Ko te koiora endoscopic te wāhanga tino nui o te tirotiro endoscopic o ia rā. Tata ki ngā tirotiro endoscopic katoa e hiahiatia ana he tautoko pathological i muri i te koiora. Hei tauira, ki te whakapaehia he mumura, he mate pukupuku, he ngoikore, he metaplasia whēkau, he mate HP rānei te mucosa o te ara kai, me te mate pukupuku HP, me whai pathology kia puta ai he hua tuturu.
I tēnei wā, e ono ngā tikanga koiora e whakahaerehia ana i Haina:
1. Whakamātautau Cytobrush
2. Te Kohikohi kiko
3. Tikanga koiora kauhanga
4. EMR me te tikanga koiora papatipu
5. Tikanga koiora pūtau katoa ESD
6. FNA e arahina ana e te Ultrasound
I tēnei rā ka arotahi tātou ki te arotake i te koiora kiko, e mōhiotia whānuitia ana ko te "whakapiripiri i tētahi wahi mīti".
Kāore e taea te mahi i te koiora i raro i te endoscopi nakunaku me te kore he kuku koiora, he taputapu anō hoki tēnei e whakamahia whānuitia ana e ngā kaiako nēhi endoscopic. Tērā pea ka whakaaro ngā kaiako e mahi ana i te nēhi endoscopic he tino māmā te whakamahi i ngā kuku koiora, he rite tonu ki te whakatuwhera me te kati. Inaa, kia mārama ai te whakamahi i ngā kuku koiora, me tino tika, me whai māramatanga me te mahi uaua, me te mōhio hoki ki te whakarāpopoto.
I.Tuatahi, me arotake tātou i te hanganga ongā kukupa koiora:
(I) Te hanganga o ngā pūwero koiora (Pikitia 1): Ko ngā pūwero koiora he mea hanga mai i te pito, te tinana me te kakau whakahaere. He rite tonu te hanganga o ngā pūwero koiora ki te hanganga o ngā pūwero koiora he maha ngā taputapu pēnei i ngā pūwero tinana ke, ngā pūwero koiora wera, ngā kutikuti, ngā kureti, me ētahi atu.
Tohutohu: E rua ngā kauae āhua kapu o te pito, ka taea te whakatuwhera me te kati. Ko te āhua o ngā kauae te mea nui ki te mahi a ngā momo kuku koiora. E whitu ngā momo ka taea te wehewehe: te momo tuwhera kotahi, te momo tuwhera rua, te momo matapihi, te momo ngira, te momo porowhita, te momo waha kokota, me te momo piko o te pito. He mea hanga ngā kauae o ngā kuku koiora ki te maitai kore waikura, ā, he koi ngā mata. Ahakoa he koi anō ngā mata o ngā kuku koiora ka taea te whakamahi anō, he iti te ātete ki te kakahu. Ko ngā mata o ngā kuku koiora ka taea te whakamahi anō ka rongoatia kia pakari ake ai.
Ngā momo noa ongā kukupa koiora
1. Momo paerewa me te matapihi
He matapihi kei waenganui o te kapu forceps, e whakaiti ana i te kino o te kiko, e whakanui ana hoki i te nui o te kiko i kohia.
2. Momo paerewa me te matapihi me te ngira
Kei waenganui o te kapu forceps he ngira hei ārai i te paheke o te koiora mā roto i te mucosa, hei āwhina hoki ki te hopu i te tauira kiko.
3. Momo ararikata
Ka ārai te kapu rawhi niho i te paheke o te kapu rawhi, ā, he koi te mata tapahi mō te pupuri pai ake.
4. Momo ararika me te ngira
He whānui te koki whakatuwheratanga o ngā kauae hei whakanui ake i te rōrahi o te koiora; he koi te mata o te mata hei pupuri mārō ake.
He ngira kei waenganui o te pane rawhi, ka taea ai te whakatikatika kia whai hua ake, kia tika ake hoki.
He pai mō te tango i te koiora ki ngā kiko mārō ake pērā i ngā pukupuku.
Tinana Pūwero: Ko te tinana o ngā pūwero koiora he mea hanga ki te ngongo miro kowiri tira, kei roto he waea rino hei kukume i te takirere pūwero hei whakatuwhera me te kati. Nā te hanganga motuhake o te ngongo miro, ka taea e te hūpē kiko, te toto me ētahi atu matū te uru ngāwari ki roto, engari ehara i te mea ngāwari ki te horoi pai. Ki te kore e horoia pai ka raru te mahi a ngā pūwero koiora, ā, e kore e maeneene te whakatuwheratanga me te kati, e kore rānei e taea te whakatuwhera. Kakau whakahaere: Ko te mowhiti i runga i te kakau whakahaere hei pupuri i te koromatua, ā, ko te awaawa porowhita whānui hei whakanoho i te maihao tohu me te maihao waenga. I raro i te mahi a ēnei maihao e toru, ka tukuna te kaha ki te takirere pūwero mā te waea kukume hei whakatuwhera me te kati.
(II) Ngā kōrero matua mō te whakamahinga o ngā kukupa koiora: Me tino tupato te whakahaere, te whakamahi me te tiaki i ngā kukupa koiora, ki te kore ka pā ki te whakamahinga o te endoscope.
1. Te kimi i mua:
I mua i te whakamahinga, kia tino whakahoromatatia ngā kukupa koiora, ā, kia whakamahia i roto i te wā whakahoromata whai mana. I mua i te whakaurunga o te awa kukupa endoscope, me whakamātau te whakatuwheratanga me te katinga o ngā kukupa (Pikitia 2).
Pikitia 2 Te kimi i ngā forceps koiora
Ko te tikanga motuhake ko te takai i te tinana o te pūwero ki roto i tētahi porowhita nui (ko te whānui o te porowhita he 20cm te whānui), kātahi ka mahi i ngā mahi whakatuwhera me te kati maha hei tirotiro mēnā ka tuwhera, ka kati pai ngā pūwero. Mēnā he 1-2 ngā wā kāore i te maeneene, he pai ake kia kaua e whakamahia te pūwero. Tuarua, me whakamātautau te katinga o ngā pūwero. Tangohia he pepa angiangi pērā i te pepa reta ka whakapiri ki te pūwero. Ka tohua mēnā kāore te pepa angiangi e taka. Tuatoru, me tirotiro mēnā kei te tino tūhono ngā kapu e rua o ngā pūwero (Pikitia 3). Mēnā he hē te tūhono, kati tonu te whakamahi, ki te kore ka rakuraku te paipa pūwero.
Pikitia 3 Te taupoki o te pūwero koiora
Ngā tuhipoka i te wā e mahi ana:
I mua i te whakaurunga o te ngongo unu, me kati ngā kauae, engari kia mahara kia kaua e kaha rawa te whakamahi i te kaha kei kore e katia, ka totoro te waea kukume, ka pā ki te whakatuwheratanga me te katinga o ngā kauae. 2. I te whakaurunga o te ngongo, tomohia mā te ahunga o te whakatuwheratanga o te ngongo unu, kaua hoki e mirimiri ki te whakatuwheratanga o te ngongo. Ki te tūtaki koe ki te ātete i te wā e tomo ana, me wetekina te pātene koki, ka ngana ki te tomo i roto i te āhua tika. Ki te kore tonu e taea e koe te puta, tangohia te endoscope mai i te tinana hei whakamātautau, whakakapia rānei ki ētahi atu unu biopsy pērā i ngā tauira iti ake. 3. I te wa e unuhia ana ngā unu biopsy, kaua e whakamahi i te kaha rawa. Me hopu e te kaiawhina ki ngā ringa e rua, kātahi ka piko. Kaua e totoro rawa ō ringa. 4. Ki te kore e taea te kati i ngā kauae, kaua e unuhia kaha ki waho. I tēnei wā, me pana atu i te tinana me te endoscope hei tukatuka anō.
II. Whakarāpopototanga o ētahi tikanga o te koiora
1. He mahi hangarau te whakatuwhera me te kati i ngā pūwero koiora. Me whai aronga te whakatuwheratanga, inā koa te koki puku, me poutū ki te wāhi i kohia ai te koiora. Me whai wā te kati. He pumau te nekehanga o te puku me te mahi a te taote pokanga, ā, kāore e taea te whakatika tonu. Me hopu e te kaiawhina te whai wāhi ki te pupuri pai me te haumaru i ngā pūwero koiora.
2. Me nui, me hōhonu hoki te tauira koiora kia tae atu ki te kiriuhi uaua.
3. Whakaarohia te pānga o te toto i muri i te kohi pūtau ki ngā kohi pūtau o muri mai. Ina hiahiatia kia kohi pūtau te koki puku me te antrum i te wā kotahi, me kohi pūtau te koki puku i te tuatahi, kātahi ka kohi te antrum; ina nui te wāhi whara, ā, me whakapiripiri ngā wahi kiko maha, me tika te wahi tuatahi, ā, me whakaaro anō hoki mēnā ka kapi te toto i muri i te whakapiripiri i ngā kiko e karapoti ana, ka pā ki te tirohanga, ki te kore ka matapo, ka noho puku te whakapiripiri i muri mai.
Te raupapatanga noa o te koiora mō ngā whara i te koki puku, me te whai whakaaro ki te pānga o te rere o te toto ki ngā koiora e whai ake nei
4. Ngāna ki te mahi i te koiora pēhanga poutū ki te wāhi e hiahiatia ana, ā, whakamahia te momi ina hiahiatia. Ka whakaitihia e te momi te kukū o te mata o te kiriuhiuhi, ka taea ai te piri hohonu ake o te kiko, ā, ka iti ake te tūponotanga ka paheke.
Me mahi poutū te koiora i te mea ka taea, ā, kaua te roa o te toronga o te kuku koiora e neke ake i te 2cm.
5. Kia tūpato ki te whiriwhiri i ngā pūwāhi tauira mō ngā momo whara rerekē; e pā ana te whiriwhiri i ngā pūwāhi tauira ki te reiti pai. He koi te kanohi o te taote pokanga, ā, me tūpato hoki ki ngā pūkenga whiriwhiri rauemi.
Ngā wāhi hei tango i te koiora Ngā wāhi kāore e tika kia tangohia te koiora
6. Ko ngā wāhanga e uaua ana ki te tango i te koiora ko te fundus o te puku e tata ana ki te cardia, te piko iti o te tinana puku e tata ana ki te pakitara o muri, me te kokonga o runga o te duodenum. Me aro te kaiawhina ki te mahi tahi. Ki te hiahia ia ki te whakatutuki i tētahi hua tino pai, me ako ia ki te whakamahere i mua me te whakarerekē i te ahunga o te taupoki rawhi i ngā wā katoa. I taua wā anō, me tere tana whakatau i te wā o te rawhi mā te whakamahi i ngā whai wāhitanga katoa. I ētahi wā, i te tatari mō ngā tohutohu mai i te taote pokanga, mā te whakaroa o te 1 hēkona ka ngaro pea ngā whai wāhitanga. Ka taea e au te tatari marie mō te whai wāhitanga e whai ake nei.
E tohu ana ngā pere i ngā wāhi e uaua ana ki te tiki rauemi, ki te aukati rānei i te toto.
7. Te Kōwhiringa o ngā Kīpī Koiora: Ko ngā kīpī koiora ko ērā he nui ngā pūaha kapu, he hohonu hoki, ko ētahi he ngira tūnga, ko ētahi he pūaha taha, he ngau taratara.
8. He tika ake te whakanui me te tae hiko hei ārahi i te koiora, inā koa mō te tango tauira i te kiriuhi esophageal.
Ko mātou, ko Jiangxi ZhuoRuiHua Medical Instrument Co.,Ltd., he kaihanga i Haina e tohunga ana ki ngā taonga endoscopic, pērā ingā kukupa koiora, hemoclip, mahanga poripi, ngira whakaora kiriuhi, pūwero rehu, paraihe cytology, waea ārahi, kete tiki kohatu, te katitere rerenga wai ihu me ētahi atue whakamahia whānuitia ana i roto iEMR, ESD, ERCPKua whai tiwhikete CE ā mātou hua, ā, kua whai tiwhikete ISO ā mātou whare hanga. Kua kaweakehia ā mātou taonga ki Ūropi, Amerika Te Raki, Te Rawhiti o Waenganui me tētahi wāhanga o Āhia, ā, kua whānuitia te mihi me te whakamoemiti a te kiritaki!
Wā tuku: Hanuere-23-2025