Iimitha zonyango ezilodwa ezikwazi ukunyanga iimeko ezithile zeengqondo ngaphandle kokuhlinzwa
I-Gamma i-radiosurgery yindlela yokucwangcisa ephakamileyo apho i-radium egxininiswe kakhulu ye-radiation isetyenziselwa ukutshabalalisa iindawo zenyama. Nangona kuthiwa utyando, inqubo yeGamma Knife ayibandakanyi ukubandakanywa okanye isithsaba.
Inkqubo inomngcipheko ongaphantsi kakhulu kunokuba utyando oluqhelekileyo kwaye unikezela ngokuchanekileyo ngakumbi xa wenza imisebenzi enobunzima, ngokuyinhloko kwengqondo.
Ngenxa yoko, ukuhlinzwa ngokugqithiseleyo kweGamma kunokuthi kwenziwe ngokugqithisileyo okanye ngokuhlala esibhedlele.
Imbali
I-radiosurgery yase-stereotactic yaqala ukuphuhliswa ngo-1949 ngu-Swedish neurosurgeon uLars Leskell ngenjongo yokunyanga iindawo ezincinci zeengqondo ngaphandle kokulimaza izicubu eziseduze.
Iimpawu zokuqala zaseLeskell zecebo elisebenzisa i-X-ray, iproton, kunye nemigqa ye-gamma ezayo ukuze ivelise umgca omncinci we-radiation kwindawo ejoliswe kuyo. Ngokuqondisa i-radiation kwii-angles ezininzi, iiplanga eziguqukayo zingahambisa i-dose ebulalayo ukutshabalalisa izicubu, ukuvimbela amathambo, okanye ukuvala imithwalo yegazi kunye nomonakalo obuthathaka.
I-Leskell yazisa ngokusemthethweni i-Gamma Knife ngo-1968. Ngama-1970, i-Gamma Knife yayisisigxina (i-three-dimensional approach) ngokusungula i-imagination resonance (IMRI) kunye ne- tomography (CT) . I-Gamma Knife yokuqala yaziswa kuphela yi-United States ngo-1979 kwilungiselelo phakathi kweLeskell kunye neYunivesithi yaseCalifornia, eLos Angeles.
I-Gamma Knife ingumhla wokubhalisa we-Elekta Instruments, Inc. e-Stockholm, eSweden.
Iimpawu ezifanayo zeeRadioosurgical Devices
Ukongeza kwiseferensi yeLeskell, isixhobo esifanayo esibizwa ngokuba yi-linear accelerator (Linac) sakhiwe ngo-1952 njengendlela yokwahlukana kwamayeza emacandelo amancinci.
Kwakuphela ngowe-1982 ukulungiswa kweso sixhobo kwakuvumela ukuba kusetyenziswe kwi-radiosurgery.
Isixhobo se-Linac sihluke kwiGamma Knife ekuthi isetyenziselwa ngokuyinhloko unyango lwe-radiation kwiindawo ezininzi zomzimba. I-Gamma Knife, ngokuphambene nayo, isetyenziselwa ukuphela kweengqondo ze-radiosurgery. Ngaphezu koko, idivaysi ye-Linac idinga iteknoloji enkulu kunye nobuchule xa isetyenziselwa i-radiosurgery kwaye idlulisela ibhanti ebanzi ngokuthelekisa i-Gamma Knife (1.1 millimeters ngokumalunga ne-0.15 millimeter ngokulandelanayo).
Umxholo omtsha obizwa ngokuba nguLinac Cyberknife waqaliswa ngo-2001 kwaye ngokuyininzi ulinganisa iGamma Knife ngcamango. I sixhobo, siqhutywe kwiengalo ze-robotic, sithumela i-radiation ejoliswe kwii-angles ezininzi kodwa, ngokungafani neGamma Knife, ayizange ibonise ixabiso lokusinda xa kuthelekiswa nezinye iindlela zesifo somhlaza we-radiation.
Uhlobo lokugqibela lwe-radiosurgery, olubizwa ngonyango lweproton (PBT) , lusetyenzisa umgqomo wee-particle ze-proton ukuxilisa izicubu ezigulayo. Nangona kunjalo, uphando olwenziwa ngo-2012 oluvela kwi-American Society of Radiation Oncology lwagqiba ukuba i-PBT ayizange ifumane inzuzo ngaphezu kweendlela eziqhelekileyo zonyango lwe-radiation ngaphandle kwee-cancer zezilwanyana zesistim se-central central, i- melanoma yamehlo kunye ne- chordomas (uhlobo lomhlaza wesifo).
Nangona kunokuba luncedo lwe-PBT, iindleko ezikhethekileyo zeenkqubo (phakathi kwe-$ 100 ukuya kwii-180 yezigidi) zenza ukuba kungenakwenzeka kuzo ezininzi izibhedlele.
Iimeko eziPhathwayo
I-Gamma i-radiosurgery isetyenziswa ngokubanzi ekuphatheni izicubu kunye nezinye izilonda kwingqondo. Kodwa inokuphinda iphumelele ekuphatheni intlungu ethile kunye neengxaki zokunyakaza kunye nokungaqhelekanga kweengcambu kwintliziyo.
I-Gamma Knife ngokuyinhloko isetyenziselwa ukuphatha le miqathango ilandelayo:
- I-Brainastases yeBrain (iisomhlaza eziye zasasazeka kwiingqondo ezivela emzimbeni kwezinye izitho)
- I-Glioblastoma (uhlobo lomhlaza wengqondo)
- I-Acoustic neuroma (i-tumorous noncercerous in the nerve ekhokelela kwindlebe yangaphakathi ukuya kwingqondo)
- I-Meningioma (isifo esingaqhenqanga esingaqhelekanga esivela kwiimbumba ezungeze ubuchopho kunye nentambo yomthambo)
- I-adenoma ye-Pituitary (i-tumor ye-pituitary gland)
- Isifo sikaCushing (isifo esingaqhelekanga apho umzimba uvelisa kakhulu i-hormone yoxinzelelo, i-cortisol, ngenxa yokuxhamla izidumbu okanye izidakamizwa ze-steroid ezifana ne- prednisone )
- I-neuralgia ye-Trigeminal (imeko apho uxinzelelo lweentlanzi ezisisigxina kubangela ubuhlungu obukhulu obukhulu)
- Ubungqungquthela obubalulekileyo (isifo sengqondo esenza ukuba kungabonakali kunye nesigxina, kunokungahambelani nesifo sikaParkinson)
- I-Malteriovenous malformation, okanye i-AVM (ukuxhamla okungaqhelekanga phakathi kwemibhobho nemivilini, ngokuqhelekileyo kwingqondo okanye emthonjeni)
I-Gamma i-radiosurgery ingasetyenziselwa kwiimeko apho i-brain lesion ayinakufikelelwa ngophando oluqhelekileyo okanye kubantu abangenako ukunyamezela inkqubo evulekileyo yokuhlinzwa ezifana ne- craniotomy .
Ngenxa yokuba inzuzo yeProgram yeGamma Knife ibonakaliswa ngokukhawuleza emva kwexesha, ayisetyenziselwa abantu abaneemfuno zabo zonyango okanye ngokukhawuleza kunyango.
Ingaba isebenza kanjani
Inkqubo yeGamma Knife ibizwa ngokuba "utyando" ngenxa yokuba inokwenziwa kwiseshoni enye kunye neenjongo zeekliniki ezifanayo zokusebenza rhoqo. Imiphumo yeGamma Knife ihluke ngohlobo lwesifo esiphathwayo:
- Xa zisetyenziselwa ukuphatha izicubu, i-radiation egxininisekile iphazamisa i-DNA kwiiseli zesisu. Oku kuphazamisa ubuchule beeseli ukuphindaphinda, kubangela ukuba i-tumor ihlehlise.
- Xa isetyenziselwa ukunyanga izifo ze-neurological, i-boram ye-radiation ibangela ukwakheka kwesilonda esithintela iimpawu ze-nerve.
- Xa zisetyenziselwa ukuphatha i-AVM, i-Gamma Knife inokunciphisa ubungakanani kunye negazi lokugeleza ngeenqanawa, ngaloo ndlela ukunciphisa umngcipheko wokuphuka okanye ukubetha.
Umatshini ngokwawo ufana noyilo kwi-MRI okanye kwi-CT yokuhlola kunye nebhedi edibeneyo kunye nedome efana netyhubhu apho intloko yakho ifakwa khona. Akunjalo nje njengomnye umatshini, nangona kunjalo, kwaye ucelile ukuze ungekho amathuba okufumana i-claustrophobia.
Yintoni ongayilindela
Inqubo yeGam knife ibandakanya iqela lezokwelapha, kuquka i-oncologist yomlambo (ugqirha womhlaza ogxininisa imitha), i-neurosurgeon, i-radiation therapist kunye nomongikazi obhalisiwe. Inkqubo ingahluka ngokuxhomekeke kwimeko ephathwayo kodwa idlalwa ngamanyathelo alandelayo:
- Xa ufika unyango, uya kucelwa ukuba ulale phantsi kwebhedi edibeneyo emva koko okanye imaski efana nesigxina okanye isicatshulwa esingasisigxina esisetyenziswe sisetyenziselwa ukuzinzisa intloko yakho kwaye uyigcine ekuhambeni.
- Kufuneka kwenziwe i-MRI okanye i-CT ukujonga indawo ekhoyo kunye nobukhulu bezakhiwo ezijoliswe kuyo okanye ukungavamile.
- Ngokusekelwe kwiziphumo, iqela liya kuceba isicwangciso sonyango kubandakanywa nenani elichanekileyo lokubhenca kunye nokubeka indawo.
- Emva kokuma endaweni, inhloko yakho yayiza kutshintshwa kwidime, kwaye unyango lwamayeza luya kuqala. Uza kuhlala uphapheme kwaye uxhumeke oogqirha ngokusebenzisa uxhumano lwamazwi. Ngokuxhomekeka kwimeko, inqubo ingathatha naphi na imizuzu embalwa ukuya kwiyure.
Imiphumo Yecala Lonyango
Nangona inkqubo yeGamma Knife ngokwayo ayibuhlungu, ukusetyenziswa kwemisebe ngamanye amaxesha kungabangela iziphumo ezisecaleni ngenxa yokugqithisa kwengqondo. Ubunzima beempawu buya kudibaniswa nobude kunye nendawo yonyango lwamayeza kwaye ingaquka:
- Intloko
- Ubungqina
- I sizathu
- Umbono ogqabileyo
- Ubuthathaka
- Ukulahlekelwa kwe-balance
- Ukulahleka kweenwele (ngokuqhelekileyo kwesikhashana)
- Ukuxhamla
Kukho ezinye iingozi ezihambelana nesimo sakho sonyango. Qiniseka ukuba uthetha nodokotela wakho ngale nto ngaphambi kokuba uqhube inkqubo yeGamma Knife.
Impumelelo
I-Gamma i-radiosurgery ibonakalise ngokuphumelelayo ekuphatheni izicubu ezinobungozi okanye ezinobungozi ukuya kwiisentimitha ezine (ububanzi obuyi-1½ intshi) ngobukhulu. Kubantu abanomdlavuza wengqondo yengqondo , le nkqubo ibonakala iyasebenza ekunikezeni ulawulo lwesisu kunye nokwandisa amaxesha okuphila.
Iingeniso zempumelelo ziyehluka ngohlobo oluphathwayo, lulandelayo:
- Ngokubhekiselele kwi-AVM, i-radiosurgery ithathwa njengoluhlobo oluphambili lwonyango namhlanje kwaye lunezinga lokunyanga phakathi kwama-54 ekhulwini kunye nama-92 ekhulwini kuye kuxhomekeke kwindawo yokukhupha.
- Okwangoku, isifundo se-2016 esivela eYurophu sabika ukuba abantu abane-trigeminal neuralgia baxhamle kakhulu kule nkqubo, ngamaphesenti angama-71.8 ashiye intlungu iminyaka emithathu kwaye i-45.3 ekhulwini ishiye intlungu engaphezu kwe-10.
- Ngokufanayo, ukuhlaziywa kwee-klinikhi zango-2012 kubhengeze ukuba iipesenti ezingama-88.3 zabantu abaphathiswe kwiimvumba ezibalulekileyo zigcinwe ukulawulwa kwemoto ngokufanelekileyo emva kweenyanga ezingama-24.
- Uvavanyo lwe-2013 oluvela kwiYunivesithi yaseVirginia School of Medicine lubonise ukuba inkqubo yeGamma Knife yanikezela ulawulo lwe-tumors ezi-98 ezinxulumene nesifo sikaCushing malunga nobude bonyaka wesifundo seminyaka emine.
Iingxaki ezihambelana nokulandela i-Gamma Knife i-radiosurgery zibhekwa njengezinto ezinqabileyo, ezininzi zihambelana nomqathango ongaphantsi kwenkqubo.
> Imithombo:
> Ohye, C .; Higuchi, Y .; Shibazaki. T. et al. "I-Gamma knife thalamotomy yesifo sikaParkinson kunye nentuthuzelo ebalulekileyo: Umfundi oza kufundisisa." Neurosurgery. 2012; 70 (3): 526-35. INGXELO: 10.1227 / NEU.0b013e3182350893.
> Ipaki, H .; Wang, E .; Ukhuphe, uCl et al. "Ukutshintsha iipateni zohlobo lweGamma Knife ngokubhekisele kwi-stereotactic radiosurgery eline-linear radiosurgery yengqondo ye-metastases e-US." J Neurosurg. 2016 ; 124 (4): 1018-1024. INGXELO: 10.3171 / 2015.4.JNS1573.
> IPlasencia, A. kunye neSantillan, A. "Ukuqulunqa kunye nokusabalalisa imirhumo yezinto ezingalunganga." Uphulo lwe-Neurol Int . 2012; 3 (iSiza 2): S90-S104. INGXELO: 10.4103 / 2152-7806.95420.
> Regis, J .; Tuleasca, C .; Ressequier, N. et al. Ukhuseleko lwexesha elide kunye nokuphumelela kweGamma Knife ukuhlinzwa kwi-classical neuralgia ye-classic: isifundo seqela lesigidi-497-isiguli. " J Neurosurg. 2016; 124 (4): 1079-87. INGXELO: 10.3171 / 2015.2.JNS142144.
> Sheehan, J .; Xu, Z; Salvetti, D. et al. "Iziphumo ze-gamma umjoza weCrew's Disease." J Neurosurg. 2013; 199 (6): 468-92. INGXELO: 10.3171 / 2013.7.JNS13217.