Mu 2017, bungwe la World Health Organization linapereka njira yogwiritsira ntchito"Kuzindikira msanga, kuzindikira msanga, ndi chithandizo msanga", chomwe cholinga chake ndi kukumbutsa anthu kuti azisamala ndi zizindikiro pasadakhale. Pambuyo pa zaka zambiri zopezera ndalama zenizeni zachipatala,Njira zitatuzi zakhala njira yothandiza kwambiri yopewera khansa.
Malinga ndi "Global Cancer Report 2020" yomwe idatulutsidwa ndi WHO, zikunenedwa kuti chiwerengero cha khansa zatsopano padziko lonse lapansi chidzakwera kufika pa 30.2 miliyoni mu 2040 ndipo chiwerengero cha imfa chidzafika pa 16.3 miliyoni.
Mu 2020, padzakhala khansa zatsopano 19 miliyoni padziko lonse lapansi.Panthawiyo, khansa zitatu zazikulu zomwe zinali ndi chiwerengero chachikulu cha khansa padziko lonse lapansi ndi izi: khansa ya m'mawere (22.61 miliyoni), khansa ya m'mapapo (2.206 miliyoni), khansa ya m'matumbo (19.31 miliyoni), ndi khansa ya m'mimba inali pamalo achisanu ndi chimodzi ndi 10.89 miliyoni,Mu chiwerengero cha khansa zatsopano, khansa ya m'matumbo ndi khansa ya m'mimba zinali 15.8% ya khansa zonse zatsopano.
Monga tonse tikudziwa, njira ya Manhua imatanthauza kuyambira pakamwa mpaka pakhomo la utawaleza, zomwe zimaphatikizapo m'mero, m'mimba, m'matumbo ang'onoang'ono, m'matumbo akuluakulu (cecum, appendix, colon, rectum ndi anal canal), chiwindi, kapamba, ndi zina zotero, ndi colorectum m'makhansa atsopano padziko lonse lapansi. Khansa ndi khansa ya m'mimba zonse ndi za m'mimba, kotero khansa zokhudzana ndi njira ya m'mimba ziyeneranso kuganiziridwa ndipo njira "yoyambirira itatu" iyenera kukhazikitsidwa.
Mu 2020, chiwerengero cha odwala khansa atsopano m'dziko langa chinafikanso pa 4.5 miliyoni, ndipo chiwerengero cha anthu omwe anamwalira ndi khansa chinali 3 miliyoni.Anthu pafupifupi 15,000 ankapezeka ndi khansa tsiku lililonse, ndipo anthu 10.4 ankapezeka ndi khansa mphindi iliyonse. Chachisanu ndi khansa ya m'mapapo.(zomwe zikuyimira 17.9% ya khansa zonse zatsopano),khansa ya m'matumbo (12.2%), khansa ya m'mimba (10.5%),khansa ya m'mawere (9.1%), ndi khansa ya chiwindi (9%). Pakati pa khansa zisanu zapamwamba zokha,Khansa ya m'mimba inali 31.7% ya khansa zonse zatsopano.Zikuoneka kuti tiyenera kusamala kwambiri pozindikira ndi kupewa khansa ya m'mimba.
Chotsatirachi ndi kope la 2020 (kafukufuku wapadera ndi malangizo opewera khansa ya anthu ya Chang Beihui) yokhudza dongosolo lopewera ululu wa m'mimba ndi kuwunika:
Khansa ya m'matumbo
1. Anthu omwe alibe zizindikiro zosonyeza matendawa azaka zopitilira 1.45;
2. Anthu opitirira zaka 240 omwe ali ndi zizindikiro za m'mimba kwa milungu iwiri:
3. Odwala omwe ali ndi zilonda zam'mimba kwa nthawi yayitali;
Anthu 4.4 atachitidwa opaleshoni ya khansa ya m'matumbo;
5. Chiwerengero cha anthu pambuyo pochiza matenda a colorectal adenoma;
6. Achibale apafupi omwe ali ndi mbiri ya banja lawo ya khansa ya m'matumbo
7. Achibale enieni a odwala omwe adapezeka ndi khansa ya m'matumbo yobadwa nayo omwe ali ndi zaka zoposa 20
1. Misonkhano Yowunikira "Anthu Onse" 1-5:
(1) Kuyezetsa khansa ya m'matumbo kumayamba munthu akakwanitsa zaka 45, mosasamala kanthu za mwamuna kapena mkazi, magazi achilengedwe (FOBT) amapezeka kamodzi pachaka.
Colonoscopy zaka 10 zilizonse mpaka zaka 75;
(2) Anthu azaka zapakati pa 76-85, omwe ali ndi thanzi labwino, komanso omwe ali ndi moyo wopitilira zaka 10, akhoza kupitiriza kusamalira zokongoletsazo.
2 Mogwirizana ndi "Kafukufuku wa zachipatala wa achibale omwe ali ndi mbiri ya banja lawo ya khansa ya m'matumbo:
(1) wachibale 1 woyamba yemwe ali ndi adenoma yapamwamba kapena ululu (zaka zoyambira sizipitirira zaka 60), 2
Achibale oyamba kapena opitilira apo omwe ali ndi adenoma yapamwamba kapena khansa (zaka zilizonse zoyambira), kuyambira ali ndi zaka 40 (kapena kuyambira ali ndi zaka 10 zochepa kuposa zaka zoyambira za wachibale wamng'ono kwambiri), Kuyesedwa kwa FOBT kamodzi pachaka, kamodzi pa zaka 5 zilizonse Colonoscopy;
(2) Anthu omwe ali pachiwopsezo chachikulu omwe ali ndi mbiri ya banja la achibale awo oyamba (m'modzi yekha, ndipo zaka zawo zoyambira ndi zopitilira zaka 60):
Yambani kuyezetsa ali ndi zaka 40, ndi mayeso a FOBT chaka chilichonse ndi colonoscopy zaka khumi zilizonse. 3 Kuyezetsa achibale a "khansa ya m'matumbo yobadwa nayo" msonkhano 7;
Kwa achibale a odwala omwe ali ndi FAP ndi HNPCC, kuyezetsa kusintha kwa majini kumalimbikitsidwa pamene kusintha kwa majini koyamba m'banjamo kuli komveka bwino.
(1) Kwa iwo omwe ali ndi mayeso abwino a kusintha kwa majini, atakwanitsa zaka 20, colonoscopy iyenera kuchitidwa chaka chilichonse 1-2; (2) Kwa iwo omwe ali ndi mayeso oipa a kusintha kwa majini, anthu onse ayenera kuyesedwa. 4 Njira zovomerezeka zowunikira:
(1) Kuyesa kwa FOBT + kufufuza pakati pa voliyumu ndiyo njira yayikulu yofufuzira ya Han, ndipo umboni ndi wokwanira:
(2) Kuzindikira majini ambiri a magazi kungathandize kukonza kulondola kwa kuwerengera, ndipo mtengo wake ndi wokwera mtengo; (3) Ngati zinthu zilola, kuyezetsa magazi kungachitike pophatikiza ndowe ndi njira zamagazi.
1. Kuchita masewera olimbitsa thupi kungathandize kuchepetsa kufalikira kwa zotupa, kutsatira utsogoleri wa masewera, ndi kusambira kuti mupewe kunenepa kwambiri;
2. Chakudya chabwino cha ubongo, kudya zipatso zatsopano ndi ulusi wosaphikidwa bwino, komanso kupewa kudya zakudya zokhala ndi mafuta ambiri komanso mapuloteni ambiri;
3 Mankhwala oletsa kutupa komanso oletsa khansa omwe si a thupi angathandize kupewa khansa ya m'matumbo. Okalamba angayesere kumwa aspirin yochepa, yomwe ingachepetse chiopsezo cha matenda a mtima ndi mitsempha ya m'magazi komanso khansa ya m'matumbo. Funsani dokotala kuti akuthandizeni kugwiritsa ntchito mankhwala enaake.
5. Chepetsani kusuta kuti mupewe poizoni wake wa nthawi yayitali komanso kuyambitsa kutupa kwa Qinghua Dao.
Khansa ya M'mimba
Aliyense amene ali ndi chimodzi mwa izi ndi chinthu chomwe chili pachiwopsezo chachikulu;
1. Zaka zoposa 60;
2 Matenda a gastritis ofooka komanso ofooka kwambiri;
3. Chilonda cha m'mimba chosatha;
4. Ma polyps a m'mimba;
5. Chizindikiro chachikulu cha mucosa wa m'mimba;
6. Mimba yotsala pambuyo pa opaleshoni chifukwa cha matenda osaopsa;
7. Mimba yotsala pambuyo pa opaleshoni ya khansa ya m'mimba (miyezi 6-12 pambuyo pa opaleshoni);
8. Matenda a Helicobacter pylori;
9. Mbiri yomveka bwino ya banja la khansa ya m'mimba kapena ya m'mero;
10. Kuchepa kwa magazi m'thupi:
11. Familyal adenomatous polyposis (FAP), mbiri ya banja ya khansa ya m'matumbo yopanda polyposis (HNPCC).
Zaka zoposa 40 zokhala ndi ululu m'mimba, kutupa m'mimba, asidi wobwerera m'mimba, kutentha pamtima ndi zizindikiro zina za kusasangalala m'mimba, komanso gastritis yosatha, gastric mucosal intestinal metaplasia, gastric polyps, residue stomach, giant gastric fold sign, chronic gastric ulcer ndi gastric epithelial atypia Hyperplasia ndi zilonda zina ndi zinthu zomwe zili ndi mbiri ya banja la zotupa ziyenera kuchitidwa gastroscopy nthawi zonse malinga ndi malangizo a dokotala.
1. Khazikitsani zizolowezi zabwino zodyera komanso kapangidwe ka zakudya, osati kudya mopitirira muyeso;
2. Kuchotsa matenda a Helicobacter pylori;
3. Chepetsani kudya zakudya zozizira, zokometsera, zotentha kwambiri, komanso zolimba, komanso zakudya zokhala ndi mchere wambiri monga zosuta ndi zokazinga.
4. Siyani kusuta;
5. Imwani mowa wochepa kapena musamwe mowa wamphamvu;
6. Pumulani ndi kuchepetsa nkhawa moyenera
Khansa ya m'mero
Zaka zoposa 40 ndipo amakumana ndi zoopsa izi:
1. Kuchokera ku dera lomwe khansa ya m'mero imafalikira kwambiri m'dziko langa (dera lomwe khansa ya m'mero imafalikira kwambiri m'dziko langa lili m'zigawo za Hebei, Henan ndi Shanxi kum'mwera kwa Phiri la Taihang, makamaka ku Cixian County, ku Qinling, Dabie Mountain, kumpoto kwa Sichuan, Fujian, Guangdong, kumpoto kwa Jiangsu, Xinjiang, ndi zina zotero. Magulu a nthaka ndi achilengedwe amapezeka m'madera omwe khansa imafalikira kwambiri);
2. Zizindikiro zam'mimba monga nseru, kusanza, kupweteka m'mimba, kubweza asidi, kusadya bwino ndi zizindikiro zina;
3. Mbiri ya banja la ululu wa m'khosi:
4. Kuvutika ndi matenda a m'mero omwe asanafike khansa kapena zilonda zomwe zisanachitike khansa:
5. Ali ndi zinthu zomwe zingayambitse khansa ya m'mero monga kusuta fodya, kumwa mowa kwambiri, kunenepa kwambiri, kukonda chakudya chotentha, khansa ya m'mutu ndi khosi kapena njira yopumira;
6. Kuvutika ndi matenda a periesophageal reflux (CERD);
7. Matenda a papillomavirus (HPV) a anthu.
Anthu omwe ali pachiwopsezo chachikulu cha khansa ya m'mero:
1. Endoscopy yachizolowezi, kamodzi pa zaka ziwiri zilizonse;
2 Endoscopy yokhala ndi zotsatira za matenda a dysplasia yofatsa, endoscopy kamodzi pachaka;
3 Endoscopy yokhala ndi zotsatira za matenda a dysplasia yapakati, endoscopy miyezi isanu ndi umodzi iliyonse
1. Musasute fodya kapena kusiya kusuta;
2. Kumwa mowa pang'ono kapena kusamwa mowa;
3. Idyani zakudya zoyenera, idyani zipatso ndi ndiwo zamasamba zatsopano zambiri
4. Limbikitsani masewera olimbitsa thupi ndikukhala ndi kulemera koyenera;
5. Musadye chakudya chotentha kapena kumwa madzi otentha.
Khansa ya chiwindi
Amuna azaka zopitilira 35 ndi akazi azaka zopitilira 45 m'magulu aliwonse otsatirawa:
1. Matenda a chiwindi cha mtundu wa B (HBV) kapena matenda a chiwindi cha mtundu wa C (HCV);
2. Anthu omwe ali ndi mbiri ya banja lawo ya khansa ya chiwindi;
3. Odwala matenda a chiwindi omwe amayamba chifukwa cha matenda a schistosomiasis, mowa, matenda a biliary cirrhosis oyamba, ndi zina zotero;
4. Odwala omwe ali ndi vuto la chiwindi chifukwa cha mankhwala;
5. Odwala omwe ali ndi matenda obadwa nawo a kagayidwe kachakudya, kuphatikizapo: hemochromatosis a-1 antitrypsin deficiency, matenda osungira glycogen, delay cutaneous porphyria, tyrosinemia, ndi zina zotero;
6. Odwala matenda a chiwindi omwe amadziteteza okha;
7. Odwala matenda a chiwindi osakhala ndi mafuta ambiri (NAFLD)
1. Amuna azaka zopitilira 35 ndi akazi azaka zopitilira 45 omwe ali pachiwopsezo chachikulu cha khansa ya chiwindi ayenera kufufuzidwa;
2. Kugwiritsa ntchito pamodzi seramu alpha-fetoprotein (AFP) ndi chiwindi B-ultrasound, kuyezetsa miyezi 6 iliyonse
1. Katemera wa Hepatitis B;
2. Odwala matenda a chiwindi osatha ayenera kulandira chithandizo cha mavairasi mwamsanga kuti achepetse kufalikira kwa kachilombo ka chiwindi.
3. Pewani kumwa mowa kapena kuchepetsa kumwa mowa;
4. Idyani zakudya zopepuka ndipo chepetsani kudya zakudya zonenepa kwambiri
5. Pewani kudya chakudya chowuma.
Khansa ya kapamba
Anthu azaka zopitilira 40, makamaka azaka zopitilira 50, omwe ali ndi chimodzi mwa zinthu zotsatirazi (chinthu chachisanu ndi chimodzi sichikuwonjezera chiopsezo cha khansa ya kapamba, koma nthawi zambiri kuyezetsa sikumachitika):
1. Mbiri ya banja la khansa ya kapamba ndi matenda a shuga;
2. Pali mbiri ya kusuta fodya kwa nthawi yaitali, kumwa mowa, kudya zakudya zokhala ndi mafuta ambiri komanso mapuloteni ambiri;
3. Kudzaza m'mimba pakati ndi pamwamba, kusapeza bwino, kupweteka m'mimba popanda chifukwa chodziwika bwino, ndi zizindikiro monga kusowa chilakolako cha chakudya, kutopa, kutsegula m'mimba, kuchepa thupi, kupweteka msana, ndi zina zotero;
4. Zochitika zobwerezabwereza za kapamba kosatha, makamaka kapamba kosatha wokhala ndi miyala ya duct ya pancreatic, main pancreatic duct-type mucinous papilloma, mucinous cystic adenoma, ndi solid pseudopapillary tumor, yokhala ndi kuchuluka kwa CA19-9 m'magazi;
5. Kuyamba mwadzidzidzi kwa matenda a shuga popanda mbiri ya banja;
6. Helicobacter pylori (HP) positive, mbiri ya matenda a m'kamwa, matenda a PJ, ndi zina zotero.
1. Anthu omwe atchulidwa pamwambapa amafufuzidwa ndi zotsatira za mayeso a magazi a zizindikiro za chotupa monga CA19-9, CA125 CEA, ndi zina zotero, kuphatikiza ndi CT ndi MRI ya m'mimba, ndipo B-ultrasound ingaperekenso thandizo loyenera;
2. Kuyezetsa CT kapena MR kamodzi pachaka kwa anthu omwe atchulidwa pamwambapa, makamaka omwe ali ndi mbiri ya m'banja komanso zilonda za kapamba zomwe zilipo kale.
1. Siyani kusuta fodya ndi kumwa mowa;
2. Limbikitsani kudya zakudya zopepuka, zosavuta kugaya, komanso zopanda mafuta ambiri;
3. Idyani nkhuku, nsomba ndi nkhanu zambiri, ndipo limbikitsani kudya ndiwo zamasamba za "+", monga kabichi wobiriwira, kabichi, radish, broccoli, ndi zina zotero;
4. Limbikitsani masewera olimbitsa thupi akunja
5. Pofuna kupewa kuwonongeka kwa zilonda zosavulaza, anthu omwe ali ndi miyala ya pancreatic duct, intraductal mucinous papilloma ndi cystic adenoma kapena zilonda zina zosavulaza za pancreatic ayenera kupita kuchipatala nthawi yomweyo.
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Nthawi yotumizira: Sep-09-2022