(1). Amasu ayisisekelo Amasu ayisisekelo e-EMR ami kanje:
Ukulandelana kwamasu
①Jova isisombululo somjovo wendawo ngezansi nje kwesilonda.
②Beka ugibe eduze kwesilonda.
③Ugibe luyaqiniswa ukuze lubambe futhi luklinywe isilonda.
④Qhubeka uqinisa ugibe ngenkathi usebenzisa ugesi ukuze unqamule isilonda.
⑤Buyisa isifanekiso esikhishiwe.
(2). Amathiphu
1.Amathiphu okukhetha indawo yomzimba kanye nokuma kwe-endoscope
Ngenxa yokuthi isilonda sidinga ukwelashwa kuyilapho sonke isithombe sibonakala, isikhundla sesiguli sibaluleke kakhulu. Zama ukusonta ububanzi ukuze isilonda sitholakala eduze nokuvulwa kwe-biopsy forceps, okungukuthi, kusukela ngo-5 kuya ku-7 ezimpondweni esikrinini.
Ngaphambi kokwelashwa, izinsalela kanye ne-pigment eyeqile kudingeka kugezwe bese isuswa ngokumuncwa.
Isibonelo, uma isilonda kukholoni ye-sigmoid eseduze sisuswa endaweni engemuva noma yesokunxele ye-decubitus engemuva, isifanekiso sizovame ukuya kukholoni eyehlayo, okwenza kube nzima ukubuyisa , ngakho-ke indawo ye-decubitus engemuva yesokudla ingcono ukuthi isuswe kabusha.
Ngokunjalo, ngokombono wokululama kwesifanekiso, indawo yesokunxele ye-decubitus esecaleni iyancanyelwa ukuze kukhishwe izilonda zekholoni eziphambanayo.
2.Amathiphu ngemijovo yendawo
Inalithi yomjovo yasendaweni ewugqinsi ingajovwa ngengcindezi ephansi, kodwa ayibukhali ngokwanele futhi imbobo yenaliti inkulu kakhulu, ngakho umbhali usebenzisa inaliti yomjovo wendawo engu-25G.
Akulona ihaba ukusho ukuthi impumelelo noma ukwehluleka kwe-EMR kuncike kakhulu emijoweni yendawo.
Ngezilonda ezincane, ukubhoboza kwenziwa kusukela ohlangothini lwendunu kuya ngaphansi nje kwesilonda.
Ngezilonda engxenyeni egobile noma ngaphesheya kwemigoqo, uma umjovo wendawo wenziwa ohlangothini lwendunu, ezimweni eziningi izilonda azicaci ngoba zibheke ohlangothini lomlomo, ngakho umjovo wendawo kufanele uqalwe ohlangothini lomlomo.
Okubalulekile Kochwepheshe be-Endoscopy
Uma uketshezi luphuma, noma kukhona ukumelana okukhulu ngesikhathi sokujova, noma kungekho ukumelana lapho uketshezi lungena kodwa kungekho qhubu olwenziwayo, umjovo kufanele umiswe futhi opharetha kufanele aziswe ngesimo ngesikhathi ukuze kuxoxwe ngezinyathelo eziphikisanayo.
Umthamo omningi womjovo, uba ngcono.
Iqhinga liwukuqhubeka nokujova ngangokunokwenzeka ngokubhoboza okukodwa kuze kube yilapho isilonda sonke sisusiwe.
3.Amathiphu wokukhetha ugibe
Uma ugibe lukumumo we-oval emide, i-mucosa evamile emlonyeni wesilonda kanye nezinhlangothi zendunu ingase ifakwe kalula futhi kungenasidingo .
Ugibe kungcono ukuthi lucishe lube yindilinga, luvuleke kalula eceleni, akulula ukulushelela, futhi lunobunzima obuthile bokucindezela isilonda ukuze ubambe isilonda.
Ubukhulu bomgibe kufanele buhambisane nobukhulu besilonda.
I-Polypectomy Snare Elahlwayo
Izibonelo ze-EMR
a. Isithombe sokukhanya okumhlophe
Isilonda se-IIa esingu-25 mm esinengxenye emaphakathi edangele kancane.
b. Izithombe zebhendi emincane (NBI).
c. Ukufafaza i-indigo carmine ukuze kwandiswe isithombe
Kwatholakala ukuthi ukudangala okwabonwa ngokubhekwa okuvamile empeleni kwakuyimifantu phakathi kwamaqabunga.
d. Isithombe esinwetshiwe se-crystal violet staining
Iphethini yomgodi wokuvuleka komgudu wezindlala onqenqemeni lwesilonda kwakuwuhlobo IV.
e. Isithombe esinwetshiwe se-crystal violet staining
maphakathi nesilonda kwakungu-VI, okungajwayelekile, futhi akukho ukungena okusobala kwe-submucosal okutholakele.
f. Umjovo wendawo
Ukubhoboza kanye nomjovo wendawo kwenziwa phakathi nendawo yesilonda, okuholele ekuqhumeni okuhle.
g. Vula ugibe
Cindezela ithiphu logibe odongeni lwekholoni ukuze uvule ugibe.
h. Vala ugibe
Vala ugibe futhi ubambe isilonda.
i.Amandla okukhipha
Akukho ukubhobozwa, ukopha noma isimila esisele esitholakele.
j. Ukulungiswa kwesifanekiso
Isifanekiso esisikiwe sasinamathiselwe eshidini lenjoloba.
Ukuxilongwa kokugcina kwe-pathological:i-intramucosal carcinoma (Tis)
4.Amathiphu okusebenza kogibe
Ithiphu yogibe ibekwe ngobumnene ku-mucosa yomlomo wesilonda, bese ivuleka kancane kancane futhi impande yogibe icindezelwe ohlangothini lwangemuva lwesilonda. Ukuvimbela ukusika kwe-lateral ukuthi kungabi kuhle, inani elincane le-mucosa evamile kufanele lifakwe.
Kumele kuqashelwe ukuthi lapho ithiphu logibe lingabonakali, kungenzeka ukuthi i-mucosa evamile ifakwe kunalokho obekulindelwe. Ngemva kokuba ugibe luqiniswe ngokugcwele, phusha futhi udonse umkhono wangaphandle wogibe ukuze ubheke ukuhamba kwesilonda. Uma ifakwe emgqeni we-muscular, ukuhamba kwe-lesion kuzoncishiswa.
Amathiphu we-electroresection
Ungacindezeli ugibe odongeni lwamathumbu, kodwa uphakamise kancane isilonda ukuze sikhishwe. Ingozi yokulibaziseka kokubhobozwa iphansi uma usebenzisa i-electrosurgical resection , kodwa ithambekele ekuhlinzweni (ngaphambi kokuhlinzwa) ukopha.
Ukuhlinza okushesha kakhulu kungase kubangele ukopha, kuyilapho ukuhlinza okunensa kakhulu kungase kubangele ukulibaziseka ukubhoboza. Uma isiguli sizwa ubuhlungu, noma umsizi ezwa ukuthi isicubu sinwebeka njengerabha futhi kunzima ukusisika, kungenzeka ukuthi izicubu zihilelekile ongqimbeni lwemisipha, futhi ukusika kufanele kumiswe ngokushesha.
Okubalulekile Kochwepheshe be-Endoscopy
Uma i-endoscopist izwa ukuthi isicubu sinwebeka njengerabha futhi kunzima ukusisika, kufanele asheshe azise opharetha ukuze baxoxe ngezinyathelo zokuphikisa.
Amathiphu okwabelana nge-EMR
Ngezilonda ezinkulu, kwesinye isikhathi kuphephe kakhudlwana ukwenza isicucu se-piecemeal kunokuthi sihlinzeke ngasikhathi sinye. Kodwa-ke, uma izingcezu ziba ziningi, makhulu amathuba okuba izinsalela zendawo ziphindeke. Ngisho ne-EMR yesiqephu, ukukhishwa kokuqala kufanele kwenziwe kukhulu ngangokunokwenzeka ngogibe olukhulu ukuze kuncishiswe inani lezicucu.
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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 ugibe
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/
Fafaza i-catheter
https://www.zrhendoscopy.com/ce-certified-disposable-endoscopic-spray-catheter-for-digestive-chromoendoscopy-product/
amabhulashi e-cytology
https://www.zrhendoscopy.com/endoscopy-accessories-disposable-endoscopic-cytology-brush-for-gastrointestinal-tract-product/
I-Guidewire
https://www.zrhendoscopy.com/gastrointestinal-endoscopic-ptfe-coated-ercp-hydrophilic-guidewire-product/
ubhasikidi wokubuyisa amatshe
https://www.zrhendoscopy.com/ercp-instrument-gallstone-stone-retrieval-basket-for-endoscopy-product/
i-catheter ye-nasal biliary drainage
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/
Isikhathi sokuthumela: Feb-13-2025