Ngo-2017, Inhlangano Yezempilo Yomhlaba ihlongoze isu loku"ukutholwa kusenesikhathi, ukuxilongwa kusenesikhathi, kanye nokwelashwa kusenesikhathi", okuhloswe ngayo ukukhumbuza umphakathi ukuthi unake izimpawu kusengaphambili.Ngemuva kweminyaka yemali yangempela yomtholampilo,lawa masu amathathu abe yindlela ephumelela kakhulu yokuvimbela umdlavuza.
Ngokombiko we-“Global Cancer Report 2020” okhishwe yi-WHO, kubikezelwa ukuthi isibalo somdlavuza omusha emhlabeni wonke sizonyuka sifinyelele ku-30.2 million ngo-2040 kanti isibalo sabashonile sizofinyelela ku-16.3 million.
Ngo-2020, kuzoba nomdlavuza omusha oyizigidi eziyi-19 emhlabeni.Ngaleso sikhathi, imidlavuza emithathu emikhulu enenombolo enkulu yomdlavuza emhlabeni yilena: umdlavuza webele (22.61 million), umdlavuza wamaphaphu (2.206 million), colon (19.31 million), kanye nomdlavuza wesisu okleliswe endaweni yesihlanu ngezigidi eziyi-10.89 ,esibalweni semidlavuza emisha, umdlavuza wamathumbu kanye nomdlavuza wesisu kubalwe ku-15.8% wawo wonke umdlavuza omusha.
Njengoba sonke sazi, ipheshana le-Manhua libhekisela emlonyeni kuya emnyango wothingo, okubandakanya umphimbo, isisu, amathumbu amancane, amathumbu amakhulu (i-cecum, i-appendix, ikholoni, i-rectum kanye ne-anal canal), isibindi, ama-pancreas, njll. kanye ne-colorectum kumdlavuza omusha emhlabeni wonke Umdlavuza kanye nomdlavuza wesisu zombili ziyingxenye yomgudu wokugaya ukudla, ngakho umdlavuza ohlobene nomgudu wokugaya ukudla nawo udinga ukunakwa futhi kufanele kuqaliswe isu "lokuthathu kusenesikhathi".
Ngo-2020, isibalo samacala amasha omdlavuza ezweni lami nawo safinyelela ezigidini ezi-4.5, kanti isibalo sababulawa umdlavuza sasiyizigidi ezi-3.Isilinganiso sabantu abangu-15,000 kwatholakala ukuthi banomdlavuza nsuku zonke, futhi abantu abangu-10.4 batholakala benomdlavuza njalo ngomzuzu.Owesihlanu umdlavuza wamaphaphu(ibalwa ku-17.9% wawo wonke umdlavuza omusha),umdlavuza we-colorectal (12.2%), umdlavuza wesisu (10.5%),umdlavuza webele (9.1%), nomdlavuza wesibindi (9%).Phakathi kwemidlavuza emihlanu ephezulu iyodwa,umdlavuza wamathumbu ubalelwa ku-31.7% wawo wonke umdlavuza omusha.Kuyabonakala ukuthi sidinga ukunaka kakhulu ukutholwa kanye nokuvinjelwa komdlavuza womgudu wokugaya ukudla.
Okulandelayo uhlelo lwango-2020 (uphenyo olukhethekile kanye nesincomo sokuvinjelwa kwesimila sabantu se-Chang Beihui) olubandakanya uhlelo lokuvimbela ubuhlungu bomgudu wokugaya ukudla kanye nohlelo lokuhlola:
Umdlavuza we-colorectal
1.Abantu abangenazimpawu ezingaphezulu kweminyaka eyi-1.45;
2.Abantu abangaphezu kweminyaka engama-240 abanezimpawu ze-anorectal amasonto amabili":
3.Iziguli ezine-ulcerative colitis isikhathi eside;
abantu abangu-4.4 ngemva kokuhlinzwa komdlavuza wesikhumba;
5. Inani labantu ngemva kokwelashwa kwe-colorectal adenoma;
6. Izihlobo eziseduze ezinomlando womndeni womdlavuza we-colorectal
7. Izihlobo eziseduze zeziguli ezitholwe zinomdlavuza we-colorectal wofuzo ezingaphezu kweminyaka engama-20
1. Ukuhlolwa "Kwabantu Okujwayelekile" Kuhlangana 1-5:
(1) Ukuhlolwa komdlavuza we-colorectal kuqala eminyakeni engama-45, kungakhathaliseki ukuthi owesilisa noma owesifazane, igazi le-fecal occult (FOBT) litholwa kanye ngonyaka.
I-Colonoscopy njalo eminyakeni eyi-10 kuze kube yiminyaka engama-75;
(2) Labo abaneminyaka engu-76-85, abanempilo enhle, nalabo abaphila iminyaka engaphezu kwengu-10, bangaqhubeka nokulondoloza umhlobiso.
2 Ngokuhambisana "nophenyo lomtholampilo lwamalungu omndeni aseduze anomlando womndeni womdlavuza we-colorectal:
(1) Isihlobo se-degree yokuqala esine-adenoma yezinga eliphezulu noma ubuhlungu (iminyaka yokuqala ingaphansi kweminyaka engama-60 ubudala), i-2
Izihlobo zeziqu zokuqala nangaphezulu ezine-adenoma yezinga eliphezulu noma umdlavuza (noma iyiphi iminyaka yokuqala), eqala eminyakeni engama-40 (noma eqala eminyakeni eyi-10 ngaphansi kweminyaka yokuqala yelungu lomndeni elincane), ukuhlolwa kwe-FOBT kanye ngonyaka, kanye njalo eminyakeni emi-5 i-Colonoscopy;
(2) Izifundo ezisengozini enkulu ezinomlando womndeni wezihlobo ze-degree yokuqala (i-1 kuphela, futhi iminyaka yokuqala ingaphezu kweminyaka engama-60 ubudala):
Qala ukuhlola uneminyaka engama-40, ngokuhlolwa kwe-FOBT njalo ngonyaka kanye ne-colonoscopy njalo eminyakeni eyishumi.3 Ukuhlolwa kwamalungu omndeni womhlangano "wofuzo we-colorectal cancer" 7;
Kumalungu omndeni eziguli ezine-FAP ne-HNPCC, ukuhlolwa kokuguqulwa kofuzo kuyanconywa lapho ukuguqulwa kofuzo esimweni sokuqala emndenini kucacile.
(1) Kulabo abanokuhlolwa kwezakhi zofuzo ezinhle, ngemva kweminyaka engama-20, i-colonoscopy kufanele yenziwe njalo eminyakeni engu-1-2;(2) Kulabo abanokuhlolwa kokuguqulwa kofuzo okunegethivu, inani labantu elijwayelekile kufanele lihlolwe.4 Izindlela ezinconyiwe zokuhlola:
(1) Ukuhlolwa kwe-FOBT + uphenyo phakathi kwevolumu kuyindlela eyinhloko yophenyo lwe-Han, futhi ubufakazi banele:
(2) Ukutholwa kwegazi okuhlosiwe kungasiza ekuthuthukiseni ukunemba kwesibalo, futhi inani libiza kakhulu;(3) Uma izimo zivuma, ukuhlolwa kungenziwa ngokuhlanganisa indle nezindlela zegazi.
1. Ukuzivocavoca kunganciphisa ngempumelelo ukwenzeka kwamathumba, kubambelele ebuholini bezemidlalo, futhi kubhukude ukuze kugwenywe ukukhuluphala;
2. Ukudla okunempilo kobuchopho, kwandise ukudla kwefiber engahluziwe nezithelo ezintsha, futhi ugweme ukudla okunamafutha amaningi nokunamaprotheni amaningi;
3 Imithi elwa nokuvuvukala kanye neyokunqanda umdlavuza ingase isebenze ekuvimbeleni umdlavuza wamathumbu.Asebekhulile bangase bazame i-aspirin yedosi ephansi, enganciphisa ingozi yezifo zenhliziyo nemithambo yegazi kanye nomdlavuza wamathumbu.Xhumana nodokotela ukuze uthole ukusetshenziswa okuqondile.
5.Yehlisa ukubhema ukuze ugweme ubuthi bayo besikhathi eside kanye nokugqugquzela ukuvuvukala ku-Qinghua Dao.
Umdlavuza Wesisu
Noma ubani onemibandela elandelayo uyinto enobungozi obukhulu;
1. Ngaphezu kweminyaka engama-60;
2 I-atrophic gastritis emaphakathi futhi eqinile;
3. Isilonda esiswini esingapheli;
4. Ama-polyps esiswini;
5. Uphawu olukhulu lwe-mucosa yesisu;
6. Isisu se-postoperative residual sezifo ezinobungozi;
7. Isisu esisele ngemva kokuhlinzwa komdlavuza wesisu (izinyanga ezingu-6-12 ngemva kokuhlinzwa);
8. Ukutheleleka nge-Helicobacter pylori;
9. Umlando ocacile womndeni womdlavuza wesisu noma womminzo;
10. I-anemia eyingozi:
11. I-Familial adenomatous polyposis (FAP), umlando womndeni we-non-polyposis colon cancer (HNPCC).
Ubudala obungaphezu kweminyaka engama-40 nobuhlungu besisu, ukuvuvukala kwesisu, ukuqunjelwa kwe-asidi, isilungulela kanye nezinye izimpawu zokungakhululeki kwe-epigastric, ne-gastritis engapheli, i-gastric mucosal intestinal metaplasia, i-polyps yesisu, isisu esisalayo, isibonakaliso esikhulu se-gastric fold, isilonda esiswini esingapheli kanye ne-gastric epithelial epitheli I-Hyperplasia nezinye izilonda kanye nezinto ezinomlando womndeni wezimila kufanele zibhekane ne-gastroscopy evamile ngokusho kwezincomo zikadokotela.
1. Yakha imikhuba yokudla enempilo kanye nesakhiwo sokudla, hhayi ukudla ngokweqile;
2. Ukuqedwa kokutheleleka nge-Helicobacter pylori;
3. Nciphisa ukudla okubandayo, okubabayo, okushiswe ngokweqile nokudla okuqinile, kanye nokudla okunosawoti omningi njengokubhenywa nokufakwe emanzini anosawoti.
4. Yeka ukubhema;
5. Phuza utshwala obuqinile obuncane noma cha;
6. Relax futhi decompress ngokunengqondo
Umdlavuza we-Esophageal
Ubudala obungaphezulu kweminyaka engama-40 futhi uhlangabezana nanoma yiziphi izici eziyingozi ezilandelayo:
1. Kusukela endaweni enezigameko eziningi zomdlavuza womminzo ezweni lami (indawo eminyene kakhulu yomdlavuza womminzo ezweni lami itholakala ezifundazweni zaseHebei, Henan naseShanxi eningizimu yeTaihang Mountain, ikakhulukazi esifundeni saseCixian, e-Qinling, e-Dabie Mountain, enyakatho yeSichuan, eFujian, e-Guangdong, enyakatho yeJiangsu, e-Xinjiang, njll.
2. Izimpawu ezingenhla zamathumbu, njengokucanuzela kwenhliziyo, ukuhlanza, ubuhlungu besisu, ukuqunjelwa kwe-asidi, ukungakhululeki kokudla nezinye izimpawu;
3. Umlando womndeni wobuhlungu bomphimbo:
4. Uhlushwa isifo somminzo precancerous noma izilonda precancerous:
5. Ukuba sengozini enkulu yomdlavuza womphimbo njengokubhema, ukuphuza kakhulu, ukukhuluphala, ukuthanda ukudla okushisayo, i-squamous cell carcinoma yekhanda nentamo noma umgudu wokuphefumula;
6. Uhlushwa yi-perisophageal reflux disease (CERD);
7. Ukutheleleka nge-Human papillomavirus (HPV).
Abantu abasengozini enkulu yomdlavuza we-esophageal:
1. I-endoscopy evamile, kanye ngemva kweminyaka emibili;
2 I-Endoscopy enemiphumela ye-pathological ye-dysplasia emnene, i-endoscopy kanye ngonyaka;
3 I-Endoscopy enemiphumela ye-pathological ye-dysplasia emaphakathi, i-endoscopy njalo ezinyangeni eziyisithupha
1. Ungabhemi noma uyeke ukubhema;
2. Isilinganiso esincane sotshwala noma ukungabi naso utshwala;
3. Yidla ukudla okunomsoco, udle izithelo nemifino
4. Thuthukisa ukuvivinya umzimba futhi ugcine isisindo esinempilo;
5. Ungakudli ukudla okushisayo noma uphuze amanzi ashisayo.
Umdlavuza wesibindi
Amadoda angaphezu kweminyaka engama-35 nabesifazane abangaphezu kweminyaka engama-45 kunoma yimaphi amaqembu alandelayo:
1. Ukutheleleka kwegciwane le-hepatitis B (HBV) elingapheli noma ukutheleleka kwegciwane le-hepatitis C (HCV) elingamahlalakhona;
2. Labo abanomlando womndeni womdlavuza wesibindi;
3. Iziguli ezine-cirrhosis yesibindi ezibangelwa i-schistosomiasis, utshwala, i-primary biliary cirrhosis, njll.;
4. Iziguli ezinokulimala kwesibindi ngenxa yezidakamizwa;
5. Iziguli ezinezifo ze-metabolic ezizuzwe njengefa, okuhlanganisa: ukushoda kwe-hemochromatosis a-1 antitrypsin, isifo sokugcinwa kwe-glycogen, ukubambezeleka kwe-cutaneous porphyria, i-tyrosinemia, njll.;
6. Iziguli ezine-autoimmune hepatitis;
7. Iziguli ze-non-alcoholic fatty liver (NAFLD).
1. Amadoda angaphezu kweminyaka engama-35 ubudala kanye nabesifazane abangaphezu kweminyaka engama-45 ubudala abasengozini enkulu yomdlavuza wesibindi kufanele baphenywe;
2. Ukusetshenziswa okuhlanganisiwe kwe-serum alpha-fetoprotein (AFP) kanye ne-B-ultrasound yesibindi, ukuhlolwa njalo ezinyangeni eziyisi-6
1. Umuthi wokugomela iHepatitis B;
2. Iziguli ezine-hepatitis engapheli kufanele zithole ukwelashwa kwe-antiviral ngokushesha ngangokunokwenzeka ukulawula ukuphindaphinda kwegciwane le-hepatitis.
3. Gwema noma unciphise ukuphuza utshwala;
4. Yidla ukudla okulula futhi unciphise ukudla okunamafutha
5. Gwema ukudla ukudla okukhuntile.
Umdlavuza we-pancreatic
Abantu abaneminyaka engaphezu kwengama-40, ikakhulukazi abaneminyaka engaphezu kwengama-50, abananoma iyiphi enye yalezi zici ezilandelayo (into yesithupha ayiwandisi ingozi yomdlavuza wamabele, kodwa ngokuvamile akwenziwa ukuhlolwa):
1. Umlando womndeni womdlavuza we-pancreatic nesifo sikashukela;
2. Kunomlando wokubhema isikhathi eside, ukuphuza, ukudla okunamafutha amaningi kanye nokudla okunamaprotheni amaningi;
3. Ukugcwala kwesisu esiphakathi nangaphezulu, ukungakhululeki, ubuhlungu besisu ngaphandle kwesizathu esicacile, nezimpawu ezifana nokulahlekelwa ukudla, ukukhathala, isifo sohudo, ukulahlekelwa isisindo, ubuhlungu obuphansi emuva, njll;
4. Iziqephu eziphindaphindiwe ze-pancreatitis engapheli, ikakhulukazi ukuvuvukala okungapheli okunamatshe epayipi le-pancreas, i-mucinous papilloma yohlobo lwe-pancreas eyinhloko, i-mucinous cystic adenoma, nesimila esiqinile se-pseudopapillary, eneserum ephakeme i-CA19-9;
5. Ukuqala okuzumayo kwakamuva kwesifo sikashukela ngaphandle komlando womndeni;
6. I-Helicobacter pylori (HP) enhle, umlando we-oral periodontitis, i-PJ syndrome, njll.
1. Izihloko ezibalulwe ngenhla zihlolwe ngemiphumela yokuhlolwa kwegazi kwezimpawu zesimila ezifana ne-CA19-9, CA125 CEA, njll., kuhlanganiswe ne-CT yesisu ne-MRI, kanye ne-B-ultrasound nayo inganikeza usizo oluhambisanayo;
2. Ukuhlolwa kwe-CT noma i-MR kanye ngonyaka kubantu ababalulwe ngenhla, ikakhulukazi labo abanomlando womndeni kanye nezilonda ezikhona zama-pancreas.
1. Yeka ukubhema nokulawula utshwala;
2. Thuthukisa ukudla okulula, okugayeka kalula, okunamafutha amancane;
3. Yidla izinkukhu eziningi, izinhlanzi kanye nezimfanzi, futhi ukhuthaze ukusetshenziswa kwemifino yezimbali "+", njengeklabishi eliluhlaza, iklabishi, isithombo, i-broccoli, njll.;
4. Thuthukisa imisebenzi ye-aerobic yangaphandle
5. Ukuze kuvinjelwe ukuwohloka kwezilonda eziyingozi, labo abanamatshe epayipi le-pancreatic, i-intraductal mucinous papilloma ne-cystic adenoma noma ezinye izilonda ze-benign pancreatic kufanele bafune usizo lwezokwelapha kusenesikhathi.
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Isikhathi sokuthumela: Sep-09-2022