Pa chithandizo cha colonoscopic, zovuta zoyimilira ndizobowola komanso kutuluka magazi.
Perforation amatanthauza dziko limene patsekeke momasuka kulumikiza patsekeke thupi chifukwa cha makulidwe minofu chilema, ndi kukhalapo kwa mpweya waulere pa X-ray kufufuza sikukhudza tanthauzo lake.
Pamene periphery of full-thickness tissue chilema ataphimbidwa ndipo palibe kulankhulana kwaulere ndi pabowo thupi, amatchedwa perforation. Tanthauzo la magazi silinatchulidwe bwino, ndipo malingaliro amakono akuphatikizapo kuchepa kwa hemoglobini yoposa 2 g/dL kapena kufunikira kwa kuikidwa magazi.
Kutaya magazi pambuyo pa opaleshoni kumatanthauzidwa ngati kuchitika kwa magazi ofunika kwambiri mu chopondapo pambuyo pa opaleshoni yomwe imafuna chithandizo cha hemostatic kapena kuikidwa magazi.
Zomwe zimachitika mwadzidzidzi zimasiyanasiyana malinga ndi chithandizo:
Mlingo woboola:
Polypectomy: 0.05%
Endoscopic mucosal resection (EMR0.58% ~ 0.8%
Zogwirizana ndi Endoscopic Consumables:Polypectomy Snare
Zogwirizana ndi Endoscopic Consumables:Zithunzi za Hemostastic
Zogwirizana ndi Endoscopic Consumables: Sclerotherapy singano
Endoscopic submucosal dissection (ESD): 2% ~ 14%
Zogwirizana ndi Endoscopic Consumables:ESD mpeni
Zogwirizana ndi Endoscopic Consumables: ZotayidwaESD mpeni
Kutuluka magazi pambuyo pa opaleshoni:
Polypectomy: 1.6%
EMR: 1.1% ~ 1.7%
ESD: 0.7% ~ 3.1%
1. Momwe mungathanirane ndi kubowola
Popeza khoma la matumbo akuluakulu ndi lochepa kwambiri kuposa la m'mimba, chiopsezo choboola ndi chachikulu. Kukonzekera kokwanira kumafunika musanachite opaleshoni kuti muthane ndi kuthekera kwa kuphulika.
Njira zopewera ma Intraoperative:
Onetsetsani kuti endoscope ikugwira ntchito bwino. Sankhani ma endoscopes oyenera, zida zochizira, madzi a jakisoni, ndi zida zoperekera mpweya wa carbon dioxide molingana ndi malo, morphology, ndi digiri ya fibrosis ya chotupacho.
Kuwongolera kwa intraoperative perforation:
Kutsekeka pompopompo: Mosasamala kanthu za malo, zojambulidwa zimasankhidwa kuti zitseke (mphamvu yolangizira: mlingo 1, mulingo waumboni: C). Mu ESD, nthawi zina malo ozungulira ayenera kuchotsedwa kaye kuti asasokoneze ntchito yopeta.
Tissue, onetsetsani malo ogwirira ntchito okwanira musanatseke.
Kuwona pambuyo pa opaleshoni: Ngati kuphulika kungathe kutsekedwa kwathunthu, opaleshoni ikhoza kupewedwa ndi chithandizo chokha cha maantibayotiki ndi kusala kudya.
Chisankho cha Opaleshoni: Kufunika kwa opaleshoni kumatsimikiziridwa pogwiritsa ntchito zizindikiro za m'mimba, zotsatira za kuyezetsa magazi, ndi kujambula m'malo mwa mpweya waulere womwe umasonyezedwa pa CT yokha.
Chithandizo cha magawo apadera:
The rectum m'munsi sichidzayambitsa kuphulika kwa m'mimba chifukwa cha mawonekedwe ake, koma kungayambitse
Kuphulika kwa chiuno, kuwonetseredwa ngati retroperitoneal, mediastinal, kapena subcutaneous emphysema.
Kusamalitsa:
Kutseka chilonda pambuyo pa opaleshoni kungalepheretse zovuta zina, koma sizitero
Pali umboni wokwanira wosonyeza kuti ndi wothandiza popewa kuchedwa kuphulika.
2. Kuyankha pa Kutaya Magazi
Kuwongolera magazi m'thupi:
Gwiritsani ntchito kutentha kwa coagulation kapenahemostatic tatifupikusiya magazi.
Kutaya magazi m'thupi laling'ono:
In EMR, nsonga ya msampha ingagwiritsidwe ntchito pa kutentha kwa thupi.
Mu ESD, nsonga ya mpeni wamagetsi imatha kugwiritsidwa ntchito kulumikizana ndi matenthedwe amadzimadzi kapena ma hemostatic forceps kuti asiye kutuluka magazi.
Kutaya magazi m'chiwiya chachikulu: Gwiritsani ntchito mphamvu za hemostatic, koma wongolerani kuchuluka kwa ma coagulation kuti musachedwe kuphulika.
Kupewa kutaya magazi pambuyo pa opaleshoni:
Kuchotsa chilonda pambuyo pa EMR:
Kafukufuku wasonyeza kuti kugwiritsa ntchito hemostatic clamps pofuna kupewa coagulation sikukhudza kwambiri kuthamanga kwa magazi pambuyo pa opaleshoni, koma pali njira yochepetsera. Kutsekeka kodziletsa kumakhudza zotupa zazing'ono, koma kumakhala kothandiza kwa zotupa zazikulu kapena odwala omwe ali pachiwopsezo chotaya magazi pambuyo pa opaleshoni (monga omwe akulandira mankhwala a antithrombotic).
Kuchotsa mabala pambuyo pa ESD:
Mitsempha yamagazi yowonekera imakhazikika, ndipo ma clip a hemostatic atha kugwiritsidwa ntchito kupewa kugunda kwa mitsempha yayikulu.
Zindikirani:
Kwa EMR ya zilonda zing'onozing'ono, chithandizo chodzitetezera nthawi zonse sichivomerezeka, koma kwa zilonda zazikulu kapena odwala omwe ali pachiopsezo chachikulu, kupopera koteteza pambuyo pa opaleshoni kumakhala ndi zotsatira zina (mphamvu yolangizira: Level 2, mlingo wa umboni: C).
Kuphulika ndi kutuluka magazi ndizovuta zomwe zimachitika pa colorectal endoscopy.
Kutenga njira zoyenera zopewera ndi kuchiza pamikhalidwe yosiyanasiyana kumatha kuchepetsa kufala kwa matenda apanthawi ndi apo ndikuwongolera chitetezo cha odwala.
Ife, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ndi opanga ku China okhazikika pazakudya zama endoscopic, mongabiopsy forceps, hemoclip, polyp msampha,sclerotherapy singano, kupopera catheter, maburashi a cytology, guidewire, dengu lochotsa miyala, catheter ya nasal biliary drainage, ureteral access sheath and ureter access sheath with suction etc. zomwe zimagwiritsidwa ntchito kwambiri mu EMR,ESD, ERCP. Zogulitsa zathu ndi zovomerezeka za CE, ndipo mbewu zathu ndi zovomerezeka za ISO. Katundu wathu watumizidwa ku Europe, North America, Middle East ndi gawo la Asia, ndipo amapeza makasitomala ambiri kuzindikira ndi kutamandidwa!
Nthawi yotumiza: Apr-18-2025