Mitauro, Maitiro uye Zvinetso zveMungwaru Biopsy
Chirwere chepapu chinogona kukurudzirwa kana iwe uine chivharo chemapapu kana hukuru, kana kana chiremba wako ane hanya kuti unogona kuva nechirwere kana imwe mamiriro emapapu. Ndeipi chirwere chepapu, zvinoitwa sei uye ndezvipi zvinetso zvinogona kuitika?
Chii Chiri Mungozi?
Chirwere chepapu ndiyo nzira yekuwana samuenzaniso yekufungidzirwa kwemapupa emapu. Nekutarisa mhando yezvinyorwa pasi pe microscope, vanachiremba vanogona kutarisisa kuti chii chaicho chiri kukonzera kusakoshesa, uye kana chirongwa chacho chiri chekenza kana kwete.
Nemukenza wemapapu, chirwere chepapu chinokosha kuti uone rudzi rwemapapu emapapu pamwe chete nemasikirini kana kuti maitiro ehutu.
Zvikonzero zveMhembwe Chirwere
Pane zvikonzero zvakasiyana-siyana mapapu emapapu angakurudzirwa:
- Kuti uongorore hutundu kana hutatu hunoonekwa pane chidzidzo chekufungidzira chechipfuva, uye kuti uone kana chiri chakanaka kana chakaipa (kenza). Mucheche wemapapu unowanikwa sei?
- Kuchengetedza pamusoro pemigumisiro isingaenzaniswi neC CT yemapapu ekuongorora. Ndeipi mikana iyo kenza apo kuongorora kwekenza yemapapu kunoratidzira chirungu ?
- Kuongorora hutachiona hwemapapu. Utachiona hutachiona hunogona kuva mabhakitiriya (akafanana nehutachivha), hutachiona kana fungal (zvakadai seaspergillosis kana kuti coccidiomycosis.)
- Kuti uongorore chirwere chemapapu chakadai sarcoidosis , pulmonary fibrosis , Wegener's granulomatosis kana chirwere chemapapu chinoputika.
- Kuita zviratidzo zvemajini (kufungidzira kwema molecule) pamukenza wemapapu . Iyi kuedza inotarisa "chinotaridzika" gadziriro-gadziriro-kureva, kuchinja kwekenza masero ayo "anotengesa" kenza, yakawanda yadzo iye zvino ine mishonga inowanikwa.
- Kutarisa rudzi rwemapapu emapapu .
- Kubatsira kutora danho remukenza wemapapu unozivikanwa.
Mwenje Inopisa Nyaya uye Nzira
Kune dzimwe nzira ina dzinokosha idzo vanachiremba vanogona kuita biopsy nzvimbo yekufungidzira mapundu emapupa:
- Nyeredzi yenzano yakashongedzwa (dzimwe nguva inonzi inonzi nheyo yebiopsy kana kuti inoshandiswa nenyuchi biopsy)
- Transbronchial biopsy (yakaitwa munguva yebronchoscopy uye endobronchial ultrasound)
- Chirwere chechirasiko
- Vhura mapapu emapapu
Ngatitarisei pane imwe neimwe yemitemo iyi zvakasiyana.
Nyore Yakagadzikana Nyuchi
Muchidimbu chengano ine mapapu emapapiro , vanachiremba vanoisa nheyo refu kuburikidza nemashure mako uye mumapapu enyu kuti vawane shanduko yemashizha. Izvi zvinoitwa nekushandiswa kweT CT scanner kana ultrasound kuti ibatsire kutungamirira nenyuchi panzvimbo yakakodzera. Nyoyo biopsy ndiyo nzira inonyanya kushandiswa yekuenzanisa nzvimbo inoshungurudza mumapapu ako, asi haisi nguva dzose kuwana mishonga yakawanda yekuita zvakakwana kuongororwa. A sindano mapapu biopsy inonziwo "transthoracic" biopsy kana kuti "percutaneous" biopsy.
Transbronchial Biopsy
A bibrsy transbronchial inogadzirwa panguva yebronchoscopy , nzira iyo nzvimbo inotungamirirwa nayo kubva mumuromo wako uye kumhepo yepamusoro yemapapu ako. Nekubatsira kwe ultrasound ( endobronchial ultrasound ), vanachiremba vanokwanisa kutungamirira nenyuchi munzvimbo inoshungurudza uye kuwana sampuli (transbronchial needle aspiration.) Iyi nzira inoshanda zvikuru kana kusina kufanana kana tumarara zviri mukati kana pedyo nemhepo huru mapapu.
Chirafu chinonzi Thoracoscopic Biopsy
Mune mapapiro emapapiro anonzi thoracoscopic, chiyero chinowanikwa kuburikidza nerusvingo rwechifuva uye munharaunda yemapapu kuti ive yakashongedzwa.
Munguva yechiroscopic biopsy, vhidhiyo kamera inoshandiswa kubatsira vanachiremba kuwana uye kushandura nzvimbo yezviviri. Munzira iyi, inozivikanwawo sevhidhiyo inobatsira chirwere chinonzi thoracoscopic (VATS), vanachiremba vangave vakakwanisa kubvisa nzvimbo yezvimedu zvinoshungurudza kana lobe yemapapu ane kenza. (Cherechedza: Havazoiti izvi pasina kukurukurirana izvi nemwi musati waita.)
Vhura Mungozi Chirwere
Sezvo nzira inonyanya kukuvadza yekuenzanisa mishonga, mapapu emapapu akazaruka dzimwe nguva anodiwa kuenzanisa mishonga apo dzimwe nzira dzakakundikana. Iyi ndiyo nzira huru yekuvhiya, yakaitwa pasi peaneshesia yakawanda. Inogona kuda kuparadzanisa nenyuchi kana kubvisa chikamu chebvu kuti uwane mapapu.
Dzimwe nguva, bhiopsy yakasununguka inoitwa sechikamu chekuvhiya kubvisa mazuru kana masero, kunyanya kana chiremba wako achiziva kuti une kenza.
Liquid Biopsy
Mvura yakasvibirira inzvimbo inofadza inodzidza kuongorora kenza yemapapu. Iyi nzira, inoda kuti ropa risiri rikwekwe, rinotarisa kupararira kwemasero emukenza kuitira kuti iongorore DNA yemararamiro yevatyairi-mutende-kutenderera-kureva, kuchinja mumasero ekenza majekesheni chaiwo angawanikwa. Dzimwe nguva kana chirwere chemapapu chiripo, vanachiremba havakwanisi kutora mishonga yakakwana kuti vaite izvi kuedza, uye mvura yakasvibirira inogona kuita kuti zviwanikwa izvi zvivepo kunze kwekunge vatevere humwe hutachiona.
Muna June 2016 yekutanga mvura inonzi biopsy yakagamuchirwa kuti ione kuchinja kwe EGFR kune vanhu vane kenza isiri duku yemapapu emapapu.
Migumisiro yeMapungiro Ako Nyuchi
Kana chiremba wako achikwanisa kuwana mukana wakanaka wezvinyama, iwe unogona kunge uchinzwa pamusoro pemigumisiro mukati memazuva maviri kusvika matatu-kunyange izvi zvinotora nguva yakareba, kunyanya kana vanopfuura imwe nyanzvi vachida kudzorera mhinduro. Zvinobatsira kubvunza chiremba wako panguva yekutongwa apo iwe unogona kutarisira kunzwa zvinowanikwa, uye kana iwe uchagamuchira foni kana iwe unofanirwa kutora nguva yekudzidza nezvemigumisiro. Vamwe vanachiremba vanonzwa vakasununguka kukushevedza pafoni kuti vakuzivise zvavanowana apo vamwe vangada kuisa sarudzo yekutevera kuti iende pamusoro pemigumisiro.
Ichi chinyorwa chinotaura nezvekuti unganzwisisa sei ruzivo rwehutano hwako kubva kumapapu ako.
Kunyange zvazvo chiremba wako angave ane pfungwa yakanaka yezvaizowanikwa, hazvisi zvisizvo kuti vanachiremba vaite zvakaipa mushure mekuona mufananidzo wezvigunwe. Mikana yekusakosha kuva kenza inoenderana nezvimwe zvinhu, imwe yadzo inosvika. Mhotukari yakakomberedzwa (mavara pamapapu anenge masendimita masendimita maviri kana kuti pasi) haashoma kuva akaipa kupfuura mapapu emapapu (nzvimbo pamapapu ayo makuru kupfuura masentimita matatu muhukuru). Nyora yezvimwe zvinokonzera zvinogona kuonekwa kuburikidza nekushambadzira pane zvinyorwa pasi apa.
Pane imwe nguva, muenzaniso wezvigunwe hazviratidzi kurwara. Mharidzo yakadai seyi inogona kudzorerwa se "isina kufanira." Kana zvakadaro, pane zvimwe zvingasarudzwa. Kana uwandu huri pasi kuti kusakosha mubhokisi rako ndikenza, unogona kusarudza kumirira uye kuita kudzokorora kuve mwedzi mishomanana. Saizvozvowo, kunyange kana iyo iyo inogona kuva nekenza uye ine kunyatsoongorora chirwere haizogadziri kurapwa, iwe ungasarudza kumirira.
Kana kune rumwe rutivi, kuongororwa kwakakosha, iwe nachiremba wako angasarudza kudzokorora biopsy kana kuwana nzira dzakasiyana dzekuwana shanduro yemavara.Ungadzidza zvakawanda pamusoro pemusiyano pakati pezvirwere zvinopisa uye zvinotyisa uye nei uchiita kuti kusiyana dzimwe nguva zvakaoma.
Molecular Profiling
Zvakakosha kucherechedza kuti munhu wose ane kenza yemusero wemapapu isiri duku inofanira kuva nejeri kuongororwa (kufungidzirwa kwema molecular) yakaitwa pachirwere chavo. Taura nechiremba wako kana usina kunzwa izvi zvataurwa. Iye zvino, mishonga inobvumirwa kune avo vane rearrangements dzeAlk , EGFR mutations , uye reRrang1 rearrangements uye mishonga kune zvimwe zvinogadziriswa zvinogadziriswa zviri kuitwa mumakiriniki ekuedzwa.
Ngozi dzeMapuranga Anopera
Ngozi dzemapapu zvinopesana zvichienderana nemhando yehutano, nzvimbo yemaviri uye hutano hwako hwose. Matambudziko anowanzobuda ari kubuda ropa kana kuti mweya unoputika kubva pamapapu ako. Zvimwe zvinetso zvinogona kuitika zvinosanganisira:
- Pneumothorax - kuwa kwemapapu (mumhepo inoputika) - Kana iwe ukakurira pneumothorax semugumisiro wehupopi, chirwere chako chinoda kuisa chikwama chepfu . Iyi ibhu rinobvumira mweya kuti ubudise mapapu ako kusvikira mweya uchinge wakanyarara.
- Bleeding.
- Kurwara.
- Ngozi yeanesthesia. Zvose munharaunda anesthesia uye general anesthesia inogona kutakura matambudziko.
- Mhepo yakagadzikana inogadziriswa - Kuvhuvhuta kwemweya mumatambudziko makuru anogona kufamba kumwoyo; iyo inonzi inonzi systemic air embolism, inowanikwa mune zvishoma pasi peyendi yezana yenzano mapapu biopsies.
- Kumhanyira "mbeu" - Pane mungozi yekufungidzira kuti tumarara ichapararira panzira yechiringano bhiopsy apo nheyo yebiopsy yapera. Iyi njodzi haigoni, uye panguva yazvino, nhengo yealopiyo inoonekwa seyo nzira yakachengeteka yekutora biopsy yemapapu painodiwa.
Manzwiro Ako Pamberi Pemhembwe Chirwere
Chero chikonzero icho chiremba wako akakurudzira chirwere chemapapu, kusava nechokwadi kunogona kuva kwakaoma kutsungirira. Vanhu vazhinji vakataura kuti vanonzwa vakasununguka murugare nematambudziko anozivikanwa kupfuura kurarama mune imwe nzvimbo yekusaziva.
Vimba pamhuri yako neshamwari nenguva ino. Itai kuti vanhu vazive kuti vachakubatsira kuti utsungirire kumirira, sekune avo vanowanzosimudza. Iyi inguva yakafanira nguva yekukumbira vadiwa venyu kuti varege "kuongorora" iwe kusvikira iwe uchiziva zvakawanda, uye kurega kugovera nyaya dzavo (zvatinoshevedza nhau dzekutya) pamusoro pevamwe vakatarisana nezvimwe zvakafanana.
Kana pfungwa dzako dzichienda kumamiriro ezvinhu akaipisisa, ramba uchifunga kuti mishonga inogara ichichinja. Kana iwe uine humwe hunoona hukuru vako makore akapfuura, hazvirevi kuti iwe uchava nechiitiko chakafanana. Paiva nemishonga mitsva yakagamuchirwa kuitira kurapwa kwemukenza wemapapu pakati pa2011 na2016 kupfuura munguva yemakore makumi mana apfuura gore ra2011.
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