Ngokutsho kwedatha efanelekileyo ye-International Agency for Research on Cancer (IARC) yoMbutho wezeMpilo weHlabathi (i-WHO), umhlaza wemiphunga uye waba lelona thumba libi kakhulu, kwaye uthintelo kunye nonyango lomhlaza wemiphunga uye waba yeyona nto iphambili. lothintelo kunye nonyango lomhlaza.
Ngokutsho data manani ezifanelekileyo, kuphela malungaI-20% yezigulane ezinomhlaza wemiphunga yeseli ezingezizo ezincinci zinokuya kunyango lotyando.Uninzi lwabaguli abanomhlaza wemiphunga sele bengaphakathiizigaba eziphambilixa befunyanisiwe, kwaye banokufumana izibonelelo ezilinganiselweyo kunyango lwe-radiotherapy kunye nonyango lwechemotherapy.Ngenkqubela phambili eqhubekayo kunye nophuhliso lwenzululwazi yezonyango, ukuvela kweunyango ablativenjengethathela indawo yotyando luzise ithemba elitsha lonyango kwizigulana ezinomhlaza wemiphunga.
1. Wazi kangakanani ngonyango lokuthomalalisa umhlaza wemiphunga?
Unyango lwe-ablative lomhlaza wemiphunga ikakhulu lubandakanyaukukhutshwa kwe-microwave kunye nokukhutshwa kwe-radiofrequency.Umgaqo wonyango ubandakanya ukufaka i-electrode ablative, eyaziwa ngokuba yi-a"phanda,"kwithumba emiphungeni.I-electrode inokubangelaukuhamba ngokukhawulezaAmasuntswana anjengeeyoni okanye iimolekyuli zamanzi ngaphakathi kwethumba, ezivelisa ubushushu ngenxa yokungqubana, okukhokelela ekubeniumonakalo ongenakulungiseka njenge-coagulative necrosis yeeseli zethumba.Kwangaxeshanye, isantya sokudlulisa ubushushu siyancipha ngokukhawuleza kwithishu yemiphunga eqhelekileyo ejikelezileyo, sigcina ubushushu ngaphakathi kwithumba, kudala ithumba."impembelelo yokufakelwa kwe-thermal."Unyango lwe-ablative lunokubulala ngokufanelekileyo ithumba ngelixaukwandisa ukukhuselwa kwezicubu zemiphunga eziqhelekileyo.
Unyango lwe-ablative luphawulwa yiloukuphindaphinda, ukungaphatheki kakuhle kwesigulana, ukwenzakala okuncinci, kunye nokuchacha ngokukhawuleza,kwaye iye yaqatshelwa ngokubanzi kwaye isetyenziswa kwiklinikhi yokusebenza.Nangona kunjalo, ukuqwalasela ukuba unyango lwe-ablative lubandakanya iinkalo ezininzi ezifana ne-radiology, i-oncology, i-radiology yokungenelela, kunye ne-anatomy yotyando, ifuna inqanaba eliphezulu lezakhono zotyando kunye neempawu ezibanzi ezivela kugqirha osebenzayo.
Namhlanje, singathanda ukwazisa kuwe ingcali eyaziwayo kwicandelo lonyango longenelelo,UGqr. Liu Chen, osebenze endle iminyaka emininzi kwaye uzinikele kuphando loguqulo lweklinikhi kunye nokuthandwa okusemgangathweni kokuxilongwa kokungenelela okuncinci kunye nonyango olufana nomngeni kunye nomngcipheko ophezulu we-tumor biopsies, ukuchithwa kwe-thermal, kunye nokufakelwa kwamasuntswana.UGqr Liu uyaziwa ngokuba "liqhawe kwincam yenaliti" kwaye uthathe inxaxheba ekuqulunqweni kwemvumelwano yeengcali kunye nezikhokelo kwiindlela ezahlukeneyo zonyango lokungenelela kumhlaza wemiphunga eChina.Ube nguvulindlela kwingqikelelo yolawulo olubanzi lwe-biopsies yomhlaza wemiphunga kwaye waseka iinkqubo zotyando ezisemgangathweni zokuphucula ukwenziwa kwesigqibo sonyango longenelelo kunyango lwasekhaya lomhlaza wemiphunga okwinqanaba lokuqala, ekhuthaza uphuhliso lulonke lokuxilongwa komhlaza wemiphunga kunye nenkqubo yonyango yaseTshayina.
"Iqhawe kwiNgcebiso yenaliti" - UGqirha Liu Chen
Isebenza ngonyango longenelelo oluncinci kunye neendlela zonyango lwamathumba phantsi kwesikhokelo sokucinga
1. Ukukhutshwa kweMicrowave/Radiofrequency
2. I-Percutaneous biopsy
3. Ukufakelwa kwamasuntswana emitha
4. Ukulawulwa kweentlungu zokungenelela
2. Injongo kunye nezibonakaliso zonyango lwe-ablative kumhlaza wemiphunga
"Imvumelwano yeNgcali kuNyango lwe-Ablative yePrayimari kunye ne-Metastatic Lung Tumors"(Uhlelo luka-2014) lwahlula unyango lokuthomalalisa umhlaza wemiphunga lube ngamacandelo amabini: lonyango kunye nelokudambisa.
Ukukhutshwa konyangoijolise ekwenzeni i-necrotize ngokupheleleyo izicubu zethumba lendawo kwaye inokufikelela kwisiphumo sonyango.Umhlaza wemiphunga okwinqanaba lakwangoko luphawu olupheleleyo lonyango lwe-ablative,ngakumbi kwizigulana ezinomsebenzi ombi wentliziyo, ukukhula ngeminyaka, ukungakwazi ukunyamezela utyando, ukwala ukwenza uqhaqho, okanye abo banethumba elinye lokuphindaphinda emva kweradiotherapy ehambelanayo, kunye nezinye izigulana ezinezilonda zomhlaza wemiphunga ezininzi ezifuna ukugcina ukusebenza kwemiphunga. .
Ukukhutshwa kwePalliativeiinjongo zokukakhulu yenza ithumba eliphambili kwizigulane ezinomhlaza wemiphunga wenqanaba eliphezulu, ukunciphisa umthwalo wethumba, ukukhulula iimpawu ezibangelwa lithumba, kunye nokuphucula umgangatho wobomi besigulana.Kwizigulana ezinomhlaza wemiphunga okwinqanaba eliphezulu, iithumba ezinobukhulu obukhulu> 5 cm okanye ezinezilonda ezininzi zinokungena kwiinaliti ezininzi, i-multipoint, okanye iiseshoni zonyango ezininzi, okanye zidityaniswe nezinye iindlela zonyango zokwandisa ixesha lokuphila.Kuba metastases ezimbi zemiphunga emva kwexesha, ukuba ulawulo amathumba extrapulmonary ilungile kwaye kuphela inani elincinane intsalela izilonda metastatic ekhoyo emiphungeni, unyango ablative inokunceda ngempumelelo ukulawula isifo kunye nokuphucula umgangatho wobomi besigulane.
3. Iingenelo zonyango lwe-ablative
Utyando olungenelelayo oluncinci, ukululama ngokukhawuleza: Unyango lwe-ablative luthathwa njengotyando olungenelelayo oluncinci.Inaliti ye-ablative electrode esetyenziswa ngokuqhelekileyo inobubanzi be1-2mm, okubangela ukuba kwenziwe utyando oluncinane ubungakanani bomngxuma yenaliti.Le ndlela inika iinzuzo ezifanaukwenzakala okuncinci, iintlungu ezincinci, kunye nokuchacha ngokukhawuleza.
Ixesha elifutshane lotyando, amava akhululekile:Unyango lwe-ablative lwenziwa ngokuqhelekileyo phantsi kwe-anesthesia yendawo okanye idibaniswe ne-intravenous sedation, ukuphelisa imfuno ye-endotracheal intubation.Izigulana zikwimeko yokulala kancinci kwaye zinokuvuswa ngokulula ngempompo ethambileyo.Ezinye izigulana zinokuziva ngathi utyando lugqityiwe emvaukulala ngokukhawuleza.
I-biopsy ngexesha elifanayo lokuxilongwa ngokuchanekileyo:Ngexesha lonyango lwe-ablative, isikhokelo se-coaxial okanye isixhobo se-synchronous puncture biopsy sinokusetyenziswa ukufumana i-biopsy yesilonda.Okulandelayoukuxilongwa kwe-pathological kunye novavanyo lwemfuzobonelela ngolwazi oluxabisekileyo lwezigqibo zonyango ezilandelayo.
Inkqubo ephindaphindwayo: Uphononongo oluninzi olusuka kwimithombo yasekhaya neyezizwe ngezizwe lubonise ukuba izinga lolawulo lwasekhaya lwezigulana ezinomhlaza wemiphunga ezikwinqanaba lakwangoko olufumana unyango lokuthomalalisa luthelekiseka nolo loqhaqho lokuqhafaza okanye unyango lwemitha ye-stereotactic.Kwimeko yokuphindaphinda kwendawo, unyango lwe-ablativeinokuphinda-phinda amaxesha amaninziukubuyisela ukulawula isifo ngelixaukwandisa umgangatho wobomi besigulana.
Ukuvuselela okanye ukuphuculwa komsebenzi wokuzivikela komzimba: Unyango lwe-ablative lujoliseukubulala iiseli ithumba ngaphakathi emzimbeni, kwaye kwezinye iimeko, inokuthi isebenze okanye ikhulise umsebenzi wokuzivikela wesigulane, okhokelela ekubeni a apho amathumba anganyangwanga kwamanye amalungu omzimba abonisa ukuhlehla.Ukongezelela, unyango lwe-ablative lunokudibaniswa kunye neyeza ze-systemic ukuvelisaisiphumo se-synergistic.
Unyango lwe-ablative lufaneleke ngakumbi kwizigulane ezingakwaziyo ukunyamezela utyando okanye i-anesthesia jikelele ngenxaukungasebenzi kakuhle kwe-cardiopulmonary, ubudala, okanye izifo ezininzi eziphantsi.Ikwalunyango olukhethwayo kwizigulane ezineamaqhuqhuva amaninzi akwinqanaba lokuqala (njengamaqhuqhuva egilasi asezantsi).
Ixesha lokuposa: Aug-23-2023