ERCP yinjiye mu gihe gishya cyo kubaga robotike

Abaganga bo muri Amerika y'Epfo bishimiye koERCPyinjiye mu gihe gishya cyo kubaga robots kandi irimo gukwirakwiza amakuru hirya no hino.

Mu kiganiro nherutse kugirana n'abaganga bo muri Amerika y'Epfo, navuze kuERCPRobot yo kubaga ya Ausway Endoscopy, ubu iri mu igeragezwa ry’ubuvuzi. Ubwo bamenyaga ko iyi sisitemu ishobora gukora hifashishijwe roboERCP, kugenzura kure endoscope yoroshye n'ibikoresho binyuze mu kuboko kwa robo kugira ngo barangize ibikorwa nko gushyira stent y'inkari nta kwambara amatafari y'icyuma kandi hamwe n'imirasire yagabanutse cyane, ikirere cyahise gihinduka amashanyarazi. Abaganga benshi barishimye cyane ku buryo bari barimo gukwirakwiza iyo nkuru hafi ya yose.

 

Mu gihe cyanjye cy'ikiruhuko, nibajije nti: kuki bari bishimye cyane?

Mfite iki kibazo mu mutwe, nongeye gusuzuma inyandiko n'amakuru bireba, kandi uko nasomaga byinshi, niko byarushagaho gusobanuka—ERCPRobots zo kubaga ni impano ikomeye ku baganga b’indwara z’imitsi, ndetse ni ikoranabuhanga rihindura ubuzima.

Hasi, ndifuza gusangira namwe: Umwicanyi ucecetse muri Endoscopy: Ikibazo cy'imirasire kiri hafi kurusha uko mubitekereza! Buri wese akoraERCPUgomba gusoma ibi

Ikintu cyoroshye kwirengagizwa mu cyumba cyo kubaga si ingorane, ahubwo ni urumuri rurimo kurundanya bucece.

Abahanga benshi mu by'ubuvuzi bw'indwara z'imitsi bazi koERCPikoresha fluoroscopy, ariko ushobora kuba utabizi—Ubu buryo bwashyizwe ku rutonde na FDA nk'isuzuma rifite ibyago byinshi “rishobora kwangiza imirasire cyane.”

Duhugiye mu kuvura amabuye n'imitsi ifata inyo, ariko akenshi twirengagiza ikintu giteye ubwoba kurushaho:

Imirasire irimo kwangiza abarwayi bucece, kandi igirira nabi buri wese uhagaze iruhande rw'umutwe wa C.

Uyu munsi, mu buryo bworoshye kumva, ndasobanura amabwiriza mpuzamahanga n'amakuru nyayo y'ubushakashatsi:

Ni ibihe bintu uhura na byo mu by'ukuri? Ni izihe ngeso "ziba" ubuzima bwawe? Ni gute wakwizeza umutekano by'ukuri?

I. Kuki ariERCPbifatwa nk'uburyo bufite ibyago byinshi bwo gukoresha imirasire?

Kubera koERCPyujuje ibisabwa byose kugira ngo umuntu "ahure n'umuti mwinshi"

● Bisaba fluoroscopy

● Uburyo bugoye bwo gukora

● Kuba hafi ya muganga

● Igihe kirekire

● Uburyo bwo gusubiramo

Ese imibare nyayo iteye ubwoba ite?

Igipimo cy'imirasire ya kimweERCPUburyo bwo gukora bungana na X-ray 312 zo mu gituza (impuzandengo).

—Inyigo yakozwe n'umuntuERCPUmushinga wo gupima imirasire muri Uruguay

Icy'ingenzi kurushaho: Ukora mirongo, amagana, cyangwa arenga mu mwaka.

II. Ni izihe ngaruka imirasire igira kuri wewe?

Kwangirika kw'imirasire kugabanyijemo ibyiciro bibiri:

1) Kwangirika kw'ibintu (bizabaho niba ingano ihagije)

● Gutukura k'uruhu

● Gutakaza umusatsi

● Gukuraho igipimo

● Ibisebe

● Indwara ya cataract (ishobora kwirundanyaho ibintu by’uburozi igihe kirekire)

Ikirahuri ni kimwe mu bice by'umubiri byoroshye cyane, kandi ICRP yagabanyije urugero rw'ikirahuri kigera kuri 20 mSv ku mwaka.

ByinshiERCPInzobere zimaze imyaka irenga icumi zikora zimaze kugira ikibazo cyo kudakora neza kw'amabara y'indorerwamo.

2) Kwangirika gutunguranye (kwangirika gushoboka)

Nta fatizo rihari.

Uko dose iba nyinshi, niko ibyago biba byinshi.

Igereranya rya ICRP: 1 mSv = 0.005% by'ibyago byo kurwara kanseri mu buzima bwose.ERCP≈ 6 mSv → Ingaruka zo kwiyongera kwa 0.03%.

Ntabwo ubikora "rimwe".

Ubikora incuro nyinshi mu mwaka, inshuro ibihumbi mu buzima bwawe.

III. Ahantu hateje akaga cyane muriERCPIcyumba niho uhagarara buri munsi.

Muri make: Uko umuyoboro wa X-ray wegera, niko ingano y'umuti iba nyinshi.

Ahantu hashobora guteza akaga gakomeye ku bakozi harimo:

● Uruhande rumwe rw'umuyoboro wa X-ray wo mu intoki wa C

● Mu gihe cyo gufata amashusho y'inguni y'inyuma

● Agace gakikije umurwayi (isoko nini y'imirasire itatanye)

● Imyanya aho abaganga b'inzobere mu gutera ikinya n'abaforomo bashyirwa

Abantu benshi ntibabizi: Aho bahagaze niho ho hejuru cyane hagaragara imirasire.

IV. Iperereza Nyaryo: 90% by'abakozi b'ubuvuzi ntibafashe ingamba zikwiye zo kubarinda

Ibyavuye mu bushakashatsi bwakozwe na Sociedad Interamericana de Endoscopía Digestiva (SIED) biratangaje:

● 22% by'abaganga ni bo bonyine bahawe amahugurwa yo kurinda imirasire.

● 17% by'abaforomo ni bo bonyine bahawe amahugurwa.

● Uretse amatafari y'icyuma, igipimo cy'ikoreshwa ry'ibindi bikoresho byo kurinda ni gito cyane.

Ese wibona ko uri "mu mutekano"? Ukuri ni uko: Abantu benshi biruka bambaye ubusa.

V. Ihame rya ALARA: Amategeko 3 Buri wese agomba gukurikiza

ALARA = Ifite agaciro gake cyane ku buryo bushoboka

1.Igihe: Ni gito cyane gishoboka.

● Gupima impumuro y'amaraso mu mubiri (pulse fluoroscopy)

● Koresha "Frozen Last Frame"

● Kurinda fluoroscopy ihoraho

2. Intera: Uko ugenda kure ni ko uba mwiza. Uko intambwe igenda isubira inyuma, igipimo → kiba 1/4 cy'icya mbere.

3.Gukingira: Gufunga uko bishoboka kose.

● Ifuro ry'icyuma (≥0.35 mmPb)

● Uburinzi bwa tiroyide

● Indorerwamo z'uburozi (zo kwirinda indwara ya cataract)

● Amarido y'ubudodo

● Ecran zihagaze

Umushumi w'amabati ushobora kugabanya imirasire itatanye ku kigero kirenga 95%.

VI. Ni hehe koko ingaruka mbi ku barwayi ziri?

BMI iri hejuru, isubirwamoERCP, dose nyinshi zitandukanye, igihe kirekire cyo kubagwa. Ibi byose bishobora gutuma abarwayi biyongera vuba mu ruhu.

Kwita ku bintu byihariye:

● Abagore

● Abagore batwite

● Abana (uburyo bwo kumva neza ×3–5)

● Imirasire isubirwamo y'agace kamwe

Aba barwayi bagomba guhabwa dose nke cyane.

VII. Abagore n'abana batwite: Amatsinda afite ibyago byinshi agomba kuganirwaho ukwayo.

ERCPAmahame agenga abagore batwite

● Ese "ni ngombwa koko"?

● Ese bishobora gusubikwa?

● Ese bikorwa n'umuganga w'inararibonye kurusha abandi?

● Ese igihe cyo gukoresha fluoroscopy cyagabanijwe ku rugero runini?

● Igihe cy'uburumbuke giteje akaga cyane (ibyumweru 10–25).

ERCPamahame agenga abana

● Ubushobozi bwo kumva ibintu ku buryo bukabije.

● Kugenzura urumuri rukomeye no kugenzura konkora ni ngombwa.

● Abakora akazi k’uburambe buhanitse ni bo bonyine bemerewe gukora.

VIII. Ibintu bitanu by'umwuga kokoERCPicyumba kigomba gukora:

1. Sisitemu y'ibipimo bibiri (isanzwe): Imwe hanze y'agapira k'icyuma, indi imbere.

2. Shyiraho DRL (Urwego rw'Isuzuma ry'Ubuvuzi): DRL iheruka mu Buyapani: 32 Gy·cm² (75th percentile).

3. Suzuma amatafari y'ubudodo buri mwaka (uzatungurwa n'uko yangiritse).

4. Guha abarwayi impapuro z'amakuru yerekeye imirasire (uburyo busanzwe bwo gukora mu mashami acungwa neza).

5. Gukurikirana abarwayi bapimwe ku rugero rwo hejuru mu gihe cy'ibyumweru 2-4 (kwangirika k'uruhu bishobora gutinda).

Mu gusoza: Kwirinda ni bwo buryo bwonyine bwo kurinda abarwayi benshi.

Imirasire uhura nayo ni: itagaragara, nta bubabare, kandi ntabwo itera gutukura, ntuhita uyiyumva ako kanya, ariko irakurundana ikakugirira nabi buri munsi.

Menya uburyo bukwiye bwo kwirinda kugira ngo ubashe:

● Akora igihe kirekire

● Kora neza kurushaho

● Kora neza

● Kora akazi k'ubunyamwuga

Buri munsiERCPmuganga, jya munsi y'urumuri, ariko ntukagire icyo ubikoraho.

ERCPIbintu bigurishwa cyane bya ZRHmed.

Sphincterotome	Insinga zitagira imitsi	Uduseke two gukuramo amabuye dukoreshwa mu gihe runaka	Catheters zo mu mazuru zishobora gukoreshwa mu gihe cyo kubura amazi

Twebwe, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ni uruganda rwo mu Bushinwa rwihariye mu bikoresho bikoreshwa mu gupima imiterere y'umubiri, rurimo umurongo wa GI nka biopsy forceps, hemoclip, polyp snare, sclerotherapy energetic, spray catheter, cytology brushes,insinga y'ubuyobozi, agasanduku ko gukurura amabuye, cathete yo mu mazuru yo gusohora amazi n'ibindi bikoreshwa cyane muri EMR, ESD,ERCPIbicuruzwa byacu bifite icyemezo cya CE kandi byemejwe na FDA 510K, kandi inganda zacu zifite icyemezo cya ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika ya Ruguru, Uburasirazuba bwo Hagati no mu gice kimwe cya Aziya, kandi byahesheje abakiriya icyubahiro n'ishimwe!