He harikoa ngā tākuta o Amerika Latina mō tēneiERCPkua uru ki tētahi wā hou o te mahi pokanga karetao, ā, kei te horahia e rātou te rongo ki ngā wāhi katoa.
I roto i tētahi kōrerorero tata nei me ngā tākuta i Amerika Latina, i kōrero ahau mōERCPhe karetao pokanga mai i Ausway Endoscopy, kei te whakahaerehia ngā whakamātautau haumanu i tēnei wā. I te wā i mōhio ai rātou ka taea e tēnei pūnaha te mahi i te āwhina a te karetaoERCP, te whakahaere mamao i te endoscope ngāwari me ngā taputapu mā te ringa karetao hei whakaoti i ngā tikanga pēnei i te whakatakotoranga stent biliary me te kore e mau i ngā āperona mata, ā, nā te iti haere o te pānga o te irahiko, ka huri te āhuarangi hei hiko. He maha ngā tākuta i tino harikoa, ā, tata tonu rātou ki te hora i te rongo.
I taku wā waatea, ka whakaaro ahau: he aha rātou i tino harikoa ai?
Me tēnei pātai i roto i tōku hinengaro, i arotakehia anō e au ngā tuhinga me ngā raraunga e tika ana, ā, i te nui haere o taku pānui, ka mārama ake—ERCPHe tino taonga nui ngā karetao pokanga mō ngā tohunga tirotiro mata, ahakoa he hangarau whakarerekē i te ao.
Kei raro nei, e hiahia ana ahau ki te whakapuaki atu ki a koutou: Te Kaikōhuru Wahangu i roto i te Endoscopy: He raruraru irahiko e tata atu ana i tō whakaaro! Kei te mahi katoa te katoaERCPMe Pānuihia tēnei
Ko te mea tino ngāwari ki te wareware i roto i te rūma pokanga ehara i te mea he raruraru, engari ko te hihi o te mārama e kohikohi mārire ana.
He maha ngā tohunga endoscopists e mōhio anaERCPe whakamahi ana i te fluoroscopy, engari kāore pea koe e mōhio—Kua whakarārangihia tēnei tikanga e te FDA hei whakamātautau mōrearea nui "tērā pea ka pā he kino nui ki te irahiko."
Kei te pukumahi mātou ki te rongoā i ngā kōhatu me ngā uauatanga o te puku, engari he maha ngā wā ka warewarehia e mātou tētahi mea e tino whakamataku ana:
Kei te pā kino puku te irahiko ki ngā tūroro, ā, ka pā kino hoki ki te hunga katoa e tū ana i te taha o te ringa-C.
I tēnei rā, mā te huarahi māmā ki te mārama, ka whakamāramahia e au ngā aratohu ā-ao me ngā raraunga rangahau tūturu:
E hia te nui o te pānga ki a koe? He aha ngā whanonga e "tahae" ana i tō hauora? Me pēhea e taea ai e koe te whakarite kia haumaru koe?
I. He aha aiERCPe kiia ana he tikanga mōrearea nui e whakamahia ana te irahiko?
Nā te meaERCPe tutuki ana i ngā whakaritenga katoa mō te "whakaatutanga horopeta nui"
● Me whai i te fluoroscopy
● Tukanga uaua
● Te tata ki te tākuta
● Roa te roa
● Ngā tikanga whakahou
Kia pēhea te whakamataku o ngā tatauranga tuturu?
Ko te horopeta irahiko o tētahiERCPhe rite tonu te tikanga ki te 312 ngā hihi-X o te uma (te toharite).
—He rangahau nā tētahiERCPkaupapa ine irahiko i Uruguay
He mea nui ake: E whiwhi ana koe i ngā tekau, i ngā rau, i ngā neke atu rānei i te tau.
II. He aha ngā pānga o te irahiko ki a koe?
E rua ngā wāhanga o te kino o te irahiko:
1) Te kino kua whakaritea (ka puta mēnā he rawaka te horopeta)
● Te whero o te kiri
● Te ngaronga o te makawe
● Te tango i te kiriuhi
● Ngā mate pukupuku
● Ngā katarata (he ngāwari ki te kohikohi roa o ngā matū paitini)
Ko te karu arotahi tētahi o ngā okana tino pakarukaru, ā, kua whakahekehia e te ICRP te paepae ki te 20 mSv/tau.
He tokomahaERCPkua kitea kētia e ngā tohunga kua mahi mō te neke atu i te tekau tau te pōuri o te arotahi.
2) Te kino matapōkere (te kino tūponotanga)
Kāore he paepae.
Ka nui ake te horopeta, ka nui ake te mōrearea.
Whakatau tata a te ICRP: 1 mSv = 0.005% te pikinga o te mōrearea matepukupuku mō te oranga katoa. KotahiERCP≈ 6 mSv → 0.03% te pikinga o te mōrearea.
Kāore koe e mahi ana i tēnei "kotahi noa iho".
E maha ngā wā e mahia ana e koe i te tau, mano ngā wā i roto i tōu oranga.
III. Te wāhi tino morearea o teERCPKo te rūma te wāhi e tū ai koe i ia rā, i ia rā.
Hei whakarāpopototanga: Ko te tata atu ki te ngongo hihi-X, ko te teitei ake o te horopeta.
Ko ngā wāhi tino mōrearea mō te tūponotanga o ngā kaimahi ko:
● Kotahi te taha o te ngongo hihi-X ringa-C
● I te wā e whakaahua ana i te koki whakarara
● Te rohe e karapoti ana i te tūroro (te pūtake nui rawa atu o te irahiko marara)
● Ngā tūranga e tū ana ngā tohunga whakamoe me ngā nēhi
He tokomaha te hunga kāore e mōhio ki tēnei: Ko ngā tūranga e tū nei rātou ko ngā wāhi tino teitei rawa atu ka pāngia e te irahiko.
IV. Te Tirotiro Tūturu: 90% o ngā Kaimahi Hauora Kāore i Whakamahi i ngā Tikanga Tiaki Tika
Ko nga kitenga o te rangahau a Sociedad Interamericana de Endoscopía Digestiva (SIED) he tino miharo:
● 22% anake o ngā tākuta kua whiwhi whakangungu tiaki i te irahiko.
● 17% anake o ngā nēhi kua whiwhi whakangungu.
● Haunga ngā āpere mata, he tino iti te whakamahinga o ētahi atu taputapu tiaki.
Kei te whakaaro koe he "haumaru" koe? Ko te mea pono: Ko te nuinga o te tangata e oma tahanga ana.
V. Te Mātāpono ALARA: Ngā Ture e 3 Me Whai e te Katoa
ALARA = Te iti rawa o te mea ka taea te whakatutuki
1. Wā: Kia poto rawa.
● Te tirotiro i te manawa
● Whakamahia te "Anga Whakamutunga Hukapapa"
● Ārai i te tirotiro pūoro tonu
2. Tawhiti: Ko te tawhiti, ko te pai. I ia hikoi whakamuri, ka huri te horopeta → ki te 1/4 o te horopeta taketake.
3. Parepare: Āraia kia maha rawa ngā ārai e taea ana.
● Āperira mata (≥0.35 mmPb)
● Te tiaki i te tairoi
● Mōhiti mata (hei ārai i te katarata)
● Ngā ārai mata
● Ngā mata whakairi
Ka taea e te ārai mata te whakaiti i te hihi marara mā te neke atu i te 95%.
VI. Kei hea ngā tūponotanga tūturu mō ngā tūroro?
BMI teitei, e whakahuatia anaERCP, ngā horopeta rerekē teitei, ngā wā tukanga roa. Ka taea e ēnei katoa te arahi ki te kohikohi tere o te horopeta kiri i roto i ngā tūroro.
Aro nui:
● Ngā Wāhine
● Ngā wāhine hapu
● Tamariki (aronga ×3–5)
● Te whakamātaotanga auau o te wāhi kotahi
Me tino iti ngā horopeta e tangohia ana e ēnei tūroro.
VII. Ngā Wahine Hapū me ngā Tamariki: Ngā Rōpū Mōrearea Nui Me Kōrero Motuhake.
ERCPNgā Mātāpono mō ngā Wahine Hapū
● He "tino mea tika" rānei?
● Ka taea te whakaroa?
● Mā te tākuta tino mātau e mahi?
● Kua whakaitihia te wā o te tirotiro ira ki te taumata teitei rawa atu?
● Ko te wā tino mōrearea o te hāputanga (10–25 wiki).
ERCPngā mātāpono mō ngā tamariki
● Tino teitei te aro o ngā kaihoko.
● he mea nui te whakahaere pūmau i te māramatanga me te whakapūmau i te pāmahana.
● Ko ngā kaiwhakahaere tino mātau anake ka whakaaetia.
VIII. E rima ngā mea hei mahi mā te tohungatanga tūturuERCPme mahi te rūma:
1. Pūnaha ine ine rua (paerewa): Kotahi i waho o te āpere mata, kotahi i roto.
2. Whakatūria te DRL (Taumata Tohutoro Tātaritanga): Ko te DRL hou o Hapani: 32 Gy·cm² (75 ōrau).
3. Tirohia ngā āpere mata i ia tau (ka ohorere koe i te tere o te pakaru).
4. Hoatu ki ngā tūroro ngā pepa mōhiohio mō te irahiko (he tikanga paerewa i roto i ngā tari e whakahaeretia pai ana).
5. Whaia ngā tūroro e horopeta nui ana mō ngā wiki e 2–4 (tērā pea ka roa te pakaru o te kiri).
Hei whakamutunga: Mā te tiaki i a koe anō te huarahi anake hei tiaki i te tini o ngā tūroro.
Ko te irahiko e pāngia ana koe: kāore e kitea, kāore he mamae, ā, kāore e puta te whero, kāore koe e rongo tonu, engari ka kohia, ka whara i a koe i ia rā, i ia rā.
Akohia te tiaki tika kia taea ai e koe:
● Mahi roa ake
● Mahi haumaru ake
● Mahi hauora ake
● Mahi ngaio ake
Mei iaERCPkia noho te tākuta i raro i te māramatanga, engari kaua rawa e whara i a koe.
ERCPNgā taonga hokohoko rongonui o ZRHmed.
Ko mātou, ko Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., he kaihanga i Haina e tohunga ana ki ngā taonga endoscopic, tae atu ki te raina GI pēnei i te biopsy forceps, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes,waea ārahi, kete tango kōhatu, kātete tango wai ihu me ētahi atu e whakamahia whānuitia ana i roto i te EMR, ESD,ERCPKua whakamanahia ā mātou hua e te tiwhikete CE me te whakaaetanga FDA 510K, ā, kua whakamanahia hoki ā mātou whare hanga e te tiwhikete ISO. Kua kaweakehia ā mātou taonga ki Ūropi, Amerika Te Raki, Te Waenganui Rawhiti me tētahi wāhanga o Āhia, ā, kua rongonuihia, kua whakamoemititia hoki e te kiritaki!
Wā tuku: Hanuere-13-2026