Nui nā poʻe maʻi maʻi maʻi ʻaʻai ʻaʻole ʻae ʻia no ka ʻoki ʻana a i ʻole nā koho lapaʻau ʻē aʻe he koho.
Nānā hihia
Ma'i ma'i 'a'ai ma'i 'a'ai 1:
Ma'i: Kane, ma'i 'a'ai mua
World ka mua HIFU lapaʻau no ka ate maʻi 'aʻai, ola no 12 makahiki.
Ma'i ma'i 'a'ai ma'i 'a'ai 2:
Ma'i: Kane, 52 makahiki, ma'i 'a'ai mua
Ma hope o ka wehe 'ana i ka radiofrequency, 'ike 'ia ke koena ma'i (ke koko kokoke i ka vena cava inferior).Ma hope o ka lua o ka HIFU lapaʻau, piha ablation o ke koena maʻi koko, me ka intact pale o ka inferior vena cava.
Ma'i ma'i 'a'ai ma'i 'a'ai 3:
Ka maʻi ʻaʻai mua
ʻO ka hahai ʻana ma hope o ʻelua pule o ka mālama ʻana i ka HIFU i hōʻike i ka nalowale loa o ka ʻōpū!
Ma'i ma'i 'a'ai ma'i 'a'ai 4:
Ma'i: Kane, 33 makahiki, metastatic ate cancer
Hoʻokahi lesion i loaʻa i kēlā me kēia lobe o ke ake.HIFU lapaʻau hana i ka manawa like, ka hopena i ka maʻi koko necrosis a absorption ekolu mahina ma hope o ka oki.
Ma'i ma'i 'a'ai ma'i 'a'ai 5:
Ma'i: Kane, 70 makahiki, ma'i 'a'ai mua
ʻIke ʻia ke koena tumora ma MRI ma hope o ka waiho ʻana o ka aila iodine ma hope o ka transarterial embolization.Ua nalowale ka hoʻonui ʻana ma hope o ka mālama ʻana i ka HIFU, e hōʻike ana i ka hoʻopau ʻana i ka maʻi maʻi.
Ma'i ma'i 'a'ai ma'i 'a'ai 6:
Ma'i: Wahine, 70 makahiki, ma'i 'a'ai mua
ʻO ka maʻi maʻi vascular kiʻekiʻe ke ana 120mm* Loaʻa ka 100mm ma ka lobe ʻākau o ke ake.Loaʻa ka hoʻopau ʻana i ka maʻi maʻi ma hope o ka mālama ʻana i ka HIFU, hoʻomoʻi mālie ʻia i ka manawa.
Ma'i ma'i ma'i 'a'ai 7:
Ma'i: Kane, 62 makahiki, ma'i 'a'ai mua
Lesion aia ma ka ʻaoʻao o ka hale diaphragmatic, vena cava inferior, a me ka ʻōnaehana vein portal.Ma hope o 5 mau manawa o ka radiofrequency a me 2 mau manawa o TACE, ʻike ʻia ke koena maʻi ma ka MRI hahai.HIFU lapaʻau holomua inactivated ke koko oiai e malama ana i ka puni koko ipu.
Ma'i ma'i ma'i 'a'ai 8:
Ma'i: Kane, 58 makahiki, ma'i 'a'ai mua
ʻIke ʻia ka hoʻihoʻi hou ʻana ma hope o ke ʻoki ʻana no ka maʻi ʻaʻai ʻāʻī lobe ʻākau.Loaʻa ka hoʻopau ʻana i ka maʻi maʻi me ka mālama ʻana i ka HIFU, i hōʻoia ʻia e ka absorption tumor 18 mau mahina ma hope.
ʻO Hyperthermia no ka maʻi maʻi ʻaʻai - Noʻonoʻo maʻamau
Hiki ke ho'ohana 'ia ka HIFU (High Intensity Focused Ultrasound) no ka mālama 'ana i ka ma'i 'a'ai.ʻO nā ʻano lapaʻau kuʻuna no ka maʻi maʻi ʻaʻai e pili ana i ka ʻoki ʻoki ʻana, transarterial embolization, a me ka chemotherapy.Eia nō naʻe, ʻike ʻia ka nui o nā maʻi ma kahi pae kiʻekiʻe a i ʻole nā maʻi koko kokoke i nā kīʻaha koko nui, ʻaʻole hiki ke hana ʻia.Eia kekahi, ʻaʻole hiki i kekahi poʻe maʻi ke hana i ka ʻokiʻoki ma muli o ko lākou kūlana kino, a ʻo nā kaʻina hana ʻokiʻoki e lawe i ka pilikia o nā pilikia.
HIFU lapaʻau no ka ake maʻi 'aʻai maʻi hāʻawi i kekahi mau pono:he mea hōʻemi liʻiliʻi, he liʻiliʻi ka ʻeha a me ka pōʻino, palekana, liʻiliʻi nā pilikia, a hiki ke hana hou inā pono.Hiki iā ia ke hoʻomaikaʻi i nā hōʻailona maʻi a hoʻolōʻihi i ko lākou ola.
Ma hope o ka HIFU lapaʻau, ʻaʻole i hōʻike ʻia nā hihia o ka haki ʻana o ka maʻi, jaundice, bile leakage, a i ʻole ʻeha vascular, e hōʻike ana he palekana ka mālama ʻana.
(1) Nā hōʻailona:ʻO ka lapaʻau ʻana no nā maʻi maʻi ʻoi loa, ka maʻi maʻi ʻaʻai mehameha ma ka lobe ʻākau me ke anawaena ma lalo o 10cm, nā ʻōpū nui ma ka lobe ʻākau me nā nodules ukali e hoʻopaʻa ʻia i ka nui o ke akepaʻa, ka hoʻi hou ʻana ma hope o ka ʻoki ʻana, portal vein tumor thrombus.
(2) Kū'ē:ʻO nā poʻe maʻi me ka cachexia, ka maʻi maʻi ate diffuse, ka hana ʻino o ka ate i ka wā hope loa, a me ka metastasis mamao.
(3) Kaʻina hana lapaʻau:Pono nā poʻe maʻi me nā maʻi maʻi ma ka lobe ʻākau e moe ma ko lākou ʻaoʻao ʻākau, aʻo ka poʻe me nā maʻi maʻi ma ka lobe hema e hoʻonoho maʻamau ʻia i kahi kūlana ʻaoʻao.Ma mua o ke kaʻina hana, hoʻohana ʻia ka ultrasound e ʻimi i ka ʻōpū no ka huli pono ʻana a me ka hoʻolālā lapaʻau.Hoʻomaʻamaʻa ʻia ka maʻi maʻi ma o ke kaʻina hana o ka hoʻopau ʻana, e hoʻomaka ana mai nā wahi pākahi a me ka holomua ʻana i nā laina, nā wahi, a ma hope o ka nui o ka tumora holoʻokoʻa.Hana ʻia ka mālama ʻana i hoʻokahi manawa i ka lā, me kēlā me kēia papa ma kahi o 40-60 mau minuke.Ke hoʻomau nei ke kaʻina hana i kēlā me kēia lā, papa ma ka papa, a hiki i ka pau ʻana o ke koko holoʻokoʻa.Ma hope o ka hoʻomaʻamaʻa ʻana, nānā ʻia ka wahi i mālama ʻia no ka pōʻino o ka ʻili, a ukali ʻia e kahi hōʻike ultrasound waho o ka wahi āpau i hoʻopaʻa ʻia e loiloi i ka pono o ka mālama ʻana.
(4) Ma hope o ka mālama ʻana:Nānā ʻia nā maʻi no ka hana ate a me nā pae electrolyte.Pono e hāʻawi ʻia ka lāʻau kākoʻo no nā poʻe maʻi me ka hana ʻino o ka ate, ascites, a i ʻole jaundice.ʻO ka hapa nui o nā maʻi he wela kino maʻamau i ka wā mālama.Hiki i kekahi helu liʻiliʻi o nā maʻi ke loaʻa i ka piʻi mālie o ka mahana i loko o 3-5 mau lā, ma lalo o 38.5 ℃.Manaʻo pinepine ʻia ka hoʻokē ʻai no 4 mau hola ma hope o ka mālama ʻana, aʻo nā mea maʻi me ka maʻi maʻi ʻaʻai lobe hema e hoʻokē ʻai no 6 mau hola ma mua o ka hoʻololi ʻana i ka meaʻai wai.Hiki i kekahi poʻe maʻi ke loaʻa i ka ʻeha o ka ʻōpū o luna no 3-5 mau lā ma hope o ka mālama ʻana, e hoʻoholo mālie ana iā ia iho.
(5) Ka loiloi o ka pono:Hiki i ka HIFU ke luku i ke akepaʻa maʻi 'aʻai kino, e hoʻololi i ka necrosis o ka maʻi 'aʻai.Hōʻike ka CT scans i ka emi ʻana o nā koina atenuation CT i loko o nā wahi i hoʻopaʻa ʻia, a hōʻoia ʻo CT i hoʻohālikelike ʻia i ka nele o ka hāʻawi ʻana i ke koko venous arterial a me portal i ka wahi i ʻimi ʻia.Hiki ke ʻike ʻia kahi hui hoʻonui ma ka ʻaoʻao lapaʻau.Hōʻike ka MRI i nā loli i ka ikaika o ka hōʻailona o ke koko ma nā kiʻi paona T1 a me T2 a hōʻike i ka nalo ʻana o ka hāʻawi koko i ka wahi i hoʻopaʻa ʻia ma nā ʻāpana venous arterial a me portal, me kahi manawa lohi e hōʻike ana i kahi hui hoʻonui ma ka palena o ka mālama ʻana.Hōʻike ka nānā ʻana i ke kani kani i ka hoʻohaʻahaʻa ʻana i ka nui o ka maʻi tumora, ka nalo ʻana o ke koko, a me ka necrosis ʻiʻo i hoʻopaʻa ʻia.
(6) Ka hahai ʻana:I nā makahiki ʻelua ma hope o ka mālama ʻana, pono e hele nā maʻi i nā kipa ʻana i kēlā me kēia ʻelua mahina.Ma hope o ʻelua mau makahiki, pono ke kipa ʻia i kēlā me kēia ʻeono mahina.Ma hope o ʻelima mau makahiki, ʻōlelo ʻia kahi nānā makahiki.Hiki ke hoʻohana ʻia nā pae alpha-fetoprotein (AFP) ma ke ʻano he hōʻailona o ka hoʻi hou ʻana o ka maʻi maʻi.Inā kūleʻa ka lapaʻau ʻana, e emi a nalo loa ka ʻōpū.I nā hihia i loaʻa ai ka ʻōpū akā ʻaʻole i loaʻa hou nā sela ola, pono e mālama ʻia ke ʻike ʻia kahi tumo me ke anawaena ʻoi aku ma mua o 5cm ma ke kiʻi, a hiki ke hoʻohana ʻia ka PET scans no ka wehewehe hou aku.
ʻO ka nānā ʻana i nā hopena ma mua a ma hope o ka mālama ʻana, me nā pae alpha-fetoprotein, ka hana ate, a me nā scan MRI,ua hōʻike i ka lapaʻau kala kala ma luna o 80% no ka ate maʻi 'aʻai maʻi lapaʻau me HIFU.Ma nā hihia kahi e hoʻolako ai i ke koko i nā ʻōpū o ke ake, hiki ke hoʻohui ʻia ka mālama ʻana HIFU me ka hana transarterial.Ma mua o HIFU lapaʻau, transcatheter arterial chemoembolization (TACE) hiki ke hana e ālai i ke koko hāʻawi i ke kikowaena maʻi 'aʻai, me ka embolic luna lawelawe ma ke ano he puu hoailona e kokua i ka HIFU huli ana.ʻO ka aila Iodine e hoʻololi i ka acoustic impedance a me ka absorption coefficient i loko o ka ʻōpū, hoʻomaʻamaʻa i ka hoʻololi ʻana o ka ikehu ma ka hiʻona HIFU a hoʻomaikaʻi..
Ka manawa hoʻouna: ʻAukake-08-2023