Maitiro Ekuongorora Mazino
Pendauluan
Kuongororwa kwemazino mubazi remazino inzira yekutora sampuro yenyama kuti iongororwe histopathological kuti ionekwe. Kunyangwe izwi rekuti "dental biopsy" richiwanzonzwika, mukuita, biopsies inowanzoitwa pamatishu akakomberedza zino (gingiva, oral mucosa, alveolar bone, periapical tissue) kana pamaronda ane chekuita nezino (semuenzaniso, radicular cysts, periapical granulomas), pane kubvisa "zvidimbu zvemazino" zvakaita seenamel nguva dzose. Nzira yekutora sampuro nemazvo yakakosha pamhando yekuongorora, sezvo tissue dzakakuvara, dzisina kukura, kana dzisina kumiririrwa dzinogona kutungamira mukududzira kusina kururama. Chinyorwa chino chinokurukura zviratidzo, kugadzirira, mhando dzematekiniki, matanho ekuita, uye kubata sampuro dzebiopsy mubazi remazino.
Zviratidzo zveBiopsy muDentistry
Kuongororwa kweropa kunoonekwa kana paine chironda kana kusarongeka kwenyama kusingagone kusimbiswa nekuongororwa kwekiriniki neX-ray chete. Zviratidzo zvinowanzoonekwa zvinosanganisira:
1. Maronda emudumbu anogara kwenguva inopfuura mavhiki maviri (maronda, mapundu machena/matsvuku, mapundu).
2. Kufungirwa kuti pane maronda asati aita kenza kana kuti ane kenza (leukoplakia, erythroplakia, maronda ekudzivirira, kubuda ropa zviri nyore).
3. Kukura kwenyama dzakadai sefibroma, papilloma, pyogenic granuloma.
4. Zvirwere zvePeriapical zvisingavandudzike mushure mekurapwa ne endodontic kana kuratidza chitarisiko chisina chokwadi che radiolucent.
5. Matumbu nemabundu ane odontogenic kana kuti asiri odontogenic anoda kusimbiswa ne histological.
6. Matambudziko emapfupa eshaya (semuenzaniso fibro-osseous loses, chronic osteomyelitis) mune mamwe mamiriro ezvinhu anoda kutorwa kwemapfupa.
Nheyo dzekutanga uye Kugadzirira
Pamberi pekuita, chiremba wemazino anofanira kuita zvinhu zvakakosha:
– Kuongororwa kwakazara kwezvirwere (nhoroondo yezvirwere zvemuviri, mishonga—kunyanya mishonga inorwisa ropa, allergies, tsika dzekusvuta).
- Kuongorora kwakanyatsojeka kwekiriniki uye kunyora magwaro ehukuru, nzvimbo, ruvara, kuenderana, pamusoro, uye hukama nemazino.
– Kuongororwa kunotsigira: periapical radiographs, panoramic, CBCT kana zvichidikanwa, kunyanya kune maronda ari mukati memapfupa.
– Kubvumirana kwakavakirwa paruzivo: tsanangura chinangwa che biopsy, nzira yacho, njodzi (kurwadziwa, kubuda ropa, hutachiona, paresthesia), uye zvingangoitika kuti zviitwe.
– Asepsis–antisepsis: nzvimbo yekushanda inocheneswa, mushandisi anoshandisa michina yekudzivirira, uye zvishandiso hazvina utachiona.
Kusarudzwa kwenzira ye biopsy kunoenderana nehukuru hweronda, kudzika kwaro, nzvimbo yemuviri waro, fungidziro yekuti pane gomarara, uye mukana wekuwana nzira yekuvhiyiwa.
Mhando dzeMaitiro eBiopsy muDentistry
1. Kuongororwa kweBacterial Biopsy
Kuchekwa kweganda (incinal biopsy) kubviswa kwenyama diki kubva pachironda, kunowanzoitwa pamaronda makuru kana anofungidzirwa kuti ane kenza. Chinangwa ndechekuwana muenzaniso unomiririra pasina kubvisa chironda chose. Nzira iyi yakanaka kana:
– Kukuvara kwacho kwakakura uye hakubvumiri kubviswa zvachose pakutanga.
– Pane fungidziro yekuti chirwere ichi chine gomarara saka chirwere ichi chinodiwa kutanga chaongororwa usati waronga kuvhiyiwa kwacho.
Nheyo inokosha: torai muenzaniso kubva munzvimbo inonyanya kuoneka—kazhinji muganhu uri pakati penyama yakajairika neisina kujairika. Dzivisai nzvimbo dzine necrosis yakanyanya inogona kukanganisa kunaka kwechirwere.
2. Kuongororwa kweExcisional Biopsy
Kubviswa kwechirwere cheganda (excisional biopsy) kunosanganisira kubvisa ronda rese uye inzira yekurapa nayo. Yakakodzera maronda madiki, asina njodzi, uye ari munzvimbo dzakadai semafibroma madiki kana mapillomas. Zvakanakira:
- Kuongororwa uye kurapwa zvinogona kuitwa nekuita chimwe chete.
- Margins anogona kuongororwa kana akaitwa nemazvo.
Njodzi: Kana ronda racho riri remaronda, kubviswa kwegomarara pasina kuronga kenza zvakakwana kunogona kuita kuti kurapwa kwacho kuome. Saka, kusarudza chirwere kwakakosha.
3. Kuongororwa kweBoopsy yeBoopsy
Kuongororwa kwepunch biopsy kunoshandisa chinhu chakapinza che cylindrical (kupwanya) kuti uwane huwandu hwakayerwa hwe mucosal tissue (kazhinji 3–6 mm). Inoshandiswa zvakanyanya pamuromo wemucosa kune maronda akatsetseka kana ma plaque. Zvakanakira zvinosanganisira kuvhiyiwa nekukurumidza uye muenzaniso wakanaka kana ukaitwa nemazvo. Kupwanya kunobvumira kuunganidzwa kwakazara kwe epithelial tissue uye pasi pe connective tissue.
4. Kuongororwa kweFine Needle Aspiration Biopsy (FNAB)
FNAB inowanzoshandiswa pakuisa nyama dzakapfava dzakadai sekukura kwemate kana mapundu emutsipa ane chekuita nenzvimbo yemaziso. Pakuongorora mazino, FNAB inogona kubatsira kusiyanisa pakati pemaronda ecystic azere nemvura, mabundu, uye bundu. Zvisinei, FNAB inopa samples dzecytological, kwete histology yemuviri wese, saka dzimwe nguva inofanirwa kuitwa biopsy yenyama.
5. Kuongororwa kweBone Biopsy/Maronda eIntraosseous
Zvironda zvePeriapical kana shaya cysts dzimwe nguva zvinoda kutorwa kwemapfupa kana mapfupa mukati mefupa kuburikidza nekuvhiyiwa. Muzviitiko zvePeriapical, sampuro dzinogona kutorwa panguva yekubvisa apicoectomy kana enucleation yecyst. Pazvironda zvikuru, biopsy ye intraosseous incisional inoitwa nekugadzira "hwindo" mubone cortex, kubvisa zvironda, uye wobva wavhara nzvimbo yacho.
Matanho Akajairika Ekuita Biopsy (Nyama Yakapfava)
Inotevera nzira inoshandiswa mukurapa biopsy yemapfupa akapfava:
1. Kuziva nzvimbo yemuenzaniso
Sarudza nzvimbo inonyanya kuratidza. Kana paine maronda asina kufanana, tora sampuli dzinopfuura imwe kana zvichidikanwa (semuenzaniso, nzvimbo dzvuku, chena, uye dzine maronda).
2. Anesthesia yemunzvimbo
Shandisa nzira yekupinda yakatenderedza gonda. Dzivisa kubaya jekiseni zvakananga mugonda kana zvichibvira, sezvo izvi zvinogona kukanganisa magadzirirwo enyama uye kukanganisa kududzirwa kwehistological.
3. Kuchekwa uye kuunganidzwa kwenyama
– Pakucheka: gadzira denderedzwa rakaita sedenderedzwa kana kuti rakaita sedenderedzwa, uchivhara chikamu chegomarara uye chidimbu chidiki chenyama yakajairika kumicheto.
– Pakubvisa ganda: gadzira denderedzwa rakatenderera gonda rine mipendero yakakodzera.
– Pakurova: dzvanya wotenderedza kurova kusvika kwasvika pakadzika zvakakwana, wobva wabvisa sampuro ne forceps diki.
4. Kubata network
Dzivisa kubata sampuro zvakanyanya ne forceps dzakakora, sezvo izvi zvinogona kukonzera kupwanya zvinhu. Zvakanaka kushandisa soft hook kana atraumatic forceps.
5. Kuvhara ropa nekuvhara maronda
Isa simba rekumanikidza, bvisa kupisa kwakanyanya kana zvichidikanwa, uye sunga nzvimbo yacho. Chenjerera nyama dzemuromo dzinobuda ropa zviri nyore; ita shuwa kuti ropa rinobuda zvakanaka.
6. Mirayiridzo mushure mekuita chiito
Ipa gwara pamusoro pezvikafu zvakapfava, kushambidzika kwemuromo, mishonga inonyaradza marwadzo kana zvichidikanwa, uye zviratidzo zvekunyevera zvakaita sekubuda ropa nguva dzose, kurwadziwa kwakanyanya, fivha, kana kuzvimba kunoramba kuchiitika.
Kubata uye Kugadzirisa Muenzaniso
Chikanganiso chinowanzoitika mukuongorora ma biopsy ndechekusabata zvakanaka kwesampuli. Kuti uwane mhedzisiro yakanaka:
– Isa tissue mu 10% buffered formalin nekukurumidza sezvinobvira. Kunonoka kunogona kukonzera autolysis.
– Shandisa huwandu hwakakwana hwe formalin (kazhinji hunowedzera kagumi kupfuura huwandu hwematishu).
– Kunyora mazita akazara: zita remurwere, zuva, nzvimbo yemuviri wake, uye rudzi rwe biopsy.
– Isa fomu rekukumbira ruzivo nezvechirwere: tsananguro yekiriniki, nguva yekukuvara, zviratidzo, tsika (kusvuta/doro), nhoroondo yekurapa, uye zvakawanikwa neX-ray, kana zviripo. Ruzivo rwekiriniki runobatsira zvikuru kuna chiremba wezvirwere pakusarudza dudziro.
Kune zvirwere zvinofungidzirwa kuti zvinoda kuongororwa kwakanyatsogadzirwa (semuenzaniso, immunofluorescence yakananga muchirwere che vesiculobullous), sampuli dzinofanira kubatwa nenzira dzakagadzirwa, kwete formalin. Saka, fungidziro yekiriniki inofanira kutaurwa nekukurumidza.
Matambudziko Ekutarisira
Mamwe matambudziko e biopsy mumuromo anosanganisira:
– Kubuda ropa: njodzi huru kune varwere vane matambudziko ekudzivirira ropa kana kushandisa mishonga inorwisa ropa.
– Kutapukirwa: hazviwanzoitiki kana asepsis yakanaka, asi zvinogona kuitika munzvimbo dzine kukuvara kana kuti dzisina kuchena.
– Marwadzo nekuzvimba: kazhinji kacho hazvina kunyanya kuoma uye zvinogona kurapwa nemishonga inonyaradza marwadzo uye inodzvanywa nechando.
– Kukuvadzwa kwetsinga: kunyanya kana biopsy iri pedyo nepfungwa, rurimi (tsinga dzemutauro), kana dzimwe nzvimbo dzine mapfupa.
– Mienzaniso yezvinhu zvakashandiswa: zvakakuvara, zvakapiswa (nekuda kwekupisa kwakanyanya), kana kuti nyama isina kudzika zvakanyanya zvinogona kuita kuti kuongororwa kwechirwere kuve kwakaoma.
Mhedziso
Maitiro ekutora tsananguro ye biopsy mukurapa mazino inyanzvi yakakosha yekurapa kuti pave neruzivo rwekuongorora maronda akasiyana-siyana emuromo neshaya. Sarudzo yenzira (incisional, excisional, punch, aspiration, kana intraosseous biopsy) inofanira kugadziriswa zvichienderana nehunhu hweronda uye fungidziro yekiriniki. Kuwedzera kune nzira chaiyo yekuvhiya, kiyi yekubudirira kwe biopsy iri mukusarudza nzvimbo yemuenzaniso, kubata kwenyama yeatraumatic, uye kugadzirisa kwakakodzera uye magwaro. Nemaitiro akakodzera, biopsy inogona kupa ruzivo rwakarurama rwe histopathological, zvichikonzera kurapwa kwakanyatsojeka, kwakachengeteka, uye kwakanangwa nemurwere.
Kana muchida, ndinogona kugadzirisa chinyorwa ichi kuita shanduro yedzidzo yepamusoro (ine mabhuku/mapepa ekunyora), kana kuita kuti chive chinoshanda zvakanyanya segwara rematanho-nematanho rekubatsira/vadzidzi vemazino.
