E ai ki ngā raraunga e tika ana mō te Tari Rangahau mō te Mate Pukupuku o te Ao (IARC) o te Whakahaere Hauora o te Ao (WHO), kua riro te mate pukupuku pūkahukahu hei tētahi o ngā pukupuku kino rawa atu, ā, ko te ārai me te rongoā i te mate pukupuku pūkahukahu kua riro hei kaupapa matua mō te ārai me te rongoā i te mate pukupuku.
E ai ki ngā raraunga tatauranga e tika ana, tata ki te20% o ngā tūroro matepukupuku pūkahukahu ehara i te pūtau iti ka taea te whiwhi maimoatanga whakaoraKo te nuinga o ngā tūroro matepukupuku pūkahukahu kei roto kē ingā wāhanga matatauina kitea te mate, ā, tera pea ka iti noa ngā painga ka puta mai i ngā maimoatanga tuku iho o te radiotherapy me te chemotherapy. I te haere tonu o te whanaketanga me te whanaketanga o te pūtaiao hauora, ka puta ake terongoā whakangāwarihei whakakapi mō te pokanga, kua puta mai he tumanako hou mō ngā maimoatanga mō ngā tūroro mate pukupuku pūkahukahu.
1. E hia ōu mōhiotanga mō te rongoā ablative mō te mate pukupuku pūkahukahu?
Ko te rongoā āpiti mō te mate pukupuku pūkahukahu kei roto i te nuinga o te wāte tango i ngā pūtau maikoro me te tango i ngā pūtau auau irirangiKo te mātāpono maimoatanga ko te whakauru i tētahi hiko whakawātea, e mōhiotia ana ko te"whakamātautau,"ki roto i te pukupuku i roto i te pukahukahu. Ka taea e te hiko te whakaputanekehanga tereo ngā matūriki pērā i ngā katote, i ngā ngota wai rānei i roto i te puku, ka whakaputa wera nā te waku, ka arahi kingā kino kāore e taea te whakakore, pērā i te nekrosis totoka o ngā pūtau pukupuku.I taua wā anō, ka tere te heke o te tere o te whakawhiti wera i roto i te kiko pūkahukahu noa e karapoti ana, ka tiakina te wera i roto i te pukupuku, ka hanga he"Pānga ārai wera."Ka taea e te rongoā āpiti te patu i te pukupuku i te wā ete whakanui ake i te tiakitanga o ngā kiko pūkahukahu noa.
Ko te rongoā ablative e tohuhia ana ete āheinga ki te whakahoki anō, te iti o te mamae o te tūroro, te iti o te whara, me te tere o te whakaoranga,ā, kua whānuitia te mōhiotia me te whakamahia i roto i ngā mahi haumanu. Heoi, i te mea he maha ngā momo kaupapa e uru ana ki te rongoā ablative pērā i te radiology, te oncology, te radiology wawaotanga, me te hanganga pokanga, me nui te pūkenga pokanga me te kounga whānui mai i te tākuta mahi.
I tēnei rā, e hiahia ana mātou ki te whakamōhio atu ki a koutou i tētahi tohunga rongonui i te ao o te maimoatanga wawaotanga,Ko Tākuta Liu Chen, kua roa e mahi ana i roto i tēnei mara, ā, e whakapau kaha ana ki te rangahau whakamaoritanga haumanu me te whakatairanga paerewa i ngā tātaritanga me ngā maimoatanga wawaotanga iti rawa te whakaekenga pērā i ngā koiora pukupuku wero me te morearea nui, te tango wera, me te whakaurunga matūriki.E mōhiotia ana a Tākuta Liu ko te "toa i te pito o te ngira" ā, kua whai wāhi ia ki te whakatakoto i te whakaaetanga a ngā tohunga me ngā aratohu mō ngā tikanga maimoatanga wawaotanga mō te mate pukupuku pūkahukahu i Haina. Nāna i ārahi te ariā o te whakahaere whānui o ngā koiora mate pukupuku pūkahukahu, ā, i whakatū hoki i ngā tikanga pokanga paerewa hei whakapai ake i te whakatau whakatau mō te maimoatanga wawaotanga i roto i te rongoā ā-rohe mō te mate pukupuku pūkahukahu i te wā tōmua, me te whakatairanga i te whanaketanga whānui o te pūnaha tātaritanga me te maimoatanga mate pukupuku pūkahukahu o Haina.
"He toa i te pito o te ngira" – Tākuta Liu Chen
He tohunga ki ngā tikanga tātaritanga me te maimoatanga wawaotanga iti rawa te whakaekenga mō ngā pukupuku i raro i te aratohu whakaahua
1. Te tango i ngā kiri mai i te ngaruiti/auau irirangi
2. Kohikohi ā-kiri
3. Te whakaurunga matūriki irahiko
4. Te whakahaere mamae wawaotanga
2. Te kaupapa me ngā tohu o te rongoā ātete mō te mate pukupuku pūkahukahu
Te "Whakaaetanga a ngā Tohunga mō te Whakaora Ablative mō ngā Puku Pūkahukahu Tuatahi me ngā Puku Pūkahukahu Metastatic"(putanga 2014) e wehea ana te rongoā ātete mō te mate pukupuku pūkahukahu kia rua ngā wāhanga: te rongoā me te rongoā mamae.
Te tangohanga whakaoraKo tōna whāinga he whakangaro katoa i te kiko pukupuku o te rohe, ā, tera pea ka puta he pānga whakaora.Ko te mate pukupuku pūkahukahu i te wā tōmua he tohu tino tika mō te rongoā ā-tinana,inā koa mō ngā tūroro he ngoikore te mahi a te manawa, he kaumātuatanga, he kore e taea te aro ki te pokanga, he kore e taea te tango pokanga, he hunga rānei he hokinga mai o te pukupuku kotahi i muri i te radiotherapy conformal, tae atu ki ētahi tūroro he maha ngā whara matepukupuku pūkahukahu tuatahi e hiahia ana kia tiakina te mahi a te pūkahukahu.
Te tango i te mamae mamaee whai ana ki tete whakakore i te pukupuku tuatahi i roto i ngā tūroro he mate pukupuku pūkahukahu kua tae ki te wāhanga matatau, te whakaiti i te taumaha o te pukupuku, te whakamamae i ngā tohu i puta mai i te pukupuku, me te whakapai ake i te kounga o te oranga o te tūroro.Mō ngā tūroro he mate pukupuku pūkahukahu kua tata te horapa, ka taea e ngā pukupuku he whānui ake i te 5 cm, he maha rānei ngā whara te whakahaere i ngā wā maimoatanga maha-ngira, maha-ira, maha rānei, ka taea rānei te whakakotahi me ētahi atu tikanga maimoatanga hei whakaroa i te oranga. Mō ngā mate pukupuku pūkahukahu kino kua horapa i te wā mutunga, mēnā he pai te whakahaere i ngā pukupuku i waho o te pūkahukahu, ā, he iti noa iho ngā whara kua horapa i roto i ngā pūkahukahu, ka taea e te rongoā ablative te āwhina pai ki te whakahaere i te mate me te whakapai ake i te kounga o te oranga o te tūroro.
3. Ngā Painga o te Whakaora Ārai Mate
Pokanga iti rawa te whakaekenga, te whakaora tere: Ko te rongoā āpitihanga e kiia ana he pokanga wawao iti rawa te whakaekenga. Ko te diameter o te ngira hiko āpitihanga e whakamahia ana he rite ki1-2mm, ka hua ake he tapahi pokanga iti te rahi o te kōhao ngira. He painga tēnei huarahi pēnei i tehe iti rawa te whara, he iti te mamae, ā, he tere ake te ora.
He poto te wā pokanga, he wheako whakamarie:Ko te rongoā whakangāwari ka mahia i raro i te whakamoe ā-rohe, i te whakakotahitanga rānei me te whakamoe ā-uaua, kia kore ai e hiahiatia te whakaurunga ngongo endotracheal. Kei roto ngā tūroro i te āhua moe māmā, ā, ka taea te whakaara ake mā te pato mārie. Tērā pea ka rite ētahi tūroro ki te mea kua oti te pokanga i muri i tehe moe poto.
Te koiora i te wā kotahi mō te tautuhi tika:I te wā o te rongoā ablative, ka taea te whakamahi i tētahi taputapu biopsy coaxial guidance, i tētahi taputapu biopsy synchronous puncture rānei hei tiki i tētahi biopsy o te whara.te tautuhi mate me te whakamātautau irawhakarato i ngā mōhiotanga whai hua mō ngā whakataunga maimoatanga a muri ake nei.
Tukanga ka taea te whakahoki: He maha ngā rangahau mai i ngā puna o te motu me te ao kua whakaatu ko te reiti whakahaere ā-rohe o ngā tūroro mate pukupuku pūkahukahu wāhanga tōmua e whiwhi ana i te rongoā ablative he rite ki te tango pokanga, ki te rongoā irahiko stereotactic rānei. Mēnā ka hoki anō te mate i te rohe, ka taea te rongoā ablativeka taea te whakahoki i ngā wā mahakia hoki mai te mana whakahaere o te mate i te wā ete whakanui ake i te kounga o te oranga o te tūroro.
Te whakahohenga, te whakarei ake rānei i te mahi ārai mate: Ko te whāinga o te rongoā āpitihanga ko tewhakamate i ngā pūtau pukupuku i roto i te tinana, ā, i ētahi wā, ka taea e ia te whakahohe, te whakarei ake rānei i te mahi ārai mate o te tūroro, ka hua ake he kei reira ngā pukupuku kāore i rongoatia i ētahi atu wāhanga o te tinana e whakaatu ana i te hokinga mai. Hei tāpiri, ka taea te whakakotahi i te rongoā ablative me te rongoā pūnaha hei whakaputahe pānga mahi tahi.
He tino pai te rongoā ablative mō ngā tūroro kāore e taea te aro ki te tango pokanga, ki te rongoā whakamoe whānui rānei nā te meate ngoikore o te mahi a te manawa, te koroheketanga, te maha rānei o ngā mate tāpiriHe maimoatanga pai hoki tēnei mō ngā tūroro e pāngia ana engā pona maha o te wāhanga tōmua (pēnei i ngā pona karāhe whenua maha).
Wā tuku: 23 o Ākuhata-2023