Nzira yekudzivirira kudzokazve kwekenza yakajeka, maitiro ekurapa kudzokazve kwekenza yakajeka mushure mekuvhiyiwa?
Colorectal cancer is a common malignant tumor, including colon cancer and rectal cancer. The incidence of colorectal cancer from high to low is rectum, sigmoid colon, ascending colon, descending colon and transverse colon. In recent years, there is a trend toward the proximal end (right colon). If kenza yakajeka is detected early, it can usually be cured.
Makore mashanu ekupona mwero wekenza yakajeka
Zvinoenderana neUS ASCO yepamutemo webhusaiti dhata, makore mashanu ekupona kwecolorectal cancer varwere i5%. Nekudaro, iyo yekupona huwandu hwecolorectal cancer inogona kusiyana zvichienderana nezvakawanda zvinhu, kunyanya danho.
For kenza yemaroni, the overall 5-year survival rate is 64%. The 5-year survival rate for limited-stage colon cancer is 90%; the 5-year survival rate is 71% for metastasis to surrounding tissues or organs and / or regional lymph nodes; the 5-year survival rate is 14% if colon cancer has metastasized distant .
Kune kenza rectal, iyo yese yemakore mashanu ekupona mwero ndeye 5%. Iyo makore mashanu-ekupona mwero weinogumira-nhanho rectal kenza iri 67%; makore mashanu ekupona kweye metastasis kumatukisi akapoterera kana nhengo uye / kana nharaunda node node ndeye 5%. Kana paine metastasis iri kure yekenza rectal, makore mashanu ekupona mwero iri 89%.
Currently, treatments for colorectal cancer include surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy. Kuvhiya ndiyo nzira yakasarudzika yekupedza colorectal cancer. Asi Vicki, mupepeti wemusha usina cancer, akadzidza kuti vangangoita 60% kusvika 80% yevarwere vane rectal cancer vanozotangazve mukati memakore maviri mushure mekuvhiyiwa.
Nzira yekudzivirira sei kunyatso kuitika kwekenza yakajeka?
Natsiridza mararamiro
Kurega kunwa, kurega kunwa, kurega kunwa, kutaura zvinhu zvakakosha katatu, unofanirwa kurega kunwa. Mukuwedzera, usasute, usanyanya kushanda, uye chengetedza mufaro.
Kudzidzira kwakakodzera, mwedzi 2-3 mushure mekuvhiyiwa, unogona kuita zvinyoro zvinyoro, zvakadai sokufamba, zvishoma nezvishoma kuwedzera kubva pamaminitsi gumi nemashanu kusvika kumaminitsi makumi mana; iwe unogona zvakare kudzidzira qigong, Tai Chi, redhiyo gymnastics uye mamwe maekisesaizi akapfava.
Nyatso cherekedza kudya, usadye chikafu chakaumbwa, bhengi, bhekoni, tofu, chikafu chine nitrite, uye usadya mushonga wechiChinese uye zvigadzirwa zvehutano.
Kudya kwemashure mekuvhiya kunonyanya kuve kwakareruka, uye kunwiwa kweprotein yemhando yepamusoro, senge zai chena uye nyama isina mafuta, yakawedzera zvakakodzera. Kudya kwemashure mekuvhiya kunowanzo shanduka kubva mumvura, porridge, mukaka, mazai ane steamed, hove, nyama yakasendamira kune chikafu chakajairwa.
Idya zvekudya zvinoyekezeka sezvazvinogona, dzivisa mafuta, zvinonhuwira, zvinogumbura, zvakanyanya kuomarara, zvinonamira uye zvimwe zvekudya, idya chikafu chakaringana, idya zvishoma uye usadye zvakanyanya pakudya kumwe nekumwe.
Kugara kudyiwa nzungu senge macashews, hazelnuts, walnuts, maarmonds, uye walnuts zvinogona kuderedza kudzoka kwegomarara remudumbu.
Postoperative mukoti mazano ekenza yakajeka
Kubviswa kwesuture kwakapedzwa mazuva 7-10 mushure mekuvhiyiwa kwegomarara remudumbu. Vakwegura varwere kana varwere vane mamwe matambudziko vanogona kunyatsowedzera iyo nguva yekubvisa tambo. Mushure mekubvisa shinda, teerera kune rucheno rwevanga kudzivirira hutachiona.
Mushure mekubvisa, iwo masisitimu anodiwa kuti uenderere mberi nekupfeka uye nekusimbisa bhandi remudumbu panguva yekupora kwemaronda kusvika pakuvhiya kwapora zvachose, izvo zvinotora inenge hafu yemwedzi.
Anenge mazuva gumi mushure mekuvhiyiwa, anosimudza ganda anogona kubviswa, uye ronda rinofanira kuchengetwa rakachena uye rakaoma zvakanyanya sezvinobvira kudzikisa ziya. Unogona kugeza, asi kwete kukwiza ronda.
Zvakajairika kunzwa chiveve chakakomberedza ronda mushure mekuvhiyiwa, uye rinopera mushure mechinguva.
Zvakajairika kuti ronda rinyungudike, uye hushoma hunogona kupihwa hutachiona hutachiona, uye kupfeka kwepamusoro kunogona kuchinjwa. Nekudaro, kana iyo huwandu hwe exudate hwakakura uye hwakatsvuka kutsvuka uye kuzvimba kunoitika, chiremba anofanirwa kufonerwa munguva yekurapa ronda.
Kana iyo incision yekuvhiya yave kuda kukura, inozonzwa ichinzwika, inowanzozivikanwa se "nyama refu". Panguva ino, dzivisa kukwenya, mvura, uye hutachiona.
Ronda harina kupora kupfuura nguva yekupora. Unofanirwa kutsvaga chiremba anovhiya kuti agadzirise, shandura kupfeka nenguva, suka ronda, uye utape hutachiona, uye utarise kudzora shuga yeropa nekusimbisa kudya kunovaka muviri.
Maronda ekurumwa anotora mwedzi mumwe chete kuti apore. Mushure mekupora, unogona zvishoma nezvishoma kudzidzira squat kufamba, 3-5 maminetsi nguva imwe neimwe, kamwe chete mangwanani nemanheru.
Kana ronda racho richipora mushe, unogona kutora bhati mazuva 7-14 mushure mekubviswa. Unogona kushandisa shawa gel kana sipo, asi nzvenga ronda.
Kugara uchiongorora
Zvinoenderana nehuwandu, huwandu hwekudzoka uye metastasis yekenza yakajeka muChina yakakwira se50%, uye inopfuura 90% yekudzokazve uye metastasis inoitika mumakore 2-3 mushure mekuvhiyiwa, uye mwero wekudzoka wakaderera mushure memakore mashanu. Naizvozvo, iko kuvhiya hakusi kamwechete uye zvachose, uye isu tinofanirwa kuomerera pakuwongorora kwakawanda mushure mekuvhiya.
Vanorwara nekenza yematumbu vanowanzo dzokazve mukati memakore matatu mushure mekuvhiyiwa. Munguva iyi, huwandu hwevarwere bvunzo-bvunzo hunofanirwa kuve hwakawandisa; mushure memakore matatu, iyo yekuongorora-zvakare nguva inogona kuwedzerwa nenzira kwayo.
Kazhinji, tarisa zvakare mwedzi mitatu mukati megore rimwe mushure mekushanda; recheck imwe neimwe yegore mune yechipiri 3-1 makore; tarisa kamwe chete pagore mumakore 2-3. Iyo yakatarwa nguva yekuongorora inodawo kutsvaga chiremba wako kuti uone. Munguva yekuongorora, zvinhu zvinofanirwa kuongororwa zvinosanganisira,
Kuyera ropa: blood routine, liver and kidney function, tumarara markers (CEA, etc.);
Kufungidzira kuongorora: mudumbu pelvic ultrasound, chifuva radiograph
Colonoscopy: Mwedzi mitatu mushure mekuvhiyiwa kuti uone kupora kweanastomosis uye kucherechedza polyps mune zvimwe zvikamu
Nzira yekurapa chirwere chegomarara chinodzokazve mushure mekuvhiyiwa?
Kuvhiya kwechipiri
Nzira yakanyanya kunaka yevarwere vane kenza yakajeka kuti vadzokerezve ndeyokubvisa maronda anodzokorodza kuzadzisa chinangwa chekurapa kwakanyanya. Chekutanga pane zvese, zvinoenderana nekuti yechipiri yekuvhiya resection inogona kuitwa. Kana ikasangana nenzira dzekuvhiya, bundu rinogona kuvhiyiwa.
Kana paine maronda mazhinji, nzvimbo yekupinda iri yakakura, kana metastasis iri kure, kana kumisikidza kuri kuita njodzi, dzimwe nzira dzekurapa dzinogona kusarudzwa kana mukana wekuvhiya usina kuvimbiswa.
Mishonga
Kenza yekoloni chemotherapy
Kazhinji chemotherapeutic mishonga ndeye 5-fluorouracil, irinotecan, oxaliplatin, calcium folinate, capecitabine, tigeol (S-1), TAS-102 (trifluridine / tipiracil).
Nekudaro, kenza yekoloni chemotherapy inowanzo kuve mubatanidzwa wemakemikari akawanda emakemikari ekurapa. Zvinowanzobatanidzwa ndezvi:
1.FOLFOX (fluorouracil, calcium folinate, oxaliplatin)
2.FOLFIRI (fluorouracil, calcium folinate, irinotecan)
3.CAPEOX (Capecitabine, Oxaliplatin)
4. FOLFOXIRI (fluorouracil, karusiyamu folinate, irinotecan, oxaliplatin)
Colon cancer yakanangana nemishonga uye immune drugs
1. KRAS / NRAS / BRAF yemusango-mhando yakanangwa zvinodhaka: cetuximab kana panitumumab (inowanzo shandiswa kuruboshwe cancer cancer)
2. Anti-angiogenesis inhibitors: bevacizumab kana ramucirumab kana ziv abercept
3. BRAF V600E yakanangwa zvinodhaka: dabrafenib + trametinib; connetinib + bimetinib
4. NTRK fusion yakanangwa mushonga: Larotinib; Entratinib
5.MSI-H (dMMR) PD-1: pembrolizumab; nivolumab ± ipilimumab
6. HER2-yakanaka yakanangwa nemushonga: trastuzumab + (pertuzumab kana lapatinib)
Pamusoro pekuvhiyiwa uye radiotherapy, gomarara repamberi rekoloni inhanho yakakosha yekurapa. Yekutanga-mutsara kurapwa kunoreva kune yekutanga nhanho yekurapa neantic
kenza mishonga, inonziwo kurapwa kwekutanga. Pane zvakawanda zvingasarudzwa zvekurapa kwekutanga kwekenza yekoloni, kazhinji yakavakirwa pachemotherapy.
Zvisinei, zvakafanira kusiyanisa murwere ezvinhu uye mumuviri ezvinhu. Mushure mekuteedzana kwebvunzo, varwere vanogona kuganhurwa mumhando mbiri dzevarwere dzakakodzera kurapwa kwakanyanya uye isina kukodzera kurapwa kwakanyanya.
Sarudzo yemishonga yakakodzera kune varwere vane yakanyanya-yakasimba kurapwa
Yakakamurwa muzvikamu zvitatu:
Chekutanga-mutsara mhinduro ne oxaliplatin
Chekutanga-mutsara mhinduro ne irinotecan
(1) Yekutanga-mutsara mhinduro ine oxaliplatin
FOLFOX ± bevacizumab
CAPEOX ± bevacizumab
FOLFOX + (cetuximab kana panitumumab) (chete yeKRAS / NRAS / BRAF yemusango-mhando yakasara cancer cancer)
(2) Yekutanga-mutsara chirongwa ne irinotecan
FOLFIRI ± bevacizumab kana
FOLFIRI + (cetuximab kana panitumumab) (chete yeKRAS / NRAS / BRAF yemusango-mhando yakasara cancer cancer)
(3) Yekutanga-mutsara mhinduro ine oxaliplatin + irinotecan
FOLFOXIRI ± bevacizumab
Sarudzo yemishonga isina kukodzera kurapwa kwakanyanya
Yekutanga-mutsara marapirwo sarudzo
1. Kuiswa mukati kwe5-fluorouracil + calcium folinate ± bevacizumab kana
2. Capecitabine + Bevacizumab
3. Cetuximab kana panitumumab (Kirasi 2B humbowo, inoshanda chete kuKRAS / NRAS / BRAF yemusango-mhando yakasara cancer cancer)
4. Nivolumab kana pembrolizumab (chete ye dMMR / MSI-H)
5. Nivolumab + Ipilimumab (Kirasi 2B humbowo, inoshanda chete kune dMMR / MSI-H)
6. Trastuzumab + (Pertuzumab kana Lapatinib) (Inoshanda kune HER2 yakawedzera uye RAS yemhando-mamota)
1) Mushure mekurapa pamusoro, hapana kuvandudzwa kwehunhu hunoshanda, sarudza kurapwa kwakanyanya kutsigira (palliative care);
2) Mushure mekurapa pamusoro, hunhu hunoshanda hunovandudzika, uye chirongwa chekutanga-chakasimba chinogona kutariswa.
Yekupedzisira mishonga sarudzo
Regefini
Trifluorothymidine + tipiracil
Kurapa kwakanyanya kutsigira (palliative care)
