Mwachidule
Nthenda yotchedwa endobronchial ultrasound ndi njira yachipatala yomwe ingathe kuchitidwa pa bronchoscopy, kuti mudziwe zambiri kuti mudziwe kapena kuti mudziwe siteji ya khansa ya m'mapapo. Njira yatsopanoyi imalola madotolo kuyang'ana madera a mapapu anu ndi malo oyandikana ndi chifuwa omwe mwachizoloŵezi amafuna njira zambiri zochitiramo opaleshoni kuti aziwunika.
Ndondomekoyi imachitika ngati njira yapadera yochitidwa opaleshoni kapena opaleshoni ya tsiku lomwelo ndipo imaonedwa ngati njira yowonongeka.
The Procedure
Chimake chotchedwa endobronchial ultrasound nthawi zambiri chimagwira pansi pa "njira yowonongeka" kutanthauza kuti mudzakhala ogona kwambiri ndipo simungamve bwino, koma simudzakhala tulo tofa nanu monga momwe mungakhalire ndi anesthetic. Komabe, ndondomekoyi ikhoza kuchitidwa ndi kugwidwa kowopsa kwa thupi ngati kuli kofunikira.
Musanapange mankhwala otchedwa endobronchial ultrasound, adokotala anu amayamba kupanga bronchoscopy. Mu njira ya bronchoscopy , chubu imayikidwa kudzera pakamwa panu kapena mphuno mwanjira yanu (mphepo yanu) ndiyeno mumalowa akuluakulu akulowera m'mapapu anu. Pambuyo pa chubuyi, madokotala amatha kugwiritsa ntchito chipangizo chodziwika bwino kuti atumize mafunde (ultrasound) kudzera m'makoma a mpweya wanu kupita kumadera oyandikana nawo, kuphatikizapo mapapo ndi mediastinum (malo omwe ali pamapapo).
Ngati malo osadziwika akuwonekera pa ultrasound, dokotala wanu akhoza kutenga chotupa cha minofu ndi singano yaying'ono yotsogoleredwa ndi ultrasound. Njira imeneyi ya biopsy imatchedwa transbronchial singano ultrasound. Nthano imayambika kudzera pakhoma la panjira yanu ndi m'mapapo anu a mapapo, pamene dokotala wanu amatha kuyang'ana nthawi yeniyeni pa ultrasound komwe kumene singano ikupita Pali chipangizo chaching'ono kumapeto kwa singano ichi chomwe chingatenge chitsanzo cha malo okayikira.
Pambuyo pomaliza ndondomeko yanu, zitsanzozo zimatumizidwa ku labu kuti ziwone kupezeka kwa khansa, kapena zina zolakwika.
Zisonyezo
Pofuna kupatsa chithandizo chabwino kwambiri cha khansara yamapapo, ndikofunikira kumvetsetsa siteji ya khansa yamapapo - ngati, ndi kutalika bwanji, khansara yayamba kufalikira. Kulemba molondola kungachepetse kuchuluka kwa minofu yomwe imachotsedwa pa opaleshoni ya khansa yamapapo . Zingakuthandizeninso kuti musapite opaleshoni yosafunikira ngati khansa yanu ingathandizidwe mwanjira ina, monga mankhwala a chemotherapy, mankhwala ochiritsira, mankhwala, ma ARV kapena kuphatikizapo mankhwalawa.
Mwachizoloŵezi, kugwiritsira ntchito molondola kumafuna zoyezetsa zosavuta monga mediastinoscopy ndi ena opaleshoni yamphongo monga thoracoscopy kapena thoracotomy. Thoracoscopy ndi ndondomeko yofanana ndi opaleshoni ya laparoscopic pamimba, koma imapangidwa pachifuwa. Thoracotomy ndi opaleshoni yamatsegulira pachifuwa yomwe nthawi zambiri imadula kudula ndi kuchotsa nthiti kapena nthiti. Nthaŵi zina, mankhwala otchedwa endobronchial ultrasound angapatse madokotala chidziwitso chomwe akufunikira kuti apange khansara popanda kupatsirana njira zowonongekazi.
Kuwonjezera pa njira yochepetsera, ulonda wa endobronchial ukhoza kuthandiza madokotala kupeza zovuta kuti afikitse madera.
Nthawi zina imatha kudziwa zambiri, komanso maselo aang'ono omwe amatha kuwonedwa ndi miyambo yamtunduwu.
Zifukwa zinayi zikuluzikulu dokotala angakulimbikitseni kuti mukhale ndi ultrasound endobronchial:
- Kufufuza kukhalapo kwa zotupa kapena zam'mimba zowonjezera .
- Kupeza zotupa m'mapapo.
- Kufufuza ma lymph nodes mu mediastinum (malo pakati pa mapapo) kapena kanyumba (malo omwe ali pafupi ndi mapapo.)
- Kupeza zotupa mu mediastinum.
Kuwonjezera pa matenda opatsirana khansa ya m'mapapo, nthenda yotchedwa endobronchial ultrasound ingagwiritsidwe ntchito pozindikira kuti matendawa ndi othandizira kupeza matenda opweteka monga sarcoidosis .
Kubwezeretsa
Anthu ambiri amavomereza njirayi bwino ndipo amatha kuchoka kuchipatala tsiku lomwelo njirayi ikuchitika. Ndondomekoyi sikutanthauza zochitika zilizonse ndipo ikukhala mchitidwe wosamalira padziko lonse.
Mavuto
Zovuta za endobronchial ultrasound makamaka zomwe zikhoza kuchitika chifukwa cha bronchoscopy kapena chifukwa cha biopsy palokha. Izi zimaphatikizapo kutaya mwazi, matenda, kugwa kwa mapapo, kapena mavuto okhudzana ndi anesthetics omwe apatsidwa kuti achite.
Zotsatira:
Mphuno, F. Bronchoscopy / Endobronchial Ultrasound. Malire mu Mankhwala Opatsirana ndi Mafilimu . 2010. 42: 55-62.
Kinsey, L, ndi D. Arenberg. Endobronchial ultrasound-yomwe inatsogoleredwa ndi transbronchial singano yakufuna kwa kansalu yopanda khansa ya mapapo. American Journal of Respiratory and Critical Care Medicine . 2014. 189 (6): 640-9.
Yasufuku, K. et al. Udindo wa endobronchial ultrasound-wotsogoleredwa ndi transbronchial singano yakufuna mu kuyang'anira khansa yamapapo. General Thoracic ndi Opaleshoni ya Mtima . 2008. 56 (6): 268-76.
Yasufuku, K. Endobronchial ultrasound: Zizindikiro, zotsutsana, ndi zovuta. Zaposachedwa. Kusinthidwa 01/08/16. http://www.uptodate.com/contents/endobronchial-ultrasound-zidziwitso-zidziwitso-ndizo