ʻO nā mea āpau āu e ʻike ai e pili ana i ka Tumor Lysis Syndrome

Anter

• He aha ka maʻi tumo lysis?
• He aha nā hōʻailona?
• No ke aha e hiki ai?
• Aia kekahi kumu pilikia?
• Pehea ia ʻike?
• Pehea e mālama ʻia ai?
• Hiki ke pale ʻia?
• He aha ke kuanaʻike?

He aha ka maʻi tumo lysis?

ʻO ka pahuhopu o ka mālama ʻana i ka maʻi ʻaʻai e luku i nā tumors. Ke wāwahi wikiwiki loa nā maʻi ʻōpū, e hana ikaika loa kou puʻupaʻa e hemo i nā mea āpau i loko o kēlā mau tumors. Inā hiki ʻole iā lākou ke mālama, hiki iā ʻoe ke hoʻomohala i kahi mea i kapa ʻia ʻo tumor lysis syndrome (TLS).

ʻO kēia maʻi ka mea maʻamau i nā poʻe me nā maʻi ʻaʻaʻa pili i ke koko, e like me kekahi mau leukemias a me nā lymphomas. Hana ʻia ia i loko o kekahi mau hola i kekahi mau lā ma hope o ka mālama mua ʻana i ka chemotherapy.

He mea maʻamau ʻole ʻo TLS, akā hiki ke lilo koke i mea hoʻoweliweli i ke ola. He mea nui ia e ʻike pehea e ʻike ai iā ia i hiki ai iā ʻoe ke ʻimi koke i ka lāʻau.

He aha nā hōʻailona?

Hoʻonui ka TLS i nā nui o nā mea i loko o kou koko, i hiki ke kumu i kahi o nā hōʻailona.

Hoʻopili kēia mau mea i:

• Pāpaʻakai. Hiki i nā pae potassium kiʻekiʻe ke alakaʻi i nā hoʻololi neurological a me nā pilikia o ka puʻuwai.
• ʻAkika Uric. Hiki ke hoʻonui ʻia ka uric acid (hyperuricemia) i nā pōhaku hakuʻala a me nā hōʻino puʻupaʻa. Hiki iā ʻoe ke hoʻomohala i nā waihona waikiki uric i loko o kou mau ami, kahi e ʻeha ai kahi ʻano ʻeha e like me ka gout.
• Phosphate. Hiki i kahi buildup o phosphate ke alakaʻi i ka maikaʻi ʻole o ka hakuʻala.
• Kalipuna. Hiki i ka nui o ka phosphate ke waiho i nā pae calcium e hāʻule i lalo, a hiki i ka hopena ʻole o ka puʻupaʻa.

ʻOiai he maʻa mau nā ʻōuli o TLS i ka hoʻomaka, ke kūkulu ʻia nā mea i loko o kou koko, ʻike paha ʻoe:

• hoʻomaha ʻole, huhū
• nawaliwali, luhi
• numbness, ʻūlū
• nausea, luaʻi
• pāhoehoe
• ʻūpē mākala
• ʻeha pū
• hoʻemi i ka urination, mimi ʻōpua

Inā haʻalele ʻole ʻia, hiki i ka TLS ke alakaʻi i nā ʻōuli ʻoi aku ka nui, e like me:

• ka nalowale ʻana o ke kaohi mākala
• arrhythmia puʻuwai
• ka hopu ʻana
• hallucination, delirium

No ke aha e hiki ai?

ʻOiai ʻo TLS i kekahi manawa e hana ʻia e kāna iho ma mua o ka mālama ʻana i ka maʻi ʻaʻai., Kākaʻikahi loa kēia. I ka hapanui o nā hihia, hiki koke ia ma hope o ka hoʻomaka ʻana o ka chemotherapy.

Hoʻopili ka Chemotherapy i nā lāʻau i hoʻolālā ʻia e hoʻouka i nā tumors. I ka wā e haki ai nā tumors, hoʻokuʻu lākou i kā lākou mea i loko o ke kahe o ke koko. ʻO ka hapanui o ka manawa, hiki i kāu mau puʻupaʻa ke kānana i kēia mau mea me ka pilikia ʻole.

Eia nō naʻe, i kekahi manawa e haki wikiwiki nā tumors ma mua o ka hiki i kāu mau puʻupaʻa ke mālama. Hoʻonui kēia i kāu mau puʻupaʻa e kānana i nā ʻike o ka tumo mai kou koko.

ʻO ka hapanui o ka manawa, hiki koke kēia ma hope o kāu hoʻomaʻamaʻa chemotherapy mua, ke luku ʻia kahi nui o nā hunaola maʻi maʻi i kahi manawa pōkole loa. Hiki iā ia ke hana ma hope ma ka lapaʻau.

Ma waho aʻe o ka chemotherapy, pili pū ʻo TLS i:

• lāʻau pāhawewe
• lāʻau hoʻoikaika kino
• hoʻolaʻa olaola
• hoʻōla kino

Aia kekahi kumu pilikia?

Nui a hewahewa nā mea i hiki ke hoʻonui i kou makaʻu i ka hoʻomohala ʻana i ka TLS, me ke ʻano o ka maʻi ʻaʻai āu. Hoʻohui pū ʻia nā kanesa me TLS.

• maʻi leukemia
• lymphoma non-Hodgkin
• myeloproliferative neoplasms, e like me myelofibrosis
• blastomas i ke akepaʻa a i ʻole ka lolo
• nā maʻi 'aʻai e pili i ka hana o ka hakuʻala ma mua o ka mālama

ʻO nā kumu pilikia ʻē aʻe e pili pū me:

• nui tumo nui
• hana ʻiʻo maikaʻi ʻole
• nā tumors e ulu wikiwiki ana
• kekahi mau lāʻau chemotherapy, e like me cisplatin, cytarabine, etoposide, a me paclitaxel

Pehea ia ʻike?

Inā ʻoe e hana ana i ka chemotherapy a loaʻa i nā mea pilikia no TLS, e hana kāu kauka i nā hoʻokolohua koko a me ka mimi maʻamau i nā hola 24 ma hope koke o kāu lapaʻau mua. ʻAe kēia iā lākou e nānā no nā hōʻailona ke kānana ʻole nei kāu mau puʻupaʻa i nā mea āpau.

ʻO nā ʻano o nā hoʻokolohua a lākou e hoʻohana ai:

• nitrogen urea koko
• kalipuna
• helu piha piha o ke koko
• hakuʻala
• lactate dehydrogenase
• pākuʻi
• electrolytes serum
• ʻākika urika

Hiki i ʻelua mau pae hoʻohālikelike ke hiki i nā kauka ke hoʻohana e kuhikuhi i nā TLS:

• Nā pae hoʻohālikelike o Cairo-Bishop. Pono e hōʻike i nā hoʻokolohua koko ma ka liʻiliʻi he 25 pakeneka e hoʻonui i nā pae o kekahi mau mea.
• Nā pae hoʻohālikelike ʻo Howard. Pono e hōʻike i nā hopena Laboratory i ʻelua a ʻoi paha mau ana ʻokoʻa ma waena o 24 mau hola.

Pehea e mālama ʻia ai?

E mālama iā TLS, e hoʻomaka paha kāu kauka ma ka hāʻawi ʻana iā ʻoe i kahi wai hoʻoheheʻe (IV) i ka nānā ʻana i ka pinepine o kou mimi. Inā ʻaʻole ʻoe e hana i ka mimi lawa, hāʻawi paha kāu kauka iā ʻoe i nā diuretics.

ʻO nā lāʻau ʻē aʻe āu e pono ai:

• allopurinol (Aloprim, Lopurin, Zyloprim) e hoʻokū i kou kino mai ka hana ʻana i ka uric acid
• rasburicase (Elitek, Fasturtec) e wāwahi i ka waikawa uric
• sodium bicarbonate a acetazolamide (Diamox Sequels) e pale aku i ka uric acid mai ka hana ʻana i nā aniani.

Aia kekahi ʻano hou aʻe o nā lāʻau i hiki ke kōkua pū kekahi.

• nā mea hoʻopale kinase waha, e like me ibrutinib (Imbruvica) a me idelalisib (Zydelig)
• B-cell lymphoma-2 protein protein, e like me venetoclax (Venclexta)

Inā kōkua ʻole nā ​​wai a me nā lāʻau lapaʻau a i ʻole hoʻomau ka hana ʻana o kāu hakuʻala, pono paha ʻoe i ka dialysis kidney. ʻO kēia kahi ʻano lapaʻau e kōkua ana e hemo i nā ʻōpala, me ia hoʻi mai nā tumors i luku ʻia, mai kou koko.

Hiki ke pale ʻia?

ʻAʻole nā ​​poʻe āpau e hana ana i ka chemotherapy e hoʻomohala iā TLS. Hoʻohui ʻia, ua ʻike maopopo nā kauka i nā mea pilikia weliweli a ʻike maʻamau ka mea i ʻoi aku ka nui o ka pilikia.

Inā loaʻa iā ʻoe kekahi o nā kumu pilikia, hoʻoholo paha kāu kauka e hoʻomaka i ka hāʻawi ʻana iā ʻoe i nā wai IV ʻelua mau lā ma mua o kāu hoʻomaʻemaʻe chemotherapy mua. E nānā lākou i kāu puka mimi ma nā lā ʻelua e hiki mai ana a hāʻawi iā ʻoe i diuretic inā ʻaʻole lawa kāu hana.

Hiki iā ʻoe ke hoʻomaka i ka lawe ʻana i ka allopurinol i ka manawa like e pale ai i kou kino mai ka hana ʻana i ka waikawa uric.

Hiki ke hoʻomau i kēia mau ana no ʻelua a ʻekolu paha mau lā ma hope o ke kau ʻana o ka chemotherapy, akā e hoʻomau paha kāu kauka i ka nānā ʻana i kou koko a me ka mimi ma ke koena o kāu lapaʻau.

He aha ke kuanaʻike?

He haʻahaʻa ka pilikia āpau o ka hoʻomohala ʻana iā TLS. Eia nō naʻe, ke hoʻomohala ka poʻe iā ia, hiki ke kumu i nā pilikia koʻikoʻi, me ka make. Inā hoʻomaka ʻoe e hoʻomaka i ka mālama ʻana i ka maʻi ʻaʻai, e nīnau e pili ana i kāu mau pilikia ʻo TLS a inā paha e koi aku kāu kauka i kahi lāʻau pale.

Pono ʻoe e ʻike pono ke ʻike nei ʻoe i nā hōʻailona āpau i hiki iā ʻoe ke hoʻomaka i ka mālama ʻana ke hoʻomaka ʻoe e ʻike iā lākou.