Kodi pancreatic endosonography imachitika bwanji, bwanji imalembedwa ndipo imapangidwa bwanji?

Mwadzidzidzi ultrasound ya kapamba imaphatikizapo kuyesa kwakunja pakhungu pogwiritsa ntchito sensor yapadera. Koma kuti tiwunikire momwe zimakhalira, kaphunzitsidwe kamafunikira. Chifukwa chake, muzochitika zotere, endosonography ya kapamba imachitika.

Kodi endo ultrasound ndi chiyani?

Pancreas endosonography, yofupikitsidwa monga endo-ultrasound, ndi njira yophatikizira yozindikira yomwe imatha kuwona chiwalocho mkati. Gawo lalikulu la mayeserowa ndikupeza chithunzi pogwiritsa ntchito sensor ya akupanga yokhala ndi kamera, kanema wa endoscope.

Endo ultrasound imapereka mwayi wotsika wolakwika kuposa njira zina zodziwitsira. Mukamawerengera, adokotala amasintha kamera kuti zikondamoyo zizioneka momwe zingatheke.

Nthawi zina, pamene endosonography sikokwanira kuti adziwe matenda, kuwunika kwathunthu kwam'mimba kumachitika. Endo-ultrasonography ya kapamba, kum'mimba ndi kumimba kumapereka chithunzi cholondola cha matenda.

About endoscopic ultrasound adokotala adzakuuzani mu kanema:

Zizindikiro zoyeserera

Zomwe zikuwonetsa endo-ultrasound ya kapamba ndi:

nseru, gag Reflex,
akuwoneka kuti ali ndi vuto
kuwonda kwakukulu
zimbudzi zotayirira
kupweteka kwakanthawi komwe kumachitika m'dera lamba.

Kutumiza kwa endo ultrasound imaperekedwa ndi akatswiri othandizira, gastroenterologist ndi endocrinologist ngati akukayikira kuti pali vuto pantchito ya kapamba.

Momwe mungakonzekerere ndondomekoyi

Asanayambe endo-ultrasound, munthu amafunsidwa ngati pali ziwonetsero, pambuyo pake Hextasiograms ndi mankhwala. Kusanthula koteroko kumatsimikizira mayendedwe ophatikizika. Izi ndizofunikira popewa kufalitsa kwa biopsy, kuti panthawi ya endo ultrasound mwa munthu musataye magazi mwadzidzidzi.

Maola asanu ndi atatu asanatulutsidwe wa endoscopic, tikulimbikitsidwa kuti tisamadye kapena kumwa kuti muchepetse nseru komanso kusanza.

Sizoletsedwa kumwa mankhwala isanachitike. Izi ndizofunikira makamaka pazitsulo ndikuyambitsa kaboni. Amayika zomwe zili m'matumbo, zomwe zimapangitsa kuti zikhale zovuta kudziwa matendawa. Koma, ngati simungathe kuchita popanda mankhwala, muyenera kumwa mankhwalawo ndi madzi ambiri.

Pamaso endo ultrasound, ndibwino kuti musasute. Njirayi imathandizira kupendekeka kosafunikira. Mu phunziroli, izi zimasokoneza kuyambitsa kwa endoscope mkati.

Phunziro lili bwanji

Ndi endo ultrasound ya zikondamoyo, munthu amayikidwa pabedi, kumanzere. Chotsatira, chovala chamlomo wapadera chimayikidwa kuti ma endoscope aikidwe mosavuta mkati ndipo asawonongeke.

Chubu ya chida chokhala ndi sensor ya akupanga imakankhidwira pang'onopang'ono kumkono wamkamwa, kenako kulowa larynx, m'mimba, ndi duodenum. Dokotala panthawi ya kafukufuku amawunika umphumphu wamakoma a esophagus, kapamba, matumbo.

Mtundu wa kumapeto umatsitsidwa mpaka pa duodenal papilla, pancreatic duct. Kenako, kusiyanitsa kumayambitsidwa kudzera pa chubu chopyapyala. Wopanga akupanga amatumiza chithunzicho pazenera. Ngati ndi kotheka, biopsy imachitika.

Zimatenga theka la ola kuti amalize endo-ultrasound. Pakadutsa mphindi 30, dokotala amawongolera momwe munthu aliri kuti pasakhale zovuta. Munthuyo akaloledwa kudya chakudya chopepuka, imwani kapu yamadzi. Zotsatira zimanenedwa tsiku lotsatira.

Dokotala adzakuuzani momwe endosonography ya kapamba imachitikira komanso chifukwa chake ikufunika:

Kulemba zotsatira

Zotsatira za endo-ultrasound zimadziwika ndi dokotala. Katswiri amasanthula zisonyezo:

Kukula. Ndi kuwonjezeka, edema ya chiwalo, kukula kwa mawonekedwe a volumetric kumadziwika. Ngati kapamba amachepetsa, izi zikuwonetsa kukhalapo kwa njira za atrophic.
Zopatsa. Ndi maonekedwe akhungu, kusakhazikika kwa chiwalo pachithunzichi, kukaikira zotupa, ma cysts amawoneka.
Mawonekedwe a kapangidwe kake. Kapangidwe kazinthu tating'onoting'ono kamayambitsa matenda amawonetsa matenda osakhazikika.
Fomu. Nthawi zina pamakhala kusintha kwapangidwe ka chiwalo komwe kamasokoneza kayendetsedwe kabwino ka chakudya m'mimba.
Mkhalidwe wa ma ducts. Kutulutsa ma ultrasound kumawonetsa kukhalapo, kusowa kwa patency kudzera mu ma ducts.
Echogenicity. Ngati hyperechoogenicity ikapezeka, kupezeka kwa zotupa ndi miyala kumadziwika. Kupanda kutero, ndi hypoechohenogenicity, nthawi zambiri amapezeka ndi pancreatitis pachimake.

An endo ultrasound ya kapamba amathandizira adokotala kuti azindikire matendawa. Mwayi wolakwitsa umachepetsedwa.

Kodi mudakayezedwapo? Tiuzeni za izi mu ndemanga. Gawani nkhaniyi ndi anzanu pa malo ochezera a pa Intaneti. Khalani athanzi.

Ndondomeko Mwachidule

Endosonography ndi njira yosakanikirana yomwe imakupatsani mwayi kuti mufufuze ziwalo zamkati kuchokera mkati, kupeza chithunzi cha ultrasound cha zida zomwe sizingatheke ku kamera. Itha kukhala njira yokhayo yodziwira gawo la pathologies.

Diagnostics imachitika pogwiritsa ntchito chida chapadera - endoscope, pamapeto pake imayikiridwa ndi sensor ya akupanga. Kubweretsa sensor ku chiwalo, kudutsa khungu, minofu ndi mafayilo ena omwe angafooketse chizindikirocho m'njira yanthawi zonse ya ultrasound, kumakupatsani zotsatira zolondola.

Pozindikira endoscopic, mitundu iyi ya endoscopy imagwiritsidwa ntchito:

Pamtunda wapamwamba wa GI. Kuti mupeze khansa yoopsa ya kapamba yodziwika bwino ndi 95%, mawonekedwe a mitsempha ya varicose yam'mimba, etc.
Pansi GI thirakiti. Amakulolani kuti muzindikire neoplasms ya colon ndikutenga zofufuzira, kuti mumvetse bwino zomwe zimayambitsa matenda.
Mtengo wa Tracheobronchial. Anazindikira ndi khansa yam'mapapo, anayeserera zamitsempha.

Kusiyana pakati pa ultrasound ndi endo ultrasound

Ultrasound ndi endo-ultrasound - njira zofananira zomwe zili ndi mfundo imodzi, zimasiyana momwe zimapangidwira komanso zotsatira za kupezeka kwake. Kuunika kwa endoscopic kumakhala ndi chithunzi cholondola, koma kumayambitsa kusagwirizana chifukwa chakuyika kwa chubu mu esophagus. Ultrasound siyimayambitsa vuto, koma chithunzi cha ziwalo ndizabwino. Maphunziro onsewa amachitika ndi ultrasound; zida za endosonography zimakhala ndi kamera yapadera.

Kukonzekera njira zonse zofufuzira ndi zofanana, koma ndi endo-ultrasound, kusunthira ndikofunikira, ngati opaleshoni yakonzekera, mankhwala operewera amafunika. An ultrasound imayikidwa kuti idziwe ma pathologies kapena kuzindikira ziwalo, monga mtundu woyamba wa mayeso. Ultrasound endoscopy ndiyothandiza ngati njira zina sizinapereke zotsatira zake kapena zotsatira zake sizodziwika.

Ultrasound imachitidwa kwa akulu ndi ana, njira ya endoscopic ultrasound imangoyambitsidwa kwa akulu okha. Ana salangizidwa kuchita zoyenera kuti apewe kuvulaza kummero wa mwana.

Kuzindikira kumawonetsedwa kwa anthu omwe ali ndi vuto la neoplasms, omwe amatha kupezeka mosavuta, amapeza zotupa zazing'ono nthawi iliyonse ya chitukuko. Ngati ndi kotheka, biopsy yovomerezeka imatengedwa.

Ndi njira yofufuzira iyi, ndizosavuta kuwona kupezeka kwa mawonekedwe a makristasi mu ma ducts komanso kusintha kwa cystic m'mimba. Kukokoloka, ma polyps, kusinthika kwa makoma am'mimba - kuphwanya kumadziwika kuti ndikugwiritsa ntchito ma ultrosis endoscopy. Zizindikiro zazikulu za phunziroli mwanjira iyi ndi:

Zotupa zam'mimba za m'mimba,
Cancers of the wall of esophagus, hollow extension of the m'mimba dongosolo, matumbo, kapamba,

Ultrasound endoscopy imakuthandizani kuti muone kuyesetsa kwa chithandizo cham'mbuyomu.

Ngakhale matenda atakayikiridwa, njirayi imachitika pokhapokha pakufufuza kachipatala, ngati zotsutsana ndi endoscopy sizinadziwike.

Kukonzekera njirayi

Kuunika kwa Endosonographic ndi njira yomwe imafunika kukonzekera mosamala. Choyamba, dokotala yemwe amapita amafufuza wodwalayo mosamala, akuphunzira za zizindikiro ndi matenda osachiritsika. Amapereka kuyesedwa kwa magazi ndi kuyesa kwamkodzo pafupipafupi, magazi a biochemistry ndi coagulogram kuti adziwe kuchuluka kwa kuchuluka kwa magazi. Ikumana ndi zokhudzana ndimomwe thupi limagwirira ntchito. Njira zonse ndizofunikira kuti muchepetse zolakwika, zomwe wodwala sangadziwe.

Dokotala ayenera kufotokozera wodwalayo za matendawa ndi zomwe zingachitike.

Masiku atatu njira isanachitike, muyenera kuyamba kuchotsa m'mimba, kuchotsa mafuta ndi mbale zolemera pazakudya. Chakudya chomaliza ndi maola 8-10 musanazindikire. Ndikulimbikitsidwa kuti muchepetse kudya kwa mapuloteni. Ndikofunika kuchotsa mkaka ndi mkaka. Musachotse yisiti kuphika kuchokera muzakudya kuti mupewe kuchuluka kwa mpweya wambiri, womwe ungasokoneze kuwunikiridwa kwa kapamba, ndi matumbo a matumbo.

Sizoletsedwa kusuta pa tsiku lolemba, kuti tisakwiyitse kuchuluka kwa malovu, omwe amachepetsa kulondola kwa zotsatira. Ndikofunikira kupatula kugwiritsa ntchito mankhwala omwe amatha kusintha mtundu wa zomwe zili m'mimba. Ola limodzi asanachitike, opaleshoniyo amaperekedwa kwa wodwala.

Njira

Njira yodziwira matenda omwe ali ndi mawonekedwe ofanana ndi esophagogastroscopy.

Phunzirolo lisanachitike, wodwalayo amapezeka kuti wagona kuchipatala, ngati kuli koyenera kutenga zinthuzo mwanjira ina kapena njira zina zakuchipatala. Nthawi yochepa yodziwitsa ndi maminiti 20. Kutalika konseku kumatengera cholinga cha mayeso ndi zovuta za ntchito zomwe madokotala amakumana nazo.

Wodwalayo wagona mbali yake yakumanzere, akugwada ndi miyendo yake pabondo ndikumuwopseza kuti akhale m'mimba. Kenako chidacho chimayikidwa mu esophagus, pomwe makoma ake amawayang'ana kuti azindikire ma pathologies osiyanasiyana. Pakadali pano, adotolo amachita ultrasonography yamitsempha yamitsempha ndi mapapo.

Pambuyo pake, zida zimagwirira ntchito mopitilira, pomwe makoma am'mimba, ndulu ndi kapamba amawunikira. Kuphatikiza apo, zida zimatsikira m'dera la duodenum, pomwe endoscopist imayang'anitsitsa ndulu za dothi, ducts, ndi mutu wa kapamba.

Chikhansa ndichinthu chovuta kumuyesa. Njira zina sizingathe kuwona bwino matenda ake. Pancreas wabwinobwino ndi kapangidwe kake kamene kamapangidwa mosalala ndi mawonekedwe ophatikizika. Ultrasound endoscopy imakupatsani mwayi woganizira zam'magazi, tengani zofufuzira, ndikuthandizira kuzindikira matenda oyipa kwambiri koyambirira ndikukulolani kuti muyambe kulandira chithandizo mwachangu.

Ma opaleshoni ndi othandizira othandizira endosonography

Mukakonzekeretsa kuchipatalachi ndi mtundu wa endvex endoscope, ndikotheka kupanga malembedwe abwino a formations omwe akupatuka panjira yokhazikika. Pambuyo pake, pulogalamuyo imatumizidwa kukayesedwa kwa mbiri yakale.

Pa phunziroli, ndikotheka kuwerengera mayendedwe ake, kusintha kwa ma cystic ndi ma lymph node, zomwe zimapangitsa kupewa opaleshoni kuti itenge zakuthupi ndikusunga nthawi yamankhwala.

Ma anemastoses amawongolera moyang'aniridwa ndi ESM, njira zamajekesedwe, ndi radiation chithandizo cha zotupa zimachitidwa.

Ndondomeko bwino analekerera, amakhala ndi chiopsezo cha zovuta.

Kuzindikira matenda oyamba a khansa ya kapamba

Matenda a pancreatic ali ndi matenda osakwanira. Nthawi zambiri imapezeka kumapeto, pomwe zotsatira zabwino za chithandizo ndizosatheka. Kufikira zaka 5 chichitikireni chithandizo, si odwala ambiri omwe akupulumuka. Zambiri pazaka zapitazo ndi ESM zidawonetsa kuti kudziwunika khansa koyambirira ndi kafukufukuyu ndikotheka. Kuphatikiza apo, njirayi imawonedwa yolondola koposa zonse zomwe zingatheke.

Endosonography ngati njira yodziwira khansa ya m'matumbo

Njirayi siigwiritsidwa ntchito pakuwunika koyambirira kwa zotupa m'mimba, koma imatsimikiza moyenera gawo la chitukuko cha khansa komanso kufalikira kwa matenda ku ziwalo zoyandikana, zamitsempha. Asanaganize zochita opaleshoni, madokotala amalimbikitsa kuti adziwe zambiri, kuphatikiza endosonography ndi laparoscopic ultrasound.

Njira za Endoscopic zochizira khansa kumayambiriro kwake ndizothandiza, koma ndizochepa kufalikira kwa metastases. Endosonography imatsimikiza bwino kuchuluka kwa matenda owopsa mu submucosal ndi zigawo za minofu.

Pambuyo pa njirayi

Njirayi ikamalizidwa, wodwalayo amapititsidwa kuchipatala kwa maola angapo kuti athe kuwunika.

Madokotala amalimbikitsa kuti odwala atakhala ndi chiyembekezo chotsimikiza amakhala ndi mtendere wam'maganizo kunyumba. Pambuyo maola 2, mutha kudya ndi madzi. Ngati mankhwala oyendetsedwa asanaperekedwe anali oyenera, madokotala amalimbikitsa kuti asamayendeyende pawokha pagalimoto ndikusiya ntchito yomwe imafunika kwambiri.

Mavuto omwe angakhalepo

Njira zochitidwa motsatira malamulo nthawi zambiri sizimayambitsa mavuto. Mavuto pa endo ultrasound ndi osowa, koma amatha kuchitika motere:

Kuvulala kwa mucous membrane am'mimba ndi esophagus, limodzi ndi magazi m'mitsempha yamagazi.
Mapangidwe a bowo lamkati chifukwa cha kuvulala komwe kumapezeka pakudziwitsa matenda ake,
Zotsatira zamankhwala,
Kufika pamtima,
Matenda opatsirana am'mapapo kapena a biliary thirakiti.

Izi pathologies sizichitika kawirikawiri. Nthawi zambiri atawunika, wodwalayo amamva kufooka komanso samva bwino.

Contraindication

Asanapereke chithandizo, dokotala amafufuza wodwalayo ndikupanga maphunziro angapo kuti adziwe zotsutsana, zomwe ndi:

Opaleshoni pamiyendo
Esophagus makina akavulala
Mtima walephera,
Pachimake matenda opatsirana ndipo aakulu pachimake siteji,
Kutupa kwa pararectal fiber
Matenda amitsempha yam'mimba yomwe imapangitsa kuti ikhale yosakhazikika,
Esophageal chotchinga, kwathunthu kapena gawo limodzi.

Ngati opaleshoni yakonzekereratu, kuphwanya kwa wachibale kumakhala kuphwanya magazi.

Endosonography ndi malo achichepere komanso odalirika pakuwonetsa ziwalo zam'mimba. Ili ndi zambiri komanso zofunikira, imalekeredwa bwino ndi odwala ndipo sizimayambitsa zovuta, kupatula zina. Ma pathologies ena amapezeka amangogwiritsa ntchito endoscopic ultrasound.

Zisonyezero za pancreatic endosonography

Endosonography imakuthandizani kuti muwerenge momwe mungathere kugaya chakudya.

Koma ngati chidziwitso cha m'mimba ndi duodenum chitha kupezeka pogwiritsa ntchito endoscopy yosavuta, ndiye kuti zinthu ndizovuta kwambiri ndi kapamba.

Pancreatic endosonography ndi njira yomwe kufunika kwake sikuyenera kunyalanyazidwa. Popeza chiwalochi chilipo, kuti mbali zake zonse zisaoneke pa sonography, endoscopic ultrasound ya kapamba imathandizira kuwona malo omwe sangafikire.

Ednoscopic ultrasound ya kapamba imagwiritsidwa ntchito pazotsatira izi:

Kukhalapo kwa zizindikiro zowopsa, zomwe zimaphatikizapo kupweteka kwa m'chiuno kumtunda ndi kumanzere kwam'mimba, nseru ndi kusanza.
Kuchepetsa thupi pang'onopang'ono kapena kuchepa thupi.
Zosintha pamtundu wa chopondapo.
Kukhalapo kwa jaundice.
Chikhodzodzo chopanda chopweteka chopanda paliponse ndi chizindikiro cha Courvoisier. Chizindikiro ichi chimadziwika ndi khansa yam'mutu ya pancreatic.
Kukhalapo kwa chotupa kapena kuchuluka kwa mawonekedwe. Gwiritsani ntchito ma ultrasound a ma pancreatic ducts amakupatsani mwayi kuwona mawonekedwe ang'onoang'ono ndi calculi.
Kudziwa kukhalapo kwa metastases m'njira yotupa imodzi.

Kuphatikiza apo, mtundu uwu wowunika wowunikira ukuwulula kuchuluka kwa kusintha kwa m'matumbo komwe kumachitika chifukwa cha matenda opatsirana monga pancreatitis.

Momwe mungakonzekerere endosonography?

Phunzirolo lisanachitike, adokotala amafunsa wodwalayo kaye za kupezeka kwa ziwopsezo, komanso amakupangira coagulogram. Izi ndizofunikira kudziwa kuphatikizika kwa magazi kuti wodwalayo asathenso kutaya magazi panthawi yophunzira. Ichi ndi chofunikira kwambiri makamaka ngati mwanjira imeneyi mukufunika kutenga kachilombo kazinyalala, komwe kamaphatikizapo kuvulala mthupi ndi mpanda wa mbali yake.

Ndikulimbikitsidwa kuti musamadye kapena kumwa musanadye maganizidwe a maola asanu ndi atatu lisanachitike phunziroli, popeza pamakhala mwayi wosanza. Pamaso pa endoscope mkati, izi zimatha kuyambitsa kusanza mwa kusanza. Zimathandizanso kukhala ndi enema yotsuka madzulo madzulo ndondomeko isanachitike.

Simalimbikitsa kumwa mankhwala musanayambe phunziroli, makamaka kukonzekera kwachitsulo ndi makala othandizira, omwe amatha kuyambitsa matumbo, zomwe zimapangitsa kuti zikhale zovuta kudziwa. Komabe, ngati munthu ali ndi matenda osachiritsika omwe amafunikira mankhwala okhazikika, amaloledwa kugwiritsa ntchito, koma amasambitsidwa ndi madzi ochepa.

Asanazindikire zamtunduwu ,alangizanso kuti musasute fodya, popeza kupatukana kwa malovu kumawonjezera, zomwe zingalepheretse kuyambitsidwa kwa endoscope.

Pancreatic endoscopic ultrasonography imachitidwa pansi pa opaleshoni yayikulu, kapena masisitere apadera amaperekedwa kwa wodwala musanayesedwe. Asanayambe njirayi, munthu amakhala kumbali yakumanzere kwake ndikuwatsogolera miyendo yake yolowera m'mimba.

Chipangizochi chimayikidwa mu lumen ya esophagus, ndipo makoma ake amawunikira. Nthawi yomweyo, adotolo ali ndi mwayi wochita ma ultrasonography amomwe amapezeka m'derali komanso mapapu. Kafukufuku wazida zakuzama ndiye phindu lalikulu lazidziwitso la njirayi,
Kenako zida zimachitidwa mwakuya ndipo makoma am'mimba amawunikiridwa, ndipo ndi ndulu ndi kapamba,
Gawo lomaliza la njirayi ndi dera la duodenum. Ultrasonography yatsambali imalola adokotala kuti aphunzire ma ndulu, bileza, mutu ndi kapamba. Ngati ndi kotheka, zinthu zotsalira za biopsy zimasonkhanitsidwa kuti ziyezetsedwe zakale.

Ndondomeko ikhoza kutenga nthawi - kuyambira mphindi 30 mpaka ola limodzi.

Ndi magawo ati a kapamba omwe adokotala amawunika pa endosonography?

Phunziroli, dokotala amawunika mkhalidwe wa kapamba.

Zambiri zimayang'aniridwa chifukwa chaichi.

Zina mwazinthu zoyeserera, zofunika kwambiri ndi:

mawonekedwe a gland (mwa anthu ambiri, mawonekedwe amtundu wa gland amatha kusiyana, zomwe zitha kuchititsa kuti magwiridwe ake asakhale otheka),
kukula kwa chithokomiro chonse ndi ziwalo zake zimapatsa dokotala chidziwitso cha kupezeka kwama voliyumu mu chiwalo - cysts, chotupa, calculi,
kumveka kwa ma contours (kufupika ndi masamba ovuta kuwonetsa kutukusira kwa chotupa kapena ziwalo zomwe zapafupi, ma abscesses ndi ma cysts ali ndi mawonekedwe omveka bwino, koma kuwuka ngati mawonekedwe)
kapangidwe kake (kapamba ndi chiwalo chomwe chili ndi chophatikiza pakatikati, mapikidwe a ndulu amayenera kukhala yunifolomu, kuchepa kwa thupi kumawonedwa mu pancreatitis yayitali, pomwe minofu yambiri yolumikizana ilipo mu mawonekedwe a gland).
Kuchepa kwa echogenicity ndi chizimba cha pancreatitis pachimake, yomwe imatha kutsatiridwa ndi edema ya gland, koma ma volumetric masamu nthawi zambiri amakhala operewera, makamaka calculi, ndipo, mwachidziwikire, ma cystic misa amawoneka ngati opanda pake komanso amakhala ndi mbali zomata,
chikhalidwe cha zikondamoyo.

Nthawi zambiri chifukwa cha kapamba sikuti ndi matenda a kapamba palokha, koma ndi matenda am'mimba. Mu matenda a gallstone, miyala, makamaka yaying'ono, imayenda pamakutu. Kuyenda kotereku kumatha kupangitsa kuti kutuluka kwa ndulu kumlingo winawake. Izi zikachitika pamwamba pamatumbo a pancreatic, munthu amatenga matenda otupa, koma ngati mwala umayima pambuyo poti chimbudzi ndikugundika wamba kwa bile, kumachitika.

Chifukwa chake, kuzindikira kwakanthawi kwa kukhalapo kwa kapangidwe ka zikondamoyo, komanso miyala yomwe imayikidwa mu dongosolo la biliary, kumathandiza kupewa kuwonongeka kwina.

Esophagus anatomy

Emophagus ndi gawo lamatumbo am'mimba, omwe amaperekedwa ngati chubu chopapatiza, chomwe chili pakati pa pharynx ndi m'mimba. Imayamba pamlingo wa 6 wa khomo lachiberekero, ndipo imathera pa 11 ya thoracic. Kutalika kwa esophagus kuli pafupifupi 23-24 cm.Ngati mawonekedwe osunthika apangidwa, tidzaona momwe esophagus imagawidwira magawo angapo (adventitia, minofu, mucous ndi submucosal zigawo). Pali magawo atatu a ma anatomiki omwe amapezeka m'maselo:

Pharyngeal
Zachi Bronchial
Kupewa.

Palinso ena ena owonjezera. Imodzi pa kusintha kwa magazi a m'mimba, ndipo inayo pamlingo wa msempha. Mwa anthu athanzi, khoma lamtundu wa esophagus silidutsa 6 mm. Danga lamtanda ndilopanda pake, ndipo kudzera mucous membrane ndikotheka kuyang'ana mitsempha yamagazi. Ndi kukula kwa njira yotupa, khoma la esophagus limadzuka, ndipo nembanemba wa mucous imapeza tint yofiira. Ndi mapangidwe a kuchulukana, mucous wosanjikiza umatha kukhala cyanotic.

Ultrasound ndi njira yofufuzira yosagwiritsa ntchito yomwe imakupatsani chithunzi cha mbali ziwiri zamkati. Zipangizo zina zimakhala ndi malingaliro apamwamba kwambiri kotero kuti ndizotheka kupanga madera osakwana 1 mm mulifupi. Ngati dokotala yemwe akuchititsa phunziroli ali ndi mulingo wofunikira komanso kudziwa, ndiye kuti izi zimathandizira kuzindikira matenda.

Mukamayendetsa ndi ultrasound, mutha kudziwa zambiri zam'mimba ndi kummero, komanso chidziwitso pazinthu zoyandikira zam'mimba komanso pazomwe zimachitika m'mimba. Kwa ana, ultrasound imawerengedwa kuti ndi njira yabwino kwambiri yodziwira matenda chifukwa cha chitetezo chachikulu.

Pa polojekiti, chifanizo cha m'mimba m'mimba chimayimiriridwa ndi chowongoka chozungulira pakati pa msempha ndi khofi wamanzere wa chiwindi. Poika sensor mu malo osunthika, mawonekedwe a esophagus amakhala ndi mawonekedwe a nyenyezi. Izi ndichifukwa choti posakhalitsa chakudya chomwe chikubwera, nembanemba ya mucous imachepa ndikupeza kupukuta kwinakwake. Choyimira chikuwonetsa kuti esophagus nthawi zambiri imagawika m'magulu atatu:

Mkati - wowonda
Yapakatikati-yopanda minyewa
Kunja - adventitia.

Makulidwe a khomalo mwa mwana nthawi zambiri sapitirira mamilimita ochepa. Mukameza, lumen ya esophagus imachulukana kukula, ndipo madera osalimba amayamba kuwonekera mkati. Ngati wodwala akumeza chakudya, ndiye kuti m'mimba mwake mumakhala kuchuluka.

Chifukwa cha kupita patsogolo kwa sayansi, njira zosiyanasiyana zodziwonera matenda zikukula chaka chilichonse. Kupita patsogolo kwa sayansi sikunadutse njira za ultrasound. Mpaka pano, mitundu ingapo ya ultrasound imasiyanitsidwa, kulola kuti mudziwe zambiri zam'mphepete. Iliyonse ya njirazi imasankhidwa payekha, kutengera mtundu wa wodwalayo komanso chikhalidwe chake:

Kuyesa kwa ultrercane. Ndiofala kwambiri ndipo nthawi zambiri amagwiritsidwa ntchito pochita zachipatala. Idakhala yotchuka chifukwa cha kuphatikiza pazambiri, zambiri zamakhalidwe ndi kusowa kwa zovuta. Panthawi ya ndalamayi, sensa imakhala ndi mafuta osaneneka ndipo imayikidwa m'khosi komanso epigastrium. Chifukwa cha izi, ndizotheka kupeza fano la magawo osiyanasiyana a esophagus. Kuti akwaniritse bwino kwambiri malingaliro, odwala amafunsidwa kuti azigwedeza mutu wawo pochita izi.
Intraesophageal ultrasound. Chinsinsi cha njirayi ndikuyambitsa sensor yapadera mu lumengus kuti mupeze mawonekedwe abwinoko a ziwalo. Pogwiritsa ntchito endo-ultrasound, mutha kuwunika momwe khoma la mayeselogus limayendera ndikusunga momwe masinthidwe amthupi mwa iwo alili. Kupatukana ndi kubera kwa m'badwo wa ana. Kupanga koteroko mwa mwana kumapangitsa kuwonongeka kwa mucous nembanemba wa esophagus. Njirayi ndiyothandiza kupenda mtima.
Madzi-siphon ultrasound kuyesa. Njirayi imagwiritsidwa ntchito poyesa ntchito yam'mimba. Kuti muchite izi, panthawi yophunzira, wodwalayo amapatsidwa madzi akumwa, chifukwa chomwe mawonekedwe a mawonekedwe a emopegus ndi chikhalidwe cha kayendedwe ka makhoma panthawi yomwe akumeza kumayesedwa.
Endosonography. Mwa limagwirira, njirayi imafanana kwambiri ndi fibrogastroduodenoscopy. Ikachitidwa, sensor yapadera imayambitsidwa ndikuwunika kwa esophagus, kumapeto kwake komwe kumalumikizidwa ndi chipangizo cha kuwala. Chifukwa cha njirayi, ndikotheka kukonza mawonekedwe omwe ali osakwana 1 mm m'mimba mwake komanso osagwirizana ndi mayeso a ultrasound. Endosonography imapereka mwayi wowunika kukula ndi kufalikira kwa chotupacho.

Pamapeto pa kafukufukuyu, dokotalayo amapatsa wodwalayo ndondomeko yomwe angagwiritse ntchito momwe akumakhalira ndi magalimoto oyenda. Malongosoledwe am'mimba, zilonda, kutembenuka mtima ndi cholinga cha kutupa kumalembedwanso mu protocol. Chifukwa cha ultrasound, mutha kudziwa matenda ambiri ammero ndi ziwalo zoyandikana.

Ngati kusokonekera kuseri kwa sternum, kukulira pakudya, muyenera kufunsa dokotala. Ngati mukukayikira kuti pamayendedwe a pathological mu emophagus, ndikulimbikitsidwa kuchita mayeso a ultrasound. Ngati chipangizocho chili ndi vuto lalikulu, ndiye kuti mukukhoza kukonza zilonda zam'mimba, kapangidwe ka khansa ndi chizindikiro cha kutupa kwa khoma lachiwalo.

Pali zisonyezo zingapo zomwe wodwalayo akulimbikitsidwa kuti ayendetse mawonekedwe a ultrasound kutsimikizira kuti ali ndi matendawa:

Achalasia
Gastroesophageal Reflux,
Kuponyera zam'matumbo mumayendedwe amlengalenga
Akukayikira diaphragmatic hernia
Kutentha kwamoto kwachidziwikire,
Zovuta za wodwalayo, momwe sizingathekere endoscopy.

Reflux esophagitis imadziwika kuti ndi njira yodziwika bwino yotsatila, yomwe imafuna njira zodziwira matenda. Vutoli limachitika chifukwa chakufooka kwa mtima ndi chidziwitso cha zinthu zakumbuyo zam'mimba. Hydrochloric acid imasokoneza mucous nembanemba ndipo, ndikakumana pafupipafupi, timayambitsa kukokoloka ndi zilonda. Kuphatikiza apo, ndikofunikira kutchula mkhalidwe monga Barrett's esophagus. Nthawi zambiri, mucosa wam'mimba amakhala ndi ma epithelium ophatikizika, komabe, motsogozedwa ndi acidic pamimba, imatha kukhala cylindrical. Matendawa ndi matenda opatsirana omwe amafunika chithandizo chamanthawi.

Chidziwitso chomwe chaperekedwa mulemba sichitsoogozo pakuchitapo kanthu. Kuti mudziwe zambiri zamatenda anu, muyenera kulumikizana ndi katswiri.

Mapangidwe ena omwe nthawi zambiri amawoneka kuti ali ndi mavuto ndi kummero ndi diverticulum. Matendawa amayamba chifukwa cha kupatulira komanso kukhazikika kwa khoma la esophagus. Potere, mthumba umapangidwa momwe ma tinthu ting'onoting'ono ta chakudya chomwe timatulutsa timatha kudzikundikira. A diverticulum imatha kuyatsidwa ndikuyambitsa mavuto pakukumeza. Ngati diverticulum ndi yobadwa nayo, ndiye chifukwa cha kufooka kwapakhoma kwa minofu.

Chinsinsi chakunyenga

Kodi ndimtundu wanji wa ultrasound wammero? Wodwalayo adaitanidwa kuchipinda chodzionetsera, komwe amafunsidwa kuti akhale pampando. Wodwalayo wagona kumbuyo kwake, ndipo adokotala amamuika mankhwala osokoneza bongo apadera m'khosi ndi m'mimba, koyenera kuti akhale ndi chizindikiro chabwino cha ultrasound. Mukakhazikitsa sensor, ndizotheka kupeza chithunzi cha ziwalo zamkati ndi m'mimba mwa esophagus. Kuti mumve zambiri mwatsatanetsatane ndikugwira ntchito kwa esophagus, wodwalayo amafunsidwa kuti amwe madzi pang'ono.

Ziwalo zina zomwe zimafunikira kuyesedwa mkati mwa gawoli zimawonekera bwino pamene wodwala ali kumbali yake. Pamapeto pa kafukufukuyu, adotolo amafotokozera zotsatila zake, amawunika mapangidwe a esophagus ndikuwonetsa kukhalapo kwa mapangidwe a pathological.

Pancreas endosonography

Endosonography imawerengedwa kuti ndi njira imodzi yothandiza kwambiri yodziwira kapamba ndipo imangoleketsa kuzindikira zodwala zam'mimba mu chitukuko chake, komanso kuneneratu kuoneka kwa metastases ya lymphoregional. Pogwiritsa ntchito endosonography, katswiri amatha kuzindikira zotupa kuti zisapezeke ndi ultrasound yodziwika ndikuwonetsetsa kuti chiwopsezo cha maselo owopsa m'mitsempha.

Pancreatic endosonography imapereka chiwongolero chapamwamba kwambiri cha kupota bwino kwa singano kuti ipeze minofu yazitsulo kuchokera ku dera lachiberekero cha chiwalo. Mwambiri, njira yodziwitsira matenda ndiyodziwika ponseponse, komabe, kugwiritsa ntchito kwake kuzindikira ma pancreatic pathologies kuyenera kuchitika kokha ndi akatswiri odziwa bwino omwe amatha kupenda zotsatira zake ndikuzigwiritsa ntchito popanga njira yothandizira wodwala. Kugwiritsa ntchito zida zamtundu wa endosonographic kulibe zotsatira zoyipa ndipo ndiotetezeka kwathunthu ku thanzi la munthu. Zotsatira za X-ray sizipezekanso kwathunthu.

Chomwe chizindikiritso cha kupanikizika kwa kapamba mwa ana ndi chosunthira cha ultrasound chomwe chimakupatsani mwayi kuti mudziwe mtundu wa matendawa, makamaka njira yake, ndikufotokozeranso zamomwe chithandizo chikubwera potengera chidziwitsochi. Kodi ndi ziti zomwe zimapangidwira?

Zisonyezero za ultrasound za kapamba mu ana

Ndikofunika kumvetsetsa kuti kwa ultrasound ya kapamba mu ana, malangizo oyenera kuchokera kwa dokotala adzafunika, olembedwa pamaziko a zizindikiro ndi zizindikiro zosonyeza kukula kwa kapamba.

Zizindikiro zazikulu za njirayi ndi: kupweteka mumkamwa, ngati kuti mukuzungulira thupi lonse, komanso nthawi yomweyo kuwonekera pamimba ndi kumbuyo. Ultrasound imakuthandizani kuti muwone kusintha kapena kuwonongeka kwa ziwalo zam'mimba zoterezi monga: duodenum 12 kapena m'mimba, zomwe zingayambenso kupweteka kwambiri.

Kuyesedwa kwa ultrasound kumayesedwanso ngati pakukayikiridwa kuti pali chotupa cha khansa kapena chotupa chomwe chimafunikira kuchotsedwa mwachangu kapena chithandizo. Chifukwa cha matenda apanthawi yake, njira zambiri zamatenda zimatha kupewedwa, chifukwa chake, ngati dokotalayo ali ndi malingaliro, palibe chifukwa choti njirayi iyenera kuimitsidwa.

Kuzindikira kwa ana kumafuna kukonzekera asanachitike.Chifukwa chake, patsiku limodzi, kapena kupitilirapo pawiri, ndikofunikira kuti muchepetse zakudya zamafuta, amchere, acid komanso yokazinga zomwe zimapangitsa kuti zikhale zowonjezera pamimba ndi kapamba.

Komanso, musanayesedwe wa ultrasound, muyenera kufunsa dokotala. Ngati ndi kotheka, kwa ana, kukonzekera kwa enzyme kungathe kutumizidwa kuti kukhudze kugwira ntchito kwa kapamba, komanso kupuma, ngati mavuto atapezeka m'mimba, monga kudzimbidwa, kutsegula m'mimba, kapena chopondapo mosakhazikika. Nthawi zambiri amalimbikitsidwa kuti mutenge makala opaleshoni, pamtengo wa piritsi 1 pa kilogalamu 10 ya kulemera, koma nkhaniyi iyeneranso kukambirana ndi dokotala mwanjira ina.

Kujambula kwa kapamba mu ana kungachitike pokhapokha ngati pali umboni woyenera wa izi kapena potsatira dokotala. Pankhaniyi, munthu sayenera kuyiwala zakufunika kwakukonzekera kopitilira muyeso wa ultrasound, yomwe imalola kupeza zotsatira zoyeseza molondola kwambiri ndikuzindikira zovuta zomwe zilipo m'mapapo.

Kuyendera ndi kulimba

Mukamayang'ana mwana yemwe akuganiza kuti pali pancreatitis yapakati, pallor ndi hyperemia ya nkhope, tachycardia komanso chizolowezi chowonjezera magazi zimadziwika. Kufalikira kwam'mimba ndi minyewa m'dera la epigastric titha kudziwikanso. Kufufuza kwamanja kwa kapamba kumawonetsa ululu wammbuyo wapakati, ndi kuwonjezeka kwa kukakamizidwa.

Ndi zowononga pachimake kapamba mu ana, ukufalikira, kuwonongeka kwa minofu ndi kusatheka kwa palpation kumadziwika. Kugunda pafupipafupi, kufooka, chizolowezi chochepetsa magazi.

Laborator diagnostics

Pozindikira matenda a kapamba mu ana, kupenda kwamkaka ndi kwamikodzo kumayesedwa, komanso apadera pakudziwa diastase mu mkodzo, serum amylase, protein ndi glucose. Kuti mudziwe katulutsidwe wa kapamba, kaphunzitsidwe kamunthu, kapangidwe kazinthu, ma microscopic a ndulu (Coprogram) ndi mbiri ya lipid zimachitika, komanso ntchito ya pancreatic elastase imatsimikizika mu chopondapo.

Mu pachimake pancreatitis yovuta kwambiri, kuyesa kwa magazi kwa mwana kumawulula leukocytosis (wapakati kapena woopsa), neutrophilia, kuwonjezeka pang'ono kwa ALT. Kusanthula kwa biochemical kumawonetsa kuwonjezeka kwapang'onopang'ono komanso kwakanthawi kantchito ya pancreatic enzyme ndi hyperglycemia. Steatorrhea ndi creatorrhea amawonetsa pancreatitis yayitali mwa mwana.

Mu pachimake owononga matenda ana, chizindikiro neutrophilic leukocytosis, kuchuluka kwa ESR, thrombocytopenia amadziwika. Ntchito yopatsa chidwi ya kapamba imatchulidwa komanso kulimbikira.

Njira zopangira zida

Mwa njira izi, kafukufuku wa ultrasound amagwiritsidwa ntchito nthawi zambiri, omwe amakupatsani mwayi kuti musinthe ma cell, madera a necrosis, compaction ndi heterogeneity ya parenchyma. Kukhalapo kwa miyala ndi mitundu ina yolimba, kusintha kwamankhwala am'mimba kumatsimikiziridwa ndi radiograph. Komanso, pa kupezeka kwa matenda a kapamba mu ana, CT ndi MRI atha kutumikiridwa. Endosonography imatha kudziwa kusintha kwam'mbuyo komanso kolowera kwa ndulu, komanso zina zomwe zimapezeka kuti sizipezeka mwachilengedwe.

Pali nthambi yamankhwala yolimbana ndi matenda a m'matumbo akulu - coloproctology. Gawo lamaphunziroli limawerengera ntchito ya kugaya kwam'mimba, komanso njira zambiri zamomwe zimapangidwira. Kuti muphunzire momwe matumbo akulu alili ndimphamvu zake, njira zambiri zakuzindikira zapangidwa zomwe zimathandizira ntchito ya proctologist. Chimodzi mwa izi ndi colonoscopy. Njirayi imakhala pogwiritsa ntchito chingwe chapadera cha fiber-optic chomwe chimapereka chithunzi cha lumen ya tinthu togaya pamalonda. Kuphatikiza pa diagnostics, colonoscopy ikhoza kugwiritsidwa ntchito pazachipangizo chosavuta chachipatala, chomwe chimalola kuthetsa mapangidwe a pathological kumayambiriro kwa chitukuko.

M'mayiko ambiri otukuka, kuyesa kwa endoscopic kumadziwika kuti ndizovomerezeka kwa anthu onse azaka zopitilira 40. Ndondomeko imaphatikizidwa ndi phukusi la inshuwaransi yokhazikika, chifukwa chake, imachitidwa monga momwe anakonzera. Chifukwa cha kunyengaku, ndikotheka kuzindikira mikhalidwe yoyambirira m'magawo oyambilira ndikuletsa kupititsa patsogolo kwawo kwa carcinoma. Mpaka pano, pali njira zina zofufuzira, koma nthawi zambiri zimataya colonoscopy molingana ndi zidziwitso komanso magwiridwe antchito.

Chipangizo cha Colonoscope

Maonekedwe a colonoscope amafanana ndi chubu chakuda. Kutalika kwa chipangizo chokhazikika ndi 2m. Danga lamkati limakhala ndi kuwala kwamafuta okufikitsa chithunzicho kuwunika. Mu Chilatini, ulusi umamveka ngati ulusi. Poona izi, njira zakufufuzira za endoscopic zimadziwikanso kuti fibroscopy.

Danga lakunja kwa chipangizacho limayimiriridwa ndi chipolopolo choteteza chomwe chimalepheretsa kuwonongeka kwa zinthu za fiber optic. Kuphatikiza apo, zingwe zimadutsa pakati pazoteteza, chifukwa chomwe malekezero a colonoscope amatha kugwira kayendedwe m'mitundu iwiri. Chingwe cha backlight ndi machubu operekera mpweya chimadutsanso mchombo wakunja. Chifukwa cha zodabwitsa za gawo lokonzekera, makoma amatumbo amatha kugwa, chifukwa chake, pakukula, kugwiritsidwa ntchito kwa mpweya wa jet, komwe kumakupatsani mwayi wopititsa patsogolo chipangizocho.

Kodi fibroscopy ndi chiyani? Monga tafotokozera pamwambapa, ma fiberscope ndi lingaliro lophatikizika lomwe limaphatikizapo zida zonse kutengera kugwiritsa ntchito fiber.

Pamutu palinso ma forceps apadera, chifukwa chake ndizotheka kupanga zitsanzo zachilengedwe kuti zithandizidwenso ndi histologist. Mitundu yatsopano ya colonoscopes imakhala ndi chomaliza kumapeto ndi kamera, yofunikira kukonza magawo "osangalatsa" a mucous membrane wa colon. Dongosolo lamapulogalamu wamba limaposa 1.5 cm.

Kuwonongerani ndalama?

Pafupifupi gawo limodzi mwa magawo atatu onse a khansa ya m'matumbo amadziwika m'magawo apambuyo, pomwe chithandizo chikhala chovuta komanso chodula. Anthu onse opitilira 50 ali pachiwopsezo chotenga matumbo a oncology. Ngati wachibale wapezeka ndi carcinoma kapena njira ina iliyonse yamatumbo, ndikulimbikitsidwa kuti achibale ena apimidwe. Pamaso pa wachibale akudwala matenda a m'matumbo, timalimbikitsidwa kuyendera matumbo mpaka zaka 50.

Pali matenda am'matumbo omwe samavulala, koma chifukwa cha zomwe zimachitika pakukula kwake, amatha kusanduka khansa. Chifukwa cha colonoscopy, zotupa zoterezi zimatha kujambulidwa ndikuchotsedwa bwinobwino.

Khansa ya Colon ndi vuto lalikulu lomwe limadetsa nkhawa madokotala onse. Caka ciliconse, ku Europe kokha, kotala miliyoni miliyoni limafa ndi nthendayi. Ku United States, chiwerengero cha anthu omwalira chimakhala chochepa, koma izi zimachitika chifukwa cha kupewa kwambiri. Posachedwa, kwakhazikitsidwa kampeni ku Western Europe yopititsa patsogolo moyo wabwino komanso kufunikira koyambirira kwamankhwala a khansa ya colorectal. Unduna wa Zaumoyo ukuyesera kufotokozera anthu kuti colonoscopy ndiye "golide wabwino kwambiri" pofufuza khansa zamatumbo. Chifukwa cha kuyesedwa kwa anthu azaka zopitilira 50, ndizotheka kukonza chotupacho poyambira ndikuchichotsa bwinobwino. Mwachitsanzo, ku Germany, mayeso ambiri amachitidwa mopanda chiyembekezo, ndiye kuti, popanda kuchipatala asanachitike.

Colonoscopy ndi chinyengo chomwe chimasankhidwa ndi proctologist kuti ayang'anire. Monga lamulo, odwala amatembenukira kwa dokotala ndi madandaulo osiyanasiyana owonetsa matumbo athu. Kuti mumve tsatanetsatane wazomwe dipatimenti iyi ikupezeka m'mimba, kuyesedwa kwa endoscopic. Kutengera ndi zomwe adalandira, adotolo amawona njira zamankhwala ena. Mkhalidwe womwe umafuna colonoscopy ndi:

Kutulutsa kwachimake mu ndowe (magazi, ntchofu),
Mavuto a pafupipafupi monga kutsekula m'mimba kapena kudzimbidwa,
Zopweteka zam'mimba zosadziwika,
Kuchepetsa maselo ofiira am'magazi ndi hemoglobin, kuphatikizapo m'mimba,
Kuchepa thupi chifukwa chakusokonekera kwa chopondapo,
Kutola kwa zinthu zachilengedwe kuti mupange kafukufuku wina wolemba mbiri.

Zosiyanasiyana za colonoscopy

Samalirani thanzi lanu - sungani cholumikizacho

Popeza kupita patsogolo kwa sayansi sikuyimilira, ikupitilizabe njira zopezera matenda zomwe zimapangitsa moyo kukhala wosavuta kwa madokotala ndi odwala. Fibroscopy ndi njira yatsopano yofufuzira matenda am'matumbo, makamaka m'maiko a CIS, komabe, opanga zida zamankhwala samasiya kukonza matekinoloje omwe amagwiritsidwa ntchito. Njira ya colonoscopy pazaka zomwe idakhalapo yathandizidwa ndikuwongolera, zomwe zidaloleza kuti ikhale muyezo wodziwika m'matenda ambiri a colon. Mkusintha kosiyanasiyana, mitundu ingapo ya colonoscopy idapangidwa.

Ileocolonoscopy

Colonoscopy imaphatikizapo kuwerenga kwa rectum, sigmoid, iliac ndi colon blind. Zida zamakono zimakupatsaninso mwayi kuti mufufuze matumbo ang'onoang'ono a distal. Kutengera ndi zida, ndikotheka kulingalira kuchokera pa 5 mpaka 100 cm ya ileum. Izi ndizofunikira kwambiri chifukwa dipatimentiyi imawonedwa ngati yovuta kupeza malinga ndi kafukufuku. Ngati m'dera lino muli matenda oyambukira, leocolonoscopy ndi njira yabwino kwambiri yodziwira matenda.

Chromocolonoscopy

Ndi mtundu wamtunduwu wa colonoscopy, utoto wapadera umagwiritsidwa ntchito polekanitsa maselo athanzi ndi maselo am'magazi. Kutengera utoto wa machitidwe ena, kuyamwa kwa utoto kumasiyana. Magawo amasintha za mucous nembanemba, chifukwa cha utoto, amaonekeratu motsutsana ndi maziko a minofu yathanzi, yomwe imakupatsani mwayi wowunikira kapena kusangalatsa anthu okhudzidwa. Utotowo umakhala wotetezeka kwathunthu ku thupi la munthu, mothandizidwa ndizotheka kukonza zosintha izi mu epithelium ya kolon:

Dysplasia
Mucosal atypia,
Epithelial metaplasia.

Chowonera-sipekitiramu endoscopy

Nthawi zina, kuyang'ana kowoneka bwino kwamapangidwe omwe akuphunzirawa amafunikira. Kufikira izi, njira idapangidwa pogwiritsira ntchito mikwingwirima yopapatiza ya buluu ndi yobiriwira. Chifukwa cha kuyatsa kwa buluu, ndizotheka kupatula bwino ma capillaries a mucous membrane ndikulimbitsa mpumulo wake. Kuwala kobiriwira kumalowa mkati mwakuya, motero ndi thandizo lake ndikotheka kuwona m'maganizidwe omwe amapezeka kumbuyo kwa khoma lamkati lamatumbo.

Nthawi zambiri, polojekiti, mucous nembanemba amatenga kuwala kobiriwira, ma capillaries amakhala a bulauni, ndipo ma venuls amakhala buluu. Malinga ndi kafukufuku wa mawerengero, njirayi siyotsika poyerekeza chromocolonoscopy malinga ndi kufotokozera.

Kanema kapisozi colonoscopy

Kodi kanema kapisozi colonoscopy ndi chiyani? Vidiyo ya kapisozi endoscopy ikulowetsedwa mwachangu pantchito. Chinsinsi cha njirayi ndikuti wodwala amaloledwa kumeza kapisozi kokhala ndi chipinda. Vidiyo ya kapisozi endoscopy imakhala ndi chidziwitso chambiri, koma imakhala yotsika poyerekeza ndi colonoscopy. Choyamba, njirayi siofala, ndipo zida zofunikira sizikupezeka konse m'malo onse azachipatala. Kachiwiri, colonoscopy imakupatsani mwayi wina wogwiritsa ntchito, chifukwa chomwe achire amachitidwa. Chachitatu, mtengo wa video capsule endoscopy ukadali wokwera kwambiri.

Pambuyo potolera zinthu zachilengedwe komanso kutengera zotsatira za mayeso a mbiri yakale, ndikotheka kukhazikitsa kukhalapo kwa vuto loipa. Ndikosatheka kutsimikizira za matendawo pokhapokha pazotsatira zamalingaliro ofufuza, chifukwa chake biopsy ndi gawo lofunikira pakuthandizira khansa. Kutengera ndi zotsatira zake, njira zamachiritso zimasankhidwa ndipo funso la kuchuluka kwa machitidwe opanga opaleshoni lasankhidwa. Kuti muwonjezere kupambana kwa biology, tikulimbikitsidwa kuti muphatikize pamodzi ndi chromendoscopy. Ma neoplasms ena omwe ndi mawonekedwe osalala sangathe kusiyanitsidwa ndi madera okhala ndi minofu yathanzi, kotero kujambula ndikofunikira kwambiri.

Chifukwa cha chipangizocho, kugwiritsa ntchito maopaleshoni azinthu zochepa zovuta kuchitika. Ngati ma polyps, adenomas, ndi benign neoplasms yamagulu ang'onoang'ono atapezeka, endoscopist imachotsa chotupa. Njirayi imawerengedwa kuti ndi yapamwamba kwambiri, chifukwa mosiyana ndi machitidwe omwe amafunikira kuti atsegule pamimba, kuchotsa kwa polyps sikumvulaza wodwala.

Colonoscope imafunikira kuti matumbo apangidwe m'mimba. Mutu wa colonoscope uli ndi:

Tochi. Ndikofunikira kuwunikira komanso kuwona bwino mawonekedwe a matumbo lumen,
Tube wothandizira mpweya. Ngati wodwalayo adakonzekera bwino, ndiye kuti m'matumbo mwake sipamakhala chyme ndi ndowe. Makoma a matumbo adzagwa, chifukwa chake, kuti akwezeretse chipangizocho ndi kupewa kuvulaza mucosa, kuthamanga kwa mpweya kumapangidwa kuchokera ku chubu.
Camcorder. Zojambulidwa "zosangalatsa" za mucous membrane. Munthawi zotsutsana, adokotala amawunikiranso zomwe zalembedwazo kuti athe kuyesa momwe matendawa aliri, kudziwa kuchuluka kwa kuwonongeka ndikusankha njira yoyenera yoyenera.
Malilime Zofunika pokolera zakuthupi.

Kuti achititse colonoscopy, wodwalayo ayenera kupita kuchipinda chodzionetsera, ndikuchotsa pansi m'chiuno ndikugona pabedi. Malo a phunziroli azikhala kumanzere. Mbali iyi ya malo omwe wodwalayo amakupatsani mwayi wotsogola matumbo kudzera m'matumbo. Wodwala atatha kuchita zofunika, mutu wa colonoscope udzayikidwa mu anus. Kuti muwongolere mucous membrane, mpweya umaperekedwa. Mukatembenuza mutu wa chipangizocho, ndizotheka kulingalira madera osakhazikika a khoma lamkati la rectum. Ma endoscopist, posuntha colonoscope kudzera m'matumbo, amawunika kapangidwe kake, kupindapinda, mtundu wake, komanso mawonekedwe am'mimba a mucous membrane. Ngati ma neoplasms okayikira apezeka, zinthu zachilengedwe zimasonkhanitsidwa. Kuti mupeze zotsatira zolondola pamikhalidwe yovuta, tikulimbikitsidwa kuwonjezera madera okayikitsa a epithelium.

Kupumula

Palibe chizindikiro chotsimikizika chofunikira chothandizira opaleshoni yapakati pa colonoscopy. Komabe, chifukwa cha chidwi chapadera cha wodwalayo, ndi chidwi chachikulu cha anus, "euthanasia" ya nkhaniyi ingafunike. Ngakhale zimagwira, colonoscopy ndi njira yosasangalatsa. Odwala ena, chifukwa cha zovuta zomwe zimakumanapo ndi phunziroli, akhoza kukana kunyengerera. Muzochitika zotere, opaleshoni yayikulu ndichofunikira chofunikira, popanda icho sichingatheke kupanga matenda ndi chithandizo chofunikira.Zizindikiro zazikulu za opaleshoni yodziwika pakatikati ka colonoscopy ndi:

Chikhumbo cha mutu wopewa kusapeza bwino munthawiyo,
Zotsatira zosasangalatsa ndi colonoscopy yapita,
Kupititsa patsogolo chidziwitso chokhudzana ndi kutsekeka kwa gawo lamaganizidwe ndi zowawa,
Kuchotsa ma polyposis ambiri munjira yoyenera,
Kukula kwachidziwitso cha sigmoid colon (dolichosigma),
Kuchulukitsa kwamphamvu kwa wodwala,
Zaka za ana.

Nthawi yogwira ntchito

Ngakhale kuvulala kwambiri komanso kusowa kwavulala kwambiri m'matumbo, colonoscopy ndi njira yolowererapo yomwe imafuna kugona kwa nthawi yayitali. Kutalika kwa kama ogona kumatsimikiziridwa ndi adokotala. Nthawi zambiri, wodwalayo amatha kusiya zipupa za chipatala tsiku loyamba atanyengerera.

Malangizo omwe aperekedwa mu lembali sikuti akuwongolera kuchitapo kanthu. Kuti mumve zambiri, muyenera kufunsa katswiri.

Ngati colonoscopy inali ya mankhwala, ndipo madera a mucosal adawonongeka, tikulimbikitsidwa kupewa mankhwala ena (aspirin, ibuprofen, analgin, paracetamol) kwa milungu iwiri. Izi zimachepetsa mwayi wakutulutsa magazi pambuyo pake. Kuphatikiza apo, ndikofunikira kukana kumwa mankhwala omwe amachepetsa magazi. Dotolo ayenera kudziwitsa odwala za zovuta zomwe zingachitike chifukwa ch kumwa mankhwalawa.

Ngati mkati mwa colonoscopy biopsy kapena kuchotsedwa kwa ma polyps kudachitika, ndiye kuti mkati mwa masiku angapo mutha kuwona mu mpando. Ngati magazi akutuluka kwambiri kapena amatha maola opitilira 48, muyenera kudziwitsa dokotala za izi.

Zizindikiro zakukhazikitsa ESM:

Matenda oopsa a kum'mero, m'mimba ndi m'mimba

Endosonography ndiyo njira yokhayo yoonera zigawo za khomalo la kum'mero, m'mimba ndi m'matumbo. Ndi khansa yoyambirira, njirayi imakulolani kuzindikira kuthekera kochotsa chotupa chifukwa chotsimikiza molondola zakuya kwa kuzindikirika ndikuzindikiritsa kusintha kwa zigawo za m'mimba. Pankhani ya njira yotupa yofika patali, kukhazikitsa kwa ESD isanachitike komanso pambuyo pa chemoradiotherapy kumalola kuwunika momwe mankhwalawo amathandizira.

Kuchulukitsa kwa mapangidwe a kum'mero, m'mimba, duodenum 12

Njira imalola munthu kudziwa wosanjikiza khoma lachipangacho pomwe limapangidwira ndikukhazikitsa kukula kwake ndikuwongolera kukula kwake (kuloza cholocha kapena tinthu tating'onoting'ono), akuwonetsa mawonekedwe a mbiri yakale ya mapangidwe a mawonekedwe a ultrasound, fotokozani chifukwa chomwe chimasinthira khoma lachiwalo, kudziwa ngati chikugwirizana ndi kukhalapo kwa kapangidwe kakang'ono kapena komwe kanayambitsidwa chifukwa cha kukakamizidwa kwa chiwalo kuchokera kunja ndi gawo loyandikana nalo. Zomwe adazipeza zimatsimikizira njira zoyendetsera wodwalayo, ndipo ngati kuli koyenera, kuchotsedwa kwa maphunziro - kuthekera kochita opaleshoni ya endoscopic.

Matenda a kapamba

Endosonography imakuthandizani kuti muzitha kuwona zotupa zazing'ono zapanconic (zosakwana 3 cm), zosagwirizana ndi njira zoyenera za ultrasound ndi makompyuta, komanso molondola kwambiri kuposa angiography, kudziwa kuwonongeka kwa chotupa mu ziwiya zam'mimba, zomwe ndizofunikira kwambiri kuti zidziwike kuthekera kwa opaleshoni.

Akatswiri a dipatimenti yathu amapanga endo-ultrasound ya pancreatobiliary dera osati ma benign kapena ma neoplasms oyipa, komanso ma cysts (cholinga chodziwika ndi cystic neoplasias), pancreatitis yovuta kwambiri komanso yovuta chifukwa cha zovuta zachipatala ndi njira zina) chotupa).

Matenda a ndulu ndi biliary thirakiti

Tikuyankhula za kusiyanasiyana kwa mayendedwe a ndulu (ma polyps, adenomyosis, biliary sludge, calculi, kusintha kwa kutupa kwa khoma la gallbladder) ndi kuzindikiritsa kwa matenda am'mitsempha ya bile (zotupa, kupindika kwa chotupa, calculi). Njirayi ndiyofunika makamaka pakudziwidwa kwa zotupa m'madipatimenti a bile ndi ma pancreatic ducts ndi Vater papilla. Izi magawo sangafikire njira zina zodziwira matenda, ndipo ma neoplasms amderali (onse oopsa komanso olakwika) siosowa.

Zovuta zaumisiri zopanga ESM

Kusintha kwa ma anatomical komwe kumalepheretsa echo endoscope (esophageal diverticulum)
Matenda owopsa a kum'mero ndi kumimba kwam'mimba
Zilonda zoyipa pang'onopang'ono komanso kufooka kwa mphamvu ya bulp 12pc
Zotsatira pambuyo opaleshoni pa esophagus ndi m'mimba, ngati m'mimba mwake wa anastomosis ndi ochepera 12-13 mm.

Ngati mwachitapo opaleshoni ziwalo zam'mimba, komanso mwakapangidwira mawonekedwe a kapangidwe kake ka m'mimba kapena m'mimba, dziwitsani adokotala pasadakhale ndikuwonetsa zolemba zake.

Kodi kafukufukuyu amachitika bwanji?

Malinga ndi njira yophera, njirayi imafanana ndi esophagogastroscopy (EGDS), koma imayendera limodzi ndi kusamva bwino kwakuthupi. Zosasangalatsa ndizosangalatsa chifukwa chazikulu kwambiri pakachulukidwe ka chubu cholowa ndi kukhazikika kwake poyerekeza ndi gastroscope, komanso nthawi yayitali. Njira yonseyi nthawi zambiri imatenga mphindi 40 mpaka 90, kutengera mtundu wa scan, komanso ngati ikuphatikizidwa ndi njira zowonjezera zowunika (elastography, puncture biopsy).

Akatswiri a dipatimenti yathu amalimbikitsa kuchita endo-ultrasound pochita opaleshoni, mankhwala omwe amalumikizidwa kudzera m'mitsempha, chifukwa Khalidwe losasamala la wodwala limatha kusokoneza ntchito ya dokotala ndikuwononga zotsatira za mayeso.

Pambuyo pochita opaleshoni ya mankhwalawa, mutha kumva kuwodzera, kutopa kwa ola limodzi. Mukadzachira kwathunthu, adokotala amakambirana nanu zotsatila za njirayi.

Opaleshoni yoyang'aniridwa ndi endo-ultrasound

Kukonzekeretsa dipatimenti ndi ma envex end endope kumathandizira kuti apangidwe koyambira kwa singano ya mankhwala oyambira ndi zotsatirapo zakale zowunika za zomwe zapezedwa. Pansi pa kuwongolera kwa ultrasound, ndikotheka kuwerengera zotupa zam'mimba komanso pancreatic-biliary zone, cystic formations ndi lymph node ya Mediastinum ndi chapamwamba pamimba pamimba. Kudzinyenga kumeneku kumapatsa odwala mwayi wapadera wopewa opaleshoni kuti apange mapangidwe a chotupa, pomwepo kupulumutsa nthawi yofunikira, ndikukulolani kuti muyambitse chithandizo cham'mbuyomu.
Mothandizidwa ndi EUS, ndikotheka kukhetsa ma pseudocyst a kapamba, bile duct ndi ma pancreatic ducts, kukhazikitsa ma anastomoses osiyanasiyana (cholangiogastrostomy, gastroenterostomy, pancreaticogastrostomy).
Neurolysis ya celiac plexus yomwe ili pansi pa ulamuliro wa endo-ultrasound ndi njira yothandiza yolimbana ndi ululu wovuta kwa odwala osagwira ntchito omwe ali ndi zotupa za chiwindi, chiwindi, zomwe ndizofunikira kwambiri kwa odwala omwe akhala akutenga analgesics yolimba kwa nthawi yayitali komanso osachita bwino.

Monga njira zina za endoscopic, endo-ultrasound ndimaphunziro otetezeka komanso olekeredwa bwino. Komabe, monga machitidwe ena azachipatala, zovuta zina nthawi zina zimabukanso. Kuchulukitsa kwa endo-ultrasound kopanda singano biopsy ndi nkhani imodzi mwa maphunziro 2000, omwe amafanana ndi kuchuluka kwa zovuta kwa FGS.

Mavuto akulu akulu akhoza kukhala ndi:

Kukongola kwamkati. Izi ndizovuta kwenikweni pomwe njira zonse zatsatidwe zimatsatiridwa.
Kutulutsa magazi kumatha kuchitika mukamagwiritsa ntchito singano ya biopsy, koma sikokwanira (0.5-1.0%).
Pancreatitis (kutupa kwa kapamba) kumatha kuchitika chifukwa chobowoleza kapena kuchiritsira kwa mankhwalawa motsogozedwa ndi endo-ultrasound pa kapamba, koma sizichitika kawirikawiri. Pancreatitis imafunika kuchipatala, kuwunika, kulowetsedwa, ndi kupweteka. Nthawi zambiri zimatha patangopita masiku ochepa.

Akatswiri a Endoscopy amalimbikitsa mwamphamvu kuti mupange kafukufuku wazofufuza mkati mwa opaleshoni yamitsempha. Zowunikira pakuchita opaleshoni yoyang'aniridwa ndi endo-ultrasound imachitidwa pansi pa opaleshoni mosalephera. Zochita zina zamankhwala zingafunike kuchipatala.

Kuti athane ndi vuto la kuchitapo kanthu pochita opaleshoni pansi paulamuliro wa endo-ultrasound, kufunsa kwa wamkulu wa dipatimenti ya endoscopy Tkachenko O.B.