Endoscopic biopsy ndiyo inonyanya kukosha yezuva nezuva endoscopic kuongororwa. Anenge ese endoscopic bvunzo anoda pathological rutsigiro pashure biopsy. Semuyenzaniso, kana digestive turakiti mucosa inofungidzirwa kuti ine kuzvimba, kenza, atrophy, intestinal metaplasia, uye HP utachiona, pathology inodiwa kupa mhedzisiro chaiyo.
Parizvino, maitiro matanhatu ebiopsy anogara achiitwa muChina:
1. Cytobrush kuongorora
2. Tissue Biopsy
3. Tunnel biopsy technique
4. EMR ine bulk biopsy technique
5. Whole bundu biopsy technique ESD
6. Ultrasound-inotungamirirwa FNA
Nhasi tichatarisa pakuongorora matishu biopsy, anowanzozivikanwa se "kusunga chimedu chenyama".
Iyo biopsy pasi pekugaya endoscopy haigone kuitwa pasina biopsy forceps, inova zvakare imwe yeanonyanya kushandiswa zvishongedzo ne endoscopic vanamukoti vadzidzisi. Vadzidzisi vanoita mukoti endoscopic vanogona kufunga kuti biopsy forceps iri nyore kushandisa, yakapusa sekuvhura nekuvhara. Muchokwadi, kushandisa biopsy forceps zvakajeka uye kusvika pakukwana, munhu anoda kuve nekunzwisisa uye kushanda nesimba, pamwe nekuve akanaka pakupfupikisa.
I.Kutanga, ngationgororei chimiro chebiopsy forceps:
(I) Chimiro chebiopsy forceps (Mufananidzo 1): Biopsy forceps inoumbwa nemuromo, muviri uye mubato wekushanda. Zvishandiso zvakawanda zvakadai semasimba ekunze emuviri, kupisa biopsy forceps, scissors, curettes, nezvimwe zvakafanana nechimiro chebiopsy forceps.
Zano: Musoro wacho unoumbwa neshaya mbiri dzakaita kapu dzinogona kuvhurwa nekuvharwa. Chimiro cheshaya ndiyo kiyi yekushanda kweakasiyana biopsy forceps. Anogona kukamurwa kuita nomwe mhando: imwe-yakavhurika mhando, kaviri-yakavhurika mhando, hwindo rudzi, tsono mhando, oval mhando, ngwena muromo mhando, uye tip curved mhando. Shaya dzebiopsy forceps dzakagadzirwa nesimbi isina tsvina uye dzine mapanga anopinza. Kunyangwe mablades eanoraswa biopsy forceps akapinza zvakare, iwo haana kushomeka kupfeka. Iwo mablades ereusable biopsy forceps anonyanya kubatwa pamusoro kuti aite kuti arambe akasimba.
Mhando dzakajairika dzebiopsy forceps
1.Standard mhando nehwindo
Kune hwindo pakati pekapu yeforceps, iyo inoderedza zvakanyanya kukuvara kwetishu uye inowedzera huwandu hwebiopsy tishu.
2. Standard mhando nehwindo netsono
Tsono iri pakati pekapu yeforceps kudzivirira biopsy kuti isatsvedza nemucosa uye kubatsira kubata sampuli yetishu.
3. Rudzi rwemangwe
Iyo serrated clamp cup inonyatso dzivirira iyo clamp cup kubva pakutsvedza, uye yekucheka mupendero inopinza kune yakachengeteka kubata.
4. Alligator mhando ine tsono
Mashaya ane yakafara kuvhura kona kuwedzera biopsy volume; mupendero weblade wakapinza kuitira kubata kwakachengeteka.
Pane tsono iri pakati pemusoro weclamp, iyo inogona kuita kuti kugadzirisa kuwedzere kushanda uye kwakarurama.
Inokodzera biopsy pamatishu akaomarara senge mamota.
Muviri weForceps: Muviri webiopsy forceps wakagadzirwa nesimbi isina tambo yakarukwa chubhu, ine waya yesimbi yekudhonza forceps vharafu kuti ivhure nekuvhara. Nekuda kwechimiro chakakosha chechubhu yakashongedzwa, matishu mucus, ropa uye zvimwe zvinhu zvinogona kupinda mairi, asi hazvisi nyore kuzvichenesa zvakakwana. Kukundikana kuichenesa zvakakwana kunokonzera kusagadzikana mukushanda kwebiopsy forceps, uye kuzarura nekuvhara hakuzove kwakatsetseka kana kunyange kusakwanisa kuzarura. Mubato wekushanda: Mhete iri pamubato wekushanda inoshandiswa kubata chigunwe, uye goroko rakafara rakatenderedzwa rinoshandiswa kuisa chigunwe chemunwe nepakati. Pasi pekushanda kwezvigunwe zvitatu izvi, simba rinoendeswa kuvharupu yeforceps kuburikidza newaya yekukwevera yekuvhura nekuvhara.
(II) Mapoinzi akakosha ekushandiswa kwebiopsy forceps: Kungwarira kukuru kunofanirwa kutorwa mukushanda, kushandiswa nekuchengetedza biopsy forceps, zvikasadaro zvinokanganisa kushandiswa kweiyo endoscope.
1. Pre-kuonekwa:
Usati washandisa, ita shuwa kuti iyo biopsy forceps yakaomeswa uye yakashandiswa mukati meinoshanda sterilization nguva. Usati waisa endoscope forceps channel, kuvhura uye kuvhara kweforceps kunofanira kuongororwa (Mufananidzo 2).
Mufananidzo 2 Biopsy forceps kuona
Iyo chaiyo nzira ndeyekumoneredza muviri webiopsy forceps kuita denderedzwa rakakura (dhayamita yedenderedzwa inenge 20cm), uyezve kuita akawanda ekuvhura nekuvhara zviito kuti uone kana simba remapupa richivhurika nekuvhara zvakanaka. Kana pane 1-2 nguva yekusagadzikana, zviri nani kusashandisa biopsy forceps. Chechipiri, zvakakosha kuyedza kuvharwa kweiyo biopsy forceps. Tora bepa rakatetepa senge bepa retsamba worisungirira nechisimba chebiopsy. Inokodzera kana bepa rakatetepa rikasadonha. Chechitatu, zvakakosha kuti uone kana makapu maviri e forceps flaps akanyatsoenderana (Mufananidzo 3). Kana pane kukanganisa, rega kuishandisa pakarepo, kana zvisina kudaro ichakwenya pombi yeforceps.
Mufananidzo 3 Biopsy forceps flap
Zvinyorwa panguva yekushanda:
Usati waisa chubhu yeforceps, shaya dzinofanira kuvharwa, asi yeuka kuti usashandise simba rakawanda nekuda kwekutya kuvharwa kwakasununguka, izvo zvichaita kuti tambo yekufambisa itambanudzwe uye inokanganisa kuzarura nekuvhara kweshaya. 2. Pakuisa chubhu, pinda uchitevedza nzira yekuvhurika kweforceps chubhu uye usakwesha painovhura chubhu. Kana ukasangana nekupokana paunopinda, unofanirwa kusunungura bhatani rekona uye edza kupinda mune yakasarudzika mamiriro. Kana iwe uchiri kutadza kupfuura, bvisa endoscope kubva mumuviri kuti uedzwe, kana kuitsiva nemamwe masimba ebiopsy akadai madiki modhi. 3. Paunenge uchidhonza biopsy forceps, dzivisa kushandisa simba rakawandisa. Mubatsiri anofanira kuchinjanisa kuibata nemaoko maviri obva aipeta. Usatambanudza maoko ako zvakanyanya. 4. Kana shaya dzisingagoni kuvharika, usaivhomora nechisimba. Panguva ino, inofanira kusundirwa kunze kwemuviri pamwe chete ne endoscope kuti iwedzere kugadziriswa.
II. Pfupiso yemamwe maitiro ebiopsy
1. Kuvhura nekuvhara biopsy forceps ese ari maviri ehunyanzvi mabasa. Kuvhura kunoda kutungamira, kunyanya gastric angle, iyo inofanirwa kunge iri perpendicular kune biopsy saiti. Kuvhara kunoda nguva. Gastrointestinal motility uye kuvhiyiwa kwechiremba kune kugadzikana uye hakugone kugadziriswa nguva dzose. Mubatsiri anofanirwa kutora mukana wekuti zvinyatso uye zvakachengeteka kusungirira biopsy forceps.
2. The biopsy specimen inofanira kuva yakakura zvakakwana uye yakadzika zvakakwana kuti isvike muscularis mucosa.
3. Funga nezvezvinokonzeresa kubuda ropa mushure mebiopsy pane zvinotevera biopsies. Kana gastric angle uye antrum zvinoda biopsied panguva imwe chete, gastric kona inofanira biopsies kutanga uye ipapo antrum; kana nzvimbo yekukuvadza yakakura uye zvidimbu zvakawanda zvenyama zvinoda kusungirirwa, chidimbu chekutanga chinofanira kunge chakanyatsojeka, uye zvakakoshawo kufunga kuti kubuda ropa mushure mekuvhara kunovhara matishu akapoteredzwa uye kukanganisa ndima yekuona, kana zvisina kudaro clamping inozotevera ichava bofu uye isingaiti.
Yakajairika biopsy kutevedzana kwezvironda pagastric angle, tichifunga nezve mhedzisiro yekuyerera kweropa pane inotevera biopsies.
4. Edza kuita vertical pressure biopsy panzvimbo yakanangwa, uye shandisa kuyamwa pazvinenge zvakakodzera. Kusveta kunoderedza kudzvinyirirwa kwepamusoro kwemucosa, zvichiita kuti nyama yacho isungirwe zvakadzika uye isinganyanyi kutsvedza.
Biopsy inofanirwa kuitwa yakatwasuka sezvinobvira, uye kureba kweiyo biopsy forceps haifanirwe kudarika 2CM.
5. Ngwarira kusarudzwa kwemasampling points emhando dzakasiyana dzemaronda; kusarudzwa kwemasampling points kwakabatana nehuwandu hwakanaka. Chiremba ane ziso rakapinza uye anofanirwawo kutarisisa kune hunyanzvi hwekusarudza zvinhu.
Nzvimbo dzinofanirwa kuve nebiopsies Nzvimbo dzisingafanirwe kuvharirwa
6. Zvikamu zvakaoma kuita biopsy zvinosanganisira fundus yemudumbu pedyo necardia, kuderera kuduku kwemuviri wegastric pedyo nemadziro emashure, uye kona yepamusoro ye duodenum. Mubatsiri anofanira kuisa pfungwa pakushandira pamwe. Kana achida kuwana mhedzisiro yakakwana, anofanirwa kudzidza kuronga kumberi uye kugadzirisa kutungamira kwechivharo chembambo chero nguva. Panguva imwecheteyo, anofanira kukurumidza kutonga nguva yekurovera nekushandisa mukana wega wega. Dzimwe nguva pakumirira mirairo kubva kuna chiremba anovhiya, lag ye1 sekondi inogona kutungamirira kumikana yakarasika. Ndinogona kungomirira nemoyo murefu mukana unotevera.
Miseve inoratidza nzvimbo dzinonetsa kuwana zvinhu kana kumisa kubuda ropa.
7. Kusarudzwa kwesimba rebiopsy: Simba reBiopsy rinosanganisira idzo dzine mikombe mikuru yakazaruka uye yakadzika, mamwe ane tsono dzekuisa, uye mamwe ane mativi akavhurika uye akarumwa neseri.
8. Kukwidziridzwa kwakasanganiswa nekusvibiswa kwemagetsi kutungamira biopsy kwakanyatso kurongeka, kunyanya kune sampling esophageal mucosa.
Isu, Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., inogadzira muChina inyanzvi mune endoscopic consumables, senge.biopsy forceps, hemoclip, polyp musungo, sclerotherapy tsono, pfapfaidza catheter, cytology brushes, guidewire, dombo rekudzosa tswanda, nasal biliary drainage catheter nezvimwewo. ayo anoshandiswa zvakanyanya muEMR, ESD, ERCP. Zvigadzirwa zvedu ndezveEC Certified, uye zvidyarwa zvedu ISO certified. Zvinhu zvedu zvakatumirwa kuEurope, North America, Middle East uye chikamu cheAsia, uye zvakanyanya kuwana mutengi wekuzivikanwa nekurumbidzwa!
Nguva yekutumira: Jan-23-2025