I-Endoscopy: Lokho Ekubonisayo, Lokho Engenakukwenza, Nokuthi Ingakulungiselela Kanjani

Ukuthatha okhiye

• I-Endoscopy ukuhlolwa kokubona ngqo: kubonisa ulwelwesi lwangaphakathi lwesitho, hhayi lokho okuphansi noma ngemuva kwaso.
• I-Endoscopy iyindlela yokuxilonga kanye neyokwelapha: ukuhlolwa kwe-biopsy, ukususwa kwe-polyp, ukulawulwa kokopha kanye nokubekwa kwe-stent konke kungenzeka ngesikhathi esifanayo.
• "I-Endoscopy" umndeni wezinqubo, akukho ukuhlolwa okukodwa; i-gastroscopy, i-colonoscopy, i-bronchoscopy, i-cystoscopy kanye ne-ERCP ziphethe amalungiselelo ahlukene kanye namaphrofayili ahlukene engozi.
• I-endoscopy evamile ayikhiphi zonke izifo ngaphandle: isifo se-pancreatic, samathumbu amancane kanye nodonga olujulile singaphuthelwa futhi singadinga izifundo ze-CT, MRI noma ze-capsule.
• Ukulungiselela kusethwa yiyunithi yokwenza: izikhathi zokuzila ukudla, ukulungiswa kwamathumbu kanye nokulungiswa kwemithi kuyahluka phakathi kwezibhedlela kanye naphakathi kwezinqubo.

Nge-shazi

Obeye aziwe njengo

• Ukuhlolwa kwe-Endoscopy, i-scopyukusetshenziswa okuvamile ezibhedlela zaseNdiya
• I-endoscopy ye-GI ephezulu / i-OGD / i-EGD / i-gastroscopyukuhlolwa komlomo wepayipi lokudla, isisu kanye ne-duodenum
• I-Colonoscopy, kwesinye isikhathi kubizwa i-GI scopy ephansi
• Ukuhlolwa kwe-Dooerbeen / ikhamera, ikhamera ye-pet ki jaanch: izincazelo ezingakahleleki iziguli ezivame ukuzisebenzisa
• I-Sigmoidoscopy: ukuhlolwa okulinganiselwe kwekholoni elingakwesokunxele kanye ne-rectum

Iyini i-endoscopy

I-endoscope iyipayipi eliqukethe umthombo wokukhanya, i-chip yekhamera noma i-fibre-optic bundle, iziteshi zomoya, amanzi kanye nokumunca, kanye nomzila osebenzayo lapho amathuluzi angadluliswa khona. Ikhamera ithumela izithombe ezibukhoma esikrinini, ukuze udokotela abone ubuso be-mucosal bukhulisiwe futhi bukhanyisiwe.

Ngenxa yokuthi amathuluzi angadlula emgudwini osebenzayo, i-endoscopy ivame ukwelapha kanye nokuxilonga. Ngesikhathi esifanayo udokotela angase athathe ama-biopsy ancishisiwe, asuse i-polyp, anqume isilonda esophayo, asuse i-band oesophageal varices, andise ukuncishiswa, abeke i-stent noma athole into egwinyiwe.

I-Endoscopy akuyona ukuhlolwa okukodwa. Ububanzi, indlela, ukulungiswa, ukudambisa kanye nezingozi konke kuyashintsha lapho isitho sifundwa. I-gastoscopy kanye ne-ERCP kwenziwa ngemishini efana kodwa kuhluke kakhulu ngobunzima kanye nesivinini sobunzima.

Kungani kwenziwa i-endoscopy

• Izimpawu ze-GI ephezulu: isilungulela esingapheli noma ukungagayi kahle ukudla okungaphenduli ekwelashweni, ubunzima noma ubuhlungu lapho ugwinya, ukuhlanza okuphindaphindiwe, isifo sesilonda okusolwa ukuthi sikhona, i-anemia engachazeki yokuntuleka kwensimbi.
• Ukopha kwe-GI: ukuhlanza igazi, indle emnyama, noma ukopha nge-rectum ngayinye, kokubili ukuthola umthombo nokuyelapha.
• Izimpawu ze-GI ephansi: ushintsho endleleni yokujwayela amathumbu, isifo sohudo esingapheli, igazi esitofini, isifo samathumbu okusolwa ukuthi sivuvukele, izithombe ezingavamile zekholoni.
• Ukutholwa nokubhekwa komdlavuza: ukuhlolwa kwezilonda ezisolisayo, ukususwa kwama-polyp emathunjini, ukulandelwa kwe-Barrett's uesophagus, isifo se-coeliac noma ama-polyp angaphambilini.
• Isifo se-biliary kanye ne-pancreatic: I-ERCP yamatshe emipayipi ye-bile, imipayipi evalekile kanye ne-jaundice edinga ukuphuma kwamanzi.
• Izinkinga zomoya kanye nomchamo: i-bronchoscopy yokukhwehlela okuqhubekayo enesithombe esingavamile sesifuba noma igazi elikhwehlelayo; i-cystoscopy yokubona igazi elibonakalayo emchameni noma ezimpawini zesinye.

Ubani okufanele acabangele i-endoscopy

I-Endoscopy iceliwe udokotela ngemuva kokuhlolwa komtholampilo, akuyona ukuhlolwa kokuhlolwa kwangaphambi kwesikhathi kwabo bonke abanesisu esibuhlungu. Ukudluliselwa kwesinye isiguli kuvame ukucatshangelwa:

• Abantu abadala abanenkinga yokugwinya, ukudla okunamathelayo, noma ukugwinya okubuhlungu kunoma yimuphi ubudala.
• Abantu abadala abanokwehla kwesisindo okungahlosiwe, ukuhlanza okuqhubekayo, noma isisu esibuhlungu kanye nokuphazamiseka kokugaya ukudla.
• Abantu abadala abane-anemia yokuntuleka kwe-iron ngaphandle kwesizathu esisobala.
• Abantu abadala abane-dyspepsia eqhubekayo naphezu kokuhlolwa okwanele kokwelashwa, noma eqala eminyakeni yabo yokugcina yokuphila.
• Noma ubani onesifo sokuphuma kwegazi esibonakalayo noma okusolwa ukuthi une-GI bleeding.
• Abantu abanesifo sokopha endulwini, ushintsho oluqhubekayo endleleni yokuzijwayeza amathumbu, noma umlando womndeni onamandla womdlavuza we-colorectal noma ama-polyps, i-colonoscopy kune-gastroscopy.
• Abantu abanesifo se-celiac esaziwayo, i-Barrett's esophagus, i-cirrhosis ene-varices, noma ama-polyps angaphambilini, ngesikhathi sokuqapha esibekwe udokotela wabo we-gastroenterologist.

Ukuthi i-endoscopy iyisinyathelo esilandelayo esifanele, nokuthi iyiphi i-endoscopy, kuncike enkingeni ethile. Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye.

Lokho i-endoscopy engenakukwazi ukukubona noma ukukukhipha

I-Endoscopy iwukuhlola okungaphezulu. Izindawo zayo ezingaboni zibalulekile:

• Ayiboni ngaphandle kodonga. Ukujula kwesimila, ama-lymph node kanye nokusabalala kwaleso sitho akuhlolwa nge-endoscopy ejwayelekile; edinga i-endoscopic ultrasound (EUS), i-CT noma i-MRI.
• I-Gastroscopy ayihloli ama-pancreas, i-gallbladder, i-liver parenchyma noma i-aorta. Ukuhlolwa kwe-gastroscopy okuvamile akukuvimbeli isifo se-gallstone, i-pancreatitis noma umdlavuza we-pancreatic.
• Ingxenye enkulu yamathumbu amancane ayifinyeleleki. I-gastoscopy ejwayelekile ifinyelela e-duodenum; i-colonoscopy ifinyelela engxenyeni yokugcina ye-ileum. Isifo esiphakathi singadinga i-capsule endoscopy, i-enteroscopy noma i-MR enterography.
• I-Colonoscopy ayiphelele. Izilonda ezisicaba, ama-polyp amancane kanye nezilonda ezingemuva kokugoba zingaphuthelwa, ikakhulukazi uma ukulungiswa kwamathumbu kungalungile noma i-caecum ingafinyelelwanga.
• I-Gastroscopy ayihloli ubuhlungu benhliziyo esifubeni. Ubuhlungu besifuba obungaba yinhliziyo budinga ukuhlolwa kwenhliziyo, hhayi ukuqinisekiswa ngokuhlolwa okuvamile.
• Ukuphazamiseka kokusebenza akubonisi lutho. I-irritable bowel syndrome, i-functional dyspepsia kanye nezinkinga eziningi zokunyakaza ziveza ulwelwesi olubukeka lujwayelekile. Umbiko ojwayelekile awusho ukuthi izimpawu ziwukucatshangelwa.
• Ukuthatha amasampula e-biopsy kuyakhethwa. I-biopsy engalungile isho ukuthi izicubu ezithathwe azizange zibonise ukukhubazeka; ayibonisi ukuthi sonke isitho sijwayelekile.

Ukutholakele "okungatholakali" ku-endoscopy akukakhishwa ngaphandle. Uma izimpawu ziqhubeka noma ziba zimbi naphezu kombiko ojwayelekile, buyela kudokotela wakho kunokuba ucabange ukuthi akukho okunye okungaba yiphutha.

Ukuhlolwa okuhlobene kodwa okuhlukile

Ayikho inqubo eyodwa engcono kakhulu kuyo yonke indawo. Lezi zivivinyo ziphendula imibuzo ehlukene, futhi ukuhlolwa kokuqala okufanele kuncike ngokuphelele enkingeni ekhona, ukopha, i-jaundice, ukukhwehlela kanye ne-dysphagia ngayinye iholela endaweni ehlukile yokuqala.

Ungalungiselela kanjani

Ukulungiselela kuyasebenza futhi kuyahlukahluka phakathi kwezibhedlela, phakathi kodokotela be-endoscopist kanye naphakathi kwezinqubo. Ishidi lemiyalelo elibhaliwe elivela eyunithini eyenza inqubo yakho liza kuqala kunanoma yisiphi iseluleko esijwayelekile, kufaka phakathi leli khasi. Amaphethini ajwayelekile:

• Ukuzila ukudla: Ukudla okuqinile kuvame ukuyekiswa amahora ambalwa ngaphambi kokuthobisa, futhi uketshezi olucacile luyayekiswa eduze kwenqubo. Izikhathi eziqondile zibekwa yiyunithi kanye nodokotela wezinzwa.
• Ukulungiswa kwamathumbu: okudingekayo ku-colonoscopy kanye ne-sigmoidoscopy. Lokhu kuhilela isisombululo sokuhlanza isisu, ngezinye izikhathi esihlukaniswe ngemithamo emibili, kanye nomkhawulo wokudla usuku noma ngaphezulu ngaphambi kwalokho.
• Imithi: Tshela ithimba ngayo yonke imithi kanye nezithasiselo, ikakhulukazi imithi yokunciphisa igazi, imithi yokunciphisa ama-platelet, i-insulin kanye neminye imithi yesifo sikashukela, amaphilisi ensimbi kanye nemithi yokucindezela i-asidi. Ungaqali, uyeke noma ushintshe noma yimuphi umuthi owunikezwe ngudokotela wedwa, buza udokotela noma ithimba le-endoscopy.
• Ukuphelezela kanye nezokuthutha: Uma kuhlelwe ukudambisa ubuhlungu, umuntu omdala onokwethenjelwa kufanele akuphelezele uye ekhaya. Ungashayeli, ugibele imoto enamasondo amabili noma usebenzise imishini lonke lolo suku.
• Imvume nomlando: ukusho ukuthi unesifo senhliziyo noma samaphaphu, i-sleep apnea, izinkinga zokubulala izinzwa zangaphambilini, ukungezwani komzimba, ukukhulelwa, ama-valve enhliziyo okwenziwa, amadivayisi afakwe kanye nokuhlinzwa kwesisu kwangaphambilini.

Uma unesifo sikashukela ekwelashweni kokwehlisa i-glucose

Ukuzila ukudla nokulungiselela amathumbu kungabangela ushukela wegazi ophansi. Imithamo ye-insulin ne-sulfonylurea ivame ukudinga ukulungiswa okuhleliwe, kanti ama-inhibitor e-SGLT2 angadinga ukuphazamiseka kwesikhashana ngaphambi kokuzila ukudla isikhathi eside. Lokhu kumele kuhlelwe kusengaphambili nodokotela wakho, ungalokothi ulungiswe nguwe.

Uma unesifo senhliziyo noma isifo sezinso esingamahlalakhona esiqhubekela phambili

Ukulungiswa kwamathumbu amakhulu kungabangela ukushintshashintsha koketshezi kanye ne-electrolyte. Tshela iyunithi ngokuhluleka kwenhliziyo, i-dialysis, i-CKD ethuthukile, i-cirrhosis ene-ascites noma noma yikuphi ukuvinjelwa koketshezi ukuze kukhethwe uhlelo lokulungiselela nokuqapha olufanele.

Uma usebenzisa imithi yokunciphisa igazi noma imithi yokunciphisa ama-platelet

Izinqumo zilinganisela ingozi yokopha ngesikhathi sokususwa kwe-biopsy noma i-polyp ngokumelene nengozi yokujiya kwegazi uma umuthi umiswe okwesikhashana, ikakhulukazi nge-coronary stents yakamuva, ama-valve omshini noma i-atrial fibrillation. Uhlelo luhlukile futhi kumele luvele kudokotela kanye nodokotela we-endoscopist.

Uma ukhulelwe noma uncelisa

I-Endoscopy ekukhulelweni yenziwa kuphela uma kudingeka ngokucacile, ngokuvamile ngenxa yokopha okukhulu, futhi ihlelwe ngokubambisana nethimba lokubeletha. Ukukhetha i-sedative, indawo, isikhathi sokukhulelwa kanye nokugwema izinqubo ezisekelwe emisebeni njenge-ERCP lapho kungenzeka konke kucatshangelwa ngqo.

Izingane

I-endoscopy yezingane isebenzisa ama-scope amancane, imithetho yokuzila ukudla eqondene nezingane futhi ngokuvamile i-anesthesia ejwayelekile noma i-deep sedation enodokotela wezingane obulala izinzwa. Izindlela zokulungisa amathumbu ezisekelwe esisindweni zihlukile kwezabantu abadala futhi kumele zinqunywe yithimba lezingane.

Abantu abadala abadala

I-sedative ivame ukunikezwa ngemithamo ephansi, kanti ubuthakathaka, ingozi yokuphelelwa amanzi emzimbeni ngesikhathi sokulungiselela amathumbu kanye nemithi esetshenziswayo idinga ukubuyekezwa ngaphambi kwenqubo.

Kwenzekani ngesikhathi se-endoscopy

• Ngena: ubunikazi, imvume, isimo sokuzila ukudla kanye nemithi kuyaqinisekiswa. Kufakwa i-cannula ukuze kuthokoziswe, futhi kubhekwa ukushaya kwenhliziyo, umfutho wegazi kanye nomoya-mpilo.
• Ukuqeda izinhlungu noma ukudambisa ubuhlungu: Ukuze kwenziwe i-gastoscopy, kungasetshenziswa i-anaesthetic throat spray yendawo, noma ngabe kufakwe i-intravenous noma cha. I-Colonoscopy ivame ukwenziwa ngaphansi kwe-sedation. Ezinye izinqubo zidinga i-anesthesia ejwayelekile.
• Ukudlula ububanzi: ulala ngohlangothi lwakho lwesobunxele ukuze uthole i-GI endoscopy. I-mouthguard ivikela amazinyo ukuze athole i-gastoscopy. Umoya noma i-carbon dioxide isetshenziselwa ukuvula i-lumen, okungabangela ukuqunjelwa noma isifiso sokubhodla noma ukudlulisa umoya, lokhu kulindeleke.
• Ukuhlolwa kanye nokwelashwa: Udokotela we-endoscopist uhlola ngokuhlelekile, athathe izithombe zemiphumela bese ethatha ama-biopsy uma kudingeka. I-Biopsy ngokwayo ayibuhlungu, njengoba ulwelwesi lungenazo iziphetho zemizwa zalolo hlobo.
• Ukubuyisela: Uphumula endaweni yokululama kuze kube yilapho uqaphile. Unganikezwa uketshezi uma i-spray yomphimbo isiphelile futhi ukugwinya sekuphephile.
• Ukuchithwa: Udokotela we-endoscopist uvame ukuchaza okutholakele okubonakalayo ngalolo suku futhi anikeze umbiko obhaliwe. Imiphumela ye-biopsy ilandela ngokwehlukana.

Inqubo ithatha isikhathi esingakanani

• I-gastroscopy yokuxilonga: ngokuvamile kuthatha imizuzu emi-5-15 yokuhlolwa.
• I-colonoscopy yokuxilonga: ngokuvamile kuthatha cishe imizuzu engama-20-45, isikhathi eside uma ama-polyp esusiwe noma ikholoni kunzima ukuyihambisa.
• I-ERCP, i-EUS kanye nezinqubo zokwelapha eziyinkimbinkimbi: ngokuvamile kusukela kumaminithi angu-45 kuya ngaphezu kwehora.
• Ukuvakashela esibhedlela sonke: ngokuvamile amahora ambalwa, okuvumela ukubhaliswa, ukuhlolwa kwangaphambi kwenqubo kanye nokululama ekuthokozisweni.
• Ukulungiswa kwamathumbu: kunezela cishe usuku lokunciphisa ukudla kanye nokusetshenziswa kwe-laxative ngaphambi kokuhlolwa kwe-colonoscopy.

Izikhathi zokuhlela zangempela kanye nezikhathi zokubuyisela ziyahlukahluka phakathi kwamayunithi futhi zincike ekuxubeni kwecala losuku.

Ukuqonda umbiko wakho

Umbiko we-endoscopy uchaza lokho okubonwe, ukuthi kuphi, nokuthi kwenziwani. Izinto ezivamile zifaka phakathi izinga elifinyelelwe, ikhwalithi yokubuka noma yokulungiselela amathumbu, izincazelo zolwelwesi, izithombe, izindawo zokuhlola, kanye nanoma yiluphi ukwelashwa okwenziwe.

• "Isifundo Esivamile": izindawo ezibonwe zazibukeka zijwayelekile. Lokhu kuyaduduza ngesifo sesakhiwo kuleyo ndawo kodwa akuchazi zonke izimpawu, futhi akumbozi izitho zomzimba ngaphandle kokufinyelela kobubanzi.
• Ukuvuvukala, ukuguguleka, i-gastritis, i-oesophagitis: amagama achazayo. Ukubukeka okubonakalayo kukodwa akubonisi imbangela; ukuhlolwa kwe-biopsy, Helicobacter pylori Kudingeka ukuhlolwa kanye nomlando wezokwelapha.
• Isilonda: kudinga imbangela ukuze kutholakale imbangela. Izilonda zesisu zivame ukuhlolwa nge-biopsy futhi zivame ukuhlolwa kabusha kamuva.
• I-Polyp: Ama-polyp amaningi amathumbu amakhulu awabi nabungozi. Umbiko wezicubu unquma uhlobo nokuthi kudingeka yini ukubhekwa.
• Imithambo ye-Varicose: imithambo emikhulu, evame ukuhlotshaniswa nesifo sesibindi; kudinga ukuphathwa ngochwepheshe.
• "Isilonda esisolisayo" noma "ukukhula": umbono obonakalayo, hhayi ukuxilongwa. Umbiko we-histopathology kuphela ongaqinisekisa noma uphikise umdlavuza.
• Ucwaningo olungaphelele: uma i-caecum ingatholakalanga noma ukulungiswa kunganele, kungase kucebiseke ukuthi kwenziwe ukuhlolwa okuphindaphindiwe noma okunye.

Amagama okulinganisa asetshenziswa ku-oesophagitis, i-gastritis noma ama-hemorrhoids ayachaza futhi ngokwengxenye ancike ekubukeni. "Ibanga" alibonisi ukuthi isimo sakho sibucayi kangakanani, futhi odokotela ababili be-endoscopist bangase balinganise ukubukeka okufanayo ngendlela ehlukile kancane. Ungathathi isinyathelo embikweni ngaphandle kokuba uhunyushwe ngudokotela owucelile.

Uma imiphumela ingadukisa

Okutholakele okungase kube okuqinisekisayo ngamanga (isifo esingabizwa ngokuthi sibi kakhulu)

• Ukulungiswa kwamathumbu kabi ifihla ama-polyp kanye nezilonda ezincane ngesikhathi se-colonoscopy.
• Ukuhlolwa okungaphelele: i-scope ayithuthukisiwe iye ku-caecum, noma i-stricture evimbela ukudlula.
• Ukwelashwa kwakamuva noma okuqhubekayo kokucindezela i-asidi ingaphulukisa izinguquko ebusweni futhi ingenza futhi H. pylori Ukuhlolwa okwenziwe ku-endoscopy kutholakale ukuthi akunamiphumela emihle.
• Ama-antibiotic akamuva noma i-bismuth ngokufanayo kunciphisa isivuno H. pylori izivivinyo ezisekelwe ku-biopsy.
• Igazi noma insalela yokudla ukufihla umbono ngesikhathi sokuphuma kwegazi.
• Izifo ezingaphandle kokufinyelela: isifo samathumbu amancane, i-pancreatic noma isifo esingaphandle kolwelwesi ngeke sivele.
• Iphutha lokuhlola: ukuhlolwa kwe-biopsy okuthathwe endaweni engavamile.

Okutholakele okungase kubukeke kubi kakhulu kunalokho okuyikho (isifo esibizwa ngokweqile)

• Ukulimala kobubanzi kungabangela imihuzuko emincane eqondile noma ukudabuka okuncane kwe-mucosal okufana nesifo.
• I-Artifact yokumunca kanye nokufakwa komoya kungadala ubomvu noma izilonda mbumbulu.
• Ukulungiswa kwamathumbu ngokwako kungabangela izinguquko ezincane ze-mucosal ezifana ne-colitis.
• "I-gastritis emnene" engacacile kubikwa kakhulu futhi ngokuvamile akunamthelela omkhulu ezimpawini.
• Amaphilisi ensimbi kungenza ulwelwesi lube mnyama futhi kufane nesifo.

Izingozi nokuphepha

Izinkinga ezinkulu ezivela ku-endoscopy yokuxilonga azivamile, kodwa azikho zero, futhi ingozi ihluka kakhulu emndenini we-endoscopy. Ingozi iyanda ngezinqubo zokwelapha, amacala okopha okuphuthumayo, kanye nakubantu abanesifo esibucayi senhliziyo, samaphaphu, sesibindi noma sezinso.

I-gastroscopy yokuxilonga

Okuvamile nokuncane: umphimbo obuhlungu, ukuqunjelwa, ukuhosha kwesikhashana. Okuvamile: ukopha ngemva kokuhlolwa kwegazi, ukusabela ekuthokozisweni, amazinga aphansi omoya-mpilo, ukufuthwa. Okuvamile: ukubhoboka kombhobho wokudla noma isisu.

I-Colonoscopy ne-polypectomy

Okuvamile: ukuqaqamba, ukuqunjelwa, igazi elincane ngemva kokususwa kwe-biopsy noma i-polyp. Okungavamile kuya kokungavamile: ukopha okukhulu ngemva kokususwa kwe-polyp (okungenzeka ezinsukwini kamuva), ukubhoboka, isifo sokusha ngemva kwe-polypectomy, izinkinga zokulungiselela amathumbu njengokuphelelwa amanzi emzimbeni noma ukuphazamiseka kwe-electrolyte.

I-ERCP

Inezinga eliphezulu kakhulu lezinkinga zezinqubo ze-GI endoscopic ezijwayelekile. Izingozi eziqashelwayo zifaka phakathi i-pancreatitis ngemuva kwenqubo, ukopha ngemva kwe-sphincterotomy, ukutheleleka kwemisele ye-bile kanye nokubhoboka. I-ERCP isebenzisa ama-X-ray, ngakho-ke ukukhulelwa kumele kumenyezelwe.

I-bronchoscopy

Ukukhwehlela, ukwehla komoya-mpilo okwesikhashana, ukopha okuncane ngemva kokuhlolwa kwegazi; umkhuhlane ongavamile, ukopha okudinga ukungenelela, noma i-pneumothorax ngemva kokuhlolwa kwamaphaphu.

I-cystoscopy

Ukusha lapho umchamo uphuma, igazi elincane, ukutheleleka ngomchamo; ukugcinwa komchamo okungajwayelekile noma ukulimala komchamo.

Ukupholisa kanye nokubulala izinzwa

Izingozi zifaka phakathi ukucindezeleka kokuphefumula, umfutho wegazi ophansi, ukufutha kanye nokusabela kwezidakamizwa. Lezi zingozi ziphezulu ekuphazamisekeni kokuphefumula kokulala, ukukhuluphala, isifo senhliziyo noma samaphaphu esibucayi, ubuthakathaka kanye nezinqubo eziphuthumayo. Ukwelapha okuqashwe ngabasebenzi abaqeqeshwe kunciphisa kodwa akususi le ngozi.

Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye. Cela udokotela wakho we-endoscopist ukuthi akunike ubungozi bakho ngenqubo ethile ehleliwe.

Izimo ezikhethekile

ukukhulelwa

I-Endoscopy iyahlehliswa ngaphandle kokuthi inkomba inamandla. I-Gastroscopy yokopha okukhulu yisona sizathu esivame kakhulu. Izinqubo ezisekelwe emisebeni ziyagwenywa noma ziyavikelwa futhi zincishiswe, futhi ithimba lokubeletha liyabandakanyeka ekuhleleni.

Izingane

I-endoscopy yezingane yenziwa ngodokotela bezifo zesisu bezingane abasebenzisa i-anesthetic support yezingane. Izinkomba zihlukile kwezabantu abadala futhi zifaka phakathi isifo se-celiac okusolwayo, ukuvuvukala kombhobho wokudla okuhlobene nokudla, umzimba osolwayo wangaphandle kanye nesifo sohudo esingamahlalakhona esinokukhula okunciphayo.

Abantu abadala abadala

Imithamo yokudambisa imvamisa iyancishiswa, ukulungiswa kwamathumbu kungadinga ukuguqulwa ukuze kugwenywe ukuphelelwa amanzi emzimbeni, futhi inzuzo yezinqubo zokuqapha ilinganiswa nempilo iyonke kanye nobude bokuphila.

Isifo sikashukela ekwelashweni kokwehlisa ushukela

Ukuzila ukudla nokulungiselela amathumbu kukhulisa ingozi ye-hypoglycemia. Kufanele kuvunyelwane ngomuthi kanye nohlelo lokuqapha ngaphambi kosuku lwenqubo. Phatha imishini yokuqapha ushukela kanye nokwelashwa koshukela ophansi esibhedlela.

Isifo sezinso esingamahlalakhona kanye nokwehluleka kwenhliziyo

Ukukhetha ukulungiselela, umthamo woketshezi kanye nokuqapha ama-electrolyte kudinga ukulungiswa. Memezela amashejuli e-dialysis ukuze isikhathi sihambisane.

Isifo sesibindi kanye ne-cirrhosis

I-Endoscopy isetshenziselwa ukubheka nokwelapha imithambo yegazi emithanjeni. Ukukhubazeka kokujiya, ama-platelet aphansi kanye nokuzwela kokudambisa isifo sesibindi esithuthukile konke kudinga ukuhlela okuqondile.

Amadivayisi afakwe kanye nama-valve okufakelwa

Ama-pacemaker kanye nama-defibrillator afakwayo athinta ukusetshenziswa kwezinsimbi zokuhlinzwa ngogesi ngesikhathi sokususwa kwe-polyp, ngakho-ke yisho. Ukumbozwa kwama-antibiotic ngaphambi kwe-endoscopy akuyona into evamile ezigulini eziningi; isinqumo singesomuntu ngamunye.

I-Endoscopy kumongo waseNdiya

• Izinkomba ezivamile zibonisa amaphethini esifo sendawo. Isifo se-acid peptic kanye Helicobacter pyloriI-gastritis ehlobene nayo iyimbangela evamile ye-gastroscopy. Isifo sofuba samathumbu siwumehluko obalulekile wezilonda ze-ileocaecal futhi singafana kakhulu nesifo sikaCrohn, futhi ukuhlolwa kwe-colonoscopy ngokuhlolwa kwezicubu kuvame ukuba yinto ebalulekile ekuhlukaniseni lezi zifo.
• Isifo sesibindi esingamahlalakhona siwumbangela omkhulu we-endoscopy ukuhlolwa kwe-variceal kanye nokubopha, okuhlanganisa nesifo sesibindi se-steatotic esihlobene notshwala kanye nokungasebenzi kahle kwe-metabolic (MASLD, igama elithathe indawo ye-NAFLD; MASH ithathe indawo ye-NASH, kanti i-MetalALD ichaza iminikelo ehambisanayo ye-metabolic kanye ne-alcohol).
• Ukulimala kwesibindi namathumbu okubangelwa izidakamizwa kusukela ekwelashweni okulwa nesifo sofuba, amaphilisi okudambisa ubuhlungu angewona ama-steroidal athengwa ngaphandle kwekhawunta, kanye neminye imithi ye-AYUSH, imithi yezitshalo kanye neyokuzivocavoca umzimba kuyindaba eyaziwayo; memezela konke okuthathayo, okuhlanganisa nemithi engewona kadokotela.
• Ukungenisa okulimazayo nokususwa komzimba wangaphandle Izimpawu ze-endoscopy eziphuthumayo zihlala zivamile, ikakhulukazi ezinganeni.
• Ukusetshenziswa kwezilimi zasekhaya kubalulekile. Iziguli kanye nezincwadi zokudlulisela zingase zithi "scopy", "camera test", "upper GI scopy" noma "pet ki jaanch", konke ngokuvamile kubhekisela ezinqubweni ezichazwe lapha, kodwa kuqinisekisa ukuthi yisiphi isitho esihlolwayo.
• Ukuvikelwa kwedatha. Izithombe ze-Endoscopy, amavidiyo kanye nemibiko kuyidatha yezempilo yomuntu siqu ebucayi; ukuphathwa kwemvume kanye namarekhodi edijithali kulawulwa yi-Digital Personal Data Protection Act, 2023, kanye nezibopho zobungcweti zobumfihlo ngaphansi kwemithetho yokuziphatha ye-National Medical Commission.
• Imithetho yokukhangisa. Izimangalo zokuthi noma iyiphi inqubo yelapha izifo azivunyelwe ngaphansi koMthetho Wezidakamizwa Nokwelapha Omlingo (Izikhangiso Ezingavumelekile) ka-1954; zingabaza amaphakheji athembisa imiphumela eqinisekisiwe.

Izindleko kanye nomshuwalense eNdiya

Izindleko ziyahlukahluka kakhulu phakathi kwamadolobha, phakathi kwezikhungo zikahulumeni nezizimele, kanye naphakathi kwezinqubo zokuxilonga nezokwelapha. Amanani acashunwe noma kuphi kufanele athathwe njengezinkomba kuphela futhi aqinisekiswe nesikhungo ngokubhala ngaphambi kwenqubo.

Izici ezishintsha intengo:

• Uhlobo lwenqubo: I-gastroscopy yokuxilonga iyona ebiza kancane kunawo wonke eqenjini; i-colonoscopy, i-EUS kanye ne-ERCP zibiza kakhulu kancane kancane.
• Ukuqeda ubuhlungu noma i-anesthesia: i-spray yomphimbo kuphela, i-hypothesis eqondayo, noma i-anesthesia ejwayelekile enodokotela wezinzwa, ngayinye ineza inani elihlukile.
• Izengezo zokwelapha: izithiyo zokususwa kwezicubu, ama-clip, ama-banding kit, ama-stents, ama-dilator, ama-injection agents kanye namadivayisi okubuyisa akhokhiswa njengezinto ezisetshenziswayo.
• I-Histopathology: Ukucutshungulwa kwe-biopsy kuyakhokhiswa ngebhulokhi ngayinye yesampula, kanye nanoma yimaphi amabala akhethekile, i-immunohistochemistry noma ukuhlolwa kwezicubu zesifo sofuba.
• Ukunakekelwa kwasemini uma kuqhathaniswa nokwelashwa esibhedlela: indawo yokutakula, isigaba segumbi kanye nanoma yikuphi ukuhlala ubusuku bonke.
• Uhlobo lwesikhungo kanye nedolobha: izinga ledolobha, isimo sokugunyazwa kanye nokuthi ngabe le yunithi inguhulumeni, iphethwe yitrasti noma yinkampani.
• Izinqubo eziphuthumayo zangaphandle kwamahora ngokuvamile kubiza kakhulu kunohlu oluhleliwe.

Amaphuzu omshwalense okufanele uwahlole: izinqubomgomo eziningi zesinxephezelo zimboza i-endoscopy uma iyingxenye yenqubo yokwamukelwa emboziwe noma yokunakekelwa kwasemini, kodwa i-endoscopy yokuxilonga isiguli kuphela ingakhishwa. Qinisekisa ukumbozwa kwenqubo yokunakekelwa kwasemini, isimo senethiwekhi engenamali, izidingo zokugunyazwa kusengaphambili, izikhathi zokulinda isifo esivele sikhona, nokuthi ngabe ukudla kanye ne-histopathology kuyakhokhwa yini. Izinhlelo zikahulumeni ezifana ne-Ayushman Bharat PM-JAY zimboza amaphakheji athile ezibhedlela ezihlanganisiwe, ukufaneleka kanye nokufakwa kwamaphakheji kufanele kuqinisekiswe nedeski lomshwalense wesibhedlela.

Izinganekwane namaqiniso

Imibuzo ejwayelekile ukubuzwa

Ingabe ngizobe ngiphapheme ngesikhathi sokuhlolwa kwe-endoscopy?

Lokho kuncike enkambisweni kanye neyunithi. I-Gastroscopy ivame ukwenziwa nge-throat spray yodwa noma nge-ladation encane, ngakho-ke ungase ulale kodwa uvuselelwe. I-Colonoscopy ivame ukwenziwa ngaphansi kwe-ladation. Ezinye izinqubo, kanye ne-endoscopy yezingane eziningi, zidinga i-anesthesia ejwayelekile. Xoxani ngalokho okuthandayo kanye nokufaneleka kwakho kusengaphambili.

Ingabe i-endoscopy ingangitshela ngokushesha ukuthi nginomdlavuza?

I-Endoscopy ingabonisa isilonda esibonakala lisolisayo, futhi udokotela we-endoscopy angasho kanjalo ngalolo suku. Ukuqinisekiswa kudinga i-histopathology ye-biopsy, ebikwa ngokwehlukana. Ukulinganisa, ukuthi kujule kangakanani nokuthi kusakazeke kangakanani, ngokuvamile kudinga ukuhlolwa okwengeziwe njenge-endoscopic ultrasound, i-CT noma i-PET-CT.

Ingabe ngidinga i-colonoscopy uma i-gastroscopy yami yayijwayelekile?

Akuzenzakaleli. I-Gastroscopy kanye ne-colonoscopy ziphendula imibuzo ehlukene mayelana nezingxenye ezahlukene zamathumbu. I-colonoscopy iyacatshangelwa lapho izimpawu, ukopha, i-anemia, umlando womndeni noma izidingo zokuqapha zikhomba ikholoni. Isinqumo singesikadokotela okuhlolayo.

Ngingadla nini bese ngibuyela emsebenzini?

Ngemva kwenqubo yokuxilonga elula ene-sedation, abantu abaningi badla uma sebevukile futhi begwinya ngokuphephile, bese beqhubeka nemisebenzi evamile ngosuku olulandelayo. Gwema ukushayela, imishini kanye nezinqumo ezibalulekile usuku lonke. Izinqubo zokwelapha zingase zibe nemikhawulo ende yokudla kanye nemisebenzi.

Ingabe i-endoscopy iphephile uma nginesifo senhliziyo noma samaphaphu?

I-Endoscopy ivame ukuba khona, kodwa ingozi yokudambisa ubuhlungu iphezulu futhi idinga ukuhlela. Tshela ithimba nge-angina, ukuhlaselwa yinhliziyo muva nje, ukwehluleka kwenhliziyo, i-arrhythmia, ama-stents, i-COPD, i-asthma, ukusetshenziswa komoya-mpilo noma i-sleep apnea. Ukuqapha, ukukhetha ukudambisa ubuhlungu kanye nokubandakanyeka kodokotela ngezinye izikhathi kulungiselelwa ngokufanele.

Kungani kufanele ngithathe amalungiselelo amakhulu kangaka e-colonoscopy?

Ama-polyp kanye nomdlavuza wokuqala kuncane futhi kulula ukukufihla ngemuva kwendle. Ikholoni ehlanzekile ithuthukisa ngqo ukutholakala futhi inciphisa amathuba okuphinda inqubo. Uma unesifo sezinso, ukwehluleka kwenhliziyo, ukuvinjelwa koketshezi noma isifo sikashukela, cela iyunithi ukuthi ikunike uhlelo lokulungiselela olufanele isimo sakho.

Kuthiwani uma izimpawu zami ziqhubeka ngemva kokuhlolwa okuvamile kwe-endoscopy?

Buyela kudokotela ocele inqubo. Izimpawu eziqhubekayo zingase zibonise isimo i-endoscopy engakwazi ukusiveza, njengokunyakaza noma ukuphazamiseka kokusebenza, i-gallbladder noma i-pancrea