Odokotela baseLatin America bajabule kakhulu ngokuthiI-ERCPisingene enkathini entsha yokuhlinzwa kwamarobhothi futhi isakaza izindaba kude nakude.
Ngesikhathi ngixoxa nodokotela baseLatin America muva nje, ngikhulume ngeI-ERCPirobhothi lokuhlinza elivela e-Ausway Endoscopy, okwamanje elivivinywa ngokwemitholampilo. Lapho bezwa ukuthi lolu hlelo lungenza umsebenzi wokusiza irobhothiI-ERCP, ukulawula kude i-endoscope eguquguqukayo kanye namathuluzi ngengalo yerobhothi ukuze kuqedwe izinqubo ezifana nokufakwa kwe-biliary stent ngaphandle kokugqoka ama-apron e-lead kanye nokuvezwa kwemisebe okuncishisiwe kakhulu, umkhathi waba ugesi ngokushesha. Odokotela abaningi babejabule kakhulu kangangokuthi babesakaza izindaba cishe.
Ngesikhathi sami sokuphumula, ngangizibuza: kungani babejabule kangaka?
Nginalo mbuzo engqondweni, ngiphinde ngabuyekeza izincwadi nedatha efanele, futhi lapho ngifunda kakhulu, kwaba sobala kakhulu—I-ERCPAmarobhothi okuhlinza ayindlela enhle ngempela yokusiza odokotela be-endoscopist, ngisho nobuchwepheshe obushintsha impilo.
Ngezansi, ngingathanda ukwabelana nani: Umbulali Othule ku-Endoscopy: Inkinga Yokushiswa Kwemisebe Iseduze Kunalokho Enikucabangayo! Wonke Umuntu UdlalaI-ERCPKumelwe Ufunde Lokhu
Into enganakwa kalula egumbini lokuhlinza akuzona izinkinga, kodwa ukukhanya okuqoqana buthule.
Odokotela abaningi be-endoscopist bayazi ukuthiI-ERCPisebenzisa i-fluoroscopy, kodwa ungase ungazi—Le nqubo ibhalwe yi-FDA njengokuhlolwa okuyingozi kakhulu “okungabangela umonakalo omkhulu wemisebe.”
Simatasa selapha amatshe enyongo kanye nokuqina kwesibindi, kodwa sivame ukunganaki into eyesabekayo nakakhulu:
Imisebe ilimaza iziguli buthule, futhi ilimaza wonke umuntu omi eduze kwengalo ye-C.
Namuhla, ngendlela elula ukuyiqonda, ngizochaza iziqondiso zomhlaba wonke kanye nedatha yocwaningo lwangempela:
Uchayeke kangakanani ngempela? Yimiphi imikhuba "eyeba" impilo yakho? Ungaqinisekisa kanjani ukuphepha ngempela?
I. Kungani kunjaloI-ERCPkubhekwe inqubo eyingozi kakhulu ehilela imisebe?
NgobaI-ERCPihlangabezana nazo zonke izimo "zokuvezwa ngomthamo ophezulu"
● Kudinga i-fluoroscopy
● Inqubo eyinkimbinkimbi
● Ukusondela eduze nodokotela
● Isikhathi eside
● Izinqubo eziphindaphindayo
Ziyesabeka kangakanani izibalo zangempela?
Umthamo wemisebe we-oneI-ERCPinqubo cishe ilingana nama-X-ray esifuba angu-312 (isilinganiso).
—Ucwaningo oluvela ku-I-ERCPiphrojekthi yokulinganisa imisebe e-Uruguay
Okubaluleke kakhulu: Uthola amashumi, amakhulu, noma ngisho nangaphezulu ngonyaka.
II. Imiphi imiphumela imisebe enayo kuwe?
Umonakalo wemisebe uhlukaniswe ngezigaba ezimbili:
1) Umonakalo oqondile (kuzokwenzeka uma umthamo wanele)
● Ukubomvu kwesikhumba
● Ukulahlekelwa izinwele
● Ukususwa kwesithunzi
● Izilonda
● Ama-cataract (avame ukunqwabelana isikhathi eside kwezinto ezinobuthi)
Ilensi ingenye yezitho ezibuthakathaka kakhulu, futhi i-ICRP yehlise umkhawulo waba ngu-20 mSv/ngonyaka.
EziningiI-ERCPOchwepheshe asebesebenze iminyaka engaphezu kweshumi kakade sebekubonile ukungabonakali kwelensi.
2) Umonakalo ongahleliwe (umonakalo ongenzeka)
Akukho mkhawulo.
Uma umthamo uphakeme, kulapho ingozi iba nkulu khona.
Isilinganiso se-ICRP: 1 mSv = ukwanda okungu-0.005% engcupheni yomdlavuza yempilo yonke.I-ERCP≈ 6 mSv → ukwanda kwengozi okungu-0.03%.
Awukwenzi "kanye".
Ukwenza kaningi ngonyaka, izinkulungwane zezikhathi empilweni yakho.
III. Indawo eyingozi kakhulu e-I-ERCPIgumbi empeleni yilapho oma khona nsuku zonke.
Ngamafuphi: Uma usondela kakhulu epayipini le-X-ray, umthamo uba mkhulu.
Izindawo eziyingozi kakhulu zokuchayeka kwabasebenzi zifaka:
● Uhlangothi olulodwa lwepayipi le-X-ray lengalo ye-C
● Ngesikhathi sokuthwebula izithombe ze-oblique angle
● Indawo ezungeze isiguli (umthombo omkhulu wemisebe esakazekile)
● Izikhundla lapho odokotela bezinzwa nabahlengikazi besebenza khona
Abantu abaningi abazi ukuthi: Izindawo abakuzo yizona zindawo eziphakeme kakhulu zokuchayeka emisebeni.
IV. Uphenyo Lwangempela: Abasebenzi Bezokwelapha abangu-90% Abazange Bathathe Izinyathelo Zokuzivikela Ezifanele
Okutholwe yinhlolovo ye-Sociedad Interamericana de Endoscopía Digestiva (SIED) kuyamangaza impela:
● Odokotela abangu-22% kuphela abaqeqeshwe ngokuvikela imisebe.
● Abahlengikazi abangu-17% kuphela abaqeqeshwe.
● Ngaphandle kwama-apron e-lead, izinga lokusetshenziswa kweminye imishini yokuzivikela liphansi kakhulu.
Ingabe uzibheka "njengophephile"? Iqiniso liwukuthi: Iningi labantu ligijima linqunu.
V. Isimiso se-ALARA: Imithetho emi-3 Wonke Umuntu Okumele Ayilandele
I-ALARA = Iphansi Kangangokufinyeleleka Okunengqondo
1. Isikhathi: Sifushane ngangokunokwenzeka.
● I-pulse fluoroscopy
● Sebenzisa "Uhlaka Lokugcina Oluqandisiwe"
● Vimbela i-fluoroscopy eqhubekayo
2. Ibanga: Uma ude kakhulu, kungcono. Ngesinyathelo ngasinye sokubuyela emuva, umthamo → uba yi-1/4 yowokuqala.
3. Ukuvikela: Vimba ngangokunokwenzeka.
● Iphinifa eliyi-lead (≥0.35 mmPb)
● Ukuvikelwa kwe-thyroid
● Izibuko ze-lead (zokuvimbela i-cataract)
● Amakhethini e-lead
● Izikrini ezilengayo
Ikhethini elinomsizi linganciphisa imisebe ehlakazekile ngamaphesenti angaphezu kuka-95%.
VI. Ziphi izingozi zangempela zeziguli?
I-BMI ephezulu, ephindaphindwayoI-ERCP, imithamo ephezulu yokungafani, izikhathi ezinde zokuhlinzwa. Konke lokhu kungaholela ekuqongeleleni okusheshayo komthamo wesikhumba ezigulini.
Ukunakwa okukhethekile:
● Abesifazane
● Abesifazane abakhulelwe
● Izingane (ukuzwela ×3–5)
● Ukukhanya okuphindaphindiwe kwendawo efanayo
Lezi ziguli kumele zibe nemithamo elinganiselwe kakhulu.
VII. Abesifazane Abakhulelwe Nezingane: Amaqembu Asengozini Enkulu Okumele Axoxwe Ngawodwa.
I-ERCPIzimiso Zabesifazane Abakhulelwe
● Ingabe "kuyadingeka ngempela"?
● Ingabe ingahlehliswa?
● Ingabe kwenziwa udokotela onolwazi oluningi?
● Ingabe isikhathi se-fluoroscopy sincishisiwe ngezinga eliphezulu?
● Isikhathi esiyingozi kakhulu sokukhulelwa (amasonto ayi-10-25).
I-ERCPizimiso zezingane
● Ukuzwela okuphezulu kakhulu kwe-ejenti.
● Ukulawula ukukhanya okuqinile kanye nokulawulwa kwe-collimation kubalulekile.
● Abasebenzi abanolwazi oluphezulu kuphela abavunyelwe.
VIII. Izinto ezinhlanu zobungcweti ngempelaI-ERCPigumbi kumele lenze:
1. Uhlelo lwe-dosimeter oluphindwe kabili (olujwayelekile): Olulodwa ngaphandle kwe-apron ye-lead, olulodwa ngaphakathi.
2. Setha i-DRL (Izinga Lokubhekisela Ekuxilongeni): I-DRL yakamuva yaseJapan: 32 Gy·cm² (iphesenti lama-75).
3. Hlola ama-apron e-lead minyaka yonke (uzoshaqeka ngesilinganiso sawo sokuphuka).
4. Nikeza iziguli amaphepha olwazi ngemisebe (umkhuba ojwayelekile eminyangweni ephethwe kahle).
5. Landela iziguli ezinemithamo ephezulu amasonto ama-2-4 (umonakalo wesikhumba ungase ubambezeleke).
Ekuphetheni: Ukuzivikela kuyindlela kuphela yokuvikela iziguli eziningi.
Imisebe obhekene nayo: ayibonakali, ayinabuhlungu, futhi ayibangeli ukubomvu, awukuzwa ngokushesha, kodwa iyaqoqana futhi ikulimaze nsuku zonke.
Funda ukuvikela okufanele ukuze ukwazi:
● Sebenza isikhathi eside
● Sebenza ngokuphephile kakhudlwana
● Sebenza kahle
● Sebenza ngobuchwepheshe obukhulu
Kwangathi njaloI-ERCPudokotela kufanele abe ngaphansi kokukhanya, kodwa ungalokothi ulinyazwe yikho.
I-ERCPUchungechunge lwezinto ezithengiswayo ezishisayo ezivela ku-ZRHmed.
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Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumkhiqizi eShayina ogxile ezintweni ezisetshenziswayo ze-endoscopic, sifaka umugqa we-GI njenge-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-spray catheter, amabhulashi e-cytology,ucingo lokuqondisa, ubhasikidi wokuthola amatshe, i-cathete yokukhipha amanzi ekhaleni njll. ezisetshenziswa kabanzi ku-EMR, ESD,I-ERCPImikhiqizo yethu inesitifiketi se-CE futhi ivunyelwe yi-FDA 510K, kanti izitshalo zethu zinesitifiketi se-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi kanye nengxenye ye-Asia, futhi zithola ukuqashelwa nokunconywa kakhulu ngamakhasimende!
Isikhathi sokuthunyelwe: Jan-13-2026