Ngokusho kwedatha efanele ye-International Agency for Research on Cancer (IARC) ye-World Health Organization (WHO), umdlavuza wamaphaphu usube ngesinye sezimila eziyingozi kakhulu, kanti ukuvimbela nokwelapha umdlavuza wamaphaphu sekuyinto eza kuqala ekuvimbeleni nasekwelapheni umdlavuza.
Ngokusho kwedatha yezibalo efanele, kuphela mayelanaAma-20% eziguli ezinomdlavuza wamaphaphu ongewona amangqamuzana amancane angakwazi ukwelashwa ngokuhlinzwa okwelaphekayoIningi leziguli ezinomdlavuza wamaphaphu selivele lisesimweni esibucayi.izigaba ezithuthukileuma bexilongwa, futhi bangathola izinzuzo ezilinganiselwe ekwelashweni ngemisebe yendabuko kanye nokwelashwa ngamakhemikhali. Ngokuthuthuka okuqhubekayo kanye nentuthuko yesayensi yezokwelapha, ukuvela kweukwelashwa okubangela ukucasukaesikhundleni sokuhlinzwa kulethe ithemba elisha lokwelashwa kweziguli ezinomdlavuza wamaphaphu.
1. Ukwazi kangakanani ngokwelashwa komdlavuza wamaphaphu okubangelwa ukuvuvukala?
Ukwelashwa komdlavuza wamaphaphu okwelapha umdlavuza wamaphaphu kuhlanganisa kakhuluukususwa kwe-microwave kanye nokususwa kwe-radiofrequencyIsimiso sokwelapha sihilela ukufaka i-electrode engasebenzi, eyaziwa nangokuthi“uphenyo,”isimila emaphashini. I-electrode ingabangelaukunyakaza okusheshayokwezinhlayiya ezifana nama-ion noma ama-molecule amanzi ngaphakathi kwesimila, okudala ukushisa ngenxa yokungqubuzana, okuholelaumonakalo ongenakulungiseka njenge-coagulative necrosis yamaseli esimila.Ngesikhathi esifanayo, ijubane lokudluliselwa kokushisa liyancipha ngokushesha ezicutshini zamaphaphu ezizungezile ezivamile, okulondoloza ukushisa ngaphakathi kwesimila, okudala"Umphumela wokuvikela ukushisa."Ukwelashwa okuhlikihlayo kungabulala ngempumelelo isimila ngenkathiukwandisa ukuvikelwa kwezicubu zamaphaphu ezivamile.
Ukwelashwa kwe-Ablative kubonakaliswa yi-ukuphindeka, ukungakhululeki okuncane kwesiguli, ukulimala okuncane, kanye nokululama okusheshayo,futhi kuye kwaqashelwa kabanzi futhi kwasetshenziswa emitholampilo. Kodwa-ke, uma sibheka ukuthi ukwelashwa okwelapha ngokuhlinza kuhilela imikhakha eminingi efana ne-radiology, i-oncology, i-interventional radiology, kanye ne-anatomy yokuhlinzwa, kudinga izinga eliphezulu lamakhono okuhlinzwa kanye nezimfanelo eziphelele ezivela kudokotela ohlinzayo.
Namuhla, singathanda ukwethula kini uchwepheshe odumile emkhakheni wokwelashwa okungenelelayo,UDkt. Liu Chen, obesebenza kulo mkhakha iminyaka eminingi futhi ozinikele ocwaningweni lokuhumusha lwezokwelapha kanye nokusabalalisa okujwayelekile kokuxilongwa okungenelelayo kanye nokwelashwa okufana nokuhlolwa kwezicubu eziyinselele neziyingozi kakhulu, ukususwa kokushisa, kanye nokufakelwa kwezinhlayiya.UDkt. Liu waziwa ngokuthi “iqhawe elisesicongweni senaliti” futhi uhlanganyele ekwakhiweni kwesivumelwano sochwepheshe kanye neziqondiso zezindlela ezahlukene zokwelapha umdlavuza wamaphaphu eShayina. Ube ngumholi womqondo wokuphathwa okuphelele kwe-biopsy yomdlavuza wamaphaphu futhi wasungula izinqubo zokuhlinzwa ezijwayelekile ukuze kuthuthukiswe ukwenziwa kwezinqumo zokwelapha umdlavuza wamaphaphu ekwelashweni kwendawo kwasekuqaleni, okukhuthaza ukuthuthukiswa okuphelele kohlelo lokuxilongwa nokwelashwa komdlavuza wamaphaphu eShayina.
“Iqhawe Elisesicongweni Senaliti” – UDokotela uLiu Chen
Igxile ekuxilongeni okungenelelayo kanye namasu okwelapha amathumba ngaphansi kwesiqondiso sezithombe
1. Ukususwa kwe-microwave/Radiofrequency
2. I-Percutaneous biopsy
3. Ukufakelwa kwezinhlayiya ezinemisebe
4. Ukuphathwa kobuhlungu okungenelelayo
2. Inhloso kanye nezinkomba zokwelapha umdlavuza wamaphaphu
"Isivumelwano Sochwepheshe Ngokwelashwa Okungavuvukali Kwama-Lung Tumors Ayinhloko Nalawo Asakazeka Kakhulu"(uhlelo luka-2014) luhlukanisa ukwelashwa kokuqeda umdlavuza wamaphaphu ngezigaba ezimbili: ukwelapha kanye nokwelapha ubuhlungu.
Ukususwa kokwelashwaihlose ukubulala ngokuphelele izicubu zesimila sendawo futhi ingafeza umphumela wokwelapha.Umdlavuza wamaphaphu wesigaba sokuqala uyisibonakaliso esiphelele sokwelashwa okuphuthumayo,ikakhulukazi ezigulini ezingasebenzi kahle kwenhliziyo namaphaphu, ezigugile, ezingakwazi ukubekezelela ukuhlinzwa, ezenqaba ukuhlinzwa, noma lezo ezinesimila esisodwa esiphinde sibuye ngemva kokwelashwa ngemisebe, kanye nezinye iziguli ezinezilonda eziningi zomdlavuza wamaphaphu ezidinga ukulondoloza ukusebenza kwamaphaphu.
Ukususwa kobuhlunguihloseukuvimbela ngokuphelele isimila esiyinhloko ezigulini ezinomdlavuza wamaphaphu osesigabeni esithuthukile, ukunciphisa umthwalo wesimila, ukuqeda izimpawu ezibangelwa isimila, kanye nokuthuthukisa ikhwalithi yokuphila kwesiguli.Ezigulini ezinomdlavuza wamaphaphu osesigabeni esithuthukile, izimila ezinobubanzi obungaphezulu kuka-5 cm noma ezinezilonda eziningi zingadlula ezikhathini zokwelashwa ezinenaliti eziningi, amaphoyinti amaningi, noma izikhathi eziningi zokwelashwa, noma zihlanganiswe nezinye izindlela zokwelapha ukuze ziqhubeke isikhathi eside ziphila. Kuma-metastases emaphashini abulalayo asesigabeni sokugcina, uma ukulawulwa kwezimila ezingaphandle kwamaphaphu kuhle futhi kunenani elincane kuphela lezilonda ezisele ezisele emaphashini, ukwelashwa okuncishisiwe kungasiza ngempumelelo ekulawuleni lesi sifo futhi kuthuthukise ikhwalithi yokuphila kwesiguli.
3. Izinzuzo zokwelapha nge-ablative
Ukuhlinzwa okungenangozi kangako, ukululama okusheshayo: Ukwelashwa kwe-Ablative kubhekwa njengokuhlinzwa kokungenelela okungenasidingo. Inaliti ye-electrode ye-ablative esetshenziswayo ngokuvamile inobubanzi obungu-1-2mm, okuholela ekusikeni okuncane kokuhlinzwa okunobukhulu obungangembobo yenalithi. Le ndlela inikeza izinzuzo ezifanaukulimala okuncane, ubuhlungu obuncane, kanye nokululama okusheshayo.
Isikhathi esifushane sokuhlinzwa, isipiliyoni esikhululekile:Ukwelashwa okuhlinzayo kuvame ukwenziwa ngaphansi kwe-anesthesia yendawo noma kuhlanganiswe nokwelapha okuhlinzayo ngemithambo yegazi, okususa isidingo sokufakwa kwe-endotracheal intubation. Iziguli zisesimweni sokulala kancane futhi zingavuswa kalula ngokumpompa kancane. Ezinye iziguli zingase zizwe sengathi ukuhlinzwa sekuqediwe ngemvaukulala kancane.
I-biopsy ngesikhathi esisodwa ukuze kutholakale ukuxilongwa okunembile:Ngesikhathi sokwelashwa okuhlinzayo, ithuluzi le-biopsy eliqondiswa yi-coaxial noma elisebenzisa i-synchronous puncture lingasetshenziswa ukuthola i-biopsy yesilonda.ukuxilongwa kwe-pathological kanye nokuhlolwa kwezakhi zofuzoukunikeza ulwazi olubalulekile ngezinqumo zokwelapha ezilandelayo.
Inqubo ephindaphindwayo: Izifundo eziningi ezivela emithonjeni yasekhaya nakwamanye amazwe zibonise ukuthi izinga lokulawula lendawo leziguli ezinomdlavuza wamaphaphu ezisezingeni lokuqala ezithola ukwelashwa okuhlinzayo lifana nelokuhlinzwa noma ukwelashwa ngemisebe ye-stereotactic. Endabeni yokubuyela kwesifo endaweni, ukwelashwa okuhlinzayokungaphindaphindwa izikhathi eziningiukuze aphinde alawule lesi sifo ngenkathiukwandisa ikhwalithi yokuphila kwesiguli.
Ukuvuselelwa noma ukuthuthukiswa kokusebenza komzimba: Ukwelashwa okubangelwa yi-Ablative kuhlosebulala amangqamuzana esimila emzimbeni, futhi kwezinye izimo, kungavuselela noma kuthuthukise ukusebenza komzimba kwesiguli, okuholela ku- lapho izimila ezingalashwanga kwezinye izingxenye zomzimba zibonisa ukwehla. Ngaphezu kwalokho, ukwelashwa okudambisayo kungahlanganiswa nemithi yesistimu ukuze kukhiqizweumphumela wokubambisana.
Ukwelashwa okubangela ukucasuka kufaneleka kakhulu ezigulini ezingakwazi ukubekezelela ukuhlinzwa noma i-anesthesia ejwayelekile ngenxa yesifo sikashukela.ukusebenza kabi kwenhliziyo namaphaphu, ukuguga, noma izifo eziningi ezihambisana nalokhuFuthi kuyindlela yokwelapha ekhethwayo yeziguli ezine-amaqhubu amaningi esigaba sokuqala (njengeziqhubu eziningi zengilazi engaphansi komhlaba).
Isikhathi sokuthunyelwe: Agasti-23-2023