebuchosheni bangaba namazinga aphansi e-luteinizing hormone noma i-follicle-stimulating hormone. Lesi simo singalashwa ngokwelashwa okufaka esikhundleni se-hormone therapy. Umthamo uzoncika eminyakeni yobudala yengane nokuthi ingane isifikile yini ebusheni.

• Isifo sikashukela esiphakathi i-insipidus: Isifo sikashukela esiphakathi singabangelwa ukungabikho noma amanani aphansi awo wonke amahomoni enziwa engxenyeni engaphambili yendlala ye-pituitary futhi akhishwe egazini. Kungenzeka kwabasindile bomdlavuza wezingane abaphathwa ngokuhlinzwa endaweni ye-hypothalamus noma i-pituitary gland. Izimpawu nezimpawu zesifo sikashukela esiphakathi zingafaka okulandelayo:

• Ukuba nenani elikhulu lomchamo noma amanabukeni amanzi angajwayelekile.

• Ukuzizwa womile kakhulu.

• Ubuhlungu bekhanda.

• Inkinga ngombono.

• Ukukhula kancane nentuthuko.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

Ukwelashwa kungafaka ukwelashwa okufaka esikhundleni se-hormone nge-vasopressin, i-hormone elawula inani lomchamo owenziwe emzimbeni.

Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zezempilo ohlelweni lwe-neuroendocrine.

Lezi nezinye izivivinyo nezinqubo zingasetshenziswa ukuthola noma ukuthola imiphumela ye-thyroid sekwephuzile:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Ucwaningo lwamakhemikhali egazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-glucose, ekhishelwa egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• Izifundo zehomoni yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lamahomoni athile akhishwe egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwesifo esithweni noma esikhunjeni esisenzayo. Igazi lingahlolwa amazinga angajwayelekile we-follicle-stimulating hormone, i-luteinizing hormone, i-estradiol, i-testosterone, i-cortisol, noma i-thyroxine yamahhala (i-T4).

• Izifundo zephrofayili ye-Lipid: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani le-triglycerides, i-cholesterol, ne-low-and high-density lipoprotein cholesterol egazini.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zemiphumela yekwephuzile ye-neuroendocrine. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Amasende namaqanda

Bheka isigaba seSistimu Yokuzala yalesi sifinyeto ukuze uthole ulwazi mayelana nemiphumela sekwephuzile emasendeni nakumaqanda.

I-Metabolic syndrome

I-Metabolic syndrome kungenzeka ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

I-Metabolic syndrome iyiqembu lezimo zezokwelapha ezibandakanya ukuba namafutha amaningi kakhulu esiswini futhi okungenani ezimbili kulokhu okulandelayo:

• Umfutho wegazi ophezulu.

• Amazinga aphezulu we-triglycerides namazinga aphansi we-high-density lipoprotein (HDL) cholesterol egazini.

• Izinga eliphakeme le-glucose (ushukela) egazini.

Ukwelashwa kwalokhu neminye imidlavuza yasebuntwaneni kungadala ukuthi isifo se-metabolic syndrome senzeke kamuva empilweni

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umdlavuza welashwa ngokufakwa kwe-stem cell.

• Umdlavuza welashwa ngemisebe esiswini, njenge-Wilms tumor noma i-neuroblastoma.

Ukwelashwa ngemisebe kwandisa ingozi yesifo se-metabolic syndrome.

Ingozi yesifo se-metabolic syndrome ingakhuphuka kwabasindile bomdlavuza wezingane ngemuva kokwelashwa nganoma yikuphi okulandelayo:

• Ukwelashwa ngemisebe ebuchosheni noma esiswini.

• Ingqikithi yemisebe yomzimba (i-TBI) njengengxenye yokufakelwa kabusha kwe-stem cell.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola isifo se-metabolic syndrome.

Lezi nezinye izivivinyo nezinqubo zingasetshenziswa ukuthola noma ukuthola isifo se-metabolic:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-glucose, ekhishelwa egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• Izifundo zephrofayili ye-Lipid: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani le-triglycerides, i-cholesterol, ne-low-and high-density lipoprotein cholesterol egazini.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukuhlolwa kanye nezinqubo zokubheka izimpawu zesifo se-metabolic syndrome. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

I-Metabolic syndrome ingadala isifo senhliziyo negazi nesifo sikashukela.

I-Metabolic syndrome ixhunyaniswe nengozi eyengeziwe yesifo senhliziyo nesogazi nesifo sikashukela. Imikhuba yezempilo eyehlisa lezi zingcuphe ifaka phakathi:

• Ukuba nesisindo esinempilo.

• Ukudla ukudla okunempilo enhliziyweni.

• Ukuzivocavoca umzimba njalo.

• Ukungabhemi.

Isisindo

Ukukhuluphala ngokweqile, ukukhuluphala ngokweqile, noma ukukhuluphela kungumphumela wephuzile ongahle uvele ngemuva kokwelashwa komdlavuza othile wezingane. Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala ushintsho esisindweni:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izicubu zobuchopho, ikakhulukazi i-craniopharyngiomas.

• Umdlavuza welashwa ngemisebe ebuchosheni, kufaka phakathi i-total-body irradiation (TBI) njengengxenye yokufakelwa kwe-stem cell.

Ukwelashwa ngemisebe kwandisa ubungozi bokukhuluphala, ukukhuluphala ngokweqile noma ukukhuluphala.

Ingozi yokuba nesisindo esiphansi iyanda ngemuva kokwelashwa nalokhu okulandelayo:

• Ingqikithi yemisebe yomzimba (i-TBI) yabesifazane.

• Ukwelashwa ngemisebe esiswini kwabesilisa.

• Izinhlobo ezithile ze-chemotherapy (ama-alkylating agents kanye nama-anthracyclines).

Ingozi yokukhuluphala iyanda ngemuva kokwelashwa ngalokhu okulandelayo:

• Ukwelashwa ngemisebe ebuchosheni.

• Ukuhlinzwa okulimaza i-hypothalamus noma i-pituitary gland, njengokuhlinzwa ukususa isimila sobuchopho se-craniopharyngioma.

Lokhu okulandelayo kungandisa ingozi yokukhuluphala:

• Ukutholakala unomdlavuza lapho uneminyaka engu-5 kuya kwengu-9.

• Ukuba ngowesifazane.

• Ukuba nokushoda kwe-hormone yokukhula noma amazinga aphansi e-hormone leptin.

• Ungenzi umsebenzi owanele womzimba ukuhlala esisindweni somzimba esinempilo.

• Ukuthatha i-anti-depressant ebizwa nge-paroxetine.

Abasinda ngomdlavuza wezingane abavocavoca umzimba ngokwanele futhi babe nenani elijwayelekile lokukhathazeka banengozi ephansi yokukhuluphala.

Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola ushintsho kusisindo.

Lokhu nokunye ukuhlolwa nezinqubo kungasetshenziswa ukuthola noma ukuthola ushintsho kusisindo:

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

• Izifundo ze-chemistry yegazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-glucose, ekhishelwa egazini ngezitho nezicubu zomzimba. Inani elingavamile (eliphakeme noma eliphansi kunokujwayelekile) lezinto kungaba uphawu lwesifo.

• Izifundo zephrofayili ye-Lipid: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani le-triglycerides, i-cholesterol, ne-low-and high-density lipoprotein cholesterol egazini.

Ukukhuluphala, ukukhuluphala ngokweqile, noma ukukhuluphala kungalinganiswa ngesisindo, inkomba yomzimba, amaphesenti amafutha omzimba, noma usayizi wesisu (amafutha esiswini).

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukuhlolwa kanye nezinqubo zokubheka izimpawu zokushintsha kwesisindo. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Amasosha omzimba

AMAPHUZU ASEMQOKA

• Ukuhlinzwa ukususa ubende kwandisa ingozi yesistimu yomzimba yokuvikela.

• Imiphumela engemuva kwesikhathi ethinta amasosha omzimba ingadala ukutheleleka.

• Izingane ezisuswe ubende zingadinga ama-antibiotic ukunciphisa ubungozi bokutheleleka.

Ukuhlinzwa ukususa ubende kwandisa ingozi yesistimu yomzimba yokuvikela.

Ingozi yezinkinga zempilo ezithinta amasosha omzimba iyakhula ngemuva kokwelashwa nalokhu okulandelayo:

• Ukuhlinzwa ukususa ubende.

• Ukwelashwa kwemisebe ephezulu emthonjeni obangela ukuthi ubende buyeke ukusebenza.

• Ukufakelwa kwe-stem cell okulandelwa yisifo se-graft-versus-host esenza ukuthi ubende buyeke ukusebenza.

Imiphumela engemuva kwesikhathi ethinta amasosha omzimba ingadala ukutheleleka.

Imiphumela engemuva kwesikhathi ethinta amasosha omzimba ingakhuphula ubungozi bokutheleleka kakhulu ngamagciwane. Le ngozi iphezulu ezinganeni ezincane kunezingane ezindala futhi ingaba nkulu eminyakeni yokuqala ngemuva kokuba ubende luyekile ukusebenza noma lususwa ngokuhlinzwa. Lezi zimpawu nezimpawu zingabangelwa ukutheleleka:

• Ububomvu, ukuvuvukala, noma ukufudumala kwengxenye ethile yomzimba.

• Ubuhlungu obukwelinye ilungu lomzimba, njengeso, indlebe, noma umphimbo.

• Imfiva.

Ukutheleleka kungadala ezinye izimpawu ezincike engxenyeni yomzimba ethintekile. Isibonelo, ukutheleleka kwamaphaphu kungadala ukukhwehlela nenkinga yokuphefumula.

Izingane ezisuswe ubende zingadinga ama-antibiotic ukunciphisa ubungozi bokutheleleka.

Ama-antibiotic ansuku zonke angabekwa ezinganeni ezineminyaka engaphansi kwemihlanu ubudala ubende obungasasebenzi noma okungenani unyaka owodwa ngemuva kokuhlinzwa ukuze kususwe ubende. Ezigulini ezithile ezisengozini enkulu, ama-antibiotic ansuku zonke angabekwa phakathi nobuntwana aze abe mdala.

Ngaphezu kwalokho, izingane ezinobungozi obandayo bokutheleleka kufanele zigonywe ngezikhathi ezithile zokuthomba ngokulandelayo:

• Isifo se-pneumococcal.

• Isifo se-Meningococcal.

• Uhlobo lwe-Haemophilus influenzae uhlobo b (Hib).

• IDiphtheria-tetanus-pertussis (DTaP).

• I-hepatitis B.

Khuluma nodokotela wengane yakho ngokuthi ngabe eminye imigomo yezingane enikezwa ngaphambi kokwelashwa komdlavuza idinga ukuphindwa yini.

Uhlelo lweMisculoskeletal

AMAPHUZU ASEMQOKA

• Imiphumela yethambo nehlangene ngokuhamba kwesikhathi kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukuhlinzwa, ukwelashwa ngamakhemikhali, ukwelashwa ngemisebe nezinye izindlela zokwelapha kukhulisa ubungozi bethambo nemiphumela ehlangene.

• Ukwelashwa ngemisebe

• Ukuhlinzwa

• I-Chemotherapy nokunye ukwelashwa kwezidakamizwa

• Ukufakelwa kwe-stem cell

• Izimpawu nezimpawu ezingaba khona zemiphumela yethambo neyokujoyina zihlanganisa ukuvuvukala ngaphezu kwethambo noma ithambo nobuhlungu bamalunga.

• Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo ethanjeni nasejoyintini.

Imiphumela yethambo nehlangene ngokuhamba kwesikhathi kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala imiphumela yethambo neyokuhlangana:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umdlavuza wamathambo.

• Izicubu zobuchopho nomgogodla.

• Ukuthola i-sarcoma.

• Umdlavuza wekhanda nentamo.

• I-Neuroblastoma.

• I-non-Hodgkin lymphoma.

• Osteosarcoma.

• I-Retinoblastoma.

• I-sarcoma yezicubu ezithambile.

• Isimila seWilms.

• Umdlavuza welashwa ngokufakwa kwe-stem cell.

Ukungondleki kahle nokuzivocavoca umzimba okwanele nakho kungadala imiphumela yamathambo.

Ukuhlinzwa, ukwelashwa ngamakhemikhali, ukwelashwa ngemisebe nezinye izindlela zokwelapha kukhulisa ubungozi bethambo nemiphumela ehlangene.

Ukwelashwa ngemisebe

Ukwelashwa ngemisebe kungamisa noma kunciphise ukukhula kwethambo. Uhlobo lwethambo nokuhlangana kwesikhathi okuhlangene kuncike engxenyeni yomzimba ethole ukwelashwa ngemisebe. Ukwelashwa ngemisebe kungadala noma ikuphi kokulandelayo:

• Izinguquko endleleni obukeka ngayo ubuso noma ugebhezi, ikakhulukazi uma kunikezwa imisebe yedosi ephezulu nge-chemotherapy noma ngaphandle kwayo kunikezwa izingane ngaphambi kweminyaka yobudala engu-5.

• Isiqu esifushane (sibe sifushane kunokujwayelekile).

• I-Scoliosis (ukugoba komgogodla) noma i-kyphosis (ukugoqa umgogodla).

• Ingalo noma umlenze owodwa mfushane kunenye ingalo noma umlenze.

• I-osteoporosis (amathambo abuthakathaka noma amancane angaphuka kalula).

• I-Osteoradionecrosis (izingxenye zethambo lomhlathi ziyafa ngenxa yokushoda kwegazi).

• I-Osteochondroma (isimila esiyingozi sethambo).

Ukuhlinzwa

Ukuhlinzekwa kokunqunywa noma kokulondolozwa kwezitho zomzimba ukususa umdlavuza nokuwunqanda ungabuyi kungadala imiphumela emuva kwesikhathi kuye ngokuthi isisu besikuphi, iminyaka yesiguli, nohlobo lokuhlinzwa. Izinkinga zempilo ngemuva kokunqunywa noma ukuhlinzwa izitho zingafaka:

• Ukuba nezinkinga ngemisebenzi yokuphila kwansuku zonke

• Ukungakwazi ukusebenza njengokujwayelekile.

• Ubuhlungu obungapheli noma ukutheleleka.

• Izinkinga ngendlela okufakwa ngayo noma okusebenza ngayo okufakelwa.

• Ithambo eliphukile.

• Ithambo kungenzeka lingapholi kahle ngemuva kokuhlinzwa.

• Enye ingalo noma umlenze mfushane kunomunye.

Ucwaningo alukhombisi mehluko ezingeni lempilo kwabasindile bomdlavuza wezingane abanqunywa isitho uma kuqhathaniswa nalabo abahlinzwa izitho zomzimba.

I-Chemotherapy nokunye ukwelashwa kwezidakamizwa

Ingcuphe ingakhuphuka kubantu abasinda emdlalweni womdlavuza abathola i-anticancer therapy efaka i-methotrexate noma i-corticosteroids noma i-glucocorticoids efana ne-dexamethasone. Ukwelashwa kwezidakamizwa kungadala noma ikuphi kokulandelayo:

• I-osteoporosis (amathambo abuthakathaka noma amancane angaphuka kalula).

• I-Osteonecrosis (ingxenye eyodwa noma ngaphezulu yethambo ifa ngokungabi khona kokugeleza kwegazi), ikakhulukazi enqulwini noma edolweni.

Ukufakelwa kwe-stem cell

Ukufakelwa kwe-stem cell kungathinta amathambo namalunga ngezindlela ezihlukile:

• Ingqikithi yemisebe yomzimba (i-TBI) enikezwe njengengxenye yokufakelwa kwe-stem cell ingathinta amandla omzimba okwenza i-hormone yokukhula futhi ibangele ubude obufushane (bufushane kunokujwayelekile). Kungadala ne-osteoporosis (amathambo abuthakathaka noma amancane angaphuka kalula).

• I-Osteochondroma (isimila esiyingozi samathambo amade, njengengalo noma amathambo omlenze) angakha.

• Isifo se-graft-versus-host esingamahlalakhona singenzeka ngemuva kokufakelwa kabusha kwe-stem cell futhi sidale izinkontileka ezihlangene (ukuqina kwemisipha okwenza ukuthi ilunga lifinyele futhi liqine kakhulu). Kungadala ne-osteonecrosis (eyodwa noma ngaphezulu izingxenye zethambo zifa ngokungabi khona kwegazi).

Izimpawu nezimpawu ezingaba khona zemiphumela yethambo neyokujoyina zihlanganisa ukuvuvukala ngaphezu kwethambo noma ithambo nobuhlungu bamalunga.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yimiphumela yethambo neyokuhlangana eyeqile noma ngezinye izimo:

• Ukuvuvukala ngaphezu kwethambo noma ingxenye yamathambo omzimba.

• Ubuhlungu ethanjeni noma ekuhlanganyeleni.

• Ububomvu noma ukufudumala phezu kwethambo noma ilunga.

• Ukuqina okuhlangene noma inkinga yokuhamba ngokujwayelekile.

• Ithambo eliphuka ngaphandle kwesizathu esaziwayo noma liphuka kalula.

• Isiqu esifushane (sibe sifushane kunokujwayelekile).

• Uhlangothi olulodwa lomzimba lubukeka luphakeme kunolunye uhlangothi noma umzimba utshekela kolunye uhlangothi.

• Ngaso sonke isikhathi uhleli noma umile endaweni yokuthambeka noma ubonakala njengomhlane ocijile.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zempilo ethanjeni nasejoyintini.

Lezi nezinye izivivinyo nezinqubo zingasetshenziswa ukuthola noma ukuthola imiphumela yethambo neyokuhlangana:

• Ukuhlolwa komzimba kanye nomlando: Ukuhlolwa komzimba ukuhlola izimpawu ezijwayelekile zempilo, kufaka phakathi nokuhlola izimpawu zezifo, njengezigaxa noma yini enye ebonakala ingajwayelekile. Kuzothathwa nomlando wemikhuba yezempilo yesiguli, ukugula okwedlule kanye nokwelashwa. Ukuhlolwa kwamathambo nemisipha ngochwepheshe nakho kungenziwa.

• Ukuskena kobuningi bamathambo : Ukuhlolwa kwe-imaging okukala ukuminyana kwethambo (inani lamathambo amaminerali enanini elithile lamathambo) ngokudlulisa ama-x-ray ngamazinga wamandla ahlukene amabili ngethambo. Isetshenziselwa ukuxilonga i-osteoporosis (amathambo abuthakathaka noma amancane angaphuka kalula). Ebizwa nangokuthi i-BMD scan, i-DEXA, i-DEXA scan, i-eneji ye-x-ray absorptiometric scan, i-x-ray absorptiometry kanye ne-DXA.

• I-X-ray: I-x-ray uhlobo lwesigongolo samandla esingangena emzimbeni bese singena kwifilimu, senza isithombe sezindawo ezingaphakathi komzimba, njengamathambo.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zethambo nemiphumela ehlanganisiwe. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Uhlelo Lokuzala

AMAPHUZU ASEMQOKA

• Amasende

• Imiphumela yesikhathi esifushane yobufakazi kungenzeka ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukuhlinzwa, ukwelashwa ngemisebe, nezinhlobo ezithile ze-chemotherapy kukhulisa ubungozi bemiphumela yesikhashana ethinta amasende.

• Imiphumela engemuva kwesikhathi ethinta amasende ingadala izinkinga ezithile zempilo.

• Amaqanda

• Imiphumela sekwephuzile yama-ovari kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukwelashwa ngemisebe esiswini kanye nezinhlobo ezithile ze-chemotherapy kwandisa ingozi yemiphumela ye-ovarian late.

• Imiphumela engemuva kwesikhathi ethinta amaqanda ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zemiphumela yekwephuzile ye-ovari zifaka phakathi ukuya esikhathini okungajwayelekile noma okungekho esikhathini nokukhanya okushisayo.

• Ukuzala nokuzala

• Ukwelashwa komdlavuza kungadala ukungabi nenzalo kwabasinde kumdlavuza wezingane.

• Abasinde kumdlavuza wezingane bangaba nemiphumela ephuzile ethinta ukukhulelwa.

• Kunezindlela ezingasetshenziswa ukusiza abasinde kumdlavuza wezingane babe nezingane.

• inqwaba yabasindile bomdlavuza wezingane ayithinteki ukwelashwa komzali ngaphambilini komdlavuza.

Amasende

Imiphumela yesikhathi esifushane yobufakazi kungenzeka ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu kanye neminye imidlavuza yengane kungadala imiphumela yamasende emuva kwesikhathi:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izimila zamangqamuzana egciwane.

• IHodgkin lymphoma.

• I-non-Hodgkin lymphoma.

• I-Sarcoma.

• Umdlavuza wamasende.

• Umdlavuza welashwa nge-total-body irradiation (TBI) ngaphambi kokufakelwa kwe-stem cell.

Ukuhlinzwa, ukwelashwa ngemisebe, nezinhlobo ezithile ze-chemotherapy kukhulisa ubungozi bemiphumela yesikhashana ethinta amasende.

Ingozi yezinkinga zempilo ezithinta amasende iyanda ngemuva kokwelashwa kokukodwa noma okuningi kokulandelayo:

• Ukuhlinzwa, njengokukhishwa kwe-testicle, ingxenye ye-prostate, noma i-lymph node esiswini.

• I-Chemotherapy enama-alkylating agents, njenge-cyclophosphamide, i-dacarbazine, i-procarbazine ne-ifosfamide.

• Ukwelashwa ngemisebe esiswini, okhalweni, noma endaweni ye-hypothalamus ebuchosheni.

• Ingqikithi yemisebe yomzimba (i-TBI) ngaphambi kokufakelwa kwe-stem cell.

Imiphumela engemuva kwesikhathi ethinta amasende ingadala izinkinga ezithile zempilo.

Imiphumela yamuva yamasende nezinkinga ezihlobene nempilo zifaka okulandelayo:

• Ukubalwa kwesidoda okuphansi: Ukubalwa kwesidoda okungu-zero noma ukubalwa kwesidoda okuphansi kungaba kwesikhashana noma unomphela. Lokhu kuya ngesilinganiso semisebe kanye nohlelo, indawo yomzimba ephethwe, kanye nobudala lapho belashwa.

• Ukungazali: Ukwehluleka ukuba nobaba wengane.

• Ukubuyisa kabusha i-ejaculation: Isidoda esincane kakhulu noma asiphumi nhlobo kupipi ngesikhathi se-orgasm.

Ngemuva kokwelashwa ngamakhemikhali noma ngemisebe, amandla omzimba okwenza isidoda angabuya ngokuhamba kwesikhathi.

Amaqanda

Imiphumela sekwephuzile yama-ovari kungenzeka kakhulu ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu kanye neminye imidlavuza yengane kungadala imiphumela ye-ovarian sekwephuzile:

• I-leukemia ye-lymphoblastic acute (BONKE).

• Izimila zamangqamuzana egciwane.

• IHodgkin lymphoma.

• Umdlavuza we-Ovarian.

• Isimila seWilms.

• Umdlavuza welashwa nge-total-body irradiation (TBI) ngaphambi kokufakelwa kwe-stem cell.

Ukwelashwa ngemisebe esiswini kanye nezinhlobo ezithile ze-chemotherapy kwandisa ingozi yemiphumela ye-ovarian late.

Ingozi yemiphumela ye-ovarian sekwephuzile ingakhuphuka ngemuva kokwelashwa nganoma yikuphi okulandelayo:

• Ukuhlinzwa ukususa i-ovari eyodwa noma womabili.

• I-Chemotherapy enama-alkylating agents, afana ne-cyclophosphamide, mechlorethamine, cisplatin, ifosfamide, lomustine, busulfan, ikakhulukazi i-procarbazine.

• Ukwelashwa ngemisebe esiswini, okhalweni, noma emhlane ongezansi. Kubasindile ababenemisebe eya esiswini, ukulimala kwamaqanda kuncike kumthamo wemisebe, ubudala ngesikhathi sokwelashwa, nokuthi ngabe sonke noma ingxenye yesisu ithole imisebe.

• Ukwelashwa ngemisebe esiswini noma okhalweni kanye nama-alkylating agents.

• Ukwelashwa ngemisebe endaweni eseduze ne-hypothalamus ebuchosheni.

• Ingqikithi yemisebe yomzimba (i-TBI) ngaphambi kokufakelwa kwe-stem cell.

Imiphumela engemuva kwesikhathi ethinta amaqanda ingadala izinkinga ezithile zempilo.

Imiphumela ye-Ovarian late nezinye izinkinga ezihlobene nezempilo zifaka okulandelayo:

• Ukunqamuka kokuqala kokuya esikhathini, ikakhulukazi kwabesifazane abasuswe ama-ovari noma belashwa ngazo zombili i-ejenti ye-alkylating kanye nokwelashwa ngemisebe esiswini.

• Izinguquko ezikhathini zokuya esikhathini.

• Ukungazali (ukungakwazi ukukhulelwa ingane).

• Ukuthomba akuqali.

Ngemuva kokwelashwa ngamakhemikhali, ama-ovari angaqala ukusebenza ngokuhamba kwesikhathi.

Izimpawu nezimpawu ezingaba khona zemiphumela yekwephuzile ye-ovari zifaka phakathi ukuya esikhathini okungajwayelekile noma okungekho esikhathini nokukhanya okushisayo.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yimiphumela ye-ovarian late noma ezinye izimo:

• Izikhathi zokuya esikhathini ezingajwayelekile noma ezingekho nhlobo.

• Ukushisa okushisayo.

• Ukujuluka ebusuku.

• Inkinga yokulala.

• Ukushintsha kwemizwelo.

• Yehlise idrayivu yocansi.

• Ukoma kwesitho sangasese sowesifazane.

• Ukungakwazi ukukhulelwa ingane.

• Izici zobulili, njengokukhulisa ingalo, inkantini, nezinwele zemilenze noma ukukhulisa amabele, akwenzeki lapho uthomba.

• I-osteoporosis (amathambo abuthakathaka noma amancane angaphuka kalula).

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Ukuzala nokuzala

Ukwelashwa komdlavuza kungadala ukungabi nenzalo kwabasinde kumdlavuza wezingane.

Ingozi yokungabi nenzalo inyuka ngemuva kokwelashwa ngalokhu okulandelayo:

• Kubafana, ukwelashwa nge-radiation therapy emasendeni.

• Emantombazaneni, ukwelashwa ngemithi yokwelashwa ngemisebe okhalweni, kufaka phakathi amaqanda nesibeletho.

• Ukwelashwa ngemisebe endaweni eseduze ne-hypothalamus ebuchosheni noma emuva okuphansi.

• Ingqikithi yemisebe yomzimba (i-TBI) ngaphambi kokufakelwa kwe-stem cell.

• I-Chemotherapy enama-alkylating agents, afana ne-cisplatin, cyclophosphamide, busulfan, lomustine ne-procarbazine.

• Ukuhlinzwa, njengokukhishwa kwesende noma i-ovary noma ama-lymph node esiswini.

Abasinde kumdlavuza wezingane bangaba nemiphumela ephuzile ethinta ukukhulelwa.

Imiphumela yamuva ekukhulelweni ifaka phakathi ingozi eyengeziwe yokulandelayo:

• Umfutho wegazi ophezulu.

• Isifo sikashukela ngesikhathi sokukhulelwa.

• Ukushoda kwegazi.

• Ukuphuphuma kwesisu noma ukuzala ingane ishonile.

• Izingane ezinesisindo esiphansi sokuzalwa.

• Umsebenzi wokuqala kanye / noma ukulethwa.

• Ukulethwa ngesigaba se-Cesarean.

• Umbungu awukho esimeni esifanele sokuzalwa (ngokwesibonelo, unyawo noma izinqe kusesimweni sokuphuma ngaphambi kwekhanda).

Ezinye izifundo azibonisanga ubungozi obukhulayo bemiphumela sekwedlule isikhathi ekukhulelweni.

Kunezindlela ezingasetshenziswa ukusiza abasinde kumdlavuza wezingane babe nezingane.

Izindlela ezilandelayo zingasetshenziswa ukuze abasinde emdlalweni womdlavuza babe nezingane:

• Ukuqanda amaqanda noma isidoda ngaphambi kokwelashwa komdlavuza ezigulini esezifinyelele ebusheni.

• Ukukhishwa kwesidoda samasende (ukukhishwa kwenani elincane lezicubu eziqukethe isidoda esenduneni).

• Umjovo wesidoda se-Intracytoplasmic (iqanda lifakwa isidoda esisodwa esifakwa eqandeni elingaphandle komzimba).

• In vitro fertilization (IVF) (amaqanda nesidoda kubekwa ndawonye esitsheni, okunikeza isidoda ithuba lokungena eqandeni).

Izingane ezisinde kumdlavuza wezingane azithinteki ekwelashweni komdlavuza komzali phambilini.

Izingane ezisinda kumdlavuza wezingane azibonakali zinengozi eyengeziwe yokukhubazeka kokuzalwa, izifo zofuzo, noma umdlavuza.

Uhlelo Lokuphefumula

AMAPHUZU ASEMQOKA

• Imiphumela yamaphaphu emuva kwesikhathi kungenzeka ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Izinhlobo ezithile ze-chemotherapy kanye nemisebe emaphashini kwandisa ingozi yemiphumela yamaphaphu emuva kwesikhathi.

• Imiphumela engemuva kwesikhathi ethinta amaphaphu ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu zemiphumela yamaphaphu sekwephuzile zibandakanya ukuphefumula kanzima nokukhwehlela.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo emaphashini.

• Imikhuba yezempilo ekhuthaza amaphaphu aphilile ibalulekile kulabo abasinda emdlavuzeni wezingane.

Imiphumela yamaphaphu emuva kwesikhathi kungenzeka ukuthi yenzeke ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu kanye neminye imidlavuza yengane kungadala imiphumela yamaphaphu emuva kwesikhathi:

• IHodgkin lymphoma.

• Isimila seWilms.

• Umdlavuza welashwa ngokufakwa kwe-stem cell.

Izinhlobo ezithile ze-chemotherapy kanye nemisebe emaphashini kwandisa ingozi yemiphumela yamaphaphu emuva kwesikhathi.

Ingozi yezinkinga zezempilo ezithinta amaphaphu iyanda ngemuva kokwelashwa nalokhu okulandelayo:

• Ukuhlinzwa ukususa lonke noma ingxenye yodonga lwamaphaphu noma lwesifuba.

• Ukwelashwa ngamakhemikhali. Kwabasindile abaphathwa ngamakhemikhali, njenge-bleomycin, i-busulfan, i-carmustine, noma i-lomustine, kanye nokwelashwa ngemisebe esifubeni, kunengozi enkulu yokulimala kwamaphaphu.

• Ukwelashwa ngemisebe esifubeni. Kwabasindile ababenemisebe esifubeni, ukulimala kwamaphaphu nodonga lwesifuba kuncike kumthamo wemisebe, noma ngabe wonke noma ingxenye yamaphaphu nodonga lwesifuba ithole imisebe, noma ngabe imisebe yanikezwa ngemithamo emincane ehlukanisiwe yansuku zonke, kanye iminyaka yengane ekwelashweni.

• Ingqikithi yemisebe yomzimba (i-TBI) noma izinhlobo ezithile zokwelashwa ngamakhemikhali ngaphambi kokufakelwa kwe-stem cell.

Ingozi yemiphumela yamaphaphu mva kakhulu kubantu abasinda emdlalweni womdlavuza abaphathwa ngokuhlanganiswa kokuhlinzwa, i-chemotherapy, kanye / noma i-radiation therapy. Ingozi iyakhuphuka nakwabasindile abanomlando walokhu okulandelayo:

• Ukutheleleka noma isifo se-graft-versus-host ngemuva kokufakelwa kwe-stem cell.

• Amaphaphu noma isifo somoya, njengesifuba somoya, ngaphambi kokwelapha umdlavuza.

• Udonga lwesifuba olungavamile.

• Ukubhema osikilidi noma ezinye izinto.

Imiphumela engemuva kwesikhathi ethinta amaphaphu ingadala izinkinga ezithile zempilo.

Imiphumela yamaphaphu emuva kwesikhathi nezinkinga zempilo ezihlobene nazo zifaka okulandelayo:

• Radiation pneumonitis (amaphaphu avuvukala abangelwa ukwelashwa ngemisebe).

• I-pulmonary fibrosis (ukwakhiwa kwezicubu ezibomvu emaphashini).

• Ezinye izinkinga zamaphaphu nezomoya okufana nesifo esingapheliyo se-pulmonary disease (COPD), inyumoniya, ukukhwehlela okungapheli, kanye nesifuba somoya.

Izimpawu nezimpawu zemiphumela yamaphaphu sekwephuzile zibandakanya ukuphefumula kanzima nokukhwehlela.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yimiphumela yamaphaphu sekwephuzile noma ngezinye izimo:

• I-Dyspnea (ukuphefumula okuncane), ikakhulukazi lapho usebenza.

• Ukuqhuma.

• Imfiva.

• Ukukhwehlela okungapheli.

• Ukucinana (umuzwa wokugcwala emaphashini kusuka kumafinyela angeziwe).

• Izifo ezingapheli zamaphaphu.

• Ukuzizwa ngikhathele.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Imiphumela yamaphaphu emumva kwabasindile bomdlavuza wobuntwana kungenzeka ihambe kancane ngokuhamba kwesikhathi noma kungabikho zimpawu. Kwesinye isikhathi ukulimala kwamaphaphu kungatholwa kuphela ngokuhlolwa kwe-imaging noma kwe-pulmonary. Imiphumela yamaphaphu emuva ingase ithuthuke ngokuhamba kwesikhathi.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo emaphashini.

Lokhu nokunye ukuhlolwa nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yamaphaphu emuva kwesikhathi:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Ukuhlolwa komsebenzi wePulmonary (PFT): Isivivinyo sokubona ukuthi amaphaphu asebenza kanjani. Kukala ukuthi amaphaphu angabamba umoya ongakanani nokuthi umoya ungene ngokushesha nangakanani emaphashini. Futhi ilinganisa ukuthi ingakanani i-oxygen esetshenziswayo nokuthi ingakanani ikhabhoni dayoksayidi ekhishwa ngesikhathi sokuphefumula. Lokhu kubizwa nangokuthi ukuhlolwa komsebenzi wamaphaphu.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukuba nezivivinyo nezinqubo zokubheka izimpawu zemiphumela yamaphaphu emuva kwesikhathi. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Imikhuba yezempilo ekhuthaza amaphaphu aphilile ibalulekile kulabo abasinda emdlavuzeni wezingane.

Abasinde kumdlavuza wezingane abanemiphumela yamaphaphu emuva kwesikhathi kufanele banakekele ukuvikela impilo yabo, kufaka phakathi:

• Ukungabhemi.

• Ukuthola imishanguzo yomkhuhlane ne-pneumococcus.

Izinzwa

AMAPHUZU ASEMQOKA

• Ukuzwa

• Izinkinga zokuzwa ziwumphumela wephuzile ongahle uvele ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukwelashwa ngemisebe ebuchosheni nasezinhlotsheni ezithile ze-chemotherapy kwandisa ingozi yokulahlekelwa ukuzwa.

• Ukulahlekelwa ukuzwa kuyisibonakaliso esivame kakhulu semiphumela yokuzwa sekwephuzile.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zezempilo ezindlebeni nasezindlebeni zezinkinga.

• Ukubona

• Izinkinga zamehlo nokubona kungumphumela wephuzile ongahle uvele ngemuva kokwelashwa komdlavuza othile wobuntwana.

• Ukwelashwa ngemisebe ebuchosheni noma ekhanda kwandisa ingozi yezinkinga zamehlo noma ukulahleka kombono.

• Imiphumela engemuva kwesikhathi ethinta iso ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zemiphumela yeso nokubona sekwephuzile zifaka izinguquko kumbono namehlo omile.

• Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo ezinkingeni zamehlo nezokubona.

Ukuzwa

Izinkinga zokuzwa ziwumphumela wephuzile ongahle uvele ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu neminye imidlavuza yengane kungadala ukuzwa imiphumela yesikhathi esedlule:

• Izicubu zobuchopho.

• Umdlavuza wekhanda nentamo.

• I-Neuroblastoma.

• I-Retinoblastoma.

• Umdlavuza wesibindi.

• Izimila zamangqamuzana egciwane.

• Umdlavuza wamathambo.

• I-sarcoma yezicubu ezithambile.

Ukwelashwa ngemisebe ebuchosheni nasezinhlotsheni ezithile ze-chemotherapy kwandisa ingozi yokulahlekelwa ukuzwa.

Ingozi yokulahleka kokuzwa iyanda kubantu abasinda emdlalweni womdlavuza ngemuva kokwelashwa ngalokhu okulandelayo:

• Izinhlobo ezithile ze-chemotherapy, njenge-cisplatin noma i-carboplatin ephezulu.

• Ukwelashwa ngemisebe ebuchosheni.

Ingozi yokulahlekelwa yizindlebe inkulu kakhulu kulabo abasinde emdlalweni womdlavuza ababesebasha ngesikhathi sokwelashwa (ingane isencane, iba sengozini enkulu), belashelwa isimila ebuchosheni, noma bathola ukwelashwa ngemisebe ebuchosheni nakwimithi yamakhemikhali ngasikhathi sinye isikhathi.

Ukulahlekelwa ukuzwa kuyisibonakaliso esivame kakhulu semiphumela yokuzwa sekwephuzile.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa ukuzwa imiphumela esekugcineni noma ngezinye izimo:

• Ukulahlekelwa ukuzwa.

• Kukhala ezindlebeni.

• Uzizwa unesiyezi.

• Ingcina eqine kakhulu endlebeni.

Ukulahlekelwa kokuzwa kungenzeka ngesikhathi sokwelashwa, ngemuva nje kokuphela kokwelashwa, noma izinyanga ezimbalwa noma iminyaka ngemuva kokuphela kokwelashwa futhi kube kubi ngokuhamba kwesikhathi. Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuxilonga izinkinga zezempilo ezindlebeni nasezindlebeni zezinkinga.

Lokhu nezinye izivivinyo nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yokuzwa ngemuva kwesikhathi:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Ukuhlolwa kwe-Otoscopic: Ukuhlolwa kwendlebe. I-otoscope isetshenziselwa ukubheka umsele wezindlebe kanye ne-eardrum ukubheka izimpawu zokutheleleka noma ukulahleka kokuzwa. Kwesinye isikhathi i-otoscope iba nesibani sepulasitiki esicindezelwe ukudedela umoya omncane okuhogela emseleni wezindlebe. Endlebeni enempilo, indlebe izohamba. Uma kukhona uketshezi ngemuva kwe-eardrum, ngeke ihambe.

• Ukuhlolwa kokuzwa : Ukuhlolwa kokuzwa kungenziwa ngezindlela ezihlukile kuye ngeminyaka yengane. Ukuhlolwa kwenziwa ukubheka ukuthi ngabe ingane ingayizwa yini imisindo ethambile futhi enomsindo nemisindo ephansi naphezulu. Indlebe ngayinye ihlolwe ngokwehlukana. Ingane nayo ingabuzwa ukuthi ingabe iyayizwa yini imisindo ephezulu yemfoloko yokuhlela lapho ibekwa ngemuva kwendlebe noma ebunzini.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zemiphumela yokuzwa sekwephuzile. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Ukubona

Izinkinga zamehlo nokubona kungumphumela wephuzile ongahle uvele ngemuva kokwelashwa komdlavuza othile wobuntwana.

Ukwelashwa kwalokhu kanye neminye imidlavuza yengane kungadala imiphumela yeso nokubona sekwephuzile:

• I-Retinoblastoma, i-rhabdomyosarcoma, nezinye izicubu zeso.

• Izicubu zobuchopho.

• Umdlavuza wekhanda nentamo.

• I-leukemia ye-lymphoblastic acute (BONKE).

• Umdlavuza welashwa nge-total-body irradiation (TBI) ngaphambi kokufakelwa kwe-stem cell.

Ukwelashwa ngemisebe ebuchosheni noma ekhanda kwandisa ingozi yezinkinga zamehlo noma ukulahleka kombono.

Ingozi yezinkinga zamehlo noma ukulahleka kombono ingakhuphuka kwabasindile bomdlavuza wezingane ngemuva kokwelashwa nganoma yikuphi okulandelayo:

• Ukwelashwa ngemisebe ebuchosheni, esweni noma esokeni leso.

• Ukuhlinzwa ukususa iso noma isimila eduze kwethambo le-optic.

• Izinhlobo ezithile ze-chemotherapy, njenge-cytarabine ne-doxorubicin noma i-busulfan ne-corticosteroids njengengxenye yokufakelwa kwe-stem cell.

• Ingqikithi yemisebe yomzimba (i-TBI) njengengxenye yokufakelwa kabusha kwe-stem cell.

• Ukufakelwa kwe-stem cell (kanye nomlando wesifo esingelapheki se-graft-versus-host).

Imiphumela engemuva kwesikhathi ethinta iso ingadala izinkinga ezithile zempilo.

Imiphumela yekwephuzile yamehlo nezinkinga ezihlobene nempilo zifaka okulandelayo:

• Ukuba nesokhethi yeso elincane elithinta ukuma kobuso bengane njengoba ikhula.

• Ukulahleka kombono.

• Izinkinga zombono, ezifana ne-cataract noma i-glaucoma.

• Ukungakwazi ukukhala.

• Ukulimala kwe-optic nerve ne-retina.

• Izimila zamehlo.

Izimpawu nezimpawu ezingaba khona zemiphumela yeso nokubona sekwephuzile zifaka izinguquko kumbono namehlo omile.

Lezi kanye nezinye izimpawu nezimpawu zingadalwa yimiphumela yeso nokubona sekwephuzile noma ngezinye izimo:

• Izinguquko embonweni, njenge:

• Ukungakwazi ukubona izinto eziseduze.

• Ukungakwazi ukubona izinto ezikude kakhulu.

• Umbono ophindwe kabili.

• Ukubona okunamafu noma okufiphele.

• Imibala ibonakala ifiphele.

• Ukuzwela ekukhanyeni noma enkingeni yokubona ebusuku.

• Ukubona ukukhanya noma i-halo ezungeze izibani ebusuku.

• Amehlo awomile angazizwa sengathi ayaluma, ayashisa, noma avuvukile, noma ngathi kukhona okuthile esweni.

• Ubuhlungu bamehlo.

• Ukubomvu kwamehlo.

• Ukuba nokukhula kujwabu leso.

• Ukudonswa kwejwabu leso eliphezulu.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Ukuhlolwa nezinqubo ezithile kusetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo ezinkingeni zamehlo nezokubona.

Lokhu nokunye ukuhlolwa nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yeso neyombono:

• Ukuhlolwa kwamehlo nomfundi ohluziwe: Ukuhlolwa kweso lapho umfundi enwetshwa khona (enwetshiwe) ngamaconsi wamehlo afakwe umuthi ukuvumela udokotela ukuthi abheke ngaphakathi kwelensi nomfundi kwi-retina. Ingaphakathi leso, kufaka phakathi i-retina kanye nomthambo we-optic, kuhlolwe kusetshenziswa ithuluzi elenza kube khona ukukhanya okuncane. Lokhu kwesinye isikhathi kubizwa ngokuthi ukuhlolwa kwesibani. Uma kukhona isimila, udokotela angathatha izithombe ngokuhamba kwesikhathi ukugcina ithrekhi yezinguquko ngosayizi wesimila nokuthi sikhula ngokushesha kangakanani.

• I-ophthalmoscopy engaqondile: Ukuhlolwa kwengaphakathi langemuva kweso kusetshenziswa ilensi encane yokukhulisa nokukhanya.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zamehlo nezokubona ngemuva kwesikhathi. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Uhlelo lwe-Urinary

AMAPHUZU ASEMQOKA

• Izinso

• Izinhlobo ezithile zokwelashwa ngamakhemikhali zandisa ubungozi bezinhlungu ezitholakala ngemuva kwesikhathi.

• Imiphumela engemuva kwesikhathi ethinta izinso ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zemiphumela yezinso ngemuva kwesikhathi zibandakanya izinkinga zokuchama nokuvuvukala kwezinyawo noma zezandla.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo ezinso.

• Imikhuba yezempilo egqugquzela izinso ezinempilo ibalulekile kwabasindile kumdlavuza wezingane.

• Isinye

• Ukuhlinzwa endaweni ye-pelvic nezinhlobo ezithile ze-chemotherapy kukhulisa ubungozi bemiphumela yesinye yesinye.

• Imiphumela engemuva kwesikhathi ethinta isinye ingadala izinkinga ezithile zempilo.

• Izimpawu nezimpawu ezingaba khona zemiphumela yesinye emuva kwesikhathi zifaka phakathi izinguquko ekuchameni nokuvuvukala kwezinyawo noma zezandla.

• Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo esinyeni.

Izinso

Izinhlobo ezithile zokwelashwa ngamakhemikhali zandisa ubungozi bezinhlungu ezitholakala ngemuva kwesikhathi.

Ingozi yezinkinga zempilo ezithinta izinso iyanda ngemuva kokwelashwa nalokhu okulandelayo:

• I-Chemotherapy kufaka phakathi i-cisplatin, carboplatin, ifosfamide, ne-methotrexate.

• Ukwelashwa ngemisebe esiswini noma maphakathi nomhlane.

• Ukuhlinzwa ukususa ingxenye noma zonke izinso.

• Ukufakelwa kwe-stem cell.

Ubungozi bemiphumela yesifo sezinso bukhulu kakhulu kulabo abasinde kumdlavuza wezingane abaphathwa ngokuhlanganiswa kokuhlinzwa, ukwelashwa ngamakhemikhali kanye / noma ukwelashwa ngemisebe.

Lokhu okulandelayo kungakhuphula nobungozi bezinhlungu ezenzeka emva kwesikhathi:

• Ukuba nomdlavuza kuzinso zombili.

• Ukuba nesifo sofuzo esandisa ubungozi bezinkinga zezinso, njenge-Denys-Drash syndrome noma i-WAGR syndrome.

• Ukwelashwa ngezinhlobo ezingaphezu kweyodwa zokwelashwa.

Imiphumela engemuva kwesikhathi ethinta izinso ingadala izinkinga ezithile zempilo.

Imiphumela yezinso engapheli noma izinkinga zempilo ezihlobene nayo zibandakanya okulandelayo:

• Ukulimala ezingxenyeni zezinso ezihlunga futhi zihlanze igazi.

• Ukulimala ezingxenyeni zezinso ezisusa amanzi amaningi egazini.

• Ukulahleka kwama-electrolyte, njenge-magnesium, calcium, noma i-potassium, emzimbeni.

• Umfutho wegazi ophezulu (umfutho wegazi ophezulu).

Izimpawu nezimpawu ezingaba khona zemiphumela yezinso ngemuva kwesikhathi zibandakanya izinkinga zokuchama nokuvuvukala kwezinyawo noma zezandla.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa imiphumela yangemuva yezinso noma ezinye izimo:

• Ukuzwa isidingo sokuchama ngaphandle kokwenza lokho.

• Ukuchama njalo (ikakhulukazi ebusuku).

• Inkinga yokuchama.

• Ukuzizwa ngikhathele kakhulu.

• Ukuvuvukala kwemilenze, amaqakala, izinyawo, ubuso, noma izandla.

• Isikhumba esilumayo.

• Isicanucanu noma ukuhlanza.

• Ukunambitheka okunjengensimbi emlonyeni noma ukuphefumula okubi.

• Ubuhlungu bekhanda.

Kwesinye isikhathi azikho izimpawu noma izimpawu ezigabeni zokuqala. Izimpawu noma izimpawu zingabonakala njengokulimala kwezinso kuqhubeka ngokuhamba kwesikhathi. Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo ezinso.

Lokhu nokunye ukuhlolwa nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yezinso:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Ucwaningo lwamakhemikhali egazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-magnesium, i-calcium, ne-potassium, ekhishwa egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwesifo sezinso.

• I-Urinalysis: Isivivinyo sokubheka umbala womchamo nokuqukethwe kuwo, njengoshukela, amaprotheni, amaseli abomvu egazi namaseli amhlophe egazi.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amagagasi omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu noma izitho zangaphakathi, ezinjengezinso, bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukwenza izivivinyo nezinqubo zokubheka izimpawu zemiphumela yesifo sezinso. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Imikhuba yezempilo egqugquzela izinso ezinempilo ibalulekile kwabasindile kumdlavuza wezingane.

Abasindile bomdlavuza wezingane abasuswe konke noma ingxenye yezinso zabo kufanele bakhulume nodokotela wabo ngalokhu okulandelayo:

• Noma ngabe kuphephile ukudlala imidlalo enengozi enkulu yokuthintana okusindayo noma umthelela onjengebhola noma iHockey.

• Ukuphepha kwebhayisikili nokugwema ukulimala kwesibambo.

• Ubophe ibhande esihlalweni okhalweni, hhayi okhalweni.

Isinye

Ukuhlinzwa endaweni ye-pelvic nezinhlobo ezithile ze-chemotherapy kukhulisa ubungozi bemiphumela yesinye yesinye.

Ingozi yezinkinga zezempilo ezithinta isinye iyanda ngemuva kokwelashwa nalokhu okulandelayo:

• Ukuhlinzwa ukususa konke noma ingxenye yesinye.

• Ukuhlinzwa okhalweni, emgogodleni, noma ebuchosheni.

• Izinhlobo ezithile ze-chemotherapy, njenge-cyclophosphamide noma i-ifosfamide.

• Ukwelashwa ngemisebe ezindaweni eziseduze nesinye, ukhalo, noma umgudu wokuchama.

• Ukufakelwa kwe-stem cell.

Imiphumela engemuva kwesikhathi ethinta isinye ingadala izinkinga ezithile zempilo.

Imiphumela yesinye yesinye isikhathi nezinkinga zempilo ezihlobene nazo zifaka okulandelayo:

• I-hemorrhagic cystitis (ukuvuvukala kwangaphakathi kodonga lwesinye, okuholela ekopha).

• Ukuqina kodonga lwesinye.

• Inkinga yokukhipha isinye.

• Ukungazibambi.

• Ukuvinjelwa kwezinso, i-ureter, isinye, noma i-urethra.

• Ukutheleleka kwe-Urinary tract (okungapheli).

Izimpawu nezimpawu ezingaba khona zemiphumela yesinye emuva kwesikhathi zifaka phakathi izinguquko ekuchameni nokuvuvukala kwezinyawo noma zezandla.

Lezi kanye nezinye izimpawu nezimpawu zingabangelwa yimiphumela yesinye yesikhashana noma ngezinye izimo:

• Ukuzwa isidingo sokuchama ngaphandle kokwenza lokho.

• Ukuchama njalo (ikakhulukazi ebusuku).

• Inkinga yokuchama.

• Ukuzizwa njengesinye akupheli ngokuphelele ngemuva kokuchama.

• Ukuvuvukala kwemilenze, amaqakala, izinyawo, ubuso, noma izandla.

• Ukulawulwa kwesinye okuncane noma cha.

• Igazi emchameni.

Khuluma nodokotela wengane yakho uma ingane yakho inalezi zinkinga.

Izivivinyo nezinqubo ezithile zisetshenziselwa ukuthola (ukuthola) nokuthola izinkinga zempilo esinyeni.

Lokhu nezinye izivivinyo nezinqubo kungasetshenziswa ukuthola noma ukuthola imiphumela yesinye yesinye:

• Ukuhlolwa komzimba kanye nomlando: 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.

• Ucwaningo lwamakhemikhali egazi: Inqubo lapho kuhlolwe khona isampula segazi ukukala inani lezinto ezithile, njenge-magnesium, i-calcium, ne-potassium, ekhishwa egazini ngezitho nezicubu zomzimba. Inani elingajwayelekile (eliphakeme noma eliphansi kunokujwayelekile) lento kungaba uphawu lwezinkinga zesinye.

• I-Urinalysis: Isivivinyo sokubheka umbala womchamo nokuqukethwe kuwo, njengoshukela, amaprotheni, amaseli abomvu egazi namaseli amhlophe egazi.

• Isiko lomchamo: Isivivinyo sokubheka amabhaktheriya, imvubelo, noma ezinye izinto ezincane emchameni lapho kunezimpawu zokutheleleka. Amasiko e-urine angasiza ekuboneni uhlobo lwe-microorganism olubangela ukutheleleka. Ukwelashwa kokutheleleka kuncike ohlotsheni lwe-microorganism olubangela ukutheleleka.

• Ukuhlolwa kwe-Ultrasound: Inqubo lapho amaza omsindo wamandla aphezulu (i-ultrasound) ehlaselwa izicubu noma izitho zangaphakathi, njengesinye, bese enza ama-echoes. Ama-echoes akha isithombe sezicubu zomzimba esibizwa nge-sonogram. Isithombe singaphrintwa ukuze sibhekwe ngokuhamba kwesikhathi.

Khuluma nodokotela wengane yakho mayelana nokuthi ngabe ingane yakho idinga ukuba nezivivinyo nezinqubo zokubheka izimpawu zemiphumela yesinye yesinye. Uma kudingeka izivivinyo, thola ukuthi kufanele zenziwe kangaki.

Ukuze ufunde kabanzi ngemiphumela yamuva yokwelashwa komdlavuza wezingane

Ngeminye imininingwane ngemiphumela yokwelashwa sekwedlule isikhathi komdlavuza wezingane, bona okulandelayo:

• Imihlahlandlela Yokulandelela Yesikhathi Eside Yabasindile Ebuntwaneni, Ebusheni, Nasemdlavuzeni Wabadala Abadala

• Isiqondisi Somthelela Wemiphumela Yamuva

• I-Computed Tomography (CT) Iskena Nomdlavuza

Ngemininingwane eminingi yomdlavuza wezingane nezinye izinsiza zomdlavuza ezijwayelekile ezivela ku-National Cancer Institute, bona okulandelayo:

• Umdlavuza Wezingane

• I-CureSearch ye-Cancer YezinganePhuma Ukuzikhulula

• Intsha kanye nabantu abadala abancane abaneCancer

• Izingane Ezinomdlavuza: Umhlahlandlela Wabazali

• Umdlavuza Ezinganeni Nasebusheni

• Isiteji

• Ukubhekana Nomdlavuza

• Imibuzo Ongayibuza Udokotela Wakho Mayelana Nomdlavuza

• Kwabasindile Nabanakekeli