Zifukwa za FNA, Ndondomeko, ndi Zotsatira Zotsatira
Dokotala wanu mwina adalimbikitsa FNA (bwino singano) ya chotupa. Kodi ndondomekoyi yachitidwa bwanji, ndi zotsatira zotani zomwe mungayembekezere, ndipo zotsatira zake zingakhale zotani?
Mwachidule
Nthenda yabwino ya singano (FNA biopsy) ndi mayesero owonetsetsa ngati chotupa chiri chosaopsa (osati khansa) kapena choipa (khansa). Mu njirayi, singano yabwino (koma yayitali) imayikidwa pamwamba pa khungu ndi mu chotupa.
Chitsanzo chaching'ono ndi aspirated ndipo singano imachotsedwa.
Chifukwa Chochitira FNA
Ngati dokotala wanu apeza chotupa pachifuwa cha x-ray kapena CT scan, akhoza kudziwa ngati ayi kapena khansa kapena khansa kapena ayi. Komabe zotupa zowononga ndi zosawoneka zingayang'ane zofanana mofanana.
Ndondomeko
Mpweya wabwino wa singano (FNA) umachitika mwa kuika singano yopyapyala kuchokera kunja kwa thupi kulowa mu chotupa ndi kuchotsa maselo omwe angathe kuyesedwa pansi pa microscope. Wodwala akuyang'ana maselo kuti awone ngati chotupa chokayikitsa ndi khansara ndipo ngati ndi khansa, ndi khansa yotani.
Ndi khansara yamapapu , singano imalowetsedwa m'chifuwa kudzera pakhungu pa chifuwa ndi chotupa chimene chimapezeka pamatenda a CT. Madokotala akhoza kutsimikizira kuti singano imapita kumalo abwino a mapapo poyang'ana kudzera mu ultrasound kapena CT scanner. Ngati mankhwalawa amapezeka mosavuta kusiyana ndi omwe ali m'mapapo (mwachitsanzo, maselo amphongo omwe amatha kuoneka), FNA ikhoza kugwiritsidwa ntchito pa sitepi m'malo mwa mapapo.
Phindu
FNA imakhala yochepa kwambiri kusiyana ndi kutseguka kwa mapapo, limodzi kudzera m'kati mwa chifuwa. Phunzirani zambiri za njira zosiyana siyana zomwe zingagwiritsidwe ntchito pofuna kudziwa khansa yamapapo .
Mu kafukufuku wa 2016, zinawoneka kuti FNA idapambana kupeza njira yopezera khansa ya m'mapapo mwadzidzidzi mwa 91 peresenti ya anthu omwe njirayi inkachitidwa.
Ndikofunika kuzindikira kuti njirayi siingatheke kwa zotupa zonse, ndipo sizingakhale zosankha za matenda kumalo ena m'mapapu.
Zolakwika
Mu phunziro lofotokozedwa pamwambapa, anapeza kuti FNA inali yowopsya kwambiri pozindikira mu kansa ya m'mapapo. Izi zinati, FNA nthawi zina ikhoza kubweretsa zotsatira zabwino zabodza, mwazinthu zina, kupeza khansara yomwe siilipo. Mu phunziro ili, anapeza kuti njira yeniyeni ya njirayi inali 81 peresenti, ikutanthawuza kuti pafupi 20 peresenti ya nthawi chithandizo cholakwika cha khansara chingapangidwe. Ichi ndi chifukwa chimodzi chofunikira chomwe madokotala nthawi zambiri amagwiritsa ntchito mayesero osiyanasiyana kuti azindikire khansa ya m'mapapo (kupatula ngati chithunzi chachikulu chikhoza kupezeka poyera.)
Mavuto
Pali zovuta zambiri zomwe zingatheke ndi FNA, koma kawirikawiri, njirayi ndi yoperewera kwambiri komanso yowonjezera kuposa njira zina zopezera zitsanzo zapadera.
- Kusuta - Inu dokotala adzakuuzani za mankhwala omwe mumatenga omwe angapangitse nthawi yakupha. Ndikofunika kuzindikira kuti zakudya zina zowonjezera zakudya ndi zowonjezera zowonjezera zikhoza kuwonjezera nthawi yowononga ndi kuwalola dokotala wanu kudziwa za mankhwala owonjezera kapena mankhwala omwe mumagwiritsa ntchito. Kupuma kwa magazi (pulmonary hemorrahge) kawirikawiri kumapezeka kwa anthu okalamba.
- Pneumothorax - Kuthamanga kwa mpweya kumakhala kovuta, ndipo mpweya wotuluka mumlengalenga umachitika pakati pa theka la anthu omwe amachita izi. Ngati pneumothorax imachitika, chifuwa cha chifuwa chiyenera kuikidwa. Nthawi zina phukusi la chifuwa liyenera kumasiyidwa m'malo kwa nthawi mpaka mapapu anu ayambe kuwonjezeka ndipo pneumothorax yathetsa.
- Kutulutsa mimba - Pali chiopsezo chakuti FNA ingabweretse mimba. Lingaliro ndiloti maselo ena amachotsedwa kupyola muzitsulo akhoza kusiya m'mbuyo mwa singano pamene achotsedwa. Ngati izi zitachitika, maselo amatha kukula pamalo omwe anasiyidwa kumbuyo ndikuyamba chotupa chatsopano (metastasis).
Kupeza Zotsatira Zanu
Lankhulani ndi dokotala wanu pa nthawi ya biopsy ndikufunseni pamene akuyembekezera kuti zotsatira zikhalepo? Kodi mungayitanidwe pa foni kapena mukufunikira kukhazikitsa ntchito yosiyana kuti mukambirane zotsatira?
Zomwe zimadziwika kuti: nsale ya aspirational biopsy (NAB), yabwino ya singano aspiration cytology (FNAC)
Zotsatira:
Capalbo, E., Peli, M., Lovisatti, M., Cosentino, M., Mariani, P., Berti, E., ndi M. Cariati. Kutupa kwa Thoracic ya Mitsempha Yamimba: FNAB kapena CNB? Zochitika Zathu ndi Kuwerengera kwa Mabuku. La Raiologica Medica . 2014. 119 (8): 572-94.
Sangha, B., Hague, C., Jessup, J., O'Connor, R., ndi J. Mayo. Transthoracic Computed Tomography-Yotsogoleredwa Mng'oma Yopopayi: Kuyerekezera Ndalama Yaikulu ndi Njira Zabwino Zopangira Mpweya. Canadian Association of Radiologists Journal . 2016. 67 (3): 284-9.