Iziguli eziningi ezinomdlavuza wesibindi ezingafanelekile ukuhlinzwa noma ezinye izindlela zokwelapha zinenketho.
Ukubuyekezwa Kwecala
Icala 1 Lokwelapha Umdlavuza Wesibindi:
Isiguli: Owesilisa, umdlavuza wesibindi oyinhloko
Ukwelashwa kokuqala emhlabeni wonke kwe-HIFU yomdlavuza wesibindi, kwasinda iminyaka engu-12.
Icala 2 Lokwelapha Umdlavuza Wesibindi:
Isiguli: Owesilisa, oneminyaka engama-52 ubudala, umdlavuza wesibindi oyinhloko
Ngemuva kokukhishwa kwe-radiofrequency, kuhlonzwe isimila esisele (isimila esiseduze ne-inferior vena cava).Ukulandela ukwelashwa kwe-HIFU kwesibili, ukukhishwa okuphelele kwesimila esisele kufinyelelwe, ngokuvikelwa okuqinile kwe-vena cava engaphansi.
Icala 3 Lokwelapha Umdlavuza Wesibindi:
Umdlavuza wesibindi oyinhloko
Ukulandelela ngemva kwamasonto amabili okwelashwa kwe-HIFU kwabonisa ukunyamalala ngokuphelele kwesimila!
Icala 4 Lokwelapha Umdlavuza Wesibindi:
Isiguli: Owesilisa, oneminyaka engama-33 ubudala, umdlavuza wesibindi we-metastatic
Isilonda esisodwa esitholakala engxenyeni ngayinye yesibindi.Ukwelashwa kwe-HIFU kwenziwa kanyekanye, okuholele ku-tumor necrosis nokumuncwa izinyanga ezintathu ngemuva kokuhlinzwa.
Icala 5 Lokwelapha Umdlavuza Wesibindi:
Isiguli: Owesilisa, oneminyaka engama-70 ubudala, umdlavuza wesibindi oyinhloko
Isimila esisele esibonwe ku-MRI ngemuva kokufakwa kukawoyela we-iodine kulandela ukugqama kwe-transarterial.Ukuthuthukiswa kwe-Patch kwanyamalala ngemva kokwelashwa kwe-HIFU, okubonisa ukukhishwa okuphelele kwesimila.
Icala 6 Lokwelapha Umdlavuza Wesibindi:
Isiguli: Owesifazane, oneminyaka engama-70 ubudala, umdlavuza wesibindi oyinhloko
Isimila se-vascular high esilinganisa i-120mm* I-100mm itholakala engxenyeni engakwesokudla yesibindi.Ukukhishwa okuphelele kwesimila okuzuzwe ngemuva kokwelashwa kwe-HIFU, kungene kancane kancane ngokuhamba kwesikhathi.
Icala 7 Lokwelapha Umdlavuza Wesibindi:
Isiguli: Owesilisa, oneminyaka engama-62 ubudala, umdlavuza wesibindi oyinhloko
Isilonda esitholakala eduze kophahla lwe-diaphragmatic, i-inferior vena cava, nesistimu ye-portal vein.Ngemuva kweseshini ye-5 ye-radiofrequency kanye neseshini ye-2 ye-TACE, i-tumor esele ikhonjwe ku-MRI yokulandelela.Ukwelashwa kwe-HIFU kwenza isimila singasebenzi ngempumelelo ngenkathi kugcinwa imithambo yegazi ezungezile.
Icala 8 Lokwelapha Umdlavuza Wesibindi:
Isiguli: Owesilisa, oneminyaka engama-58 ubudala, umdlavuza wesibindi oyinhloko
Ukuphindaphinda okubonwa ngemva kokuhlinzwa umdlavuza wesibindi we-lobe yangakwesokudla.Ukukhishwa okuphelele kwesimila okuzuzwe ngokwelashwa kwe-HIFU, okuqinisekiswe ukumuncwa kwesimila ezinyangeni eziyi-18 kamuva.
I-Hyperthermia ye-Cancer Yesibindi - Ucwaningo Olumisiwe
I-HIFU (High Intensity Focused Ultrasound) ingasetshenziswa ukwelapha umdlavuza wesibindi.Izindlela zokwelapha zendabuko zomdlavuza wesibindi zihlanganisa ukuhlinzwa kabusha, i-transarterial embolization, kanye ne-chemotherapy.Nokho, iziguli eziningi zitholakala sezisezingeni eliphezulu noma zinezimila eduze kwemithambo yegazi emikhulu, okwenza ukuhlinzwa kungenzeki.Ukwengeza, ezinye iziguli azikwazi ukuhlinzwa ngenxa yesimo sazo somzimba, futhi izinqubo zokuhlinzwa ngokwazo zithwala ingozi yezinkinga.
Ukwelashwa kwe-HIFU komdlavuza wesibindi kunikeza izinzuzo ezimbalwa:ihlasela kancane, ibangela ubuhlungu obuncane kanye nomonakalo, iphephile, inezinkinga ezimbalwa, futhi ingaphindaphindwa uma kunesidingo.Ingathuthukisa izimpawu zesiguli futhi yandise ukusinda kwazo.
Ukwelashwa kwe-Post-HIFU, azikho izimo zokuphuka kwesimila, i-jaundice, ukuvuza kwe-bile, noma ukulimala kwe-vascular kuye kwabikwa, okubonisa ukuthi ukwelashwa kuphephile.
(1) Izinkomba:Ukwelashwa okudabukisayo kwamathumba asethuthukile, umdlavuza wesibindi uwedwa engxenyeni engakwesokudla enobubanzi obungaphansi kuka-10cm, izimila ezinkulu engxenyeni yesokudla enamaqhuqhuva esathelayithi ahlala evalekile esixukwini sesibindi esingakwesokudla, ukuphindaphinda kwendawo ngemva kokuhlinzwa, i-portal vein tumor thrombus.
(2) I-Contraindications:Iziguli ezine-cachexia, umdlavuza wesibindi osakazwayo, ukungasebenzi kahle kwesibindi ekupheleni kwesigaba, kanye ne-metastasis ekude.
(3) Inqubo yokwelapha:Iziguli ezinezimila ku-lobe engakwesokudla kufanele zilale ngohlangothi lwazo lwesokudla, kuyilapho lezo ezinamathumba ku-lobe yesokunxele zivame ukubekwa endaweni ephansi.Ngaphambi kwenqubo, i-ultrasound isetshenziselwa ukuthola isimila ukuze kuqondiswe okunembile nokuhlela ukwelashwa.Isimila sibe sesilashwa ngenqubo yokukhishwa okulandelanayo, kusukela emaphuzwini ngamanye futhi siqhubekele emigqeni, ezindaweni, futhi ekugcineni ivolumu yonke yesimila.Ukwelashwa ngokuvamile kwenziwa kanye ngosuku, ungqimba ngalunye luthatha cishe imizuzu engama-40-60.Inqubo iqhubeka nsuku zonke, isendlalelo ngesendlalelo, kuze kube yilapho sonke isimila sisuliwe.Ngemuva kokwelashwa, indawo ephathwayo ihlolwe noma yikuphi ukulimala kwesikhumba, kulandelwa i-ultrasound yangaphandle scan yendawo yonke ehlosiwe ukuze kuhlolwe ukusebenza kokwelashwa.
(4) Ukunakekelwa ngemva kokwelashwa:Iziguli zigadwa ukusebenza kwesibindi namazinga e-electrolyte.Ukwelashwa okusekelayo kufanele kunikezwe iziguli ezingasebenzi kahle kwesibindi, ama-ascites, noma i-jaundice.Iziguli eziningi zinezinga lokushisa lomzimba elivamile ngesikhathi sokwelashwa.Inani elincane leziguli lingase libe nokukhuphuka okuncane kwezinga lokushisa phakathi kwezinsuku ezi-3-5, ngokuvamile libe ngaphansi kuka-38.5℃.Ukuzila ukudla ngokuvamile kunconywa amahora angu-4 ngemva kokwelashwa, kuyilapho iziguli ezinomdlavuza wesibindi kwesokunxele kufanele zizile amahora angu-6 ngaphambi kokushintshela ekudleni okuwuketshezi kancane kancane.Ezinye iziguli zingase zithole ubuhlungu obuncane besisu obuphansi izinsuku ezingu-3-5 ngemva kokwelashwa, okuzixazulula kancane kancane.
(5) Ukuhlolwa kokusebenza kahle:I-HIFU ingabhubhisa izicubu zomdlavuza wesibindi, ibangele i-necrosis engalungiseki yamangqamuzana omdlavuza.Amaskena e-CT abonisa ukwehla okuphawulekayo kwamanani e-CT attenuation ngaphakathi kwezindawo ezihlosiwe, futhi i-CT ethuthukisiwe iqinisekisa ukungabikho kokunikezwa kwegazi kwe-arterial kanye ne-portal venous endaweni okuhlosiwe.Ibhande lokuthuthukisa lingabonwa emaphethelweni okwelashwa.I-MRI ibona ngeso lengqondo izinguquko zokushuba kwesignali yesimila ezithombeni ezinesisindo se-T1 kanye ne-T2 futhi ibonise ukunyamalala kokunikezwa kwegazi endaweni okuqondiwe kuyo ezigabeni ze-arterial kanye ne-portal venous, nesigaba esibambezelekile esibonisa ibhande lokuthuthukisa eduze kwemajini yokwelashwa.Ukuqapha kwe-Ultrasound kukhombisa ukuncipha kancane kancane kosayizi wesimila, ukunyamalala kokunikezwa kwegazi, kanye ne-tissue necrosis egcina imuncwe.
(6) Ukulandelela:Eminyakeni emibili yokuqala ngemva kokwelashwa, iziguli kufanele zibe nokuvakasha kokulandelela njalo ngemva kwezinyanga ezimbili.Ngemuva kweminyaka emibili, ukuvakasha kokulandelela kufanele kwenzeke njalo ezinyangeni eziyisithupha.Ngemuva kweminyaka emihlanu, kunconywa ukuhlolwa kwaminyaka yonke.Amazinga e-Alpha-fetoprotein (AFP) angasetshenziswa njengenkomba yokuphindaphinda kwesimila.Uma ukwelashwa kuphumelela, isimila sizoshwabana noma sinyamalale ngokuphelele.Ezimweni lapho isimila sisekhona kodwa singasenawo amaseli asebenzayo, kufanele kuqashelwe uma isimila esinobubanzi obungaphezu kuka-5cm sibonakala ezithombeni, futhi ama-PET scan angase asetshenziswe ukuze kucaciswe okwengeziwe.
Ukubhekwa komtholampilo kwemiphumela yangaphambi nangemuva kokwelashwa, okuhlanganisa amazinga e-alpha-fetoprotein, ukusebenza kwesibindi, nezikena ze-MRI,baye babonisa izinga lokukhululwa emtholampilo elingaphezu kwama-80% ezigulini ezinomdlavuza wesibindi ezilashwa nge-HIFU.Ezimweni lapho ukunikezwa kwegazi kumathumba esibindi kucebile, ukwelashwa kwe-HIFU kungahlanganiswa nokungenelela kwe-transarterial.Ngaphambi kokwelashwa kwe-HIFU, i-transcatheter arterial chemoembolization (TACE) ingenziwa ukuze kuvinjwe ukuhlinzekwa kwegazi endaweni yesimila esimaphakathi, ne-embolic agent esebenza njenge-tumor marker ukusiza ekuqondisweni kwe-HIFU.Amafutha e-iodine ashintsha i-acoustic impedance kanye ne-coefficient yokumuncwa ngaphakathi kwesimila, enze kube lula ukuguqulwa kwamandla ekugxilweni kwe-HIFU nokwenza ngcono..
Isikhathi sokuthumela: Aug-08-2023