Maselo amodzi okha omwe amatha kuchiza ubongo wina popanda opaleshoni
Radiyo ya Gamma Knife ndi njira yopangira opaleshoni yomwe imagwiritsa ntchito poyesa kuwononga malo a minofu. Ngakhale kuti amatchedwa opaleshoni, ndondomeko ya Gamma Knife imaphatikizapo kusakaniza kapena scalpel.
Njirayi imakhala yovuta kwambiri kuposa opaleshoni yowonongeka ndipo imapereka chanzeru kwambiri pakuchita ntchito zovuta, makamaka pa ubongo.
Chifukwa chaichi, ma opaleshoni a Gamma Knife amatha kuchitidwa pafupipafupi kapena ali ndi chipatala usiku wonse.
Mbiri
Kuyambira koyamba mu 1949 katswiri wa sayansi ya sayansi ya ku Sweden, dzina lake Lars Leskell, anayamba kupanga tizilombo toyambitsa matenda.
Zojambula zoyambirira za Leskell za chipangizo chogwiritsa ntchito X-ray, proton, ndi gamma zamtundu wina popereka chingwe chochepa cha ma radiation kupita ku mfundo yovuta ya ubongo. Pogwiritsa ntchito ma radiation ochokera m'magulu angapo, matabwa omwe amatha kusintha angapereke mlingo woopsa kuti uwononge matenda, kutseka mitsempha, kapena kutseka mitsempha ya magazi popanda kuwonongeka kochepa.
Leskell anadziwitsa gulu la Gamma Knife m'chaka cha 1968. Pofika m'ma 1970, Gamma Knife inali ya stereotactic (itatu-dimensional approach) yomwe imayambitsa mafilimu (MRI) ndi computed tomography (CT) . Gulu loyamba la Gamma Knife linangobweretsedwa ku United States mu 1979 mu dongosolo pakati pa Leskell ndi yunivesite ya California, ku Los Angeles.
Masiku ano Gamma Knife ndi chizindikiro cha Elekta Instruments, Inc. ku Stockholm, Sweden.
Momwemonso Ma Radiosurgical Devices
Kuphatikiza pa chipangizo cha Leskell, chida chomwecho chotchedwa linear particle accelerator (Linac) chinakhazikitsidwa mu 1952 ngati mawonekedwe a mankhwala ochepa kwambiri.
Zinali mu 1982 zokonzanso zomwe zidapangidwa kuti zigwiritsidwe ntchito pa radiyo.
Chipangizo cha Linac chimasiyana ndi Gamma Knife kuti chimagwiritsidwa ntchito makamaka pa mankhwala a radiation m'magulu angapo a thupi. Gamma Knife, mosiyanitsa, imagwiritsidwa ntchito kokha ku ubongo wa ubongo. Komanso, chipangizo cha Linac chimafuna teknoloji ndi luso lapamwamba kwambiri ngati zimagwiritsidwa ntchito pazitsulo zamagetsi komanso zimapanga mtanda waukulu kwambiri poyerekeza ndi Gamma Knife (1.1 millimeters peresenti ya 0.15 millimeter).
Lingaliro latsopano lomwe linatchedwa Linac Cyberknife linayambitsidwa mu 2001 ndipo makamaka limatsanzira Gamma Knife mu lingaliro. Chipangizocho, chikugwiritsidwa ntchito pazombo zowonongeka, zimapereka ma radiation opangidwa kuchokera m'magulu angapo koma, mosiyana ndi Gamma Knife, sinawonetsere kupulumuka kwa chiwerengero cha matenda opatsirana pogonana.
Mtundu wotsiriza wa radiosurgery, wotchedwa proton beam treatment (PBT) , umagwiritsa ntchito mtanda wa proton particles kuti uwononge minofu ya matenda. Komabe, kafukufuku wa 2012 kuchokera ku American Society of Radiation Oncology anatsimikizira kuti PBT siidapindule ndi mitundu yowonjezereka ya mankhwala opatsirana ndi mphamvu kupatulapo khansa ya ana ya pakatikati ya mitsempha, maso oopsa a maso , ndi khansa ya mafupa.
Ngakhale kupindula kwa PBT, mtengo wapadera wa dongosolo (pakati pa $ 100 mpaka $ 180 miliyoni) zimapangitsa kukhala kosatheka kwa zipatala zambiri.
Zinthu Zinachitiridwa
Kawirikawiri Gamma Knife ya radiosurgery imagwiritsidwa ntchito pochizira matumbo ndi zilonda zina mu ubongo. Koma zingakhalenso zothandiza pakupweteka ululu wina komanso kusokonezeka kwa kayendetsedwe ka ubongo komanso zovuta za ubongo.
Gamma Knife imagwiritsidwa ntchito makamaka pofuna kuthana ndi izi:
- Matenda a mitsempha (khansa yomwe yafalikira ku ubongo kuchokera m'mimba mwa ziwalo zina)
- Glioblastoma (mtundu wa khansara ya ubongo)
- Acoustic neuroma (chotupa chosasunthika chomwe chimachokera kumutu wamkati kupita ku ubongo)
- Meningioma (chotupa chosasunthika chomwe chimachokera ku ma membrane ozungulira ubongo ndi msana)
- Pituitary adenoma (chotupa chosasunthika cha gland pituitary)
- Matenda a Cushing ( matenda osokoneza thupi omwe thupi limapanga mahomoni ochuluka kwambiri, cortisol, chifukwa chokhala ndi zilonda zam'mimba kapena mankhwala osokoneza bongo monga prednisone )
- Trigeminal neuralgia (vuto limene limapangitsa kuti mafupa a trigeminal apweteke kwambiri amachititsa kupweteka kwa nkhope)
- Kusokonezeka kwakukulu (matenda a ubongo omwe amachititsa kusagwedezeka komanso kugwedezeka kwa thupi, kosagwirizana ndi matenda a Parkinson)
- Matenda osokoneza bongo, kapena AVM (kugwirizana kosagwirizana pakati pa mitsempha ndi mitsempha, kawirikawiri mu ubongo kapena msana)
Radiyo yamagetsi ya Gamma Knife ingagwiritsidwe ntchito pa nthawi imene matenda a ubongo sangathe kuchitika ndi opaleshoni yowonongeka kapena anthu omwe sangalekerere opaleshoni yotseguka monga craniotomy .
Chifukwa zopindulitsa za ndondomeko ya Gamma Knife imawonetsa pang'onopang'ono pakapita nthawi, siigwiritsidwe ntchito kwa anthu omwe chikhalidwe chawo chimafuna mwamsanga kapena mwamsanga mankhwala.
Momwe Ikugwirira Ntchito
Ndondomeko ya Gamma Knife imatchedwa "opaleshoni" chifukwa ikhoza kuchitidwa gawo limodzi ndi zolinga zomwe zimagwira ntchito nthawi zonse. Zotsatira za Gamma Knife zimasiyana ndi mtundu wa matenda omwe amachiritsidwa:
- Pogwiritsidwa ntchito pochizira zotupa, kuwala kwapadera kumawononga DNA mu maselo otupa. Izi zimalepheretsa mphamvu ya selo kubwereza, kuchititsa kuti chotupacho chichepetse.
- Pogwiritsidwa ntchito pofuna kuchiza matenda a ubongo, dothi la ma radiation limayambitsa mapangidwe a mitsempha omwe amalepheretsa zizindikiro za mitsempha.
- Pogwiritsidwa ntchito popanga AVM, Gamma Knife ingachepetse kukula ndi kuchuluka kwa magazi akuyenda m'chombo, motero kuchepetsa ngozi ya kupweteka kapena kupweteka.
Makinawo ali ofanana ndi mapangidwe a MRI kapena CT scan ndi bedi lathyathyathya ndi dome-ngati dome yomwe mutu wanu waikidwa. Sichikuya ngati makina ena, komabe, ndipo amakhala chete kuti simungathe kukhala ndi claustrophobia.
Zimene muyenera kuyembekezera
Ndondomeko ya Gamma Knife imaphatikizapo gulu lachipatala, kuphatikizapo dokotala wodziwika ndi matenda a khansa (dokotala wodwala khansa wodziwika bwino kwambiri), wodwala matenda a ubongo, wothandizira mazira, ndi namwino wovomerezeka. Ndondomekoyi imatha kusiyana mosiyana ndi matendawa koma kawirikawiri imachitidwa motere:
- Mukafika kuchipatala, mudzafunsidwa kuti mugone pabedi lathyathyathya pambuyo pake ngati mthunzi ngati maski kapena mutu wopepuka ukhoza kugwiritsidwa ntchito kuti mukhazikitse mutu wanu ndikusunga kusuntha.
- MRI kapena CT scan idzachitidwa kuti iwonetse malo enieni ndi miyeso ya mawonekedwe ake kapena zosaoneka.
- Malingana ndi zotsatira, gululo lidzapanga mapulani a mankhwala kuphatikizapo nambala yeniyeni yowonekera ndi malo opangira chingwe.
- Pambuyo pokhala pamalo, mutu wanu udzasunthira mu dome, ndipo chithandizo cha ma radiation chidzayamba. Mudzakhala maso komanso ogwirizana kwa madokotala anu kudzera muzolumikizana. Malingana ndi vutoli, ndondomekoyi ikhoza kutenga pena paliponse mphindi zingapo mpaka ola limodzi.
Zotsatira Zochiza Chithandizo
Ngakhale njira ya Gamma Knife yokha ili yopweteka, kugwiritsa ntchito ma radiation nthawi zina kungayambitse zotsatira zoyipa chifukwa makamaka kutupa kwa ubongo. Kuwopsa kwa zizindikiro kumayenderana ndi nthawi ndi malo a chithandizo cha ma radiation ndipo angaphatikizepo:
- Mutu
- Numbness
- Nausea
- Masomphenya a Blurry
- Kufooka
- Kutaya malire
- Kutaya tsitsi (kawirikawiri kanthawi)
- Kugonjetsa
Pangakhale zoopsa zina zogwirizana ndi matenda anu enieni. Onetsetsani kuti mungalankhule ndi dokotala wanu musanayambe kutsatira njira ya Gamma Knife.
Mphamvu
Radiyo yamagetsi ya Gamma Knife yatsimikizirika kuti ikugwira ntchito pochizira zilonda zoopsa kapena zowopsa mpaka masentimita anayi (pafupifupi 1½ mainchesi) kukula. Kwa anthu omwe ali ndi khansara ya ubongo , njirayi imawoneka kuti ikugwira ntchito popereka chithokomiro ndikuwonjezera nthawi yamoyo.
Mavuto opambana amasiyana malinga ndi momwe amachitira, motere:
- Ponena za AVM, radiosurgery imaonedwa ngati njira yoyamba ya mankhwala masiku ano ndipo imakhala ndi chithandizo cha mankhwala pakati pa 54 peresenti ndi 92 peresenti malingana ndi malo a chotengera.
- Panthawiyi, maphunziro a 2016 ochokera ku Ulaya adanena kuti anthu omwe ali ndi trigeminal neuralgia amapindula kwambiri ndi ndondomekoyi, ndipo 71,8 peresenti akhalabe opanda ululu kwa zaka zitatu ndipo 45.3 peresenti akhala opanda zopweteka kwaposa khumi.
- Mofananamo, kafukufuku wa maphunziro a kachipatala a 2012 adanena kuti 88,3 peresenti ya anthu omwe amachitira mankhwala oponderezedwa amatsitsimutso abwino pambuyo pa miyezi 24.
- Phunziro la 2013 kuchokera ku yunivesite ya Virginia School of Medicine linawonetsa kuti njira ya Gamma Knife inapatsa 98 mphamvu zowononga zokhudzana ndi matenda a Cushing kwa nthawi ya phunziro la zaka zinayi.
Mavuto aakulu omwe akutsatiridwa ndi Radiyo ya Gamma Knife amawoneka kuti ndi osowa, omwe amakhala okhudzana kwambiri ndi vutoli m'malo mwa njira yokhayo.
> Zotsatira:
> Ohye, C .; Higuchi, Y .; Shibazaki. T. et al. "Mpeni wamagetsi wotchedwa thalamotomy wa matenda a Parkinson ndi kuwopsya kwakukulu: Phunziro lokhala ndi multicenter." Neurosurgery. 2012; 70 (3): 526-35. DOI: 10.1227 / NEU.0b013e3182350893.
> Park, H ;; Wang, E ;; Ruffer, C. et al. "Kusintha kagwiritsidwe ntchito ka Gamma Knife motsutsana ndi ma radio radiurgurgery omwe amagwiritsa ntchito mofulumira kwambiri a ubongo ku United States." J Neurosurg. 2016 ; 124 (4): 1018-1024. DOI: 10.3171 / 2015.4.JNS1573.
> Plasencia, A. ndi Santillan, A. "Kukhazikitsa ndi mafilimu opangira mavutowo." Opaleshoni Neurol Int . 2012; 3 (Suppl 2): S90-S104. DOI: 10.4103 / 2152-7806.95420.
> Regis, J ;; Tuleasca, C ;; Ressequier, N. et al. "Kukhalitsa kwa nthawi yaitali komanso kuthandizira kwa opaleshoni ya Gamma Knife mu classical trigeminal neuralgia: wophunzira wazaka 497 wolemba mbiri yakale." J Neurosurg. 2016; 124 (4): 1079-87. DOI: 10.3171 / 2015.2.JNS142144.
> Sheehan, J .; Xu, Z .; Salvetti, D. et al. "Zotsatira za opaleshoni ya gamma wakupha kwa Cushing's Disease." J Neurosurg. 2013; 199 (6): 468-92. DOI: 10.3171 / 2013.7.JNS13217.