Colonoscopy: Kuwongolera zovuta

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 wa zonse makulidwe minofu chilema ataphimbidwa ndipo alibe kulankhulana kwaulere ndi thupi patsekeke, amatchedwa perforation.
Tanthauzo la magazi silinatchulidwe bwino; zomwe panopo zimalimbikitsa zikuphatikizapo kuchepa kwa hemoglobini yoposa 2 g/dL kapena kufunika koikidwa 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 (EMR): 0.58% ~ 0.8%
Endoscopic submucosal dissection (ESD): 2% ~ 14%
Kuchuluka kwa magazi pambuyo pa opaleshoni:
Polypectomy: 1.6%
EMR1.1% ~ 1.7%
ESD0.7% ~ 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:
Kutseka msanga: Mosasamala kanthu za malo, kutseka kwa clip ndi njira yomwe amakonda (mphamvu yolangizira: Gulu 1, mulingo waumboni: C).

In ESD, pofuna kupewa kusokoneza ntchito ya dissection, minofu yozungulira iyenera kuphwanyidwa poyamba kuti iwonetsetse kuti malo ogwirira ntchito okwanira asanatseke.
Kuwona pambuyo pa opaleshoni: Ngati kuphulika kungathe kutsekedwa kwathunthu, opaleshoni ikhoza kupewedwa ndi mankhwala opha maantibayotiki okha ndi kusala kudya.
Chisankho cha Opaleshoni: Kufunika kwa opaleshoni kumatsimikiziridwa potengera kuphatikizika kwa zizindikiro za m'mimba, zotsatira za kuyezetsa magazi, ndi kujambula m'malo mongokhala pa gasi waulere wowonetsedwa pa CT.
Chithandizo cha magawo apadera:
Kutsika kwa rectum sikungayambitse kuphulika kwa m'mimba chifukwa cha mawonekedwe ake, koma kungayambitse kuphulika kwa chiuno, kuwonetsa ngati retroperitoneal, mediastinal, kapena subcutaneous emphysema.
Kusamalitsa:
Kutsekedwa kwa bala pambuyo pa opaleshoni kungalepheretse zovuta pamlingo wina, koma palibe umboni wokwanira wosonyeza kuti kungathe kuteteza kuchedwa kuphulika.

2. Kuyankha pa Kutaya Magazi
Kuwongolera magazi m'thupi:
Gwiritsani ntchito kutentha kwapang'onopang'ono kapena ma tapi a hemostatic kuti musiye magazi.
Kutaya magazi m'thupi laling'ono:
EMR, nsonga ya msampha ingagwiritsidwe ntchito pa kutentha kwa thupi.
ESD, nsonga ya mpeni wamagetsi ingagwiritsidwe ntchito kukhudzana ndi kutentha kwa matenthedwe kapena mphamvu za hemostatic kuti asiye kutuluka.
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 pakeEMR :
Kafukufuku wasonyeza kuti kugwiritsa ntchito hemostatic forceps pofuna kuteteza coagulation sikukhudza kwambiri kuchuluka kwa magazi pambuyo pa opaleshoni, koma pali chizolowezi chochepa.
Kudulira kwa prophylactic kumakhudza pang'ono zilonda zazing'ono, koma ndizothandiza kwa zotupa zazikulu kapena odwala omwe ali pachiwopsezo chotaya magazi pambuyo pa opaleshoni (monga omwe akulandira mankhwala a antithrombotic).
ESD, chilondacho chimachotsedwa ndipo mitsempha yamagazi yowonekera imakhazikika. Ma tatifupi a hemostatic angagwiritsidwenso ntchito kupewa kutsekeka 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,chotupa cha ureterndiureral kulowa m'chimake ndi kuyamwaetc. omwe amagwiritsidwa ntchito kwambiri muEMR, 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!