Kuyezetsa magazi m'mimba (endoscopic biopsy) ndi gawo lofunika kwambiri pa kuyezetsa magazi tsiku ndi tsiku. Pafupifupi mayeso onse a endoscopic amafunika thandizo la matenda pambuyo pa kuyezetsa magazi. Mwachitsanzo, ngati mucosa ya m'mimba ikuganiziridwa kuti ili ndi kutupa, khansa, kufooka, metaplasia ya m'mimba, ndi matenda a HP, matenda amafunika kuti apereke zotsatira zenizeni.
Pakadali pano, njira zisanu ndi chimodzi zoyezera magazi (biopsy) zimachitika nthawi zonse ku China:
1. Kuyesa Cytobrush
2. Kufufuza Minofu
3. Njira yofufuzira matenda a ngalande
4. EMR yokhala ndi njira yofufuzira zambiri
5. Njira yodziwira matenda a chotupa chonse ESD
6. FNA yotsogozedwa ndi ultrasound
Lero tikambirana kwambiri za biopsy ya minofu, yomwe imadziwika kuti "kumanga chidutswa cha nyama".
Kuyeza magazi pogwiritsa ntchito endoscopy ya m'mimba sikungatheke popanda kugwiritsa ntchito forceps ya biopsy, yomwe ndi imodzi mwazowonjezera zomwe aphunzitsi a unamwino amagwiritsa ntchito. Aphunzitsi omwe amagwira ntchito yophunzitsa unamwino pogwiritsa ntchito endoscopic angaganize kuti forceps ya biopsy ndi yosavuta kugwiritsa ntchito, yosavuta monga kutsegula ndi kutseka. Ndipotu, kuti munthu agwiritse ntchito forceps ya biopsy bwino komanso mwangwiro, ayenera kukhala ndi chidziwitso ndi khama, komanso kukhala waluso pofotokoza mwachidule.
I.Choyamba, tiyeni tiwonenso kapangidwe kamphamvu ya biopsy:
(I) Kapangidwe ka forceps ya biopsy (Chithunzi 1): forceps ya biopsy imapangidwa ndi nsonga, thupi ndi chogwirira ntchito. Zowonjezera zambiri monga forceps ya thupi lachilendo, forceps ya biopsy yotentha, lumo, ma curette, ndi zina zotero zimafanana ndi kapangidwe ka forceps ya biopsy.
Langizo: Nsonga yake imapangidwa ndi nsagwada ziwiri zooneka ngati chikho zomwe zimatha kutsegulidwa ndi kutsekedwa. Kapangidwe ka nsagwada ndiye chinsinsi cha ntchito ya ma forceps osiyanasiyana a biopsy. Zitha kugawidwa m'magulu asanu ndi awiri: mtundu wotseguka kamodzi, mtundu wotseguka kawiri, mtundu wa zenera, mtundu wa singano, mtundu wa oval, mtundu wa pakamwa pa ng'ona, ndi mtundu wopindika wa nsonga. Nsagwada za ma forceps a biopsy zimapangidwa ndi chitsulo chosapanga dzimbiri ndipo zimakhala ndi masamba akuthwa. Ngakhale kuti masamba a ma forceps a biopsy omwe amatayidwa nawonso ndi akuthwa, satha kusweka bwino. Masamba a ma forceps a biopsy omwe angagwiritsidwenso ntchito amakonzedwa makamaka pamwamba kuti akhale olimba kwambiri.
Mitundu yodziwika bwino yamphamvu ya biopsy
1. Mtundu wokhazikika wokhala ndi zenera
Pakati pa chikho cha forceps pali zenera, lomwe limachepetsa kwambiri kuwonongeka kwa minofu ndikuwonjezera kuchuluka kwa minofu ya biopsy.
2. Mtundu wamba wokhala ndi zenera ndi singano
Singano ili pakati pa kapu ya forceps kuti iteteze kuti biopsy isalowe mu mucosa ndikuthandizira kugwira chitsanzo cha minofu.
3. Mtundu wa ngwenya
Chikho cholumikizira mano chomwe chili ndi mano chimateteza bwino chikho cholumikizira mano kuti chisaterereke, ndipo m'mphepete mwake ndi wakuthwa kuti chigwire bwino.
4. Mtundu wa ngwenya wokhala ndi singano
Nsagwada zili ndi ngodya yotseguka kwambiri kuti ziwonjezere kuchuluka kwa biopsy; m'mphepete mwa tsamba ndi wakuthwa kuti ligwire bwino.
Pali singano pakati pa mutu wa chogwirira, yomwe ingathandize kuti chogwiriracho chikhale chogwira ntchito bwino komanso cholondola.
Yoyenera kuchitidwa biopsy pa minofu yolimba monga zotupa.
Thupi la Forceps: Thupi la biopsy forceps limapangidwa ndi chubu chosapanga dzimbiri chopangidwa ndi ulusi, chomwe chili ndi waya wachitsulo wokokera valavu ya forceps kuti itsegule ndi kutseka. Chifukwa cha kapangidwe kake kapadera ka chubu chopangidwa ndi ulusi, mamina a minofu, magazi ndi zinthu zina zimatha kulowa mosavuta, koma sizophweka kuyeretsa bwino. Kulephera kuyeretsa bwino kumabweretsa zovuta pakugwira ntchito kwa biopsy forceps, ndipo kutsegula ndi kutseka sikudzakhala kosalala kapena kosatheka kutsegula. Chogwirira chogwirira: Mphete yomwe ili pa chogwirira chogwirira imagwiritsidwa ntchito kugwira chala chachikulu, ndipo mpata waukulu wozungulira umagwiritsidwa ntchito kuyika chala cham'tsogolo ndi chala chapakati. Pogwiritsa ntchito zala zitatuzi, mphamvuyo imatumizidwa ku valavu ya forceps kudzera mu waya wokokera kuti itsegule ndi kutseka.
(II) Mfundo zazikulu zogwiritsira ntchito biopsy forceps: Kusamala kwambiri kuyenera kuchitidwa pakugwiritsa ntchito, kugwiritsa ntchito, ndi kusamalira biopsy forceps, apo ayi zingakhudze kugwiritsa ntchito endoscope.
1. Kuzindikira pasadakhale:
Musanagwiritse ntchito, onetsetsani kuti forceps ya biopsy yatsukidwa bwino ndipo yagwiritsidwa ntchito mkati mwa nthawi yoyenera yotsukidwa bwino. Musanaike njira ya endoscope forceps, muyenera kuyesa kutsegula ndi kutseka kwa forceps (Chithunzi 2).
Chithunzi 2 Kuzindikira mphamvu za biopsy
Njira yeniyeni ndiyo kukulunga thupi la biopsy forceps kukhala bwalo lalikulu (m'mimba mwake mwa bwalo ndi pafupifupi 20cm), kenako kuchita zinthu zingapo zotsegula ndi kutseka kuti muwone ngati ma forceps flaps akutseguka ndi kutseka bwino. Ngati pali kusasalala ka 1-2, ndibwino kuti musagwiritse ntchito biopsy forceps. Kachiwiri, ndikofunikira kuyesa kutsekedwa kwa biopsy forceps. Tengani pepala lopyapyala monga pepala lolembera ndikuliyika ndi biopsy forceps. Limayesedwa ngati pepala lopyapyala silikugwa. Kachitatu, ndikofunikira kuwona ngati makapu awiri a ma forceps flaps ali olunjika kwathunthu (Chithunzi 3). Ngati pali kusalingana bwino, siyani kugwiritsa ntchito nthawi yomweyo, apo ayi idzakanda chitoliro cha forceps.
Chithunzi 3: Chivundikiro cha Biopsy forceps
Malangizo pa nthawi yogwira ntchito:
Musanalowetse chubu cha forceps, nsagwada ziyenera kutsekedwa, koma kumbukirani kuti musagwiritse ntchito mphamvu zambiri poopa kutsekedwa kosasunthika, komwe kungapangitse waya wokokera kutambasulidwa ndikukhudza kutsegula ndi kutseka kwa nsagwada. 2. Mukalowetsa chubu, lowani motsatira njira yotsegulira chubu cha forceps ndipo musamakhudze kutsegula kwa chubu. Ngati mukukumana ndi kukana mukalowa, muyenera kumasula batani la ngodya ndikuyesera kulowa molunjika mwachibadwa. Ngati simungathebe kudutsa, chotsani endoscope m'thupi kuti muyesedwe, kapena muyisinthe ndi forceps zina za biopsy monga zitsanzo zazing'ono. 3. Mukatulutsa forceps za biopsy, pewani kugwiritsa ntchito mphamvu zambiri. Wothandizira ayenera kuigwira ndi manja onse awiri kenako n’kuipinda. Musatambasule manja anu kwambiri. 4. Ngati nsagwada sizingatsekedwe, musazichotse mwamphamvu. Panthawiyi, ziyenera kukankhidwa kunja kwa thupi pamodzi ndi endoscope kuti zikonzedwenso.
II. Chidule cha njira zina zofufuzira za biopsy
1. Kutsegula ndi kutseka mphamvu ya biopsy ndi ntchito zaukadaulo. Kutsegula kumafuna njira, makamaka ngodya ya m'mimba, yomwe iyenera kukhala yolunjika pamalo a biopsy. Kutseka kumafuna nthawi. Kuyenda kwa m'mimba ndi opaleshoni ya dokotala ndizokhazikika ndipo sizingakonzedwe nthawi zonse. Wothandizira ayenera kugwiritsa ntchito mwayiwu kuti amange mphamvu ya biopsy moyenera komanso mosamala.
2. Chitsanzo cha biopsy chiyenera kukhala chachikulu mokwanira komanso chakuya mokwanira kuti chifike ku mucosa wa minofu.
3. Ganizirani momwe kutuluka magazi pambuyo pa biopsy kumakhudzira biopsy yotsatira. Pamene ngodya ya m'mimba ndi antrum ziyenera kuchitidwa biopsy nthawi imodzi, ngodya ya m'mimba iyenera kuchitidwa biopsy kaye kenako antrum; pamene malo otupa ndi akulu ndipo zidutswa zingapo za minofu ziyenera kuikidwa, chidutswa choyamba chiyenera kukhala cholondola, ndipo ndikofunikiranso kuganizira ngati kutuluka magazi pambuyo pa clamping kudzaphimba minofu yozungulira ndikukhudza gawo la masomphenya, apo ayi clamping yotsatira idzakhala yopanda maso komanso yopanda kanthu.
Njira yodziwika bwino yodziwira matenda omwe ali pangodya ya m'mimba, poganizira momwe magazi amayendera pa biopsy yotsatira.
4. Yesetsani kuchita biopsy yoyimirira pamalo omwe mukufuna, ndipo gwiritsani ntchito kuyamwa ngati pakufunika kutero. Kuyamwa kumachepetsa mphamvu ya pamwamba pa mucosa, zomwe zimathandiza kuti minofu ikhale yolimba kwambiri komanso kuti isaterereke mosavuta.
Biopsy iyenera kuchitidwa molunjika momwe zingathere, ndipo kutalika kwa biopsy forceps sikuyenera kupitirira 2CM.
5. Samalani kusankha malo operekera zitsanzo za mitundu yosiyanasiyana ya zilonda; kusankha malo operekera zitsanzo kumagwirizana ndi kuchuluka kwa positive. Dokotala wa opaleshoni ali ndi diso lakuthwa ndipo ayeneranso kusamala ndi luso losankha zipangizo.
Malo oti afotokozedwe mbiri ya thupi Malo oti afotokozedwe mbiri ya thupi
6. Zigawo zomwe zimakhala zovuta kuzifufuza ndi monga fundus ya m'mimba pafupi ndi cardia, kupindika kochepa kwa thupi la m'mimba pafupi ndi khoma lakumbuyo, ndi ngodya yapamwamba ya duodenum. Wothandizira ayenera kuyang'ana kwambiri pakugwirizana. Ngati akufuna kupeza zotsatira zabwino, ayenera kuphunzira kukonzekera pasadakhale ndikusintha momwe clamp flap imayendera nthawi iliyonse. Nthawi yomweyo, ayenera kuweruza mwachangu nthawi yogwirira ntchito pogwiritsa ntchito mwayi uliwonse. Nthawi zina poyembekezera malangizo kuchokera kwa dokotala wa opaleshoni, kuchedwa kwa sekondi imodzi kungayambitse kuphonya mwayi. Ndingoyembekezera moleza mtima mwayi wotsatira.
Mivi imasonyeza malo omwe zimakhala zovuta kupeza zinthu kapena kuletsa kutuluka kwa magazi.
7. Kusankha njira zoyezera magazi: Njira zoyezera magazi zimaphatikizapo zomwe zili ndi mabowo akuluakulu a chikho ndi akuya, zina zokhala ndi singano zoyikira, ndipo zina zokhala ndi mabowo a m'mbali ndi kuluma kokhala ndi mano.
8. Kukulitsa pamodzi ndi utoto wamagetsi kuti utsogolere biopsy ndikolondola kwambiri, makamaka poyesa mucosa wa m'mero.
Ife, Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., ndi opanga ku China omwe amagwira ntchito kwambiri pazinthu zogwiritsidwa ntchito m'ma endoscopic, mongamphamvu ya biopsy, hemoclip, msampha wa polyp, singano ya sclerotherapy, katheta wopopera, maburashi a cytology, waya wotsogolera, dengu lotengera miyala, katheta wa mphuno ya ndulu ndi zina zoterozomwe zimagwiritsidwa ntchito kwambiri muEMR, ESD, ERCPZogulitsa zathu zili ndi satifiketi ya CE, 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-23-2025