Kev Tswj Xyuas Qhov Mob Hauv Mob Cancer
Qhov mob yog ib qho ntawm cov teeb meem uas tshwm sim ntau tshaj plaws thiab ua rau mob siab rau cov neeg mob qog noj ntshav. Qhov mob tuaj yeem tshwm sim thaum ntxov ntawm tus kab mob, thaum kuaj pom, thaum lub sijhawm kho mob (phais mob, chemotherapy, radiotherapy), thiab txawm tias nyob rau theem tom qab. Nws qhov cuam tshuam tsis yog tsuas yog lub cev xwb, tab sis kuj yog kev xav, kev sib raug zoo, thiab sab ntsuj plig. Yog li ntawd, kev tswj qhov mob hauv qog noj ntshav yog ib feem tseem ceeb ntawm kev saib xyuas kom zoo uas tsom mus rau kev txhim kho lub neej zoo rau cov neeg mob thiab lawv tsev neeg.
Nkag Siab Txog Qhov Mob Hauv Mob Cancer
Qhov mob ntawm mob qog noj ntshav tsis yog txhua lub sijhawm txhais tau tias mob qog noj ntshav zuj zus tuaj, tab sis feem ntau nws muaj feem cuam tshuam nrog ntau yam txheej txheem. Qhov mob tuaj yeem tshwm sim los ntawm qhov mob qog nqaij hlav nias rau ntawm cov hlab ntsha, pob txha, lossis cov kabmob; mob qog noj ntshav kis mus rau pob txha; o; kev thaiv; lossis cov teebmeem ntawm kev kho mob. Tsis tas li ntawd, qhov mob tuaj yeem cuam tshuam los ntawm kev ntxhov siab, kev nyuaj siab, kev pw tsaug zog tsis zoo, thiab kev mob yav dhau los.
Feem ntau, mob qog noj ntshav muaj peev xwm muab faib ua ntau hom:
1. Mob uas ua rau mob tsis hnov mob: tshwm sim los ntawm kev puas tsuaj ntawm cov nqaij (piv txwv li, mob pob txha lossis mob vim muaj kev nyem los ntawm qog nqaij hlav). Feem ntau nws zoo li mob taub hau, mob siab, lossis mob.
2. Mob Neuropathic: tshwm sim los ntawm kev puas tsuaj rau cov hlab ntsha lossis kev khaus (piv txwv li, vim muaj kev nias rau ntawm cov hlab ntsha los ntawm qog lossis cov teebmeem ntawm kev kho mob chemotherapy). Feem ntau qhov mob no piav qhia tias yog kub hnyiab, tingling, tapped, lossis zoo li hluav taws xob poob siab.
3. Mob sib xyaws: kev sib xyaws ntawm ob hom saum toj no, uas feem ntau pom muaj nyob rau hauv cov neeg mob qog noj ntshav.
4. Mob hnyav heev: mob uas tshwm sim sai sai thiab hnyav txawm tias qhov mob tseem ceeb tau raug tswj los ntawm kev siv tshuaj kho mob niaj hnub.
Kev nkag siab txog hom mob yog qhov tseem ceeb vim nws yuav coj cov kev xaiv kho mob zoo tshaj plaws.
Kev Ntsuas Qhov Mob: Kauj Ruam Tseem Ceeb Thawj Zaug
Kev tswj qhov mob pib nrog kev ntsuam xyuas zoo. Cov pab pawg kho mob feem ntau ntsuam xyuas qhov mob los ntawm kev nug txog nws qhov chaw, qhov mob hnyav, lub sijhawm ntev npaum li cas, tus cwj pwm, cov yam ntxwv ua rau mob hnyav dua lossis txo qhov mob, thiab nws qhov cuam tshuam rau cov dej num txhua hnub. Feem ntau siv qhov ntsuas qhov mob ntawm 0-10: 0 txhais tau tias tsis muaj mob, thiab 10 yog qhov mob hnyav tshaj plaws uas xav tau.
Daim ntawv ntsuam xyuas kuj suav nrog keeb kwm ntawm kev siv tshuaj, qhov muaj cov kev mob tshwm sim, kev ua haujlwm ntawm lub raum thiab daim siab, thiab cov yam ntxwv ntawm kev puas siab puas ntsws. Cov neeg mob raug txhawb kom ua siab ncaj thiab qhib siab thaum piav qhia txog qhov mob, vim tias qhov mob yog qhov mob ntawm tus kheej thiab tsuas yog tus neeg mob thiaj li tuaj yeem ntsuam xyuas qhov mob hnyav.
Cov Ntsiab Cai Tseem Ceeb ntawm Kev Tswj Qhov Mob hauv Mob Cancer
Lub hom phiaj tseem ceeb ntawm kev tswj qhov mob yog: txo qhov mob hnyav, txhim kho kev ua haujlwm thiab lub neej zoo, thiab txo cov kev phiv los ntawm kev kho mob. Cov ntsiab cai feem ntau siv suav nrog:
- Kev kho mob tus kheej: txhua tus neeg mob muaj cov mob thiab kev kam rau ua sib txawv.
– Kev noj tshuaj tsis tu ncua: rau qhov mob uas kav ntev, kev noj tshuaj yuav zoo dua yog tias muab raws sijhawm, tsis yog thaum mob xwb.
- Kev siv ntau hom kev kho mob: kev siv tshuaj, kev kho mob cuam tshuam, thiab kev txhawb nqa kev puas siab puas ntsws.
– Kev saib xyuas thiab ntsuam xyuas tsis tu ncua: qhov ntau npaum li cas thiab hom kev kho mob tuaj yeem hloov kho raws li qhov teb.
Kev Kho Mob Pharmacological: Analgesic Ladder thiab Kev Kho Mob
Ib txoj kev kho mob qub yog "analgesic ladder" uas pib kho raws li qib mob thiab nce ntxiv raws li qhov xav tau.
1. Tshuaj Kho Mob Me Me: Tsis Muaj Tshuaj Opioid
Yog tias mob me ntsis, cov tshuaj xws li paracetamol lossis cov tshuaj nonsteroidal anti-inflammatory drugs (NSAIDs) siv tau. Cov NSAIDs tuaj yeem pab tau rau kev mob pob txha lossis mob nrog rau qhov mob o. Txawm li cas los xij, cov NSAIDs yuav tsum tau siv nrog kev ceev faj rau cov neeg mob uas muaj teeb meem plab lossis raum, lossis muaj kev pheej hmoo ntawm kev los ntshav.
2. Cov tshuaj opioids rau qhov mob nruab nrab mus rau mob hnyav
Yog tias qhov mob nruab nrab mus rau hnyav lossis tsis tswj tau nrog cov tshuaj uas tsis yog opioid, cov tshuaj opioids yuav yog ib qho kev xaiv. Piv txwv li suav nrog tramadol (rau qhov mob nruab nrab), thiab morphine, oxycodone, lossis fentanyl (rau qhov mob hnyav dua). Cov tshuaj opioids tuaj yeem muab rau ntau hom: ntsiav tshuaj, tshuaj ntsiav qeeb qeeb, tee, daim ntawv nplaum, lossis koob tshuaj.
Feem ntau muaj kev txhawj xeeb txog kev vam khom tshuaj, tab sis thaum siv tshuaj kho mob uas kws kho mob saib xyuas rau mob qog noj ntshav, qhov tseem ceeb tshaj plaws yog kev tswj cov tsos mob thiab kev ua haujlwm ntawm cov tshuaj. Kev pheej hmoo tuaj yeem txo qis los ntawm kev xaiv cov tshuaj kom raug, kev qhia, thiab kev saib xyuas ze.
3. Cov Tshuaj Pab Txhawb Rau Mob Neuropathic
Qhov mob neuropathic feem ntau tsis zoo rau cov tshuaj opioid nkaus xwb. Yog li ntawd, cov tshuaj adjuvant xws li:
- qee cov tshuaj antidepressants (piv txwv li duloxetine lossis amitriptyline),
- tshuaj tiv thaiv qaug dab peg (piv txwv li gabapentin lossis pregabalin),
- cov tshuaj corticosteroids kom txo qhov o/mob hauv qee kis,
- tshuaj loog hauv zos hauv qee yam mob.
4. Kov Yeej Qhov Mob Uas Tshwm Sim Tshiab
Feem ntau, kev mob hnyav yuav tsum tau noj tshuaj uas ua haujlwm sai, uas yog "koob tshuaj cawm siav," ntxiv rau cov tshuaj niaj hnub. Koj tus kws kho mob yuav txiav txim siab seb hom tshuaj twg, koob tshuaj npaum li cas, thiab txoj kev siv tshuaj kom muaj kev nyab xeeb.
Kev Tswj Xyuas Cov Kev Mob Tsis Zoo ntawm Kev Kho Mob
Kev siv cov tshuaj loog mob, tshwj xeeb tshaj yog cov tshuaj opioid, tuaj yeem ua rau muaj kev phiv xws li xeev siab, tsaug zog, qhov ncauj qhuav, thiab feem ntau, cem quav. Kev cem quav nrog cov tshuaj opioid yuav luag ib txwm tshwm sim yam tsis muaj kev tiv thaiv, yog li cov tshuaj laxatives feem ntau raug sau tseg thaum xub thawj. Yog tias xeev siab lossis tsaug zog, tus kws kho mob tuaj yeem hloov kho qhov koob tshuaj, hloov hom tshuaj opioid, lossis ntxiv cov tshuaj txhawb nqa.
Nws yog ib qho tseem ceeb rau cov neeg mob kom qhia txog cov kev mob tshwm sim sai li sai tau. Ua li no, kev kho mob tuaj yeem ua tau zoo tshaj plaws yam tsis muaj kev cuam tshuam rau kev nplij siab.
Kev Kho Mob Uas Tsis Yog Tshuaj: Ib Txoj Kev Pab Ntxiv
Kev tswj qhov mob zoo tsis yog tsuas yog siv tshuaj xwb. Ntau txoj kev kho mob uas tsis yog siv tshuaj tuaj yeem pab txo qhov mob thiab txhim kho kev ua siab ntev ntawm lub hlwb, suav nrog:
- kev txhawb nqa kev puas siab puas ntsws (kev qhia tswv yim, kev kho mob hlwb-kev coj cwj pwm),
- kev so thiab kev ua pa,
- kev xav, kev ua tib zoo xav, lossis kev thov Vajtswv raws li koj txoj kev ntseeg,
- kev kho mob physiotherapy kom tswj tau kev txav mus los thiab txo qhov mob ntawm cov leeg nqaij;
- cov ntaub so sov/txias hauv qee qhov xwm txheej,
– kev siv koob txhaj tshuaj los yog kev zaws (nrog rau kev xav txog kev nyab xeeb, tshwj xeeb tshaj yog tias muaj pob txha metastases lossis cov ntshav txhaws tsis zoo),
- kev txhawb nqa tsev neeg thiab kev txhawb nqa hauv zej zog.
Kev kho mob uas tsis siv tshuaj muaj nqis heev vim lawv pab cov neeg mob kom muaj zog dua thiab txo kev ntxhov siab uas tuaj yeem ua rau mob hnyav dua.
Kev Tiv Thaiv Kab Mob Cancer thiab Kev Kho Mob Ua Kev Tswj Qhov Mob
Qee zaum, qhov mob tuaj yeem tswj tau zoo dua nrog kev kho mob, piv txwv li:
- kev kho mob radiotherapy palliative rau qhov mob metastatic ntawm pob txha,
- cov hlab ntsha thaiv lossis cov tshuaj loog rau qee qhov mob,
- lub twj tso kua tshuaj loog lossis tshuaj opioid hauv cov xwm txheej tshwj xeeb,
- cov txheej txheem orthopedic rau kev pheej hmoo ntawm pob txha tawg vim yog metastases,
- phais mob palliative kom txo qhov txhaws lossis siab ntawm qhov loj ntawm qog.
Tsis tas li ntawd xwb, kev kho mob qog noj ntshav nws tus kheej (chemotherapy, targeted therapy, immunotherapy) qee zaum txo qhov mob los ntawm kev ua kom lub qog me dua. Yog li ntawd, kev sib txuas lus ntawm cov pab pawg oncology thiab palliative care yog qhov tseem ceeb heev.
Lub Luag Haujlwm ntawm Pab Pawg Saib Xyuas Palliative thiab Kev Sib Txuas Lus nrog Cov Neeg Mob
Kev kho mob palliative tsis yog rau theem kawg ntawm lub neej xwb. Nws yog ib txoj hauv kev uas tsom mus rau qhov zoo ntawm lub neej txij li thaum pib muaj tus kab mob, suav nrog kev tswj qhov mob thiab lwm yam tsos mob, nrog rau kev txhawb nqa kev puas siab puas ntsws. Kev koom tes ntawm cov kws kho mob, cov kws tu mob, cov kws muag tshuaj, cov kws kho mob hlwb, thiab cov xibhwb tuaj yeem pab cov neeg mob tau txais kev kho mob dav dav.
Cov neeg mob kuj yuav tsum koom nrog kev txiav txim siab. Kev piav qhia txog lub hom phiaj kev kho mob, kev cia siab, thiab cov kev xaiv muaj yuav ua rau kev ua raws li txoj cai thiab txo kev ntxhov siab.
Xaus
Kev tswj qhov mob qog noj ntshav yog ib qho txheej txheem uas tau npaj tseg, maj mam, thiab ua raws li tus kheej xav tau. Kev mob qog noj ntshav tuaj yeem tswj tau los ntawm kev siv tshuaj sib xyaw ua ke, kev kho mob ntxiv, cov txheej txheem tsis yog tshuaj, thiab kev kho mob thaum xav tau. Kev ntsuas qhov mob kom raug, kev saib xyuas cov kev mob tshwm sim, thiab kev sib txuas lus zoo ntawm tus neeg mob, tsev neeg, thiab pab pawg neeg saib xyuas kev noj qab haus huv yog qhov tseem ceeb rau kev vam meej. Nrog kev tswj qhov mob kom zoo, cov neeg mob qog noj ntshav muaj lub sijhawm ntau dua los ua cov haujlwm txhua hnub nrog kev nplij siab, lub ntsiab lus, thiab kev hwm.
