ʻO ka biopsy endoscopic ka mea nui loa o ka hoʻokolokolo endoscopic i kēlā me kēia lā. Kokoke i nā hoʻokolohua endoscopic e koi i ke kākoʻo pathological ma hope o ka biopsy. No ka laʻana, inā i manaʻo ʻia he ʻulaʻula ka mucosa digestive, ka maʻi kanesa, atrophy, metaplasia intestinal, a me ka maʻi HP, pono ka pathology e hāʻawi i kahi hopena paʻa.
I kēia manawa, ʻeono mau ʻano biopsy i hana mau ʻia ma Kina:
1. Nānā Cytobrush
2. ʻAiʻi Biopsy
3. ʻenehana biopsy tunnel
4. EMR me ka hana biopsy nui
5. ʻO ka ʻenehana biopsy tumor holoʻokoʻa ESD
6. FNA alakaʻi ʻia e ka ultrasound
I kēia lā, e nānā mākou i ka nānā ʻana i ka biopsy kiko, i kapa ʻia ʻo "clamping a piece of meat".
ʻAʻole hiki ke hana ʻia ka biopsy ma lalo o ka digestive endoscopy me ka ʻole o ka biopsy forceps, ʻo ia kekahi o nā mea hoʻohana maʻamau e nā kumu kahu hānai endoscopic. Manaʻo paha nā kumu e hana ana i nā kahu hānai endoscopic he maʻalahi loa ka hoʻohana ʻana i nā forceps biopsy, e like me ka maʻalahi e like me ka wehe a pani ʻana. ʻO ka ʻoiaʻiʻo, no ka hoʻohana ʻana i ka biopsy forceps me ka maopopo a me ka maikaʻi, pono e loaʻa i ka ʻike a me ka hana paʻakikī, a me ka maikaʻi i ka hōʻuluʻulu ʻana.
I.ʻO ka mua, e nānā kākou i ke ʻano o kabiopsy forceps:
(I) Ka hana o ka biopsy forceps (Figure 1): Biopsy forceps i haku ʻia me ka piko, ke kino a me ka lima hana. Nui nā lako e like me ke kino kino haole, hot biopsy forceps, ʻoki, curettes, etc.
Manaʻo kōkua: Ua haku ʻia ka piko i ʻelua mau ʻāwae kīʻaha kīʻaha hiki ke wehe a pani ʻia. ʻO ke ʻano o nā ʻauwae ke kī i ka hana o nā ʻano biopsy forceps. Hiki ke hoʻokaʻawale ʻia lākou i ʻehiku ʻano: ʻano hāmama hoʻokahi, ʻano hāmama pālua, ʻano puka makani, ʻano nila, ʻano oval, ʻano waha crocodile, a me ke ʻano curved tip. Hana ʻia nā ʻāwae o ka biopsy forceps i ke kila kila a he ʻoi ʻoi. ʻOiai ʻoi aku ka ʻoi o nā pahi o ka biopsy forceps i hoʻohana ʻia, ʻaʻole maikaʻi ko lākou pale ʻana. Hoʻomaʻamaʻa kūikawā ʻia nā ʻili o ka biopsy forceps hiki ke hoʻohana hou ʻia i mea e ʻoi aku ka lōʻihi.
Nā ʻano maʻamau obiopsy forceps
1.ʻano maʻamau me ka puka makani
Aia kekahi puka makani ma waenakonu o ke kīʻaha forceps, e hoʻemi nui ana i ka pōʻino o ke kino a hoʻonui i ka nui o ka biopsy tissue.
2. Keʻano maʻamau me ka puka makani a me ka nila
Aia ka nila ma waenakonu o ke kīʻaha forceps e pale ai i ka paheʻe ʻana o ka biopsy i loko o ka mucosa a kōkua i ka hopu ʻana i ka laʻana o ke kino.
3. ʻAno Alligator
ʻO ke kīʻaha kīʻaha serrated e pale pono i ke kīʻaha kīʻaha mai ka paheʻe ʻana, a ʻoi aku ka ʻoki ʻoki no ka paʻa paʻa.
4. ʻAno Alligator me ka nila
Loaʻa i nā iwi āpau kahi kihi ākea ākea e hoʻonui i ka nui biopsy; ʻoi aku ka ʻoi o ka maka no ka paʻa paʻa.
Aia kahi nila ma waenakonu o ke poʻo pipili, hiki ke hoʻoikaika a pololei ka hoʻoponopono.
He kūpono no ka biopsy ma nā ʻiʻo ʻoi aku ka paʻakikī e like me ke koko.
Kino Forceps: Ua hana ʻia ke kino o ka lāʻau biopsy me ke kila kila kila, i loaʻa i kahi uwea kila no ka huki ʻana i ka valve forceps e wehe a pani. Ma muli o ke ʻano kūikawā o ka paipu threaded, hiki ke maʻalahi ke komo ʻana o ka ʻiʻo, ke koko a me nā mea ʻē aʻe, akā ʻaʻole maʻalahi ka hoʻomaʻemaʻe pono ʻana. ʻO ka hoʻomaʻemaʻe ʻole ʻana iā ia e hoʻopilikia i ka hana ʻana o nā mea biopsy forceps, a ʻo ka wehe ʻana a me ka pani ʻana ʻaʻole e maʻalahi a hiki ʻole ke wehe. Ka lima hana: Hoʻohana ʻia ke apo ma ka lima hana no ka paʻa ʻana i ka manamana nui, a hoʻohana ʻia ke awāwa ākea ākea e kau i ka manamana lima a me ka manamana waena. Ma lalo o ka hana ʻana o kēia mau manamana lima ʻekolu, hoʻouna ʻia ka ikaika i ka valve forceps ma o ke kaula huki no ka wehe a pani ʻana.
(II) Nā mea nui no ka hoʻohanaʻana i nā lāʻau biopsy: Pono e mālama nui i ka hana, ka hoʻohanaʻana a me ka mālamaʻana i nā lāʻau biopsy, iʻole e pili ana i ka hoʻohanaʻana i ka endoscope.
1. ʻIke mua:
Ma mua o ka hoʻohana ʻana, e hōʻoia i ka hoʻohana ʻia ʻana o ka biopsy forceps a hoʻohana ʻia i loko o ka manawa sterilization kūpono. Ma mua o ka hoʻokomo ʻana i ke kahawai endoscope forceps, pono e hoʻāʻo ʻia ka wehe ʻana a me ka pani ʻana o nā forceps (Figure 2).
Hōʻike 2 Biopsy forceps ʻike
ʻO ke ʻano kikoʻī, ʻo ia ka wili ʻana i ke kino o ka lāʻau biopsy i loko o kahi pōʻai nui (ʻo ke anawaena o ka pōʻai ma kahi o 20cm), a laila hana i nā hana wehe a pani ʻana e ʻike ai inā hāmama a pani maikaʻi nā puʻupuʻu. Inā he 1-2 mau manawa o ka unsmoothness, ʻoi aku ka maikaʻi o ka hoʻohana ʻana i ka biopsy forceps. ʻO ka lua, pono ia e hoʻāʻo i ka pani ʻana o ka biopsy forceps. E lawe i kahi ʻāpana pepa lahilahi e like me ka pepa leka a hoʻopaʻa iā ia me ka biopsy forceps. Ua kūpono inā ʻaʻole hāʻule ka pepa lahilahi. ʻO ke kolu, pono e nānā inā pili pono nā kīʻaha ʻelua o nā pā forceps (Figure 3). Inā he kuhi hewa, e ho'ōki koke i ka hoʻohana ʻana, i ʻole e ʻoki ʻia ka paipu forceps.
Kiʻi 3 Biopsy forceps flap
Nā memo i ka wā o ka hana:
Ma mua o ka hoʻokomo ʻana i ka paipu forceps, pono e pani ʻia nā ʻauwae, akā e hoʻomanaʻo ʻaʻole e hoʻohana i ka ikaika nui no ka makaʻu i ka wehe ʻana o ka pani ʻana, ʻo ia ka mea e hoʻolōʻihi ʻia ke kaula huki a pili i ka wehe ʻana a me ka pani ʻana o nā ʻauwae. 2. I ka hoʻokomo ʻana i ka paipu, e komo ma ka ʻaoʻao o ka wehe ʻana o ka paipu forceps a ʻaʻole e hamo i ka puka o ka paipu. Inā ʻike ʻoe i ke kūʻē i ke komo ʻana, pono ʻoe e wehe i ke pihi kihi a hoʻāʻo e komo i kahi kūlana pololei maoli. Inā ʻaʻole hiki iā ʻoe ke hele, e hoʻihoʻi i ka endoscope mai ke kino no ka hoʻāʻo ʻana, a i ʻole e hoʻololi iā ia me nā mea hana biopsy ʻē aʻe e like me nā ʻano liʻiliʻi. 3. I ka wā e huki ai i ka biopsy forceps, e pale i ka hoʻohana ʻana i ka ikaika nui. Pono ke kōkua e hopu iā ia me nā lima ʻelua a laila e kulou. Mai kikoo nui aku i kou mau lima. 4. Ke hiki ole ke paniia na auwae, mai uhuki ikaika. I kēia manawa, pono e hoʻokuʻu ʻia i waho o ke kino me ka endoscope no ka hana hou ʻana.
II. ʻO ka hōʻuluʻulu o kekahi mau ʻenehana o ka biopsy
1. ʻO ka wehe ʻana a me ka pani ʻana i nā forceps biopsy ʻelua mau hana ʻenehana. Pono ka wehe ʻana i ke kuhikuhi, ʻoi aku ka nui o ka ʻōpū o ka ʻōpū, pono e kū pololei i ka pae biopsy. Pono ka pani ʻana i ka manawa. ʻO ka ʻōpū o ka ʻōpū a me ka hana ʻana o ke kauka lapaʻau paʻa a ʻaʻole hiki ke hoʻopaʻa mau ʻia. Pono ka mea kōkua e hopu i ka manawa kūpono e hoʻopaʻa pono a palekana i nā forceps biopsy.
2. Pono ka nui a me ka hohonu o ka biopsy a hiki i ka muscularis mucosa.
3. E noʻonoʻo i ka hopena o ke koko ma hope o ka biopsy i nā biopsies ma hope. I ka manawa e pono ai e biopsied ka huina ʻōpū a me ka antrum i ka manawa like, pono e biopsied mua ka kihi ʻōpū a laila ka antrum; i ka nui o ka lesion wahi a me na apana o ke kino e pono e pipili, o ka mua apana e pololei, a he pono no hoi e noonoo ina ke koko ma hope o clamping e uhi i ka puni a pili i ke kula o ka hihio, i ole ia ka hope clamping e makapo a passive.
ʻO ke kaʻina biopsy maʻamau no nā ʻeha ma ke kihi ʻōpū, e noʻonoʻo ana i ka hopena o ke kahe koko ma nā biopsies ma hope.
4. E ho'āʻo e hana i ka biopsy kaomi ma luna o ka wahi i manaʻo ʻia, a e hoʻohana i ka ʻūhā inā pono. Hoʻemi ʻia ka ʻumeke ʻana o ka ʻili o ka mucosa, e ʻae ana i ka ʻiʻo e hoʻopaʻa hohonu a emi ʻole ka paheʻe.
Pono e hana ʻia ka biopsy e like me ka hiki ke hiki, a ʻaʻole pono ka lōʻihi o ka lōʻihi o ka biopsy forceps ma mua o 2CM.
5. E noʻonoʻo i ke koho ʻana i nā wahi laʻana no nā ʻano lesion like ʻole; ʻo ke koho ʻana i nā helu hōʻailona pili i ka helu maikaʻi. He maka koʻikoʻi ko ke kauka lapaʻau a pono e hoʻolohe i nā mākau koho o nā mea.
Nā wahi e biopsied Nā wahi ʻaʻole e biopsied
6. ʻO nā ʻāpana paʻakikī i ka biopsy ʻo ia ka waihona o ka ʻōpū kokoke i ka cardia, ka liʻiliʻi curvature o ke kino ʻōpū kokoke i ka paia hope, a me ke kihi o luna o ka duodenum. Pono ka mea kōkua e noʻonoʻo i ka hana ʻana. Inā makemake ʻo ia e hoʻokō i kahi hopena maikaʻi loa, pono ʻo ia e aʻo e hoʻolālā i mua a hoʻoponopono i ke kuhikuhi o ka pā paʻi i kēlā me kēia manawa. I ka manawa like, pono ʻo ia e hoʻoholo koke i ka manawa o ka hoʻopili ʻana ma o ka hoʻohana ʻana i kēlā me kēia manawa. I kekahi manawa ke kali nei i nā ʻōlelo aʻo mai ke kauka lapaʻau, hiki i kahi lag o 1 kekona ke alakaʻi i nā manawa i hala. Hiki iaʻu ke kali me ka hoʻomanawanui no ka manawa e hiki mai ana.
Hōʻike nā pua i nā wahi paʻakikī ke loaʻa mai nā mea a i ʻole ke hoʻōki i ke koko.
7. Ke koho ʻana i nā lāʻau lāʻau biopsy: ʻO nā pūlima biopsy nā mea me nā puka kīʻaha nui a me nā mea hohonu, ʻo kekahi me nā nila hoʻonohonoho, a ʻo kekahi me ka wehe ʻaoʻao a me ka nahu serrated.
8. ʻOi aku ka pololei o ka hoʻonui ʻana i hui pū ʻia me ka ʻili uila e alakaʻi i ka biopsy, ʻoi aku ka pololei no ka hoʻohālikelike ʻana i ka mucosa esophageal.
ʻO mākou, ʻo Jiangxi ZhuoRuiHua Medical Instrument Co., Ltd., he mea hana ma Kina i mea kūikawā i nā mea endoscopic consumables, e like mebiopsy forceps, hemoclip, pahele polyp, nila sclerotherapy, pāpaʻi pāpaʻi, cytology brushes, uea alakaʻi, hīnaʻi kiʻi pōhaku, nasal biliary drainage catheter etc. i hoohana nui ia maEMR, ESD, ERCP. Ua hōʻoia ʻia kā mākou huahana, a ua hōʻoia ʻia kā mākou mea kanu. Ua lawe ʻia kā mākou waiwai i ʻEulopa, ʻAmelika ʻAmelika, Middle East a me kahi hapa o Asia, a loaʻa nui i ka mea kūʻai aku o ka ʻike a me ka hoʻomaikaʻi!
Ka manawa hoʻouna: Jan-23-2025