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與傳統(tǒng)手術(shù)相比,微創(chuàng)手術(shù)具有創(chuàng)傷小、恢復(fù)性快、降低患者痛苦等優(yōu)勢(shì)。而內(nèi)窺鏡微創(chuàng)醫(yī)療器械作為醫(yī)生的“眼睛”能夠有效地幫助醫(yī)生“看清“病灶。隨著微創(chuàng)手術(shù)技術(shù)在全球范圍內(nèi)的普及,內(nèi)窺鏡也進(jìn)入快速發(fā)展時(shí)期。據(jù)Markets and Markets報(bào)告顯示,2019年全球內(nèi)窺鏡的市場(chǎng)容量約為256億美金,將以6.6%的復(fù)合年增長(zhǎng)率增長(zhǎng),到2024年將達(dá)到352億美金。而傳統(tǒng)內(nèi)窺鏡的交叉感染問(wèn)題又該如何解決呢?
Compared with traditional surgery, minimally invasive surgery has advantages such as minimal trauma, fast recovery, and reduced patient pain. Endoscopic minimally invasive medical devices, as the "eyes" of doctors, can effectively help them "see" lesions clearly. With the popularization of minimally invasive surgical technology worldwide, endoscopes have also entered a period of rapid development. According to the Markets and Markets report, the global market capacity of endoscopes was about 25.6 billion US dollars in 2019, which will grow at a compound annual growth rate of 6.6% and reach 35.2 billion US dollars by 2024. And how to solve the problem of cross infection in traditional endoscopes?
一、內(nèi)窺鏡歷史
1、 History of Endoscopy
醫(yī)學(xué)內(nèi)鏡即內(nèi)窺鏡至今已有 200 多年歷史,其發(fā)展經(jīng)歷了四個(gè)階段:硬式內(nèi)窺鏡、半可屈式內(nèi)窺鏡、纖維內(nèi)窺鏡和電子內(nèi)窺鏡。1806年德國(guó)法蘭克福BOZZini制造的以蠟燭為光源的膀胱與直腸內(nèi)部器械,這是硬式內(nèi)窺鏡最初的雛形。1932年Schindler與Wolf合作研制成功真正意義上的半可屈式內(nèi)窺鏡,開(kāi)辟了胃鏡檢查的新紀(jì)元。為了更好的解決內(nèi)窺鏡照明效果差、圖像色彩扭曲的缺點(diǎn),1957年Hirschowitz及其研發(fā)團(tuán)隊(duì)研制出了世界上第一個(gè)檢查胃、十二指腸的光導(dǎo)纖維內(nèi)窺鏡。
Medical endoscopy, also known as endoscopy, has a history of over 200 years and has gone through four stages of development: rigid endoscope, semi flexible endoscope, fiber endoscope, and electronic endoscope. In 1806, Bozzini in Frankfurt, Germany, manufactured a bladder and rectal endoscope with candles as the light source, which was the initial prototype of a rigid endoscope. In 1932, Schindler and Wolf collaborated to develop a truly semi flexible endoscope, ushering in a new era of gastroscopy examination. In order to better address the shortcomings of poor illumination and distorted image colors in endoscopes, Hirschowitz and his research team developed the world's first fiber-optic endoscope for examining the stomach and duodenum in 1957.
1983年,美國(guó)Welch Allyn公司成功研制出CCD微型圖像傳感器代替了內(nèi)鏡的光導(dǎo)纖維導(dǎo)像術(shù),第一臺(tái)電子內(nèi)鏡誕生。經(jīng)歷了四個(gè)階段的發(fā)展,內(nèi)鏡技術(shù)不斷得到了更新,這也為微創(chuàng)手術(shù)的普及成為了可能,而微創(chuàng)手術(shù)的繁榮也豐富了內(nèi)鏡的種類(lèi)。隨著微創(chuàng)手術(shù)的繁榮發(fā)展,新型的內(nèi)鏡產(chǎn)品仍在不斷的推陳出新。?二、內(nèi)窺鏡分類(lèi)
In 1983, Welch Allyn, an American company, successfully developed a CCD miniature image sensor to replace the optical fiber guidance of endoscopy, and the first electronic endoscope was born. After four stages of development, endoscopic technology has been continuously updated, which has made it possible for the popularization of minimally invasive surgery. The prosperity of minimally invasive surgery has also enriched the types of endoscopes. With the flourishing development of minimally invasive surgery, new endoscopic products are still constantly being introduced.? 2、 Classification of endoscopes
內(nèi)窺鏡在臨床中被廣泛應(yīng)用于不同科室和不同疾病治療。主要分為軟管式內(nèi)窺鏡(簡(jiǎn)稱(chēng)軟鏡)和硬管式內(nèi)窺鏡(簡(jiǎn)稱(chēng)硬鏡),軟鏡主要是胃鏡、腸鏡、喉鏡、纖維支氣管鏡等;硬鏡包括腹腔鏡、胸腔鏡、輸尿管鏡、膀胱鏡、關(guān)節(jié)鏡、宮腔鏡等。
Endoscopy is widely used in clinical practice for the treatment of different departments and diseases. It is mainly divided into flexible tube endoscopes (referred to as soft endoscopes) and rigid tube endoscopes (referred to as hard endoscopes). Soft endoscopes mainly include gastroscopes, colonoscopes, laryngoscopes, fiberoptic bronchoscopes, etc; Hard endoscopes include laparoscopy, thoracoscopy, ureteroscopy, cystoscopy, arthroscopy, hysteroscopy, etc.
1、硬鏡
1. Hard Mirror
硬鏡可以分為腹腔鏡、胸腔鏡、宮腔鏡等類(lèi)別。各類(lèi)型硬鏡與配套設(shè)備搭配使用完成各種類(lèi)型疾病的診斷和治療。硬鏡的主要配套設(shè)備有攝像系統(tǒng)主機(jī),攝像頭,冷光源,監(jiān)視器,臺(tái)車(chē)等。硬鏡主要進(jìn)入人體無(wú)菌組織、器官或者經(jīng)外科切口進(jìn)入人體無(wú)菌腔室,如腹腔鏡、胸腔鏡、關(guān)節(jié)鏡、椎間盤(pán)鏡、腦室鏡等。硬鏡為棱鏡光學(xué)系統(tǒng),最大優(yōu)點(diǎn)是成像清晰,可配多個(gè)工作通道,選取多個(gè)視角。
Hard endoscopes can be divided into categories such as laparoscopy, thoracoscopy, hysteroscopy, etc. Various types of hard lenses are used in conjunction with supporting equipment to diagnose and treat various types of diseases. The main supporting equipment for hard mirrors includes a camera system host, a camera, a cold light source, a monitor, a trolley, etc. Hard endoscopes mainly enter sterile tissues and organs of the human body or enter sterile chambers through surgical incisions, such as laparoscopy, thoracoscopy, arthroscopy, discoscopy, ventriculoscopy, etc. The hard mirror is a prism optical system, with the greatest advantage of clear imaging. It can be equipped with multiple working channels and select multiple viewing angles.
2、軟鏡
What? 2. Soft mirror
軟鏡主要通過(guò)人體的自然腔道來(lái)完成檢查、診斷和治療,如胃鏡、腸鏡、喉鏡、支氣管鏡等主要通過(guò)人體的消化道、呼吸道及泌尿道進(jìn)入人體。軟鏡的光學(xué)系統(tǒng)為光導(dǎo)纖維光學(xué)系統(tǒng),此光纖內(nèi)窺鏡最大特點(diǎn)是鏡頭部分可被術(shù)者操縱改變方向,擴(kuò)大應(yīng)用的范圍,但成像效果不如硬質(zhì)鏡效果好。軟鏡現(xiàn)已應(yīng)用在消化內(nèi)科、呼吸內(nèi)科、耳鼻喉科、泌尿外科、肛腸科、胸腔外科、婦科等多個(gè)科室,從簡(jiǎn)單的疾病篩查到復(fù)雜的賁門(mén)失弛緩癥的治療,帶給患者診治及時(shí)準(zhǔn)確、風(fēng)險(xiǎn)性低、手術(shù)創(chuàng)傷小和術(shù)后恢復(fù)快等益處。
Soft endoscopy mainly completes examination, diagnosis, and treatment through the natural cavity of the human body, such as gastroscopy, colonoscopy, laryngoscopy, bronchoscopy, etc. It mainly enters the human body through the digestive tract, respiratory tract, and urinary tract. The optical system of the soft endoscope is an optical fiber optic system. The biggest feature of this fiber optic endoscope is that the lens part can be manipulated by the surgeon to change direction, expanding the range of applications. However, the imaging effect is not as good as that of the hard endoscope. Soft endoscopy has been applied in multiple departments such as gastroenterology, respiratory medicine, otolaryngology, urology, proctology, thoracic surgery, gynecology, etc. It provides patients with timely and accurate diagnosis and treatment, low risk, minimal surgical trauma, and fast postoperative recovery, from simple disease screening to complex treatment of achalasia.
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