Endoscopic Ultrasound (EUS) hloov kev kuaj mob thiab kev tswj hwm ntawm txoj kab mob plab (GI) thiab cov kab mob uas nyob ib puag ncig. Cov Eus rab koob ua lub luag haujlwm tseem ceeb hauv cov ntaub so ntswg rau cytological thiab keeb kwm kev tshuaj xyuas lub sijhawm cov cuab yeej no. Nyob rau peb xyoo dhau los, txuas ntxiv thev naus laus zis hauv koob ntsuas, thiab kev ua haujlwm tau zoo kho kev kuaj mob, kev nyab xeeb, thiab kev siv tshuaj kho mob.
Eus rab koob yog feem ntau siv rau ob lub hom phiaj:
Kev ntsuas lub taub tsho zoo (FNA): FNA yog tsim rau kev ntsuas cycreatic, tshwj xeeb yog muaj txiaj ntsig nyob rau hauv pancreatic masses, cov qog ntshav, thiab cov nqaij ntshiv.
Cov mos txwv sib luag (FNB): FNB yog engineered los khaws cov ntaub ntawv ntawm cov ntaub qhwv nqaij nqaij thiab tshuaj tiv thaiv kev tiv thaiv thiab immunohistochemistry.
Beveled koob, Franseen - cov taub, rab rawg - ntshws yog qee cov qauv kev tsim. Gauges ib txwm los ntawm 19g mus rau 25g, nrog ntsuas qhov yooj yim, cov ntaub so ntswg, thiab kev nyab xeeb. Piv txwv, 25 GAs muab kev pheej hmoo siab thiab txo cov kev pheej hmoo ua kom zoo dua cov kws kho mob siab
Qhov Zoo Ntawm Eus Koob
1. Txo kev tsis zoo: muab cov ntaub so ntswg yam tsis muaj kev phais mob qhib.
2. Nrog kev kuaj mob siab: los ntawm qee qhov tsis ntev los no -}}}}}}}}}}}}}}}}}} Cov ncauj lus kws tshuaj ntsuam xyuas ntawm 85-90% rau kev kuaj kom muaj qhov txhab siab.
3. Muaj kev nyab xeeb: cov nqi sib xyaw nyob qis dua qis (<2%), mainly consisting of mild bleeding, infection, or pancreatitis.
4. Versatility: Nws tau siv rau qhov txhab qis hauv cov txiav, Mediastinum, mob siab, cov qog ntshav, thiab cov qog ua plaub hau.
Txawm li cas los xij, cov tshuab rab koob tshiab tau txais cov nyom:
1. Qauv Txawv Teb: FAN qee zaum cog qoob loo tsis muaj ntaub so ntswg, tsim nyog rov ua dua cov txheej txheem.
2. Neeg tsav tsheb vam khom: kev vam meej yog heev cuam tshuam los ntawm endoscopist kev txawj ntse thiab muaj nrawm ntawm- kev ntsuas ntawm kev ntsuas ntawm lub vev xaib (Rose).
3. Kev nyuaj nyuaj: loj {{- caliber muter yuav nyuaj rau kev ua haujlwm hauv cov kab mob ntawm lub GI hauv GI.
4. Cov kev txiav txim siab tau txais: Advanced Biopsy Pho txheej txheem nce cov txheej txheem kev siv nyiaj, uas yuav txwv kev saws me nyuam-} Constrained Chaw.
Cov ntaub ntawv pov thawj kuaj mob thiab cov ntaub ntawv pov thawj
Ntau cov kev tshawb fawb thoob ntiaj teb thiab cov lus qhia kev tshawb fawb txog kev kho mob ntawm cov kab mob hauv kev kho mob ntawm cov ntaub so ntswg:
Pancreatic Fresions (Bang et al., Gastroenterology, 2018) Qhia tawm cov lus zoo siab dua nrog Franseen-} Cov taub hau muab piv rau cov tsoos FA.
Subepithelial qog: rooj plaub series qhia tau hais tias cov - fnb enables immunohistinal seeb ombal qog (gist) kev kuaj mob.
Lymphadenopathy: Large cohort studies confirm >85% qhov tseeb hauv kev pom qhov txawv ntawm malignant los ntawm benign cov qog ntshav.
Kev siv tshuaj kho mob tshwm sim: Cov Ntawv Tshaj Tawm Cov Lus Qhia Txog Kev Ua Si Eus {0} Taug Kev txhaj tshuaj, Fiducial tso, thiab cyst kua siv tshwj xeeb koob.
Tam sim no cov ncauj lus tam sim no
Ua haujlwm los ntawm fNB: rab koob koob tshiab nrog cov ntaub so ntswg ua kom zoo dua yog cov kev xav tau ntawm cov kev ntsuas thiab tso cai rau qhov kev thov kom meej.
Kev sib xyaw nrog kev sim molecular: cov tshuaj - fnb kuaj tam sim no txhawb nqa tom ntej no (ngs), ua kom muaj kev kho mob kheesxaws ntxiv.
Koobtse Innovation: Yooj lwv alloy shafts, hloov cov cim cim, thiab ergonomic khi txhim kho kom pom tau zoo thiab tswj.
Kev xav yav tom ntej
Lub neej yav tom ntej ntawm Eus rab koob thev naus laus zis yog qhov zoo li yuav ua los ntawm peb qhov tseem ceeb ntawm peb cov tseem ceeb:
Nrog ntau koob: Cov ntaub mos tau txaus tuaj yeem muab rho tawm rau kev txheeb xyuas ib zaug.
Tus kheej tshuaj: thov kom high - Cov ntaub so ntswg zoo tsav tsheb uas kev saws me uas txhawb molecular profiling.
Kho Eus: Koobsws yuav tuaj yeem hloov zuj zus mus rau hauv ntau cov cuab yeej siv cov khoom siv tshuaj hauv paus hauv plab, npau taws rau hauv tes.
AI: kev sib xyaw ua ke ntawm Ai -}} Pab cov kev xav tuaj yeem txhim kho cov phiaj xwm kev ua haujlwm thiab txo cov neeg teb xov tooj sib txawv.
