I-ESDimisebenzi ayivunyelwe kakhulu ukwenziwa ngokungahleliwe noma ngokunganaki.
Kusetshenziswa amasu ahlukene ezingxenyeni ezahlukene. Izingxenye eziyinhloko yi-esophagus, isisu, kanye ne-colorectum. Isisu sihlukaniswe saba yi-antrum, indawo ye-prepyloric, i-angle yesisu, i-gastric fundus, kanye nokugoba okukhulu komzimba wesisu. I-colorectum ihlukaniswe yaba yi-colon kanye ne-rectum. Phakathi kwazo,I-ESD yezilonda ezigobile kakhulu ze-antrumkuyingxenye yezinga lokuqala, kuyilapho i-ESD ye-engeli yesisu, i-cardia, kanye nezilonda zekholoni langakwesokudla inzima kakhulu.
Umgomo ojwayelekile ukucabangela isici esiphansi sokudonsa bese uqala ngengxenye enzima bese kuba yingxenye elula. Qala ukusikwa bese ususa endaweni ephansi yokudonsa. Ngesikhathi sokusikwa, ukususa kufanele futhi kuqale engxenyeni enzima kakhulu. I-ESD yomlomo ingenziwa ngokusikwa kohlobo lokusunduza. Indlela yokusikwa kanye nokususa izilonda zesisu kufanele yakhelwe kusengaphambili. Izilonda ekhoneni lesisu, ukugoba okuncane komzimba wesisu, kanye nendawo ye-prepyloric kungadalulwa ngokudonswa. Ubuchwepheshe bomhubhe kanye nendlela yephakethe kokubili kuyingxenye yesu le-ESD. Ubuchwepheshe obususelwa ku-ESD buhlanganisa i-ESTD, i-EFTR, i-ESE, i-POEM, njll. Lobu buchwepheshe buphinde bube ubuchwepheshe obuvela ngokwemvelo ngemva kokuba amakhono e-ESD eseqondwe kahle. Ngakho-ke i-ESD iyisisekelo.
2. Imininingwane yokusebenza kwe-ESD
I-ESDImininingwane yokusebenza iyimininingwane ngaphansi kwesiqondiso sesu elikhulu.
Imininingwane Yokusebenza
Imininingwane yokusebenza ifaka phakathi ukumaka, ukujova, ukuhlubula, njll.
Kunamaqhinga amabili: elinye liwukukhetha ummese olawulekayo ngaphansi kokubona ngqo (sebenzisa ukukhetha ummese ongaboni kahle ngangokunokwenzeka), kanti elinye liwukucubungula okulawulwayo kwemingcele nezinhlangano ezincane.
Ukulebula kanye nokufaka umjovo
Ukumaka nge-electrocoagulation kusetshenziselwa 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 ngaphakathi kwama-5 mm, futhi kufanele sibonakale lapho i-endoscope iseduze nensimu yokubona.
Kuze kube seqophelweni elilandelayo eliphawuliwe. Umjovo usekelwe emikhubeni yomuntu siqu. Ngemva kokujova ungqimba lwe-submucosal, inaliti kufanele ihoxiswe kancane bese ijovwa futhi ukuqinisekisa ukuthi isilonda siphakanyisiwe safinyelela ukuphakama okwanele ukuze kuqhumeke futhi kuhlutshulwe.
Sika
Ukusikwa, ezinye izingxenye zisikwa kusukela kude kuya eduze noma kusukela eduze kuya kude (ukusika ngokusunduza), ngokwemikhuba yomuntu siqu kanye nezingxenye ezithile, kuyadingeka futhi ukusika kusukela endaweni ephansi kakhulu yamandla adonsela phansi kuqala. Ukusika kufaka phakathi ukusika okungajulile kanye nokusika kwangaphambili okujulile. Ukusika kwangaphambili kumele kube "okunembile" futhi "okwanele". Ukujula kokusika kumele kube ngokwanele ngaphambi kokuba kwenziwe umsebenzi olandelayo wokukhipha. Njengokuthatha ummese nokufaka ifasitela lengelosi. Uma ungena efasiteleni lengelosi,
I-ESD isho ukufeza indlela ephumelelayo. Kodwa empeleni, akuwona wonke ama-ESD angangena efasiteleni lengelosi. Izilonda eziningi ezincane kanye nezilonda ezikhethekile i-ESD empeleni azikwazi ukungena efasiteleni lengelosi. Ngalesi sikhathi, kuncike kakhulu ekusebenzeni kommese ocwengekile.
Susa: Susa ingxenye okunzima ukuyiphatha kuqala. Uma ususa ingxenye engaphansi kwe-mucosal, kufanele kwenziwe kusukela ezinhlangothini zombili kuya enkabeni, kwakhiwe "ukhiye" ofana no-V. Ukujula kokusikwa kwangaphambili kwe-peripheral kufanele kwanele, ngaphandle kwalokho kulula ukukususa ngale komngcele. Uma izicubu ezisele zincane, kulapho izinga lenkululeko likhula khona. Kuyadingeka ukulawula ummese ukuze usike izicubu ngqo, ikakhulukazi izicubu zokugcina. Uma ukulawula kungalungile, kulula ukusika kakhulu noma kancane kakhulu.
Indlela yokubamba isibuko
Kunezindlela ezimbili zokubamba isikopu se-ESD, zombili ezilawula umzimba wesikopu, ama-knob, kanye nezesekeli eziphumayo nezingena ngaphakathi. Kunezindlela ezimbili: “ukuqondisa kwesobunxele + izesekeli” kanye “nezandla ezimbili kuya kwezine”. Umgomo oyinhloko wokubamba isikopu ukugcina insimu yokusebenza izinzile futhi ingalawuleka. Njengamanje, indlela yezandla ezimbili kuya kwezine inokuqina okungcono kokulawula isikopu futhi isetshenziswa kabanzi. Kuphela uma isikopu sizinzile lapho ukusebenza kokuchayeka kwezicubu ezincane + ama-flaps kungaphathwa kangcono.
Kuphela ngendlela yokubamba isibuko lapho ummese ungalawulwa kangcono khona. Indlela yokukhetha ummese ingalawula kangcono indlela, inhloso ukuhlala kude nongqimba lwemisipha nokusika izicubu eziqondiwe. Uma wenza i-I-ESDUma ukusika kwe-submucosal, kuyadingeka ukusika eduze kwengqimba yemisipha, ukujula kokusika kwezicubu kwanele, futhi kulula ukuyeka ukopha. Into ebaluleke kakhulu ukuqinisekisa ukuthi ukusika akujulile kakhulu noma akudluli, futhi inqubo yokukha imimese iyikhono elibalulekile ngalesi sikhathi.
Ukulawulwa kombono
Ukulawulwa kwesiqondiso kubonakala nasekuvezweni nasekulawulweni kwensimu yokubuka. Ngaphezu kokujikeleza i-knob kanye nomzimba welensi, izivalo nezesekeli ezisobala nazo zisetshenziselwa ukwembula insimu yokubuka noma izicubu eziqondiwe, ikakhulukazi amandla amancane asetshenziswa ukwembula nokuphakamisa izicubu ezincane, okuwukuguquguquka kwezicubu okuncane kakhulu.
Lawula ibanga lensimu yokubona. Kuphela uma insimu yokubona igcinwe ebangeni elifanele lapho ingasebenza futhi ilawulwe khona. Uma ikude kakhulu noma iseduze kakhulu, kuzoba nzima ukulawula ummese ngokungaguquki. Ukunyakaza okucashile kungase kubonakale sengathi akukho ukunyakaza, kodwa izicubu sezivele zinamandla okuguquka. Yingakho i-ESD kumele isebenzise ibanga elifanele kanye nokuguqulwa okufanele.
Imininingwane engenhla, ukubamba ilensi, kanye nokulawula insimu yokubuka yizinto eziyinhloko eziku-I-ESD"Ukulawula ilensi".
Thina, iJiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumkhiqizi eShayina ogxile ezintweni ezisetshenziswayo ze-endoscopic, njengei-biopsy forceps, i-hemoclip, ugibe lwe-polyp, inaliti ye-sclerotherapy, i-catheter yokufafaza, amabhulashi e-cytology, ucingo lokuqondisa, ubhasikidi wokuthola amatshe, i-catheter yokukhipha amanzi ekhaleni,isivikelo sokufinyelela urethrafuthiisivikelo sokufinyelela urethra esinommuncanjll. ezisetshenziswa kabanzi ku-I-EMR, I-ESD, I-ERCPImikhiqizo yethu inesitifiketi se-CE, kanti izitshalo zethu zinesitifiketi se-ISO. Izimpahla zethu zithunyelwe eYurophu, eNyakatho Melika, eMpumalanga Ephakathi kanye nengxenye ye-Asia, futhi zithola ukuqashelwa nokunconywa kakhulu ngamakhasimende!
Isikhathi sokuthunyelwe: Julayi-14-2025