(1). Iindlela ezisisiseko Iindlela ezisisiseko ze-EMR zezi zilandelayo:
Ulandelelwano lweendlela
①Faka isisombululo senaliti esikufutshane nenxeba.
②Beka isithiyelo sijikeleze isilonda.
③Umgibe uqinisiwe ukuze ubambe kwaye ukrwitshe isilonda.
④Qhubeka uqinisa umgibe ngelixa usebenzisa umbane ukusika isilonda.
⑤ Fumana isampuli esusiweyo.
(2). Iingcebiso
1. Iingcebiso zokukhetha indawo yomzimba kunye nokubeka i-endoscope
Ngenxa yokuba isilonda kufuneka sinyangwe ngelixa umfanekiso wonke ubonakala, indawo yesigulana ibaluleke kakhulu. Zama ukujika i-scope ukuze isilonda sibe kufutshane nomnyango we-biopsy forceps, oko kukuthi, ukusuka ngentsimbi yesi-5 ukuya kweyesi-7 kwisikrini.
Ngaphambi konyango, intsalela kunye nombala ogqithisileyo kufuneka zihlanjwe zize zisuswe ngokufunxwa.
Umzekelo, ukuba isilonda kwikholoni ye-sigmoid ekufutshane sisusiwe kwindawo yokulala okanye kwindawo yokutyela ecaleni kwesobunxele, isampuli iya kuhlala iye kwikholoni ehlayo, nto leyo eyenza kube nzima ukuyikhupha, ngoko ke indawo yokutyela ecaleni kwekhohlo kwekhohlo kwekunene ingcono xa kunqunyulwa.
Ngokufanayo, ngokwembono yokubuyiselwa kwesampuli, indawo ye-decubitus esecaleni ekhohlo ikhethwa kakhulu xa kunqunyulwa izilonda ze-colon ezinqamlezileyo.
2. Iingcebiso zokufaka inaliti kwindawo ethile
Inaliti enkulu yenaliti yendawo ingafakwa ngoxinzelelo oluphantsi, kodwa ayibukhali ngokwaneleyo kwaye umngxuma wenaliti mkhulu kakhulu, ngoko umbhali usebenzisa inaliti yenaliti yendawo engama-25G.
Asikokubaxa izinto ukuthi impumelelo okanye ukungaphumeleli kwe-EMR kuxhomekeke kakhulu kwiinaliti zasekuhlaleni.
Kwizilonda ezincinci, ukubhobozwa kwenziwa ukusuka kwicala lempundu lesilonda ukuya ngaphantsi kwesilonda.
Kwizilonda ezikwindawo egobileyo okanye ezijikeleze imiphetho, ukuba inaliti yendawo yenziwe kwicala lempundu, kwiimeko ezininzi izilonda azicaci kuba zijonge kwicala lomlomo, ngoko ke inaliti yendawo kufuneka iqalwe kwicala lomlomo.
Izinto ezibalulekileyo kwiingcali ze-Endoscopy
Ukuba ulwelo luvuza, okanye kukho ukumelana okukhulu ngexesha lokujova, okanye akukho ukumelana xa ulwelo lungena kodwa kungekho bundu, kufuneka kumiswe ukujova kwaye umqhubi kufuneka aziswe ngemeko ngexesha elifanelekileyo ukuze kuxoxwe ngamanyathelo okulwa nawo.
Okukhona umthamo wenaliti uphezulu, kokukhona kungcono.
Icebo kukuqhubeka nokufaka inaliti kangangoko kunokwenzeka ngokubhoboza kube kanye de kube kuphume yonke inxeba.
3. Iingcebiso zokukhetha umgibe
Ukuba i-snare ikwimo ye-oval ende, i-mucosa eqhelekileyo emlonyeni wesilonda nasemacaleni empundu inokufakwa ngokulula nangokungeyomfuneko.
I-snare ingcono ukuba ijikeleze phantse, kulula ukuyivula ecaleni, ayityibiliki lula, kwaye inobunzima obuthile bokucinezela inxeba ukuze ibambe inxeba.
Ubungakanani bomgibe bufanele bulungelelaniswe nobukhulu besilonda.
Umgibe wePolypectomy oLahlwayo
Imizekelo ye-EMR
a. Umfanekiso wokukhanya okumhlophe
Isilonda sohlobo lwe-IIa esingama-25 mm esinenxalenye ephakathi exineneyo kancinci.
b. Imifanekiso ye-Narrow band imaging (NBI)
c. Ukutshiza i-indigo carmine ukuze kwandiswe umfanekiso
Kwafunyaniswa ukuba imingxunya eyayibonwa ngokujonga okuqhelekileyo yayiyimiqolomba phakathi kwamagqabi.
d. Umfanekiso owandisiweyo wombala wekristale violet
Ipatheni yomngxuma wombhobho we-glandular emphethweni wesilonda yayiluhlobo lwe-IV.
e. Umfanekiso owandisiweyo wedayi yekristale violet
embindini wesilonda kwakukho i-VI, ingaqhelekanga kancinci, kwaye akukho kungena okucacileyo kwe-submucosal okufunyenweyo.
f. Inaliti yendawo
Ukubhoboza kunye nokufakwa kwenaliti embindini wesilonda, nto leyo eyabangela ukuba iqhuma kakuhle.
g. Vula umgibe
Cinezela incam yesibatha eludongeni lwekholoni ukuze uvule isibatha.
h. Vala umgibe
Vala umgibe uze ubambe isilonda.
i. Amandla okususa
Akukho mbobo, ukopha okanye ithumba eliseleyo elifunyenweyo.
j. Ukulungiswa kwesampuli
Isampuli ekhutshweyo yayincamathiselwe kwiphepha lerabha.
Ukuxilongwa kokugqibela kwesifo:umhlaza wangaphakathi kwesisu (iTis)
4. Iingcebiso zokusebenza kwe-snare
Incam yesitrayi ibekwa kancinci kwi-mucosa yomlomo yesilonda, ize ivulwe kancinci kwaye ingcambu yesitrayi icinezelwe kwicala lempundu lesilonda. Ukuthintela ukuba isitrayi esisecaleni singabi sihle, kufuneka kufakwe inani elincinci le-mucosa eqhelekileyo.
Kufuneka kuqatshelwe ukuba xa incam yesnare ingabonakali, kusenokwenzeka ukuba i-mucosa ifakiwe ngendlela eqhelekileyo kunokuba bekulindelwe. Emva kokuba isnare iqiniswe ngokupheleleyo, tyhala uze utsale umkhono wangaphandle wesnare ukuze ubone ukuhambahamba kwesilonda. Ukuba sifakwe kumaleko wemisipha, ukuhambahamba kwesilonda kuya kuncipha.
Iingcebiso zokususa umbane
Musa ukucinezela umgibe eludongeni lwamathumbu, kodwa phakamisa kancinci isilonda ukuze unqunyulwe. Umngcipheko wokugqobhoka okulibazisekileyo uphantsi xa usebenzisa i-electrosurgical resection, kodwa unokuba nokopha emva kotyando (kwangoko emva kokususwa).
Ukususwa ngokukhawuleza kakhulu kunokubangela ukopha, ngelixa ukususwa kancinci kakhulu kunokubangela ukugqobhoka okulibazisekileyo. Ukuba isigulane siva iintlungu, okanye umncedisi uvakalelwa kukuba izicubu zithambile njengerabha kwaye kunzima ukuzisika, kusenokwenzeka ukuba izicubu zibandakanyekile kumaleko wemisipha, kwaye ukususwa kufuneka kumiswe ngoko nangoko.
Izinto ezibalulekileyo kwiingcali ze-Endoscopy
Ukuba ingcali ye-endoscopist ivakalelwa kukuba izicubu zithambile njengerabha kwaye kunzima ukuzisika, kufuneka yazise umqhubi ngoko nangoko ukuze baxoxe ngamanyathelo okuzichasa.
Iingcebiso zokufaka i-Sharding EMR
Kwizilonda ezinkulu, ngamanye amaxesha kukhuselekile ukwenza utyando oluncinci endaweni yotyando olunyanzeliswayo ngaxeshanye. Nangona kunjalo, xa kukho iziqwenga ezininzi, kokukhona amathuba okuba intsalela yendawo ibuyele kwakhona. Nokuba kukho i-EMR encinci, utyando lokuqala kufuneka lwenziwe lukhulu kangangoko kunokwenzeka nge-snare enkulu ukuze kuncitshiswe inani leziqwenga.
Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumvelisi eTshayina ogxile kwizinto ezisetyenziswayo ze-endoscopic, ezifana ne-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-spray catheter, iibhrashi ze-cytology, i-guidewire, i-stone retrieval basket, i-nasal biliary drainage catheter njl. ezisetyenziswa kakhulu kwi-EMR, ESD, ERCP. Iimveliso zethu ziqinisekisiwe yi-CE, kwaye izityalo zethu ziqinisekisiwe yi-ISO. Iimpahla zethu zithunyelwe eYurophu, eMntla Melika, eMbindi Mpuma nakwinxalenye ye-Asia, kwaye zifumana umthengi udumo kunye nendumiso!
Iiforceps zeBiopsy:
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/
umgibe we-polyp
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/
I-catheter yokutshiza
https://www.zrhendoscopy.com/ce-certified-disposable-endoscopic-spray-catheter-for-digestive-chromoendoscopy-product/
iibhrashi ze-cytology
https://www.zrhendoscopy.com/endoscopy-accessories-disposable-endoscopic-cytology-brush-for-gastrointestinal-tract-product/
Ucingo lwesikhokelo
https://www.zrhendoscopy.com/gastrointestinal-endoscopic-ptfe-coated-ercp-hydrophilic-guidewire-product/
ibhaskithi yokuqokelela amatye
https://www.zrhendoscopy.com/ercp-instrument-gallstone-stone-retrieval-basket-for-endoscopy-product/
i-catheter yokukhupha amanzi empumlweni
https://www.zrhendoscopy.com/medical-instrument-disposable-nasal-biliary-drainage-catheter-for-ercp-operation-product/
I-EMR
https://www.zrhendoscopy.com/emresd/
I-ESD
https://www.zrhendoscopy.com/emresd/
I-ERCP
https://www.zrhendoscopy.com/ercp/
Ixesha leposi: Februwari-13-2025