Izinhlobo ze-esophageal / gastric zingumphumela wemiphumela ephikelelayo ye-porttension ye-porttension futhi cishe i-95% ebangelwa yi-cirrhosis yezimbangela ezahlukahlukene. Ukopha i-Varicose Helin kuvame ukubandakanya ukopha okukhulu kokopha kanye nokufa okuphezulu, neziguli ezinokopha zinokubekezelela okuncane kokuhlinzwa.
Ngokwenza ngcono kanye nokusetshenziswa kwe-Digestive Endoscopic Technology Technology, ukwelashwa kwe-endoscopic sekusenye yezindlela eziphambili zokwelapha ukopha okuhlukahluka kwe-esophageal / gastric. Kufaka ikakhulukazi i-Endoscopic Sclerotherapy (EVS), i-endoscopic variceal ligation (evl) kanye ne-endoscopic izicubu ze-glue umjovo wokujova (evht).
I-Endoscopic Sclerotherapy (EVS)
Ingxenye 1
1) Isimiso se-Endoscopic Sclerotherapy (EVS):
Ukujova kwe-IntraVASdular: Umenzeli we-Sclerosing ubangela ukuvuvukala ezungeze imithambo, ulukhuni imithambo yegazi futhi ivimbele ukuhamba kwegazi;
Ukujova kweParavascular: Kubangela ukusabela kokuvuvukala oyinyumba kumathambo ukudala i-thrombosis.
2) izinkomba ze-EVS:
(1) Ukuqhamuka kwe-eV acture nokopha;
(2) umlando owedlule wokuqhamuka kwe-ev kuqhuma nokopha;
(3) Iziguli eziphindaphindwayo ngemuva kokuhlinzwa;
(4) Labo abangafanele ukwelashwa okuhlinzayo.
3) Contraindings of EVS:
(1) Ukuphikisana okufanayo njenge-gastroscopy;
(2) I-hepatic encephalopathy stage 2 noma ngaphezulu;
(3) Iziguli ezinesibindi esibi nokungasebenzi kahle kwezinso, amanani amakhulu ama-ASCITE, kanye ne-jaundice enzima.
4) Ukuqashwa kokuxhumana
E-China, ungakhetha i-lauromaCrol (sebenzisainaliti ye-sclerotherapy). Ngemithambo yegazi emikhulu, khetha umjovo we-intravasfular. IVolumu yomjovo ngokuvamile ingu-10 kuye ku-15 ml. Ngemithambo yegazi emincane, ungakhetha umjovo wephasishi. Zama ukugwema ukujova ngamaphoyinti ahlukene ahlukahlukene endizeni efanayo (izilonda kungenzeka ziholele ekulethweni kwe-esophageal). Uma ukuphefumula kuthinteka ngesikhathi sokusebenza, i-Transparent cap ingangezwa ku-gastroscope. Emazweni angaphandle, i-balloon ivame ukungezwa ku-gastroscope. Kufanelekile ukufunda kusuka.
5) ukwelashwa kwe-postoperative of EVS
(1) Ungadli noma uphuze amahora angama-8 ngemuva kokuhlinzwa, futhi kancane kancane uphinde uqhubeke nokudla okuwuketshezi;
(2) sebenzisa amanani afanele ama-antibiotics ukuvikela ukutheleleka;
(3) Sebenzisa izidakamizwa ukwehlisa ingcindezi ye-portal njengokufanele.
6) Inkambo yokwelashwa ye-EVS
I-Multiple Sclerotherapy iyadingeka kuze kube yilapho imithambo ye-varicose inyamalale noma inyamalale ngokuyisisekelo, ngesikhawu esingamaviki angu-1 phakathi kokwelashwa ngakunye; I-Gastroscopy izobuyekezwa ngenyanga eyi-1, izinyanga ezi-3, izinyanga eziyi-6, nonyaka owodwa ngemuva kokuphela kwenkambo yokwelashwa.
7) Izinkinga ze-EVS
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(2) Izinkinga zendawo: izilonda, ukopha, i-stenosis, i-esophageal motility dysfunction, Odnophagia, ama-lacerations. Izinkinga zesifunda zifaka i-MediaSTinitis, i-Yodwa, i-Pleural Pheral, kanye ne-Portal Hryplopathy enengozi eyandayo yokopha.
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I-endoscopic varicose vein litation (evl)
Ingxenye 2
1) Izinkomba ze-EVL: Kuyafana ne-EVS.
2) Ukuphambana kwe-EVL:
(1) Ukuphikisana okufanayo njenge-gastroscopy;
(2) eV ephelezelwa yi-GV esobala;
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3) Ukusebenza kanjani
Kubandakanya ukulethelwa kwezinwele ezizodwa, i-hair litation amaningi, kanye ne-nylon ngezintambo.
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(2) Ukuqapha
Ngezinhlobo ezilinganiselayo kuya ezinhlobonhlobo ze-esophageal, umthambo ngamunye we-varicose uvinjelwe ngendlela ephakeme esuka phezulu ukusuka phansi kuya phezulu. I-ligator kufanele isondele ngangokunokwenzeka kwithoni yokufudumala yethagethi ye-varicose vein, ukuze iphuzu ngalinye litholwe ngokuphelele futhi lithambekele kakhulu. Zama ukumboza umthambo we-varicose ngamunye ngamaphuzu angaphezu kwama-3.
Kuthatha cishe amasonto ayi-1 kuye kwangama-2 ukuthi i-necrosis iwele ngemuva kwe-bandage necrosis. Isonto elilodwa ngemuva kokuhlinzwa, izilonda zasendaweni zingadala ukopha okukhulu, i-Skin band iwela, futhi ukusika kwemishini kwemithambo ye-varicose kokopha. I-EVL ingasusa imithambo ye-varicose ngokushesha futhi inezinkinga ezimbalwa, kepha imithambo ye-varicose ivela. Ingxenye isenhlalo eliphezulu;
I-EVL ingavimba ama-compantling egazi e-gastric vein yangakwesobunxele, umthambo we-esophageal, ne-vena cava. Kodwa-ke, ngemuva kokuthi ukugeleza kwegazi kwe-esophageal kuvinjelwe, umthambo we-coronary wesisu kanye ne-perigastric venexus plexus izokwanda, ukugeleza kwegazi kuzokwanda, futhi izinga lokuphinda liye landa ngokuhamba kwesikhathi. Ngakho-ke, kuvame ukuphindwa ukuphindwa kweqembu le-band kuyadingeka ukuhlanganisa ukwelashwa. Ububanzi be-Varicose Vein Sitation kufanele bube ngaphansi kwama-1.5 cm.
4) Izinkinga ze-EVL
(1) ukopha okukhulu ngenxa yezilonda zasendaweni cishe ngeviki eli-1 ngemuva kokuhlinzwa;
(2) ukopha okungabambisane, ukulahleka kwebhendi lesikhumba, nokopha okubangelwa imithambo ye-varicose;
(3) ukutheleleka.
5) Ukubuyekezwa kwe-postoperative of evl
Ngonyaka wokuqala ngemuva kokuhlinzwa kwe-EVL, ukuhlinzwa kwesibindi nasozinso, i-B-ultrasound, inqubo yegazi, njll. Kufanele ibukezwe njalo ezinyangeni ezintathu kuya kwezi-6. I-Endoscopy kufanele ibukezwe njalo ezinyangeni ezi-3, bese kuthi njalo izinyanga eziyi-0 kuye kwezingu-12.
6) evs vs evl
Uma kuqhathaniswa ne-sclerotherapy kanye ne-sclerotherapy kanye ne-sclerother, akukho mehluko omkhulu ekufeni kwabantu kanye namazinga okuhlambalaza phakathi kwalokhu okubili. Ezigulini ezidinga ukwelashwa okuphindaphindwayo, kuningi kunconyelwa kakhulu. Kwesinye isikhathi i-ligation ne-sclerotherapy futhi kuhlanganiswe, okungathuthukisa ukwelashwa. Umphumela. Emazweni angaphandle, ama-Metal Stents ambozwe ngokuphelele asetshenziselwa ukumisa ukopha.
I-Endoscopic Tissus glue Clue Changer Therapy (EVHT)
Ingxenye 3
Le ndlela ilungele ukungezwani kwesisu kanye nokopha okungenakuvuleka kwe-esophageal ezimweni eziphuthumayo.
1) Izinkinga ze-EVHT: Inkawu ye-pulmonary artery kanye ne-portal vein embolism, kepha izehlakalo ziphansi kakhulu.
2) Izinzuzo ze-EVHT: Imithambo ye-Varicose iyanyamalala ngokushesha, izinga lokuphinda likhulule liphansi, izinkinga zimbalwa, izinkomba zibanzi futhi ubuchwepheshe bulula kakhulu.
3) Izinto okufanele uphawule:
E-Endoscopic izicubu ze-glue okujovako ekwelashweni, inani lomjovo kufanele lanele. I-endoscopic ultrasound idlala indima enhle kakhulu ekwelapheni imithambo ye-varicose futhi inganciphisa ubungozi bokuphamba kabusha.
Kunemibiko ezincwadini zakwamanye amazwe ukuthi ukwelashwa kwezinguquko zesisu noma ama-cyanoacrylate ngaphansi kokuholwa kwe-endoscopic ultrasound kuyasebenza ngentengo yasendaweni yasendaweni. Uma kuqhathaniswa nemijovo ye-cyanoacrylate, ukubambano okuqondiswa yi-endoscopic okuqondiswa yi-endoscopic kudinga imijovo embalwa engaphakathi futhi kuhlotshaniswa nemicimbi embalwa engemihle.
We, Jiangxi Zhuoruihui Medical Incument Co, Ltd, umenzi waseChina ochwepheshe kokudla kwe-endoscopic, njengeI-Biopsy Forceps, hemoclip, I-PolyP Snare, inaliti ye-sclerotherapy, fafaza i-catheter, ama-cytolology amabhulashi, Umhlahlandlela, I-Stone Retrieval Basket, I-Catheter ye-Nasal Buily Catheternjll. Kusetshenziswe kabanziEMR, Ivi, I-ERCPP. Imikhiqizo yethu iqinisekisiwe, futhi izitshalo zethu ziqinisekisiwe ze-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi nendawo nengxenye ye-Asia, futhi zithola amakhasimende wokuqashelwa nokudumisa!
Isikhathi Seposi: Aug-15-2024