Uke wacelwa yini ukuthi wenze i-Endoscopic Ultrasound (EUS)? Ake sixoxe ngalokhu kalula!

Uma udokotela ekutshela ukuthi udinga ukuhlolwa kwe-`(Endoscopic Ultrasound)` noma `(EUS)`, ungazizwa wesaba kancane, akunjalo? "Yiluphi uvivinyo olusha lolu?" "Ingabe luzobuhlungu?" "Kungani kwenziwa lokhu?" Imibuzo eminingi efana naleyo cishe ifika engqondweni. Kujwayelekile. Ngakho-ke namuhla, sizoxoxa ngalokhu kuhlolwa kwe-`(EUS)` ngamazwi alula, njengoba nje ungakhuluma nomngane. Khona-ke ungathola ukuqonda okungcono ngakho.

Ngakho-ke, iyini le-endoscopic ultrasound (EUS)?

Kalula nje, i-EUS ukuhlolwa okukhethekile okubheka ngaphakathi kohlelo lwakho lokugaya ukudla . Lokhu kwenziwa udokotela ogxile ohlelweni lokugaya ukudla (ngokuvamile obizwa ngokuthi i-gastroenterologist).

Lolu vivinyo lwe-`(EUS)` lusebenzisa inhlanganisela yezinto ezimbili eziyinhloko:

1. I-endoscope: Cabanga ngayo njengepayipi elincane kakhulu, elide, eliguquguqukayo elinekhamera encane nokukhanya okunamathiselwe kolunye uhlangothi. Yilokhu okuvumela udokotela ukuthi abone kahle ngaphakathi emzimbeni wakho.

2. I-Ultrasound: Ekugcineni kwe-endoscope, kanye nekhamera, kukhona idivayisi encane ye-ultrasound (i-probe). Lokhu kusebenzisa amaza omsindo ukudala izithombe zezitho zakho zangaphakathi, izicubu, kanye nemithambo yegazi . Kufana nokuskena kwe-ultrasound ingane yakho ekutholayo, kodwa kwenziwa ngaphakathi emzimbeni wakho.

Ngakho-ke uma lokhu okubili kuhlanganiswa, udokotela angathola isithombe esicacile hhayi nje kuphela sezindonga (izingqimba) zesistimu yakho yokugaya ukudla, kodwa nezinye izitho eziseduze nayo (isibonelo, i-pancreas kanye ne-gallbladder).

Ubani ovame ukudinga lolu vivinyo lwe-EUS?

Akuwona wonke umuntu odinga ukwenza lokhu kuhlolwa "(EUS)``. Udokotela angase akuncome ukuze ahlole noma aqinisekise izimo ezithile zezokwelapha. Nazi izibonelo ezimbalwa:

• Uma unesifo sesisu esingapheli noma ubuhlungu besifuba , thola imbangela.
• Uma kukhona ukusola ukuthi umdlavuza ususakazekele kwezinye izingxenye zomzimba (umdlavuza osakazekile) .
• Uma uke wabona iqhubu, isilonda, noma ukukhula ku-CT scan noma ku-MRI scan yangaphambilini, thola ukuthi kuyini ngempela.
• Uma unezinkinga ngesistimu yakho yokugaya ukudla , isibonelo, izimo ezifana ne-Inflammatory Bowel Disease (IBD), umdlavuza wamathumbu amakhulu, noma imifantu yendunu.
• Isifo senyongo , okusho ukuthi uma unamatshe enyongo noma uma unesifo sokuvuvukala kwenyongo (i-cholecystitis).
• Thola ulwazi ngezifo ezithile zamaphaphu , njengomdlavuza wamaphaphu.
• Izifo ze-pancreaticThola ulwazi ngalokhu. Lokhu kufaka phakathi izimo ezifana nomdlavuza we-pancreatic, ama-cyst e-pancreatic, kanye ne-pancreatitis.
• Uma unenkinga yokugwinya ukudla , isibonelo, izimo ezifana nokuthi "u-Barrett's esophagus".

Kusezimweni ezinjengalezi lapho i-EUS ingasiza odokotela ukuthi babone ngaphakathi futhi benze ukuxilongwa okunembile.

Yiziphi izinhlobo eziyinhloko zokuhlolwa kwe-EUS?

Ukuhlolwa kwe-EUS kungahlukaniswa ngezigaba ezimbili eziyinhloko, kuye ngokuthi ukuhlolwa kwenziwa kuphi.

1. I-EUS Ephezulu

Lokhu kubheka ingxenye engenhla yesistimu yakho yokugaya ukudla. Okungukuthi:

• Ulwelwesi lwangaphakathi lomphimbo wakho (ipayipi lokudla), isisu (isisu), kanye nengxenye engenhla yamathumbu akho amancane (i-duodenum).
• Ama-lymph node ahlobene, imithambo yegazi, ama-cyst, kanye nama-tumors.
• Ingahlola nezitho eziseduze njenge-pancreas, i-gallbladder, kanye ne-bile ducts.

2. I-EUS ephansi

Lokhu kuhlolwa kubheka ingxenye engezansi yesistimu yakho yokugaya ukudla. Okungukuthi:

• Imisipha ezungeze umgodi wendunu (i-anal sphincter).
• Imithambo yegazi, ama-lymph node, ama-cyst, kanye nezimila ezinomdlavuza kuleyo ndawo.
• Ingqimba engaphakathi yengxenye yokugcina yamathumbu amakhulu (i-rectum kanye ne-colon).

Udokotela uzonquma ukuthi iyiphi yalezi "EUS" ezimbili okufanele iyenze ngokusekelwe ezimpawini nasezidingweni zakho.

Ingabe ezinye izivivinyo zenziwa kanye ne-EUS?

Yebo, ngezinye izikhathi, ngenkathi kwenziwa i-EUS, kungenziwa enye inqubo ebalulekile. Okungukuthi, i-Endoscopic Ultrasound-guided Fine-Needle Aspiration (FNA) .

Lokhu kungase kubonakale njengegama elide, kodwa nje yilokhu: Ngesikhathi ebheka ngaphakathi nge-``(EUS)``, udokotela angabuka izithombe ze-ultrasound, adlulise inalithi encane kakhulu nge-endoscope, bese ethatha ucezu oluncane lwezicubu noma uketshezi endaweni esolisayo . Lokhu kubizwa ngokuthi ``(FNA)``, kanti abanye abantu bakubiza nangokuthi ``(biopsy)```.

Isampula ithunyelwa elabhorethri, lapho isazi sezifo siyihlola khona ngaphansi kwe-microscope ukuze sibheke noma yimaphi amangqamuzana angajwayelekile, njengamaseli omdlavuza. Lokhu kusiza ukuqinisekisa uhlobo oluqondile lwesifo .

Yini okudingeka ngiyenze ngaphambi kokuhlolwa kwe-EUS?

Uma uhlelelwe ukuhlolwa kwe-EUS, udokotela wakho noma umhlengikazi uzokunikeza imiyalelo yokuthi yini okufanele uyenze nokuthi yini okungafanele uyenze ngosuku olwandulelayo. Kubalulekile ukuyilandela ngqo ukuqinisekisa ukuthi ukuhlolwa kuphumelele . Ngokuvamile zifaka izinto ezinjengalezi:

• Mayelana nemithi oyithathayo: Uma uthatha imithi yezinto ezifana nesifo sikashukela, umfutho wegazi ophakeme, noma isifo senhliziyo, ikakhulukazi imithi yokunciphisa igaziUma uthatha imithi yokunciphisa igazi (isib. iCoumadin®, iPlavix®) noma i-insulin, kufanele utshele udokotela wakho kusenesikhathi. Udokotela wakho angase afune ukushintsha umthamo noma ayeke ukuthatha imithi izinsuku ezimbalwa.
• Ukudla Nokuphuza: Uzocelwa ukuthi ungadli noma uphuze lutho amahora amaningana ngaphambi kokuhlolwa (ngokuvamile amahora angu-6-8). Kubalulekile ukuba nesisu esingenalutho ukuze ukuhlolwa kucace.
• Ukulungiswa kwamathumbu: Uma une-EUS ephansi, udokotela wakho uzokunikeza uketshezi olukhethekile olubizwa ngokuthi "ukulungiswa kwamathumbu" ukuze kuhlanzwe ikholoni lakho. Lokhu kuzokuvumela ukuthi ubone ingaphakathi lekholoni lakho ngokucacile.
• Esinye iseluleko: Ungase unikezwe iseluleko esiqondile. Lalela konke ngokucophelela bese usilandela.

Kwenzekani ngempela ngesikhathi se-EUS ephezulu?

I-EUS ephezulu ivame ukuba inqubo yokulaliswa esibhedlela. Ngeke ungeniswe esibhedlela ngale nqubo. Kodwa-ke, ngoba uzonikezwa umuthi wokudambisa (i-anesthesia) kule nqubo, uzodinga umuntu ozokuhambisa ekhaya ngemuva kwenqubo. Kungumqondo omuhle futhi ukuba nomuntu ohlala nawe usuku lonke. Inqubo ye-EUS ephezulu ivame ukuthatha cishe imizuzu engama-60 .

Izinto ezilandelayo zenzeka ngesikhathi sokuhlolwa:

1. Uzophendukela kwesobunxele bese ulaliswa phansi.

2. Umhlengikazi uzofaka i-cannula encane emthanjeni engalweni yakho bese ekunika umuthi wokudambisa . Lokhu kuzokusiza uphumule futhi ungazizwa uvivinyo.

3. Ngizofafaza umuthi wokukwenza uzizwe ungenamizwa.

4. Kuzofakwa isivikelo somlomo sepulasitiki emlonyeni wakho ukuvimbela ukulimala kwamazinyo akho nokukuvimbela ekuhlafuneni i-endoscope.

5. Udokotela uzobe esefaka kancane i-ultrasound endoscope ngomlomo wakho, yehle ngomhubhe wakho, iye esiswini sakho, bese ingena engxenyeni engenhla yamathumbu akho amancane (i-duodenum). Ngeke uzizwe ubuhlungu phakathi nalesi sikhathi . Uzokwazi ukuphefumula ngendlela evamile.

6. Udokotela ubheka izithombe ze-ultrasound kusikrini bese ehlola ingxenye engenhla yesistimu yakho yokugaya ukudla, izitho ezizungezile, amaqhubu, kanye nezimila.

7. Uma kudingeka, i-`(FNA)` okukhulunywe ngayo ngaphambilini, okusho ukuthatha isampula yezicubu, yenziwa ngalesi sikhathi.

8. Uma ukuhlolwa sekuqediwe, udokotela uzosusa kancane i-endoscope. Umuthi wokudambisa uzomiswa. Ngemuva kwalokho uzoyiswa ekamelweni lokululama bese ulinde ukuthi ubuye uqonde kancane kancane.

Kwenzekani ngesikhathi se-EUS ephansi?

I-subtotal ultrasound (EUS) iyafana ne-supratotal ultrasound, futhi iyisivivinyo sosuku olufanayo . Uzophinde unikezwe umuthi wokudambisa, ngakho-ke kuzodingeka othile akuyise ekhaya ngemoto.

Lokhu kuhlolwa kuvame ukuthatha imizuzu engaphansi kwengu-60.Yilokho okwenzekayo. Endabeni ye-`(EUS)` eyenziwa ngaphansi kwesikhumba, i-`(FNA)` ayivamile kangako.

Yilokhu okwenzekayo ngesikhathi sokuhlolwa:

1. Uzophendukela kwesobunxele bese ulaliswa phansi.

2. Uzonikezwa iphilisi lokulala nge-IV ukuze likusize uphumule.

3. Udokotela ufaka i-ultrasound endoscope nge-anus yakho kanye ne-rectum bese eyiqondisa emathunjini akho. Ngeke uzwe ubuhlungu noma ukungakhululeki phakathi nale nqubo . Uzokwazi ukuphefumula ngendlela evamile.

4. Udokotela ubheka izithombe ze-ultrasound kusikrini bese ehlola ingxenye engezansi yesistimu yakho yokugaya ukudla, izitho ezizungezile, kanye nanoma yiziphi izigaxa.

5. Uma ukuhlolwa sekuqediwe, i-endoscope izosuswa kancane kancane bese umuthi wokudambisa umiswa. Uzophinde uqaphe kancane kancane.

Uzizwa kanjani ngemva kokuhlolwa kwe-EUS?

Imiphumela yomuthi wokudambisa owunikiwe ivame ukuphela phakathi kwemizuzu engama-30 kuya ehoreni . Ngemva kwalokho, ungase uzwe ukungakhululeki okuncane, okufana nalokhu:

• Uma une-EUS ephansi, ungase ube ne -gas, ukuqunjelwa, noma ukuqaqamba kwamalunga .
• Uma wenza i-EUS ephezulu: umphimbo obuhlungu .

Lezi zimpawu zivame ukunyamalala ngokuphelele zingakapheli amahora angama-24 , ngakho-ke akukho okufanele ukhathazeke ngakho.

Kungcono ukuphumula usuku lonke ngemva kokuhlolwa. Ungaqhubeka nemisebenzi yakho evamile ngosuku olulandelayo.

Yiziphi izingozi noma izinkinga ezingaba khona ngokuhlolwa kwe-EUS?

I-EUS ngokuvamile ibhekwa njengenqubo ephephile kakhulu . Kodwa-ke, njenganoma iyiphi inqubo yezokwelapha, kunethuba elincane lokuthi izinkinga zingase zenzeke, ezingavamile kakhulu. Lokhu kufaka phakathi:

• Ukusabela kokungezwani komzimba ne-anesthesia.
• Noma yimuphi umonakalo ohlelweni lokugaya ukudla noma ukopha.
• Ku-EUS ephezulu, uketshezi oluvela emlonyeni noma esiswini lungena emaphashini (ukufiphaza kwamaphaphu).
• Ukuvuvukala kwe-pancreas (i-pancreatitis) (lokhu kungenzeka ikakhulukazi ngemva kwe-endoscopy ephezulu (i-EUS) kanye ne-biopsy yenaliti).
• Imbobo (ukubhoboka/ukudabuka) odongeni lwamathumbu.

Lezi zinto azenzeki kaningi , kodwa kuhle ukuzazi. Uma kunenkinga, udokotela uzoyelapha ngendlela efanele.

Ngizoyazi nini imiphumela yokuhlolwa kwe-EUS?

Lapho nje ukuhlolwa sekuqediwe, udokotela uzokunikeza umbono oqondile walokho okubonwe ngesikhathi se-EUS. Kodwa-ke, uma isampula yezicubu (i-biopsy) ithathwe ku-FNA yathunyelwa elabhorethri, kungathatha amasonto ambalwa ukuthola umbiko ogcwele . Ngemva kokuba lowo mbiko ufikile, udokotela uzokubuyisela futhi akuchazele wona.

Kunini lapho udinga ukubonana nodokotela ngokushesha?

Uma uhlangabezana nesinye noma ngaphezulu salezi zimpawu ngemva kokuhlolwa, shayela udokotela wakho ngokushesha noma uye esibhedlela esiseduze:

• Uma kukhona igazi esitulweni (`igazi esitulweni`).
• Uma unenkinga noma ubuhlungu lapho uya endlini yangasese.
• Uma unomkhuhlane noma ezinye izimpawu zokutheleleka (njengokugodola nobuhlungu bomzimba).
• Uma unenkinga yokugwinya ukudla.
• Uma unesicanucanu esingapheli nokuhlanza.
• Ubuhlungu besisu noma isifuba obungabekezeleleki, obukhulu, obuqhubekayo.
• Ukuphelelwa umoya.

Uma unalezi zinto, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.

Okokugcina, izinto okufanele uzikhumbule

Kulungile, ngakho-ke ngithemba ukuthi usunombono omuhle mayelana nokuhlolwa kwe-`(Endoscopic Ultrasound - EUS)`.

I-endoscopic ultrasound (EUS) iyindlela ephephile kakhulu futhi ephumelelayo yokuhlola ngaphakathi kohlelo lwakho lokugaya ukudla. Ingasiza odokotela ukuthola imbangela yezimpawu zakho, ikakhulukazi izinkinga zokugaya ukudla, umdlavuza, kanye nokusabalala komdlavuza. Uma kudingeka, kungathathwa isampula yezicubu (i-biopsy / FNA).

Lokhu ukuhlolwa "okungavamile kakhulu", okusho ukuthi kwenziwa ngaphandle kokusikwa okukhulu futhi ungaya ekhaya ngalolo suku. Ngakho-ke, uma udokotela ekutshela ukuthi wenze "(EUS)``, ungesabi ngokungadingekile. Uma uneminye imibuzo, khuluma nodokotela wakho ngayo.

I- ultrasound ye-endoscopic, i-EUS, uhlelo lokugaya ukudla, i-endoscopy, i-ultrasound, i-biopsy, ukuhlolwa komdlavuza