txheem
Sigmoid colon cancer tuaj yeem tshwm sim rau txhua lub hnub nyoog. Tab sis nyob rau hauv 60% ntawm cov neeg mob nws muaj nyob rau hauv cov neeg laus cov neeg laus txog 50 xyoo. Hauv qhov no, cov txiv neej feem ntau cuam tshuam.
Lub plab hnyuv sigmoid nyob saum lub qhov quav ntawm sab laug ntawm lub plab. Nws muaj S-puab. Nws yog vim li no tias cov zaub mov bolus, txav los ntawm cov hnyuv, nyob rau hauv qhov chaw ntev dua. Lub sij hawm ntawm kev nthuav tawm cov khoom noj khoom haus rau lub cev mucosa nce. Qhov no ua rau muaj kev pheej hmoo ntawm kev mob qog noj ntshav.
Dab tsi yog sigmoid colon cancer
Sigmoid colon cancer yog kab mob oncological. Hauv 95% ntawm cov neeg mob, hom neoplasm pom yog adenocarcinoma. Cov qog feem ntau tshwm sim nyob rau hauv lub Uppermost txheej ntawm txoj hnyuv - lub mucosa.
Raws li kev txheeb cais, feem ntau hom mob qog noj ntshav no tau kuaj pom nyob rau theem kawg. Tus kab mob no nyuaj rau pom thaum ntxov, feem ntau nws tsis ua rau nws tus kheej hnov txhua. Nws yog ib qho tseem ceeb kom ua tib zoo saib xyuas raws li qhov ua tau rau tag nrho cov tsos mob tsis txaus ntseeg, txij li nyob rau theem kawg ntawm kev mob qog noj ntshav sigmoid tsis kho. Tus neeg mob tsuas txo cov tsos mob.
Cov zaub mov tsis zoo thiab kev noj zaub mov tsis zoo yuav cuam tshuam rau cov hnyuv. Feem ntau, malnutrition ua rau cem quav - stagnation ntawm cov quav, txo txoj hnyuv motility.
Ua rau mob qog noj ntshav sigmoid
Mob qog noj ntshav ntawm sigmoid nyuv yog provoked los ntawm ntau yam laj thawj. Kev sib xyaw ua ke ntawm ntau yam tuaj yeem ua rau muaj tus kab mob no.
Genetic predisposition plays lub luag haujlwm tseem ceeb. Yog hais tias ib tug ntawm cov txheeb ze twb tau mob plab hnyuv, yuav muaj mob yuav ntau dua. Kuj tseem muaj ib qho kev xav rau kev tsim ntawm polyps - benign formations. Tab sis dhau sijhawm, lawv tuaj yeem hloov mus rau hauv daim ntawv malignant.
Nws provokes mob thiab tas li inflammatory txheej txheem nyob rau hauv txoj hnyuv - colitis, Crohn tus kab mob thiab lwm yam pathologies.
Nrog lub hnub nyoog, qhov kev pheej hmoo ntawm sigmoid colon cancer nce. Tab sis tsis yog xyoo yog qhov ua rau, tab sis ib qho kev hloov hauv ib tug neeg txoj kev ua neej: tsis tshua muaj kev txav mus los, kev rog, noj tshuaj ntau zaus.
Rau txhua tus neeg, kev mob siab rau ntau dhau rau cov khoom noj carcinogenic, nqaij, thiab carbohydrates ceev yuav txaus ntshai. Mob qog noj ntshav yog tshwm sim los ntawm cawv thiab haus luam yeeb.
Kev qaug cawv tsis tu ncua ntawm lub cev nrog cov khoom lwj, raug rau co toxins ntawm txoj hnyuv mucosa ua rau atypical loj hlob ntawm epithelium. Kev loj hlob ntawm epithelium yog lub teeb liab uas muaj polyp tau pib tsim. Tus mob no yog suav tias yog precancerous thiab tsis muaj kev soj ntsuam thiab kev kho mob, polyp tuaj yeem rov qab los.
Hauv sigmoid nyuv, cov ntshav khiav qeeb. Qhov no kuj ua rau cov qog loj hlob qeeb, yog li lawv tuaj yeem txhim kho tau ntev. Phab ntsa ntawm peritoneum tsis tso cai rau pom tsawg kawg yog qee qhov kev qhia sab nraud ntawm cov qog loj hlob. Tag nrho cov no, ntxiv rau qhov tsis tshua muaj cov tsos mob, ua rau sigmoid colon cancer nyuaj rau kev kuaj mob.
Cov theem ntawm sigmoid colon cancer
Cancer muab faib ua theem nyob ntawm qhov tsis saib xyuas ntawm tus kab mob. Nrog rau txhua theem, tus neeg mob lub sijhawm kom muaj sia nyob thiab ua kom lub neej ntev tom qab kev kho mob tsawg kawg yog 5 xyoos txo.
Qib 0. Nws tseem hu ua "cancer in situ" - nyob rau hauv situ. Qhov no yog qhov ntxov tshaj plaws ntawm tus kab mob. Hauv qhov no, cov txheej txheem pathological tshwm sim tsuas yog hauv cov hnyuv mucosa.
Qib 1. Twb muaj cov qog loj hlob nyob rau hauv lub mucous daim nyias nyias, tab sis nws tsis mus dhau nws. Qhov tshwm sim ntawm kev kho nyob rau theem no yog siab heev - hauv 96 - 99% ntawm cov neeg mob.
Qib 2. Nws muab faib ua ob hom nyob ntawm seb cov qog loj hlob li cas.
- hom II-A - cov ntaub so ntswg cuam tshuam rau hauv cov hnyuv lumen, thaiv nws los ntawm yuav luag ib nrab, qhov ciaj sia taus yog li 95%;
- hom II-B - cov qog tob tob rau hauv cov ntaub so ntswg ntawm phab ntsa ntawm lub plab zom mov, tab sis cov hlwb metastatic tsis kis, feem pua ntawm cov ciaj sia nyob hauv hom no qis dua.
Qib 3. Nws yog nyob rau theem no uas metastases tuaj yeem tshwm sim. Theem 3 kuj muab faib ua subtypes.
- hom III-A - cov qog kis mus rau hauv txoj hnyuv lumen, tsis muaj metastasis, tab sis cov qog yog voluminous uas nws clogs yuav luag tag nrho cov plab hnyuv lumen, ib tug zoo prognosis yog sau tseg rau 58 - 60% ntawm cov neeg mob;
- hom III-B - cov qog nkag mus rau hauv cov phab ntsa hauv plab hnyuv, ib qho metastases rau cov qog ntshav tau pom, qhov ciaj sia taus kuj txo qis - tsuas yog 40 - 45% ntawm cov neeg mob.
Qib 4. Nyob rau theem kawg, metastases kis mus rau cov kab mob nyob deb thiab cov qog ntshav qab zib. Cov qog nyob rau tib lub sijhawm tob rau hauv cov ntaub so ntswg ntawm cov kabmob uas nyob ze - feem ntau hauv daim siab. Nws yog qhov nyuaj los pab cov neeg mob nyob rau theem no; tsuas yog 8-10% ntawm cov neeg mob tuaj yeem rov zoo.
Nyob rau theem no, tseem muaj kev faib ua subtypes, vim cov qog muaj feem cuam tshuam rau thaj chaw sib txawv.
- subtype 4A - cov qog loj hlob los ntawm tag nrho cov txheej txheem ntawm txoj hnyuv, muaj tsawg kawg yog 1 nyob deb metastasis (piv txwv li, rau lub ntsws), thaum lub cev nyob sib ze yuav tsis raug cuam tshuam los ntawm cov qog;
- subtype 4B - cov qog tag nrho los yog ib feem sprouts lub plab hnyuv phab ntsa, muaj tsawg kawg yog 1 metastasis rau cov kab mob nyob deb, los yog ob peb mus rau cov qog nqaij hlav, tej zaum yuav muaj los yog tsis muaj metastases rau cov kab mob nyob ze;
- subtype 4C - cov qog tau loj hlob los ntawm lub plab hnyuv tag. Muaj cov kab mob metastases nyob ze ntawm lub cev, cov qog tuaj yeem kis mus rau qhov chaw deb ntawm lub peritoneum, yuav tsis muaj metastases nyob deb.
Cov tsos mob ntawm sigmoid colon cancer
Hauv cov theem pib, tej zaum yuav tsis muaj tsos mob tshwm sim, thiab qhov no yog qhov txaus ntshai ntawm tus kab mob. Cov tsos mob uas tshwm sim feem ntau tsis meej pem nrog lwm cov kab mob los yog tsis mus cuag kws kho mob txhua.
Mob qog noj ntshav ntawm sigmoid nyuv tuaj yeem tshwm sim los ntawm flatulence, belching, rumbling hauv plab. Mob plab thiab cem quav feem ntau hloov. Cov kua qaub thiab cov ntshav tuaj yeem tshwm sim hauv cov quav - ntau qhov tsis meej pem qhov no nrog hemorrhoids. Nrog rau kev loj hlob ntawm cov qog, mob hauv plab, tsis xis nyob thaum lub plab zom mov, qhov kev xav ntawm kev ua tsis tiav ntawm txoj hnyuv yog cuam tshuam.
Nyob rau theem tom ntej ntawm tus kab mob, cov tsos mob tshwm sim: qaug zog, xeev siab, ua npaws, mob taub hau. Ib tug neeg poob phaus, poob qab los noj mov. Cov tawv nqaij ua greyish los yog daj, daj ntseg. Lub siab yuav loj tuaj thiab cov hemoglobin hauv cov ntshav yuav txo.
Kev kho mob ntawm sigmoid colon cancer
Kev kho mob ntawm tus kab mob no ib txwm nyuaj - koj tsis tuaj yeem ua nrog tsuas yog ib txoj kev, txawm tias qhov zoo tshaj plaws. Kev kho mob yuav suav nrog kev phais, xov tooj cua thiab kws khomob.
Lub luag haujlwm tseem ceeb yog muab rau kev kho mob phais. Yog tias cov qog me me thiab nws cov contours pom tseeb, cov ntaub so ntswg tuaj yeem raug tshem tawm. Ib feem nws yog tsim nyog rau excise ib feem ntawm cov hnyuv cuam tshuam, nrog rau cov qog ntshav. Yog tias cov qog yog "yooj yim" - me me thiab qib qis, nws tuaj yeem raug tshem tawm nrog txoj kev maj mam. Los ntawm me me punctures, ib qho endoscope yog ntxig, uas tsis txhob phais plab.
Hauv kev kho mob qog noj ntshav ntawm theem kawg hauv cov neeg mob siab, kev tshem tawm tag nrho ntawm cov hnyuv sigmoid yog qhov kev zam. Txhawm rau tshem tawm cov quav thiab cov pa roj, lub colostomy raug teeb tsa, qee zaum rau lub neej, vim nws tsis tuaj yeem tshem tawm cov khoom lag luam ua zaub mov li niaj zaus.
diagnostics
Kev ntsuam xyuas yuav tsum tau ua kom tiav, nws yog qhov txaus ntshai heev kom tsis txhob ua rau mob qog noj ntshav nrog rau lwm yam, tsis tshua muaj kab mob txaus ntshai.
Yog tias muaj kev tsis txaus siab, tus kws kho mob tuaj yeem kuaj xyuas lub qhov quav. Tom ntej no, ib qho kev ntsuam xyuas endoscopic yog muab: colonoscopy, sigmoidoscopy. Cov txheej txheem yog mob, qee zaum yuav tsum tau siv tshuaj loog. Qee cov neeg mob yuav tsum tsis txhob muaj qhov colonoscopy. Thaum txoj kev tshawb no, endoscope yog muab tso rau hauv lub qhov quav, tshuaj xyuas cov hnyuv. Lawv kuj coj ib tug biopsy ntawm qhov chaw tsis txaus ntseeg - nws yuav muaj peev xwm txiav txim siab qhov muaj pes tsawg leeg thiab cov qauv ntawm cov qog, nws ntau yam. Kev kho mob kuj yuav nyob ntawm qhov no.
Muaj ib txoj hauv kev tsawg dua - irrigoscopy. Tus neeg mob siv cov tshuaj barium uas ua rau cov hnyuv. Tom ntej no, ib qho x-ray yog coj, uas qhia cov qauv ntawm txoj hnyuv thiab nws cov khoov.
Ob leeg ultrasound thiab MRI ntawm lub plab kab noj hniav yog siv. Nrog lawv cov kev pab, koj tuaj yeem ntsuas qhov loj ntawm cov qog, muaj cov metastases. Kev kuaj ntshav rau cov qog nqaij hlav kuj yuav tsum tau ua.
Kev kho mob niaj hnub
Ntxiv nrog rau kev kho phais, cov qog tau cuam tshuam ntau dua. Tshuaj tua kab mob rhuav tshem cov ntaub so ntswg thiab tiv thaiv cov qog tsis loj hlob. Cov tshuaj toxicity cuam tshuam rau tag nrho lub cev, tab sis kev kho mob zoo heev. Chemotherapy inhibits qog loj hlob thiab tiv thaiv kev rov tshwm sim ntawm tus kab mob. Nws raug sau tseg ob qho tib si ua ntej thiab tom qab kev phais kom sib sau cov nyhuv.
Radiotherapy yog siv nrog ceev faj, vim muaj kev pheej hmoo ntawm kev puas tsuaj rau cov phab ntsa hauv plab. Nws kuj tseem muaj txiaj ntsig zoo hauv kev mob qog noj ntshav ntawm cov hnyuv sigmoid.
Kev tiv thaiv ntawm sigmoid colon cancer hauv tsev
Txhua tus neeg yuav tsum tau kuaj xyuas. Tseem muaj cov kev pabcuam hauv lub xeev rau kev kuaj mob plab hnyuv - lawv siv tau rau txhua tus neeg muaj hnub nyoog 50 xyoo. Qhov kev zov me nyuam suav nrog kev kuaj ntshav fecal (yuav tsum tau coj txhua 2 xyoos) thiab kuaj ntshav colonoscopy (txhua 5 xyoos).
Nws yog ib qho tseem ceeb uas yuav tsum tau saib xyuas koj cov zaub mov, tsis txhob cem quav thiab raws plab, noj cov nqaij tsawg thiab cov hmoov nplej dawb, thiab zaub thiab fiber ntau. Kev ua kis las, kev ua neej nyob yuav pab tau, txwv tsis pub txoj hnyuv motility yuav inevitably qeeb.
Nws yog ib qho tseem ceeb tsis txhob pib kho cov kab mob plab hnyuv xws li colitis. Tsis txhob haus luam yeeb thiab cawv.
Nrov lus nug thiab lus teb
Txhawm rau tiv thaiv koj tus kheej los ntawm cov kab mob txaus ntshai, muab koj tus kheej nrog cov ntaub ntawv thiab mus ntsib kws kho mob raws sij hawm ntawm qhov tsis txaus ntseeg. Teb cov lus nug tseem ceeb tshaj plaws txog kev mob qog noj ntshav sigmoid Tus kws kho mob Yulia Tkachenko.
Cov kev tshawb fawb loj tau pom tias kev noj zaub mov ntau hauv cov nqaij liab, nrog rau cov nroj tsuag fiber ntau, cov nplej tag nrho, thiab calcium, cuam tshuam nrog kev loj hlob ntawm cov kab mob qog noj ntshav. Cov neeg nyob hauv nroog paub tias noj cov nplej tsawg dua thiab yog li raug mob plab hnyuv ntau dua li cov neeg nyob deb nroog.
Kev txo qis hauv lub cev thiab kev rog rog kuj tseem yog qhov tseem ceeb, uas yog qhov zoo rau cov neeg nyob hauv nroog ntau dua li cov neeg nyob hauv cov zos thiab cov zos.
Cov tsos mob ntxhov siab yog qhov hloov ntawm qhov quav. Constipation alternates nrog cov quav quav. Tej zaum yuav muaj kev sib xyaw ntawm cov ntshav, qhov mob, kev xav ntawm kev ua tsis tiav.
Tsis tas li ntawd, muaj ntau cov tsos mob, xws li lub cev kub tsis tu ncua mus rau 37-37,5 degrees, poob phaus, tsis qab los noj mov thiab aversion rau zaub mov, kev qaug zog. Tag nrho cov tsos mob no qhia tau tias koj yuav tsum mus ntsib kws kho mob sai li sai tau.
Yog tias koj txhawj xeeb txog kev mob plab lossis kev hloov hauv cov quav, ces koj yuav tsum pib nrog kev sab laj nrog kws kho mob gastroenterologist. Thiab nyob rau hauv cov ntaub ntawv ntawm cov teeb meem nrog lub plab thiab cov tsos ntawm cov ntshav nyob rau hauv cov quav, nws yog zoo dua mus cuag ib tug proctologist. Yog tias tsuas yog cov tsos mob ua rau koj thab koj, koj yuav tsum sab laj nrog tus kws kho mob lossis tus kws kho mob.
Hmoov tsis zoo, peb tsis tuaj yeem hloov cov caj ces predisposition, yog li nws yog ib qho tsim nyog los kho cov yam ntxwv ntawm kev ua neej. Kev txiav luam yeeb, ua kom nquag plias, thiab poob phaus mus rau theem ib txwm yuav pab txo qis kev pheej hmoo ntawm mob qog noj ntshav. Koj kuj yuav tsum tau saib xyuas koj cov zaub mov. Nws yog ib qho tseem ceeb heev kom nkag siab txog qhov yuav tsum tau muaj kev ntsuam xyuas tsis tu ncua, tom qab 50 xyoo txhua tus xav tau.