Kugufasha gusobanukirwa uburyo bwo gusuzuma no kuvura uduheri two mu bihaha - Cryoablation yo gusuzuma no gukuramo uduheri two mu bihaha Biopsy na Ablation

Kuvura udukoko two mu bihaha

Kanseri y'ibihaha n'uturemangingo tw'ibihaha duteye impungenge

Amakuru aturuka mu Kigo Mpuzamahanga Gishinzwe Ubushakashatsi ku Kanseri cy’Umuryango w’Abibumbye wita ku Buzima, agaragaza ko mu Bushinwa hagaragaye abarwayi bashya ba kanseri bagera kuri miliyoni 4.57 mu 2020,kanseri y'ibihaha ifata abantu bagera ku 820.000Mu ntara n'imijyi 31 byo mu Bushinwa, igipimo cy'indwara ya kanseri y'ibihaha ku bagabo kiza ku mwanya wa mbere mu turere twose uretse Gansu, Qinghai, Guangxi, Hainan, na Tibet, kandi igipimo cy'impfu ni cyo kiri hejuru cyane hatitawe ku gitsina.Igipimo rusange cy’indwara z’ibihaha mu Bushinwa kibarirwa hagati ya 10% na 20%, aho bishobora kuba byinshi mu bantu barengeje imyaka 40. Ariko, ni ngombwa kumenya ko inyinshi mu tubyimba tw’ibihaha ari ibisebe bidahumanya.

Gusuzuma uduheri two mu bihaha

Utubyimba tw'ibihahayerekeza ku gicucu kinini gifite ishusho y'uruziga mu bihaha, gifite ingano zitandukanye n'impande zisobanutse cyangwa zitagaragara neza, hamwe n'umurambararo uri munsi ya cm 3 cyangwa ungana nacyo.

Gusuzuma amashusho:Muri iki gihe, uburyo bwo gupima amashusho bushingiye ku ibara ry’umukara (scanning imaging) buzwi nka ground-glass opacity nodule imaging diagnosis, bukoreshwa cyane. Impuguke zimwe zishobora kugera ku gipimo cy’uburwayi kigera kuri 95%.

Isuzuma ry'indwara:Ariko, gusuzuma amashusho ntibishobora gusimbura gusuzuma indwara z’imitsi, cyane cyane mu gihe habayeho ubuvuzi bwihariye bw’ikibyimba gisaba gusuzuma indwara z’imitsi ku rwego rw’uturemangingo.Gusuzuma indwara bikomeje kuba igipimo cy’ingenzi.

Uburyo Busanzwe bwo Gusuzuma no Kuvura Utubyimba tw'Ibihaha

Isuzuma ry'umubiri ku ruhu:Gusuzuma indwara z'imitsi no gusuzuma indwara z'ibinyabutabire bishobora kugerwaho hakoreshejwe ikinya cyo mu gace runaka binyuze mu gutobora ingingo. Igipimo mpuzandengo cy'intsinzi mu gusuzuma indwara ni hafi 63%,ariko ingorane nka pneumothorax na hemothorax zishobora kubaho. Ubu buryo bufasha gusa gusuzuma indwara kandi biragoye kuvura icyarimwe.Hari kandi ibyago byo kwangirika kw'uturemangingo tw'ikibyimba no kwangirika kw'uturemangingo. Uburyo busanzwe bwo gusuzuma ingingo ku ruhu butanga ingano nke y'uturemangingo,bituma gusuzuma indwara z'imitsi mu buryo bwihuse bigorana.

Kubaga Igifu Bifashijwe na Video mu Gukoresha Innesmetike (VAT) mu Kubaga Igifu Bifashijwe na Video mu Gupima Igifu (Lobectomy): Ubu buryo butuma umuntu asuzuma indwara kandi akayivura icyarimwe, aho igipimo cyo kuyivura cyegera 100%. Ariko, ubu buryo bushobora kuba budakwiye ku barwayi bageze mu zabukuru cyangwa mu byiciro byihariye.batihanganira ikinya rusange, abarwayi bafite utubyimba tw’ibihaha turi munsi ya mm 8 cyangwa ubucucike buri hasi (<-600), utubyimba turi hagati y’uduce twinshi, kandiutudomo mu gace k'imbere mu gitereko hafi y'imiterere y'inyumaByongeye kandi, kubagwa bishobora kuba atari amahitamo akwiye yo gusuzuma no kuvura mu bihe birimokongera kugaragara nyuma yo kubagwa, kugaragara kw'utubyimba mu buryo butunguranye, cyangwa kugaragara kw'ibibyimba mu buryo butunguranye.

Uburyo bushya bwo kuvura uduheri two mu bihaha - Cryoablation

Bitewe n'iterambere rihoraho ry'ikoranabuhanga mu buvuzi, kuvura kanseri byinjiye mu gihe cya "gusuzuma neza no kuvura neza“. Uyu munsi, tuzabagezaho uburyo bwo kuvura bukoreshwa mu gace runaka, bufite akamaro kanini ku ndwara z’ibibyimba bitari indwara n’uturemangingo tw’ibihaha tudakwirakwira, ndetse n’uturemangingo tw’ibibyimba mu ntangiriro (munsi ya cm 2) –gutwikira.

Ubumenyi bw'amarira

Uburyo bwo gukaraba ubushyuhe buke cyane (cryotherapy), buzwi kandi nka cryosurgery cyangwa cryoablation, ni uburyo bwo kubaga bukoresha gukonjesha mu kuvura ingingo z’umubiri. Dukurikije amabwiriza ya CT, aho umubiri uherereye neza haboneka gutobora ingingo z’ikibyimba. Iyo umuntu ageze aho igisebe cyabereye, ubushyuhe bw’aho hantu bugabanuka vuba kugeza ku-140°C kugeza -170°Cgukoreshagaze ya argonmu minota mike, bityo kugera ku ntego yo kuvura kanseri.

Ihame ryo gukaraba ku mitsi yo mu bihaha

1. Ingaruka z'urubura: Ibi ntibigira ingaruka ku ndwara kandi bituma umuntu asuzuma indwara vuba mu gihe cyo kubagwa.Cryoablation yica uturemangingo twa kanseri mu buryo bw’umubiri kandi igatera kuziba kw’imitsi mito.

2. Ingaruka zo guhindura ubudahangarwa bw'umubiri: Ibi bituma ubudahangarwa bw'umubiri bukomeza gukora neza ku kibyimba. Bituma habaho irekurwa rya antigen, bigatera imbaraga ubudahangarwa bw'umubiri, kandi bikagabanya imbaraga z'ubudahangarwa bw'umubiri.

3. Gutuza ingingo zigenda zihagarara (nk'ibihaha n'umwijima): Ibi byongera igipimo cyo gukora biopsy. Umupira ukonje ukorwa, bigatuma byoroha kuwufata neza, kandi impande zawo zigaragara neza kandi zigaragara ku mashusho. Ubu buryo bworoshye kandi bufite akamaro.

Bitewe n'ibintu bibiri biranga cryoablation -"Ingaruka zo gukonjesha no gufunga ingingo" na "imiterere y'ingingo imeze neza nyuma yo gukonjesha nta ngaruka ku ndwara", ishobora gufasha mu gusuzuma udukoko two mu bihaha,kugera ku gusuzuma indwara mu buryo bwihuse mu gihe cyo kubagwa, no kunoza igipimo cy'uko biopsy igenze neza.Bizwi kandi nka “gupima no gupima ibinure byo mu bihaha".

Ibyiza byo gukaraba

1. Gukemura ibibazo by'ubuhumekero:Gukonjesha byo mu gace bitera gutuza ibihaha (bikoresheje uburyo bwo gukonjesha bwa coaxial cyangwa bypass).

2. Kurwanya pneumothorax, hemoptysis, n'ibyago byo kubura umwuka no gutera ibibyimba: Nyuma yo gukora umupira ukonje, hashyirwaho umuyoboro ufunganye w’umuvuduko utari mwiza uturutse hanze y’umubiri kugira ngo umenye niba urwaye indwara kandi uyivure.

3. Kugera ku ntego zo gusuzuma no kuvura indwara mu buryo bumwe: Habanza gukorwa uburyo bwo gukaraba imitsi y'ibihaha, hagakurikiraho kongera gushyuha no gupima imiterere y'umubiri mu buryo butandukanye bwa 360° kugira ngo hongerwe ingano y'imitsi y'umubiri.

Nubwo uburyo bwo kuvura kanseri ari uburyo bwo kugenzura ikibyimba mu gace runaka, bamwe mu barwayi bashobora kugaragaza ko ubudahangarwa bw’umubiri budashobora kugira ingaruka nziza. Ariko, amakuru menshi agaragaza ko iyo uburyo bwo kuvura kanseri buhujwe n’ubuvuzi bushingiye ku maraso, imiti ivura indwara, uburyo bwo kuvura indwara, n’ubundi buryo bwo kuvura, uburyo bwo kugenzura ikibyimba mu gihe kirekire bushobora kugerwaho.

Ibimenyetso byerekana uburyo bwo gukaraba hakoreshejwe CT (Percutaneous Cryoablation)

Utunyangingo tw’ibihaha byo mu gace ka B: Ku tunyangingo tw’ibihaha dukeneye gucibwa ibice bibiri cyangwa byinshi, gucibwa ibice bibiri bishobora gutanga igisubizo cy’ukuri mbere yo kubagwa.

Utudomo tw'ibihaha byo mu gace ka A: Uburyo bwo guca mu bihaha cyangwa kubishyira mu mwanya wa oblique (intego ni ugushyiraho umuyoboro w'ibihaha, byaba byiza ufite uburebure bwa cm 2).

Ibimenyetso

Ibibyimba bitari bibi n'udusimba tw'ibihaha tudakwirakwira:

Ibi birimo ibisebe bitarafata kanseri (hyperplasia idasanzwe, kanseri isanzwe), ibisebe bikwirakwira mu mubiri, uduheri twitwa inflammatory, uduheri n'ibisebe byo mu mubiri, hamwe n'uduheri twitwa proliferative scarces.

Utubyimba twa kanseri yo mu cyiciro cya mbere:

Dukurikije ubunararibonye busanzweho, uburyo bwo kuvura hakoreshejwe uburyo bwa cryoablation nabwo ni uburyo bwiza bwo kuvura bugereranywa no kubaga uduce tw’ibirahuri bitagaragara neza dufite ubunini bwa cm 2 dufite ibice bikomeye biri munsi ya 25%.