Tam sim no, tus naj npawb ntawm cov kab mob oncological tau loj hlob txhua hnub. Muaj ntau yam yuav tsum tau ua ua ntej rau qhov no, tab sis nyob rau hauv cov xwm txheej zoo li no nws yog ib qho tseem ceeb heev uas yuav tsum tau kuaj xyuas kom raug thiab sai sai, tsuas yog tom qab ntawd tuaj yeem kho tau zoo. Muaj ntau txoj hauv kev los kuaj mob qog noj ntshav, ib qho ntawm lawv yog biopsy. Cov hom, lub ntsiab lus ntawm txoj kev no yuav txawv, peb yuav sim kom paub nrog lawv nyob rau hauv peb tsab xov xwm.
Lub ntsiab ntawm kev kuaj ntshav
Txoj kev tshawb no yog tsim los qhia meej qhov kev kuaj mob lossis qhia meej txog qhov uas twb muaj lawm. Biopsy qhov tseeb yog yuav luag 100%. Thaum txoj kev tshawb no, ib cheeb tsam me me yog muab los ntawm ib lub cev, nyob ntawm qhov chaw ntawm cov qog thiab pathology.
Yog tias xav tias oncology, ib qho kev kuaj ntshav tau muab tshuaj rau thawj qhov chaw. Thaum kuaj biopsy, cov khoom siv roj ntsha raug coj mus kuaj thiab kuaj hauv lub tshuab kuaj kab mob. Yog tias muaj kev loj hlob ntawm cov qog nqaij hlav cancer lossis lwm yam txheej txheem pathological, tom qab ntawd kev hloov pauv ib txwm pib hauv cov ntaub so ntswg uas yooj yim tsis tuaj yeem saib xyuas hauv lub tshuab tsom.
Ntau yam ntawm biopsy
Hom kev kuaj ntshav tuaj yeem sib txawv, lawv tuaj yeem sib txawv nyob ntawm cov tshuaj:
- Puncture biopsy. Cov khoom siv roj ntsha raug coj mus rau kev tshawb fawb siv lub koob txhaj tshuaj lossis rab phom aspiration.
- Smears-prints. Xws li biopsy yog txo kom siv lub iav swb rau saum npoo ntawm cov qog kom tau txais qee yam khoom siv rau kev kawm.
- Excisional biopsy cuam tshuam nrog kev tshem tawm tag nrho cov qog nrog rau cov ntaub so ntswg ib puag ncig.
- Incisional biopsy yog tshem tawm cov khoom lom ntawm cov qog nws tus kheej.
- Trepan biopsy. Nws yog nqa tawm siv cov koob tshwj xeeb, nrog rau lawv cov kev pab ib kem ntawm cov ntaub so ntswg tau txais los ntawm neoplasm.
Vydklyayut tsis tsuas yog ntau hom kev kuaj ntshav, tab sis kuj tseem siv cov khoom siv lom neeg rau kev tshawb fawb.
Txoj kev coj mus kuaj cov khoom siv lom neeg
Nyob ntawm qhov chaw ntawm cov qog, cov kws kho mob siv ib lossis lwm txoj hauv kev noj cov khoom.
Zoo koob tshuaj tiv thaiv kab mob. Nrog rau hom no, cov khoom siv nrog rab koob, uas tau muab tso rau hauv thaj chaw pathological.
Pap smears raug tshem tawm ntawm lub ncauj tsev menyuam yog tias xav tias mob qog noj ntshav.
Zoo-needle biopsy yuav tsum tau txais cov ntaub so ntswg ntxiv, piv txwv li, yog tias xav tias oncology ntawm daim siab, prostate, lub mis.
Aspiration biopsy. Cov khoom yog muab nrog kev pab los ntawm ib tug aspirator. Txoj kev no tso cai rau koj kom tau txais ntau cov ntaub so ntswg nyob rau tib lub sijhawm.
Cov khoom siv tuaj yeem ua tau raws li kev tswj hwm ntawm lub scan, nws tuaj yeem yog X-ray, MRI lossis ultrasound. Lawv cia tus kws kho mob tswj txoj hauj lwm ntawm rab koob.
Biopsy tuaj yeem ua tiav thaum lub sijhawmphais.
Cov khoom siv kuaj pom thaum lub sij hawm endoscopy lossis fibrogastroduodenoscopy. Txoj kev no feem ntau siv rau kev xav tias mob qog noj ntshav ntawm txoj hnyuv, plab, esophagus.
Tau qhov mob hnyav ntawm pathology, nws qhov chaw nyob, tus kws kho mob txiav txim siab txog cov txheej txheem ntawm kev noj cov khoom siv rau kev kuaj cytological.
Lab qog nqaij hlav biopsy
Txawm li cas los xij koj tus kws kho mob siv tshuaj biopsy, cytology tuaj yeem pab koj kuaj xyuas qhov tseeb. Tom qab cov khoom siv roj ntsha raug coj mus, nws raug xa mus rau chav kuaj rau kev tshawb fawb.
Ua qhov kev tshawb fawb histological ntawm cov ntaub so ntswg. Cov khoom siv ua ntej yog lub cev qhuav dej siv cov kev daws teeb meem tshwj xeeb kom nws thiaj li tau impregnated nrog paraffin. Tom qab ntawd cov seem thinnest yog ua thiab muab tso rau ntawm ib lub iav swb. Kev npaj yog feem ntau stained kom pom kev zoo dua.
Ua kev kuaj cytological. Cov txheej txheem ntawm kev npaj cov ntaub so ntswg tshem tawm yog xyaum zoo ib yam li qhov kev kawm dhau los. Tab sis muaj qhov sib txawv ntawm cytology - cov kab mob oncological tau tsim los ntawm cov yam ntxwv zoo ntawm cov qog nqaij hlav cancer. Txoj kev kawm no suav hais tias tsis tshua muaj ntaub ntawv, tab sis yog tias nws tsis tuaj yeem tshem tawm cov ntaub so ntswg, nws yog qhov zoo.
Type of mis biopsy
mob qog noj ntshav mis yog ib yam kab mob tshwm sim ntawm cov poj niam. Hom mob qog noj ntshav no tam sim no zoo heev rau kev kho mob,yog tias kuaj pom thaum ntxov, tab sis tsis yog txhua tus poj niam coj lawv txoj kev noj qab haus huv, uas qee zaum ua rau muaj kev nyuaj siab. Feem ntau peb mus ntsib kws kho mob thaum tus kab mob no dhau mus lawm. Txhawm rau kuaj xyuas qhov tseeb hauv kev kuaj mob ntawm lub mis, cov khoom siv hauv qab no yog siv:
- Zoo koob aspiration. Nws yog siv thaum thaj chaw pathological hauv lub hauv siab zoo palpable. Nyob rau tib lub sijhawm, tus poj niam tuaj yeem zaum, qhov chaw biopsy tau kho tau zoo nrog cov tshuaj tua kab mob, ib rab koob nyias, tom qab ntawd ib qho me me ntawm cov ntaub so ntswg los yog kua yog kos rau hauv lub syringe yog tias nws yog cyst.
- Stereotactic fine koob biopsy. Nrog kev pab ntawm ib rab koob, cov ntaub so ntswg raug coj mus kuaj los ntawm ntau qhov chaw ntawm cov qog. Nrog rau qhov chaw sib sib zog nqus ntawm pathology, lawv tuaj yeem siv cov khoom siv nrog kev pab ntawm ultrasound lossis mammography txhawm rau txiav txim siab qhov chaw ntawm cov qog.
- Ib qho tseem ceeb biopsy ntawm lub mis yog ua kom tau txais thaj tsam loj ntawm cov ntaub so ntswg. Rau qhov no, siv rab koob tuab nrog cov cuab yeej tshwj xeeb txiav.
- Incisional biopsy yog ua nyob rau hauv cov tshuaj loog hauv zos, vim nws yog ib qho tsim nyog kom tau txais ib daim ntaub so ntswg los ntawm cov qog nws tus kheej.
- Ib qho kev phais mob qog nqaij hlav yog ib hom kev ua haujlwm me me thaum tus kws kho mob txiav tawm tsuas yog ib feem lossis tag nrho cov qog, nws tag nrho nyob ntawm nws qhov loj.
Rau qhov pathologies ntawm cov qog mammary qog nqaij hlav yog tshuaj
Ntau hom kev kuaj ntshav hauv oncology tseem ceeb, tab sis txoj kev tshawb no tuaj yeem kuaj pom lwm yam kab mob,los yog, tsis suav nrog oncology nrog lawv:
- mastitis, uas feem ntau tshwm sim hauv cov poj niam pub niam mis;
- mastopathy, nws los ntawm ntau hom thiab ib qho ntawm lawv tuaj yeem hloov mus rau hauv oncology;
- mis nyuj;
- fibroadenoma;
- intraductal papilloma.
Rau tag nrho cov kab mob no, kev kuaj ntshav biopsy yog qhov yuav tsum tau txiav txim siab txog tus kab mob hnyav dua thiab ua qhov kev kuaj mob kom raug.
Cervical biopsy
Peb tau tshuaj xyuas seb qhov kev kuaj mob biopsy yog dab tsi (txhais tau, hom mob qog noj ntshav mis), tab sis nws kuj yog ib qho kev tshawb fawb rau pathologies ntawm lub ncauj tsev menyuam. Tus kws kho mob gynecologist tau sau cov txheej txheem no thiab ua raws cov hom phiaj hauv qab no: kom paub meej, qhia meej lossis tsis lees paub qhov kev kuaj mob uas tau ua tom qab kuaj cytological.
Lub hauv paus rau kev teem caij kuaj mob ntawm lub ncauj tsev menyuam yog qhov muaj cov kab mob hauv qab no:
- yaig, vim tus kab mob tuaj yeem ua rau mob qog noj ntshav;
- kuaj pom lub foob lossis neoplasm thaum kuaj;
- HPV positive;
- hloov pauv cov qauv ntawm tes uas tau tshwm sim tom qab kuaj cytological;
- exophytic warts.
Hom kev kuaj ntshav ntawm ncauj tsev menyuam tej zaum yuav txawv, nyob ntawm lub hom phiaj thiab qhov loj ntawm thaj chaw pathological. Nov yog hom siv ntau tshaj plaws:
- Lub hom phiaj biopsy yog ua nrog rab koob nyias nyob rau hauv kev tswj ntawm lub colposcope.
- Loop, lossis xov tooj cua yoj, kuaj ntshav. Thaum nws sivib lub voj ntawm cov hlau yog superimposed rau ntawm qhov chaw yuav tsum tau kawm, thiab ib tug tam sim no tau dhau los ntawm nws, uas ua rau necrosis. Cov khoom tau los ntawm txoj kev no tsis puas thiab npaj rau kev tshawb fawb.
- Npaj biopsy yog ua nrog scalpel. Epithelial thiab connective cov ntaub so ntswg yog excised mus rau ib tug tob ntawm 3 mm. Tom qab qhov kev cuam tshuam zoo li no, kev siv cov sutures.
Hom kev kuaj ntshav ntawm ncauj tsev menyuam raug xaiv los ntawm tus kws kho mob suav nrog txhua qhov ntsuas.
Cervical biopsy technique
Qhov xav tau rau kev kuaj qhov ncauj qhov ntswg yuav tsum tau tham nrog tus neeg mob. Tus kws kho mob qhia tus poj niam txog qhov yuav tshwm sim thiab ua nws daim ntawv tso cai rau tus txheej txheem. Nws yog ua rau hnub 5-7 ntawm lub hli.
Ua ntej noj cov khoom, lub ncauj tsev menyuam tau ua tib zoo kho nrog tshuaj tua kab mob. Cov txheej txheem yog tswj los ntawm cov iav los yog colposcope. Yog tias yuav tsum tau muaj kev cuam tshuam loj, tom qab ntawd tshuaj loog.
Nyob ntawm seb hom kev kuaj mob biopsy, tag nrho thaj chaw pathological lossis ib feem ntawm nws yog excised. Tom qab tus txheej txheem, lub qhov txhab yog kho nrog ib tug hemostatic muaj pes tsawg leeg thiab, yog hais tias tsim nyog, sutures yog thov.
Cov txiaj ntsig ntawm qhov ncauj qhov ntswg qhia tau dab tsi?
Tom qab tshem tawm cov khoom siv lom neeg, nws raug xa mus rau kev kuaj mob histological thiab cytological, uas qhia txog cov kab mob hauv qab no:
- carcinoma;
- dysplasia;
- keeb kwm keeb kwm ntawm ntau yam keeb kwm.
Thaum tshawb fawb, nws yuavKev kuaj mob txaus ntshai tsis tau lees paub, tab sis kev hloov pauv me me hauv cov qauv ntawm tes raug kuaj pom uas tuaj yeem ua rau:
- qog nqaij hlav zoo;
- kab mob sib kis;
- hormonal ntshawv siab.
Cervical biopsy yog ib txoj kev kuaj mob tseem ceeb. Nws cov txiaj ntsig ua rau nws tuaj yeem kuaj xyuas qhov tseeb txog li 100%, uas pab txhawb kev xaiv kev kho mob rau tus kws kho mob.
Qhia rau cov neeg mob ua ntej kuaj ntshav
Ntau zaus, cov txheej txheem biopsy tau ua ncaj qha rau hauv tus kws kho mob lub chaw haujlwm, txawm tias nws yog tus kws kho mob mammologist, gynecologist lossis lwm tus kws tshaj lij. Muaj tsawg zaus, yuav tsum tau pw hauv tsev kho mob.
Ua ntej tus txheej txheem, tus kws kho mob yuav tsum xa cov ntaub ntawv hauv qab no rau tus neeg mob:
- Yuav tsum tsum tso tseg ib ntus noj tshuaj tiv thaiv kab mob.
- Siv tshuaj tiv thaiv kab mob.
- Tsis txhob noj ob peb hnub tom ntej ua ntej tus txheej txheem "Aspirin" thiab nws cov analogues.
- Yog pom tias tsis muaj kev ntxhov siab ntawm lub siab, tus kws kho mob pom zoo kom noj tshuaj sedatives.
- Ua ntej tus txheej txheem nws tus kheej, koj yuav tsum tsis txhob noj lossis haus.
- Yuav tsum ua raws li kev ua raws li asepsis thiab tshuaj tua kab mob.
Yog tus kws kho mob tham txog tag nrho cov teeb meem no nrog tus neeg mob ua ntej, ces, raws li txoj cai, cov txheej txheem ua haujlwm ib txwm.
Qhov tshwm sim tsis zoo ntawm kev kuaj ntshav
Peb saib seb qhov kev kuaj ntshav yog dab tsi, hom, lub ntsiab lus. Muaj ntau txoj kev kawm sib txawv, tab sis qhov no yog cov ntaub ntawv tshaj plaws, nwstso cai rau koj kom raug thiab sai ua kev kuaj mob. Tsis tshua muaj tshwm sim, muaj teeb meem tom qab biopsy. Yog tias tus txheej txheem ua los ntawm tus kws tshaj lij, ces txhua yam mus zoo thiab tsis muaj qhov tshwm sim, tab sis kev txhim kho ntawm cov xwm txheej tsis zoo hauv qab no yuav tsum tsis txhob txiav tawm.
Tej zaum yuav muaj ntshav los ntawm qhov chaw kuaj. Tom qab cov txheej txheem, lub qhov txhab yog ib txwm kho nrog cov tshuaj hemostatic thiab ntaub qhwv yog siv yog tias tsim nyog. Nws yog ib qho tseem ceeb kom tsis txhob los ntshav thaum lub ntsws bronchoscopy, txwv tsis pub nws tuaj yeem ua rau muaj qhov tshwm sim loj.
Nws paub meej tias kev kuaj ntshav ua rau lub cev puas tsuaj. Tab sis cov ntaub so ntswg rupture thiab hematoma tsim tshwm sim thaum cov txheej txheem yog ua los ntawm ib tug kws tshwj xeeb tsis txawj. Hauv cov xwm txheej no, nws yog ib qho tseem ceeb los tiv thaiv kev kis kab mob.
Tej zaum yuav kis tus kab mob ntawm qhov chaw sim. Qhov no tshwm sim yog tias cov cai ntawm asepsis thiab antisepsis tsis ua raws.
Septic shock tuaj yeem ua rau muaj kev sib kis ntawm cov kab mob.
Nws tuaj yeem zam tau txhua yam teeb meem, txawm tias siv hom kev kuaj ntshav li cas, yog tias koj siv cov cuab yeej siv niaj hnub no thiab ua raws li cov cai ntawm kev huv. Qhov no yuav tiv thaiv kev kis kab mob los ntawm kev nkag mus rau hauv lub qhov txhab thiab cov tsos mob tshwm sim.
Yog li, peb tau saib cov hom kev kuaj mob kom ntxaws. Pathoanatomy yog ib txoj kev tshawb fawb uas kawm txog cov txheej txheem pathological hauv cov ntaub so ntswg. Yog li kev kuaj ntshav biopsy yog ib qho ntawm nws txoj kev, tab sis kuv yuav tsum hais tias nws yog cov ntaub ntawv tshaj plaws thiab raug. Qhov tseem ceeb tshaj plaws yog cov neeg mob mus ntsib kws kho mob raws sij hawm, ces koj tsis tuaj yeem tso txoj cai xwbkev kuaj mob, tab sis kuj tsis lig nrog kev kho mob.
Saib xyuas koj tus kheej thiab saib xyuas koj txoj kev noj qab haus huv.
