Esimeni esiguqukayo njalo sokuxilongwa kwezokwelapha,izinaliti ze-biopsyzidlala indima ebalulekile ekutholeni amasampula ezicubu ukuze kuhlolwe ukugula okunembile, futhi ukukhetha kwawo kuhlobene ngokuqondile nokunemba kwe-biopsy, ukuphepha kanye nolwazi lwesiguli. Okulandelayo ukuhlaziya izinqubo ze-biopsy,izinhlobo zezinaliti ze-biopsy, izilinganiso zezinaliti ezimaphakathi kuya kwe-fine, kanye nezici ezibalulekile zokukhetha ukuze kunikezwe isiqondiso esihlelekile sokusebenza komtholampilo.
1. Ukuqonda izinqubo ze-biopsy
Umgomo oyinhloko wenqubo ye-biopsy ukuthola isampula yethishu yekhwalithi ephezulu ukuze kucaciswe uhlobo lwesilonda noma ukuthuthukisa uhlelo lokwelapha. Isidingo senaliti ye-biopsy sihluka kakhulu phakathi kwezimo ze-biopsy:
- Ukuxilongwa kwesimila: ivolumu yethishu eyanele iyadingeka ukusekela isigaba se-pathologic kanye nokuhlolwa kofuzo (isb, i-EGFR, ukuguqulwa kwe-ALK).
- Izifo ezivuthayo: i-cytology iyadingeka ukuze kucaciswe uhlobo lwe-pathogen noma i-immune cell cell.
- Ukuhlolwa kwangaphambi kokuhlinzwa: ukutholwa kwesampula okusheshayo kuyadingeka ukuze kuqondiswe izinqubo zokuhlinzwa (isb, ukuhlonzwa koquqaba lwamabele olubi noma olubi).
2. Izinhlobo zeizinaliti ze-biopsykanye nezicelo zomtholampilo
- Isimiso: Ukuthola ucu lwesampula lwethishu ngokusikwa ngomshini.
- Izinzuzo:
Isampula eliphelele, elilungele isimila esiqinile (isb, ibele, i-prostate) kanye ne-bone tissue biopsy.
Usayizi wesampula wanele ukusekela i-immunohistochemistry kanye nokuhlolwa kwamangqamuzana.
- Imikhawulo: ukuhlukumezeka okukhulu, kudingeka ukubamba ngokuqinile izinkomba.
(2) I-Fine Aspiration Biopsy Needle
- Isimiso: Ukusetshenziswa kwe-negative pressure suction ukuze uthole ukumiswa kweseli.
- Izinzuzo:
Ukuhlukumezeka okuncane, kufanelekile kuma-lymph nodes angaphandle, izilonda zegilo namaphaphu.
Kulula ukwenza, ingathola ngokushesha ukumiswa kwamaseli.
Kulula ukwenza, ivumela ukuxilongwa okusheshayo kwe-cytological.
- Imikhawulo: ukuhlukaniswa kwesampula, ayikwazi ukuhlangabezana nezidingo zokuhlolwa kwe-histology.
(3) Inalithi Ye-Biopsy Esizwa Ngevacuum (VAB)
- Isimiso: Ihlanganisa ukusika kwemishini kanye nokumunca ingcindezi engalungile ukuze kuthuthukiswe ukusebenza kahle kwamasampula.
- Izinzuzo:
Amasampula amaningi angatholakala ngokubhoboza okukodwa, afanele i-breast microcalcified foci.
Yehlisa ingcuphe yokuphindaphinda ukubhoboza futhi ithuthukise ukubekezelelana kwesiguli.
(4) Ukusika Inalithi Ye-Biopsy
- Isimiso: Izicubu zisikwa ithiphu eligobile noma i-blade ejikelezayo.
- Izinhlobo:
Inalithi Ecijile: Isib. Inaliti ye-Tru-Cut Biopsy, yezicubu ezithambile.
Inalithi Yokubhoboza Indandatho: isb. Inalithi Ye-Bone Marrow Biopsy, yezicubu zethambo.
3. I-biopsy yenaliti eyinhloko vs isifiso senaliti esihle
| Inkomba | I-Core inaliti biopsy | I-aspiration yenaliti enhle |
| Izinhlobo Zesampula | Isampula yezicubu ze-strip | Ukumiswa kweseli |
| Ukunemba kokuxilonga | Okuphezulu (i-histology) | Okumaphakathi (cytology) |
| Izinga lokuhlukumezeka | Okukhudlwana | Encane |
| Isikhathi sokusebenza | Mude | Kafushane |
| Izimo | Izimila eziqinile, izicubu zamathambo | Izilonda ezingaphezulu, ama-lymph nodes |
4. Izici eziyinhloko okufanele zicatshangelwe lapho ukhetha izinaliti ezifanele ze-biopsy
(1) Indawo okuhloswe ngayo i-Biopsy
- Izitho zangaphandle (isb., indlala yegilo, ibele): izinaliti ezicolekile noma izinaliti eziwumgogodla zikhethwa ukulinganisa ukuhlukumezeka kanye nezidingo zokuxilonga.
- Izitho ezijulile (isb, isibindi, izinso): izinaliti ezinde ze-biopsy zikhethwa ukuze kuqinisekiswe ukujula kokungena.
- Izicubu zethambo: izinaliti zokubhoboza iringi (isb. izinaliti ze-biopsy yomnkantsha) kufanele zisetshenziswe ukugwema ukuhlukana kwezicubu.
(2) Izici eziqondene nesiguli
- Ubudala kanye nomthethosisekelo: izingane noma iziguli ezibuthakathaka kufanele zikhethe inaliti encane (isb, 20G) ukunciphisa izinkinga.
- Umsebenzi we-coagulation: iziguli ezinokuphazamiseka kwe-coagulation zidinga ukugwema izinaliti ezimahhadla (isb, 16G) ukuze kuncishiswe ingozi yokopha.
- Isimo sengqondo: Iziguli ezikhathazekile zingakhetha izinaliti ze-vacuum-assisted biopsy ukuze zifinyeze isikhathi sokusebenza.
(3) Ukuminyana kwezicubu nendawo
- Izicubu eziminyene (isb, i-prostate, isibindi): khetha inaliti ye-biopsy enamandla okusika aqinile (isb., inaliti ecijile engu-18G).
- Imithambo yegazi/imizwa engumakhelwane: Ukuhlinzwa okwenziwa nge-ultrasound/CT-guided kuyadingeka ukuze ukhethe inaliti ye-biopsy ebhalwe ngokuthuthukayo.
(4) Ubukhulu benaliti nobude
- Ukukhetha imininingwane:
Inaliti enhle (20-22G): ye-cytology noma izilonda ezingaphezulu.
Inaliti eqinile (14-18G): ilungele ukuhlolwa kwe-histological noma izilonda ezijulile.
- Ukukhetha ubude: kunqunywa ukujula kokubhoboza (isb. I-biopsy yamaphaphu idinga ukuba ≥15cm).
(5) Idizayini yethiphu yenaliti
- Ithiphu yenaliti egobile: ilungele izicubu ezithambile ukunciphisa ukumelana.
- Ithiphu enezinhlangothi ezintathu: esebenza esicutshini samathambo, ukuthuthukisa ukungena.
- Ukumaka: Izinaliti ze-biopsy eziqondiswa yi-MRI kufanele zibhalwe nge-titanium alloy.
(6) Ukuhambisana nezindlela zokucabanga
- Isiqondiso se-Ultrasound: Izinaliti ze-Biopsy ezinamasongo akhulayo zidinga ukukhethwa.
- Isiqondiso se-CT/MRI: izinto ezingezona uzibuthe noma eziphansi ze-artifact (isb, i-titanium alloy) kufanele kukhethwe.
(7) Indlela yokukhipha isampula
- Ukusika ngomshini: kusebenza kumathumba aqinile anesampula ephelele.
- Ukumunca ingcindezi engalungile: ilungele ukuhlolwa kwe-cytological, kulula ukuyisebenzisa.
- Isizwa nge-vacuum: isebenza kumasampula amasayithi amaningi, ithuthukisa ukusebenza kahle.
(8) Ukunethezeka nokuphepha kwesiguli
- Ukulawula izinhlungu: inaliti ecolekile ayihlukumezeki kakhulu futhi ibekezeleleka kakhulu ezigulini.
- Ukuvimbela izinkinga: gwema ukubhoboza ngokuphindaphindiwe ngenaliti ewugqinsi, nciphisa ingozi ye-pneumothorax nokopha.
(9) Izindleko nokufinyeleleka
- Ukusebenza kahle kwezindleko: izinaliti ze-biopsy ezizenzakalelayo (isb., i-TSK) zibiza kakhulu, kodwa zinezinga eliphezulu lempumelelo yamasampula.
- Ukuhlinzekwa komshwalense wezokwelapha: isidingo sokukhetha imikhiqizo engaphakathi kwesilinganiso sokubuyisela ngokuvumelana nezinqubomgomo zendawo.
5. Isiphetho
Ukukhethwa kweizinaliti ze-biopsykudinga ukuhlolwa okuphelele kohlobo lwesilonda, isimo sesiguli, izimo zobuchwepheshe kanye nezici zezomnotho. Emsebenzini womtholampilo, izimiso ezilandelayo kufanele zilandelwe:
1. ukufanisa okunembile: khetha uhlobo lwenaliti ngokuya ngendawo okuqondiswe kuyo i-biopsy (isb. inaliti egobile yebele engu-14G, inaliti engu-20G yegilo).
2. Beka phambili ukuphepha: gwema izinaliti eziwugqinsi ezigulini ezinokuphazamiseka kwe-coagulation, futhi usebenze ngaphansi kokuqondiswa kwesithombe ngezilonda eziseduze zemithambo.
3. Ukusebenza kahle nokunethezeka: izinaliti ze-biopsy ezisizwa nge-vacuum zingathuthukisa ukusebenza kahle, futhi izinaliti ezinhle zinganciphisa ubuhlungu besiguli.
Ngokukhethwa kwesayensi kwezinaliti ze-biopsy, ukunemba kokuxilonga kungathuthukiswa kakhulu, ingcuphe yezinkinga ingancishiswa, futhi ekugcineni kutholakale umuthi wokunemba ngamunye.
Isikhathi sokuthumela: May-19-2025