Umhlaza wesisu ngomnye weethumba ezinobungozi ezibeka ubomi babantu esichengeni kakhulu. Kukho amatyala amatsha ayi-1.09 yezigidi ehlabathini minyaka le, kwaye inani lamatyala amatsha kwilizwe lam lifikelela kuma-410,000. Oko kukuthi, malunga ne-1,300 yabantu kwilizwe lam bafunyanwa benomhlaza wesisu yonke imihla.
Izinga lokusinda kwezigulane ezinomhlaza wesisu linxulumene kakhulu nenqanaba lokuqhubela phambili komhlaza wesisu. Izinga lokunyangwa komhlaza wesisu kwasekuqaleni linokufikelela kwi-90%, okanye liphele ngokupheleleyo. Izinga lokunyangwa komhlaza wesisu okwinqanaba eliphakathi liphakathi kwe-60% kunye ne-70%, ngelixa izinga lokunyangwa komhlaza wesisu ophucukileyo liyi-30% kuphela, ngoko ke umhlaza wesisu kwasekuqaleni ufunyenwe. Kwaye unyango lwasekuqaleni lubalulekile ekunciphiseni ukufa komhlaza wesisu. Ngethamsanqa, ngokuphuculwa kwetekhnoloji ye-endoscopic kwiminyaka yakutshanje, ukuvavanywa komhlaza wesisu kwasekuqaleni kuye kwenziwa kakhulu kwilizwe lam, nto leyo eye yaphucula kakhulu izinga lokufunyaniswa komhlaza wesisu kwasekuqaleni;
Ngoko ke, yintoni umhlaza wesisu kwangethuba? Ungawubona njani umhlaza wesisu kwangethuba? Ungawunyanga njani?
1 Ingcamango yomhlaza wesisu kwangethuba
Ngokwezonyango, umhlaza wesisu wasekuqaleni ubhekisa kakhulu kumhlaza wesisu onezilonda zasekuqaleni, izilonda ezincinci kwaye akukho zimpawu zicacileyo. Umhlaza wesisu wasekuqaleni uchongwa kakhulu nge-gastroscopic biopsy pathology. Ngokwe-pathological, umhlaza wesisu wasekuqaleni ubhekisa kwiiseli zomhlaza ezilinganiselwe kwi-mucosa kunye ne-submucosa, kwaye nokuba ithumba likhulu kangakanani na kwaye nokuba kukho i-lymph node metastasis, lixhomekeke kumhlaza wesisu wasekuqaleni. Kwiminyaka yakutshanje, i-dysplasia enzima kunye ne-intraepithelial neoplasia ephezulu nazo zihlelwa njengomhlaza wesisu wasekuqaleni.
Ngokobungakanani bethumba, umhlaza wesisu wasekuqaleni wahlulwe waba: umhlaza wesisu omncinci: ububanzi be-cancer foci yi-6-10 mm. Umhlaza wesisu omncinci: Ububanzi be-tumor foci bungaphantsi okanye bulingana ne-5 mm. I-punctate carcinoma: I-gastric mucosa biopsy ngumhlaza, kodwa akukho zicubu zomhlaza ezinokufunyanwa kuthotho lweesampuli zotyando.
Ngokwe-endoscopic, umhlaza wesisu wasekuqaleni wahlulwe ngokwahlukeneyo: uhlobo (uhlobo lwe-polypoid): abo banobunzima bethumba obuphumayo obumalunga ne-5 mm nangaphezulu. Uhlobo lwesibini (uhlobo olungaphandle): Ubunzima bethumba buphakanyisiwe okanye buncitshisiwe ngaphakathi kwe-5 mm. Uhlobo lwesithathu (uhlobo lwesilonda): Ubunzulu boxinzelelo lobunzima bomhlaza budlula i-5 mm, kodwa abudluli kwi-submucosa.
2 Zithini iimpawu zomhlaza wesisu kwangethuba
Uninzi lomhlaza wesisu wasekuqaleni awunazo iimpawu ezikhethekileyo, oko kukuthi, iimpawu zokuqala zomhlaza wesisu azinazo iimpawu.
Ezo mpawu zibizwa ngokuba ziimpawu zokuqala zomhlaza wesisu ezijikeleza kwi-intanethi azizompawu zokuqala. Nokuba ngugqirha okanye ngumntu ohloniphekileyo, kunzima ukugweba ngokweempawu kunye neempawu. Abanye abantu banokuba neempawu ezithile ezingaqhelekanga, ikakhulu ukungagayi kakuhle, njengeentlungu zesisu, ukudumba, ukuhlutha kwangoko, ukuphelelwa ngumdla wokutya, ukuphinda kugayiwe yi-asidi, isitshiso sentliziyo, ukurhawuzelelwa, ukurhawuzelelwa, njl. Ezi mpawu zifana kakhulu neengxaki zesisu eziqhelekileyo, ngoko ke azisoloko zitsala ingqalelo yabantu. Ke ngoko, kubantu abangaphezu kweminyaka engama-40 ubudala, ukuba baneempawu ezicacileyo zokungagayi kakuhle, kufuneka baye esibhedlele ukuze bafumane unyango kwangethuba, kwaye benze i-gastroscopy ukuba kuyimfuneko, ukuze bangaphoswa lelona xesha lifanelekileyo lokufumanisa umhlaza wesisu kwangethuba.
3 Indlela yokufumanisa umhlaza wesisu kwangethuba
Kwiminyaka yakutshanje, iingcali zonyango kwilizwe lethu, kunye nemeko yokwenyani yelizwe lethu, ziye zaqulunqa "Iingcali zeNkqubo yoHlolo loMhlaza weSisu eTshayina".
Iya kudlala indima enkulu ekuphuculeni izinga lokufunyaniswa kwesifo kunye nezinga lokunyangwa komhlaza wesisu kwangethuba.
Ukuhlolwa komhlaza wesisu kwangethuba kujoliswe ikakhulu kwizigulana ezisengozini enkulu, ezifana nezigulana ezine-Helicobacter pylori, izigulana ezinembali yomhlaza wesisu kusapho, izigulana ezingaphezulu kweminyaka engama-35 ubudala, abantu abatshaya ixesha elide, nabathanda ukutya okuphekiweyo.
Indlela ephambili yokuvavanya ikakhulu kukufumanisa inani labantu abanomhlaza wesisu abasengozini enkulu ngovavanyo lwe-serological, oko kukuthi, ngokusebenzisa umsebenzi wesisu kunye nokufunyanwa kwe-Helicobacter pylori antibody. Emva koko, amaqela anomngcipheko ophezulu afunyenwe kwinkqubo yokuqala yokuvavanya ahlolwa ngononophelo yi-gastroscope, kwaye ukujongwa kwezilonda kunokwenziwa kube nobuchule ngakumbi ngokusebenzisa ukukhulisa, ukudaya, i-biopsy, njl.njl., ukuze kuqinisekiswe ukuba izilonda zinomhlaza na kwaye zinokunyangwa phantsi kwe-microscope.
Kakade ke, ikwayindlela engcono yokufumanisa umhlaza wesisu kwangethuba ngokufaka i-gastrointestinal endoscopy kwizinto eziqhelekileyo zovavanyo lomzimba kubantu abaphilileyo ngokuhlolwa komzimba.
4 Yintoni uvavanyo lomsebenzi wesisu kunye nenkqubo yokufumana amanqaku okuhlolwa komhlaza wesisu
Uvavanyo lomsebenzi wesisu kukufumanisa umlinganiselo we-pepsinogen 1 (PGI), i-pepsinogen (PGl1, kunye ne-protease) kwi-serum.
(PGR, PGI/PGII) umxholo we-gastrin 17 (G-17), kwaye inkqubo yokuvavanya umhlaza wesisu isekelwe kwiziphumo zovavanyo lomsebenzi wesisu, kunye namanqaku apheleleyo afana ne-Helicobacter pylori antibody, ubudala kunye nesini, ukugweba. Indlela yomngcipheko womhlaza wesisu, ngokusebenzisa inkqubo yokuvavanya umhlaza wesisu, inokuchonga amaqela aphakathi naphezulu omngcipheko womhlaza wesisu.
I-Endoscopy kunye nokulandelela kuya kwenziwa kumaqela aphakathi nalawo asemngciphekweni ophezulu. Amaqela asemngciphekweni ophezulu aya kuhlolwa ubuncinane kanye ngonyaka, kwaye amaqela asemngciphekweni ophakathi aya kuhlolwa ubuncinane kanye kwiminyaka emi-2. Ukufunyanwa kokwenyani ngumhlaza wasekuqaleni, onokunyangwa ngotyando lwe-endoscopic. Oku akunakuphucula kuphela izinga lokufunyanwa komhlaza wesisu kwangethuba, kodwa kunciphise ne-endoscopy engeyomfuneko kumaqela asemngciphekweni ophantsi.
5 Yintoni iGastroscopy
Ngamafutshane, i-gastroscopy kukwenza uhlalutyo lwe-endoscopic morphological lwezilonda ezirhanelekayo ezifunyenwe ngaxeshanye ne-gastroscopy eqhelekileyo, kuquka i-endoscopy yokukhanya okumhlophe eqhelekileyo, i-chromoendoscopy, i-magnifying endoscopy, i-confocal endoscopy kunye nezinye iindlela. I-lesion ifunyaniswa ukuba ayinabungozi okanye ayirhaneleki kwi-malignancy, kwaye emva koko kwenziwa i-biopsy ye-malignancy lesion erhanelwayo, kwaye ukuxilongwa kokugqibela kwenziwa yi-pathology. Ukufumanisa ukuba kukho izilonda zomhlaza, ubungakanani bokungena komhlaza ecaleni, ubunzulu bokungena ngokuthe nkqo, umlinganiselo wokwahluka, kunye nokuba kukho na imiqondiso yonyango lwe-microscopic.
Xa kuthelekiswa ne-gastroscopy eqhelekileyo, uvavanyo lwe-gastroscopy kufuneka lwenziwe phantsi kweemeko ezingenabuhlungu, nto leyo evumela izigulane ukuba ziphumle ngokupheleleyo kwimeko yokulala okufutshane kwaye zenze i-gastroscopy ngokukhuselekileyo. I-gastroscopy ineemfuno eziphezulu kubasebenzi. Kufuneka iqeqeshwe ekufumaneni umhlaza kwangethuba, kwaye iingcali ze-endoscopist ezinamava zinokwenza uhlolo oluneenkcukacha ngakumbi, ukuze zikwazi ukubona ngcono izilonda kwaye zenze uhlolo olufanelekileyo kunye nezigwebo.
I-Gastroscopy ineemfuno eziphezulu kwizixhobo, ingakumbi ngeteknoloji zokuphucula umfanekiso ezifana ne-chromoendoscopy/i-chromoendoscopy ye-elektroniki okanye i-magnifying endoscopy. I-ultrasound gastroscopy nayo iyafuneka ukuba kuyimfuneko.
Unyango olu-6 lomhlaza wesisu kwangethuba
1. Ukususwa kwe-Endoscopic
Xa umhlaza wesisu ufunyenwe kwangoko, ukususwa kwe-endoscopic lolona khetho lokuqala. Xa kuthelekiswa notyando lwendabuko, ukususwa kwe-endoscopic kuneengenelo zokulimala okuncinci, iingxaki ezimbalwa, ukuchacha ngokukhawuleza, kunye neendleko eziphantsi, kwaye ukusebenza kakuhle kwezi zimbini kuyafana. Ke ngoko, ukususwa kwe-endoscopic kuyacetyiswa ekhaya nakwamanye amazwe njengonyango olukhethwayo lomhlaza wesisu kwangoko.
Okwangoku, iindlela zokususwa kwe-endoscopic ezisetyenziswa rhoqo ziquka ukususwa kwe-endoscopic mucosal resection (EMR) kunye ne-endoscopic submucosal dissection (ESD). Itekhnoloji entsha ephuhlisiweyo, i-ESD single-channel endoscopy, inokuphumeza ukususwa kwezilonda kube kanye nzulu kwi-muscularis propria, ngelixa ikwabonelela ngenqanaba elichanekileyo le-pathological ukunciphisa ukuphinda kuvele emva kwexesha.
Kufuneka kuqatshelwe ukuba utyando lwe-endoscopic resection lutyando olungenabungozi kangako, kodwa kusekho iingxaki ezininzi, kuquka ukopha, ukugqobhoka, i-Stenosis, iintlungu zesisu, usulelo, njl. Ngoko ke, unyango lwesigulana emva kotyando, ukuchacha, kunye nokuhlolwa kufuneka kusebenzisane nogqirha ukuze siphile ngokukhawuleza.
2 Utyando lweLaparoscopic
Utyando lwe-laparoscopic lunokuqwalaselwa kwizigulana ezinomhlaza wesisu kwangethuba ezingenako ukususwa nge-endoscopic resection. Utyando lwe-laparoscopic lukukuvula imijelo emincinci esiswini sesigulana. Ii-laparoscopes kunye nezixhobo zokusebenza zifakwa ngale mijelo ngaphandle komonakalo omkhulu kwisigulana, kwaye idatha yomfanekiso kwisisu idluliselwa kwisikrini sokubonisa nge-laparoscope, egqitywa phantsi kwesikhokelo se-laparoscope. Utyando lwe-laparoscopic lunokugqibezela utyando lwe-laparotomy yendabuko, lwenze i-gastrectomy enkulu okanye iyonke, luqhaqhe ii-lymph nodes ezikrokrelekayo, njl.njl., kwaye lunokopha okuncinci, umonakalo omncinci, inxeba elincinci emva kotyando, iintlungu ezincinci, kunye nokubuyela ngokukhawuleza komsebenzi wesisu emva kotyando.
3. Utyando oluvulekileyo
Ekubeni i-5% ukuya kwi-6% yomhlaza wesisu ongaphakathi kwi-mucosal kunye ne-15% ukuya kwi-20% yomhlaza wesisu ongaphantsi kwe-mucosal une-perigastric lymph node metastasis, ingakumbi i-adenocarcinoma engachazwanga kubasetyhini abancinci, i-laparotomy yendabuko inokuqwalaselwa, enokususwa ngokupheleleyo kwaye i-Lymph node isuswe.
isishwankathelo
Nangona umhlaza wesisu uyingozi kakhulu, awubi mbi kakhulu. Logama nje ulwazi lokuthintela luphucukile, umhlaza wesisu unokubonwa ngexesha kwaye unyangwe kwangethuba, kwaye kunokwenzeka ukufumana unyango olupheleleyo. Ke ngoko, kuyacetyiswa ukuba amaqela asengozini ephezulu emva kweminyaka engama-40, nokuba anengxaki yokugaya ukutya, kufuneka ahlolwe kwangethuba umhlaza wesisu, okanye kufuneka kongezwe i-endoscopy kuvavanyo oluqhelekileyo lomzimba ukuze kufunyanwe imeko yomhlaza kwangethuba kwaye kusindiswe ubomi kunye nosapho olonwabileyo.
Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumvelisi eTshayina ogxile kwizinto ezisetyenziswayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip,umgibe we-polyp, inaliti ye-sclerotherapy, i-catheter yokutshiza, iibhrashi ze-cytology, ucingo lwesikhokelo, ibhaskithi yokuqokelela amatye, i-catheter yokukhupha amanzi empumlweninjl. ezisetyenziswa kakhulu kwi-EMR, ESD, ERCP. Iimveliso zethu ziqinisekisiwe yi-CE, kwaye izityalo zethu ziqinisekisiwe yi-ISO. Iimpahla zethu zithunyelwe eYurophu, eMntla Melika, eMbindi Mpuma nakwinxalenye ye-Asia, kwaye zifumana umthengi udumo nodumo!
Ixesha lokuthumela: Juni-21-2022