I roto i ngā tau 50 kua pahure ake nei, kua whanake te hangarau ERCP mai i te taputapu tātaritanga māmā ki te tūāpapa iti rawa te whakaekenga e whakauru ana i te tātaritanga me te maimoatanga. Nā te whakaurunga o ngā hangarau hou pēnei i te endoscopy o te awa biliary me te pancreatic me te endoscopy tino kikokore, kei te huri haere te ERCP i te tauira tātaritanga me te maimoatanga tuku iho mō ngā mate biliary me te pancreatic. Kua nui te ahunga whakamua ki te whakapai ake i te tika o te tātaritanga, te whakawhānui ake i te whānuitanga o ngā tohu, me te whakaiti i te mōrearea o ngā raruraru, e whakaata ana i te ia whanaketanga o "te pokanga hauora e piki haere ana te pokanga me te pokanga e piki haere ana te whakaekenga iti rawa," e whakarato ana i ngā tūroro ki ngā kōwhiringa maimoatanga tika me te whai hua. Heoi, he iti hoki ngā herenga kei roto i te tono haumanu, pēnei i ngā paepae hangarau teitei me te whakawhirinaki nui ki ngā taputapu.
E toru ngā wāhanga matua o ngā hangarau ERCP hou: ngā pūnaha endoscopic mō ngā awa au me ngā awa pancreatic, ngā endoscope tino angiangi, me ngā pūnaha auaha i hangaia i te motu. Mā ngā pūnaha endoscopic pērā i a SpyGlass me Insight-eyeMax ka taea te tiro tika, ā, ka āwhina i te maimoatanga tika.
I roto i ēnei, ko te diameter o waho o te pūnaha SpyGlass he 9F-11F te whānui, ā, ko te diameter o te awa mahi he 1.2mm, 2.0mm rānei, e āhei ai te whakaurunga takitahi o te tirohanga iti o te awa biliary me te pancreatic hei tiro tika i te mucosa. Kei roto i te pūnaha Insight-eyeMax te kounga whakaahua whakamāramatanga teitei 160,000-pika, he tirohanga whānui 120°, me te paninga tino pahekeheke, e whakarato ana i te tirohanga mārama ake me te whānui ake. Ka whakamahia e ngā endoscope tino angiangi he diameter ngongo iti (he iti iho i te 5mm te nuinga) hei tomo tika ki te awa biliary, engari nā te hanganga uaua o te ara kai o runga, he maha ngā wā e hiahiatia ana ngā taputapu āwhina pēnei i ngā poihau whakapūmau, ngā cannulas o waho, me ngā mahanga. He painga ēnei pūnaha ki te tirotiro i te mucosa o te awa biliary me te mahi biopsies, engari he uaua ake te whakahaere.
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| SpyGlass | Insight-eyeMax |
Ko te painga matua o te hangarau ERCP hou ko tōna nekehanga mai i te tirotiro ā-kore ki te tātaritanga tika, e āhei ai ngā tākuta ki te tirotiro i ngā whara o te ate me te kiriuhi o te awa pancreatic me te mahi i ngā koiora me ngā maimoatanga tika i te wā kotahi i te wā o te tukanga tātaritanga. Ko tōna uara haumanu e whakaatahia ana i roto i ngā āhuatanga e toru: te whakapai ake i te tika o te tātaritanga, te whakawhānui ake i te whānuitanga o ngā tohu, me te whakaiti i te mōrearea o ngā raruraru.
Mō te whakapai ake i te tika o te tātaritanga, mā te cholangiopancreatography (ERCP) ka taea e ngā tākuta te tiro tika i te kiriuhi o te awa au me te pancreas, ka tino whakapai ake i te kaha ki te wehewehe i waenga i ngā uauatanga pai me ngā uauatanga kino. Ko te ERCP tuku iho e whakawhirinaki ana ki ngā kaihoko rerekē hei tiro i te hanganga o te lumen, ā, ko te aromatawai i ngā whara o te mucosal e whakawhirinaki ana ki ngā tohu ā-kore. Ko te aro o te paraihe pūtau awa au he 45%-63% noa iho, ā, ko te aro o te koiora kiko he 48.1% noa iho.
He rerekē, mā te cholangiopancreatography (CP) ka taea te tiro tika i te mucosa, ka pai ake te aro ki te tātaritanga. Ina honoa ki te MRCP, ka eke te reiti tika ki te 97.4%, ā, ko te tika o te tātaritanga mō ngā kōhatu awaawa he nui ake i te 9mm te whānui e tata ana ki te 100%. Mō ngā putanga maimoatanga, he teitei te reiti angitu o te ERCP tuku iho mō te tango i ngā kōhatu awaawa pancreatic he iti iho i te 5mm te whānui, engari he teitei ake te reiti kore angitu mō ngā kōhatu uaua (pērā i ērā he nui ake i te 2cm, i muri rānei i te hanga hou o te puku). Mā te CP me te laser lithotripsy ka taea te whakapai ake i te reiti angitu ki te tata ki te taumata o te pokanga tuwhera.
Mō te whakawhānui ake i te whānuitanga o ngā tohu, ka tino whakapai ake te hangarau hou i te reiti angitu o te ERCP i roto i ngā tūroro i muri i te pokanga whakahuri i te puku, ka taea ai e rātou te whakahaere i ngā mate biliary me te pancreatic uaua ake. Hei tauira, i roto i ngā take uaua pēnei i te cholangitis i muri i te whakawhitinga ate me te IPMN o te pancreatic duct, ka taea e te endoscopy o te biliary me te pancreatic duct te whakarato i tētahi tirohanga mārama ake, ka taea ai te tautuhi me te maimoatanga tika.
Ko te auau o te mate pāwera i muri i te ERCP tuku iho he tata ki te 3%-10%. Mā ngā tikanga hou, mā te tirohanga tika, ka whakaitihia te whakaurunga hē o te awaawa pāwera, ka arotau i ngā tikanga, ka whakapoto i te wā pokanga, ka tino whakaitihia te auau o te mate pāwera i muri i te pokanga me ētahi atu raruraru. I roto i tētahi tātaritanga o te 50 tūroro he nui te cholangiocarcinoma, ko te wā patency stent me ngā putanga maimoatanga i roto i te rōpū cholangiopancreatography transoral (TCP) he rite ki ērā i roto i te rōpū ERCP tuku iho, engari i whakaatuhia e te rōpū TCP he painga nui i roto i ngā reiti raruraru.
Kei te pā tonu te hangarau ERCP hou ki ētahi herenga i roto i te tono haumanu. Tuatahi, he teitei te paepae hangarau, ā, he uaua hoki, e hiahia ana ki ngā tohunga tirotiro endoskopiko mohio. Tuarua, he nui te whakawhirinaki ki ngā taputapu, he nui hoki ngā utu tiaki me te whakahaere, e whakawhāiti ana i tōna whakamahinga whānui i roto i ngā hōhipera tiaki tuatahi. Tuatoru, he iti tonu ngā tohu, ā, kei te tūpono tonu te korenga o te tikanga i roto i ētahi āhuatanga. Hei tauira, i roto i ngā take o te uaua nui o te puku (pēnei i te whara o te korokoro) te aukati katoa rānei o te pukupuku, me huri tonu ki te PTCD, ki te pokanga rānei.
Ko ngā whanaketanga o ngā hangarau ERCP hou ā muri ake nei e aro nui ana ki ngā āhuatanga e toru: te whakatairanga i te taumata taketake, te whakaurunga o te AI, me te whakatairanga i te pokanga awatea. Mō te whakatairanga i te taumata taketake, ka āta whakapai ake ngā kaupapa whakangungu me ngā painga utu o ngā taputapu i hangaia i roto i te motu i ngā kaha ERCP o ngā hōhipera tuatahi. Mō te whakaurunga o te AI, he pono te hangarau mōhio whakaahua wā-tūturu mō te whakapai ake i te whai huatanga o te tātaritanga, engari he wero kei mua i a ia pērā i te paerewa raraunga me te māramatanga o te tauira, me te hiahia kia arotauhia anō.
Mō te rongonuitanga o te pokanga awatea, e whakatairanga ana te whakaaetanga o te tau 2025 i te whakaurunga o te ERCP ki roto i te whakahaere pokanga awatea, kia taea ai e te nuinga o ngā tūroro te whakaoti i te tukanga o te whakaurunga hōhipera, te pokanga, te tirotiro i muri i te pokanga, me te tuku i te hōhipera i roto i ngā haora 24. Ehara i te mea ka whakapoto noa i ngā nohoanga hōhipera engari ka whakaitihia hoki ngā utu hauora me te whakapai ake i te whai huatanga o te whakamahinga rauemi hauora. I te whanaketanga me te rongonuitanga o te hangarau, e tumanakohia ana ka whakamahia te ERCP i roto i ngā whare hauora maha atu, ka whakarato i ngā ratonga tātaritanga me te maimoatanga tika me te whai hua ake mō ngā tūroro maha atu e pāngia ana e ngā mate biliary me te pancreatic.
Whakarāpopototanga me ngā Taunakitanga
Ko te ERCP, he hangarau hou, he whanaketanga nui i roto i te tātaritanga me te maimoatanga o ngā mate biliary me te pancreas. Ka whakapai ake i te tika o te tātaritanga mā te tirohanga tika me te koiora tika, ka whakaiti i te mōrearea o ngā raruraru mā te arotau i te tikanga me te whakapoto i te wā maimoatanga, ā, ka whai hua ki ngā tūroro maha atu mā te whakawhānui ake i te whānuitanga o ngā tohu. Heoi, kei te pāngia hoki tēnei hangarau hou e ngā herenga i roto i te tono haumanu, pērā i ngā arai hangarau teitei me te whakawhirinaki kaha ki ngā taputapu, e hiahia ana ki te tautoko a ngā tīma hauora motuhake me ngā taputapu matatau. E taunakihia ana kia whakapakarihia e ngā whare hauora te whakangungu ERCP me te haumi taputapu hei whakapai ake i ngā pūkenga tākuta me te wātea o ngā taputapu. E taunakihia ana hoki kia whiriwhiria ngā tikanga maimoatanga tika i runga i te āhua o te tūroro; mō ngā mate biliary me te pancreas uaua, ka taea te whakaaro ki te maimoatanga ERCP e āwhinahia ana e ngā hangarau hou. Hei tāpiri, e taunakihia ana kia arotau ake i te mahi me te utu o te ERCP, kia aro atu ki ngā take o te whakawhanuitanga me te māramatanga o ngā pūnaha āwhina-AI, me te whakatairanga i te whakamahinga whānui o te ERCP i roto i ngā hōhipera tiaki tuatahi.
Ngā taonga hokohoko rongonui o te raupapa ERCP mai i ZRHmed.
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| Sphincterotomy | Ngā Waea Arataki Kore-Waea | Ngā Kete Whakaemi Kōhatu Whakakore | Ngā Catheters Nasobiliary Whakakore |
Ko mātou, ko Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., he kaihanga i Haina e tohunga ana ki ngā taonga pau endoscopic, tae atu ki ngā raina GI pēnei i te forceps biopsy, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes, guidewire, kete tango kohatu, cathete ihu biliary drainage me ētahi atu e whakamahia whānuitia ana i roto i te EMR, ESD, ERCP. He tiwhikete CE ā mātou hua me te whakaaetanga FDA 510K, ā, he tiwhikete ISO ā mātou tipu. Kua kaweakehia ā mātou taonga ki Uropi, Amerika Te Raki, Middle East me tetahi wāhanga o Āhia, ā, he whānuitia te whiwhinga o te kiritaki i te mihi me te whakamoemiti!
Sphincterotomy、Waea Arataki、Kete Tango Kōhatu、Te Wairewa NasobiliaryTātā、ERCP
Wā tuku: Hakihea-20-2025