Wikipedia

Zafin Kansa

Ciwo a cikin ciwon daji na iya tasowa daga matsewar ƙwayar cuta ko shiga sassan jikin da ke kusa; daga jiyya da hanyoyin bincike; ko daga fata, jijiya da sauran canje-canjen da ke haifar da rashin daidaituwa na hormone ko amsawar rigakafi. Yawancin ciwo na yau da kullum (dadewa) yana haifar da rashin lafiya kuma mafi yawan ciwo mai tsanani (na gajeren lokaci) yana haifar da magani ko hanyoyin bincike. Koyaya, aikin rediyo, tiyata da chemotherapy na iya haifar da yanayi mai raɗaɗi wanda ke daɗe bayan an gama jiyya.

Zafin Kansa
Description (en) Fassara
Iri pain (en) Fassara
Alamun Cutar Daji
Sanadi Sankara, Chemotherapy, hormone therapy (en) Fassara
targeted therapy (en) Fassara
Identifier (en) Fassara
MeSH D000072716
Cutar daji
Yanayin hormones

Kasancewar jin zafi ya dogara ne akan wurin da ciwon daji yake da kuma matakin cutar.[1] A kowane lokaci, kusan rabin mutanen da aka gano suna da mummunar cutar kansa suna fama da ciwo, kuma kashi biyu cikin uku na wadanda ke fama da ciwon daji suna fama da zafi na irin wannan tsanani wanda ya yi mummunar tasiri ga barci, yanayi, zamantakewar zamantakewa da kuma ayyukan rayuwar yau da kullum.[1][2][3]

Tare da ingantaccen kulawa, ana iya kawar da ciwon daji ko kuma sarrafa shi sosai a cikin 80% zuwa 90% na lokuta, amma kusan 50% na masu fama da ciwon daji a cikin ƙasashen da suka ci gaba suna samun ƙasa da kulawa mafi kyau. A duk duniya, kusan kashi 80 cikin 100 na mutanen da ke fama da ciwon daji suna samun ɗan magani kaɗan ko babu.[4] Ciwon daji a cikin yara da kuma mutanen da ke da nakasar hankali kuma an ba da rahoton cewa ba a yi musu magani ba.[5]

Hukumar Lafiya ta Duniya (WHO) da sauran su ne suka buga ka'idojin amfani da kwayoyi wajen kula da ciwon daji. [6] [7] Ma'aikatan kiwon lafiya suna da haƙƙin ɗabi'a don tabbatar da cewa, duk lokacin da zai yiwu, majiyyaci ko mai kula da majiyyaci suna da masaniya game da haɗari da fa'idodin da ke tattare da zaɓuɓɓukan sarrafa ciwo . Ingantacciyar kulawar jin zafi na iya ɗan ɗan rage rayuwar mutum da ke mutuwa.[8]

Ciwo

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An lasafta ciwo a matsayin m (gajeren lokaci) ko na yau da kullum (dogon lokaci).[9] Jin zafi na yau da kullun na iya kasancewa mai ci gaba tare da haɓaka mai kaifi lokaci-lokaci cikin ƙarfi (flares), ko tsaka-tsaki: lokutan rashin jin zafi da ke haɗuwa da lokutan zafi. Duk da jin zafi da ake sarrafa shi da kyau ta hanyar magunguna masu dadewa ko wasu jiyya, ana iya jin bacin rai lokaci-lokaci; wannan shi ake kira ciwon ci gaba, kuma ana bi da shi tare da maganin analgesics masu saurin aiki.[10]

Yawancin mutanen da ke fama da ciwo mai tsanani suna lura da ƙwaƙwalwar ajiya da matsalolin kulawa. Gwajin tunani mai ma'ana ya samo matsaloli tare da ƙwaƙwalwa, hankali, ikon magana, sassaucin tunani da saurin tunani.[11] Har ila yau, ciwo yana haɗuwa da ƙara yawan damuwa, damuwa, tsoro, da fushi.[12] Ciwo mai tsayi yana rage aiki da kuma rayuwar rayuwa gabaɗaya, kuma yana lalata da rashin ƙarfi ga mutumin da ke fama da ciwo da kuma waɗanda ke kula da su.[10]

Ƙarfin zafi ya bambanta da rashin jin daɗi. Alal misali, yana yiwuwa ta hanyar ilimin halin mutum da wasu magungunan ƙwayoyi, ko kuma ta hanyar shawarwari (kamar yadda yake a cikin hypnosis da placebo ), don rage ko kawar da rashin jin daɗi na ciwo ba tare da rinjayar ƙarfinsa ba.[13]

Wani lokaci, ciwon da ake samu a wani sashe na jiki yana jin kamar yana fitowa daga wani sashe na jiki. Wannan shi ake kira ciwon kai .

Za a iya haifar da ciwo a cikin ciwon daji ta hanyar inji (misali pinching) ko sinadarai (misali kumburi) ƙwanƙwasawa na ƙwararrun jijiyoyi masu alamar ciwo da aka samo a yawancin sassan jiki (wanda ake kira ciwon nociceptive ), ko kuma yana iya haifar da cututtuka, lalacewa ko matsawa. jijiyoyi, a cikin abin da ake kira ciwon neuropathic . Ciwon neuropathic sau da yawa yana tare da wasu ji kamar fil da allura .[14]

Bayanin mai haƙuri shine mafi kyawun ma'aunin zafi; yawanci ana tambayar su don ƙididdige ƙima akan sikelin 0-10 (tare da 0 ba tare da ciwo ba kuma 10 shine mafi munin zafi da suka taɓa ji).[10] Wasu marasa lafiya, duk da haka, na iya kasa ba da amsa ta baki game da zafinsu. A cikin waɗannan lokuta dole ne ku dogara ga alamun ilimin lissafi kamar yanayin fuska, motsin jiki, da murya kamar nishi.[15]

Dalili

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Kimanin kashi 75 cikin dari na ciwon daji na haifar da cutar da kanta; mafi yawan saura ana haifar da su ta hanyoyin bincike da magani.[16]

Tumor mai alaƙa

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Ciwon ciwace-ciwace suna haifar da zafi ta hanyar murƙushewa ko shigar da nama, haifar da kamuwa da cuta ko kumburi, ko sakin sinadarai waɗanda ke sa abubuwan motsa jiki marasa raɗaɗi.

Mamaye kashi ta hanyar ciwon daji shine mafi yawan tushen ciwon daji. Yawancin lokaci ana jin shi azaman taushi, tare da ciwon baya akai-akai da kuma lokuta na tashin hankali na kai tsaye ko motsi, kuma ana bayyana shi akai-akai da mai tsanani.[17][18] Karayar haƙarƙari ya zama ruwan dare a cikin ƙirjin nono, prostate da sauran cututtukan daji tare da metastases.[19]

Tsarin jijiya (jini) na iya shafar ciwace-ciwace masu ƙarfi. Tsakanin kashi 15 zuwa 25 na thrombosis mai zurfi yana haifar da ciwon daji (sau da yawa ta hanyar ciwace-ciwacen daji) kuma yana iya zama alamar farko cewa ciwon daji ya kasance. Yana haifar da kumburi da zafi a ƙafafu, musamman maraƙi, da (da wuya) a cikin hannuwa. [19] Mafi girma vena cava (babban jijiya dauke da kewayawa, de-oxygenated jini a cikin zuciya) na iya matsawa da wani ƙari, haifar da m vena cava ciwo, wanda zai iya haifar da kirji bango zafi a tsakanin sauran bayyanar cututtuka.[19] [20]

Lokacin da ciwace-ciwacen daji suka damfara, mamayewa ko ƙone sassa na tsarin jijiya (kamar kwakwalwa, kashin baya, jijiyoyi, ganglia ko plexa ), suna iya haifar da ciwo da sauran alamun.[21] Ko da yake naman kwakwalwa ba su ƙunshi na'urori masu auna zafi ba, ciwon daji na kwakwalwa na iya haifar da ciwo ta hanyar danna kan tasoshin jini ko membrane da ke rufe kwakwalwa ( meninges ), ko a kaikaice ta hanyar haifar da tarin ruwa ( edema ) wanda zai iya matsawa nama mai jin zafi. .[22]

Jin zafi daga ciwon daji na gabobin, irin su ciki ko hanta ( ciwowar visceral ), yana yaduwa kuma yana da wuya a gano, kuma sau da yawa ana magana da shi zuwa mafi nisa, yawanci na sama, shafuka. Mamaye nama mai laushi ta hanyar ciwace-ciwacen daji na iya haifar da ciwo ta hanyar kumburi ko injin motsa jiki na na'urori masu auna zafi, ko lalata tsarin wayar hannu kamar ligaments, tendons da skeletal tsokoki.[23]

Ciwon da ciwon daji ke haifarwa a cikin ƙashin ƙugu ya bambanta dangane da abin da ya shafa. Yana iya bayyana a wurin ciwon daji amma sau da yawa yana haskakawa zuwa cinya na sama, kuma yana iya komawa zuwa ƙananan baya, al'aurar waje ko perineum .

Hanyoyin bincike

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Wasu hanyoyin bincike, irin su lumbar huda (duba post-dural-puncture ciwon kai ), venipuncture, paracentesis, da thoracentesis na iya zama mai raɗaɗi.[24]

Jiyya da ke da alaƙa

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Chemotherapy kwayoyi

Maganin ciwon daji mai iya ƙunawa sun haɗa da:

  • immunotherapy wanda zai iya haifar da haɗin gwiwa ko ciwon tsoka;
  • radiotherapy, wanda zai iya haifar da halayen fata, enteritis, fibrosis, myelopathy, necrosis kashi, neuropathy ko plexopathy ;
  • chemotherapy, sau da yawa hade da chemotherapy induced peripheral neuropathy, mucositis, ciwon haɗin gwiwa, ciwon tsoka, da ciwon ciki saboda zawo ko maƙarƙashiya;
  • maganin hormone, wanda wani lokaci yana haifar da ciwo mai zafi;
  • hanyoyin da aka yi niyya, irin su trastuzumab da rituximab, wanda zai iya haifar da tsoka, haɗin gwiwa ko ciwon kirji;
  • masu hana angiogenesis kamar bevacizumab, wanda aka sani a wasu lokuta yana haifar da ciwon kashi;
  • tiyata, wanda zai iya haifar da ciwon bayan tiyata, ciwo bayan yankewa ko kuma myalgia na pelvic.

Kamuwa da cuta

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Canje-canjen sinadarai da ke da alaƙa da kamuwa da ƙwayar cuta ko naman da ke kewaye da shi na iya haifar da haɓakar zafi da sauri, amma kamuwa da cuta wani lokaci ana mantawa da shi azaman mai yiwuwa dalili. Ɗaya daga cikin binciken[25] ya gano cewa kamuwa da cuta shine dalilin ciwo a cikin kashi hudu na kusan mutane 300 da ke fama da ciwon daji da aka kira don rage jin zafi. Wani rahoto ya bayyana wasu mutane bakwai da ke fama da cutar kansa, wadanda a baya-bayanan ciwon da aka sarrafa su ya karu sosai a cikin kwanaki da yawa. Maganin rigakafi ya haifar da jin zafi a cikin su duka a cikin kwanaki uku.[26]

Gudanarwa

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Maganin ciwon daji yana nufin sauƙaƙe zafi tare da ƙananan sakamako masu illa na jiyya, ƙyale mutum kyakkyawan yanayin rayuwa da matakin aiki da kuma mutuwa marar zafi. [27] Kodayake kashi 80-90 na ciwon daji za a iya kawar da shi ko kuma a sarrafa shi sosai, kusan rabin mutanen da ke fama da ciwon daji a cikin kasashen da suka ci gaba da kuma fiye da kashi 80 cikin dari na mutanen da ke fama da ciwon daji a duk duniya suna samun kulawa mafi kyau.[28]

Ciwon daji yana canzawa a tsawon lokaci, kuma kulawa da ciwo yana buƙatar yin la'akari da wannan. Ana iya buƙatar nau'ikan magani daban-daban yayin da cutar ke ci gaba. Masu kula da ciwo ya kamata su bayyana wa marasa lafiya a fili dalilin ciwon da kuma yiwuwar jiyya daban-daban, kuma ya kamata suyi la'akari, da kuma maganin miyagun ƙwayoyi, gyaran gyare-gyaren cututtuka kai tsaye, tayar da kofa na ciwo, katsewa, lalata ko ƙarfafa hanyoyin jin zafi, da bada shawara. gyara salon rayuwa. Taimakawa na tunani, zamantakewa da damuwa na ruhaniya shine mabuɗin mahimmanci a cikin ingantaccen kulawar ciwo.

Mutumin da ba za a iya sarrafa ciwonsa da kyau ba ya kamata a tura shi zuwa ga likitan kwantar da hankali ko ƙwararren kula da ciwo ko asibiti.

Ilimin halin dan Adam

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Dabarun magancewa

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Hanyar da mutum ke amsawa ga jin zafi yana rinjayar tsananin zafin su (matsakaici), matakin nakasa da suke fuskanta, da kuma tasirin zafi akan yanayin rayuwarsu . Dabarun da mutane ke amfani da su don magance ciwon daji sun haɗa da neman taimakon wasu; dagewa tare da ayyuka duk da ciwo; karkatarwa; sake yin tunani mara kyau; da addu'a ko al'ada. [29]

Wasu mutanen da ke fama da ciwo suna mayar da hankali kan da kuma kara girman ma'anar barazanar zafi, kuma suna kimanta ikon su na magance ciwo a matsayin matalauta. Ana kiran wannan ɗabi'a "catastrophizing".[30] Ƙananan binciken da aka gudanar a yanzu zuwa bala'i a cikin ciwon daji sun nuna cewa yana da alaƙa da matakan zafi da damuwa na tunani. Mutanen da ke fama da ciwon daji waɗanda suka yarda cewa jin zafi zai dawwama kuma duk da haka suna iya yin rayuwa mai ma'ana ba su da sauƙi ga bala'i da baƙin ciki a cikin binciken daya. Mutanen da ke fama da ciwon daji waɗanda ke da maƙasudin maƙasudi, da dalili da kuma nufin cimma waɗannan manufofin, an samo su a cikin binciken biyu don samun ƙananan ƙananan matakan zafi, gajiya da damuwa.

Mutanen da ke fama da ciwon daji waɗanda ke da kwarin gwiwa kan fahimtar yanayin su da maganinta, kuma suna da tabbaci kan iyawar su (a) sarrafa alamun su, (b) yin haɗin gwiwa cikin nasara tare da masu kula da su na yau da kullun da (c) sadarwa yadda ya kamata tare da masu ba da kiwon lafiya sun sami kwarewa mafi kyau. sakamakon zafi. Don haka ya kamata likitoci su ɗauki matakai don ƙarfafawa da sauƙaƙe sadarwa mai inganci, kuma yakamata suyi la'akari da shiga tsakani na zamantakewa .

Manazarta

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  1. ↑ 1.0 1.1 Hanna M, Zylicz Z, eds. (1 January 2013). Cancer Pain. Springer. pp. vii & 17. ISBN 978-0-85729-230-8.
  2. ↑ Marcus DA (August 2011). "Epidemiology of cancer pain". Current Pain and Headache Reports. 15 (4): 231–4. doi:10.1007/s11916-011-0208-0. PMID 21556709. S2CID 11459509.
  3. ↑ Sheinfeld Gorin S, Krebs P, Badr H, Janke EA, Jim HS, Spring B, et al. (February 2012). "Meta-analysis of psychosocial interventions to reduce pain in patients with cancer". Journal of Clinical Oncology. 30 (5): 539–47. doi:10.1200/JCO.2011.37.0437. PMC 6815997. PMID 22253460.
  4. ↑ Hanna M, Zylicz Z (2013). "Introduction". In Hanna M, Zylicz Z (eds.). Cancer pain. Springer. p. 1. ISBN 9780857292308. LCCN 2013945729.
  5. ↑ Millard, Samantha K.; de Knegt, Nanda C. (December 2019). "Cancer Pain in People With Intellectual Disabilities: Systematic Review and Survey of Health Care Professionals". Journal of Pain and Symptom Management. 58 (6): 1081–1099.e3. doi:10.1016/j.jpainsymman.2019.07.013. ISSN 0885-3924. PMID 31326504.
  6. ↑ WHO guidelines:
  7. ↑ Other clinical guidelines:
  8. ↑ Randall F (2008). "Ethical issues in cancer pain management". In Sykes N, Bennett MI, Yuan CS (eds.). Clinical pain management: Cancer pain (2nd ed.). London: Hodder Arnold. pp. 93–100. ISBN 978-0-340-94007-5.
  9. ↑ Portenoy RK, Conn M (23 June 2003). "Cancer pain syndromes". In Bruera ED, Portenoy RK (eds.). Cancer Pain: Assessment and Management. Cambridge University Press. p. 8. ISBN 978-0-521-77332-4.
  10. ↑ 10.0 10.1 10.2 Induru RR, Lagman RL (July 2011). "Managing cancer pain: frequently asked questions". Cleveland Clinic Journal of Medicine. 78 (7): 449–64. doi:10.3949/ccjm.78a.10054. PMID 21724928. S2CID 19598761.
  11. ↑ Kreitler S, Niv D (July 2007). "Cognitive impairment in chronic pain". Pain: Clinical Updates. XV (4). Archived from the original on 2013-12-03. Retrieved 2019-06-21.
  12. ↑ Bruehl S, Burns JW, Chung OY, Chont M (March 2009). "Pain-related effects of trait anger expression: neural substrates and the role of endogenous opioid mechanisms". Neuroscience and Biobehavioral Reviews. 33 (3): 475–91. doi:10.1016/j.neubiorev.2008.12.003. PMC 2756489. PMID 19146872.
  13. ↑ Melzack R & Casey KL (1968). "Sensory, motivational and central control determinants of chronic pain: A new conceptual model". In Kenshalo DR (ed.). The skin senses: Proceedings of the first International Symposium on the Skin Senses, held at the Florida State University in Tallahassee, Florida. Springfield: Charles C. Thomas. pp. 423–443.
  14. ↑ Kurita GP, Ulrich A, Jensen TS, Werner MU, Sjøgren P (January 2012). "How is neuropathic cancer pain assessed in randomised controlled trials?". Pain. 153 (1): 13–7. doi:10.1016/j.pain.2011.08.013. PMID 21903329. S2CID 38733839.
  15. ↑ Potter, Patricia Ann (2016-02-25). Fundamentals of nursing. Potter, Patricia Ann,, Perry, Anne Griffin,, Hall, Amy (Amy M.),, Stockert, Patricia A. (Ninth ed.). St. Louis, Mo. ISBN 9780323327404. OCLC 944132880.
  16. ↑ Portenoy RK (June 2011). "Treatment of cancer pain". Lancet. 377 (9784): 2236–47. doi:10.1016/S0140-6736(11)60236-5. PMID 21704873. S2CID 1654015.
  17. ↑ Twycross R, Bennett M (2008). "Cancer pain syndromes". In Sykes N, Bennett MI, Yuan CS (eds.). Clinical pain management: Cancer pain (2nd ed.). London: Hodder Arnold. pp. 27–37. ISBN 978-0-340-94007-5.
  18. ↑ Urch CE, Suzuki R (2008). "Pathophysiology of somatic, visceral, and neuropathic cancer pain". In Sykes N, Bennett MI, Yuan CS (eds.). Clinical pain management: Cancer pain (2nd ed.). London: Hodder Arnold. pp. 3–12. ISBN 978-0-340-94007-5.
  19. ↑ 19.0 19.1 19.2 Koh M, Portenoy RK (2010). Bruera ED, Portenoy RK (eds.). Cancer Pain Syndromes. Cambridge University Press. pp. 53–85. ISBN 9780511640483.
  20. ↑ Gundamraj NR, Richmeimer S (January 2010). "Chest Wall Pain". In Fishman SM, Ballantyne JC, Rathmell JP (eds.). Bonica's Management of Pain. Lippincott Williams & Wilkins. pp. 1045–. ISBN 978-0-7817-6827-6. Retrieved 10 June 2013.
  21. ↑ Foley KM (2004). "Acute and chronic cancer pain syndromes". In Doyle D, Hanks G, Cherny N, Calman K (eds.). Oxford textbook of palliative medicine. Oxford: OUP. pp. 298–316. ISBN 0-19-851098-5.
  22. ↑ Fitzgibbon & Loeser 2010, p. 34
  23. ↑ Fitzgibbon & Loeser 2010, p. 35
  24. ↑ International Association for the Study of Pain Archived 2011-09-28 at the Wayback Machine Treatment-Related Pain
  25. ↑ Gonzalez GR, Foley KM, Portenoy RK (1989). "Evaluative skills necessary for a cancer pain consultant". American Pain Society Meeting, Phoenix Arizona.
  26. ↑ Bruera E, MacDonald N (May 1986). "Intractable pain in patients with advanced head and neck tumors: a possible role of local infection". Cancer Treatment Reports. 70 (5): 691–2. PMID 3708626.
  27. ↑ Empty citation (help)
  28. ↑ Deandrea S, Montanari M, Moja L, Apolone G (December 2008). "Prevalence of undertreatment in cancer pain. A review of published literature". Annals of Oncology. 19 (12): 1985–91. doi:10.1093/annonc/mdn419. PMC 2733110. PMID 18632721.
  29. ↑ Porter LS, Keefe FJ (August 2011). "Psychosocial issues in cancer pain". Current Pain and Headache Reports. 15 (4): 263–70. doi:10.1007/s11916-011-0190-6. PMID 21400251. S2CID 37233457.
  30. ↑ Rosenstiel AK, Keefe FJ (September 1983). "The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment". Pain. 17 (1): 33–44. doi:10.1016/0304-3959(83)90125-2. PMID 6226916. S2CID 21533907.
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