I roto i ngā tau 50 kua pahure ake nei,ERCPKua whanake te hangarau mai i tētahi taputapu tātaritanga māmā noa iho ki tētahi tūāpapa iti rawa te whakaekenga e whakauru ana i te tātaritanga me te maimoatanga. Nā te whakaurunga mai o ngā hangarau hou pēnei i te endoscopy o te awa biliary me te pancreatic me te endoscopy tino kikokore,ERCPKei te whakarerekē haere i te tauira tātaritanga me te maimoatanga tuku iho mō ngā mate ate me te repeure. Kua nui te ahunga whakamua i roto i 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 ki te pokanga me te pokanga e piki haere ana ki te iti rawa te whakaekenga," e whakarato ana i ngā kōwhiringa maimoatanga tika me te whai hua ki ngā tūroro. Heoi, he iti anō hoki ōna herenga i roto i te tono haumanu, pērā i ngā paepae hangarau teitei me te whakawhirinaki nui ki ngā taputapu.
HouERCPE toru ngā wāhanga matua o ngā hangarau: 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 mea houERCPKo te hangarau nei kua eke ki tētahi taumata mai i te tirotiro ā-kore ki te tātaritanga tika, ā, ka taea e ngā tākuta 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 roto i 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, ko te cholangiopancreatography (ERCP) ka taea e ngā tākuta te tiro tika i te kiriuhi o te ate me te puku o te pancreas, ka whakapai ake i te kaha ki te wehewehe i waenga i ngā uauatanga pai me ngā uauatanga kino. Tuku IhoERCPe whakawhirinaki ana ki ngā kaihoko rerekētanga 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 awaawa 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 tere tika ki te 97.4%, ā, ko te tika o te tātaritanga mō ngā kōhatu awaawa >9mm te whānui e tata ana ki te 100%. Mō ngā putanga maimoatanga, ko te tikanga tuku ihoERCPhe nui te angitu mō te tango i ngā kōhatu o te awa repeure e iti iho ana i te 5mm te whānui, engari he nui ake te kore angitu mō ngā kōhatu uaua (pērā i ngā mea neke atu i te 2cm, i muri rānei i te hanganga anō o te puku). Mā te CP me te laser lithotripsy ka taea te whakapai ake i te 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 oERCPi roto i ngā tūroro i muri i te pokanga whakahuri i te puku, ka taea ai e rātou te whakahaere i ngā mate uaua o te biliary me te pancreatic. 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.
Te auau o te pancreatitis i muri i te tikanga tuku ihoERCPtata ki te 3%-10%. Mā ngā tikanga hou, mā te tirohanga tika, ka whakaitihia te whakaurunga hē o te awa pancreatic, ka arotau i ngā tikanga, ka whakapoto i te wā pokanga, ka tino whakaitihia te maha o ngā mate pancreatitis 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 tuku iho.ERCPrōpū, engari i whakaatuhia e te rōpū TCP he painga nui i roto i ngā reiti raruraru.
Ko te mea houERCPKei te pā tonu te hangarau 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 mataotao 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.
Ngā whanaketanga o ngā momo hou ā muri ake neiERCPE toru ngā āhuatanga matua o ngā hangarau: te whakatairanga i te taumata taketake, te whakaurunga o te AI, me te whakatairanga i te mahi pokanga i te 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 te motu.ERCPngā āheinga 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 whakataurite raraunga me te māramatanga o te tauira, e hiahia ana kia arotauhia anō.
Mō te rongonuitanga o te pokanga awatea, e whakatairanga ana te whakaaetanga o te tau 2025 i te whakaurunga oERCPi roto i te whakahaere pokanga i te awatea, e āhei ai te nuinga o ngā tūroro ki te whakaoti i te tukanga o te hōhipera, te pokanga, te tirotiro i muri i te pokanga, me te tukunga 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 rongonui haere o te hangarau,ERCPe tūmanakohia ana kia whakamahia i roto i ngā whare hauora maha atu, kia pai ake ai te tautuhi me te maimoatanga mō ngā tūroro e mate ana i te ate me te pancreas.
Whakarāpopototanga me ngā Taunakitanga
ERCP, he hangarau hou, he putanga nui i roto i te tātaritanga me te maimoatanga o ngā mate biliary me te pancreatic. 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 ake ki ngā tūroro 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, me te tautoko a ngā tīma hauora motuhake me ngā taputapu matatau. E taunakihia ana kia whakapakarihia e ngā whare hauoraERCPwhakangungu 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 uaua o te ate me te pancreas,ERCPka taea te whakaaro ki te maimoatanga e āwhinahia ana e ngā hangarau hou. Hei tāpiri, e taunakihia ana kia arotau ake i te mahi me te utu oERCP, te aro atu ki ngā take o te whakawhanuitanga me te māramatanga o ngā pūnaha āwhina-AI, me te whakatairanga i te whakamahinga whānui oERCPi roto i ngā hōhipera tiaki tuatahi.
ERCPNgā taonga hokohoko rongonui o 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 endoscopic, tae atu ki te raina GI pēnei i te biopsy forceps, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes,waea ārahi, kete tiki kohatu, he kātete whakaheke 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: Hakihea-20-2025