Umhlaza wesisu lelinye lamathumba ayingozi abeka ubomi bomntu engozini. Kukho amatyala amatsha ayi-1.09 yezigidi emhlabeni minyaka le, kwaye inani lamatyala amatsha kwilizwe lam liphezulu ukuya kuma-410,000. Oko kukuthi, malunga ne-1,300 yabantu kwilizwe lam bafunyaniswa benomhlaza wesisu yonke imihla.
Izinga lokusinda kwezigulana zomhlaza wesisu linxulumene ngokusondeleyo nenqanaba lokuqhubeka komhlaza wesisu. Izinga lokunyangwa komhlaza wesisu osekuqaleni unokufikelela kuma-90%, okanye nokuba unyangeke ngokupheleleyo. Izinga lokunyangwa komhlaza wesisu okwinqanaba eliphakathi liphakathi kwama-60% kunye nama-70%, ngelixa izinga lokunyangwa komhlaza wesisu okwinqanaba eliphezulu lingama-30% kuphela. ngeenxa zonke, ngoko kwafunyanwa umhlaza wesisu kwangoko. Kwaye unyango lwakwangoko lungundoqo ekunciphiseni ukubhubha komhlaza wesisu. Ngethamsanqa, ngokuphuculwa kobugcisa be-endoscopic kwiminyaka yakutshanje, ukuhlolwa komhlaza wesisu kwasekuqaleni kuye kwenziwa ngokubanzi kwilizwe lam, eliphucule kakhulu izinga lokubona umhlaza wesisu sokuqala;
Ke, yintoni umhlaza wesisu sokuqala? Ungawubona njani umhlaza wesisu kwangoko? Indlela yokuyinyanga?
1 Ingqikelelo yomhlaza wesisu sakwangoko
Ngokoklinikhi, umhlaza wesisu sakwangoko ubhekisa ikakhulu kumhlaza wesisu onezilonda zakwangoko, izilonda ezilinganiselweyo kwaye akukho zimpawu zicacileyo. Umhlaza wesisu sokuqala ufunyaniswa ikakhulu yi-gastroscopic biopsy pathology. Ngokwe-Pathologically, umhlaza wesisu sokuqala ubhekisa kwiiseli zomhlaza ezikhawulelwe kwi-mucosa kunye ne-submucosa, kwaye nokuba likhulu kangakanani na ithumba kunye nokuba kukho i-lymph node metastasis, yeyomhlaza wesisu sokuqala. Kwiminyaka yakutshanje, i-dysplasia enzima kunye ne-high-grade intraepithelial neoplasia nazo zihlelwa njengomhlaza wesisu sokuqala.
Ngokutsho kobukhulu be-tumor, umhlaza wesisu sokuqala uhlukaniswe: umhlaza omncinci wesisu: ububanzi be-foci yomhlaza ngu-6-10 mm. Umhlaza wesisu esincinci: Ububanzi be-tumor foci bungaphantsi okanye bulingana ne-5 mm. I-Punctate carcinoma: I-gastric mucosa biopsy ngumhlaza, kodwa akukho zicubu zomhlaza ezinokuthi zifumaneke kuthotho lwemizekelo yoqhaqho.
I-Endoscopically, umhlaza wesisu wangaphambili wahlulwe ngakumbi: uhlobo (uhlobo lwe-polypoid): abo banobunzima bethumba eliphumayo malunga ne-5 mm okanye ngaphezulu. Uhlobo lwe-II (uhlobo oluphezulu): Ubunzima be-tumor buphakanyiswe okanye budandathekile ngaphakathi kwe-5 mm. Uhlobo lwe-III (uhlobo lwesilonda): Ubunzulu bokudakumba kobunzima bomhlaza budlula i-5 mm, kodwa abudluli i-submucosa.
2 Zeziphi iimpawu zomhlaza wesisu sakwangoko
Uninzi lwee-cancer zesisu zokuqala azinazimpawu zikhethekileyo, oko kukuthi, iimpawu zokuqala zomhlaza wesisu azikho iimpawu. inethiwekhi
Ezo zibizwa ngokuba ziimpawu zokuqala zomhlaza wesisu ojikeleza kwi-Intanethi ayizizo iimpawu zokuqala. Ingaba ngugqirha okanye umntu ohloniphekileyo, kunzima ukugweba kwiimpawu kunye neempawu. Abanye abantu banokuba neempawu ezingezizo ezikhethekileyo, ingakumbi ukugatya kokutya, ezinje ngeentlungu zesisu, ukudumba, ukuhlutha kwangoko, ukuphelelwa ngumdla wokutya, ukuqunjelwa kweasidi, isitshisa, ukubhitya, ukurhawuzelela, njl njl. ngokufuthi ayitsali ingqalelo yabantu. Ngoko ke, kubantu abangaphezu kweminyaka engama-40 ubudala, ukuba baneempawu ezicacileyo zokugaya ukutya, kufuneka baye esibhedlele ukuze bafumane unyango lwezonyango ngexesha, kwaye benze i-gastroscopy xa kuyimfuneko, ukuze bangaphuthelwa ixesha elifanelekileyo lokubona umhlaza wesisu sokuqala.
3 Ungawubona njani umhlaza wesisu kwangoko
Kwiminyaka yakutshanje, iingcali zonyango kwilizwe lethu, zidibaniswe nemeko yangempela yelizwe lethu, ziye zaqulunqa "Iingcali zeNkqubo yokuHlola iCancer yeGastric Early eChina".
Iya kudlala indima enkulu ekuphuculeni izinga lokuxilongwa kunye nesantya sokunyanga umhlaza wesisu sakwangoko.
Ukuhlolwa komhlaza wesisu kwangethuba kujolise ikakhulu kwizigulana ezisemngciphekweni omkhulu, njengezigulana ezinosulelo lwe-Helicobacter pylori, izigulane ezinembali yosapho lomhlaza wesisu, izigulana ezingaphezulu kweminyaka engama-35 ubudala, abantu abatshayayo ixesha elide, kunye nabathanda ukutya okucoliweyo.
Eyona ndlela yokuhlola eyona nto iphambili kukumisela umngcipheko omkhulu womhlaza wesisu ngovavanyo lwe-serological, oko kukuthi, ngokusebenza kwesisu kunye nokufunyanwa kwe-antibody ye-Helicobacter pylori. Emva koko, amaqela asemngciphekweni omkhulu afunyenwe kwinkqubo yokuqala yokuhlola ahlolwe ngononophelo nge-gastroscope, kwaye ukuqwalaselwa kwezilonda kunokwenziwa ngakumbi ngeendlela zokwandisa, ukubola, i-biopsy, njl., ukwenzela ukuba kuqinisekiswe ukuba izilonda zinomhlaza. kunye nokuba zinokunyangwa phantsi kwe-microscope.
Ewe kunjalo, ikwayindlela engcono yokubona umhlaza wesisu kwangoko ngokubandakanya i-endoscopy yesisu kwizinto eziqhelekileyo zovavanyo lomzimba kubantu abasempilweni ngovavanyo lomzimba.
4 Yintoni uvavanyo lomsebenzi wesisu kunye nenkqubo yokuhlola umhlaza wesisu
Uvavanyo lomsebenzi wesisu kukubona umlinganiselo wepepsinogen 1 (PGI), pepsinogen (PGl1, kunye neprotease) kwiserum.
(PGR, PGI / PGII) umxholo we-gastrin 17 (G-17), kunye nenkqubo yokuhlola umhlaza womhlaza wesisu isekelwe kwiziphumo zokuvavanya umsebenzi wesisu, kunye namanqaku abanzi afana ne-Helicobacter pylori antibody, ubudala kunye nesini, ukugweba Indlela yomngcipheko womhlaza wesisu, ngenkqubo yokuhlola umhlaza wesisu, inokukhusela amaqela asemngciphekweni ophakathi kunye nomngcipheko omkhulu womhlaza wesisu.
I-Endoscopy kunye nokulandelwa kuya kwenziwa kumaqela aphakathi kunye nomngcipheko ophezulu. Amaqela asemngciphekweni omkhulu aya kuhlolwa ubuncinane kanye ngonyaka, kwaye amaqela asemngciphekweni ophakathi aya kuhlolwa ubuncinane kanye kwiminyaka emi-2. Eyona nto ifunyenwe ngumhlaza wokuqala, onokunyangwa ngotyando lwe-endoscopic. Oku akunako nje ukuphucula izinga lokufunyanwa kwangoko komhlaza wesisu, kodwa nokunciphisa i-endoscopy engeyomfuneko kumaqela asemngciphekweni ophantsi.
5 Yintoni iGastroscopy
Ukuyibeka ngokulula, i-gastroscopy kukwenza uhlalutyo lwe-endoscopic morphological of izilonda ezikrokrelayo ezifunyenwe ngaxeshanye ne-gastroscopy yesiqhelo, kubandakanywa ne-endoscopy yokukhanya okumhlophe okuqhelekileyo, i-chromoendoscopy, i-endoscopy yokukhulisa, i-endoscopy ye-confocal kunye nezinye iindlela. I-lesion izimisele ukuba i-benign okanye ikrokre ngenxa yecala elibi, kwaye emva koko i-biopsy ye-lesion ekrokrayo eyingozi yenziwa, kwaye ukuxilongwa kokugqibela kwenziwa yi-pathology. Ukufumanisa ukuba kukho izilonda zomhlaza, ubungakanani bokungenwa komhlaza ngasecaleni, ubunzulu bokungena ngokuthe nkqo, inqanaba lokwahlula, nokuba kukho imiqondiso yonyango oluncinci.
Xa kuthelekiswa ne-gastroscopy eqhelekileyo, uvavanyo lwe-gastroscopic kufuneka lwenziwe phantsi kweemeko ezingenabuhlungu, ezivumela izigulane ukuba ziphumle ngokupheleleyo kwimeko yokulala okufutshane kwaye zenze i-gastroscopy ngokukhuselekileyo. I-Gastroscopy ineemfuno eziphezulu kubasebenzi. Kufuneka iqeqeshelwe ukufunyaniswa komhlaza kwangethuba, kwaye ii-endoscopists ezinamava zinokuqhuba uviwo oluneenkcukacha ezithe chatha, ukuze zichonge ngcono izilonda kwaye zenze uhlolo olufanelekileyo kunye nezigwebo.
I-Gastroscopy ineemfuno eziphezulu kwizixhobo, ngakumbi ngeteknoloji yokuphucula imifanekiso efana ne-chromoendoscopy / i-chromoendoscopy yombane okanye i-endoscopy yokukhulisa. I-Ultrasound gastroscopy nayo iyafuneka ukuba kuyimfuneko.
6 Unyango lomhlaza wesisu kwangoko
1. I-Endoscopic resection
Nje ukuba umhlaza wesisu ufunyaniswe kwangoko, i-endoscopic resection lukhetho lokuqala. Xa kuthelekiswa notyando lwendabuko, i-endoscopic resection ineenzuzo zokulimala okuncinci, iingxaki ezimbalwa, ukubuyisela ngokukhawuleza, kunye neendleko eziphantsi, kunye nokusebenza kwezi zibini zifana ngokusisiseko. Ke ngoko, i-endoscopic resection iyacetyiswa ekhaya nakwamanye amazwe njengonyango olukhethwayo lomhlaza wesisu sokuqala.
Okwangoku, ukusetyenziswa kwe-endoscopic resections esetyenziswa ngokuqhelekileyo kubandakanya i-endoscopic mucosal resection (EMR) kunye ne-endoscopic submucosal dissection (ESD). Itekhnoloji entsha ephuhlisiwe, i-ESD-channel endoscopy, inokufezekisa ukuphinda kuphinde kuphinde kuphindeke kade kade.
Kufuneka kuqatshelwe ukuba i-endoscopic resection lutyando oluncinci, kodwa kusekho iziganeko eziphezulu zeengxaki, ngokukodwa kubandakanywa ukopha, ukubhobhoza, i-stenosis, intlungu yesisu, ukusuleleka, njl. sebenzisana ngokukhutheleyo nogqirha ukuze uchache ngokukhawuleza.
2 Utyando lweLaparoscopic
Utyando lwe-Laparoscopic lunokuqwalaselwa kwizigulane ezinomhlaza wesisu sokuqala esingenako ukuqhutyelwa kwi-endoscopic resection. Utyando lweLaparoscopic kukuvula imijelo emincinci kwisisu sesigulana. I-Laparoscopes kunye nezixhobo zokusebenza zibekwe ngale mijelo ngomonakalo omncinci kwisigulane, kwaye idatha yomfanekiso kwisigxina sesisu idluliselwa kwisikrini sokubonisa nge-laparoscope, egqitywe phantsi kwesikhokelo se-laparoscope. utyando lomhlaza wesisu. Utyando lweLaparoscopic lunokugqiba ukusebenza kwelaparotomy yesintu, ukwenza i-gastrectomy enkulu okanye iyonke, ukuqhawula iilymph nodes ezirhanelwayo, njl.
3. Utyando oluvulekileyo
Ekubeni i-5% ukuya kwi-6% yomhlaza wesisu se-intramucosal kunye ne-15 ukuya kwi-20% ye-submucosal umhlaza wesisu une-perigastric lymph node metastasis, ngokukodwa i-adenocarcinoma engacatshangelwayo kubasetyhini abancinci, i-laparotomy yendabuko inokuqwalaselwa, enokuthi isuswe ngokukhawuleza kunye ne-Lymph node dissection.
isishwankathelo
Nangona umhlaza wesisu uyingozi kakhulu, awuyoyiki. Logama nje ulwazi ngothintelo luphuculwe, umhlaza wesisu unokubonwa kwangethuba kwaye unyangwe kwangethuba, kwaye kunokwenzeka ukuba kufumaneke unyango olupheleleyo. Ngoko ke, kucetyiswa ukuba amaqela asemngciphekweni omkhulu emva kweminyaka engama-40 ubudala, kungakhathaliseki ukuba anengxaki yokugaya ukutya, kufuneka ahlole kwangethuba umhlaza wesisu, okanye i-endoscopy yesisu kufuneka yongezwe kuvavanyo oluqhelekileyo lomzimba ukuze kubonwe imeko kwangethuba. umhlaza kwaye ugcine ubomi kunye nosapho olonwabileyo.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ngumvelisi e-China ogxile 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 yeempumlonjl ezisetyenziswa ngokubanzi kwi-EMR, ESD, 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: Jun-21-2022