Nigute wahitamo urushinge rwa biopsy rukwiye mu gikorwa cyo kwa muganga?

Mu gihe cy'impinduka zikomeje kwiyongera mu bijyanye no gusuzuma indwara,inshinge za biopsybigira uruhare runini mu kubona ingero z'uturemangingo kugira ngo dusuzumwe neza indwara, kandi guhitamo kwatwo bifitanye isano itaziguye n'ukuri kwa biopsy, umutekano n'uburambe bw'umurwayi. Ibi bikurikira ni isesengura ry'uburyo biopsy ikorwamo,ubwoko bw'inshinge za biopsy, ingano y'urushinge rw'ibanze kuva ku ntoya kugeza ku ntoya, hamwe n'ibintu by'ingenzi byo guhitamo kugira ngo bitange ubuyobozi buhamye mu ivuriro.

1. Gusobanukirwa uburyo bwo gusuzuma imiterere y'ibiyobyabwenge

Intego nyamukuru y'uburyo bwo gukora biopsy ni ukubona icyitegererezo cy'uturemangingo twiza kugira ngo hamenyekane neza imiterere y'igisebe cyangwa gutegura gahunda yo kuvura. Gukenera urushinge rwa biopsy biratandukanye cyane bitewe n'imiterere ya biopsy:

- Gusuzuma ikibyimba: hakenewe ingano ihagije y'ingingo kugira ngo habeho isuzuma ry'indwara no gupima imiterere y'uturemangingo (urugero, EGFR, ALK mutations).

- Indwara ziterwa n'ububyimbirwe: ubuvuzi bw'umubiri burakenewe kugira ngo hamenyekane ubwoko bw'uturemangingo tw'indwara cyangwa ubudahangarwa bw'umubiri.

- Isuzuma mbere yo kubagwa: hakenewe kubona icyitegererezo byihuse kugira ngo habeho uburyo bwo kubaga (urugero, kumenya amabere y’ibere adafite ingaruka mbi n’afite ububabare).

2. Ubwoko bwainshinge za biopsyn'ikoreshwa ry'ubuvuzi

(1)Urushinge rw'ibanze rwa Biopsy

- Ihame: Kubona agace k'ingero z'ibinyabutabire hakoreshejwe uburyo bwo gukata.

- Ibyiza:

Gufata ingero zuzuye, bikwiranye n'ikibyimba gikomeye (urugero, ibere, prostate) n'ibipimo by'igufwa.

Ingano y'icyitegererezo irahagije kugira ngo ishyigikire isuzuma rya immunohistochemistry n'iry'uturemangingo.

- Inzitizi: ihungabana rinini, ugomba gusobanukirwa neza ibimenyetso.

(2) Urushinge rwo gusuzuma imiterere y'umubiri (biopsy)

- Ihame: Gukoresha uburyo bwo gukurura umuvuduko mubi kugira ngo uturemangingo dushobore guhagarara.

- Ibyiza:

Ntibitera impagarara cyane, bibereye ku ndwara zo mu mitsi yo hejuru, indwara ya tiroyide n'ibihaha.

Byoroshye gukora, bishobora kubona vuba uburyo bwo guhagarika uturemangingo.

Byoroshye gukora, bituma umuntu amenya vuba indwara ya cytological.

- Imbogamizi: gucikamo ibice by'icyitegererezo, kutabasha guhaza ibyo gusuzuma histologiya bikenewe.

(3) Urushinge rwo gupima indwara hakoreshejwe imashini ikoresha umwuka (VAB)

- Ihame: Ihuza uburyo bwo gukata hakoreshejwe ikoranabuhanga no gukurura umuvuduko mubi kugira ngo yongere imikorere myiza y'ingero.

- Ibyiza:

Ingero nyinshi zishobora kuboneka mu gupfumura rimwe, zikwiriye amabere afite kalisiyumu nkeya.

Bigabanya ibyago byo kongera gutobora no kunoza ubushobozi bw'abarwayi bwo kwihanganira indwara.

(4) Gukata urushinge rwa Biopsy

- Ihame: Uduce ducibwa n'umutwe ufite imigozi cyangwa icyuma kizunguruka.

- Ubwoko:

Urushinge rufite imigozi: urugero: Urushinge rwa Tru-Cut Biopsy, ku ngingo zoroshye.

Urushinge rwo gucukura impeta: urugero: Urushinge rwo gusuzuma igufwa ry'umuyonga w'amagufwa, rw'ingingo z'amagufwa.

3. gusuzuma urushinge rw'ibanze ugereranije n'uburyo urushinge ruto rukoreshwa mu gusukura neza

4. Ibintu by'ingenzi ugomba kuzirikana mu gihe uhitamo inshinge zikwiye zo gupima

(1) Agace kagenewe gusuzuma indwara ya Biopsy

- Ibihimba by'umubiri byo hejuru (urugero, tiroyide, ibere): inshinge nto cyangwa inshinge zo mu gice cy'imbere ni byo byiza kugira ngo habeho kuringaniza ibikomere n'ibikenewe mu gusuzuma indwara.

- Ingingo z’imbere mu mubiri (urugero, umwijima, impyiko): inshinge ndende zo mu gice cy’imbere cy’umubiri ni zo zikundwa cyane kugira ngo harebwe ko zinjira mu buryo bwimbitse.

- Uduce tw'amagufwa: inshinge zo gucukura impeta (urugero: inshinge zo gupima umwongo w'amagufwa) zigomba gukoreshwa kugira ngo hirindwe ko ingirangingo zicikamo ibice.

(2) Ibintu byihariye ku murwayi

- Imyaka n'imiterere: abana cyangwa abarwayi bafite intege nke bagomba guhitamo urushinge ruto (urugero, 20G) kugira ngo bagabanye ingorane.

- Imikorere yo gufungana kw'amaraso: abarwayi bafite ibibazo byo gufungana kw'amaraso bagomba kwirinda inshinge zikomeye (urugero, 16G) kugira ngo bagabanye ibyago byo kuva amaraso.

- Imiterere yo mu mutwe: Abarwayi bafite impungenge bashobora guhitamo guterwa inshinge zo mu bwoko bwa biopsy hakoreshejwe vacuum kugira ngo bagabanye igihe cyo kubagwa.

(3) Ubucucike bw'ingingo n'aho ziherereye

- Udusimba twinshi (urugero, prostate, umwijima): hitamo urushinge rwa biopsy rufite imbaraga zikomeye zo gukata (urugero, urushinge rufite imiyoboro ya 18G).

- Imitsi/imitsi y'amaraso yegereye: igikorwa cya ultrasound/CT gikozwe na ultrasound kirakenewe kugira ngo hatoranywe urushinge rwa biopsy rufite ikimenyetso cy'iterambere.

(4) Ingano n'uburebure bw'urushinge

- Guhitamo ibipimo:

Urushinge ruto (20-22G): ku ndwara ya cytology cyangwa ibisebe byo hejuru.

Urushinge rukomeye (14-18G): rukwiriye gupimwa histologic cyangwa ibisebe byimbitse.

- Guhitamo uburebure: bigenwa n'ubujyakuzimu bw'aho umuntu yatobowe (urugero: isuzuma ry'ibihaha rigomba kuba ≥15cm).

(5) Igishushanyo cy'urushinge

- Isonga ry'urushinge rufite imigozi: rikwiriye ingingo zoroshye kugira ngo zigabanye imbaraga zo kurwanya.

- Agace k'igufwa gafite impande eshatu: gakoreshwa ku ngingo z'amagufwa, kugira ngo kongere uburyo bwo kwinjira.

- Ikimenyetso: Inshinge za biopsy ziyobowe na MRI zigomba gushyirwaho ikimenyetso cya titaniyumu.

(6) Guhuza n'uburyo bwo gufata amashusho

- Ubuyobozi bwa Ultrasound: Hagomba gutoranywa inshinge za Biopsy zifite impeta zikura.

- Ubuyobozi bwa CT/MRI: ibikoresho bidafite ingufu za rukuruzi cyangwa bike (urugero, aloyi ya titaniyumu) ​​bigomba gutoranywa.

(7) Uburyo bwo gukuramo ingero

- Gukata hakoreshejwe ikoranabuhanga: bikoreshwa ku tumori dukomeye hamwe n'ingero zuzuye.

- Gukurura umuvuduko mubi: bibereye gusuzuma imikorere y'umubiri, byoroshye gukoresha.

- Gukoresha imashini ikoresha umwuka udafite umwuka: bikoreshwa mu gupima ahantu henshi, byongera imikorere myiza.

(8) Ihumure n'umutekano by'umurwayi

- Kugabanya ububabare: urushinge ruto ntirutera cyane kandi rushobora kwihanganirwa n'abarwayi.

- Kwirinda ingorane: irinde gutobora inshuro nyinshi ukoresheje urushinge runini, kugabanya ibyago byo kurwara pneumothorax no kuva amaraso.

(9) Ikiguzi n'uburyo bwo kugerwaho

- Kunoza ikiguzi: inshinge za biopsy zikora ku buryo bwikora (urugero, TSK) zirahenze cyane, ariko zifite igipimo cyo hejuru cyo gutsinda mu gupima.

- Ubwishingizi bw'ubuvuzi: ugomba guhitamo ibicuruzwa biri mu rwego rwo kwishyurwa hakurikijwe politiki z'ibanze.

5. Umwanzuro

Amahitamo yainshinge za biopsybisaba isuzuma ryimbitse ry’imiterere y’igisebe, uko umurwayi ahagaze, imiterere ya tekiniki n’ibintu by’ubukungu. Mu buvuzi, amahame akurikira agomba gukurikizwa:

1. Guhuza neza: Hitamo ubwoko bw'urushinge ukurikije agace kagenewe gupimwamo (urugero: urushinge rwa 14G rwometse ku ibere, urushinge ruto rwa 20G rwometse kuri tiroyide).

2. Shyira imbere umutekano: irinde inshinge nini ku barwayi bafite ibibazo byo kuvura amaraso, kandi ubakorere ku buryo bukurikije ifoto ku bisebe by’imitsi biri hafi aho.

3. Ingufu n'uburyohe: inshinge zo gupima hakoreshejwe imashini zikoresha umwuka udafite umwuka zishobora kongera imikorere, naho inshinge nto zishobora kugabanya ububabare bw'umurwayi.

Binyuze mu gutoranya inshinge za biopsy mu buryo bwa siyansi, uburyo bwo gusuzuma bushobora kunozwa cyane, ibyago byo kugira ibibazo bishobora kugabanuka, kandi amaherezo uburyo bwo kuvura bushobora kugerwaho hifashishijwe ikoranabuhanga.