Ngokwedatha efanelekileyo ye-International Agency for Research on Cancer (IARC) ye-World Health Organisation (WHO), umhlaza wemiphunga uye waba ngomnye wemiphunga eyingozi kakhulu, kwaye ukuthintela nokunyanga umhlaza wemiphunga kuye kwaba yeyona nto iphambili ekuthinteleni nasekunyangweni komhlaza.
Ngokweenkcukacha-manani ezifanelekileyo, malungaAma-20% ezigulana ezinomhlaza wemiphunga ezingezizo iiseli ezincinci zinokunyangwa ngotyando olunyangwayoUninzi lwezigulane ezinomhlaza wemiphunga sele zikwi-amanqanaba aphambilixa bexilongiwe, kwaye banokufumana iingenelo ezilinganiselweyo kunyango lwe-radiotherapy kunye nonyango lwe-chemotherapy. Ngokuqhubeka nophuhliso lwesayensi yezonyango, ukuvela kwe-unyango lokuphelisaNjengendlela yokuthatha indawo yotyando kuzise ithemba elitsha lonyango kwizigulane ezinomhlaza wemiphunga.
1. Unolwazi olungakanani ngonyango lomhlaza wemiphunga olungena kwi-ablative?
Unyango lokuphelisa umhlaza wemiphunga lubandakanya ikakhuluukususwa kwe-microwave kunye nokususwa kwe-radiofrequencyUmgaqo wonyango ubandakanya ukufaka i-electrode eqhekezayo, eyaziwa ngokuba yi-“uphando,”ithumba elisemphungeni. I-electrode inokubangelaintshukumo ekhawulezayoiinxalenye ezifana nee-ion okanye iimolekyuli zamanzi ngaphakathi kwithumba, zivelisa ubushushu ngenxa yokungqubana, okukhokelelaumonakalo ongenakuguqulwa ofana ne-coagulative necrosis yeeseli zethumba.Kwangaxeshanye, isantya sokudluliselwa kobushushu sincipha ngokukhawuleza kwizicubu zemiphunga eziqhelekileyo ezijikelezileyo, sigcina ubushushu ngaphakathi kwethumba, nto leyo edala"Isiphumo sokukhusela ubushushu."Unyango olususayo lunokubulala ithumba ngempumelelo ngelixaukukhulisa ukhuseleko lwezicubu zemiphunga eziqhelekileyo.
Unyango lwe-Ablative luphawulwa yiyoukungaphindwa, ukungonwabi okuncinci kwesigulana, ukwenzakala okuncinci, kunye nokuchacha ngokukhawuleza,kwaye iye yaqatshelwa ngokubanzi kwaye isetyenziswa kwizonyango. Nangona kunjalo, xa ucinga ukuba unyango olusebenzisa i-ablative lubandakanya iinkalo ezininzi ezifana ne-radiology, i-oncology, i-interventional radiology, kunye ne-anatomy yotyando, lufuna izakhono eziphezulu zotyando kunye neempawu ezipheleleyo ezivela kugqirha otyando.
Namhlanje, singathanda ukukwazisa ingcali eyaziwayo kwicandelo lonyango olungenelelayo,UGqr. Liu Chen, obesebenza kweli candelo kangangeminyaka emininzi kwaye ezinikele kuphando lwezonyango oluguqulela izinto kunye nokwazisa ngokubanzi iindlela zokuxilongwa okuncinci okungafunekiyo kunye nonyango olufana ne-biopsies yethumba enzima neyingozi kakhulu, ukususwa kobushushu, kunye nokufakelwa kwamasuntswana.UGqr. Liu waziwa njenge "qhawe elisencamini yenaliti" kwaye uthabathe inxaxheba ekuqulunqweni kwesivumelwano seengcali kunye nezikhokelo zeendlela ezahlukeneyo zonyango lomhlaza wemiphunga eTshayina. Uqalise ingcamango yolawulo olupheleleyo lwee-biopsy zomhlaza wemiphunga kwaye waseka iinkqubo zotyando ezisemgangathweni ukuphucula ukwenziwa kwezigqibo zonyango lonyango lwasekhaya lomhlaza wemiphunga okwinqanaba lokuqala, ekhuthaza uphuhliso olupheleleyo lwenkqubo yokuxilonga nonyango lomhlaza wemiphunga eTshayina.
"Iqhawe elikwincam yenaliti" - Ugqirha uLiu Chen
Ingcali kwiindlela zokuxilonga ezingenelelayo kunye neendlela zonyango lwezimila ezingaphantsi kovavanyo oluqhelekileyo phantsi kwesikhokelo somfanekiso
1. Ukususwa kwe-microwave/Radiofrequency
2. I-Percutaneous biopsy
3. Ukufakelwa kwamasuntswana anemitha
4. Ulawulo lweentlungu ezingenelelayo
2. Injongo kunye neempawu zonyango lokuphelisa umhlaza wemiphunga
"Imvumelwano yeengcali malunga nonyango oluphelisa ukuvuvukala kwamathumba emiphunga aphambili kunye nalawo aqala ukusasazeka"(uhlelo luka-2014) lwahlula unyango oluphelisa umhlaza wemiphunga lube ngamacandelo amabini: oluphilisayo noluthomalalisa umhlaza.
Ukususwa kwesisu okunyangayoIjolise ekubulaleni ngokupheleleyo izicubu zethumba zasekuhlaleni kwaye inokufezekisa isiphumo sokunyanga.Umhlaza wemiphunga okwinqanaba lokuqala luphawu olupheleleyo lonyango lokuphelisa umhlaza,Ingakumbi kwizigulana ezingasebenzi kakuhle kwentliziyo, ubudala, ukungakwazi ukunyamezela utyando, ukwala ukuhlinzwa, okanye abo banesimila esinye esiphinda sibuye emva konyango lwe-conformal radiotherapy, kunye nezinye izigulana ezinezilonda ezininzi zomhlaza wemiphunga ekufuneka zigcine ukusebenza kwemiphunga.
Ukususwa kwesisu okubangela ukudakumbaijolise kuukuvala ngokupheleleyo ithumba eliphambili kwizigulane ezinomhlaza wemiphunga okwinqanaba eliphezulu, ukunciphisa umthwalo wethumba, ukunciphisa iimpawu ezibangelwa yithumba, kunye nokuphucula umgangatho wobomi besigulana.Kwizigulane ezine-stage advanced lung cancer, ii-tumor ezinobubanzi obungaphezulu kwe-5 cm okanye ezine-lesions ezininzi zinokunyangwa nge-multi-needle, multipoint, okanye ii-multi-points, okanye zidityaniswe nezinye iindlela zonyango ukuze ziqhubeke ziphila. Kwi-malignant lung metastases ezikwi-late stage, ukuba ulawulo lwee-extrapulmonary tumors lulungile kwaye kukho inani elincinci le-metastatic lesions eziseleyo kwimiphunga, unyango lwe-ablative lunokunceda ngempumelelo ukulawula isifo kwaye luphucule umgangatho wobomi besigulana.
3. Iingenelo zonyango olungasebenziyo
Utyando olungenabungozi kangako, ukuchacha ngokukhawuleza: Unyango lwe-Ablative luthathwa njengotyando oluncinci olungena ngaphakathi. Inaliti ye-electrode ye-ablative esetyenziswayo idla ngokuba nobubanzi obungu1-2mm, nto leyo ebangela ukugruzuka okuncinci okunobukhulu obufana nomngxuma wenaliti. Le ndlela inika iingenelo ezifanaukwenzakala okuncinci, iintlungu ezingaphantsi, kunye nokuchacha ngokukhawuleza.
Ixesha elifutshane lotyando, amava akhululekileyo:Unyango olukhawulezileyo lwenziwa phantsi kwe-anesthesia yendawo okanye ludityaniswe ne-intravenous sedation, nto leyo ephelisa isidingo sokufakwa kwe-endotracheal intubation. Izigulana zilele kancinci kwaye zinokuvuswa ngokulula ngokucofa kancinci. Ezinye izigulana zinokuziva ngathi utyando lugqityiwe emva kokubaubuthongo obufutshane.
I-biopsy ngaxeshanye ukuze kufunyanwe ngokuchanekileyo isifo:Ngexesha lonyango olususayo, isixhobo se-coaxial guidance okanye isixhobo se-synchronous puncture biopsy singasetyenziswa ukufumana i-biopsy yesilonda.ukuxilongwa kwezifo kunye novavanyo lwemfuzaukubonelela ngolwazi oluxabisekileyo kwizigqibo zonyango ezilandelayo.
Inkqubo ephinda-phindwayo: Izifundo ezininzi ezivela kwimithombo yasekhaya nakwamanye amazwe zibonise ukuba izinga lolawulo lwasekuhlaleni lwezigulane ezinomhlaza wemiphunga ezikwinqanaba lokuqala ezisebenzisa unyango lwe-ablative lifana nelo lotyando lokususwa okanye unyango lwe-stereotactic radiation. Kwimeko yokubuyela umva kwesifo, unyango lwe-ablativeinokuphindwa amaxesha amaninziukuze aphinde alawule esi sifo ngelixaukuphucula umgangatho wobomi besigulana.
Ukuvuselela okanye ukuphucula ukusebenza komzimba: Unyango lwe-Ablative lujolise ekubulala iiseli zethumba emzimbeni, kwaye kwezinye iimeko, inokuvuselela okanye iphucule ukusebenza komzimba wesigulana, nto leyo ekhokelela kwi- apho iithumba ezinganyangwanga kwezinye iindawo zomzimba zibonisa ukubuyela umva. Ukongeza, unyango olukhawulezileyo lungadityaniswa namayeza asetyenziswa emzimbeni ukuvelisaisiphumo sokusebenzisana.
Unyango lwe-Ablative lufanelekile ngakumbi kwizigulana ezingakwaziyo ukunyamezela ukususwa kotyando okanye i-anesthesia ngokubanzi ngenxaukusebenza kakubi kwentliziyo, ukwaluphala, okanye ezinye izifo ezibangelwa zizifo ezithileKwakhona lunyango olukhethwayo kwizigulana ezine-amaqhuqhuva amaninzi akwinqanaba lokuqala (njengeeqhuqhuva ezininzi zeglasi engaphantsi komhlaba).
Ixesha lokuthumela: Agasti-23-2023