Ntchito za ESD ndizovuta kwambiri kuti zichitike mwachisawawa kapena mosasamala.
Njira zosiyanasiyana zimagwiritsidwa ntchito pazinthu zosiyanasiyana. Ziwalo zazikulu ndi zam'mimba, m'mimba, ndi colorectum. Mimba imagawidwa kukhala antrum, prepyloric area, gastric angle, gastric fundus, ndi kupindika kwakukulu kwa chapamimba thupi. The colorectum imagawidwa m'matumbo ndi rectum. Pakati pawo, ESD ya zotupa zazikulu zopindika ndi gawo lolowera, pomwe ESD yam'mimba, cardia, ndi zotupa zakumanja zimakhala zovuta kwambiri.
Mfundo yaikulu ndikulingalira za mphamvu yokoka yotsika ndikuyamba ndi gawo lovuta ndiyeno gawo losavuta. Yambitsani kudulidwa ndikuvula kuchokera pamalo otsika yokoka. Pakuvula, kuvula kuyeneranso kuyambira pagawo lovuta kwambiri. Esophageal ESD imatha kuchitidwa ndi mtundu wokankhira. Njira yocheka ndi kuchotsa zilonda zam'mimba ziyenera kukonzedwa pasadakhale. Zilonda zam'mimba zam'mimba, kupindika pang'ono kwa m'mimba, komanso malo a prepyloric amatha kuwululidwa ndi kukokera. Ukadaulo wa tunnel ndi njira ya mthumba zonse ndi gawo la njira ya ESD. Ukadaulo wopangidwa ndi ESD umaphatikizapo ESTD, EFTR, ESE, POEM, ndi zina zambiri. Ukadaulo uwu ndiwonso matekinoloje omwe mwachibadwa amatuluka pambuyo poti luso la ESD lakhazikika. Chifukwa chake ESD ndiye maziko.
2. Tsatanetsatane wa ntchito ya ESD
Tsatanetsatane wa ntchito ya ESD ndi tsatanetsatane motsogozedwa ndi njira yayikulu.
Tsatanetsatane wa Ntchito
Tsatanetsatane wa opareshoniyo ndikuyika chizindikiro, jekeseni, peeling, ndi zina.
Pali zidule ziwiri: imodzi ndi kunyamula mpeni molunjika (gwiritsani ntchito kutola mpeni wakhungu momwe mungathere), ndipo inayo ndikuwongolera malire ndi mabungwe ang'onoang'ono.
Kulemba zilembo ndi jakisoni
Electrocoagulation marking imagwiritsidwa ntchito polemba. Kawirikawiri, malire a zilonda (2-5 mm kunja) amagwiritsidwa ntchito ngati chizindikiro. Kuyika chizindikiro kumatha kuchitidwa molunjika kapena kuchokera ku zazikulu mpaka zazing'ono. Pamapeto pake, nthawi yapakati pazigawo ziwiri zolembera iyenera kukhala mkati mwa 5 mm, ndipo iyenera kuwoneka pamene endoscope ili pafupi ndi gawo la masomphenya.
Kumalo olembedwa otsatirawa. Jekeseni amatengera zizolowezi zamunthu. Pambuyo jekeseni mu submucosal wosanjikiza, singano ayenera kuchotsedwa pang'ono ndiyeno jekeseni kachiwiri kuonetsetsa kuti chotupacho chikukwera mpaka kutalika kokwanira kuti adulidwe ndi peeling.
Dulani
Kudulidwa, mbali zina zimadulidwa kuchokera kutali kupita kufupi kapena pafupi ndi kutali (kukankhira kudula), malingana ndi zizoloŵezi zaumwini ndi mbali zinazake, m'pofunikanso kudula kuchokera kumalo otsika kwambiri a mphamvu yokoka. Kudulira kumaphatikizapo kudulidwa kozama komanso kudula kozama. Kudula koyambirira kuyenera kukhala "kolondola" ndi "kokwanira". Kuzama kwa kudula kuyenera kukhala kokwanira musanayambe ntchito ya peeling yotsatira. Monga kunyamula mpeni ndikukhazikitsa zenera la angelo. Atangolowa pawindo la angelo,
ESD imatanthauza kukwaniritsa njira yabwino. Koma zenizeni, si ESD iliyonse yomwe ingalowe muzenera la Angelo. Zilonda zambiri zazing'ono ndi zotupa zapadera ESD kwenikweni sizingalowe muzenera la Mngelo. Panthawi imeneyi, izo makamaka zimadalira woyengeka mpeni ntchito.
Chola: Chotsani kaye gawo lovuta kugwira. Mukachotsa gawo la submucosal, liyenera kuchitidwa kuchokera kumbali zonse mpaka pakati, ndikupanga "kiyi" yooneka ngati V. Kuzama kwa zotumphukira zodulidwiratu kuyenera kukhala kokwanira, apo ayi ndikosavuta kupukuta kupyola malire. Minofu yotsalayo ikachepa, m'pamenenso pali ufulu wambiri. M`pofunika kulamulira mpeni kudula minofu mwachindunji, makamaka otsiriza minofu. Ngati kuwongolera sikuli bwino, ndikosavuta kudula kwambiri kapena pang'ono.
Momwe mungagwirire kalirole
Pali njira ziwiri zogwirizira kukula kwa ESD, zonse zomwe zimayang'anira kuchuluka kwa thupi, ma knobs, ndi zida zamkati ndi kunja. Pali njira ziwiri: "kumanzere kumanja + zowonjezera" ndi "manja awiri m'manja anayi". Mfundo yofunika kwambiri yogwirizira kukula ndikusunga malo ogwirira ntchito kukhala okhazikika komanso owongolera. Pakalipano, njira ya manja awiri mpaka anayi ili ndi kukhazikika kwa kayendetsedwe ka kayendetsedwe kake ndipo imagwiritsidwa ntchito kwambiri. Pokhapokha ngati kukula kwake kuli kokhazikika komwe kumagwira ntchito kwa timinofu tating'ono + ting'onoting'ono kumatha kuyendetsedwa bwino.
Pokhapokha ndi galasi yabwino yogwiritsira ntchito njira yomwe mpeni ukhoza kuyendetsedwa bwino. Njira yotolera mpeni imatha kuyendetsa bwino njira, cholinga chake ndikukhala kutali ndi minofu ndikudula minofu yomwe mukufuna. Mukapanga ESD submucosal incision, ndikofunikira kudula pafupi ndi minofu, kuya kwa minofu ndikokwanira, ndipo ndikosavuta kusiya magazi. Chofunika kwambiri ndikuwonetsetsa kuti kudulidwako sikunali kozama kwambiri kapena kupyola, ndipo njira yotolera mpeni ndiyo luso lofunika kwambiri panthawiyi.
Kuwongolera masomphenya
Kuwongolera mayendedwe kumawonekeranso pakuwonetseredwa ndi kuwongolera gawo lakuwona. Kuphatikiza pa kuzungulira kozungulira ndi thupi la lens, zipewa zowonekera ndi zowonjezera zimagwiritsidwanso ntchito kuwonetsa malo owonera kapena minofu yomwe mukufuna, makamaka mphamvu yaying'ono yomwe imagwiritsidwa ntchito povumbulutsa ndi kukweza minyewa yaying'ono, yomwe imakhala yocheperako kwambiri.
Kulamulira mtunda wa munda wa masomphenya. Pokhapokha pamene gawo la masomphenya likusungidwa pa mtunda woyenerera likhoza kuyendetsedwa ndi kuyendetsedwa. Ngati uli patali kwambiri kapena uli pafupi kwambiri, zidzakhala zovuta kuulamulira mosasunthika. Kusuntha kosawoneka bwino kungawoneke ngati sikusuntha, koma minofuyo ili kale ndi mphamvu yosinthika. Ichi ndichifukwa chake ESD iyenera kugwiritsa ntchito mtunda woyenera ndi mapindikidwe oyenera.
Zomwe zili pamwambazi, kusunga ma lens, ndi kuyang'anira mawonedwe ndizomwe zili mu ESD "control lens".
Ife, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ndi opanga ku China okhazikika pazakudya zam'mimba, monga biopsy forceps, hemoclip, polyp msampha, singano ya sclerotherapy, catheter yopopera, maburashi a cytology, waya wotsogola, dengu lobweza mwala, chotengera cholowera m'mphuno. kuyamwa ndi zina 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: Jul-14-2025