Umhlaza wesisu unesehlo esikhulu phakathi kwawo onke amathumba okugaya ukutya kwihlabathi liphela.Nangona kunjalo, yimeko enokuthinteleka kwaye iyanyangeka.Ngokuphila ngendlela enempilo, ukuxilongwa rhoqo, kunye nokufuna ukuxilongwa kwangaphambili kunye nonyango, sinokulwa nesi sifo ngokufanelekileyo.Ngoku masikunike ingcaciso kwimibuzo elithoba ebalulekileyo ukukunceda uqonde ngcono umhlaza wesisu.
1. Ngaba umhlaza wesisu uyahluka ngokobuhlanga, ummandla, kunye nobudala?
Ngokwedatha yamva nje yomhlaza wehlabathi ngo-2020, i-China iye yanika ingxelo malunga ne-4.57 yezigidi zeemeko zomhlaza, kunye nomhlaza wesisumalunga neemeko ezingama-480,000, okanye i-10.8%, zibalwa phakathi kwabathathu abaphezulu.Umhlaza wesisu ubonisa ukuhluka okucacileyo malunga nobuhlanga kunye nommandla.Ummandla waseMpuma Asia yindawo esemngciphekweni omkhulu womhlaza wesisu, kunye neTshayina, iJapan, kunye noMzantsi Korea zibalelwa malunga ne-70% yamatyala ewonke kwihlabathi liphela.Oku kubalelwa kwizinto ezifana nemfuzo, ukusetyenziswa kokutya okugcadiweyo kunye nokuvuthwa, kunye namazinga aphezulu okutshaya kulo mmandla.Kwilizwe laseTshayina, umhlaza wesisu uxhaphakile kwimimandla eselunxwemeni enezidlo ezinetyuwa eninzi, kunye nendawo ephakathi nendawo esezantsi yoMlambo iYangtze kunye neendawo ezihlwempuzekileyo.
Ngokumalunga nobudala, umyinge wokuqalisa komhlaza wesisu uphakathi kwama-55 nama-60 ubudala.Kule minyaka ilishumi idlulileyo, izinga lezehlo zomhlaza wesisu e-China lihleli lizinzile, nokonyuka okuncinci.Nangona kunjalo, umlinganiselo wokwenzeka phakathi kolutsha uye wanyuka ngokukhawuleza, udlula umlinganiselo welizwe.Ukongeza, ezi meko zihlala zifunyaniswa njengomhlaza wesisu osasazekileyo, obonisa imingeni yonyango.
2. Ngaba umhlaza wesisu unezilonda ezinobungozi?Zeziphi iimpawu eziphambili?
Iipolyps zesisu, i-atrophic gastritis engapheliyo, kunye nesisu esishiyekileyo zizinto ezinobungozi obuphezulu bomhlaza wesisu.Ukuphuhliswa komhlaza wesisu yinkqubo ye-multifactorial, i-multilevel, kunye ne-multistage.Kwinqanaba lokuqala lomhlaza wesisu,izigulana zihlala zingabonakalisi zimpawu zicacileyo, okanye zinokufumana ukungonwabi kancinci kumantla esisu,iintlungu ezisezantsi zesisu, ukuphelelwa ngumdla wokutya, ukuqunjelwa, ukugquma, yaye kwezinye iimeko, ilindle elimnyama okanye ukugabha igazi.Xa iimpawu zivela ngakumbi,ebonisa phakathi ukuya kwinqanaba eliphezulu lomhlaza wesisu, izigulane zinokufumana ukwehla kobunzima obungachazwanga, i-anemia,hypoalbuminemia (amanqanaba aphantsi eprotheni egazini)i-edema,iintlungu eziqhubekayo zesisu, ukuhlanza igazi, kunyeilindle elimnyama, phakathi kwabanye.
3. Banokubonwa njani kwangethuba abantu abasemngciphekweni omkhulu womhlaza wesisu?
Imbali yosapho lwamathumba: Ukuba kukho iimeko zenkqubo yokugaya ukutya okanye ezinye izihlunu kwizizukulwana ezibini okanye ezithathu zezalamane, amathuba okuba nomhlaza wesisu uphezulu.Indlela ecetyiswayo kukwenza uvavanyo lobuchwephesha lwethumba ubuncinci iminyaka eyi-10-15 ngaphambi kobudala obuncinci balo naliphi na ilungu losapho elinomhlaza.Ngomhlaza wesisu, uvavanyo lwe-gastroscopy kufuneka luqhutywe rhoqo emva kweminyaka emithathu, njengoko kucetyiswa ngugqirha.Ngokomzekelo, ukuba umncinci welungu lentsapho elinomhlaza uneminyaka engama-55 ubudala, uvavanyo lokuqala lwe-gastroscopy kufuneka lwenziwe kwiminyaka engama-40.
Abantu abanembali ende yokutshaya, ukusetyenziswa kotywala, ukukhetha ukutya okushushu, okucoliweyo, okuqhotsiweyo, kunye nokutya okuninzi okunetyuwa kufuneka bayilungise ngokukhawuleza le mikhwa ingenampilo, njengoko inokubangela umonakalo omkhulu esiswini.
Izigulane ezinezilonda zesisu, i-gastritis engapheliyo, kunye nezinye izifo zesisu kufuneka zifune ngokukhawuleza unyango lokuthintela ukuqhubela phambili kwesifo kwaye zihlolwe rhoqo esibhedlele.
4. Ngaba i-gastritis engapheliyo kunye nezilonda zesisu zikhokelela kumhlaza wesisu?
Ezinye izifo zesisu zinomngcipheko ophezulu womhlaza wesisu kwaye kufuneka zithathwe ngokungathí sina.Nangona kunjalo, ukuba nezifo zesisu akuthethi ukuba umntu uya kuba nomhlaza wesisu.Izilonda zesisu zinxulunyaniswa ngokucacileyo nomngcipheko okhulayo wokuba nomhlaza.I-gastritis yexesha elide kunye nobunzima obungapheliyo, ngakumbi ukuba ibonisa iimpawu ze-atrophy, i-intestinal metaplasia, okanye i-hyperplasia ye-atypical, idinga ukubeka iliso elisondeleyo.Kubalulekile ukuyeka ngoko nangoko imikhwa engafanelekanga njengeukumisa ukutshaya, ukunciphisa ukusetyenziswa kotywala, kunye nokuphepha ukutya okuqhotsiweyo kunye netyuwa eninzi.Ukongezelela, kucetyiswa ukuba kuhlolwe rhoqo ngonyaka kunye nengcali ye-gastrointestinal ukuvavanya imeko ethile kunye nokuqwalasela iingcebiso ezifana ne-gastroscopy okanye amayeza.
5. Ngaba kukho ubudlelwane phakathi kwe-Helicobacter pylori kunye nomhlaza wesisu?
I-Helicobacter pylori yibhaktheriya ehlala ifumaneka kwisisu, kwaye inxulunyaniswa nohlobo oluthile lomhlaza wesisu.Ukuba umntu uvavanya ukuba une-Helicobacter pylori kwaye unezifo ezingapheliyo zesisu ezifana ne-gastritis engapheliyo okanye izilonda zesisu, umngcipheko wokuba nomhlaza wesisu uyanda.Ukufuna unyango ngexesha elifanelekileyo kubalulekile kwiimeko ezinjalo.Ukongeza kumntu ochaphazelekayo ofumana unyango, amalungu osapho kufuneka ahlolwe kwaye athathele ingqalelo unyango oluhambelanayo ukuba kuyimfuneko.
6. Ngaba kukho enye indlela engebuhlungu kangako kwi-gastroscopy?
Enyanisweni, ukwenza i-gastroscopy ngaphandle kwamanyathelo okunciphisa intlungu kunokungakhululeki.Nangona kunjalo, xa kufikwa ekufumaneni umhlaza wesisu wenqanaba lokuqala, i-gastroscopy okwangoku yeyona ndlela isebenzayo.Ezinye iindlela zokuxilonga zisenokungawuboni umhlaza wesisu kwasekuqaleni, nto leyo enokuchaphazela kakhulu amathuba onyango oluyimpumelelo.
Inzuzo ye-gastroscopy kukuba ivumela oogqirha ukuba bajonge ngqo isisu ngokufaka ityhubhu encinci, eguquguqukayo kwi-esophagus kunye nokusebenzisa i-probe encinci efana nekhamera.Oku kubenza babe nombono ocacileyo wesisu kwaye bangaphoswa naluphi na utshintsho olufihlakeleyo.Iimpawu zakwangoko zomhlaza wesisu zinokufihlakala kakhulu, zifana neqhekeza elincinci esandleni sethu esinokuthi singalihoyi, kodwa kunokubakho utshintsho oluncinci kumbala wesisu.Ngelixa ii-CT scans kunye ne-agent echaseneyo zinokuchonga iziphako ezithile ezinkulu zesisu, zisenokungazibambi ezo nguqu zifihlakeleyo.Ngoko ke, abo bacetyiswayo ukuba bafumane i-gastroscopy, kubalulekile ukuba unganqikazi.
7. Uthini umgangatho wegolide wokuxilongwa komhlaza wesisu?
I-Gastroscopy kunye ne-pathological biopsy ngumgangatho wegolide wokuxilonga umhlaza wesisu.Oku kubonelela ngoxilongo olusemgangathweni, olulandelwa yisiteji.Utyando, unyango lwemitha, ichemotherapy, kunye nokhathalelo oluxhasayo zezona ndlela zonyango zomhlaza wesisu.Utyando lolona nyango luphambili kumhlaza wesisu wenqanaba lokuqala, kwaye unyango olubanzi lwezifundo ezininzi okwangoku lujongwa njengeyona ndlela iphambili yonyango lomhlaza wesisu.Ngokusekelwe kwisimo somzimba wesigulane, ukuqhubela phambili kwesifo, kunye nezinye izinto, iqela leengcali ezininzi ezihlukeneyo ziphuhlisa isicwangciso sonyango lomntu ngamnye, oluyimfuneko kakhulu kwizigulane ezineemeko ezinzima.Ukuba isiteji kunye nokuxilongwa kwesigulane kucacile, unyango lunokwenziwa ngokwemigaqo efanelekileyo yomhlaza wesisu.
8. Umntu kufuneka alufune njani unyango lomhlaza wesisu ngendlela yenzululwazi?
Unyango olungaqhelekanga lunokukhuthaza ukukhula kweeseli zethumba kunye nokwandisa ubunzima bonyango olulandelayo.Ukuxilongwa kokuqala kunye nonyango lubalulekile kwizigulana ezinomhlaza wesisu, ngoko ke kubalulekile ukufuna unyango kwisebe elikhethekileyo le-oncology.Emva kokuxilongwa ngokucokisekileyo, ugqirha uya kuvavanya imeko yesigulane kwaye anike iingcebiso zonyango, ekufuneka zixoxwe kunye nesigulane kunye namalungu entsapho zabo ngaphambi kokwenza isigqibo.Izigulana ezininzi ziziva zinexhala kwaye zifuna ukuxilongwa kwangoko namhlanje kunye notyando ngomso.Abanakulinda emgceni wokuhlolwa okanye ukulala esibhedlele.Nangona kunjalo, ukuze ufumane unyango olukhawulezileyo, ukuya kwizibhedlele ezingezizo ezodwa kunye nezingezizo iingcaphephe kunyango olungaqhelekanga kunokubangela imingcipheko kulawulo olulandelayo lwesi sifo.
Xa umhlaza wesisu ufunyenwe, udla ngokubakho ixesha elithile.Ngaphandle kokuba kukho iingxaki ezinzulu ezifana nokugqobhoza, ukopha, okanye umqobo, akukho mfuneko yakuba nexhala lokuba ukulibazisa utyando olukhawulezileyo kuya kukhawulezisa ukuqhubeka kwethumba.Ngapha koko, ukuvumela ixesha elaneleyo lokuba oogqirha baqonde ngokucokisekileyo imeko yesigulana, bavavanye ukunyamezela kwabo ngokomzimba, kwaye bahlalutye iimpawu zethumba kubalulekile kwiziphumo ezingcono zonyango.
9. Sifanele siyijonge njani intetho ethi “isinye kwisithathu sabaguli sisoyika ukufa”?
Le ngxelo ibaxiwe ngokugqithisileyo.Enyanisweni, umhlaza awuyoyiki njengoko sinokucinga.Abantu abaninzi baphila nomhlaza kwaye baphila ubomi obanelisayo.Emva kokuxilongwa komhlaza, kubalulekile ukulungisa indlela yokucinga kunye nokuzibandakanya kunxibelelwano oluhle kunye nezigulana ezinethemba.Kubantu abakwinqanaba lokuchacha emva konyango lomhlaza wesisu, amalungu osapho kunye noogxa babo akufuneki babaphathe njengezidalwa ezibuthathaka, zibathintele ekwenzeni nantoni na.Le ndlela inokwenza izigulana zizive ngathi ixabiso lazo aliqatshelwa.
Izinga lokunyanga umhlaza wesisu
Izinga lokunyanga umhlaza wesisu e-China limalunga ne-30%, elingekho phantsi kakhulu xa lithelekiswa nezinye iintlobo zomhlaza.Kumhlaza wesisu okwinqanaba lakwangoko, izinga lokunyanga lihlala limalunga nama-80% ukuya kuma-90%.Kwinqanaba II, liqhelekile malunga nama-70% ukuya kuma-80%.Nangona kunjalo, ngenqanaba le-III, elithathwa njengelihamba phambili, izinga lokunyanga liyehla ukuya kuma-30%, kwaye kwinqanaba le-IV, lingaphantsi kwe-10%.
Ngokubhekiselele kwindawo, umhlaza wesisu esikude unezinga eliphezulu lokunyanga xa kuthelekiswa nomhlaza wesisu osondele.Umhlaza wesisu esikude sibhekisa kumhlaza obekwe kufutshane nepylorus, ngelixa umhlaza wesisu osondeleyo ubhekisa kumhlaza obekwe kufutshane ne-cardia okanye umzimba wesisu.I-signet ring cell carcinoma inzima kakhulu ukuyibhaqa kwaye ithande ukuba metastasize, nto leyo ekhokelela kwiqondo elisezantsi lokunyanga.
Ke ngoko, kubalulekile ukunikela ingqalelo kulo naluphi na utshintsho olwenzekayo emzimbeni womntu, ukuya kuxilongo lwezonyango rhoqo, kwaye ufune unyango olukhawulezileyo ukuba ufumana ukungakhululeki okuthe gqolo kwesisu.Ukuba kuyimfuneko, i-gastroscopy kufuneka yenziwe.Izigulane eziye zafumana unyango lwe-endoscopic kwixesha elidlulileyo kufuneka kwakhona zibe nokuqeshwa ngokulandelelana rhoqo kunye neengcali zesisu kwaye zihambelane neengcebiso zonyango kwiimviwo ze-gastroscopy zexesha.
Ixesha lokuposa: Aug-10-2023