Ngaba ukhe wacelwa ukuba wenze i-Endoscopic Ultrasound (EUS)? Masithethe ngale nto ngokulula!

Xa ugqirha ekuxelela ukuba kufuneka wenze uvavanyo lwe-`(Endoscopic Ultrasound)` okanye lwe-`(EUS)`, ungaziva usoyika kancinci, akunjalo? "Luvavanyo luni olutsha olu?" "Ngaba luza kuba buhlungu?" "Kutheni oku kwenziwa?" Imibuzo emininzi efana naleyo isenokufika engqondweni. Kuqhelekile. Ke namhlanje, siza kuthetha ngolu vavanyo lwe-`(EUS)` ngokulula, njengokuba ubuya kuthetha nomhlobo. Emva koko ungaluqonda ngcono.

Ngoko ke, yintoni i-endoscopic ultrasound (EUS)?

Ngamafutshane, i-EUS luvavanyo olukhethekileyo olujonga ngaphakathi kwinkqubo yakho yokwetyisa . Oku kwenziwa ngugqirha ogxile kwinkqubo yokwetyisa (odla ngokubizwa ngokuba yi-gastroenterologist).

Olu vavanyo lwe-``(EUS)`` lusebenzisa indibaniselwano yezinto ezimbini eziphambili:

1. I-endoscope: Yicinge njengetyhubhu encinci kakhulu, ende, eguquguqukayo enekhamera encinci kunye nokukhanya okuqhotyoshelwe kwelinye icala. Yile nto evumela ugqirha ukuba abone ngokucacileyo ngaphakathi emzimbeni wakho.

2. I-Ultrasound: Ekupheleni kwe-endoscope, kunye nekhamera, kukho isixhobo esincinci se-ultrasound (probe). Esi sixhobo sisebenzisa amaza esandi ukwenza imifanekiso yamalungu akho angaphakathi, izicubu, kunye nemithambo yegazi . Kufana ne-ultrasound scan umntwana wakho ayifumanayo, kodwa yenziwa ngaphakathi emzimbeni wakho.

Ngoko ke xa ezi zimbini zidityanisiwe, ugqirha unokufumana umfanekiso ocacileyo kungekuphela nje wodonga (iingqimba) zenkqubo yakho yokugaya ukutya, kodwa kunye nezinye izitho ezikufutshane nayo (umzekelo, i-pancreas kunye ne-gallbladder).

Ngubani odla ngokufuna olu vavanyo lwe-EUS?

Akuyena wonke umntu omele enze olu vavanyo "(EUS)``. Ugqirha angalucebisa ukuze ajonge okanye aqinisekise iimeko ezithile zempilo. Nazi imizekelo embalwa:

• Ukuba uneentlungu zesisu ezingapheliyo okanye esifubeni , fumana unobangela.
• Ukuba kukho ukurhanelwa kokuba umhlaza usasazeke kwamanye amalungu omzimba (umhlaza osasazekayo) .
• Ukuba ukhe wabona iqhuma, isilonda, okanye ukukhula kwi-CT scan yangaphambili okanye kwi-MRI scan, fumana ukuba yintoni kanye kanye.
• Ukuba uneengxaki ngenkqubo yakho yokugaya ukutya , umzekelo, iimeko ezifana ne-Inflammatory Bowel Disease (IBD), umhlaza wamathumbu amakhulu, okanye imifantu yempundu.
• Isifo senyongo , oko kuthetha ukuba unamatshe enyongo okanye ukuba unesifo sokudumba kwenyongo (cholecystitis).
• Fumana ulwazi ngezifo ezithile zemiphunga , ezifana nomhlaza wemiphunga.
• Izifo zePancreaticFumana ulwazi malunga. Oku kuquka iimeko ezifana nomhlaza wepancreatic, ii-cysts zepancreatic, kunye ne-pancreatitis.
• Ukuba unengxaki yokuginya ukutya , umzekelo, iimeko ezifana ne-"Barrett's esophagus".

Kukwiimeko ezinje apho i-EUS inokunceda oogqirha ukuba babone ngaphakathi baze benze uxilongo oluchanekileyo.

Ziziphi iintlobo eziphambili zovavanyo lwe-EUS?

Uvavanyo lwe-EUS lunokwahlulwahlulwa lube ziindidi ezimbini eziphambili, kuxhomekeke kwindawo oluqhutywa kuyo uvavanyo.

1. I-EUS ephezulu

Oku kujonga inxalenye ephezulu yenkqubo yakho yokugaya ukutya. Oko kukuthi:

• Ulwelo olungaphakathi lwe-esophagus yakho (umbhobho wokutya), isisu (isisu), kunye nenxalenye ephezulu yamathumbu akho amancinci (i-duodenum).
• Ii-lymph nodes ezinxulumeneyo, imithambo yegazi, ii-cysts, kunye neethumba.
• Ingahlola nezitho ezikufutshane ezifana nepancreas, gallbladder, kunye ne-bile ducts.

2. I-EUS ephantsi

Olu vavanyo lujonga inxalenye esezantsi yenkqubo yakho yokugaya ukutya. Oko kukuthi:

• Izihlunu ezijikeleze umngxuma wempundu (i-anal sphincter).
• Imithambo yegazi, ii-lymph nodes, ii-cysts, kunye neethumba ezinomhlaza kuloo ndawo.
• Umaleko ongaphakathi wenxalenye yokugqibela yamathumbu amakhulu (i-rectum kunye ne-colon).

Ugqirha uza kugqiba ukuba yeyiphi kwezi "EUS" zimbini ekufuneka yenziwe ngokusekelwe kwiimpawu neemfuno zakho.

Ngaba ezinye iimvavanyo zenziwa kunye ne-EUS?

Ewe, ngamanye amaxesha, ngelixa kusenziwa i-EUS, kunokwenziwa enye inkqubo ebalulekileyo. Oko kukuthi, i-Endoscopic Ultrasound-guided Fine-Needle Aspiration (FNA) .

Oku kungabonakala ngathi ligama elide, kodwa yile: Xa ejonga ngaphakathi esebenzisa i-``(EUS)``, ugqirha angajonga imifanekiso ye-ultrasound, adlulise inaliti encinci kakhulu kwi-endoscope, aze athathe iqhekeza elincinci lesicwili okanye ulwelo kwindawo erhanelekayo . Oku kubizwa ngokuba yi-``(FNA)``, kwaye abanye abantu bakubiza ngokuba yi-``(biopsy)```.

Emva koko isampuli ithunyelwa kwilabhoratri, apho ingcali yezifo iyihlola phantsi kwemakroskopu ukuze ijonge naziphi na iiseli ezingaqhelekanga, ezifana neeseli zomhlaza. Oku kunceda ukuqinisekisa uhlobo oluchanekileyo lwesifo .

Yintoni ekufuneka ndiyenze ngaphambi kovavanyo lwe-EUS?

Xa ucwangciselwe uvavanyo lwe-EUS, ugqirha wakho okanye umongikazi uya kukunika imiyalelo yoko umele ukwenze noko ungamele ukwenze ngosuku olungaphambili. Kubalulekile ukuyilandela ngokuchanekileyo ukuqinisekisa uvavanyo oluphumelelayo . Zihlala ziquka izinto ezinje:

• Malunga namayeza owasebenzisayo: Ukuba uthatha amayeza ezinto ezifana nesifo seswekile, uxinzelelo lwegazi oluphezulu, okanye isifo sentliziyo, ingakumbi amayeza okunciphisa igazi,Ukuba uthatha amayeza okunciphisa igazi (umz., iCoumadin®, iPlavix®) okanye i-insulin, kufuneka uxelele ugqirha wakho kwangaphambili. Ugqirha wakho usenokufuna ukutshintsha idosi okanye ayeke ukuthatha amayeza kangangeentsuku ezimbalwa.
• Ukutya Neziselo: Uza kucelwa ukuba ungatyi okanye ungaseli nto kangangeeyure ezininzi ngaphambi kovavanyo (ngesiqhelo iiyure ezi-6-8). Kubalulekile ukuba nesisu esingenanto ukuze uvavanyo lucace.
• Ukulungiswa kwamathumbu: Ukuba une-EUS ephantsi, ugqirha wakho uya kukunika ulwelo olukhethekileyo olubizwa ngokuba yi-"bowel prep" ukuze ucoce ikholoni yakho. Oku kuya kukuvumela ukuba ubone ingaphakathi lekholoni yakho ngokucacileyo.
• Elinye icebiso: Usenokunikwa icebiso elicacileyo ngakumbi. Liphulaphule lonke ngononophelo uze ulilandele.

Kwenzeka ntoni kanye kanye ngexesha le-EUS ephezulu?

I-EUS ephezulu idla ngokuba yinkqubo yokulaliswa ngaphandle kwesibhedlele. Awuyi kungeniswa esibhedlele ngale nkqubo. Nangona kunjalo, kuba uza kunikwa i-sedative (i-anesthesia) kule nkqubo, kuya kufuneka umntu akuqhubele ekhaya emva kwenkqubo. Kukwangumbono olungileyo ukuba nomntu abe nawe imini yonke. Inkqubo ye-EUS ephezulu idla ngokuthatha malunga nemizuzu engama-60 .

Ezi zinto zilandelayo zenzeka ngexesha lovavanyo:

1. Uza kujika uye ngasekhohlo uze ulale phantsi.

2. Umongikazi uza kufaka i-cannula encinci emthanjeni engalweni yakho aze akunike isithomalalisi ngayo. Oku kuya kukunceda uphumle kwaye ungaziva uvavanyo.

3. Ndiza kutshiza iyeza lokukubangela ukuba ungabi nanto.

4. Isixhobo sokukhusela umlomo esiplastiki siya kufakwa emlonyeni wakho ukuthintela ukonakala kwamazinyo akho nokukuthintela ekuhlafuneni i-endoscope.

5. Ugqirha uza kungenisa kancinci i-ultrasound endoscope ngomlomo wakho, ehle nge-esophagus yakho, esiswini sakho, aze angene kwinxalenye ephezulu yamathumbu akho amancinci (duodenum). Awuyi kuva ntlungu ngeli xesha . Uya kukwazi ukuphefumla ngokuqhelekileyo.

6. Ugqirha ujonga imifanekiso ye-ultrasound kwisikrini aze ahlole inxalenye ephezulu yenkqubo yakho yokugaya ukutya, amalungu angqongileyo, amaqhuma, kunye namathumba.

7. Ukuba kuyimfuneko, i-`(FNA)` ekhankanyiweyo ngaphambili, oko kuthetha ukuthatha isampuli yethishu, yenziwa ngeli xesha.

8. Xa uxilongo lugqityiwe, ugqirha uza kuyisusa kancinci i-endoscope. Isixhobo sokuthomalalisa siya kuyekwa. Emva koko uza kusiwa kwigumbi lokuchacha aze akulinde ukuba ubuyele engqondweni kancinci kancinci.

Kwenzeka ntoni ngexesha le-EUS ephantsi?

I-subtotal ultrasound (EUS) iyafana ne-supratotal ultrasound, kwaye luvavanyo lwangosuku olunye . Uza kunikwa neyeza lokuthomalalisa, ngoko ke kuya kufuneka umntu akuqhubele ekhaya.

Olu vavanyo ludla ngokuthatha ngaphantsi kwemizuzu engama-60.Yiloo nto eyenzekayo. Kwimeko ye-`(EUS)` eyenziwa phantsi kwesikhumba, i-`(FNA)` ayixhaphakanga kangako.

Nantsi into eyenzekayo ngexesha lovavanyo:

1. Uza kujika uye ngasekhohlo uze ulale phantsi.

2. Uza kunikwa ipilisi yokulala nge-IV ukuze ikuncede uphumle.

3. Ugqirha ufaka i-ultrasound endoscope nge-anus yakho nakwi-rectum aze ayikhokele kumathumbu amakhulu. Awuyi kuva ntlungu okanye ukungakhululeki ngexesha lenkqubo . Uya kukwazi ukuphefumla ngokuqhelekileyo.

4. Ugqirha ujonga imifanekiso ye-ultrasound kwisikrini aze ahlole inxalenye esezantsi yenkqubo yakho yokugaya ukutya, amalungu angqongileyo, kunye nazo naziphi na izigaqa.

5. Xa uviwo lugqityiwe, i-endoscope iya kususwa kancinci kwaye iyekwe i-sedative. Uya kubuyela engqondweni kancinci kancinci.

Uziva njani emva kovavanyo lwe-EUS?

Iziphumo zeyeza lokuthomalalisa olinikiweyo zihlala ziphela kwimizuzu engama-30 ukuya kwiyure . Emva koko, unokufumana ukungakhululeki okuncinci, okufana noku:

• Ukuba une-EUS ephantsi, unokufumana: igesi, ukudumba, okanye ukuqaqamba .
• Ukuba wenza i-EUS ephezulu: umphimbo obuhlungu .

Ezi mpawu zihlala ziphela ngokupheleleyo kwiiyure ezingama-24 , ngoko ke akukho nto inokubangela ukuba ukhathazeke.

Kungcono ukuphumla usuku lonke emva kovavanyo. Ungaqhubeka nemisebenzi yakho yesiqhelo ngosuku olulandelayo.

Zeziphi iingozi okanye iingxaki ezinokwenzeka ngovavanyo lwe-EUS?

I-EUS ngokubanzi ithathwa njengenkqubo ekhuselekileyo kakhulu . Nangona kunjalo, njengakweyiphi na inkqubo yezonyango, kukho ithuba elincinci lokuba iingxaki zinokwenzeka, ezingaqhelekanga kakhulu. Ezi ziquka:

• Ukusabela kokunganyamezelani ne-anesthesia.
• Nakuphi na ukonakala kwenkqubo yokugaya ukutya okanye ukopha.
• Kwi-EUS ephezulu, ulwelo oluvela emlonyeni okanye esiswini lungena emiphungeni (i-lung aspiration).
• Ukudumba kwepancreas (i-pancreatitis) (oku kunokwenzeka ngakumbi emva kwe-endoscopy ephezulu (EUS) kunye ne-needle biopsy).
• Umngxuma (ukugqobhoka/ukukrazuka) eludongeni lwamathumbu.

Ezi zinto azenzeki rhoqo , kodwa kulungile ukuzazi. Ukuba kukho ingxaki, ugqirha uza kuyinyanga ngokufanelekileyo.

Ndiza kuzazi nini iziphumo zovavanyo lwe-EUS?

Nje ukuba uvavanyo lugqityiwe, ugqirha uza kukunika umbono ocacileyo wento ebonwe ngexesha le-EUS. Nangona kunjalo, ukuba isampuli yethishu (i-biopsy) ithathwe kwi-FNA yaze yathunyelwa kwilebhu, kungathatha iiveki ezininzi ukufumana ingxelo epheleleyo . Emva kokuba loo ngxelo ifikile, ugqirha uza kukubuyisela aze akuchazele yona.

Kunini apho kufuneka ubone ugqirha ngokukhawuleza?

Ukuba ufumana enye okanye ezingaphezulu kwezi mpawu emva kovavanyo, fowunela ugqirha wakho ngoko nangoko okanye uye kwisibhedlele esikufutshane:

• Ukuba kukho igazi kwi-tune (`igazi kwi-tune`).
• Ukuba unengxaki okanye unentlungu xa usiya kwindlu yangasese.
• Ukuba unomkhuhlane okanye ezinye iimpawu zosulelo (ezifana nokugodola kunye neentlungu zomzimba).
• Ukuba unengxaki yokuginya ukutya.
• Ukuba unesicaphucaphu nokuhlanza okungapheliyo.
• Intlungu yesisu okanye yesifuba enganyamezelekiyo, enzima, engapheliyo.
• Ukuqhawukelwa ngumphefumlo.

Ukuba unazo ezi zinto, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngaphandle kokulibazisa.

Okokugqibela, izinto ekufuneka uzikhumbule

Kulungile, ngoko ke ndiyathemba ukuba ngoku unembono elungileyo malunga novavanyo lwe-`(Endoscopic Ultrasound - EUS)`.

I-endoscopic ultrasound (EUS) yindlela ekhuselekileyo nesebenzayo yokujonga ngaphakathi kwenkqubo yakho yokugaya ukutya. Inokunceda oogqirha bafumane unobangela weempawu zakho, ingakumbi iingxaki zokugaya ukutya, umhlaza, kunye nokusasazeka komhlaza. Ukuba kuyimfuneko, isampuli yezicubu (i-biopsy / FNA) ingathathwa.

Olu luvavanyo oluthi "lungenelela kancinci", oko kuthetha ukuba lwenziwa ngaphandle kokusikwa okukhulu kwaye ungaya ekhaya ngaloo mini inye. Ngoko ke, ukuba ugqirha ukuxelela ukuba wenze "(EUS)``, musa ukuyoyika ngokungeyomfuneko. Ukuba unemibuzo, thetha nogqirha wakho ngayo.

I- ultrasound ye-Endoscopic, i-EUS, inkqubo yokugaya ukutya, i-endoscopy, i-ultrasound, i-biopsy, iimvavanyo zomhlaza