Endoscopy: Zvainoratidza, Zvaisingakwanise, uye Maitiro Ekugadzirira

Key tora kutora

• Endoscopy inzira yekuongorora zvakananga: inoratidza mukati menhengo, kwete zviri pasi kana shure kwayo.
• Endoscopy inonyatsoongorora uye inorapa: biopsy, kubviswa kwepolyp, kudzora kubuda ropa uye kuiswa kwestent zvese zvinogoneka panguva imwe chete.
• "Endoscopy" imhuri yemaitiro, hapana bvunzo imwe chete; gastroscopy, colonoscopy, bronchoscopy, cystoscopy uye ERCP zvine mishonga yakasiyana uye marongero akasiyana enjodzi.
• Kuongororwa kwe endoscopy hakubvisi chirwere chimwe nechimwe: chirwere chepancreas, ura hudiki uye kudzika kwemadziro chinogona kushaikwa uye chingada CT, MRI kana zvidzidzo zve capsule.
• Kugadzirira kunogadzwa nechikamu chinoita basa: nguva dzekutsanya, kugadzirira ura uye kugadziriswa kwemishonga zvinosiyana pakati pezvipatara uye pakati penzira dzekurapwa nadzo.

Pakuona

Uyewo anozivikanwa se

• Kuongororwa kweEndoscopy, scopy: kushandiswa kwakajairika muzvipatara zveIndia
• Endoscopy yepamusoro yeGI / OGD / EGD / gastroscopy: kuongororwa kwenzira yemuromo yepombi yechikafu, dumbu uye duodenum
• Colonoscopy, dzimwe nguva inonzi GI scopy yakaderera
• Kuyedzwa kweDooerbeen / kamera, kamera yemhuka diki jaanch: tsananguro dzisina kurongeka dzinowanzo shandiswa nevarwere
• Sigmoidoscopy: kuongororwa kushoma kweura rekuruboshwe nerectum

Chii chinonzi endoscopy

Endoscope ichubhu ine chiedza, kamera chip kana fibre-optic bundle, nzira dzemhepo, mvura nekusvuta, uye nzira inoshanda iyo michina inogona kupfuudzwa nayo. Kamera inotumira mifananidzo mhenyu kuchiratidziro, saka chiremba anoona pamusoro pemucosal pakakwirira uye pakavhenekerwa.

Nekuti michina inogona kupfuudza nzira inoshanda, endoscopy inowanzo rapa pamwe nekuongorora. Panguva imwe chete, chiremba anogona kutora biopsy, kubvisa polyp, kubvisa chironda chinobuda ropa, kubvisa varices yemudumbu, kuwedzera kutetepa, kuisa stent kana kutora chinhu chakamedzwa.

Endoscopy haisi bvunzo imwe chete. Chiyero, nzira, gadziriro, kunyaradza uye njodzi zvese zvinochinja nenhengo iri kudzidzwa. Gastroscopy neERCP zvinoitwa nemidziyo yakafanana asi zvakasiyana zvikuru pakuoma uye mwero wekuoma kwechirwere.

Nei endoscopy ichiitwa

• Zviratidzo zveGI yepamusoro: chirungurira chinogara chiripo kana kusadya zvakanaka kana kurapwa kwacho kuchiramba kuchiitika, kuoma kana kurwadziwa pakumedza, kurutsa kakawanda, chirwere chemaronda chinofungidzirwa, anemia isina tsananguro yekushomeka kwesimbi mumuviri.
• Kubuda ropa mudumbu: kurutsa ropa, tsvina nhema, kana kubuda ropa rega rega, zvese kuti uwane kwarinobva uye kuti rirapwe.
• Zviratidzo zveGI yakaderera: kuchinja kwemaitiro emudumbu, manyoka asingaperi, ropa mutsvina, chirwere chinofungidzirwa kuti chinozvimba mudumbu, mifananidzo isina kujairika yemudumbu.
• Kuongororwa uye kutariswa kwegomarara: kuongororwa kwezvironda zvinofungirwa, kubviswa kwepolyp muura, kuteverwa kweBarrett's esophagus, chirwere checoeliac kana polyps dzakambovapo.
• Chirwere chenduru nepancreas: ERCP yematombo emugero wenyongo, migero yakavharika uye jaundice inoda kubuda ropa.
• Matambudziko emhepo uye weti: bronchoscopy yekukosora kunogara kwenguva refu nemifananidzo isina kujairika yechipfuva kana ropa rekukosora; cystoscopy yekuyera ropa rinoonekwa muweti kana zviratidzo zvedundira.

Ndiani anofanira kufunga nezve endoscopy

Endoscopy inokumbirwa nachiremba mushure mekuongororwa kwekiriniki, haisi bvunzo yekuongorora munhu wese ane dumbu rakagumbuka. Kutumira varwere kunowanzo fungwa nezve:

• Vakuru vane dambudziko rekumedza, kunamatira kwechikafu, kana kurwadza kumedza chero pazera ripi zvaro.
• Vakuru vane kudzikira kwehuremu vasingazive, kurutsa nguva dzose, kana kuti vane dumbu rakakora pamwe chete nekushaya kudya.
• Vakuru vane anemia yekushomeka kwesimbi mumuviri vasina chikonzero chakajeka.
• Vakuru vane dyspepsia inoramba iripo pasinei nekuyedzwa kwakakwana kwekurapwa, kana kuti inotanga mukukura kwavo.
• Munhu wese ane ropa rinobuda mumuviri rinoonekwa kana rinofungidzirwa kuti rine GI.
• Vanhu vane kubuda ropa mudumbu, kuchinja kwemaitiro emudumbu nguva dzose, kana nhoroondo yakasimba yemhuri yekenza yemudumbu kana polyps, colonoscopy pane gastroscopy.
• Vanhu vane chirwere checoeliac chinozivikanwa, Barrett's esophagus, cirrhosis vane varices, kana kuti vakambova nemapolyps, vari panguva yekuongororwa kwakaitwa nachiremba wezvekudya.

Kuti endoscopy ndiyo danho rinotevera rakakodzera here, uye kuti ndeipi endoscopy, zvinoenderana nedambudziko racho. Mhedzisiro yacho inosiyana zvichienderana nemamiriro ezvinhu ekiriniki emunhu mumwe nemumwe.

Izvo endoscopy isingakwanise kuona kana kusabvisa

Endoscopy iongororo yepamusoro. Mavara ayo asingaonekwe anokosha:

• Haioni nepamadziro. Kudzika kwebundu, ma lymph nodes uye kupararira kwenhengo hazviongororwi ne endoscopy yakajairwa; inoda endoscopic ultrasound (EUS), CT kana MRI.
• Gastroscopy haiongorore pancreas, gallbladder, liver parenchyma kana aorta. Kuongororwa kwegastroscopy kwakajairika hakubvisi chirwere chegallstone, pancreatitis kana kenza yepancreas.
• Matumbu madiki akawanda haasvikiki. Gastroscopy yakajairika inosvika muduodenum; colonoscopy inosvika kuchikamu chekupedzisira cheileum. Chirwere chiri pakati chingada capsule endoscopy, enteroscopy kana MR enterography.
• Colonoscopy haina kukwana. Maronda akati sandara, ma polyps madiki uye maronda ari kumashure kwezviputi anogona kushaikwa, kunyanya kana gadziriro yedumbu isina kunaka kana kuti caecum isina kusvika.
• Gastroscopy haiongorori marwadzo emwoyo pachipfuva. Marwadzo epachipfuva angangove emwoyo anoda kuongororwa kwemoyo, kwete kusimbiswa nekuongorora kwakajairika.
• Matambudziko ekushanda kwemuviri haaratidzi chinhu. Dambudziko rekusagadzikana kwemudumbu, kusagadzikana kwebasa, uye matambudziko mazhinji ekufamba kunoita kuti jira riite seriri nyore. Kutaurwa kwakajairika hazvirevi kuti zviratidzo zvacho ndezvekufungidzira.
• Kutora sampuro ye biopsy kunosarudza. Kuongororwa kweropa kunoratidza kuti nyama yakatorwa haina kuratidza kuti nhengo yese yakajairika; hazviratidzi kuti nhengo yese yakajairika.

Zvakawanikwa "zvisingazivikanwe" pa endoscopy hazvina kubviswa. Kana zviratidzo zvikaramba zvichiwedzera kana zvikawedzera pasinei nezvakataurwa, dzokera kuna chiremba wako pane kufunga kuti hapana chimwe chingave chakaipa.

Bvunzo dzakabatana asi dzakasiyana

Hapana nzira imwe chete iri nani pane dzose. Miedzo iyi inopindura mibvunzo yakasiyana, uye bvunzo yekutanga chaiyo inoenderana nedambudziko riripo, kubuda ropa, jaundice, kukosora uye dysphagia, zvese zvinotungamira kune imwe nzvimbo yakasiyana.

Maitiro ekugadzirira

Kugadzirira kunoshanda uye kunosiyana zvichienderana nezvipatara, pakati pevanachiremba ve endoscopist uye pakati penzira dzekuvhiya. Pepa remirairo rakanyorwa kubva kuchikamu chinoita kuvhiya kwako rinotanga kupfuura chero zano rakajairika, kusanganisira peji rino. Maitiro akajairika:

• Kutsanya: Chikafu chakasimba chinowanzomiswa maawa akati wandei usati wapedza kunwa mushonga wekunyaradza, uye mvura yakachena inomiswa pedyo nekuvhiyiwa. Nguva chaiyo inotarwa neyuniti neanorapisa.
• Kugadzirira ura: zvinodiwa pa colonoscopy ne sigmoidoscopy. Izvi zvinosanganisira mushonga wekubvisa dumbu, dzimwe nguva unokamurwa kuita madosi maviri, pamwe nekurambidzwa kudya kwezuva rimwe kana kupfuura zvisati zvaitika.
• Mishonga: Udza timu nezvemushonga wese uye zvinowedzerwa, kunyanya mishonga inodzikisa ropa, mishonga inorwisa maplatelet, insulin nemimwe mishonga yeshuga, mapiritsi esimbi uye mishonga inodzvinyirira acid. Usatange, kumisa kana kuchinja chero mushonga wakanyorerwa wega, bvunza chiremba kana timu ye endoscopy.
• Kuperekedza uye kutakura: Kana ukaronga kunwa mushonga wekuzorora, munhu mukuru ane mutoro anofanira kukuperekedza kumba. Usatyaira motokari, kutasva mota ine mavhiri maviri kana kushandisa michina kwezuva rose.
• Mvumo nenhoroondo: kutaura nezvechirwere chemwoyo kana mapapu, kushaya hope, matambudziko ekurwadziwa nepfungwa, allergies, pamuviri, mavharuvhu emwoyo ekugadzira, michina yakaiswa mudumbu uye kuvhiyiwa kwedumbu kwakamboitwa.

Kana uine chirwere cheshuga uri pakurapwa kuderedza shuga yeropa

Kutsanya uye kugadzirira ura kunogona kukonzera shuga shoma muropa. Mishonga ye insulin ne sulfonylurea inowanzoda kugadziriswa kwakarongwa, uye mishonga inodzivirira SGLT2 inogona kuda kumbomiswa kwechinguva usati watsanya kwenguva refu. Izvi zvinofanirwa kurongwa pachine nguva nechiremba wako, usingambogadziriswi wega.

Kana uine chirwere chemwoyo kana chirwere cheitsvo chisingaperi

Kugadzirira ura kwakakura kunogona kukonzera kuchinja kwemvura uye electrolyte. Udza chiremba nezvekushaya simba kwemoyo, dialysis, CKD yakakura, cirrhosis ine ascites kana chero kudziviswa kwemvura kuitira kuti chirongwa chakakodzera chekugadzirira nekutarisa chigone kusarudzwa.

Kana uri kushandisa mishonga inobvisa ropa rakawanda kana mishonga inorwisa maplatelet

Sarudzo dzinoenzanisa njodzi yekubuda ropa panguva yekubvisa biopsy kana polyp kubva panjodzi yekugwamba kweropa kana mushonga ukamiswa, kunyanya ne coronary stents ichangoburwa, mechanical valves kana atrial fibrillation. Chirongwa chacho ndechemunhu oga uye chinofanira kubva kuna chiremba pamwe chete ne endoscopist.

Kana uine pamuviri kana kuti uchiyamwisa

Endoscopy panguva yekuzvitakura inoitwa chete kana zvichidikanwa, kazhinji kana ropa rakawanda richibuda, uye inorongwa pamwe chete nechikwata chevana vanozvara. Kusarudza nguva yekurara, nzvimbo yauri kugara, nguva yauri kuzvitakura uye kudzivirira nzira dzekurapa dzine chekuita nemwaranzi dzakadai seERCP kana zvichibvira zvese zvinonyatsofungwa.

Children

Kuongororwa kwevana kunoshandisa maskopu madiki, mitemo yekutsanya yakanangana nevana uye kazhinji kacho anesthesia yakajairika kana kuraramisa zvakanyanya neanorapisa vana. Nzira dzekugadzirira ura dzinoenderana nehuremu dzakasiyana nedzevakuru uye dzinofanira kunyorwa nechikwata chevana.

Vakuru vakuru

Kunyaradza kunowanzoitwa kana paine donhwe shoma, uye kushaya simba, njodzi yekushaya mvura mumuviri panguva yekugadzirira ura uye mishonga inoshandiswa pamwe chete inofanira kuongororwa usati waita oparesheni.

Chii chinoitika panguva ye endoscopy

• Pinda: kuzivikanwa, kubvumirana, mamiriro ekutsanya uye mishonga zvinosimbiswa. Cannula inoiswa kuti inyaradze, uye kuongororwa kwekurova kwemoyo, BP uye okisijeni zvinonamirwa.
• Kunzwa kuda kurutsa kana kunyaradza: Pakuvhiyiwa kwegastroscopy, mushonga wekurapa pahuro unogona kushandiswa, kana wakapinzwa kana usina. Colonoscopy inowanzoitwa pasi pemushonga wekuderedza kushushikana. Mamwe maitiro anoda mushonga wekuderedza kushushikana.
• Kupfuura chiyero: Unorara nerutivi rwako rweruboshwe kuti uongorore GI endoscopy. Chinodzivirira muromo chinodzivirira mazino kuti asapindwe negastroscopy. Mhepo kana kabhoni dioxide zvinoshandiswa kuvhura lumen, izvo zvinogona kukonzera kuzvimba kana kuda kurira kana kupfuudza mhepo, izvi zvinotarisirwa.
• Kuongororwa uye kurapwa: Nyanzvi ye endoscopist inoongorora zvakanyatsorongeka, inotora mifananidzo yezvakawanikwa uye inotora biopsy kana zvichidikanwa. Biopsy pachayo hairwadzi, sezvo jira racho risina marwadzo etsinga dzerudzi irworwo.
• Kudzorera: Unozorora munzvimbo yekupora kusvika waziva. Unogona kupihwa mvura kana mushonga wekupfapfaidza pahuro wapera uye kumedza kwakachengeteka.
• nezvinoyerera: Nyanzvi ye endoscopist inowanzo tsanangura zvakaonekwa pazuva iroro uye inopa mushumo wakanyorwa. Zvakabuda mu biopsy zvinotevera zvakasiyana.

Zvinotora nguva yakareba sei kuti maitiro acho aite

• Kuongorora gastroscopy: kazhinji kacho inotora maminetsi mashanu kusvika gumi nemashanu.
• Kuongorora colonoscopy: kazhinji maminetsi angangoita 20-45, kana polyps ikabviswa kana ura hukaoma kufamba.
• ERCP, EUS uye nzira dzakaoma dzekurapa: kazhinji maminetsi makumi mana nemashanu kusvika anopfuura awa.
• Kushanya kuchipatara chose: kazhinji maawa mashoma, zvichibvumira kunyoresa, kuongororwa kwemaitiro ekutanga uye kupora kubva pakunyaradza.
• Kugadzirira ura: inowedzera kanenge zuva rimwe chete rekuzvidzora pakudya uye kushandisa mushonga wekunyaradza dumbu usati waitwa colonoscopy.

Nguva chaiyo yekuronga nguva uye nguva yekupora inosiyana pakati pezvikamu uye zvinoenderana nemusanganiswa wekesi yezuva.

Kunzwisisa mushumo wako

Mushumo we endoscopy unotsanangura zvakaonekwa, kupi, uye zvakaitwa. Zvinhu zvakajairika zvinosanganisira huwandu hwakasvikwa, kunaka kwekuona kana kugadzirira ura, tsananguro yemukati, mapikicha, nzvimbo dze biopsy, uye chero kurapwa kwakaitwa.

• "Kudzidza Kwakajairika": nzvimbo dzakaonekwa dzairatidzika zvakanaka. Izvi zvinonyaradza kune chirwere chemuviri munharaunda iyoyo asi hazvitsananguri zviratidzo zvese, uye hazvifukidze nhengo dziri kunze kwenzvimbo.
• Kuzvimba, kukwesha, gastritis, esophagitis: mashoko anotsanangura. Chitarisiko chemuviri chega hachizivise chikonzero; biopsy, Helicobacter pylori Kuongororwa uye nhoroondo yekiriniki zvinodiwa.
• Chironda: inoda chikonzero kuti chionekwe. Maronda emudumbu anowanzoongororwa uye anowanzo ongororwazve gare gare.
• Mapundu: Ma polyps mazhinji emudumbu haana njodzi. Mushumo wetishu unoratidza rudzi uye kana kutariswa kuchidikanwa.
• Varicose mutsinga: tsinga dzakakura, dzinowanzo konzerwa nechirwere chechiropa; dzinoda kurapwa nachiremba.
• "Chironda chinofungirwa" kana "kukura": chiratidzo chinoonekwa, kwete kuongororwa. Mushumo wehistopathology chete ndiwo unogona kusimbisa kana kuramba kenza.
• Chidzidzo chisina kukwana: kana caecum isina kuwanikwa kana kugadzirira kusina kukwana, bvunzo yekudzokorora kana imwe nzira inogona kukurudzirwa.

Mazita ekuongorora anoshandiswa pakurapa oesophagitis, gastritis kana hemorrhoids anotsanangura uye anoenderana nekutarisa. "Giredhi" hariratidzi kuti chirwere chako chakakomba zvakadii, uye vanachiremba vaviri ve endoscop vanogona kuratidza chitarisiko chakafanana zvishoma. Usaite chimwe chinhu pane mushumo usina kududzirwa nachiremba akaukumbira.

Kana mhedzisiro inogona kutsausa

Zvakawanikwa zvinogona kunge zvichinyepedzera kuva zvinonyaradza (chirwere chisingazivikanwe zvakanyanya)

• Kusagadzirira zvakanaka ura inovanza ma polyps nemaronda madiki panguva ye colonoscopy.
• Kuongorora kusina kukwana: scope haina kuendeswa ku caecum, kana kuti stricture inodzivirira kupfuura.
• Kurapa kunoderedza acid munguva pfupi yapfuura kana kuri kuenderera mberi inogona kurapa shanduko dzepamusoro uye inogonawo kuita kuti H. pylori bvunzo dzakaitwa pa endoscopy dzichinyepedzera kuti hapana chirwere.
• Mishonga inorwisa mabhakitiriya kana bismuth yazvino saizvozvo kuderedza goho re H. pylori bvunzo dzinobva ku biopsy.
• Ropa kana kuti zvasara zvekudya kuvharidzira maonero panguva yekubuda ropa.
• Zvirwere zviri kunze kwenzvimbo: chirwere chidiki chedumbu, pancreatic kana extraluminal hachizongoonekwi.
• Kukanganisa kwekutora sampuli: biopsy inobviswa panzvimbo isina kujairika.

Zvakawanikwa zvingaita sezviri kuipa kupfuura zvazviri (chirwere chinodanwa zvakanyanya)

• Kukuvara kwenzvimbo zvinogona kukonzera mavanga madiki kana kuti kuputika kudiki kwemucosal kunoratidzika sechirwere.
• Chinhu chinobvisa mweya uye kuputira mweya zvinogona kukonzera kutsvuka kana maronda ekunyepedzera.
• Kugadzirira ura pachako zvinogona kukonzera shanduko diki dzemucosal dzakaita sechirwere checolitis.
• "Gastritis isina kunyanya kuoma" inowanzotaurwa nezvayo uye kazhinji haina chekuita zvakanyanya nezviratidzo.
• Mapiritsi esimbi zvinogona kusviba jira remukati uye kutevedzera chirwere.

Njodzi nekuchengetedzeka

Matambudziko akakomba anobva mukuongorora endoscopy haawanzoitiki, asi haasi zero, uye njodzi dzinosiyana zvakanyanya mumhuri yese ye endoscopy. Njodzi inowedzera kana nzira dzekurapa dzikashandiswa, kubuda ropa nekukurumidza, uye muvanhu vane chirwere chemwoyo, mapapu, chiropa kana itsvo.

Kuongororwa kwegastroscopy

Zvinowanzoitika uye zvidiki: pahuro panorwadza, kuzvimba, kuchema kwechinguva. Zvisingawanzoitiki: kubuda ropa mushure mekuongorora, kupindura kumuromo, mwero weokisijeni wakaderera, kusvuta. Zvishoma: kubooka kwepaipi yechikafu kana dumbu.

Colonoscopy uye polypectomy

Zvinowanzoitika: kurwadziwa mudumbu, kuzvimba, ropa diki mushure mekubviswa kwepolyp. Zvinowanzoitika kana zvisingawanzoitiki: kubuda ropa kwakawanda mushure mekubviswa kwepolyp (izvo zvinogona kuitika mazuva mashoma gare gare), kubooka, post-polypectomy burn syndrome, matambudziko ekugadzirira ura akadai sekushaya mvura mumuviri kana kusagadzikana kwe electrolyte.

ERCP

Inotakura huwandu hwakanyanya hwematambudziko ekurapa kweGI endoscopic. Njodzi dzinozivikanwa dzinosanganisira pancreatitis mushure mekuvhiyiwa, kubuda ropa mushure mekuvhiyiwa, hutachiona hwemutsinga dzemudumbu uye kubooka. ERCP inoshandisa X-rays, saka pamuviri unofanira kuziviswa.

Bronchoscopy

Kukosora, kudonha kweokisijeni kwenguva pfupi, kubuda ropa kudiki mushure me biopsy; fivha isingawanzoitiki, kubuda ropa kusingadi kupindira, kana pneumothorax mushure me biopsy yemapapu.

Cystoscopy

Kupisa pakubvisa weti, ropa shoma, hutachiona hweweti; kashoma kuchengetedza weti kana kukuvara kweurethra.

Kunyaradza uye anesthesia

Njodzi dzinosanganisira kuora mwoyo pakufema, BP yakaderera, kusvuta fodya uye kusashanda zvakanaka kwemishonga. Njodzi idzi dzakanyanya mu obstructive sleep apnea, kufuta, chirwere chemwoyo kana mapapu, kushaya simba uye muzviitiko zvekukurumidzira. Kurara kunoongororwa nevashandi vakadzidziswa kunoderedza asi hakubvisi njodzi iyi.

Mhedzisiro yacho inosiyana zvichienderana nemamiriro ezvinhu ekurapa ega ega. Bvunza chiremba we endoscopist kuti akuverengere njodzi yako yekurapa kwacho kwakarongwa.

Mamiriro ezvinhu anokosha

Kuberekwa

Endoscopy inombomiswa kunze kwekunge chiratidzo chacho chakasimba. Gastroscopy yekubuda ropa rakawanda ndicho chikonzero chinowanzoitika. Maitiro ekurapa achishandisa radiation anodziviswa kana kudzivirirwa uye anoderedzwa, uye timu yevana vanozvara inobatanidzwa mukuronga.

Children

Kuongororwa kwe endoscopy yevana kunoitwa nevana vanoongorora gastroenterologists vane rubatsiro rweanesthetics yevana. Zviratidzo zvakasiyana nevakuru uye zvinosanganisira chirwere chinofungidzirwa kuti chiri mudumbu, kuzvimba kwepombi yechikafu chinokonzerwa nechikafu, muviri unofungidzirwa kuti uri kunze kwemuviri uye manyoka asingaperi ane kukura kushoma.

Vakuru vakuru

Mishonga yekunyaradza inowanzo deredzwa, kugadzirira ura kungada kuchinjwa kudzivirira kupera mvura mumuviri, uye kubatsira kwemaitiro ekutarisa kunoyerwa zvichienderana nehutano hwese uye hupenyu hwemunhu.

Chirwere cheshuga chiri pakurapwa kuderedza shuga yeropa

Kutsanya uye kugadzirira ura zvinowedzera njodzi yekuderera kweglucose mumuviri. Mushonga nehurongwa hwekutarisa zvinofanirwa kubvumirana neanopa mushonga usati wasvika zuva rekuvhiyiwa. Takura michina yekutarisa shuga nekurapwa kweshuga shoma kuchipatara.

Chirwere cheitsvo chisingaperi uye kutadza kwemoyo

Sarudzo yekugadzirira, huwandu hwemvura uye kuongororwa kwema electrolyte zvinoda kugadziriswa. Taura nguva yekuongorora dialysis kuitira kuti nguva ienderane.

Chirwere chechiropa uye cirrhosis

Endoscopy inoshandiswa kutsvaga nekurapa varices dzemudumbu. Kusawirirana kwekuvhara ropa, maplatelet mashoma uye kunzwa kwekunyaradza muzvirwere zvechiropa zvakanyanya zvinoda kurongwa kwakananga.

Zvishandiso zvakaiswa mumachira nemavharuvhu ekugadzira

Vagadziri vepacemakers nema defibrillators anoiswa mumuviri anokanganisa kushandiswa kwemidziyo yekuvhiya nemagetsi panguva yekubvisa polyp, saka taurai nezvazvo. Kuvhara mishonga inorwisa mabhakitiriya usati watanga endoscopy hakusi chinhu chinoitwa nevarwere vazhinji; sarudzo yacho ndeyemunhu mumwe nemumwe.

Endoscopy muIndia

• Zviratidzo zvinowanzoonekwa zvinoratidza maitiro ezvirwere zvemunzvimbo iyoyo. chirwere cheacid peptic uye Helicobacter pylori- gastritis inokonzerwa nechirwere ichi ndizvo zvinowanzokonzera gastroscopy. TB yemudumbu ndiyo mutsauko mukuru wezvironda zvemaronda emudumbu uye inogona kutevedzera chirwere cheCrohn, uye kuongorora matumbu ne colonoscopy kunowanzova chinhu chikuru pakusiyanisa chirwere ichi.
• Chirwere chechiropa chisingaperi ndicho chinonyanya kukonzera endoscopy yekuongorora variceal uye kubatanidzwa kwesimbi, kusanganisira chirwere chechiropa chesteatotic chinokonzerwa nedoro uye metabolic dysfunction (MASLD, izwi rakatsiva NAFLD; MASH yakatsiva NASH, neMetALD ichitsanangura mipiro yemetabolic uye ine chekuita nedoro pamwe chete).
• Kukuvara kwechiropa neura kunokonzerwa nemishonga kubva mukurapa kwechirwere cheTB, mishonga yekurwadziwa kwemwoyo isiri steroidal inotengwa pasina kunyorerwa mushonga, uye mimwe mishonga yeAYUSH, mishonga yemishonga yemishonga yemishonga yemishonga yemishonga yekurovedza muviri inyaya inozivikanwa; taura zvese zvaunotora, kusanganisira mishonga isiri yakanyorerwa nachiremba.
• Kumedza zvinoparadza uye kubviswa kwemuviri wekunze zviratidzo zve endoscopy zvinoramba zvichiitika nguva nenguva, kunyanya kuvana.
• Kushandiswa kwemashoko echivanhu kunokosha. Varwere netsamba dzekuti vabatwe vanogona kuti "scopy", "camera test", "upper GI scopy" kana kuti "pet ki jaanch", zvese zvinowanzo taura nezvemaitiro anotsanangurwa pano, asi zvinosimbisa kuti ndeipi nhengo iri kuongororwa.
• Dziviriro yedata. Mifananidzo, mavhidhiyo nemishumo yeEndoscopy idata rehutano hwemunhu; kubata mvumo uye zvinyorwa zvedhijitari kunotongwa neMutemo weDhijitari weDziviriro yeData reMunhu, 2023, pamwe chete nemabasa ekuchengetedza zvakavanzika pasi pemitemo yeNational Medical Commission.
• Mitemo yekushambadza. Zvinotaurwa zvekuti chero nzira ipi zvayo inorapa chirwere zvinorambidzwa pasi peDrugs and Magic Remedies (Objectionable Advertisements) Act, 1954; hazvina chokwadi kuti zvirongwa zvinovimbisa mhedzisiro.

Mutengo neinishuwarenzi muIndia

Mitengo inosiyana zvikuru pakati pemaguta, pakati pezvipatara zvehurumende nezvevanhu, uye pakati penzira dzekuongorora nedzekurapa. Mitengo inotorwa chero kupi inofanira kutorwa seyekuratidza chete uye kusimbiswa nechipatara nekunyora usati watanga kurapwa.

Zvinhu zvinochinja mutengo:

• Rudzi rwemaitiro: Kuongororwa kwegastroscopy yekuongorora chirwere ndicho chinodhura zvishoma pane zvose; colonoscopy, EUS uye ERCP zvinodhura zvishoma nezvishoma.
• Kurara kana anesthesia: mushonga wekupfapfaidza pahuro chete, mushonga wekunyaradza murwere achiziva, kana mushonga weanesthesia uchishandisa anesthesia, chimwe nechimwe chinowedzera huwandu hwakasiyana.
• Zvimwe zvekuwedzera pakurapa: mishonga yekubvisa mavanga, ma "polypectomy strangers", ma "banding kits", ma "stents", ma "dilators", ma "injection agents" uye michina yekubvisa mavanga zvinobhadhariswa sezvinhu zvinodyiwa.
• Histopathology: Kugadziriswa kwe biopsy kunobhadhariswa pachikamu chimwe nechimwe chemuenzaniso, pamwe chete nechero mavara akakosha, immunohistochemistry kana kuongororwa kwetiibhii.
• Kuchengetwa kwevana masikati kana kuti kuchipatara: nzvimbo yekupora, chikamu chemakamuri uye chero kugara kwehusiku.
• Rudzi rwenzvimbo uye guta: danho reguta, chinzvimbo chekubvumidzwa uye kana chikamu chacho chiri chehurumende, chetrust kana chekambani.
• Maitiro ekukurumidzira ekunze kwekunge nguva yapera kazhinji inodhura kupfuura runyorwa rwakarongwa.

Zvinhu zveinishuwarenzi zvekutarisa: mapolisi mazhinji emari yekudzivirira anovhara endoscopy kana iri chikamu chemushonga unovharirwa wekupinda kana wekuchengeta vana masikati, asi endoscopy yekuongororwa kwevarwere vekunze inogona kusabatanidzwa. Tarisa kuti kuvharwa kwenzira yekutarisira vana masikati, mamiriro enetwork isina mari, zvinodiwa kuti munhu abvumidzwe, nguva yekumirira chirwere chiripo, uye kana zvinhu zvinoshandiswa uye histopathology zvichibhadharwa. Zvirongwa zvehurumende zvakaita seAyushman Bharat PM-JAY zvinovhara mapakeji akatarwa muzvipatara zvakagadziriswa, kukodzera uye kuiswa kwemapakeji kunofanirwa kusimbiswa nedhipatimendi reinishuwarenzi rechipatara.

Ngano nezvokwadi

Mibvunzo inowanzobvunzwa

Ndichamuka here panguva ye endoscopy?

Izvi zvinoenderana nemaitiro acho uye chikamu chaanoita. Gastroscopy inowanzoitwa nekushandisa mushonga wekupfapfaidza pahuro chete kana nekuderedza kushushikana, saka unogona kunge uine hope asi uchikwanisa kumutswa. Colonoscopy inowanzoitwa pasi pekurapwa. Mamwe maitiro, uye akawanda e endoscopy evana, anoda anesthesia. Taurai zvamunoda uye hutano hwemuviri wenyu pachine nguva.

Endoscopy inogona kundizivisa pakarepo kana ndine kenza here?

Endoscopy inogona kuratidza ronda rinoratidzika serinofungirwa, uye chiremba we endoscopist anogona kutaura izvozvo pazuva iroro. Kusimbiswa kunoda histopathology ye biopsy, iyo inoshumwa yoga. Kuyera, kuti yakadzika sei uye kuti yakapararira sei, kunowanzoda mimwe miedzo yakaita se endoscopic ultrasound, CT kana PET-CT.

Ndinoda colonoscopy here kana gastroscopy yangu yaive yakajairika?

Hazviitiki zvoga. Gastroscopy necolonoscopy zvinopindura mibvunzo yakasiyana nezvezvikamu zvakasiyana zvemudumbu. Colonoscopy inoongororwa kana zviratidzo, kubuda ropa, kushayiwa ropa, nhoroondo yemhuri kana zvinodiwa pakuongororwa zvichiratidza kuti ura huri mudumbu. Sarudzo ndeyachiremba ari kukuongorora.

Ndingadya nguvai ndodzokera kubasa?

Mushure mekuongororwa zviri nyore nekushandisa mushonga wekunyaradza, vanhu vazhinji vanodya kana vanyatsomuka uye vamedza zvakachengeteka, vozotangazve kuita mabasa avo ezuva rinotevera. Dzivisa kutyaira, kushandisa michina uye kusarudza zvinhu zvakakosha kwezuva rose. Maitiro ekurapa anogona kuva nemiganhu yakareba yekudya uye yekushanda.

Endoscopy yakachengeteka here kana ndine chirwere chemwoyo kana mapapu?

Endoscopy inowanzo goneka, asi njodzi yekunyaradza yakanyanya uye inoda kurongwa. Udza timu nezve angina, kurwara kwemoyo munguva pfupi yapfuura, kutadza kushanda kwemoyo, kusagadzikana kwemoyo, stents, COPD, asthma, kushandiswa kweokisijeni kana kushaya mweya pakurara. Kuongororwa, sarudzo yekunyaradza uye dzimwe nguva kubatanidzwa kweanorexia kunogadziriswa zvinoenderana.

Sei ndichifanira kutora gadziriro yakakura kudaro ye colonoscopy?

Mapolyps nekenza dzekutanga zvidiki uye zviri nyore kuvanza mushure metsvina. Kurapwa kwakachena kunoita kuti zvionekwe zviri nani uye kunoderedza mukana wekuti kuvhiyiwa kudzokororwe. Kana uine chirwere cheitsvo, mwoyo wako upere, mvura shoma kana chirwere cheshuga, kumbira chiremba kuti akupe mushonga unoenderana nechirwere chako.

Ko kana zviratidzo zvangu zvikaramba zvichienderera mberi mushure mekuongororwa kwe endoscopy kwakajairika?

Dzokera kuna chiremba akakumbira kuvhiyiwa. Zviratidzo zvinoramba zvichiitika zvinogona kuratidza chirwere chisingaonekwe ne endoscopy, senge kufamba kana kusagadzikana kwebasa, gallbladder kana pancrea