Cryoablation no ka Pulmonary Nodule
ʻO ka maʻi maʻi maʻi maʻi maʻi a me nā nodules pulmonary weliweli
Wahi a ka ʻikepili mai ka International Agency for Research on Cancer of the World Health Organization, ma kahi o 4.57 miliona mau maʻi maʻi maʻi hou i ʻike ʻia ma Kina i 2020,me ka maʻi maʻi maʻi maʻi ma kahi o 820,000 mau hihia.Ma waena o nā panalāʻau a me nā kūlanakauhale he 31 ma Kina, ʻo ka nui o ka nui o ka maʻi kanesa maʻi i nā kāne ke kūlana mua ma nā wahi āpau koe wale nō ʻo Gansu, Qinghai, Guangxi, Hainan, a me Tibet, a ʻo ka nui o ka make ka mea kiʻekiʻe loa me ka nānā ʻole i ke kāne.Ua manaʻo ʻia ka nui o ka nui o nā nodules pulmonary ma Kina ma kahi o 10% a 20%, me kahi maʻi maʻi nui i waena o nā poʻe ma mua o 40 mau makahiki.Eia nō naʻe, pono e hoʻomaopopo ʻia ʻo ka hapa nui o nā nodules pulmonary he mau lesion benign.
ʻO ka hōʻoia ʻana o nā Nodules Pulmonary
Nā nodule pulmonarye nānā i nā aka mānoanoa me ka poʻe poʻe i loko o ka māmā, me nā ʻano nui like ʻole a me nā ʻaoʻao akaka a popopo paha, a ʻoi aku ka liʻiliʻi o ke anawaena ma mua o 3 knm.
Hōʻike Kiʻi:I kēia manawa, hoʻohana nui ʻia ka ʻenehana scanning imaging, i ʻike ʻia ʻo ka ground-glass opacity nodule imaging diagnostic.Hiki i kekahi poʻe loea ke hoʻokō i kahi helu correlation pathological a hiki i 95%.
ʻO ka hōʻike ʻana o ka pathological:Eia nō naʻe, ʻaʻole hiki ke hoʻololi i ka ʻike kiʻi kiʻi i ka maʻi pathology o ka ʻiʻo, ʻoi aku ka nui o nā hihia o ka hoʻomaʻamaʻa pololei kikoʻī kikoʻī e koi ana i ka maʻi pathological molecular ma ka pae kelepona.ʻO ka maʻi pathological e hoʻomau i ke kūlana gula.
ʻO nā ʻano hoʻokolohua maʻamau a me nā mea lapaʻau no nā nodules pulmonary
Biopsy Percutaneous:Hiki ke hoʻokō ʻia ka maʻi maʻi pathology a me ka maʻi molecular pathology ma lalo o ka anesthesia kūloko ma o ka puncture percutaneous.ʻO ka awelika o ka holomua o ka biopsy ma kahi o 63%,akā, hiki mai nā pilikia e like me ka pneumothorax a me ka hemothorax.Kākoʻo wale kēia ʻano hana i ka maʻi maʻi a paʻakikī ke hana i ka mālama like ʻana.Aia kekahi pilikia o ka hoʻoheheʻe ʻana o nā cell tumor a me ka metastasis.Hāʻawi ka biopsy percutaneous maʻamau i ka nui o nā kiko kiko,paʻakikī ka hoʻomaʻamaʻa ʻana i ka maʻi pathology i ka manawa maoli.
ʻO ka Lobectomy i kōkua ʻia e ka Video-Assisted Thoracoscopic Surgery (VATS): Hāʻawi kēia ala i ka maʻi a me ka mālama ʻana i ka manawa like, me ka helu kūleʻa kokoke i 100%.Eia naʻe, ʻaʻole kūpono kēia ʻano hana no nā poʻe maʻi ʻelemakule a i ʻole nā kānaka kūikawāʻaʻole hoʻomanawanui i ka maʻi anesthesia āpau, nā poʻe maʻi me nā nodules pulmonary liʻiliʻi ma mua o 8 mm ka nui a i ʻole ka haʻahaʻa haʻahaʻa (<-600), nā nodules e waiho hohonu ana ma waena o nā ʻāpana like ʻole, anā nodules ma ka ʻāina mediastinal kokoke i nā hale hilar.Eia hou, ʻaʻole hiki ke ʻoki i kahi koho diagnostic a me ka therapeutic kūpono no nā kūlana e pili anaka hoʻi hou ʻana ma hope o ka hana ʻana, nā nodules hou, a i ʻole nā maʻi maʻi metastatic.
Hana Hana Hou no nā Nodules Pulmonary - Cryoablation
Me ka hoʻomau mau ʻana o ka ʻenehana lapaʻau, ua komo ka lāʻau lapaʻau i ke au o "ʻike pololei a me ka hoʻoponopono pololei“.I kēia lā, e hoʻolauna mākou i kahi ala lapaʻau kūloko i kūpono loa no nā maʻi maʻi non-malignant a me nā nodules pulmonary proliferative non-vascular, a me nā nodules tumor mua (emi ma lalo o 2 cm) -cryoablation.
Cryotherapy
ʻO ka ʻenehana cryoablation ultra-low temperature (cryotherapy), i ʻike ʻia ʻo cryosurgery a i ʻole cryoablation, he ʻenehana lapaʻau ʻokiʻoki e hoʻohana ana i ka hau no ka mālama ʻana i nā ʻiʻo.Ma lalo o ke alakaʻi ʻana o CT, loaʻa ke kūlana pololei ma ke kī ʻana i ka ʻiʻo tumora.Ma hope o ka hōʻea ʻana i ka lesion, hoʻemi koke ʻia ka mahana kūloko ma ke kahua-140°C a i -170°Choʻohanakinoea argoni loko o nā minuke, a laila e hoʻokō ai i ka pahuhopu o ka mālama ʻana i ka maʻi tumor.
Kumu o ka Cryoablation no ka Pulmonary Nodules
1. Ka hopena hau: ʻAʻole pili kēia i ka pathology a hiki i ka wikiwiki intraoperative pathological diagnostic.Hoʻopau kino ka cryoablation i nā pūnaewele maʻi a hoʻoulu i ka microvascular occlusion.
2. Ka hopena immunomodulatory: Loaʻa kēia i kahi pane pale mamao e kūʻē i ka ʻōpū. Hoʻoikaika ia i ka hoʻokuʻu antigen, hoʻōla i ka ʻōnaehana pale, a hoʻomaha i ka hoʻopau ʻana i ka pale.
3. Hoʻokūpaʻa ʻia o nā ʻōhua kelepona (e like me ke akemāmā a me ke akepaʻa): Hoʻonui kēia i ka holomua o ka biopsy. Hoʻokumu ʻia kahi pōpō hau hau, e maʻalahi ka hoʻopaʻa ʻana, a maopopo a ʻike ʻia nā ʻaoʻao ma ke kiʻi.He maʻalahi a maikaʻi kēia noi patented.
Ma muli o nā ʻano ʻelua o ka cryoablation -"ka hoʻopaʻa ʻana a me ka hopena hoʻopaʻa paʻa" a me "ka ʻiʻo paʻa paʻa ma hope o ka maloʻo me ka ʻole e pili ana i ka maʻi pathological"Hiki iā ia ke kōkua i ka biopsy nodule lung,e hoʻokō i ka hōʻoia pathological i ka manawa maoli i ka wā o ke kaʻina hana, a hoʻomaikaʻi i ka holomua o ka biopsy.Ua ʻike ʻia ʻo ia ʻo "cryoablation no ka biopsy nodule pulmonary“.
Pono o Cryoablation
1. Hoʻoponopono i ka pilikia hanu:Hoʻopaʻa ka maloʻo kūloko i ka ʻiʻo māmā (me ka hoʻohana ʻana i nā ʻano hoʻoheheʻe coaxial a i ʻole bypass).
2. Ka hoʻoponopono ʻana i ka pneumothorax, hemoptysis, a me ka pilikia o ka embolism o ka ea a me ka kanu ʻana i ka maʻi tumora: Ma hope o ka hoʻokumu ʻana i ka pōleʻa hau, ua hoʻokumu ʻia kahi kahawai extracorporeal kaomi ʻino i pani ʻia no ka maʻi ʻana a me nā kumu lapaʻau.
3. Loaʻa i ka hoʻokō ʻana i ka maʻi ma ka pūnaewele a me nā pahuhopu lapaʻau: Hana ʻia ka cryoablation o ka nodule māmā, a ma hope o ka hoʻomehana hou ʻana a me ka biopsy multidirectional 360 ° e hoʻonui i ka nui o ka biopsy tissue.
ʻOiai ʻo ka cryoablation kahi ala no ka mālama ʻana i ka maʻi maʻi kūloko, hiki i kekahi poʻe maʻi ke hōʻike i kahi pane kūlohelohe mamao.Eia nō naʻe, hōʻike ka nui o ka ʻikepili i ka wā e hui pū ʻia ai ka cryoablation me ka radiotherapy, chemotherapy, targeted therapy, immunotherapy, a me nā ʻano lapaʻau ʻē aʻe, hiki ke hoʻokō ʻia ka mālama ʻana i ka tumor lōʻihi.
Nā hōʻailona no ka Cryoablation Percutaneous ma lalo o ke alakaʻi CT
Nā nodule māmā B-zone: No nā nodules māmā e koi ana i ka wehe ʻana i ka ʻāpana a i ʻole ka nui o nā ʻāpana, hiki i ka cryoablation percutaneous ke hāʻawi i kahi maʻi maʻi preoperative.
Nā nodule māmā A-zone: Bypass a oblique approach (ʻo ka pahuhopu ka hoʻokumu ʻana i kahi kaila ʻiʻo māmā, ʻoi aku ka maikaʻi me ka lōʻihi o 2 knm).
Nā hōʻailona
ʻO nā maʻi maʻi ʻole a me nā nodules pulmonary proliferative non-vascular:
Loaʻa kēia i nā ʻeha precancerous (atypical hyperplasia, in situ carcinoma), immune reactive proliferative lesions, pseudotumor inflammatory, cysts localized a me abscesses, a me nā nodules scar proliferative.
ʻO nā nodules tumor mua:
Ma muli o ka ʻike e loaʻa nei, ʻo ka cryoablation kekahi ʻano hana lapaʻau maikaʻi e hoʻohālikelike ʻia me ka ʻoki ʻoki ʻana no nā nodules opacity ground-glass opacity nodules liʻiliʻi ma mua o 2 knm me ka liʻiliʻi o 25% mea paʻa.
Ka manawa hoʻouna: Sep-05-2023