Sibutsetelo
I-endobronchial ultrasound yinkqubo yezokwelapha engase yenziwe ngesikhathi se-bronchoscopy, ukuhlinzeka ngolwazi olwengeziwe ukuxilonga noma ukunquma isigaba somdlavuza wamaphaphu. Le nqubo emisha ivumela odokotela ukuba babheke izifunda zamapayipi akho kanye nesifuba esiseduze esivame ukufuna izinqubo eziningi zokuhlinzeka ezingenayo ukuze zihlolwe.
Inqubo ivame ukusebenza njengendlela yokuphulukisa iziguli noma ukuhlinzwa okufanayo ngosuku futhi kuthathwa njengenqubo encane yokuhlasela.
Inqubo
I-endobronchial ultrasound ivame ukuqhutshwa ngaphansi kwe-"anesthesia yenqubo" okusho ukuthi uzolala kakhulu futhi ngeke uzizwe ungakhululekile, kodwa ngeke ube nokulala ngokujulile njengoba uzobe unesifo esibuhlungu sokujwayelekile. Nokho, inqubo ingenziwa nge-anesthetic jikelele uma kudingeka.
Ngaphambi kokwenza i-endobronchial ultrasound, udokotela wakho uzoqala ukwenza i-bronchoscopy. Inqubo ye-bronchoscopy , i-tube itholakala emlonyeni wakho noma emakhaleni wakho ku-trachea yakho (i-windpipe yakho) bese ungena emoyeni omkhulu oholela emaphashini akho. Ngemuva kokuba i-tube isendaweni, odokotela basebenzisa i-probe ye-ultrasound ekhethekile ukuthumela amagagasi omsindo (i-ultrasound) ngokusebenzisa izindonga ze-airways yakho ezindaweni ezizungezile, kufaka phakathi amaphaphu kanye ne- mediastinum (indawo yesifuba ephakathi kwamaphaphu).
Uma izindawo ezingavamile zibonakala kwi-ultrasound, udokotela wakho angathatha isampula yamathambo ngenaliti encane eholwa yi-ultrasound. Le ndlela ye-biopsy ibizwa ngokuthi i-transbronchial needle ultrasound. Inaliti isetshenziselwa odongeni lomoya wakho futhi ungene emathunjini akho emaphaphu, kanti udokotela wakho angabuka ngesikhathi sangempela kwi-ultrasound ngqo lapho inaliti ihamba khona Kukhona idivayisi encane ekugcineni kwale sindane okungathatha isampula kwanoma yimuphi izifunda ezisolisayo.
Ngemuva kokuthi inqubo yakho igcwaliswe, isampula ithunyelwa ebhokisini ukuze ihlolwe khona ukuba khona komdlavuza, noma ezinye izinto ezingavamile.
Izinkomba
Ukuncoma ukwelashwa okungcono kakhulu kumdlavuza wamaphaphu, kubaluleke kakhulu ukuqonda isigaba somdlavuza wamaphaphu - uma, futhi kangakanani, umdlavuza usakazeke. Ukulinganisa okunembile kunganciphisa inani lamathambo elikhishwa ngesikhathi sokuhlinzwa ngomdlavuza wamaphaphu . Kungase futhi kukuvikele ekungangeni ekuhlinzekeni okungadingekile uma umdlavuza wakho ungaphathwa kangcono ngenye indlela, njenge-chemotherapy, ukwelashwa okuhlosiwe, imithi ye- immunotherapy , i-radiation therapy, noma inhlanganisela yalezo zonyango.
Ngokwesiko, imidwebo enembile ivame ukufuna ukuhlolwa okungahleliwe njenge- mediastinoscopy nezinye izinhlinzeko zesifuba njenge-thoracoscopy noma i-thoracotomy. I-thoracoscopy yinkambiso efana nokuhlinzwa okwe-laparoscopic esiswini, kuphela kwenziwa esikhwameni. I-thoracotomy iyindlela yokuvuleka esifubeni evulekile eyayihilela ukusika nokususa ingxenye yenzambo noma izimbambo. Kwezinye izimo, i-endobronchial ultrasound inganikeza odokotela ulwazi oludingayo ukuze basungulwe umdlavuza ngaphandle kokuncoma izinqubo eziyingozi kakhulu.
Ngaphandle kokuba inqubo encane encane, i-endobronchial ultrasound ingasiza odokotela ukufinyelela kunzima ukufinyelela ezindaweni.
Ngezinye izikhathi kungase kutholakale okunye, futhi amancane amancane angama-lymph nodes angabonwa nge-mediastinoscopy yendabuko.
Izizathu ezine eziyinhloko udokotela wakho angase ancoma i-endobronchial ultrasound:
- Ukubheka ukutholakala kwezidumbu noma izitho zamakhansela ezikhulisiwe.
- Ukuthola izicubu ngaphakathi kwamaphaphu.
- Ukuhlola i-lymph nodes ku-mediastinum (indawo emkhatsini wamaphaphu) noma i- hilum (isifunda esiseduze nenhla yamaphaphu.)
- Ukuhlola izicubu ku-mediastinum.
Ngaphezu kokuthola umdlavuza wamaphaphu we-diagnostic and stage, i-endobronchial ultrasound ingasetshenziselwa ukuthola izifo noma ukusiza ukuxilonga izimo zamaphaphu ezivuthayo njenge- sarcoidosis .
Ukubuyisela
Iningi labantu libekezelela le nqubo kahle futhi likwazi ukuphuma esibhedlela ngosuku olufanayo inqubo eyenziwa. Le nqubo ayidingi noma iyiphi imibono futhi isheshe ibe yinkinga yokunakekela izwe lonke.
Izinkinga
Izinkinga ze-endobronchial ultrasound ngokuyinhloko yizo ezingenzeka ngenxa ye-bronchoscopy noma ngenxa ye-biopsy ngokwayo. Lokhu kungafaka ukuphuma kwegazi, ukutheleleka, ukuwa kwamaphaphu, noma izinkinga ezihlobene ne-anesthetics ezinikezwe ukwenza inqubo.
Imithombo:
Uhhafu, F. Bronchoscopy / Endobronchial Ultrasound. Imingcele yezokwelashwa kwe-Radiation kanye ne-Oncology . 2010. 42: 55-62.
Kinsey, L, no-D. Arenberg. I-endobronchial ultrasound-eqondiswa i-transbronchial inaliti isifiso se-non-encane yesifo somdlavuza wesifo samaphaphu. I-American Journal of Respiratory and Critical Care Medicine . 2014. 189 (6): 640-9.
Yasufuku, K. et al. Indima ye-endobronchial ultrasound-eqondiswayo ye-transbronchial inaliti yokufisa ekulawuleni umdlavuza wamaphaphu. I-General Thoracic and Surgery Cardiovascular . 2008. 56 (6): 268-76.
I-Yasufuku, K. i-Endobronchial ultrasound: Izinkomba, ukuphikisana nezinkinga. Kusesikhathini. Kubuyekezwe 01/08/16. http://www.uptodate.com/contents/endobronchial-ultrasound-indications-contraindications-and-complications