Endopopique biopsy nigice cyingenzi mugupima endoskopi ya buri munsi. Ibizamini bya endoskopi hafi ya byose bisaba ubufasha bwa patologi nyuma ya biopsy. Kurugero, niba mucosa yinzira yigifu ikekwa kuba ifite uburibwe, kanseri, atrophy, metaplasia yo munda, hamwe na HP, indwara ya patologiya irasabwa gutanga ibisubizo nyabyo.
Kugeza ubu, tekinike esheshatu za biopsy zirakorwa mubushinwa:
1. Ikizamini cya Cytobrush
2. Biopsy
3. Tekinike ya biopsy tekinike
4. EMR hamwe na tekinike ya biopsy
5. Ubuhanga bwibibyimba byose biopsy tekinike ESD
6. Ultrasound iyobowe na FNA
Uyu munsi tuzibanda ku gusuzuma biopsy ya tissue, bakunze kwita "gufata inyama".
Biopsy iri munsi ya endoskopi igogora ntishobora gukorwa idafite ingufu za biopsy, nayo ikaba ari kimwe mubikoresho bikoreshwa cyane nabarimu baforomo ba endoskopi. Abarimu bakora umwuga w'ubuforomo wa endoskopi barashobora gutekereza ko imbaraga za biopsy zoroshye gukoresha, kimwe no gufungura no gufunga. Mubyukuri, kugirango ukoreshe imbaraga za biopsy neza kandi neza, umuntu agomba kugira ubushishozi nakazi gakomeye, kimwe no kuba incamake.
I.Ubwa mbere, reka dusubiremo imiterere yabiopsy imbaraga:
. Ibikoresho byinshi nkimbaraga zumubiri zamahanga, ingufu za biopsy zishyushye, imikasi, curettes, nibindi bisa nuburyo bwimikorere ya biopsy.
Impanuro: Inama igizwe nurwasaya rumeze nk'igikombe rushobora gukingurwa no gufungwa. Imiterere y'urwasaya ni urufunguzo rw'imikorere ya biopsy forceps zitandukanye. Birashobora kugabanwa mubice birindwi: gufungura ubwoko bumwe, gufungura kabiri, ubwoko bwidirishya, ubwoko bwurushinge, ubwoko bwa oval, ubwoko bwingona, nubwoko bugoramye. Urwasaya rwingufu za biopsy rukozwe mubyuma bidafite ingese kandi bifite ibyuma bityaye. Nubwo ibyuma byimbaraga za biopsy zikoreshwa nabyo birakaze, bifite imbaraga zo kwihanganira kwambara. Ibyuma byongera ingufu za biopsy byongeye gukoreshwa kubutaka bwihariye kugirango bikorwe neza.
Ubwoko rusange bwabiopsy imbaraga
1.Ubwoko bwa Standard hamwe nidirishya
Hano hari idirishya hagati yigikombe cya forceps, kigabanya cyane kwangirika kwinyama kandi byongera ubwinshi bwimitsi ya biopsy.
2. Ubwoko busanzwe hamwe nidirishya ninshinge
Urushinge ruherereye hagati yigikombe cyingufu kugirango wirinde biopsy kunyerera mumitsi no gufasha gufata icyitegererezo.
3. Ubwoko bwa Alligator
Igikombe gikaranze gikingira neza igikombe cya clamp kunyerera, kandi gukata birakaze kugirango bifate neza.
4. Ubwoko bwa Alligator hamwe nurushinge
Urwasaya rufite inguni nini yo gufungura kugirango yongere ubwinshi bwa biopsy; inkota yicyuma irakaze kugirango ifate neza.
Hano hari urushinge rwagati rwumutwe wa clamp, rushobora gutuma gukosora neza kandi neza.
Bikwiranye na biopsy kumyenda ikomeye nkibibyimba.
Umubiri wa Forceps: Umubiri wingufu za biopsy zikozwe mubyuma bitagira umuyonga wicyuma, urimo insinga zicyuma zo gukurura valve imbaraga kugirango zifungure kandi zifunge. Bitewe nuburyo bwihariye bwigitereko cyurudodo, mucus tissue, maraso nibindi bintu birashobora kubyinjiramo byoroshye, ariko ntibyoroshye kubisukura neza. Kunanirwa kuyisukura neza bizatera ikibazo mumikorere ya biopsy Force, kandi gufungura no gufunga ntibizoroha cyangwa ntibishoboka gufungura. Igikoresho gikora: Impeta iri kumikorere ikoreshwa mugufata igikumwe, naho ubugari bugari bukoreshwa mugushira urutoki rwerekana urutoki. Mubikorwa byintoki eshatu, imbaraga zoherezwa kumurongo wimbaraga zinyuze mumashanyarazi yo gukingura no gufunga.
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1. Mbere yo gutahura:
Mbere yo kuyikoresha, menya neza ko ingufu za biopsy zahinduwe kandi zikoreshwa mugihe cyiza cyo kuboneza urubyaro. Mbere yo kwinjiza umuyoboro wa endoscope, gufungura no gufunga imbaraga bigomba kugeragezwa (Ishusho 2).
Igishushanyo 2 Biopsy forceps detection
Uburyo bwihariye nuguhuza umubiri wa biopsy imbaraga mumuzingi munini (diameter yumuzingi ni nka 20cm), hanyuma ugakora ibikorwa byinshi byo gufungura no gufunga kugirango urebe niba imbaraga zifunguye zifunguye kandi zifunga neza. Niba hari inshuro 1-2 zidahwitse, nibyiza kudakoresha imbaraga za biopsy. Icya kabiri, birakenewe kugerageza gufunga ingufu za biopsy. Fata urupapuro ruto nk'urupapuro rw'inyuguti hanyuma uhambire hamwe na biopsy. Byujuje ibisabwa niba impapuro zoroheje zitaguye. Icya gatatu, birakenewe kureba niba ibikombe bibiri bya flaps flaps bihujwe rwose (Ishusho 3). Niba hari ukudahuza, hagarika kuyikoresha ako kanya, bitabaye ibyo izashushanya umuyoboro w'ingufu.
Igishushanyo cya 3 Biopsy forceps flap
Inyandiko mugihe gikora:
Mbere yo gushyiramo umuyoboro w'ingufu, urwasaya rugomba gufungwa, ariko wibuke kudakoresha imbaraga nyinshi kubera gutinya gufunga ubusa, bizatera insinga zikurura kurambura bikagira ingaruka no gufungura no gufunga urwasaya. . Niba uhuye nuburwanya mugihe winjiye, ugomba kurekura buto yinguni hanyuma ukagerageza kwinjira muburyo busanzwe bugororotse. Niba udashobora kurengana, kura endoscope mumubiri kugirango ugerageze, cyangwa uyisimbuze izindi mbaraga za biopsy nka moderi nto. 3. Mugihe ukuramo ingufu za biopsy, irinde gukoresha imbaraga zikabije. Umufasha agomba guhinduranya ayifata n'amaboko yombi hanyuma akayunama. Nturambure amaboko cyane. 4. Iyo urwasaya rudashobora gufungwa, ntukuremo ku gahato. Muri iki gihe, igomba gusunikwa hanze yumubiri hamwe na endoscope kugirango irusheho gutunganywa.
II. Inshamake yubuhanga bumwe na bumwe bwa biopsy
1. Gufungura no gufunga ingufu za biopsy byombi ni imirimo ya tekiniki. Gufungura bisaba icyerekezo, cyane cyane inguni ya gastric, igomba kuba perpendicular kurubuga rwa biopsy. Gufunga bisaba igihe. Imikorere ya Gastrointestinal nigikorwa cyo kubaga irahagaze neza kandi ntishobora gukosorwa ubudahwema. Umufasha agomba gukoresha umwanya wo gukora neza kandi neza umutekano wa biopsy.
2. Urugero rwa biopsy rugomba kuba runini bihagije kandi rwimbitse kugirango rugere kumitsi ya muscularis.
3. Reba ingaruka zo kuva amaraso nyuma ya biopsy kuri biopsies ikurikira. Iyo inguni ya gastric na antrum igomba gukenerwa icyarimwe, inguni ya gastric igomba kubanza gukoporora hanyuma ikavuga; mugihe agace ka lesion ari nini kandi ibice byinshi byingingo bigomba gufatanwa, igice cya mbere kigomba kuba gisobanutse neza, kandi ni ngombwa no gusuzuma niba kuva amaraso nyuma yo gufunga bizaba bitwikiriye imyenda ikikije kandi bikagira ingaruka kumyerekezo, naho ubundi gukurikiraho bizaba impumyi kandi byoroshye.
Urutonde rwa biopsy rusanzwe rwibisebe kuri gastric, urebye ingaruka zamaraso atembera kuri biopsies
4. Gerageza gukora biopsy yumuvuduko uhagaze kumwanya wateganijwe, kandi ukoreshe guswera mugihe bibaye ngombwa. Kunywa bigabanya uburemere bwimiterere ya mucosa, bigatuma ingirabuzimafatizo zifatirwa cyane kandi ntibishobora kunyerera.
Biopsy igomba gukorwa mu buryo buhagaritse bishoboka, kandi uburebure bwagutse bwingufu za biopsy ntibugomba kurenza 2CM.
5. Witondere guhitamo ingingo zicyitegererezo kuburyo butandukanye; guhitamo ingingo zicyitegererezo zijyanye nigipimo cyiza. Umuganga ubaga afite ijisho rityaye kandi agomba no kwitondera ubuhanga bwo guhitamo ibikoresho.
Ahantu ho kuba biopsied Ahantu hatagomba kuba biopsied
6. Ibice bigoye biopsy harimo ikigega cyigifu hafi yumutima, kugabanuka gukabije kwumubiri wigifu hafi yurukuta rwinyuma, no mugice cyo hejuru cya duodenum. Umufasha agomba kwibanda ku bufatanye. Niba ashaka kugera ku gisubizo cyiza, agomba kwiga gutegura mbere no guhindura icyerekezo cya flamp flap umwanya uwariwo wose. Muri icyo gihe, agomba kumenya vuba igihe cyo gukomera akoresheje amahirwe yose. Rimwe na rimwe, iyo utegereje amabwiriza yatanzwe na muganga, gutinda kw'isegonda 1 bishobora kuganisha ku mahirwe yabuze. Nshobora gutegereza gusa kwihangana amahirwe akurikira.
Imyambi yerekana ahantu bigoye kubona ibikoresho cyangwa guhagarika kuva amaraso.
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8. Gukura hamwe no gusiga ibyuma bya elegitoronike kugirango biyobore biopsy birasobanutse neza, cyane cyane kubitondekanya mucosa esofageal.
Twe, Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., Ni uruganda mu Bushinwa ruzobereye mu gukoresha endoskopi, nkabiopsy imbaraga, hemoclip, umutego, inshinge, spray catheter, cytology, kuyobora, igitebo cyo kugarura amabuye, izuru biliary drainage catheter nibindi. zikoreshwa cyane muriEMR, ESD, ERCP. Ibicuruzwa byacu byemewe na CE, kandi ibihingwa byacu byemewe na ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika y'Amajyaruguru, Uburasirazuba bwo hagati ndetse no muri Aziya, kandi bigera ku bakiriya bamenyekana kandi bashimwe!
Igihe cyo kohereza: Mutarama-23-2025