BỆNH HỌC UNG THƯ docx

BỆNH HỌC UNG THƯ
  
 Information 


Lê Đình Sáng

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

THÔNG TIN

THÔNG BÁO VỀ VIỆC XUẤT BẢN BÁCH KHOA Y HỌC 2010 :

 






ỦNG HỘ :






-00000-84877

CẢNH BÁO :
  


ng thông tin


ày


 
 

GIỚI THIỆU









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


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Lê Đình Sáng ch

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










 
--


Nghiêm cấm 
 



sách này nêu ra.











Đô Lương, Nghệ An. Tháng 8/2010

ABOUT

ebook editor: Le Dinh Sang
Hanoi Medical University
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
FOREWORD

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
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This book is the material collected and translated by a medical student rather than a
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happy and have a prosperous life.





MỤC LỤC

THÔNG TIN
ABOUT
1. 
2.  T NG 
3. HI TRIBH
4. NGUYÊN NHÂN UNG T
5. H
6. THM KHÁM KH U

7. CHN ÁNH UNG 
8. CHT CH  UNG 
9.  PHU THUT BH UNG 
10.  TIA  BNH UNG 
11. HÓA T T
12.  GIM AU TRONG UNG 
13.  HNG K GIAI ON CU
14. -2010
15. 
16. 
17. 
18. 
19. 
20. 
21. 
22. 
23. U LYMPHO KHÔNG HODGKIN
24. 
25. 
26. 
27. 
28. 
29. 
30. 
31. 
32. 

1. ĐẠI CƯƠNG VỀ UNG THƯ

  

I.  NGHA


Trong  i ngày na dù khoa   có n tin   bc c  là
trong l  phân t, tuy  ng bnh ung là g
không d dàng.
Tuy nhiên chúng ta có th  ng ung   là quá trình bnh lý trong  
 ào thoát ra   kim soát,   sinh lý c  bào và tip  nhân
lên. Nh bào này có  nng xâm ln và phá hy các  cc chung quanh.
ng th chúng di trú và n phát trican khác nhau và hình thành
nên di cn, ng ung  gây ng do:
- Các chng p tính nh: xut huychèn ép não, ngt th.


-   nng dn tin n   c nng c các c quan do  di n
iu nng hô hp, suy ch nng gan thn.
- Sái trin dn dn, kéo dài dn suy  và cng bnh nhân tg.


II. QUÁ TRÌNH TIN   NHIÊN  UNG TH


  ung  u có  tin  khác nhau, tuy nhiên nu ung  không
 iu  các giaau:


1.1. B 



 y ra rt nhanh, sau khi các  bào tp xúc  các tác nhân gây ung th:
tác nhân vt lý, tác nhân hóa c, tác nhân virus. Các tác nhân này gây ra t
 DNA c tào không c.
1.2. Gia y


Do tip xúc liên  kéo dài  các cht gây ung  làm   và duy trì ng
u tiên.
B  u và giai on thúc y chúng ta c   qua mô hình thí
nghim và

 nghiên c dch  ung ng


1.3. Gian


Các  bào nhân lên khôn soát c, phát tr     nn
hóa, xâc  cho di cn.

Hình 1: iai  k 



  phòng giai n  u sinh ung  ng ta phi bo  tránh tip xúc

 các tác nhân gây ung h á, benzol, nhi cht khác nhau, tia
phóng x, virus v.v.
 tin trin


Sn ca bnh ung  gíc bn cht ca bnh ung  gì: 
u phá c cxâm  và cho di cn toàn thân.
Khi tin trin ung ã xy ra, có nhiá cng n tri


+ Sàng lc và rcác  tng th.


+ Sàng lc và   nh un kích c còn  (c yu bng phu 
hoc tia x).
+ u  tích c các un ang còn  c (tt    t  

hóa c t).




Hình 2: Các giai  tin tring th





 

Di n ung  là tình trng các  bào ung  tách  ra  u nguyên phát 
n c phát trin thành khcan khác qua các ác nhau:
 bch huyt, n k n.v.v.
Di ng bch huyt


+ Loi ung   mô t cn n các trm hh bch huyt khu vc. Khi
 u tin n thành bch huyt, t bào un xâm  nhanh chóng qua thành
bh huyt v   thông bh huyt man trm hh u tiên.
Khi các  bào   n hh ng ta nhn thy phn ng c  g là
viêm bh mh mn tính c hiu (specific chronic lymphadenitis).
[1]  bào ung rtiên phát chy  thech bch huy 
hh v tinh
[2] Hh ph tiêu dào ung 


[3]  bào ung i trong hh không có phn 


[4]  bào ung chy qua hh v tinh mà không có phng c 







[5]  bào ung át trin và xâh bh huyt

[6]  bào ung  v  xâm lc chung quanh


[7]  bào ung n hh k n


[8] Tc gây  bh ch



1. Khi các  bào ung th bong ra   u, chúng trôi  theo dòng chy ca 
 bh huyt n hh v tinh.
2. Ph c  bh huyt ct các ào ung 


 bào ung li trong hch bch huyt mà không có phng gì, gi là di cn
vi th.


t bào ung   tinh mà không có phng c hiu nào


5. Ng   bào ung t nhân lên, xâm nhp toàn  hh bh huyt,  ra
hình nh u (hh cng, không au, c).
6. Hh clà do t bào ung há ao và xâm lác c chung
quanh.


7. Các t bào ung  có  di trú  hch  n  ra  ng viêm 

bh huyt dng ung (carcinomatous lymphangitis).
8. Nhng ng trên hình 8 gích tình trng bch huyt và phù bch huyt.


S   c n bh huyt trên  bnh phm phu  hoc s xâm
 hh bh huyt là c  ca  ang tin  Tiên ng
nghèo nàn và các nhà un phi tx  hóa 
tit, miau phu 
Di ng máu:


+ Các  ung  c  c liên kt (ung t xg, ung  phn 

 di cn theng máu n các ng xa nha


Hình 5: Ung
th
di theo
ng
máu

Di ng  c:


+ Di n hay   theo ch máu và  kinh, theo  ít n   là
ung  dày lan qua lp thanh mc vàng gây di ng ng.
+ Dao  ng c phu  có  gây gieo   bào  ra  khác trong
phtrc tip vàu.
III.  PHÒNG UNG TH

 du  có ng tn  rt  trong lnh vc   ung  trong hai  k
qua ung vn còn là  bnh khó c
Tuy vy khong 50% tr  bnh ung  có  phòng tránh c.  phòng
un là  vai trò  rt quan     c các thy  trong th k
21.  c ng



phòng cng ung  thy  phi tính n khía nh luân lý và  do cá
nhân, các chính sách phòng cng tích cc ph vào c  khoa c.
1. Vai trò c


Ng ã cng minh   gây ra nhi 


+ Bng các nghiên cv  c.


+ Bnng nghiên c thành phn ch trong á.


+ Bng  khám phá ra    gen c  c  bào  u và  bào
bình t ng n
+ Bng  phát  nh  thc c bn   chuyn hóa c amines c
 lá.
Qua nghiên c    và sinh  có ên quan rõ rt g  lá và các
unaây:

+ P


+ Thanh qun


+ Khoang ming


+  


+ Bàng quang


Nghiên c  thành phn c trong thuc lá ng ta  tìm thy  4000
 hóa ch  cht chính gây ra ung 
+ Polycyclic aromatic hydrocarbons


+ Nitrosamines



+ Heterocyclic hydrocarbons


+ Benzen

+ Radioactive 210-polonium


Tt c ng hóa cht  trên có  gây ra   u và thúc y quá trình sinh
 P pháp  phòng tích c nht là không nên hút  lá  
 n cha hút c  là  em, vi ng  hút phi có hình 
h   ng hút    lá và các  pháp nhm g thiu tác
hi c  lá  cm hút  ni công cg, in hình logo lên ba
2. Y truyn


 vn v di truyn: là   pháp  trong   ung  N ta
phi xem xét nh khía nh khác nhau  có thái x l n.   c
 khám di truyn trong ung 
+ ánh giá nguy c di truyn ca ung     xác  có hay không có di
truyn.
+ a ra ng chính sách sàng guy cng ó.


+ Khi có cnh ct nghiên câ gen di truyn.


+ Gii quy ytâm lý lo lng ca bnh nhân  nguy ctruyn.


+  hoh theo dõi tgian dài cho cá nhân và gia  h.


t

Ng nhn thy rng  i t g ung 