Gomarara remudumbu ndeimwe yemabundu akaipa anoisa hupenyu hwevanhu panjodzi huru. Kune vanhu vanosvika mamiriyoni 1.09 vanobatwa negomarara remudumbu gore rega rega, uye huwandu hwevanhu vanobatwa negomarara iri munyika yangu hunosvika 410,000. Izvi zvinoreva kuti, vanhu vanosvika chiuru nemazana matatu munyika yangu vanoonekwa vaine gomarara remudumbu zuva rega rega.
Huwandu hwevanhu vanorarama nekenza yemudumbu hunoenderana zvikuru nehuwandu hwekufambira mberi kwekenza yemudumbu. Huwandu hwevanhu vanorapwa nekenza yemudumbu hunogona kusvika 90%, kana kutopora zvachose. Huwandu hwevanhu vanorapwa nekenza yemudumbu iri pakati pe60% ne70%, nepo huwandu hwevanhu vanorapwa nekenza yemudumbu iri pakati pe30% chete, saka kenza yemudumbu yakawanikwa kare. Uye kurapwa kwekutanga ndiko kunoderedza kufa kwekenza yemudumbu. Nerombo rakanaka, nekuvandudzwa kwetekinoroji ye endoscopic mumakore achangopfuura, kuongororwa kwekenza yemudumbu kwave kuchiitwa zvakanyanya munyika yangu, izvo zvakavandudza zvakanyanya huwandu hwevanhu vanorapwa nekenza yemudumbu kare;
Saka, chii chinonzi kenza yemudumbu yekutanga? Ungaziva sei kenza yemudumbu yekutanga? Ungairapa sei?
1 Pfungwa yekenza yemudumbu yekutanga
Pakurapa, kenza yemudumbu yekutanga inonyanya kureva kenza yemudumbu ine maronda ekutanga, maronda mashoma uye pasina zviratidzo zvakajeka. Kenza yemudumbu yekutanga inonyanya kuongororwa negastroscopic biopsy pathology. Pakurapa, kenza yemudumbu yekutanga inoreva masero ekenza akaganhurirwa ku mucosa ne submucosa, uye zvisinei nekuti bundu racho rakakura sei uye kana paine lymph node metastasis, ikenza yekutanga yemudumbu. Mumakore achangopfuura, dysplasia yakanyanya uye high-grade intraepithelial neoplasia zvakaiswawo muchikamu chekenza yekutanga yemudumbu.
Zvichienderana nehukuru hwebundu, kenza yemudumbu yekutanga yakakamurwa kuita: kenza yemudumbu diki: dhayamita yegomarara regomarara iri 6-10 mm. Kenza yemudumbu diki: Dhayamita yegomarara regomarara iri pasi kana kuti yakaenzana ne5 mm. Punctate carcinoma: Biopsy yemudumbu mucosa igomarara, asi hapana ganda regomarara rinogona kuwanikwa muzvikamu zvekuongorora kuvhiyiwa.
Mukuongorora kenza yemudumbu, kenza yemudumbu yekutanga inopatsanurwawo kuita seizvi: mhando (polypoid type): idzo dzine bundu rakabuda rinosvika 5 mm kana kupfuura. Rudzi rwechipiri (superficial type): Bundu racho rinokwira kana kudzika mukati me5 mm. Rudzi rwechitatu (ulcer type): Kudzika kwekudzika kwebundu rekenza kunodarika 5 mm, asi hakupfuuri submucosa.
2 Ndezvipi zviratidzo zvegomarara remudumbu rekutanga
Mazhinji ekenza yemudumbu yekutanga haana zviratidzo zvakakosha, kureva kuti, zviratidzo zvekutanga zvekenza yemudumbu hazvina zviratidzo.
Zviratidzo zvegomarara remudumbu zvinoonekwa paInternet hazvisi zviratidzo zvegomarara remudumbu. Zvingave zviri chiremba kana munhu ane hunhu hwakanaka, zvakaoma kutonga kubva pazviratidzo. Vamwe vanhu vanogona kunge vaine zvimwe zviratidzo zvisiri zvega, kunyanya kugaya chikafu, zvakaita sekurwadziwa mudumbu, kuzvimba, kuguta nekukurumidza, kurasikirwa nechido chekudya, acid regurgitation, chirungurira, belching, hiccups, nezvimwewo. Zviratidzo izvi zvakafanana nematambudziko emudumbu, saka hazviwanzokwezva kutariswa kwevanhu. Saka, kune vanhu vane makore anopfuura makumi mana, kana vaine zviratidzo zvegomarara remudumbu, vanofanira kuenda kuchipatara kunorapwa nenguva, uye kuita gastroscopy kana zvichidikanwa, kuitira kuti vasapotsa nguva yakanakisa yekuona gomarara remudumbu nekukurumidza.
3 Maitiro ekuona kenza yemudumbu nekukurumidza
Mumakore achangopfuura, nyanzvi dzezvekurapa munyika yedu, pamwe chete nemamiriro chaiwo enyika yedu, dzakagadzira "Nyanzvi dzeKuongorora Kenza Yekutanga Mudumbu muChina".
Izvi zvichabatsira zvikuru mukuvandudza huwandu hwechirwere uye huwandu hwekenza yemudumbu inotanga kurapwa.
Kuongororwa kwegomarara remudumbu nekukurumidza kunonyanya kunangana nevamwe varwere vane njodzi huru, vakaita sevarwere vane hutachiona hweHelicobacter pylori, varwere vane nhoroondo yemhuri yegomarara remudumbu, varwere vane makore anopfuura makumi matatu nemashanu ekuberekwa, vanoputa fodya kwenguva refu, uye vanofarira chikafu chakabikwa muhari.
Nzira huru yekuongorora kenza yemudumbu ndeyekuona huwandu hwevanhu vane njodzi huru yekenza yemudumbu kuburikidza nekuongorora kwemasero, ndiko kuti, kuburikidza nekushanda kwemudumbu uye kuonekwa kweHelicobacter pylori antibody. Zvadaro, mapoka ane njodzi huru anowanikwa pakutanga kwekuongorora anoongororwa nokungwarira negastroscope, uye kuonekwa kwezvirwere kunogona kuitwa kuti zvive nyore kuburikidza nekuwedzera, kudhirowa, biopsy, nezvimwewo, kuitira kuti zvionekwe kana zvipembenene zvine kenza uye kana zvichigona kurapwa pasi pemaikorosikopu.
Ehe, inzira iri nani yekuona kenza yemudumbu nekukurumidza nekuisa endoscopy yemudumbu muongororo yenguva dzose yemuviri yevanhu vane hutano kuburikidza nekuongorora muviri.
4 Chii chinonzi bvunzo yekushanda kwemudumbu uye system yekuongorora kenza yemudumbu
Kuyedzwa kwebasa remudumbu ndekwekuona huwandu hwepepsinogen 1 (PGI), pepsinogen (PGl1, uye protease) muropa.
(PGR, PGI/PGII) gastrin 17 (G-17), uye system yekuongorora kenza yemudumbu yakavakirwa pamhedzisiro yekuyedzwa kwebasa remudumbu, pamwe chete nemapoinzi akakwana akadai seHelicobacter pylori antibody, zera uye murume kana mukadzi, kuti vatonge. Nzira yekuona njodzi yekenza yemudumbu, kuburikidza nesystem yekuongorora kenza yemudumbu, inogona kuongorora mapoka epakati neakanyanya ekenza yemudumbu.
Kuongororwa kweEndoscopy nekutevera zvichaitwa kumapoka ari pakati nepakati neari panjodzi huru. Mapoka ari panjodzi huru achaongororwa kanenge kamwe chete pagore, uye mapoka ari pakati nepakati achaongororwa kanenge kamwe chete mumakore maviri ega ega. Kuwanikwa chaiko kwekenza yekutanga, iyo inogona kurapwa nekuvhiyiwa kwe endoscopic. Izvi hazvingogone chete kuvandudza huwandu hwekenza yemudumbu inoonekwa nekukurumidza, asiwo kuderedza endoscopy isina kukodzera mumapoka ari panjodzi shoma.
5 Chii chinonzi Gastroscopy
Zvichitaurwa zviri nyore, gastroscopy ndeyekuita ongororo ye endoscopic morphological yezvipembenene zvinofungidzirwa zvinowanikwa panguva imwe chete negastroscopy yenguva dzose, kusanganisira endoscopy yechiedza chechena, chromoendoscopy, magnifying endoscopy, confocal endoscopy nedzimwe nzira. Chironda chinoonekwa kuti hachina njodzi kana kuti hachina chokwadi chegomarara, uye biopsy yegomarara rinofungidzirwa kuti rine gomarara inozoitwa, uye kuongororwa kwekupedzisira kunoitwa nechirwere. Kuti uone kana paine maronda egomarara, huwandu hwegomarara rinopinda mudumbu, kudzika kwekupinda kwaro mudumbu, mwero wekusiyana, uye kana paine zviratidzo zvekurapa ne microscopic.
Zvichienzaniswa negastroscopy yakajairika, kuongororwa kwegastroscopy kunofanirwa kuitwa mumamiriro ezvinhu asingarwadzi, zvichibvumira varwere kuzorora zvakakwana vari mumamiriro ekurara kwenguva pfupi uye kuita gastroscopy zvakachengeteka. Gastroscopy ine zvinodiwa zvakanyanya kuvashandi. Inofanira kudzidziswa kuona kenza nekukurumidza, uye vanachiremba vane ruzivo vanogona kuita ongororo dzakadzama, kuitira kuti vaone zviri nani maronda uye vaongorore zvine musoro uye vasarudze zvine musoro.
Gastroscopy ine zvinodiwa zvakanyanya pamichina, kunyanya nehunyanzvi hwekuvandudza mifananidzo hwakadai sechromoendoscopy/electronic chromoendoscopy kana magnifying endoscopy. Ultrasound gastroscopy inodiwawo kana zvichidikanwa.
6 Kurapa kenza yemudumbu yekutanga
1. Kubviswa kweEndoscopic
Kana kenza yemudumbu yaonekwa pakutanga, kubviswa kwe endoscopic resection ndiyo sarudzo yekutanga. Kana tichienzanisa nekuvhiyiwa kwechinyakare, kubviswa kwe endoscopic resection kune zvakanakira zvekukuvara kushoma, matambudziko mashoma, kupora nekukurumidza, uye mutengo wakaderera, uye kushanda kwezviviri izvi kwakafanana. Saka, kubviswa kwe endoscopic resection kunokurudzirwa kumba nekune dzimwe nyika senzira inodiwa yekurapa kenza yemudumbu yekutanga.
Parizvino, nzira dzinoshandiswa zvakanyanya dzekubvisa maronda emukati (endoscopic resection) dzinosanganisira endoscopic mucosal resection (EMR) uye endoscopic submucosal dissection (ESD). Tekinoroji itsva yakagadzirwa, ESD single-channel endoscopy, inogona kubvisa maronda kamwe chete mukati me muscularis propria, ukuwo ichipawo nzira chaiyo yekurapa kuti ideredze kudzoka kwechirwere kunonoka.
Zvinofanira kucherechedzwa kuti kubviswa kwe endoscopic resection kuvhiyiwa kusinganyanyi kupindira mumuviri, asi kuchine matambudziko akawanda, anosanganisira kubuda ropa, kubooka, Stenosis, kurwadziwa mudumbu, hutachiona, nezvimwewo. Saka, kutarisirwa kwemurwere mushure mekuvhiyiwa, kupora, uye kuongororwa kunofanirwa kushanda pamwe chete nachiremba kuti apore nekukurumidza.
2 Kuvhiyiwa kweLaparoscopic
Kuvhiyiwa kweLaparoscopic kunogona kufungwa nezvako kune varwere vane kenza yemudumbu vasati vakwanisa kubviswa endoscopic resection. Kuvhiyiwa kweLaparoscopic ndekwekuvhura nzira diki mudumbu remurwere. Laparoscopes nezvishandiso zvinoshandiswa zvinoiswa kuburikidza nenzira idzi pasina kukuvara kushoma kumurwere, uye data remufananidzo mudumbu rinotumirwa kuchiratidziro kuburikidza nelaparoscope, iyo inopedzwa pasi pekutungamirirwa kwelaparoscope. Kuvhiyiwa kweLaparoscopic kunogona kupedzisa kuvhiyiwa kwe laparotomy yechinyakare, kuita kuvhiyiwa kukuru kana kwakazara kwegastrointestinal gastrectomy, kupatsanurwa kwema lymph nodes anofungidzirwa, nezvimwewo, uye kune kubuda ropa kushoma, kukuvara kushoma, vanga shoma mushure mekuvhiyiwa, kurwadziwa kushoma, uye kupora nekukurumidza kwebasa remudumbu mushure mekuvhiyiwa.
3. Kuvhiyiwa kwakavhurika
Sezvo 5% kusvika 6% yekenza yemudumbu iri mudumbu uye 15% kusvika 20% yekenza yemudumbu iri mudumbu ine perigastric lymph node metastasis, kunyanya urema hwemudumbu husina kupatsanurwa mumadzimai madiki, laparotomy yechinyakare inogona kufungwa nezvayo, iyo inogona kubviswa zvachose uye Lymph node dissection.
pfupiso
Kunyangwe kenza yemudumbu ichikuvadza zvikuru, haina kuipa. Chero bedzi ruzivo rwekudzivirira rwuchivandudzwa, kenza yemudumbu inogona kuonekwa nenguva uye kurapwa nekukurumidza, uye zvinokwanisika kuwana mushonga wakakwana. Nokudaro, zvinokurudzirwa kuti mapoka ane njodzi yakakura mushure memakore makumi mana, zvisinei nekuti vane kusagadzikana kwekugaya, vanofanira kuongororwa kenza yemudumbu nekukurumidza, kana kuti gastrointestinal endoscopy inofanira kuwedzerwa pakuongororwa kwemuviri kwakajairika kuti vaone nyaya yekenza yemudumbu nekukurumidza uye kuponesa hupenyu nemhuri inofara.
Isu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., tinogadzira zvinhu muChina zvine chekuita ne endoscopic consumables, zvakaita sesimba re biopsy, hemoclip,musungo wepolyp, tsono yekurapa sclerotherapy, katheta yekupfapfaidza, mabhurashi e cytology, waya yekufambisa, tswanda yekutorwa kwematombo, katheta yekubuditsa mvura yemumhinonezvimwewo zvinoshandiswa zvakanyanya muEMR, ESD, ERCP. Zvigadzirwa zvedu zvakanyoreswa neCE, uye mafekitori edu akanyoreswa neISO. Zvinhu zvedu zvakatumirwa kuEurope, North America, Middle East nechikamu cheAsia, uye zvinowana vatengi vakawanda mukurumbira nerumbidzo!
Nguva yekutumira: Chikumi-21-2022