Umdlavuza wesisu ungomunye wamathumba amabi abeka impilo yabantu engozini enkulu. Kunamacala amasha ayizigidi ezingu-1.09 emhlabeni minyaka yonke, futhi inani lamacala amasha ezweni lakithi lifinyelela ku-410,000. Lokho kusho ukuthi, abantu ababalelwa ku-1,300 ezweni lakithi batholakala benomdlavuza wesisu nsuku zonke.
Izinga lokusinda kweziguli ezinomdlavuza wesisu lihlobene kakhulu nezinga lokuqhubeka komdlavuza wesisu. Izinga lokwelashwa komdlavuza wesisu wasekuqaleni lingafinyelela ku-90%, noma lize lilapheke ngokuphelele. Izinga lokwelashwa komdlavuza wesisu osezingeni eliphakathi liphakathi kuka-60% no-70%, kuyilapho izinga lokwelashwa komdlavuza wesisu othuthukile lingu-30% kuphela, ngakho-ke umdlavuza wesisu wasekuqaleni utholakale. Futhi ukwelashwa kwasekuqaleni kuyisihluthulelo sokunciphisa ukufa komdlavuza wesisu. Ngenhlanhla, ngokuthuthukiswa kobuchwepheshe be-endoscopic eminyakeni yamuva nje, ukuhlolwa komdlavuza wesisu kwasekuqaleni kuye kwenziwa kabanzi ezweni lakithi, okuye kwathuthukisa kakhulu izinga lokutholwa komdlavuza wesisu wasekuqaleni;
Ngakho-ke, uyini umdlavuza wesisu wasekuqaleni? Ungawuthola kanjani umdlavuza wesisu wasekuqaleni? Ungawelapha kanjani?
1 Umqondo womdlavuza wesisu wasekuqaleni
Ngokwezokwelapha, umdlavuza wesisu wasekuqaleni ubhekisela kakhulu kumdlavuza wesisu onezilonda zakuqala, izilonda ezilinganiselwe futhi azikho izimpawu ezisobala. Umdlavuza wesisu wasekuqaleni utholakala kakhulu nge-gastroscopic biopsy pathology. Ngokwe-pathologically, umdlavuza wesisu wasekuqaleni ubhekisela kumaseli omdlavuza akhawulelwe ku-mucosa kanye ne-submucosa, futhi kungakhathaliseki ukuthi isimila sikhulu kangakanani nokuthi kukhona yini i-lymph node metastasis, singesomdlavuza wesisu wasekuqaleni. Eminyakeni yamuva nje, i-dysplasia enzima kanye ne-intraepithelial neoplasia yezinga eliphezulu nazo zihlukaniswa njengomdlavuza wesisu wasekuqaleni.
Ngokusho kobukhulu besimila, umdlavuza wesisu wasekuqaleni uhlukaniswe kanje: umdlavuza wesisu omncane: ububanzi be-foci yomdlavuza bungu-6-10 mm. Umdlavuza wesisu omncane: Ububanzi be-foci ye-tumor bungaphansi noma bulingana no-5 mm. I-punctate carcinoma: I-gastric mucosa biopsy ingumdlavuza, kodwa akukho zicubu zomdlavuza ezingatholakala ochungechungeni lwezibonelo zokuhlinzwa.
Ngokwe-endoscopic, umdlavuza wesisu wasekuqaleni uhlukaniswe kabanzi ngalezi: uhlobo (uhlobo lwe-polypoid): labo abanesisindo sesimila esivele cishe esingu-5 mm noma ngaphezulu. Uhlobo II (uhlobo olungaphandle): Isisindo sesimila siphakanyisiwe noma sicindezelwe ngaphakathi kuka-5 mm. Uhlobo III (uhlobo lwesilonda): Ukujula kokucindezelwa kwesisindo somdlavuza kudlula u-5 mm, kodwa akudluli i-submucosa.
2 Yiziphi izimpawu zomdlavuza wesisu ekuqaleni
Iningi lomdlavuza wesisu wasekuqaleni alinazo izimpawu ezikhethekile, okungukuthi, izimpawu zokuqala zomdlavuza wesisu azinazo izimpawu.
Lezo zimpawu zokuqala zomdlavuza wesisu ezisakazwa kwi-inthanethi empeleni azizona izimpawu zokuqala. Kungakhathaliseki ukuthi udokotela noma umuntu ohloniphekile, kunzima ukwahlulela ngezimpawu nezimpawu. Abanye abantu bangase babe nezimpawu ezithile ezingezona eziqondile, ikakhulukazi ukungagayi kahle, njengobuhlungu besisu, ukuqunjelwa, ukusutha kwasekuqaleni, ukulahlekelwa isifiso sokudla, ukuphinda udle i-asidi, isilungulela, ukubhoboza, ama-hiccups, njll. Lezi zimpawu zifana kakhulu nezinkinga zesisu ezivamile, ngakho-ke ngokuvamile azidonseli ukunaka kwabantu. Ngakho-ke, kubantu abangaphezu kweminyaka engama-40 ubudala, uma benezimpawu ezisobala zokungagayi kahle, kufanele baye esibhedlela ukuze bathole ukwelashwa ngesikhathi, futhi benze i-gastroscopy uma kudingeka, ukuze bangaphuthelwa isikhathi esihle kakhulu sokuthola umdlavuza wesisu kwasekuqaleni.
3 Indlela yokuthola umdlavuza wesisu kusenesikhathi
Eminyakeni yamuva nje, ochwepheshe bezokwelapha ezweni lakithi, kanye nesimo sangempela sezwe lakithi, baklame “Ochwepheshe Benqubo Yokuhlola Umdlavuza Wesisu Esaqalayo eShayina”.
Kuzodlala indima enkulu ekuthuthukiseni izinga lokuxilonga kanye nezinga lokwelapha umdlavuza wesisu ekuqaleni.
Ukuhlolwa komdlavuza wesisu kusenesikhathi kuhloselwe ikakhulukazi ezinye iziguli ezisengozini enkulu, njengeziguli ezinegciwane le-Helicobacter pylori, iziguli ezinomlando womndeni womdlavuza wesisu, iziguli ezingaphezu kweminyaka engama-35 ubudala, abantu ababhema isikhathi eside, kanye nabantu abathanda ukudla okufakwe usawoti.
Indlela eyinhloko yokuhlola ngokuyinhloko iwukuthola inani labantu abasengozini enkulu yomdlavuza wesisu ngokuhlolwa kwe-serological, okungukuthi, ngokusebenzisa ukusebenza kwesisu kanye nokutholwa kwama-antibody e-Helicobacter pylori. Ngemuva kwalokho, amaqembu asengozini enkulu atholakala enkambisweni yokuqala yokuhlola ahlolwa ngokucophelela yi-gastroscope, futhi ukubonwa kwezilonda kungenziwa kube nomqondo obanzi ngokusebenzisa ukukhuliswa, ukudaya, i-biopsy, njll., ukuze kutholakale ukuthi izilonda zinomdlavuza nokuthi zingelashwa yini ngaphansi kwe-microscope.
Yiqiniso, kuyindlela engcono futhi yokuthola umdlavuza wesisu kusenesikhathi ngokufaka i-endoscopy yesisu ezintweni zokuhlolwa ngokomzimba ezivamile kubantu abaphilile ngokuhlolwa ngokomzimba.
4 Kuyini ukuhlolwa kokusebenza kwesisu kanye nohlelo lokuhlola umdlavuza wesisu
Ukuhlolwa kokusebenza kwesisu ukuthola isilinganiso se-pepsinogen 1 (PGI), i-pepsinogen (PGl1, kanye ne-protease) ku-serum.
(PGR, PGI/PGII) okuqukethwe kwe-gastrin 17 (G-17), kanye nohlelo lokuhlola umdlavuza wesisu lusekelwe emiphumeleni yokuhlolwa kokusebenza kwesisu, kuhlanganiswe namaphuzu aphelele njenge-Helicobacter pylori antibody, ubudala kanye nobulili, ukuze kwahlulelwe. Indlela yokubeka engcupheni yomdlavuza wesisu, ngokusebenzisa uhlelo lokuhlola umdlavuza wesisu, ingahlola amaqembu aphakathi naphezulu omdlavuza wesisu.
I-Endoscopy kanye nokulandelela kuzokwenziwa kumaqembu aphakathi nasengozini enkulu. Amaqembu asengozini enkulu azohlolwa okungenani kanye ngonyaka, kanti amaqembu aphakathi nasengozini azohlolwa okungenani kanye eminyakeni emi-2. Ukutholwa kwangempela umdlavuza wasekuqaleni, ongelashwa ngokuhlinzwa kwe-endoscopic. Lokhu akugcini nje ngokuthuthukisa izinga lokutholakala komdlavuza wesisu kusenesikhathi, kodwa futhi kunciphisa i-endoscopy engadingekile kumaqembu asengozini encane.
5 Kuyini i-Gastroscopy
Kalula nje, i-gastroscopy iwukwenza ukuhlaziywa kwesimo se-endoscopic kwezilonda ezisolisayo ezitholakala ngesikhathi esifanayo ne-gastroscopy evamile, okuhlanganisa i-endoscopy evamile yokukhanya okumhlophe, i-chromoendoscopy, i-magnifying endoscopy, i-confocal endoscopy nezinye izindlela. I-lesion itholakala ukuthi ayinabungozi noma iyasolisa uma kukhona umdlavuza, bese kwenziwa i-biopsy ye-lesion enobungozi esolwayo, bese kwenziwa ukuxilongwa kokugcina nge-pathology. Ukuthola ukuthi ngabe kukhona yini izilonda zomdlavuza, izinga lokungena komdlavuza ohlangothini, ukujula kokungena okuqondile, izinga lokwehluka, nokuthi ngabe kukhona yini izinkomba zokwelapha nge-microscope.
Uma kuqhathaniswa ne-gastroscopy evamile, ukuhlolwa kwe-gastroscopy kudingeka kwenziwe ngaphansi kwezimo ezingenabuhlungu, okuvumela iziguli ukuthi ziphumule ngokuphelele esimweni sokulala esifushane futhi zenze i-gastroscopy ngokuphephile. I-gastroscopy inezidingo eziphezulu kubasebenzi. Kumele iqeqeshwe ekutholeni umdlavuza kusenesikhathi, futhi odokotela be-endoscop abanolwazi bangenza ukuhlolwa okuningiliziwe, ukuze bathole kangcono izilonda futhi benze ukuhlolwa okunengqondo kanye nezahlulelo.
I-Gastroscopy inezidingo eziphezulu emishinini, ikakhulukazi ngobuchwepheshe bokuthuthukisa isithombe njenge-chromoendoscopy/i-chromoendoscopy kagesi noma i-magnifying endoscopy. I-ultrasound gastroscopy nayo iyadingeka uma kudingeka.
Izindlela ezi-6 zokwelapha umdlavuza wesisu oqalayo
1. Ukususwa kwe-Endoscopic
Uma umdlavuza wesisu usutholakale kusenesikhathi, ukususwa kwe-endoscopic kuyindlela yokuqala okufanele ikhethwe. Uma kuqhathaniswa nokuhlinzwa kwendabuko, ukususwa kwe-endoscopic kunezinzuzo zokuthi ukulimala okuncane, izinkinga ezimbalwa, ukululama okusheshayo, kanye nezindleko eziphansi, futhi ukusebenza kahle kwalokhu okubili kuyafana. Ngakho-ke, ukususwa kwe-endoscopic kunconywa ekhaya nakwamanye amazwe njengokwelashwa okuthandwayo komdlavuza wesisu kusenesikhathi.
Njengamanje, ukususwa kwe-endoscopic okuvame ukusetshenziswa kakhulu kufaka phakathi ukususwa kwe-endoscopic mucosal (EMR) kanye nokususwa kwe-endoscopic submucosal (ESD). Ubuchwepheshe obusha obuthuthukisiwe, i-ESD single-channel endoscopy, bungafeza ukususwa kwezilonda kanye kuphela ngaphakathi kwe-muscularis propria, kuyilapho futhi buhlinzeka ngesigaba esinembile se-pathological ukuze kuncishiswe ukuphinda kuvele sekwephuzile.
Kufanele kuqashelwe ukuthi ukuhlinzwa kwe-endoscopic resection kuyindlela yokuhlinzwa engadingi ukungenelela okuningi, kodwa kusenezigameko eziningi zezinkinga, okuhlanganisa ukuphuma kwegazi, ukubhoboka, i-Stenosis, ubuhlungu besisu, ukutheleleka, njll. Ngakho-ke, ukunakekelwa kwesiguli ngemva kokuhlinzwa, ukululama, kanye nokubuyekezwa kumele kubambisane nodokotela ngenkuthalo ukuze silulame ngokushesha okukhulu.
2 Ukuhlinzwa kwe-Laparoscopic
Ukuhlinzwa kwe-laparoscopic kungacatshangelwa iziguli ezinomdlavuza wesisu ekuqaleni ezingakwazi ukuhlinzwa nge-endoscopic resection. Ukuhlinzwa kwe-laparoscopic kuwukuvula iziteshi ezincane esiswini sesiguli. Ama-laparoscope nezinsimbi zokusebenza kufakwa ngalezi ziteshi ngaphandle kokulimala okukhulu esigulini, futhi idatha yesithombe esiswini idluliselwa esikrinini sokubonisa nge-laparoscope, eqedwa ngaphansi kwesiqondiso se-laparoscope. Ukuhlinzwa kwe-laparoscopic kungaqedela ukusebenza kwe-laparotomy yendabuko, kwenziwe i-gastrectomy enkulu noma ephelele, ukuhlukaniswa kwama-lymph node asolisayo, njll., futhi kunokopha okuncane, umonakalo omncane, isibazi esincane sokusika ngemva kokuhlinzwa, ubuhlungu obuncane, kanye nokubuyiselwa okusheshayo komsebenzi wesisu ngemva kokuhlinzwa.
3. Ukuhlinzwa okuvulekile
Njengoba u-5% kuya ku-6% womdlavuza wesisu wangaphakathi kanye no-15% kuya ku-20% womdlavuza wesisu ongaphansi kwe-mucosal une-metastasis ye-perigastric lymph node, ikakhulukazi i-adenocarcinoma engahlukanisiwe kwabesifazane abasebasha, i-laparotomy yendabuko ingacatshangelwa, engasuswa ngokuphelele futhi i-Lymph node ihlukaniswe.
isifinyezo
Nakuba umdlavuza wesisu uyingozi kakhulu, awubi kakhulu. Uma nje ulwazi lokuvimbela luthuthuka, umdlavuza wesisu ungatholakala ngesikhathi futhi welashwe kusenesikhathi, futhi kungenzeka ukuthola ukwelashwa okuphelele. Ngakho-ke, kunconywa ukuthi amaqembu asengozini enkulu ngemva kweminyaka engu-40, kungakhathaliseki ukuthi anokungakhululeki komgudu wokugaya ukudla, kufanele ahlolwe kusenesikhathi umdlavuza wesisu, noma i-endoscopy yesisu kumele ifakwe ekuhlolweni okujwayelekile komzimba ukuze kutholakale icala lomdlavuza kusenesikhathi futhi kusindiswe impilo nomndeni ojabulayo.
Thina, iJiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumkhiqizi eShayina ogxile ezintweni ezisetshenziswayo ze-endoscopic, njengei-biopsy forceps, i-hemoclip,ugibe lwe-polyp, inaliti ye-sclerotherapy, i-catheter yokufafaza, amabhulashi e-cytology, ucingo lokuqondisa, ubhasikidi wokuthola amatshe, i-catheter yokukhipha amanzi ekhaleninjll. ezisetshenziswa kabanzi ku-EMR, ESD, ERCP. Imikhiqizo yethu inesitifiketi se-CE, kanti izitshalo zethu zinesitifiketi se-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi kanye nengxenye ye-Asia, futhi zithola ukuqashelwa nokunconywa kakhulu kumakhasimende!
Isikhathi sokuthunyelwe: Juni-21-2022