Umuti Uhungabanya Ubuvuzi Endoskopi Mubikorwa byubuhumekero

1 break Impinduka zimpinduramatwara mubuhanga bwo gusuzuma

1. Electromagnetic Navigation Bronchoscopy (ENB)

Guhungabanya: Gukemura ikibazo cyo gusuzuma indwara ya perepheri ya pompe pompe (≤ 2cm), igipimo cyiza cya biopsy cyavuye kuri 30% muri bronchoskopi gakondo kigera kuri 80%.

Ikoranabuhanga ryibanze:

CT ibyiciro bitatu byo kwiyubaka + kumwanya wa electromagnetic: nka Veran Medical's SPiN Thoracic Navigation Sisitemu, ishobora gukurikirana umwanya wibikoresho mugihe nyacyo (hamwe nikosa ritarenze 1mm).

Indishyi zubuhumekero: SuperDimension ™ Sisitemu ikuraho ingaruka zo kwimuka kwubuhumekero binyuze muri 4D.

Amakuru y’ubuvuzi:

Kwipimisha neza kuri nodules 8-10mm ni 85% (ubushakashatsi bwa Chester 2023).

Gukomatanya byihuse kurubuga rwa cytologiya (ROSE) birashobora kugabanya igihe cyo gukora 40%.

2. Robo yafashaga bronchoscopy

Sisitemu yo guhagararira:

Ihuriro rya Monarch (Ubuzima bwa Auris): Ukuboko kwa robo yoroheje igera kuri 360 ° kuyobora kugirango igere kuri bronchi yo ku rwego rwa 8 kugeza ku ya 9.

Ion (Intuitive): 2.9mm ultra-nziza ya catheter + tekinoroji yo kwiyumvisha imiterere, hamwe no gutobora neza kwa 1.5mm.

Ibyiza:

Intsinzi yo kubona nodules kuva kumurongo wo hejuru wibihaha yongerewe kugera kuri 92% (ugereranije na 50% gusa na microscopi gakondo).

Mugabanye ingorane nka pneumothorax (igipimo cyanduye <2%).

3. Laser Endoscopy ya Confocal (pCLE)

Ibikoresho bya tekinike: Cellvizio ® 100 μ m probe irashobora kwerekana imiterere ya alveolar mugihe nyacyo (imiterere ya 3.5 μ m).

Ibisabwa:

Gutandukanya ako kanya hagati ya kanseri yibihaha na hyperplasia idasanzwe (AAH).

Muri vivo patologue isuzuma indwara yibihaha (ILD) kugirango igabanye gukenera biopsy yo kubaga ibihaha.

2 solutions Ibisubizo bidahwitse murwego rwo kuvura

1. Gukuraho kanseri y'ibihaha ya endoskopi

Gukuraho Microwave (MWA):

Kuyoborwa na electromagnetic nogukoresha, gukuraho bronchial byageze ku gipimo cya 88% (≤ 3cm ikibyimba, JTO 2022 ）。

Ugereranije na radiotherapi: nta ngaruka zo kwandura pneumonite kandi birakwiriye kanseri y'ibihaha yo hagati.

Cryoablation:

Sisitemu ya Rejuvenair iva mubuvuzi bwa CSA muri Reta zunzubumwe zamerika ikoreshwa muguhindura reanalisation yo guhagarika inzira yo guhumeka hagati.

2. Bronchoplasty (BT)

Guhungabanya: Ubuvuzi bwibikoresho bya asima yangiritse, bigamije gukuraho imitsi neza.

Sisitemu ya Alair (Boston Scientific):

Kubagwa gatatu byagabanije indwara ya asima ikabije 82% (Ikigeragezo cya AIR3).

Amabwiriza yavuguruwe 2023 arasabwa abarwayi ba GINA bo mucyiciro cya 5.

3. Airway stent impinduramatwara

Icapiro rya 3D ryihariye:

Ukurikije amakuru ya CT yihariye, ukemure inzira igoye yo guhumeka neza (nka post igituntu cyanduye).

Iterambere ryibikoresho: Biodegradable magnesium alloy stent (icyiciro cyubushakashatsi, cyinjijwe neza mumezi 6).

Kunywa ibiyobyabwenge:

Paclitaxel yometse kuri stent ibuza kongera kubyimba (kugabanya igipimo cya restenosis 60%).

3 、 Gusaba mubihe bikomeye kandi byihutirwa

1. ECMO ihujwe na bronchoscopy

Iterambere ry'ikoranabuhanga:

Gushyigikirwa na ECMO igendanwa (nka Cardiohelp sisitemu), lavage ya bronchoalveolar (BAL) ikorerwa abarwayi ba ARDS.

Kugenzura umutekano wibikorwa kubarwayi bafite ogisijeni <100mmHg (ICM 2023).

Agaciro ka Clinical: Sobanura nyirabayazana w'umusonga ukabije kandi uhindure gahunda ya antibiotique.

2. Gutabara byihutirwa kuri hemoptysis nini

Ubuhanga bushya bwa hemostatike:

Argon plasma coagulation (APC): kudahuza hemostasis hamwe nubujyakuzimu bugenzurwa (1-3mm).

Gukonjesha probe hemostasis: -40 clos ubushyuhe buke bwo gufunga imiyoboro yamaraso, igipimo cyo kugaruka <10%.

4 direction Icyerekezo cyubushakashatsi bwimbibi

1. Amashusho yerekana amashusho ya endoskopi:

Fluorescent labels ya PD-L1 antibodies (nka IMB-134) kugirango yerekane igihe nyacyo mikorobe ikingira kanseri yibihaha.

2. Kugendana na AI igihe nyacyo:

Sisitemu ya Johnson & Johnson C-SATS ihita itegura inzira nziza ya bronchial, igabanya igihe cyo gukora 30%.

3. Micro robot cluster:

MIT ya magnetiki ya MIT irashobora gutwara ibiyobyabwenge kuri alveolar intego yo kurekura.

Imbonerahamwe yo Kugereranya Imbonerahamwe

Ibyifuzo byo gushyira mubikorwa

Ibitaro byibanze: bifite ultrasound bronchoscopy (EBUS) yo kubika mediastinal.

Ibitaro byo mucyiciro cya gatatu: Gushiraho ikigo cyita kuri robot ENB + kugirango gikore isuzumabumenyi hamwe no kuvura kanseri y'ibihaha.

Ikigo cyubushakashatsi: Kwibanda kumashusho ya molekuline no kwiteza imbere biodegradable.

Izi tekinoroji zirimo kuvugurura imikorere yubuvuzi bwubuhumekero binyuze mubintu bitatu byingenzi: kubyara neza, gusuzuma ubwenge, no kuvura ultra minimally. Mu myaka 5 iri imbere, hamwe niterambere rya AI na nanotehnologiya, gusuzuma no kuvura indwara zifata ibihaha bishobora kugera ku "micungire idahwitse ifunga imiyoborere".