Oogqirha baseLatin America bayavuya kakhulu kubaI-ERCPingenile kwixesha elitsha lotyando lwerobhothi kwaye isasaza iindaba kuyo yonke indawo.
Ngexesha lencoko yam yakutshanje noogqirha baseLatin America, ndikhankanyeI-ERCPirobhothi yotyando evela kwi-Ausway Endoscopy, evavanywayo ngoku. Bathi bakufumanisa ukuba le nkqubo inokwenza i-robot-assistedI-ERCP, ukulawula kude i-endoscope eguquguqukayo kunye nezixhobo ngengalo yerobhothi ukuze kugqitywe iinkqubo ezifana nokubekwa kwe-biliary stent ngaphandle kokunxiba ii-apron zelothe kunye nokuvezwa kwemitha okuncitshisiweyo kakhulu, umoya waba ngumbane ngoko nangoko. Oogqirha abaninzi babevuya kakhulu kangangokuba babesasaza iindaba phantse.
Ngexesha lam lokuphumla, bendizibuza: kutheni babevuya kangaka?
Ndicinga ngalo mbuzo, ndiphinde ndawujonga uncwadi kunye nedatha efanelekileyo, kwaye okukhona ndifunda, kokukhona icaca ngakumbi—I-ERCPIirobhothi zotyando ziluncedo ngokwenene kwiingcali ze-endoscopist, kwaneteknoloji etshintsha ubomi.
Ngezantsi, ndingathanda ukwabelana nani: Umbulali Othuleyo kwi-Endoscopy: Ingxaki Yokutsalwa Kwemitha Isondele Kunokuba Ucinga! Wonke Umntu UdlalaI-ERCPKufuneka Ufunde Oku
Eyona nto ilula ukuyihoya kwigumbi lokutyanda ayizongxaki, kodwa lukukhanya okuqokeleleka kancinci.
Iingcali ezininzi ze-endoscopist ziyayazi loo ntoI-ERCPisebenzisa i-fluoroscopy, kodwa usenokungazi—Le nkqubo idweliswe yi-FDA njengovavanyo olunobungozi obukhulu “olunokubangela umonakalo omkhulu kwimitha.”
Sixakekile sinyanga amatye enyongo kunye ne-strictures, kodwa sihlala singayinaki into eyoyikisayo nangakumbi:
Imitha ilimaza izigulane kancinci kancinci, kwaye ilimaza wonke umntu omi ecaleni kwengalo ye-C.
Namhlanje, ngendlela elula ukuyiqonda, ndiza kuchaza izikhokelo zamazwe ngamazwe kunye nedatha yophando lokwenyani:
Uchanabeke kangakanani ngokwenene? Zeziphi izinto ezibangela "ukuba" impilo yakho? Ungaqinisekisa njani ngokwenene ukhuseleko?
I. Kutheni kunjaloI-ERCPkucingelwa ukuba inkqubo enobungozi obuphezulu ebandakanya imitha?
KubaI-ERCPihlangabezana nazo zonke iimeko "zokuvezwa kwidosi ephezulu"
● Ifuna i-fluoroscopy
● Inkqubo enzima
● Ukusondela kakhulu kugqirha
● Ixesha elide
● Iinkqubo eziphindaphindwayo
Ziyoyikisa kangakanani ezi zibalo zokwenyani?
Idosi yemitha yesinyeI-ERCPInkqubo ilingana ne-312 chest X-rays (umndilili).
—Uphando oluvela kwi-I-ERCPiprojekthi yokulinganisa imitha eUruguay
Okubaluleke ngakumbi: Ufumana amashumi, amakhulu, okanye nangaphezulu ngonyaka.
II. Zeziphi iziphumo ezibangelwa yimitha kuwe?
Umonakalo wemitha uhlukaniswe ngamacandelo amabini:
1) Umonakalo oqinisekileyo (uya kwenzeka ukuba idosi yanele)
● Ubomvu besikhumba
● Ukulahlekelwa ziinwele
● Ukuchithwa kwesakhiwo
● Izilonda
● Iicataracts (ezinokuqokelelana kwezinto ezinobungozi ixesha elide)
Ilensi yenye yezona zitho zibuthathaka kakhulu, kwaye i-ICRP iwuthobile umda wayo ukuya kwi-20 mSv ngonyaka.
UninziI-ERCPIingcali ezisebenze iminyaka engaphezu kweshumi sele zinamava okungabonakali kwelensi.
2) Umonakalo ongacwangciswanga (umonakalo onokwenzeka)
Akukho mda.
Okukhona idosi iphezulu, kokukhona umngcipheko uba mkhulu.
Uqikelelo lwe-ICRP: 1 mSv = 0.005% yokunyuka komngcipheko womhlaza ebomini bonke.I-ERCP≈ 6 mSv → Ukwanda komngcipheko nge-0.03%.
Awukwenzi "kanye".
Uyenza kaninzi ngonyaka, amawakawaka amaxesha ebomini bakho.
III. Eyona ndawo iyingozi kakhuluI-ERCPIgumbi yindawo omi kuyo yonke imihla.
Ngamafutshane: Okukhona ityhubhu ye-X-ray isondela, kokukhona idosi iphezulu.
Iindawo ezinobungozi obukhulu bokuchaphazeleka ngabasebenzi ziquka:
● Icala elinye letyhubhu ye-X-ray yengalo ye-C
● Ngexesha lomfanekiso we-oblique angle
● Indawo ejikeleze isigulana (umthombo omkhulu wemitha esasazekileyo)
● Izikhundla apho kubekwa khona iingcali zokubulala iintlungu kunye nabongikazi
Abantu abaninzi abazi ukuba: Iindawo abakuyo zezona ndawo ziphezulu apho bachaphazeleka khona yimitha.
IV. Uphando Lokwenyani: Ama-90% abasebenzi bezonyango abazange bathathe amanyathelo afanelekileyo okuzikhusela
Iziphumo zophando lwe-Sociedad Interamericana de Endoscopía Digestiva (SIED) ziyamangalisa:
● Yi-22% kuphela yoogqirha abafumene uqeqesho lokukhusela imitha.
● Yi-17% kuphela yabongikazi abaye bafumana uqeqesho.
● Ngaphandle kwee-aproni zelothe, izinga lokusetyenziswa kwezinye izixhobo zokukhusela liphantsi kakhulu.
Ngaba uzibona "ukhuselekile"? Inyani yile: Uninzi lwabantu lubaleka luze.
V. Umgaqo we-ALARA: Imithetho emi-3 ekufuneka wonke umntu ayilandele
I-ALARA = Iphantsi Kangangoko Kunokwenzeka
1.Ixesha: Lifutshane kangangoko.
● I-pulse fluoroscopy
● Sebenzisa "iFrozen Last Frame"
● Thintela i-fluoroscopy eqhubekayo
2. Umgama: Okukhona umgama usiya phambili kokukhona kungcono. Ngokubuyela umva inyathelo ngalinye, umthamo → uba yi-1/4 yowokuqala.
3. Ukukhusela: Vimba kangangoko kunokwenzeka.
● I-apron yentsimbi (≥0.35 mmPb)
● Ukukhuselwa kwe-thyroid
● Iiglasi zelothe (zokuthintela i-cataract)
● Amakhethini e-lead
● Izikrini ezixhonyiweyo
Ikhethini yelothe inokunciphisa imitha esasazekileyo ngaphezulu kwama-95%.
VI. Ziphi iingozi zokwenyani kwizigulane?
I-BMI ephezulu, ephindaphindwayoI-ERCP, iidosi eziphezulu zomahluko, amaxesha amade otyando. Zonke ezi zinto zinokukhokelela ekuqokeleleni ngokukhawuleza kwedosi yolusu kwizigulana.
Ingqwalasela ekhethekileyo:
● Abafazi
● Abafazi abakhulelweyo
● Abantwana (uvakalelo ×3–5)
● Ukukhanya okuphindaphindiweyo kwendawo efanayo
Ezi zigulana kufuneka zinikwe iidosi ezilinganiselweyo.
VII. Abafazi Abakhulelweyo Nabantwana: Amaqela Asemngciphekweni Omkhulu Amele Axoxwe Ngawo Odwa.
I-ERCPImigaqo Yabasetyhini Abakhulelweyo
● Ngaba "kuyimfuneko ngokwenene"?
● Ngaba ingarhoxiswa?
● Ingaba yenziwa ngugqirha onamava kakhulu?
● Ngaba ixesha le-fluoroscopy lincitshisiwe kangangoko?
● Ixesha eliyingozi kakhulu lokukhulelwa (iiveki ezili-10–25).
I-ERCPimigaqo yabantwana
● Uvakalelo oluphezulu kakhulu lwe-agent.
● Ulawulo oluqinileyo lokukhanya kunye nokukhanya kwe-collimation kubalulekile.
● Kuphela ngabaqhubi abanamava aphezulu abavumelekileyo.
VIII. Izinto ezintlanu eziziingcali ngokweneneI-ERCPigumbi kufuneka lenze oku:
1. Inkqubo yedosimitha ezimbini (esemgangathweni): Enye ngaphandle kwe-apron yentsimbi, enye ngaphakathi.
2. Misela i-DRL (iNqanaba lokuHlola): i-DRL yamva nje yaseJapan: 32 Gy·cm² (ipesenti ezingama-75).
3. Hlola ii-apron zelothe rhoqo ngonyaka (uza kumangaliswa kukubona ukuba ziyaphuka kangakanani).
4. Ukubonelela izigulane ngamaphepha olwazi ngemitha (indlela eqhelekileyo yokusebenza kumasebe alawulwa kakuhle).
5. Landela izigulane ezinedosi ephezulu kangangeeveki ezi-2-4 (umonakalo wolusu unokulibaziseka).
Ukuqukumbela: Ukuzikhusela yindlela ekuphela kwayo yokukhusela izigulane ezininzi.
Imitha ojongene nayo ayibonakali, ayibuhlungu, kwaye ayibangeli bomvu, awuyiva ngoko nangoko, kodwa iyaqokelelana kwaye ikwenzakalise yonke imihla.
Funda ukhuseleko olufanelekileyo ukuze ukwazi:
● Sebenza ixesha elide
● Sebenza ngokukhuselekileyo ngakumbi
● Sebenza kakuhle
● Sebenza ngobuchule ngakumbi
Ngamana yonkeI-ERCPugqirha makabe phantsi kokukhanya, kodwa ungonzakaliswa kuko.
I-ERCPIzinto ezithengiswayo ezishushu ezivela kwi-ZRHmed.
 |  |  |  |
| I-Sphincterotome | Iingcingo zesikhokelo ezingezizo zemithambo yegazi | Iibhaskithi zokuBuyisela amatye aLahlwayo | IiCatheters zeNasobiliary ezilahlwayo |
Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumvelisi eTshayina ogxile kwizinto ezisetyenziswayo ze-endoscopic, kuquka umgca we-GI ofana ne-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-spray catheter, iibhrashi ze-cytology,ucingo lwesikhokelo, ibhaskithi yokuqokelela amatye, i-cathete yokukhupha amanzi empumlweni njl.njl. ezisetyenziswa kakhulu kwi-EMR, ESD,I-ERCPIimveliso zethu ziqinisekisiwe yi-CE kwaye zivunyiwe yi-FDA 510K, kwaye izityalo zethu ziqinisekisiwe yi-ISO. Iimpahla zethu zithunyelwe eYurophu, eMntla Melika, eMbindi Mpuma nakwinxalenye ye-Asia, kwaye zifumana umthengi udumo nodumo ngokubanzi!
Ixesha leposi: Jan-13-2026