I-Endoscopic biopsy iyingxenye ebaluleke kakhulu yokuhlolwa kwe-endoscopic nsuku zonke. Cishe zonke izivivinyo ze-endoscopic zidinga ukwesekwa kwe-pathological ngemuva kwe-biopsy. Isibonelo, uma i-mucosa yokugaya ukudla kusolakala ukuthi inokuvuvukala, umdlavuza, i-atrophy, i-metaplasia yamathumbu, kanye nokutheleleka nge-HP, i-pathology iyadingeka ukunikeza umphumela oqondile.
Njengamanje, izindlela eziyisithupha ze-biopsy zenziwa njalo eChina:
1. Ukuhlolwa kwe-Cytobrush
2. I-Biopsy yezicubu
3. Inqubo ye-Tunnel biopsy
4. I-EMR ngesu lenqwaba ye-biopsy
5. Inqubo ye-ESD ye-tumor biopsy
6. I-FNA eqondiswa yi-Ultrasound
Namuhla sizogxila ekubuyekezeni i-tissue biopsy, eyaziwa ngokuthi "i-clamping ucezu lwenyama".
I-biopsy ngaphansi kwe-endoscopy yokugaya ayinakwenziwa ngaphandle kwe-biopsy forceps, ephinde ibe ngenye yezinsiza ezisetshenziswa kakhulu ngothisha abahlengikazi be-endoscopic. Othisha abenza ubuhlengikazi be-endoscopic bangase bacabange ukuthi i-biopsy forceps ilula kakhulu ukuyisebenzisa, ilula njengokuvula nokuvala. Eqinisweni, ukusebenzisa i-biopsy forceps ngokucacile futhi ekupheleleni, umuntu udinga ukuba nokuqonda nokusebenza kanzima, kanye nokwazi ukufingqa.
I.Okokuqala, ake sibuyekeze ukwakheka kwe-i-biopsy forceps:
(I) Isakhiwo se-biopsy forceps (Umfanekiso 1): I-Biopsy forceps yakhiwe ithiphu, umzimba nesibambo sokusebenza. Izesekeli eziningi ezifana ne-forcep yomzimba wangaphandle, i-hot biopsy forceps, isikelo, ama-curettes, njll. zifana nesakhiwo se-biopsy forceps.
Ithiphu: Ithiphu yakhiwe imihlathi emibili emise okwenkomishi engavuleka futhi ivalwe. Ukuma kwemihlathi kuyisihluthulelo somsebenzi we-biopsy forceps ehlukahlukene. Zingahlukaniswa cishe zibe izinhlobo eziyisikhombisa: uhlobo oluvulekile olulodwa, uhlobo oluvulekile kabili, uhlobo lwewindi, uhlobo lwenaliti, uhlobo oluyiqanda, uhlobo lomlomo wengwenya, nohlobo olugobile lwethiphu. Imihlathi ye-biopsy forceps yenziwe ngensimbi engagqwali futhi inama-blade abukhali. Nakuba izindwani zama-forceps alahlwayo we-biopsy nazo zibukhali, azikwazi ukumelana nokugqokwa. Ama-blades of reusable biopsy forceps aphathwa ngokukhethekile ukuze awenze aqine kakhudlwana.
Izinhlobo ezijwayelekile zei-biopsy forceps
1.Uhlobo olujwayelekile olunefasitela
Kunefasitela enkabeni yenkomishi ye-forceps, elinciphisa kakhulu ukulimala kwezicubu futhi likhulise inani lezicubu ze-biopsy.
2. Uhlobo olujwayelekile olunefasitela nenaliti
Inalithi itholakala maphakathi nenkomishi ye-forceps ukuvimbela i-biopsy ukuthi ingasheleli ku-mucosa kanye nokusiza ukubamba isampula yethishu.
3. Uhlobo lwengwenya
Inkomishi yokuqinisa i-serrated ivimbela ngempumelelo inkomishi yokuqinisa ukuthi ingasheleli, futhi unqenqema lokusika lubukhali ukuze libambe okuvikeleke kakhudlwana.
4. Uhlobo lwengwenya enenaliti
Imihlathi ine-engeli yokuvula ebanzi yokwandisa ivolumu ye-biopsy; umphetho we-blade ubukhali ukuze ubambe okuphephile.
Kukhona inaliti phakathi nendawo yekhanda le-clamp, engenza ukulungiswa kuphumelele futhi kunembile.
Ifanele i-biopsy ezicutshini eziqinile njengezimila.
Umzimba We-Forceps: Umzimba we-forceps ye-biopsy wenziwe ngeshubhu elinentambo yensimbi engenasici, equkethe intambo yensimbi yokudonsa i-valve ye-forceps ukuze ivuleke futhi ivale. Ngenxa yesakhiwo esikhethekile se-tube ene-threaded, i-mucus yezicubu, igazi nezinye izinto zingangena kalula, kodwa akulula ukuyihlanza kahle. Ukwehluleka ukuyihlanza kahle kuzodala ukuphazamiseka ekusebenzeni kwe-biopsy forceps, futhi ukuvulwa nokuvala ngeke kube bushelelezi noma kungenakwenzeka ukuvula. Isibambo esisebenzayo: Iringi esibanjeni sokusebenza isetshenziselwa ukubamba isithupha, futhi umsele obanzi oyindilinga usetshenziselwa ukubeka umunwe wenkomba nomunwe ophakathi. Ngaphansi kokusebenza kwale minwe emithathu, amandla adluliselwa ku-valve ye-forceps ngocingo lokudonsa ukuze uvule futhi uvale.
(II) Amaphuzu abalulekile okusetshenziswa kwe-biopsy forceps: Kufanele kuqashelwe kakhulu ekusebenzeni, ekusetshenzisweni nasekugcinweni kwe-biopsy forceps, ngaphandle kwalokho kuzothinta ukusetshenziswa kwe-endoscope.
1. Ukutholwa ngaphambilini:
Ngaphambi kokusetshenziswa, qiniseka ukuthi i-biopsy forceps ivalwe inzalo futhi yasetshenziswa phakathi nesikhathi esisebenzayo sokuvala inzalo. Ngaphambi kokufaka isiteshi se-endoscope forceps, ukuvulwa nokuvalwa kwe-forceps kufanele kuhlolwe (Umfanekiso 2).
Umfanekiso 2 Ukutholwa kwe-Biopsy forceps
Indlela eqondile iwukugoqa umzimba we-biopsy forceps ube yindilinga enkulu (ububanzi bendilinga bungaba ngu-20cm), bese wenza izenzo eziningi zokuvula nokuvala ukuze kubhekwe ukuthi ama-forceps avuleka futhi avaleke kahle yini. Uma kunezikhathi ezingu-1-2 zokungabi bushelelezi, kungcono ukungasebenzisi i-forceps ye-biopsy. Okwesibili, kuyadingeka ukuhlola ukuvalwa kwe-forceps ye-biopsy. Thatha ucezu lwephepha elincanyana njengephepha lezinhlamvu bese ulibopha ngama-forceps we-biopsy. Kuyafaneleka uma iphepha elincanyana lingawi. Okwesithathu, kuyadingeka ukubheka ukuthi izinkomishi ezimbili ze-forceps flaps zihambisana ngokuphelele (Umfanekiso 3). Uma kukhona ukungahambi kahle, yeka ukuyisebenzisa ngokushesha, ngaphandle kwalokho izoklwebha ipayipi le-forceps.
Umfanekiso 3 I-Biopsy forceps flap
Amanothi ngesikhathi sokusebenza:
Ngaphambi kokufaka ishubhu ye-forceps, imihlathi kufanele ivalwe, kodwa khumbula ukuthi ungasebenzisi amandla amaningi ngenxa yokwesaba ukuvaleka okuxekethile, okuzokwenza ukuthi ucingo lokudonsa lunwetshwe futhi kuthinte ukuvuleka nokuvalwa kwemihlathi. 2. Uma ufaka ithubhu, faka ngokulandela isiqondiso sokuvula ithubhu ye-forceps futhi ungahlikihli ngokuvula ithubhu. Uma uhlangabezana nokumelana lapho ungena, kufanele ukhulule inkinobho ye-engeli bese uzama ukungena esimweni esiqondile ngokwemvelo. Uma namanje ungakwazi ukudlula, khipha i-endoscope emzimbeni ukuze uyihlole, noma uyishintshe ufake amanye ama-biopsy forceps njengamamodeli amancane. 3. Lapho ukhipha amandla e-biopsy, gwema ukusebenzisa amandla amaningi. Umsizi kufanele ayibambe ngezandla zombili abese eyigoba. Ungaluleki izingalo zakho kakhulu. 4. Lapho imihlathi ingakwazi ukuvaleka, ungayikhiphi ngenkani. Ngalesi sikhathi, kufanele iphushelwe ngaphandle komzimba kanye ne-endoscope ukuze kuqhutshekwe kucutshungulwe .
II. Isifinyezo sezinye izindlela ze-biopsy
1. Ukuvula nokuvala ama-forceps e-biopsy kokubili kuyimisebenzi yobuchwepheshe. Ukuvula kudinga isiqondiso, ikakhulukazi i-engeli yesisu, okufanele ibe yi-perpendicular indawo ye-biopsy. Ukuvala kudinga isikhathi. Ukuhamba kwamathumbu kanye nokusebenza kukadokotela kuzinzile futhi akukwazi ukulungiswa ngokuqhubekayo. Umsizi kufanele abambe leli thuba ukuze abambe ngempumelelo futhi ngokuphepha ama-forceps e-biopsy.
2. Isampula ye-biopsy kufanele ibe nkulu ngokwanele futhi ijule ngokwanele ukuze ifinyelele i-muscularis mucosa.
3. Cabangela umthelela wokopha ngemva kwe-biopsy kuma-biopsies alandelayo. Lapho i-engeli yesisu kanye ne-antrum kudinga ukucutshungulwa ngesikhathi esifanayo, i-engeli yesisu kufanele i-biopsied kuqala bese kuba i-antrum; lapho indawo ye-lesion inkulu futhi izingcezu eziningi zezicubu zidinga ukucindezelwa, ucezu lokuqala kufanele lunembe, futhi kuyadingeka futhi ukucabangela ukuthi ukuphuma kwegazi ngemva kokubopha kuzovala izicubu ezizungezile futhi kuthinte insimu yombono, ngaphandle kwalokho i-clamping elandelayo izoba yimpumputhe futhi ingenzi lutho.
Ukulandelana kwe-biopsy okuvamile kwezilonda engeli yesisu, kucatshangelwa umphumela wokugeleza kwegazi kuma-biopsies alandelayo
4. Zama ukwenza i-vertical pressure biopsy endaweni eqondiwe, futhi usebenzise ukumunca lapho kudingeka. Ukumunca kunciphisa ukungezwani okungaphezulu kwe-mucosa, okuvumela izicubu ukuba ziboshwe zijule futhi mancane amathuba okuthi zishelele.
I-Biopsy kufanele yenziwe ngokuqondile ngangokunokwenzeka, futhi ubude bokunwetshwa kwe-biopsy forceps akufanele budlule u-2CM.
5. Naka ukukhethwa kwamasampula ezinhlobo ezahlukene zezilonda; ukukhethwa kwamaphuzu okusampula kuhlobene nenani elihle. Udokotela ohlinzayo uneso elibukhali futhi kufanele futhi anake amakhono okukhetha izinto.
Izindawo okuzokwenziwa kuzo i-biopsy Izindawo okungafanele zenziwe nge-biopsy
6. Izingxenye okunzima ukwenza i-biopsy zihlanganisa i-fundus yesisu eduze kwe-cardia, ukugoba okuncane komzimba wesisu eduze nodonga olungemuva, kanye nekhoneni eliphezulu le-duodenum. Umsizi kufanele agxile ekubambisaneni. Uma efuna ukuzuza umphumela ophelele, kufanele afunde ukuhlela kusengaphambili futhi alungise isiqondiso se-flap ye-clamp nganoma yisiphi isikhathi. Ngesikhathi esifanayo, kufanele ahlulele ngokushesha isikhathi sokubopha ngokusebenzisa wonke amathuba. Ngezinye izikhathi lapho ulinde imiyalelo evela kudokotela ohlinzayo, ukugoba kwesekhondi elingu-1 kungase kuholele emathubeni aphuthelwe. Ngingalinda kuphela ngesineke ithuba elilandelayo.
Imicibisholo ikhombisa izindawo lapho okunzima khona ukuthola izinto ezibonakalayo noma ukumisa ukopha.
7. Ukukhethwa kwama-biopsy forceps: Amandla e-Biopsy ahlanganisa lawo anezimbobo ezinkulu zenkomishi nezijulile, amanye anezinaliti zokubeka indawo, kanti amanye anokuvulwa emaceleni nokulunywa okunezimbotshana.
8. Ukukhulisa kuhlanganiswe nokungcoliswa kwe-elekthronikhi ukuze kuqondiswe i-biopsy kunembe kakhudlwana, ikakhulukazi ekuthathweni kwe-mucosa yomminzo.
Thina, i-Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., singumkhiqizi waseChina ogxile ezintweni ezisetshenziswa endoscopic, ezifanai-biopsy forceps, i-hemoclip, polyp ugibe, inaliti ye-sclerotherapy, fafaza i-catheter, amabhulashi e-cytology, guidewire, ubhasikidi wokubuyisa amatshe, i-nasal biliary drainage catheter njll. ezisetshenziswa kakhulu kuI-EMR, ESD, I-ERCP. Imikhiqizo yethu iqinisekiswe yi-CE, futhi izitshalo zethu ziqinisekiswe yi-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi nasengxenyeni ye-Asia, futhi zithola kabanzi ikhasimende lokuqashelwa nokudumisa!
Isikhathi sokuthumela: Jan-23-2025