Vazhinji varwere vekenza yechiropa vasina kukodzera kuvhiyiwa kana dzimwe nzira dzekurapa vane sarudzo.
Nyaya Yekuongorora
Kurapa Kenza Yechiropa Nyaya 1:
Murwere: Murume, kenza yepakutanga yechiropa
Kurapa kwekutanga pasi rose kweHIFU kwegomarara rechiropa, kwakararama kwemakore gumi nemaviri.
Chirwere Chekurapa Kenza Chirwere Chechipiri:
Murwere: Murume, ane makore makumi mashanu nemaviri, kenza yechiropa yekutanga
Mushure me radiofrequency ablation, bundu rinosara rakaonekwa (bundu riri pedyo ne inferior vena cava).Kutevera kurapwa kweHIFU kwechipiri, kubviswa kwakakwana kwebundu rakasara rawanikwa, nekuchengetedzwa kwakasimba kweiyo yakaderera vena cava.
Chirwere cheMarapirwo eGomarara reChiropa Chechitatu:
Chekutanga kenza yechiropa
Kutevera mushure memavhiki maviri ekurapwa kweHIFU kwakaratidza kunyangarika zvachose kwebundu!
Chiropa Kurapa Kenza Nyaya 4:
Murwere: Murume, 33 makore, metastatic chiropa kenza
Chironda chimwe chete chinowanikwa muchikamu chega chega chechiropa.HIFU kurapwa kwakaitwa panguva imwe chete, zvichikonzera bundu necrosis uye kutorwa mwedzi mitatu mushure mekuvhiyiwa.
Chiropa Kurapa Kenza Nyaya yechishanu:
Murwere: Murume, ane makore makumi manomwe, kenza yechiropa yekutanga
Residual bundu rakacherechedzwa paMRI mushure mekuiswa kweodhine mafuta zvichitevera transarterial embolization.Kuwedzeredzwa kwePatchy kwakanyangarika mushure mekurapwa kweHIFU, zvichiratidza kubviswa kwebundu.
Chirwere Chekurapa Kenza Chirwere chechitanhatu:
Murwere: Mukadzi, makore makumi manomwe, kenza yechiropa yekutanga
Yakanyanya vascular bundu rinoyera 120mm* 100mm inowanikwa muchikamu chekurudyi chechiropa.Yakazara bundu ablation yakawanikwa mushure mekurapwa kweHIFU, zvishoma nezvishoma yakanyura nekufamba kwenguva.
Chirwere Kurapa Kenza Nyaya yechinomwe:
Murwere: Murume, ane makore makumi matanhatu nemaviri, kenza yepakutanga yechiropa
Lesion iri padyo nedenga re diaphragmatic, yakaderera vena cava, uye portal vein system.Mushure mezvikamu zve 5 zve radiofrequency uye 2 zvikamu zveTACE, bundu rakasara rakaonekwa pakutevera MRI.Kurapwa kweHIFU kwakabudirira kudzima bundu uku uchichengetedza tsinga dzeropa dzakatenderedza.
Chiropa Kurapa Kenza Nyaya yechisere:
Murwere: Murume, ane makore makumi mashanu nemasere, kenza yechiropa yekutanga
Kudzokororwa kwakacherechedzwa mushure mekuvhiyiwa kwekurudyi lobe kenza yechiropa.Yakazara bundu ablation yakawanikwa neHIFU kurapwa, yakasimbiswa nekutorwa kwebundu mwedzi gumi nemisere gare gare.
Hyperthermia yeCancer Chiropa - Yakamisikidzwa Tsvagiridzo
HIFU (High Intensity Focused Ultrasound) inogona kushandiswa kurapa gomarara rechiropa.Nzira dzechinyakare dzekurapa gomarara rechiropa dzinosanganisira kuvhiyiwa resection, transarterial embolization, uye chemotherapy.Zvisinei, varwere vakawanda vanoonekwa vakura kana kuti vane mapundu pedyo netsinga huru dzeropa, zvichiita kuti kuvhiyiwa kusashande.Pamusoro pezvo, vamwe varwere havagone kuvhiyiwa nekuda kwechimiro chavo chemuviri, uye kuvhiya ivo pachavo vanotakura njodzi yezvinetso.
Kurapwa kweHIFU kwegomarara rechiropa kunopa zvakati wandei zvakanakira:inopinda zvishoma, inokonzera kurwadziwa uye kukuvadza kushoma, yakachengeteka, ine matambudziko mashoma, uye inogona kudzokororwa kana zvichidiwa.Inogona kuvandudza zviratidzo zvevarwere uye kuwedzera hupenyu hwavo.
Kurapa kwePost-HIFU, hapana zviitiko zvekuputika kwebundu, jaundice, bile leakage, kana kukuvara kwevascular zvakataurwa, zvichiratidza kuti kurapwa kwakachengeteka.
(1) Zvinoratidza:Palliative kurapwa kwemamota epamusoro, gomarara rechiropa riri parobe rekurudyi rine dhayamita isingasviki 10cm, mapundu mahombe parobe rekurudyi ane mazamu esatellite anoramba akavharirwa kuchiropa chekurudyi, kudzoka kwenzvimbo mushure mekuvhiyiwa, portal vein tumor thrombus.
(2) Contraindications:Varwere vane cachexia, gomarara rechiropa rinopararira, kusashanda zvakanaka kwechiropa munguva yekupedzisira, uye metastasis iri kure.
(3) Kurapa maitiro:Varwere vane mabundu ari kurudyi lobe vanofanira kurara nedivi ravo rekurudyi, nepo avo vane mamota kuruboshwe rwobe kazhinji vanoiswa munzvimbo yekumashure.Pamberi pemaitiro, Ultrasound inoshandiswa kutsvaga bundu kune chaiyo kunanga uye kuronga kurapwa.Bundu racho rinobva rarapwa kuburikidza nemaitiro ekutevedzana ablation, kutanga kubva pamunhu ega uye kuenda kumitsara, nzvimbo, uye pakupedzisira bundu rose vhoriyamu.Kurapa kunowanzoitwa kamwe chete pazuva, nechikamu chimwe nechimwe chinotora anenge 40-60 maminetsi.Maitiro acho anoenderera zuva nezuva, layer by layer, kusvika bundu rose rabviswa.Mushure mekurapa, nzvimbo yakarapwa inoongororwa kune chero kukuvara kweganda, inoteverwa nekunze kwe ultrasound scan yenzvimbo yese inotarirwa kuti iongorore kushanda kwekurapa.
(4) Kuchengeta mushure mekurapwa:Varwere vanotariswa nezvekushanda kwechiropa uye mazinga e electrolyte.Kutsigira kurapwa kunofanira kupiwa kune varwere vane urombo hwechiropa, ascites, kana jaundice.Varwere vazhinji vane tembiricha yemuviri panguva yekurapa.Nhamba diki yevarwere inogona kuona kuwedzera kunyoro kwekushisa mukati memazuva 3-5, kazhinji pasi pe38.5 ℃.Kutsanya kunowanzokurudzirwa kwemaawa mana mushure mekurapwa, nepo varwere vane kenza yechiropa yekuruboshwe vanofanira kutsanya kwemaawa matanhatu vasati vachinja zvishoma nezvishoma kune chikafu chemvura.Vamwe varwere vanogona kunzwa kurwadziwa kwepamusoro kwepamusoro kwepamusoro kwemazuva 3-5 mushure mekurapa, iyo inogadzirisa zvishoma nezvishoma pachayo.
(5) Ongororo yekubudirira:HIFU inogona kuparadza matishu egomarara rechiropa, zvichikonzera necrosis isingachinjiki yemasero egomarara.CT scans inoratidza kuderera kwakanyanya kweC CT attenuation values mukati menzvimbo dzakatarwa, uye mutsara-inosimudzira CT inosimbisa kusavapo kwe arterial uye portal venous ropa rekupa kunzvimbo inotarirwa.Bhandi rekusimudzira rinogona kucherechedzwa pamucheto wekurapa.MRI inoona shanduko mukusimba kwechiratidzo chebundu paT1 uye T2-yakayerwa mifananidzo uye inoratidza kunyangarika kweropa rekupa kunzvimbo inotangwa mu arterial uye portal venous phases, nechikamu chinonokerwa chinoratidza bhendi rekusimudzira padivi pekurapwa.Ultrasound yekutarisa inoratidza kudzikira zvishoma nezvishoma muhukuru hwebundu, kunyangarika kweropa, uye tishu necrosis inozopedzisira yanyura.
(6) Kutevera:Mumakore maviri ekutanga mushure mekurapwa, varwere vanofanirwa kuve nekutevera kushanya mwedzi miviri yega yega.Mushure memakore maviri, kushanya kwekutevera kunofanira kuitika mwedzi mitanhatu yega yega.Mushure memakore mashanu, kuongororwa kwegore negore kunokurudzirwa.Alpha-fetoprotein (AFP) mazinga anogona kushandiswa sechiratidzo chekudzoka kwebundu.Kana kurapwa kwakabudirira, bundu racho rinogona kupera kana kupera zvachose.Muzviitiko apo bundu richiripo asi risisina masero anoshanda, kungwarira kunofanirwa kushandiswa kana bundu rine dhayamita rakakura kupfuura 5cm richionekwa pakufungidzira, uye PET scans inogona kushandiswa kuti iwedzere kujekeswa.
Kucherechedzwa kwekiriniki yemhedzisiro uye mushure mekurapa, kusanganisira alpha-fetoprotein mazinga, chiropa chinoshanda, uye MRI scans,vakaratidza mwero wekuregererwa wekiriniki wepamusoro pe80% kune varwere vegomarara rechiropa vanorapwa neHIFU.Mumamiriro ezvinhu apo ropa rinopiwa kumamota echiropa rakapfuma, kurapwa kweHIFU kunogona kusanganiswa nekupindira kwemukati.Tisati tarapwa neHIFU, transcatheter arterial chemoembolization (TACE) inogona kuitwa kuvhara kubuda kweropa kunzvimbo yepakati bundu, ine embolic agent inoshanda sebundu marker kubatsira muHIFU kunanga.Iodine mafuta inoshandura iyo acoustic impedance uye absorption coefficient mukati mebundu, kufambisa shanduko yesimba paHIFU inotarisa uye kugadzirisa..
Nguva yekutumira: Aug-08-2023