Imisebenzi ye-ESD ayivumelekile ukuba yenziwe ngokungahleliwe noma ngokungafanele.
Amasu ahlukene asetshenziselwa izingxenye ezahlukene. Izingxenye eziyinhloko yi-esophagus, isisu, ne-colorectum. Isisu sihlukaniswe nge-antrum, indawo ye-prepyloric, i-gastric angle, i-gastric fundus, kanye nokugoba okukhulu komzimba wesisu. I-colorectum ihlukaniswe ikholoni kanye ne-rectum. Phakathi kwazo, i-ESD yezilonda ze-antrum curvature enkulu iyingxenye yezinga lokungena, kuyilapho i-ESD ye-gastric angle, cardia, nezilonda zamakholoni angakwesokudla kunzima kakhulu.
Umgomo ojwayelekile uwukucabangela i-low gravity factor bese uqala ngengxenye enzima bese kuba ingxenye elula. Qala ukusika futhi ukhumule usuka endaweni ephansi ye-gravity. Ngesikhathi sokuhlubula, ukuhlubula kufanele futhi kuqale engxenyeni enzima kakhulu. I-ESD ye-Esophageal ingenziwa ngokusika uhlobo lwe-push. Isiqondiso sokusika nokukhumula izilonda zesisu kufanele kuklanywe kusengaphambili. Izilonda ku-engeli yesisu, ukugoba okuncane komzimba wesisu, nendawo ye-prepyloric kungavezwa ngokudonsa. Ubuchwepheshe bomhubhe kanye nendlela yephaketheni kokubili kuyingxenye yesu le-ESD. Ubuchwepheshe obususelwa ku-ESD buhlanganisa i-ESTD, EFTR, ESE, POEM, njll. Lobu buchwepheshe buphinde buwubuchwepheshe obuvela ngokwemvelo ngemva kokuba amakhono e-ESD eseyingcweti. Ngakho i-ESD iyisisekelo.
2. Imininingwane yokusebenza kwe-ESD
Imininingwane yokusebenza kwe-ESD imininingwane ngaphansi kokuqondisa kwesu elikhulu.
Imininingwane Yokusebenza
Imininingwane yokusebenza ihlanganisa ukumaka, umjovo, ukuxebuka, njll.
Kunamaqhinga amabili: elilodwa ukukha ummese olawulekayo ngaphansi kokubona okuqondile (sebenzisa ukucosha ummese oyimpumputhe kancane ngangokunokwenzeka), kanti elinye ukucutshungulwa okulawulwayo kwemingcele nezinhlangano ezincane.
Ukulebula nokujova
I-Electrocoagulation marking isetshenziselwa ukumaka. Ngokuvamile, umngcele wesilonda (2-5 mm ngaphandle) usetshenziswa njengophawu. Ukumaka kungenziwa iphuzu ngephuzu noma kusukela kokukhulu kuya kokuncane. Ekugcineni, isikhawu phakathi kwamaphuzu amabili okumaka kufanele sibe phakathi kuka-5 mm, futhi kufanele sibonakale lapho i-endoscope iseduze nensimu yombono.
Ephuzwini elimakiwe elilandelayo. Umjovo usekelwe emikhubeni yomuntu siqu. Ngemuva kokujova kungqimba olungaphansi kwe-submucosal, inaliti kufanele ihoxiswe kancane bese ijovwe futhi ukuze kuqinisekiswe ukuthi isilonda siphakanyiswe ukuphakama okwanele kokusikwa nokucwecwa okulandelayo.
Sika
I-incision, ezinye izingxenye zisikwa kusukela kude kuya eduze noma eduze kuya kude (push cutting), ngokusho kwemikhuba yomuntu siqu kanye nezingxenye ezithile, kuyadingeka futhi ukusika kusukela endaweni ephansi kakhulu ye-gravity kuqala. Ukusika kuhlanganisa ukusika okungajulile nokujula kwangaphambili. Ukusika kwangaphambili kufanele kube "okunembile" futhi "kwanele". Ukujula kokusika kufanele kube ngokwanele ngaphambi kokuthi kuqhutshwe umsebenzi wokucwecwa okulandelayo. Okufana nokucosha ummese nokumisa iwindi lengelosi. Lapho engena efasiteleni lengelosi,
I-ESD isho ukuzuza indlela ephumelelayo. Kodwa empeleni, akuwona wonke ama-ESD angangena eFasiteleni Lengelosi. Izilonda eziningi endaweni encane kanye nezilonda ezikhethekile I-ESD ngokuyisisekelo ayikwazi ukungena Efasiteleni Lengelosi. Ngalesi sikhathi, kuncike kakhulu ekusebenzeni kommese ocwengekile.
Susa: Susa ingxenye okunzima ukuyiphatha kuqala. Uma ususa ingxenye ye-submucosal, kufanele yenziwe kusukela ezinhlangothini zombili kuya enkabeni, yakha "ukhiye" owenziwe nge-V. Ukujula kwe-peripheral pre-cut kufanele kube ngokwanele, ngaphandle kwalokho kulula ukuxebuka ngaphesheya komngcele. Uma izicubu ezisele ziyancipha, izinga lenkululeko likhulu. Kuyadingeka ukulawula ummese ukusika izicubu ngokuqondile, ikakhulukazi izicubu zokugcina. Uma isilawuli singesihle, kulula ukusika kakhulu noma kuncane kakhulu.
Indlela yokubamba isibuko
Kunezindlela ezimbili zokubamba ububanzi be-ESD, zombili ezilawula umzimba wesikophu, amafindo, nezisetshenziswa zangaphakathi nangaphandle. Kunezindlela ezimbili: "isiqondiso sesandla sokunxele + izesekeli" kanye "nezandla ezimbili ezandleni ezine". Umgomo oyinhloko wokubamba ububanzi ukugcina inkambu yokusebenza izinzile futhi iyalawuleka. Njengamanje, indlela yezandla ezimbili ukuya kwezine inokusimama okungcono kokulawula isikophu futhi isetshenziswa kabanzi. Kuphela uma ububanzi buzinzile lapho ukusebenza kokuchayeka kwezicubu ezincane + ama-flap kungaphathwa kangcono.
Kuphela ngendlela enhle yokubamba isibuko lapho ummese ungalawuleka kangcono. Isu lokukha ummese lingakwazi ukulawula kangcono isiqondiso, inhloso ukuhlala kude nongqimba lwemisipha futhi usike izicubu ezihlosiwe. Uma wenza i-ESD submucosal incision, kuyadingeka ukusika eduze nongqimba lwemisipha, ukujula kokusika kwezicubu kwanele, futhi kulula ukumisa ukopha. Into ebaluleke kakhulu ukuqinisekisa ukuthi ukusika akujulile kakhulu noma akujulile, futhi indlela yokukhetha ummese iyikhono eliyinhloko ngalesi sikhathi.
Ukulawula ukubona
Ukulawulwa kwezikhombisi nakho kubonakala ekuchayekeni nasekulawuleni inkambu yokubuka. Ngaphezu kokuzungezisa i-knob nomzimba welensi, amakepisi abonisa ngale kanye nezinsiza nazo zisetshenziselwa ukuveza indawo yokubuka noma izicubu eziqondiwe, ikakhulukazi amandla amancane asetshenziselwa ukuveza nokuphakamisa izicubu ezincane, okuwukonakala kwezicubu ezincane kakhulu.
Lawula ibanga lenkundla yokubona. Kuphela uma umkhakha wokubona ugcinwe ebangeni elifanele lapho ungasebenza futhi ulawuleke. Uma ukude kakhulu noma kuseduze kakhulu, kuzoba nzima ukulawula ummese ngokuzinza. Ukunyakaza okucashile kungase kubonakale sengathi akunyakazi, kodwa izicubu sezivele zinamandla okuguquguquka okungokwemvelo. Kungakho i-ESD kufanele isebenzise ibanga elifanele kanye nokuguqulwa okufanele.
Imininingwane engenhla, ukubamba ilensi, kanye nenkundla yokulawula ukubuka okuqukethwe okuyinhloko kwe-ESD “yokulawula ilensi”.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., singumkhiqizi e-China onguchwepheshe ngezinto ezisetshenziswayo ze-endoscopic, njenge-biopsy forceps, i-hemoclip, i-polyp snare, inaliti ye-sclerotherapy, i-sclerotherapy catheter, amabhulashi e-cytology, i-guidewire, ubhasikidi wokubuyisela itshe, i-drainteral sheterary ukumunca njll. ezisetshenziswa kakhulu ku-EMR, ESD, 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: Jul-14-2025