Isisombululo esiphazamisayo se-Endoscope yezoNyango kuNgenelelo lweNkqubo yokuphefumla

I-1, inguqu yempumelelo kwitekhnoloji yokuxilonga

1. I-Electromagnetic Navigation Bronchoscopy (ENB)

Ukuphazamisa: Ukujongana nomngeni wokuxilonga we-peripheral pulmonary nodules (≤ 2cm), izinga le-biopsy positivity liye landa ukusuka kwi-30% kwi-bronchoscopy yendabuko ukuya kwi-80%.

Itekhnoloji engundoqo:

I-CT yolwakhiwo olunamacala amathathu+ubume bombane: njengeVeran Medical's SPiN Thoracic Navigation System, enokulandelela indawo yezixhobo ngexesha lokwenyani (ngempazamo engaphantsi kwe-1mm).

Imbuyekezo yentshukumo yokuphefumla: I-SuperDimension ™ Inkqubo iphelisa impembelelo yokufuduka kokuphefumula ngokubeka i-4D.

Idatha yonyango:

Ukuchaneka kwe-diagnostic ye-8-10mm ye-pulmonary nodules yi-85% (uphando lwe-Chester 2023).

Uvavanyo oludityanisiweyo olukhawulezayo kwisiza lwe-cytological (ROSE) lunokunciphisa ixesha lokusebenza ngama-40%.

2. Irobhothi encediswa yibronchoscopy

Inkqubo yomelo:

I-Monarch Platform (i-Auris Health): Ingalo yerobhothi eguquguqukayo ifezekisa i-360 ° yokulawula ukufikelela kwi-8th ukuya kwi-9th level bronchi.

Ion (Intuitive): 2.9mm ultra-fine catheter+shape sensing technology, kunye nokuchaneka kwe-puncture ye-1.5mm.

Izinto eziluncedo:

Izinga lempumelelo yokufumana amaqhuqhuva kwilobe engaphezulu yomphunga liye lanyuka laya kutsho kuma-92% (xa kuthelekiswa ne-50% kuphela ye-microscopy yesintu).

Ukunciphisa iingxaki ezifana ne-pneumothorax (izinga leziganeko <2%).

3. I-Confocal Laser Endoscopy (pCLE)

Ubume bobugcisa: I-Celvizio ® I-100 μ m probe ingabonisa isakhiwo se-alveolar ngexesha langempela (isisombululo se-3.5 μ m).

Iimeko zesicelo:

Umahluko okhawulezileyo phakathi komhlaza wemiphunga we-situ kunye ne-atypical adenomatous hyperplasia (AAH).

Kwi-vivo pathological evaluation ye-interstitial lung disease (ILD) ukunciphisa imfuno yotyando lwe-lung biopsy.

2, Izisombululo eziphazamisayo kwintsimi yonyango

1. Ukukhutshwa komhlaza wemiphunga kwi-Endoscopic

Ukukhutshwa kweMicrowave (MWA):

Ikhokelwa kukuhamba nge-electromagnetic navigation, i-bronchial ablation iphumelele ukulawulwa kwendawo ye-88% (≤ 3cm tumor, JTO 2022)

Xa kuthelekiswa neradiotherapy: akukho mngcipheko we-radiation pneumonitis kwaye ifaneleke ngakumbi kumhlaza wemiphunga osembindini.

I-Cryoablation:

Inkqubo ye-Rejuvenair evela kwi-CSA Medical e-United States isetyenziselwa ukuhlaziya umkhenkce wokuvalwa kwendlela yomoya.

2. I-Bronchoplasty (BT)

Ukuphazamisa: Unyango lwesixhobo se-asthma ephikisayo, ejolise ekuphuhlisweni kwemisipha egudileyo.

Inkqubo yeAlair (iBoston Science):

Utyando oluthathu lwehlise uhlaselo lombefu oluqatha ngama-82% (AIR3 Trial).

Izikhokelo ezihlaziyiweyo ze-2023 zinconywa kwizigulane ze-GINA zebanga lesi-5.

3. I-Airway stent revolution

Isibiyeli soshicilelo olulolwakho lwe-3D:

Ngokusekelwe kwi-CT data customization, sombulula i-stenosis ye-airway eyinkimbinkimbi (njenge-post tuberculosis stenosis).

Impumelelo yezinto: I-Biodegradable magnesium alloy stent (inqanaba lovavanyo, lifunxe ngokupheleleyo kwiinyanga ezi-6).

I-stent yokunciphisa iziyobisi:

I-Paclitaxel coated stents inqanda ukukhula kwakhona kwethumba (ukunciphisa izinga lokuphumla nge-60%).

3, Isicelo kwiimeko ezinzima kunye nezingxamisekileyo

1. I-ECMO idibene ne-bronchoscopy

Impumelelo yetekhnoloji:

Ukuxhaswa yi-ECMO ephathekayo (efana ne-Cardiohelp system), i-bronchoalveolar lavage (BAL) yenziwa kwizigulane ze-ARDS.

Ukuqinisekiswa kokhuseleko lokusebenza kwizigulane ezine-oxygenation index<100mmHg (ICM 2023).

Ixabiso leklinikhi: Cacisa i-pathogen ye-pneumonia enzima kwaye ulungelelanise i-antibiotic regimen.

2. Ungenelelo olungxamisekileyo kwi-hemoptysis enkulu

Itekhnoloji entsha ye-hemostatic:

Argon plasma coagulation (APC): non-contact hemostasis nobunzulu obulawulekayo (1-3mm).

Umkhenkce probe hemostasis: -40 ℃ ubushushu obuphantsi ukuvalwa imithambo ukopha, izinga lokuphinda<10%.

4. Umda wokuhlola umkhombandlela

1. I-endoscopy yomfanekiso wemolekyuli:

Ukuleyibhile okuFluorescent kwe-PD-L1 antibodies (ezifana ne-IMB-134) ukubonisa i-immune microenvironment yexesha lokwenyani yomhlaza wemiphunga.

2. I-AI yokukhangela ngexesha lokwenyani:

Inkqubo kaJohnson & Johnson C-SATS icwangcisa ngokuzenzekelayo indlela efanelekileyo ye-bronchial, ukunciphisa ixesha lokusebenza nge-30%.

3. Iqela lerobhothi encinci:

I-MIT's magnetic microrobots inokuthwala amachiza kwiithagethi ze-alveolar ukuze zikhutshwe.

Itheyibhile yokuthelekisa impembelelo yezonyango

Iingcebiso zendlela yokuphumeza

Izibhedlele eziziiprayimari: zixhotyiswe nge-ultrasound bronchoscopy (EBUS) ye-mediastinal staging.

Isibhedlele sodidi lwesithathu: Ukuseka i-ENB+iziko longenelelo ngerobhothi ukwenza uxilongo oluhlanganisiweyo kunye nonyango lomhlaza wemiphunga.

Iziko loPhando: Ukujolisa kumfanekiso wemolekyuli kunye nophuhliso lwescaffold enokubola.

Ezi tekhnoloji zihlengahlengisa inkqubo yongenelelo lokuphefumla ngokusebenzisa izinto ezintathu eziphambili: unikezelo oluchanekileyo, ukuxilongwa ngobukrelekrele, kunye nonyango olungenabungozi kakhulu. Kwiminyaka emi-5 ezayo, ngophuhliso lwe-AI kunye ne-nanotechnology, ukuxilongwa kunye nokunyangwa kwamaqhuqhuva e-pulmonary kunokufikelela "ulawulo olungena-invasive oluvaliweyo".