Tumour melts: It is " low " Threshold " tight " Supervision

Tumour melts: It is " low " Threshold " tight " Supervision
Staff reporter Li TianShu
"Technology is a kind of general name achieving technology a little that tumour melts, include many kinds of technological means, there is a very great difference between each other, but the common point is that the guide in image technology makes the target to ' eliminates ' tumour. " Associate professor Wang Wei of general hospital of PLA says.
Not long ago, in the clinic allowed to launch in Ministry of Public Health in the first batch should use the third kind of medical technology, tumour melts the treatment technology is included in it, and issued>(hereafter referred to as " standardard management ") ,Have carried on the regulation to hospital and doctor qualification which launched this kind of technology.
The entry threshold reflects the technological characteristic
"Technology is not a kind of technological type that tumour melts. Have considered this characteristic while making the policy, so has set up more extensive standard. " Wang Wei says.
It is reported tumour melt, treat, it adopts physics or chemical methods to be some to kill the technology of tumour directly, it operates to be under the intersection of image and guide of technology basically, use target of treating etc. to treat, including radio frequency, microwave, laser, supersound, high-frequency electricity burn, freeze etc. and melt the treatment technology, or inject the methods such as anhydrous ethanol, second acid of chemical medicine, deactivate the tumour cells of pathological change district, treat the route including open surgery under the skin, inner mirror.
Wang Wei introduces, in " standardard management ", the entry threshold of the medical organization is not high, the hospital demanding to launch this kind of technology needs to meet the following conditions: Second first grade and the above hospital, have relevant subject of making a diagnosis that health authorities check and approve registration, possess, supervise administration bureau sanction, use clinical tumour that treat for melt apparatus by national the intersection of food and medicines.
" the standardard management " set up lower threshold by the intersection of tumour and doctor treated to melt engaged ining too, only require the clinical working experience made a diagnosis in tumour above for 3 years, have attending physician and post qualifications of the above professional technique, melt technical training through corresponding tumour at the same time.
Opposite to this, because the reliance on the medical apparatus of technology that tumour melts, " standardard management " requires the medical organization needs to possess the relevant technical equipment that the image guides, for instance supersound, CT or MRI,etc., and possess the contrast used for assessing some curative effect and strengthen the image and check the technological condition; Allocate multi-functionally and guard the appearance, can monitor electricity of heart, breathing, blood pressure, pulse, blood and oxygen saturation lever in the course of melting; Can rescue and recover the heart, lung, brain, there are essential first aid apparatus and medicineses such as oxygen passway, anaesthesia machine, defibrillating device, aspirator,etc..
In addition treatment technology of melting under the mirror, need mirror check and treat the apparatus possess, launch, possess the administrative system of picture and text of the medical image; Make and melt in the open surgery of the exhibition the treatment technology, need to possess the technical equipment that the image guides in surgery; Possess condition of operating room needed in tumour operation, such as anaesthetize and guard system, other corresponding instruments and apparatus,etc..
Zhongshan University attaches to the first hospital liver and gall surgical chief physician Lu MingDe to point out, compared with other third kind of medical technology, it is a relatively ripe technology that tumour melts. On one hand, melted technological development had already had a history of more than 20 years, the intensity approved by medical circle and patient is higher; On the other hand, this technical operation is uncomplicated, while making the standardard management, the threshold of the entry should be a bit lower, have reflected the characteristic of this kind of technology.
Unstandard behavior of strict control treatment
Though the threshold is not high, do not mean supervising and relaxing. Wei Wang point out because tumour melt technology to be simple and easy to do, so some technology have abuse, unstandard phenomenon. The related departments include it in the third kind of medical technology, show the attitude of strict control.
Wang Wei points out, if indication is chosen improperly, the doctor's technology does not pass, apparatus of hospital uncomplete, risk patient undertake open surgery to be even loud than tradition even. For example, there is high strength of the independent intellectual property right of our country that is focused on the supersound (HIFU) ,Though Chinese Medical Association made the concrete application guide as far back as 2005, but because lack the scientific regulatory ystem, even in all parts take the ordinary heating device to replace the phenomenon of HIFU.
Relevant experts point out, the radio frequency melts technology has certain indication, it is not any surgery that can all use it to replace, must depend on patient's concrete symptom. For example, a small hepatocarcinoma takes place on liver cirrhosis, obvious liver fiber liver, not under peritoneoscope lumps some excise,in spite of bleeding much greater than conventionally operation open in risk. As to this, expert emphasize as to the thing that suitable person who excises operation, want as first-selected with regular operation, it can be with appropriate achieving the target to part melting or condoning tumour load of decrease of treatment means a little not to fit for the person who excises surgery.
Lu MingDe says, in fact, the technological content that tumour melts is not low. In respects such as how to hold indication, pay attention to the function that the image leads and monitors, avoid happening and dealing carefully with complication correctly, do not for instance possess the corresponding condition, will lead to the fact that can not reach treatment, waste medical resources and increase complication.
Technology needs guidance to different types of areas
"Consider various means each have a characteristic, need to carry on the guidance to different types of areas. " Lu MingDe says, tumour melts and treats every technological means greatest difference to lie in the treating device, if radio frequency, microwave, the laser, supersound, high-frequency electricity are burnt, frozen therapentic instrument, or absolute alcohol, hot brine, hot distilled water are injected etc.. Though various in style, generality relatively strong on management expectancy, can interconnected system equal to guidance. To different characteristic of technology, need, treat with a certain discrimination, as to to select rule and indication that treat choose various technology, carry on the guidance to different types of areas.
Wang Wei points out, tumour melts to treat and need to set up therapeutic effect and appraising the system at present, should follow and melt the place different from surgery, serial indexes of totally deactivating according to tumour cells etc., to establish the system of appraising and third party's supervision system.
Wang Wei says, after the standardard management, expect too that the norm of clinical practice of different classes of this technology appears, to guide the concrete implementation of technology, promote and standardize the development of this technology.
|