Cryoablation ya Nodule
Indwara ya Kanseri y'ibihaha hamwe na Nodules iteye ubwoba
Dukurikije imibare yaturutse mu kigo mpuzamahanga gishinzwe ubushakashatsi kuri kanseri y’umuryango w’ubuzima ku isi, mu Bushinwa hagaragaye abagera kuri miliyoni 4.57 banduye kanseri mu 2020,hamwe na kanseri y'ibihaha ihwanye n'abantu 820.000.Mu ntara 31 n’imijyi yo mu Bushinwa, umubare wa kanseri y'ibihaha ku bagabo uri ku mwanya wa mbere mu turere twose usibye Gansu, Qinghai, Guangxi, Hainan, na Tibet, kandi umubare w'abapfa niwo munini utitaye ku gitsina.Umubare rusange w’indwara zifata ibihaha mu Bushinwa bivugwa ko uri hafi 10% kugeza kuri 20%, hamwe nibishobora kuba byinshi mubantu barengeje imyaka 40.Ariko, twakagombye kumenya ko ubwinshi bwimitsi ihumeka ari ibikomere byiza.
Gupima Indwara Yumutima
Imitsi ihumekareba igicucu kimeze nk'igicucu cyijimye mu bihaha, gifite ubunini butandukanye kandi busobanutse neza cyangwa butagaragara, na diameter iri munsi cyangwa ingana na cm 3.
Gusuzuma Ishusho:Kugeza ubu, tekinoroji yo gusikana yerekana amashusho, izwi ku izina rya hasi-ibirahuri opacity nodule yerekana amashusho, irakoreshwa cyane.Abahanga bamwe barashobora kugera ku gipimo cya patologi kigera kuri 95%.
Gusuzuma indwara:Nyamara, isuzuma ryerekana amashusho ntirishobora gusimbuza indwara ya pathologiya, cyane cyane mugihe cyo kuvura ibibyimba byihariye bisaba kwisuzumisha kwa molekuline kurwego rwa selire.Kwipimisha indwara bikomeza kuba zahabu.
Uburyo busanzwe bwo gusuzuma no kuvura uburyo bwo guhumeka
Biopsy itandukanye:Kwipimisha indwara ya tissue hamwe no gupima indwara ya molekuline irashobora kugerwaho mugihe cya anesteziya yaho binyuze mumyanya mibi.Ikigereranyo cyo gutsinda cya biopsy ni 63%,ariko ingorane nka pneumothorax na hemothorax zirashobora kubaho.Ubu buryo bushigikira kwisuzumisha gusa kandi biragoye kuvura icyarimwe.Hariho kandi ibyago byo kumeneka kanseri yibibyimba na metastasis.Ubusanzwe biopsy ya percutaneous itanga ingano yimyenda,gukora igihe-nyacyo tissue pathology kwisuzumisha bigoye.
Anesthesia Rusange Ifashwa na Thoracoscopic Kubaga (VATS) Lobectomy: Ubu buryo butuma hasuzumwa icyarimwe no kuvurwa icyarimwe, hamwe nitsinzi yegereye 100%.Nyamara, ubu buryo ntibushobora kuba bubereye abarwayi bageze mu zabukuru cyangwa abantu badasanzweabatihanganira anesthesia rusange, abarwayi bafite ibihaha bito bitarenze mm 8 z'ubunini cyangwa ubucucike buri hasi (<-600), node iri hagati y ibice bitandukanye, nanodules mukarere ka mediastinal hafi yimiterere ya hilar.Byongeye kandi, kubaga ntibishobora kuba amahitamo akwiye yo kwisuzumisha no kuvura kubibazo birimonyuma yo kubagwa, gusubiramo inshuro nyinshi, cyangwa ibibyimba metastatike.
Uburyo bushya bwo kuvura indwara zifata ibihaha - Cryoablation
Hamwe niterambere ryiterambere ryikoranabuhanga ryubuvuzi, kuvura ibibyimba byinjiye mugihe cya “gusuzuma neza no kuvura neza“.Uyu munsi, tuzashyiraho uburyo bwo kuvura bwaho bufite akamaro kanini kubibyimba bidafite ububi ndetse nudusimba twinshi twinshi two mu bihaha, ndetse no kubyimba ibibyimba hakiri kare (munsi ya cm 2) -cryoablation.
Cryotherapy
Ubuhanga bukabije bwa cryoablation tekinike (cryotherapy), izwi kandi nka cryosurgie cyangwa cryoablation, ni tekinike yubuvuzi yo kubaga ikoresha ubukonje mu kuvura ingirangingo.Ku buyobozi bwa CT, imyanya iboneye igerwaho no gutobora ibibyimba.Nyuma yo kugera kuri lesion, ubushyuhe bwaho kurubuga buragabanuka vuba-140 ° C kugeza kuri -170 ° C.gukoreshagazi ya argonmu minota mike, bityo ukagera ku ntego yo kuvura ibibyimba.
Ihame rya Cryoablation kuri Nodules
1. Ingaruka ya ice-kristu: Ibi ntabwo bigira ingaruka kuri patologiya kandi bigushoboza kwisuzumisha byihuse.Cryoablation yica ingirabuzimafatizo kandi itera mikorobe.
2. Ingaruka zo gukingira indwara: Ibi bigera kumubiri wa kure urwanya ikibyimba. Itera kurekura antigen, igakora sisitemu yubudahangarwa, kandi igabanya ubudahangarwa bw'umubiri.
3. Guhindura ingingo zigendanwa (nk'ibihaha n'umwijima): Ibi byongera umuvuduko wa biopsy. Umupira wafunzwe urakorwa, bigatuma byoroha guhagarara, kandi impande zirasobanutse kandi zigaragara kumashusho.Iyi porogaramu yemewe iroroshye kandi ikora neza.
Bitewe nibintu bibiri biranga cryoablation -“Gukonjesha inanga no gukosora” hamwe n '“imiterere yimyenda idahwitse nyuma yo gukonja bitagize ingaruka ku gusuzuma indwara”, irashobora gufasha mubihaha nodule biopsy,kugera ku gihe nyacyo cyahagaritswe kwisuzumisha mugihe cyo kubikora, no kunoza intsinzi ya biopsy.Bizwi kandi nka “cryoablation ya pulmonary nodule biopsy“.
Ibyiza bya Cryoablation
1. Gukemura ikibazo cy'ubuhumekero:Gukonjesha kwaho bihindura ibihaha (ukoresheje coaxial cyangwa bypass uburyo bwo gukonjesha).
2. Gukemura pneumothorax, hemoptysis, hamwe ningaruka zo kwanduza ikirere no gutera ibibyimba: Nyuma yo gukora umupira wafunzwe, umuyoboro mubi ufunze umuyoboro udasanzwe wa extraacorporeal ushyirwaho mugusuzuma no kuvura.
3. Kugera ku ntego hamwe no gusuzuma intego zo kuvura: Cryoablation ya nodule y'ibihaha ikorwa mbere, ikurikirwa no kongera gushyuha hamwe na 360 ° biopsy yibice byinshi kugirango yongere ubwinshi bwimitsi.
Nubwo cryoablation ari uburyo bwo kurwanya ibibyimba byaho, abarwayi bamwe bashobora kwerekana ubudahangarwa bw'umubiri.Nyamara, umubare munini wamakuru yerekana ko mugihe cryoablation ihujwe na radiotherapi, chimiotherapie, imiti igamije, immunotherapie, nubundi buryo bwo kuvura, kugenzura ibibyimba igihe kirekire bishobora kugerwaho.
Ibyerekana kuri Cryoablation ya Percutaneous munsi ya CT
B-zone ibihaha nodules: Kubihaha bisaba ibice cyangwa ibyiciro byinshi, cryoablation ya percutaneous irashobora gutanga isuzuma ryuzuye mbere yo gutangira.
A-zone ibihaha nodules: Bypass cyangwa oblique inzira (intego ni ugushiraho umuyoboro wamahaha, byaba byiza ufite uburebure bwa cm 2).
Ibyerekana
Ibibyimba bidafite ububi hamwe nudukoko twinshi twinshi twinshi:
Ibi birimo ibisebe byabanjirije (hyperplasia idasanzwe, muri kanseri ya situ), ibikomere birinda indwara, pseudotumors yumuriro, cysts hamwe na ibisebe byaho, hamwe nudusebe twinshi.
Ikibyimba hakiri kare:
Ukurikije ubunararibonye buriho, cryoablation nuburyo bwiza bwo kuvura bugereranywa no kubagwa kubutaka bwa kirahure opacity nodules ntoya ya cm 2 hamwe nibintu bitarenze 25%.
Igihe cyo kohereza: Nzeri-05-2023