He nui nā poʻe maʻi kanesa o ke akepaʻa i kūpono ʻole no ke ʻoki ʻana a i ʻole nā koho lapaʻau ʻē aʻe i kahi koho.
Loiloi Hihia
Ka hihia lapaʻau no ke kanesa o ke akepaʻa 1:
Maʻi: Kāne, maʻi ʻaʻai ake mua
ʻO ka lāʻau lapaʻau HIFU mua loa o ka honua no ka maʻi ʻaʻai akepaʻa, ua ola no 12 mau makahiki.
Ka hihia lapaʻau no ke kanesa o ke akepaʻa 2:
Maʻi: Kāne, 52 makahiki, maʻi ʻaʻai ake mua
Ma hope o ka ablation radiofrequency, ua ʻike ʻia ke koena o ka puʻupuʻu (ʻo ka puʻupuʻu kokoke i ka vena cava inferior). Ma hope o ka lua o ka mālama ʻana iā HIFU, ua hoʻokō ʻia ka ablation piha o ke koena o ka puʻupuʻu, me ka pale piha ʻana o ka vena cava inferior.
Ka hihia lapaʻau no ke kanesa o ke akepaʻa 3:
Ka maʻi ʻaʻai ate mua
Ua hōʻike ka nānā ʻana ma hope o ʻelua pule o ka mālama ʻana iā HIFU i ka nalo loa ʻana o ka puʻupuʻu!
Ka hihia lapaʻau no ke kanesa o ke akepaʻa 4:
Maʻi: Kāne, 33 makahiki, maʻi kanesa akepaʻa metastatic
Hoʻokahi ʻeha i loaʻa ma kēlā me kēia lobe o ke ake. Ua hana like ʻia ka mālama ʻana o HIFU, e hopena ana i ka necrosis tumor a me ka omo ʻana i ʻekolu mahina ma hope o ke ʻoki ʻana.
Ka hihia lapaʻau no ke kanesa o ke akepaʻa 5:
Maʻi: Kāne, 70 makahiki, maʻi ʻaʻai ake mua
Ua ʻike ʻia ke koena o ka puʻupuʻu ma ka MRI ma hope o ka waiho ʻana o ka ʻaila iodine ma hope o ka embolization transarterial. Ua nalowale ka hoʻonui ʻana ma hope o ka mālama ʻana iā HIFU, e hōʻike ana i ka ablation piha o ka puʻupuʻu.
Ka hihia lapaʻau no ke kanesa o ke akepaʻa 6:
Maʻi: Wahine, 70 makahiki, maʻi ʻaʻai ake mua
ʻO ka puʻupuʻu koko kiʻekiʻe e ana ana he 120mm* Loaʻa he 100mm ma ka ʻaoʻao ʻākau o ke ake. Hoʻopau piha ʻia ka puʻupuʻu ma hope o ka mālama ʻana iā HIFU, komo mālie i ka hala ʻana o ka manawa.
Ka hihia lapaʻau no ke kanesa o ke akepaʻa 7:
Maʻi: Kāne, 62 makahiki, maʻi ʻaʻai ake mua
Aia ka ʻeha ma ka ʻaoʻao o ka ʻili diaphragmatic, ka vena cava haʻahaʻa, a me ka ʻōnaehana vein portal. Ma hope o 5 mau kau o ka radiofrequency a me 2 mau kau o TACE, ua ʻike ʻia ke koena o ka puʻupuʻu ma ka MRI hahai. Ua hoʻopau pono ka mālama ʻana o HIFU i ka puʻupuʻu me ka mālama ʻana i nā kīʻaha koko a puni.
Ka hihia lapaʻau ʻana i ka maʻi ʻaʻai akepaʻa 8:
Maʻi: Kāne, 58 makahiki, maʻi ʻaʻai ake mua
Ua ʻike ʻia ka hana hou ʻana ma hope o ke ʻoki ʻana no ka maʻi ʻaʻai akepaʻa lobe ʻākau. Ua hoʻokō ʻia ka ablation piha o ka puʻupuʻu me ka mālama ʻana iā HIFU, i hōʻoia ʻia e ka omo ʻana o ka puʻupuʻu 18 mau mahina ma hope.
Hyperthermia no ke Kanesa Ake - Noiʻi Kūlana
Hiki ke hoʻohana ʻia ka HIFU (High Intensity Focused Ultrasound) e mālama i ka maʻi kanesa o ke ake. ʻO nā ʻano lapaʻau kuʻuna no ka maʻi kanesa o ke ake e komo pū me ka resection ʻoki, transarterial embolization, a me ka chemotherapy. Eia nō naʻe, ua ʻike ʻia ka nui o nā maʻi i kahi pae holomua a i ʻole he mau puʻupuʻu kokoke i nā kīʻaha koko nui, e hana ana i ke ʻoki ʻana he mea hiki ʻole ke hana. Eia kekahi, ʻaʻole hiki i kekahi mau maʻi ke hana ʻoki ma muli o ko lākou kūlana kino, a ʻo nā kaʻina hana ʻoki ponoʻī ke lawe i ka pilikia o nā pilikia.
Hāʻawi ka mālama ʻana o HIFU no ka maʻi ʻaʻai akepaʻa i kekahi mau pono:he mea hoʻopilikia iki ia, hōʻeha iki i ka ʻeha a me ka pōʻino, palekana, emi nā pilikia, a hiki ke hana hou ʻia inā pono. Hiki iā ia ke hoʻomaikaʻi i nā hōʻailona o ka mea maʻi a hoʻolōʻihi i ko lākou ola.
Ma hope o ka mālama ʻana me HIFU, ʻaʻohe hihia o ka haki ʻana o ka puʻupuʻu, ka jaundice, ka liki ʻana o ka bile, a i ʻole ka hōʻeha ʻana o ke koko i hōʻike ʻia, e hōʻike ana ua palekana ka lāʻau.
(1) Nā Hōʻailona:Lāʻau hoʻomanawanui no nā ʻōpū holomua, ka maʻi ʻaʻai akepaʻa hoʻokahi ma ka lobe ʻākau me ke anawaena ma lalo o 10cm, nā ʻōpū nui ma ka lobe ʻākau me nā nodules satellite e waiho mau ana i ka puʻu akepaʻa ʻākau, ka hoʻi hou ʻana ma hope o ke ʻoki ʻana, ka thrombus ʻōpū vein portal.
(2) Nā mea e pale aku ai:Nā maʻi me ka cachexia, ka maʻi ʻaʻai ate pālahalaha, ka hana koʻikoʻi o ke akepaʻa i ka wā hope loa, a me nā metastasis mamao.
(3) Kaʻina hana lapaʻau:Pono nā maʻi me nā puʻupuʻu ma ka lobe ʻākau e moe ma ko lākou ʻaoʻao ʻākau, ʻoiai ʻo ka poʻe me nā puʻupuʻu ma ka lobe hema e kau pinepine ʻia ma ke kūlana moe. Ma mua o ke kaʻina hana, hoʻohana ʻia ka ultrasound e ʻimi i ka puʻupuʻu no ka hoʻolālā kikoʻī a me ka hoʻolālā mālama ʻana. A laila mālama ʻia ka puʻupuʻu ma o ke kaʻina hana o nā ablations e hiki mai ana, e hoʻomaka ana mai nā kiko pākahi a holomua i nā laina, nā wahi, a ma hope loa ka nui o ka puʻupuʻu holoʻokoʻa. Hana pinepine ʻia ka mālama ʻana i hoʻokahi manawa i ka lā, me kēlā me kēia papa e lawe ana ma kahi o 40-60 mau minuke. Hoʻomau ke kaʻina hana i kēlā me kēia lā, papa ma ka papa, a hiki i ka wā e ablated ai ka puʻupuʻu holoʻokoʻa. Ma hope o ka mālama ʻana, nānā ʻia ka wahi i mālama ʻia no kekahi hōʻino ʻili, a ukali ʻia e kahi scan ultrasound waho o ka wahi pahuhopu holoʻokoʻa e loiloi i ka pono o ka mālama ʻana.
(4) Mālama ma hope o ka mālama ʻana:Nānā ʻia nā maʻi no ka hana o ke akepaʻa a me nā pae electrolyte. Pono e hāʻawi ʻia nā lāʻau lapaʻau kākoʻo no nā maʻi me ka hana maikaʻi ʻole o ke akepaʻa, ascites, a i ʻole jaundice. Loaʻa i ka hapa nui o nā maʻi ka mahana kino maʻamau i ka wā o ka mālama ʻana. Hiki i kahi helu liʻiliʻi o nā maʻi ke ʻike i kahi piʻi iki 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, ʻoiai ʻo nā maʻi me ka maʻi ʻaʻai akepaʻa hema e hoʻokē ʻai no 6 mau hola ma mua o ka neʻe mālie ʻana i ka ʻai wai. Hiki i kekahi mau maʻi ke ʻeha iki i ka ʻōpū o luna no 3-5 mau lā ma hope o ka mālama ʻana, kahi e hoʻomaha mālie ai iā ia iho.
(5) Loiloi o ka pono:Hiki i ka HIFU ke hoʻopau i nā ʻiʻo kanesa o ke akepaʻa, e hoʻoulu ai i ka necrosis irreversible o nā cell cancer. Hōʻike nā scan CT i ka emi nui ʻana o nā waiwai attenuation CT i loko o nā wahi i manaʻo ʻia, a hōʻoia ka CT i hoʻonui ʻia i ka contrast i ka nele o ka lako koko arterial a me ka portal venous i ka wahi i manaʻo ʻia. Hiki ke ʻike ʻia kahi hui hoʻonui ma ka palena mālama. Hōʻike ka MRI i nā loli i ka ikaika hōʻailona o ka puʻupuʻu ma nā kiʻi T1 a me T2-weighted a hōʻike i ka nalo ʻana o ka lako koko i ka wahi i manaʻo ʻia i nā pae arterial a me ka portal venous, me kahi pae lohi e hōʻike ana i kahi hui hoʻonui ma ka palena mālama. Hōʻike ka nānā ʻana o Ultrasound i ka emi mālie o ka nui o ka puʻupuʻu, ka nalo ʻana o ka lako koko, a me ka necrosis ʻiʻo e komo hope ʻia.
(6) Hana hou:I nā makahiki ʻelua mua ma hope o ka mālama ʻana, pono i nā maʻi ke kipa ʻana i kēlā me kēia ʻelua mahina. Ma hope o ʻelua makahiki, pono e hana ʻia nā kipa ʻana i kēlā me kēia ʻeono mahina. Ma hope o ʻelima mau makahiki, ua 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 puʻupuʻu. Inā holomua ka mālama ʻana, e emi a nalowale loa paha ka puʻupuʻu. I nā hihia kahi e mau ana ka puʻupuʻu akā ʻaʻohe mau cell ola, pono e akahele i ka wā e ʻike ʻia ai kahi puʻupuʻu me ke anawaena ma mua o 5cm ma ke kiʻi ʻana, a hiki ke hoʻohana ʻia nā scan PET no ka wehewehe hou aku.
Ka nānā ʻana i nā hopena lapaʻau ma mua a ma hope o ka mālama ʻana, me nā pae alpha-fetoprotein, ka hana o ke ake, a me nā scan MRI,ua hōʻike i kahi helu kala ʻana ma ke ʻano lapaʻau ma luna o 80% no nā poʻe maʻi maʻi kanesa o ke akepaʻa i mālama ʻia me HIFU.I nā hihia kahi i nui ai ke koko i nā ʻōpū o ke akepaʻa, hiki ke hoʻohui ʻia ka mālama ʻana o HIFU me ke komo ʻana o ka transarterial. Ma mua o ka mālama ʻana o HIFU, hiki ke hana ʻia ka transcatheter arterial chemoembolization (TACE) e ālai i ke koko i ka wahi ʻōpū waena, me ka mea embolic e lawelawe ana ma ke ʻano he māka ʻōpū e kōkua i ka HIFU targeting. Hoʻololi ka ʻaila Iodine i ka acoustic impedance a me ka absorption coefficient i loko o ka ʻōpū, e hoʻomaʻamaʻa ana i ka hoʻololi ʻana o ka ikehu ma ke kikowaena HIFU a hoʻomaikaʻi..
Ka manawa hoʻouna: Aug-08-2023