Endoscopic biopsy ndiye gawo lofunikira kwambiri pakuwunika kwa endoscopic tsiku lililonse. Pafupifupi mayeso onse a endoscopic amafunika chithandizo chamankhwala pambuyo pa biopsy. Mwachitsanzo, ngati m'mimba thirakiti mucosa akuganiziridwa kuti kutupa, khansa, atrophy, matumbo metaplasia, ndi matenda HP, matenda chofunika kupereka yotsimikizika zotsatira.
Pakadali pano, njira zisanu ndi imodzi za biopsy zimachitika pafupipafupi ku China:
1. Kufufuza kwa Cytobrush
2. Tissue Biopsy
3. Njira yopangira ma tunnel biopsy
4. EMR ndi njira yochuluka ya biopsy
5. Njira yonse ya chotupa biopsy ESD
6. FNA yoyendetsedwa ndi Ultrasound
Lero tiyang'ana kwambiri pakuwunika kwa minofu, yomwe imadziwika kuti "clamping chidutswa cha nyama".
Biopsy pansi pa digestive endoscopy sichingachitike popanda biopsy forceps, yomwenso ndi imodzi mwazinthu zomwe zimagwiritsidwa ntchito kwambiri ndi aphunzitsi a unamwino a endoscopic. Aphunzitsi omwe amachita unamwino wa endoscopic angaganize kuti biopsy forceps ndiyosavuta kugwiritsa ntchito, yosavuta ngati kutsegula ndi kutseka. M'malo mwake, kuti agwiritse ntchito mphamvu za biopsy momveka bwino komanso mwangwiro, munthu ayenera kukhala ndi luntha komanso kugwira ntchito molimbika, komanso kukhala waluso pofotokoza mwachidule.
I.Choyamba, tiyeni tikambirane kamangidwe kabiopsy forceps:
(I) Mapangidwe a biopsy forceps (Chithunzi 1): Biopsy forceps imapangidwa ndi nsonga, thupi ndi chogwirira ntchito. Zida zambiri monga mphamvu zakunja zakunja, mphamvu zotentha za biopsy, lumo, ma curettes, ndi zina zambiri ndizofanana ndi kapangidwe ka biopsy forceps.
Langizo: Nsonga yake ili ndi nsagwada ziwiri zooneka ngati kapu zomwe zimatha kutsegulidwa ndi kutseka. Maonekedwe a nsagwada ndi chinsinsi cha ntchito zosiyanasiyana biopsy forceps. Atha kugawidwa pafupifupi mitundu isanu ndi iwiri: mtundu wotseguka umodzi, wotseguka kawiri, mtundu wazenera, mtundu wa singano, mtundu wa oval, mtundu wapakamwa pa ng'ona, ndi mtundu wopindika. Nsagwada za biopsy forceps zimapangidwa ndi chitsulo chosapanga dzimbiri ndipo zimakhala ndi masamba akuthwa. Ngakhale masamba a biopsy forceps omwe amatha kutaya nawonso ndi akuthwa, samatha kuvala bwino. Masamba a biopsy forceps ogwiritsidwanso ntchito amapangidwa mwapadera kuti akhale olimba.
Mitundu yodziwika bwino yabiopsy forceps
1.Standard mtundu ndi zenera
Pali zenera pakati pa kapu ya forceps, yomwe imachepetsa kwambiri kuwonongeka kwa minofu ndikuwonjezera kuchuluka kwa minofu ya biopsy.
2. Standard mtundu ndi zenera ndi singano
Singano ili pakatikati pa kapu ya forceps kuletsa biopsy kuti isadutse mucosa ndikuthandizira kugwira chitsanzo cha minofu.
3. Mtundu wa alligator
Kapu ya serrated clamp imalepheretsa kapu yochepetsera kutsetsereka, ndipo m'mphepete mwake ndi chakuthwa kuti mugwire motetezeka.
4. Mtundu wa ng'ombe wokhala ndi singano
Zibwano zili ndi ngodya yotsegula kuti iwonjezere voliyumu ya biopsy; m'mphepete mwa tsamba ndi lakuthwa kuti mugwire bwino.
Pali singano pakatikati pa mutu wa clamp, womwe ungapangitse kukonzako kukhala kothandiza komanso kolondola.
Oyenera biopsy pa minofu yolimba monga zotupa.
Thupi la Forceps: Thupi la biopsy forceps limapangidwa ndi chubu chachitsulo chosapanga dzimbiri, chomwe chimakhala ndi waya wachitsulo wokoka valavu ya forceps kuti atsegule ndi kutseka. Chifukwa cha kapangidwe kake ka ulusi chubu, minofu ntchofu, magazi ndi zinthu zina mosavuta kulowa izo, koma si zophweka kuyeretsa bwinobwino. Kulephera kuyeretsa bwino kungayambitse kusokoneza ntchito ya biopsy forceps, ndipo kutsegula ndi kutseka sikudzakhala kosalala kapena kosatheka kutsegula. Chogwirira ntchito: Mphete yomwe ili pa chogwirira chogwirira ntchito imagwiritsidwa ntchito kugwira chala chachikulu, ndipo poyambira mozungulira imagwiritsidwa ntchito kuyika chala chamlozera ndi chala chapakati. Pansi pa ntchito ya zala zitatuzi, mphamvuyi imatumizidwa ku valve ya forceps kupyolera mu waya wokoka kuti atsegule ndi kutseka.
(II) Mfundo zazikuluzikulu zogwiritsira ntchito mphamvu za biopsy: Chisamaliro chachikulu chiyenera kuchitidwa pa opaleshoni, kugwiritsa ntchito ndi kukonza mphamvu za biopsy, mwinamwake zidzakhudza kugwiritsa ntchito endoscope.
1. Kudziwiratu:
Musanagwiritse ntchito, onetsetsani kuti ma biopsy forceps atsekedwa ndikugwiritsidwa ntchito mkati mwanthawi yotseketsa. Musanalowetse njira ya endoscope forceps, kutsegula ndi kutseka kwa forceps kuyenera kuyesedwa (Chithunzi 2).
Chithunzi 2 Kuzindikira kwamphamvu kwa Biopsy
Njira yeniyeni ndiyo kukulunga thupi la biopsy forceps kukhala bwalo lalikulu (m'mimba mwake mwa bwaloli ndi pafupifupi 20cm), ndiyeno kuchitapo kanthu kotsegula ndi kutseka kangapo kuti muwone ngati mphamvuzo zikutseguka ndikutseka bwino. Ngati pali 1-2 nthawi zosasalala, ndibwino kuti musagwiritse ntchito biopsy forceps. Kachiwiri, m'pofunika kuyesa kutseka kwa biopsy forceps. Tengani kapepala kakang'ono ngati kapepala ka zilembo ndikumangirira ndi mphamvu za biopsy. Ndikoyenera ngati pepala lopyapyala silikugwa. Chachitatu, ndikofunikira kuyang'ana ngati makapu awiri a zipolopolozo ali ogwirizana kwathunthu (Chithunzi 3). Ngati pali kusamvetsetsana, siyani kugwiritsa ntchito nthawi yomweyo, apo ayi zidzakwapula chitoliro cha forceps.
Chithunzi 3 Biopsy forceps flap
Zizindikiro pa ntchito:
Musanalowetse chubu cha forceps, nsagwada ziyenera kutsekedwa, koma kumbukirani kuti musagwiritse ntchito mphamvu zambiri chifukwa choopa kutsekedwa kosalekeza, zomwe zingapangitse waya wokokera kutambasula ndikukhudza kutsegula ndi kutseka kwa nsagwada. 2. Mukalowetsa chubu, lowetsani motsatira njira yotsegulira chubu cha forceps ndipo musapakane ndi kutsegula kwa chubu. Ngati mukukumana ndi kukana mukalowa, muyenera kumasula batani la ngodya ndikuyesera kulowa molunjika mwachilengedwe. Ngati simungadutsebe, chotsani endoscope m'thupi kuti mukayesedwe, kapena m'malo mwake ndi zida zina za biopsy monga zitsanzo zing'onozing'ono. 3. Potulutsa mphamvu za biopsy, pewani kugwiritsa ntchito mphamvu zambiri. Wothandizirayo akuyenera kuigwira ndi manja onse awiri ndikuipinda. Osatambasula manja anu kwambiri. 4. Pamene nsagwada sizingatseke, musatulutse mokakamiza. Panthawiyi, iyenera kukankhidwira kunja kwa thupi pamodzi ndi endoscope kuti ipitirire kukonzanso.
II. Chidule cha njira zina za biopsy
1. Kutsegula ndi kutseka mphamvu za biopsy ndi ntchito zaukadaulo. Kutsegula kumafuna malangizo, makamaka chapamimba ngodya, amene ayenera perpendicular kwa biopsy malo. Kutseka kumafuna nthawi. Kuyenda kwa m'mimba ndi opaleshoni ya dokotalayo ndi yokhazikika ndipo sangathe kukhazikitsidwa mosalekeza. Wothandizirayo ayenera kugwiritsa ntchito mwayiwo kuti atseke mwamphamvu komanso mosamala ma biopsy forceps.
2. Chitsanzo cha biopsy chiyenera kukhala chachikulu mokwanira ndi chozama kuti chifike ku muscularis mucosa.
3. Ganizirani momwe magazi amakhudzira pambuyo pa biopsy pa biopsy yotsatira. Pamene chapamimba ngodya ndi antrum ayenera biopsies pa nthawi yomweyo, chapamimba ngodya ayenera biopsies poyamba ndiyeno antrum; pamene chotupa m'dera lalikulu ndi angapo minofu ayenera clamped, chidutswa choyamba ayenera kukhala yeniyeni, ndi m'pofunikanso kuganizira ngati magazi pambuyo clamping kuphimba zimakhala ozungulira ndi kukhudza munda wa masomphenya, apo ayi clamping wotsatira adzakhala akhungu ndi kungokhala chete.
Kalozera wamba wa biopsy wa zilonda zam'mimba, poganizira momwe magazi amayendera pama biopsies otsatirawa.
4. Yesetsani kupanga biopsy yowongoka pamalo omwe mukufuna, ndipo mugwiritseni ntchito kuyamwa ngati kuli kofunikira. Kuyamwa kumachepetsa kuthamanga kwa pamwamba pa mucosa, zomwe zimapangitsa kuti minofu ikhale yozama komanso kuti isagwere.
Biopsy iyenera kuchitidwa molunjika momwe mungathere, ndipo kutalika kwa mphamvu za biopsy kuyenera kupitirira 2CM.
5. Samalani ndi kusankha kwa zitsanzo za mitundu yosiyanasiyana ya zilonda; kusankhidwa kwa sampuli kumagwirizana ndi mlingo wabwino. Dokotalayo ali ndi diso lakuthwa ndipo ayeneranso kumvetsera luso la kusankha zipangizo.
Malo oyenera kukhala ndi biopsies Malo oti asamapangidwe
6. Ziwalo zomwe zimakhala zovuta ku biopsy zimaphatikizapo fundus ya m'mimba pafupi ndi cardia, kupindika pang'ono kwa chapamimba thupi pafupi ndi khoma lakumbuyo, ndi ngodya yapamwamba ya duodenum. Wothandizira ayenera kuyang'ana pa kugwirizana. Ngati akufuna kupeza zotsatira zabwino, ayenera kuphunzira kukonzekera pasadakhale ndikusintha komwe akuwongolera chotchingira nthawi iliyonse. Panthaŵi imodzimodziyo, ayenera kuweruza mwamsanga nthaŵi yokhotakhota mwa kugwiritsira ntchito mpata uliwonse. Nthawi zina podikirira malangizo kuchokera kwa dokotala, kuchedwa kwa 1 sekondi kungayambitse mwayi wophonya. Ndingodikirira moleza mtima mwayi wotsatira.
Mivi imasonyeza malo omwe zimakhala zovuta kupeza zinthu kapena kusiya kutuluka magazi.
7. Kusankha mphamvu za biopsy: Mphamvu za Biopsy zikuphatikizapo zokhala ndi makapu akuluakulu otseguka ndi zakuya, zina zokhala ndi singano zoyikapo, ndi zina zotsegula m'mbali ndi zoluma.
8. Makulitsidwe pamodzi ndi madontho pakompyuta kutsogolera biopsy ndi yolondola kwambiri, makamaka zitsanzo kummero mucosa.
Ife, Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., ndi opanga ku China okhazikika pazakudya zama endoscopic, mongabiopsy forceps, hemoclip, polyp msampha, sclerotherapy singano, kupopera catheter, maburashi a cytology, guidewire, dengu lochotsa miyala, nasal biliary drainage catheter etc. zomwe zimagwiritsidwa ntchito kwambiri muEMR, ESD, ERCP. Zogulitsa zathu ndi zovomerezeka za CE, ndipo mbewu zathu ndi zovomerezeka za ISO. Katundu wathu watumizidwa ku Europe, North America, Middle East ndi gawo la Asia, ndipo amapeza makasitomala ambiri kuzindikira ndi kutamandidwa!
Nthawi yotumiza: Jan-23-2025