Ukuhlolwa kwe-EBUS (Endobronchial Ultrasound): Indlela yokubheka ngaphakathi kwamaphaphu ngekhamera!

Nawe kungenzeka ukuthi utshelwe udokotela ngokuhlolwa kwamaphaphu. Mhlawumbe babone okuthile okuncane ku-"(X-ray)" noma ku-"(CT scan)" yakho bathi badinga ukukubheka kabanzi. Ezimweni ezinjalo, lokhu ukuhlolwa okukhethekile okubizwa ngokuthi i-EBUS okwenziwa ukuze kubonwe ukuthi kwenzekani ngaphakathi kwamaphaphu. Ingabe singakhuluma kabanzi ngalokhu?

Kuyini i-EBUS (i-ultrasound ye-endobronchial)?

Kalula nje, i-EBUS (i-Endobronchial Ultrasound) inqubo lapho kufakwa khona idivayisi encane efana nekhamera emaphashini akho ukuze kubonakale ukuthi yini engaphakathi kwawo ngokucacile. Lokhu kufana ne-bronchoscopy. Kodwa-ke, kulokhu, umshini we-ultrasound unamathiselwe ekugcineni kwe-bronchoscope. Lokhu kusho ukuthi udokotela angabona okungaphakathi kwamaphaphu akho njengezithombe ze-ultrasound. Cabanga ngakho njengokuskena kwe-ultrasound kwengane esibelethweni, okubheka izimila kanye nama-lymph node emaphashini.

Le ndlela isetshenziselwa ukuthola izifo ezahlukahlukene emaphashini, ikakhulukazi ukuthola ukuthi kukhona yini umdlavuza (`(Umdlavuza)`) nokuthi ususakazeke kangakanani (`(Isigaba)`). Enye into enhle ukuthi phakathi nalolu vivinyo lwe-EBUS, uma kudingeka, kungathathwa ingcezu yezicubu bese ithunyelwa ukuze kuhlolwe i-`(Biopsy)`. Ngemuva kwalokho ungenza izinto ezimbili ngesikhathi esisodwa.

Ngakho-ke uyini umehluko phakathi kwe-`(Bronchoscopy)` kanye ne-EBUS?

Umbuzo omuhle! `(Bronchoscopy)` yigama elinikezwe ithuluzi (`(Bronchoscope)`) kanye nenqubo evame ukusetshenziswa ukubheka ngaphakathi kwamaphaphu. Lokhu kuvumela odokotela ukuthi babone okungaphakathi kwamaphaphu ngekhamera, noma ukuthatha amasampula ezicubu (`(Biopsy sample)`) noma amasampula oketshezi.

I-EBUS nayo iyi-`(Bronchoscopy)`. Kodwa okukhethekile ukuthi kule `(Bronchoscope)`, ikhono le-`(Ultrasound)` liyangezwa . Ngakho-ke, ngisho nezinto ezifana nama-lymph node angaphandle kwezindonga zamaphaphu futhi angenakubonwa nge-`(Bronchoscope)` evamile zingabonakala ngokucacile ngale EBUS. Futhi, kuyasiza kakhulu ukuthatha i-`(Biopsy)` ngokubheka lezo zithombe ze-`(Ultrasound)` bese uthumela inalithi endaweni eqondile.

Ingabe kukhona izinhlobo zokuhlolwa kwe-EBUS?

Yebo, kunezinhlobo eziningana eziyinhloko zokuhlolwa kwe-EBUS. Udokotela ukhetha uhlobo oluzokwenziwa ngokusekelwe kulokho okudingekayo ngaleso sikhathi.

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

Lokhu `(RP-EBUS)` kungakunikeza umbono ocacile kakhulu, ongama-degree angu-360 wengaphakathi lezindlela zakho zomoya . Kungangena ngokujulile emaphashini futhi kuthole imibono enemininingwane engcono kunezinye izinhlobo. Kodwa-ke, uma udinga ukuthatha `(i-Biopsy)`, kufanele usebenzise imishini ehlukile yalokho.

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

Lokhu `(CP-EBUS)` kungasetshenziswa kuphela emigudwini yakho yokuphefumula eyinhloko (okungukuthi, i-trachea kanye ne-bronchi). Lokho kusho ukuthi akukwazi ukungena ngokujulile emaphashini. Kodwa lokhu kunakhoInzuzo enkulu ukuthi `(I-Biopsy)` ingathathwa ngesikhathi sokuhlolwa uma kudingeka. Kodwa-ke, umbono otholwe kulokhu ulinganiselwe kancane futhi awunamininingwane eminingi kune `(RP-EBUS)`.

I-EBUS-Transbronchial Needle Aspiration (EBUS-TBNA)

Lolu akulona uhlobo oluhlukile. Uma kwenziwa isivivinyo se-`(CP-EBUS)`, indlela esetshenziswa ukuthatha isampula yezicubu (`(Izicubu)`) noma uketshezi (`(Uketshezi)`) lwe-`(Biopsy`)` ibizwa ngokuthi `(EBUS-TBNA)`. Ukuze kube sobala, inaliti encane (`(Inaliti)`) idlula odongeni lomoya , kusetshenziswa `(Ultrasound)`, bese kuthathwa isampula endaweni oyifunayo.

Uzodinga nini ukuhlolwa kwe-EBUS?

Ngokuvamile, udokotela uzoyala ukuhlolwa kwe-EBUS uma bebona into engavamile esifubeni sakho nge-X-ray noma nge-CT scan ukuze bayihlole kabanzi. Isibonelo, ukuhlolwa kwe-CT kungabonisa iqhubu elincane emaphashini akho, noma ama-lymph node avuvukele. Ezimweni ezinjalo, ukuhlolwa kwe-EBUS kungasiza ekutholeni ukuthi kuyini ngempela.

Ukuhlolwa kwe-EBUS kusetshenziselwa ukuxilonga izimo ezifana nalezi:

• Ukutheleleka kwamaphaphu kanye namathumba
• Umdlavuza wamaphaphu noma umdlavuza wesikhala esiphakathi kwamaphaphu (mediastinum)
• Izimo zamaphaphu ezivuvukalayo njenge-sarcoidosis kanye ne-silicosis
• I-stenosis yomoya (ukuncipha kwemigudu yomoya)
• Amaqhubu amancane emaphashini (amaqhubu e-pulmonary)

Ngaphezu kwalokho, ukuhlolwa kwe-EBUS kusetshenziselwa nokunquma isigaba (`umdlavuza`) sezinye izimo zomdlavuza, okungukuthi, ukuthi umdlavuza ususakazeke kangakanani.

Ukuhlolwa kwe-EBUS kusebenza kanjani ngempela?

Lokhu kuhlolwa kwe-EBUS kwenziwa udokotela ogxile ezifweni zamaphaphu (`(Pulmonologist)`). Ufaka ipayipi elincane, elikhanyayo (`(Bronchoscope)`) ngemigudu yakho yomoya (`(Airways)`), kungaba ngekhala noma ngomlomo wakho. Umsebenzi wenziwa kusetshenziswa idivayisi ye-`(Ultrasound)` enamathiselwe esicongweni sale `(Bronchoscope)`.

Cabanga nje, le `(Ultrasound)` isebenzisa amaza omsindo ukuthumela izithombe ezicacile zalokho okungaphakathi kwamaphaphu akho kumqaphi. Udokotela angabuka lezo zithombe, akhombe i-`(Bronchoscope)` ngqo lapho afuna ukubheka khona, bese ehlola leyo ndawo ngokuningiliziwe. Isebenza njengohlelo lwe-`(Sonar)` ukuthola izinto ngaphansi kolwandle.

Ngingakulungiselela kanjani ukuhlolwa kwe-EBUS?

Udokotela wakho noma abasebenzi basesibhedlela bazokunikeza imiyalelo yokuthi ungalungiselela kanjani ukuhlolwa kwakho kwe-EBUS. Uma kukhona okungacacile emiyalweni, qiniseka ukuthi ubuza futhi. Ngokuvamile, kuzodingeka wenze okulandelayo:

• Ungase ucelwe ukuthi wenze umsebenzi wegazi ngaphambi kokuhlolwa.
• Uzocelwa ukuthi ungadli noma uphuze lutho amahora ambalwa ngaphambi kokuhlolwa (`(Ukuzila ukudla)`) . Ngokuvamile kufanele uzile ukudla cishe amahora ayisithupha kuya kwayisishiyagalombili.
• Ungase ucelwe ukuthi uyeke ukuthatha imithi ethile (njengemithi yokunciphisa igazi) ezinsukwini ezimbalwa ngaphambi kokuhlolwa. Kufanele futhi utshele udokotela wakho ngayo yonke imithi oyithathayo, okuhlanganisa nanoma yiziphi izithasiselo ozithathayo.
• Thola umuntu ozokuhambisa ekhaya ngemuva kokuhlolwa. Uzophuza utshwala, ngakho ngeke ukwazi ukushayela ngemuva kokuhlolwa. Kubalulekile ukuba nomuntu ohamba nawe.

Kwenzekani ngesikhathi sokuhlolwa kwe-EBUS? Ingabe ngizozwa ubuhlungu?

Ngaphambi kokuhlolwa, uzolaliswa embhedeni noma etafuleni. Bese:

Ngaphambi kokuhlolwa

• Uma kudingeka, abahlengikazi bazokusiza ukuthi uhlale uqonde.
• Ipayipi elincane (`(Intravenous - IV)`) lifakwa emthanjeni ongalweni yakho bese kunikezwa isisombululo se-saline. Le `(IV)` yilapho umhlengikazi obulala izinzwa noma udokotela obulala izinzwa ezokunikeza khona imithi edingekayo. Le mithi ngeke ikwenze uzizwe ungakhululekile noma ubuhlungu kuze kube yilapho ukuhlolwa sekuphelile. Ngezinye izikhathi uzonikezwa umuthi wokudambisa ophakathi nendawo (`(I-Medium sedation)`), noma umuthi wokudambisa ojwayelekile (`(General anesthesia)`) . Udokotela wakho uzokutshela ngalokhu kusenesikhathi.
• Kuzofakwa i-spray yokufutha emlonyeni wakho (noma ekhaleni) nasemphinjeni. Lokhu kuzoyithuntubeza indawo, ngakho ngeke uzizwe ungakhululekile lapho kufakwa i-bronchoscope.

Ngesikhathi sokuhlolwa

Ngemva kokukwenza ukhohlwe futhi umphimbo wakho uphelelwe amandla, udokotela wamaphaphu:

• Udokotela uzofaka i-bronchoscope ngekhala noma ngomlomo wakho.
• Iyayithatha ngemigudu yomoya bese iyiqondisa lapho idinga ukubhekwa khona.
• Uma kudingeka, kuzothathwa isampula eyodwa noma ngaphezulu ye-biopsy.
• Ngemuva kwalokho i-bronchoscope isuswa kancane kancane.

Ngeke uzwe ubuhlungu ngesikhathi sokuhlolwa ngoba uzonikezwa i-anesthesia. Kodwa-ke, ungase uzwe umphimbo obuhlungu, ukukhwehlela, noma ukushaqeka cishe usuku lonke ngemva kokuhlolwa. Ngaphandle kwalokho, uma uzwa ubuhlungu obukhulu, kufanele utshele udokotela wakho ngokushesha.

Kuthatha isikhathi esingakanani ukuhlolwa kwe-EBUS?

Ukuhlolwa kwe-EBUS kuvame ukuthatha imizuzu engama-30 kuya kwengama-90 (cishe ihora nesigamu) . Kodwa-ke, lesi sikhathi singahluka kuye ngesimo sakho. Ngakho buza udokotela wakho ukuthi kuzothatha isikhathi esingakanani. Ngemva kokuphela kokuhlolwa, kuzodingeka uhlale esibhedlela cishe ihora noma amabili ngaphambi kokuba uye ekhaya.

Yini ongayilindela ngemva kokuhlolwa kwe-EBUS?

Ngokuvamile ungaya ekhaya emahoreni ambalwa ngemva kokuhlolwa. Abasebenzi bezokwelapha bazokunakekela uze uvuke ngokuphelele, uphefumule kahle, futhi ukwazi ukugwinya. Bazokutshela nokuthi uzoyithola nini imiphumela yokuhlolwa kwakho nokuthi kufanele uphinde umbone nini udokotela.

Lokhu okulandelayo kungenzeka cishe usuku olulodwa ngemva kokuhlolwa:

• Umphimbo obuhlungu
• Izwi elihoshozelayo
• Ukukhwehlela

Kuvamile ukukhwehlela igazi elincane , futhi lizophela emahoreni noma ezinsukwini ezimbalwa. Kodwa-ke, uma lingayeki ngemva kwezinsuku ezimbalwa, noma uma kunegazi eliningi, kufanele nakanjani wazise udokotela wakho .

Ingabe zikhona izingozi ngokuhlolwa kwe-EBUS?

I-EBUS inqubo enobungozi obuphansi kakhulu , kodwa akuvamile ukuthi kube nezinkinga ezithile. Lokhu kufaka phakathi:

• Ukopha (`(Ukopha)`)
• Ukutheleleka (`(Ukutheleleka)`)
• Iphaphu eligoqekile (noma i-Pneumothorax) - Yilapho umoya othile ovela emaphashini ungavuza ungene esifubeni.
• Ukucindezeleka kokuphefumula - Lokhu kusho izinkinga zokuphefumula, njengokungakwazi ukukhipha kahle i-carbon dioxide emzimbeni.

Yiziphi izinzuzo zokuhlolwa kwe-EBUS?

Uma kuqhathaniswa nezinye izindlela zokuthwebula izithombe kanye nezindlela ze-biopsy, i-EBUS inezinzuzo eziningana.

• Udokotela angasebenzisa i-"Bronchoscope" futhi aqondise i-"Ultrasound" endaweni eqondile edingekayo ukuze kutholakale izithombe ezifunwayo ngokucacile.
• Ukuthatha i-biopsy nokuthatha izithombe kungenziwa kokubili esivivinyweni esifanayo. Asikho isidingo sokuba nezivivinyo ezimbili ezihlukene. Ngezinye izikhathi, kungenzeka ukuthola umdlavuza bese unquma isigaba sawo ngesikhathi esisodwa.
• Lena inqubo yokulaliswa esibhedlela . Lokhu kusho ukuthi ngeke ugcinwe esibhedlela futhi ungaya ekhaya ngalolo suku.
• Lena inqubo engadingi ukungenelela okuningi . Lokho kusho ukuthi ayinazo izingozi ezifanayo nokuhlinzwa okuvulekile. Ngakho ungalulama ngokushesha.

Iyini imiphumela yokuhlolwa kwe-EBUS? Isho ukuthini?

Uma ukuhlolwa kwakho kwe-EBUS kuhilela ukuthatha ingcezu yezicubu noma isampula yoketshezi, udokotela wakho uzoyithumela elabhorethri ukuze ahlole ukutheleleka, umdlavuza, noma ezinye izimo, kuye ngesimo sakho. Udokotela wakho uzochaza imiphumela futhi akutshele ukuthi wenzeni ngokulandelayo. Kungase kudingeke ulinde izinsuku ezimbalwa ukuze imiphumela ibuye.

Kufanele ngimbone nini udokotela?

Uma unemibuzo noma imiphumela emibi engalindelekile, khuluma nodokotela wakho . Kufanele ufune iseluleko sezokwelapha ngokushesha uma unezimpawu zokutheleleka. Izimpawu ezinjalo zifaka:

• Umkhuhlane (`(Umkhuhlane)`)
• Ubuhlungu besifuba (`(Ubuhlungu besifuba)`)
• Ubunzima bokuphefumula
• Ubunzima bokugwinya
• Ukukhwehlela igazi okuqhubekayo
• Ukungakwazi ukuchama/ukuchama - Nakuba lokhu kungahlobene ngqo ne-EBUS, ngezinye izikhathi kungenzeka ngemva kokubulala izinzwa, ngakho-ke kubalulekile ukukusho uma kwenzeka.

Okokugcina, izinto okufanele uzikhumbule

I-EBUS (i-Endobronchial Ultrasound) inqubo engangenisi kakhulu, engasetshenziswa emtholampilo wangaphandle enganikeza umbono ocacile noningiliziwe wezinguquko ngaphakathi kwamaphaphu. Ingathatha futhi amasampula ezicubu noketshezi, ngezingozi ezimbalwa kunezinye izindlela.

Khumbula, ungangabazi ukubuza udokotela wakho noma yimiphi imibuzo onayo mayelana nendlela ukuhlolwa okwenziwa ngayo, ukuthi odokotela bafunani, nokuthi imiphumela izotholakala nini. Ukwazi ukuthi yini ongayilindela kusenesikhathi kuzosiza ekunciphiseni ukukhathazeka kwakho. Hlala uphilile!

` I-EBUS, i-Endobronchial Ultrasound, Ukuhlolwa kwamaphaphu, i-Bronchoscopy, i-Ultrasound, i-Biopsy, umdlavuza wamaphaphu, izifo zokuphefumula