Chiyambi
Zizindikiro zazikulu za matenda a hemorrhoids ndi magazi m'chimbudzi, kupweteka kwa m'matako, kugwa ndi kuyabwa, ndi zina zotero, zomwe zimakhudza kwambiri moyo wa munthu. Pa milandu yoopsa, ingayambitse matenda a hemorrhoids omwe ali m'malo obisika komanso kuchepa kwa magazi m'thupi komwe kumachitika chifukwa cha magazi m'chimbudzi. Pakadali pano, chithandizo chokhazikika chimadalira kwambiri mankhwala, ndipo chithandizo cha opaleshoni chikufunika pa milandu yoopsa.
Chithandizo cha endoscopic ndi njira yatsopano yochiritsira yomwe yapangidwa m'zaka zaposachedwa, yomwe ndi yoyenera kwambiri m'zipatala za anthu wamba. Lero, tifotokoza mwachidule ndikukonza.
1. Kuzindikira matenda, kapangidwe ka thupi ndi chithandizo cha kale cha matenda a hemorrhoids
Kuzindikira Matenda a Ma Hemorrhoids
Kuzindikira matenda a hemorrhoids kumadalira kwambiri mbiri ya wodwalayo, kuwunika, kuyezetsa kwa digito kwa rectal ndi colonoscopy. Ponena za mbiri yachipatala, ndikofunikira kumvetsetsa kupweteka kwa kumaliseche, magazi m'chimbudzi, kutuluka kwa magazi m'magazi ndi kubwezeretsa magazi m'thupi, ndi zina zotero. Kuyezetsaku kumamvetsetsa makamaka mawonekedwe a hemorrhoids, ngati pali fistula ya kumaliseche ya kutupa kwa perianal, ndi zina zotero, ndipo kuyezetsa kwa digito kwa rectal kuyenera kumvetsetsa kulimba kwa anus ndi ngati pali nthawi yopuma. Colonoscopy iyenera kudziwa matenda ena monga zotupa, zilonda zam'mimba, ndi zina zotero zomwe zimayambitsa kutuluka magazi. Kugawa ndi kugawa kwa hemorrhoids.
Pali mitundu itatu ya ma hemorrhoids: ma hemorrhoids amkati, ma hemorrhoids akunja, ndi ma hemorrhoids osakanikirana.
Ma Hemorrhoids: Ma Hemorrhoids Amkati, Akunja, ndi Osakanikirana
Ma hemorrhoids amatha kugawidwa m'magulu I, II, III, ndi IV. Amagawidwa malinga ndi kuchulukana kwa magazi, kutuluka kwa magazi ndi kubwerera.
Zizindikiro za chithandizo cha endoscopic ndi ma hemorrhoids amkati a giredi I, II, ndi III, pomwe ma hemorrhoids amkati a giredi IV, ma hemorrhoids akunja, ndi ma hemorrhoids osakanikirana ndi zotsutsana ndi chithandizo cha endoscopic. Mzere wolekanitsa pakati pa chithandizo cha endoscopic ndi mzere wa mano.
Kapangidwe ka Ma Hemorrhoids
Mzere wa anal, mzere wa mano, anal pad, ndi ma hemorrhoids ndi mfundo zomwe akatswiri a endoscop ayenera kuzidziwa bwino. Kuzindikira endoscopic kumafuna luso lina. Mzere wa mano ndi malo olumikizirana a anal squamous epithelium ndi columnar epithelium, ndipo malo osinthira pakati pa mzere wa anal ndi mzere wa mano amaphimbidwa ndi columnar epithelium koma osati thupi lonse. Chifukwa chake, chithandizo cha endoscopic chimachokera pa mzere wa mano. Chithandizo cha endoscopic chikhoza kuchitika mkati mwa mzere wa mano, ndipo chithandizo cha endoscopic sichingachitike kunja kwa mzere wa mano.
Chithunzi 1.Mawonekedwe akutsogolo a mzere wa mano pansi pa endoscope. Muvi wachikasu umaloza ku mzere wa mano wozungulira womwe uli ndi serrated annular, muvi woyera umaloza ku mzati wa anal ndi netiweki yake yayitali ya mitsempha yamagazi, ndipo muvi wofiira umaloza ku valavu ya anal.
1A:chithunzi cha kuwala koyera;1B:Kujambula Kuwala kwa Narrowband
Chithunzi 2Kuwona chivundikiro cha anal (muvi wofiira) ndi kumapeto kwa mzati wa anal (muvi woyera) motsatira maikulosikopu
Chithunzi 3Kuwona papilla ya m'makoswe pogwiritsa ntchito maikulosikopu (muvi wachikasu)
Chithunzi 4.Mzere wa m'makoswe ndi mzere wa mano zinaonedwa pogwiritsa ntchito njira yowunikira kumbuyo. Muvi wachikasu umaloza ku mzere wa mano, ndipo muvi wakuda umaloza ku mzere wa m'makoswe.
Malingaliro a anal papilla ndi anal column amagwiritsidwa ntchito kwambiri mu opaleshoni ya anorectal ndipo sadzabwerezedwanso pano.
Chithandizo chapadera cha hemorrhoids:Pali makamaka chithandizo chochirikiza ndi chithandizo cha opaleshoni. Chithandizo chochirikiza chimaphatikizapo kugwiritsa ntchito mankhwala a perianal ndi kusamba, ndipo njira zochizira opaleshoni zimaphatikizapo kuchotsa magazi ndi kuchotsa stapled excision (PPH). Popeza chithandizo cha opaleshoni ndi chachikhalidwe, zotsatira zake zimakhala zokhazikika, ndipo chiopsezo chake ndi chochepa, wodwalayo ayenera kugonekedwa m'chipatala kwa masiku 3-5.
2. Chithandizo cha endoscopic cha hemorrhoids yamkati
Kusiyana pakati pa chithandizo cha endoscopic cha hemorrhoids yamkati ndi chithandizo cha EGV:
Cholinga cha chithandizo cha endoscopic cha mitsempha ya m'mimba ndi mitsempha yamagazi yotupa, ndipo cholinga cha chithandizo cha hemorrhoid yamkati si mitsempha yamagazi yosavuta, koma ma hemorrhoid opangidwa ndi mitsempha yamagazi ndi minofu yolumikizana. Chithandizo cha ma hemorrhoids ndikuchepetsa zizindikiro, kukweza chotchingira cha m'makoswe chomwe chimatsika, ndikupewa zovuta monga stenosis ya m'makoswe yomwe imachitika chifukwa cha kutha kwa ma hemorrhoids (mfundo ya "kuchotsa chilichonse" imayambitsa stenosis ya m'makoswe).
Cholinga cha chithandizo cha endoscopic: Kuchepetsa kapena kuthetsa zizindikiro, osati kuchotsa hemorrhoids.
Chithandizo cha endoscopic chimaphatikizapochithandizo cha sclerotherapyndikulumikiza gulu.
Pozindikira ndi kuchiza matenda a m'mimba, colonoscopy imagwiritsidwa ntchito pofufuza, ndipo gastroscope imalimbikitsidwa pochiza. Kuphatikiza apo, malinga ndi momwe chipatala chilichonse chilili, mungasankhe chithandizo chakunja kapena chamkati.
①Sclerotherapy (yothandizidwa ndi chivundikiro chowonekera)
Chothandizira kutsekula kwa magazi ndi jakisoni wa lauryl alcohol, ndipo jakisoni wa lauryl alcohol wa thovu ungagwiritsidwenso ntchito. Ndikofunikiranso kugwiritsa ntchito jakisoni wa methylene blue ngati chinthu chosowa kuti mumvetse momwe magazi amayendera komanso momwe magazi amafalikira.
Cholinga cha chivundikiro chowonekera bwino ndikukulitsa masomphenya. Singano yojambulira imatha kusankhidwa kuchokera ku singano wamba yojambulira mucosal. Nthawi zambiri, kutalika kwa singano ndi 6mm. Madokotala omwe alibe chidziwitso chokwanira ayenera kuyesetsa kupewa kugwiritsa ntchito jakisoni yayitali ya singano, chifukwa jakisoni yayitali ya singano imakonda kuperekedwa jakisoni wa ectopic ndi jakisoni. Chiwopsezo chachikulu ndi kubweretsa ziphuphu za perianal ndi kutupa.
Malo obayira jakisoni amasankhidwa pamwamba pa mbali ya pakamwa ya mzere wa mano, ndipo malo a singano ya jakisoni ali pansi pa hemorrhoid yomwe mukufuna. Singano imayikidwa pa 30°~40° pansi pa endoscope, ndipo singano imayikidwa mozama pansi pa hemorrhoid. Pangani mulu wolimba pansi pa hemorrhoid, tulutsani singanoyo mukamabayira jakisoni, pafupifupi 0.5~2mL, ndikuyimitsa jakisoniyo mpaka hemorrhoid itakhala yayikulu komanso yoyera. Jakisoni ikatha, yang'anani ngati pali kutuluka magazi pamalo omwe jakisoniyo adayikidwa.
Kuchiza ndi endoscopic sclerotherapy kumaphatikizapo jakisoni wagalasi lakutsogolo ndi jakisoni wagalasi lopindika. Nthawi zambiri, jakisoni wagalasi lopindika ndiye njira yayikulu.
② chithandizo cha bandeji
Kawirikawiri, chipangizo chomangirira cha multi-ring chimagwiritsidwa ntchito, osapitirira mphete zisanu ndi ziwiri. Kumangirira kumachitika pa 1 mpaka 3 cm pamwamba pa mzere wa mano, ndipo kumangirira nthawi zambiri kumayamba pafupi ndi mzere wa anal. Kungakhale kumangirira mitsempha yamagazi kapena kumangirira mucosal kapena kumangirira pamodzi. Kumangirira galasi lozungulira ndiyo njira yayikulu, nthawi zambiri nthawi imodzi kapena ziwiri, ndi nthawi ya mwezi umodzi.
Chithandizo cha opaleshoni: kusala kudya sikofunikira mukatha opaleshoni, kusunga ndowe yosalala, komanso kupewa kukhala pansi kwa nthawi yayitali komanso kugwira ntchito yolemetsa. Kugwiritsa ntchito maantibayotiki nthawi zonse sikofunikira.
3. Mkhalidwe wamakono ndi mavuto omwe alipo m'zipatala za anthu wamba
Kale, malo akuluakulu ochizira matenda a hemorrhoids anali mu dipatimenti ya anorectal. Chithandizo cha dongosolo mu dipatimenti ya anorectal chimaphatikizapo mankhwala osungira, jakisoni wa sclerotherapy, ndi chithandizo cha opaleshoni.
Madokotala a m'mimba sadziwa bwino za kapangidwe ka ziwalo za m'mimba pogwiritsa ntchito endoscopy, ndipo zizindikiro za chithandizo cha endoscopy ndizochepa (ma hemorrhoids amkati okha ndi omwe angachiritsidwe). Opaleshoni imafunikanso kuti munthu achire mokwanira, zomwe zakhala zovuta kwambiri pakukula kwa polojekitiyi.
Mwachidule, chithandizo cha endoscopic cha hemorrhoids yamkati ndi choyenera kwambiri m'zipatala zazikulu, koma kwenikweni, sichili chofanana ndi momwe amaganizira.
Ife, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ndi opanga ku China omwe amagwira ntchito kwambiri pazinthu zogwiritsidwa ntchito m'ma endoscopic, mongamphamvu ya biopsy, hemoclip, msampha wa polyp, singano ya sclerotherapy, katheta wopopera, maburashi a cytology, waya wotsogolera, dengu lotengera miyala, katheta yotulutsira madzi m'mphunondi zina zotero zomwe zimagwiritsidwa ntchito kwambiri muEMR, ESD, ERCPZogulitsa zathu zili ndi satifiketi ya CE, ndipo mafakitale athu ali ndi satifiketi ya ISO. Katundu wathu watumizidwa ku Europe, North America, Middle East ndi mbali ina ya Asia, ndipo makasitomala ambiri amalandira ulemu ndi kutamandidwa!
Nthawi yotumizira: Julayi-11-2022