Endoscopic Sclerotherapy (EVS) Gawo 1

1) Mfundo ya endoscopic sclerotherapy (EVS):

Intravascular jekeseni: sclerosing wothandizira amachititsa kutupa kuzungulira mitsempha, kuumitsa mitsempha ndi midadada magazi;

Jakisoni wa paravascular: zimayambitsa kutupa kosabala m'mitsempha kumayambitsa thrombosis.

2) Zizindikiro za EVS:

(1) Kuphulika kwakukulu kwa EV ndi kutuluka magazi;

(2) Anthu omwe ali ndi mbiri ya EV kupasuka ndi magazi;(3) Anthu omwe ali ndi vuto la EV pambuyo pa opaleshoni;(4) Anthu amene sali oyenerera kuchitidwa opaleshoni.

3) Zotsutsana za EVS:

(1) Mofanana ndi gastroscopy;

(2) Chiwindi encephalopathy siteji 2 ndi pamwamba;

(3) Odwala omwe ali ndi vuto lalikulu la chiwindi ndi impso, kuchuluka kwa ascites, ndi jaundice yoopsa.

4) Njira zodzitetezera

Ku China, mutha kusankha lauromacrol.Pamitsempha yokulirapo, sankhani jakisoni wa intravascular.Kuchuluka kwa jakisoni nthawi zambiri kumakhala 10 ~ 15mL.Kwa mitsempha yaying'ono yamagazi, mutha kusankha jakisoni wa paravascular.Yesetsani kupewa kubaya jekeseni pamalo osiyanasiyana mundege imodzi (mwina Zilonda zitha kuchitika zomwe zimatsogolera kukumero).Ngati kupuma kumakhudzidwa panthawi ya opaleshoni, kapu yowonekera ikhoza kuwonjezeredwa ku gastroscope.M'mayiko akunja, buluni nthawi zambiri imawonjezeredwa ku gastroscope.Ndikoyenera kuphunzirapo.

5) Kuwongolera pambuyo pa ntchito ya EVS

(1) Osadya kapena kumwa kwa maola 8 mutatha opaleshoni ndikuyambiranso chakudya chamadzimadzi pang'onopang'ono;

(2) Gwiritsani ntchito mlingo woyenera wa maantibayotiki kuti mupewe matenda;(3) Gwiritsani ntchito mankhwala omwe amachepetsa kuthamanga kwa portal ngati kuli koyenera.

6) Maphunziro a chithandizo cha EVS

Multiple sclerotherapy imafunika mpaka mitsempha ya varicose itatha kapena kutha, ndi nthawi ya sabata imodzi pakati pa chithandizo chilichonse;gastroscopy idzawunikidwa mwezi umodzi, miyezi itatu, miyezi 6, ndi chaka chimodzi pambuyo pa kutha kwa mankhwala.

 7) Zovuta za EVS

(1) Zovuta zodziwika: ectopic embolism, zilonda zam'mimba, ndi zina zambiri

Ndikosavuta kuyambitsa magazi kutuluka kapena kutuluka magazi pabowo la singano pamene singano yatulutsidwa.

(2) Zovuta za m'deralo: zilonda, kutuluka magazi, stenosis, kusokonekera kwa esophageal motility, odynophagia, lacerations.Zovuta zachigawo zimaphatikizapo mediastinitis, perforation, pleural effusion, ndi portal hypertensive gastropathy yokhala ndi chiopsezo chochulukira magazi.

(3) Zovuta zadongosolo: sepsis, chibayo cholakalaka, hypoxia, bacterial peritonitis wokhazikika, ndi portal vein thrombosis.

Endoscopic varicose vein ligation (EVL)

1) Zizindikiro za EVL:Zofanana ndi EVS.

2) Zotsutsana za EVL:

(1) Zotsutsana zofanana ndi gastroscopy;

(2) EV limodzi ndi GV zoonekeratu;

(3) limodzi ndi chiwindi kwambiri ndi impso kukanika, kuchuluka kwa ascites, jaundice

Gangrene ndi chithandizo chaposachedwa cha multiple sclerotherapy kapena mitsempha yaying'ono ya varicose

Kutenga Mzera wa Han ngati pafupi-duofu kumatanthauza kuti anthu a Hua adzatha kuyenda momasuka, kapena ma tendon ndi pulses adzatambasulidwa kumadzulo.

Wolemba.

3) Momwe mungagwiritsire ntchito

Kuphatikizira kulumikiza tsitsi limodzi, kulumikiza tsitsi zingapo, ndi kulumikizana kwa zingwe za nayiloni.

Mfundo yofunikira: Letsani kutuluka kwa magazi kwa mitsempha ya varicose ndikupereka magazi mwadzidzidzi → venous thrombosis pamalo olumikizira → minofu necrosis → fibrosis → kutha kwa mitsempha ya varicose.

(2) Kusamala

Pamitsempha yocheperako mpaka yoopsa kwambiri, mitsempha ya varicose imalumikizidwa mozungulira mozungulira kuchokera pansi kupita pamwamba.The ligator ayenera kukhala pafupi kwambiri ndi chandamale ligation mtsempha wa varicose, kotero kuti mfundo iliyonse ligated ndi densely ligated.Yesetsani kuphimba mitsempha ya varicose pamtunda wopitilira 3 mfundo.