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與傳統手術相比,微創手術具有創傷小、恢復性快、降低患者痛苦等優勢。而內窺鏡微創醫療器械作為醫生的“眼睛”能夠有效地幫助醫生“看清“病灶。隨著微創手術技術在全球范圍內的普及,內窺鏡也進入快速發展時期。據Markets and Markets報告顯示,2019年全球內窺鏡的市場容量約為256億美金,將以6.6%的復合年增長率增長,到2024年將達到352億美金。而傳統內窺鏡的交叉感染問題又該如何解決呢?
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、內窺鏡歷史
1、 History of Endoscopy
醫學內鏡即內窺鏡至今已有 200 多年歷史,其發展經歷了四個階段:硬式內窺鏡、半可屈式內窺鏡、纖維內窺鏡和電子內窺鏡。1806年德國法蘭克福BOZZini制造的以蠟燭為光源的膀胱與直腸內部器械,這是硬式內窺鏡最初的雛形。1932年Schindler與Wolf合作研制成功真正意義上的半可屈式內窺鏡,開辟了胃鏡檢查的新紀元。為了更好的解決內窺鏡照明效果差、圖像色彩扭曲的缺點,1957年Hirschowitz及其研發團隊研制出了世界上第一個檢查胃、十二指腸的光導纖維內窺鏡。
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Welch Allyn公司成功研制出CCD微型圖像傳感器代替了內鏡的光導纖維導像術,第一臺電子內鏡誕生。經歷了四個階段的發展,內鏡技術不斷得到了更新,這也為微創手術的普及成為了可能,而微創手術的繁榮也豐富了內鏡的種類。隨著微創手術的繁榮發展,新型的內鏡產品仍在不斷的推陳出新。?二、內窺鏡分類
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
內窺鏡在臨床中被廣泛應用于不同科室和不同疾病治療。主要分為軟管式內窺鏡(簡稱軟鏡)和硬管式內窺鏡(簡稱硬鏡),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、關節鏡、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、宮腔鏡等類別。各類型硬鏡與配套設備搭配使用完成各種類型疾病的診斷和治療。硬鏡的主要配套設備有攝像系統主機,攝像頭,冷光源,監視器,臺車等。硬鏡主要進入人體無菌組織、器官或者經外科切口進入人體無菌腔室,如腹腔鏡、胸腔鏡、關節鏡、椎間盤鏡、腦室鏡等。硬鏡為棱鏡光學系統,最大優點是成像清晰,可配多個工作通道,選取多個視角。
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
軟鏡主要通過人體的自然腔道來完成檢查、診斷和治療,如胃鏡、腸鏡、喉鏡、支氣管鏡等主要通過人體的消化道、呼吸道及泌尿道進入人體。軟鏡的光學系統為光導纖維光學系統,此光纖內窺鏡最大特點是鏡頭部分可被術者操縱改變方向,擴大應用的范圍,但成像效果不如硬質鏡效果好。軟鏡現已應用在消化內科、呼吸內科、耳鼻喉科、泌尿外科、肛腸科、胸腔外科、婦科等多個科室,從簡單的疾病篩查到復雜的賁門失弛緩癥的治療,帶給患者診治及時準確、風險性低、手術創傷小和術后恢復快等益處。
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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