Wilms 'ʻeho: Symptoms, lapaʻau

Mai o ke kanaka kino mea i kino i makemake mau, a ma lalo o nā kumu e noho ola. Eia naʻe, ua waiho nui maʻi, a mā, a hiki ma ka utero. Ma kekahi o ia mākou e'ōlelo i loko o kā mākou 'atikala. He nui nā poʻe malihini me Wilms 'ʻeho. He aha ka mea, kekahi e ole e ike. He 'atikala e ho'āʻo i ka hana me ka symptoms, kumu a me nā kaʻa mokulele o ka hana ana o keia maʻi.

Ka manaʻo o Wilms 'ʻeho

Wilms 'ʻeho, a me ka mea i kapaia, nephroblastoma, pili i ka malignant maʻi o nā puʻupaʻa, a hōʻike loa pinepine i loko o kamaliʻi. Ua Ua ana diagnosed ma waena o nā makahiki o 2-5 makahiki. Wilms 'ʻeho i loko o nā mākua mea pohihihi keia, no laila, uuku? Anoee.

K Eia naʻe, na keiki ka mea e ae mai i kēia maʻi, he loa pinepine a me nā abnormalities i loko o ka ulu ana. Ua Ua manaoio aku i ke kahua o ka hikoko ke hoʻomaka i utero, no ka mea, ia manawa i loko o elua pule ke kamaiki ke huai ae ia.

Wilms 'ʻeho ua ana IIeEeAIEUIeXAIIUE i kekahiʻaoʻao, akā, he mau hihia, a meʻeluaʻaoʻaoʻaʻa puʻuwai lesions. Inā 'oe e nana i ka maʻi kino, ka mea, i ke kaulana i kona ili ka haoʻa, ke oki hiki mau o ka hemorrhage a me ka necrosis, ma kekahi mau wahi, aia no na cysts. Ma keia hihia, ua olelo aku nei au i ka hoʻomanawanui loaʻa cystic Wilmsʻeho.

Ma mua, i kaʻeho ua IIeEeAIEUIeXAIIUE loko puʻupaʻaʻelua. A me ka mea hope kūpono 'ana, ua ulu i loko o ka puni'aʻaʻa a me nā loko - penei e halii mai i metastases.

i ka maʻi ke kahua

Kēia malignantʻeho i loko o kona ulu ana he mauʻanuʻu:

1. I ka hoʻomaka o ka nephroblastoma mea hoʻokahi wale nō hakuʻala. Children i loko o kēia manawa e ole ka mahina discomfort, aʻaʻohe hoopii i ole.
2. Kaʻeho hoʻomaka e hohola iho la ma kela aoao o ka hakuʻala, akā,ʻaʻole metastases i keia manawa i loaʻa.
3. E möakäka hou 'ana ua pu ma ka germination capsules a me ka pio e loli ai i ka wahi a nā loko, a lymph aka wahi.
4. Loaʻa metastases ma ke akepaʻa, maʻiʻaʻai, iwi.
5. Ma ka hope ke kahua o ka hooulu ana o Wilmsʻeho ma keiki e loli ai i nā puʻupaʻaʻelua.

Oe paha e ole e wehewehe i ka mua heʻeho ua diagnosed, ka oi optimistic Outlook ke haawi aku i ka hoʻomanawanui.

symptomatology o ka maʻi

Mai kaʻike, o ka pathology hiki ia i loko o kekahi kahua o ka hoʻonaʻauao, na hoailona a me ke kaumaha ma muli mea e ĸokoĸa ana nä pane. More ma mua,ʻaʻole pinepine, ina he mea kekahi Wilms 'ʻeho, e' akomi i ka symptoms like penei:

• mau malaise;
• nawaliwali, a ina i ke keiki mea uuku loa, ka mea i mau ala;
• ikaika loa ka makemake ka ho'ēmiʻana;
• ae nānā mau kaumaha ka ho'ēmiʻana;
• Ma kekahi mau hihia, he mea e ke kuni nui;
• ili i lenalena;
• hiki mahuahua ke koko;
• Koko Ka Ikepili hōʻike i ka mahuahua ESR , a hoemiia hemoglobin;
• he mea koko i loko o ka mimi;
• i loa na, ka mea hiki ke malama intestinal iaʻi, e like me kaʻeho compresses ia.

Inā kekahi mai e hoʻololi i ka hana o ke keiki, a me Wilms 'ʻeho ma keiki mea i koe. Mom mau hiki koke hāʻupu aʻe i ka mea hewa ke keiki i kekahi mea.

I ka wā o ka maʻi e hele aku, a laila, i kaʻeho mea palpable maikai lima. Ma keia hihia, i ka pēpē Kahalaopuna eha, no ka mea, he mea mīkini'opihia no e pili nā loko, i ua ālai 'ia mai functioning maʻamau. Ma kekahi nā mea maʻi, ka mea maoli he'ōpū ina diagnosed Wilms 'ʻeho. Ke Hawaii photo ma lalo o ka ÷ maikai.

A hiki i ka nui helu o metastases, ke keiki hoʻomaka e hikiwawe loa mi kino. Loa pinepine, make ia lŘlŘ like me ka hopena o ka hoʻokō 'ole' naehana hanu a me ka excessive exhaustion. Remarkably, ka hanana o metastases hilinaʻi nui, e aho,ʻaʻole ma ka nui o kaʻeho, akā, oi ma ka hoʻomanawanui ka makahiki. Ua huli mai i keiki loa'ōpio i kēiaʻike i ka maikaʻi wale o ka piha ke ola.

Akā, oi pinepine i diagnosed wale ma mua o Wilms 'ʻeho, ka mea, ua ana pu ma nā developmental kāna hana.

Comorbidities

kākaʻikahi lawa i kaʻeho ua diagnosed like me ka wale haiahū kūmau ma ka ulu ana. Loa pinepine ka mea, ua pu ma comorbidities:

• hypospadias, i ka wa a ka urethra ma keikikane ua wehe henehene kou ma ka waena o ka penis a hiki ma ka crotch;
• hoonee aku na nā loko, no ka laʻana, nui elelo;
• kekahi lala oi ma mua o ka mea'ē aʻe;
• cryptorchidism;
• wa e kaawale aku o na iris o ka maka (ke aloha i ka haumāna ua i hoʻopuniʻia e kekahi mea).

Diagnosing Wilmsʻeho

I ka nephroblastoma mea ma ka loa hoʻomaka o kona ulu wale, i ka pololeiʻike, ka pilikia, no ka mea, aohe hai symptoms. No keia mea, i loko o ka hapanui o na hihia ano hoʻomaka lapaau ia kaʻeho mea ma ka 3 a me 4 kahua o ka hoʻonaʻauao.

I nā mākua Pono e pili loa kanaka hoʻoponopono i ke kūlana o ke keiki, a ina he mau pallor, kiʻekiʻe ke koko, ua hoʻemi leo, he mea hiki, e hoao i kaʻeho, oe e ike koke undergo i ka piha ninaninau. Ua hookuu nā nā kēia mauʻano o ka lapaʻau 'ana:

1. Ka Ikepili o ke koko a me ka mimi. Loaʻa i loko o ka mimi proteinuria, ua mahuahua hematuria, a me ke koko erythrocyte sedimentation ana, he mea anaemia.
2. Urography apono 'pololeiʻike, i oi aku mamua o 70% o ka hihia. Hiki ole nānā i nā contours o ka hakuʻala, a ma ke alo o kaʻeho hiki i ka iki loli ma ke kino shape a me ka dysfunction.
3. E ho ohana i Ultrasound kiʻi mea i oluolu i ka ike i ka nui o kaʻeho a me kona wahi.
4. Wilms 'ʻeho ma luna o ultrasound nana e like me ka pili-ʻaʻahu ho okumu ana o cysts loko.
5. E ho ohana X-Ray kamepiula tomography hiki ole ike ole wale i kaʻeho ma kekahi hakuʻala, akā, no hoi, e kālailai i ka lua o ka moku'āina, a me ka nānā i ke alo o metastases ma e pili nā loko.
6. No ka nui nui o kaʻeho ua ana hoakaka angiography. He ua hana i ka mea e hou möakäka hou i ka nephroblastoma wahi pili i ka nui o na moku i ke koko, no laila, ia i ka hana i ka surgeon i ka manao o ke kulana.
7. Ultrasonography a HI hiki hooholo i ka degere o ka metastasis i loko o nā loko a me nā'aʻaʻa.

Currently, 'inikua noiʻi epekema mea ma na o ka pae o ka? Acaeoey e ae i ka pololeiʻike, i loko o aneane 95% o ka hihia. Akā, 5% a pau i ka mea hewa e hiki mai, no kekahi laʻana, ina he ultrasound multilokulyarnuyu cyst kuhihewa no Wilms 'ʻeho, ia mea wale nō i ka hana ia mea hiki ke huai ae. A hiki i ke kani ultrasonic kaʻimiʻana pololei o 97%, a me iki emi ma RT. 'Oiai, he mea hihia i ka wa a ka Wilmsʻeho ua hui me ka cyst.

E möakäka hou keia hookolokolo ana ua kuhikuhi 'ana i ka ka loaʻaʻana o nā metastases, alaila, e koho i ka pono nā kaʻa mokulele iapaau ana o ka maʻi. Inā ulu Wilmsʻeho ma na keiki, lapaʻau lawelawe i loko o kēlā me kēia hihia, ua pili i ka kino, a me ka kahua o ka maʻi.

Kumu o ka nephroblastoma

Me ka pololei, e olelo aku i ka aoao o kaʻeho ulu, he mea hiki ole. Ua Ua manaoio aku i ke kumu o keia mea ka mutation i loko o ka DNA o aeee. Ma ka uuku pakeneka o ka hoopii, e ua pū i hiki mai nā mākua i nā keiki. Akā, oi pinepine, noiʻi mai i loaʻa i ka pilina ma waena o nā kūpuna a me ka ulu ana o Wilms 'ʻeho.

Kauka manaʻo e loaʻa nō kekahi kamepiula kumumea e alakai ai i ka muli o ke nephroblastoma. O nā nā kēia:

1. Female. Wahi a ka 'ikepili helu, kaikamahine pinepine e ae mai i kēia maʻi ma mua o nā keikikāne.
2. Hereditary succession. Oiai na hihia o kaʻohana maʻi i loa pohihihi keia.
3. Pili ana i ka Negroid heihei. I waena o kēiaʻano o ka heluna kanaka maʻi ia lŘlŘ i loko o 2 manawa hou aku pinepine.

Ma mau, ka mea e e kaulana ia pela a hiki i i hoʻokumu i ka kiko'ī kumu o ka hooulu ana o Wilms 'ʻeho.

nephroblastoma lapaʻau

E like me ka rula, hiki ke hele lapaau ana i kekahi maʻi, mai kekahi pana pua. I ka loaʻa Wilmsʻeho ma keiki, ua haawiia lapaau ma ka hopena o histological ninaninau. Poe akamai i manaʻo i ka histology maikai haawi i ka oi maikaʻi prognosis. Akā, i kēia aʻole i manaʻo 'ia heʻino paha kālailai lawelawe like me ka hōʻailona, e hooki i ka iapaau ana.

Inā mākou e kamailio e pili ana i nephroblastoma, e hoʻohana i ke kēia mau kiʻina hana i ka hana ia.

• ʻoki kino;
• radiotherapy.

Kekahi haawi ana maikaʻi hualoaʻa chemotherapy no Wilms 'ʻeho.

Nā kaʻa mokulele o ka lapaʻau ua koho pākahi no kēlā wahi a 'Isaaka. Ia e hilinaʻi i wale ma ke kahua o kaʻeho? Acaeoey, akā, no hoi ma ke keiki ka kino kulana.

ʻoki lāʻau lapaʻau 'uao

No kona wehe 'ana o nā puʻupaʻa - Ua nefroektomiya. Ua mea no kekahi mau 'ano:

1. Simple. Ma keia hihia, ke surgeon i ka hana pono e lawe aku oe i ka loli ana o hakuʻala. Inā ka lua o ke kino, ua ola, a laila ka mea, e pono e holopono ana "i mau".
2. Hapa nefroektomiya. Iloko o keiaʻoki kino, i ke kauka e lawe aku oe wale ka cancerousʻeho i loko o ka hakuʻala, a puni'aʻaʻa poho. Loa pinepine ia manipulation i e pana aku au i ina o ka lua o ka hakuʻala, ua wehe 'ia ai ua maʻi.
3. 'ano'ē wehe 'ana. Ua hopuʻAʻole wale i ka hakuʻala a hiki i ka puni hale, akā, i ka ureter, ka adrenal gland. Lymph aka wahi e wehe hoi i ina ka mea, aia no iloko olaila e loaʻa Ka maʻi 'aʻai keena.

Iloko o ka hana hiki mau loaʻa i ka puni'aʻaʻa ua poino, a laila ka mea i pono, e kālele ana ma luna o ka pilikia, a, e wehe i mea hoʻohaumia. I loa hoopii, ka wā nephroblastoma (Wilms 'ʻeho) e loli ai nā puʻupaʻa ma ke keiki, ia mea pono, e hoola i ke ola o ke keiki, e wehe i na kino elua.

Ma hopeʻeluaʻaoʻao nephrectomy keiki hoakaka dialysis e hoomaemae i ke koko o toxins. E ola ma hope o kona wehe 'ia o nā puʻupaʻa hiki e piha wale ma hope transplants o ka hui, mai ka mau pou, i mea nō paʻakikī e loaʻa. Mau hoʻomanawanui iki mai i kekahi manawa no ka makahiki i loko o ka lālani no ka transplant.

Ma hope oʻoki kino, e lawe aku i konaʻeho ua hoouna no Ka Ikepili, e nana i ka specificity o Ka maʻi 'aʻai keena, kā lākou aggressiveness, uku o ka'ōlelo. He mea pono e koho i ka loa ka hoʻokō papa o ka chemotherapy.

Chemotherapy ma ka iapaau ana o ka nephroblastoma

Inā kaʻeho mea i hiki ke wehe i ka iapaau ana ua hoemi ia i nā ki ina hana like e like me ka hoʻohana o chemotherapy.

I loko o kēia hana i hoakakaia chemotherapy ai ', a he hoʻonui ai i ka make ana o ka maʻi' aʻai keena. Ma lapaʻau hana, o ka loa pinepine hoakaka no keia mea:

• "Vincristine".
• "Dactinomycin".
• "Doxorubicin".

Oia lapaʻau Ua paʻakikī no ka meaola, nā loli ana i loko o ka hana ana i na mea he nui kūloko ma nā loko, no kekahi laʻana:

• meaʻehaʻeha kaʻina hana o ka hematopoiesis;
• poino lauoho follicles, a me keia ua kauoha ae ka lauoho kahe i chemotherapy;
• ae aku gastrointestinal aeee i hoʻonāukiukiʻana mai o ka lilo o ka ikaika loa ka makemake, ka luaʻi, nausea;
• hoemiia e hoʻonele i hana i ke kino nui susceptible i nā mea palahēhē.

I nā mākua e ma mua o ka loaa ana chemotherapy ai ', e noi aku i kou kauka e pili ana i hiki' oleʻaoʻao, a, e lawe i ka mea ana e kākoʻo kino i ke keiki ka.

Inā he keiki ua puʻe wale akula kēlā, e koho i kekahi kiʻekiʻe-mahele lāʻau lāʻau, e ao aku i ka kauka oe i keia e i ka luku ana o ka iwi lolo keena, a kaumaha aku iā lākou i ka pa ahau. Ma hope o lapaʻau ka mea, hiki ke thawed, a hahao i loko o ke kino pēpē, e hoʻomaka lākou pololei kuleana no ka? Iecaianoaaiiie o ke koko keena. No ka iwi loloʻeha i chemotherapy, hoihoi hou ia.

pāhawewe Inc

Inā ikaika Wilmsʻeho progresses, lapaʻau ua koi 'ia e nā hou a me ka radiotherapy. Ua Ua hui me ka chemotherapy ina nephroblastoma mea 3-4 kahua o ka hoʻonaʻauao o? Acaeoey. Ka pāhawewe ke Inc kōkua pepehi Ka maʻi 'aʻai aeee i i "pakele" ma ka surgeon iʻoki kino.

I ka manawa o ia ke kaʻina hana, e mea pono ia i ke keiki e moe ana ole, like 'ana ma luna o kaʻeho āpana e kuhikuhi kedera. Inā ka hoʻomanawanui mea uuku loa a me kona immobility e problematic, alaila, o ka hana mua ka mea, ua lawelawe iho la no he uuku mahele lāʻau o ke kiaha dala.

Irradiation pono kaʻaeʻana i kūlike loa koi. Ka wahi ma luna o ka mea e e hoouna kukuna, 'ae' ia me ka kalameaʻai. A pau e pono ole haule i loko o ka irradiation ciia ua uhiia e kuikawa pale kaua.

All kaiapuni, naʻe, 'aʻole e mālama aku i kaʻaoʻao waiwai i laila, e ala mai oe:

• nausea;
• nawaliwali;
• ili ae hookaawale i ke kahua o ka irradiation;
• diarrhea.

Ke kahuna lapaau e pono e koho ai 'e kōkua i ka hoʻomanawanui ka ana, a me kaʻaoʻao waiwai e e wehe.

Inc e like me ke kahua o ka maʻi

No kekahi maʻi lapaau ua mau wae pākahi. He mea oi loa aku hoi oiaio na keiki. Wilmsʻeho kekahi pono akahele Ka Ikepili a me ka koho ana i kūpono therapies. Ua lawe i loko no o ka kahua o ka maʻi,ʻaʻole wale nō e ulu ai, akā, i ka makahiki o ke keiki, o kona ano, ka oi aku i ke kino.

1. Ka mua a me ka lua o ka kahua o kaʻeho? Acaeoey ka wā i ke kaʻina komo ai hoʻokahi wale hakuʻala Ka maʻi 'aʻai keena, a mai ole oko aggressiveness, lapaau ana komo ai i ka wehe' ia o ka maikaʻiʻole ia ma hui, a mahope chemotherapy. Oe i Pono hou a me ka radiotherapy.
2. 3 a me 4 nephroblastoma ke kahua kauoha he okoa kokoke loa i kahi. Kaʻeho kŰlń ao ma kēlāʻaoʻao o ka hakuʻala, no laila ia mea ole hou i hiki ke wehe i ole hitting i ka pili nā loko. Ma keia hihia i hoʻokohu 'ia i kaʻoki lāʻau lapaʻau ana o kaʻeho, hahai ma chemotherapy a me ka irradiation.
3. Ke kahua me 5 Ua wehewehe aku ma keʻano o ka maʻi i loko o nā puʻupaʻa. E lawe mai i ka hapaʻeho pōpilikia 'ana, a pela pili i ke kokoke lymph aka wahi. Ma hope o ka hana, lawe mai i ka papa o ka pāhawewe a me ka chemotherapy. Inā 'oe i ke wehe nā puʻupaʻa, ke hoʻomanawanui hiki ke dialyzed, a laila' oe makemake e transplant ola nā loko.

Keiki i nā mea a pau okoa, a me kēlā kanaka naoh o ka meaola i kaʻeho Inc. Mua iʻaelike ai i ka lapaʻau kumumanao, na makua pono a pau i nā nīnūnē kūkākūkā me ke kauka. Ka mea, Pono, e ike i ka hookoia ai 'i ma luna o ke kino, pehea e pale aku ai mitigate i kaʻaoʻao waiwai i lapaau.

lapaʻau e hookolokolo ai

Kela a me keia makahiki, he mea hou 'ana i kūpono a me epekema no ka iapaau ana o kekahi mau maʻi. He oi loa oiaio no ka maʻi 'aʻai like pono me ka palaho, mai ia mea kiʻekiʻe.

Ma na aina, nā mākua,ʻaʻole wale akā, na keiki ke lawe i kuleana i loko o lapaʻau hookolokolo o hou ohe. No ka pehu ana Wilms. I nā mākua ke noi aku i ke kauka, ina e lawe mai ia e ho'āʻo ai ma ko makou aina, he mea ka manawa e komo 'ana i loko o ia mau mea.

Inā ka pahiki mea ma laila, i ke kauka e haawi piha 'ike ma luna o ka maluhia o ka nohoʻana. Ua mea waiwai 'ana i kumumanaʻo mea pinepine komo i loko o ka mana ho'āʻo ma haawi he keu paha i loko o ke kaua ana i ka maʻi.

Akā, ke kauka pono i ao aku e pili ana i ka mea i loko o ka papa o ka iapaau ana i i unpredictableʻaoʻao 'ole i i ole hui mua, e like me 100% hoolaia ole i kekahi ke ole kumu hoʻomalu.

relapse

Ia mea nui,ʻaʻole wale e Makuakane i ka maʻi, akā, no hoi, e hōʻoia 'ia ka mea, i ole i kekahi relapse. Eia naʻe, i kēia hana e nephroblastoma nā i lapaau, a ma hope o ia. Lawelawe kālailai, a ina ka mea, ua kupono, a laila, hāʻawi aku eiiet noaia chemotherapeutic ai ':

• "Vincristine".
• "Doxorubicin".
• "Cyclophosphamide" ma ka hui pu ana, me ka "dactinomycin" a me "ifosfamide".
• "Carboplatin".

Kēlā me kēia hihia mea okoa, a ma ka hihia o kekahi hoʻomanawanui iki mai relapse lawelawe i ka kiʻekiʻe mahele lāʻau o ka chemotherapy, ukali ma anei i aeea transplantation ke koko. Best o nā mea a pau o ke kanawai, ina ua hui pu ihoʻoki kino me ka radiotherapy a me ka polychemotherapy.

Wilms 'ʻeho mea he mōʻaukala o ka wahine hapai

Nā puʻupaʻa i loko o ke kanaka kino, e hana i kekahi o na kumu nui mana - koko maʻemaʻe o toxins a me metabolic huahana. Ma hāpai keiki, ka mea, e lawe papalua no hoi lakou kuleana ole wale no ke ano o ka makuwahine, akā, no hoi no ke ola o ka mea hou, ulu meaola.

Inā ka expectant makuahine akaaka maluʻoki kino no ka hakuʻala hoopau loa ma mua hāpai keiki, o ka prognosis hiki ia he pono. He nui na wahine ana e lawe i ka hāpai keiki, a hanau i ola na keiki.

Akā, he mau hewa, ma o ka hou moku'āina ke kāhea i ka relapse. A laila 'oe i ka abortion, e hoola i ka wahine o ka ola.

I kekahi manawa, ua hoano e ia ma kamaliʻi Wilms 'ʻeho e hoʻonāukiuki aku i ka ulu ana o ka pyelonephritis, e like me ka mea hiki ke loli ka iaea ooieoeiiaeuiiai kūpono' ana o ke fetus. E hoʻowahāwahā i ka mea i ka hapanui o nā 'ano hope o ka hāpai keiki, i ka pilikia o ka metastasis a me sohraniyaetsya 10-20 makahiki ma hope o hakuʻala pōpilikia' ana.

Ke prognosis no nā mea maʻi me ka nephroblastoma

E haawi aku i kekahi mau 'kēla i loko o ke alo o Wilms'ʻeho, ia mea pono i ka manaʻo kona nui, kahua o ka? Acaeoey a me histological Ka Ikepili. Ke loa lakou malaila o ke alo aku o kaʻeho oi ma mua o 500 g. A me 3-4 kahua o ka? Acaeoey me ka poe ilihune histology.

Inā i hoakaka ia noniakahi kaapuni e pono Inc, i ka hoʻomanawanui ola i kela mea ma kahi o 60%. Ma nā kahua o ka hoʻonaʻauao loiloi mua o kaʻeho mea amenable i oi ka hoʻokō lapaʻau, loaa ia lŘlŘ i loko o 80-90% o kanaka.

Ua haawiia i ka mea kūikawā ana o Kāohiʻana o ka maʻi hakuʻole, a laila, ua hiki wale waiho aku undergo regular nana, ina he keiki mea ma kamepiula. I ka mua heʻeho ua loaʻa, i ka maikaʻi o ka manawa o ke ola.