Umdlavuza wesisu unesigameko esikhulu kunazo zonke kuzo zonke izimila zokugaya ukudla emhlabeni jikelele.Nokho, kuyisimo esigwemeka futhi esingelapheka.Ngokuphila impilo enempilo, ukuyohlolwa njalo, nokufuna ukuxilongwa kusenesikhathi nokwelashwa, singalwa ngempumelelo nalesi sifo.Manje ake sikunikeze izincazelo zemibuzo eyisishiyagalolunye ebalulekile ukuze sikusize uqonde kangcono umdlavuza wesisu.
1. Ingabe umdlavuza wesisu uyahluka ngokohlanga, isifunda, nobudala?
Ngokwemininingwane yakamuva yomdlavuza womhlaba wonke ngonyaka ka-2020, iChina ibike cishe abantu abayizigidi ezingama-4.57 abantu abasha abanomdlavuza, okubalwa nomdlavuza wesisu.cishe amacala angu-480,000, noma u-10.8%, akleliswe phakathi kwamathathu aphezulu.Umdlavuza wesisu ukhombisa ukuhluka okucacile ngokobuhlanga kanye nesifunda.Isifunda sase-East Asia siyindawo esengozini enkulu yomdlavuza wesisu, kanti iChina, iJapan, neSouth Korea ibalwa cishe ngama-70% wamacala aphelele emhlabeni jikelele.Lokhu kubangelwa izici ezifana nezakhi zofuzo, ukusetshenziswa kokudla okugazingiwe nokufakwe emanzini anosawoti, namazinga aphezulu okubhema endaweni.Ezweni laseShayina, umdlavuza wesisu udlangile ezindaweni ezisogwini ezinosawoti omningi, kanye nendawo emaphakathi nephansi yoMfula i-Yangtze kanye nezindawo ezimpofu kakhulu.
Ngokweminyaka yobudala, isilinganiso sokuqala somdlavuza wesisu siphakathi kweminyaka engama-55 nengama-60 ubudala.Kule minyaka eyishumi edlule, izinga lokutholakala komdlavuza wesisu eChina lisalokhu lizinzile, nokwenyuka kancane.Nokho, izinga lokwenzeka kwentsha liye lenyuka ngesivinini, lidlula isilinganiso sikazwelonke.Ukwengeza, lezi zimo zivame ukutholakala njengomdlavuza wesisu osabalele, oletha izinselele zokwelashwa.
2. Ingabe umdlavuza wesisu unezilonda eziyingozi?Yiziphi izimpawu eziyinhloko?
Ama-polyps esiswini, i-atrophic gastritis engapheli, kanye nesisu esisele yizici ezisengozini enkulu yomdlavuza wesisu.Ukuthuthukiswa komdlavuza wesisu kuyinqubo ye-multifactorial, multilevel, ne-multistage.Ezigabeni zokuqala zomdlavuza wesisu,iziguli ngokuvamile azibonisi izimpawu ezisobala, noma zingase zibe nokungakhululeki okuncane engxenyeni engenhla yesisu,ubuhlungu be-atypical obuphezulu besisu, ukungakuthandi ukudla, ukuqunjelwa, ukuqunjelwa, futhi kwezinye izimo, indle emnyama noma ukuhlanza igazi.Lapho izimpawu ziba sobala kakhulu,okubonisa phakathi nezigaba eziphambili zomdlavuza wesisu, iziguli zingase zibe nokuncipha kwesisindo okungachazeki, i-anemia,hypoalbuminemia (amazinga aphansi amaprotheni egazini)i-edema,ubuhlungu besisu obuphikelelayo, ukuhlanza igazi, kanyeindle emnyama, phakathi kwabanye.
3. Abantu abasengozini enkulu yomdlavuza wesisu bangabonwa kanjani kusenesikhathi?
Umlando womndeni wamathumba: Uma kunezimo zezimila zesistimu yokugaya noma ezinye izimila ezizukulwaneni ezimbili noma ezintathu zezihlobo, amathuba okuba nomdlavuza wesisu aphezulu.Indlela enconyiwe iwukuhlolelwa isimila okuchwepheshile okungenani eminyakeni eyi-10-15 ngaphambi kweminyaka encane kunawo wonke yanoma yiliphi ilungu lomndeni elinomdlavuza.Ngomdlavuza wesisu, ukuhlolwa kwe-gastroscopy kufanele kwenziwe njalo eminyakeni emithathu, njengoba kululekwa udokotela.Isibonelo, uma iminyaka encane yelungu lomndeni elinomdlavuza ineminyaka engu-55 ubudala, ukuhlolwa kokuqala kwe-gastroscopy kufanele kwenziwe eneminyaka engu-40.
Abantu abanomlando omude wokubhema, ukuphuza utshwala, ukuthanda ukudla okushisayo, okufakwe emanzini anosawoti nokudla okuthosiwe, kanye nokudla okunosawoti omningi kufanele balungise ngokushesha le mikhuba engemihle, ngoba ingabangela umonakalo omkhulu esiswini.
Iziguli ezinezilonda esiswini, i-gastritis engapheli, nezinye izifo zesisu kufanele zikhuthale zifune ukwelashwa ukuze zigweme ukuqhubeka kwesifo futhi zihlolwe njalo esibhedlela.
4. Ingabe i-gastritis engapheli kanye nezilonda zesisu zingaholela kumdlavuza wesisu?
Ezinye izifo zesisu ziyizici ezisengozini enkulu yomdlavuza wesisu futhi kufanele zithathwe ngokungathí sina.Nokho, ukuba nezifo zesisu akusho ukuthi umuntu uzoba nomdlavuza wesisu.Izilonda zesisu zihlotshaniswa ngokucacile nengozi eyengeziwe yokuba nomdlavuza.I-gastritis ehlala isikhathi eside futhi enzima, ikakhulukazi uma ibonisa izimpawu ze-atrophy, i-metaplasia yamathumbu, noma i-atypical hyperplasia, idinga ukuqapha okuseduze.Kubalulekile ukuyeka ngokushesha imikhuba engemihle njengeukuma ukubhema, ukunciphisa ukuphuza utshwala, futhi ugweme ukudla okuthosiwe nokudla okunosawoti omningi.Ukwengeza, kuyalulekwa ukuthi kube nokuhlolwa njalo ngonyaka nochwepheshe wezifo zesisu ukuze ahlole isimo esithile futhi acabangele izincomo ezifana ne-gastroscopy noma imithi.
5. Ingabe bukhona ubuhlobo phakathi kwe-Helicobacter pylori nomdlavuza wesisu?
I-Helicobacter pylori igciwane elivame ukutholakala esiswini, futhi lihlotshaniswa nohlobo oluthile lomdlavuza wesisu.Uma umuntu ehlolwa ukuthi une-Helicobacter pylori futhi enezifo ezingapheli zesisu njenge-gastritis engapheli noma izilonda zesisu, amathuba okuba nomdlavuza wesisu ayanda.Ukufuna ukwelashwa okufika ngesikhathi kubalulekile ezimweni ezinjalo.Ngokungeziwe kumuntu othintekile othola ukwelashwa, amalungu omndeni kufanele futhi ahlolwe futhi acabangele ukwelashwa okuvunyelanisiwe uma kunesidingo.
6. Ingabe ikhona enye indlela ebuhlungu kakhulu kune-gastroscopy?
Ngempela, ukwenza i-gastroscopy ngaphandle kwezinyathelo zokunciphisa ubuhlungu kungase kungakhululeki.Kodwa-ke, uma kuziwa ekutholeni umdlavuza wesisu wesigaba sokuqala, i-gastroscopy njengamanje iyindlela ephumelela kakhulu.Ezinye izindlela zokuxilonga zingase zingawuboni umdlavuza wesisu kusenesikhathi, okungaba nomthelela omkhulu emathubeni okwelashwa ngempumelelo.
Inzuzo ye-gastroscopy ukuthi ivumela odokotela ukuba babone ngeso lengqondo isisu ngokuqondile ngokufaka ithubhu elincanyana, eliguquguqukayo nge-esophagus nokusebenzisa i-probe encane efana nekhamera.Lokhu kubenza bakwazi ukuba nombono ocacile wesisu futhi bangaphuthelwa noma yiziphi izinguquko ezicashile.Izimpawu zakuqala zomdlavuza wesisu zingase zicashe kakhulu, zifane nesiqephu esincane esisesandleni sethu esingase singasinaki, kodwa kungase kube noshintsho oluncane embala wolwelwesi lwesisu.Nakuba ama-CT scans nama-ejenti wokuqhathanisa angakwazi ukuhlonza okuthile okungavamile okukhulu kwesisu, angase angathathi izinguquko ezinjalo ezicashile.Ngakho-ke, kulabo abanconywa ukuba benze i-gastroscopy, kubalulekile ukungangabazi.
7. Ithini indinganiso yegolide yokuxilongwa komdlavuza wesisu?
I-Gastroscopy kanye ne-pathological biopsy iyindinganiso yegolide yokuxilonga umdlavuza wesisu.Lokhu kunikeza ukuxilongwa kwekhwalithi, okulandelwa yisiteji.Ukuhlinzwa, ukwelapha ngemisebe, i-chemotherapy, nokunakekelwa okusekelayo kuyizindlela eziyinhloko zokwelapha umdlavuza wesisu.Ukuhlinzwa kuyindlela yokwelapha eyinhloko yomdlavuza wesisu osaqala, futhi ukwelashwa okuhlanganisa imikhakha eminingi okwamanje kuthathwa njengendlela yokwelapha ethuthuke kakhulu yomdlavuza wesisu.Ngokusekelwe esimweni somzimba wesiguli, ukuqhubekela phambili kwesifo, nezinye izici, ithimba lochwepheshe bemikhakha eminingi ngokubambisana lenza uhlelo lokwelapha lomuntu siqu lwesiguli, oludingeka kakhulu ezigulini ezinezimo eziyinkimbinkimbi.Uma isiteji nokuxilongwa kwesiguli kucacile, ukwelashwa kungenziwa ngokulandela iziqondiso ezifanele zomdlavuza wesisu.
8. Umuntu kufanele afune kanjani usizo lwezokwelapha ngomdlavuza wesisu ngendlela yesayensi?
Ukwelashwa okungekho emthethweni kungase kukhuthaze ukukhula kwamangqamuzana esimila futhi kwandise ubunzima bokwelashwa okulandelayo.Ukuxilongwa kokuqala nokwelashwa kubalulekile ezigulini ezinomdlavuza wesisu, ngakho-ke kubalulekile ukufuna usizo lwezokwelapha emnyangweni okhethekile we-oncology.Ngemva kokuhlolwa okuphelele, udokotela uzohlola isimo sesiguli futhi anikeze izincomo zokwelashwa, okufanele emva kwalokho kuxoxwe nesiguli namalungu omndeni waso ngaphambi kokwenza isinqumo.Iziguli eziningi zizizwa zikhathazekile futhi zifuna ukuxilongwa ngokushesha namuhla nokuhlinzwa kusasa.Abakwazi ukulinda emgqeni wokuhlolwa noma umbhede wasesibhedlela.Kodwa-ke, ukuze uthole ukwelashwa ngokushesha, ukuya ezibhedlela ezingakhethekile nezingezona uchwepheshe ukuze uthole ukwelashwa okungajwayelekile kungase kube yingozi ekulawuleni okulandelayo kwalesi sifo.
Lapho umdlavuza wesisu utholwa, ngokuvamile uye waba khona isikhathi esithile.Ngaphandle uma kunezinkinga ezinzima ezifana nokubhoboza, ukopha, noma ukuvinjelwa, asikho isidingo sokukhathazeka ngokuthi ukubambezeleka kokuhlinzwa ngokushesha kuzosheshisa ukukhula kwesimila.Eqinisweni, ukuvumela isikhathi esanele sokuba odokotela basiqonde kahle isimo sesiguli, bahlole ukubekezelelana kwaso ngokomzimba, futhi bahlaziye izici zesimila kubalulekile ukuze kube nemiphumela engcono yokwelashwa.
9. Kufanele siyibheke kanjani inkulumo ethi “ingxenye eyodwa kwezintathu yeziguli yesaba ukufa”?
Lesi sitatimende sinehaba ngokweqile.Eqinisweni, umdlavuza awusabisi ngendlela esingase sicabange ngayo.Abantu abaningi baphila nomdlavuza futhi baphila ukuphila okwanelisayo.Ngemva kokuxilongwa komdlavuza, kubalulekile ukulungisa isimo sengqondo somuntu futhi uhlanganyele ekukhulumisaneni okuhle neziguli ezinethemba.Kubantu abasesigabeni sokululama ngemva kokwelashwa komdlavuza wesisu, amalungu omndeni kanye nozakwabo akufanele babaphathe njengezidalwa ezibuthakathaka, babavimbele ekwenzeni noma yini.Le ndlela yokwenza iziguli zizwe sengathi ukubaluleka kwazo akubonakali.
Izinga lokwelapha umdlavuza wesisu
Izinga lokwelapha umdlavuza wesisu e-China lilinganiselwa ku-30%, elingekho kakhulu eliphansi uma liqhathaniswa nezinye izinhlobo zomdlavuza.Ngomdlavuza wesisu osanda kuqala, izinga lokwelapha ngokuvamile libalelwa ku-80% kuya ku-90%.Esigabeni II, ngokuvamile sicishe sibe ngu-70% kuya ku-80%.Kodwa-ke, ngesigaba III, esithathwa njengesithuthukisiwe, izinga lokwelapha lehla lifinyelele cishe ku-30%, futhi esigabeni IV, lingaphansi kuka-10%.
Ngokuya ngendawo, umdlavuza wesisu we-distal unezinga eliphezulu lokwelapha uma uqhathaniswa nomdlavuza wesisu oseduze.Umdlavuza wesisu esikude ubhekisela kumdlavuza oseduze ne-pylorus, kanti umdlavuza wesisu oseduze ubhekisela kumdlavuza oseduze nenhliziyo noma umzimba wesisu.I-signet ring cell carcinoma inzima kakhulu ukuyibona futhi ijwayele ukumetastase, okuholela ekwelapheni okuphansi.
Ngakho-ke, kubalulekile ukunaka noma yiziphi izinguquko emzimbeni womuntu, ahlolwe njalo udokotela, futhi afune usizo lwezokwelapha ngokushesha uma ehlushwa ukungakhululeki okungapheli kwesisu.Uma kunesidingo, i-gastroscopy kufanele yenziwe.Iziguli eziye zathola ukwelashwa kwe-endoscopic esikhathini esidlule kufanele futhi zibe nokuqokwa kokulandelela njalo nochwepheshe besisu futhi zihambisane neseluleko sezokwelapha sokuhlolwa kwe-gastroscopy ngezikhathi ezithile.
Isikhathi sokuthumela: Aug-10-2023