(1). Ubuchule obusisiseko Iindlela ezisisiseko ze-EMR zezi zilandelayo:
Ukulandelelana kobuchule
①Tofa isisombululo senaliti yendawo ngezantsi nje kwesilonda.
②Beka umgibe ujikeleze isilonda.
③Umgibe uyaqiniswa ukuze ubambe kwaye ukrwitshe isilonda.
④Qhubeka uqinisa umgibe ngelixa usebenzisa umbane ukusika isilonda.
⑤Fumana isampuli ehlaziyiweyo.
(2). Iingcebiso
1.Iingcebiso zokukhetha indawo yomzimba kunye nokubeka i-endoscope
Ngenxa yokuba isilonda sifuna ukunyangwa ngelixa wonke umfanekiso ubonakala, indawo yesigulane ibaluleke kakhulu. Zama ukujija ububanzi ukuze isilonda sibekwe kufuphi nokuvulwa kwe-biopsy forceps, oko kukuthi, ukusuka kwi-5 ukuya kwi-7 intsimbi kwisikrini.
Ngaphambi kokuba unyango, intsalela kunye ne-pigment engaphezulu kufuneka ihlanjwe kwaye isuswe ngokufunxa.
Umzekelo, ukuba isilonda esikwi-proximal sigmoid colon sisusiwe kwi-supine okanye kwi-lateral decubitus position, i-specimen iya kuhlala isiya kwi-colon ehlayo, nto leyo eyenza kube nzima ukuyibuyisela, ngoko ke indawo ye-decubitus esecaleni esecaleni ingcono ukuba isetyenziswe.
Ngokunjalo, ngokwembono yokubuyiswa kwe-specimen, indawo yekhohlo ye-decubitus esecaleni ikhethwa ukuba i-resection yezilonda ze-colon transverse.
Iingcebiso ze-2.Izitofu zendawo
Inaliti eshinyeneyo yenaliti yendawo inokutofwa kuxinzelelo oluphantsi, kodwa ayibukhali ngokwaneleyo kwaye umngxuma yenaliti mkhulu kakhulu, ngoko ke umbhali usebenzisa inaliti ye-25G yendawo.
Asikokubaxa ukuba ukuphumelela okanye ukungaphumeleli kwe-EMR kuxhomekeke kakhulu kwiinaliti zendawo.
Kwizilonda ezincinci, ukugqobhoza kwenziwa ukusuka kwicala leempundu ukuya kutsho ngaphantsi kwesilonda.
Kwizilonda kwindawo egobileyo okanye kwimigoqo, ukuba inaliti yendawo iyenziwa ukusuka kwicala le-anal, kwiimeko ezininzi izilonda azicaci ngenxa yokuba zijongene necala lomlomo, ngoko ke inaliti yendawo kufuneka iqalwe ukusuka kwicala lomlomo.
Izinto ezibalulekileyo kwiiGcisa ze-Endoscopy
Ukuba ulwelo luphuma ngaphandle, okanye kukho ukuxhathisa okukhulu ngexesha lokutofa, okanye akukho ukuxhathisa xa ulwelo lungena kodwa akukho qhuma lenziweyo, inaliti kufuneka imiswe kwaye umqhubi kufuneka aziswe ngemeko ngexesha elifanelekileyo ukuze axoxe ngamanyathelo okuthintela.
Okukhona umthamo wokutofa ungaphezulu, kokukhona ungcono.
Ubuqhetseba kukuqhubeka nokutofa kangangoko kunokwenzeka ngepuncture enye de isilonda sonke siphakanyiswe.
3. Iingcebiso zokukhetha umgibe
Ukuba umgibe ukwimo ye-oval emide, i-mucosa eqhelekileyo emlonyeni wesilonda kunye namacala e-anus ingaba lula kwaye ingabandakanywa ngokungeyomfuneko.
Umgibe kukhethwa ukuba uphantse ube setyhula, kulula ukuwuvula ecaleni, akukho lula ukuwutyibilika, kwaye unobulukhuni obuthile bokucinezela isilonda ukubamba isilonda.
Ubungakanani bomgibe kufuneka bulungelelaniswe nobukhulu be-lesion.
I-Polypectomy Elahlayo
Imizekelo ye-EMR
a. Umfanekiso wokukhanya okumhlophe
I-25 mm yodidi lwe-IIa isilonda esinesahlulo esincinci esidangeleyo.
b. Imifanekiso yebhendi emxinwa (NBI) imifanekiso
c. Ukutshiza i-indigo carmine ukwandisa umfanekiso
Kwafunyaniswa ukuba ukudakumba okubonwa ngokujongwa okuqhelekileyo yayiyimijelo phakathi kwamagqabi.
d. Umfanekiso owandisiweyo we-crystal violet staining
Ipateni yomngxuma wokuvuleka kombhobho wedlala kumda wesilonda yayiluhlobo IV.
e. Umfanekiso owandisiweyo we-crystal violet staining
embindini wesilonda yi-VI, ingaqhelekanga kancinci, kwaye akukho nto icacileyo yokungena kwe-submucosal efunyenweyo.
f. Isitofu sasekhaya
I-puncture kunye ne-injection yendawo yenziwa phakathi kwe-lesion, okubangela ukuba kubekho i-bulge enhle.
g. Vula umgibe
Cinezela inqaku lomgibe kudonga lwekholoni ukuvula umgibe.
h. Vala umgibe
Vala umgibe kwaye ubambe isilonda.
i.Amandla ekususeni
Akukho kugqobhoza, ukopha okanye ithumba elishiyekileyo lifunyenweyo.
j. Ukulungiswa komfanekiso
Lo mzekelo ukhutshiweyo uncanyathiselwe kwiphepha lerabha.
Ukuxilongwa kokugqibela kwe-pathological:intramucosal carcinoma (Tis)
4.Iingcebiso zokusebenza komgibe
I-tip yomgibe ibekwe ngobunono kwi-mucosa yomlomo wesilonda, emva koko ivule ngokukhawuleza kwaye ingcambu yomgibe icinezelwe kwicala le-anal lesion. Ukuthintela i-lateral incision ekubeni ilungile, inani elincinci le-mucosa eqhelekileyo kufuneka lifakwe.
Kufuneka kuqatshelwe ukuba xa i-tip yomgibe ingabonwa, kunokwenzeka ukuba i-mucosa eqhelekileyo ifakwe kunokuba ilindelwe. Emva kokuba umgibe uqiniswe ngokupheleleyo, tyhala kwaye utsale umkhono wangaphandle womgibe ukujonga ukuhamba kwesilonda. Ukuba ifakwe kwi-muscular layer, ukuhamba kwe-lesion kuya kuncitshiswa.
Iingcebiso ze-electroresection
Musa ukucinezela umgibe kudonga lwamathumbu, kodwa uphakamise kancinane isilonda sokuqhafaza. Umngcipheko wokulibaziseka kwe-perforation uphantsi xa usebenzisa i-electrosurgical resection, kodwa ixhomekeke kwi-intraoperative (ekuqaleni emva kokutshatyalaliswa) ukopha.
Ukukhutshwa okukhawulezileyo kakhulu kunokubangela ukopha, ngelixa ukukhupha okucotha kakhulu kunokubangela ukulibaziseka kokugqobhoza. Ukuba isigulane siva intlungu, okanye umncedisi uvakalelwa kukuba i-tissue i-elastic njenge-rubber kwaye kunzima ukuyisika, kunokwenzeka ukuba i-tissue ibandakanyeka kwi-muscle layer, kwaye ukukhutshwa kufuneka kumiswe ngokukhawuleza.
Izinto ezibalulekileyo kwiiGcisa ze-Endoscopy
Ukuba i-endoscopist ivakalelwa kukuba i-tissue iyalastiki njengerabha kwaye kunzima ukuyisika, kufuneka ngoko nangoko axelele umqhubi ukuba axoxe ngamanyathelo okuthintela.
Iingcebiso zokwabelana nge-EMR
Kwizilonda ezinkulu, ngamanye amaxesha kukhuselekile ukwenza i-piecemeal resection kunokunyanzeliswa konke-kanye. Nangona kunjalo, okukhona kukho amaqhekeza amaninzi, kokukhona amathuba okuba intsalela iphinde iphindeke. Nokuba kunye ne-EMR yeqhekeza, ukutyunjwa kokuqala kufuneka kwenziwe kukhulu ngokusemandleni kunye nomgibe omkhulu ukunciphisa inani lamaqhekeza.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ngumenzi e-China okhethekileyo kwizinto ezityiwayo ze-endoscopic, ezifana ne-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-sclerotherapy catheter, iibhrashi ze-cytology, i-guidewire, i-stone retrieval basket, i-drain ye-nasal esetyenziswa kwi-EMR, njl. I-ERCP. Iimveliso zethu ziqinisekisiwe nge-CE, kwaye izityalo zethu ziqinisekisiwe nge-ISO. Impahla yethu ithunyelwe eYurophu, kuMntla Melika, kuMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana ngokubanzi umthengi wokuqatshelwa kunye nendumiso!
I-Biopsy forceps:
https://www.zrhendoscopy.com/single-use-endoscopic-tissue-biopsy-forceps-with-graduation-product/
I-Hemoclip
https://www.zrhendoscopy.com/disposable-rotatable-endoscopic-hemoclip-for-gastroscopy-use-product/
polyp umgibe
https://www.zrhendoscopy.com/disposable-endoscopic-resection-polypectomy-snare-for-gastroenterology-product/
inaliti ye-sclerotherapy
https://www.zrhendoscopy.com/gastroenterology-accessories-endoscopic-sclerotherapy-injection-needle-product/
Tshiza i-catheter
https://www.zrhendoscopy.com/ce-certified-disposable-endoscopic-spray-catheter-for-digestive-chromoendoscopy-product/
iibrashi zecytology
https://www.zrhendoscopy.com/endoscopy-accessories-disposable-endoscopic-cytology-brush-for-gastrointestinal-tract-product/
ibhasikithi yokubuyiswa kwamatye
https://www.zrhendoscopy.com/ercp-instrument-gallstone-stone-retrieval-basket-for-endoscopy-product/
i-catheter ye-biliary drainage yeempumlo
https://www.zrhendoscopy.com/medical-instrument-disposable-nasal-biliary-drainage-catheter-for-ercp-operation-product/
I-EMR
https://www.zrhendoscopy.com/emresd/
ESD
https://www.zrhendoscopy.com/emresd/
I-ERCP
https://www.zrhendoscopy.com/ercp/
Ixesha lokuposa: Feb-13-2025