Umdlavuza we-pleura yisimila esiyingozi kulwelwesi oluzungeze iphaphu. Lo mdlavuza ubangelwa ikakhulukazi ukuchayeka isikhathi eside ku-asbestos, into eyayisetshenziswa kabanzi ngaphambi kokuba uvinjelwe eFrance ngo-1997 ngenxa yezingozi zayo zempilo.

Incazelo yomdlavuza we-pleural

Ngokwencazelo, umdlavuza we-pleura iyithumba eliyingozi ku-pleura. Lesi sakamuva sithathwa njengemvilophu yamaphaphu. Yakhiwe ngamashidi amabili: ungqimba lwe-visceral olunamathela ephashini kanye nolwelwesi lwe-parietal olubekwe odongeni lwesifuba. Phakathi kwalawa mashidi amabili, sithola uketshezi lwe-pleural okwenza kube nokwenzeka ikakhulukazi ukukhawulela ukungqubuzana ngenxa yokunyakaza kokuphefumula.

Izimbangela zomdlavuza we-pleural

Kunamacala amabili:

• umdlavuza oyinhloko we-pleura, noma i-mesothelioma ye-pleural eyingozi, lapho ukuthuthukiswa komdlavuza kuqala ku-pleura;
• umdlavuza wesibili we-pleura, noma i-pleural metastases, ebangelwa ukusabalala komdlavuza osuvele kwenye indawo yomzimba njengomdlavuza we-bronchopulmonary noma umdlavuza webele.

Icala elivame kakhulu, umdlavuza oyinhloko we-pleura ngokuvamile umphumela wokuchayeka isikhathi eside ku-asbestos. Njengesikhumbuzo, i-asbestos iyinto evinjelwe ukusetshenziswa kwayo eFrance ngenxa yezingozi zayo zempilo. Manje sekuboniswe kabanzi ukuthi ukuhogela imicu ye-asbestos kungadala izifo ezinzima zokuphefumula okuhlanganisa umdlavuza we-pleura kanye ne-pulmonary fibrosis (asbestosis).

Ivinjelwe namuhla, i-asbestos iseyinkinga enkulu yezempilo yomphakathi. Kubalulekile ukwazi ukuthi izinkinga zokuchayeka ku-asbestos zingavela eminyakeni engaphezu kwengu-20 kamuva. Ngaphezu kwalokho, i-asbestos isekhona ezakhiweni eziningi ezakhiwa ngaphambi kokuba ivinjelwe ngo-1997.

Abantu abathintekayo

Abantu abachayeke ku-asbestos banengozi eyengeziwe yokuba nomdlavuza we-pleura. I-Malignant pleural mesothelioma ibhekwa njengomdlavuza ongavamile. Imele ngaphansi kwe-1% yawo wonke umdlavuza otholakele. Noma kunjalo, izehlakalo ze-pleural mesothelioma eziyingozi bezilokhu zikhula kusukela ngeminyaka yawo-1990s ngenxa yokusetshenziswa okukhulu kwe-asbestos phakathi kweminyaka yama-50s kanye nama-80s. Abanye ochwepheshe bakhathazekile futhi ngokuchayeka emikhiqizweni ye-asbestos evela emazweni lapho i-asbestos ingavinjelwe khona, njengeRussia neChina.

Ukuxilongwa komdlavuza we-pleural

Ukuxilonga umdlavuza we-pleura kunzima ngoba izimpawu zawo ziyafana nezinye izifo eziningi. Kungase kudingeke ukuhlolwa okuningana:

• ukuhlolwa komtholampilo ukuze kutholakale izimpawu ezingase ziphakamise umdlavuza we-pleura;
• ukuhlolwa kokusebenza kwamaphaphu okusiza ekuqhubekiseni ukuxilongwa;
• ukubuyekezwa komlando wokuchayeka kwe-asbestos;
• i-x-ray ukuhlola isimo se-pleura;
• i-pleural puncture ukuqoqa isampula yoketshezi lwe-pleural futhi ayihlaziye;
• i-pleural puncture-biopsy ehlanganisa ukukhipha nokuhlaziya ucezu lwepheshana ku-pleura;
• i-thoracoscopy ehlanganisa ukwenza ukusika phakathi kwezimbambo ezimbili ukuze ubone ngeso lengqondo i-pleura usebenzisa i-endoscope (insimbi yokubona yezokwelapha).

I-Epanchement pleural

Izimila ze-pleura zingase zinganakwa ezigabeni zokuqala zokukhula kwazo. Isibonakaliso sokuqala somdlavuza we-pleura i-pleura effusion, okuwukunqwabelana okungavamile koketshezi emgodini we-pleural (isikhala esiphakathi kwezingqimba ezimbili ze-pleura). Iziveza ngokuthi:

• i-dyspnea, okuwukuphefumula noma ukushaywa umoya;
• ubuhlungu besifuba kwezinye izimo.

Izimpawu ezihambisana nazo

Umdlavuza we-pleura ungabuye ubangele:

• ukukhwehlela okuba kubi kakhulu noma okuqhubekayo;
• izwi eliyisihosha;
• ubunzima bokugwinya.

Izimpawu ezingaqondile

Umdlavuza we-pleura ungabangela:

• ukujuluka ebusuku;
• ukuncipha kwesisindo okungachazeki.

Ukuphathwa komdlavuza we-pleura kuncike esigabeni sokukhula kanye nesimo somuntu othintekayo. Ukukhethwa kokwelashwa kungase kuhlanganise ochwepheshe abahlukene.

Ukwelashwa ngamakhemikhali

Ukwelashwa okujwayelekile komdlavuza we-pleura i-chemotherapy, okuwukusetshenziswa kwezidakamizwa ngomlomo noma ngomjovo ukuze kubulawe amangqamuzana omdlavuza.

Radiotherapy

Ukwelashwa ngemisebe kwesinye isikhathi kusetshenziselwa ukwelapha kusenesikhathi kanye/noma umdlavuza wasendaweni we-pleura. Le nqubo ihlanganisa ukuveza indawo yesimila emisebeni enamandla amakhulu noma izinhlayiya.

Ukuhlinzwa okwelaphayo

Ukwelashwa kokuhlinzwa komdlavuza we-pleura kuhilela ukususa izingxenye zezicubu. Ukuhlinzwa kubhekwa kuphela ngaphansi kwezimo ezithile.

Amasu amabili angacatshangwa:

• i-pleurectomy, noma i-pleurectomy-decortication, ehlanganisa ukususa ingxenye engaphezulu noma engabalulekile ye-pleura;
• I-extrapleural pneumonectomy, noma i-extra-pleural pleuro-pneumonectomy, ehilela ukususa i-pleura, iphaphu elimboze, ingxenye ye-diaphragm, ama-lymph nodes kuthorax, futhi ngezinye izikhathi ne-pericardium.

Ukwelashwa okusacwaningwayo

Ucwaningo luyaqhubeka ngokwelashwa komdlavuza we-pleura ngezindlela ezithembisayo ezifana ne-immunotherapy. Inhloso yawo ukubuyisela amandla amasosha omzimba ngokumelene namangqamuzana omdlavuza.

Ukuvimbela umdlavuza we-pleura kuhlanganisa ukukhawulela ukuchayeka ku-asbestos, ikakhulukazi ngokwenza imisebenzi yokususa i-asbestos nokugqoka izinto zokuzivikela zabasebenzi abachayeke ku-asbestos.