Nā ʻAno Hana Laʻana Biopsy Niho
Pendahuluan
ʻO ka biopsy i loko o ke niho ke kaʻina hana o ka lawe ʻana i kahi hāpana ʻiʻo no ka hoʻokolokolo histopathological e hoʻokumu i kahi hōʻailona. ʻOiai ua lohe pinepine ʻia ka huaʻōlelo "biopsy niho", i ka hana maoli, hana pinepine ʻia nā biopsies ma nā ʻiʻo e hoʻopuni ana i ka niho (gingiva, mucosa waha, iwi alveolar, ʻiʻo periapical) a i ʻole ma nā lesions e pili ana i ka niho (e.g., radicular cysts, periapical granulomas), ma mua o ka wehe mau ʻana i nā "ʻāpana niho" e like me ka enamel. He mea nui ke ʻano hana laʻana pololei no ka maikaʻi o ka hōʻailona, no ka mea, ʻo ka ʻiʻo i hōʻino ʻia, liʻiliʻi, a i ʻole ʻaʻole hōʻike i ka hiki ke alakaʻi i nā wehewehe hewa. Kūkākūkā kēia ʻatikala i nā hōʻailona, ka hoʻomākaukau ʻana, nā ʻano hana, nā ʻanuʻu hana, a me ka lawelawe ʻana i nā hāpana biopsy i loko o ke niho.
Nā hōʻailona no ka Biopsy ma Dentistry
Manaʻo ʻia kahi biopsy ke loaʻa kahi lesion a i ʻole kahi ʻano ʻē o nā ʻiʻo i hiki ʻole ke hōʻoia ʻia e ka hoʻokolokolo lapaʻau a me ka radiographic wale nō. ʻO nā hōʻailona maʻamau:
1. Nā ʻeha mucosal mau no nā pule he 2 a ʻoi (nā ʻōpū, nā palaki keʻokeʻo/ʻulaʻula, nā puʻupuʻu).
2. Ke kānalua nei i nā ʻeha precancerous a i ʻole cancerous (leukoplakia, erythroplakia, indurative lesions, easy bleeding).
3. Ka hoʻonui ʻia ʻana o nā ʻiʻo e like me fibroma, papilloma, pyogenic granuloma.
4. Nā ʻano ʻē o ka periapical i hoʻomaikaʻi ʻole ʻia ma hope o ka mālama ʻana o ka endodontic a i ʻole hōʻike i kahi hiʻohiʻona radiolucent kānalua.
5. Nā cysts a me nā puʻupuʻu odontogenic a i ʻole non-odontogenic e pono ai ka hōʻoia histological.
6. Nā maʻi o ka iwi ʻauwae (e.g. nā lesion fibro-osseous, osteomyelitis mau) ma kekahi mau kūlana e pono ai nā hāpana iwi.
Nā Kumumanaʻo Kumu a me ka Hoʻomākaukau
Ma mua o ke kaʻina hana, pono ke kauka niho e hana i kekahi mau mea nui:
– Anamnesis piha (mōʻaukala o nā maʻi ʻōnaehana, nā lāʻau lapaʻau—ʻoi aku hoʻi nā anticoagulants, nā maʻi allergies, nā hana puhipaka).
– Ka hoʻokolokolo pono ʻana i ke kauka a me ka palapala ʻana i ka nui, ka wahi, ke kala, ke kūlike, ka ʻili, a me ka pilina me nā niho.
– Nā hoʻokolohua kākoʻo: nā radiographs periapical, panoramic, CBCT inā pono, ʻoi aku hoʻi no nā ʻeha intraosseous.
– ʻAe ʻia me ka ʻike: wehewehe i ke kumu o ka biopsy, ke kaʻina hana, nā pilikia (ʻeha, ke kahe koko, ka maʻi, ka paresthesia), a me nā hana e hiki ai ke hana.
Asepsis-antisepsis: hoʻomaʻemaʻe ʻia ka wahi o ka hana, hoʻohana ka mea hoʻohana i nā lako pale, a ua maʻemaʻe nā mea hana.
ʻO ke koho ʻana o ke ʻano biopsy e hoʻopili ʻia e ka nui o ka lesion, ka hohonu, ka wahi anatomical, ke kānalua o ka malignancy, a me ke komo ʻana i ke kaʻina hana.
Nā ʻAno o nā Hana Biopsy ma ka Dentistry
1. Biopsy ʻokiʻoki
ʻO ka biopsy ʻokiʻoki ka wehe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo mai kahi ʻeha, i hana pinepine ʻia ma nā ʻeha nui a i ʻole nā ʻeha i manaʻo ʻia he ʻino. ʻO ka pahuhopu ka loaʻa ʻana o kahi hāpana koho me ka ʻole o ka wehe ʻana i ka ʻeha holoʻokoʻa. He kūpono kēia ʻano hana i ka wā:
- Ua ākea ka ʻeha a ʻaʻole ʻae ʻia ka ʻoki piha ʻana i ke kahua mua.
– Aia kekahi kānalua no ka maʻi ʻino no laila pono e ʻike mua ʻia kahi maʻi ma mua o ka hoʻolālā ʻana i ke ʻoki kino hope loa.
He kumumanaʻo koʻikoʻi: e kiʻi i kahi hāpana mai kahi i hōʻike nui ʻia—ʻo ia hoʻi ka palena ma waena o nā ʻiʻo maʻamau a me nā ʻiʻo ʻē. E pale i nā wahi o ka necrosis koʻikoʻi e hiki ke hoʻopilikia i ka maikaʻi o ka hōʻailona.
2. Biopsy ʻokiʻoki
ʻO ka biopsy excisional e pili ana i ka wehe ʻana i ka lesion holoʻokoʻa a he hana hoʻōla nō hoʻi. He kūpono ia no nā lesions liʻiliʻi, benign, a me nā lesions kūloko e like me nā fibromas liʻiliʻi a i ʻole papillomas. ʻO kona mau pono:
- Hiki ke hoʻokō ʻia ka ʻike a me ka lāʻau lapaʻau ma ka hana hoʻokahi.
- Hiki ke hoʻololi i nā ʻāpana inā hana pono ʻia.
Nā Pōʻino: Inā he ʻino ka lesion, hiki i ka ʻoki ʻana me ka ʻole o ka hoʻolālā oncology kūpono ke hoʻopilikia i ka mālama hou aku. No laila, he mea koʻikoʻi ke koho ʻana i ka hihia.
3. Biopsy Kuʻi
Hoʻohana ka biopsy punch i kahi mea hana cylindrical ʻoi (punch) e loaʻa ai kahi nui o ka ʻiʻo mucosal i ana ʻia (maʻamau 3-6 mm). Hoʻohana nui ʻia ia ma ka mucosa waha no nā ʻeha pālahalaha a i ʻole nā plaques. ʻO kona mau pono e komo pū me kahi kaʻina hana wikiwiki a me kahi laʻana maikaʻi inā hana pololei ʻia. ʻAe ka punch i ka hōʻiliʻili piha ʻana o ka ʻiʻo epithelial a me nā ʻiʻo hoʻopili ma lalo.
4. Biopsy Hoʻomoe ʻAila Maikaʻi (FNAB)
Hoʻohana pinepine ʻia ka FNAB no nā ʻiʻo palupalu e like me ka hoʻonui ʻia ʻana o ke kelepa salivary a i ʻole nā puʻupuʻu ʻāʻī e pili ana i ka ʻāpana maxillofacial. I loko o ka pōʻaiapili o kahi biopsy niho, hiki i ka FNAB ke kōkua i ka hoʻokaʻawale ʻana ma waena o nā lesion cystic i piha i ka wai, nā abscesses, a me nā tumors. Eia nō naʻe, hāʻawi ka FNAB i nā laʻana cytological, ʻaʻole ka histology o ke kino holoʻokoʻa, no laila pono i kekahi manawa kahi biopsy ʻiʻo maʻamau.
5. Biopsy Iwi/Nā ʻeha Intraosseous
ʻO nā ʻeha periapical a i ʻole ʻūpā ʻāwae I kekahi manawa, pono ka laʻana ʻana o ka iwi a i ʻole nā ʻiʻo intraosseous ma o ke komo ʻana i ke ʻoki kino. I nā hihia periapical, hiki ke lawe ʻia nā laʻana i ka wā o ka apicoectomy a i ʻole ka enucleation cyst. No nā ʻeha nui, hana ʻia kahi biopsy incisional intraosseous ma ka hana ʻana i kahi puka makani i loko o ka cortex iwi, e wehe ana i nā ʻiʻo lesion, a laila pani i ka wahi.
Nā Kaʻina Hana Laulā o ke Kaʻina Biopsy (ʻIʻo Palupalu)
Eia kekahi kahe i hoʻohana pinepine ʻia i ka hana lapaʻau no ka biopsy palupalu:
1. Ke hoʻoholo nei i ka wahi o ka laʻana
E koho i ka wahi i hōʻike nui ʻia. No nā ʻeha like ʻole, e lawe i nā hāpana he nui inā pono (e.g., ʻulaʻula, keʻokeʻo, a me nā wahi ʻeha).
2. ʻO ka anesthesia kūloko
E hoʻohana i ka infiltration a puni ka lesion. E pale i ka hoʻokomo pololei ʻana i loko o ka lesion inā hiki, no ka mea hiki i kēia ke hoʻopilikia i ke ʻano o nā ʻiʻo a hoʻopilikia i ka wehewehe histological.
3. ʻOki ʻana a me ka hōʻiliʻili ʻana i nā ʻiʻo
– No ka ʻoki ʻana: e hana i kahi ʻoki elliptical a i ʻole ke ʻano wedge, e uhi ana i kahi ʻāpana o ka ʻeha a me kahi liʻiliʻi o nā ʻiʻo maʻamau ma nā kihi.
– No ka ʻoki ʻana: e hana i kahi ʻoki elliptical a puni ka ʻeha me nā kaʻe kūpono.
– No ka punch: e kaomi a hoʻohuli i ka punch a hiki i ka hohonu o nā ʻiʻo kūpono, a laila e wehe i ka hāpana me nā forceps lahilahi.
4. Ka lawelawe ʻana i ka pūnaewele
Mai hoʻopaʻa ikaika i ka hāpana me ka hoʻohana ʻana i nā tweezers. nā niho no ka mea hiki ke hana e wāwahi i nā mea hana. ʻOi aku ka maikaʻi o ka hoʻohana ʻana i kahi makau maikaʻi a i ʻole nā tweezers atraumatic.
5. Hemostasis a me ka pani ʻana o ka ʻeha
E kaomi, e hoʻomoe māmā inā pono, a e humuhumu i ka wahi. E makaʻala i nā ʻiʻo waha e kahe koke ana ke koko; e hōʻoia i ka kaohi pono ʻana i ke kahe ʻana o ke koko.
6. Nā kuhikuhi ma hope o ka hana
E hāʻawi i ke alakaʻi no nā meaʻai palupalu, ka hoʻomaʻemaʻe waha, nā lāʻau analgesic inā pono, a me nā hōʻailona hōʻike e like me ke kahe mau ʻana o ke koko, ka ʻeha nui, ke kuni, a i ʻole ka pehu holomua.
Ka lawelawe ʻana a me ka hoʻopaʻa ʻana i nā laʻana
ʻO kahi hewa maʻamau i nā biopsies ka lawelawe maikaʻi ʻole ʻana i nā hāpana. No ka hoʻokō ʻana i nā hopena maikaʻi loa:
– E kau i ka ʻiʻo i loko o ka 10% buffered formalin i ka hikiwawe loa. Hiki i ka lohi ke hana i ka autolysis.
– E hoʻohana i ka nui kūpono o ka formalin (ma ke ʻano maʻamau he 10 manawa o ka nui o nā ʻiʻo).
– Ka lepili piha: inoa o ka mea maʻi, ka lā, ka wahi anatomical, a me ke ʻano o ka biopsy.
– E hoʻokomo i kahi palapala noi pathology ʻike: ka wehewehe ʻana o ke kauka, ka lōʻihi o ka lesion, nā hōʻailona, nā ʻano maʻamau (puahi/ʻona), ka mōʻaukala lapaʻau, a me nā ʻike radiographic, inā he. He mea kōkua nui ka ʻike lapaʻau no ka pathologist i ka hoʻoholo ʻana i ka wehewehe ʻana.
No nā maʻi i manaʻo ʻia e pono ai ka hoʻāʻo kūikawā (e laʻa, immunofluorescence pololei i ka maʻi vesiculobullous), pono e lawelawe ʻia nā hāpana ma nā mea hana kūikawā, ʻaʻole formalin. No laila, pono e hoʻāla mua ʻia ke kānalua lapaʻau.
Nā pilikia e manaʻo ai
ʻO kekahi mau pilikia o ka biopsy i loko o ka waha waha:
- Ke kahe koko: ʻoi aku ka nui o ka pilikia i nā maʻi me nā maʻi coagulation a i ʻole ka hoʻohana ʻana i nā anticoagulants.
– Ka maʻi: kākaʻikahi inā maikaʻi ka asepsis, akā hiki ke hana ma nā wahi i loaʻa ai ka trauma a i ʻole ka maʻemaʻe maikaʻi ʻole.
– ʻEha a me ka edema: ma ke ʻano laulā he akahai a hiki ke mālama ʻia me nā analgesics a me nā ʻūlū anu.
– Ka hōʻino ʻana o ke aʻalolo: ʻoiai inā kokoke ka biopsy i ka foramen noʻonoʻo, ke alelo (ʻaʻalolo lingual), a i ʻole kekahi mau wahi intraosseous.
– Nā mea hana laʻana: i hōʻino ʻia, puhi ʻia (ma muli o ke cautery nui ʻana), a i ʻole nā ʻiʻo pāpaʻu loa e paʻakikī ai ka ʻike ʻana.
Ka hopena
ʻO nā ʻano hana laʻana biopsy i loko o ke niho he mau mākau lapaʻau koʻikoʻi no ka hoʻokumu ʻana i ka ʻike o nā ʻano ʻeha waha a me nā ʻāwae. Pono e hoʻopilikino ʻia ke koho ʻana o ke ʻano (incisional, excisional, punch, aspiration, a i ʻole intraosseous biopsy) i nā ʻano o ka lesion a me ke kānalua lapaʻau. Ma waho aʻe o ke ʻano hana ʻoki kūpono, ʻo ke kī i kahi biopsy holomua e waiho ana i ke koho ʻana i kahi wahi laʻana koho, ka lawelawe ʻana i nā ʻiʻo atraumatic, a me ka hoʻopaʻa pono ʻana a me ka palapala. Me nā kaʻina hana kūpono, hiki i nā biopsies ke hāʻawi i ka ʻike histopathological pololei, e hopena ana i ka lāʻau lapaʻau maʻi pololei, palekana, a kuhikuhi ʻia.
Inā makemake ʻoe, hiki iaʻu ke hoʻololi i kēia ʻatikala i loko o kahi mana hoʻonaʻauao (me nā ʻōlelo kuhikuhi puke/moʻolelo), a i ʻole e hoʻolilo iā ia i mea pono e like me ke alakaʻi ʻanuʻu no nā kōkua niho/haumāna.
