EMR ndi chiyani? Tiyeni tijambule!

Odwala ambiri m'madipatimenti a gastroenterology kapena malo opangira endoscopy amalimbikitsidwa kuti azichotsa mucosal resection.EMR). Amagwiritsidwa ntchito nthawi zambiri, koma kodi mukudziwa zizindikiro zake, zolepheretsa, ndi njira zodzitetezera pambuyo pa opaleshoni?

Nkhaniyi ikutsogolerani mwatsatanetsatane zambiri za EMR kuti zikuthandizeni kupanga chisankho mozindikira komanso molimba mtima.

Ndiye, EMR ndi chiyani? Tiyeni tijambule kaye ndipo tiwone…

❋Kodi malangizo ovomerezeka amati chiyani za zisonyezo za EMR? Malinga ndi malangizo a Japan Gastric Cancer Treatment Guidelines, Chinese Expert Consensus, ndi malangizo a European Society of Endoscopy (ESGE), zisonyezo zomwe zikulimbikitsidwa pakali pano za EMR ndi izi:

Ⅰ. Ma polyps abwino kapena adenomas

● Zilonda ≤ 20 mm ndi malire omveka bwino

● Palibe zizindikiro zoonekeratu za kuwukira kwa submucosal

● Laterally Spreading Tumor (LST-G)

Ⅱ. Focal high-grade intraepithelial neoplasia (HGIN)

● Mucosal-limited, palibe zilonda

● Zotupa zochepera 10 mm

● Osiyana kwambiri

Ⅲ. Dysplasia yofatsa kapena zotupa zotsika zokhala ndi matenda owoneka bwino komanso kukula pang'onopang'ono

◆ Odwala amaonedwa kuti ndi oyenera kuchotsedwa pambuyo poyang'anitsitsa

⚠Zindikirani: Ngakhale malangizowo akunena kuti EMR ndi yovomerezeka kwa khansa yoyambirira ngati chilondacho chili chaching'ono, chosakhala ndi zilonda, ndipo chimakhala mucosa, muzochitika zenizeni zachipatala, ESD (endoscopic submucosal dissection) nthawi zambiri imakonda kuonetsetsa kuti kuchotsedwa kwathunthu, chitetezo, ndi kuwunika kolondola kwa matenda.

ESD imapereka maubwino angapo:

En bloc resection ya chotupa ndizotheka

Imathandizira kuwunika kwa malire, kuchepetsa chiopsezo chobwereza

Oyenera zilonda zazikulu kapena zovuta kwambiri

Chifukwa chake, EMR pakadali pano imagwiritsidwa ntchito makamaka pazachipatala kwa:

1. Zilonda zowopsa popanda chiopsezo cha khansa

2. Ma polyps ang'onoang'ono, osavuta kutulutsa kapena ma LST amtundu

⚠Njira Zodzitetezera Pambuyo pa Opaleshoni

1.Dietary Management: Kwa maola 24 oyambirira mutatha opaleshoni, pewani kudya kapena kumwa zakumwa zomveka bwino, kenako pang'onopang'ono musinthe ku zakudya zofewa. Pewani zakudya zokometsera, zoziziritsa thupi, komanso zokwiyitsa.

2.Kugwiritsa Ntchito Mankhwala: Proton pump inhibitors (PPIs) amagwiritsidwa ntchito kawirikawiri pambuyo pa opaleshoni ya zilonda zam'mimba kulimbikitsa machiritso a zilonda ndi kupewa kutaya magazi.

3.Complication Monitoring: Khalani tcheru chifukwa cha zizindikiro za pambuyo pa opaleshoni ya magazi kapena kuphulika, monga melena, hematemesis, ndi ululu wa m'mimba. Pitani kuchipatala msanga ngati pali vuto lililonse.

4. Unikaninso Dongosolo: Konzani maulendo obwereza ndikubwereza ma endoscopies potengera zomwe zapezeka.

Chifukwa chake, EMR ndi njira yofunikira pakuchotsa zotupa zam'mimba. Komabe, ndikofunikira kumvetsetsa bwino zomwe zikuwonetsa ndikupewa kugwiritsa ntchito mopitilira muyeso kapena kugwiritsa ntchito molakwika. Kwa madokotala, izi zimafuna chiweruzo ndi luso; kwa odwala, pamafunika kukhulupirirana ndi kumvetsetsa.

Tiyeni tiwone zomwe tingapereke kwa EMR.

Nawa ma EMR athu okhudzana ndi endoscopic consumables omwe akuphatikizapoZithunzi za Hemostatic,Polypectomy Snare,Jekeseni singanondiBiopsy Forceps.