老年人容易忽略的癌症—多发性骨髓瘤
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 一名七十几岁的爷爷,<span style="color: black;">近期</span>抱怨下背痛、<span style="color: black;">头昏</span>、疲倦,家人以为是老化现象,带爷爷至医院<span style="color: black;">检测</span>,经由多项<span style="color: black;">检测</span>才<span style="color: black;">发掘</span>,爷爷是<span style="color: black;">病患</span>了「多发性骨髓瘤」,赶紧转诊血液肿瘤科接受治疗。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 什么是「多发性骨髓瘤」?</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发性骨髓瘤(multiplemyeloma)并非是骨科的<span style="color: black;">疾患</span>,是属于一种血液方面的癌症,淋巴系统是人体的防卫作战部队,其中淋巴球有分为B细胞、T细胞及自然杀手(NK)细胞,B细胞有部分会转成「浆细胞」,它<span style="color: black;">能够</span>制造免疫球蛋白(抗体),<span style="color: black;">帮忙</span>人体消灭有害病原,当「浆细胞」产生不正常的变异时,就会形成「骨髓瘤细胞」而侵犯身上多处骨头形成肿瘤,<span style="color: black;">引起</span>骨头<span style="color: black;">病痛</span>不舒服,<span style="color: black;">叫作</span>之为「多发性骨髓瘤」,平均罹病年龄约60-70岁,且男多于女。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> <span style="color: black;">平常</span><span style="color: black;">那些</span>症状?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">骨头<span style="color: black;">病痛</span>:最<span style="color: black;">平常</span>,以夜间或活动时最<span style="color: black;">显著</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 高血钙:当骨头被破坏时,<span style="color: black;">本来</span>存在于骨头中的钙质就会游离出来,跑到血液中,<span style="color: black;">引起</span>血液中的钙离子浓度<span style="color: black;">上升</span>,会有口渴、疲倦、肌肉<span style="color: black;">没</span>力<span style="color: black;">乃至</span><span style="color: black;">认识</span>不清等症状。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">肾衰竭:<span style="color: black;">太多</span>的有害物质和钙,堆积在肾脏使其<span style="color: black;">没</span>法正常运作,会<span style="color: black;">显现</span>尿中<span style="color: black;">泡泡</span>多、蛋白尿、下肢或全身水肿等症状。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">贫血:骨髓造血细胞被骨髓癌细胞取代,而使得红血球减少,<span style="color: black;">同期</span>细胞激素的<span style="color: black;">控制</span><span style="color: black;">功效</span><span style="color: black;">诱发</span>贫血,病人容易感到疲倦或<span style="color: black;">头昏</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">感染:正常免疫球蛋白被<span style="color: black;">反常</span>免疫球蛋白压抑,<span style="color: black;">因此呢</span>很容易感染,最<span style="color: black;">平常</span>的感染是肺炎及泌尿道感染。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">神经功能受损:有少部分病人因肿瘤压或脊椎骨骨折,而压迫脊椎神经,会<span style="color: black;">导致</span>渐进性<span style="color: black;">病痛</span>、感觉异常、小腿软弱、半身麻痹、<span style="color: black;">没</span>法<span style="color: black;">掌控</span>尿液或大便之排泄等问题。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> <span style="color: black;">血液</span>过度黏稠症候群:血液中的单株免疫球蛋白太高,会<span style="color: black;">导致</span>血液黏性过高的现象,<span style="color: black;">导致</span><span style="color: black;">流血</span>、眩晕、痉挛、全身疲倦<span style="color: black;">没</span>力、视网膜病变等症状。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">高尿酸血症:骨髓瘤细胞增生及凋亡会释放尿酸,及化学治疗后骨髓瘤细胞急速<span style="color: black;">海量</span>破坏时,细胞核内核酸<span style="color: black;">亦</span>会释出,<span style="color: black;">导致</span>尿酸高,病人会有恶心、呕吐、腹泻、少尿或<span style="color: black;">没</span>尿、尿液浓度<span style="color: black;">升高</span>或<span style="color: black;">显现</span>沉淀物、急性关节<span style="color: black;">阻碍</span>(如痛风)等症状。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> <span style="color: black;">平常</span>生活须<span style="color: black;">重视</span>事项?</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 预防骨折:浆细胞会活化蚀骨细胞,使骨头变松而<span style="color: black;">导致</span>病理性骨折,而适量运动可减少骨头钙质的流失,预防骨折,<span style="color: black;">按照</span>医师指示,正确<span style="color: black;">运用</span>背架,腰部勿过度向前倾或搬重物的动作。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">预防感染:维持良好的卫生习惯,<span style="color: black;">重视</span>口腔卫生清洁,避免感冒,<span style="color: black;">重视</span>保暖,<span style="color: black;">重视</span><span style="color: black;">膳食</span>卫生。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 预防<span style="color: black;">流血</span>:平时应避免碰撞、跌倒或其他外伤,刷牙时请<span style="color: black;">选取</span>软毛牙刷,且避免便秘情形产生,以减轻可能<span style="color: black;">流血</span>的<span style="color: black;">出现</span>。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> <span style="color: black;">病痛</span><span style="color: black;">掌控</span>:必要时依医嘱<span style="color: black;">运用</span>止痛<span style="color: black;">药品</span>,或<span style="color: black;">运用</span><span style="color: black;">有些</span>辅助治疗<span style="color: black;">包含</span>:自我放松技巧、冥想等,减轻<span style="color: black;">病痛</span>感。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">弥补</span>营养:<span style="color: black;">平衡</span><span style="color: black;">膳食</span>,适量<span style="color: black;">弥补</span>水分。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">渐进式活动:避免跌倒,下肢较<span style="color: black;">没</span>力者,可先训练手肩之肌肉,以<span style="color: black;">帮助</span>行走,勿因下背酸痛而<span style="color: black;">自动</span>按摩或<span style="color: black;">按摩</span>,以避免<span style="color: black;">导致</span>更严重的<span style="color: black;">损伤</span>,应听从医师指示处理。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">多发性骨髓瘤是一种<span style="color: black;">很难</span>根治的血液癌症,且容易复发,但近年来医疗的进步,新药的<span style="color: black;">面世</span>,<span style="color: black;">药品</span>的<span style="color: black;">运用</span><span style="color: black;">已然</span><span style="color: black;">能够</span>有效的<span style="color: black;">帮忙</span>病情的<span style="color: black;">掌控</span>,延长存活期,许多病人经规则治疗后,<span style="color: black;">亦</span>慢慢恢复正常生活,<span style="color: black;">加强</span>生活质量。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"> 因患病的病人大多都是老年人,症状不<span style="color: black;">显著</span>者,容易被忽略,<span style="color: black;">因此呢</span><span style="color: black;">发掘</span>时已被诊断较晚期,<span style="color: black;">针对</span><span style="color: black;">疾患</span>接受度及对<span style="color: black;">疾患</span>的认识程度,<span style="color: black;">亦</span><span style="color: black;">必须</span>一段时间去调节、<span style="color: black;">认识</span>,此时家人的支持和<span style="color: black;">陪同</span>是非常<span style="color: black;">要紧</span>的,<span style="color: black;">意见</span>寻求医疗人员的咨询<span style="color: black;">帮助</span>,<span style="color: black;">一起</span>给予病人身心灵的照顾,<span style="color: black;">帮忙</span><span style="color: black;">她们</span><span style="color: black;">一块</span>面对<span style="color: black;">疾患</span>调适的过程。</p>
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