Zvichienderana nedata rakakodzera reInternational Agency for Research on Cancer (IARC) reWorld Health Organization (WHO), kenza yemapapu yave imwe yemabundu akaipisisa, uye kudzivirira nekurapa kenza yemapapu kwave chinhu chinonyanya kukosheswa pakudzivirira nekurapa kenza.
Zvichienderana nedata rehuwandu rakakodzera, chete nezve20% yevarwere vane kenza yemapapu vasiri masero madiki vanogona kurapwa nekuvhiyiwa.Vazhinji vevarwere vegomarara remapapu vatove mumatanho epamusorokana vaongororwa, uye vanogona kuwana mabhenefiti mashoma kubva mukurapa nemwaranzi yemagetsi uye chemotherapy. Nekufambira mberi kuri kuramba kuchiitika uye kukura kwesainzi yezvekurapa, kubuda kwekurapa kwekubvisaSenzira yekutsiva kuvhiyiwa, kwaunza tariro itsva yekurapwa kwevarwere vekenza yemapapu.
1. Unoziva zvakawanda sei nezvekurapa gomarara remapapu?
Kurapa kenza yemapapu kunosanganisira kunyanyakubvisa microwave uye kubvisa radiofrequencyNheyo yekurapa inosanganisira kuisa electrode yekubvisa mabhakitiriya, inozivikanwawo se"kuongorora,"bundu riri mumapapu. Electrode inogona kukonzerakufamba nekukurumidzazvidimbu zvakaita semaion kana mamorekuru emvura ari mubundu, zvichikonzera kupisa nekuda kwekukweshana, zvichikonzerakukuvara kusingadzoreki kwakadai sekuvharika kwemasero egomarara.Panguva imwe chete, kumhanya kwekupisa kunoderera nekukurumidza mumapapu akajairwa, zvichichengetedza kupisa mukati mebundu, zvichigadzira"Mhedzisiro yekudzivirira kupisa."Kurapa kwekubvisa bundu kunogona kuuraya bundu iri panguva imwe chete.kuwedzera kuchengetedzwa kwenyama yemapapu yakajairika.
Kurapa kweAblative kunoratidzwa nekudzokororwa, kusanzwa zvakanaka kwemurwere, kukuvara kudiki, uye kupora nekukurumidza,uye yave ichizivikanwa uye ichishandiswa zvakanyanya mukurapa. Zvisinei, tichifunga kuti kurapa kwe ablative kunosanganisira mativi akasiyana-siyana akadai se radiology, oncology, interventional radiology, uye surgical anatomy, zvinoda hunyanzvi hwepamusoro hwekuvhiya uye hunhu hwakakwana kubva kuna chiremba wekuvhiya.
Nhasi, tinoda kukuzivisai nyanzvi ine mukurumbira munyaya dzekurapa kwekurapa,Dr. Liu Chen, avo vanga vachishanda mubasa iri kwemakore mazhinji uye vakazvipira kutsvagurudzo yekiriniki uye kufambiswa kwemaitiro ekurapa kwezvirwere zvisinganyanyi kupindira mumuviri zvakaita sekuongorora tumors dzine njodzi huru, kubvisa thermal ablation, uye kuisa tumors mumasero.Dr. Liu anozivikanwa se "gamba riri pamusoro petsono" uye akabatanidzwa mukugadzira nhungamiro dzenyanzvi dzekurapa kenza yemapapu muChina. Akatanga chirongwa chekutarisira zvakakwana biopsies yekenza yemapapu uye akatanga nzira dzekuvhiya dzakajairwa kuti avandudze sarudzo dzekurapa kenza yemapapu mukurapa kenza yemapapu iri padanho rekutanga, zvichikurudzira kukura kwehurongwa hwekuongorora nekurapa kenza yemapapu muChina.
"Gamba riri pamuromo wetsono" - Chiremba Liu Chen
Inyanzvi mukuongorora zvirwere zvishoma zvinopinda mumuviri uye nzira dzekurapa mabundu pasi pekutungamirirwa nemifananidzo
1. Kubviswa kwe microwave/Radiofrequency
2. Kuongororwa kweganda nepaganda
3. Kuisa zvikamu zvine radioactive muropa
4. Kugadzirisa marwadzo ekudzivirira
2. Chinangwa uye zviratidzo zvekurapa gomarara remapapu
"Kubvumirana kweNyanzvi pakurapa kweAblative kwePuratory neMetastatic Lung Bumps"(Chinyorwa cha2014) chinokamura kurapa kwekenza yemapapu muzvikamu zviviri: kunorapa uye kunonyaradza marwadzo.
Kubvisa marwadzo emudumbuChinangwa chekubvisa zvachose bundu remunzvimbo iyoyo uye chinogona kurapa.Kenza yemapapu iri padanho rekutanga chiratidzo chakakwana chekurapa kwekubvisa chirwere,kunyanya kune varwere vane chirwere chemwoyo chisina kumira zvakanaka, vakwegura, vasingakwanise kushivirira kuvhiyiwa, kuramba kubviswa nhengo dzemuviri, kana avo vane bundu rinodzoka kamwe chete mushure mekurapwa nemagetsi, pamwe nevamwe varwere vane maronda akawanda ekenza yemapapu avo vanoda kuchengetedza mashandiro emapapu.
Kubvisa marwadzo ekurwadziwachinangwa cheKudzivirira zvakanyanya bundu rekutanga muvarwere vane kenza yemapapu iri padanho repamusoro, kuderedza mutoro webundu, kuderedza zviratidzo zvinokonzerwa nebundu, uye kuvandudza hupenyu hwemurwere.Kune varwere vane kenza yemapapu iri padanho repamusoro, bundu rine dhayamita yepamusoro >5 cm kana vane maronda akawanda vanogona kurapwa netsono dzakawanda, nzvimbo dzakawanda, kana kuti kurapwa kwakawanda, kana kusanganiswa nedzimwe nzira dzekurapa kuti vararame kwenguva refu. Kune varwere vane kenza yemapapu iri padanho rekupedzisira, kana kudzora bundu riri kunze kwemapapu kwakanaka uye paine maronda mashoma aripo mumapapu, kurapwa kwekubvisa kenza kunogona kubatsira kudzora chirwere uye kuvandudza hupenyu hwemurwere.
3. Mabhenefiti ekurapa kwe ablative
Kuvhiyiwa kusinganyanyi kupindira mumuviri, kupora nekukurumidza: Kurapa kweAblative kunoonekwa sekuvhiyiwa kwekupindira kusingapindi zvakanyanya. Tsono yeablative electrode inoshandiswa inowanzova nedhayamita ye1-2mm, zvichikonzera kucheka kudiki kwakaenzana neburi retsono. Nzira iyi inopa zvakanakira zvakaita sekukuvara kushoma, marwadzo mashoma, uye kupora nekukurumidza.
Nguva pfupi yekuvhiyiwa, ruzivo rwakasununguka:Kurapa kweAblative kunowanzoitwa pasi peanesthesia yemunzvimbo kana pamwe chete ne intravenous sedation, zvichibvisa kudiwa kwe endotracheal intubation. Varwere vanenge vari mumamiriro ekurara zvishoma uye vanogona kumutswa zviri nyore nekungobaya zvinyoro nyoro. Vamwe varwere vanogona kunzwa sekunge kuvhiyiwa kwapera mushure mekungekurara nekukurumidza.
Kuongororwa kwakaitwa panguva imwe chete kuti uwane kuongororwa kwakarurama:Munguva yekurapwa kwekubvisa kenza, chishandiso che coaxial guidance kana kuti synchronous puncture biopsy chinogona kushandiswa kuwana biopsy yechironda.kuongororwa kwezvirwere uye kuongororwa kwemajinikupa ruzivo rwakakosha rwekusarudza kurapwa kunotevera.
Maitiro anodzokororwa: Ongororo dzakawanda dzakabva kumasangano emuno neekunze kwenyika dzakaratidza kuti huwandu hwevarwere vekenza yemapapu vari kutanga kurapwa nekubvisa kenza hwakafanana nehwekuvhiyiwa kana stereotactic radiation therapy. Kana chirwere ichi chikadzoka, kurapwa nekubvisa kenza.inogona kudzokororwa kakawandakuti vadzore simba rechirwere ichi panguvakuwedzera kunaka kwehupenyu hwemurwere.
Kushanda kana kuvandudza mashandiro emuviri ekudzivirira chirwere: Kurapa kweAblative kunangwakuuraya masero egomarara mumuviri, uye mune dzimwe nguva, zvinogona kumutsa kana kuwedzera mashandiro emuviri wemurwere, zvichikonzera uko bundu risina kurapwa mune dzimwe nhengo dzemuviri rinoratidza kudzokera shure. Pamusoro pezvo, kurapwa kwekubvisa bundu kunogona kusanganiswa nemishonga yemuviri kuti kugadzire bundu.mhedzisiro yekubatana.
Kurapa kweAblative kwakakodzera varwere vasingakwanise kushivirira kubviswa kwebvudzi kana anesthesia nekuda kwekusashanda zvakanaka kwemwoyo nemapapu, kukwegura, kana zvimwe zvirwere zvinokonzerwa nazvoInzira inofarirwawo nevarwere vanemapundu akawanda epakutanga (akadai semapundu akawanda egirazi).
Nguva yekutumira: Nyamavhuvhu-23-2023