Menene Ciwon Tumbin Pancoast kuma Yaya ake Kula dasu?

Wadatacce

• Kwayar cututtukan cututtukan Pancoast
• Dalilin cututtukan Pancoast
• Ta yaya ake bincikar ƙwayar cuta ta Pancoast?
• Jiyya don ciwon sankara
• Tsayawa
• Jiyya
• Jin zafi
• Adadin rayuwa don ciwan Pancoast
• Outlook

Bayani

Ciwon daji na Pancoast nau'ikan nau'ikan cututtukan huhu ne. Irin wannan kumburin yana nan a saman (ƙoli) na huhun dama ko hagu. Yayinda ƙari ya girma, wurinsa yana ba shi damar mamaye jijiyoyin da ke kewaye, tsokoki, ƙwayoyin lymph, kayan haɗin kai, haƙarƙarin sama, da kuma kashin baya. Wannan yana haifar da ciwo mai tsanani a kafaɗa da hannu.

An gano jinkirin gano cututtukan Pancoast sau da yawa, saboda ciwan baya nuna alamun alamomin kansar huhu, kamar tari.

Pancoast ciwace-ciwacen sanannu ana kuma san su da manyan ciwan sulcus. Abubuwan da suka dace na bayyanar cututtuka ana kiran su Ciwan Pancoast. Na mutane masu fama da ƙari sun kusan shekara 60. Maza sun fi mata rauni.

Wannan cutar kansa an sanya mata suna ne, masanin kimiyyar rediyo na Philadelphia wanda ya fara bayanin ciwace-ciwacen a shekarun 1924 da 1932.

Tyananan ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin cuta na Pancoast sune:

• cutar sankara
• adenocarcinomas
• carcinomas mai girma
• ƙananan ƙwayoyin carcinomas

Kwayar cututtukan cututtukan Pancoast

Jin zafi na kafada shine mafi yawan alamun bayyanar cututtukan Pancoast a farkon matakansa.Sauran cututtukan sun dogara ne da wuraren da kumburin ya mamaye kewayen bude kirji (thoracic inlet).

Yayinda ƙari ya girma, ciwon kafaɗa yana ƙara tsanani da rauni. Zai iya haskakawa zuwa gaɓaɓɓu (axilla), ƙugu na kafaɗa, da ƙashin da ke haɗa kafada da hannu (scapula).

A cikin fiye da na larurar Pancoast, kumburin yana mamaye ɗakunan baya da na tsakiya na buɗe kirji. Jin zafi zai iya haskakawa:

• saukar da hannu a gefen jiki yana bin jijiyar ulnar (jijiyar da ke gangarowa daga gefen hannunka zuwa ruwan hoda, tsayawa a wuyan hannu)
• zuwa wuya
• zuwa babban haƙarƙarin
• ga cibiyar sadarwar jijiyoyin da ta kai ga hakarkarinsa, da jijiyoyin baya, da guntun kafa

Sauran alamun sun hada da:

• kumburin hannu na sama
• rauni a cikin tsokoki na hannu
• asarar lalacewar hannu
• ɓata ƙwayar tsoka a hannu
• tingling ko suma a hannu
• matse kirji
• gajiya
• asarar nauyi

Gaba ɗaya waɗannan alamun ana kiran su da cutar Pancoast.

A cikin mutanen da ke fama da ciwan Pancoast, ciwon daji na mamaye jijiyoyin da suka isa har cikin fuska. Ana kiran wannan cutar ta Claude-Bernard-Horner, ko kuma kawai cutar ta Horner. A gefen abin ya shafa, kana iya samun:

• fatar ido mai ruɓewa (blepharoptosis)
• rashin iya yin zufa kullum (anhidrosis)
• wankewa
• Matsar da kwayar idonka (enophthalmos)

Jin zafi na ciwon Pancoast mai tsanani ne kuma mai ɗorewa. Yawanci baya amsawa ga masu sauƙin ciwo mai-kan-kan-counter. Ciwon ya kasance ko kuna zaune, a tsaye, ko kwance.

Dalilin cututtukan Pancoast

Abubuwan da ke haifar da cututtukan Pancoast suna kama da na sauran cututtukan daji na huhu. Wadannan sun hada da:

• shan taba
• bayyanar da hayaki na biyu
• dadewa zuwa nauyi karafa, sinadarai, ko shaye-shayen dizal
• dogon lokaci zuwa asbestos ko babban matakan radon

A wasu lokuta ba safai ba, cutar ta Pancoast na alamomin na iya haifar da wasu dalilai, kamar sauran cututtukan daji, cututtukan ƙwayoyin cuta ko fungal, ko tarin fuka (TB) da sauran cututtuka.

Ta yaya ake bincikar ƙwayar cuta ta Pancoast?

Ganewar asali na cututtukan Pancoast yana da ƙalubale kuma galibi ana jinkirta shi saboda alamun ta sun yi kama da na cututtukan ƙashi da haɗin gwiwa. Hakanan, cututtukan Pancoast ba safai ba kuma suna iya zama sanannun likitoci. Ciwon daji na Pancoast ya kunshi dukkan cututtukan huhu.

Likitanku zai tambaye ku game da alamun ku, lokacin da suka fara, kuma idan sun canza a tsawon lokaci. Zasu gudanar da gwajin jiki kuma suyi odar gwaje-gwaje don neman kumburi da duk wata yaduwar cutar kansa. Idan an gano kumburi, likitanku na iya yin odar ƙarin gwaje-gwaje don ƙayyade matakin ƙwayar.

Gwaje-gwaje na iya haɗawa da:

• X-haskoki. Wani lokacin ƙari saboda matsayinta.
• CT dubawa. Matsayinsa mafi girma na iya gano yaduwar kumburin zuwa yankunan da ke kusa.
• Binciken MRI. Wannan gwajin hoto na iya nuna yaduwar kumburin da kuma ba da jagora don tiyata.
• Mediastinoscopy. Bututun da aka saka ta cikin wuya yana bawa likita damar ɗaukar samfurin ƙwayoyin lymph.
• Biopsy. Cire ƙwayar ƙwayar cuta don bincike ana ɗauka don tabbatar da matakin ƙwayar cuta da ƙayyade magani.
• Taimako na bidiyo-taimaka thoracoscopy (VATS). Wannan aikin tiyatar mai ƙananan haɗari yana ba da damar isa ga nama don bincike.
• Mini-thoracotomy. Wannan aikin yana amfani da ƙananan ƙananan, don samun damar nama don bincike.
• Sauran sikanin. Ana iya buƙatar waɗannan don bincika yaduwar cutar kansa zuwa ƙasusuwa, kwakwalwa, da sauran yankuna na jiki.

Jiyya don ciwon sankara

Kodayake da zarar an yi la'akari da mutuwa, amma yau ciwan Pancoast ana iya magance shi, kodayake har yanzu ba za'a iya warkewa ba.

Jiyya don ciwon sankara na Pancoast ya dogara da yadda tun da farko aka gano shi, yadda yaɗu, wuraren da abin ya shafa, da kuma yanayin lafiyar ku gaba ɗaya.

Tsayawa

Ciwon “Pancoast” ana “shirya shi” ta hanya mai kama da sauran cututtukan huhu, ana amfani da adadin roman na I zuwa na IV da ƙananan nau'in A ko B don nuna yadda cutar ta ci gaba. Saitin jagora ne don takamaiman maganin da zaku karɓa.

Bugu da kari, ciwukan Pancoast ana kara rarraba su da haruffa da lambobi 1 zuwa 4 waɗanda ke nuna tsananin:

• T yana nuna girman da yaduwar kumburin.
• N yayi bayanin shigar kumburin lymph.
• M yana nufin ko an mamaye shafuka masu nisa (metastases).

Yawancin kumburin Pancoast ana rarraba su kamar T3 ko T4, saboda wurin da suke. An rarraba ƙwayar cutar a matsayin T3 idan sun mamaye bangon kirji ko jijiyoyin tausayi. Su ƙari ne na T4 idan sun mamaye wasu sifofi, kamar su vertebrae ko jijiyoyin bugun zuciya.

Hatta farkon cututtukan Pancoast an shirya su azaman IIB, kuma saboda wurin su.

Jiyya

Jiyya don ciwace-ciwacen Pancoast ya bambanta kuma ya haɗa da haɗarin cutar sankara, radiation, da tiyata.

Tumwayoyin cututtukan Pancoast waɗanda suka ƙayyade zuwa yankunan da ke bayan kirji na iya zama ba 'yan takarar tiyata ba.

Chemotherapy da radiation sune matakai na farko kafin aikin tiyata. Sa'an nan kuma an sake nazarin ƙari tare da wani CT scan ko wani gwajin hoto. Yin aikin tiyata da kyau ya gudana makonni uku zuwa shida bayan ilimin kimiya da raɗaɗi, kafin kowane tabo ya sami hanyar tiyata.

A wasu tsare-tsaren magani, ƙarin tiyata na iya biyo bayan tiyata don kashe sauran ƙwayoyin cutar kansa.

Manufar tiyata ita ce kawar da kayan cutar kansa gaba daya daga tsarin da ta mamaye. Wannan ba koyaushe ba ne mai yiwuwa, kuma cutar na iya sake dawowa. Wani karamin binciken da aka yi a Maryland ya gano cewa cutar ta sake dawowa a kashi 50 cikin dari na wadanda suka halarci tiyatar cutar sankara ta Pancoast.

Ci gaban fasaha a cikin fasahohin tiyata sun ba da damar yin tiyata a kan ƙwayar T4 Pancoast, amma hangen nesa ya fi na sauran matakan cutar.

Jin zafi

Saurin ciwo don ciwan Pancoast a yau ya haɗa da amfani da magungunan opioids da likita ya umurta. Koyaya, wannan yana zuwa tare da cututtukan da ba'a so. Wasu masu binciken sunyi jayayya don komawa ga matakan pre-opioid wadanda suke da tasiri ba tare da sakamako masu illa ba.

Hakanan za'a iya amfani da radiation don taimakawa ciwo lokacin da tiyata ba zai yiwu ba.

Za a iya sauƙaƙa tsananin ciwo tare da ciwukan Pancoast tare da aikin tiyata wanda zai kawar da jijiyoyin da ke tafiyar da ciwo a cikin kashin baya. Wannan shi ake kira CT wanda aka shiryar da shi, wanda a ciki ana amfani da hoton CT don jagorantar likitan.

A cikin binciken daya, daga waɗanda ke tare da ciwon sukari na Pancoast sun ba da rahoton ingantaccen ci gaba tare da wannan aikin. Tsarin jijiyoyin jiki koda a makonnin ƙarshe na rayuwa na iya ba da taimako mai zafi.

Sauran hanyoyin magancewa don sauƙaƙe ciwon tumo na Pancoast sun haɗa da:

• lalata laminectomy (tiyata wanda ke kawar da matsin lamba akan jijiyoyi na kashin baya)
• phenol toshe (allurar phenol don toshe jijiyoyi)
• derarfafa transdermal (ta amfani da ƙananan lantarki kai tsaye a kan kwakwalwa)
• stellate ganglion block (allurar rigakafi a cikin jijiyoyi a cikin wuyansa)

Adadin rayuwa don ciwan Pancoast

Yawan rayuwa bayan chemotherapy, radiation, da tiyata sun bambanta. Wani rahoton asibitin Cleveland ya lura da yawan rayuwar shekaru biyu bayan tiyata kamar kashi 55 zuwa 70. Adadin rayuwa na shekaru 5 don tiyatar da ta cire asalin ƙwayar Pancoast gaba ɗaya ya kasance kashi 54 cikin ɗari zuwa kashi 77.

Outlook

Shekaru da yawa, cututtukan Pancoast ba su da magani. Saboda yanayin kumburin, an yi tunanin cewa tiyata ba zai yiwu ba.

A cikin 'yan shekarun da suka gabata, hangen nesa ga mutanen da ke da cututtukan Pancoast ya inganta ƙwarai. Sabbin fasahohin tiyata sun ba da damar yin aiki a kan ciwace-ciwacen da a da ba a ɗauka cewa ba za su iya aiki ba. Matsayi na yau da kullun wanda ya shafi chemotherapy, radiation, da tiyata ya ƙara ƙimar rayuwa.

Gano farko na cututtukan Pancoast yana da mahimmanci wajen tabbatar da nasarar maganin. Ganin likitanka yanzunnan idan kana da alamomin, ka kuma dauki matakan kariya kamar barin shan sigari idan ka sha sigari.