Endoscopic biopsy shine mafi mahimmancin sashi na gwajin endoscopic na yau da kullun. Kusan duk gwaje-gwajen endoscopic suna buƙatar tallafin ilimin cututtuka bayan biopsy. Misali, idan ana zargin mucosa na hanji yana da kumburi, ciwon daji, atrophy, metaplasia na hanji, da kamuwa da cuta na HP, ana buƙatar ilimin ilimin cuta don ba da tabbataccen sakamako.
A halin yanzu, ana aiwatar da dabarun biopsy guda shida akai-akai a kasar Sin:
1. Gwajin cytobrush
2. Tissue Biopsy
3. Dabarun biopsy na rami
4. EMR tare da fasaha mai girma biopsy
5. Gabaɗayan fasaha na biopsy ƙari ESD
6. Ultrasound FNA
A yau za mu mayar da hankali ne kan yin bitar biopsy na nama, wanda aka fi sani da "clamping wani yanki na nama".
Ba za a iya yin biopsy da ke ƙarƙashin endoscopy na narkewa ba ba tare da ƙarfin biopsy ba, wanda kuma yana ɗaya daga cikin na'urorin da aka fi amfani da su ta hanyar malaman jinya na endoscopic. Malaman da ke cikin aikin jinya na endoscopic na iya tunanin cewa karfin biopsy yana da sauƙin amfani, kamar yadda yake da sauƙi kamar buɗewa da rufewa. A gaskiya ma, don yin amfani da karfi na biopsy a bayyane kuma zuwa kamala, mutum yana buƙatar samun basira da aiki tukuru, da kuma zama mai kyau a taƙaitawa.
I.Da farko, bari mu sake duba tsarin tsarinbiopsy forceps:
(I) Tsarin karfi na biopsy (Hoto na 1): Ƙwararrun ƙwayoyin cuta sun ƙunshi tip, jiki da kuma kayan aiki. Na'urorin haɗi da yawa kamar su ƙarfin jiki na waje, ƙarfin ƙwayar cuta mai zafi, almakashi, curettes, da sauransu sun yi kama da tsarin ƙarfin biopsy.
Tukwici: Tushen ya ƙunshi muƙamuƙi masu siffar kofi guda biyu waɗanda za a iya buɗewa da rufewa. Siffar muƙamuƙi shine mabuɗin aikin ƙarfin ƙwayoyin cuta daban-daban. Ana iya raba su kusan zuwa nau'ikan bakwai: nau'in buɗaɗɗe ɗaya, nau'in buɗaɗɗe biyu, nau'in taga, nau'in allura, nau'in oval, nau'in bakin kada, da nau'in lanƙwasa tip. An yi muƙamuƙi na ƙarfin kwayar halitta da bakin karfe kuma suna da kaifi mai kaifi. Ko da yake ruwan wulakancin da za a iya zubarwa suma suna da kaifi, ba su da juriya mara kyau. An yi maganin ruwan wukake na karfi na biopsy da za a sake amfani da su na musamman don sanya su dawwama.
Nau'ukan gama gari nabiopsy forceps
1.Standard type tare da taga
Akwai taga a tsakiyar kofin tilastawa, wanda ke rage lalacewar nama sosai kuma yana ƙara adadin ƙwayoyin ƙwayoyin cuta.
2. Standard type tare da taga da allura
Ana samun allura a tsakiyar kofin tilastawa don hana kwayar halitta daga zamewa ta cikin mucosa kuma don taimakawa wajen gane samfurin nama.
3. Nau'in Alligator
Kofin matsi na serrated yadda ya kamata yana hana kofin matsawa daga zamewa, kuma yankan gefen yana da kaifi don mafi amintaccen riko.
4. Nau'in Alligator tare da allura
jaws suna da faɗin kusurwar buɗewa don ƙara ƙarar biopsy; gefen ruwa yana da kaifi don mafi amintaccen riko.
Akwai allura a tsakiyar ƙwanƙwasa kai, wanda zai iya sa gyara ya fi tasiri da daidai.
Ya dace da biopsy akan kyallen kyallen takarda kamar ciwace-ciwace.
Jikin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarfafa don buɗewa da rufewa. Saboda tsari na musamman na bututun zaren, ƙwayar nama, jini da sauran abubuwa na iya shiga cikin sauƙi cikin sauƙi, amma ba shi da sauƙi a tsaftace shi sosai. Rashin tsaftace shi da kyau zai haifar da rashin jin daɗi a cikin aikin ƙwayar ƙwayar cuta, kuma buɗewa da rufewa ba za su kasance da santsi ba ko ma wuya a buɗe. Hannun Aiki: Ana amfani da zoben da ke hannun mai aiki don riƙe babban yatsan yatsa, kuma ana amfani da tsagi mai faɗi mai faɗi don sanya yatsan hannu da na tsakiya. Karkashin aikin wadannan yatsu guda uku, ana isar da karfin zuwa ga bawul din karfi ta hanyar wayar tarko don budewa da rufewa.
(II) Mahimman bayanai don amfani da ƙarfin ƙwayar cuta: Dole ne a ba da kulawa sosai a cikin aiki, amfani da kiyaye ƙarfin biopsy, in ba haka ba zai shafi amfani da endoscope.
1. Pre-ganewa:
Kafin amfani, tabbatar da cewa an haifuwa da ƙarfi na biopsy kuma an yi amfani da su cikin ingantaccen lokacin haifuwa. Kafin shigar da tashar ƙarfi ta endoscope, dole ne a gwada buɗewa da rufewar ƙarfin (Hoto 2).
Hoto na 2 Gano abin da ya tilastawa biopsy
Takamammen hanyar ita ce a murƙushe jikin ƙwayar ƙwayar cuta zuwa cikin babban da'irar (diamita na da'irar kusan 20cm ne), sannan a aiwatar da ayyuka da yawa na buɗewa da rufewa don lura ko motsin ƙarfi ya buɗe kuma ya rufe sumul. Idan akwai sau 1-2 na rashin kwanciyar hankali, yana da kyau kada a yi amfani da karfi na biopsy. Abu na biyu, wajibi ne a gwada ƙulli na ƙarfin biopsy. Ɗauki takarda siririn kamar takardan wasiƙa kuma ku matse ta da ƙarfin ƙwayar cuta. Yana da cancanta idan takarda mai bakin ciki ba ta fadi ba. Na uku, ya zama dole a lura ko kofuna biyu na filayen karfi sun daidaita gaba daya (Figure 3). Idan akwai rashin daidaituwa, dakatar da amfani da shi nan da nan, in ba haka ba zai toshe bututun tilastawa.
Hoto na 3 Ƙarƙashin ƙwayar ƙwayar cuta
Bayanan kula yayin aiki:
Kafin shigar da bututun karfi, yakamata a rufe jaws, amma ku tuna kada ku yi amfani da karfi da yawa don tsoron rufewar sako-sako, wanda zai haifar da shimfidawa da igiyar igiya kuma ta shafi budewa da rufe jaws. 2. Lokacin shigar da bututu, shiga tare da jagorancin buɗaɗɗen bututun tilastawa kuma kada ku shafa a kan bututun bututu. Idan kun ci karo da juriya lokacin shigarwa, yakamata ku sassauta maɓallin kusurwa kuma kuyi ƙoƙarin shiga cikin yanayin madaidaiciyar dabi'a. Idan har yanzu ba za ku iya wucewa ba, cire endoscope daga jiki don gwaji, ko musanya shi da wasu magungunan biopsy kamar ƙananan ƙira. 3. Lokacin fitar da karfin kwayar halitta, guje wa amfani da karfi da yawa. Ya kamata mataimaki ya kama shi da hannaye biyu sannan ya lanƙwasa. Kada ku shimfiɗa hannuwanku da yawa. 4. Lokacin da ba za a iya rufe jaws ba, kar a fitar da shi da karfi. A wannan lokacin, ya kamata a fitar da shi daga jiki tare da endoscope don ƙarin aiki.
II. Takaitacciyar wasu dabaru na biopsy
1. Budewa da rufe magungunan biopsy duka ayyukan fasaha ne. Budewa yana buƙatar jagora, musamman kusurwar ciki, wanda yakamata ya kasance daidai da wurin biopsy. Rufewa yana buƙatar lokaci. Motsin hanji da aikin likitan fiɗa suna da ƙarfi kuma ba za a iya gyara su ba. Dole ne mataimaki ya yi amfani da damar don yadda ya kamata da kuma amintaccen manne karfin kwayar halitta.
2. Samfurin biopsy yakamata ya zama babba kuma yayi zurfi ya isa ga mucosa na muscularis.
3. Yi la'akari da tasirin zubar jini bayan biopsy akan biopsies na gaba. Lokacin da kusurwar ciki da antrum suna buƙatar biopsied a lokaci guda, yakamata a fara biopsied kusurwar ciki sannan kuma antrum; lokacin da yankin da ke da rauni ya kasance babba kuma ana buƙatar daɗaɗɗen nau'i na nama, kashi na farko ya kamata ya zama daidai, kuma wajibi ne a yi la'akari da ko zubar da jini bayan clamping zai rufe kyallen da ke kewaye da shi kuma ya shafi filin hangen nesa, in ba haka ba clamping na gaba zai zama makaho da m.
Tsarin biopsy na yau da kullun don raunuka a kusurwar ciki, la'akari da tasirin kwararar jini akan biopsies na gaba.
4. Yi ƙoƙarin yin biopsy na matsa lamba a tsaye akan wurin da aka nufa, kuma amfani da tsotsa idan ya cancanta. Tsotsawa yana rage tashin hankalin saman mucosa, yana barin nama ya matse zurfi kuma ba zai yuwu ba.
Ya kamata a yi biopsy a tsaye gwargwadon yiwuwa, kuma tsayin ƙarfin kwayar halitta bai kamata ya wuce 2CM ba.
5. Kula da zaɓin abubuwan samfuri don nau'ikan raunuka daban-daban; zaɓin maki samfurin yana da alaƙa da ƙimar inganci. Likitan tiyata yana da kaifi ido kuma dole ne kuma ya kula da dabarun zaɓi na kayan.
Wuraren da za a biopsied Wuraren da ba za a yi amfani da su ba
6. Sassan da ke da wuyar tantancewa sun haɗa da fundus na ciki kusa da zuciya, ƙananan lanƙwasa na jikin ciki kusa da bangon baya, da kusurwar duodenum na sama. Dole ne mataimaki ya mai da hankali kan haɗin kai. Idan yana son cimma kyakkyawan sakamako, dole ne ya koyi yin shiri gaba da daidaita alkiblar manne a kowane lokaci. Har ila yau, dole ne ya yi gaggawar yin hukunci game da lokacin manne ta hanyar amfani da kowace dama. Wani lokaci lokacin jiran umarni daga likitan fiɗa, jinkirin daƙiƙa 1 na iya haifar da damar da aka rasa. Zan iya jira kawai da haƙuri don dama ta gaba.
Kibiyoyi suna nuna wuraren da ke da wahalar samun abu ko dakatar da zubar jini.
7. Zaɓin ƙarfin ƙwayar cuta: Ƙwararrun ƙwayoyin cuta sun haɗa da waɗanda ke da manyan buɗaɗɗen kofi da masu zurfi, wasu masu alluran matsayi, wasu kuma tare da budewar gefe da cizo.
8. Girman haɓakawa tare da tabo na lantarki don jagorantar biopsy ya fi dacewa, musamman don samfurin mucosa na esophageal.
Mu, Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., wani manufacturer ne a kasar Sin ƙware a cikin endoscopic consumables, kamarbiopsy forceps, hemoclip, polyp tarko, allurar sclerotherapy, fesa catheter, cytology goge, jagora, kwandon dawo da dutse, hanci biliary drainage catheter da dai sauransu. wadanda ake amfani da su sosai a cikiEMR, ESD, ERCP. Samfuran mu suna da takardar shedar CE, kuma tsire-tsire namu suna da takaddun ISO. An fitar da kayanmu zuwa Turai, Arewacin Amurka, Gabas ta Tsakiya da wani yanki na Asiya, kuma suna samun abokin ciniki yabo da yabo!
Lokacin aikawa: Janairu-23-2025