Njira Yosokoneza Ya Medical Endoscope Mu Respiratory System Intervention

1, Kusintha kosinthika muukadaulo wozindikira matenda

1. Electromagnetic Navigation Bronchoscopy (ENB)

Zosokoneza: Pothana ndi vuto la matenda a zotumphukira za m'mapapo (≤ 2cm), kuchuluka kwa biopsy positivity kwakwera kuchoka pa 30% mu bronchoscopy yachikhalidwe kufika pa 80%.

Core Technology:

CT yomanganso mbali zitatu + yamagetsi yamagetsi: monga Veran Medical's SPiN Thoracic Navigation System, yomwe imatha kutsata zida munthawi yeniyeni (ndi cholakwika chochepera 1mm).

Kulipira koyenda mopumira: SuperDimension ™ Dongosolo limachotsa kukhudzidwa kwa kupuma kwapang'onopang'ono kudzera mu 4D malo.

Zambiri zachipatala:

Kulondola kwa matenda a 8-10mm pulmonary nodules ndi 85% (kafukufuku wa Chester 2023).

Kuphatikizika kofulumira kwa cytological assessment (ROSE) kumatha kuchepetsa nthawi yogwira ntchito ndi 40%.

2. Roboti yothandizira bronchoscopy

Dongosolo loyimilira:

Monarch Platform (Auris Health): Dzanja losinthika la robotic limakwaniritsa chiwongolero cha 360 ° kuti lifike pa 8th mpaka 9th level bronchi.

Ion (Mwachidziwitso): 2.9mm ultra-fine catheter+shape sensing teknoloji, yokhala ndi kulondola kwa 1.5mm.

Ubwino:

Kupambana kopeza tinatake tozungulira kuchokera kumtunda kwa mapapu kwawonjezeka kufika pa 92% (poyerekeza ndi 50% yokha ndi ma microscopy achikhalidwe).

Chepetsani zovuta monga pneumothorax (chiwerengero cha zochitika <2%).

3. Confocal Laser Endoscopy (pCLE)

Zowunikira paukadaulo: Cellvizio ® Probe ya 100 μ m imatha kuwonetsa mawonekedwe a alveolar mu nthawi yeniyeni (kutsimikiza kwa 3.5 μ m).

Zochitika zantchito:

Kusiyanitsa komweko pakati pa khansa ya m'mapapo ya in situ ndi atypical adenomatous hyperplasia (AAH).

Mu vivo pathological evaluation of interstitial lung disease (ILD) kuti muchepetse kufunika kopanga opaleshoni yam'mapapo.

2. Zothetsera zosokoneza pankhani ya chithandizo

1. Kuchotsa khansa ya m'mapapo

Kutulutsa kwa Microwave (MWA):

Motsogozedwa ndi ma electromagnetic navigation, bronchial ablation idakwanitsa kuwongolera kwanuko 88% (≤ 3cm chotupa, JTO 2022).

Poyerekeza ndi radiotherapy: palibe chiwopsezo cha radiation pneumonitis ndipo ndiyoyenera kwambiri ku khansa yapakati yamapapo.

Cryoablation:

Dongosolo la Rejuvenair lochokera ku CSA Medical ku United States limagwiritsidwa ntchito pokonzanso zotsekereza zapakati panjira ya mpweya.

2. Bronchoplasty (BT)

Zosokoneza: Kuchiza kwa chipangizo cha mphumu ya refractory, kulunjika kutulutsa minofu yosalala.

Alair system (Boston Scientific):

Maopaleshoni atatu adachepetsa kudwala mphumu ndi 82% (AIR3 Trial).

Maupangiri osinthidwa a 2023 akulimbikitsidwa kwa odwala a GINA giredi 5.

3. Airway stent Revolution

3D kusindikiza makonda bulaketi:

Kutengera makonda a data a CT, thetsani zovuta za airway stenosis (monga postTB stenosis).

Kupambana kwazinthu: Biodegradable magnesium alloy stent (gawo loyesera, lokhazikika mkati mwa miyezi 6).

Kuchepetsa stent:

Paclitaxel yokutidwa ndi stents amalepheretsa kukula kwa chotupa (kuchepetsa restenosis ndi 60%).

3. Kugwiritsa ntchito pazovuta komanso zadzidzidzi

1. ECMO pamodzi ndi bronchoscopy

Kupambana kwaukadaulo:

Mothandizidwa ndi ECMO yonyamula (monga Cardiohelp system), bronchoalveolar lavage (BAL) imachitidwa kwa odwala ARDS.

Kutsimikizika kwa chitetezo chogwira ntchito kwa odwala omwe ali ndi oxygenation index <100mmHg (ICM 2023).

Thandizo lachipatala: Fotokozani tizilombo toyambitsa matenda a chibayo chachikulu ndikusintha ndondomeko ya maantibayotiki.

2. Kuthandizira mwadzidzidzi kwa hemoptysis yaikulu

Tekinoloje yatsopano ya hemostatic:

Argon plasma coagulation (APC): hemostasis yosalumikizana ndi kuya kowongolera (1-3mm).

Kuzizira kafukufuku hemostasis: -40 ℃ otsika kutentha kutseka kwa magazi ziwiya, zisadzachitikenso <10%.

4. Njira yowunikira kutsogolo

1. Kujambula kwa mamolekyulu a endoscopy:

Kulemba kwa fluorescent kwa ma antibodies a PD-L1 (monga IMB-134) kuti awonetse zenizeni zenizeni zachilengedwe za khansa ya m'mapapo.

2. AI pa nthawi yeniyeni:

Makina a Johnson&Johnson C-SATS amangokonzekera njira yabwino kwambiri ya bronchial, kuchepetsa nthawi ya opaleshoni ndi 30%.

3. Gulu la maloboti ang'onoang'ono:

Ma MIT maginito ma microrobots amatha kunyamula mankhwala kupita ku alveolar chandamale kuti amasulidwe.

Tchalitchi Chofananitsa Chotsatira Chachipatala

Malangizo okonzekera njira

Zipatala zoyambira: zokhala ndi ultrasound bronchoscopy (EBUS) ya mediastinal staging.

Chipatala cha Third class: Khazikitsani ENB+robot intervention Center kuti muzindikire komanso kuchiza khansa ya m'mapapo.

Bungwe lofufuza: Kuyang'ana pa kujambula kwa ma molekyulu ndi chitukuko cha scaffold cha biodegradable.

Ukadaulo uwu ukusinthanso kachitidwe kachipatala kothandizira kupuma kudzera m'njira zitatu zazikulu: kubereka molondola, kuzindikira mwanzeru, ndi chithandizo chamankhwala chochepa kwambiri. M'zaka zotsatira za 5, ndi chitukuko cha AI ndi nanotechnology, matenda ndi chithandizo cha pulmonary nodules akhoza kukwaniritsa "non invasive closed-loop management".