Nzira yekusarudza tsono chaiyo ye biopsy yekurapwa?

Mumamiriro ezvinhu ari kuramba achichinja ekuongorora zvirwere,tsono dze biopsyvanoita basa guru mukuwana sampuro dzenyama kuti dziongororwe nemazvo, uye kusarudzwa kwadzo kwakabatana zvakananga nekururama kwe biopsy, kuchengetedzeka uye ruzivo rwemurwere. Zvinotevera ongororo yemaitiro e biopsy,mhando dzetsono dze biopsy, huwandu hwetsinga dzinobva pakati kusvika padiki, uye zvinhu zvakakosha zvekusarudza kuti zvipe gwara rakarongeka rekurapa.

1. Kunzwisisa maitiro e biopsy

Chinangwa chikuru che biopsy ndechekuwana sampuro yemhando yepamusoro yenyama kuti ijekese rudzi rweronda kana kugadzira hurongwa hwekurapa. Kudiwa kwetsono ye biopsy kunosiyana zvakanyanya zvichienderana nemamiriro ezvinhu e biopsy:

- Kuongororwa kwegomarara: huwandu hwakakwana hwenyama hunodiwa kuti hutsigire kurongwa kwezvirwere uye kuongororwa kwemajini (semuenzaniso, EGFR, ALK mutations).

- Zvirwere zvekuzvimba: cytology inodiwa kuti ijekese rudzi rwehutachiona kana masero ekudzivirira muviri.

- Ongororo isati yaitwa kuvhiyiwa: kutora sampuro nekukurumidza kunodiwa kuti utungamirire maitiro ekuvhiya (semuenzaniso, kuziva mazamu asina njodzi uye ane kenza).

2. Mhando dzetsono dze biopsyuye mashandisirwo ekiriniki

(1)Tsina yeCore Biopsy

- Musimboti: Kuwana chidimbu chetishu nekucheka nemaoko.

- Zvakanakira:

Kuongororwa kwakazara, kwakakodzera bundu rakasimba (semuenzaniso, rezamu, reprostate) uye biopsy yemapfupa.

Saizi yemuenzaniso yakakwana kutsigira immunohistochemistry uye kuyedzwa kwemamorekuru.

- Zvipingamupinyi: kukuvara kukuru, kunofanirwa kunyatsonzwisisa zviratidzo.

(2) Tsono yeKuongorora Kufema Kwemhepo Nekufemera Kwakanaka

- Musimboti: Kushandisa nzira yekukweva pressure isina simba kuti masero akwanise kusungirirwa.

- Zvakanakira:

Zvishoma zvinorwadza, zvakakodzera kune lymph nodes yepamusoro, thyroid nemapapu.

Zviri nyore kuita, zvinogona kukurumidza kuwana masero ekumisikidzwa.

Zviri nyore kuita, zvinoita kuti kuongororwa kwecytological kuitike nekukurumidza.

- Zvipingamupinyi: kupatsanurwa kwemuenzaniso, kusakwanisa kusangana nezvinodiwa nekuongorora histologic.

(3) Tsina yeBiopsy Inobatsirwa neVacuum (VAB)

- Musimboti: Inosanganisa kucheka kwemuchina nekusveta simba rekumanikidza kuti ivandudze kushanda zvakanaka kwesampuli.

- Zvakanakira:

Mienzaniso yakawanda inogona kuwanikwa nekuboorwa kamwe chete, yakakodzera mazamu ane calcium yakawanda.

Inoderedza njodzi yekuboorwazve uye inovandudza kushivirira kwemurwere.

(4) Kucheka tsono yeBiopsy

- Musimboti: Nyama inochekwa nemuromo une mupendero kana kuti banga rinotenderera.

- Mhando:

Tsono ine mitswe: semuenzaniso tsono yeTru-Cut Biopsy, yenyama yakapfava.

Tsono yekuboorera neRing: semuenzaniso tsono yeBone Marrow Biopsy, yenyama yemapfupa.

3. core needle biopsy vs small neck aspiration

4. Zvinhu zvikuru zvekufunga nezvazvo pakusarudza tsono dzakakodzera dze biopsy

(1) Nzvimbo yakanangana neBiopsy

- Nhengo dzemuviri (semuenzaniso, thyroid, zamu): tsono diki kana tsono dzemukati dzinosarudzwa kuti pave nekuenzanisa zvinodiwa pakukuvara uye kuongororwa kwechirwere.

- Nhengo dzakadzika (semuenzaniso, chiropa, itsvo): tsono refu dze biopsy dzinodiwa kuti pave nechokwadi chekuti kudzika kwekupinda kweropa kwakadzika.

- Nyama yemapfupa: tsono dzekuboorera rin'i (semuenzaniso tsono dzekuongorora tsandanyama yemapfupa) dzinofanira kushandiswa kudzivirira kuputsika kwenyama.

(2) Zvinhu zvinoenderana nemurwere

- Zera uye chimiro chemuviri: vana kana varwere vasina simba vanofanira kusarudza tsono yakatetepa (semuenzaniso, 20G) kuderedza matambudziko.

- Kushanda kwekuvhara ropa: varwere vane matambudziko ekuvhara ropa vanofanira kudzivirira tsono dzakakora (semuenzaniso, 16G) kuderedza njodzi yekubuda ropa.

- Mamiriro epfungwa: Varwere vane kuzvidya mwoyo vangada tsono dze biopsy dzinoshandiswa ne vacuum kuti vapfupise nguva yekuvhiyiwa.

(3) Kuwanda kwenyama uye nzvimbo yayo

- Nyama yakakora (semuenzaniso, prostate, chiropa): sarudza tsono ye biopsy ine simba rakasimba rekucheka (semuenzaniso, tsono yakavharika ye18G).

- Mitsipa/tsinga dzeropa dziri pedyo: kuvhiyiwa kunotungamirirwa ne ultrasound/CT kunodiwa kuti usarudze tsono ye biopsy yakanyorwa seyakagadzirwa.

(4) Saizi neurefu hwetsono

- Sarudzo yezvakakosha:

Tsono diki (20-22G): ye cytology kana maronda epamusoro.

Tsono yakakora (14-18G): yakakodzera kuongororwa kwe histologic kana maronda akadzika.

- Kusarudzwa kwehurefu: kunotsamira pahudzamu hwekuboorwa (semuenzaniso, biopsy yemapapu inofanira kunge iri ≥15cm).

(5) Dhizaini yemuromo wetsono

- Musoro wetsono wakachekwa: wakakodzera nyama dzakapfava kuderedza kusimba kwemuviri.

- Musoro une mativi matatu: unoshanda pamapfupa, kuti uwedzere kupinda kweropa.

- Kunyora: Tsinga dze biopsy dzinotungamirirwa neMRI dzinofanira kunyorwa ne titanium alloy.

(6) Kuenderana nemaitiro ekutora mifananidzo

- Kutungamirirwa neultrasound: Tsinga dzebiopsy dzine mhete dziri kukura dzinofanira kusarudzwa.

- CT/MRI gwara: zvinhu zvisina magineti kana kuti zvinhu zvechinyakare (semuenzaniso, titanium alloy) zvinofanira kusarudzwa.

(7) Nzira yekubvisa sampuro

- Kucheka nemaoko: kunoshanda kumabundu akaoma nekutorwa kwesampuli yakazara.

- Kusveta simba risina kunaka: rakakodzera kuongororwa kwemasero emuviri, riri nyore kushandisa.

- Inobatsirwa ne vacuum: inoshanda pakutora sampuro munzvimbo dzakawanda, zvichiwedzera kushanda zvakanaka.

(8) Kunyaradzwa uye kuchengetedzeka kwemurwere

- Kudzora marwadzo: tsono diki haina kunyanya kurwadza uye inoshivirira varwere.

- Kudzivirira matambudziko: dzivisa kuboorwa kakawanda netsono gobvu, kuderedza njodzi yepneumothorax uye kubuda ropa.

(9) Mutengo uye kuwanikwa

- Kushanda zvakanaka kwemutengo: tsono dze biopsy dzinozvigadzira dzoga (semuenzaniso, TSK) dzinodhura zvakanyanya, asi dzine mwero wekubudirira kwekutora sampuli.

- Inishuwarenzi yezvekurapa: vanofanira kusarudza zvigadzirwa zviri mukati mehurongwa hwekudzoserwa mari zvichienderana nemitemo yemuno.

5. Mhedziso

Kusarudzwa kwetsono dze biopsyinoda kuongororwa kwakazara kwerudzi rwechironda, mamiriro emurwere, mamiriro ehunyanzvi uye zvinhu zvehupfumi. Mukurapa, misimboti inotevera inofanirwa kuteverwa:

1. Kufananidza kwakanyatsojeka: sarudza mhando yetsono zvichienderana nenzvimbo yaunoda kuvhiyiwa (semuenzaniso tsono ine 14G yezamu, tsono diki ye20G yethyroid).

2. Isa zvinhu zvakakosha pakuchengetedza: dzivisa tsono dzakakora dzevarwere vane matambudziko ekugwamba kweropa, uye shandisa uchitungamirirwa nemufananidzo wezvironda zvetsinga dziri pedyo.

3. Kushanda zvakanaka uye kunyaradzwa: tsono dze biopsy dzinoshandiswa ne vacuum dzinogona kuwedzera kushanda zvakanaka, uye tsono diki dzinogona kuderedza marwadzo emurwere.

Kuburikidza nesarudzo yesainzi yetsono dze biopsy, kururama kwekuongorora kunogona kuvandudzwa zvakanyanya, njodzi yematambudziko inogona kuderedzwa, uye pakupedzisira mushonga chaiwo wemunhu wega wega unogona kuwanikwa.