Mokhoa oa ho khetha nale e nepahetseng ea biopsy bakeng sa ts'ebetso ea bongaka?

Sebakeng se lulang se fetoha sa tlhahlobo ea bongaka,lisebelisoa tsa biopsye bapala karolo ea bohlokoa ho fumaneng lisampole tsa lisele bakeng sa tlhahlobo e nepahetseng ea mafu, 'me khetho ea bona e amana ka kotloloho le ho nepahala ha biopsy, polokeho le boiphihlelo ba mokuli. Se latelang ke tlhahlobo ea mekhoa ea biopsy,mefuta ea linale tsa biopsy, core-to-fine needle ratios, le lintlha tsa bohlokoa tsa khetho ho fana ka tataiso e hlophisitsoeng bakeng sa boikoetliso ba meriana.

1. Ho utloisisa mekhoa ea biopsy

Sepheo sa mantlha sa ts'ebetso ea biopsy ke ho fumana sampole ea boleng bo holimo ea linama ho hlakisa mofuta oa leqeba kapa ho theha moralo oa kalafo. Tlhokahalo ea nale ea biopsy e fapana haholo lipakeng tsa maemo a biopsy:

- Tlhahlobo ea hlahala: molumo o lekaneng oa lisele oa hlokahala ho tšehetsa boemo ba pathologic le tlhahlobo ea liphatsa tsa lefutso (mohlala, EGFR, ALK liphetoho).

- Mafu a ho ruruha: cytology e hlokeha ho hlakisa pathogen kapa mofuta oa lisele tsa 'mele.

- Tekolo ea pele ho ts'ebetso: ho hlokahala sampole e potlakileng ho tataisa liprothokholo tsa ho buoa (mohlala, ho tsebahatsa matsoele a mabe le a kotsi).

2. Mefuta ealisebelisoa tsa biopsyle lits'ebetso tsa kliniki

(1)Nale ea Core Biopsy

- Molao-motheo: Ho fumana sampole ea lisele ka ho itšeha ka mochini.

- Melemo:

Sampling e felletseng, e loketseng hlahala e tiileng (mohlala, sefuba, prostate) le biopsy ea lisele tsa masapo.

Boholo ba sampole bo lekane ho ts'ehetsa immunohistochemistry le tlhahlobo ea limolek'hule.

- Meeli: tsietsi e batlang e le kholo, e hloka ho utloisisa matšoao.

(2) Fine Aspiration Biopsy Nale

- Molao-motheo: Tšebeliso ea khatello e mpe ea khatello ho fumana ho emisoa ha lisele.

- Melemo:

Ho fokotseha ho fokolang, ho loketse bakeng sa li-lymph nodes tse ka holimo, qoqotho le matšoafo a matšoafo.

Ho bonolo ho e etsa, e ka fumana kapele ho emisoa ha lisele.

E bonolo ho e etsa, e lumella tlhahlobo e potlakileng ea cytological.

- Meeli: karohano ea sampole, ha e khone ho fihlela litlhoko tsa tlhahlobo ea nalane.

(3) Nale ea Biopsy e Thusang ka Vacuum (VAB)

- Molao-motheo: E kopanya ho itšeha ka mochini le khatello e mpe ea khatello ho ntlafatsa lisampole.

- Melemo:

Mehlala e mengata e ka fumanoa ka phuncture e le 'ngoe, e loketseng matsoele a microcalcified foci.

E fokotsa kotsi ea ho phunya hape hape e ntlafatsa mamello ea mokuli.

(4) Ho Seha Nale ea Biopsy

- Molao-motheo: Lesela le sehoa ka ntlha e kolobisitsoeng kapa lehare le potolohang.

- Mefuta:

Nale e Slotted: mohlala, Tru-Cut Biopsy Nale, bakeng sa linale tse bonolo.

Nale ea ho Epa: mohlala, Nale ea Bone Marrow Biopsy, bakeng sa lisele tsa masapo.

3. core nale biopsy vs khaballo ea nale

4. Lintlha tse ka sehloohong tse lokelang ho nahanoa ha u khetha lisebelisoa tse nepahetseng tsa biopsy

(1) Sebaka sa sepheo sa Biopsy

- Litho tse ka holimo (mohlala, qoqotho, sefuba): linale tse ntle kapa linale tsa mantlha li khethoa ho leka-lekanya litlhoko tsa ts'oaetso le tlhahlobo.

- Litho tse tebileng (mohlala, sebete, liphio): linale tse telele tsa biopsy li khethoa ho netefatsa botebo ba ho kenella.

- Linale tsa lesapo: linale tsa ho phunya lesapo (mohlala, linale tsa biopsy ea moko oa masapo) li tlameha ho sebelisoa ho qoba ho arohana ha lisele.

(2) Lintlha tse tobileng mokuli

- Lilemo le molao-motheo: bana kapa bakuli ba fokolang ba lokela ho khetha nale e tšesaane (mohlala, 20G) ho fokotsa mathata.

- Ts'ebetso ea coagulation: bakuli ba nang le mathata a coagulation ba hloka ho qoba linale tse mahoashe (mohlala, 16G) ho fokotsa kotsi ea ho tsoa mali.

- Boemo ba kelello: Bakuli ba tšoenyehileng ba ka khetha linale tsa biopsy tse thusoang ka vacuum ho khutsufatsa nako ea ts'ebetso.

(3) Boima ba lisele le sebaka

- Lithipa tse teteaneng (mohlala, tšoelesa ea senya, sebete): khetha nale ea biopsy e nang le matla a matla a ho seha (mohlala, nale e potiloeng ea 18G).

- Methapo / methapo ea mali ea boahelani: ho hlokahala ts'ebetso ea ultrasound / CT ho khetha nale e ngotsoeng ka tsoelo-pele ea biopsy.

(4) Boholo le bolelele ba nale

- Khetho ea likhetho:

Nale e ntle (20-22G): bakeng sa cytology kapa liso tse ka holimo.

Nale e mahoashe (14-18G): e loketse tlhahlobo ea histological kapa liso tse tebileng.

- Khetho ea bolelele: e khethoa ke botebo ba ho phunya (mohlala, biopsy ea matšoafo e hloka ho ba ≥15cm).

(5) Moqapi oa malebela

- Keletso ea nale e betliloeng: e loketse lisele tse bonolo ho fokotsa khanyetso.

- Keletso e nang le mahlakore a mararo: e sebetsa ho lisele tsa masapo, ho matlafatsa ho kenella.

- Ho tšoaea: Linale tsa biopsy tse tataisoang ke MRI li lokela ho ngoloa ka alloy ea titanium.

(6) Ho lumellana le mekhoa ea litšoantšo

- Tataiso ea Ultrasound: Linale tsa biopsy tse nang le mehele e ntseng e hola li hloka ho khethoa.

- Tataiso ea CT / MRI: lisebelisoa tse seng tsa makenete kapa tse tlase (mohlala, titanium alloy) li lokela ho khethoa.

(7) Mokhoa oa ho ntša mohlala

- Ho itšeha ka mochini: ho sebetsa ho lihlahala tse tiileng tse nang le sampole e felletseng.

- Khatello e mpe ea khatello: e loketse tlhahlobo ea cytological, e bonolo ho sebetsa.

- Thuso ea Vacuum: e sebetsa ho sampole ea libaka tse ngata, e ntlafatsa ts'ebetso.

(8) Matšeliso le tšireletseho ea mokuli

- Taolo ea bohloko: nale e ntle ha e utloise bohloko haholo ebile e mamelleha ho bakuli.

- Thibelo ea mathata: qoba ho phunya khafetsa ka nale e teteaneng, fokotsa kotsi ea pneumothorax le ho tsoa mali.

(9) Litšenyehelo le phihlello

- Tšebeliso e ntle ea litšenyehelo: linale tsa biopsy tse iketsetsang ka botlalo (mohlala, TSK) li bitsa chelete e ngata, empa li na le katleho e phahameng ea sampole.

- Ts'ireletso ea inshorense ea bongaka: ho hlokahala ho khetha lihlahisoa ka har'a sebaka sa puseletso ho latela maano a lehae.

5. Qetello

Khetho ealisebelisoa tsa biopsye hloka tlhahlobo e felletseng ea mofuta oa leqeba, boemo ba mokuli, maemo a tekheniki le lintlha tsa moruo. Ts'ebetsong ea kliniki, melao-motheo e latelang e lokela ho lateloa:

1. ho nyalana ka nepo: khetha mofuta oa nale ho latela sebaka seo u batlang ho se fumana (mohlala, nale e kolobisitsoeng ka 14G bakeng sa letsoele, nale ea 20G bakeng sa qoqotho).

2. Beha tšireletseho pele: qoba linale tse teteaneng bakeng sa bakuli ba nang le mathata a coagulation, 'me u sebetse tlas'a tataiso ea setšoantšo bakeng sa liso tsa vascular tse haufi.

3. Ho sebetsa ka katleho le matšeliso: linale tsa biopsy tse thusoang ka vacuum li ka ntlafatsa katleho, 'me linale tse ntle li ka fokotsa bohloko ba mokuli.

Ka khetho ea mahlale ea linale tsa biopsy, ho nepahala ha tlhahlobo ho ka ntlafatsoa haholo, kotsi ea mathata e ka fokotsoa, ​​​​mme qetellong ho ka fumaneha meriana e nepahetseng ea motho ka mong.