Izindlela kancane koda nokwelashwa nomdlavuza wesibindi iziguli

ukususwa Steel izimila isibindi inikeza inamathuba lokuthi uzophulukiswa. Ngeshwa, izimila isibindi ngokuvamile makhulu kakhulu noma umxhwele imithambo yegazi ezinkulu, nokunye ukwakheka okubalulekile. Lokhu kwenza ukuhlinzwa enkulu yokungaphumeleli noma kungenzeke lokho. ukususwa Steel akunakwenzeka 30-40% kweziguli eyinhloko futhi 90% eziguli nge yesibili nomdlavuza wesibindi.

Ngokomlando, izidakamizwa ukuthi ayizwakali ekwelapheni umdlavuza wesibindi. Ngakho-ke, kukhona eziningi amasu evumela ukulwa nalesi sifo.

izinhlobo

Primary nomdlavuza wesibindi: Ifomu ezivame kakhulu zomdlavuza eyinhloko kungukuhlasela carcinoma hepatocellular (HCC). Lokhu kuwuphawu lwesimila ukuthi iqala amaseli main kwesibindi. nomdlavuza wesibindi Primary kuyizikhathi ezimbili zanda amadoda kuka kwabesifazane. HCC landile ngulabagulako nge isibindi sibe sesomile.

Metastatic Isibindi Cancer: Umdlavuza angadluliselwa kusuka kunoma iyiphi ingxenye yomzimba kwesibindi. Sikwazi ukukhula amaseli Kukhona anomdlavuza izinyanga noma iminyaka ngaphambi kokuba zitholiwe. Isibindi metastases ngokuvamile izimila kapopopo ingemuva. Iziguli nezinye izinhlobo umdlavuza nabo basengozini yokuba nomdlavuza wesibindi.

Isibindi uba sokuqala esiteshini ngoba amangqamuzana omdlavuza afundwa kakhulu egazini. Sikwazi ukukhula Lezi amaseli bese akha isimila. Kukholakala ukuthi u-70% wabo bonke abanomdlavuza engalawuliwe ekugcineni etholwe izimila isibindi lesibili noma metastases (izimila ezakhiwe amangqamuzana omdlavuza eyinhloko ukuthi baye basakaza kusuka kwamanye amasayithi umdlavuza).

ukuhlola

Kunezindlela eziningana ukuhlolwa ezingasiza kule komdlavuza, kuhlanganise ukuhlolwa kwegazi, behlolwa futhi ezihlukahlukene izindlela zokuthwebula izithombe zokwelapha kuhlanganise-X-ray, tomography ngekhompyutha (CT), i-magnetic resonance imaging (MRI) kanye ultrasound.

Ngokuvamile, uphethwe wokugcina azikwazi ukwenziwa kuze kube yilesi sikhathi, uze wenze biopsy. Ngemva kokuhlola isampula biopsy, ochwepheshe kungacacisa ukuthi onjani umdlavuza likhona futhi ngokushesha kanjani ungasabalalisa. Lolu lwazi kubalulekile lapho senza izinqumo mayelana uhlobo ukwelashwa.

ukwelashwa

Izimila kudingeka kwegazi ke ngenkuthalo ukukhiqiza, ukuzondla futhi ukhule. Radiologists kanye ongoti emkhakheni ukuhlinzwa semithambo nokuhambisa imithi abahlosiwe busuka imithambo yegazi ngokusebenzisa ipayipi ngomzimba.

Ekwelapheni abanomdlavuza, radiologists kungaba ukuhlasela isimila ezithinta therefrom ngu embolization nomsakazo amagagasi. Embolization athuthukiswe kahle indlela Radiology interventional, esetshenziselwa yokuphatha abalimele nge ukopha okukhulu, ukulawula ukopha ngemuva kokubeletha, ukunciphisa ukopha ngaphambi nje kokuba ahlinzwe futhi ekwelapheni izimila.

Ekwelapheni abanomdlavuza, embolization isetshenziswa ukunciphisa igazi eligciniwe ukuba izimila, ukulethwa ngemisebe (radioembolizatsiya) noma ukuhlanganisa le ndlela nokwelashwa ngamakhemikhali ukuletha umdlavuza izidakamizwa ngqo izimila (chemoembolization).

Ngaphezu kwalokho, amangqamuzana omdlavuza zibulawa izindlela ezishisayo (radiofrequency ablation) noma isimila eqandisiwe (cryoablation).

chemoembolization

Chemoembolization kuyinto ukuphathwa kancane koda of nomdlavuza wesibindi, angasetshenziswa kokubili ngokuzimela kanye ngokuhlanganyela nezinye izinqubo. Chemoembolization inikeza abaphathi ebulilini himioembolizata ngqo uhlaka, wayencisha isimila igazi layo ukunikezela nge nokuvimba noma embolization kwemithambo yegazi ukusuthisa lwesimila. Ukusebenzisa ukufundwa isithwebuli isiqondiso, radiologist interventional eyethula ipayipi omncane angene kule Umthambo femoral. Isebenzisa umthamo enkulu izidakamizwa, inqubo njengoba ngokukhetha uqhuba futhi, ngokufanelekile, izidakamizwa kancane ukhiphela amaseli okunempilo emzimbeni. Chemoembolization ngokuvamile kuhilela ukuhlala esibhedlela ka emalanga lamabili kuya kulamane. Iziguli ngokuvamile ukuphinde benze imisebenzi evamile ingakapheli nenyanga.

Chemoembolization siyasebenza ngokweqile ekwelapheni izimila isibindi abulalayo, ikakhulukazi lihambisana yingaba yini engakusiza. Chemoembolization uye kubonise imiphumela ethembisa ekwelapheni izimila metastatic. Kuyinto lolu hlobo ukwelashwa evunywe FDA ekwelapheni metastases.

Radioembolizatsiya

Radioembolizatsiya kakhulu efana chemoembolization kodwa nokusetshenziswa microspheres enemisebe. Lokhu ukwelashwa isetshenziselwa ukwelapha kokubili izimila isibindi okuyinhloko kanye metastatic. sphere ezisetshenzisiwe embolic we IKhompyuthaYami enemisebe yttrium-90 ukuletha emisebeni ngqo yesimila. Ngamunye Sphere usayizi amahlanu egazi abomvu ububanzi. Lezi elimbudumbudu yethulwe ngokusebenzisa ipayipi ku imbilapho kanye imbangela yokufa kwamangqamuzana engokwemvelo. Ubuchwepheshe ihlinzeka ephakeme, umthamo wendawo emisebeni ngaphandle ingozi ukuze inyama ephilile.

Lena yokwelapha empeleni esasisesisha, owawungumnyaka ekwelapheni izifo nomdlavuza wesibindi eyinhloko futhi metastatic. It has ayinayo imiphumela eminingi engemihle uma kuqhathaniswa nezindlela ezivamile yokwelapha abantu abanomdlavuza.

radiofrequency ablation

Ukuze izimila isibindi inoperable, radiofrequency ablation inikeza ukwelashwa ehunyushelwe non-kuhlinzwa esibulala isimila cells ukushisa engashiyi izicubu isibindi enempilo. Ngakho, le ndlela yokwelapha, kuba lula kakhulu ukuze isiguli kuka ukwelashwa letindzala. Ivunywe yi-FDA RFA ekwelapheni izimila isibindi.

Ngo inombolo encane izimo, RFA ongalinikeza izimpilo zeziguli. Kuye ngobukhulu yesimila RFA kungaba ukuncipha noma ukubulala isimila, okwandisa isikhathi nesineke okusinda kakhulu ekuthuthukiseni izinga lempilo yabo. Ngoba impatho zendawo akusho ukulimaza izicubu onempilo, ukwelapha kungaba liphindwe kaningi njengoba kudingeka ukuze iziguli zihlale zone induduzo. Lena inqubo ephephile kakhulu, nge inkinga izinga le-oda amabili kuya kwamathathu amaphesenti, futhi isineminyaka kusukela ngeminyaka yawo-1990 ngasekupheleni.

Umdlavuza zokwelapha okusha

Radiology interventional udlala indima ebalulekile bethuthukisa izinqubo ezintsha okuthe kungathuthukisa ukwelashwa komdlavuza esikhathini esizayo, kuhlanganise nokusetshenziswa izinhlayiya magnetic kanye ukulethwa nesidoda okunikelwe, ngokuthi ukwelapha ngezakhi zofuzo, ukulwa noma ungabi nomdlavuza. Lezi zindlela zisekhona investigational futhi ebanika ithemba elisha empini yokulwa nomdlavuza.

"Magnetic" Ukwelashwa ngamakhemikhali

radiologists interventional okwamanje siphenya indlela entsha lapho odonsa zisetshenziselwa donsa ejenti chemotherapeutic ukuze yesimila. izinhlayiya ezincane kazibuthe Banamathele izidakamizwa futhi inikelwe ngokusebenzisa ipayipi abe isitsha esihle ngegazi elalisesandleni uyasondla isimila. I ezingavamile emhlabeni uzibuthe ibekwe phezu komzimba lesiguli ngokuqondile ngenhla indawo yesimila. izinhlayiya Magnet ukuze awele lwesimila. Nakuba inqubo kusahlolwa, kodwa ethembisa kakhulu. Odokotela banethemba lokuthi kuyoba ukugcina imiphumela emibi yokwelashwa ngamakhemikhali ngenkathi kugwenywa ezinye imiphumela engemihle ezifana nezinwele nesicanucanu.

ukwelapha ngezakhi zofuzo

Eminyakeni yamuva, ososayensi baye bayiqonda olusha mayelana izakhi zofuzo - eyisisekelo amayunithi begazi ufuzo futhi indima abayidlalayo kwetinhlavu isifo. Lolu lwazi kuye kwasusa isayensi yezokwelapha - ukwelapha ngezakhi zofuzo. Nakuba isayensi namanje ngasekuqaleni izigaba zokuhlola, abacwaningi lokuthi esikhathini esizayo ingasetshenziswa ukuze:

• wokwelapha isifo somdlavuza kanye nezinye izifo ezibangelwa ufuzo;
• izinguquko emangqamuzaneni omzimba isiguli nomdlavuza futhi wababuyisela umzimba, lapho ayengase ukuhlasela sifo noma isenzo njengoba yokugoma;
• esikhundleni esakhini sofuzo esingafanele obhekene ukwanda komdlavuza ku isakhi "okuhle".

Enye yezinkinga zokwelapha izici zofuzo ukuthola izindlela eziphephile futhi eziphumelelayo ukuletha zezakhi zofuzo noma amaseli okushintshwe izakhi ku yesimila.

Odokotela babe amathemba okusezingeni eliphezulu intuthuko futhi isicelo sabo okusheshayo zokwelapha.