Ukwelashwa kwamatshe e-ERCP anzima

·Ngemva kokuhlinzwa kwe-LC, ukwakheka komgudu wenyongo akujwayelekile futhi umgudu wenyongo uyasonteka. PhakathiI-ERCPukusebenza, ucingo oluqondisayo "lula ukulubeka phansi kodwa akulula ukulufaka" (luwa ngephutha ngemva kokukhuphuka ekugcineni), ngakho-ke uma ucingo oluqondisayo selufakiwe, kufanele lugcinwe ukuze luvimbele ukuphuka nokuwa kocingo oluqondisayo. ngaphandle kwe-bile duct.

·I-Mirizz Syndrome iwukungajwayelekile kwe-anatomical okugeja kalula futhi kunganakwa. Isifundo: Ngemva kokuhlinzwa kwe-LC, isiguli esinamatshe e-cystic duct sacindezela i-bile duct evamile, kwabangela i-Mirrizz syndrome. Amatshe awakwazanga ukususwa ngaphansi kokubhekwa kwe-X-ray. Ekugcineni, inkinga yaxazululwa ngemva kokuxilongwa nokususwa ngaphansi kombono oqondile nge-eyeMAX.

·OkweI-ERCPUkususwa kwetshe le-bile duct ezigulini zesisu ngemva kokuhlinzwa kwe-Bi II, ukhiye uwukufinyelela ingono ngobubanzi. Kwesinye isikhathi kuthatha isikhathi eside (okudinga ingqondo eqinile) ukufinyelela ingono, futhi uma i-guidewire inganakekelwa kahle, ingaphuma kalula.

③Ezinye izimo

I-Peripapillary diverticulum ehlanganiswe namatshe e-bile duct ivame kakhulu. Ubunzima bokusebenza ngalesi sikhathi ingozi yokusikwa kwengono nokwanda. Le ngozi inkulu kakhulu ezingonweni ngaphakathi kwe-diverticulum, futhi ingozi yezingono eduze ne-diverticulum incane.

Ngalesi sikhathi, kuyadingeka futhi ukubamba izinga lokunwetshwa. Umgomo ojwayelekile wokwandisa ukunciphisa umonakalo odingekayo ukuze kukhishwe amatshe. Ukulimala okuncane kusho ubungozi obuncane. Namuhla, i-balloon expansion (CRE) yengono ezungeze i-diverticula ngokuvamile isetshenziselwa ukugwema i-EST.

Iziguli ezinezifo ze-hematological, umsebenzi we-cardiopulmonary ongakwazi ukubekezelelaI-ERCP, noma izifo ezihlangene zomgogodla ezingakwazi ukubekezelela ukuma okuthambekele kwesokunxele isikhathi eside kufanele zinakwe futhi zihlolwe lapho zihlangana namatshe anzima.m

02I-psychology yokubhekana "namatshe anzima"

Umqondo ongalungile lapho ubhekene "namatshe anzima": ukuhaha nempumelelo, ukunganaki, ukudelela ngaphambi kokusebenza, njll.

·Ukuhaha nothando ngezimpumelelo ezinkulu

Uma sibhekene namatshe e-bile duct, ikakhulukazi lawo anamatshe amaningi, sihlale sifuna ukususa wonke amatshe. Lolu uhlobo "lokuhaha" nempumelelo enkulu.

Eqinisweni, kulungile ukuthatha konke nokuhlanzekile, kodwa ukuthatha okuhlanzekile kuzo zonke izindleko "kulungile", okungaphephile futhi kuzoletha ubunzima obuningi nobunzima. Amatshe amaningi we-bile duct kufanele anqunywe ngokuphelele ngokusekelwe esimweni sesiguli. Ezimweni ezikhethekile, ithubhu kufanele ibekwe kuphela noma isuswe ngamaqoqo.

Uma amatshe amakhulu e-bile duct kunzima ukuwasusa okwesikhashana, "ukuchithwa kwe-stent" kungacatshangwa. Ungaphoqi ukususwa kwamatshe amakhulu, futhi ungazifaki esimweni esiyingozi kakhulu.

·budedengu

Okusho ukuthi, ukusebenza okuyimpumputhe ngaphandle kokuhlaziya okuphelele nokucwaninga kuvame ukuholela ekuhlulekeni kokususwa kwamatshe. Ngakho-ke, amacala amatshe e-bile duct kufanele ahlolwe ngokugcwele ngaphambi kokuhlinzwa, ahlolwe ngokufanele (okudinga amandlaI-ERCPodokotela ukuze bafunde izithombe), ukuthatha izinqumo ngokucophelela kanye nezinhlelo eziphuthumayo kufanele zenziwe ukuvimbela ukususwa kwamatshe okungalindelekile.

II-ERCPipulani yokukhipha amatshe kufanele ibe ngokwesayensi, inhloso, iphelele, futhi ikwazi ukumelana nokuhlaziywa nokucatshangelwa. Kumelwe sihambisane nomgomo wokwandisa inzuzo yesiguli futhi singabi ngokuzikhethela.

·ukudelela

Amatshe amancane engxenyeni engezansi ye-bile duct kulula ukuwashaya indiva. Uma amatshe amancane ehlangabezana nezinkinga zesakhiwo engxenyeni engezansi ye-bile duct kanye nokuphuma kwayo, kuyoba nzima kakhulu ukususa itshe.

I-ERCPUkwelashwa kwamatshe e-bile duct kunezinhlobonhlobo eziningi kanye nezingozi eziphezulu. Kunzima futhi kuyingozi kakhulu noma ngaphezulu kwalokhoI-ERCPukwelashwa kwamathumba e-bile duct. Ngakho-ke, uma ungayithathi kancane, uzozishiyela indlela yokuphunyuka efanele.

03Ungabhekana kanjani "namatshe anzima"

Lapho uhlangabezana namatshe anzima, kufanele kwenziwe ukuhlolwa okuphelele kwesiguli, ukunwetshwa okwanele kufanele kwenziwe,ubhasikidi wokubuyisa amatshekufanele kukhethwe futhi kulungiswe i-lithotripter, futhi uhlelo olwakhiwe ngaphambili kanye nohlelo lokwelapha kufanele lwenziwe.

Njengenye indlela, izinzuzo nezingozi kufanele zihlolwe ngokusekelwe esimweni sesiguli ngaphambi kokuqhubeka.

·Ukuvula ukucubungula

Ubukhulu bokuvuleka busekelwe esimweni setshe elihlosiwe kanye ne-bile duct. Ngokuvamile, ukusika okuncane + okukhulu (okumaphakathi) kusetshenziselwa ukwandisa ukuvulwa. Ngesikhathi se-EST, kuyadingeka ukugwema ezinkulu ngaphandle nezincane ngaphakathi.

Uma ungenaso isipiliyoni kulula ukusika “okukhulu ngaphandle kodwa kube kuncane ngaphakathi” okusho ukuthi ingono ibukeka inkulu ngaphandle, kodwa ayikho ngaphakathi. Lokhu kuzokwenza ukuthi ukususwa kwetshe kuhluleke.

Uma wenza i-EST, "umnsalo ongashoni kanye nokusika kancane" kufanele kusetshenziswe ukuvimbela ukusika uziphu. Ukusika kufanele kube ngokushesha njengokusikwa ngakunye. Ummese akufanele "uhlale unganyakazi" ngesikhathi sokusikwa ukuze uvimbele ukuphazamiseka kwengono futhi ubangele i-pancreatitis. .

·Ukucubungula ukuhlolwa kwesigaba esiphansi kanye nokuthekelisa

Amatshe avamile we-bile duct adinga ukuhlolwa kwengxenye engezansi kanye nokuphuma kwe-bile duct evamile. Zombili izingosi kufanele zihlolwe. Inhlanganisela yakho kokubili inquma ubungozi nobunzima benqubo yokusika ingono.

·I-Lithotripsy ephuthumayo

Amatshe amakhulu kakhulu futhi aqinile namatshe angakwazi ukukhishwa iglavu adinga ukwelashwa nge-lithotripter ephuthumayo (i-lithotripter ephuthumayo).

Amatshe e-Bile pigment ngokuyisisekelo angaphulwa abe yizicucu, futhi iningi lamatshe e-cholesterol aqinile nawo angaxazululwa ngale ndlela. Uma idivayisi ayikwazi ukukhululwa ngemva kokubuyiselwa, futhi i-lithotripter ayikwazi ukuphula amatshe, "ubunzima" bangempela. Ngalesi sikhathi, i-eyeMAX ingase idingeke ukuze kuhlonzwe ngokuqondile nokwelapha amatshe.

Qaphela: Ungasebenzisi i-lithotripsy engxenyeni engezansi kanye nokuphuma kwe-bile duct evamile. Ungasebenzisi i-lithotripsy ngokugcwele ngesikhathi se-lithotripsy, kodwa shiya indawo yakho. I-lithotripsy ephuthumayo iyingozi. Ngesikhathi se-lithotripsy ephuthumayo, i-axis yokugcina ingase ingahambisani ne-bile duct axis, futhi ukungezwani kungase kube kukhulu kakhulu ukubangela ukubhobozwa.

·Itshe elincibilikayo

Uma itshe likhulu kakhulu futhi kunzima ukususa, ungacabangela ukuchithwa kwe-stent - okungukuthi, ukubeka i-stent yepulasitiki. Linda kuze kube yilapho itshe lincipha ngaphambi kokususa itshe, khona-ke ithuba lokuphumelela liyoba phezulu kakhulu.

·Amatshe e-intrahepatic

Odokotela abasebasha abanolwazi oluncane kungcono ukuthi bangenzi ukwelashwa kwe-endoscopic yamatshe e-intrahepatic bile duct. Ngenxa yokuthi amatshe akule ndawo angase angakwazi ukuvaleleka noma angase ajule futhi avimbele ukuqhubeka nokusebenza, umgwaqo uyingozi kakhulu futhi umncane.

·Amatshe emigudu yebile ahlanganiswe ne-peripapillary diverticulum

Kuyadingeka ukuhlola ubungozi kanye nokulindela ukwanda. Ingozi yokubhobozwa kwe-EST iphezulu uma kuqhathaniswa, ngakho-ke okwamanje indlela yokukhulisa ibhaluni ikhethwa ngokuyisisekelo. Usayizi wokunweba kufanele ube ngokwanele ukususa itshe. Inqubo yokunweba kufanele ihambe kancane futhi isinyathelo ngesinyathelo, futhi akukho ukwanda okunodlame noma ukunwetshwa okuvunyelwe. Isirinji siyakhula ngokuthanda kwakho. Uma kunokopha ngemva kokunwetshwa, ukwelashwa okufanele kuyadingeka.

Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., singumkhiqizi waseChina ogxile ezintweni ezisetshenziswayo ze-endoscopic, ezifanai-biopsy forceps,i-hemoclip,polyp ugibe,inaliti ye-sclerotherapy,fafaza i-catheter,amabhulashi e-cytology,guidewire,ubhasikidi wokubuyisa amatshe,i-nasal biliary drainage catheter njll. ezisetshenziswa kakhulu kuI-EMR,ESD,I-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!