Wilms tumor

Matumbo a Wilms (nephroblastoma) ndi matenda osokoneza bongo, omwe amapezeka kwambiri pakati pa ana a zaka 2 mpaka 15. Matenda opitirira 80 peresenti ya matenda opatsirana ana amapezeka mu nephroblastoma. Kawirikawiri, zilonda zam'mimba zokhudzana ndi impso. Amakhulupirira kuti chitukukochi chimayambitsidwa chifukwa cha kuphwanya mapangidwe a impso mu nthawi ya embryonic.

Wilms tumor ana: classification

Pafupifupi, pali magawo asanu a matendawa:

1. Chotupacho chili mkati mwa impso chabe. Monga lamulo, mwanayo samakhala ndi vuto lililonse ndipo samadandaula.
2. Chotupa kunja kwa impso, palibe metastasis.
3. Chotupacho chimabala kapsule ndi ziwalo zozungulira. Zilonda zam'mimba zimakhudzidwa.
4. Pali metastases (chiwindi, mapapo, mafupa).
5. Kuphatikizidwa kwa mimba ndi chifuwa.

Matenda a Wilms: zizindikiro

Malingana ndi msinkhu wa mwanayo ndi siteji ya matenda, zizindikiro zotsatirazi zimasiyanasiyana:

• kufooka kwakukulu;
• kudzimva;
• kuchepetsa chilakolako;
• kupweteka;
• kutentha kwa thupi;
• kupweteka kwa khungu;
• kuwonjezeka pang'ono kwa kuthamanga kwa magazi;
• m'mayesero a magazi pali kuwonjezeka kwa ESR ndi kuchepa kwa chitsulo;
• macrogematuria (magazi mu mkodzo);
• Nthawi zina pamakhala kutsekula kwa m'mimba chifukwa cha kupweteka kwa m'mimba.

Komanso, pamaso pa chotupa cha Wilms, khalidwe la mwanayo lingasinthe.

Kumapeto kwa nthendayi, n'zotheka kufufuza minofu pamimba. Mwanayo akhoza kudandaula za ululu umene umakhala chifukwa cha kufinyidwa kwa ziwalo zoyandikana nawo (chiwindi, minofu ya retroperitoneal, diaphragm).

Mavitamini amatha kufalikira m'mapapo, chiwindi, impso zosiyana, ubongo. Ndi kuchuluka kwa metastases, mwana wodwala amayamba kuchepa thupi ndi mphamvu mwamsanga. Zotsatira zake zikhoza kuchitika chifukwa cha kuperewera kwa pulmonari ndi kutopa kwa thupi.

Matumbo a Wilms angaperekedwe limodzi ndi matenda ena oopsa omwe amachititsa kuti matendawa asapangidwe: hypospadias, cryptorchidism, ectopia, kuphatikizapo impso, hemihypertrophy.

Nkhroblast ya impso kwa ana: mankhwala

Popanda kukayikira pang'ono pakhosi pamimba pamimba, dokotala akufotokoza njira zogwiritsira ntchito:

• uzi wa ziwalo zonse ndi machitidwe;
• chisamaliro;
• mafilimu;
• chiwerengero;
• renal arteriography;
• Kusakanikirana kwa radioisotope pofuna kudziwitsa miyambo m'mimba ya mwana.

Chotupacho chikuchiritsidwa opaleshoni, ndipo chimatsatiridwa ndi mankhwala a radiotherapy ndi amphamvu. Mankhwala othandizira ma ARV angagwiritsidwe ntchito nthawi yapitayi komanso yothandizira. Ntchito yogwiritsira ntchito mitundu yosiyanasiyana ya mankhwala (vinblastine, doxirubicin, vincristine). Monga lamulo, mankhwala osokoneza bongo samagwiritsidwa ntchito pochiza ana osakwana zaka ziwiri.

Ngati atabwereranso, mankhwala oopsa a mankhwala, mankhwala opaleshoni ndi radiotherapy amachitika. Kuopsa kwa kubwereranso sizoposa 20% mosasamala kanthu za msinkhu wa zaka.

Ngati chotupacho sichitha kugwiritsidwa ntchito, ndiye kuti njira yogwiritsira ntchito chemotherapy imagwiritsidwa ntchito, yotsatiridwa ndi kafukufuku wa impso (kuchotsedwa).

Malingana ndi siteji ya matenda, zizindikirozi ndi zosiyana: chiwerengero chachikulu cha kupulumuka (90%) chimadziwika pa gawo loyamba, lachinayi - kufika 20%.

Zotsatira za mankhwala zimakhudzidwa ndi zaka za mwanayo pamene chotupa chinapezeka. Monga lamulo, ana amapulumuka mpaka chaka chimodzi mu 80%, ndipo patatha chaka - osaposa theka la ana.