Isingeniso
Izimpawu eziyinhloko zama-hemorrhoids yigazi esitulweni, ubuhlungu bendunu, ukuwa nokulunywa, njll., okuthinta kakhulu ikhwalithi yokuphila. Ezimweni ezimbi kakhulu, kungabangela ama-hemorrhoids avalelekile kanye ne-anemia engapheli ebangelwa igazi esitulweni. Njengamanje, ukwelashwa okulondolozayo kusekelwe kakhulu emithini, futhi ukwelashwa ngokuhlinzwa kuyadingeka ezimweni ezimbi kakhulu.
Ukwelashwa nge-endoscopic kuyindlela yokwelapha esanda kuthuthukiswa eminyakeni yamuva nje, efaneleka kakhulu ezibhedlela ezivamile. Namuhla, sizofingqa futhi silungise.
1. Ukuxilongwa kwezokwelapha, ukwakheka komzimba kanye nokwelashwa kwangaphambilini kwama-hemorrhoids
Ukuxilongwa kwama-Hemorrhoids
Ukuxilongwa kwama-hemorrhoids kusekelwe kakhulu emlandweni, ekuhlolweni, ekuhlolweni kwe-digital rectal kanye ne-colonoscopy. Ngokuphathelene nomlando wezokwelapha, kubalulekile ukuqonda ubuhlungu be-anal, igazi esitulweni, ukuphuma kwegazi kanye nokubuyiselwa kwezicubu, njll. Ukuhlolwa kuqonda kakhulu ukubonakala kwama-hemorrhoids, ukuthi ngabe kukhona yini i-fistula ye-anal yokuvuvukala kwe-perianal, njll., kanye nokuhlolwa kwe-digital rectal kudinga ukuqonda ukuqina kwe-anus nokuthi ngabe kukhona yini ukunwetshwa. I-Colonoscopy idinga ukuqaphela ezinye izifo ezifana nezimila, i-ulcerative colitis, njll. ezibangela ukopha. Ukuhlukaniswa kanye nokuhlelwa kwama-hemorrhoids
Kunezinhlobo ezintathu zama-hemorrhoids: ama-hemorrhoids angaphakathi, ama-hemorrhoids angaphandle, nama-hemorrhoids axubile.
Ama-Hemorrhoids: Ama-Hemorrhoids Angaphakathi, Angaphandle, Nama-Mixed
Ama-hemorrhoids angahlukaniswa ngamabanga oku-1, oku-II, oku-III, kanye noku-IV. Ahlukaniswa ngokwezinga lokuminyana, ukuphuma kwama-hemorrhoids kanye nokubuya kwawo.
Izinkomba zokwelapha nge-endoscopic yi-internal hemorrhoids yebanga loku-1, lesi-II, nelesi-III, kuyilapho i-internal hemorrhoids yebanga lesi-IV, i-external hemorrhoids, kanye ne-mixed hemorrhoids kuyizinto ezingahambisani nokwelashwa nge-endoscopic. Umugqa ohlukanisayo phakathi kokwelashwa nge-endoscopic umugqa wamazinyo.
Ukwakheka Kwama-Hemorrhoids
Umugqa wendunu, umugqa we-dentate, i-anal pad, kanye nama-hemorrhoids yimibono okudingeka izazi ze-endoscopists. Ukuhlonza i-endoscopic kudinga ulwazi oluthile. Umugqa we-dentate uwukuhlangana kwe-anal squamous epithelium kanye ne-columnar epithelium, kanti indawo yokuguquka phakathi komugqa we-anal kanye nomugqa we-dentate imbozwe yi-columnar epithelium kodwa ayigcinwanga ngumzimba. Ngakho-ke, ukwelashwa kwe-endoscopic kusekelwe kumugqa we-dentate. Ukwelashwa kwe-endoscopic kungenziwa ngaphakathi komugqa we-dentate, futhi ukwelashwa kwe-endoscopic akukwazi ukwenziwa ngaphandle komugqa we-dentate.
Umfanekiso 1.Umbono wangaphambili womugqa wamazinyo ngaphansi kwe-endoscope. Umcibisholo ophuzi ukhomba emgqeni wamazinyo ahlanganisiwe, umcibisholo omhlophe ukhomba ikholomu yendunu kanye nenethiwekhi yayo yemithambo yegazi ende, kanti umcibisholo obomvu ukhomba ivalvu yendunu.
1A:isithombe sokukhanya okumhlophe;1B:Isithombe Sokukhanya Okuncane
Umfanekiso 2Ukuqaphela i-anal flap (umcibisholo obomvu) kanye nengxenye engezansi yekholomu ye-anal (umcibisholo omhlophe) nge-microscope
Umfanekiso 3Ukubonwa kwe-anal papilla nge-microscope (umcibisholo ophuzi)
Umfanekiso 4.Umugqa wendunu kanye nomugqa we-dentate kubonwe nge-reverse endoscopy. Umcibisholo ophuzi ukhomba emgqeni we-dentate, kanti umcibisholo omnyama ukhomba emgqeni we-anal.
Imibono ye-anal papilla kanye ne-anal column isetshenziswa kabanzi ekuhlinzeni kwe-anorectal futhi ngeke iphinde iphindwe lapha.
Ukwelashwa okuvamile kwama-hemorrhoids:Kukhona ikakhulukazi ukwelashwa okulondolozayo kanye nokwelashwa kokuhlinzwa. Ukwelashwa okulondolozayo kufaka phakathi ukusetshenziswa kwemithi ye-perianal kanye nokugeza nge-sitz, kanti izinqubo zokuhlinzwa zifaka phakathi i-hemorrhoidectomy kanye ne-stapled excision (PPH). Ngenxa yokuthi ukwelashwa kokuhlinzwa kuyinto evamile, umphumela uzinzile, futhi ingozi incane, isiguli sidinga ukulaliswa esibhedlela izinsuku ezingu-3-5.
2. Ukwelashwa nge-endoscopic kwama-hemorrhoids angaphakathi
Umehluko phakathi kokwelashwa nge-endoscopic kwama-hemorrhoids angaphakathi kanye nokwelashwa nge-EGV:
Umgomo wokwelashwa kwe-endoscopic kwama-varice esophagogastric yimithambo yegazi ekhuphukile, kanti umgomo wokwelashwa kwe-hemorrhoid yangaphakathi akuyona imithambo yegazi elula, kodwa ama-hemorrhoid akhiwe yimithambo yegazi nezicubu ezixhumeneyo. Ukwelashwa kwama-hemorrhoid ukuqeda izimpawu, ukuphakamisa i-anal pad ehamba phansi, nokugwema izinkinga ezifana ne-anal stenosis ebangelwa ukunyamalala kwama-hemorrhoids (isimiso "sokubulala yonke into" sithambekele ekushayweni yi-anal stenosis).
Umgomo wokwelashwa nge-endoscopic: Ukuqeda noma ukuqeda izimpawu, hhayi ukuqeda ama-hemorrhoids.
Ukwelashwa nge-Endoscopic kuhlanganisaukwelashwa nge-sclerotherapyfuthiukubopha ibhendi.
Ukuze kutholakale futhi kwelashwe ama-hemorrhoids angaphakathi, kusetshenziswa i-colonoscopy ukuze kuhlolwe, kanti i-gastroscope iyanconywa ukuze kutholakale ukwelashwa. Ngaphezu kwalokho, ngokwesimo sangempela sesibhedlela ngasinye, ungakhetha ukwelashwa ngaphandle noma ngaphakathi.
①Ukwelashwa nge-Sclerotherapy (kusizwa nge-transparent cap)
I-ejenti ye-sclerosing iwumjovo we-lauryl alcohol, kanti umjovo we-foam lauryl alcohol ungasetshenziswa. Kubalulekile futhi ukusebenzisa umjovo we-methylene blue ongaphansi kwe-mucosal njenge-ejenti engekho ukuze uqonde indlela yokugeleza kanye nokumbozwa kwe-ejenti ye-sclerosing.
Inhloso yesivalo esibonakalayo ukwandisa insimu yokubona. Inaliti yomjovo ingakhethwa ezinalitini ezijwayelekile zomjovo we-mucosal. Ngokuvamile, ubude benaliti buyi-6mm. Odokotela abangenalo ulwazi oluningi kufanele bazame ukugwema ukusebenzisa imijovo yenaliti ende, ngoba imijovo yenaliti ende ivame ukujova ectopic kanye nomjovo. Ingozi ejulile futhi iholela ekuvuvukeni kwe-perianal kanye nokuvuvukala.
Indawo yokujova ikhethwa ngaphezu kohlangothi lomlomo lomugqa wamazinyo, futhi indawo yenaliti yokujova itholakala phansi kwe-hemorrhoid eqondiwe. Inaliti ifakwe ku-30°~40° ngaphansi kokubona okuqondile (ngaphambili noma ngemuva) kwe-endoscope, bese inaliti ifakwe ngokujulile phansi kwe-hemorrhoid. Yakha inqwaba eqinile phansi kwe-hemorrhoid, khipha inaliti ngenkathi ujova, cishe u-0.5~2mL, bese umisa umjovo kuze kube yilapho i-hemorrhoid iba nkulu futhi imhlophe. Ngemva kokuphela komjovo, bheka ukuthi kukhona yini ukopha endaweni yomjovo.
Ukwelashwa nge-endoscopic sclerotherapy kuhlanganisa ukujova kwesibuko sangaphambili kanye nokujova kwesibuko esiphendukezelwe. Ngokuvamile, ukujova kwesibuko esiphendukezelwe kuyindlela eyinhloko.
② ukwelashwa ngebhandeji
Ngokuvamile, kusetshenziswa idivayisi yokubopha enezindandatho eziningi, hhayi ngaphezu kwezindandatho eziyisikhombisa okungenani. Ukubopha kwenziwa ku-1 kuya ku-3 cm ngaphezu komugqa wamazinyo, futhi ukubopha kuvame ukuqaliswa eduze komugqa wendunu. Kungaba ukubopha kwemithambo yegazi noma ukubopha kwe-mucosal noma ukubopha okuhlanganisiwe. Ukubopha kwesibuko okuguquliwe kuyindlela eyinhloko, ngokuvamile izikhathi ezingu-1-2, kanye nesikhawu esingaba yinyanga eyodwa.
Ukwelashwa ngezikhathi ezithile: ukuzila ukudla akudingeki ngemuva kokuhlinzwa, gcina indle ibushelelezi, futhi ugweme ukuhlala isikhathi eside nokusebenza kanzima ngokomzimba. Ukusetshenziswa njalo kwama-antibiotic akudingeki.
3. Isimo samanje nezinkinga ezikhona zezibhedlela ezisezingeni eliphansi
Esikhathini esidlule, indawo eyinhloko yokwelashwa kwama-hemorrhoids yayisesigabeni se-anorectal. Ukwelashwa okuhlelekile emnyangweni we-anorectal kuhlanganisa imithi yokulondoloza izicubu, umjovo we-sclerotherapy, kanye nokwelashwa ngokuhlinzwa.
Odokotela be-endoscopist besisu abanalo ulwazi oluningi ekutholeni i-perianal anatomy ngaphansi kwe-endoscopy, futhi izinkomba zokwelapha nge-endoscopic zilinganiselwe (ama-hemorrhoids angaphakathi kuphela angelashwa). Ukuhlinzwa kuyadingeka futhi ukuze kutholakale ukululama okuphelele, okuye kwaba yiphuzu elinzima ekuthuthukisweni kwephrojekthi.
Ngokwethiyori, ukwelashwa nge-endoscopic kwama-hemorrhoids angaphakathi kufaneleka kakhulu ezibhedlela eziyinhloko, kodwa empeleni, akusikho okuningi njengoba bekucatshangwa.
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 ekhaleninjll. 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-11-2022