Pancreatic biopsy

Pancreatic biopsy imachitidwa ku Chipatala cha Yinza ku Yauza. Uku ndikuboola kapamba, kochitidwa moyang'aniridwa ndi ultrasound, ndi kusonkhanitsa kwazinthu zakuthupi kuti zidziwike mu mbiriyakale. Njira iyi imagwiritsidwa ntchito pamaso paopezeka neoplasms yachilengedweyi kuti afotokozere chikhalidwe chawo, kuphatikizapo kupezeka ndi khansa ya kapamba.

Pali njira zingapo zakusiyana kwa kapamba.

• Percutaneous biopsy (singano yabwino yofunsa biopsy, yofupikitsidwa - TIAB)
  Imachitika ndi singano yopyapyala yayitali pansi pa mankhwala oletsa ululu kudzera pakhungu lamkati lam'mimba moyang'aniridwa ndi ultrasound kapena computer tomography. Mwanjira imeneyi, zimakhala zovuta kuti singano ikhale ndi chotupa chochepa (zosakwana 2 cm). Chifukwa chake, njirayi imagwiritsidwa ntchito posinthanitsa (zofala) mu gland, mwachitsanzo, kusiyanitsa kutukusira ndi njira ya oncological (khansa ya kapamba, kuzindikira matenda).
• Intraoperative ndi laparoscopic biopsy
  An intraoperative biopsy ndi biopsy zitsanzo zomwe zimachitika pa opareshoni - zotseguka, zochitidwa kudzera pakuloweka kwakukulu, kapena laparoscopic, zosapweteka. Laparoscopy imagwiritsidwa ntchito kudzera m'makoma a khoma lam'mimba pogwiritsa ntchito kamera yosanja yocheperako yomwe imatumiza chithunzi chokulirapo. Ubwino wa njirayi ndikutha kupenda zam'mimbamo kuti mupeze metastases, kulowetsedwa kwa kutupa. Dokotala amatha kuwona momwe khansa yapakhungu ilili, kuchuluka kwa njira yotupa m'matumbo a pancreatitis, kudziwa kukhalapo kwa necrosis, ndikutenga biopsy kuchokera kudera latsamba lomwe limakayikitsa malinga ndi oncology.

Kukonzekera TIAB

• Chenjezani dokotala wanu za zovuta zilizonse zamagulu osokoneza bongo, matenda ena ndi mthupi, monga kutenga pakati, matenda am'mapapo komanso matenda a mtima, komanso kutuluka magazi kwambiri. Mungafunike kuyesedwa.
• Ngati mukumwa mankhwala aliwonse, dziwitsani dokotala pasadakhale. Mutha kulangizidwa kuti musakane kutenga ena a iwo.
• Ndondomeko imachitidwa mosamalitsa pamimba yopanda kanthu, phunzirolo lisanathe ngakhale kumwa madzi.
• Tsiku loti biopsy lisinthe, muyenera kusiya kusuta ndi kumwa mowa.
• Ngati mukuopa kwambiri njira yomwe ikubwera, auzeni dokotala za izi, mutha kupatsidwa jakisoni wa tranquilizer (sedative).

Phunziroli nthawi zambiri limachitika pang'onopang'ono (pokhapokha ngati pakuchita opaleshoni ya biopsy komanso opaleshoni).

Pogwiritsa ntchito singano yabwino kwambiri, mankhwala ogwiritsira ntchito mankhwalawa amagwiritsidwa ntchito, pogwiritsa ntchito mankhwala oletsa kupindika ndi laparoscopic.

Kutalika kwa kafukufukuyu kuyambira pa mphindi 10 mpaka ola limodzi, kutengera njira.

Pambuyo biopsy wa kapamba

• Wodwala akangodwala kumene, wodwalayo amakhalabe m'chipatala moyang'aniridwa ndi achipatala kwa maola awiri ndi atatu. Kenako, atakhala ndi thanzi labwino, akhoza kubwerera kwawo.
• Ndi chithandizo cha opaleshoni - wodwalayo amakhalabe oyang'aniridwa ndi ogwira ntchito zamankhwala kwa tsiku limodzi kapena kupitilira. Zimatengera kuchuluka kwa maopareshoni.
• Pambuyo pa opaleshoni, wodwala sangathe kuyendetsa yekha.
• Masana pambuyo pa njirayi, mowa ndi kusuta ndizoletsedwa.
• Pakupita masiku awiri, ndikofunikira kupatula zolimbitsa thupi.
• Dokotala wanu angakulimbikitseni kuti musiye kumwa mankhwala patatha sabata limodzi pambuyo pa kukomoka.

Biopsy (puncture) pakuwonetsa khansa yapathengo

Matenda ambiri a kapamba, kuphatikizapo khansa ya kapamba, ndiwopseza kwambiri. Posakhalitsa matenda atapezeka, pamakhala mwayi waukulu woti akuchira. Kuzindikira mochedwa khansa ya kapamba kumalumikizidwa ndi kusapezeka kwa zizindikiro za matendawa.

Dziwani ngati khansa yamapamba yoyambirira zotheka ndi njira yophatikizira, kuphatikiza:

• chidwi pa madandaulo a wodwala (omwe akukayikira kwambiri ndi kupweteka kwa epigastric ndi kulowerera kumbuyo, kuchepetsa thupi),
• diagnostic radiation (ultrasound, endo-ultrasound, CT, MRI, cholangiopancreatography, angiography),
• kutsimikiza kwa zotupa zolembera - CA 19-9, CEA,
• chizindikiritso cha chibadwa.
• diagnostic laparoscopy,
• kuboola komanso kusindikiza kwamankhwala osokoneza bongo kwa kufufuza kwa mbiriyakale ndikuwonetsetsa kuti wapezeka.

Njira yokhayo yothanirana ndi khansa ya pancreatic yomwe imapatsa chiyembekezo chakuchita bwino ndi nthawi yake, opaleshoni yoyambirira, yothandizidwa ndi radiation yakutali kapena chemotherapy.

Mu Chipatala cha Yachinema ku Yauza, mutha kudziwa zambiri zamatenda a kapamba.

Ntchito mu zilankhulo ziwiri: Russian, English.
Siyani nambala yanu ya foni ndipo tidzakuyimbaninso.

Mitundu yayikulu ndi njira za biopsy

Kutengera luso la njirayi, pali njira zinayi zakusonkha zinthu zakutchire pakufufuza:

1. Mgwirizano. Chidutswa cha minofu amatengedwa pa opaleshoni lotseguka pa kapamba. Mtunduwu wa biopsy ndi wofunikira mukamafunika kutenga zitsanzo kuchokera mthupi kapena mchira wa gland. Iyi ndi njira yovuta komanso yoopsa.
2. Laparoscopic Njirayi imalola kuti isangotenga zitsanzo za biopsy kuchokera ku malo omwe akufotokozedwa bwino, komanso kupenda zam'mimba kuti mupeze metastases. Mtunduwu wa biopsy suyenera kungokhala pa oncological pathologies, komanso kudziwa volumetric madzimadzi mu mpangidwe wa retoperitoneal motsutsana ndi maziko a pancreatitis pachimake, komanso foci ya mafuta pancreatic necrosis.
3. Njira ya transdermal kapena singano yoyenera ya biopsy. Njira yodziwikirayi imakupatsani mwayi kusiyanitsa njira ya oncological ku pancreatic. Njirayi siigwira ntchito ngati kukula kwa chotupa kuli ochepera 2 cm, popeza ndizovuta kulowa nawo molondola, komanso sikuchitidwa opareshoni yam'mimba yomwe ikubwera. Njirayi siyichita mwakhungu, koma yowonetsedwa pogwiritsa ntchito ma ultrasound kapena makina ophatikizira.
4. Endoscopic, kapena transduodenal, njira. Zimaphatikizapo kuyambitsa kwa endoscope kudzera mu duodenum ndipo biopsy imatengedwa kuchokera kumutu wa kapamba. Ndikofunika kuti mugwiritse ntchito mtunduwu wa biopsy ngati neoplasm ili mkati mozama kapamba komanso yaying'ono.

Kukonzekera kofunikira musanachitike

Zachilengedwe zimatengedwa pamimba yopanda kanthu. Ngati wodwala akudwala flatulence, ndiye kuti masiku atatu asanakwane ndendende, zakudya zomwe zimathandizira kuti mapangidwe amipweya (masamba osaphika, nyemba, mkaka, buledi wa bulauni) asiyidwe kunja kwa zakudya.

Kuchita biopsy kumachitika pokhapokha ngati zotsatira za mayeso a zasayansi zilipo:

• kusanthula kwa magazi ndi mkodzo,
• Mitsempha yamagazi
• nthawi yokumana
• nthawi ya magazi
• prothrombin index.

Ngati magazi atulukiridwa kwambiri kapena wodwalayo ali m'mavuto akulu kwambiri, ndiye kuti zitsanzo zotsutsa za biopsy zimatsutsana.

Kubwezeretsa nthawi komanso zovuta zomwe zingachitike

Ngati zitsanzo za biopsy zimatengedwa pakuchita opaleshoni yam'mimba, ndiye pambuyo pake wodwala amatengedwa kupita kumalo osamalira odwala kuti akhazikitse zomwe zikuwonekera. Ndipo pomwepo amusamutsa ku dipatimenti yochitira opaleshoni yayikulu, komwe akapitiliza kuyang'aniridwa ndi ogwira ntchito pachipatala.

Ngati njira ya singano yoyenera ya bulugamu idagwiritsidwa ntchito, ndiye kuti wodwalayo amayenera kuyang'aniridwa ndi akatswiri osachepera maola awiri mutangomaliza kupanga. Matenda ake akhazikika, ndiye kuti atatha nthawi imeneyi amamasulidwa kunyumba. Koma wodwala samalimbikitsidwa kuyendetsa, motero zingakhale bwino ngati wina wapafupi kuti amuperekeze kuchipatala.

Pambuyo pa njirayi, wodwalayo ayenera kupewa kulimbitsa thupi kwa masiku atatu. Ndikulimbikitsidwanso kuti musiye kumwa mowa ndi kusuta.

Monga lamulo, odwala amalolera njira yodziwunzira bwino. Komabe, nthawi zina, mitsempha ya magazi ikawonongeka, magazi amatha kutuluka, ndipo nthawi zina, ma cysts abodza, mawonekedwe a fistulas, kapena peritonitis. Izi zitha kupewedwa ngati njirayi ikuchitika ndi katswiri woyenera kuchipatala chotsimikiziridwa.