Madokotala aku Latin America akusangalala kutiERCPyalowa mu nthawi yatsopano ya opaleshoni ya robotic ndipo ikufalitsa nkhaniyi kutali ndi kulikonse.
Posachedwapa, pa zokambirana zanga ndi madokotala ku Latin America, ndinatchula zaERCPRoboti yochita opaleshoni yochokera ku Ausway Endoscopy, yomwe pakadali pano ikuyesedwa kuchipatala. Ataphunzira kuti makinawa amatha kuchita opaleshoni pogwiritsa ntchito robotiERCP, kulamulira patali endoscope yosinthasintha ndi zida pogwiritsa ntchito mkono wa robotic kuti amalize njira monga kuyika stent ya biliary popanda kuvala ma apron a lead komanso chifukwa cha kuchepa kwa mphamvu ya radiation, mlengalenga nthawi yomweyo unakhala wamagetsi. Madokotala ambiri anali okondwa kwambiri moti anali kufalitsa nkhaniyi.
Mu nthawi yanga yopuma, ndimadzifunsa kuti: n’chifukwa chiyani anali okondwa kwambiri?
Ndi funso ili m'maganizo, ndinabwerezanso mabuku ndi deta yoyenera, ndipo pamene ndimawerenga kwambiri, ndi pamene zinamveka bwino—ERCPMaloboti opangira opaleshoni ndi mphatso yabwino kwa akatswiri a endoscopist, ngakhale ukadaulo wosintha moyo.
Pansipa, ndikufuna kugawana nanu: Wopha Chete mu Endoscopy: Vuto la Radiation Loyandikira Kuposa Momwe Mumaganizira! Aliyense AkuchitaERCPMuyenera Kuwerenga Izi
Chinthu chomwe sichimasamalidwa mosavuta m'chipinda chochitira opaleshoni si mavuto, koma kuwala komwe kukuwunjikana pang'onopang'ono.
Akatswiri ambiri a endoscopist amadziwa zimenezoERCPimagwiritsa ntchito fluoroscopy, koma mwina simungadziwe—Njira imeneyi yalembedwa ndi FDA ngati njira yowunikira yomwe ingawononge kwambiri kuwala kwa dzuwa.”
Tili otanganidwa kuchiza miyala ya m'mimba ndi zopinga za m'mimba, koma nthawi zambiri timanyalanyaza chinthu choopsa kwambiri:
Mphamvu ya radiation ikuvulaza odwala pang'onopang'ono, ndipo ikuvulaza aliyense amene wayima pafupi ndi mkono wa C.
Lero, m'njira yosavuta kumva, ndifotokoza malangizo apadziko lonse lapansi ndi deta yeniyeni yofufuza:
Kodi mumakumana ndi zinthu zotani kwenikweni? Ndi zizolowezi ziti zomwe “zikuba” thanzi lanu? Kodi mungatani kuti mukhale otetezeka?
I. Chifukwa chiyaniERCPKodi njira yochizira matenda a radiation imaonedwa kuti ndi yoopsa kwambiri?
ChifukwaERCPimakwaniritsa zofunikira zonse kuti munthu azitha kumwa mankhwala ambiri
● Amafunika fluoroscopy
● Njira zovuta
● Pafupi ndi dokotala
● Nthawi yayitali
● Njira zobwerezabwereza
Kodi ziwerengero zenizeni n’zoopsa bwanji?
Mlingo wa radiation wa chimodziERCPNjirayi ndi yofanana ndi ma X-ray 312 pachifuwa (avereji).
—Kafukufuku wochokera kwaERCPpulojekiti yoyezera kuwala kwa dzuwa ku Uruguay
Chofunika kwambiri: Mumapeza makumi ambiri, mazana, kapena kuposerapo pachaka.
II. Kodi zotsatira za radiation pa inu ndi ziti?
Kuwonongeka kwa radiation kumagawidwa m'magulu awiri:
1) Kuwonongeka kotsimikizika (kudzachitika ngati mlingowo ndi wokwanira)
● Kufiira kwa khungu
● Tsitsi limataya
● Kuchotsa chilema
● Zilonda
● Matenda a m'maso (omwe nthawi zambiri amakhala ndi poizoni wambiri)
Lenzi ndi imodzi mwa ziwalo zofooka kwambiri, ndipo ICRP yachepetsa malire kufika pa 20 mSv/chaka.
AmbiriERCPAkatswiri omwe agwira ntchito kwa zaka zoposa khumi akumana kale ndi vuto la kutseguka kwa ma lens.
2) Kuwonongeka mwachisawawa (kuwonongeka koyembekezereka)
Palibe malire.
Mlingo wochuluka ukachuluka, chiopsezo chimakhala chachikulu.
Chiyerekezo cha ICRP: 1 mSv = kuwonjezeka kwa 0.005% pachiwopsezo cha khansa kwa moyo wonse.ERCP≈ 6 mSv → Kuwonjezeka kwa chiopsezo ndi 0.03%.
Simukuchita "kamodzi".
Mukuchita izi kambirimbiri pachaka, nthawi zikwizikwi m'moyo wanu.
III. Malo oopsa kwambiri muERCPChipinda ndi komwe mumayima tsiku lililonse.
Mwachidule: Pamene chubu cha X-ray chili pafupi, mlingo wake umakwera.
Malo omwe anthu amakumana ndi zoopsa kwambiri ndi awa:
● Mbali imodzi ya chubu cha X-ray cha mkono wa C
● Panthawi yojambula chithunzi cha ngodya yopingasa
● Malo ozungulira wodwala (gwero lalikulu la ma radiation omwazikana)
● Malo omwe madokotala ogonetsa ndi anamwino amagwirira ntchito
Anthu ambiri sadziwa zimenezo: Malo omwe ali ndi malo omwe amakhudzidwa kwambiri ndi kuwala kwa dzuwa.
IV. Kafukufuku Weniweni: 90% ya Ogwira Ntchito Zachipatala Sanatenge Njira Zoyenera Zodzitetezera
Zotsatira za kafukufuku wa Sociedad Interamericana de Endoscopía Digestiva (SIED) ndizodabwitsa kwambiri:
● Madokotala 22% okha ndi omwe aphunzitsidwa za chitetezo cha poizoni.
● Anamwino 17% okha ndi omwe aphunzitsidwa.
● Kupatula ma aproni a lead, kuchuluka kwa zida zina zodzitetezera komwe kumagwiritsidwa ntchito n'kotsika kwambiri.
Kodi mumadziona kuti ndinu “otetezeka”? Zoona zake n’zakuti: Anthu ambiri akuthamanga amaliseche.
V. Mfundo ya ALARA: Malamulo 3 Amene Aliyense Ayenera Kutsatira
ALARA = Yotsika Kwambiri Yotheka Kukwaniritsa
1. Nthawi: Yaifupi momwe ingathere.
● Kuyeza kwa pulse fluoroscopy
● Gwiritsani ntchito “Frozen Last Frame”
● Pewani fluoroscopy yosalekeza
2. Kutalikirana: Kutalikirana kumakhala bwino. Mukabwerera mmbuyo, mlingo → umakhala 1/4 ya woyamba.
3. Kuteteza: Kutseka momwe mungathere.
● Epuloni yopangidwa ndi lead (≥0.35 mmPb)
● Chitetezo cha chithokomiro
● Magalasi a lead (opewera matenda a cataract)
● Makatani a lead
● Zophimba zopachikidwa
Katani yopangidwa ndi lead imatha kuchepetsa kuwala kwa dzuwa kofalikira ndi zoposa 95%.
VI. Kodi zoopsa zenizeni kwa odwala zili kuti?
BMI yapamwamba, yobwerezedwaERCP, mlingo wosiyana kwambiri, nthawi yayitali yochitira opaleshoni. Zonsezi zingayambitse kuchulukana kwa mlingo wa khungu mwa odwala.
Chisamaliro chapadera:
● Akazi
● Azimayi oyembekezera
● Ana (kukhudzidwa ndi kutentha × 3–5)
● Kuwala mobwerezabwereza kwa dera lomwelo
Odwala awa ayenera kumwa mankhwala ochepa okha.
VII. Azimayi ndi Ana Oyembekezera: Magulu Omwe Ali Pangozi Kwambiri Omwe Ayenera Kukambidwa Payokha.
ERCPMfundo Zofunika kwa Azimayi Oyembekezera
● Kodi “ndizofunikiradi”?
● Kodi ikhoza kuchedwetsedwa?
● Kodi imachitidwa ndi dokotala wodziwa bwino ntchito yake?
● Kodi nthawi yogwiritsira ntchito fluoroscopy imachepetsedwa kwambiri?
● Nthawi yoopsa kwambiri ya mimba (masabata 10–25).
ERCPmfundo za ana
● Kumva bwino kwambiri kwa mankhwala.
● Kuwongolera kuwala kolimba ndi kusinthasintha kwa kuwala ndikofunikira.
● Ogwira ntchito odziwa bwino ntchito okha ndi omwe amaloledwa.
VIII. Zinthu zisanu ndi katswiri weniweniERCPchipinda chiyenera kuchita izi:
1. Dongosolo la dosimeter iwiri (yachizolowezi): Limodzi kunja kwa epuloni ya lead, lina mkati.
2. Khazikitsani DRL (Diagnostic Reference Level): DRL yaposachedwa ku Japan: 32 Gy·cm² (75th percentile).
3. Yang'anani ma aproni a lead chaka chilichonse (mudzadabwa ndi kuchuluka kwawo kosweka).
4. Kupatsa odwala mapepala odziwitsa za ma radiation (machitidwe odziwika bwino m'madipatimenti oyendetsedwa bwino).
5. Tsatirani odwala omwe ali ndi mlingo waukulu kwa milungu iwiri mpaka inayi (kuwonongeka kwa khungu kungachedwe).
Pomaliza: Kudziteteza ndiyo njira yokhayo yotetezera odwala ambiri.
Kuwala komwe mumakumana nako ndi: kosaoneka, kosapweteka, ndipo sikumayambitsa kufiira, simukumva nthawi yomweyo, koma kumakusonkhanitsani ndikukupwetekani tsiku lililonse.
Phunzirani chitetezo choyenera kuti muthe:
● Gwirani ntchito nthawi yayitali
● Gwirani ntchito mosamala kwambiri
● Gwirani ntchito bwino
● Gwirani ntchito mwaukadaulo
Mulole aliyenseERCPdokotala akhale pansi pa kuwala, koma musavulale nako.
ERCPMndandanda wa zinthu zogulitsa zotentha kuchokera ku ZRHmed.
Ife, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ndi opanga ku China omwe amagwira ntchito kwambiri pazinthu zogwiritsidwa ntchito m'ma endoscopic, kuphatikizapo mzere wa GI monga biopsy forceps, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes,waya wotsogolera, dengu lotengera miyala, cathete yotulutsira madzi m'mphuno ndi zina zotero. zomwe zimagwiritsidwa ntchito kwambiri mu EMR, ESD,ERCPZogulitsa zathu zili ndi satifiketi ya CE ndipo zili ndi chilolezo cha FDA 510K, ndipo mafakitale athu ali ndi satifiketi ya ISO. Katundu wathu watumizidwa ku Europe, North America, Middle East ndi mbali ina ya Asia, ndipo makasitomala ambiri amalandira ulemu ndi kutamandidwa!
Nthawi yotumizira: Januwale-13-2026