Iziguli eziningi eminyangweni ye-gastroenterology noma ezikhungweni ze-endoscopy zinconyelwe ukukhishwa kwe-endoscopic mucosal (I-EMR). Isetshenziswa kaningi, kodwa ingabe uyazi izinkomba zayo, imikhawulo, kanye nezinyathelo zokuphepha zangemva kokuhlinzwa?
Lesi sihloko sizokuqondisa ngendlela ehlelekile ngolwazi oluyisihluthulelo lwe-EMR ukukusiza wenze isinqumo esinolwazi nesizethembayo.
Ngakho, yini i-EMR? Asidwebe kuqala futhi sibone...
❋Ithini imihlahlandlela egunyaziwe mayelana nezinkomba ze-EMR? Ngokwemihlahlandlela yokwelashwa komdlavuza wesisu waseJapan, i-Chinese Expert Consensus, kanye nemihlahlandlela ye-European Society of Endoscopy (ESGE), izinkomba ezinconyiwe njengamanje ze-EMR zifaka okulandelayo:
Ⅰ. Ama-polyps amahle noma i-adenomas
● Izilonda ≤ 20 mm ezinamamajini acacile
● Azikho izimpawu ezisobala zokuhlasela kwe-submucosal
● I-Laterally Spreading Tumor (LST-G)
Ⅱ. I-Focal high-grade intraepithelial neoplasia (HGIN)
● I-mucosal-limited, ayikho izilonda
● Izilonda ezincane kuno-10 mm
● Ihluke kahle
Ⅲ. I-dysplasia emaphakathi noma izilonda zebanga eliphansi ezine-pathology ecacile nokukhula kancane
◆ Iziguli ezibhekwa njengezifanele ukuhlinzwa ngemva kokubhekwa kokulandelela
⚠Qaphela: Nakuba imihlahlandlela ithi i-EMR iyamukeleka kumdlavuza wesigaba sangaphambi kwesikhathi uma isilonda sisincane, singenazilonda, futhi sivalelekile ku-mucosa, ekusebenzeni kwangempela komtholampilo, i-ESD (i-endoscopic submucosal dissection) ngokuvamile ikhethwa ukuze kuqinisekiswe ukuqaqa okupheleleyo, ukuphepha, nokuhlolwa okunembile kwe-pathological.
I-ESD inikeza izinzuzo ezimbalwa ezibalulekile:
Ukususwa kwe-En bloc kwesilonda kungenzeka
Ilungiselela ukuhlolwa kwe-margin, ukunciphisa ingozi yokuphinda
Ifanele izilonda ezinkulu noma eziyinkimbinkimbi
Ngakho-ke, i-EMR okwamanje isetshenziswa ngokuyinhloko ekusebenzeni komtholampilo:
1. Izilonda ezingezinhle ezingenabungozi bomdlavuza
2. Ama-polyp amancane, akhipheka kalula noma ama-LST anemibala
⚠Izinyathelo zokuqapha ngemuva kokuhlinzwa
1.Ukuphatha Ukudla: Emahoreni angu-24 okuqala ngemva kokuhlinzwa, gwema ukudla noma ukudla uketshezi olucacile, bese kancane kancane ushintshela ekudleni okuthambile. Gwema ukudla okubabayo, okuqeda amandla, nokucunula.
2.Ukusetshenziswa Kwemithi: I-Proton pump inhibitors (PPIs) ivame ukusetshenziswa ngemva kokuhlinzwa kwezilonda zesisu ukuze kukhuthazwe ukuphulukiswa kwesilonda nokuvimbela ukopha.
3.I-Complication Monitoring: Qaphela izimpawu ze-postoperative yokopha noma ukubhoboza, njenge-melena, i-hematemesis, nobuhlungu besisu. Thola usizo lwezokwelapha ngokushesha uma kukhona okungavamile okwenzekayo.
4. Uhlelo Lokubuyekeza: Hlela ukuvakashela kokulandelela futhi uphinde ama-endoscopies ngokusekelwe ekutholweni kwe-pathological.
Ngakho-ke, i-EMR iyindlela ebalulekile yokukhishwa kabusha kwezilonda zesisu. Kodwa-ke, kubalulekile ukuqonda kahle izinkomba zayo futhi ugweme ukusetshenziswa ngokweqile noma ukusetshenziswa kabi. Kodokotela, lokhu kudinga ukwahlulela nekhono; ezigulini, kudinga ukwethenjwa nokuqonda.
Ake sibone ukuthi yini esinganikela ngayo nge-EMR.
Nazi izinto zethu ezisetshenziswayo ze-endoscopic ezihlobene ne-EMR ezihlanganisaIziqeshana ze-Hemostatic,I-Polypectomy Snare,Inalithi YomjovofuthiI-Biopsy Forceps.
Isikhathi sokuthumela: Sep-01-2025