Uninzi lwezigulane zomhlaza wesibindi ezingafanelanga utyando okanye ezinye iindlela zonyango zinokukhetha.
Uphononongo lwetyala
Imeko 1 yoNyango lomhlaza wesibindi:
Isigulana: Indoda, umhlaza wesibindi osisiseko
Unyango lokuqala lwe-HIFU lwehlabathi lomhlaza wesibindi, lwasinda iminyaka eyi-12.
Imeko yesi-2 yoNyango lomhlaza wesibindi:
Isigulana: Indoda, iminyaka engama-52 ubudala, umhlaza wesibindi osisiseko
Emva kwe-radiofrequency ablation, i-tumor eseleyo ichongiwe (i-tumor kufuphi ne-inferior vena cava).Ukulandela unyango lwe-HIFU lwesibini, ukukhutshwa okupheleleyo kwe-tumor eseleyo kufezekisiwe, kunye nokhuseleko oluchanekileyo lwe-vena cava engaphantsi.
Imeko yesi-3 yoNyango loMhlaza weSibindi:
Umhlaza wesibindi osisiseko
Ukulandelela emva kweeveki ezimbini zonyango lwe-HIFU lubonise ukunyamalala ngokupheleleyo kwethumba!
Imeko yesi-4 yoNyango loMhlaza weSibindi:
Isigulana: Indoda, iminyaka engama-33 ubudala, umhlaza wesibindi we-metastatic
Isilonda esinye esifunyenwe kwilobe nganye yesibindi.Unyango lwe-HIFU lwenziwa ngaxeshanye, olukhokelela kwi-tumor necrosis kunye nokufunxa iinyanga ezintathu emva kotyando.
Imeko yesi-5 yoNyango lomhlaza wesibindi:
Isigulana: Indoda, iminyaka engama-70 ubudala, umhlaza wesibindi osisiseko
I-tumor eshiyekileyo ebonwe kwi-MRI emva kokubekwa kweoyile ye-iodine emva kokufakwa kwe-transarterial embolization.Uphuculo lwe-Patch lwanyamalala emva konyango lwe-HIFU, ebonisa ukukhutshwa okupheleleyo kwethumba.
Imeko yesi-6 yoNyango loMhlaza weSibindi:
Isigulana: Ibhinqa, iminyaka engama-70 ubudala, umhlaza wesibindi osisiseko
Ithumba eliphezulu lemithambo elinomlinganiselo we-120mm* I-100mm ifunyenwe kwilobe elungileyo yesibindi.Gqibezela ithumba ablation okuzuzwe emva konyango HIFU, ngokuthe ngcembe ifunxwe ngokuhamba kwexesha.
Imeko yesi-7 yoNyango loMhlaza weSibindi:
Isigulana: Indoda, iminyaka engama-62 ubudala, umhlaza wesibindi osisiseko
Isilonda esibekwe ecaleni kophahla lwe-diaphragmatic, i-vena cava engaphantsi, kunye ne-portal vein system.Emva kweeseshoni ze-5 ze-radiofrequency kunye neeseshoni ze-2 ze-TACE, i-tumor eseleyo ichongiwe kwi-MRI yokulandelela.Unyango lwe-HIFU lwenze ngempumelelo ithumba ngelixa ligcina imithambo yegazi engqongileyo.
Imeko yesi-8 yoNyango loMhlaza weSibindi:
Isigulana: Indoda, iminyaka engama-58 ubudala, umhlaza wesibindi osisiseko
Ukuphinda kuqatshelwe emva kotyando lomhlaza wesibindi we-right lobe.Gqibezela ithumba ablation iphunyezwe ngonyango HIFU, iqinisekiswa ukufunxa ithumba kwiinyanga ezili-18 kamva.
I-Hyperthermia yoMhlaza weSibindi-uPhando olusemgangathweni
I-HIFU (High Intensity Focused Ultrasound) ingasetyenziselwa ukunyanga umhlaza wesibindi.Iindlela zonyango zesintu zomhlaza wesibindi zibandakanya uqhaqho loqhaqho, i-transarterial embolization, kunye nechemotherapy.Nangona kunjalo, abaguli abaninzi bafunyaniswa bekwinqanaba eliphezulu okanye banethumba kufutshane nemithambo yegazi emikhulu, nto leyo eyenza utyando lungasebenzi.Ukongeza, ezinye izigulana azikwazi ukwenza utyando ngenxa yemeko yazo yomzimba, kwaye iinkqubo zotyando ngokwazo zinomngcipheko weengxaki.
Unyango lwe-HIFU lomhlaza wesibindi lubonelela ngeenzuzo ezininzi:i-invasive encinci, ibangela intlungu encinci kunye nomonakalo, ikhuselekile, ineengxaki ezimbalwa, kwaye inokuphinda iphindwe ukuba kuyimfuneko.Inokuphucula iimpawu zesigulane kunye nokwandisa ixesha lokuphila kwabo.
Unyango lwe-Post-HIFU, akukho ziganeko zokuphulwa kwe-tumor, i-jaundice, ukuvuza kwe-bile, okanye ukulimala kwe-vascular kuye kwabikwa, ebonisa ukuba unyango lukhuselekile.
(1) Iimpawu:Unyango lwe-Palliative lwamathumba aphezulu, umhlaza wesibindi wedwa kwi-lobe yasekunene kunye nobubanzi obungaphantsi kwe-10cm, amathumba amakhulu kwi-lobe yasekunene kunye namaqhuqhuva esathelayithi ahlala evalelwe kubunzima besibindi esifanelekileyo, ukuphindaphinda kwendawo emva kotyando, i-portal vein tumor thrombus.
(2) Izinto ezichaseneyo:Izigulana ezine-cachexia, zisasaze umhlaza wesibindi, ukungasebenzi kakuhle kwesibindi kwinqanaba lokugqibela, kunye ne-metastasis ekude.
(3) Inkqubo yonyango:Izigulana ezinamathumba kwi-lobe yasekunene kufuneka zilale kwicala lazo lasekunene, ngelixa ezo zinamathumba kwi-lobe esekhohlo zihlala zibekwe kwindawo esezantsi.Ngaphambi kwenkqubo, i-ultrasound isetyenziselwa ukufumana i-tumor ekujoliswe kuyo ngokuchanekileyo kunye nokucwangciswa kwonyango.Ithumba ke iphathwa ngenkqubo ablations ezilandelelanayo, ukususela amanqaku ngamnye kwaye inkqubela kwimigca, iindawo, yaye ekugqibeleni ithumba umthamo wonke.Unyango lwenziwa kanye ngemini, umaleko ngamnye uthatha malunga nemizuzu engama-40-60.Inkqubo iyaqhubeka imihla ngemihla, umaleko ngomaleko, de ithumba lonke licinywe.Emva kokonyango, indawo ephathwayo ihlolwe naluphi na umonakalo wesikhumba, ilandelwa yi-ultrasound yangaphandle ye-scan yendawo yonke ekujoliswe kuyo ukuvavanya ukuphumelela kwonyango.
(4) Ukhathalelo emva konyango:Izigulane zibekwe esweni ukusebenza kwesibindi kunye namanqanaba e-electrolyte.Unyango oluxhasayo kufuneka lunikezelwe kwizigulane ezinomsebenzi wesibindi esibi, i-ascites, okanye i-jaundice.Uninzi lwezigulane zinobushushu bomzimba obuqhelekileyo ngexesha lonyango.Inani elincinci lezigulane linokufumana ukunyuka okungephi kubushushu phakathi kweentsuku ezi-3-5, ngokuqhelekileyo ngaphantsi kwe-38.5 ℃.Ukuzila ukutya ngokuqhelekileyo kunconywa kwiiyure ze-4 emva konyango, ngelixa izigulane ezinomhlaza wesibindi se-lobe ekhohlo kufuneka zizile iiyure ze-6 ngaphambi kokuba ngokuthe ngcembe zitshintshele kwi-liquid diet.Ezinye izigulana zinokufumana iintlungu ezisezantsi zesisu kwiintsuku ze-3-5 emva konyango, olusombulula ngokuthe ngcembe ngokwalo.
(5) Uvavanyo lwempumelelo:I-HIFU inokutshabalalisa izicubu zomhlaza wesibindi, ibangele i-necrosis engatshintshiyo yeeseli zomhlaza.I-CT scans ibonisa ukuhla okuphawulekayo kwi-CT attenuation values ngaphakathi kweendawo ekujoliswe kuzo, kwaye i-CT ephuculweyo iqinisekisa ukungabikho kwe-arterial kunye ne-portal venous blood supply kwindawo ekujoliswe kuyo.Ibhendi yokwandisa inokubonwa kumda wonyango.I-MRI ibona utshintsho kumandla omqondiso wethumba kwimifanekiso enobunzima be-T1 kunye ne-T2 kwaye ibonise ukunyamalala konikezelo lwegazi kwindawo ekujoliswe kuyo kwizigaba ze-arterial kunye ne-portal venous, kunye nesigaba sokulibaziseka esibonisa ibhendi yophuculo ecaleni komda wonyango.Ukujongwa kwe-Ultrasound kubonisa ukuhla kancinci kobungakanani bethumba, ukunyamalala konikezelo lwegazi, kunye ne-necrosis yezicubu ethi ekugqibeleni ifunxe.
(6) Ukulandelela:Kwiminyaka emibini yokuqala emva kwonyango, izigulane kufuneka zibe notyelelo lokulandelelana rhoqo emva kweenyanga ezimbini.Emva kweminyaka emibini, utyelelo lokulandelela kufuneka lwenzeke rhoqo emva kweenyanga ezintandathu.Emva kweminyaka emihlanu, kucetyiswa ukuba uhlolwe rhoqo ngonyaka.Amanqanaba e-Alpha-fetoprotein (AFP) angasetyenziswa njengesalathisi sokuphindaphinda kwe-tumor.Ukuba unyango luphumelele, ithumba liya kuncipha okanye linyamalale ngokupheleleyo.Kwiimeko apho i-tumor isekhona kodwa ingasekho iiseli ezisebenzayo, isilumkiso kufuneka sisetyenziswe xa i-tumor enobubanzi obungaphezulu kwe-5cm ibonakala kwi-imaging, kwaye i-PET scans ingasetyenziselwa ukucaciswa ngakumbi.
Ukuqwalaselwa kweklinikhi yeziphumo zangaphambili kunye nasemva konyango, kubandakanywa amanqanaba e-alpha-fetoprotein, ukusebenza kwesibindi, kunye ne-MRI scans,baye babonisa izinga loxolelo lwezonyango olungaphezu kwama-80% kwizigulane ezinomhlaza wesibindi ezinyangwa nge-HIFU.Kwiimeko apho unikezelo lwegazi kumathumba esibindi kutyebile, unyango lwe-HIFU lunokudityaniswa nongenelelo lwe-transarterial.Ngaphambi konyango lwe-HIFU, i-transcatheter arterial chemoembolization (TACE) inokwenziwa ukuvala unikezelo lwegazi kwindawo ye-tumor ephakathi, kunye ne-embolic agent esebenza njenge-tumor marker ukunceda ekujoliseni kwe-HIFU.Ioyile ye-iodine iguqula i-acoustic impedance kunye ne-absorption coefficient ngaphakathi kwethumba, iququzelele ukuguqulwa kwamandla kugxininiso lwe-HIFU kunye nokuphucula..
Ixesha lokuposa: Aug-08-2023