Khansara ya m'mimba ndi imodzi mwa zotupa zowopsa zomwe zimayika moyo wa munthu pachiwopsezo. Pali milandu yatsopano 1.09 miliyoni padziko lonse lapansi chaka chilichonse, ndipo chiwerengero cha milandu yatsopano mdziko langa ndi chokwera mpaka 410,000. Izi zikutanthauza kuti, pafupifupi anthu 1,300 m'dziko lathu amadwala khansa ya m'mimba tsiku lililonse.
Kupulumuka kwa odwala khansa ya m'mimba kumagwirizana kwambiri ndi kukula kwa khansa ya m'mimba. Kuchiza kwa khansa yoyambirira ya m'mimba kumatha kufika 90%, kapena kuchiritsidwa kwathunthu. Kuchiza kwa khansa yapakatikati ya m'mimba ndi pakati pa 60% ndi 70%, pomwe machiritso a khansa yapamwamba ya m'mimba ndi 30% yokha. kuzungulira, kotero kuti khansa ya m'mimba yoyambirira inapezeka. Ndipo chithandizo chamankhwala msanga ndicho chinsinsi chochepetsera kufa kwa khansa ya m’mimba. Mwamwayi, ndi kusintha kwaukadaulo wa endoscopic m'zaka zaposachedwa, kuyezetsa koyambirira kwa khansa ya m'mimba kwakhala kukuchitika m'dziko langa, zomwe zathandizira kwambiri kuzindikira kwa khansa yoyambirira ya m'mimba;
Kotero, kodi khansa ya m'mimba yoyambirira ndi chiyani? Kodi kudziwa oyambirira chapamimba khansa? Kodi kuchitira izo?
1 Lingaliro la khansa yoyambirira ya m'mimba
Kachipatala, khansa ya m'mimba yoyambirira imanena za khansa ya m'mimba yokhala ndi zotupa zoyamba, zotupa zochepa ndipo palibe zizindikiro zowonekera. Khansara yoyambirira ya m'mimba imapezeka makamaka ndi gastroscopic biopsy pathology. Pathologically, khansa ya m'mimba yoyambirira imatanthawuza maselo a khansa omwe amangokhala mucosa ndi submucosa, ndipo ziribe kanthu kuti chotupacho ndi chachikulu bwanji komanso ngati pali metastasis ya lymph node, ndi ya khansa yoyambirira ya m'mimba. M'zaka zaposachedwa, dysplasia yoopsa komanso intraepithelial neoplasia yapamwamba imatchedwanso khansa yoyambirira ya m'mimba.
Malinga ndi kukula kwa chotupacho, khansa ya m'mimba yoyambirira imagawidwa kukhala: khansa yaing'ono yam'mimba: m'mimba mwake ya khansa ya foci ndi 6-10 mm. Khansa yaying'ono yam'mimba: Kutalika kwa chotupa foci ndikochepera kapena kofanana ndi 5 mm. Punctate carcinoma: The gastric mucosa biopsy ndi khansa, koma palibe minofu ya khansa yomwe ingapezeke mndandanda wa zitsanzo za opaleshoni.
Endoscopically, khansa yoyambirira ya m'mimba imagawidwanso kukhala: mtundu (mtundu wa polypoid): omwe ali ndi chotupa chotuluka pafupifupi 5 mm kapena kupitilira apo. Type II (mtundu wapamwamba): Chotupacho chimakwezedwa kapena kupsinjika mkati mwa 5 mm. Type III (mtundu wa chilonda): Kuzama kwa kupsinjika kwa khansa kupitirira 5 mm, koma sikudutsa submucosa.
2 Kodi zizindikiro zoyambirira za khansa ya m'mimba ndi ziti
Ambiri oyambirira khansa ya m'mimba alibe zizindikiro zapadera, ndiko kunena kuti, zizindikiro zoyambirira za khansa ya m'mimba palibe zizindikiro. network
Zomwe zimatchedwa zizindikiro zoyambirira za khansa ya m'mimba zomwe zikuyenda pa intaneti sizizindikiro zoyambirira. Kaya ndi dokotala kapena munthu wolemekezeka, ndizovuta kuweruza kuchokera ku zizindikiro ndi zizindikiro. Anthu ena akhoza kukhala ndi zizindikiro zina zomwe sizinali zenizeni, makamaka kusadya bwino, monga kupweteka kwa m'mimba, kutupa, kukhuta msanga, kusowa chilakolako cha kudya, kutsekemera kwa asidi, kutentha pamtima, belching, hiccups, ndi zina zotero. Zizindikirozi ndizofanana kwambiri ndi mavuto a m'mimba, choncho nthawi zambiri sizikopa chidwi cha anthu. Choncho, kwa anthu opitirira zaka 40, ngati ali ndi zizindikiro zoonekeratu za kudzimbidwa, ayenera kupita kuchipatala kuti akalandire chithandizo chamankhwala panthawi yake, ndikuchita gastroscopy ngati kuli kofunikira, kuti musaphonye nthawi yabwino yodziwira khansa ya m'mimba.
3 Momwe mungadziwire khansa yapamimba yoyambirira
M'zaka zaposachedwa, akatswiri azachipatala m'dziko lathu, kuphatikizapo momwe zinthu zilili m'dziko lathu, apanga "Akatswiri a Njira Yowunikira Khansa ya M'mimba ku China".
Idzathandiza kwambiri pakuwongolera kuchuluka kwa matenda komanso kuchiritsa khansa yoyambirira ya m'mimba.
Kuyezetsa koyambirira kwa khansa ya m'mimba makamaka makamaka kwa odwala omwe ali pachiopsezo chachikulu, monga odwala matenda a Helicobacter pylori, odwala omwe ali ndi mbiri ya khansa ya m'mimba, odwala zaka 35, osuta fodya kwa nthawi yaitali, komanso amakonda zakudya zokazinga.
Njira yowunikira kwambiri ndiyo kudziwa kuchuluka kwa anthu omwe ali pachiwopsezo chachikulu cha khansa ya m'mimba kudzera pakuwunika kwa serological, ndiko kuti, kudzera m'mimba komanso kuzindikira kwa antibody ya Helicobacter pylori. Kenako, magulu omwe ali pachiwopsezo chachikulu omwe amapezeka pakuwunika koyambirira amawunikiridwa mosamalitsa ndi gastroscope, ndipo kuyang'ana kwa zilonda kumatha kupangidwa mokulirapo mwa kukulitsa, kuwononga, biopsy, ndi zina zambiri, kuti adziwe ngati zilondazo zili ndi khansa komanso ngati zitha kuthandizidwa ndi maikulosikopu.
Zachidziwikire, ndi njira yabwinoko yodziwira khansa yapamimba yoyambilira mwa kuphatikiza endoscopy ya m'mimba muzoyeserera zanthawi zonse mwa anthu athanzi kudzera pakuwunika thupi.
4 Kodi mayeso a gastric function ndi njira yowunikira khansa ya m'mimba ndi chiyani
Kuyezetsa kwa m'mimba ndiko kupeza chiŵerengero cha pepsinogen 1 (PGI), pepsinogen (PGl1, ndi protease) mu seramu.
(PGR, PGI/PGII) gastrin 17 (G-17) okhutira, ndi kansa ya m'mimba kuyezetsa scoring dongosolo zimachokera pa zotsatira za chapamimba ntchito kuyezetsa, pamodzi ndi zambiri zambiri monga Helicobacter pylori antibody, zaka ndi jenda, kuweruza Njira ya chiopsezo khansa ya m'mimba, kupyolera mu m'mimba dongosolo la m'mimba ndi magulu a khansa ya m'mimba akhoza kuyang'anitsitsa khansa ya m'mimba ya m'mimba.
Endoscopy ndi kutsata zidzachitidwa kwa magulu apakati komanso omwe ali pachiwopsezo chachikulu. Magulu omwe ali pachiwopsezo chachikulu adzayang'aniridwa kamodzi pachaka, ndipo magulu omwe ali pachiwopsezo chapakati adzayang'aniridwa kamodzi pazaka 2 zilizonse. Kupezeka kwenikweni ndi khansa yoyambirira, yomwe imatha kuthandizidwa ndi opaleshoni ya endoscopic. Izi sizingangowonjezera kuzindikira koyambirira kwa khansa ya m'mimba, komanso kuchepetsa zosafunika endoscopy m'magulu otsika chiopsezo.
5 Kodi Gastroscopy ndi chiyani
Kunena mwachidule, gastroscopy ndi kupanga endoscopic morphological kusanthula kwa zotupa zokayikitsa zomwe zimapezeka nthawi yomweyo monga gastroscopy yachizolowezi, kuphatikizapo endoscopy yoyera yoyera, chromoendoscopy, kukulitsa endoscopy, confocal endoscopy ndi njira zina. Chotupacho chimatsimikiziridwa kukhala chosaopsa kapena chokaikitsa chifukwa cha zilonda, ndiyeno biopsy ya chotupa chomwe amaganiziridwa kuti ndi chowopsa chimachitidwa, ndipo matenda omaliza amapangidwa ndi matenda. Kuti mudziwe ngati pali zotupa za khansa, kuchuluka kwa khansa yomwe imalowa m'mbali, kuya kwa kulowetsedwa kolowera, kuchuluka kwa kusiyana, komanso ngati pali zizindikiro za chithandizo chochepa kwambiri.
Poyerekeza ndi gastroscopy wamba, kuyezetsa kwa gastroscopic kuyenera kuchitidwa pansi pamikhalidwe yopanda ululu, kulola odwala kuti apumule kwathunthu pakugona kwakanthawi komanso kuchita gastroscopy mosamala. Gastroscopy ili ndi zofunika kwambiri kwa ogwira ntchito. Iyenera kuphunzitsidwa kuzindikira za khansa yoyambirira, ndipo akatswiri odziwa bwino za endoscopic amatha kuyeza mwatsatanetsatane, kuti azindikire bwino zotupa ndikuwunika ndikuwunika moyenera.
Gastroscopy ili ndi zofunika kwambiri pazida, makamaka ndi matekinoloje opititsa patsogolo zithunzi monga chromoendoscopy/electronic chromoendoscopy kapena magnifying endoscopy. Ultrasound gastroscopy imafunikanso ngati pakufunika.
6 Chithandizo cha khansa yoyambirira ya m'mimba
1. Endoscopic resection
Khansara ya m'mimba ikapezeka, endoscopic resection ndiye chisankho choyamba. Poyerekeza ndi opaleshoni yachikhalidwe, endoscopic resection ili ndi ubwino wocheperako kuvulala, zovuta zochepa, kuchira msanga, ndi kutsika mtengo, ndipo mphamvu za ziwirizi ndizofanana. Choncho, endoscopic resection tikulimbikitsidwa kunyumba ndi kunja monga yokondeka mankhwala oyambirira chapamimba khansa.
Pakadali pano, zosefera zomwe zimagwiritsidwa ntchito nthawi zambiri zimaphatikizapo endoscopic mucosal resection (EMR) ndi endoscopic submucosal dissection (ESD). Tekinoloje yatsopano yopangidwa, ESD single-channel endoscopy, imatha kukwaniritsa zotupa kamodzi kokha mu muscularis propria, komanso kupereka njira zolondola zamatenda kuti achepetse kubwereza mochedwa.
Tiyenera kuzindikira kuti endoscopic resection ndi opaleshoni yochepa kwambiri, koma pali zovuta zambiri, makamaka kuphatikizapo magazi, kuphulika, stenosis, kupweteka kwa m'mimba, matenda, ndi zina zotero.
2 Opaleshoni ya Laparoscopic
Opaleshoni ya Laparoscopic imatha kuganiziridwa kwa odwala omwe ali ndi khansa yam'mimba yoyambirira omwe sangathe kuchitidwa opaleshoni ya endoscopic. Opaleshoni ya Laparoscopic ndi yotsegula tinjira tating'onoting'ono m'mimba mwa wodwalayo. Laparoscopes ndi zida opaleshoni anaika kudzera njira izi ndi vuto pang'ono kwa wodwalayo, ndi deta chithunzi pamimba pamimba imafalikira kwa chinsalu chowonetsera kudzera laparoscope, amene anamaliza motsogozedwa ndi laparoscope. opaleshoni ya khansa ya m'mimba. Opaleshoni ya Laparoscopic imatha kumaliza opaleshoni yamtundu wa laparotomy, kupanga gastrectomy yayikulu kapena yonse, kutulutsa ma lymph nodes okayikitsa, ndi zina zotero, ndipo imakhala ndi magazi ochepa, osawonongeka, ochepa pambuyo pa opaleshoni yodula chilonda, kupweteka kochepa, komanso kuchira msanga kwa m'mimba pambuyo pa opaleshoni.
3. Opaleshoni yotsegula
Popeza 5% mpaka 6% ya intramucosal chapamimba khansa ndi 15% mpaka 20% ya submucosal chapamimba khansa ndi perigastric mwanabele metastasis, makamaka undifferentiated adenocarcinoma mu atsikana, chikhalidwe laparotomy akhoza kuganiziridwa, amene akhoza kwambiri kuchotsedwa ndi Lymph mfundo dissection.
mwachidule
Ngakhale khansa ya m'mimba ndi yovulaza kwambiri, si yoopsa. Malingana ngati chidziwitso cha kupewa chikukula, khansa ya m'mimba imatha kuzindikirika panthawi yake ndikuchiritsidwa mwamsanga, ndipo n'zotheka kuchiza kwathunthu. Choncho, tikulimbikitsidwa kuti magulu omwe ali pachiopsezo chachikulu atakwanitsa zaka 40, mosasamala kanthu kuti ali ndi vuto la m'mimba, ayenera kuyang'anitsitsa khansa ya m'mimba, kapena endoscopy ya m'mimba iyenera kuwonjezeredwa ku kafukufuku wamba kuti azindikire khansa yoyambirira ndi kupulumutsa moyo ndi banja losangalala.
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, catheter ya nasal biliary drainagendi zina zomwe zimagwiritsidwa ntchito kwambiri mu EMR, 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: Jun-21-2022