Neuroblastoma ana, 4 gawo. Zoyambitsa, zizindikiro, zizindikiro, madokotala ananena zawo. neuroblastoma mankhwala a mwana

Neuroblastoma - khansara wa mantha dongosolo chisoni. Nthawi zambiri, matenda wapezeka ana. Panthawi yake kudziwika ake kumawonjezera mwayi wa kuchira kwathunthu. Ku zipangizo za nkhaniyi mudzaphunzira zimachititsa matenda, kodi zizindikiro ndi limodzi, kumene chithandizo chofunika.

Amazing chikhalidwe cha neuroblastoma mwana

Neuroblastoma - ambiri chotupa ndi zilonda khalidwe. Chimachititsa pafupifupi 15% milandu polisi ya zotupa za nthawi neonatal ndi kumayambiriro kwa mwana. Akatswiri ambiri limasonyeza chotupa ana kwa zaka zisanu, koma pali milandu ya matenda achinyamata 11 ndipo ngakhale zaka 15. Ndi kukula ndi chitukuko cha mwana mosakayikira amakumana ndi matenda sioneka yafupika chaka chilichonse.

Kutupa neuroblasts, malinga ndi madokotala, kuti wapatsidwa luso lodabwitsa. Makamaka mwamakani ndipo sachedwa metastasis mu gawo lirilonse la thupi. Nthawi zambiri amadwala ntchito yake fupa ndi dongosolo lymphatic. Nthawi zina madokotala atathana neuroblast kukula foci magawano awo ndi mapangidwe wotsatira wa zotupa. Iye poyamba metastasizes, ndiye suspend chitukuko ndi kuyamba amayambiranso. Malignancies wa mtundu wina yodziwika ndi zizindikiro zimenezi.

Brain neuroblastoma ana koyamba ankafufuza asayansi ku Germany, Rudolfom Virhovym mu 1865. dokotala lotchedwa chotupa "glioma." A zaka makumi angapo wasayansi American Dzheyms Rayt kufukulidwa mwatsatanetsatane neoplasm ndipo anafotokoza mwatsatanetsatane dongosolo la mapangidwe ake.

Magawo chitukuko cha neuroblastoma

Monga zotupa ina khansa, neuroblastoma ana udzadutsa magawo angapo a chitukuko cha ochiritsira, linanena limakupatsani perekani mankhwala:

• Gawo 1 amakhala ndi kukhalapo kwa zotupa resectable amene kukula si upambana masentimita 5, ndiponso kusapezeka kwa metastases lymph mfundo.
• Gawo 2A. Umboni wa zotupa isanafalikire, ambiri mwa imvera kuchotsa.
• Khwelero 2B. Lymph mfundo metastases zimachitika unilaterally.
• Gawo 3. Yodziwika ndi maonekedwe zotupa amgwirizano.
• Gawo 4 (A-B). Neoplasm chikamakula, pali metastasis kwa mafupa, chiwindi ndi lymph mfundo.

Tiyenera kuganiziranso mmene gawo lotsiriza la osauka neuroblastoma ana. Gawo 4 losiyana si achilendo kwachilengedwenso makhalidwe neoplasias mpumulo, ali ndi madokotala ananena zawo zabwino, ndipo ngati mankhwala yake amapereka ndalama kupulumuka mkulu.

Zimayambitsa chachikulu cha chitukuko chotupa

Neuroblastoma, komanso mitundu ina ya khansa, akufotokozera pa maziko a masinthidwe majini mu chamoyo. Panopa, akatswiri sindingakhoze kunena kuti zinagwira kusintha. Amaganiza kuti udindo ankaimba ndi otchedwa zinthu carcinogenic, ie, mankhwala ndi cheza. Chifukwa maselo kusintha anayamba zikupitiriza, n'kupanga chotupa. Zilonda neoplasm yodziwika ndi luso kugawana chimene chimasiyanitsa izo kwa mtima wabwino.

Kafukufuku wa n'zothandiza mapangidwe neuroblastoma ikutuluka nthawi ya chitukuko yoopsa kapena atangobereka mwana wake. Choncho, odwala ambiri - grudnichki. Magwero a chotupa umayamba neuroblasts. Izi mwana maselo ubongo, zomwe anapanga pa mwana wosabadwayo pa chitukuko intrauterine. Mu njira yachibadwa ya neuroblasts mimba kuganiza ntchito ulusi mitsempha kapena maselo ndi udindo mapangidwe zopangitsa kwa adrenal.

ambiri a iwo kale anapanga nthawi ya kubadwa kwa mwanayo. maselo mwana zambiri kutha. Pamene pathological ndondomeko ya neuroblasts pa Poyankha izi mu chotupa. Umboni wokha wa chinthu khansa - kumakhala kutengera za kumtundu. Komabe, ngozi ya matenda a kumtundu si upambana 2%.

Nthawi zambiri, madokotala oterewa retroperitoneal neuroblastoma, dera ankakonda kumene kutanthauzira - ndi zopangitsa adrenal. Theoretically, chotupacho angachokere kulikonse mu thupi. Retroperitoneal neuroblastoma ana zimachitika 50% milandu, 30% odwala anayamba chotupa tinatake tozungulira wa mitsempha lumbar dera, otsala 20% kusankha kwa kutanthauzira wa khomo lachiberekero ndi thoracic.

Kodi chotupa?

Pa siteji yoyamba ya ndondomeko pathological zizindikiro zenizeni si anati. Choncho, chotupacho zimachitika pa matenda ena yeniyeni gulu m'badwo uwu.

Zizindikiro za neuroblastoma ana zimachitika malinga ndi malo a zotupa kutanthauzira, madera kufala metastatic ndi mlingo wa zinthu vasoactive. Mwachibadwa, Woyambirira chotupa mfundo ndi danga retroperitoneal, yeniyeni mu zopangitsa kwa adrenal. Nthawi zina, izo isanafalikire mu khosi kapena mediastinum lapansi.

Kodi neuroblastoma ana? Zizindikiro za matendawa amayambika ndi kutuluka mahomoni ndi maselo a khansa kapena zotupa sanasiye kutiuza chimodzi kapena thupi ena. Nthawi zina kukula zimakhudza ntchito kwa matumbo ndi chikhodzodzo. Chifukwa psinjika Mitsempha odwala amapezeka scrotum ndi m'munsi malekezero edema.

Pabuka kapena bluish mawanga pa khungu komanso ndi zizindikiro za neuroblastoma ana. maonekedwe awo limasonyeza okhudzidwa mu ndondomeko pathological maselo epidermal. Ndi malowedwe a chotupa mwachindunji mu mafupa a mwana amakhala ofooka, amadwala. Pankhaniyi, ngakhale chilonda yaing'ono kungachititse magazi ochuluka.

Atazindikira zizindikiro za neuroblastoma, makolo ayenera kukaonana ndi dokotala. kudziwika khansa pa siteji oyambirira angapulumutse moyo wa mwana.

Retroperitoneal neuroblastoma

Neoplasm chiyambi neurogenic minofu amenewa amapezeka mu danga retroperitoneal, yodziwika ndi kukula mofulumira. Mu nthawi yochepa, izo likulowerera mu ngalande msana, n'kupanga kugwirizana wandiweyani chotupa, amene angathe kuonedwa ndi palpation.

Neuroblastoma ya England adrenal ana poyamba alibe zizindikiro zenizeni mpaka akafika kukula chidwi ndipo akuyamba angagwirizanitse zimakhala moyandikana. ndi zizindikiro za chotupa kudziwa?

1. Pamaso pa mapangidwe wandiweyani mu zonse m'mimba.
2. Kutupa kwa thupi lonse.
3. Ululu komanso ululu m'dera lumbar.
4. kuwonda.
5. Kuwonjezeka kutentha.
6. Kusintha zizindikiro magazi umboni magazi m'thupi.
7. Dzanzi ziwalo za miyendo m'munsi.
8. Kusokoneza luso zinchito wa kapepalako m'mimba ndi dongosolo mkodzo.

Other kutanthauzira a zotupa neurogenic chiyambi

Neuroblastoma zapambuyo mediastinum ana limodzi ndi lakuthwa kuwonda, amavutika kumeza matenda ntchito kupuma. Nthawi zina, matenda kumabweretsa kusintha mawonekedwe a chifuwa.

Zotupa zaglazno malo n'zochepa kwambiri, koma iwo amadziwa zambiri za iwo. Ichi ndi chifukwa chakuti zizindikiro zonse ndondomeko pathological kuoneka apoyera. Neoplasm yodziwika ndi maonekedwe a mawanga mdima pa diso, amene amaoneka ngati yotupa yachibadwa. chizindikiro china ndi adatchithisira neuroblastoma chikope. Limafotokoza ndi mwana wa diso unnaturally oumbidwa.

mitundu neuroblastomas

Pa akatswiri pano kusiyanitsa neuroblastoma Mawonekedwe anai, omwe ali ndi malo ena ndi kutanthauzira makhalidwe chosiyana.

• Medulloblastoma. Neoplasm zimachokera kwambiri cerebellum, ndilo chifukwa izo sizingakhoze kuchotsedwa ndi opaleshoni. kudwala The wofanana ndi metastasis mofulumira. Zizindikiro oyambirira a khansa kuoneka incoordination.
• Retinoblastoma. Izi chotupa chotupa chija zokhudza diso kwa diso mu achinyamata amene akudwala. Chosowa chithandizo kumabweretsa okwana khungu ndi ubongo metastases.
• Neyrofibrosarkoma. chotupa ichi isanafalikire mu zonse m'mimba.
• Simpatoblastoma. chotupa ichi ndi zilonda, amene ndi "nyumba" wake amasankha dongosolo wachifundo mantha ndi zopangitsa adrenal. Neoplasm aumbike mwa mwana wosabadwayo pa chitukuko intrauterine. Chifukwa kuwonjezeka mofulumira mu chingwe msana angakhudzidwe kukula simpatoblastomy zimenezi zingabweretse ziwalo.

Kodi kuzindikira neuroblastoma?

Poyamba, dokotala n'kukulemberani ndi amaganiziridwa matenda 'Neuroblastoma' magazi ndi mkodzo mayesero. Ana, zizindikiro za matenda ofanana ndi matenda ena, ndi zasayansi chiyesedwe cha zipangizo kwachilengedwenso kumatha zinthu zina zotheka. Mkulu mitengo mahomoni catecholamine mu mkodzo limasonyeza kukhalapo kwa khansara.

Pofuna kudziwa kukula kwa chotupa, ndi kutanthauzira odwala ana ake Kwalamulidwa CT, ultrasound ndi Kujambula. njira yofunika kwambiri ndi matenda biopsy. Pa njirayi, katswiri amapanga maselo mpanda khansa kwa zasayansi Kupenda wotsatira, kusanthula histological.

Kuchokera pa zotsatira dokotala akufotokozera njira za chithandizo, chikupatsani chitsogozo cha mankhwala ndi njira ya moyo wa wodwalayo.

Zosintha mankhwala

Chithandizo cha neuroblastoma mwana kawirikawiri nawo angapo katswiri Oncology dipatimenti (himioterapevt, dokotala, radiologist). Ataphunzira makhalidwe a chotupa ndi madokotala akupanga njira za uwonongedwe. Zimadalira m'mene chotupa kuyankha ntchito ikuchitika, ndi Mapa pa nthawi ya matenda komaliza.

Nthawi zambiri, chithandizo cha neuroblastoma ana zikuphatikizapo njira zotsatirazi:

1. Morning. Ndondomeko imeneyi imaphatikizapo oyamba mankhwala odana ndi khansa pa ziwembu ndi mwapadera. Kukonzekera ingafooketse maselo a khansa, kuteteza kubalana awo. Ndi iwo anakhudzidwa mbali zina za thupi, imbaenda zotsatira wamba mbali (tsitsi imfa, nseru, m'mimba). Mphamvu ya mankhwala ndi chinawonjezeka ndi kangapo molumikizana ndi kupatsidwa zina za mafuta.
2. Opaleshoni mankhwala kumafuna kuchotsa zotupa. Pamaso opaleshoni umagwiritsidwa ntchito mankhwala amphamvu. Timatha inu m'mbuyo kukula chotupa ndi chifukwa mgwirizano wa metastases. Lagamula kumaliza kuchotsa umadalira pa malo ndi kukula. A chotupa yaing'ono imene ili pafupi ndi chingwe msana, kupanga alowererepo yowopsa kwambiri.
3. Cheza mankhwala kuchita ano mankhwala sikawirikawiri ntchito. Iwo chikupitiriza zisakuyenda m'malo opaleshoni komanso cheza Si bwino ndipo amanyamula kuopseza zina kuti moyo wa mwanayo. mankhwala cheza tikulimbikitsidwa mosamalitsa umboni, pamene pali dzuwa otsika njira zina zochizira, mu nkhani ya unresectable neuroblastoma ana.

A zakudya zapadera ndi matenda odwala wamng'ono si anasonyeza. Makolo ambiri kuyesera kuchita mitundu yonse ya njira ya moyo ya Chad, kusintha zakudya wake. Iwo imatsimikizirika kuti ena mwa mankhwala kapena, yeniyeni, zinthu zili iwo, kuwonjezera chitetezo cha mthupi ndi ndinasintha ziletsa kukula zotupa. Zinthu zimenezi ndi monga nthaka, chitsulo, betaine, mavitamini osiyanasiyana. Iwo ali olemera mu zipatso amadyera wamng'ono, kaloti, dzungu.

Bwino chithandizo chilichonse zimadalira neuroblastoma lalikulu bwanji ana. The zimayambitsa matenda ndi siteji ya matenda zili zofunikira. The ntchito njira kwakukulu magawo oyambirira mapangidwe chotupa amapereka chiyembekezo kuti apeze zonse. Komabe, sikuti kuthetsa wodwala ang'onoang'ono maulendo dokotala ndipo popitapita kumupima kuti kupewa zisadzachitikenso zotheka.

Mwina kuchira yomaliza akuchotsedwa mu sitepe yachiwiri, malinga ntchito bwino ndi mankhwala amphamvu.

mavuto ena angabuke magawo yotsirizira ya kudwala ichi monga neuroblastoma. Ana 4 siteji ya khansara nthawi limodzi ndi Zoneneratu zokhumudwitsa. Kuyambiranso n'zotheka pambuyo kuchotsa chotupa, pa maziko a mwakuwoneka kuchira. M'badwo wotsatira wa chilengedwe zilonda nthawi aumbike mwa malo kale. The odziŵa stepi ino ndi 20% kupulumuka kwa zaka zisanu. Pankhaniyi, zonse zimadalira maphunziro a akatswiri, kupezeka kwa zida zina zofunika mankhwala.

kaonedwe

Pambuyo tima mankhwala Oncology madokotala ananena zawo odwala ambiri ndi yabwino. Ana ndi isanafalikire chotupa ndondomeko, madokotala kuti ayenera kuti achire mwamsanga. Pankhani gulu la anthu odwala, chotupacho akhoza kutha ngakhale popanda opaleshoni, koma tima mankhwala mankhwala mu nkhani iyi ndi kuvomerezedwa. Mu ana okulirapo, popeza anayala chotupa mwayi kuchira kwathunthu ndi ochepa kwambiri. Komanso, chotupacho akhoza anawathetsa akuyambiranso.

Zotsatira za mankhwala nthawi zambiri chimagwira neuroblastoma sekondale ana. Mapa mu nkhani iyi si yabwino kwambiri. Chotupa angaoneke patadutsa zaka zingapo, kuphatikizapo mankhwala bwino. mtundu uwu matanthauzo mankhwala anatchula zotsatira m'ma mbali. N'chifukwa chake odwala onse popanda yekha, patapita Inde mankhwala tikulimbikitsidwa madokotala nthawi zonse anaona.

zodzitetezera

Madokotala musataye ayamikira mwachindunji pofuna kupewa chitukuko cha chikhalidwe zilonda za chotupacho komanso chifukwa mapangidwe ake adakali bwino bwino, ndi kupatulapo amayenera cholowa chimene chingawapangitse kukhala zidakwa. Ngati achibale nthawi anali kulimbana ndi sioneka izi anapezeka pa mapulani mimba zabwino kupita ku upo wa zachibadwa doctor-. zikuoneka kuti tipewe chisokonezo tsogolo kugwirizana ndi kubadwa kwa mwana woipa.

Mwatsoka, khansa tsopano kunadetsa matenda odwala wamng'ono palibe neuroblastoma kupatulapo ana. Photo kudwala angapezeke mu mabuku apadera zachipatala pakuyenerera. The njira yeniyeni ya kapewedwe, madokotala sangathe kupereka chifukwa cha bwinobwino etiology kudwala. Pamene zizindikiro chachikulu maganizo a matenda, n'kofunika pitani kuchipatala. Pokhapokha kudutsa lathunthu kuwunika matenda angathe kuweruza khalidwe la zotupa ndi kukhala chitsanzo chabwino mankhwala njira. Mkuluyo kale adzatsimikizira matenda komaliza bwino mwayi kuti apeze zonse. Khalani wathanzi!