I-Endoscopic biopsy yeyona nto ibalulekileyo yovavanyo lwe-endoscopic yemihla ngemihla. Phantse zonke iimviwo ze-endoscopic zifuna inkxaso ye-pathological emva kwe-biopsy. Umzekelo, ukuba kurhanelwa ukuba umjelo wokugaya ukutya unokuvuvukala, umhlaza, i-atrophy, i-intestinal metaplasia, kunye nosulelo lwe-HP, i-pathology iyafuneka ukunika isiphumo esiqinisekileyo.
Okwangoku, iindlela ezintandathu ze-biopsy ziqhutywa rhoqo eTshayina:
1. Uviwo lweCytobrush
2. I-Biopsy yezicubu
3. Ubuchule be-tunnel biopsy
4. I-EMR nge-bulk biopsy technique
5. I-ESD ye-tumor biopsy technique
6. I-FNA ekhokelwa yi-Ultrasound
Namhlanje siza kugxila ekuphononongeni i-biopsy yezicubu, eyaziwa ngokuba "yi-clamping iqhekeza lenyama".
I-biopsy phantsi kwe-endoscopy yokwetyisa ayinakwenziwa ngaphandle kwe-biopsy forceps, ekwayenye yezona zinto zixhaphakileyo zisetyenziswa ngootitshala abangabongikazi be-endoscopic. Ootitshala abenza ukonga kwe-endoscopic banokucinga ukuba i-biopsy forceps ilula kakhulu ukuyisebenzisa, ilula njengokuvula nokuvala. Ngapha koko, ukusebenzisa i-biopsy forceps ngokucacileyo kunye nokugqibelela, umntu kufuneka abe nokuqonda kunye nokusebenza nzima, kwaye abe nobuchule ekushwankatheleni.
I.Okokuqala, makhe sihlolisise ubume bei-biopsy forceps:
(I) Ubume be-biopsy forceps (Umfanekiso 1): I-Biopsy forceps yenziwe ngencam, umzimba kunye nomqheba wokusebenza. Izixhobo ezininzi ezifana ne-forcep body yangaphandle, i-hot biopsy forceps, izikere, ii-curettes, njl.
Icebiso: Incam inemihlathi emibini emile okwekomityi enokuvulwa ivalwe. Ubume bemihlathi ngundoqo kumsebenzi weentlobo ezahlukeneyo ze-biopsy forceps. Zinokwahlulwa ngokurhabaxa zibe ziindidi ezisixhenxe: uhlobo oluvulekileyo olunye, uhlobo oluvulwe kabini, uhlobo lwefestile, uhlobo lwenaliti, uhlobo olumbhoxo, uhlobo lomlomo wengwenya, kunye nohlobo olugobileyo lwencam. Imihlathi ye-biopsy forceps yenziwe ngensimbi engenasici kwaye inamacangca abukhali. Nangona iincakuba ze-biopsy forceps ezilahlwayo nazo zibukhali, azikwazi ukunxiba kakuhle. Amagqabi e-biopsy forceps anokuphinda asetyenziswe aphathwa ngokukodwa ukuze awenze omelele ngakumbi.
Iintlobo eziqhelekileyo zei-biopsy forceps
1.Uhlobo oluqhelekileyo olunefestile
Kukho ifestile embindini wekomityi ye-forceps, enciphisa kakhulu umonakalo wezicubu kunye nokwandisa inani lezicubu ze-biopsy.
2. Uhlobo oluqhelekileyo kunye nefestile kunye nenaliti
Inaliti ibekwe kumbindi wekomityi yeforceps ukuthintela i-biopsy ukuba ingatyibiliki kwi-mucosa kunye nokunceda ukubamba isampulu yethishu.
3. Uhlobo lwengwenya
I-serrated clamp cup ikhusela ngokufanelekileyo ikomityi yokubamba ukuba ingatyibiliki, kwaye umphetho wokusika ubukhali ukuze ubambe ngokukhuselekileyo.
4. Uhlobo lwengwenya ngenaliti
Imihlathi ine-angle yokuvula ebanzi yokwandisa umthamo we-biopsy; i-blade edge ibukhali ukwenzela ukubamba okukhuselekileyo.
Kukho inaliti embindini wentloko ye-clamp, enokwenza ukulungiswa kusebenze ngakumbi kwaye kuchanekile.
Ifanelekile kwi-biopsy kwizihlunu ezinzima ezifana namathumba.
Umzimba we-Forceps: Umzimba we-biopsy forceps wenziwe ityhubhu yentsimbi engenasici, equlethe ucingo lwentsimbi lokutsala ivalve yeforceps ukuze ivuleke kwaye ivale. Ngenxa yesakhiwo esikhethekileyo sombhobho odibeneyo, i-mucus ye-tissue, igazi kunye nezinye izinto zinokungena ngokulula, kodwa akulula ukuyicoca ngokucokisekileyo. Ukungaphumeleli ukuyicoca ngokucokisekileyo kuya kubangela ukuphazamiseka ekusebenzeni kwe-forceps ye-biopsy, kwaye ukuvulwa kunye nokuvala akuyi kuba lula okanye kungenakwenzeka ukuvula. Isibambo sokusebenza: Iringi kwisiphatho sokusebenza isetyenziselwa ukubamba isithupha, kwaye i-groove ebanzi ejikelezayo isetyenziselwa ukubeka umnwe wesalathisi kunye nomnwe ophakathi. Ngaphantsi kokusebenza kwale minwe mithathu, amandla adluliselwa kwivalve ye-forceps ngokusebenzisa ucingo lokutsalela ukuvula nokuvala.
(II) Amanqaku aphambili okusetyenziswa kwe-biopsy forceps: Ukunyamekela okukhulu kufuneka kuthathwe ekusebenzeni, ukusetyenziswa kunye nokugcinwa kwe-forceps ye-biopsy, ngaphandle koko kuya kuchaphazela ukusetyenziswa kwe-endoscope.
1. Ukubhaqwa kwangaphambili:
Ngaphambi kokusetyenziswa, qiniseka ukuba i-biopsy forceps yenziwe inzala kwaye isetyenziswe ngexesha elisebenzayo lokuvala inzala. Ngaphambi kokufaka i-endoscope forceps channel, ukuvulwa kunye nokuvalwa kwe-forceps kufuneka kuhlolwe (Umfanekiso 2).
Umzobo we-2 Ukufumanisa i-Biopsy forceps
Indlela ekhethekileyo kukubhijela umzimba we-biopsy forceps kwisangqa esikhulu (ububanzi besangqa malunga ne-20cm), kwaye emva koko wenze izenzo ezininzi zokuvula nokuvala ukujonga ukuba i-forceps flaps ivula kwaye ivale kakuhle. Ukuba kukho amaxesha angama-1-2 okungahambi kakuhle, kungcono ukuba ungasebenzisi i-forceps ye-biopsy. Okwesibini, kuyimfuneko ukuvavanya ukuvalwa kwe-biopsy forceps. Thatha isiqwenga sephepha elibhityileyo njengephepha leleta kwaye ulibambe ngeenyanzeliso ze-biopsy. Ifanelekile ukuba iphepha elincinci aliwi. Okwesithathu, kuyimfuneko ukujonga ukuba iikomityi ezimbini ze-forceps flaps zihambelana ngokupheleleyo (Umfanekiso 3). Ukuba kukho ukungahambi kakuhle, yeka ukuyisebenzisa ngokukhawuleza, ngaphandle koko iya kukrwela umbhobho we-forceps.
Umzobo 3 I-Biopsy forceps flap
Amanqaku ngexesha lokusebenza:
Ngaphambi kokufaka ityhubhu ye-forceps, imihlathi kufuneka ivalwe, kodwa khumbula ukuba ungasebenzisi amandla amaninzi ngenxa yokwesaba ukuvala ukuvalwa, okuya kubangela ukuba ucingo lwe-traction lunwenwe kwaye luchaphazele ukuvula nokuvalwa kwemihlathi. 2. Xa ufaka ityhubhu, faka ecaleni kwendlela yokuvula ityhubhu ye-forceps kwaye musa ukugubha ngokuvula ityhubhu. Ukuba ufumana ukuxhathisa xa ungena, kufuneka ukhulule iqhosha leengile kwaye uzame ukungena kwimeko ethe nkqo ngokwendalo. Ukuba awukakwazi ukudlula, rhoxisa i-endoscope emzimbeni ukuze uyivavanye, okanye uyibuyisele kwezinye iiforcep ze-biopsy ezinjengeemodeli ezincinci. 3. Xa ukhupha i-forceps ye-biopsy, kuphephe ukusebenzisa amandla amaninzi. Umncedisi kufuneka ayibambe ngezandla zombini aze ayigobe. Sukuzolula kakhulu iingalo zakho. 4. Xa imihlathi ingakwazi ukuvaleka, musa ukuyikhupha ngenkani. Ngeli xesha, kufuneka ityhalwe ngaphandle komzimba kunye ne-endoscope ukuze iqhubeke nokusebenza.
II. Isishwankathelo seendlela ezithile ze-biopsy
1. Ukuvula nokuvala i-biopsy forceps yimisebenzi yobugcisa yomibini. Ukuvulwa kufuna ulwalathiso, ngakumbi i-angle yesisu, ekufuneka i-perpendicular kwindawo ye-biopsy. Ukuvala kufuna ixesha. I-gastrointestinal motility kunye nokusebenza kogqirha kuzinzile kwaye akunakulungiswa ngokuqhubekayo. Umncedisi makasebenzise ithuba lokubamba ngokufanelekileyo nangokukhuselekileyo i-forceps ye-biopsy.
2. Umzekelo we-biopsy kufuneka ube mkhulu ngokwaneleyo kwaye ube nzulu ngokwaneleyo ukufikelela kwi-muscularis mucosa.
3. Qwalasela impembelelo yokopha emva kokuxilongwa kwe-biopsy kwii-biopsies ezilandelayo. Xa i-angle ye-gastric kunye ne-antrum kufuneka i-biopsies ngexesha elifanayo, i-angle ye-gastric kufuneka ihlaziywe kuqala kwaye emva koko i-antrum; xa indawo ye-lesion inkulu kwaye iziqwenga ezininzi zezicubu kufuneka zinyanzeliswe, isiqwenga sokuqala kufuneka sichaneke, kwaye kuyafuneka kwakhona ukuba kuqwalaselwe ukuba ukopha emva kokuba i-clamping iya kugubungela izicubu ezijikelezileyo kwaye ichaphazele intsimi yombono, ngaphandle koko i-clamping elandelayo iya kuba yimfama kunye ne-passive.
Ulandelelwano lwe-biopsy eqhelekileyo yezilonda kwi-angle yesisu, kuthathelwa ingqalelo isiphumo sokuhamba kwegazi kwii-biopsies ezilandelayo
4. Zama ukwenza i-vertical pressure biopsy kwindawo ekujoliswe kuyo, kwaye usebenzise ukufunxa xa kuyimfuneko. Ukufunxa kunciphisa ukunyanzeliswa komphezulu we-mucosa, ukuvumela ukuba izicubu zinyanzeliswe nzulu kwaye zincinci ukuba zityibilike.
I-Biopsy kufuneka yenziwe ngokuthe nkqo ngokusemandleni, kwaye ubude bokwandiswa kwe-forceps ye-biopsy akufanele idlule i-2CM.
5. Nika ingqalelo ekukhethweni kwamanqaku okusampula kwiindidi zezilonda ezahlukeneyo; ukukhethwa kwamanqaku eesampuli kuhambelana nezinga elihle. Ugqirha wotyando uneliso elibukhali kwaye kufuneka kwakhona anikele ingqalelo kwizakhono zokukhetha izinto.
Iindawo ekuza kujongwa kuzo iBiopsied
6. Amalungu anzima ukwenza i-biopsy abandakanya i-fundus yesisu kufuphi ne-cardia, i-curvature encinci ye-gastric body kufuphi nodonga olungasemva, kunye nekona ephezulu ye-duodenum. Umncedisi kufuneka agxininise kwintsebenziswano. Ukuba ufuna ukufikelela kwisiphumo esigqibeleleyo, kufuneka afunde ukucwangcisa kwangaphambili kwaye alungelelanise isalathiso se-clamp flap nangaliphi na ixesha. Kwangaxeshanye, kufuneka akhawuleze aligwebe ixesha lokuqhobosha ngokulisebenzisa ithuba elivelayo. Ngamanye amaxesha xa ulindele imiyalelo evela kugqirha wotyando, i-lag ye-1 yesibini inokukhokelela kumathuba alahlekileyo. Ndingalinda ngomonde kuphela ithuba elilandelayo.
Iintolo zibonisa iindawo apho kunzima ukufumana izinto eziphathekayo okanye ukuyeka ukopha.
7. Ukukhethwa kwezinyanzelo ze-biopsy: I-Biopsy forceps iquka ezo zineekomityi ezinkulu ezivulekileyo kunye nezinzulu, ezinye zinenaliti zokubeka indawo, kwaye ezinye ezinokuvulwa kwecala kunye nokulunywa kwe-serrated.
8. Ukukhulisa okudityaniswe ne-electronic staining ukukhokela i-biopsy ichaneke ngakumbi, ngakumbi kwisampulu ye-esophageal mucosa.
Thina, i-Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., ngumenzi waseTshayina okhethekileyo kwizinto ezityiwayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip, polyp umgibe, inaliti ye-sclerotherapy, fafaza i-catheter, iibrashi zecytology, guidewire, ibhasikithi yokubuyiswa kwamatye, i-catheter ye-biliary drainage yeempumlo njl. ezisetyenziswa ngokubanzi kwiI-EMR, ESD, I-ERCP. Iimveliso zethu ziqinisekisiwe nge-CE, kwaye izityalo zethu ziqinisekisiwe nge-ISO. Impahla yethu ithunyelwe eYurophu, kuMntla Melika, kuMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana ngokubanzi umthengi wokuqatshelwa kunye nendumiso!
Ixesha lokuposa: Jan-23-2025