I-Colon Polyps sisifo esiqhelekileyo kwaye senzekile rhoqo kwi-gastroenterology. Babhekisa kwi-Intralsusions ephakamileyo kune-mucosa ye-mucosa. Ngokubanzi, ikhombacoscopy ineqondo lokubutha ubuncinci i-10% ukuya kwi-15%. Ireyithi yeNkunyatho ihlala inyuka ngeminyaka. vuka. Ukususela ngaphezulu kwe-90% yemihla ye-coloretal ebangelwa yinguqu eguqukayo ye-polyps, unyango ngokubanzi kukwenziwa kwe-endoscopic kwakamsinya nje emva kokuba i-polyps ibonwa.
Kwimihla ngemihla colonoscopy, i-80% ukuya kwi-90% ye-polyps ingaphantsi kwe-1 cm. Ngee-addenomatous polyps okanye i-polyps ngobude obuyi-5 mm (ingaba i-addenomatous okanye hayi), i-endoscopic ye-endoscopic iyacetyiswa. Inokwenzeka ye-colon micropollyps (i-diameter ye-diameter ≤5mm) equkethe izixhobo ze-tumor iphantsi kakhulu (0 ~ 0.6%). Kwimicropolyps kwi-rectum kunye ne-sigmoid colon, ukuba i-gossoscopist inokuchonga ngokuchanekileyo, akukho mfuneko yokuba i-Polyps, akukho mfuneko yokuba isetyenziselwe ukuthunyelwa, kodwa le ndawo ingentla isetyenziselwe ukuziqhelanisa neklinikhi yase China.
Ukongeza, iipesenti ezi-5 zeepolyps ziflethi okanye zikhule ecaleni kwendlela, kunye ne-diameter engaphezulu kwe-2 cm, kunye okanye ngaphandle kwezinto ezimbi. Kule meko, ezinye iindlela ze-gollsCopic ze-golyp ze-volyp ziyafuneka, njengeEmskwayeEsd. Makhe sijonge amanyathelo aneenkcukacha zokususwa kwePolyp.
Inkqubo yoqhaqho
Isigulana sigqibe uvavanyo lwe-anesthesia ofanelekileyo, yabekwa kwisikhundla sasemva kwexesha, kwaye sanikwa i-anesthesiaus anesthesia ene-propofol. Uxinzelelo lwegazi, ireyithi yentliziyo, i-electrocardiogram, kunye ne-phendhegel band yabekwa esweni ngexesha lokusebenza.
I-1 ibanda / ishushuI-biopsy godpsUkwahlula
Ilungele ukususwa kwee-polyps ezincinci ≤5mm, kodwa kusenokwenzeka ukuba kubekho ingxaki yokususwa okungaphelelanga kwePolyps 4 ukuya kwi-5mm. Kwisiseko se-biopsy ebandayo, i-biopsy ye-biopsy inokusebenzisa i-free-frequency yangoku ukuya kwi-leuters yendawo yentsalela kwaye yenze unyango lwe-heastistis kwinxeba. Nangona kunjalo, ukhathalelo kufuneka luthathelwe ukunqanda ukonakala kwi-serosa udonga lodonga lwamathumbu ngenxa yokungaphezulu kwe-elektrocoaaaaagraction.
Ngexesha lokusebenza, isiphelo sentloko se-polyp kufuneka sikhutshiwe, siphakanyiswe ngokufanelekileyo (ukunqanda ukonakalisa umaleko womsipha), kwaye sigcinwe kumgama ofanelekileyo ovela kudonga olufanelekileyo. Xa i-polyp pedicle ijika imhlophe, yeka i-elektrocooaducocition kwaye ikhwele isilonda. Kufuneka kuqatshelwe ukuba akukho lula ukususa i-polyp enkulu kakhulu, kungenjalo iyakukhulisa ixesha lokufakelwa kunye nokwandisa umngcipheko wokonakalisa ngokupheleleyo (umzobo 1).
2 Kubanda / kushushuI-Polypectomy ye-Polypectomyindlela yokukhupha
Ilungele izilonda eziphakanyisiweyo zobukhulu obahlukeneyo, ndichwetheza kwaye ndincinci (<2cm) Kwizilonda ezincinci ze-IP, ukuqhubela phambili kwe-SUP kulula. Imigibe ebandayo okanye eshushu ingasetyenziselwa ukutshatiswa. Ngexesha lokuhamba, ubude obuthile be-pedicle kufuneka bugcinwe okanye kumgama othile ukusuka kudonga oluthile ngelixa uqinisekisa ukususwa ngokupheleleyo kwesilonda. Emva kokuqinisa umgibe, kufuneka inyibilikiswe umgibe, qaphela ukuba ijikeleze i-mucosa eqhelekileyo ye-MUCOSA kwaye ifake kunye ukuthintela umonakalo kudonga lwamathumbu.
Umzobo 1 we-Schematric umfanekiso we-biopsy forms fiopsys, ngaphambi kokususwa kwe-formps, b inxeba emva kokususwa kwe-curneps. I-CD: Amanyathelo okuqala kwi-thermali-biopsy godpsUkususwa. Ukuba i-polyp inkulu kakhulu, iya kukhulisa ixesha le-electrocoalicals kwaye libangele ukonakala kwendalo.
Umzobo 2 wekratshi lomzobo we-thermal smmare ye-SPRY I-SPOS
3 Ems
■ izilonda
Kwizilonda ezinkulu eziphezulu, ukongeza kwezi zinto zingasentla, imigibe ye-thermal kufuneka isetyenziselwe ukuqhubela phambili. Phambi kokuba inaliti, inaliti eyaneleyo yenkumbulu kufuneka yenziwe kwisiseko se-pedicle (i-2 ukuya kwi-10 ml ye-10,000 ye-10,000 ye-intshi ye-MUCOSA ikhutshiwe i-MUCOSA (i-Istic) i-Supecle (i-Lesion). I-Loop evaliweyo kunye nokutshisa udonga lwamathumbu.
Umzobo 3 we-schematic yomzobo weEmsUnyango lwezilonda ze-LP
Kuya kufuneka kuqatshelwe ukuba uhlobo olukhulu lwe-Polyp lunengxaki enkulu, inokuba neVasa vasarm enkulu, kwaye iya kuphalaza ngokulula emva kokususwa. Ngexesha lenkqubo yokuqhubela phambili, indlela yokucofa i-COAYIC-COOCT inokusetyenziselwa ukunciphisa umngcipheko wokopha. Ezinye iipolyps ezinkulu zinokwenziwa kwiziqwenga zokunciphisa ubunzima bokusebenza, kodwa le ndlela ayihambelani novavanyo lwendalo.
■ I-LLA-C EQHELEKILEYO
Kwizilonda ze-Ila-C Inaliti ye-submucosal yolwelo inokunyusa ukuphakama kwesilonda kwaye kuncitshiswe ubunzima bomgibe kunye nokufika kwimeko. Enoba kukho umphakamo ngexesha lotyando sisiseko esibalulekileyo sokumisela ukuba ngaba i-Adenoma ingaba i-adenoma ingenayo okanye imbi kwaye ingaba zikho iimpawu zonyango lwe-endoscopic. Le ndlela inokunyusa umgangatho wokuphela kwe-Adenos<2cm ubukhulu.
Umzobo 4EmsItshati yokuhamba konyango yohlobo lwe-Polyps
4 Esd
Kwi-Adenoms ene-diameter inkulu kune-2cm efuna ukutshahamba kwexesha kunye nokuphakamisa okungalunganga, kunye nomhlaza wokuqala,EmsI-Ressives okanye ukuphindaphinda okunzima ukunyanga,EsdUnyango lunokwenziwa. Amanyathelo ngokubanzi:
I-1. Emva kokubekwa kwe-amososcopic, umda wesilonda ucacisiwe ngokucacileyo kwaye umqobo ophawulwe (isilonda siphawuliwe (isilonda sinokumakishwa ukuba umda we-lesion ucacile).
2. I-Submucosselly ye-submucossell ukwenza izilonda ziphakame ngokucacileyo.
3. Ngokuyinxenye okanye ngokungahambi kakuhle okanye ngokungagungqiyo ukonakalisa i-MUCOSA ukuba ibhenca i-submucosa.
I-4. Khulula izicubu ezinxibelelanayo kwi-submucosa kwaye ngokuthe ngcembe yaphosa izicubu zesifo.
5. Qwalasela inxeba ngononophelo kwaye uphathe imithambo yegazi ukuthintela iingxaki.
6. Emva kokulungisa iisampuli eziphindwayo, zithumele kuviwo lwe-pathological.
Umzobo 5EsdUnyango lwezilonda ezinkulu
Amanyathelo okhuseleko ngaphakathi
I-Endoscopic Colon Relyp Rection ifuna indlela efanelekileyo yokukhethwa ngokusekwe kwiimpawu zePolyp, indawo, inqanaba lezakhono zomsebenzi, kunye nezixhobo ezikhoyo. Kwangelo xesha, ukufuduswa kwePolyp kwakhona kulandela imigaqo eqhelekileyo, ekufuneka siyilandele kangangoko sinakho ukuqinisekisa ukuba inkqubo yezonyango ikhuselekile kwaye isebenza kwaye izigulana ziyasebenza kuyo.
1. Ukusetwa kwangaphambili kwesicwangciso sonyango sisitshixo sokugqitywa ngempumelelo kunyango lwePolyp (ikakhulu i-polyps enkulu). Ngeepoli ezintsonkothileyo, kuyimfuneko ukukhetha indlela ehambelanayo ngaphambi konyango, nxibelelana nabongikazi, i-anesthesiologists kunye nabanye abasebenzi ngexesha elifanelekileyo, kwaye balungiselele izixhobo zonyango. Ukuba iimeko zemvume, zinokugqitywa phantsi kwesikhokelo so utyando oluPhezulu ukuthintela iingozi ezahlukeneyo zokuhlinzwa.
2. Ukugcina isidanga senkululeko elungileyo "emzimbeni wesipili ngexesha lonyango kukuqinisekisa ukuba kuyafezekiswa khona injongo yokusebenza. Xa ungena esipilini, landela ngokungqongqo "ulungiso lwe-axis kunye nendlela yokuvala" ukugcina indawo yokunyanga "yokugcina indawo yonyango kwi-Loop-free State, elungele unyango oluchanekileyo.
3. Umbono oSebenzayo oSebenzayo wenza inkqubo yonyango ilula kwaye ikhuseleke. Amathumbu esigulana kufuneka alungiselele ngononophelo ngaphambi konyango, isikhundla somguli kufuneka sigqitywe ngaphambi kotyando, kwaye iipolyps kufuneka zivezwe ngokupheleleyo ngumxhuzulane. Ihlala ingcono ukuba i-leson ikwicala elichaseneyo lombhobho oseleyo kwi-cavilal cavity.
Thina, iJiangxi Zhuoruhiuuuuuuuhui-biopsy godps, i-hemoclip, I-Polyp gorare, Inaliti ye-sclerotherapy, ukutshiza i-catheter, Ibrashi ye-cytology, isikhokelo, Ibhasikithi yokubuyisa ilitye, I-Nasal Biling Drasheter Casheter catheternjl.Ems, Esd, I-ERCP. Iimveliso zethu kufuneka ziqinisekiswe, kwaye izityalo zethu ziqinisekisiwe. Impahla yethu ithunyelwe eYurophu, iMntla Melika, eMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana umthengi wokuqonda kunye nokudumisa!
IXESHA LOKUQALA: AUG-02-2024