Bone metastases.

Limodzi mwa mavuto aakulu kwambiri a khansa zonse - pa mosalephera isanayambike chomaliza - siteji ya metastasis. Metastasis foci ndi zilonda neoplasms kuti otaya lymph kapena magazi analembedwa ziwalo kutali ndipo zimakhala m'mene chimayamba kukhala ndondomeko neoplastic.

Khansa ya pafupifupi ziwalo zonse ndipo zimakhala mwina metastasize kwa fupa. zotupa oterewa tingawapeze pafupifupi aliyense nyumba fupa. The kaŵirikaŵiri - metastases mu nsana, osachepera mu mafupa a chiuno, nthiti ndi miyendo.

Kodi zotupa metastasize kuti fupa?

Nthawi zambiri, ndondomeko izi zimachitika pamene mabele khansa England, Prostate ndi mammary zopangitsa.

Pali mitundu iwiri zoyambirira za ndondomeko pathological mu fupa - osteoblastic ndi osteolytic metatstazirovanie. Pakuti loyamba mawonekedwe chisindikizo Ndi mmene minofu fupa, makamaka chigawo ake mchere. Mawonekedwe chachiwiri amathandiza "kuchapa" mchere, kumene kumakhala kumatanthauza kupatulira ndi fractures.

The pathogenesis matenda ichi ndi chimene kumapangitsa maselo chotupa. Ngati metastasis khansa kumafuna osteoblasts mu ndondomeko - osauka osteoblastic mawonekedwe. Pamene chotupa choyamba mu njira zawo wakumana ndi fupa resorbing maselo (osteoclasts) - ndi mapangidwe metastases osteolysis.

Nthawi zambiri, maonekedwe a metastases mu fupa amayambitsa kupweteka lomaliza. syndrome ululu chifukwa cha kuwonongeka kwa molekezera mitsempha chotupa zophuka, kuwonjezeka kuthamanga mwa fupa, ndi chifukwa mkwiyo mathero ulusi mitsempha allocated metastasis zinthu. Komanso, ululu kumachitika pamene fupa fractures chifukwa cha kupatulira wa lomaliza (khalidwe la mitundu osteolytic). Kupanga osteoblastic khalidwe anasonyeza hypercalcemia (magazi kashiamu).

Kuopsa fractures ndi mkulu Mwina mavuto - embolism m'mapapo mwanga, chakuya mtsempha thromboembolism (pamapeto pake zimenezi zimadzetsa kufa zinchito potsegula chiwalo kapena nthambi ndi viability).

metastases Bone amapezeka ntchito X-ray. Chifukwa chaichi, ntchito radiography kumveka pa multiplicity a zotupa metastatic, komanso mawonekedwe osteolytic. Pankhani ya osteoblastic anagwira mapanga sikani radionuclide. Imodzi mwa njira chizindikiritso, imene Tingaone osati metastases fupa, komanso mu ziwalo zina ndi zimakhala - PET 18P-deoxyglucose.

Opaleshoni chithandizo cha metastases fupa akuonetsedwa pa zotheka wovulala lomaliza. Mafupa dokotala opaleshoni kulimbitsa mafupa ndi kulowetsa zikhomo ndi kuiwala ndi fupa simenti chotupa.

Cheza mankhwala pa mlingo wa khumi - twente-faifi Gy (choikidwa ndi tuzigawo twa zinayi), theka la odwala ndi mofulumira ululu. Mlingo wa makumi atatu - makumi asanu Gy zimayambitsa kusintha kwambiri mmene mtima, makamaka patsogolo ngati chinatenga padzuwa lotsatira awiri - masabata atatu.

Sewerolo chachiwiri pambuyo mankhwala dzuwa, ndi ntchito strontium nyukiliya. Panopa chimagwiritsidwa ntchito mankhwala bisphosphonate. Izi zidulo wapadera kuti ziletsa ntchito osteoclasts. Komanso, mankhwala kufooketsa kukula kwa ululu fractures mafupa, komanso ndi kukula kwa zotupa.

Choncho, madokotala ananena zawo kwa metastasis kuti fupa angakhale osiyana, malinga ndi kutanthauzira za osteblastnoy kapena osteolytic maonekedwe ndi njira mankhwala.