Whakamātautau EBUS (Endobronchial Ultrasound): Me pēhea te tirotiro i roto i ngā pukahukahu me te kāmera!

Tērā pea kua kōrerotia atu ki a koe e te tākuta mō tētahi whakamātautau pūkahukahu. Tērā pea i kite rātou i tētahi mea iti i runga i tō "(X-ray)" me tō "(CT scan)" rānei, ā, i kī mai me tirotirohia anō e rātou. I roto i ēnei āhuatanga, he whakamātautau motuhake tēnei e kiia nei ko te EBUS, e mahia ana hei tirotiro i te āhua o roto o ngā pūkahukahu. Me kōrero anō tātou mō tēnei?

He aha te EBUS (ultrasound endobronchial)?

I te whakarapopototanga, ko te EBUS (Endobronchial Ultrasound) he tikanga e whakaurua ai he taputapu iti rite ki te kāmera ki roto i ō pūkahukahu kia mārama ai te kite i ngā mea kei roto. He rite tēnei ki te bronchoscopy. Heoi, i tēnei wā, ka tāpirihia hoki he mīhini ultrasound ki te pito o te bronchoscopy. Ko te tikanga ka taea e te tākuta te kite i ngā mea kei roto i ō pūkahukahu hei whakaahua ultrasound. Whakaarohia he rite ki te matawai ultrasound o te pēpi i roto i te kōpū, e rapu ana i ngā pukupuku me ngā kōpuku lymph i roto i ngā pūkahukahu.

Ka whakamahia tēnei tikanga hei kimi i ngā mate maha i roto i ngā pukahukahu, inā koa hei kimi mēnā he matepukupuku (`(Cancer)`) me te tawhiti kua horapa (`(Staging)`). Ko tētahi atu mea pai ko te wā o tēnei whakamātautau EBUS, mēnā e tika ana, ka taea te tango i tētahi wahi kiko ka tukuna mō te whakamātautau `(Biopsy)`. Kātahi ka taea e koe te mahi i ngā mea e rua i te wā kotahi.

Nā, he aha te rerekētanga i waenga i te `(Bronchoscopy)` me te EBUS?

He pātai pai! Ko te `(Bronchoscopy)` te ingoa i hoatu ki te taputapu (`(Bronchoscope)`) me te tikanga e whakamahia whānuitia ana hei tirotiro i roto i ngā pukahukahu. Mā tēnei ka taea e ngā tākuta te kite i ngā mea kei roto i ngā pukahukahu mā te kāmera, te tango tauira kiko (`(Biopsy sample)`) rānei, tauira wai rānei.

He `(Bronchoscopy)` anō hoki te EBUS. Engari ko te mea motuhake ko te mea i roto i tēnei `(Bronchoscope)`, ka tāpirihia te āheinga `(Ultrasound)` . Nō reira, ahakoa ngā mea pēnei i ngā kōpū lymph kei tua atu i ngā pakitara o te pukahukahu, ā, kāore e kitea mā te `(Bronchoscope)` noa, ka kitea mārama mā te `(Bronchoscope)`. He āwhina nui hoki te tango `(Biopsy)` mā te titiro ki aua whakaahua `(Ultrasound)` me te tuku ngira ki te wāhi tika.

He momo whakamātautau EBUS anō kei reira?

Ae, he maha ngā momo matua o ngā whakamātautau EBUS. Ka whiriwhiria e te tākuta te momo hei mahi i runga i ngā mea e hiahiatia ana i taua wā.

EBUS Probe Radial `(Radial Probe EBUS - RP-EBUS)`

Ka taea e tēnei `(RP-EBUS)` te hoatu ki a koe he tirohanga tino mārama, 360-tohu o roto o ō ara manawa . Ka taea e ia te haere hohonu atu ki roto i ngā pukahukahu, ā, ka pai ake te kite i ngā tirohanga taipitopito atu i ētahi atu momo. Heoi, ki te hiahia koe ki te tango i tētahi `(Biopsy)`, me whakamahi koe i ētahi atu taputapu mō tēnā.

EBUS Probe Convex `(Probe Probe EBUS - CP-EBUS)`

Ka taea anake te whakamahi i tēnei `(CP-EBUS)` i runga i ō ara manawa matua (arā, te trachea me te bronchi). Ko te tikanga kāore e taea te uru hohonu ki roto i ngā pukahukahu. Engari kei tēneiKo te painga nui ko te taea te tango i te `(Biopsy)` i te wā o te whakamātautau mēnā e tika ana. Heoi, he iti ake te tirohanga i puta mai i tēnei, ā, he iti ake te taipitopito i te `(RP-EBUS)`.

EBUS-Transbronchial Needle Aspiration (EBUS-TBNA)

Ehara tēnei i te momo motuhake. I te wā e whakahaerehia ana he whakamātautau `(CP-EBUS)`, ko te tikanga e whakamahia ana hei tango tauira o te kiko (`(Tissue)`) te wai rānei (`(Fluid)`) mō te `(Biopsy`)` ka kiia ko `(EBUS-TBNA)`. Hei whakamārama tika, ka tukuna he ngira iti (`(Needle)`) mā roto i te pakitara o te ara manawa , mā te whakamahi i te `(Ultrasound)`, ā, ka tangohia he tauira mai i te wāhi e hiahiatia ana.

Āhea koe e hiahia ai ki tētahi whakamātautau EBUS?

I te nuinga o te wā, ka whakahau te tākuta i tētahi whakamātautau EBUS mēnā ka kitea he mea rerekē i roto i tō hihi-X o te uma, i tō matawai CT rānei hei tirotiro atu. Hei tauira, ka kitea pea i roto i te matawai CT he puku iti i roto i tō pukahukahu, he puku lymph rānei e pupuhi ana. I roto i ēnei āhuatanga, ka taea e te whakamātautau EBUS te āwhina ki te whakatau he aha te mea.

Ka whakamahia te whakamātautau EBUS hei tautuhi i ngā āhuatanga pēnei i:

• Ngā mate pūkahukahu me ngā whēwhe
• Te mate pukupuku pūkahukahu, te mate pukupuku rānei o te āputa i waenganui i ngā pūkahukahu (mediastinum)
• Ngā mate pūkahukahu mumura pērā i te sarcoidosis me te silicosis
• Te whakawhāititanga o ngā ara manawa (te whakapūmautanga o ngā ara manawa)
• Ngā puku iti i roto i ngā pukahukahu (ngā pona pūkahukahu)

Hei tāpiritanga, ka whakamahia hoki te whakamātautau EBUS hei whakatau i te wāhanga ('Te whakarārangitanga o te mate pukupuku') o ētahi āhuatanga mate pukupuku, arā, te whānui o te horapa o te mate pukupuku.

He pēhea rawa te mahi a te whakamātautau EBUS?

Mā te tākuta tohunga ki ngā mate pūkahukahu (`(Pulmonologist)` tēnei whakamātautau EBUS e whakahaere. Ka whakaurua e ia he ngongo angiangi, mārama (`(Bronchoscope)`) mā roto i ō ara manawa (`(Airways)`), mā roto rānei i tō ihu, i tō waha rānei. Mā te whakamahi i tētahi taputapu `(Ultrasound)` e piri ana ki te pito o tēnei `(Bronchoscope)` ka mahia te mahi.

Whakaarohia, ka whakamahia e tēnei `(Ultrasound)` ngā ngaru oro hei tuku pikitia mārama o ngā mea kei roto i ō pukahukahu ki tētahi mata tirotiro. Ka taea e te tākuta te tiro i aua pikitia, te tohu i te `(Bronchoscope)` ki te wāhi e hiahia ana ia ki te titiro, me te tirotiro i taua wāhi me te tino taipitopito. He rite tonu tana mahi ki tētahi pūnaha `(Sonar)` hei kimi i ngā mea i raro i te moana.

Me pēhea taku whakarite mō te whakamātautau EBUS?

Mā tō tākuta, mā ngā kaimahi hōhipera rānei koe e tohutohu mō te whakarite mō tō whakamātautau EBUS. Mēnā he mea kāore i te mārama i roto i ngā tohutohu, me pātai anō. Ko te tikanga, me mahi e koe ēnei e whai ake nei:

• Tērā pea ka tonoa koe kia mahi i ētahi whakamātautau toto i mua i te whakamātautau.
• Ka tonoa koe kia kaua e kai, e inu rānei i tetahi mea mō ētahi haora i mua i te whakamātautau (`(Nohopuku)`) . I te nuinga o te wā me nohopuku koe mō te 6 ki te 8 haora.
• Tērā pea ka tonoa koe kia mutu te tango i ētahi rongoā (pēnei i ngā rongoā whakaiti toto) i ētahi rā i mua i te whakamātautau. Me kōrero hoki koe ki tō tākuta mō ngā rongoā katoa e tangohia ana e koe, tae atu ki ngā tāpiringa katoa e tangohia ana e koe.
• Kimihia tētahi hei taraiwa i a koe ki te kāinga i muri i te whakamātautau. Ka whakamoea koe, nō reira kāore e taea e koe te taraiwa i muri i te whakamātautau. He mea nui kia noho tahi koe me tētahi.

He aha ngā mea ka puta i te wā o te whakamātautau EBUS? Ka mamae ahau?

I mua i te whakamātautau, ka meinga koe kia takoto ki runga i te moenga, i te tēpu rānei. Kātahi:

I mua i te whakamātautau

• Ki te tika, ka āwhina ngā nēhi i a koe kia tū tika.
• Ka werohia he ngongo iti ("(Intravenous - IV)") ki roto i te uaua i roto i tō ringa, ā, ka hoatu he wai tote. Ko tēnei `(IV)` te wāhi ka hoatu ai e te nēhi whakamoe, e te tohunga whakamoe rānei te rongoā e tika ana ki a koe. E kore tēnei rongoā e whakararuraru, e whakamamae rānei i a koe kia oti rā anō te whakamātautau. I ētahi wā ka hoatu he rongoā whakamoe ngawari ki a koe ("(Moderate sedation)"), he rongoā whakamoe whānui rānei ("(General anesthesia)") . Mā tō tākuta koe e kōrero mō tēnei i mua i te wā.
• Ka pania he rehu whakangote ki tō waha (ki tō ihu rānei) me tō korokoro. Ka whakangote tēnei i te rohe, kia kore ai koe e pāngia e te mamae ina whakaurua te bronchoscope.

I te wā o te whakamātautau

I muri i te wareware i a koe, me te koretake o tō korokoro, ka mea te tākuta manawa:

• Ka whakaurua e te tākuta he pūkahukahu mā roto i tō ihu, i tō waha rānei.
• Ka haria e ia mā roto i ngā ara manawa , ka tukuna ki te wāhi e tika ana kia tirohia.
• Mena e tika ana, ka tangohia tētahi, neke atu rānei o ngā tauira koiora.
• Kātahi ka tangohia mārire te pūkahukahu.

Kāore koe e mamae i te wā o te whakamātautau nā te mea ka hoatu he rongoā whakamoe ki a koe. Heoi anō, tera pea ka mamae tō korokoro, ka maremare, ka pāorooro rānei mō te rā kotahi i muri i te whakamātautau. Ki te kore, ki te tino mamae koe, me kōrero tonu atu koe ki tō tākuta .

Kia pēhea te roa o te whakamātautau EBUS?

Ko te roa o te whakamātautau EBUS i waenga i te 30 me te 90 meneti (tata ki te haora me te hawhe) . Heoi, ka rerekē pea tēnei wā i runga i tō āhua. Nō reira, pātai atu ki tō tākuta kia pēhea te roa. Kia oti te whakamātautau, me noho tonu koe ki te hōhipera mō te haora, e rua rānei i mua i tō hokinga ki te kāinga.

He aha ngā mea ka taea e koe te tumanako i muri i te whakamātautau EBUS?

I te nuinga o te wā ka taea e koe te hoki ki te kāinga i muri i ētahi haora. Ka tiaki ngā kaimahi hauora i a koe kia tino ara ake koe, kia pai te manawa, kia taea ai e koe te horomi. Ka kī atu hoki rātou ki a koe āhea koe ka whiwhi ai i ngā hua o tō whakamātautau, me te wā me kite anō koe i te tākuta.

Tērā pea ka puta ngā mea e whai ake nei i roto i te rā kotahi i muri i te whakamātautau:

• He korokoro mamae
• He reo pākū
• He maremare

He mea noa te maremare toto iti , ā, ka memeha i roto i ētahi hāora, i ētahi rā rānei. Heoi, ki te kore e mutu i muri i ētahi rā, ki te nui rānei te toto, me whakamōhio atu koe ki tō tākuta .

He mōrearea kei roto i te whakamātautau EBUS?

He tino iti te mōrearea o te tikanga EBUS, engari he tino onge te puta o ētahi raruraru. Kei roto i ēnei ko:

• Te toto (`(Te toto)`)
• Mate urutā (`(Pango)`)
• Te hinga o te pukahukahu (te Pneumothorax rānei) - Koinei te wā ka turuturu te hau mai i ngā pukahukahu ki roto i te uma.
• Te pōuri o te manawa - Ko te tikanga tēnei he raruraru manawa, pērā i te kore e taea te whakaputa tika i te hauhā waro mai i te tinana.

He aha ngā painga o te whakamātautau EBUS?

Ki te whakaritea ki ētahi atu tikanga whakaahua me ngā tikanga koiora, he maha ngā painga o EBUS.

• Ka taea e te tākuta te whakamahi i te ``Bronchoscope'' me te tuku i te ``Ultrasound'' ki te wāhi tika e hiahiatia ana kia mārama ai te tiki i ngā whakaahua e hiahiatia ana.
• Ka taea te tango i te koiora me te tango whakaahua i roto i te whakamātautau kotahi. Kāore he take ki te whai i ngā whakamātautau e rua. I ētahi wā, ka taea te tautuhi i te mate pukupuku me te whakatau i tōna taumata i te wā kotahi.
• He tikanga tēnei mō te noho i waho o te hōhipera . Ko te tikanga, kāore koe e puritia ki te hōhipera, ā, ka taea e koe te hoki ki te kāinga i taua rā anō.
• He tikanga tino iti te whakaekenga o tēnei. Arā, kāore e rite ngā mōrearea ki te pokanga tuwhera. Nō reira, ka taea e koe te ora wawe.

He aha ngā hua o te whakamātautau EBUS? He aha te tikanga o aua hua?

Mena kei roto i tō whakamātautau EBUS te tango i tētahi wahi kiko, i tētahi tauira wai rānei, ka tukuna e tō tākuta ki tētahi taiwhanga hei tirotiro mō te mate urutā, te mate pukupuku, ētahi atu āhuatanga rānei, i runga i tō āhua. Ka whakamāramahia e tō tākuta ngā hua ki a koe, ā, ka kī atu ki a koe he aha te mahi e whai ake nei. Me tatari pea koe mō ētahi rā kia puta mai ngā hua.

Āhea ahau me toro atu ki te tākuta?

Mena he pātai āu, he pānga taha ohorere rānei, kōrero ki tō tākuta . Me rapu tohutohu hauora tonu koe mēnā ka kitea he tohu mate. Ko ēnei tohu ko:

• Kirika (`(Kirika)`)
• Mamae o te uma (`(Mamae o te uma)`)
• Te uaua ki te manawa
• Te uaua ki te horomi
• Te maremare toto tonu
• Te kore e taea te mimi/mimi - Ahakoa kāore tēnei e pā tika ana ki te EBUS, ka pā pea i ētahi wā i muri i te rongoā whakamoe, nō reira he mea nui kia whakahuatia mēnā ka pā.

Hei whakamutunga, ngā mea hei maumahara

He tikanga iti rawa te whakaekenga o te EBUS (Endobronchial Ultrasound), he tikanga waho-waho, ka taea te whakarato i tētahi tirohanga mārama, taipitopito hoki ki ngā huringa i roto i ngā pukahukahu. Ka taea hoki te tango tauira kiko me te wai, me te iti ake o ngā mōrearea i ērā atu tikanga.

Kia maumahara, kaua e mangere ki te pātai atu ki tō tākuta mō ngā pātai e pā ana ki te whakahaerenga o te whakamātautau, ngā mea e rapuhia ana e ngā tākuta, me te wā e puta ai ngā hua. Mā te mōhio ki ngā mea hei tumanakohia i mua atu ka āwhina i te whakaiti i tō manukanuka. Kia ora tonu!

` EBUS, Ultrasound Endobronchial, Whakamātautau Pūkahukahu, Bronchoscopy, Ultrasound, Biopsy, Matepukupuku Pūkahukahu, Ngā Mate Manawa