Ekwelashweni kwe-colonoscopy, izinkinga ezimele ukubhoboza nokuphuma kwegazi.
I-perforation ibhekisela esimweni lapho i-cavity ixhunywe khona ngokukhululekile emgodini womzimba ngenxa yesiphambeko sezicubu ezigcwele, futhi ukuba khona komoya okhululekile ekuhlolweni kwe-X-ray akuthinti incazelo yayo.
Lapho i-periphery of the full-thickness defect defect imboziwe futhi kungekho ukuxhumana okukhululekile nomgodi womzimba, kubizwa ngokuthi i-perforation. Incazelo yokopha ayichazwa kahle, futhi izincomo zamanje zihlanganisa ukwehla kwe-hemoglobin engaphezu kuka-2 g/dL noma isidingo sokumpontshelwa.
Ukopha kwangemva kokuhlinzwa ngokuvamile kuchazwa njengokuvela kwegazi elibalulekile esitulweni ngemva kokuhlinzwa okudinga ukwelashwa kwe-hemostatic noma ukumpontshelwa igazi.
Izehlakalo zalezi zenzakalo zengozi ziyehluka ngokuya ngokwelashwa:
Izinga lokubhoboza:
I-Polypectomy: 0.05%
I-Endoscopic Consumables Ehlobene: Ugibe Lwe-Polypectomy Elahlwayo
Ukukhishwa kwe-endoscopic mucosal (EMR): 0.58%~0.8%
I-Endoscopic Consumables Ehlobene:Iziqeshana Ze-Hemostasis Ezilahlwayo
Okuhlobene Kwe-Endoscopic Consumables:Inaliti Yomjovo Elahlwayo
I-Endoscopic submucosal dissection (ESD): 2%~14%
I-Endoscopic Consumables Ehlobene: Ummese we-ESD Olahlwayo
Izinga lokopha kwangemva kokuhlinzwa:
I-Polypectomy: 1.6%
I-EMR: 1.1%~1.7%
I-ESD: 0.7%~3.1%
1. Ungabhekana kanjani nokubhobozwa
Njengoba udonga lwamathumbu amakhulu luncane kunolwesisu, ingozi yokubhoboza iphezulu. Ukulungiselela okwanele kuyadingeka ngaphambi kokuhlinzwa ukuze kubhekwane nokwenzeka kokubhobozwa.
Izinyathelo zokuphepha ze-intraoperative:
Qinisekisa ukusebenza kahle kwe-endoscope. Khetha ama-endoscopes afanelekile, amathuluzi okwelapha, uketshezi lomjovo, nemishini yokulethwa kwegesi ye-carbon dioxide ngokuya ngendawo, i-morphology, kanye nezinga le-fibrosis yesimila.
Ukuphathwa kwe-intraoperative perforation:
Ukuvalwa ngokushesha: Kungakhathalekile indawo, iziqeshana zincanyelwa ukuvalwa (amandla okuncoma: ileveli 1, ileveli yobufakazi: C). Ku-ESD, ngezinye izikhathi indawo ezungezile kufanele ihlulwe kuqala ukuze kugwenywe ukuphazamisa ukusebenza kokucwecwa.
Izicubu, qinisekisa indawo yokusebenza eyanele ngaphambi kokuvala.
Ukubuka kwangemva kokuhlinzwa: Uma ukubhoboza kungavalwa ngokuphelele, ukuhlinzwa kungagwenywa kuphela ngokwelashwa ngama-antibiotic nokuzila ukudla.
Isinqumo sokuhlinzwa: Isidingo sokuhlinzwa sinqunywa ngokusekelwe enhlanganisela yezimpawu zesisu, imiphumela yokuhlolwa kwegazi, nokuthwebula izithombe kunegesi yamahhala eboniswa ku-CT kuphela.
Ukwelashwa kwezingxenye ezikhethekile:
I-rectum engezansi ngeke ibangele ukubhobozwa kwesisu ngenxa yezimpawu zayo ze-anatomical, kodwa ingabangela
I-pelvic perforation, ebonakala njenge-retroperitoneal, i-mediastinal, noma i-emphysema engaphansi.
Izinyathelo zokuzivikela:
Ukuvala isilonda ngemva kokuhlinzwa kungase kuvimbele izinkinga ngezinga elithile, kodwa akunjalo
Kunobufakazi obanele obubonisa ukuthi iyasebenza ekuvimbeleni ukulibaziseka ukubhobozwa.
2. Ukusabela Ekopheni
Ukulawula ukopha kwangaphakathi kokuhlinzwa:
Sebenzisa i-heat coagulation noma iziqeshana ze-hemostatic ukumisa ukopha.
Ukopha komkhumbi omncane:
Ku-EMR, ithiphu yogibe ingasetshenziselwa ukuhlangana kwe-thermal.
Ku-ESD, ichopho lommese kagesi lingasetshenziswa ukuxhumana ne-thermal coagulation noma i-hemostatic forceps ukumisa ukopha.
Ukopha komkhumbi omkhulu: Sebenzisa i-hemostatic forceps, kodwa lawula ububanzi bokuhlangana ukuze ugweme ukulibaziseka ukubhoboza.
Ukuvimbela ukopha kwangemva kokuhlinzwa:
Ukukhishwa kwenxeba ngemva kwe-EMR:
Ucwaningo luye lwabonisa ukuthi ukusetshenziswa kwama-clamp e-hemostatic for preventive coagulation akunawo umthelela obalulekile ezingeni lokopha kwangemva kokuhlinzwa, kodwa kunomkhuba obheke ekwehliseni. Ukugoqa okuvimbelayo kunomphumela olinganiselwe ezilonda ezincane, kodwa kusebenza kahle ezilonda ezinkulu noma ezigulini ezisengozini enkulu yokopha ngemva kokuhlinzwa (njengalezo ezithola ukwelashwa kwe-antithrombotic).
Ukukhishwa kwenxeba ngemva kwe-ESD:
Imithambo yegazi eveziwe iyajiya, futhi iziqeshana ze-hemostatic zingasetshenziswa ukuvimbela ukubopha kwemithambo yegazi emikhulu.
Qaphela:
Ku-EMR yezilonda ezincane, ukwelashwa kokuvimbela okujwayelekile akukhuthazwa, kodwa ezilonda ezinkulu noma iziguli ezinobungozi obukhulu, ukunqanyulwa kokuvimbela ngemuva kokuhlinzwa kunomphumela othile (amandla okuncoma: Izinga 2, izinga lobufakazi: C).
Ukubhoboza nokopha kuyizinkinga ezivamile ze-endoscopy ye-colorectal.
Ukuthatha izinyathelo ezifanele zokuvimbela kanye nokwelapha izimo ezihlukahlukene kunganciphisa ngempumelelo izehlakalo zezifo ezingavamile futhi kuthuthukise ukuphepha kwesiguli.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., singumkhiqizi waseChina ogxile ezintweni ezisetshenziswayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip, polyp ugibe, inaliti ye-sclerotherapy, fafaza i-catheter, amabhulashi e-cytology, i-guidewire, ubhasikidi wokubuyisa amatshe, i-catheter ye-nasal biliary drainage,Ukungena emgodleni we-ureralfuthiUkungena emgodleni we-ureral ngokumuncwanjll ezisetshenziswa kakhulu kuI-EMR, ESD, I-ERCP. Imikhiqizo yethu iqinisekiswe yi-CE, futhi izitshalo zethu ziqinisekiswe yi-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi nasengxenyeni ye-Asia, futhi zithola kabanzi ikhasimende lokuqashelwa nokudumisa!
Isikhathi sokuthumela: Mar-21-2025