An ukufakelwa kwe-autologous stem cell Ukwelashwa okujulile lapho isiguli sithola ama-stem cells aso emuva. Lokhu kuhlukile lapho uthola ama-stem cell womunye umuntu (owanikelayo), abizwa ngokuthi i- i-allogeneic stem cell transplant.
Uhlolojikelele lwe-autologous stem cell transplant
I-autologous stem cell transplant ingachazwa ngokuthi Khulula ukwelashwa. I-autologous stem cell isetshenziswa njengendlela yokuhlenga amasosha omzimba. 'Autologous' igama elisemthethweni lento evela kumina, ngokuphambene nokuthile okuvela komunye umuntu. Ku-autologous stem cell transplant, amaseli atshalwe kabusha amaseli esiguli abuyiselwa kuwo.
Isizathu sokuthi igama lokuhlenga lingasetshenziswa ukuchaza ukufakelwa kwe-stem cell okuzenzakalelayo, kungenxa yokuthi lapho i-lymphoma ingaphenduli ekwelashweni, noma ilokhu ibuya ngemva kokwelashwa izinyathelo eziqinile ezidingekayo ukuzama ukuqeda i-lymphoma unomphela. Lokhu ngokuvamile kuhilela imithamo ephezulu kakhulu imiphumela emibi yokwelashwa ngamakhemikhali.
Le mithamo ephezulu kakhulu izobulala amasosha omzimba (kuhlanganise ne-lymphoma). Kodwa-ke, imiphumela yokwelashwa okunzima kangako isho ukuthi amasosha omzimba ngeke akwazi ukululama ngokwawo, amaseli e-autologous stem ahlinzeka ngokuhlenga amasosha omzimba awonakele futhi asisize ukuthi abuyele futhi asebenze.
Inhloso yokufakelwa kwe-stem cell
Kunezizathu eziningi zokuthi kungani iziguli ze-lymphoma zingadinga ukufakelwa kwe-stem cell kuhlanganise:
- Ukwelapha iziguli ze-lymphoma esezixolelwe, kodwa 'zinengozi enkulu' yokubuya kwe-lymphoma yazo
- I-lymphoma ibuyile ngemuva kokwelashwa okujwayelekile komugqa wokuqala, ngakho-ke i-chemotherapy enamandla kakhulu (enamandla) isetshenziselwa ukuyibuyisela ekuxolelweni (asikho isifo esitholakalayo)
- I-lymphoma iyaphika (ayikaphenduli ngokuphelele) ekwelashweni okujwayelekile komugqa wokuqala ngenhloso yokuthola ukuxolelwa.
I-Autologous (amaseli angowakho) ukufakelwa kwe-stem cell
Uma ama-stem cell e-autologous engazange alawulwe, amasosha omzimba abeyoba buthakathaka kakhulu ukuze alwe nanoma yiziphi izifo. Okusho ukuthi izifo ezithathelwanayo amasosha omzimba aqinile angaziboni, zingaholela ezifweni ezisongela ukuphila futhi ekugcineni zife.
Inqubo yokufakelwa i-autologous stem cell
UDkt Amit Khot, Udokotela Wegazi kanye nodokotela wokufakelwa komnkantsha
Peter MacCallum Cancer Center kanye nesibhedlela saseRoyal Melbourne
- Ukulungiselela: lokhu kuhlanganisa ukwelashwa okuthile ukunciphisa i-lymphoma (lokhu kungafaka imithamo emi-2 ye-chemotherapy). Okunye ukwelashwa kwenziwa ukuze kugqugquzelwe umnkantsha ukuthi ukhiqize ama-stem cells anele ukuze kuqoqwe.
- Iqoqo le-stem cell: lena inqubo yokuvuna ama-stem cells, ngokuvamile eyenziwa ngomshini we-apheresis osiza ukuhlunga ama-stem cells aphume egazini elijikelezayo. Ama-stem cells ayaqaqwa futhi agcinwe kuze kube usuku lokubuyisela kabusha.
- Ukwelashwa kwe-conditioning: lena i-chemotherapy elawulwa ngemithamo ephezulu kakhulu ukuze kuqedwe yonke i-lymphoma
- Ukufakwa kabusha kwama-stem cell: uma ukwelashwa ngethamo eliphezulu sekwenziwe, ama-stem cells esiguli ayeqoqwe ngaphambilini, aphinde abuyiselwe emgudwini wegazi.
- I-engraftment: lena inqubo lapho amangqamuzana abuyiselwe ahlala khona emzimbeni futhi aqinise amasosha omzimba, ayikhulule ku-neutropenia ende.
Ukufakelwa kwe-stem cell kuyindlela yokwelapha ejulile futhi kunezibhedlela ezikhethiwe kuphela e-Australia ezinganikeza lokhu kwelashwa. Ngakho-ke, kwezinye izimo kungase kusho ukuthuthela emadolobheni amakhulu lapho isibhedlela sokufakelwa kabusha sikhona.
Kungathatha izinyanga eziningi futhi ngezinye izikhathi ngisho neminyaka ukuze amasosha omzimba alulame ngokugcwele ngemva kokufakelwa kwe-autologous. Iningi labantu abafakelwa i-autologous stem cell bazoba sesibhedlela amaviki ama-3 - 6 ngokwesilinganiso. Ngokuvamile bangeniswa esibhedlela ezinsukwini ezimbalwa ngaphambi koSuku Lokufakelwa kabusha (usuku amangqamuzana abuyiselwa ngalo) futhi bahlale esibhedlela kuze kube yilapho amasosha abo omzimba eseluleme aze afike ezingeni eliphephile.
Ukulungiselela
Ngaphambi kokufakelwa kwe-stem cell, kukhona amalungiselelo adingekayo. Konke ukufakelwa kuhlukile, ithimba lakho lokufakelwa kabusha kufanele likuhlelele yonke into. Amanye amalungiselelo angabandakanya:
Ukufakwa komugqa omaphakathi
Uma isiguli singenawo umugqa omaphakathi, khona-ke uzofakwa ngaphambi kokufakelwa. Ulayini omaphakathi kungaba yi-PICC (i-catheter emaphakathi efakwe nge-peripherally) noma ingaba i-CVL (umugqa we-venous omaphakathi). Udokotela uzonquma ukuthi yimuphi umugqa ophakathi olungele isiguli.
Umugqa omaphakathi unikeza indlela yokuthi iziguli zithole imithi eminingi ehlukene ngesikhathi esisodwa. Iziguli ngokuvamile zidinga imithi eminingi ehlukene kanye nokuhlolwa kwegazi ngesikhathi sokufakelwa futhi umugqa omaphakathi usiza abahlengikazi ukuphatha ukunakekelwa kwesiguli.
Ukwelashwa ngamakhemikhali
I-chemotherapy enedosi ephezulu ihlale ilawulwa njengengxenye yenqubo yokufakelwa kabusha. I-chemotherapy yomthamo omkhulu ibizwa ngokuthi ukwelashwa kwe-conditioning. Ngaphandle komthamo omkhulu we-chemotherapy, ezinye iziguli zidinga i-salvage chemotherapy. I-Salvage therapy yilapho i-lymphoma inolaka futhi idinga ukuncishiswa ngaphambi kokuba yonke inqubo yokufakelwa iqhubeke. Igama salvage kuvela ekuzameni ukuhlenga umzimba ku-lymphoma.
Ukuthutha ukuze uthole ukwelashwa
Izibhedlela ezithile kuphela e-Australia ezikwazi ukwenza ukufakelwa kwe-stem cell. Ngenxa yalokhu, iziguli kungase kudingeke zithuthe ekhaya lazo ziye endaweni eseduze nesibhedlela. Ezinye izibhedlela zokufakelwa kabusha zinendawo yokuhlala yesiguli isiguli kanye nomnakekeli abangahlala kuzo. Uma unosonhlalakahle esikhungweni sokwelashwa khuluma naye ukuze uthole okwengeziwe mayelana nezindlela zokulala.
Ukulondolozwa kokuzala
Ukufakelwa kwe-stem cell kungase kuthinte ikhono lokuba nezingane. Kubalulekile ukuthi iziguli zixoxe ngezinketho ezitholakalayo zokulondoloza inzalo. Uma ungakabi nazo izingane noma usafuna ukuqhubeka nomndeni wakho kungcono ukhulume nethimba lezokwelapha mayelana nokuzala ngaphambi kokuba ukwelashwa kuqale.
USteve kwatholakala ukuthi une-mantle cell lymphoma ngo-2010. U-Steve uye wasinda ekufakweni kwe-autologous kanye ne-allogeneic stem cell. Lena indaba kaSteve.
Amathiphu asebenzayo okulungiselela ukufakelwa
Ukufakelwa i-stem cell ngokuvamile kuhilela ukuhlala isikhathi eside esibhedlela. Kungase kube usizo ukupakisha ezinye zalezi zinto:
- Amapheya amaningana ezingubo ezithambile, ezinethezekile noma amaphijama nenqwaba yezingubo zangaphansi
- Isixubho (sithambile), umuthi wokuxubha, insipho, isikhuthazi esithambile, isiqedaphunga esithambile
- Umcamelo ongowakho (geza ngokushisa umcamelo kanye nanoma yiziphi izingubo zokulala/ziphonse omata ngaphambi kokungeniswa esibhedlela - ziwashe ngokushisa ukuze unciphise amagciwane njengoba amasosha akho omzimba azoba sengozini kakhulu).
- Ama-slippers noma izicathulo ezikhululekile kanye namapheya amaningi amasokisi
- Izinto zomuntu siqu zokukhanyisa igumbi lasesibhedlela (isithombe sabathandekayo bakho)
- Izinto zokuzijabulisa njengezincwadi, omagazini, amagama ahlukene, i-iPad/laptop/tablet. Isibhedlela singaba nesicefe kakhulu uma ungenayo into ongayenza.
- Ikhalenda lokugcina umkhondo wedethi, ukulaliswa esibhedlela isikhathi eside kungafiphalisa zonke izinsuku ndawonye.
Ukuqoqwa kwama-stem cells
Iqoqo le-peripheral stem cell
Iqoqo le-peripheral stem cell iqoqo lamaseli elisuka emgudwini wegazi we-peripheral.
Lapho kuholela ekuqoqweni kwe-peripheral stem cell, iziguli eziningi zithola imijovo yesici sokukhula. Izici zokukhula zikhuthaza ukukhiqizwa kwe-stem cell. Lokhu kusiza ama-stem cells asuke emnkantsheni, aye egazini, alungele ukuqoqwa.
Ama-stem cells aqoqwa ngenqubo eyaziwa ngokuthi i-apheresis. Umshini we-apheresis usetshenziselwa ukuqoqa bese uhlukanisa ama-stem cells kulo lonke igazi.
Ngaphambi kokuqoqwa kwe-stem cell uzothola ukwelashwa ngamakhemikhali, ukunciphisa noma ukuqeda i-lymphoma ngaphambi kokuqoqwa.
Amaseli e-stem aqoqiwe ayafrizwa futhi agcinwe kuze kube yilapho usulungele ukuthi aphinde afakwe noma atshalwe kabusha. . Lawa ma-stem cells azoncibilika ngokushesha ngaphambi kokuba afakwe kabusha, ngokuvamile eduze kombhede.
Isebenza kanjani i-apheresis
Umshini we-apheresis uhlukanisa izingxenye ezihlukene zegazi. Lokhu ikwenza ngokuhlukanisa ama-stem cells anele adingekayo ukuze kutshalwe kabusha. I-Apheresis ihlanganisa ukufaka i-cannula (inaliti/i-catheter) emithanjeni enkulu engalweni noma ku-vascath (umugqa omaphakathi okhethekile). I-cannula noma i-vascath isiza igazi ukuthi liphume emzimbeni liye emshinini we-apheresis.
Umshini ube usuhlukanisa ama-stem cells ube yisikhwama sokuqoqa. Uma igazi selihambe esigabeni sokuqoqwa kwamaseli. Ibuyela emzimbeni. Le nqubo ithatha amahora ambalwa (cishe amahora angu-2 - 4). Iqoqo le-apheresis liphinda ezinsukwini ezimbalwa kuze kube yilapho kuqoqwa umthamo weqoqo noma ama-stem cells anele.
Ukuqoqwa kwe-peripheral stem cell akubangeli ubuhlungu obuqhubekayo. Kukhona ukungaphatheki kahle okuvela enalitini (i-cannula noma i-vascath) efakwe emthanjeni. Kungase futhi kube khona 'ubuhlungu bethambo' obuncane obuzwiwa ngenxa yemijovo yesici sokukhula. Lobu buhlungu ngokuvamile bulawulwa kahle nge-paracetamol yomlomo. I-Apheresis iyindlela evamile kakhulu yokuqoqa ama-stem cells namuhla.
Ukwelashwa kwe-conditioning
I-Conditioning therapy i-chemotherapy enedosi ephezulu esetshenziswa ezinsukwini eziholela ekufakeni. I-conditioning therapy i-chemotherapy futhi ngezinye izikhathi ukwelashwa nge-radiation kunikezwa ngokuhlangene. Izinhloso ezimbili ze-conditioning therapy yilezi:
- Ukubulala i-lymphoma eningi ngangokunokwenzeka
- Yehlisa inani lama-stem cell
Kunezinhlanganisela eziningi ezahlukene ze-chemotherapy kanye ne-radiation therapy engasetshenziswa ezimisweni zokubeka isimo. Ithimba elelaphayo lizonquma ukuthi iyiphi i-conditioning regime elungele isiguli. Lokhu kuzoncika kuhlobo oluncane lwe-lymphoma, umlando wokwelashwa nezinye izici zomuntu ngamunye ezifana neminyaka, impilo ejwayelekile kanye nokuqina.
Iziguli ezinezifo ezihambisanayo futhi ezisengozini enkulu yokuba nenkinga, ngokuvamile zizoba nokwelashwa okunciphile. Lokhu kubizwa 'umbuso wokwenza isimo esincishisiwe'. Ukwelashwa kwe-conditioning kungase kube ukuphakama okuphezulu noma ukuncipha. Kuyo yomibili le mithi ukwelashwa kunolaka. Ngenxa yalokho, amangqamuzana amaningi anempilo ayafa kanye ne-lymphoma.
Ukungeniswa esibhedlela kuvame ukuqala kusukela ekuqaleni kokwelashwa kwe-conditioning. Ezinye izindlela zokwelapha ezilungisa isimo zingenziwa emitholampilo yeziguli ezingalaliswanga kodwa ukungeniswa esibhedlela kuzokwenzeka ezinsukwini ezi-1-2 ngaphambi kokufakelwa. Iziguli zingalaliswa esibhedlela isikhathi esingamaviki ama-3-6. Lona umhlahlandlela njengoba konke ukufakelwa kwehlukile futhi ezinye iziguli zizodinga ukunakekelwa okwengeziwe kwezokwelapha isikhathi eside kunamaviki angu-6.
Kuma-lymphomas, enye yezindlela ezijwayelekile zokumisa isimo yi-chemotherapy protocol ebizwa ngokuthi i-BEAM:
- B - I-BCNU® noma i-BCNU noma i-carmustine
- E - Etoposide
- A - I-Ara-C noma i-cytarabine
- M – Melphalan
I-BEAM isetshenziswa esibhedlela ezinsukwini eziyisi-6 ngaphambi kokuba ama-stem cells esiguli abuyiselwe. Izidakamizwa zinikezwa ngomugqa ophakathi.
I-countdown yokwenza ama-stem cells akho abuyele emuva kusukela osukwini oluqalwa ngalo ukwelapha isimo. Usuku lweziro luhlala luwusuku amaseli amukelwa ngalo. Isibonelo, uma ubuthola iphrothokholi ye-BEAM ethatha izinsuku ezingu-6, usuku lokuqala lwale nqubo lubizwa ngokuthi usuku –6 (minus 6). Ibala phansi usuku ngalunye ngosuku lwesibili olwaziwa ngokuthi usuku -5, njll., uze ufike osukwini 0 lapho amaseli esiguli ebuyiselwa khona.
Ngemva kokuba isiguli sithole ama-stem cells, izinsuku zibalela phezulu. Usuku ngemva kokutholwa kwamaseli lubizwa ngokuthi usuku +1 (kanye nelilodwa), usuku lwesibili usuku +2, njll.
Ukubuyisela ama-stem cells
Ngemva kokuphela kokwelashwa okunamandla ngamakhemikhali, ama-stem cells ayabuyiselwa. Lama-stem cells kancane kancane aqala ukukhiqiza amaseli egazi amasha, anempilo. Ekugcineni, azokhiqiza amangqamuzana anempilo anele ukuze agcwalise wonke umnkantsha wamathambo, agcwalise lonke igazi namangqamuzana omzimba omzimba.
Ukubuyisela ama-stem cells kuyinqubo eqondile. Kufana nokumpontshelwa igazi futhi amaseli anikezwa ngomugqa emgqeni omaphakathi. Usuku ama-stem cell abuyiselwa ngalo yi-“Day Zero”.
Nganoma iyiphi inqubo yezokwelapha, kunengozi yokuba nokusabela ekufakweni kwe-stem cell. Ezigulini eziningi akukho ukusabela, kodwa abanye bangase bahlangabezane:
- Ukuzizwa ugula noma ukugula
- Ukunambitheka okubi noma umuzwa ovuthayo emlonyeni
- Umfutho wegazi ophezulu
- Ukusabela okweqile
- Ukutheleleka
Ku-autologous (self) transplant, ama-stem cells ayaqandiswa futhi agcinwe ngaphambi kokufakwa kabusha. Le nqubo yokuqandisa ihlanganisa ukuxuba amangqamuzana endaweni yokulondoloza imvelo. Ezinye iziguli zingakwazi ukusabela kulesi silondolozi kunokuba sisabele kuma-stem cells. Umphumela ovamile walesi silondolozi ukushintsha kokuphefumula, kubangela ukuthi umoya unuke kamnandi.
Ukwakhiwa kwama-stem cell
I-Engraftment yilapho ama-stem cells amasha eqala ukuthatha kancane kancane njengama-primary stem cell. Lokhu ngokuvamile kwenzeka emasontweni angu-2-3 ngemva kokumnika ama-stem cells.
Ngenkathi ama-stem cell amasha efakwa, isiguli sisengozini enkulu kakhulu yokuthola ukutheleleka. Ngokuvamile iziguli kufanele zihlale esibhedlela ngalesi sikhathi, ngoba zingagula futhi zidinga ukuthola ukwelashwa ngokushesha.
Izinkinga zokufakelwa kwe-stem cell
Imiphumela emibi ye-conditioning chemotherapy
Iziguli kungenzeka zithole imiphumela emibi evela ekwelashweni komthamo omkhulu we-chemotherapy. Kunesigaba esihlukile kokujwayelekile imiphumela emibi yokwelashwa kwe-lymphoma, okuhlanganisa namathiphu asebenzayo okuthi ungabhekana kanjani nezinye ezivamile:
- I-Oral Mucositis (umlomo obuhlungu)
- I-anemia (isibalo esiphansi samaseli abomvu)
- I-Thrombocytopenia (inani eliphansi leplatelet)
- I-nausea nokuhlanza
- Izinkinga zokugaya ukudla (isifo sohudo noma ukuqunjelwa)
Ingozi Yokutheleleka
Ngemuva kokufakelwa kwe-stem cell, imithamo ephezulu ye-chemotherapy izobe iqede inqwaba yamangqamuzana egazi amhlophe, okuhlanganisa nengqamuzana elimhlophe legazi elibizwa ngokuthi ama-neutrophils, abangela i-neutropenia. I-neutropenia ende ibeka iziguli engcupheni enkulu kakhulu yokuthola ukutheleleka. Izifo zingelapheka, kodwa uma zingabanjwanga kusenesikhathi futhi zelashwe ngokushesha zingaba yingozi empilweni.
Ngenkathi usesibhedlela, ngokushesha ngemva kokufakelwa kwe-stem cell, ithimba elelaphayo lizobe lithatha izinyathelo zokuphepha ukuze kuvinjelwe ukutheleleka ngezifo kanye nokuqapha ngokucophelela izimpawu zokutheleleka. Nakuba kuthathwa izinyathelo eziningi zokuphepha ukuze kuncishiswe ingozi yokuthola ukutheleleka, iziguli eziningi ezinokufakelwa kwe-stem cell okuzenzakalelayo zizothola ukutheleleka.
Ezinsukwini ezimbalwa zokuqala ngemva kokufakelwa iziguli kulapho iziguli zisengozini enkulu kakhulu yokuthola izifo ezibangelwa amagciwane njengezifo ezithinta igazi, inyumoniya, izifo zesistimu yokugaya ukudla noma izifo zesikhumba.
Ezinyangeni ezimbalwa ezizayo, iziguli zisengozini enkulu yokuthola izifo ezibangelwa amagciwane. Lawa kungase kube amagciwane abelele elele emzimbeni ngaphambi kokufakelwa futhi angase aqubuke lapho amasosha omzimba ephansi. Azibangeli izimpawu ngaso sonke isikhathi kodwa ukuhlolwa kwegazi okuvamile ngemva kokufakelwa kufanele kubonise ukuqubuka kokutheleleka ngegciwane okubizwa ngokuthi i-cytomegalovirus (CMV). Uma ukuhlolwa kwegazi kubonisa ukuthi i-CMV ikhona - ngisho nangaphandle kwezimpawu - isiguli sizolashwa ngemithi elwa namagciwane.
Izibalo zegazi ziqala ukukhuphuka phakathi kwamaviki ama-2 kuya kwamane ngemva kokufakelwa i-autologous stem cell. Nokho, kungathatha izinyanga eziningi, noma ngezinye izikhathi ngisho neminyaka, ukuze amasosha omzimba alulame ngokugcwele.
Iziguli kufanele zelulekwe uma ziya ekhaya ukuthi yiziphi izimpawu zokutheleleka okufanele zibheke nokuthi ubani okufanele axhumane nazo uma kungase kube sengozini yokutheleleka noma enye into ekhathaza isiguli.
Late Effects
Imiphumela yakamuva yizinkinga zempilo ezingase zikhule izinyanga noma iminyaka ngemuva kokuphela kokwelashwa kwe-lymphoma. Izikhungo eziningi zokufakelwa kabusha zinikezele ngezinsizakalo zemiphumela yakamuva ezinikezela ngezinhlelo zokuhlola ukuze kutholwe imiphumela yakamuva ngokushesha okukhulu. Lokhu kunikeza isiguli ithuba elihle kakhulu lokwelashwa ngempumelelo uma kuvela imiphumela yakamuva.
Ithimba lokufakelwa lizokwazisa ukuthi yini ethinta sekwephuzile iziguli ezisengcupheni yokuthuthukiswa nokuthi yini okufanele yenze ukunciphisa ubungozi bokuvela kwalokhu. Ukuze uthole ulwazi olwengeziwe, bheka 'Late Effects'
Iziguli nazo zingase zibe sengcupheni yokukhula I-post-transplant lymphoproliferative disorder (PTLD) - ama-lymphomas angakhula ezigulini ezithatha izidakamizwa ezivimbela ukuzivikela komzimba ngemva kokufakelwa. Kodwa-ke, i-PTLD ayivamile futhi iziguli eziningi ezike zafakwa ezitshalweni aziyikhi i-PTLD. Ithimba lokufakelwa lizoxoxa nganoma yiziphi izingozi zomuntu ngamunye nanoma yiziphi izimpawu noma izimpawu okufanele uzibheke.
Ukunakekelwa kokulandelela
Ngemuva kokufakelwa kwe-stem cell, iziguli zizobonana njalo nodokotela wazo. Lawa ma-aphoyintimenti azokwehla njengoba isikhathi sihamba futhi kwenzeka nokululama. Ukulandelela kuzoqhubeka izinyanga neminyaka ngemva kokwelashwa, kodwa kancane kancane njengoba isikhathi sihamba. Ekugcineni odokotela bokufakelwa bazokwazi ukunikeza ukunakekelwa kokulandelela, kudokotela wakho.
Cishe izinyanga ezi-3 ngemva kokufakelwa, i-PET scan, i-CT scan kanye/noma i-bone marrow aspirate (BMA) ingase iyalwe ukuze ihlole ukuthi ukululama kuhamba kanjani.
Kujwayelekile ukuthi ubuyele esibhedlela ukuze uyokwelashwa emasontweni nasezinyangeni ezilandela ukufakelwa kodwa ngokuhamba kwesikhathi, ingozi yezinkinga ezinkulu iyancipha.
Iziguli zokufakelwa kabusha kungenzeka futhi zibe nemiphumela engemihle evela ekwelashweni kwethamo eliphezulu. Ngezinye izikhathi iziguli zingazizwa zingaphilile futhi zikhathele kakhulu. Kubalulekile ukuthatha isikhathi sokululama ekufakweni kwe-stem cell.
Ithimba lezokwelapha kufanele linikeze iseluleko mayelana nezinye izici okufanele zicatshangelwe phakathi nesigaba sokululama.
Kwenzekani ngemva kokufakelwa kwe-stem cell
Ukuqeda ukwelashwa kungaba isikhathi esiyinselele kubantu abaningi, njengoba bebuyela ekuphileni ngemva kokufakelwa. Abanye abantu bangase bangaqali ukuzwa ezinye zalezi zinselele amasonto kuya ezinyangeni ngemva kokuqedwa kokwelashwa komdlavuza, njengoba beqala ukucabanga ngalokho ababhekana nakho noma banomuzwa wokuthi bayelulama sekuphelile, njengoba beqala ukucabanga ngokuhlangenwe nakho kwabo noma ukwenza kanjalo. bangabi nomuzwa wokuthi balulama ngokushesha njengoba kufanele. Okunye okukhathazayo okuvamile kungahlotshaniswa nalokhu:
- Physical
- Ukuphila kwengqondo
- Impilo engokomzwelo
- Relationships
- Umsebenzi, ukufunda kanye nemisebenzi yomphakathi
Ezempilo nokuphila kahle
Kungenzeka ukuthi usuvele unempilo enempilo, noma ungase ufise ukwenza izinguquko ezithile endleleni yokuphila eyakhayo ngemva kokwelashwa. Ukwenza izinguquko ezincane ezifana nokudla nokukhulisa ukuqina kwakho kungathuthukisa impilo yakho nokuphila kahle futhi kusize umzimba wakho ukuthi ululame. Kuningi amasu okuzinakekela lokho kungakusiza ukuthi ululame ekwelashweni.
