第一节 化疗前一周医生给患者做血常规检查,检查的主要项目是白细胞、红细胞和血小板,这三个指标严重不合格化疗医生会停止化疗。
白细胞、红细胞、和血小板数值正常是患者身体耐受化疗的重要依据,医生每次化疗前都要检查患者的指标是否合格,指标严重不合格将停止化疗至患者休息调养合格之后恢复化疗,患者和家属一定要每次注意这三个指标是否将接近正常数字底限,提早做好补血补气的食疗调养工作。
白细胞:人体防御的免疫卫士
白细胞是人体重要的免疫细胞,对人体具有保护和防御功能。白细胞的正常参考值(4.0-10.0)×10^9个/L。
白细胞根据形态可以分为中性粒细胞、淋巴细胞、单核细胞、嗜酸性粒细胞和嗜碱性粒细胞。
中性粒细胞
在白细胞中所占百分率最高,达到(50%——70%),它能够吞噬和杀死细菌,防止细菌和有害物质侵入机体,是影响白细胞总数的关键。
淋巴细胞
与免疫有关,它是机体保护自己不受病原体侵袭的主要细胞,主要是通过体液免疫和细胞免疫来发挥作用的。
单核细胞
具有很强的吞噬功能,能够从血液中清除死亡和不健康的细胞、废物和碎片以及杀死入侵的细菌。
白细胞低于正常值人体的免疫力会严重下降,会导致一系列免疫性疾病,并发症增多。营养不良的肿瘤患者免疫力降低,术后发生肺不张、伤口感染、菌血症、肺水肿、尿道感染及脓毒症等并发症的发生率明显增加。
病理性增多
常见于急性感染、白细胞超标一般是患者体内有急性炎症,导致白细胞动员还没有成熟的白细胞童子军出来战斗,血常规发现白细胞计数超标的患者要检查身体哪里有炎症。
红细胞:诊断贫血的一个标准
血红蛋白是红细胞的主要成分,负责氧气的输送。
它将氧气输送到各个组织,再将组织中的二氧化碳输送到肺脏后呼出体外,血液的颜色是红色的,也与血红蛋白有关,故俗称为“血色素”。
血红蛋白的正常参考值是:
男性120–160g/L,女性110–150g/L,临床上常用血红蛋白的指标作为贫血的一个诊断标准。
常见的贫血包括缺铁性贫血、维生素B12叶酸缺乏的营养性贫血、再生障碍性贫血以及溶血性贫血等。
不同的贫血有不同的治疗方法,而肠癌患者多数因为肠道肿瘤表面溃烂长期出血,导致肠癌患者普遍都有贫血的现象,因此,补气补血是患者确诊后至五年康复期内,一直要不懈努力的一项最有意义的调理工作。
血小板:人体的修补工
血小板的主要功能是止血和凝血、修补破损血管。血小板的正常参考值(100-300)×10^9/L。
血小板若低于正常值:必须加以重视,因为它可能提示很多疾病,如免疫性血小板减少症、脾功能亢进、再生障碍性贫血、急性白血病等。
但是,肠癌患者的血小板降低主要是放化疗的骨髓遏制,通常调理的方法是服用五红汤,和红花生皮加枸杞煮水喝!
医生对指标偏离正常值的解读
医生会根据病人的性别、年龄、临床的症状以及体征等因素,结合其他指标进行分析和诊断。
一般白细胞、红细胞、血小板其中有任何一个指标低于化疗标准时,专业医院的医生会停止化疗,让患者休息调养到血指标恢复之后再恢复化疗,而地级市不专业的化疗医生,经常会在患者的血指标都严重不合格了,还不顾患者的风险继续化疗,这对患者身体的破坏远远多于化疗的受益,患者和家属术后每次查血常规都要自己学会粗看血常规的几个重要数值,一般看白细胞计数、红细胞计数、和血小板计数是否接近、低于正常值下限就大差不差了,对这三个指标接近正常值下限时要通过食疗,把血指标提上去,起码要维持住指标不下降,下降也要阻止它急速下降。
什么情况下应该到血液科检查
1.面色苍白、头昏、乏力、心悸,皮肤黏膜淤斑淤点、黄染等。
2.血液检查白细胞、红细胞、血红蛋白和血小板异常增高或降低。
3.颌下、颈部、腋下、腹股沟淋巴结肿大,肝脾肿大等。
4.其他如不明原因的发热,或不思饮食,日渐消瘦等。
第二节 化疗前看生化指标报告,判断患者肝功能是否符合化疗的简易方法
肝脏的肝功能是患者化疗时,帮助人体把化疗药的毒性排出体外的主力器官之一,肝脏和肾脏在化疗期间同心协力把化疗药的毒性维持在身体能够耐受的水平,肝肾功能不合格继续化疗,患者身体的化疗药毒性将会在体内积聚,伤害患者的身体。所以肝肾功能不合格是医生暂停化疗的因素之一。患者和家属要粗略看懂生化报告的肝肾功能指标,适时的调理好肝肾功能,配合医生完成全部化疗疗程。
肝功能检查是通过各种生化实验方法监测与肝脏功能代谢有关的各项指标,以反映肝脏的功能基本状况。肝功能化验单是对肝功能化验结果的显示,医生通过对肝功能化验单的查看,可以很好的判断出一个人肝功能的情况,如果出现病变的话,医生可以根据患者的检查结果得出相应的结论。以此作为参考的依据。对于不同的医院来说,其肝功能化验单的所显示的结果的参考值可能会存在着差别,这是由不同的检测仪器基线决定的。
在肝功能的化验单中显示了包括对转氨酶,像谷丙转氨酶、谷草转氨酶,白蛋白,球蛋白,白球比值,胆红素,胆汁酸等多项检查结果的显示。每一项检查结果显示的内容所代表的意思不尽相同,通过对肝功能化验单所显示的分析,再和参考值结果对比分析,可以判断出一个人的肝脏是否出现了问题,或者是问题的严重程度,不过很多人看不懂肝功能化验单,因此说学会看肝功能化验单很重要。
一般患者和家属看化疗前的生化报告,看肝功能是否健全、是否符合化疗条件一般看几个转氨酶指标,要是那次生化报告发现有1-2个转氨酶指标超标了,就要提醒医生开相应的护肝药调理肝功能问题,一般医生开护肝药患者调理之后不影响下次的化疗,而要是本次化疗前有1-2个转氨酶指标超标,医生没有开护肝药给患者吃的话,下次指标就会急速上升,而导致肝功能不合格被化疗医生停止化疗,就是化疗医生勉强同意化疗,化疗对患者的肝功能损害将非常大。
第三节 化疗前医生看生化报告指标,判断患者肾功能是否符合化疗的简易方法
肾脏是人体最重要的器官之一,也是患者化疗时代谢化疗药毒性排出体外的主力器官,其功能主要是分泌和排泄尿液、废物、毒物和药物;调节和维持体液容量和成分(水分和渗透压、电解质、酸碱度);维持机体内环境(血压、内分泌)的平衡。每日经肾小球滤过的血浆大约有180L。
变态反应、感染、肾血管病变、代谢异常、先天性疾病、全身循环和代谢性疾病、药物、毒素对肾脏的损害,均可影响肾功能,主要表现为肾功能检查指标的异常,在临床诊断和治疗上具有重要的意义。
临床意义
临床常用于检查肾功能的指标是血清尿素、血肌酐、血β2-微球蛋白、尿酸等。
- 血清尿素(BUN)
血清尿素正常值(速率法)
成人:3.2~7.1μmol/L
婴儿、儿童:1.8~6.5mmol/L
血清尿素是人体蛋白质的代谢产物,主要是经肾小球滤过而随尿液排出体外,当肾实质受损害时,肾小球滤过率降低,致使血液中血清尿素浓度增加,因此通过测定尿素,可了解肾小球的滤过功能。
1.血清尿素增高
(1)肾脏疾病慢性肾炎、严重的肾盂肾炎等。肾功能轻度受损时,尿素检测值可无变化。当此值高于正常时,说明有效肾单位的超过50%已受损害。因此,尿素测定不能作为肾病早期肾功能的测定指标,但对肾衰竭,尤其是氮质血症的诊断有特殊的价值。
(2)泌尿系统疾病泌尿道结石、肿瘤、前列腺增生、前列腺疾病使尿路梗阻等引起尿量显著减少或尿闭时,也可造成血清尿素增高。
(3)其他高蛋白饮食、脱水、蛋白质分解代谢增高、腹水、水肿、胆道手术后、上消化道出血、妊娠后期妇女、磷、砷等化学中毒等,心输出量减少或继发于失血或其他原因所致的肾脏灌注下降均会引起BUN升高。
2.血清尿素降低
见于中毒性肝炎、急性肝萎缩、类脂质肾病等。
- 血肌酐 正常值
血肌酐(Taffe法)
男性:62~115μmol/L
女性:53~97μmol/L
血清肌酐浓度可在一定程度上准确反映肾小球滤过功能的损害程度。肾功能正常时,肌酐排出率恒定,当肾实质受到损害时,肾小球的滤过率就会降低。当滤过率降低到一定程度后,血肌酐浓度就会急剧上升。
1.增高
血肌酐增高主要见于急、慢性肾小球肾炎等肾脏疾病。早期或轻度肾功能损害时,由于肾的储备力和代偿力很强,血肌酐浓度可以表现为正常,当肾小球滤过功能下降到30%~50%时,血肌酐数值才明显上升。在正常肾血流条件下,血肌酐176~355μmol/L时,提示有中度至严重肾损害。血肌酐和尿素如同时增高,提示肾功能损害很严重。
2.降低
见于进行性肌肉萎缩、白血病、贫血、肝功能障碍及妊娠。
- 血β2-微球蛋白
血β2-微球蛋白正常值(检测方法不同,参考值不同)
血清:2.14~4.06mg/L
血β2-微球蛋白是由淋巴细胞、血小板、多形核白细胞产生的一种小分子蛋白,其绝大部分在近端肾小管吸收。增高见于:
1.肾功能减退
如各种急性或慢性肾炎、肾衰竭、糖尿病肾病、肾肿瘤、肾移植排斥反应等。在评估肾小球滤过功能方面,比血肌酐更灵敏。
2.恶性肿瘤
原发性肝癌、肺癌、胃癌、多发性骨髓瘤、恶性淋巴瘤等。
3.自身免疫性疾病
系统性红斑狼疮、类风湿关节炎、自身免疫性溶血性贫血等。
- 尿酸
.尿酸正常值
男性:150~440μmol/L
女性:95~360μmol/L
尿酸是体内嘌呤代谢的终末产物。主要经肾脏排泄,因而测定尿酸能够了解肾脏的功能。增高见于:
1.痛风
血清尿酸增高是诊断痛风的主要依据。
2.肾脏病变
急性或慢性肾炎、肾盂肾炎、肾结核等可使血清尿酸升高。
3.恶性肿瘤
各种恶性肿瘤都可导致血清尿酸升高。
患者化疗前发现上述四种肾功能指标;一、血清尿素(BUN)、二、血肌酐、三、血β2-微球蛋白、四、尿酸四项主要的肾功能指标超标时,要适时挂号看泌尿科医生,提前调理好肾脏功能,肾功能不合格继续化疗,患者身体的化疗药毒性将会在体内积聚,伤害患者的身体。所以肾功能不合格是医生暂停化疗的因素之一。患者和家属要学会粗略看懂生化报告的肾功能指标,适时的调理好肝肾功能,配合医生完成全部化疗疗程。
我化疗后期就深深的感受到肾功能处于代谢极限时,整个泌尿系统都处于将近崩溃的那种感觉,和化疗药毒性因为肝肾功能处于极限状态,而人体处于化疗药毒性积聚处于最高值时,手麻脚麻那种手脚末端神经被化疗药毒性伤害的感觉。所以患者和家属要学会粗略看懂生化报告的肝肾功能指标,指标不合格就要适时看肝胆内科医生或者泌尿科医生,调理好患者的肝肾功能才能顺利的完成化疗疗程,降低患者化疗期间受毒性副作用的伤害。
Your blog has become one of my favorite resources. I can’t wait for new posts.
I’m still learning from you, but I’m improving myself. I absolutely enjoy reading everything that is written on your website.Keep the tips coming. I loved it!
Woah! I’m really digging the template/theme of this site. It’s simple, yet effective. A lot of times it’s tough to get that “perfect balance” between superb usability and visual appeal. I must say you’ve done a great job with this. In addition, the blog loads super fast for me on Firefox. Outstanding Blog!
After study a few of the blog posts on your web site now, and I truly like your approach of blogging. I bookmarked it to my bookmark website listing and will likely be checking back soon. Pls take a look at my web page as effectively and let me know what you think.
WONDERFUL Post.thanks for share..extra wait .. …
Hey very nice blog!! Guy .. Beautiful .. Amazing .. I will bookmark your blog and take the feeds also…I’m glad to find numerous useful information here in the publish, we want work out extra techniques in this regard, thanks for sharing. . . . . .
I actually wanted to write a quick remark in order to say thanks to you for all of the nice suggestions you are showing on this website. My long internet search has finally been paid with incredibly good information to share with my family and friends. I would assume that most of us visitors actually are unequivocally endowed to live in a fine network with so many brilliant people with helpful basics. I feel pretty lucky to have seen the web page and look forward to really more pleasurable times reading here. Thank you once again for everything.
Thank you for sharing with us, I believe this website really stands out : D.
I went over this internet site and I think you have a lot of good information, saved to fav (:.
What is Boostaro? Boostaro revolutionizes romantic performance enhancement through its reliance on the wisdom of natural ingredients
Thank you for another informative blog. The place else could I am getting that type of info written in such an ideal method? I have a undertaking that I am simply now working on, and I have been on the glance out for such info.
I got what you intend, appreciate it for putting up.Woh I am delighted to find this website through google.
Hi there, just became alert to your blog through Google, and found that it is really informative. I’m going to watch out for brussels. I will be grateful if you continue this in future. Numerous people will be benefited from your writing. Cheers!
Real excellent visual appeal on this website , I’d value it 10 10.
I¦ve learn several good stuff here. Certainly worth bookmarking for revisiting. I wonder how much attempt you set to create any such magnificent informative website.
I’m typically to blogging and i really admire your content. The article has really peaks my interest. I am going to bookmark your web site and keep checking for brand spanking new information.
There is evidently a lot to know about this. I feel you made some good points in features also.
Ikaria Lean Belly Juice is a fast-acting weight loss supplement that is developed to incinerate stubborn fat.
What Is FitSpresso? The 100 natural formula is formulated using a potent blend of 6 ingredients
I haven’t checked in here for a while because I thought it was getting boring, but the last several posts are great quality so I guess I will add you back to my everyday bloglist. You deserve it my friend 🙂
You are a very clever individual!
Dentitox Pro is marketed as a natural oral health supplement designed to support dental health and hygiene.
When I originally commented I clicked the “Notify me when new comments are added” checkbox and now each time a comment is added I get three e-mails with the same comment. Is there any way you can remove people from that service? Appreciate it!
Very nice layout and excellent subject matter, nothing else we need : D.
The following time I read a weblog, I hope that it doesnt disappoint me as a lot as this one. I imply, I know it was my choice to learn, however I actually thought youd have one thing attention-grabbing to say. All I hear is a bunch of whining about one thing that you can repair if you werent too busy in search of attention.
There is noticeably a bundle to know about this. I assume you made certain nice points in features also.
We are a group of volunteers and opening a new scheme in our community. Your website provided us with valuable information to work on. You’ve done a formidable job and our whole community will be grateful to you.
Hello! I just would like to give a huge thumbs up for the great info you have here on this post. I will be coming back to your blog for more soon.
Java Burn is the world’s first and only 100 safe and proprietary formula designed to boost the speed and efficiency of your metabolism by mixing with the natural ingredients in coffee.
excellent post, very informative. I wonder why the other specialists of this sector do not notice this. You should continue your writing. I’m confident, you have a huge readers’ base already!
Very interesting information!Perfect just what I was searching for!
Wow! Thank you! I constantly wanted to write on my blog something like that. Can I include a portion of your post to my blog?
I will right away grab your rss feed as I can not find your e-mail subscription link or e-newsletter service. Do you’ve any? Kindly let me know so that I could subscribe. Thanks.
I’ve been surfing online more than three hours lately, but I by no means found any attention-grabbing article like yours. It’s lovely worth sufficient for me. In my view, if all web owners and bloggers made good content material as you did, the web will likely be much more helpful than ever before. “We are not retreating – we are advancing in another Direction.” by Douglas MacArthur.
Howdy! I could have sworn I’ve been to this blog before but after checking through some of the post I realized it’s new to me. Anyhow, I’m definitely glad I found it and I’ll be book-marking and checking back frequently!
Hello there, I discovered your web site by way of Google even as looking for a related topic, your web site got here up, it seems to be great. I have bookmarked it in my google bookmarks.
What Is LeanBiome? LeanBiome, a new weight loss solution, includes beneficial strains of gut bacteria that work fast for weight loss.
As I website possessor I think the written content here is real superb, thankyou for your efforts.
Hi, i read your blog from time to time and i own a similar one and i was just wondering if you get a lot of spam responses? If so how do you reduce it, any plugin or anything you can recommend? I get so much lately it’s driving me crazy so any assistance is very much appreciated.
Hey There. I found your blog using msn. This is a very well written article. I will make sure to bookmark it and come back to read more of your useful info. Thanks for the post. I’ll definitely return.
Some genuinely prize posts on this internet site, saved to fav.
Can I just say what a relief to find someone who actually knows what theyre talking about on the internet. You definitely know how to bring an issue to light and make it important. More people need to read this and understand this side of the story. I cant believe youre not more popular because you definitely have the gift.
Thanks for the sensible critique. Me and my neighbor were just preparing to do some research on this. We got a grab a book from our local library but I think I learned more from this post. I’m very glad to see such magnificent info being shared freely out there.
I love what you guys are up too. This sort of clever work and coverage! Keep up the amazing works guys I’ve added you guys to my own blogroll.
You really make it seem so easy with your presentation but I find this matter to be actually something which I think I would never understand. It seems too complicated and extremely broad for me. I’m looking forward for your next post, I’ll try to get the hang of it!
I love your blog.. very nice colors & theme. Did you design this website yourself or did you hire someone to do it for you? Plz respond as I’m looking to create my own blog and would like to know where u got this from. thank you
I have read several good stuff here. Definitely worth bookmarking for revisiting. I wonder how much effort you put to make such a fantastic informative site.
whoah this blog is great i love reading your articles. Keep up the good work! You know, many people are hunting around for this information, you could aid them greatly.
It is appropriate time to make some plans for the future and it’s time to be happy. I have read this post and if I could I desire to suggest you few interesting things or tips. Perhaps you could write next articles referring to this article. I want to read even more things about it!
This is very interesting, You are a very skilled blogger. I have joined your feed and look forward to seeking more of your fantastic post. Also, I have shared your web site in my social networks!
I got good info from your blog
Thank you, I’ve just been looking for info approximately this topic for ages and yours is the greatest I’ve found out so far. However, what in regards to the conclusion? Are you positive about the source?
I got good info from your blog
Thankyou for this post, I am a big big fan of this web site would like to proceed updated.
Hi, Neat post. There is an issue along with your website in internet explorer, might check this… IE still is the marketplace leader and a good portion of other folks will miss your wonderful writing due to this problem.
You should take part in a contest for one of the best blogs on the web. I will recommend this site!
I discovered your blog site on google and check a few of your early posts. Continue to keep up the very good operate. I just additional up your RSS feed to my MSN News Reader. Seeking forward to reading more from you later on!…
With almost everything which appears to be building within this subject matter, all your points of view happen to be somewhat refreshing. Nevertheless, I beg your pardon, because I do not give credence to your whole strategy, all be it refreshing none the less. It would seem to us that your comments are actually not entirely justified and in simple fact you are generally yourself not even thoroughly certain of your point. In any event I did take pleasure in looking at it.
Very insightful piece! Its always refreshing to see such well-researched articles. I’d love to discuss this topic further with anyone interested. Check out my profile for more engaging discussions.
I enjoy the efforts you have put in this, thank you for all the great blog posts.
Hello There. I found your blog using msn. This is a very well written article. I’ll make sure to bookmark it and return to read more of your useful info. Thanks for the post. I will definitely return.
Hello.This post was really interesting, especially since I was browsing for thoughts on this matter last Friday.
It’s perfect time to make some plans for the future and it is time to be happy. I’ve read this post and if I could I want to suggest you few interesting things or advice. Perhaps you can write next articles referring to this article. I want to read even more things about it!
I’ll immediately grasp your rss feed as I can’t find your email subscription link or newsletter service. Do you have any? Please allow me recognise so that I may subscribe. Thanks.
I have learn several good stuff here. Definitely value bookmarking for revisiting. I surprise how a lot effort you put to create any such fantastic informative web site.
I think you have noted some very interesting points, regards for the post.
Valuable info. Lucky me I found your web site by accident, and I’m shocked why this accident did not happened earlier! I bookmarked it.
I would like to thnkx for the efforts you’ve put in writing this website. I’m hoping the same high-grade site post from you in the upcoming as well. In fact your creative writing skills has encouraged me to get my own blog now. Actually the blogging is spreading its wings rapidly. Your write up is a good example of it.
Do you have a spam problem on this site; I also am a blogger, and I was wanting to know your situation; we have created some nice procedures and we are looking to exchange solutions with others, please shoot me an e-mail if interested.
Great write-up, I?¦m normal visitor of one?¦s site, maintain up the nice operate, and It is going to be a regular visitor for a lengthy time.
I’ll immediately grab your rss as I can not find your e-mail subscription hyperlink or e-newsletter service. Do you’ve any? Please let me understand so that I may subscribe. Thanks.
When I originally commented I clicked the “Notify me when new comments are added” checkbox and now each time a comment is added I get four emails with the same comment. Is there any way you can remove me from that service? Cheers!
I will right away snatch your rss feed as I can’t find your e-mail subscription hyperlink or newsletter service. Do you’ve any? Kindly let me know so that I could subscribe. Thanks.
I discovered your weblog website on google and check just a few of your early posts. Proceed to keep up the superb operate. I just further up your RSS feed to my MSN News Reader. Seeking forward to reading extra from you in a while!…
Hey! Quick question that’s completely off topic. Do you know how to make your site mobile friendly? My website looks weird when viewing from my iphone 4. I’m trying to find a template or plugin that might be able to fix this issue. If you have any suggestions, please share. Appreciate it!
Thanks for another informative site. Where else could I get that kind of information written in such an ideal way? I have a project that I am just now working on, and I’ve been on the look out for such information.
Rattling great visual appeal on this internet site, I’d rate it 10 10.
Nice read, I just passed this onto a friend who was doing a little research on that. And he just bought me lunch since I found it for him smile Thus let me rephrase that: Thank you for lunch! “How beautiful maleness is, if it finds its right expression.” by D. H. Lawrence.
Hi, I think your website might be having browser compatibility issues. When I look at your blog site in Chrome, it looks fine but when opening in Internet Explorer, it has some overlapping. I just wanted to give you a quick heads up! Other then that, superb blog!
Thank you for the auspicious writeup. It in fact was a amusement account it. Look advanced to far added agreeable from you! However, how can we communicate?
This web site can be a walk-by for the entire information you needed about this and didn’t know who to ask. Glimpse right here, and also you’ll definitely discover it.
Some truly great blog posts on this internet site, thanks for contribution.
of course like your web site but you have to take a look at the spelling on quite a few of your posts. A number of them are rife with spelling issues and I find it very bothersome to tell the truth on the other hand I will surely come again again.
As I website possessor I believe the content matter here is rattling wonderful , appreciate it for your efforts. You should keep it up forever! Best of luck.
I love it when people come together and share opinions, great blog, keep it up.
Sweet web site, super layout, really clean and employ friendly.