I roto i te mara o te tātaritanga mate nakunaku, ko te endoscopy tētahi o ngā taputapu tino nui. Kei roto ko te gastroscopy, te colonoscopy, te enteroscopy, te endoscopy kore mamae, me ētahi atu.
Engari he aha rawa ēnei tikanga? Mā wai ēnei tikanga e tika ana? Mā wai e karo? Ā, he aha ngā mea matua hei whakaaroaro mā te whakarite me te whai muri i te tikanga?
Kia tūhuratia ia mea.
Te tirotiro puku
Mā te Gastroscopy ka taea te tiro tika i te mucosa o te esophagus, te puku, te puku duodenal, me te duodenum e heke ana. Ka āwhina i te tautuhi i ngā whara, te whakatau i ō rātou āhua, me te tiki tauira koiora mō te tātaritanga histopathological. He mea whakamahi noa hei kite i te mumura, te mate pukupuku, te pukupuku, te polyp, te diverticula, te strictures, te malformations, te tinana ke rānei i roto i te ara gastrointestinal o runga (GI).
Ngā tohu:
1. Ngā tohu o te pūnaha kūnatu o runga (hei tauira, te ngau o te puku, te kore e taea te kōrero i te nui o te kai, te mamae o te puku, te ruaki) me te whakapae he mate te esophageal, te puku, te duodenum rānei, me whakaū.
2. Aromatawai whai muri, aromatawai maimoatanga rānei mō ngā mate GI o runga e mōhiotia ana, pērā i te mate pukupuku peptic, te mate pukupuku korokoro, te mate pukupuku puku rānei.
3. Te toto o te puku kāore i te mōhiotia te pūtake, te wāhi rānei.
4. Ngā whara whakararuraru o te puku whakarunga i tautuhia e ngā rangahau whakaahua e hiahia ana kia tautuhia.
5. Te noho mai o ngā tinana ke o te whekau o runga.
6. Te hiahia mō te wawaotanga endoscopic, pērā i te herenga variceal, te sclerotherapy rānei mō ngā varices esophageal, te tapahi endoscopic submucosal (ESD) rānei mō te mate pukupuku puku wawe.
7. He hītori whānau mō te mate pukupuku puku, ētahi atu āhuatanga mōrearea rānei mō te mate pukupuku puku.
8. Kua whakaūtia te mate H. pylori me aromatawai i ngā huringa o te kiriuhi puku, me whakamātautau rānei i te pānga ki te ahurea me te ārai i ngā paturopi hei ārahi i te maimoatanga.
Ngā ārai:
Tino: Te ngoikore nui o te ngākau me te pūkahukahu, te ohorere, te mate kino rānei, te tūroro kāore e mahi tahi, te mumura kino, te pakaru o te uaua o roto i te ara whakauru.
Whānaungatanga: Te ngoikore o te mahi a te manawa, te āhua toto me te hemoglobin
Te Whakarite i mua i te Tukanga：
1. Ngā Rongoā Antiplatelet/Anticoagulant: Me kōrero ngā tūroro e tango ana i te aspirin, clopidogrel, warfarin, me ētahi atu rongoā rite ki tā rātou tākuta mō te whakamutu i te tango i te aspirin i te iti rawa i te wiki i mua i te tikanga hei whakaiti i te mōrearea o te toto nui o te gastrointestinal.
2. Nohopuku: Kaua e kai, kaua hoki e inu wai i muri i te 10:00 i te pō i mua i te whakamātautau.
3. Rongoā mō te toto toto tiketike: I te ata o te pokanga, tangohia he rongoā mō te toto toto tiketike me te inu iti i te wai hei ārai i ngā raruraru e pā ana ki te toto toto tiketike.
4. Rongoā mō te mate huka: Kaua e tango i ngā rongoā whakaheke huka ā-waha, i te insulin rānei i te ata o te whakamātautau.
5. Te momi hikareti: Me mutu te momi hikareti a ngā tūroro i te iti rawa i te kotahi rā i mua i te mahi hei whakaiti i te maremare i te wā o te whakamātautau. Ka whakaitihia hoki e te whakamutu momi hikareti te whakaputanga waikawa o te puku, ka pai ake te tirohanga.
6. Ngā Whakamātautau Taiwhanga i mua i te Tukanga: Me whai tatau toto katoa, whakamātautau mahi ate, kōtaha toto totoka, me te tirotiro i ngā mate pipiri (hei tauira, te hepatitis, te HIV).
7. Aromatawai Manawa Pūkahukahu mō ngā Tūroro Kaumātua: Tērā pea ka hiahiatia he hihi-X o te uma, he electrocardiogram (ECG), me te echocardiography hei aromatawai i te manawanui ki te tikanga.
8. Nohopuku i muri i te Tukanga: Nā te mea he toenga o te moepuku, kaua e kai, kaua e inu mō ngā haora e rua i muri i te whakamātautau. I muri i ngā haora e rua, ngana ki te inu wai. Ki te kore he uaua ki te horomi, ki te maremare rānei, me haere mārire ki ngā kai ngawari, mahana.
9. Te Here i te Kai: Āta karohia ngā kai whakapataritari mō ngā rā 1–2 i muri i te tikanga.
10. Āhea me Rapu Hauora: Me ripoata wawe tonu te mamae nui o te puku, te tūtae mangu, te tūtae waikura rānei ki te kaiwhakarato hauora.
Ngā Tūponotanga me ngā Whakararuraru: He tino onge ngā raruraru pēnei i te toto, te pakaru o te uaua, te mate, te arrhythmia, te ischemia o te uaua o te ngākau, te whara o te korokoro, me te nekehanga o te hononga temporomandibular i te wā o te gastroscopy auau, ā, ka taea te whakaiti mā te whakarite tika me te tikanga tupato.
Te tirotiro koroni
Mā te colonoscopy ka taea te tiro i te mucosa rectal, sigmoid, descending, transverse, ascending, me te cecal, tae atu ki te terminal ileum. Ko te nuinga o te whakamahinga hei tātaritanga i te mumura o te koroni me te rectum, ngā pukupuku pai me te kino, ngā polyps, ngā diverticula, me ētahi atu mate.
Ngā tohu:
1. Te toto toto o raro o te puku kāore i te mārama, tae atu ki te hematochezia kitea, te kitea tonu rānei o te toto huna o te paru.
2. Ngā tohu o te GI iti (hei tauira, te mamae o te puku, te korere, te mate kōroke, te pupuhi e kitea ana, te huringa o te ahua o te puku) e tohu ana i te mate colorectal.
3. Ngā whara whakapae i kitea mā te barium enema, mā te whakaahua rānei e hiahia ana kia tautuhia te āhua o te mate.
4. Te tautuhi rerekētanga o te mate puku mumura (IBD), te whakatau i te whānuitanga me te kaha o te mate, me te aroturukitanga i muri i te maimoatanga.
5. Aroturuki auau i muri i te tango i te pukupuku colorectal, i te tango rānei i te polypectomy.
Ngā ārai:
Haunga ērā kua whakarārangihia mō te gastroscopy, ko ngā contraindications ko te aukati i te puku, te megacolon paitini, me te mate pāwera ki ngā wāhanga o te otinga whakarite puku.
Te Whakarite i mua i te Tukanga
He rite ki te gastroscopy, engari ko ngā rerekētanga e whai ake nei:
1. Me tango te rongoā toto toto tiketike pērā i ngā wā o mua i te ata o te mahi.
2. Me whakarērea te tango rongoā mō te mate huka i te ata o te whakamātautau.
3. He kai iti-toenga (hei tauira, te kūkamo, te nūru, te taro, te kāte hua manu) i te rā i mua atu hei whakapai ake i te ma o te puku.
4. Kaua e kai i muri i te tina i te ahiahi o mua (ka whakaaetia ngā wai mārama).
Te Whakarite i te Puku：
1. He mea nui te whakarite tika o te whekau kia tangohia ai te paru, kia mārama ai te tirohanga o te kiriuhi mucous o te koroni.
2. Ko ngā kai horoi noa i Haina ko ngā electrolytes polyethylene glycol (PEG), te 50% konupora whanariki, me te mannitol.
3. Whai muri i te tango i te rongoā, me hikoi haere ngā tūroro hei whakaoho i te nekenekehanga me te tere ake o te tukunga. Ki te kore e pena, ka raru pea te ma o te puku.
4. Ki te puta he pupuhi nui, he mamae rānei, whakaroahia te inu, kati rānei te inu mō tētahi wā poto, kātahi ka tīmata anō ina memeha ngā tohu. Ko te tūtae mārama, wai hoki e tohu ana i te whakarite tika.
5. Mō ngā tūroro kāore i te pai te horoinga o te puku, me whakamahi pea he enema horoi, he whakarite whakapakaritia rānei.
Te Tiaki i Muri i te Tukanga：
1. He mea noa te mamae ngawari o te puku, te pupuhi rānei, ā, e pā ana ki te pupuhi o te hau i te wā e mahia ana. Kāore he take e manukanuka ai.
2. Ki te puta he mamae nui, he pupuhi nui, he toto rānei i te pūkahukahu, me rapu wawe tonu i te awhina hauora.
3. Tīmata ki te kai me te inu i muri i te memeha haere o ngā tohu. Tīmata ki ngā kai ngohengohe (hei tauira, te kūkamo, te ika) ā, karohia ngā kai he nui te muka, ngā kai raukikī rānei.
4. He onge ngā mōrearea me ngā raruraru (te pakaru o te uaua, te toto, te mate pāwera, te arrhythmia, te ischemia o te uaua ngākau, ngā raruraru electrolyte) ā, ka taea te whakaiti mā te whakarite me te tikanga tika.
Ultrasound Endoscopy (EUS) – Ultrasound + Endoscopy
Ka whakakotahi te EUS i te endoscopy me te ultrasound auau teitei. Ka whakatakotoria he taputapu ultrasound iti ki te pito o te endoscope, ka tukuna rānei mā te hongere mahi, kia taea ai te tirotiro taipitopito i ngā paparanga pakitara o te puku me ngā hanganga tata pēnei i te ate, ngā awaawa au, me te pancreas.
Ahakoa he pai rawa te gastroscopy me te colonoscopy paerewa mō te aromatawai i te mata o te mucosal, kāore e taea e rātou te aromatawai i ngā whara o raro i te mucosal, i ngā hanganga rānei i waho o te lumen. Ka whakakīia tēnei āputa e te EUS.
Ngā tohu:
1. Whakatauhia te pūtake me te āhua o ngā pukupuku o raro i te kiriuhi mucous.
2. Aromatawai i te hōhonutanga o te whakaekenga o ngā pukupuku GI, me te kimi i te horapa o te kōpū lymph.
3. Aromatawai i te āheinga ki te tango i te pokanga.
4. Tātarihia ngā whara pai me ngā whara kino o te pūkahukahu me te awaawa pūkahukahu noa mai waenganui ki tawhiti.
5. Aromatawai i ngā whara o te repeure.
6. Wehewehea ngā pukupuku ampullary.
7. Whakaarohia ngā whara o te taha o te puku.
8. Aromatawai i ngā varicose esophageal me te urupare ki te sclerotherapy.
Ngā ārai:
1. Tūroro kāore e mahi tahi
2. Te whakapae he poka i te GI
3. Te diverticulitis whakapeka
4. Te mate pukuriri
5. Te ngoikore nui o te ngākau me te pūkahukahu
Endoscopy Kore Mamae (Gastroscopy Whakamarie/Colonoscopy) – Tino Whakamarie
I roto i te endoscopy kore mamae, ka whakanohoia te tūroro ki te tūranga tika, ka whakanohoia he waha, ka tukuna he hāora. Ka werohia e te tohunga whakamoe he rongoā whakamoe poto-mahi (hei tauira, propofol) ki roto i te uaua, ka moe i roto i te 30 hēkona. Ka mahia te tikanga, ā, ka mutu te whakamoe ina mutu te tango. Ka oho tonu te tūroro.
Ngā Tohu me te Whakaritenga：
He rite ki te gastroscopy me te colonoscopy paerewa.
Ngā ārai:
1. Mate manawa kino: Mate manawa whakapeka, niumōnia, COPD kino, whakararuraru huango whakapeka, apnea moe aukati (OSA) me te hypoxia taketake.
2. Ngā āwangawanga āhuahanga o te ara manawa: Mā te whakatuwheratanga iti o te waha, te nekehanga iti o te kaki, o te kauae rānei, te āhua poto, momona rānei o te tinana ka raru pea te uruhanga o te ara manawa.
3. Āhua kino whānui: Te ngoikore o te ngākau, te mate ngakau, te whiu, te koma, te ngoikore o te ate, te whatukuhu rānei, te anemia kino, te myasthenia gravis, ngā tūroro kaumātua ngoikore rānei.
4. Te mōrearea nui o te mimiti: Te aukati i te korokoro, te ngakau, te pyloric, te puku rānei, te ruaki, te toto toto kaha rānei. Whakaarohia te tango i te pēhanga puku (ngoi nasogastric) i mua i te whakamoe.
5. He maha ngā mate pāwera ki ngā rongoā – te āheinga ki te pāwera.
Te haputanga.
Ngā Whakaaro i mua me muri i te Tukanga mō te Endoscopy Kore Mamae:
1. Kaua e momi hikareti i te rā i mua atu hei whakaiti i te maremare i te wā o te mahi.
2. Me haere tahi koe me tētahi mema pakeke o te whānau, me tētahi hoa rānei. Tangohia ngā niho rūpahu i mua i te mahi.
3. Kaua e kai i muri i te tina i te pō i mua atu. Kaua e inu wai mārama i te ata o te mahi.
4. Whakamōhiotia tō tākuta mō ōna hītori hauora o mua me ngā mate pāwera ki ngā rongoā.
5. Me noho tētahi hoa ki a koe mō ngā haora e 3 i muri i te tikanga.
6. Āta karohia ngā kai raukikī me te waipiro mō ngā haora e 8 i muri i te tikanga.
7. Kaua e taraiwa, kaua e whakahaere mīhini, kaua hoki e mahi i ngā teitei mō ngā hāora e 8 i muri i te tikanga.
8. Mena i mahia he wawaotanga endoscopic, whai i te tirotiro a te hōhipera, i ngā tohutohu rānei a te tākuta.
Te Whakamāmā (Transnasal / Ultrashin) Gastroscopy – Ka mahia i a koe e noho ana, e kōrero ana
Ko te gastroscopy whakamarie, e mōhiotia ana ko te gastroscopy transnasal, ko te gastroscopy tino angiangi rānei, he iti noa te riri o te korokoro, ā, tata kore mamae. Ko te gastroscopy tikanga e whakamahi ana i te huarahi ā-waha me te diameter o te tirohanga tata ki te 10 mm, he maha ngā wā ka puta te kōkō me te whakapairuaki.
Ka whakamahia he karu tino angiangi mō te gastroscopy transnasal, he 5.9 mm anake te whānui. He ngāwari te tikanga, ā, ka nui te wā e wātea ana ki te tākuta mō te tirotiro taipitopito me te whakapai ake i te hua tātaritanga.
Ngā Painga o te Ultrathin Gastroscope：
1. Angiangi: Whānuitanga noa: 10 mm. Tino angiangi transisal: 5.9 mm anake.
2. He iti ake te mamae, he iti ake ngā mōrearea, he iti ake ngā raruraru: He tino whai hua mō ngā tamariki, ngā tino mate, ngā kaumātua, ngā ngoikore, me ngā tūroro he ngoikore te mahi a te manawa.
3. He maha ngā ara whakauru: Ka taea te whakauru mā te ihu, mā te waha rānei, me te kore e hiahiatia he whakamahinga motuhake.
4. Ka taea e te tūroro te kōrero i te wā e whakahaerehia ana: Ka whakaiti i te manukanuka, ā, ka taea te wheako tirotiro marino, pai hoki.
Ngā Tohu me ngā Āraitanga:
He rite ngā tohu ki te gastroscopy tuku iho. He tino pai mō ngā tūroro kāore e manawanui ki te mamae.
Ngā Ārai: Te piko o te ihu, te peka ke nui o te septal ihu, te rhinitis whakapeka. Ahakoa he pai mō ētahi wawaotanga (hei tauira, te whakatakotoranga stent, te whakaurunga ngongo whāngai jejunal), kāore e pai mō te polypectomy, te hemostasis rānei.
Te Whakamātautau-Teitei (Te Tika) o te Gastroscope / Colonoscopy – He Taputapu Kaha mō te Kitenga Wawe o te Mate Pukupuku GI
He ariā hou te endoscopy tika e aro ana ki te whakapai ake i te tere o te kitenga o te mate pukupuku puku i te wā tōmua. He whanaketanga nui tēnei i roto i te tautuhi wawe, te aromatawai i ngā whara, me te aratohu maimoatanga.
I roto i te mahi, ka whakakotahihia e ia te endoscopy mārama-mā whakamāramatanga teitei me te chromoendoscopy, te whakanui hiko, me te koiora kua arotahihia hei whakaiti i ngā whara e ngaro ana.
Mēnā ka kitea he whara whakapae, mēnā rānei kei roto te tūroro i tētahi rōpū mōrearea nui ki te mate pukupuku o te puku, o te korokoro rānei, me mahi te tirotiro endoscopic tino tika.
Ngā Rerekētanga Matua mai i te Endoscopy Paerewa
Ngā whakaritenga mō ngā kaimahi: Me mahi e te endoscopist he tohunga ki te kimi wawe i te mate pukupuku me te nui o te wheako. Ka mahia he rapunga "whāriki" tino tika o te mucosa esophageal, te puku, me te duodenal. Ka tirotirohia anō ngā wāhi whakapae mā te chromoendoscopy, te whakanui, me te koiora tika hei tiro i ngā hanganga moroiti me te mata moroiti.
Ngā whakaritenga taputapu: Me whai kaha whakanui teitei te endoscope me te chromoendoscopy hiko hei whakarei ake i te kitenga wawe o te mate pukupuku. Ina kitea he whara whakapae, ka whakamahia he tae matū, he tae hiko rānei hei whakanui ake i te wāhi, te whānuitanga, me te āhua, me ngā tuhinga taipitopito me te hopu whakaahua.
Tērā pea e hiahiatia he EUS mō ētahi atu aromatawai.
Te Enteroscopy (Te Endoscopy o te Pīkau Iti)
Ngā tohu:
1. Te korere kāore i te mārama, te mamae o te puku, te kore toto, te pupuhi o te puku, te whakapairuaki, te ruaki rānei.
2. Te toto o te puku kāore i te mārama, te anemia rānei nā te korenga o te rino.
3. Ngā whara o te whekau iti e whakapaetia ana i runga i te rangahau barium, i tētahi atu whakaahua rānei, kāore e taea te tautuhi.
4. Te aroturuki i ngā mate whekau iti e mōhiotia ana (hei tauira, IBD, polyposis, kohi puku).
5. He hītori whānau mō te GI polyposis e hiahia ana kia tirohia te whekau iti.
6. Ētahi atu mate pūnaha, ngā kitenga haumanu rānei e hiahia ana kia arotakehia te whekau iti.
Te Whakaurunga Poihau-Rua (DBE)
Ngā ārai:
1. He nui te mōrearea o te toto, te pakaru rānei o te puku (hei tauira, te pakaru o te puku, te mate puku kino)
2. Te aukati i te puku (kāore e whakaaetia te whakarite me te tirotiro ā-waha)
3. Mate kino o te ngākau, te whatukuhu, te ate rānei; te toto toto tiketike kāore i te whakahaeretia; te mate hinengaro
4. Ētahi atu ārai ki te tirotiro i te taha whakarunga
Kia mōhio: Nā te uauatanga hangarau me te nui ake o te mōrearea, he nui ake te whakamahinga o te capsule endoscopy mō te aromatawai i te whekau iti i ēnei rā.
Te Endoscopy Capsule – He tino pai mō te tirotiro i te mate pukupuku puku me te mate whekau iti
Ko te whakamātautau ine i te puku karāhe he horomi i tētahi karāhe rite ki te pire, he mea whakamahi noa, kei roto he kāmera me te pūtake mārama. I a ia e haere ana i roto i te ara GI mā te peristalsis, ka hopukina ngā whakaahua ka tukuna ki tētahi taputapu hopu e mau ana te tūroro. (Ko te whakamātautau ine i te puku karāhe e whakahaerehia ana e te aukume, e wātea ana i Haina, ka taea te whakahaere mamao i te nekehanga o te karāhe i roto i te puku.)
Ngā tohu:
1. Te toto o te puku kāore i te mārama
2. Te anemia koretake o te rino kāore i te whakamāramahia
3. Te whakapae he pukupuku whekau iti
4. Te whakapae, te mate pāwera rānei
5. Te kitenga i te whara o te kiriuhi o te whekau iti i puta mai i te NSAID
6. Te whakapae haumanu mō te mate puku iti
7. Te aroturuki me te ārahi i te maimoatanga i te mate a Crohn
8. Te tirotiro i ngā mate pukupuku o te whekau iti
Ngā ārai:
Tino: Kāore he āheinga pokanga, kāore rānei e taea te pokanga i te puku (mēnā me tango pokanga te pupuri i te kāpūru).
Whānaunga:
1. E mōhiotia ana, e whakapaetia ana rānei he aukati i te GI, he stricture, he fistula rānei
2. He taputapu whakatere manawa kua whakauruhia, he taputapu hiko rānei
3. Te mate horomi
4. Te haputanga
Te Whakarite i mua i te Tukanga：
1. Nohopuku: Kaua e kai mō ngā hāora 10–12 i mua i te horomitanga o te kāpūru.
2. Te whakarite i te puku: Pērā i te colonoscopy, i mahia i te ahiahi i mua atu hei whakapai ake i te kounga o te ahua.
3. Simethicone (whiringa): Ka taea te tango 30 meneti i mua i te tikanga hei whakaiti i ngā mirumiru.
4. Whai muri i te horomitanga: Me inu he wai mārama i muri i ngā hāora e 2; me kai māmā i muri i ngā hāora e 4. Ka mutu te rangahau ina pau te pākahiko o te kāpū, ina uru rānei te kāpū ki te koroni ki tua atu i te takirere ileocecal.
Ngā raruraru me ngā herenga：
1. Te pupuri i te kāpū: Ko te tikanga he pupuri i roto i te ara GI mō te >2 wiki. Me mahi pokanga, me te tango mai rānei mā te poihau.
2. He onge te mimiti ki roto i te ara manawa engari ka taea tonu.
3. Herenga: Kāore e taea e te kāpū tirotiro endoskopika te tiki tauira kiko, ā, ka whakawhāiti i tōna kaha ki te tautuhi tika i ētahi whara.
Kei muri i ia tikanga endoscopy angitu, he mahi nui tā ngā taputapu pono, engari he maha ngā wā ka warewarehia. Mai i te hemostasis ki te polypectomy me te kohi kiko, ka pā tika te kounga o ngā mea e pau ana ki ngā putanga haumanu me te whai huatanga o te rere mahi.
I ZRHmed, ka arotahi mātou ki ngā mea e pā ana ki te whānuitanga:
Ngā topenga hemostatic mō te whakahaere toto tika
Ngā mahanga polypectomy (makariri me te wera) hei tango i te polyp
Ngā ngira Sclerotherapy mō te hiki i te kiriuhi raro i te mucosa
Ngā paraihe horoi me ētahi atu taputapu endoscopic
Mā te tiwhikete MDR CE me te tipu haere o te aroaro o te ao, ka tautoko mātou i ngā waeine me ngā kaituku endoscopy me ngā hua kua hangaia mō te haumaru, te pono, me te ngāwari o te whakamahi.
Nā te mea ehara i te mea he whānuitanga nui anake e hiahiatia ana mō tētahi tikanga pai – engari me ētahi atu taputapu pai hoki.
Whakamutunga
Ko te tirotiro puku puku te paerewa koura mō te tautuhi i ngā mate puku. Kāore he hangarau matatau, he taputapu rānei e taea te whakakapi.
Kaua e tinihangatia e ngā kereme pēnei i te "kotahi pata toto hei kimi i te mate pukupuku o te puku." Mena kei a koe ngā tohumate o te GI, he mea nui kia tirotirohia tika te puku mā te endoscopic.
Me whakatau e te tohunga mēnā me whakamahi he endoscopy, ko tēhea momo e tika ana, me pēhea te whakarite, i runga i tō āhua ake. Mā te whakarite tika ka noho haumaru te tūroro me te kounga o te whakamātautau.
Kia ora tonu tō hauora o te pūnaha gastrointestinal mō te wā roa.
Mō ZRHmed
He kaihanga Hainamana a ZRHmed mō ngā taputapu endoscopic, tae atu kiNgā Kēpi Koiora, Ngā Topenga Hemostatic, Ngā Mahanga Polypectomy, Ngā ngira whakaora kiri, Pūwero Rehu, Ngā Paraihe Cytology, Waea Arataki,Kete Whakaemi Kōhatu, Te Tātaritanga Waipuke Ihume ētahi atu. Kua whai tiwhikete MDR CE ā mātou hua matua, ā, e whakamahia ana e ngā kaituku me ngā kaiwhakarato hauora o te ao katoa.
Kāore mātou e hanga ana i ngā endoscope. Mā mātou e hanga ngā taputapu hei whakahaere i aua taputapu.
Wā tuku: 28 Paenga-whāwhā 2026