Xalka Qallafsan ee Endoscope-ka Caafimaadka ee Fargelinta Nidaamka Neefsashada

1. Horumarka kacaanka ee tignoolajiyada ogaanshaha

1. Bronchoscopy Navigation Electromagnetic (ENB)

Burbursan: Wax ka qabashada caqabada ogaanshaha ee qanjidhada sambabada ee sambabada (≤ 2cm), heerka cad-cad ee ka-soo-baxa ayaa ka kordhay 30% bronchoscopy-dhaqameedka oo gaadhay in ka badan 80%.

Farsamada Muhiimka ah:

Dib-u-dhiska saddex-geesoodka ah ee CT+ meelaynta korantada: sida Veran Medical's SPiN Thoracic Navigation System, kaas oo la socon kara booska qalabka wakhtiga dhabta ah (oo leh qalad ka yar 1mm).

Magdhowga dhaqdhaqaaqa neefsiga: SuperDimension ™ Nidaamku wuxuu baabi'iyaa saameynta barakaca neefsashada iyadoo loo marayo meelaynta 4D.

Xogta caafimaad:

Saxnaanta ogaanshaha qanjidhada sambabada ee 8-10mm waa 85% (daraasadda Chester 2023).

Isku darka qiimaynta sayloojiyada degdega ah ee goobta (ROSE) waxay hoos u dhigi kartaa wakhtiga hawlgalka 40%.

2. Robot-ka caawiya bronchoscopy

Nidaamka matalayaasha:

Platform Monarch (Auris Health): Gacanta Robotka dabacsan waxay gaartaa 360 ° isteerinka si ay u gaarto heerka 8aad ilaa 9aad ee bronki.

Ion (Dareen): 2.9mm tignoolajiyada dareenka qaab-catheter ultra-fine, oo leh saxnaanta dalool ee 1.5mm.

Faa'iidooyinka

Heerka guusha ee helitaanka qanjidhada qanjidhada sare ee sambabada ayaa la kordhiyay ilaa 92% (marka la barbar dhigo 50% kaliya oo leh microscopy dhaqameed).

Iska yaree dhibaatooyinka sida pneumothorax (heerka dhacdooyinka <2%).

3. Confocal Laser Endoscopy (pCLE)

Farsamada iftiiminta: Cellvizio ® Baadhitaanka 100 μm wuxuu soo bandhigi karaa qaab-dhismeedka alveolar wakhtiga dhabta ah (xalka 3.5 μm).

Xaaladaha codsiga:

Kala duwanaansho degdeg ah oo u dhexeeya kansarka sambabada ee goobta iyo adenomatous hyperplasia (AAH).

In vivo qiimaynta cudurada sambabada ee interstitial sambabada (ILD) si loo yareeyo baahida qaliinka sambabada.

2. Xalalka qallafsan ee goobta daaweynta

1. Ka saarida kansarka sanbabada Endoscopic

Ka-baxa Microwave (MWA):

Iyadoo lagu hagayo navigation elektromagnetic, ablation bronki wuxuu gaadhay heerka kontoroolka maxalliga ah ee 88% (≤ 3cm buro, JTO 2022)

Marka la barbardhigo daaweynta shucaaca: ma jirto khatar shucaac oof-wareen ah waxayna aad ugu habboon tahay kansarka sanbabada dhexe.

Cyoablation:

Nidaamka Rejuvenair ee CSA Medical ee Maraykanka waxaa loo isticmaalaa soo celinta la qaboojiyey ee xannibaadda marin-haweedka dhexe.

2. Bronchoplasty (BT)

Burbursan: daawaynta aaladda ee neefta refractory, ee bar-tilmaameedsanaysa baabiinta muruqa siman.

Nidaamka Alair (Sayniska Boston):

Saddex qaliin ayaa 82% hoos u dhigay weerarada neefta ee ba'an (AIR3 Trial).

Tilmaamaha la cusboonaysiiyay ee 2023 ayaa lagula talinayaa bukaannada darajada 5 ee GINA.

3. Kacaanka stent hawo-mareenka

Daabacaadda 3D ee gaarka loo leeyahay:

Iyada oo ku saleysan habaynta xogta CT, xalli stenosis marin-haweedka adag (sida stenosis tuberculosis post).

Horumarka walxaha: stent magnesium alloy biodegradable (marxalad tijaabo ah, oo si buuxda u nuugtay 6 bilood gudahood).

Daawadu waxay baabi'isaa stent:

Paclitaxel stent ee dahaarka leh ayaa joojiya dib u kobcinta burada (waxay yaraynaysaa heerka restenosis 60%).

3. Codsiga xaaladaha adag iyo xaaladaha degdega ah

1. ECMO oo lagu daray bronchoscopy

Horumarka tignoolajiyada:

Oo ay taageerto ECMO la qaadan karo (sida nidaamka Wadnaha), bronchoalveolar lavage (BAL) ayaa loo sameeyaa bukaanka ARDS.

Xaqiijinta badbaadada shaqada ee bukaanada leh tusaha ogsijiinta <100mmHg (ICM 2023).

Qiimaha bukaan-socod: cadee cudur-sidaha sambabada daran oo hagaaji habka antibiyootiga.

2. Faragelinta degdega ah ee hemoptysis weyn

Tignoolajiyada cusub ee hemostatic:

Argon balasmaha xinjirowga (APC): hemostasis aan la xiriirin oo qoto dheer la xakameyn karo (1-3mm).

Hemostasis baraf qaboojinta: -40 ℃ Xiritaanka heerkulka hoose ee xididdada dhiigga, heerka soo noqnoqda <10%.

4. Jihada sahaminta xuduudka

1. Sawir-qaadista molecular endoscopy:

Calaamadaynta fluorescent ee unugyada difaaca jirka ee PD-L1 (sida IMB-134) si loo muujiyo waqtiga-dhabta ah ee difaaca difaaca ee microevironment ee kansarka sanbabada.

2. Hagidda waqtiga-dhabta ah ee AI:

Nidaamka Johnson&Johnson C-SATS wuxuu si toos ah u qorsheeyaa dariiqa ugu wanaagsan ee boronkiitada, isagoo hoos u dhigaya wakhtiga hawlgalka 30%.

3. Kooxda yar ee robot:

Microrobot-yada magnetic MIT waxay u qaadi karaan daawooyinka bartilmaameedyada alveolar si loo sii daayo.

Shaxda Isbarbardhigga Saamaynta Kiliinikada

Talooyinka fulinta

Isbitaalada aasaasiga ah: oo lagu qalabeeyay ultrasound bronchoscopy (EBUS) oo loogu talagalay habaynta dhexdhexaadinta.

Cusbitaalka heerka saddexaad: Samee ENB+ xarunta wax ka qabadka robot si loo sameeyo ogaanshaha isku dhafan iyo daaweynta kansarka sanbabada.

Hay'adda cilmi-baarista: Diirada saarista sawirka molecular iyo horumarinta qolofka noole.

Farsamooyinkan ayaa dib u qaabaynaya ku dhaqanka kiliinikada ee faragelinta neefsashada iyada oo loo marayo saddex horumar oo waaweyn: dhalmo sax ah, ogaanshaha caqli-gal ah, iyo daawaynta ugu yar ee aadka u yar. Sanadaha 5 ee soo socda, oo leh horumarinta AI iyo nanotechnology, ogaanshaha iyo daaweynta qanjidhada sambabada ayaa laga yaabaa inay gaaraan "maareynta xiran-loop-ka-soo-baxa".