Cyoablation maka Pulmonary Nodule
Ọrịa cancer akpa ume juru ebe niile na nodules na-egbu mgbu
Dabere na data sitere na International Agency for Research on Cancer of the World Health Organisation, ihe dị ka nde mmadụ 4.57 ka achọpụtara ọrịa kansa ọhụrụ na China na 2020.nwere ọrịa cancer akpa ume na-aza ihe dị ka ikpe 820,000.N'ime ógbè na obodo 31 dị na China, ọnụ ọgụgụ ọrịa cancer akpa ume na ụmụ nwoke na-ebute ụzọ na mpaghara niile ma e wezụga Gansu, Qinghai, Guangxi, Hainan, na Tibet, ọnụ ọgụgụ ọnwụ bụ nke kachasị elu n'agbanyeghị okike.A na-eme atụmatụ n'ozuzu ọnụ ọgụgụ nke nodules pulmonary na China dị ihe dịka 10% ruo 20%, nke nwere ike gbasaa n'etiti ndị mmadụ karịrị afọ 40.Otú ọ dị, ekwesịrị ịmara na ihe ka ọtụtụ n'ime nodules pulmonary bụ ọnya na-adịghị mma.
Nchọpụta nke Nodules Pulmonary
Pulmonary nodulesrụtụ aka na ndò dị okirikiri dị okirikiri dị na ngụgụ, nwere nha dị iche iche na oke doro anya ma ọ bụ cha cha, yana dayameta na-erughị ma ọ bụ hà nhata 3 cm.
Nchọpụta onyonyo:Ka ọ dị ugbu a, a na-eji usoro onyonyo onyonyo ezubere iche, nke a maara dị ka nchọpụta onyonyo nodule opacity opacity ala, nke a na-ejikarị eme ihe.Ụfọdụ ndị ọkachamara nwere ike nweta ọnụ ọgụgụ mmekọrịta nke pathological ruo 95%.
Nchọpụta ọrịa pathological:Agbanyeghị, nchoputa onyonyo enweghị ike dochie nchoputa nke ọrịa anụ ahụ, ọkachasị n'ihe gbasara ọgwụgwọ izizi kpọmkwem etuto nke chọrọ nyocha ihe omimi nke mkpụrụ ndụ na ọkwa cellular.Nchọpụta ọrịa pathological ka bụ ọkọlọtọ ọla edo.
Usoro nchọpụta nchọpụta na usoro ọgwụgwọ maka nodules Pulmonary
Biopsy percutaneous:Enwere ike nweta nchoputa nke akwara anụ ahụ na nchọpụta ihe omimi nke mkpụrụ ndụ n'okpuru mgbakasị mpaghara site na nkuku percutaneous.Nkezi ọnụego ihe ịga nke ọma nke biopsy bụ ihe dịka 63%,ma nsogbu ndị dị ka pneumothorax na hemothorax nwere ike ime.Usoro a na-akwado naanị nyocha yana ọ siri ike ịme ọgwụgwọ n'otu oge.Enwerekwa ihe ize ndụ nke ịwụfu cell tumor na metastasis.Biopsy percutaneous nke a na-ahụkarị na-enye oke anụ ahụ nwere oke.na-eme nchọpụta pathology anụ ahụ n'ezie siri ike.
Ịwa Ahụhụ Thoracoscopic Enyere Enyemaka Ozuruọnụ Anesthesia (VATS) Lobectomy: Usoro a na-enye ohere maka nchoputa na ọgwụgwọ n'otu oge, na-enwe ọganihu na-erute 100%.Agbanyeghị, usoro a nwere ike ọ gaghị adabara ndị ọrịa agadi ma ọ bụ ndị mmadụ pụrụ ichendị na-adịghị anabata ọgwụgwọ ngụgụ izugbe, ndị ọrịa nwere nodules pulmonary dị obere karịa 8 mm n'ogo ma ọ bụ njupụta dị ala (<-600), nodules dị omimi n'etiti akụkụ aka ike, nanodules na mpaghara mediastinal n'akụkụ ihe owuwu hilar.Na mgbakwunye, ịwa ahụ nwere ike ọ gaghị abụ nhọrọ nyocha na ọgwụgwọ kwesịrị ekwesị maka ọnọdụ ndị metụtaranlọghachi azụ mgbe arụ ọrụ gasịrị, nodules ugboro ugboro, ma ọ bụ etuto metastatic.
Usoro ọgwụgwọ ọhụrụ maka nodules akpa ume - Cryoablation
Site na mmepe teknụzụ ahụike na-aga n'ihu, ọgwụgwọ etuto abanyela n'oge “nchoputa nkenke na ọgwụgwọ ziri ezi".Taa, anyị ga-ewebata usoro ọgwụgwọ mpaghara nke dị irè nke ukwuu maka etuto ahụ na-adịghị njọ na nodules na-abụghị vaskụla proliferative pulmonary nodules, yana mmalite mmalite nke nodules (ihe na-erughị 2 cm) -mkpu ákwá.
Cryotherapy
Usoro cryoablation dị ala dị ala (cryotherapy), nke a makwaara dị ka cryosurgery ma ọ bụ cryoablation, bụ usoro ịwa ahụ nke na-eji friza na-agwọ anụ ahụ ezubere iche.N'okpuru nduzi CT, a na-enweta ọnọdụ ziri ezi site n'ịkụnye anụ ahụ tumor.Mgbe ha rutere ọnya ahụ, okpomọkụ mpaghara na saịtị ahụ na-ebelata ngwa ngwa-140°C ruo -170°Cijiargon gasn'ime nkeji ole na ole, si otú a na-enweta ihe mgbaru ọsọ nke ọgwụgwọ ablation tumor.
Ụkpụrụ nke Cryoablation maka Pulmonary Nodules
1. Mmetụta ice-kristal: Nke a anaghị emetụta pathology ma na-enyere aka ngwa ngwa nchọpụta pathological intraoperative.Cryoablation n'anụ ahụ na-egbu mkpụrụ ndụ etuto ma na-akpata occlusion microvascular.
2. Mmetụta immunomodulatory: Nke a na-enweta nzaghachi mgbochi dị anya megide etuto ahụ. Ọ na-akwalite mwepụta antigen, na-eme ka usoro ahụ ji alụso ọrịa ọgụ rụọ ọrụ, ma na-ebelata nkwụsị nke usoro ahụ ji alụso ọrịa ọgụ.
3. Nkwụsi ike nke akụkụ ndị na-agagharị agagharị (dị ka ngụgụ na imeju): Nke a na-eme ka ọnụọgụ biopsy na-aga nke ọma. A na-emepụta bọọlụ oyi kpọnwụrụ, na-eme ka ọ dị mfe ịkwado, na akụkụ ya doro anya ma na-ahụ anya na eserese.Ngwa ikike ikike a dị mfe ma rụọ ọrụ nke ọma.
N'ihi njirimara abụọ nke cryoablation -"Nrụgide na-ekpo ọkụ na nkwụsịtụ" na "nhazi anụ ahụ na-adịghị mma mgbe ọ kwụsịrị na-enweghị emetụta nchọpụta ọrịa", ọ nwere ike inye aka na nodule biopsy,nweta ezigbo nchoputa ọrịa ọrịa oyi kpọnwụrụ n'oge a na-eme ya, ma melite ọnụego biopsy na-aga nke ọma.A na-akpọkwa ya “cryoablation maka pulmonary nodule biopsy".
Uru nke Cryoablation
1. Na-edozi nsogbu iku ume:Igwe oyi na mpaghara na-eme ka anụ ahụ kwụsie ike (na-eji coaxial ma ọ bụ ụzọ oyiri).
2. Na-agwa pneumothorax, hemoptysis, na ihe ize ndụ nke ikuku embolism na akpụ mkpụrụ: Mgbe emechara bọọlụ jụrụ oyi, a na-ewepụta ọwa nrụgide na-adịghị mma nke extracorporeal maka nyocha na ebumnuche ọgwụgwọ.
3. Imezu ebumnuche nyocha na ọgwụgwọ n'otu oge: A na-ebu ụzọ mee cryoablation nke nodule nku ume, na-esote ya na-ekpo ọkụ na 360º multidirectional biopsy iji mụbaa anụ ahụ biopsy.
Ọ bụ ezie na cryoablation bụ ụzọ maka njikwa etuto mpaghara, ụfọdụ ndị ọrịa nwere ike igosipụta nzaghachi mgbochi ọrịa dị anya.Otú ọ dị, ọnụ ọgụgụ buru ibu nke data na-egosi na mgbe a na-ejikọta cryoablation na radiotherapy, chemotherapy, ọgwụgwọ ezubere iche, immunotherapy, na ụzọ ọgwụgwọ ndị ọzọ, enwere ike nweta njikwa ụbụrụ ogologo oge.
Ngosipụta maka Cryoablation Percutaneous n'okpuru nduzi CT
B-mpaghara akpa ume nodules: Maka nodules ngụgụ na-achọ akụkụ ma ọ bụ ọtụtụ resection nke akụkụ, percutaneous cryoablation nwere ike inye nyocha nke ọma tupu ịwa ahụ.
A-zone akpa ume nodules: Gafefe ma ọ bụ ụzọ oblique (ihe mgbaru ọsọ bụ ịmepụta ọwa anụ ahụ ngụgụ, ọkacha mma na ogologo 2 cm).
Ngosipụta
Ụbụrụ na-adịghị njọ na nodules na-abụghị vaskụla proliferative pulmonary nodules:
Nke a na-agụnye ọnya ndị na-ebute ọrịa kansa (hyperplasia a na-ahụkarị, na ọnọdụ carcinoma), ọnya proliferative na-emeghachi omume nke na-alụso ọrịa ọgụ, pseudotumors mkpali, cysts na abscesses, na nodules na-amụba.
nodules tumor nke mmalite:
Dabere na ahụmịhe dị ugbu a, cryoablation bụkwa usoro ọgwụgwọ dị irè ma e jiri ya tụnyere ịwa ahụ maka nodules opacity opacity ala-glass nke na-erughị 2 cm nwere ihe na-erughị 25% siri ike.
Oge nzipu: Sep-05-2023