Unyango lwamatye e-ERCP anzima

·Emva kotyando lwe-LC, ubume bombhobho wenyongo awuqhelekanga kwaye umbhobho wenyongo uyajijeka. NgexeshaI-ERCPukusebenza, ucingo lwesikhokelo "lula ukubeka phantsi kodwa akukho lula ukuyibeka" (iwela ngaphandle ngengozi emva kokunyuka ekugqibeleni), ngoko xa ucingo lwesikhokelo lubekwe phezulu, kufuneka lugcinwe ukuze luthintele ukuphuma kwentambo yesikhokelo kwaye iwele ngaphandle kwe-bile duct.

·I-Mirizz syndrome sisenzo esingaqhelekanga se-anatomical esiphoswa lula kwaye singahoywa. I-Case study: Emva kotyando lwe-LC, isigulane esinamatye e-cystic duct sacinezela umbhobho wenyongo oqhelekileyo, obangela i-Mirrizz syndrome. Amatye awakwazanga ukususwa phantsi koqwalaselo lweX-reyi. Ekugqibeleni, ingxaki yasombululwa emva kokuxilongwa kunye nokususwa phantsi kombono othe ngqo nge-eyeMAX.

·KubaI-ERCPukususwa kwelitye lenyongo kwizigulane zesisu emva kotyando lwe-Bi II, isitshixo kukufikelela kwingono ngobubanzi. Ngamanye amaxesha kuthatha ixesha elide (okufuna ingqondo eqinileyo) ukufikelela kwingono, kwaye ukuba i-guidewire ayigcinwanga kakuhle, inokuphuma ngokulula.

③Ezinye iimeko

I-Peripapillary diverticulum edityaniswe ne-bile duct amatye ixhaphake kakhulu. Ubunzima bolu tyando ngeli xesha kumngcipheko wokusikwa kwengono kunye nokwandiswa. Lo mngcipheko mkhulu kwiingono ngaphakathi kwe-diverticulum, kwaye umngcipheko weengono ezikufutshane ne-diverticulum uncinci.

Ngeli xesha, kuyafuneka ukuba ubambe inqanaba lokwandiswa. Umgaqo oqhelekileyo wokwandiswa kukunciphisa umonakalo ofunekayo ukususa amatye. Umonakalo omncinci uthetha iingozi ezincinci. Kule mihla, ukwandiswa kwebhaluni (CRE) yengono ejikeleze i-diverticula ngokuqhelekileyo isetyenziselwa ukuphepha i-EST.

Izigulane ezinezifo ze-hematological, umsebenzi we-cardiopulmonary ongenakunyamezelaI-ERCP, okanye izifo ezidibeneyo zomgogodla ezingakwaziyo ukunyamezela ixesha elide lokushiya indawo ekhohlo kufuneka ziqwalaselwe kwaye zihlolwe xa zidibana namatye anzima.m

02Ingqondo yokujongana "namatye anzima"

Ingqondo engalunganga xa ujongene "namatye anzima": ukuhaha kunye nempumelelo, ukungakhathali, ukudelela kwangaphambili, njl.

·Ukubawa nothando kwimpumelelo enkulu

Xa sijongene namatye e-bile duct, ngakumbi lawo anamatye amaninzi, sihlala sifuna ukulahla onke amatye. Olu luhlobo "lokunyoluka" kunye nempumelelo enkulu.

Enyanisweni, kuchanekile ukuthabatha konke kunye nokucocekileyo, kodwa ukuthatha okucocekileyo kuzo zonke iindleko "kufanelekile", okungakhuselekanga kwaye kuya kuzisa ubunzima obuninzi kunye nobunzima. Amatye amaninzi e-bile duct kufuneka agqitywe ngokubanzi ngokusekelwe kwimeko yesigulane. Kwiimeko ezikhethekileyo, ityhubhu kufuneka ibekwe kuphela okanye isuswe kwiibhetshi.

Xa amatye amakhulu e-bile duct kunzima ukuwasusa okwethutyana, "i-stent dissolution" inokuqwalaselwa. Musa ukunyanzelisa ukukhutshwa kwamatye amakhulu, kwaye ungazibeki kwimeko eyingozi kakhulu.

·ngenankathalo

Oko kukuthi, ukusebenza ngokungaboniyo ngaphandle kohlalutyo olubanzi kunye nophando luhlala lukhokelela ekungaphumeleli kokususa amatye. Ke ngoko, iimeko zamatye e-bile duct kufuneka zihlolwe ngokupheleleyo phambi kotyando, zivavanywe ngokuchanekileyo (ezifuna amandlaI-ERCPoogqirha ukuba bafunde imifanekiso), ukwenza izigqibo ngokucophelela kunye nezicwangciso ezingxamisekileyo kufuneka zenziwe ukuthintela ukukhutshwa kwamatye okungalindelekanga.

II-ERCPisicwangciso sokutsalwa kwamatye kufuneka sibe senzululwazi, sinenjongo, sibanzi, kwaye sikwazi ukumelana nohlalutyo nokuqwalaselwa. Kufuneka sibambelele kumgaqo wokwandisa inzuzo yesigulane kwaye singabi ngqongqo.

·indelelo

Amatye amancinci kwindawo engezantsi ye-bile duct kulula ukuyihoxisa. Ukuba amatye amancinci adibana neengxaki zesakhiwo kwindawo engezantsi ye-bile duct kunye ne-outlet yayo, kuya kuba nzima kakhulu ukususa ilitye.

I-ERCPunyango amatye kwinyongo ineenguqu ezininzi kunye nemingcipheko ephezulu. Kunzima kwaye kuyingozi kakhulu okanye ngaphezulu kunokoI-ERCPunyango amathumba kwinyongo. Ke ngoko, ukuba awuyithathi lula, uya kuzishiyela indlela efanelekileyo yokusaba.

03Indlela yokujongana "namatye anzima"

Xa udibana namatye anzima, uvavanyo olubanzi lwesigulana kufuneka lwenziwe, ukwandiswa okwaneleyo kufuneka kwenziwe,ibhasikithi yokubuyisela ilityekufuneka kukhethwe kwaye i-lithotripter ilungiswe, kwaye isicwangciso esilungiselelwe kunye nesicwangciso sonyango kufuneka siyilwe.

Njengenye indlela, i-pros and cons kufuneka ihlolwe ngokusekelwe kwimeko yesigulane ngaphambi kokuba kuqhutywe.

·Ukuvula inkqubo

Ubungakanani bokuvula busekelwe kwimeko yelitye ekujoliswe kuyo kunye ne-bile duct. Ngokuqhelekileyo, i-incision encinci + enkulu (ephakathi) i-dilation isetyenziselwa ukwandisa ukuvula. Ngexesha le-EST, kuyimfuneko ukuphepha enkulu ngaphandle kunye encinci ngaphakathi.

Xa ungenamava, kulula ukwenza umzobo "omkhulu ngaphandle kodwa ube mncinci ngaphakathi", oko kukuthi, ingono ibonakala inkulu ngaphandle, kodwa akukho nto ngaphakathi. Oku kuya kubangela ukuba ukususwa kwelitye kungaphumeleli.

Xa usenza i-EST, "i-sallow bow kunye ne-slow slow" kufuneka isetyenziswe ukukhusela i-zipper. Ukusikwa kufuneka kukhawuleze njengokusikwa ngakunye. Imela akufuneki "ihlale ihleli" ngexesha lokusikwa ukunqanda ukuphazamiseka kwengono kwaye kubangele ipancreatitis. .

·Ukwenziwa kovavanyo lwecandelo elisezantsi kunye nokuthunyelwa ngaphandle

Amatye aqhelekileyo etyholo lenyongo afuna uvavanyo lwecandelo elisezantsi kunye nokuphuma kombhobho oqhelekileyo wenyongo. Zombini iziza kufuneka zivavanywe. Indibaniselwano yazo zombini imisela umngcipheko kunye nobunzima benkqubo yokusika iingono.

·Lithotripsy kaxakeka

Amatye amakhulu kakhulu kwaye anzima kunye namatye angenako ukukhutshwa kufuneka aphathwe nge-lithotripter engxamisekileyo (i-lithotripter engxamisekileyo).

Amatye e-Bile pigment anokwaphulwa abe ziziqwenga, kwaye uninzi lwamatye e-cholesterol anzima nawo anokusombulula ngale ndlela. Ukuba isixhobo asikwazi ukukhutshwa emva kokufunyanwa, kwaye i-lithotripter ayikwazi ukuphula amatye, "ubunzima" bokwenene. Ngeli xesha, i-eyeMAX inokufuneka ukuxilongwa ngokuthe ngqo kunye nokunyanga amatye.

Qaphela: Musa ukusebenzisa i-lithotripsy kwicandelo elisezantsi kunye nokuphuma kwi-bile duct eqhelekileyo. Musa ukusebenzisa i-lithotripsy epheleleyo ngexesha le-lithotripsy, kodwa yishiye indawo. I-lithotripsy engxamisekileyo inobungozi. Ngexesha le-lithotripsy engxamisekileyo, i-axis yokuphela inokungahambelani ne-bile duct axis, kwaye uxinzelelo lunokuba lukhulu kakhulu ukuba lubangele ukubhoboza.

·Ilitye elinyibilikayo

Ukuba ilitye likhulu kakhulu kwaye kunzima ukulisusa, unokuqwalasela ukuchithwa kwe-stent - oko kukuthi, ukubeka i-stent yeplastiki. Lindela de ilitye liyancipha ngaphambi kokususa ilitye, ngoko ithuba lokuphumelela liya kuba liphezulu kakhulu.

·Amatye e-intrahepatic

Oogqirha abancinci abanamava amancinci bangcono ukuba bangenzi unyango lwe-endoscopic lwamatye e-intrahepatic bile duct. Ngenxa yokuba amatye akule ndawo akanakukwazi ukubanjiswa okanye aqhube nzulu kwaye athintele ukusebenza okuqhubekayo, indlela iyingozi kakhulu kwaye imxinwa.

·Amatye ebhobhobhobhosi adityaniswe ne-peripapillary diverticulum

Kuyimfuneko ukuvavanya umngcipheko kunye nokulindela ukwanda. Umngcipheko wokugqobhoza kweEST uphezulu kakhulu, ngoko ke ngoku indlela yokwandiswa kwebhaluni ikhethwa ngokwesiseko. Ubungakanani bokwandiswa kufuneka bube ngokwaneleyo ukususa ilitye. Inkqubo yokwandisa kufuneka icothe kwaye inyathelo ngenyathelo, kwaye akukho ukwanda okunobundlobongela okanye ukwandiswa kuvunyelwe. Isirinji iyanda ngokuthanda. Ukuba kukho ukopha emva kokuhlanjululwa, unyango olufanelekileyo luyafuneka.

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 njl. 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 kunye nenxalenye yeAsia, kwaye ifumana ngokubanzi umthengi wokuqatshelwa kunye nendumiso!