Khansa ya pleura ndi chotupa choopsa chomwe chili mu nembanemba chomwe chimazungulira mapapo. Khansara imeneyi imayamba makamaka chifukwa chokhala ndi asibesitosi kwa nthawi yaitali, zinthu zimene zinkagwiritsidwa ntchito kwambiri asanaletsedwe ku France mu 1997 chifukwa cha kuopsa kwa thanzi lake.

Tanthauzo la khansa ya pleural

Mwa kutanthauzira, khansa ya pleura ndi chotupa choopsa mu pleura. Chomalizacho chimatengedwa kuti ndi envelopu ya m'mapapo. Amapangidwa ndi mapepala awiri: mawonekedwe a visceral omwe amamatira kumapapu ndi parietal wosanjikiza khoma la pachifuwa. Pakati pa mapepala awiriwa, timapeza pleural fluid yomwe imapangitsa kuti zikhale zotheka makamaka kuchepetsa kukangana chifukwa cha kayendedwe ka kupuma.

Zifukwa za khansa ya pleural

Pali milandu iwiri:

• khansa yoyamba ya pleura, kapena malignant pleural mesothelioma, amene chitukuko cha khansa amayamba mu pleura;
• khansa yachiwiri ya pleura, kapena pleural metastases, yomwe imabwera chifukwa cha kufalikira kwa khansa yomwe yayamba kudera lina la thupi monga khansa ya bronchopulmonary kapena khansa ya m'mawere.

Chochitika chofala kwambiri, khansara yoyamba ya pleura nthawi zambiri imakhala chifukwa chokhala ndi asibesitosi kwa nthawi yayitali. Monga chikumbutso, asibesitosi ndi zinthu zomwe kugwiritsidwa ntchito kwake ndikoletsedwa ku France chifukwa cha ngozi zake zaumoyo. Tsopano zasonyezedwa kwambiri kuti kupuma kwa ulusi wa asibesitosi kungayambitse matenda aakulu a kupuma kuphatikizapo khansa ya pleura ndi pulmonary fibrosis (asbestosis).

Oletsedwa lero, asibesitosi akadali vuto lalikulu laumoyo wa anthu. Ndikofunikira kudziwa kuti zovuta za kukhudzana ndi asibesitosi zitha kuwoneka patatha zaka zopitilira 20. Kuphatikiza apo, asibesitosi akadalipo m'nyumba zambiri zomangidwa asanaletsedwe mu 1997.

Anthu okhudzidwa

Anthu omwe ali ndi asibesitosi ali ndi chiopsezo chowonjezereka chokhala ndi khansa ya pleura. Malignant pleural mesothelioma imatengedwa ngati khansa yosowa. Zimayimira zosakwana 1% za khansa zonse zomwe zapezeka. Komabe, zochitika za malignant pleural mesothelioma zakhala zikuchulukirachulukira kuyambira ma 1990s chifukwa chogwiritsa ntchito kwambiri asibesitosi pakati pa 50s ndi 80s. Akatswiri ena amakhudzidwanso ndi kukhudzana ndi zinthu za asibesitosi zochokera kumayiko omwe asibesito saletsedwa, monga Russia ndi China.

Kuzindikira khansa ya pleural

Kuzindikira khansa ya pleura ndizovuta chifukwa zizindikiro zake ndi zofanana ndi matenda ena ambiri. Mayeso angapo angafunike:

• kuyesa kwachipatala kuti azindikire zizindikiro zomwe zingasonyeze khansa ya pleura;
• kuyezetsa ntchito m'mapapo komwe kumathandizira kuzindikira;
• kuwunika kwa mbiri yakale ya asibesitosi;
• X-ray kuti awone momwe pleura alili;
• pleural puncture kusonkhanitsa chitsanzo cha pleural fluid ndikuusanthula;
• pleural puncture-biopsy yomwe imakhala ndi kuchotsa ndi kusanthula kachidutswa ka kapepala kuchokera ku pleura;
• thoracoscopy yomwe imakhala yodula pakati pa nthiti ziwiri kuti athe kuwona pleura pogwiritsa ntchito endoscope (chida chachipatala).

Epanchement pleural

Zotupa za pleura zimatha kusazindikirika kumayambiriro kwa kukula kwawo. Chizindikiro choyamba cha khansa ya pleura ndi pleural effusion, komwe ndi kudzikundikira kwamadzimadzi mumtsempha wa pleural (danga lapakati pa zigawo ziwiri za pleura). Zimadziwonetsera ndi:

• dyspnea, yomwe ndi kupuma movutikira kapena kupuma;
• kupweteka pachifuwa nthawi zina.

Zizindikiro zophatikiza

Khansa ya pleura ingayambitsenso:

• chifuwa chomwe chikukulirakulira kapena kupitilirabe;
• mawu osamveka;
• zovuta kumeza.

Zizindikiro zosadziwika

Khansa ya pleura ingayambitsenso:

• thukuta usiku;
• kuonda kosadziwika.

Kuwongolera khansa ya pleura kumadalira pa siteji ya chitukuko ndi chikhalidwe cha munthu amene akukhudzidwa. Kusankha mankhwala kungaphatikizepo akatswiri osiyanasiyana.

mankhwala amphamvu

Chithandizo chokhazikika cha khansa ya pleura ndi chemotherapy, yomwe ndi kugwiritsa ntchito mankhwala pakamwa kapena jekeseni kupha maselo a khansa.

Radiotherapy

Thandizo la radiation nthawi zina limagwiritsidwa ntchito pochiza khansa yoyambirira komanso / kapena yamtundu wa pleura. Njira imeneyi imaphatikizapo kuyika chotupacho ku cheza champhamvu kwambiri kapena tinthu ting'onoting'ono.

Maopaleshoni ochiritsa

Opaleshoni ya khansa ya pleura imaphatikizapo kuchotsa mbali za minofu. Kuchita opaleshoni kumangoganiziridwa pazifukwa zina.

Njira ziwiri zitha kuganiziridwa:

• pleurectomy, kapena pleurectomy-decortication, yomwe imakhala ndi kuchotsa mbali yofunika kwambiri ya pleura;
• extrapleural pneumonectomy, kapena extra-pleural pleuro-pneumonectomy, yomwe imaphatikizapo kuchotsa pleura, mapapo omwe ali mkati mwake, mbali ya diaphragm, ma lymph nodes ku thorax, ndipo nthawi zina pericardium.

Mankhwala akuphunziridwa

Kafukufuku akupitilira pa chithandizo cha khansa ya pleura ndi njira zodalirika monga immunotherapy. Cholinga chake ndi kubwezeretsa mphamvu ya chitetezo cha mthupi motsutsana ndi maselo a khansa.

Kupewa khansa ya pleura kumaphatikizapo kuchepetsa kukhudzana ndi asibesitosi, makamaka pochotsa asibesitosi ndi kuvala zida zodzitetezera kwa ogwira ntchito omwe ali ndi asibesitosi.