Endoscopy: Zimene Imasonyeza, Zimene Singathe, ndi Momwe Mungakonzekerere

Njira zazikulu

• Endoscopy ndi njira yoyezera maso mwachindunji: imasonyeza mkati mwa chiwalo, osati chomwe chili pansi kapena kumbuyo kwake.
• Endoscopy ndi yowunikira komanso yochiritsa: biopsy, kuchotsa ma polyp, kuletsa kutuluka magazi ndi kuika stent zonse ndizotheka panthawi yomweyi.
• "Endoscopy" ndi gulu la njira zochizira matenda., palibe mayeso amodzi; gastroscopy, colonoscopy, bronchoscopy, cystoscopy ndi ERCP zimakhala ndi mankhwala osiyanasiyana komanso zoopsa zosiyanasiyana.
• Kuyeza kwa endoscopy sikuchotsa matenda onse: matenda a kapamba, matumbo ang'onoang'ono ndi khoma lozama akhoza kuphonya ndipo angafunike maphunziro a CT, MRI kapena capsule.
• Kukonzekera kumakhazikitsidwa ndi gawo lochita: nthawi yosala kudya, kukonzekera matumbo ndi kusintha kwa mankhwala zimasiyana pakati pa zipatala ndi pakati pa njira zochizira.

Pang'onopang'ono

Amadziwikanso monga

• Mayeso a Endoscopy, skopi: kugwiritsidwa ntchito kofala m'zipatala zaku India
• Endoscopy ya Upper GI / OGD / EGD / gastroscopy: Kufufuza njira yolowera mkamwa mwa chitoliro cha chakudya, m'mimba ndi duodenum
• Colonoscopy, nthawi zina amatchedwa GI yotsika
• Kuyesa kwa Dooerbeen / kamera, kamera ya pet ki jaanch: mafotokozedwe osavomerezeka omwe odwala nthawi zambiri amagwiritsa ntchito
• Sigmoidoscopy: kufufuza pang'ono kwa m'matumbo akumanzere ndi rectum

Kodi endoscopy ndi chiyani

Endoscope ndi chubu chokhala ndi gwero la kuwala, kamera chip kapena fiber-optic bundle, njira zopumira mpweya, madzi ndi kuyamwa, komanso njira yogwirira ntchito yomwe zida zitha kupititsidwa. Kamera imatumiza zithunzi zamoyo pazenera, kotero dokotala amawona pamwamba pa mucosal pakukula ndi kuunikira.

Popeza zida zimatha kudutsa munjira yogwirira ntchito, endoscopy nthawi zambiri imakhala yochiritsa komanso yowunikira. Pa nthawi yomweyo dokotala angatenge biopsies pang'ono, kuchotsa polyp, kudula chilonda chotuluka magazi, mitsempha ya m'mimba, kufutukula kufupika, kuyika stent kapena kuchotsa chinthu chomwe chamezedwa.

Endoscopy si njira imodzi yofufuzira. Kukula, njira, kukonzekera, kuletsa kupweteka, ndi zoopsa zonse zimasintha ndi chiwalo chomwe chikuphunziridwa. Gastroscopy ndi ERCP zimachitika ndi zida zofanana koma zimasiyana kwambiri pazovuta komanso kuchuluka kwa zovuta.

Chifukwa chiyani endoscopy imachitidwa

• Zizindikiro za GI yapamwamba: kutentha pamtima kosalekeza kapena kusagwira bwino ntchito kwa m'mimba osayankha chithandizo, kuvutika kapena kupweteka pomeza, kusanza mobwerezabwereza, matenda a zilonda zam'mimba omwe akuganiziridwa, kuchepa kwa magazi m'thupi kosafotokozedwa bwino chifukwa cha kusowa kwa ayoni.
• Kutuluka magazi m'mimba: kusanza magazi, ndowe zakuda, kapena kutuluka magazi m'matumbo onse, zonse ziwiri kuti mupeze komwe kumachokera komanso kuti muchiritse.
• Zizindikiro za GI yotsika: kusintha kwa chizolowezi cha m'mimba, kutsegula m'mimba kosatha, magazi m'chimbudzi, matenda okayikiridwa otupa m'matumbo, zithunzi zosazolowereka za m'matumbo.
• Kuzindikira ndi kuyang'anira khansa: kuwunika zilonda zokayikitsa, kuchotsa ma polyp a m'matumbo, kutsatira Barrett's esophagus, matenda a coeliac kapena ma polyp akale.
• Matenda a biliary ndi pancreatic: ERCP ya miyala ya ndulu, misempha yotsekeka ndi jaundice yomwe ikufunika kutuluka madzi.
• Mavuto a mpweya ndi mkodzo: bronchoscopy ya chifuwa chosatha ndi chithunzi chachilendo cha chifuwa kapena magazi otsokomola; cystoscopy ya magazi omwe amaoneka mu mkodzo kapena zizindikiro za chikhodzodzo.

Ndani ayenera kuganizira za endoscopy

Dokotala amapempha kuti achite endoscopy akamaliza kuyezetsa kuchipatala, si mayeso oti munthu aliyense amene ali ndi vuto la m'mimba azifufuzidwa. Nthawi zambiri munthu amene wapatsidwa chithandizo chamankhwala amaganiziridwa kuti ndi wothandiza pa izi:

• Akuluakulu omwe amavutika kumeza, kukana chakudya, kapena kupweteka kumeza ali ndi zaka zilizonse.
• Akuluakulu omwe ali ndi kuchepa thupi mwadala, kusanza kosalekeza, kapena kutsekeka m'mimba pamodzi ndi dyspepsia.
• Akuluakulu omwe ali ndi vuto la kuchepa kwa magazi chifukwa cha kusowa kwa ayodini popanda chifukwa chomveka bwino.
• Akuluakulu omwe ali ndi vuto la dyspepsia lomwe limapitirira ngakhale atayesedwa mokwanira ndi chithandizo, kapena lomwe limayamba atakula.
• Aliyense amene akuoneka kapena akukayikiridwa kuti ali ndi magazi m'mimba mwake.
• Anthu omwe ali ndi vuto la kutuluka magazi m'matumbo, kusintha kosalekeza kwa chizolowezi cha m'mimba, kapena mbiri yakale ya m'banja la khansa ya m'matumbo kapena polyps, colonoscopy m'malo mwa gastroscopy.
• Anthu omwe ali ndi matenda odziwika bwino a celiac, Barrett's esophagus, cirrhosis ndi varices, kapena polyps zakale, pa nthawi yoyang'aniridwa ndi dokotala wawo wa gastroenterologist.

Kaya endoscopy ndi sitepe yotsatira yoyenera, komanso endoscopy iti, zimadalira vuto lenilenilo. Zotsatira zimasiyana malinga ndi momwe matenda alili.

Zimene endoscopy singathe kuzizindikira kapena kuzichotsa

Endoscopy ndi njira yowunikira pamwamba. Malo osawona ndi ofunika:

• Sichiwona kudzera pakhoma. Kuzama kwa chotupa, ma lymph nodes ndi kufalikira kwina kwa chiwalo sizimayesedwa pogwiritsa ntchito endoscopy yokhazikika; yomwe imafunika endoscopic ultrasound (EUS), CT kapena MRI.
• Gastroscopy siyesa kapamba, ndulu, chiwindi parenchyma kapena aorta. Kuyeza bwino gastroscopy sikuchotsa matenda a ndulu, kapamba kapena khansa ya kapamba.
• Matumbo ambiri ang'onoang'ono sapezeka mosavuta. Gastroscopy yokhazikika imafika pa duodenum; colonoscopy imafika kumapeto kwa ileum. Matenda omwe ali pakati pa matendawa angafunike capsule endoscopy, enteroscopy kapena MR enterography.
• Colonoscopy si yabwino kwenikweni. Zilonda zathyathyathya, ma polyp ang'onoang'ono ndi zilonda zomwe zili kumbuyo kwa makwinya zimatha kuphonya, makamaka ngati matumbo sali bwino kapena ngati caecum sikupezeka.
• Gastroscopy siizindikira kupweteka kwa mtima pachifuwa. Kupweteka pachifuwa komwe kungakhale kwa mtima kumafuna kuunika mtima, osati kutsimikiziridwa ndi kuwunika kwabwinobwino.
• Matenda a ntchito sasonyeza chilichonse. Matenda a m'mimba okwiya, dyspepsia yogwira ntchito komanso mavuto ambiri oyenda amachititsa kuti mkati mwake muwoneke bwino. Lipoti labwinobwino silitanthauza kuti zizindikiro zake ndi zongopeka.
• Kusankha zitsanzo za biopsy ndi kusankha. Kuyezetsa magazi kopanda umboni kumatanthauza kuti minofu yomwe yatengedwa sinasonyeze vuto lililonse; sizitsimikizira kuti chiwalo chonsecho ndi chabwinobwino.

Zomwe zapezeka pa endoscopy sizinatchulidwe. Ngati zizindikiro zikupitirira kapena zikuipiraipira ngakhale lipoti lakhala lachizolowezi, bwererani kwa dokotala wanu m'malo moganiza kuti palibe cholakwika china chilichonse.

Mayeso ofanana koma osiyana

Palibe njira imodzi yabwino kwambiri pazochitika zonse. Mayesowa amayankha mafunso osiyanasiyana, ndipo mayeso oyamba oyenera amadalira vuto lomwe lilipo, kutuluka magazi, chikasu cha m'mimba, chifuwa ndi dysphagia, zonsezi zimapangitsa kuti pakhale poyambira kosiyana.

Momwe mungakonzekerere

Kukonzekera kumagwira ntchito ndipo kumasiyana malinga ndi zipatala, pakati pa akatswiri a endoscopist ndi pakati pa njira zochizira. Malangizo olembedwa ochokera ku unit yomwe ikuchita opaleshoni yanu ndi ofunika kuposa malangizo onse, kuphatikizapo tsamba lino. Makhalidwe onse:

• Kusala kudya: Chakudya cholimba nthawi zambiri chimayimitsidwa maola angapo munthu asanagone, ndipo madzi oyera amayimitsidwa pafupi ndi nthawi yochita opaleshoni. Nthawi yeniyeni imakhazikitsidwa ndi chipangizocho ndi dokotala wogonetsa.
• Kukonzekera matumbo: Chofunika pa colonoscopy ndi sigmoidoscopy. Izi zimaphatikizapo mankhwala otsegula m'mimba, nthawi zina amagawidwa m'magawo awiri, komanso kuchepetsa zakudya kwa tsiku limodzi kapena kuposerapo.
• Mankhwala: Uzani gulu lanu za mankhwala ndi zowonjezera zilizonse, makamaka mankhwala ochepetsa magazi, mankhwala oletsa magazi kutuluka m'magazi, mankhwala a insulin ndi mankhwala ena a shuga, mapiritsi achitsulo ndi mankhwala oletsa asidi. Musayambe, kusiya kapena kusintha mankhwala aliwonse omwe mwapatsidwa nokha, funsani dokotala kapena gulu la endoscopy.
• Kuperekeza ndi mayendedwe: Ngati mukukonzekera kupereka mankhwala ochepetsa ululu, munthu wamkulu wodalirika ayenera kukutsogolerani kunyumba. Musayendetse galimoto, kukwera njinga ya mawilo awiri kapena kugwiritsa ntchito makina tsiku lonselo.
• Chilolezo ndi mbiri: kulengeza matenda a mtima kapena mapapo, sleep apnea, mavuto am'mbuyomu oletsa ululu, ziwengo, mimba, ma valve a mtima opangidwa, zipangizo zoyikidwa m'thupi komanso opaleshoni yam'mimba yomwe idachitika kale.

Ngati muli ndi matenda a shuga pa chithandizo chochepetsa shuga m'magazi

Kusala kudya ndi kukonzekera matumbo kungayambitse shuga wotsika m'magazi. Mlingo wa insulin ndi sulfonylurea nthawi zambiri umafunika kusintha kokonzedweratu, ndipo zoletsa za SGLT2 zingafunike kuyimitsidwa kwakanthawi musanadye nthawi yayitali. Izi ziyenera kukonzedwa pasadakhale ndi dokotala wanu, osati nokha.

Ngati muli ndi vuto la mtima kapena matenda aakulu a impso

Kukonza matumbo ambiri kungayambitse kusintha kwa madzi ndi ma electrolyte. Uzani gululo za kulephera kwa mtima, dialysis, CKD yowonjezereka, cirrhosis yokhala ndi ascites kapena kuletsa madzi kuti asankhe dongosolo loyenera lokonzekera ndi kuyang'anira.

Ngati mukumwa mankhwala ochepetsa magazi kapena mankhwala oletsa ma platelet

Zisankho zimalinganiza chiopsezo cha kutuluka magazi panthawi yochotsa ma polyp kapena kuchotsa ma polyp motsutsana ndi chiopsezo cha magazi kuundana ngati mankhwalawa ayimitsidwa, makamaka ndi ma coronary stents aposachedwa, ma mechanical valves kapena atrial fibrillation. Ndondomekoyi ndi yaumwini ndipo iyenera kuchokera kwa dokotala wopereka mankhwala pamodzi ndi endoscopist.

Ngati muli ndi pakati kapena mukuyamwitsa

Endoscopy pa nthawi ya mimba imachitika pokhapokha ngati pakufunika kutero, nthawi zambiri pakakhala kutuluka magazi ambiri, ndipo imakonzedwa limodzi ndi gulu la oyembekezera. Kusankha nthawi yogona, malo ogona, nthawi yomwe ali ndi pakati komanso kupewa njira zochizira pogwiritsa ntchito ma radiation monga ERCP komwe kungatheke zonse zimaganiziridwa mwapadera.

ana

Kuyeza kwa endoscopy ya ana kumagwiritsa ntchito ma scope ang'onoang'ono, malamulo okhudza kusala kudya kwa ana komanso nthawi zambiri kupatsa mankhwala oletsa ululu kapena kugonetsa kwambiri ndi dokotala wogonetsa ululu wa ana. Njira zokonzekera matumbo pogwiritsa ntchito kulemera zimasiyana ndi za akuluakulu ndipo ziyenera kuperekedwa ndi gulu la ana.

Achikulire achikulire

Kugonetsa nthawi zambiri kumaperekedwa mu mlingo wochepa, ndipo kufooka, chiopsezo cha kutaya madzi m'thupi panthawi yokonzekera matumbo ndi mankhwala ogwiritsidwa ntchito limodzi ziyenera kuunikidwanso musanachite opaleshoniyo.

Zomwe zimachitika panthawi ya endoscopy

• Lembetsani: Kudziwika, chilolezo, momwe munthu alili kusala kudya komanso mankhwala zimatsimikiziridwa. Kandulo imayikidwa kuti ipumule, ndipo kuyang'anira kugunda kwa mtima, kuthamanga kwa magazi ndi mpweya kumayikidwa.
• Kuchepetsa kapena kuletsa kugona: Pa gastroscopy, mankhwala otsukira pakhosi angagwiritsidwe ntchito, ngakhale atagwiritsidwa ntchito m'mitsempha kapena ayi. Colonoscopy nthawi zambiri imachitika pansi pa mankhwala otsukira. Njira zina zimafuna mankhwala otsukira onse.
• Kudutsa muyeso: Mumagona cha kumanzere kuti mupeze endoscopy ya m'mimba. Choteteza pakamwa chimateteza mano kuti asawonongeke. Mpweya kapena carbon dioxide imagwiritsidwa ntchito kutsegula lumen, zomwe zingayambitse kutupa kapena chilakolako chofuna kuluma kapena kutulutsa mphepo, izi zikuyembekezeredwa.
• Kufufuza ndi chithandizo: Dokotala wa endoscopist amafufuza mosamala, kujambula zomwe zapezeka ndikujambula biopsy ngati pakufunika. Biopsy yokha si yopweteka, chifukwa mkati mwake mulibe ululu wa mitsempha yamtunduwu.
• Kubwezeretsa: Mumapuma pamalo opumulira mpaka mutazindikira. Mungapatsidwe madzi opopera pakhosi akatha ndipo kumeza kuli bwino.
• kumaliseche: Dokotala wa endoscopist nthawi zambiri amafotokoza zomwe zapezeka tsiku lomwelo ndipo amapereka lipoti lolembedwa. Zotsatira za biopsy zimatsatira padera.

Kodi njirayi imatenga nthawi yayitali bwanji

• Kuzindikira matenda a gastroscopy: nthawi zambiri imakhala pafupifupi mphindi 5-15.
• Kuzindikira matenda a colonoscopy: Kawirikawiri zimatenga pafupifupi mphindi 20-45, kupitirira apo ngati ma polyps achotsedwa kapena m'matumbo muli zovuta kuyendamo.
• ERCP, EUS ndi njira zovuta zochiritsira: nthawi zambiri kuyambira mphindi 45 mpaka ola limodzi.
• Ulendo wonse kuchipatala: nthawi zambiri maola ochepa, zomwe zimathandiza kulembetsa, kufufuza njira zoyendetsera ntchito komanso kuchira ku mankhwala oletsa ululu.
• Kukonzekera matumbo: amawonjezera pafupifupi tsiku limodzi la zakudya zoletsa komanso kugwiritsa ntchito mankhwala ofewetsa ululu musanachite colonoscopy.

Nthawi yeniyeni yokonzekera ndi nthawi yobwezeretsa zinthu zimasiyana malinga ndi mayunitsi ndipo zimadalira kusakanikirana kwa tsikulo.

Kumvetsa lipoti lanu

Lipoti la endoscopy limafotokoza zomwe zinaoneka, komwe zinachitikira, ndi zomwe zinachitikira. Zinthu zodziwika bwino zikuphatikizapo kuchuluka komwe kunafikiridwa, mtundu wa mawonekedwe kapena kukonzekera matumbo, kufotokozera za mkati mwa chiberekero, zithunzi, malo oyeretsera, ndi chithandizo chilichonse chomwe chinachitidwa.

• "Kuphunzira Kwachizolowezi": Malo omwe adawonedwa adawoneka bwino. Izi ndizolimbikitsa matenda am'thupi m'derali koma sizimafotokoza zizindikiro zonse, ndipo sizimaphimba ziwalo zomwe sizingafikire.
• Kutupa, kukokoloka kwa nthaka, gastritis, esophagitis: mawu ofotokozera. Maonekedwe owoneka okha sazindikira chomwe chimayambitsa; Helicobacter pylori Kuyezetsa ndi mbiri yachipatala ndizofunikira.
• Chilonda: Pakufunika chifukwa chodziwikiratu. Zilonda zam'mimba nthawi zambiri zimafufuzidwa ndi biopsy ndipo nthawi zambiri zimafufuzidwanso pambuyo pake.
• Polyp: Ma polyps ambiri a m'matumbo ndi abwino. Lipoti la minofu limatsimikiza mtundu ndi ngati kuyang'aniridwa ndikofunikira.
• Mitsempha ya Varicose: Mitsempha yotupa, yomwe nthawi zambiri imakhudzana ndi matenda a chiwindi; imafunika chithandizo cha akatswiri.
• "Chilonda chokayikitsa" kapena "kukula": chithunzi chooneka, osati matenda. Lipoti la histopathology lokha ndi lomwe lingatsimikizire kapena kutsutsa khansa.
• Kafukufuku wosakwanira: Ngati caecum sinafike kapena kukonzekera sikunali kokwanira, mayeso obwerezabwereza kapena ena angalangizedwe.

Mawu ofotokozera momwe matenda a esophagitis, gastritis kapena haemorrhoids amafotokozera ndipo amadalira pang'ono kwa omwe amawawona. "Giredi" yokha sikutanthauza kuti vuto lanu ndi lalikulu bwanji, ndipo akatswiri awiri a endoscop angasonyeze mawonekedwe ofanana mosiyana pang'ono. Musachitepo kanthu pa lipoti popanda kulitanthauzira ndi dokotala amene wakupemphani.

Pamene zotsatira zingakhale zosokeretsa

Zomwe zapezeka zomwe zingakhale zolimbikitsa zabodza (matenda samadziwika bwino)

• Kukonzekera bwino matumbo imabisa ma polyps ndi zilonda zazing'ono panthawi ya colonoscopy.
• Mayeso osakwanira: sikelo yopita patsogolo ku caecum, kapena stricture yoletsa njira.
• Mankhwala aposachedwa kapena omwe akupitilira kupondereza asidi imatha kuchiritsa kusintha kwa pamwamba ndipo ingapangitsenso H. pylori mayeso otengedwa pa endoscopy abodza kuti alibe.
• Mankhwala opha tizilombo kapena bismuth aposachedwa mofananamo kuchepetsa phindu la H. pylori mayeso ozikidwa pa biopsy.
• Magazi kapena chakudya chotsalira kubisa mawonekedwe panthawi ya kutuluka magazi.
• Matenda omwe sapezeka mosavuta: matenda a m'matumbo ang'onoang'ono, kapamba kapena kunja kwa luminal sadzawonekera.
• Cholakwika pakupanga zitsanzo: biopsy yochotsedwa pamalo osazolowereka.

Zomwe zapezeka zomwe zingawoneke zoyipa kuposa momwe zilili (matenda amatchulidwa mopitirira muyeso)

• Kuvulala kwa malo Zingayambitse mikwingwirima yaying'ono kapena kung'ambika pang'ono kwa mucosal komwe kumawoneka ngati matenda.
• Chokoka ndi mpweya woipa kungayambitse kufiira kapena zilonda zabodza.
• Kukonzekera matumbo kokha zingayambitse kusintha pang'ono kwa mucosal komwe kumafanana ndi colitis.
• "Gastritis yofatsa" yosadziwika bwino imanenedwa kawirikawiri ndipo nthawi zambiri imakhala ndi zotsatira zochepa pa zizindikiro.
• Mapiritsi achitsulo zimatha kufinya denga la mkati ndi kutsanzira matenda.

Zoopsa ndi chitetezo

Mavuto aakulu ochokera ku endoscopy yozindikira matenda ndi osowa kwambiri, koma si zero, ndipo chiopsezo chimasiyana kwambiri m'banja lonse la endoscopy. Chiwopsezo chimawonjezeka ndi njira zochiritsira, milandu yotuluka magazi mwachangu, komanso mwa anthu omwe ali ndi matenda aakulu a mtima, mapapo, chiwindi kapena impso.

Kuzindikira matenda a gastroscopy

Zofala komanso zazing'ono: kupweteka pakhosi, kudzimbidwa, kusanza kwakanthawi. Zosazolowereka: kutuluka magazi pambuyo pa biopsy, kuyankhidwa ndi mankhwala oletsa kupweteka, mpweya wochepa, kutulutsa madzi m'mimba. Zosowa: kuboola kwa chitoliro cha chakudya kapena m'mimba.

Colonoscopy ndi polypectomy

Zofala: kupweteka m'mimba, kudzimbidwa, magazi ochepa pambuyo pochotsa polyp kapena biopsy. Zosazolowereka kapena zosazolowereka: kutuluka magazi kwambiri pambuyo pochotsa polyp (zomwe zingachitike patatha masiku angapo), kubooka, matenda oyaka pambuyo pa polypectomy, mavuto okonzekera matumbo monga kusowa madzi m'thupi kapena kusokonezeka kwa electrolyte.

Kutumiza

Ndiwo omwe ali ndi mavuto ambiri kuposa njira zachizolowezi zochizira matenda a GI endoscopy. Zoopsa zomwe zimazindikirika ndi monga kutupa kwa kapamba pambuyo pa opaleshoni, kutuluka magazi pambuyo pa sphincterotomy, matenda a ndulu ndi kuboola kwa ndulu. ERCP imagwiritsa ntchito X-ray, kotero mimba iyenera kulengezedwa.

Bronchoscopy

Chifuwa, kuchepa kwa mpweya m'thupi kwa kanthawi kochepa, kutuluka magazi pang'ono pambuyo pa biopsy; kutentha thupi kochepa, kutuluka magazi kofunikira thandizo, kapena pneumothorax pambuyo pa biopsy m'mapapo.

Zosindikiza

Kupsa mkodzo ukatuluka, magazi ochepa, matenda a mkodzo; nthawi zambiri mkodzo umasungidwa kapena kuvulala kwa mkodzo.

Kugonetsa ndi kuletsa ululu

Zoopsa zimaphatikizapo kupuma movutikira, kuthamanga kwa magazi pang'ono, kukhuta ndi kugwiritsa ntchito mankhwala osokoneza bongo. Zoopsazi zimakhala zambiri mu vuto la kupuma movutikira, kunenepa kwambiri, matenda oopsa a mtima kapena mapapo, kufooka komanso pazochitika zadzidzidzi. Kugona movutikira ndi ogwira ntchito ophunzitsidwa bwino kumachepetsa koma sikuchotsa chiopsezochi.

Zotsatira zimasiyana malinga ndi momwe matenda alili. Funsani dokotala wanu wa endoscopist kuti akuuzeni zoopsa zomwe mungakumane nazo pa njira yomwe mwakonza.

Zinthu zapadera

Pregnancy

Endoscopy imachedwetsedwa pokhapokha ngati chizindikirocho chili champhamvu. Gastroscopy ya kutuluka magazi kwambiri ndiyo chifukwa chofala kwambiri. Njira zochiritsira pogwiritsa ntchito kuwala kwa dzuwa zimapewedwa kapena kutetezedwa ndikuchepetsedwa, ndipo gulu la oyembekezera limakhudzidwa ndi kukonzekera.

ana

Kuyeza kwa endoscopy ya ana kumachitika ndi madokotala a gastroenterologists omwe ali ndi chithandizo cha ana choletsa ululu. Zizindikiro zimasiyana ndi za akuluakulu ndipo zimaphatikizapo matenda okayikiridwa a celiac, kutupa kwa chitoliro cha chakudya chifukwa cha chakudya, thupi lachilendo lomwe limakayikiridwa ndi kutsegula m'mimba kosatha komwe kukula kumachepa.

Achikulire achikulire

Mlingo wa mankhwala ogonetsa nthawi zambiri umachepetsedwa, kukonzekera matumbo kungafunike kusinthidwa kuti munthu asataye madzi m'thupi, ndipo phindu la njira zowunikira limayesedwa poyerekeza ndi thanzi la munthu komanso nthawi yomwe munthu amayembekezera kukhala ndi moyo.

Matenda a shuga pa chithandizo chochepetsa shuga m'magazi

Kusala kudya ndi kukonzekera matumbo kumawonjezera chiopsezo cha hypoglycemia. Mankhwala ndi dongosolo loyang'anira ziyenera kuvomerezedwa ndi dokotala musanafike tsiku la opaleshoni. Nyamulani zipangizo zowunikira shuga ndi chithandizo cha shuga wotsika kupita kuchipatala.

Matenda a impso osatha komanso kulephera kwa mtima

Kusankha kukonzekera, kuchuluka kwa madzi ndi kuyang'anira ma electrolyte kumafunika kusintha. Fotokozani nthawi ya dialysis kuti nthawi igwirizane.

Matenda a chiwindi ndi cirrhosis

Endoscopy imagwiritsidwa ntchito pofufuza ndi kuchiza mitsempha ya m'mimba. Kutsekeka kwa magazi, kuchepa kwa ma platelet ndi kufooka kwa minofu m'thupi mwa matenda a chiwindi omwe akukula, zonsezi zimafuna kukonzekera mwapadera.

Zipangizo zobzalidwa ndi ma valve opangira

Opanga ma pacemaker ndi ma defibrillator obzalidwa m'thupi amakhudza kugwiritsa ntchito zida zamagetsi pochotsa ma polyp, choncho dziwani izi. Kuphimba ma antibiotic musanagwiritse ntchito endoscopy si chinthu chachizolowezi kwa odwala ambiri; chisankho ndi cha munthu aliyense payekha.

Endoscopy mu nkhani ya ku India

• Zizindikiro zodziwika bwino zimasonyeza momwe matenda am'deralo amachitikira. Matenda a asidi m'mimba ndi Helicobacter pyloriMatenda a gastritis okhudzana ndi matendawa nthawi zambiri ndi omwe amachititsa kuti munthu azitha kuchira matenda a gastroscopy. Chifuwa chachikulu cha m'mimba ndi chizindikiro chofunikira kwambiri cha zilonda za ileocaecal ndipo chimatha kufanana kwambiri ndi matenda a Crohn, ndipo ma biopsies a colonoscopy okhala ndi mayeso a minofu nthawi zambiri amakhala ofunikira kwambiri powasiyanitsa.
• Matenda a chiwindi osatha ndi omwe amachititsa kuti endoscopy ichitike. poyesa mitsempha ya variceal ndi kuyika m'mabande, kuphatikizapo matenda a chiwindi a steatotic okhudzana ndi mowa komanso metabolic dysfunction (MASLD, mawu omwe adalowa m'malo mwa NAFLD; MASH idalowa m'malo mwa NASH, ndipo MetalALD imafotokoza za zomwe zimachitika nthawi imodzi zokhudzana ndi metabolism ndi mowa).
• Kuvulala kwa chiwindi ndi matumbo chifukwa cha mankhwala Kuchokera ku mankhwala oletsa chifuwa chachikulu, mankhwala ochepetsa ululu osagwiritsa ntchito steroidal omwe amagulidwa pa kauntala, ndi mankhwala ena a AYUSH, mankhwala azitsamba ndi owonjezera pa masewera olimbitsa thupi ndi vuto lodziwika bwino; lengezani chilichonse chomwe mumamwa, kuphatikizapo mankhwala osaperekedwa ndi dokotala.
• Kumeza zinthu zowononga ndi kuchotsa thupi lachilendo Zizindikiro za endoscopy yadzidzidzi zimakhalapo nthawi zambiri, makamaka kwa ana.
• Kugwiritsa ntchito kwa anthu wamba n'kofunika. Odwala ndi makalata otumizira odwala anganene kuti "scopy", "camera test", "upper GI scopy" kapena "pet ki jaanch", onse nthawi zambiri amanena za njira zomwe zafotokozedwa pano, koma amatsimikizira kuti ndi chiwalo chiti chomwe chikuyesedwa.
• Kuteteza deta. Zithunzi, makanema ndi malipoti a endoscopy ndi deta yachinsinsi ya thanzi la munthu; kugwiritsa ntchito chilolezo ndi zolemba za digito kumayendetsedwa ndi Digital Personal Data Protection Act, 2023, pamodzi ndi maudindo aukadaulo achinsinsi pansi pa malamulo a National Medical Commission.
• Malamulo otsatsa malonda. Zonena kuti njira iliyonse imachiritsa matenda ndizoletsedwa motsatira lamulo la Mankhwala ndi Machiritso Amatsenga (Zotsatsa Zosavomerezeka) la 1954; zikukayikira kuti njira zomwe zikulonjeza zotsatira zotsimikizika.

Mtengo ndi inshuwalansi ku India

Mitengo imasiyana kwambiri pakati pa mizinda, pakati pa zipatala za boma ndi zachinsinsi, komanso pakati pa njira zodziwira matenda ndi njira zochiritsira. Mitengo yomwe yatchulidwa kulikonse iyenera kuonedwa ngati yosonyeza kokha ndipo iyenera kutsimikiziridwa ndi chipatalacho mwa kulemba opaleshoni isanachitike.

Zinthu zomwe zimasintha mtengo:

• Mtundu wa ndondomeko: Kuyeza matenda a gastroscopy ndiko kotsika mtengo kwambiri kuposa ena onse; colonoscopy, EUS ndi ERCP zimadula pang'onopang'ono.
• Kuletsa kapena kuletsa ululu: mankhwala opopera pakhosi okha, mankhwala oletsa kupweteka omwe amachokera ku conscious sedation, kapena mankhwala oletsa ululu omwe amagwiritsidwa ntchito ndi dokotala wogonetsa, aliyense amawonjezera kuchuluka kosiyana.
• Zowonjezera zothandizira: Zipangizo zochotsera mabala, ma clip, zida zomangira mabala, ma stents, ma dilator, ma injection agents ndi zipangizo zochotsera mabala zimayikidwa ngati zinthu zogwiritsidwa ntchito.
• Histopathology: Kukonza biopsy kumalipidwa pa bolodi lililonse la chitsanzo, kuphatikiza madontho apadera, immunohistochemistry kapena kuyezetsa minofu ya chifuwa chachikulu.
• Kusamalira ana masana poyerekeza ndi kugonekedwa m'chipatala: malo opumulirako, gulu la zipinda ndi malo aliwonse ogona usiku wonse.
• Mtundu wa malo ndi mzinda: gulu la mzinda, udindo wovomerezeka komanso ngati gawolo ndi la boma, loyendetsedwa ndi trust kapena la kampani.
• Njira zadzidzidzi zakunja kwa nthawi yogwira ntchito nthawi zambiri zimadula ndalama zambiri kuposa mndandanda womwe unakonzedwa.

Mfundo za inshuwaransi zoyenera kuziyang'anira: mfundo zambiri zolipirira zimaphimba endoscopy ngati ndi gawo la njira yolandirira odwala kapena yosamalira ana masana, koma endoscopy yodziwira matenda yokhayo ingachotsedwe. Tsimikizani chithandizo cha njira yosamalira ana masana, momwe netiweki yopanda ndalama ilili, zofunikira pasadakhale, nthawi yodikira matenda omwe alipo kale, komanso ngati zinthu zogwiritsidwa ntchito ndi histopathology zili zolipira. Mapulani aboma monga Ayushman Bharat PM-JAY amaphimba ma phukusi ena m'zipatala zothandizidwa, kuyenerera ndi ma phukusi ayenera kutsimikiziridwa ndi ofesi ya inshuwaransi ya chipatala.

Nthano ndi mfundo zenizeni

MAFUNSO OFUNSIDWA KAWIRIKAWIRI

Kodi ndidzakhala maso panthawi ya endoscopy?

Zimenezo zimadalira njira ndi chipangizo. Gastroscopy nthawi zambiri imachitika ndi mankhwala opopera pakhosi okha kapena ndi mankhwala ochepetsa ululu pang'ono, kotero mutha kugona koma mutha kudzuka mosavuta. Colonoscopy nthawi zambiri imachitika pansi pa mankhwala ochepetsa ululu. Njira zina, komanso ma endoscopy ambiri a ana, zimafuna mankhwala oletsa ululu. Kambiranani zomwe mumakonda komanso thanzi lanu pasadakhale.

Kodi endoscopy ingandidziwitse nthawi yomweyo ngati ndili ndi khansa?

Endoscopy ingasonyeze chotupa chomwe chikuwoneka chokayikitsa, ndipo dokotala wa endoscopy anganene zimenezo tsiku limenelo. Kutsimikizira kumafuna histopathology ya biopsy, yomwe imanenedwa padera. Kuyeza magawo, kuchuluka kwa kuzama ndi kufalikira kwake, nthawi zambiri kumafuna mayeso ena monga endoscopic ultrasound, CT kapena PET-CT.

Kodi ndikufunika colonoscopy ngati gastroscopy yanga inali yabwinobwino?

Osati zokha. Gastroscopy ndi colonoscopy zimayankha mafunso osiyanasiyana okhudza ziwalo zosiyanasiyana za m'mimba. Colonoscopy imaganiziridwa pamene zizindikiro, kutuluka magazi, kuchepa kwa magazi m'thupi, mbiri ya banja kapena zofunikira zoyang'aniridwa zikusonyeza kuti m'matumbo muli matenda. Chisankhocho ndi cha dokotala amene akukuyezani.

Kodi ndingadye nthawi yayitali bwanji ndikubwerera kuntchito?

Pambuyo pochita njira yosavuta yodziwira matenda ndi mankhwala oletsa kutopa, anthu ambiri amadya akadzuka bwino ndikumeza bwino, kenako n’kuyambiranso kuchita zinthu zomwe amachita tsiku lotsatira. Pewani kuyendetsa galimoto, kugwiritsa ntchito makina ndi kusankha zinthu zofunika tsiku lonse. Njira zochiritsira zingapangitse kuti pakhale nthawi yayitali yoletsa kudya komanso kuchita zinthu zina.

Kodi endoscopy ndi yotetezeka ngati ndili ndi matenda a mtima kapena mapapo?

Endoscopy nthawi zambiri imakhala yotheka, koma chiopsezo cha kugonetsa munthu ndi chachikulu ndipo chikufunika kukonzekera. Uzani gulu lanu za angina, matenda a mtima omwe achitika posachedwapa, kulephera kwa mtima, kusakhazikika kwa mtima, stent, COPD, mphumu, kugwiritsa ntchito mpweya kapena sleep apnea. Kuyang'anira, kusankha kugonetsa munthu komanso nthawi zina kutenga nawo mbali kwa dokotala wogonetsa munthu kumasinthidwa moyenerera.

Nchifukwa chiyani ndiyenera kutenga matumbo akuluakulu chonchi kuti ndikachite colonoscopy?

Ma polyps ndi khansa yoyambirira ndi ang'onoang'ono ndipo n'zosavuta kubisala kuseri kwa ndowe. Kutumbo koyera kumathandiza kuzindikira matendawa mwachindunji ndipo kumachepetsa mwayi wobwerezabwereza opaleshoniyi. Ngati muli ndi matenda a impso, kulephera kwa mtima, kuchepa kwa madzi m'thupi kapena matenda a shuga, funsani dokotala kuti akupatseni mankhwala oyenera matenda anu.

Nanga bwanji ngati zizindikiro zanga zikupitirira nditamaliza endoscopy yachibadwa?

Bwererani kwa dokotala amene anapempha kuti muchite opaleshoniyi. Zizindikiro zomwe zikupitirira zingasonyeze vuto lomwe endoscopy silingathe kusonyeza, monga kuyenda kapena vuto la magwiridwe antchito, ndulu kapena kapamba