Zvinoenderana nedata rakakodzera reInternational Agency for Research on Cancer (IARC) yeWorld Health Organisation (WHO), gomarara remapapu rave rimwe remamota akaipisisa, uye kudzivirira uye kurapwa kwegomarara remapapu rave chinhu chinonyanya kukosha. yekudzivirira uye kurapwa kwegomarara.
Zvinoenderana neakakodzera manhamba data, chete nezve20% yevasiri diki cell cancer yemapapu varwere vanogona kuvhiyiwa kurapwa.Ruzhinji rwevarwere vekenza yemapapu vatopindamatanho epamusorokana vaongororwa, uye vanogona kuwana mabhenefiti mashoma kubva pachinyakare radiotherapy uye chemotherapy kurapwa.Nekuenderera mberi nekuenderera mberi kwesainzi yekurapa, kubuda kweablative therapysechinotsiva kuvhiyiwa kwaunza tariro itsva yekurapa kuvarwere vekenza yemapapu.
1. Zvakawanda sei zvaunoziva nezve ablative therapy yegomarara remapapu?
Ablative therapy yekenza yemapapu inonyanya kusanganisiramicrowave ablation uye radiofrequency ablation.Nheyo yekurapa inosanganisira kuisa ablative electrode, inozivikanwawo sea"probe,"mubundu riri mumapapu.Iyo electrode inogona kukonzerakukurumidza kufambayezvimedu zvakaita semaion kana mamorekuru emvura mukati mebundu, zvichigadzira kupisa nekuda kwekukweshana, zvichitungamirakukuvara kusingachinjiki senge coagulative necrosis yemamota masero.Panguva imwecheteyo, kumhanya kwekupisa kwekushisa kunoderera nekukurumidza mune yakatenderedza mapapu tishu, kuchengetedza kupisa mukati mebundu, zvichiita"Thermal insulation effect."Ablative therapy inogona kuuraya bundu panguvakuwedzera kuchengetedzwa kweakajairika mapapu tishu.
Ablative therapy inoratidzwa neyokudzokorora, kushomeka kwemurwere, kushungurudzika kudiki, uye kukurumidza kupora,uye yave ichizivikanwa zvakanyanya uye yakashandiswa mumakiriniki maitiro.Nekudaro, tichifunga kuti kurapa kweablative kunosanganisira maitiro akawanda akadai seradiology, oncology, interventional radiology, uye anatomy yekuvhiya, inoda hunyanzvi hwepamusoro hwekuvhiya uye hunhu hwakakwana kubva kuna chiremba anoshanda.
Nhasi, tinoda kukuzivisai nyanzvi ine mukurumbira mundima yekupindira kurapwa,Dr. Liu Chen, anga achishanda mumunda kwemakore akawanda uye akazvipira kukiriniki yekududzira tsvakiridzo uye yakamisikidzwa mukurumbira weishoma invasive interventional diagnostics uye marapirwo akadai sekunetsa uye ane njodzi yakakura bundu biopsies, thermal ablation, uye particle implantation.Dr. Liu anozivikanwa se "gamba pane tsono tip" uye akatora chikamu mukugadzirisa kwekubvumirana kwenyanzvi uye mazano ehutano hwakasiyana-siyana hwekurapa kenza yemapapu muChina.Akapayona pfungwa yekutonga kwakazara kwekenza yemapapu uye akamisa maitiro ekuvhiya kuti avandudze kuita sarudzo yekurapa kwekupindira mukurapa kwenzvimbo kwekutanga kenza yemapapu, kusimudzira kukura kwese kweChina chirwere chegomarara remapapu uye nzira yekurapa.
"Gamba Patsono Zano" - Chiremba Liu Chen
Nyanzvi mune zvishoma invasive kupindira kuongororwa uye nzira dzekurapa dzemamota pasi pekutungamira kwekufungidzira
1. Microwave/Radiofrequency ablation
2. Percutaneous biopsy
3. Radioactive particle implantation
4. Kupindira kwemarwadzo ekugadzirisa
2. Chinangwa uye zviratidzo zveablative therapy yekenza yemapapu
Iyo "Nyanzvi Kubvumirana paAblative Therapy yePrimary uye Metastatic Lung Tumors"(2014 edition) inokamura ablative kurapa kenza yemapapu muzvikamu zviviri: kurapa uye palliative.
Curative ablationinovavarira kunyatso necrotize yemuno tumor tissue uye inogona kuwana kurapa mhedzisiro.Kenza yemapapu ekutanga-danho rekutanga chiratidzo chakakwana cheablative therapy,kunyanya kune varwere vane urombo hwe cardiopulmonary function, kuchembera, kusakwanisa kushivirira kuvhiyiwa, kuramba kuvhiyiwa, kana avo vane bundu rimwe chete rekudzoka mushure me conformal radiotherapy, pamwe nevamwe varwere vane maronda mazhinji ekutanga kenza yemapapu vanoda kuchengetedza basa remapapu. .
Palliative ablationzvinangwa kuzvakanyanya kumisa bundu rekutanga muvarwere vane danho repamusoro rekenza, kuderedza bundu kuremerwa, kubvisa zviratidzo zvinokonzerwa nebundu, nekuvandudza hupenyu hwemurwere.Kune varwere vane danho repamusoro rekenza yemapapu, mapundu ane dhayamita yakakura> 5 masendimita kana ane maronda akawanda anogona kusangana netsono dzakawanda, multipoint, kana akawanda kurapwa masesheni, kana kusanganiswa nedzimwe nzira dzekurapa kuti uwedzere kurarama.Kunonoka-nhanho inouraya metastases yemapapu, kana kudzora kwemamota ekunze kwemapapu kwakanaka uye kunongova nenhamba shoma yemaronda asara mumapapu, kurapa kweablative kunogona kubatsira kudzora chirwere nekuvandudza hupenyu hwemurwere.
3. Zvakanakira ablative therapy
Minimally invasive kuvhiya, kukurumidza kupora: Ablative therapy inoonekwa sekuvhiyiwa kwekupindira zvishoma.Iyo ablative electrode tsono inoshandiswa kazhinji ine dhayamita ye1-2mm, zvichiita kuti pave nekuvhiyiwa kudiki diki saizi yeburi retsono.Iyi nzira inopa zvakanakira sengekukuvadzwa kudiki, kurwadziwa kushoma, uye kukurumidza kupora.
Nguva pfupi yekuvhiya, ruzivo rwakagadzikana:Ablative therapy inowanzoitwa pasi peanesthesia yemunharaunda kana kusanganiswa ne intravenous sedation, kubvisa kudiwa kwe endotracheal intubation.Varwere vari muchimiro chekurara chakareruka uye vanogona kumutswa nyore nekupomba zvinyoro.Vamwe varwere vanganzwa sekunge kuvhiyiwa kwapera mushurekukurumidza kurara.
Simltaneous biopsy yechokwadi kuongororwa:Munguva yeablative therapy, coaxial kutungamira kana synchronous puncture biopsy chiridzwa chinogona kushandiswa kuwana biopsy yechironda.Zvinoteverapathological kuongororwa uye genetic testipa ruzivo rwakakosha kune dzinotevera sarudzo dzekurapa.
Nzira inodzokororwa: Zvidzidzo zvakawanda kubva kudzimba nekune dzimwe nyika zvakaratidza kuti chiyero chekudzora chemuno chevarwere vekenza yemapapu ekutanga vanorapwa ablative therapy inofananidzwa neiyo yekuvhiya resection kana stereotactic radiation therapy.Muchiitiko chekudzoka kwemunharaunda, ablative therapyinogona kudzokororwa kakawandakuti udzokezve kutonga kwechirwere panguvakuwedzera hupenyu hwemurwere.
activation kana kuwedzera immune function: Abblative therapy inovavarirauraya bundu masero mukati memuviri, uye mune dzimwe nguva, inogona kushandura kana kuwedzera simba rekudzivirira remurwere, zvichiita kuti a uko mapundu asina kurapwa mune mamwe mativi emuviri anoratidza kudzikira.Pamusoro pezvo, ablative therapy inogona kusanganiswa ne systemic mushonga kugadziraa synergistic effect.
Ablative therapy inonyanya kukodzera kune varwere vasingakwanisi kushivirira kuvhiyiwa resection kana general anesthesia nekuda kwekusashanda zvakanaka kwecardiopulmonary, kuchembera, kana kuwanda kuri kuita comorbidities.Iyo zvakare inosarudzwa kurapwa kune varwere vaneekutanga-nhanho akawanda ma nodule (akadai seakawanda pasi-magirazi nodules).
Nguva yekutumira: Aug-23-2023