Cov ntsiab lus tseem ceeb ntawm 2023 Canadian Cov Lus Qhia Txog Kev Tswj Xyuas Kab Mob Cystic Renal
Jun 25, 2023
Kab mob cystic ntawm lub raum feem ntau pom tshwm sim hauv cov kev tshawb fawb niaj hnub. Nrog rau qhov muaj ntau ntxiv ntawm kev kuaj mob plab, ntau thiab ntau tus neeg raug kuaj pom muaj kab mob cystic raum. Kab lus no yog qhov hloov tshiab ntawm 2017 cov lus qhia rau kev tswj cov kab mob hauv lub raum, muab cov lus qhia rau cov kws kho mob hauv kev tswj cov kab mob cystic raum.
Nyem rau cistanche herba rau mob raum
Cov lus pom zoo 1:
Rau cov neeg mob uas muaj cov kab mob hauv lub raum ua ntej kuaj pom ntawm ultrasonography, txhim kho cov duab hla ntu yog pom zoo kom ua kom cov hlwv sib txawv zoo dua ntxiv (zoo me ntsis, pom zoo kom muaj zog).
Cov lus pom zoo 2:
Cov neeg mob uas tau txheeb xyuas tias muaj lub raum mob yuav tsum tau muab cais raws li 2019 Bosniak grading system (Expert Opinion).
Cov lus pom zoo 3:
Rau cov neeg mob uas muaj kev tsis pom zoo lossis tsis ntseeg hauv kev faib cov kab mob hauv lub raum nyuaj, pab pawg kws tshaj lij no ntseeg tias yog tias cov xwm txheej no tuaj yeem cuam tshuam rau txoj kev kho mob, lawv yuav tsum raug xa mus rau lub rooj sib tham sib tham (MDT) rau kev sib tham (tus kws tshaj lij kev xav).
Cov lus pom zoo 4:
Rau cov neeg mob uas muaj Bosniak qib I thiab II cysts, tsis pom zoo ua raws li cov duab (qhov zoo, kev pom zoo zoo).
Cov lus pom zoo 5:
Hauv cov neeg mob uas muaj Bosniak qib I thiab II cysts, kev cuam tshuam tsuas yog yuav tsum tau yog tias lub cyst yog cov tsos mob (piv txwv li, los ntshav, kis kab mob, lossis mob) (cov ntsiab lus kho mob).
Cov lus pom zoo 6:
Rau cov neeg mob uas muaj Bosniak qib IIF cysts, kev soj ntsuam xyuas yog pom zoo txhua txhua 6-12 lub hlis rau thawj xyoo thiab txhua xyoo yog tias cov cyst ruaj khov (cov kws tshaj lij kev xav).
Cov lus pom zoo 7:
Rau cov neeg mob uas muaj Bosniak qib IIF cysts yam tsis muaj kev nce qib ntawm cov duab hluav taws xob, kev pom zoo ib xyoos ib zaug (cov lus pom zoo, cov pov thawj tsis tshua muaj tseeb).
Cov lus pom zoo 8:
Rau cov neeg mob uas muaj Bosniak qib III los yog IV complex lub raum hlwv Tsawg dua los yog sib npaug li 2 cm, active surveillance raug pom zoo raws li qhov kev xaiv (kev pom zoo, tsis tshua muaj pov thawj).
Cov lus pom zoo 9:
Rau Bosniak qib III thiab IV hlwv nrog ib txoj kab uas hla ntawm 2-4 cm, active soj ntsuam los yog kev kho mob phais yog pom zoo raws li thawj xaiv (kev pom zoo, tsis tshua muaj pov thawj).
Pom zoo 10:
For patients with Bosniak grade III or IV cysts >4 cm, phais resection yog pom zoo raws li qhov kev xaiv (kev pom zoo, tsis tshua muaj pov thawj).
Cov lus pom zoo 11:
Rau cov neeg mob uas muaj Bosniak qib III lossis IV lub raum ua rau lub raum tsis zoo uas muaj cov kab mob tseem ceeb thiab / lossis kev cia siab rau lub neej tsawg, kev soj ntsuam (lossis tos saib xyuas) raug pom zoo raws li qhov kev xaiv (kev pom zoo, cov pov thawj tsis tshua muaj tseeb).
Cov lus pom zoo 12:
Rau cov neeg mob uas muaj Bosniak qib III lossis IV cov hlwv uas tab tom phais, ib feem ntawm nephrectomy (tsis yog radical nephrectomy) raug pom zoo thaum muaj peev xwm thiab oncologically ua tau, tshwj xeeb tshaj yog rau cov hlwv me me (kev pom zoo, cov pov thawj tsis tshua muaj tseeb).
Cov lus pom zoo 13:
Rau cov neeg mob uas muaj Bosniak qib III lossis IV cysts ntawm kev soj ntsuam nquag, cov kev xaiv kho mob yuav tsum tau muab thaum muaj kev pheej hmoo oncologic nce lossis thaum tus neeg mob xav tau kev kho mob rau tus kheej. Thaum muaj kev sib tw txaus ntshai tshaj qhov txiaj ntsig kev kho mob, cov neeg mob yuav tsum hloov mus rau kev soj ntsuam ceev faj (kev kho mob hauv paus ntsiab lus).
Cov lus pom zoo 14:
Cov neeg mob uas muaj Bosniak qib III lossis IV hlwv Tsawg dua lossis sib npaug li 3 cm uas raug txiav txim siab rau thermal ablation yuav tsum tau ceeb toom txog qhov tsis paub tseeb ntawm qhov ua tau zoo thiab cov ntaub ntawv tsis zoo ntawm percutaneous thermal ablation piv nrog rau kev phais (Cov Kev Pom Zoo).
Cov lus pom zoo 15:
Kev kuaj ntshav biopsy yuav raug txiav txim siab hauv cov neeg mob uas muaj Bosniak qib IV cysts yog tias lawv muaj cov khoom siv biopsy uas muaj txiaj ntsig zoo thiab cov kev tshawb pom tuaj yeem hloov kho kev xaiv. Lub raum loj uas tsis muaj cov khoom tseem ceeb yuav tsum tsis txhob muab biopsied vim tias tsis muaj kev kuaj pom muaj txiaj ntsig (cov kws tshaj lij kev xav).
Saum toj no:
Piv nrog rau CUA cov lus qhia qub rau kev tswj cov kab mob hauv lub raum, cov kev hloov tshiab tseem ceeb ntawm 2023 cov lus qhia nyob hauv peb yam: (1) cov neeg mob lub raum yuav tsum tau muab cais raws li 2019 Bosniak grading system; (2) Bosniak III thiab tsawg dua lossis sib npaug li 2 cm Rau qib IV hlwv, kev soj ntsuam nquag raug pom zoo raws li lub tswv yim nyiam; (3) Rau Bosniak qib III thiab IV hlwv nrog ib txoj kab uas hla ntawm 2-4 cm, active soj ntsuam los yog kev kho mob phais yog pom zoo. Lub vaj huam sib luag tau ua cov kev hloov kho no los txo lub nra ntawm kev kho mob rau cov neeg mob tab sis lees paub tias qhov zoo ntawm cov pov thawj txhawb nqa lawv tsawg. Yog li ntawd, cov kws kho mob yuav tsum muaj kev sib txuas lus thiab qhia kev txiav txim siab nrog cov neeg mob thaum xaiv cov kev kho mob, thiab cov neeg mob uas xaiv cov tswv yim kho mob uas tsis yog phais yuav tsum paub txog qhov tsis paub tseeb ntawm cov ntaub ntawv txhawb nqa lawv txoj kev kho mob.
Cov ntaub ntawv:
[1] Richard PO, Violette PD, Bhindi B, et al. 2023 HLOOV TSHIAB - Canadian Urological Association cov lus qhia: Kev tswj cov kab mob hauv lub raum tuaj yeem Urol Assoc J 2023;17(6):162-74.
