(1). Amasu ayisisekelo Amasu ayisisekelo e-EMR alandelayo:
Ukulandelana kwamasu
①Jova isisombululo somjovo sendawo ngaphansi nje kwesilonda.
②Beka ugibe nxazonke kwesilonda.
③Ugibe luqinisiwe ukuze lubambe futhi luklinye isilonda.
④Qhubeka uqinisa ugibe ngenkathi usebenzisa ugesi ukuze unqume isilonda.
⑤Landa isampula esusiwe.
(2). Amathiphu
1. Amathiphu okukhetha isikhundla somzimba kanye nokubeka i-endoscope
Ngenxa yokuthi isilonda sidinga ukwelashwa ngesikhathi isithombe sonke sibonakala, indawo yesiguli ibaluleke kakhulu. Zama ukusonta i-scope ukuze isilonda sibe eduze kokuvulwa kwe-biopsy forceps, okungukuthi, kusukela ngo-5 kuya ku-7 ezikrinini.
Ngaphambi kokwelashwa, okusele kanye nombala osele kudingeka kugezwe bese kususwa ngokumunca.
Isibonelo, uma isilonda kukholoni ye-proximal sigmoid sisuswa endaweni yokulala phansi noma kwesobunxele ye-lateral decubitus, isampula ivame ukuya kukholoni eyehlayo, okwenza kube nzima ukuyikhipha, ngakho-ke indawo ye-lateral decubitus yesokudla ingcono kakhulu ekusikweni kabusha.
Ngokufanayo, ngokombono wokubuyiselwa kwesampula, indawo yesobunxele ye-lateral decubitus iyathandwa kakhulu ekusikweni kabusha kwezilonda zekholoni eziphambene.
2. Amathiphu okusebenzisa imijovo yendawo
Inaliti yomjovo yendawo ebanzi ingafakwa ngengcindezi ephansi, kodwa ayibukhali ngokwanele futhi imbobo yenaliti inkulu kakhulu, ngakho umbhali usebenzisa inaliti yomjovo yendawo engu-25G.
Akukhona ukweqisa ukusho ukuthi impumelelo noma ukwehluleka kwe-EMR kuncike kakhulu ekujovweni kwendawo.
Ngezilonda ezincane, ukubhoboza kwenziwa kusukela ohlangothini lwendunu yesilonda kuya ngaphansi kwesilonda.
Uma kwenzeka izilonda engxenyeni egobile noma emagoqweni, uma kwenziwa umjovo wendawo ohlangothini lwendunu, ezimweni eziningi izilonda azicaci ngoba zibheke ohlangothini lomlomo, ngakho-ke umjovo wendawo kufanele uqalwe ohlangothini lomlomo.
Okubalulekile Kochwepheshe Be-Endoscopy
Uma uketshezi luvuza, noma kukhona ukumelana okukhulu ngesikhathi somjovo, noma kungekho ukumelana lapho uketshezi lungena kodwa kungavuvukalanga, umjovo kumele umiswe futhi opharetha kumele aziswe ngesimo ngesikhathi esifanele ukuze kuxoxwe ngezinyathelo zokulwa nawo.
Uma umthamo womjovo uphezulu, kuba ngcono.
Icebo liwukuqhubeka nokujova ngangokunokwenzeka ngokubhoboza kanye kuze kube yilapho yonke inxeba isiphelile.
3. Amathiphu okukhetha ugibe
Uma ugibe lusesimweni se-oval ende, i-mucosa evamile emlonyeni wesilonda kanye nezinhlangothi ze-anus ingafakwa kalula futhi ngokungadingekile.
I-snare ingcono kakhulu cishe iyindilinga, kulula ukuyivula ibheke eceleni, akulula ukuyishelela, futhi inobunzima obuthile bokucindezela inxeba ukuze ibambe inxeba.
Usayizi womgibe kufanele uvumelane nosayizi wesilonda.
Ugibe Lokususwa Kwe-Polypectomy Olulahlwayo
Izibonelo ze-EMR
a. Isithombe sokukhanya okumhlophe
Isilonda sohlobo lwe-IIa esingu-25 mm esinengxenye ephakathi ecindezelekile kancane.
b. Izithombe ze-Narrow band imaging (NBI)
c. Ukufutha i-indigo carmine ukuze kwandiswe isithombe
Kwatholakala ukuthi izimbobo ezazibonwa ngokubuka okuvamile empeleni kwakuyimifantu phakathi kwamaqabunga.
d. Isithombe esikhulisiwe sombala we-crystal violet
Iphethini yomgodi wokuvulwa komsele we-glandular emaphethelweni esilonda kwakuyi-type IV.
e. Isithombe esikhulisiwe sombala we-crystal violet
maphakathi nesilonda kwakukhona i-VI, ingajwayelekile kancane, futhi akukho ukungena okusobala kwe-submucosal okutholiwe.
f. Umjovo wendawo
Ukubhoboza kanye nomjovo wendawo kwenziwe phakathi nendawo yesilonda, okwaholela ekuvuvukeni okuhle.
g. Vula ugibe
Cindezela isihloko sesicupho odongeni lwekholoni ukuze uvule isicupho.
h. Vala ugibe
Vala ugibe bese ubamba isilonda.
i. Amandla okususa
Akukho ukubhoboka, ukopha noma isimila esisele esitholakele.
j. Ukulungiswa kwesampula
Isampula ekhishwe yayinamathiselwe ephepheni lerabha.
Ukuxilongwa kokugcina kwe-pathological:i-intramucosal carcinoma (i-Tis)
4. Amathiphu okusebenza ngogibe
Isihloko sesitha sibekwa ngobumnene ku-mucosa yomlomo yesilonda, bese sivulwa kancane kancane bese impande yesitha icindezelwa ohlangothini lwendunu lwesilonda. Ukuze kuvinjelwe ukuthi ukusikwa kwe-lateral kube kuhle, kufanele kufakwe inani elincane le-mucosa evamile.
Kufanele kuqashelwe ukuthi uma i-snare tip ingabonakali, kungenzeka ukuthi kufakwe i-mucosa evamile kunalokho obekulindelekile. Ngemva kokuba i-snare isiqiniswe ngokuphelele, cindezela bese udonsa umkhono wangaphandle we-snare ukuze ubone ukuhamba kwesilonda. Uma sifakwa engqimbeni yemisipha, ukuhamba kwesilonda kuzoncipha.
Amathiphu okususa ugesi
Ungacindezeli ugibe odongeni lwamathumbu, kodwa phakamisa kancane isilonda ukuze usike kabusha. Ingozi yokubhoboka okubambezelekile iphansi uma usebenzisa ukususwa kwe-electrosurgical resection, kodwa ivame ukopha ngesikhathi sokuhlinzwa (ekuseni ngemva kokususwa kabusha).
Ukusika okusheshayo kakhulu kungabangela ukopha, kanti ukusika okuhamba kancane kakhulu kungabangela ukubhoboka okulibazisekile. Uma isiguli sizwa ubuhlungu, noma umsizi ezwa ukuthi izicubu zinwebeka njengerabha futhi kunzima ukuzisika, kungenzeka ukuthi izicubu zihilelekile engqimbeni yemisipha, futhi ukusika kufanele kumiswe ngokushesha.
Okubalulekile Kochwepheshe Be-Endoscopy
Uma udokotela we-endoscopist enomuzwa wokuthi izicubu zinwebeka njengerabha futhi kunzima ukuzisika, kufanele azise ngokushesha opharetha ukuze baxoxe ngezinyathelo zokuzivikela.
Amathiphu Okushintsha I-EMR
Ngezilonda ezinkulu, ngezinye izikhathi kuphephile ukwenza ukususwa kwezicubu ezincane kunokusikwa okuphoqelelwe ngasikhathi sinye. Kodwa-ke, uma izingcezu ziningi, amathuba okuphinda kuvele izinsalela zendawo ayanda. Ngisho nange-EMR encane, ukususwa kokuqala kufanele kwenziwe okukhulu ngangokunokwenzeka nge-snare enkulu ukuze kuncishiswe inani lezingcezu.
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Ama-forceps e-biopsy:
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/
ugibe lwe-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 yokufutha
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/
Ucingo Lokuqondisa
https://www.zrhendoscopy.com/gastrointestinal-endoscopic-ptfe-coated-ercp-hydrophilic-guidewire-product/
ubhasikidi wokuthola amatshe
https://www.zrhendoscopy.com/ercp-instrument-gallstone-stone-retrieval-basket-for-endoscopy-product/
i-catheter yokukhipha amanzi ekhaleni
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/
Isikhathi sokuthunyelwe: Feb-13-2025