I-PANCREATIC BIOPSY: INDLELA YOKWENZA, IZINDLELA, INQUBO NGAPHANSI KOKULAWULWA KWE-ULTRASOUND

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I-pancreatic biopsy ithatha izicubu endaweni ethile ukuze ihlolwe ngemicroscopic.

Ikuvumela ukuthi ufunde i-pathology eyenziwe ngaphakathi kwesitho ezingeni lamaselula futhi uyihlukanise.

Le ndlela ithembeke kakhulu futhi isebenza ngempumelelo kuzo zonke izindlela ezisetshenziselwa ukuxilongwa komdlavuza we-pathologies.

Ngokusekelwe emiphumeleni yocwaningo olunjalo, singenziwa isinqumo sokuphinda sikhiphe ama-pancreas.

Izinkomba kanye ne-contraindication yokukhethwa kwezicubu

Ucwaningo kumele lwenziwe kumacala alandelayo:

okuqukethwe okunganele kwezindlela zezindlela zokuhlonza ezingabonakali ezihlaselayo;
isidingo sokwenza umehluko woshintsho olwenzeka ezingeni lamaselula, okubaluleke kakhulu lapho kusolwa izifo zesimila;
isidingo sokusungula ukuphambuka noma ukugxila kokuguguleka kwengqondo.

Contraindication ngenqubo:

ukwenqaba kwesiguli ukuqhuba isifundo se-pancreatic;
ukuphazamiseka okukhulu kwegazi;
ukuba khona kwezithiyo ekwazisweni kwensimbi (neoplasms);
kungenzeka ukwenza izindlela zokuxilonga ezingezona ezihlaselayo ezingekho ngaphansi kwe-biopsies kokuqukethwe kwemininingwane.

Izinzuzo Zokucwaninga:

amandla okuthola i-cytology yezicubu futhi uthole lonke ulwazi oludingekayo mayelana ne-degree, ubukhulu besifo;
i-pathology ingabonakala esigabeni sokuqala sokukhula kwayo futhi nezinkinga eziningi eziyingozi zingavinjelwa;
i-biopsy ikuvumela ukuthi unqume inani lokuhlinzwa okuzayo ezigulini ezinomdlavuza.

Inhloso eyinhloko yale nqubo ukukhomba ubunjalo nohlobo lwenqubo ye-pathological etholakala kumuntu kwizicubu ezifundwe. Uma kunesidingo, le ndlela ingasekelwa ezinye izindlela zokuxilonga, kufaka phakathi i-x-ray, ukuhlaziywa kwe-immunological, i-endoscopy.

Ividiyo evela kusazi:

Izindlela ze-Biopsy

I-biopsy ingenziwa ngesikhathi sokuhlinzwa noma kwenziwa njengohlobo oluzimele lokufunda. Inqubo ifaka ukusetshenziswa kwezinaliti ezikhethekile ezinamameterayidi ahlukile.

Isithwebuli se-ultrasound, i-CT scan (i-computer tomograph) isetshenziselwa ukufeza, noma indlela ye-laparoscopic ingasetshenziswa.

Izindlela zokucwaninga ngezinto ezibonakalayo:

Umlando. Le ndlela ifaka phakathi ukwenza ukuhlolwa okuncane kakhulu kwesigaba sezicubu. Ibekwa ngaphambi kocwaningo kusisombululo esikhethekile, bese kuba yiparafini bese ibekwa amabala. Lokhu kwelashwa kukuvumela ukuba uhlukanise phakathi kwezindawo zeseli futhi wenze isiphetho esifanele. Isiguli sithola umphumela ngemuva kwesikhathi esiyizinsuku ezine kuya kwezingu-14. Kwezinye izimo, lapho kudingeka ukunquma ngokushesha uhlobo lwe-neoplasm, ukuhlaziya kwenziwa ngokushesha, ngakho-ke isiphetho sikhishwa ngemuva kwemizuzu engama-40.
I-Cytology. Le ndlela isuselwa ekufundweni kwezakhiwo zamaseli. Kusetshenziswa ezimweni ezingenakwenzeka ukuthola izingcezu zezicubu. I-Cytology ikuvumela ukuthi uhlole uhlobo lokubonakala kwemfundo futhi uhlukanise isimila esibuhlungu esisebusweni be-benign. Naphezu kokulula nokushesha kokuthola umphumela, le ndlela iphansi kune-histology ekuthembekeni.

Izinhlobo zokukhethwa kwezicubu:

inaliti biopsy enhle;
indlela ye-laparoscopic;
indlela ye-transduodenal;
ukubamba ngokubambisana.

Zonke izindlela ezingenhla zifaka iqoqo lezinyathelo ukuvimba ukungena kwama-microorganisms we-pathogenic esilondeni.

Isifiso esihle senalithi

Ukubhoboza i-pancreatic kuphephile futhi akukho okuxakayo ngenxa yokusebenzisa isibhamu noma isirinji eyenzelwe le njongo.

Ekupheleni kwayo kukhona ummese okhethekile ongasabalalisa masinyane izicubu ngaleso sikhathi sokudubula ubambe indawo yesitho somzimba.

Isiguli sibhekana ne-anesthesia yendawo ngaphambi kwe-biopsy ukunciphisa izinhlungu.

Ngemuva kwalokho, ngaphansi kokulawulwa kwe-scanner ye-ultrasound noma kusetshenziswa isisetshenziswa se-CT, inaliti ifakwa odongeni lwe-peritoneum ezingxenyeni ze-pancreatic ukuze kutholakale isampula ye-biopsy enalithi.

Uma kusetshenziswa isibhamu esikhethekile, khona-ke i-lumen yenaliti igcwele ikholomu yamaseli ngesikhathi sokwenza ifoni isebenze.

I-biopsy yenaliti enhle ayisebenzi ezimweni lapho isiguli sihlelelwe ukwenza:

i-laparoscopy, enezikhonkwane zodonga lwe-peritoneal;
i-laparotomy eyenziwa ngokususa izicubu ze-peritoneal.

Le ndlela ayisetshenziswa uma ubukhulu bendawo ethintekile abudluli cm 2 .. Lokhu kungenxa yobunzima bokungena endaweni yezicubu ezifundwe.

I-Laparoscopic

Le ndlela ye-biopsy ithathwa njengeyfundisayo futhi ephephile. Yehlisa ingozi yokuhlukumezeka, futhi iphinde futhi yenze ukuthi sikwazi ukubuka ngokuqondile ama-pancreas nezitho ezitholakala kwi-peritoneum ukukhomba i-foci eyengeziwe ye-necrosis, metastases evelayo nezinqubo zokuvuvukala.

Ngosizo lwe-laparoscopy, impahla okuhleliwe ukuthi ihlolwe ingathathwa endaweni ethile. Akuwona wonke amasu anale nzuzo, ngakho-ke abalulekile ezinhlelweni zokuxilonga.

I-Laparoscopy ayinabuhlungu, njengoba yenziwa ngaphansi kwe-anesthesia ejwayelekile. Ngenkathi yokuqaliswa kokusebenza kwayo, i-laparoscope namathuluzi adingekayo wokungenelela kokuhlinzwa kanye ne-biopsy kwethulwa emgodini wesisu ngokusebenzisa amakhonkco akhethekile odongeni.

I-Transduodenal

Lolu hlobo lokuthathwa kwezipuni lusetshenziselwa ukutadisha ukwakheka okuncane okukhona ezingxenyeni ezijulile zesitho.

I-biopsy yenziwa ngokusebenzisa i-endoscope efakiwe ngokusebenzisa i-oropharynx, ekuvumela ukuthi uthwebule okukukhanda kwekhanda lendlala. Le nqubo ayikwazi ukusetshenziselwa ukutadisha izilonda ezikwezinye izingxenye zomzimba.

Ukusebenzisana

Ukubhoboza ngale ndlela kufaka phakathi ukuqoqwa kwezinto ngemuva kwe-laparotomy. Ezimweni eziningi, kwenziwa ngesikhathi sokusebenza okuhleliwe, kepha kwesinye isikhathi kungaba ukungenelela okuzimele.

I-biopsy ye-intraoperative ibhekwa njengekhohlisayo eyinkimbinkimbi, kepha iyisifundo kunazo zonke. Ngesikhathi sokuqaliswa kwaso, ezinye izitho ezitholakala emgodini wesisu ziyahlolwa. Kwenziwa ngaphansi kwe-anesthesia futhi kuhambisana nokuhlukaniswa kwezindonga ze-peritoneum.

Ubunzima obukhulu be-biopsy yengozi ekhulayo yokuhlukumezeka, isidingo sokulaliswa esibhedlela isikhathi eside, isikhathi eside sokubuyisa kanye nentengo ephezulu.

Ukulungiselela

I-biopsy ephumelelayo idinga ukulungiswa okufanele, okubandakanya:

Ukubhema ukuyeka.
Ukubulawa yindlala ngosuku olungaphambi kwesifundo.
Ukwenqaba uphuzo oludakayo, kanye nakuluphi uketshezi.
Kwenziwa ukuhlaziya okwengeziwe.
Ukunikeza usizo olukhethekile lwezengqondo olungadingeka ezigulini eziningi. Abantu abakwesaba ukungenelela okunjalo kufanele bavakashele isazi sokusebenza kwengqondo ukulandela ukutholwa kwaso.

Ukuhlolwa okudingekile okufanele kuthathwe ngaphambi kwe-biopsy:

ukuhlolwa kwegazi, ukuhlolwa komchamo;
ukuzimisela kwezinkomba zokuqina.

Ngemuva kokuba inqubo isiqediwe, iziguli zidinga ukuhlala esibhedlela isikhathi esithe xaxa. Isikhathi salesi sikhathi sincike kuhlobo lwe-biopsy eyenziwe. Uma ucwaningo lwezicubu ze-pancreatic lwenziwa ngaphandle kwesisekelo, khona-ke ngemuva kwamahora ama-2-3 umuntu angakwazi ukuya ekhaya. Lapho uthatha i-biopsy ngokuhlinzwa, isiguli sihlala esibhedlela amasonto ambalwa.

Endaweni yenqubo, izinhlungu zingahlala ezinye izinsuku eziningana. Ukungajabuli okukhulu kufanele kumiswe ngama-analgesics. Imithetho yokunakekela indawo yokubhoboza incike ohlotsheni lwenqubo ephelele. Uma ukuhlinzwa kungelwenziwe, lapho-ke i-bandage ivunyelwe ukususwa ngosuku olulandelayo, bese ugeza.

Izinkinga ezingaba khona

Ukuvimbela imiphumela emibi, isiguli kufanele sigweme ukuzikhandla ngokomzimba, shiye imikhuba emibi, futhi futhi singashayeli imoto ngemuva kokukhohliseka okunjalo.

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