Dhiyabhorosi-miviri yakakwana inogona kukwanisa humwe hutano hwehuropi pasina chirwere
Gamma Knife radiosurgery inoshandiswa pakushandura kwakanyanyisa umo danda rakanyatsotarisa remirairo rinoshandiswa kuparadza zvakananga nzvimbo dzemaviri. Kunyange zvazvo inonzi chirwere, chirongwa cheGamma Knife chinosanganisa kusanzwisisika kana kuvhara.
Nzira yacho inonyanya kusvibiswa kupfuura chirwere chenguva dzose uye inopa kunyatsogadzirisa paunenge uchiita basa rakaoma, zvikurukuru muuropi.
Nemhaka yeizvi, chirwere cheGamma Knife chinogona kuitika pamusana pechirwere chekare kana kuti nekugara kuchipatara kugara.
Nhoroondo
Stereotactic radiosurgery yakatanga kuumbwa muna 1949 neSweden neurosurgeon Lars Leskell nechinangwa chekubata nzvimbo shoma dzeuropi pasina kukuvadza mimwe michina.
Leskell's early designs for the device used X-ray, proton, and later gamma rays to deliver a radiation of radiation to a point on the brain. Nokutungamirira mazaisai kubva mumakumbo akawanda, mishonga inoshanduka inogona kuunza dambudziko rinouraya kuparadza matumbu, kubvisa mitsetse, kana kupfigira midziyo yeropa pasina kukuvara kwakanyanya.
Leskell akazarura mutemo weGamma Knife muna 1968. Pakazosvika 1970, Gamma Knife yakanga yakazara stereotactic (nhatu-dimensional in approach) nekuiswa kwe magnetic resonance imaging (MRI) uye computed tomography (CT) . Gamba rekutanga raGamma Knife rakauyiswa neUnited States muna 1979 mune urongwa pakati peLeskell uye University of California, Los Angeles.
Iyo Gamma Knife ndiyo nhasi marongerwo akanyorwa akanyorwa eElta Instruments, Inc. muStockholm, Sweden.
Saizvozvowo Radiosurgical Devices
Mukuwedzera kune imwe yeLeskell, chimbo chakafanana chinonzi linear particle accelerator (Linac) chakaumbwa muna 1952 sechimiro chemazana akawandisa (multi-dose) remishonga inonzi radiation.
Kwaingova muna 1982 kuti kugadziriswa kwechigadzirwa chacho kwakabvumira kuti ishandiswe murasiyo.
Imwe ye Linac yakasiyana neGamma Knife mune iyo inoshandiswa kunyanya kumushonga weradiation muzvikamu zvakawanda zvemuviri. Izvozvi Gamma Knife, zvakasiyana, inoshandiswa inenge inoshandiswa chete neuropi yehurogiurgeri. Uyezve, chidimbu chinonzi Linac chinoda teknolojia yakawanda zvikuru uye unyanzvi kana yakashandiswa pakurasirairi uye inopa bhuru rakareba zvakadanidza Gamma Knife (1.1 millimita kusvika 0.15 millimita, maererano).
Imwe pfungwa itsva inonzi Linac Cyberknife yakatangwa muna 2001 uye inonyanya kufanana neGamma Knife mupfungwa. Chigadzirwa chacho, chakasungirirwa paine robotic, chinounza mazai akachengetedzwa kubva kumakumbo akawanda asi, kusiyana neGamma Knife, haina kuratidza huwandu hwehupenyu hunoenzaniswa kana huchienzaniswa nemamwe marudzi erapa inorapwa mahara.
Rudzi rwekupedzisira rwemaharasurgery, rinozivikanwa paproton beam therapy (PBT) , rinoshandisa danda reproton michina kuti irradiate zvirwere zvinorwara. Zvisinei, chidzidzo che2012 kubva kuAmerican Society of Radiation Oncology yakagumisa kuti PBT haina kupa rubatsiro pamusoro pemhando dzakasiyana-siyana dzehutachiona hwehutachiona kunze kwevana vemukondombera hwehutachiona hwehutachiona, maziso anonzi melanoma , uye chordomas (rudzi rwekenza yemapfupa).
Pasinei nezvinogona kubatsirwe kwePBT, mari inoshamisa yehurongwa (pakati pe $ 100 kusvika ku $ 180 mamiriyoni) inoita kuti irege kushandiswa kwezvipatara zvakawanda.
Mamiriro Ekutongwa
Gamma Knife radiosurgery inowanzoshandiswa kurapa matumire nezvimwe zvipembenene muuropi. Asi zvinogonawo kubatsira mukurapa marwadzo ega uye kushungurudzika kwechikwata pamwe nekusawirirana kwezvipembenene muuropi.
Iyo Gamma Knife inonyanya kushandiswa kugadzirisa zvinotevera:
- Brain metastases (kanzira dzakapararira kuuropi kubva mumatumbu mune dzimwe nhengo)
- Glioblastoma (rudzi rwechirwere chepfungwa)
- Acoustic neuroma (iyo isina kugadzirisa tumarara pamutsara unotungamirira kubva munzeve yomukati kuenda kuuropi)
- Meningioma (inowanzosava nechokutupa inomuka inobva pamaberere akakomberedza uropi nemutsipa wesipinha)
- Pituitary adenoma (iyo isina kugadzirisa tumarara yeplandia gland)
- Chirwere cheCushing (chirwere chisina kuchena umo muviri unobereka huwandu hwemakemikari anokonzera kushungurudzika, cortisol, zvichienderana nekunakidza tumarara kana mishonga inonzi steroid sezvakaitwa prednisone )
- Trigeminal neuralgia (mamiriro ezvinhu umo kushungurudzika kwetatu kunokonzera kurwadziwa kwakakomba kumeso)
- Zvinonyanya kudengenyeka (chirwere chepfungwa chinokonzera kusagadzikana uye kugadzikana kwemashoko, kusina kufanana nechirwere chePasinson)
- Arteriovenous malformation, kana AVM (kushamwaridzana kusinganzwisisiki pakati pemishonga uye mitsipa, kazhinji muuropi kana musana)
Gamma Knife radiosurgery inogona kushandiswa mumamiriro ezvinhu apo chirwere cheuropi hachikwanisi kuwanikwa nekuvhiyiwa kwemazuva ose kana kuvanhu vasingakwanisi kubvumira chirongwa chekuvhima chakazaruka chakadai sekrianiotomy .
Nemhaka yokuti zvinobatsira zveGamma Knife zvinoratidzika zvishoma nezvishoma pamusoro penguva, hazvishandisi vanhu vane mamiriro ezvinhu anoda nguva pfupi kana kukurumidza kurapwa.
Iyo Inoshanda Sei
Iyo Gamma Knife nzira inonzi "kuvhiyiwa" nokuti inogona kuitwa muchikamu chimwe chete nemakirinikichetechete emakiriniki ekugara achishanda. Migumisiro yeGamma Knife yakasiyana nerudzi rwechirwere chinotapwa:
- Kana yakashandiswa kurapa tumarara, majekesa anoisa pfungwa paanovhiringidza DNA mumasero emarara. Izvi zvinovhiringidza kukwanisa kwema cell kuti adzore, zvichiita kuti chironda chacho chive chichikanganiswa.
- Kana ishandiswa kugadzirisa zvirwere zvepfungwa, danda remirairo rinokonzera kuumbwa kwechigunwe chinodzivirira nerve zviratidzo.
- Kana yakashandiswa kuronga AVM, Gamma Knife inogona kuderedza ukuru uye kuwanda kweropa rinoyerera mumudziyo, nokudaro kuderedza dambudziko rekuputsika kana kurohwa.
Mushonga wacho pachawo wakafanana mukugadzira kune MRI kana CT scan nebhedha rakasvibirira uye tube-yakafanana nedome umo musoro wako unoiswa. Haisi sepakadzika semamwe mishonga, zvisinei, uye yakanyarara zvachose kuitira kuti iwe usanyanya kunyatsoona claustrophobia.
Zvaunotarisira
A Gamma Knife nzira inowanzobatanidza boka rekurapa, kusanganisira mazairo oncologist (chiremba wekenza unyanzvi mune mazairo), neurosurgeon, muroti wehutachiona, uye mukoti akanyoreswa. Iyo nzira inogona kusiyanisa zvishoma zvichienderana nemamiriro ekurapa asi inowanzoitwa mumatanho anotevera:
- Paunosvika pakurapwa, iwe unogona kukumbirwa kurara pasi pamubhedha wakadzika shure mushure mokunge mesh-seki mask kana chekudzivirira musoro musoro unogona kushandiswa kuti ugadzikane musoro wako uye urichengetedze kubva pakufamba.
- MRI kana CT scan yaizoitwa kuitira kuti ione nzvimbo chaiyo uye zviyero zvechinangwa chairo kana kuti kusakoshesa.
- Maererano nemigumisiro, boka racho richagadzira chirongwa chekurapa kusanganisira nhamba chaiyo yekutsvaira uye kuburitsa danda.
- Mushure mokumiswa munzvimbo, musoro wako waizoendeswa mukati mehara, uye kuporesa kwemaawa kunotanga. Iwe unenge wakanyatsove wakasvinura uye wakabatana kuna vanachiremba vako kuburikidza nehutano hwekunzwa. Zvichienderana nemamiriro acho ezvinhu, nzira yacho inogona kutora chero ipi zvayo kubva pamaminitsi mashomanana kusvika kune awa.
Kuchengetedzwa Kwemazuva Akasiyana
Kunyange zvazvo Gamma Knife nzira yacho pachayo isingabatsiri, kushandiswa kwemazuva ano dzimwe nguva kunokonzera migumisiro yechirwere inonyanya kukosha kuropi kuputika. Kuoma kwezviratidzo kunowanzobatanidzwa nehuwandu uye nzvimbo yehutano hwemaawa uye inogona kusanganisira:
- Headache
- Numbness
- Nausea
- Blurry chiratidzo
- Kushaya simba
- Kurasikirwa kweyero
- Kuora bvudzi (kazhinji kanguva)
- Kugumburwa
Panogona kunge kune dzimwe njodzi dzinobatanidza nehutano hwako hwehutano. Iva nechokwadi chekutaura nachiremba wako pamusoro peizvi usati watanga nzira yeGamma Knife.
Kubudirira
Gamma Knife radiosurgery yakaratidza kubudirira pakurapa zvirwere zvinouraya kana zvinouraya kusvika masendimita mana (inenge 1½ inches) muhukuru. Kune vanhu vane kenza yemukondomu , chirongwa chinoratidzika kuva chakabudirira pakupa tumarara kutonga nekuwedzera nguva dzekugara.
Kubudirira kwehuwandu hunosiyana nemamiriro ekurapa, sezvinotevera:
- NezveVVM, radiosurgery inoonekwa seyo maitiro makuru ekurapa nhasi uye ine chirwere chepuresi iri pakati pe 54 kubva muzana ne92 muzana zvichienderana nenzvimbo yemudziyo.
- Munguva iyi, chidzidzo che 2016 kubva kuEurope chakashuma kuti vanhu vane trigeminal neuralgia vakabatsirwa zvikuru kubva pakurongeka, uye 71.8 muzana vakaramba vasina marwadzo kwemakore matatu uye 45,3 kubva muzana vanoramba vasina marwadzo vanopfuura 10.
- Saizvozvowo, kuongorora kwechirongwa che2011 kuchipatara kwakarondedzera kuti 88,3 muzana yevanhu vakabatwa nokuda kwekumanikidzwa kwakakosha kwakachengetwa zvakanaka-kusvika-yakanakisisa motokari yekugadzirisa mushure memwedzi miviri.
- Chidzidzo che2013 kubva kuYunivhesiti yeVirginia School of Medicine chakaratidza kuti Gamma Knife yakaronga kuti 98 itonge masimba ane chokuita neCushing's disease kwehuwandu hwekudzidza kwemakore mana.
Dambudziko rakaoma rinotevera Gamma Knife rejasipuriro rinonzi harifaniri, uye rinowirirana nechepamusoro pemamiriro ezvinhu zviripo asi nzira yacho pachayo.
> Sources:
> Ohye, C .; Higuchi, Y .; Shibazaki. T. et al. "Gamma knife thalamotomy nokuda kwechirwere chaPacinson uye kudengenyeka kunokosha: Anotarisira kuwanda kwemashoko." Neurosurgery. 2012; 70 (3): 526-35. DOI: 10.1227 / NEU.0b013e3182350893.
> Park, H ;; Wang, E ;; Ruffer, C. et al. "Kuchinja maitiro eGamma Knife kunopesana nhepfenyuro inonzi accereatoric-based stereotactic radiosurgery yeuropi metastases muU.S." J Neurosurg. 2016 ; 124 (4): 1018-1024. DOI: 10.3171 / 2015.4.JNS1573.
> Plasencia, A. uye Santillan, A. "Kubata nekudhirogiyuta kwekutadza kwemashoko." Surgery Neurol Int . 2012; 3 (Suppl 2): S90-S104. DOI: 10.4103 / 2152-7806.95420.
> Regis, J .; Tuleasca, C .; Ressequier, N. et al. "Kuchengetedza kwenguva refu nekubudirira kweGamma Knife kuvhiyiwa mu classical trigeminal neuralgia: a 497-murwere wekare wekudzidza." J Neurosurg. 2016; 124 (4): 1079-87. DOI: 10.3171 / 2015.2.JNS142144.
> Sheehan, J .; Xu, Z .; Salvetti, D. et al. "Zvibereko zvekugadzirwa kwema gamma kweCushing's Disease." J Neurosurg. 2013; 199 (6): 468-92. DOI: 10.3171 / 2013.7.JNS13217.