Gomarara remudumbu ndiro rine huwandu hwakanyanya hwemagomarara emudumbu pasi rose. Zvisinei, chirwere chinodzivirirwa uye chinorapika. Nekurarama hupenyu hune hutano, kuongororwa nguva dzose, uye kutsvaga kuongororwa nekukurumidza uye kurapwa, tinogona kurwisa chirwere ichi zvinobudirira. Ngatikupei zvino tsananguro pamibvunzo mipfumbamwe inokosha kuti tikubatsirei kunzwisisa zviri nani gomarara remudumbu.
1. Ko gomarara remudumbu rinosiyana zvichienderana nerudzi, dunhu, uye zera here?
Zvichienderana nedata repasi rose regomarara muna 2020, China yakashuma nyaya itsva dzegomarara dzinosvika mamiriyoni 4.57, uye gomarara remudumbu ndiro rakakonzera chirwere ichi.nyaya dzinosvika 480,000, kana kuti 10.8%, dziri pakati penyaya nhatu dzepamusoro.Gomarara remudumbu rinoratidza kusiyana kwakajeka maererano nerudzi nenzvimbo. Dunhu reEast Asia inzvimbo ine njodzi huru yekubatwa negomarara remudumbu, China, Japan, neSouth Korea zvichitora 70% yehuwandu hwevanhu vanobatwa negomarara pasi rose. Izvi zvinokonzerwa nezvinhu zvakaita semajini, kudya chikafu chakagochwa nechakabikwa muhari, uye kusvuta fodya kwakanyanya munzvimbo iyi. MuChina, gomarara remudumbu rakawanda munzvimbo dziri kumahombekombe dzine kudya kwakawanda, pamwe nenzvimbo dziri pakati nepazasi dzeRwizi rweYangtze nenzvimbo dzine urombo.
Panyaya yezera, avhareji yekutanga kwekenza yemudumbu iri pakati pemakore makumi mashanu nemashanu nemakumi matanhatu. Mumakore gumi apfuura, huwandu hwevanhu vanobatwa nekenza yemudumbu muChina hwakaramba hwakagadzikana, nekuwedzera kudiki. Zvisinei, huwandu hwevanhu vanobatwa nekenza yemudumbu hwave huchikwira nekukurumidza, zvichipfuura avhareji yenyika. Pamusoro pezvo, nyaya idzi dzinowanzoonekwa sekenza yemudumbu inopararira, iyo ine matambudziko ekurapa.
2. Ko kenza yemudumbu ine maronda asati aita kenza here? Ndezvipi zviratidzo zvikuru?
Mapolyps emudumbu, gastritis isingaperi isingawanzoitiki, uye dumbu rinosara ndizvo zvinhu zvine njodzi huru yekenza yemudumbu.Kukura kwegomarara remudumbu inzira inoitika muzvikamu zvakawanda, mazinga akawanda, uye nhanho dzakawanda.Pakutanga kwegomarara remudumbu,varwere havawanzo ratidza zviratidzo zviri pachena, kana kuti vanogona kungonzwa kusagadzikana kudiki mudumbu repamusoro,kurwadziwa kwemudumbu kwekumusoro kusingawanzoitiki, kurasikirwa nechido chekudya, kuzvimba, kusviba, uye mune dzimwe nguva, tsvina nhema kana kurutsa ropa. Kana zviratidzo zvikanyanya kuoneka,zvichiratidza nhanho dzepakati kusvika padanho repamusoro rekenza yemudumbu, varwere vanogona kurasikirwa nehuremu zvisina tsarukano, kupererwa neropa,hypoalbuminemia (huwandu hwakaderera hweprotein muropa)kuzvimba,kurwadziwa kwemudumbu kunoramba kuripokurutsa ropa, uyezvituru zvitema, pakati pezvimwe.
3. Vanhu vane njodzi huru yekenza yemudumbu vangaonekwa sei nekukurumidza?
Nhoroondo yemhuri yemagomarara: Kana paine zviitiko zvegomarara remudumbu kana mamwe magomarara muzvizvarwa zviviri kana zvitatu zvehama, mukana wekuwana gomarara remudumbu wakakwira. Nzira inokurudzirwa ndeyekuongororwa kwegomarara nenyanzvi makore gumi kusvika gumi nemashanu pamberi pezera remudiki pane chero nhengo yemhuri ine gomarara. Kune gomarara remudumbu, kuongororwa kwegomarara kunofanirwa kuitwa makore matatu ega ega, sezvakarairwa nachiremba. Semuenzaniso, kana zera remudiki pane nhengo yemhuri ine gomarara riri nemakore makumi mashanu nemashanu ekuberekwa, kuongororwa kwekutanga kwegomarara kunofanirwa kuitwa pazera remakore makumi mana.
Vanhu vane nhoroondo yakareba yekuputa fodya, kunwa doro, kufarira chikafu chinopisa, chakabikwa muhari, uye chakagochwa, uye kudya chikafu chine munyu wakawanda vanofanira kukurumidza kugadzirisa tsika idzi dzisina kunaka, sezvo dzinogona kukonzera kukuvara kukuru mudumbu.
Varwere vane maronda emudumbu, gastritis isingaperi, nezvimwe zvirwere zvemudumbu vanofanira kutsvaga kurapwa kuti vadzivise kufambira mberi kwechirwere uye kuti vaongororwe nguva nenguva kuchipatara.
4. Gastritis isingaperi nemaronda emudumbu zvinogona kukonzera kenza yemudumbu here?
Zvimwe zvirwere zvemudumbu zvinhu zvine njodzi huru yekenza yemudumbu uye zvinofanira kutorwa zvakakomba. Zvisinei, kuva nezvirwere zvemudumbu hazvirevi kuti munhu achatanga kenza yemudumbu. Maronda emudumbu anobatanidzwa zviri pachena nenjodzi yakakura yekuva nekenza. Gastritis inogara kwenguva refu uye yakaoma, kunyanya kana ichiratidza zviratidzo zvekupera simba, metaplasia yemudumbu, kana hyperplasia isingawanzoitiki, inoda kutariswa zvakanyanya. Zvakakosha kurega tsika dzisina kunaka dzakadai sekumira kusvuta, kuderedza kunwa doro, uye dzivisa chikafu chakakangwa uye chine munyu wakawandaPamusoro pezvo, zvinokurudzirwa kuti ugare uchiongororwa nachiremba wezvekudya gore rega rega kuti uongorore mamiriro acho ezvinhu uye kuti ufunge nezvemazano akadai segastroscopy kana mishonga.
5. Pane hukama here pakati peHelicobacter pylori negomarara remudumbu?
Helicobacter pylori ibhakitiriya rinowanzo kuwanikwa mudumbu, uye rinobatanidzwa nerudzi rwakati rwekenza yemudumbu. Kana munhu akaonekwa aine Helicobacter pylori uye aine zvirwere zvemudumbu zvisingaperi zvakaita sechirwere chegastritis chisingaperi kana maronda emudumbu, njodzi yavo yekuva nekenza yemudumbu inowedzera. Kutsvaga kurapwa nenguva kwakakosha mumamiriro ezvinhu akadaro. Kuwedzera kune munhu ane chirwere ichi, nhengo dzemhuri dzinofanirawo kuongororwa uye kufunga nezvekurapa kwakabatana kana zvichidikanwa.
6. Pane imwe nzira isinganyanyi kurwadza panzvimbo pegastroscopy here?
Zvechokwadi, kuvhiyiwa gastroscopy pasina nzira dzekuderedza marwadzo kunogona kurwadza.Zvisinei, kana zvasvika pakuona kenza yemudumbu iri padanho rekutanga, gastroscopy ndiyo nzira inoshanda zvakanyanya parizvino.Dzimwe nzira dzekuongorora chirwere dzinogona kusaona kenza yemudumbu pakutanga, izvo zvinogona kukanganisa zvikuru mikana yekurapwa zvakanaka.
Chinhu chakanaka che gastroscopy ndechekuti inobvumira vanachiremba kuona dumbu zvakananga nekuisa chubhu yakatetepa, inochinjika kuburikidza negurokuro uye vachishandisa kamuchina kadiki kakaita sekamera. Izvi zvinoita kuti vakwanise kuona dumbu zvakajeka uye vasapotsa chero shanduko dzisinganzwisisike. Zviratidzo zvekutanga zvegomarara remudumbu zvinogona kunge zvisinganzwisisike, zvakafanana nekavara kadiki paruoko rwedu katingasatarisa, asi panogona kunge paine shanduko diki muruvara rwemukati memudumbu. Kunyange hazvo CT scans uye contrast agents zvichigona kuona zvimwe zvirwere zvikuru zvemudumbu, zvinogona kusaona shanduko dzakadaro dzisinganzwisisike. Saka, kune avo vanokurudzirwa kuita gastroscopy, zvakakosha kuti vasazeze.
7. Ndeipi nzira yakanakisisa yekuongorora kenza yemudumbu?
Gastroscopy ne pathological biopsy ndiwo mwero wepamusoro wekuongorora kenza yemudumbu. Izvi zvinopa kuongororwa kwemhando yepamusoro, zvichiteverwa nematanho ekuongorora. Kuvhiyiwa, kurapwa nemwaranzi, chemotherapy, uye rubatsiro rwekutsigira ndidzo nzira huru dzekurapa kenza yemudumbu. Kuvhiyiwa ndiko kurapwa kwekutanga kwekenza yemudumbu iri padanho rekutanga, uye kurapwa kwakazara kwemarudzi akasiyana-siyana pari zvino kunoonekwa senzira yepamusoro yekurapa kenza yemudumbu. Zvichienderana nemamiriro emuviri wemurwere, kufambira mberi kwechirwere, nezvimwe zvinhu, timu yenyanzvi dzakasiyana-siyana inoshanda pamwe chete kugadzira hurongwa hwekurapa hwemurwere, hunonyanya kukosha kune varwere vane matambudziko akaomarara. Kana matanho ekuongorora uye kuongororwa kwemurwere zvakajeka, kurapwa kunogona kuitwa zvichienderana nenhungamiro dzakakodzera dzekenza yemudumbu.
8. Munhu anofanira kutsvaga sei rubatsiro rwechiremba nezvegomarara remudumbu nenzira yesainzi?
Kurapwa kusingawanzoitiki kunogona kukurudzira kukura kwemasero egomarara uye kuwedzera kuoma kwekurapwa kunotevera. Kuongororwa kwekutanga uye kurapwa kwakakosha kune varwere vane kenza yemudumbu, saka zvakakosha kutsvaga rubatsiro kubva kubazi rezvekurapa rekenza. Mushure mekuongororwa kwakakwana, chiremba achaongorora mamiriro emurwere uye opa mazano ekurapwa, ayo anofanira kukurukurwa nemurwere nemhuri yake vasati vaita sarudzo. Varwere vazhinji vanonetseka uye vanoda kuongororwa nekukurumidza nhasi uye kuvhiyiwa mangwana. Havagoni kumirira mumutsara kuti vaongororwe kana kuti varapwe muchipatara. Zvisinei, kuti vawane kurapwa nekukurumidza, kuenda kuzvipatara zvisina nyanzvi uye zvisiri nyanzvi kuti varapwe zvisina kujairika kunogona kuisa njodzi kuhutano hwechirwere chinotevera.
Kana kenza yemudumbu yaonekwa, inowanzo kuvepo kwenguva yakati. Kunze kwekunge paine matambudziko akakomba akadai sekuboorwa, kubuda ropa, kana kuvharika, hapana chikonzero chekunetseka kuti kunonoka kuvhiyiwa nekukurumidza kuchakurumidzisa kukura kwegomarara. Kutaura zvazviri, kupa vanachiremba nguva yakakwana yekunzwisisa mamiriro emurwere zvakakwana, kuongorora kushivirira kwavo mumuviri, uye kuongorora hunhu hwegomarara kwakakosha kuti pave nemigumisiro iri nani yekurapwa.
9. Tinofanira kuona sei mashoko ekuti "chikamu chimwe muzvitatu chevarwere vanotya kusvika vafa"?
Mashoko aya akawandisa. Muchokwadi, kenza haisi chinhu chinotyisa sezvatingafungidzira. Vanhu vazhinji vanorarama nekenza uye vanorarama hupenyu hunogutsa. Mushure mekuonekwa vaine kenza, zvakakosha kugadzirisa mafungiro avo uye kutaura zvakanaka nevarwere vane tariro. Kune vanhu vari muchikamu chekupora mushure mekurapwa kenza yemudumbu, nhengo dzemhuri nevanoshanda navo havafanirwe kuvabata sevanhu vasina simba, vachivarambidza kuita chero chinhu. Maitiro aya anogona kuita kuti varwere vanzwe sekunge kukosha kwavo hakusi kuzivikanwa.
Mwero wekurapwa kwegomarara remudumbu
Mwero wekurapwa kwegomarara remudumbu muChina ungangoita 30%, izvo zvisiri zvishoma kana tichienzanisa nedzimwe mhando dzegomarara. Kune gomarara remudumbu riri padanho rekutanga, mwero wekurapwa unowanzoita 80% kusvika 90%. Kune danho rechipiri, kazhinji unenge uri 70% kusvika 80%. Zvisinei, padanho rechitatu, iro rinoonekwa serakakwira, mwero wekurapwa unodzikira kusvika pa30%, uye padanho rechina, usingasviki 10%.
Kana tichitarisa nzvimbo, kenza yemudumbu iri kure ine mwero wekurapwa wakakwira zvichienzaniswa nekenza yemudumbu iri kure. Kenza yemudumbu iri kure inoreva kenza iri pedyo ne pylorus, nepo kenza yemudumbu iri kure inoreva kenza iri pedyo ne cardia kana gastric body. Kenza yeSignet ring cell carcinoma yakaoma kuona uye inowanzo pararira, zvichikonzera mwero wekurapwa wakaderera.
Saka, zvakakosha kunyatsoteerera chero shanduko dziri kuitika mumuviri wemunhu, kugara uchiongororwa nachiremba, uye kutsvaga rubatsiro rwechiremba nekukurumidza kana paine kusagadzikana kwemudumbu nguva dzose. Kana zvichidikanwa, gastroscopy inofanira kuitwa. Varwere vakamborapwa ne endoscopic kare vanofanirawo kugara vachionana nachiremba wemudumbu uye kutevedzera mazano echiremba ekuongorora gastroscopy nguva nenguva.
Nguva yekutumira: Nyamavhuvhu-10-2023