Txhua Yam Koj Yuav Tsum Tau Paub Txog Tumor Lysis Syndrome

Zoo Siab

• Mob lysis mob ntsws yog dab tsi?
• Cov tsos mob zoo li cas?
• Vim li cas nws tshwm sim?
• Puas muaj kev pheej hmoo?
• Nws kuaj tau li cas?
• Yuav kho nws li cas?
• Puas tiv thaiv puas tau?
• Qhov tshwm sim yog dab tsi?

Mob lysis mob ntsws yog dab tsi?

Lub hom phiaj ntawm kev kho mob cancer yog los rhuav tshem qog. Thaum cov qog mob qog noj sai sai, koj ob lub raum yuav tsum sib zog ua haujlwm ntxiv kom tshem tawm txhua yam tshuaj uas nyob hauv cov qog ntawd. Yog tias lawv tsis tuaj yeem ua raws li, koj tuaj yeem tsim qee yam hu ua qog mob syys (lysis syndrome) (TLS).

Tus mob no feem ntau rau cov neeg muaj ntshav qog nqaij hlav, nrog rau qee cov leukemias thiab lymphomas. Feem ntau nws tshwm sim li ntawm ob peb teev mus rau ob peb hnub tom qab siv tshuaj tua kab mob thawj zaug.

TLS tsis tshua muaj tshwm sim, tab sis nws tuaj yeem ua rau muaj kev pheej hmoo sai sai txog lub neej. Nws tseem ceeb heev uas yuav tsum paub kom paub txog nws yog li koj tuaj yeem nrhiav kev kho sai.

Cov tsos mob zoo li cas?

TLS tsub kom ntau ntawm ntau cov tshuaj hauv koj cov ntshav, uas tuaj yeem ua kom muaj ntau ntawm cov tsos mob.

Cov tshuaj no suav nrog:

• Qab Zib. Theem ntau ntawm cov poov tshuaj tuaj yeem ua rau lub paj hlwb hloov pauv thiab mob plawv.
• Uric acid. Ntau cov uric acid (hyperuricemia) yuav ua rau lub raum pob zeb thiab lub raum puas. Koj tseem tuaj yeem txhim kho uric acid tso rau hauv koj cov pob qij txha, uas ua rau kom mob mob zoo li mob ntawm gout.
• Ntsev. Ib txoj kev muab cov phosphate tuaj yeem ua rau lub raum tsis ua haujlwm.
• Tshuaj calcium. Cov ntsev ntau dhau kuj tseem tuaj yeem ua rau cov calcium nyob rau qib qis, uas yuav ua rau lub raum tsis ua haujlwm.

Thaum cov tsos mob ntawm TLS ib txwm me me rau thaum pib, vim cov tshuaj txuam hauv koj cov ntshav, koj yuav muaj:

• nyob tsis tswm, txob taus
• tsis muaj zog, qaug zog
• loog, tingling
• xeev siab, ntuav
• zawv plab
• mob leeg
• mob tej pob txha
• tso zis tsawg dua, tso zis muaj pos huab

Yog tias tsis kho, TLS tuaj yeem ua rau cov tsos mob hnyav ntxiv, suav nrog:

• poob ntawm cov leeg tswj
• mob plawv dhia tsis zoo
• qaug dab peg
• ua kom loog, delirium

Vim li cas nws tshwm sim?

Thaum qee zaum TLS qee zaum tshwm sim nws tus kheej ua ntej kho mob qog noj ntshav, qhov no tsis tshua muaj tshwm sim. Feem ntau, nws tshwm sim sai sai tom qab pib siv tshuaj kho.

Kev siv tshuaj kho mob suav nrog cov tshuaj uas tsim los tua qog. Raws li cov qog hlav ua kom tawg, lawv tso lawv cov ntsiab lus rau hauv cov ntshav. Feem ntau, koj lub raum tuaj yeem lim cov tshuaj no yam tsis muaj teeb meem.

Txawm li cas los xij, qee zaum qog qog yuav nrawm dua li koj lub raum ua tau. Qhov no ua rau nws nyuaj rau koj ob lub raum los lim tawm cov ntsiab lus ntawm cov qog ntshav los ntawm koj cov ntshav.

Feem ntau, qhov no tshwm sim sai sai tom qab koj thawj zaug tshuaj kho mob, thaum ntau ntawm cov qog nqaij hlav cancer raug puas tsuaj hauv lub sijhawm luv luv. Nws kuj tseem tuaj yeem tshwm sim tom qab hauv kev kho mob.

Ntxiv nrog rau kev siv tshuaj kho mob, TLS kuj tseem txuas rau:

• hluav taws xob kho
• kev kho tshuaj hormones
• kev kho mob xyoob ntoo
• kev kho mob corticosteroid

Puas muaj kev pheej hmoo?

Muaj ob peb yam uas tuaj yeem ua kom koj txoj kev pheej hmoo loj ntawm TLS, suav nrog hom mob cancer uas koj muaj. Cov khees xaws uas nquag muaj nrog TLS suav nrog:

• mob leukemia
• tsis-Hodgkin's lymphoma
• myeloproliferative neoplasms, xws li myelofibrosis
• blastomas nyob rau hauv daim siab lossis lub hlwb
• mob qog noj ntshav uas cuam tshuam rau lub raum ua haujlwm ua ntej kho

Lwm qhov kev pheej hmoo txaus ntshai muaj xws li:

• loj qog loj
• lub raum tsis zoo ua haujlwm
• ceev-loj hlav hlav
• qee yam tshuaj khomob siv, suav nrog cisplatin, cytarabine, etoposide, thiab paclitaxel

Nws kuaj tau li cas?

Yog tias koj tab tom kho cov tshuaj khes mis thiab muaj feem ua rau muaj kev pheej hmoo rau TLS, koj tus kws kho mob yuav kuaj ntshav thiab zis hauv 24 teev tam sim tom qab koj kho thawj zaug. Qhov no tso cai rau lawv kuaj xyuas qee qhov cim qhia tias koj lub raum tsis tau lim tawm txhua yam.

Cov kev xeem uas lawv siv muaj:

• ntshav urea nitrogen
• calcium
• ua tiav cov ntshav ntawm tes suav
• neeg tsim tswv
• lactate dehydrogenase
• phosphorus
• ntshiab ntshiab electrolytes
• uric acid

Muaj ob qhov kev teeb tsa cov kws kho mob tuaj yeem siv los kuaj xyuas TLS:

• Cai-Npis Sov txheej txheem. Kev kuaj ntshav yuav tsum pom tsawg kawg 25 feem pua ​​nce ntxiv ntawm cov qib ntawm qee yam tshuaj.
• Howard cov qauv. Kev sim ntsuas yuav tsum pom ob lossis ntau qhov ntsuas txawv txawv hauv 24 teev.

Yuav kho nws li cas?

Txhawm rau kho TLS, koj tus kws kho mob yuav pib los ntawm kev muab kua dej rau (IV) rau koj thaum saib xyuas koj tso zis ntau npaum li cas. Yog koj tsis tso zis txaus, tej zaum koj tus kws kho mob tseem yuav muab koj cov diuretics.

Lwm yam tshuaj uas koj yuav tsum muaj:

• allopurinol (Aloprim, Lopurin, Zyloprim) kom cheem koj lub cev tsis ua uric acid
• rasburicase (Elitek, Fasturtec) txhawm rau txo cov kua qaub uric
• sodium bicarbonate lossis acetazolamide (Diamox Sequels) txhawm rau tiv thaiv uric acid los ntawm kev tsim cov muaju

Kuj tseem muaj ob yam tshuaj tshiab dua uas yuav pab tau zoo ib yam:

• qhov ncauj kinase inhibitors, xws li ibrutinib (Imbruvica) thiab idelalisib (Zydelig)
• B-cell lymphoma-2 cov tshuaj tiv thaiv kab mob ntshav, xws li venetoclax (Venclexta)

Yog kua nruab nrog cev thiab tshuaj pab tsis pab lossis koj lub raum tsis ua haujlwm, koj yuav tsum lim ntshav hauv lub raum. Nov yog ib hom kev kho mob uas pab tshem cov khib nyiab, suav nrog cov qog ua kom puas, los ntawm koj cov ntshav.

Puas tiv thaiv puas tau?

Tsis yog txhua tus neeg siv tshuaj kho mob yuav loj hlob los ntawm TLS. Ntxiv rau, cov kws kho mob tau qhia meej meej txog cov teeb meem pheej hmoo tseem ceeb thiab feem ntau paub tias leej twg muaj kev pheej hmoo siab dua.

Yog tias koj muaj ib qho kev pheej hmoo, koj tus kws kho mob yuav txiav txim siab pib muab tshuaj rau dej rau koj ob zaug ua ntej ob zaug ua kev kho mob rau thawj zaug. Lawv yuav soj ntsuam koj cov zis tso tawm nyob rau ob hnub tom ntej thiab muab tshuaj rau koj tso ntshav yog tias koj tsis ua haujlwm txaus.

Koj tseem tuaj yeem pib noj allopurinol tib lub sijhawm los tiv thaiv koj lub cev los ntawm kev ua uric acid.

Cov kev ntsuas no tuaj yeem txuas ntxiv mus rau ob lossis peb hnub tom qab lub sijhawm siv tshuaj tua kab mob, tab sis koj tus kws kho mob yuav soj ntsuam koj cov ntshav thiab zis mus tas koj txoj kev kho mob.

Qhov tshwm sim yog dab tsi?

Tag nrho txoj kev pheej hmoo ntawm kev txhim kho TLS tseem tsawg. Txawm li cas los xij, thaum tib neeg tsim nws, nws tuaj yeem ua rau mob hnyav, suav nrog kev tuag. Yog tias koj tab tom pib kho mob qog noj ntshav, nug txog koj li kev pheej hmoo TLS thiab seb koj tus kws kho mob xav kom muaj kev tiv thaiv dab tsi.

Koj yuav tsum paub tseeb tias koj yuav paub txog tag nrho cov tsos mob kom koj tuaj yeem pib nrhiav kev kho mob kom sai li sai tau thaum koj pib pom lawv.