Ua noi ʻia anei ʻoe e hana i kahi Endoscopic Ultrasound (EUS)? E kamaʻilio maʻalahi kākou e pili ana i kēia!

Ke haʻi aku ke kauka iā ʻoe e pono ʻoe e hana i kahi hoʻāʻo `(Endoscopic Ultrasound)` a i ʻole `(EUS)`, hiki iā ʻoe ke makaʻu iki, ʻeā? "He aha kēia hoʻāʻo hou?" "E ʻeha anei?" "No ke aha e hana ʻia ai kēia?" Nui nā nīnau e like me ia e hiki mai ana i ka noʻonoʻo. He mea maʻamau ia. No laila i kēia lā, e kamaʻilio mākou e pili ana i kēia hoʻāʻo `(EUS)` ma nā ʻōlelo maʻalahi, e like me kāu e kamaʻilio ai me kahi hoaaloha. A laila hiki iā ʻoe ke hoʻomaopopo maikaʻi i ia mea.

No laila, he aha ka endoscopic ultrasound (EUS)?

I ka ʻōlelo maʻalahi, he hoʻāʻo kūikawā ka EUS e nānā i loko o kāu ʻōnaehana hoʻoheheʻe . Hana ʻia kēia e ke kauka loea i ka ʻōnaehana hoʻoheheʻe (i kapa pinepine ʻia he gastroenterologist).

Hoʻohana kēia hoʻāʻo ``(EUS)`` i ka hui pū ʻana o ʻelua mau mea nui:

1. He endoscope: E noʻonoʻo iā ia e like me kahi ʻōmole lahilahi loa, lōʻihi, a palupalu me kahi kāmela liʻiliʻi a me ke kukui i hoʻopili ʻia ma kekahi wēlau. ʻO kēia ka mea e hiki ai i ke kauka ke ʻike maopopo i loko o kou kino.

2. Ultrasound: Ma ka hopena o ka endoscope, me kahi kāmela, aia kahi mea ultrasound liʻiliʻi (probe). Hoʻohana kēia i nā nalu kani e hana i nā kiʻi o kou mau ʻōpū kūloko, nā ʻiʻo, a me nā kīʻaha koko . Ua like ia me ke scan ultrasound a kāu pēpē e loaʻa ai, akā hana ʻia i loko o kou kino.

No laila, ke hui pū ʻia kēia mau mea ʻelua, hiki i ke kauka ke loaʻa i kahi kiʻi maopopo loa ʻaʻole wale nā ​​​​paia (nā papa) o kāu ʻōnaehana hoʻoheheʻe ʻana, akā ʻo nā ʻōpū ʻē aʻe e kokoke ana iā ia (no ka laʻana, ka pancreas a me ka gallbladder).

ʻO wai ka mea maʻamau e pono ai kēia hoʻokolohua EUS?

ʻAʻole pono nā kānaka a pau e hana i kēia hoʻāʻo "(EUS)". Hiki i ke kauka ke ʻōlelo aku iā ia e nānā a hōʻoia paha i kekahi mau kūlana olakino. Eia kekahi mau laʻana:

• Inā loaʻa iā ʻoe ka ʻeha ʻōpū mau a i ʻole ka ʻeha umauma , e ʻimi i ke kumu.
• Inā he kānalua ua pālahalaha kahi maʻi kanesa i nā ʻāpana ʻē aʻe o ke kino (maʻi kanesa metastatic) .
• Inā ua ʻike ʻoe i kahi puʻupuʻu, lesion, a i ʻole ka ulu ʻana ma kahi CT scan a MRI scan paha ma mua, e ʻike pono i ke ʻano o ia mea.
• Inā loaʻa iā ʻoe kekahi mau pilikia me kāu ʻōnaehana hoʻoheheʻe , no ka laʻana, nā kūlana e like me ka Inflammatory Bowel Disease (IBD), ka maʻi ʻaʻai colon, a i ʻole anal fissures.
• ʻO ka maʻi ʻōpū gallbladder , ʻo ia hoʻi inā he mau pōhaku gallstones kou a inā paha he mumū o ka gallbladder (cholecystitis).
• E ʻike e pili ana i kekahi mau maʻi māmā , e like me ke kanesa o ka māmā.
• Nā maʻi pancreaticE ʻike e pili ana. Hoʻokomo pū kēia i nā kūlana e like me ke kanesa pancreatic, nā cysts pancreatic, a me ka pancreatitis.
• Inā pilikia ʻoe i ka ale ʻana i ka meaʻai , no ka laʻana, nā kūlana e like me ka "Barrett's esophagus".

I nā hihia e like me kēia e hiki ai i kahi EUS ke kōkua i nā kauka e ʻike i loko a hana i kahi hōʻailona pololei.

He aha nā ʻano nui o ka hoʻokolokolo EUS?

Hiki ke hoʻokaʻawale ʻia nā hoʻokolohua EUS i ʻelua mau māhele nui, ma muli o kahi i hana ʻia ai ka hoʻokolohua.

1. EUS Kiʻekiʻe

Nānā kēia i ka ʻaoʻao o luna o kāu ʻōnaehana hoʻoheheʻe. ʻO ia hoʻi:

• ʻO ka uhi o loko o kou esophagus (paipu meaʻai), ʻōpū (ʻōpū), a me ka ʻaoʻao o luna o kou ʻōpū liʻiliʻi (duodenum).
• Nā pūnana lymph e pili ana, nā kīʻaha koko, nā cysts, a me nā puʻupuʻu.
• Hiki iā ia ke nānā i nā ʻōpū kokoke e like me ka pancreas, gallbladder, a me nā ʻāpana bile.

2. EUS haʻahaʻa

Nānā kēia hoʻāʻo i ka ʻāpana haʻahaʻa o kāu ʻōnaehana hoʻoheheʻe. ʻO ia hoʻi:

• ʻO nā ʻiʻo a puni ka puka anal (anal sphincter).
• Nā kīʻaha koko, nā lymph node, nā cysts, a me nā puʻupuʻu kanesa ma ia wahi.
• ʻO ka papa o loko o ka ʻāpana hope loa o ka ʻōpū nui (rectum a me colon).

Na ke kauka e hoʻoholo i ka mea o kēia mau "EUS" ʻelua e hana ai ma muli o kāu mau hōʻailona a me nā pono.

Ke hana ʻia nei nā hoʻokolohua ʻē aʻe me ka EUS?

ʻAe, i kekahi manawa, ʻoiai e hana ana i ka EUS, hiki ke hana ʻia kekahi kaʻina hana koʻikoʻi. ʻO ia hoʻi, he Endoscopic Ultrasound-guided Fine-Needle Aspiration (FNA) .

Me he inoa lōʻihi paha kēia, akā penei wale nō: ʻOiai e nānā ana i loko me ka ``(EUS)``, hiki i ke kauka ke nānā i nā kiʻi ultrasound, e hoʻokomo i kahi nila lahilahi loa ma o ka endoscope, a lawe i kahi ʻāpana liʻiliʻi o ka ʻiʻo a i ʻole ka wai mai kahi wahi kānalua . Ua kapa ʻia kēia ʻo ``(FNA)``, a kapa pū kekahi poʻe iā ia ʻo ``(biopsy)``.

A laila hoʻouna ʻia ka hāpana i kahi keʻena hoʻokolohua, kahi e nānā ai kahi pathologist iā ia ma lalo o kahi microscope e nānā i nā cell ʻano ʻē, e like me nā cell kanesa. Kōkua kēia i ka hōʻoia ʻana i ke ʻano pololei o ka maʻi .

He aha kaʻu e pono ai e hana ma mua o ka hoʻāʻo EUS?

Ke hoʻonohonoho ʻia ʻoe no kahi hoʻokolohua EUS, e hāʻawi kāu kauka a kahu maʻi paha iā ʻoe i nā kuhikuhi no ka mea e hana ai a me ka mea e hana ʻole ai i ka lā ma mua. He mea nui e hahai pololei iā lākou i mea e hōʻoia ai i kahi hoʻokolohua holomua . Hoʻokomo pinepine lākou i nā mea e like me:

• E pili ana i nā lāʻau lapaʻau āu e lawe nei: Inā ʻoe e lawe nei i nā lāʻau lapaʻau no nā mea e like me ka maʻi diabetes mellitus, ke koko kiʻekiʻe, a i ʻole ka maʻi puʻuwai, ʻoiai nā lāʻau hoʻokahe koko,Inā ʻoe e lawe ana i nā lāʻau hoʻokahe koko (e laʻa, Coumadin®, Plavix®) a i ʻole insulin, pono ʻoe e haʻi mua i kāu kauka . Makemake paha kāu kauka e hoʻololi i ka nui o ka lāʻau a hoʻōki paha i ka lawe ʻana i ka lāʻau no kekahi mau lā.
• ʻAi a me ka Mea Inu: E noi ʻia ʻoe ʻaʻole e ʻai a inu paha i kekahi mea no kekahi mau hola ma mua o ka hoʻāʻo (ʻo ka maʻamau he 6-8 mau hola). He mea nui ka loaʻa ʻana o ka ʻōpū hakahaka e maopopo ai ka hoʻāʻo.
• Hoʻomākaukau ʻōpū: Inā he EUS haʻahaʻa kou, e kuhikuhi kāu kauka i kahi wai kūikawā i kapa ʻia ʻo "bowel prep" e hoʻomaʻemaʻe i kou kolona. E ʻae kēia iā ʻoe e ʻike maopopo i loko o kou kolona.
• ʻŌlelo aʻoaʻo ʻē aʻe: Hiki ke hāʻawi ʻia aku iā ʻoe nā ʻōlelo aʻoaʻo kikoʻī. E hoʻolohe pono i nā mea a pau a hahai.

He aha ka mea e hana maoli ana i ka wā o kahi EUS kiʻekiʻe?

ʻO ka EUS luna he hana ma waho o ka haukapila maʻamau. ʻAʻole ʻoe e hoʻokomo ʻia i ka haukapila no kēia hana. Eia nō naʻe, no ka mea e hāʻawi ʻia ʻoe i kahi mea hoʻomaha (anesthesia) no kēia hana, pono ʻoe i kekahi e hoʻokele iā ʻoe i ka home ma hope o ke kaʻina hana. He manaʻo maikaʻi nō hoʻi e loaʻa kekahi me ʻoe no ke koena o ka lā. ʻO ka maʻamau, ʻo ka hana ʻana o ka EUS luna ma kahi o 60 mau minuke .

Eia nā mea e hana ʻia i ka wā o ka hoʻāʻo:

1. E hoʻohuli ʻia ʻoe i ka hema a e hoʻomoe ʻia i lalo.

2. E hoʻokomo kahi kahu maʻi i kahi cannula liʻiliʻi i loko o kahi aa koko ma kou lima a hāʻawi iā ʻoe i kahi mea hoʻomaha ma o ia mea. E kōkua kēia iā ʻoe e hoʻomaha a ʻaʻole e manaʻo i ka hoʻāʻo.

3. E pīpī au i ka lāʻau lapaʻau e hoʻomāʻū i kou puʻu.

4. E kau ʻia kahi pale waha plastik i loko o kou waha e pale aku i ka hōʻino ʻana i kou mau niho a e pale aku iā ʻoe mai ka nau ʻana i ka endoscope.

5. A laila e hoʻokomo mālie ke kauka i ka endoscope ultrasound ma kou waha, i lalo i kou esophagus, i loko o kou ʻōpū, a laila i loko o ka ʻaoʻao o luna o kou ʻōpū liʻiliʻi (duodenum). ʻAʻole ʻoe e ʻeha i kēia manawa . E hiki iā ʻoe ke hanu maʻamau.

6. Nānā ke kauka i nā kiʻi ultrasound ma kahi monitor a nānā i ka ʻaoʻao o luna o kāu ʻōnaehana hoʻoheheʻe, nā ʻōpū a puni, nā puʻupuʻu, a me nā puʻupuʻu.

7. Inā pono, hana ʻia ka `(FNA)` i ʻōlelo mua ʻia, ʻo ia hoʻi ka lawe ʻana i kahi hāpana ʻiʻo, i kēia manawa.

8. Ke pau ka hoʻokolokolo ʻana, e wehe mālie ke kauka i ka endoscope. E hoʻōki ʻia ka lāʻau hoʻomaha. A laila e lawe ʻia ʻoe i kahi lumi hoʻōla a kali ʻia a hiki i kou hoʻi hou ʻana i ka ʻike.

He aha ka mea e hana ʻia i ka wā o ka EUS haʻahaʻa?

Ua like ka ultrasound subtotal (EUS) me ka ultrasound supratotal, a he hoʻāʻo ia i ka lā hoʻokahi . E hāʻawi ʻia nō hoʻi ʻoe i kahi mea hoʻomaha, no laila pono kekahi e hoʻokele iā ʻoe i ka home.

ʻO ka maʻamau, ʻaʻole ma mua o 60 mau minuke kēia hoʻāʻo.ʻO ia ka mea e hana nei. I ke ʻano o ka `(EUS)` i hana ʻia ma lalo o ka ʻili, ʻaʻole i maʻamau ka `(FNA)`.

Eia ka mea e hana ʻia i ka wā o ka hoʻāʻo:

1. E hoʻohuli ʻia ʻoe i ka hema a e hoʻomoe ʻia i lalo.

2. E hāʻawi ʻia ʻoe i kahi lāʻau hiamoe ma o kahi IV e kōkua iā ʻoe e hoʻomaha.

3. Hoʻokomo ke kauka i ka endoscope ultrasound ma kou anus a me ka rectum a alakaʻi iā ia ma kou colon. ʻAʻole ʻoe e ʻike i kekahi ʻeha a ʻoluʻolu ʻole paha i ka wā o kēia kaʻina hana . E hiki iā ʻoe ke hanu maʻamau.

4. Nānā ke kauka i nā kiʻi ultrasound ma ka monitor a nānā i ka ʻaoʻao haʻahaʻa o kāu ʻōnaehana hoʻoheheʻe, nā ʻōpū e hoʻopuni ana, a me nā puʻupuʻu.

5. Ke pau ka hoʻokolokolo ʻana, e wehe mālie ʻia ka endoscope a e hoʻōki ʻia ka lāʻau hoʻomaha. E hoʻi mālie ʻoe i ka ʻike.

Pehea kou manaʻo ma hope o ka hoʻāʻo EUS?

ʻO ka hopena o ka lāʻau hoʻomaha i hāʻawi ʻia iā ʻoe e nalowale pinepine i loko o 30 mau minuke a i hoʻokahi hola . Ma hope o kēlā, hiki iā ʻoe ke loaʻa i kekahi ʻoluʻolu iki, e like me:

• Inā he EUS haʻahaʻa kou, hiki iā ʻoe ke ʻike i: ke kinoea, ka pehu ʻana, a i ʻole ka ʻūmiʻi .
• Inā ʻoe e hana i kahi EUS o luna: he ʻeha puʻu .

ʻO ka maʻamau, nalo loa kēia mau hōʻailona i loko o 24 mau hola , no laila ʻaʻohe mea e hopohopo ai.

ʻOi aku ka maikaʻi o ka hoʻomaha no ke koena o ka lā ma hope o ka hoʻāʻo. Hiki iā ʻoe ke hoʻomaka hou i kāu mau hana maʻamau i ka lā aʻe.

He aha nā pilikia a i ʻole nā ​​​​pilikia e hiki mai me kahi hoʻāʻo EUS?

Ua manaʻo ʻia ʻo EUS he kaʻina hana palekana loa . Eia nō naʻe, e like me nā kaʻina hana lapaʻau āpau, aia kahi manawa liʻiliʻi e hiki mai ai nā pilikia, he mea kakaikahi loa ia. ʻO kēia mau mea:

• He hopena maʻi i ka anesthesia.
• ʻO kēlā me kēia hōʻino ʻana i ka ʻōnaehana hoʻoheheʻe a i ʻole ke kahe ʻana o ke koko.
• I loko o kahi EUS o luna, komo ka wai mai ka waha a i ʻole ka ʻōpū i loko o nā māmā (ka makemake ʻana i ka māmā).
• Ka mumū o ka pancreas (pancreatitis) (hiki ke hana ʻia kēia ma hope o ka endoscopy luna (EUS) a me ka biopsy nila).
• He puka (perforation/haehae) ma ka paia o ka ʻōpū.

ʻAʻole hana pinepine kēia mau mea , akā he mea maikaʻi ke ʻike iā lākou. Inā he pilikia, e mālama ke kauka iā ia e like me ia.

Āhea wau e ʻike ai i nā hopena o ka hoʻokolohua EUS?

I ka pau ʻana o ka hoʻāʻo ʻana, e hāʻawi ke kauka iā ʻoe i kahi manaʻo kikoʻī o ka mea i ʻike ʻia i ka wā o ka EUS. Eia nō naʻe, inā ua lawe ʻia kahi hāpana ʻiʻo (biopsy) mai ka FNA a hoʻouna ʻia i ka lab, hiki ke hala i kekahi mau pule e loaʻa ai ka hōʻike piha . Ma hope o ka hiki ʻana mai o kēlā hōʻike, e hoʻihoʻi mai ke kauka iā ʻoe a wehewehe iā ʻoe.

I ka manawa hea e pono ai ʻoe e ʻike koke i ke kauka?

Inā ʻike ʻoe i hoʻokahi a ʻoi aku paha o kēia mau hōʻailona ma hope o ka hoʻāʻo ʻana, e kāhea koke i kāu kauka a i ʻole e hele i ka haukapila kokoke loa:

• Inā he koko i loko o ka ʻōpala ('blood in stool').
• Inā pilikia a ʻeha paha ʻoe i ka wā e hele ai i ka lua.
• Inā he kuni kou a i ʻole nā ​​hōʻailona ʻē aʻe o ka maʻi (e like me ke anu a me ka ʻeha o ke kino).
• Inā pilikia ʻoe i ka ale ʻana i ka meaʻai.
• Inā loaʻa iā ʻoe ka nausea a me ka luaʻi mau.
• ʻEha ʻōpū a ʻeha umauma paha i hiki ʻole ke hoʻomanawanui, koʻikoʻi, a mau loa.
• Pōkole o ka hanu.

Inā loaʻa iā ʻoe kēia mau mea, he mea nui loa e ʻimi koke i ke kōkua lapaʻau.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

ʻAe, ke lana nei koʻu manaʻo ua loaʻa iā ʻoe kahi manaʻo maikaʻi e pili ana i ka hoʻāʻo `(Endoscopic Ultrasound - EUS)`.

He ala palekana a maikaʻi loa ka ultrasound endoscopic (EUS) e nānā ai i loko o kāu ʻōnaehana hoʻoheheʻe. Hiki iā ia ke kōkua i nā kauka e ʻike i ke kumu o kāu mau hōʻailona, ​​​​ʻoiai nā pilikia hoʻoheheʻe, ke kanesa, a me ka laha ʻana o ke kanesa. Inā pono, hiki ke lawe ʻia kahi hāpana ʻiʻo (biopsy / FNA).

He hoʻāʻo "minimally invasive" kēia, ʻo ia hoʻi, hana ʻia me ka ʻole o kahi ʻoki nui a hiki iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi. No laila, inā haʻi aku ke kauka iā ʻoe e loaʻa i kahi "(EUS)", mai makaʻu pono ʻole iā ia. Inā he mau nīnau ʻē aʻe kāu, e kamaʻilio me kāu kauka e pili ana iā lākou.

ʻO ke kani uila endoscopic, EUS, ʻōnaehana hoʻoheheʻe, endoscopy, ultrasound, biopsy, nā hoʻāʻo maʻi kanesa