Ukuqalisa
Izimpawu eziphambili ze-hemorrhoids ziyigazi esihlalweni, izinhlungu ze-anal, ziwe futhi zilunywa, njll, ezithinta kakhulu ikhwalithi yempilo. Ezimweni ezinzima, kungadala ama-hemorrhoid afakiwe kanye ne-anemia engapheli eye yabangelwa yigazi esihlalweni. Njengamanje, ukwelashwa okulondoloziwe kuncike kakhulu ezidakamizweni, kanye nokwelashwa kokuhlinzwa kuyadingeka ezimweni ezinzima.
Ukwelashwa kwe-Endoscopic kuyindlela entsha yokwelashwa ethuthukile eminyakeni yamuva nje, elungele izibhedlela zezimpande zotshani. Namuhla, sizofingqa futhi sixazulule.
1. Ukuxilongwa kwemitholampilo, i-anatomy kanye nokwelashwa kwangaphambilini kwama-hemorrhoids
Ukuxilongwa kwama-hemorrhoids
Ukuxilongwa kwama-hemorrhoids ikakhulukazi kusekelwe emlandweni, ekuhlolweni, ukuhlolwa kwe-digital rectal kanye ne-colonoscopy. Ngokuya komlando wezokwelapha, kuyadingeka ukuqonda ubuhlungu be-anal, igazi esihlalweni, ukuphuma kwe-hemorrhoid kanye nokuhlolwa kokuvuvukala kokuvuvukala kwe-perianal, njll. IColonoscopy idinga ukuqaphela ezinye izifo ezinjengethumba, i-ulcerative colitis, njll. Lokho kubangela ukopha. Ukuhlukaniswa kanye nokuhlelwa kwama-hemorrhoids
Kunezinhlobo ezintathu ze-hemorrhoids: ama-hemorrhoid angaphakathi, ama-hemorrhoid angaphandle, nama-hemorrhoids ahlanganisiwe.
Ama-Hemorrhoids: Ama-hemorrhoids angaphakathi, angaphandle, ahlanganisiwe
Ama-hemorrhoid angahlukaniswa emabangeni I, II, III, no-IV. Ibalwa ngokwesigcawu, ukuphuma kwe-hemorrhoid bese ubuya.
Izinkomba zokwelashwa kwe-endoscopic zingamabanga amabanga i, ii, kanye ne-III ama-hemorrhoids, ngenkathi iBanga I-Hemorrhoids, ama-hemorrhoid angaphandle, nama-hemorrhoids ahlanganisiwe angqubuzana nokwelashwa kwe-endoscopic. Umugqa ohlukanisayo phakathi kwe-Endoscopic ukwelashwa ngumugqa wamazinyo.
Anatomy of hemorrhoids
Umugqa we-anal, umugqa wamazinyo, i-anal pad, nama-hemorrhoids yimiqondo ama-endoscopists adinga ukujwayela. Ukukhonjwa kwe-endoscopic kudinga isipiliyoni esithile. I-Dentate Line ngumhlangeli we-epithelium ye-anal squamous epithelium, kanye nendawo yokuguqula phakathi komugqa we-anal kanye nomugqa wamazinyo embozwe yi-epithelium ye-columntar kodwa hhayi phakathi komzimba. Ngakho-ke, ukwelashwa kwe-endoscopic kususelwa kulayini wamazinyo. Ukwelashwa kwe-endoscopic kungenziwa ngaphakathi komugqa wamazinyo, futhi ukwelashwa kwe-endoscopic akunakwenziwa ngaphandle komugqa wamazinyo.
Umdwebo 1.Ukubuka kwangaphambili komugqa wamazinyo ngaphansi kwe-endoscope. Umcibisholo ophuzi ukhomba umugqa we-dellate ojwayelekile we-anrate anrate, umcibisholo omhlophe ukhomba kwikholomu ye-anal kanye nenethiwekhi yayo ye-vascular ende ende, kanye neRed Arrow ekhomba i-anal valve
1a:isithombe esimhlophe esimhlophe;I-1B:Kukhanya kancane
Umdwebo 2Ukuqashelwa kwe-anal flap (umcibisholo obomvu) kanye nokuphela okuphansi kwekholomu ye-anal (umcibisholo omhlophe) kanye nama-microscope
Umdwebo 3Ukuqashelwa kwe-anal papilla kanye nemicroscope (umcibisholo ophuzi)
Umdwebo 4.Umugqa we-anal nomugqa wamazinyo waqashelwa yi-reverse endoscopy. Umcibisholo ophuzi ukhomba kulayini wamazinyo, futhi umcibisholo omnyama ukhomba kulayini wokuhlaziya.
Imiqondo ye-Anal Papilla ne-Anal Colourum isetshenziswa kabanzi ekuhlinzweni kwe-anoretal futhi ngeke iphindwe lapha.
Ukwelashwa kwakudala kwama-hemorrhoid:Kunokulashwa okulondoloziwe ikakhulukazi nokwelashwa kokuhlinzwa. Ukwelashwa okulondoloziwe kufaka phakathi uhlelo lokusebenza lwe-Perianal kanye nokugeza kwe-Sitz, kanye nezinqubo zokuhlinzwa ikakhulukazi zibandakanya i-hemorrhoidectomy kanye ne-stapled exporision (PPH). Ngenxa yokuthi ukwelashwa okuhlile kuyizinziloko, umphumela uzinzile, futhi ingozi incane, isiguli sidinga ukulaliswa esibhedlela izinsuku ezingama-3-5.
2. Ukwelashwa kwe-endoscopic kwama-hemorrhoid angaphakathi
Umehluko phakathi kokuphathwa kwe-endoscopic kwama-herrhoid angaphakathi ne-EGV ukwelashwa:
Inkomba yokwelashwa kwe-endoscopic yama-esophagogaSTRASTRASTRASTRASTRIC Variaces Varicose Varicose Imithambo yegazi, kanye nethagethi yokwelashwa kwe-hemorrhoid yangaphakathi akuyona imithambo yegazi elula, kepha ama-hemorrhoids ahlanganiswe nemithambo yegazi nezicubu ezithintekayo. Ukwelashwa kwama-hemorrhoids ukukhulula izimpawu, kuphakamise i-anal pad eshukumisela phansi, futhi ugweme izinkinga ezifana ne-anal stenosis ebangelwa ukunyamalala kwama-hemorrhoids (umgomo wokubulala yonke into "uvame ukuba yi-anal stenosis).
Injongo yokwelashwa kwe-endoscopic: ukudambisa noma ukuqeda izimpawu, hhayi ukuqeda ama-hemorrhoids.
Ukwelashwa kwe-endoscopic kufaka phakathisclerotherapyna-I-Band Sigation.
Ngokuxilongwa nokwelashwa kwama-hemorrhoid angaphakathi, i-colonoscopy isetshenziselwa ukuhlolwa, futhi i-gastroscope inconyelwe ukwelashwa. Ngaphezu kwalokho, ngokuya ngesimo sangempela sesibhedlela ngasinye, ungakhetha ukwelashwa okungaphandle noma okukhona.
①Sclerotherapy (esizwa nge-trapparent cap)
Umenzeli we-sclerosing ungumjovo we-lauryl utshwala, kanti umjovo we-foam lauryl utshwala futhi ungasetshenziswa. Kuyadingeka futhi ukusebenzisa umjovo we-submucosal we-methylene oluhlaza okwesibhakabhaka njengo-ejenti olahlekile ukuze aqonde ukugeleza kokugeleza kanye nokumbozwa kwe-ejenti yokugeleza.
Inhloso ye-cap esobala ukwandisa insimu yombono. Inaliti yomjovo ingakhethwa kusuka ezinaneni ezijwayelekile ze-mucosal umjovo. Ngokuvamile, ubude benaliti bungu-6mm. Odokotela abangatholakali kakhulu kufanele bazame ukugwema ukusebenzisa imijovo yenaliti ende, ngoba imijovo yenaliti emide ithambekele emjovo we-ectopic kanye nomjovo. Ubungozi obujulile futhi buholele emaphulweni ePerianal kanye nokuvuvukala.
Iphuzu lomjovo likhethwe ngaphezulu kohlangothi lomlomo lomugqa wamazinyo, kanye nesikhundla senaliti ye-Umjovo sisesisekelweni se-hemorrhoid eqondiwe. Inaliti ifakwe ku-30 ° ~ 40 ° ngaphansi kombono oqondile (ngaphambili noma ukubuyela emuva) kwe-endoscope, futhi inaliti ifakwe kakhulu esisekelweni se-hemorrhoid. Yakha inqwaba elukhuni ngaphansi kwe-hemorrhoid, ihoxise inaliti ngenkathi ijova, cishe ngo-0,5 ~ 2ml, bese umisa umjovo kuze kube yilapho i-hemorrhoid iba mnene futhi imhlophe. Ngemuva kokuthi umjovo usuphelile, bheka ukuthi ngabe kukhona ukopha indawo yokujova.
I-Endoscopic Sclerotherapy ifaka phakathi umjovo wesibuko wangaphambili kanye nomjovo wesibuko ongenele. Ngokuvamile, umjovo wesibuko we-inverted expended yindlela esemqoka.
② Ukwelashwa nge-bandage
Ngokuvamile, kusetshenziswa idivaysi ye-multi-rings ring, azikho ngaphezu kwamasongo ayisikhombisa okungenani. I-ligation yenziwa ngo-1 kuye ku-3 cm ngaphezulu komugqa wamazinyo, futhi kuvame ukuqalwa eduze komugqa wokuhlaziya. Kungaba yi-vascular motation noma i-mucosal motation noma i-ligation ehlanganisiwe. I-Mirror Sigation engenele yindlela eyinhloko, imvamisa izikhathi ezi-1-2, ngesikhawu senyanga ecishe ibe yi-1.
Ukwelashwa okusebenzayo: Ukuzila ukudla akudingekile ngemuva kokusebenza, gcina isihlalo esisheshayo, futhi uvikele ukuhlala isikhathi eside nokusebenza kanzima. Ukusetshenziswa okujwayelekile kwama-antibiotic akudingekile.
3. Isimo samanje nezinkinga ezikhona zezibhedlela zezimpande zotshani
Esikhathini esedlule, isikhundla esiyinhloko sokwelashwa kwama-hemorrhoids sasisemnyangweni we-anorectal. Ukwelashwa okuhlelekile emnyangweni we-anorectal kufaka umuthi wokulondolozela, umjovo we-sclerotherapy, kanye nokwelashwa okuhlile.
Ama-endoscopis ase-Gastrointestinal awatholakali kakhulu ekuhlonzeni kwe-anatomy perianal ngaphansi kwe-endoscopy, futhi izinkomba zokwelashwa kwe-endoscopic zilinganiselwe (kuphela ama-hemorrhoid angaphakathi angalashwa). Ukuhlinzwa kuyadingeka futhi ukwenza ukululama okugcwele, okuye kwaba yiphuzu elinzima ekuthuthukisweni kwephrojekthi.
Emcabangweni, ukwelashwa kwe-endoscopic kwama-hemorrhoid angaphakathi kufanelekile ikakhulukazi ezibhedlela zamabanga aphansi, kodwa ekusebenzeni, akukucatshangwa njengokucabanga.
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, ESD, ECCP. 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: Jul-11-2022