Gastric cancer yog ib qho ntawm cov qog nqaij hlav uas ua rau tib neeg lub neej txaus ntshai.Muaj 1.09 lab tus neeg mob tshiab hauv ntiaj teb txhua xyoo, thiab tus naj npawb ntawm cov neeg mob tshiab hauv kuv lub tebchaws yog siab txog 410,000.Qhov ntawd yog hais, kwv yees li 1,300 tus neeg hauv kuv lub tebchaws raug kuaj mob plab hnyuv txhua hnub.
Kev ciaj sia ntawm cov neeg mob qog noj ntshav plab yog ze ze rau qib ntawm kev mob qog noj ntshav plab.Kev kho tus mob cancer plab thaum ntxov tuaj yeem ncav cuag 90%, lossis txawm tias kho tau tag nrho.Kev kho tus mob qog nqaij hlav hauv nruab nrab theem nrab yog nyob nruab nrab ntawm 60% thiab 70%, thaum kho tus mob qog noj ntshav siab tsuas yog 30%.nyob ib ncig ntawm, thiaj li pom mob qog noj ntshav thaum ntxov.Thiab kev kho mob thaum ntxov yog tus yuam sij kom txo qis kev mob qog noj ntshav hauv plab.Hmoov zoo, nrog kev txhim kho ntawm endoscopic thev naus laus zis nyob rau xyoo tas los no, kev kuaj mob qog noj ntshav plab thaum ntxov tau ua tiav hauv kuv lub tebchaws, uas tau txhim kho qhov kev kuaj pom tus mob qog noj ntshav thaum ntxov;
Yog li, dab tsi yog mob qog noj ntshav thaum ntxov?Yuav ua li cas txhawm rau kuaj mob qog noj ntshav thaum ntxov?Yuav kho li cas?
1 Lub tswv yim ntawm kev mob qog noj ntshav thaum ntxov
Clinically, kab mob plab thaum ntxov feem ntau yog hais txog mob qog noj ntshav nrog cov kab mob ntxov ntxov, cov kab mob me me thiab tsis muaj cov tsos mob pom tseeb.Thaum ntxov mob qog noj ntshav feem ntau yog kuaj los ntawm gastroscopic biopsy pathology.Pathologically, mob qog noj ntshav thaum ntxov yog hais txog cov qog nqaij hlav qog nqaij hlav rau cov mucosa thiab submucosa, thiab txawm tias cov qog loj npaum li cas thiab seb puas muaj cov qog nqaij hlav qog nqaij hlav, nws yog cov qog nqaij hlav ntxov ntxov.Nyob rau hauv xyoo tas los no, mob hnyav dysplasia thiab qib high-qib intraepithelial neoplasia kuj raug cais raws li kev mob plab thaum ntxov.
Raws li qhov loj ntawm cov qog, cov qog nqaij hlav plab thaum ntxov tau muab faib ua: mob plab me me: txoj kab uas hla ntawm cov qog nqaij hlav foci yog 6-10 hli.Mob qog noj ntshav me me: Txoj kab uas hla ntawm cov qog foci tsawg dua lossis sib npaug li 5 hli.Punctate carcinoma: Lub plab mucosa biopsy yog mob qog noj ntshav, tab sis tsis muaj cov qog nqaij hlav cancer tuaj yeem pom nyob rau hauv cov qauv ntawm kev phais phais.
Endoscopically, kab mob plab thaum ntxov tau muab faib ua: hom (polypoid hom): cov neeg uas muaj cov qog nqaij hlav loj txog li 5 hli lossis ntau dua.Hom II (hom superficial): Lub qog loj yog uplifted los yog kev nyuaj siab nyob rau hauv 5 hli.Hom III (rooj hom): Qhov tob ntawm kev nyuaj siab ntawm cov qog nqaij hlav cancer ntau tshaj 5 hli, tab sis tsis tshaj qhov submucosa.
2 Dab tsi yog cov tsos mob ntawm mob qog noj ntshav thaum ntxov
Feem ntau cov qog nqaij hlav plab thaum ntxov tsis muaj cov tsos mob tshwj xeeb, uas yog hais, cov tsos mob thaum ntxov ntawm plab hnyuv tsis muaj tsos mob.network
Cov npe hu ua cov cim qhia ntxov ntawm mob qog noj ntshav nyob hauv Is Taws Nem yog qhov tseeb tsis yog qhov tshwm sim ntxov.Txawm hais tias nws yog kws kho mob lossis tus neeg muaj koob muaj npe, nws nyuaj rau txiav txim los ntawm cov tsos mob thiab cov cim qhia.Qee tus neeg yuav muaj qee cov tsos mob uas tsis yog tshwj xeeb, feem ntau yog plab zom mov, xws li mob plab, plab plab, thaum ntxov satiety, tsis qab los noj mov, acid regurgitation, heartburn, belching, hiccups, thiab lwm yam. Cov tsos mob no zoo ib yam li cov teeb meem plab, yog li lawv feem ntau tsis nyiam tib neeg txoj kev xav.Yog li ntawd, rau cov neeg muaj hnub nyoog tshaj 40 xyoo, yog tias lawv muaj cov tsos mob tshwm sim ntawm kev zom zaub mov, lawv yuav tsum mus rau tsev kho mob kom tau txais kev kho mob raws sij hawm, thiab ua gastroscopy yog tias tsim nyog, kom tsis txhob nco lub sijhawm zoo tshaj plaws los kuaj mob plab thaum ntxov.
3 Yuav ua li cas txhawm rau kuaj mob qog noj ntshav thaum ntxov
Nyob rau hauv xyoo tas los no, cov kws kho mob hauv peb lub teb chaws, suav nrog cov xwm txheej tiag tiag ntawm peb lub tebchaws, tau tsim "Cov Kws Tshaj Lij Tshaj Lij Tshaj Lij Tshaj Lij Tshaj Lij Tshaj Lij Tshaj Plaws hauv Suav teb".
Nws yuav ua lub luag haujlwm zoo hauv kev txhim kho tus nqi kuaj mob thiab kho tus nqi ntawm kev mob qog noj ntshav thaum ntxov.
Kev kuaj mob qog noj ntshav thaum ntxov yog tsom rau qee cov neeg mob uas muaj kev pheej hmoo siab, xws li cov neeg mob uas muaj tus kab mob Helicobacter pylori, cov neeg mob uas muaj tsev neeg keeb kwm mob qog noj ntshav, cov neeg mob uas muaj hnub nyoog 35 xyoos, cov neeg haus luam yeeb ntev, thiab nyiam cov zaub mov noj.
Thawj txoj kev tshuaj ntsuam yog tsuas yog los txiav txim siab cov neeg muaj kev pheej hmoo siab ntawm mob qog noj ntshav los ntawm kev kuaj serological, uas yog, los ntawm kev ua haujlwm ntawm plab hnyuv thiab Helicobacter pylori antibody nrhiav.Tom qab ntawd, cov pab pawg muaj kev pheej hmoo siab pom nyob rau hauv cov txheej txheem kev tshuaj ntsuam thawj zaug tau ua tib zoo tshuaj xyuas los ntawm gastroscope, thiab kev soj ntsuam ntawm cov kab mob tuaj yeem ua rau muaj kev cuam tshuam ntau dua los ntawm kev nthuav dav, staining, biopsy, thiab lwm yam, txhawm rau txiav txim siab seb qhov mob puas yog mob qog noj ntshav. thiab seb lawv puas tuaj yeem kho tau raws li lub tshuab microscope.
Tau kawg, nws kuj yog ib txoj hauv kev zoo dua los kuaj xyuas kab mob plab thaum ntxov los ntawm kev siv lub plab zom mov endoscopy rau hauv cov khoom kuaj lub cev niaj hnub hauv cov neeg noj qab haus huv los ntawm kev kuaj lub cev.
4 Dab tsi yog qhov kev kuaj mob plab thiab kev kuaj mob qog noj ntshav hauv plab
Kev kuaj mob plab yog txhawm rau txheeb xyuas qhov sib piv ntawm pepsinogen 1 (PGI), pepsinogen (PGl1, thiab protease) hauv cov ntshav.
(PGR, PGI/PGII) gastrin 17 (G-17) cov ntsiab lus, thiab kev kuaj mob qog noj ntshav hauv plab yog ua raws li cov txiaj ntsig ntawm kev kuaj mob plab, ua ke nrog cov qhab nia zoo xws li Helicobacter pylori antibody, hnub nyoog thiab poj niam txiv neej, los txiav txim. txoj kev pheej hmoo mob qog noj ntshav, los ntawm kev kuaj mob qog noj ntshav hauv plab, tuaj yeem tshuaj xyuas cov pab pawg nruab nrab thiab muaj kev pheej hmoo siab mob qog noj ntshav.
Endoscopy thiab taug qab yuav ua rau cov pab pawg nruab nrab thiab muaj kev pheej hmoo siab.Cov pab pawg muaj kev pheej hmoo siab yuav raug tshuaj xyuas tsawg kawg ib xyoos ib zaug, thiab cov pab pawg muaj kev pheej hmoo nruab nrab yuav raug tshuaj xyuas tsawg kawg ib zaug txhua 2 xyoos.Qhov kev tshawb pom tiag tiag yog mob qog noj ntshav thaum ntxov, uas tuaj yeem kho tau los ntawm kev phais endoscopic.Qhov no tuaj yeem tsis tsuas yog txhim kho kev tshawb pom ntxov ntawm kev mob qog noj ntshav, tab sis kuj txo qis qhov tsis tsim nyog endoscopy hauv cov pab pawg uas tsis tshua muaj kev pheej hmoo.
5 Gastroscopy yog dab tsi
Txhawm rau muab nws yooj yim, gastroscopy yog ua qhov kev tshuaj ntsuam xyuas endoscopic morphological ntawm cov kab mob tsis txaus ntseeg pom nyob rau tib lub sijhawm raws li niaj hnub gastroscopy, suav nrog lub teeb dawb dawb endoscopy, chromoendoscopy, magnifying endoscopy, confocal endoscopy thiab lwm txoj hauv kev.Cov kab mob tau txiav txim siab ua benign los yog tsis txaus ntseeg rau malignancy, thiab tom qab ntawd kev kuaj ntshav ntawm qhov xav tias malignant lesion yog ua, thiab qhov kev kuaj zaum kawg yog tsim los ntawm pathology.Txhawm rau txiav txim siab seb puas muaj cov kab mob qog noj ntshav, qhov ntev ntawm kev nkag mus rau sab nraud ntawm cov qog nqaij hlav, qhov tob ntawm txoj kab ntsug infiltration, qib ntawm kev sib txawv, thiab seb puas muaj cov cim qhia rau kev kho mob microscopic.
Piv nrog rau qhov zoo tib yam gastroscopy, kev kuaj mob gastroscopic yuav tsum tau ua nyob rau hauv qhov tsis muaj mob, tso cai rau cov neeg mob so kom txaus rau lawv tus kheej hauv lub xeev pw luv luv thiab ua gastroscopy yam xyuam xim.Gastroscopy muaj kev xav tau siab rau cov neeg ua haujlwm.Nws yuav tsum tau raug cob qhia thaum ntxov muaj mob qog nqaij hlav, thiab cov kev kawm endoscopists tuaj yeem ua kom pom cov ncauj lus kom ntxaws ntxiv, yog li txhawm rau txhawm rau tshuaj thiab ua kom tsim nyog thiab txiav txim.
Gastroscopy muaj cov kev xav tau siab ntawm cov cuab yeej, tshwj xeeb tshaj yog nrog cov duab txhim kho thev naus laus zis xws li chromoendoscopy / electron chromoendoscopy lossis magnifying endoscopy.Ultrasound gastroscopy kuj yuav tsum tau yog tias tsim nyog.
6 Kev kho mob qog noj ntshav thaum ntxov
1. Endoscopic resection
Thaum kuaj mob qog noj ntshav thaum ntxov, endoscopic resection yog thawj qhov kev xaiv.Piv nrog rau kev phais ib txwm, endoscopic resection muaj qhov zoo ntawm kev raug mob tsawg dua, muaj teeb meem tsawg dua, rov qab sai dua, thiab tus nqi qis dua, thiab qhov ua tau zoo ntawm ob qho tib si yeej zoo ib yam.Yog li ntawd, endoscopic resection yog pom zoo nyob rau hauv tsev thiab txawv teb chaws raws li cov kev kho mob uas nyiam rau thaum ntxov gastric cancer.
Tam sim no, feem ntau siv endoscopic resections feem ntau suav nrog endoscopic mucosal resection (EMR) thiab endoscopic submucosal dissection (ESD).Ib lub tshuab tshiab tsim, ESD ib leeg-channel endoscopy, tuaj yeem ua tiav ib zaug ntawm qhov kev txiav txim siab ntawm cov kab mob sib sib zog nqus mus rau hauv cov leeg nqaij propria, thaum tseem muab qhov tseeb pathological staging kom txo qis rov tshwm sim lig.
Nws yuav tsum tau muab sau tseg hais tias endoscopic resection yog ib tug minimally invasive phais, tab sis tseem muaj ib tug siab tshwm sim ntawm cov teeb meem, feem ntau nrog rau los ntshav, perforation, Stenosis, mob plab, kis kab mob, thiab lwm yam. Yog li ntawd, tus neeg mob lub postoperative kev kho mob, recuperation, thiab tshuaj xyuas yuav tsum. koom tes nrog tus kws kho mob kom rov zoo sai li sai tau.
2 Laparoscopic phais
Kev phais laparoscopic tuaj yeem txiav txim siab rau cov neeg mob qog noj ntshav thaum ntxov uas tsis tuaj yeem ua tiav endoscopic resection.Laparoscopic phais yog qhib cov kab me me hauv tus neeg mob lub plab.Laparoscopes thiab cov cuab yeej ua haujlwm tau muab tso rau hauv cov kab no uas muaj kev phom sij me ntsis rau tus neeg mob, thiab cov duab cov ntaub ntawv hauv plab kab noj hniav raug xa mus rau lub vijtsam zaub los ntawm laparoscope, ua tiav raws li kev taw qhia ntawm laparoscope.Kev phais mob plab.Laparoscopic phais tuaj yeem ua tiav kev ua haujlwm ntawm laparotomy ib txwm ua, ua qhov loj lossis tag nrho gastrectomy, tshem tawm cov qog ntshav qab zib, thiab lwm yam, thiab muaj cov ntshav tsawg dua, tsis muaj kev puas tsuaj, tsawg dua tom qab phais qhov caws pliav, mob tsawg dua, thiab rov qab ua haujlwm sai dua tom qab kev phais.
3. Qhib kev phais
Txij li 5% mus rau 6% ntawm intramucosal gastric cancer thiab 15% mus rau 20% ntawm submucosal gastric cancer muaj perigastric lymph node metastasis, tshwj xeeb tshaj yog undifferentiated adenocarcinoma nyob rau hauv cov poj niam hluas, ib txwm laparotomy tuaj yeem txiav txim siab, uas tuaj yeem raug tshem tawm radically thiab Lymph node dissection.
Cov ntsiab lus
Txawm hais tias mob qog noj ntshav ua rau mob plab heev, nws tsis txaus ntshai.Ntev npaum li kev paub txog kev tiv thaiv zoo dua, mob qog noj ntshav tuaj yeem kuaj tau lub sijhawm thiab kho ntxov, thiab nws muaj peev xwm ua tiav kev kho tiav.Yog li, nws raug pom zoo tias cov pab pawg muaj kev pheej hmoo siab tom qab hnub nyoog 40 xyoo, txawm tias lawv puas muaj lub plab zom mov tsis zoo, yuav tsum tau kuaj xyuas ntxov rau kev mob qog noj ntshav, lossis kab mob plab hnyuv yuav tsum tau ntxiv rau kev kuaj lub cev ib txwm ua kom pom qhov xwm txheej ntxov. mob cancer thiab cawm lub neej thiab tsev neeg zoo siab.
Peb, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., yog cov chaw tsim khoom hauv Suav teb tshwj xeeb hauv cov khoom siv endoscopic, xws libiopsy forceps, hemoclip,polyp nuv, koob sclerotherapy, tshuaj tsuag catheter, cytology txhuam, phau ntawv qhia, pob zeb retrieval pob tawb, qhov ntswg biliary kua catheterthiab lwm yam uas tau siv dav hauv EMR, ESD, ERCP.Peb cov khoom muaj ntawv pov thawj CE, thiab peb cov nroj tsuag tau ntawv pov thawj ISO.Peb cov khoom tau raug xa tawm mus rau Tebchaws Europe, North America, Middle East thiab ib feem ntawm Asia, thiab tau txais cov neeg siv khoom ntawm kev lees paub thiab qhuas!
Post lub sij hawm: Jun-21-2022