Mu njira zochotsera endoscopic, nthawi zambiri timaika chiyembekezo chathu pa zipangizo zamakono, koma nthawi zambiri timanyalanyaza mfundo zazikulu za njira zoyambira. N’chifukwa chiyani ngakhale pamene chilondacho chikuoneka kuti chagwidwa bwino, chimatha msanga pamene tachimanga? Lero, tikupeza mfundo kuchokera m’bukuli.Njira ya Oho: Njira Zoyambira mu Endoscopy ya M'mimbaTiyeni tipeze tsatanetsatane wa zinthu zazing'ono kwambiri zomwe zimasonyeza kupambana kapena kulephera kwa misampha.
Madokotala a endoscopist mwina onse akumana ndi nthawi izi 'zokwera magazi': Mumayendetsa mosamala kwambiri chotupacho, mumakonza bwino momwe magazi amagwirira ntchito, ndikuponda pa pedal—koma mumamva 'kuwomba', ndipo chotupacho chimatuluka, kapena choipa kwambiri, chimachotsedwa pang'ono.
Munthawi zimenezi, anthu ambiri amayamba kudzudzula anthu kuti ndi omwe achititsa tsoka kapena zida zolakwika. Komabe, m'maso mwa akatswiri odziwa bwino ntchito omwe awunikira njira zambiri, izi sizimakhala nkhani ya mwayi. Nthawi zambiri zimakhala ngati bomba lomwe limayikidwa ndi zizolowezi zoipa.
Lero, pogwiritsa ntchito nzeru zaukadaulo za katswiri wodziwika bwino wa endoscopist waku Japan Dr. Ken Oho, tiyeni tilowe mu 'malo awiri osawoneka' mu snare resection omwe amanyalanyazidwa mosavuta ndi oyamba kumene komanso akale - omwegawo lathunthundipakati.
Ndondomeko Yaikulu ya Kusodza - Masitepe Olumikizana, Aliyense Ndi Wofunika Kwambiri
Akamagwiritsa ntchito msampha, anthu ambiri atsopano amakonda kuthamangira ku chilonda akangolandira chipangizocho. Ngakhale kuti mayendedwe awo ndi achangu, nthawi zambiri amakhala osakhazikika komanso osakhazikika.
Mu "Njira ya Oho," kukonza msampha kumatsatira ndondomeko yolondola, yomwe nthawi zambiri imagawidwa m'magawo anayi:
Konzani msampha:Choyamba, dziwani malo ofunikira kuti chidacho chikhazikike.
Chotsani chivundikiro chakunja kuti mutsegule msampha ndikusintha kukula kwake:Gawo ili limatsimikiza kukula kwa njira yochotsera chilonda. Liyenera kusinthidwa bwino malinga ndi kukula kwa chilondacho.
Gwirani ndi kulimbitsa ngati kuti "mukulandira" chilondacho mumsampha:Iyi ndi njira yogwira ntchito yolandirira chilondacho, m'malo mongoyembekezera kuti chigwere mkati.
Patsogolo chivundikiro chakunja uku mukuchimangirira kuti nsonga ya msampha isasunthike:Iyi ndi sitepe yofunika kwambiri, ndipo ndi pamene akatswiri ambiri a endoscopist nthawi zambiri amalephera. Ngati chigoba chakunja sichinapitirire patsogolo, mphamvu yomangirira idzakoka nsonga ya msampha kumbuyo, zomwe zimapangitsa kuti chilondacho chisawonekere.
Njirayi ingamveke yosavuta, koma sitepe iliyonse imafuna mgwirizano waukulu pakati pa dzanja ndi maso.
Yang'anani pa Nsonga ya Msampha - Kupeza "Mfundo Yokhazikika"
Chifukwa chiyani nsonga yake ndi yofunika kwambiri? Chifukwa mu lumen yofewa komanso yogwira ntchito ya m'matumbo, nsonga yake imagwira ntchito ngati "nangula" wathu.
Madokotala ambiri a endoscopist amazolowera kugwiritsa ntchito gawo lopapatiza la matumbo kapena mbali yotsutsana ndi cholumikizira cha mesenteric ngati fulcrum, koma izi nthawi zambiri zimapangitsa kuti munthu aterere.
Chinsinsi cha "Oho Method" chili mu izi:pogwiritsa ntchito nsonga ya msampha ngati maziko.
Pali njira ziwiri zenizeni zothandiza pa izi. Aliyense akhoza kuyang'ana bwino Chithunzi 1 (Kukonza Msampha), chomwe ndachitenga m'bukuli:
Njira 1 (Chithunzi 1a):Tsegulani bwino msamphawo ndikuphimba chotupacho kuchokera pamwamba. Iyi ndi njira yodziwika bwino yomwe imagwiritsidwa ntchito ngati matumbo ali owongoka pang'ono ndipo chotupacho n'chosavuta kuchigwira.
Njira 2 (Chithunzi 1b):Gwiritsani ntchito khoma la m'mimba lomwe lili kumbali ya mkamwa ngati thunthu, ndipo pang'onopang'ono tsegulani msampha.
Njira 3 (Chithunzi 1c):Ngati palibe fulcrum yokhazikika pakamwa, mutha kugwiritsa ntchito khoma la m'mbali ngati fulcrum m'malo mwake. Kenako, tsegulani pang'onopang'ono snare; izi zimapangitsa kuti zikhale zosavuta kuwona chotupacho.
Zindikirani:Titha kupitiriza ndi masitepe otsegulira ndi kulimbitsa pambuyo pake ngati nsonga ya msampha yakhazikika bwino komanso yokhazikika bwino popanda kutsetsereka. Ngati nsongayo singagwire bwino ntchito, njira zonse zotsatizana nazo sizingaphule kanthu.
Yang'anani Pakati pa Msampha - Pewani Kuganiza Kuti "Mumaona Zinthu Monga Zoona"
"Kumangirira molunjika msampha kungapangitse kuti chilondacho chichoke pakati."
Chifukwa chiyani? Pali chinthu chobisika kwambiri chomwe chikuchitika pano.
Tikamangirira snare, imabwerera m'chimake chakunja. Panthawiyi, maziko a snare (kumapeto kolumikizidwa ndi snare) amagwiritsa ntchito mphamvu yokankhira kunja. Izi zimapangitsa kuti pakhale zotsatirapo zofunika kwambiri: nthawi zambiri chotupacho chimakokedwa kwambiri pakati pa snare m'malo mopita kumunsi kwake.
Ngati simunasinthe bwino malo omwe muli musanamange, gawo lokha la chilondacho lingakhale mkati mwa msampha pomwe lina lonselo limasiyidwa panja. Mukangoyambitsa electrocautery, gawo lowonekera silidzachotsedwa, zomwe zimapangitsa kuti "kuchotsedwa pang'ono."
Ndiye, kodi yankho lake ndi lotani?
Pa nthawi yeniyeni yomangirira chitseko, muyenera kupititsa patsogolo chitseko chakunja pang'onopang'ono. Cholinga chokankhira chitsekocho kunja uku chikumangirira ndikuwonetsetsa kuti chilondacho chili pakati pa chitseko (monga momwe zasonyezedwera pa Chithunzi 2).
Musanyoze njira yosavuta iyi ya 'kukankhira pang'ono musanayimange'—imakupatsani mwayi wowona bwino chilondacho chikutsekedwa kwathunthu pa chowunikira, m'malo mongodalira 'kumva'.
Mfundo Yofunika Kwambiri ya Dr. Ohba - Khalani Oyang'ana Kwambiri Kuti Mupewe 'Kuphonya Cholinga'
Dokotala Ohba wafotokoza mwachidule tanthauzo lenileni la kugwiritsa ntchito misampha.
Ngati nsonga ya snare siikukanikiza mwamphamvu minofu, nsongayo idzachoka pamene mukulimbitsa snare, zomwe zimapangitsa kuti chilondacho chizimiririke. Mosiyana ndi zimenezi, ngati nsongayo yakanikiza mwamphamvu kwambiri, fulcrum idzasuntha kuchoka ku nsonga kupita ku chivundikiro chakunja. Chifukwa chake, ndikofunikira kuti"Nsonga ya msampha imakhala thunthu."
"Ndikukhulupirira kuti aliyense wakhala akuganiza kuti, 'Ndinali wotsimikiza kuti chilonda chonsecho chinali mkati mwa msampha,' kenako nkuchotsedwa pang'ono. Izi si tsoka chabe; pali chifukwa chake. Tiyenera kukhala osamala kwambiri kuti chilonda chonsecho chili mkati mwa msampha, ndikuchiletsa kuti chisatuluke panthawi yomangirira!"
Mawu awa akugwirizanadi ndi akatswiri ambiri a endoscopist. Zimene timatcha kuti "mwayi woipa" kwenikweni ndi kunyalanyaza tsatanetsatane wa njira yathu.
Powerenga izi, kodi muli ndi "nthawi yoti aa"? Zikuoneka kuti zinthu zazing'ono zomwe nthawi zambiri timazinyalanyaza panthawi ya ndondomekoyi zafotokozedwa kale momveka bwino ndi akale athu.
"Ngati mukufuna kuphunzira mwadongosolo njira yogwiritsira ntchito endoscopic iyi ya 'buku lophunzirira' ndikumvetsetsa bwino momwe Dr. Ken Ohba amasinthira njira iliyonse yofunikira kwambiri, ndikukulimbikitsani kuti muwerenge."Endoscopy Yogaya M'mimba: Njira Zoyambira za Ohba StyleKudziwa bwino zoyambira ndiye chinsinsi cha kupita patsogolo kosalekeza komanso kosatha.
Msampha Woyenera Umathandiza Kuti Njira Igwire Bwino
Kudziwa bwino ntchito yopangira zida ndi pakati ndiye maziko. Koma munthu waluso amafunikanso chida chodalirika. Chapamwamba kwambirimsampha wochotsa polypectomyayenera kupereka:
Kutsegula ndi kutseka bwino
Palibe kugwedezeka, palibe kuzengereza
Mphamvu yozungulira yokhazikika
Kugwira kodalirika popanda kung'amba minofu
Kugwirizana kwa electrosurgical
Kudula ndi kutsekeka kwa magazi komwe kumayembekezeredwa
Kusinthasintha
Kuwongolera molondola mu kapangidwe ka thupi kovuta
Ku ZRHmed, timapanga misampha yochotsa ma polypectomy yomwe imapangidwa pogwiritsa ntchito njira zamakono izi. Misampha yathu imapezeka mu mawonekedwe ozungulira, a hexagonal, ndi a crescent, yokhala ndi njira zozungulira komanso zosazungulira, yogwiritsidwa ntchito yozizira komanso yotentha, komanso kutalika kwa ntchito kuyambira 1200mm mpaka 2300mm. Zogulitsa zonse ndi za MDR CE ndipo zimapangidwa motsatira ISO 13485.
Sitipanga ma endoscope. Timapanga zida zomwe zimakuthandizani kuti mugwire bwino ntchito.
Nthawi yotumizira: Juni-05-2026