Umdlavuza wesisu ungesinye sezimila eziyingozi ezibeka impilo yomuntu engcupheni. Kunamacala amasha ayizigidi eziyi-1.09 emhlabeni wonke unyaka nonyaka, kanti isibalo samacala amasha ezweni lami sifinyelela ku-410,000. Okusho ukuthi, cishe abantu abayi-1,300 ezweni lami batholakala benomdlavuza wesisu nsuku zonke.
Izinga lokusinda kweziguli ezinomdlavuza wesisu lihlobene eduze nezinga lokuqhubeka komdlavuza wesisu. Izinga lokwelapha umdlavuza wesisu wangaphambi kwesikhathi lingafinyelela ku-90%, noma lilapheke ngokuphelele. Izinga lokwelapha umdlavuza wesisu ophakathi kwesigaba liphakathi kuka-60% no-70%, kanti izinga lokwelapha umdlavuza wesisu osuthuthukile lingama-30 kuphela%. nxazonke, ngakho kwatholakala umdlavuza wesisu wakuqala. Futhi ukwelashwa kusenesikhathi kuwukhiye wokunciphisa ukufa komdlavuza wesisu. Ngenhlanhla, ngokuthuthukiswa kobuchwepheshe be-endoscopic eminyakeni yamuva, ukuhlolwa komdlavuza wesisu kwasekuqaleni kuye kwenziwa kabanzi ezweni lami, okuye kwathuthukisa kakhulu izinga lokuthola umdlavuza wesisu;
Ngakho-ke, uyini umdlavuza wokuqala wesisu? Ungawuthola kanjani umdlavuza wesisu wakuqala? Indlela yokwelapha?
1 Umqondo womdlavuza wesisu wakuqala
Ngokomtholampilo, umdlavuza wesisu wasekuqaleni ubhekisela ikakhulukazi kumdlavuza wesisu onezilonda ezisanda kuqala, izilonda ezilinganiselwe futhi ezingenazo izimpawu ezisobala. Umdlavuza wesisu wasekuqaleni utholwa ikakhulukazi yi-gastroscopic biopsy pathology. Ngokwe-Pathologically, umdlavuza wesisu wasekuqaleni ubhekisela kumaseli omdlavuza kuphela ku-mucosa kanye ne-submucosa, futhi kungakhathaliseki ukuthi sikhulu kangakanani isimila nokuthi kukhona i-lymph node metastasis, umdlavuza wesisu wasekuqaleni. Eminyakeni yamuva nje, i-dysplasia enzima kanye ne-high-grade intraepithelial neoplasia nazo zihlukaniswa njengomdlavuza wesisu wakuqala.
Ngokusho kobukhulu be-tumor, umdlavuza wokuqala wesisu uhlukaniswe: umdlavuza omncane wesisu: ububanzi be-foci yomdlavuza buyi-6-10 mm. Umdlavuza omncane wesisu: Ububanzi be-tumor foci bungaphansi noma bulingana no-5 mm. I-Punctate carcinoma: I-gastric mucosa biopsy ingumdlavuza, kodwa azikho izicubu zomdlavuza ezingatholakala ochungechungeni lwezibonelo zokuhlinza.
Ngokwe-Endoscopically, umdlavuza wesisu wasekuqaleni uhlukaniswa futhi kwaba: uhlobo (uhlobo lwe-polypoid): labo abanesisindo sesimila esiphumayo esingaba ngu-5 mm noma ngaphezulu. Uhlobo II (uhlobo olungaphezulu): Isisindo sesimila siyaphakanyiswa noma sicindezelekile phakathi kuka-5 mm. Uhlobo III (uhlobo lwesilonda): Ukujula kokudangala kwesisindo somdlavuza kudlula u-5 mm, kodwa akudluli i-submucosa.
2 Yiziphi izimpawu zomdlavuza wesisu wakuqala
Iningi lomdlavuza wesisu wakuqala awunazo izimpawu ezikhethekile, okusho ukuthi, izimpawu zokuqala zomdlavuza wesisu azikho izimpawu. inethiwekhi
Lezo okuthiwa yizimpawu zokuqala zomdlavuza wesisu ozungeza ku-inthanethi empeleni akuzona izimpawu zokuqala. Kungakhathaliseki ukuthi udokotela noma umuntu ohloniphekile, kunzima ukwahlulela ngezimpawu nezimpawu. Abanye abantu bangase babe nezimpawu ezithile ezingaqondile, ikakhulukazi ukungagayeki kahle kokudla, njengobuhlungu besisu, ukuqunjelwa, ukusutha ngaphambi kwesikhathi, ukuphelelwa ukudla, ukuqunjelwa kwe-asidi, isilungulela, isilungulela, ukuqunjelwa, njll. Lezi zimpawu zifana kakhulu nezinkinga zesisu ezivamile, ngakho-ke ziya ngokuvamile azidonseli ukunaka kwabantu. Ngakho-ke, kubantu abangaphezu kweminyaka engama-40 ubudala, uma benezimpawu ezicacile zokugaya ukudla, kufanele baye esibhedlela ukuze bathole ukwelashwa ngesikhathi, futhi benze i-gastroscopy uma kunesidingo, ukuze bangaphuthelwa isikhathi esingcono kakhulu sokuthola umdlavuza wesisu.
3 Ungawubona kanjani umdlavuza wesisu kusenesikhathi
Eminyakeni yamuva, ochwepheshe bezokwelapha ezweni lakithi, kuhlangene nesimo sangempela sezwe lethu, baye bakha "Ochwepheshe Benqubo Yokuhlola Umdlavuza Wesisu Okuqala E-China".
Izodlala indima enkulu ekuthuthukiseni izinga lokuxilongwa kanye nezinga lokwelapha umdlavuza wesisu wasekuqaleni.
Ukuhlolwa komdlavuza wesisu kusenesikhathi kuhloswe kakhulu ezigulini ezisengozini enkulu, njengeziguli ezinokutheleleka nge-Helicobacter pylori, iziguli ezinomlando womndeni womdlavuza wesisu, iziguli ezingaphezu kweminyaka engama-35, ababhemayo isikhathi eside, nabathanda ukudla okufakwe emanzini anosawoti.
Indlela yokuhlola eyinhloko iwukuthola ngokuyinhloko inani labantu abasengozini enkulu yomdlavuza wesisu ngokuhlolwa kwe-serological, okungukuthi, ngokusebenza kwesisu kanye nokutholwa kwe-Helicobacter pylori antibody. Khona-ke, amaqembu asengozini enkulu atholakala enqubweni yokuqala yokuhlola ahlolwa ngokucophelela nge-gastroscope, futhi ukubhekwa kwezilonda kungenziwa kube yinkimbinkimbi ngokusebenzisa ukukhulisa, ukugcoba, i-biopsy, njll, ukuze kutholakale ukuthi izilonda zinomdlavuza yini. nokuthi zingelashwa yini ngesibonakhulu.
Yebo, futhi kuyindlela engcono yokuthola umdlavuza wesisu wangaphambi kwesikhathi ngokuhlanganisa i-endoscopy yamathumbu ezintweni ezijwayelekile zokuhlola ngokomzimba kubantu abanempilo ngokuhlola umzimba.
4 Kuyini ukuhlolwa kokusebenza kwesisu kanye nohlelo lokuhlola umdlavuza wesisu
Ukuhlolwa kokusebenza kwesisu ukuthola isilinganiso se-pepsinogen 1 (PGI), i-pepsinogen (PGl1, ne-protease) ku-serum.
(PGR, PGI/PGII) okuqukethwe kwe-gastrin 17 (G-17), kanye nohlelo lokuhlola umdlavuza wesisu lusekelwe emiphumeleni yokuhlolwa kokusebenza kwesisu, kuhlanganiswe nezikolo eziphelele ezifana ne-Helicobacter pylori antibody, ubudala nobulili, ukwahlulela Indlela yengozi yomdlavuza wesisu, ngohlelo lokuhlola umdlavuza wesisu, ingahlola amaqembu aphakathi nendawo asengozini enkulu yomdlavuza wesisu.
I-Endoscopy kanye nokulandelela kuzokwenziwa emaqenjini aphakathi nendawo asengozini enkulu. Amaqembu asengozini enkulu azohlolwa okungenani kanye ngonyaka, futhi amaqembu asengozini ephakathi azohlolwa okungenani kanye njalo eminyakeni emi-2. Ukutholwa kwangempela umdlavuza wangaphambi kwesikhathi, ongelashwa ngokuhlinzwa kwe-endoscopic. Lokhu akukwazi nje ukuthuthukisa izinga lokutholwa kusenesikhathi komdlavuza wesisu, kodwa futhi kunciphise i-endoscopy engadingekile emaqenjini asengozini encane.
5 Iyini i-Gastroscopy
Ukukubeka kalula, i-gastroscopy iwukwenza ukuhlaziywa kwe-endoscopic morphological of izilonda ezisolisayo ezitholakala ngesikhathi esifanayo ne-gastroscopy evamile, kuhlanganise ne-endoscopy yokukhanya okumhlophe okujwayelekile, i-chromoendoscopy, i-endoscopy yokukhulisa, i-confocal endoscopy nezinye izindlela. I-lesion inqunywa ukuthi iyingozi noma isola ngokulimaza, bese i-biopsy ye-lesion esolwayo eyingozi yenziwa, futhi ukuxilongwa kokugcina kwenziwa yi-pathology. Ukunquma ukuthi akhona yini amanxeba omdlavuza, izinga lokungenwa komdlavuza eceleni, ukujula kokungena uqonde ngqo, izinga lokuhlukaniswa, kanye nokuthi zikhona yini izinkomba zokwelapha nge-microscopic.
Uma kuqhathaniswa ne-gastroscopy evamile, ukuhlolwa kwe-gastroscopic kudinga ukwenziwa ngaphansi kwezimo ezingenabuhlungu, okuvumela iziguli ukuba ziphumule ngokuphelele esimweni esifushane sokulala futhi zenze i-gastroscopy ngokuphepha. I-Gastroscopy inezidingo eziphezulu kubasebenzi. Kumelwe iqeqeshelwe ukuhlonza umdlavuza kusenesikhathi, futhi odokotela abanolwazi lwe-endoscopic bangenza izivivinyo ezinemininingwane eyengeziwe, ukuze bathole kangcono izilonda futhi benze ukuhlola nokwahlulela okunengqondo.
I-Gastroscopy inezidingo eziphezulu kumishini, ikakhulukazi ngobuchwepheshe bokuthuthukisa isithombe njenge-chromoendoscopy/i-chromoendoscopy ye-elekthronikhi noma i-endoscopy yokukhulisa. I-Ultrasound gastroscopy nayo iyadingeka uma kunesidingo.
6 Ukwelashwa komdlavuza wesisu wakuqala
1. Ukukhishwa kwe-Endoscopic
Uma umdlavuza wesisu usutholakele, ukukhishwa kwe-endoscopic kuyisinqumo sokuqala. Uma kuqhathaniswa nokuhlinzwa kwendabuko, ukukhishwa kwe-endoscopic kunezinzuzo zokuhlukumezeka okuncane, izinkinga ezimbalwa, ukululama ngokushesha, kanye nezindleko eziphansi, nokusebenza kwakho kokubili kuyafana ngokuyisisekelo. Ngakho-ke, ukukhishwa kwe-endoscopic kunconywa ekhaya naphesheya njengokwelashwa okuthandwayo komdlavuza wesisu wakuqala.
Njengamanje, ukukhishwa kwe-endoscopic okuvame ukusetshenziswa ikakhulukazi kufaka phakathi i-endoscopic mucosal resection (EMR) kanye ne-endoscopic submucosal dissection (ESD). Ubuchwepheshe obusha obuthuthukisiwe, i-ESD single-channel endoscopy, ingafinyelela ukukhishwa kwezilonda ngesikhathi esisodwa kwe-muscularis propria, kuyilapho ihlinzeka ngezigaba ezinembile ze-pathological ukuze kuncishiswe ukuphindeka sekwephuzile.
Kumele kuqashelwe ukuthi ukuhlinzwa kwe-endoscopic ukuhlinzwa okuncane kakhulu, kodwa kusenezinkinga ezinkulu, ikakhulukazi ezihlanganisa ukopha, ukubhoboza, i-stenosis, ubuhlungu besisu, ukutheleleka, njll. Ngakho-ke, ukunakekelwa kwesiguli ngemva kokuhlinzwa, ukululama, nokubuyekezwa kufanele bambisane ngenkuthalo nodokotela ukuze ululame ngokushesha ngangokunokwenzeka.
2 Ukuhlinzwa kwe-Laparoscopic
Ukuhlinzwa kwe-laparoscopic kungacatshangelwa iziguli ezinomdlavuza wesisu zakuqala ezingakwazi ukukhishwa kwe-endoscopic. Ukuhlinzwa kwe-Laparoscopic ukuvula imigudu emincane esiswini sesiguli. I-Laparoscopes nezinsimbi zokusebenza kubekwa ngalezi ziteshi ngokulimala okuncane esigulini, futhi idatha yesithombe emgodini wesisu idluliselwa esikrinini sokubonisa nge-laparoscope, eqedwa ngaphansi kokuqondisa kwe-laparoscope. ukuhlinzwa komdlavuza wesisu. Ukuhlinzwa kwe-laparoscopic kungaqeda ukusebenza kwe-laparotomy yendabuko, ukwenza i-gastrectomy enkulu noma isiyonke, ukuhlinza ama-lymph node asolisayo, njll., futhi kunokopha okuncane, umonakalo omncane, isibazi esincane sokusikwa kwangemva kokuhlinzwa, ubuhlungu obuncane, nokululama ngokushesha kokusebenza kwamathumbu ngemva kokuhlinzwa.
3. Vula ukuhlinzwa
Njengoba i-5% kuya ku-6% yomdlavuza we-intramucosal gastric kanye ne-15% kuya ku-20% yomdlavuza we-submucosal gastric ine-perigastric lymph node metastasis, ikakhulukazi i-adenocarcinoma engahlukanisi kwabesifazane abasha, i-laparotomy yendabuko ingacatshangelwa, engasuswa kakhulu futhi i-Lymph node dissection.
isifinyezo
Nakuba umdlavuza wesisu uyingozi kakhulu, awubi kabi. Uma nje ukuqwashisa ngokuvimbela kusengcono, umdlavuza wesisu ungatholwa ngesikhathi futhi welashwe kusenesikhathi, futhi kungenzeka ukuthi kutholakale ukwelashwa okuphelele. Ngakho-ke, kunconywa ukuthi amaqembu asengozini enkulu ngemva kweminyaka engama-40, kungakhathaliseki ukuthi anenkinga yokugaya ukudla, kufanele ahlolelwe umdlavuza wesisu kusenesikhathi, noma i-endoscopy yesisu kufanele yengezwe ekuhlolweni okujwayelekile komzimba ukuze kutholakale icala kusenesikhathi. umdlavuza futhi usindise ukuphila nomndeni ojabulayo.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., singumkhiqizi waseChina ogxile ezintweni ezisetshenziswayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip,polyp ugibe, inaliti ye-sclerotherapy, fafaza i-catheter, amabhulashi e-cytology, guidewire, ubhasikidi wokubuyisa amatshe, i-catheter ye-nasal biliary drainagenjll. ezisetshenziswa kakhulu ku-EMR, ESD, 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: Jun-21-2022