Kunyango lwe-colonoscopy, iingxaki ezimeleyo zi-perforation kunye nokuphuma kwegazi.
I-Perforation ibhekisela kwimeko apho i-cavity idityaniswe ngokukhululekileyo kwi-cavity yomzimba ngenxa yesiphako se-tissue egcweleyo, kwaye ubukho bomoya okhululekileyo kwiimviwo ze-X-ray akuchaphazeli inkcazo yayo.
Xa i-periphery yesiphene sezicubu ezityebileyo sigqunyiwe kwaye ingenalo unxibelelwano lwasimahla kunye nomngxuma womzimba, kubizwa ngokuba yi-perforation.
Inkcazo yokuphuma kwegazi ayichazwanga kakuhle; amacebiso akhoyo ngoku aquka ukuncipha kwehemoglobin engaphezu kwe-2 g/dL okanye imfuneko yotofelo-gazi.
Ukuphuma kwegazi emva kokuhlinzwa ngokuqhelekileyo kuchazwa njengesiganeko segazi elibalulekileyo kwi-stool emva kokuhlinzwa okudinga unyango lwe-hemostatic okanye utofelo-gazi.
Izehlo zezi ziganeko ziyahluka ngonyango:
Izinga lokugqobhoza:
Polypectomy: 0.05%
I-Endoscopic mucosal resection (EMR): 0.58% ~ 0.8%
I-Endoscopic submucosal dissection (ESD): 2% ~ 14%
Izinga lokopha emva kotyando:
Polypectomy: 1.6%
I-EMR: 1.1%~1.7%
ESD: 0.7%~3.1
1. Indlela yokujongana nokugqobhoza
Ekubeni udonga lwamathumbu amakhulu luncinci kunesisu, umngcipheko wokubhoboza uphezulu. Ukulungiswa okwaneleyo kuyafuneka phambi kotyando ukujongana nokwenzeka kokubhoboza.
Imiqathango yonyango lwangaphakathi:
Qinisekisa ukusebenza kakuhle kwe-endoscope.
Khetha ii-endoscopes ezifanelekileyo, izixhobo zonyango, ulwelo lwenaliti kunye nezixhobo zokuhambisa igesi yekharbon diokside ngokwendawo, i-morphology kunye neqondo le-fibrosis yethumba.
Ulawulo lokugqobhoza kwangaphakathi:
Ukuvalwa kwangoku: Kungakhathaliseki ukuba yiphi na indawo, ukuvalwa kwekliphu yeyona ndlela ikhethwayo (amandla engcebiso: iBakala 1, inqanaba lobungqina: C).
In ESD, ukwenzela ukuba ugweme ukuphazamiseka ekusebenzeni kwe-dissection, izicubu ezijikelezileyo kufuneka zihlanjululwe kuqala ukuze kuqinisekiswe indawo yokusebenza eyaneleyo ngaphambi kokuvala.
Ukuqwalaselwa kwe-Postoperative: Ukuba i-perforation inokuvalwa ngokupheleleyo, utyando lunokuphetshwa kuphela unyango lwe-antibiotic kunye nokuzila ukudla.
Isigqibo sotyando: Isidingo sotyando sinqunywe ngokusekelwe kwindibaniselwano yeempawu zesisu, iziphumo zovavanyo lwegazi, kunye nemifanekiso kunokuba kuphela igesi yamahhala eboniswe kwi-CT.
Unyango lwamalungu akhethekileyo:
I-rectum esezantsi ayiyi kubangela ukugqobhoza kwesisu ngenxa yeempawu zayo ze-anatomical, kodwa inokubangela ukugqobhoza kwe-pelvic, kubonakala njenge-retroperitoneal, i-mediastinal, okanye i-emphysema engaphantsi.
Ukulumkela:
Ukuvalwa kwenxeba emva kokuhlinzwa kunokuthintela iingxaki ukuya kwinqanaba elithile, kodwa akukho bungqina obaneleyo bokubonisa ukuba kunokuthintela ngokufanelekileyo ukulibaziseka kwe-perforation.
2. Ukusabela ekopheni
Ulawulo lokopha kwangaphakathi:
Sebenzisa ukujija kobushushu okanye iikliphu ze-hemostatic ukumisa ukopha.
Ukopha kwenqanawa encinci:
I-EMR, i-tip yomgibe ingasetyenziselwa i-thermal coagulation.
ESD, incam yemela yombane inokusetyenziselwa ukudibanisa i-thermal coagulation okanye i-hemostatic forceps ukumisa ukopha.
Ukopha kwesitya esikhulu: Sebenzisa i-hemostatic forceps, kodwa lawula uluhlu lwe-coagulation ukunqanda ukulibaziseka ukugqobhoza.
Uthintelo lokopha emva kokuhlinzwa:
Ukususwa kwenxeba emvaI-EMR :
Uphononongo lubonise ukuba ukusetyenziswa kwe-hemostatic forceps kwi-coagulation yokuthintela ayinayo impembelelo ebalulekileyo kumazinga okopha emva kokuhlinzwa, kodwa kukho umkhwa wokunciphisa.
I-prophylactic clipping inefuthe elilinganiselweyo kwizilonda ezincinci, kodwa iyasebenza kwizilonda ezinkulu okanye izigulane ezisengozini enkulu yokopha emva kokuhlinzwa (ezifana nezo zifumana unyango lwe-antithrombotic).
ESD, inxeba liyasuswa kwaye imithambo yegazi evelileyo iyajiya. Iikliphu zeHemostatic nazo zingasetyenziselwa ukuthintela ukuxinana kwemithambo yegazi emikhulu.
Phawula:
Kwi-EMR yezilonda ezincinci, unyango oluqhelekileyo lokukhusela alukhuthazwa, kodwa kwizilonda ezinkulu okanye izigulane ezinobungozi obuphezulu, i-postoperative yokuthintela i-clipping inomphumo othile (amandla okucebisa: iNqanaba 2, inqanaba lobungqina: C).
Ukugqobhoza kunye nokopha ziingxaki eziqhelekileyo ze-endoscopy ye-colorectal.
Ukuthatha amanyathelo afanelekileyo okukhusela kunye nonyango kwiimeko ezahlukeneyo kunokunciphisa ngokufanelekileyo iziganeko zezifo ze-sporadic kunye nokuphucula ukhuseleko lwesigulane.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ngumvelisi e-China ogxile kwizinto ezityiwayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip, polyp umgibe, inaliti ye-sclerotherapy, fafaza i-catheter,iibrashi zecytology, guidewire, ibhasikithi yokubuyiswa kwamatye, i-catheter ye-biliary drainage yeempumlo,Ukungena kwi-ureral sheathkwayeUkungena kwi-ureral sheath ngokufunxanjl ezisetyenziswa ngokubanzi kwiI-EMR, ESD, I-ERCP. Iimveliso zethu ziqinisekisiwe nge-CE, kwaye izityalo zethu ziqinisekisiwe nge-ISO. Impahla yethu ithunyelwe eYurophu, kuMntla Melika, kuMbindi Mpuma nakwinxalenye yeAsia, kwaye ifumana ngokubanzi umthengi wokwamkelwa nokudumisa!
Ixesha lokuposa: May-24-2025