Rustitzky-Kahler tus kab mob los yog myeloma yog ib qho kab mob oncological ntawm lub cev. Tus cwj pwm ntawm cov kab mob kis tau yog vim tias muaj qee qhov mob qog nqaij hlav hauv cov ntshav, cov plasmocytes (hlwb uas tsim cov tshuaj immunoglobulins) tsub kom, ua rau pib muaj ntau hom pathological immunoglobulin (paraprotein).
Ntau yam myeloma - nws cov lus yooj yooj yim yog dab tsi?
Ntau yam myeloma yog ib hom mob ntawm myeloma. Plasmocyte-striking tumor nyob rau hauv tus kab mob no tshwm sim nyob rau hauv cov pob txha pob txha. Cov xwm txheej, cov leeg pob txha ntawm cov pob txha, pob txha, pelvis, ribs, thorax, thiab, tsis tshua pom, cov pob txha ntawm lub cev, ntau dua. Malignant formations (plasmacytomas) nrog ntau yam mob myeloma ntes ob peb cov pob txha thiab ncav cuag qhov loj ntawm 10-12 cm inch.
Plasmocytes yog ib feem ntawm lub cev tsis muaj zog. Lawv tsim cov tshuaj tiv thaiv kab mob tiv thaiv kab mob tshwj xeeb (uas yog immunoglobulin yuav tsum tau ua los ntawm "prompting" lub hlwb tshwj xeeb). Cov ntshav plasma kis tau tus kab mob (plasmomyeloma hlwb) tsis tuaj yeem tsim cov tshuaj tiv thaiv kab mob (immunoglobulins) uas tsis muaj peev xwm tiv thaiv tau lub cev, tab sis muaj ntau yam kabmob hauv cov kabmob thiab cuam tshuam lawv txoj haujlwm. Ntxiv rau, lub plasmacytoma ua rau:
- txo cov naj npawb ntawm erythrocytes, platelets thiab leukocytes;
- nce immunodeficiency thiab muaj zog ntau dua rau ntau yam kabmob;
- hematopoiesis thiab ntshav nce siab;
- ua txhaum ntawm cov ntxhia thiab protein ntau metabolism;
- qhov tsos ntawm infiltrates nyob rau hauv lwm yam kabmob, tshwj xeeb tshaj yog feem ntau nyob rau hauv ob lub raum;
- pathological hloov hauv cov pob txha pob txha hauv cheeb tsam qog - cov pob txha yog thinned thiab rhuav tshem, thiab thaum cov qog sprouts los ntawm nws, nws penetrates rau cov nqaij mos.
Ua rau ntawm myeloma
Tus mob ntawm Rustitskiy-Kahler tau kawm los ntawm cov kws kho mob, tab sis tsis muaj kev pom zoo vim li cas nws tshwm sim hauv cov chaw kho mob. Pom tau tias nyob rau hauv lub cev ntawm tus neeg mob, cov kab mob lymphatic ntawm T lossis B yog feem ntau tshwm sim, thiab vim cov ntshav tawm ntawm B-lymphocytes, kev ua txhaum ntawm txoj kev no ua rau tsis ua hauj lwm thiab pib ntawm kev tsim ntawm pathoplasmocytes.
Ntxiv rau kab mob viral, nws muaj pov thawj tias myeloma tuaj yeem raug txhais tau los ntawm hluav taws xob kis. Cov kws kho mob kawm cov neeg cuam tshuam rau hauv Hiroshima thiab Nagasaki, nyob hauv cheeb tsam tawg ntawm Chernobyl nuclear fais fab nroj tsuag. Nws tau pom tias cov neeg tau txais cov koob tshuaj tawg, feem pua ntawm cov mob myeloma thiab lwm cov kab mob uas cuam tshuam rau ntshav thiab lymphatic yog siab.
Ntawm cov yam tsis zoo uas cuam tshuam txog kev pheej hmoo ntawm kev cog lus myeloma, cov kws kho mob hu rau:
- Kev haus luam yeeb - qhov ntev tshaj ntawm kev haus luam yeeb thiab ntau ntau cov luam yeeb, ntau dua qhov muaj feem xyuam;
- immunodeficiency;
- cuam tshuam rau lub cev ntawm cov tshuaj lom neeg;
- genetic predisposition.
Myeloma - cov tsos mob
Cov kab mob hu ua Myeloma no tshwm sim rau hnub nyoog laus, cuam tshuam rau cov poj niam thiab txiv neej. Tus kab mob Rustitskogo-Kahler - cov tsos mob thiab cov duab saib mob, pom hauv cov neeg mob:
- swb tus hemopoietic thiab pob txha tshuab;
- ua txhaum ntawm kev ua metabolic;
- pathological hloov nyob rau hauv qhov mob ntawm urinary.
Ntau cov tsos mob ntawm tus mob myeloma:
- cov tsos mob ntawm tus mob myeloma yog mob hauv cov pob txha (nyob rau hauv txha caj qaum, hauv siab, pob txha taub hau), mob pob txha tawg, deformation pob txha thiab muaj cov qog formations;
- nquag pneumonia thiab lwm yam kab mob, ua rau lub caij nplooj ntoos zeeg ntawm kev tiv thaiv thiab txwv cov pa taw vim tshwm sim los ntawm kev hloov hauv pob txha ntawm lub hauv siab;
- dystrophic hloov hauv cov leeg ntawm lub plawv, lub plawv tsis ua hauj lwm;
- nce spleen thiab siab;
- myeloma nephropathy - ib qhov teeb meem nyob rau hauv ob lub raum nrog cov yam ntxwv nce hauv cov nqaijrog nyob hauv cov zis, uas txhais mus ua kab mob hauv lub plab;
- normochromic anemia - txo tus naj npawb ntawm erythrocytes thiab hemoglobin;
- Hypercalcemia - ntau ntxiv cov calcium hauv plasma thiab zis, tus mob no yog qhov txaus ntshai, nws cov tsos mob - ntuav, xeev siab, nkees nkees, vestibular apparatus kev cuam tshuam, kev mob hlwb;
- txo qis ntawm cov tshuaj tiv thaiv kab mob hauv cev;
- hemopoiesis ntshawv siab - los ntshav ntawm cov xoos mucous, nqaij, qhov ncauj ntawm cov hlab ntsha phalanges, hemorrhagic diathesis;
- Paresthesia ("creepy"), mob taub hau, tsaug zog, tig mus rau hauv ib lub pob ntseg, qaug dab peg, kiv taub hau, lag ntseg, mob plab;
- nyob rau theem kawg - hnyav, ua npaws, ua mob hnyav.
Cov ntaub ntawv ntawm myeloma
Raws li kev soj ntsuam kab mob qog-anatomical, myeloma yog ntawm cov ntaub ntawv hauv qab no:
- luaj myeloma - nrog ib lub qog nyob rau hauv cov pob txha los yog cov qog ntshav hauv;
- ntau yam (generalized) myeloma - nrog rau ntau qhov mob qog nqaij hlav.
Ntxiv rau, ntau yam mob myeloma yuav ua tau:
- diffuse - nyob rau hauv cov ntaub ntawv no pathologically lub formations tsis muaj ciam teb, tab sis permeate tag nrho cov qauv ntawm cov pob txha marrow;
- ntau-focal - lub plasmacytoma ntawm cov pob txha tsim nyob rau hauv cov cheeb tsam tsawg, thiab tsis tas li, qog yuav tshwm sim nyob rau hauv cov qog ntshav, tus po.
- diffuse focal - combining cov tsos mob ntawm diffuse thiab ntau.
Tus kab mob hu ua Myeloma - theem
Cov kws kho mob thim peb theem ntawm ntau hom mob myeloma, qhov thib ob theem yog qhov sib pauv, thaum lub khauj khaum tshaj siab tshaj thawj zaug, tab sis qis tshaj hauv qhov thib peb (qhov hnyav tshaj):
- Tus thawj theem yog tshwm sim los ntawm ib qho hemoglobin rau 100 g / l, ib txwm calcium, tsis muaj concentration ntawm paraproteins thiab Bens-Jones protein, ib lub qog tsom ntawm 0.6 kg / m², tsis muaj osteoporosis, pob txha deformation.
- Qhov thib peb theem yog tshwm sim los ntawm 85 g / l thiab tsawg dua hemoglobin, calcium concentration nyob rau hauv cov ntshav saum 12 mg ib 100 ml, ntau hlav, high concentration of paraproteins thiab cov protein ntau Bens-Jones, tag nrho tumor loj ntawm 1.2 kg / m² lossis tshaj, cov cim qhia ntawm osteoporosis.
Cov teeb meem ntawm myeloma
Rau ntau yam mob myeloma, cov teeb meem txuam nrog kev ua kom puas ntawm qog yog yam ntxwv:
- mob hnyav thiab pob txha ntawm pob txha (pob txha);
- lub raum tsis ua hauj lwm nrog qhov kev xav tau rau hemodialysis ;
- persistent kis kab mob;
- anemia nyob rau hauv ib theem loj, yuav tsum tau transfusions.
Myeloma - mob
Nrog rau kev kuaj mob ntawm myeloma, nyias muaj nyias mob nyuab heev, tshwj xeeb tshaj yog thaum muaj qhov tsis muaj cov kabmob khov pom tseeb. Tus neeg mob tau soj ntsuam los ntawm ib tus neeg hematologist uas tau lees paub tias kev kuaj mob ntawm myeloma, nws thawj zaug ua kev tshawb fawb thiab pom tias puas muaj tej yam zoo li mob pob txha, mob ntshav, cov kab mob sib kis mob heev. Tsis tas li ntawd, cov kev tshawb fawb ntxiv tau ua kom pom tseeb qhov kev ntsuam xyuas, nws cov duab thiab qhov:
- kev ntsuam xyuas ntshav thiab zis;
- lub hauv siab thiab kev xoo hluav taws xob;
- computed tomography;
- biochemical ntshav kuaj ;
- coagulogram ;
- kev kawm txog tus nqi ntawm paraproteins nyob rau hauv cov ntshav thiab zis;
- pob txha pob txha pob txha;
- kawm txog Mancini ntawm lub ntsiab lus ntawm immunoglobulins.
Myeloma - kev kuaj ntshav
Yog tias kev kuaj mob ntawm myeloma xav tias, tus kws kho mob muab cov kev kuaj ntshav dav dav thiab kuaj biochemical. Cov cim nram qab no yog raug rau tus kab mob:
- hemoglobin - tsawg dua 100 g / l;
- erythrocytes - tsawg dua 3.7 t / l (poj niam), tsawg dua 4.0 t / l (txiv neej);
- platelets - tsawg dua 180 g / l;
- leukocytes - tsawg dua 4,0 g / l;
- ESR - ntau tshaj 60 hli ib teev twg;
- protein - 90 g / l thiab siab dua;
- albumin - 35 g / l thiab hauv qab;
- urea - 6.4 mmol / L thiab siab dua;
- calcium - 2.65 mmol / l thiab siab dua.
Myeloma - Xoo hluav taws xob
Qhov tseem ceeb tshaj plaws ntawm txoj kev tshawb no nrog myeloma yog X-ray. Tus mob ntawm ntau yam mob myeloma uas yog siv hluav taws xob tuaj yeem paub tseeb los yog tawm hauv kev ntseeg. Tagnrho cov xoo hluav taws xob yog pom meej, thiab ntxiv rau - tus kws kho mob tau soj ntsuam txog kev puas tsuaj thiab kev hloov ntawm pob txha. Diffusive qhov teebmeem ntawm xoo hluav taws xob tshaj qhia nyuaj, yog li ntawd tus kws kho mob yuav xav tau lwm txoj hau kev.
Mob hlwb Myeloma - kev kho mob
Tam sim no, rau kev kho mob ntawm myeloma, ib qho kev ua ke siv, nrog rau kev siv thawj cov tshuaj hauv ob peb ua ke. Txoj kev kho mob yuav tsum tau kho lub vertebrae vim lawv qhov kev puas tsuaj. Ntau yam mob myeloma - kev kho tshuaj muaj xws li:
- Targeted therapy , stimulating lub synthesis ntawm proteins, ua rau sib ntaus nrog paraproteins;
- chemotherapy, inhibiting qhov kev loj hlob ntawm kev mob hlwb thiab tua lawv;
- Kev Txhaj Tshuaj Tiv Thaiv Zog Tsom Cai Kev Txhim Kho Kev Txhaj Tshuaj Lub Yeem Kho Kev Txhim Kho Kev Txhim Kho;
- corticosteroid therapy, uas pab txhawb kev kho mob yooj yim;
- kev kho mob nrog cov kab mob ntsws uas ua kom pob txha muaj zog;
- kev txhim kho tshuaj loog rau kev txo cov kev mob qhov mob.
Myeloma - tshuaj ntsuam pom zoo
Hmoov tsis, nws tsis tuaj yeem rov qab los ntawm kev mob hauv myeloma, txoj kev kho yog tsom mus rau lub caij nyoog muaj sia. Ua li no, koj yuav tsum ua raws li qee cov cai. Kev mob ntawm myeloma - kev pom zoo ntawm cov kws kho mob:
- Ua tib zoo soj ntsuam txoj kev kho mob uas tus kws kho mob hais.
- Txhim kho kev tiv thaiv tsis yog rau cov tshuaj xwb, tab sis kuj nrog kev taug kev, dej cov txheej txheem, sunbathing (siv tshuaj pleev thaiv hnub thiab thaum siv hnub ci ua si tsawg - thaum sawv ntxov thiab yav tsaus ntuj).
- Txhawm rau tiv thaiv kab mob - saib xyuas tus kheej txoj cai kev nyiam huv, tsis txhob muaj neeg coob coob, ntxuav tes ua ntej noj tshuaj, ua ntej noj mov.
- Tsis txhob taug kev barefoot, vim hais tias ntawm lub yeej ntawm peripheral qab haus huv nws yog ib qho yooj yim kom tau raug mob thiab tsis pom nws.
- Saib xyuas cov piam thaj hauv cov zaub mov, raws li qee cov tshuaj siv pab rau txoj kev mob ntshav qab zib.
- Tuav tus cwj pwm zoo, vim hais tias qhov tus cwj pwm zoo yog qhov tseem ceeb rau txoj kev mob.
Kws khomob rau ntau yam kabmob
Kws khomob rau cov tshuaj myeloma tuaj yeem ua tiav nrog rau ib lossis ntau cov tshuaj. Txoj kev kho no yuav ua kom tiav kev kho mob ntawm 40% ntawm cov neeg, ib nrab - nyob rau hauv 50%, tiam sis, rov huam mob ntawm tus kab mob no ntau zaus, raws li tus kab mob cuam tshuam ntau lub cev thiab cov ntaub so ntswg. Plasmacytoma - kho cov kws khomob:
- Thaum thawj theem ntawm kev kho mob, cov kws khomob tau sau los ntawm tus kws kho mob hauv daim ntawv ntawm cov ntsiav tshuaj lossis kev hno tshuaj yuav raug coj mus raws li lub tswv yim.
- Hauv ob theem, yog tias cov kws khomob zoo, cov pob txha hlwb pob txha hlwb txauv hlwb - coj lub pob, tshem cov qia hlwb thiab xa lawv rov qab.
- Ntawm cov kev kawm ntawm cov kws kho mob, cov kev kho mob ntawm kev kho mob nrog cov tshuaj interferon-alpha yog siv tawm - kom muaj kev sib zog ntau dua.
Ntau hom mob myeloma - kev mob qoob loo
Hmoov tsis, nrog rau kev mob ntawm myeloma, qhov kev poob siab yog disappointing - cov kws kho mob tsuas yog muaj peev xwm los mus ntev ntev lub remission. Feem ntau cov neeg mob uas muaj myeloma tuag los ntawm kev mob ntsws, ua rau tuag taus los ntawm kev ua txhaum ntawm cov ntshav khaus, pob txha, ua rau lub raum tsis ua hauj lwm, lub plab. Qhov zoo tshaj plaws yog qhov me me thiab hnub nyoog thawj ntawm tus kab mob, qhov kev phem tshaj plaws yog nyob rau hauv cov neeg laus dua 65 xyoos nrog cov kab mob ntawm ob lub raum thiab lwm yam kabmob, ntau cov hlav.
Ntau lub paj hlwb - lub neej kev cia siab:
- 1-2 xyoos - tsis kho;
- mus txog 5 xyoos - qhov nruab nrab ntawm kev cia siab ntawm myeloma rau cov neeg tsis nyob hauv kev kho mob;
- mus txog 10 xyoo - lub neej kev cia siab nrog kev teb zoo rau cov kws khomob thiab kab mob nyob rau hauv ib qho yooj yim theem;
- ntau tshaj 10 xyoo tuaj yeem nyob nrog cov neeg mob uas muaj ib qho kev mob qog nqaij hlav xwb, ntse tau raug tshem tawm los ntawm kws kho mob.