I.Patient Kugadzirira
1. Nzwisisa nzvimbo yacho, zvisikwa, saizi uye kutsanangurwa kwezvinhu zvekunze
Tora pachena X-Rays
2. Kutsanya uye Mvura Kukurumidza Nguva
Nenzira yekugara, varwere vanokurumidza kwemaawa matanhatu kusvika masere kuti vasiye mwemukati medumbu, uye kutsanya nekutsanya nguva nenguva kunogona kuzorora nenzira kwayo kune emergency gastoroscopy.
3. Anesthesia Rubatsiro
Vana, avo vane matambudziko epfungwa, avo vasingashande, kana avo vakasungwa miviri yekune dzimwe nyika, miviri yevatorwa, kana kuwanda kwemukati, kana kutora nguva yakareba kuti ishandiswe pasi pechibereko chesangano. Bvisa zvinhu zvekunze.
Ii. Zvigadzirwa zveMidziyo
1. Kusarudzwa kwekusarudza
Marudzi ese epamberi-kutarisa gastroscopy inowanikwa. Kana zvikafungidzirwa kuti zvakaoma kubvisa muviri wekunze kana muviri wekunze wakakura, kaviri-chitubu chekuvhiya gastroscopy inoshandiswa. Endoscopes ine diki rekunze dhata rinogona kushandiswa kwevacheche nevana vadiki.
2. Kusarudzwa kweSolicPs
Inonyanya kuenderana nehukuru uye chimiro chemuviri wekunze. Zviridzwa zvinowanzoshandiswa zvinosanganisira biopsy forceps, zvitatu-zvidhinha, zvigaro zvemukati, zvidhori zvemarongo.
Iko kusarudzwa kwechiridzwa kunogona kutsanangurwa zvichibva pane saizi, chimiro, mhando, nezvimwewo zvemukati zvekunze. Maererano nemishumo yemabhuku, zvigaro zvechinzvimbo zvigaro zvinoshandiswa zvakanyanya. Rate yeiyo yekushandisa yeRat-zino rezvemazino ndeye 24.0% ~ 46,6% yezviridzwa zvese zvinoshandiswa, uye mitezo yakanangana ne4,0% ~ 23.6%. Zvinowanzofungidzirwa kuti misungo iri nani kune miviri yematanga okumwe. Vakadaro thermometers, mazino, bamboo chopsticks, mapeni, zvipuni, nezvimwe, uye zvakasarudzika zvichaita kuti ubude kuibatidza kadhia.
2.1 tsvimbo-yakaumbwa miviri yekune dzimwe nyika uye nzvimbo dzekunze dzekunze
Zvezvinyorwa zvetsvimbo. Zvekunze kwenyika zvinhu (zvakadai se cores, goridhe mabhatani, etc.), shandisa bhasikiti iri kubviswa kwetombo kana bhegi rematombo kuti uzviitise zvakaoma kutsvedza.
2.2 refu nzvimbo dzekunze dzakatorwa, zvekudya zvekudya, uye matombo makuru mudumbu
Kwemombe refu dzekunze, iyo refu-axis yemuviri wekunze inofanira kufanana neiyo refuitudinal axis yeummen, nekupera kwakapinza kana kupera kwakadzika kutarisana nekudzika mhepo. Zvemichironi-yakavezwa yemhando dzekunze kana miviri yekune dzimwe nyika ine maburi, yakachengeteka kushandisa nzira yekudzika kuti ubvise;
Zvekukanda zvekudya uye nematombo makuru mudumbu, kuruma kweMauto kunogona kushandiswa kuvapwanya uye wozobviswa kune matatu-haya-shaya-shaya.
3. Kuchengetedza Midziyo
Shandisa michina yekudzivirira zvakanyanya sezvinobvira kune zvinhu zvekunze zvakaoma kubvisa uye zvine njodzi. Parizvino, zvinowanzoshandiswa zvinodzivirira zvishandiso zvinosanganisira macapurs akajeka, machubhu ekunze, uye zvifukidzo zvinodzivirira.
3.1 transparent cap
Munguva yekunze kwemuviri kubvisa mari, iyo tabuke cap inofanirwa kushandiswa pakupera kweiyo endoscopic len Inogona zvakare kubatsira kupomhodza uye kubvisa muviri wekunze, izvo zvinobatsira kubviswa kwemuviri wekunze. buritsa panze.
Zvemitumbi yematanho ekunze yakadzvanywa muCofa pamigumo yeiyo Esophagus, iyo inopedzwa yekupera kweiyo Esophagel Wall madziro kuti udzivise itsforgial inobviswa.
Iyo tabuketi cap inogona zvakare kupa nzvimbo yakakwana yekuvhiya kwechiridzwa, izvo zviri nyore kuona uye kubviswa kwemiviri yekune dzimwe nyika mune yakamanikana yesephageal mutsipa chikamu chemutsipa.
Panguva imwecheteyo, iyo taburitsa cap inogona kushandisa zvisina kunaka kudzvinyirira kuti ibetsere kutora chikafu chekudya uye kufambisa inotevera kugadzirisa.
3.2 Kubvisa Kunze
Ndichiri kuchengetedza esophagus neyepfageal-gastric Junction mucosa, iyo yekunze inopa kubviswa kwenguva refu, nekureba kwemari yekukanda, nekudaro ichidzora zviitiko zvekudya panguva yekudziya kweGastrointestinal kubvisa muviri. Wedzera kuchengetedza uye kushanda kwekurapwa.
Overbes haina kuwanzoshandiswa muvana nekuda kwengozi yekukuvadza esophagus panguva yekuisa.
3.3 Proming Car
Isa iyo yekudzivirira yekuvhara yakakwira pasi pemhedzisiro yeEndoscope. Mushure mekunyepedzera chinhu chekunze, flip iyo yekudzivirira chivharo pamusoro uye kuputira chinhu chekunze kana uchibvisa iyo endoscope kuti udzivise zvinhu zvekunze.
Iyo inosvika mukubatana neiyo mucous membrane yeiyo yekugaya turakiti uye inoita basa rekudzivirira.
4. Nzira dzekurapa dzemhando dzakasiyana dzemiviri yekune dzimwe nyika mune yepamusoro gastrointestinal turakiti
4.1 Chikafu Chakawanda muEsophagus
Mishumo inoratidza kuti zvidiki zvidiki zvekudya muzvikwata zvakawanda zvinogona kusundidzirwa zvinyoronyoro mudumbu uye kuruboshwe kuti zvisarurwe pachena, zviri nyore, zviri nyore, zvakaringana uye zvishoma kuti zvikonzere matambudziko. Munguva yeGastoroscopy kufambira mberi maitiro, inflation yakakodzera inogona kuunzwa muEsophageal Lumen, asi vamwe varwere vanogona kuperekedzwa neEsophageal Malignant tumors kana post-esophageal anastonomot stenosis (Mufananidzo 1). Kana paine kupokana uye iwe unosundira nechisimba, uchishandisa zvakanyanyisa kudzvanywa kuchawedzera njodzi yekutsanangurwa. Zvinokurudzirwa kushandisa bhasikiti yetombo yematombo kana ibwe rinobvisa netambo kuti ubvise zvakananga. Kana chikafu chakakura kwazvo, iwe unogona kushandisa nzvimbo dzekunze dzemuviri, misungo, etces, etc. kuti isimbise usati waakamuka. Bvisa kunze.
Mufananidzo 1 Mushure mekuvhiyiwa kwekenza yeEsophageal, murwere aiperekedzwa neEsophageal Stenosis uye chikafu Bolus Kuchengeta.
4.2 kupfupi uye kupaza zvinhu zvekunze
Mazhinji mitezo mitezo yehondo yematare anogona kubviswa kuburikidza nemisungo yemuviri, misungo, inobvisa mabhasikiti, matombo anobvisa mabheji, nezvimwe (Mufananidzo weChinyorwa 2). Kana iyo yekune dzimwe nyika mu esophagus yakaoma kubvisa zvakananga, inogona kusundidzirwa mudumbu kuti igadzirise nzvimbo yayo uye woedza kuibvisa. Pfupi, blunt mamwe miviri ine dhayeti ye> 2.5 cm mudumbu iri zvakanyanya kuoma kupfuura neplorus, uye kupindira kwekupedzisira kunofanirwa kuitwa nekukurumidza sezvinobvira; Kana miviri yekune dzimwe nyika ine madiki madiki mudumbu kana duodenum hairatidzi gastrointingtinal kukuvara, vanogona kumirira kwavo kusikwa. Kana zvichiramba zvichingoita vhiki dzinopfuura 3-4 uye hadzigone kudzingwa, inofanira kubviswa endoscopically.
Mufananidzo 2 Plastiki Zvekunze Zvinhu uye Kubvisa nzira
4.3 Yokunze Miviri
Zvinhu zvekunze zvine urefu hwe ≥6 cm (sekuti thermometers, mazino, bamboo zvimiti, mapepa, saka anowanzounganidzwa nebhasikiti kana matanda emabwe.
Musungo unogona kushandiswa kuvhara imwe mugumo (kwete anopfuura 1 cm kure kusvika kumagumo), uye yakaiswa mune yakajeka cap yekubvisa kunze. Iyo yekunze cannula mudziyo inogona zvakare kushandiswa kubata iyo muviri wokunze uye wobva wadzoka zvakanyatsopinda mune yekunze cannula yekudzivirira kukuvadza mucosa.
4.4 Kupinza zvinhu zvevatorwa
Mapepa ekunze ehope akadai semapfupa ehove, mafupa ehuku, mazino, mazino, mapepa emapepa, uye piritsi tin bhokisi rekuputika (Mufananidzo 3) unofanirwa kupihwa hanya zvakakwana. Zvinhu zvekunze zvekunze zvinogona kukuvadza zviri nyore mucous membranes uye mitsipa yeropa uye kutungamira kune matambudziko akadai sekutsanangurwa kunofanirwa kubatwa nokungwarira. Emergency endoscopic manejimendi.
Mufananidzo 3 mhando dzakasiyana dzezvinhu zvakapinza zvekunze zvinhu
Paunenge uchibvisa nzvimbo dzakapinza dzakatorwa pasi pekupedzisiraOscope, zviri nyore kukanda mucosa yeiyo yekugaya turakiti. Inokurudzirwa kushandisa iyo pachena cap, iyo inogona kufumura zvizere lumen uye dzivisa kukanda madziro. Edza kuunza mugumo wekupaza kwemuviri wekunze uri padyo nemugumo weEndoscopic lens kuti ubudise mutumbi wekunze, wobva waedza kuchengeta denderedzwa remuviri wekunze wakafanana neyesophagus usati wabvisa kubva pachiyero. Miviri yekune dzimwe nyika yakanyorwa mune rimwe divi reiyo esophagus inogona kubviswa nekuisa cap yepamutemo pamucheto wekupedzisira weEndoscope uye zvishoma nezvishoma kupinda maEsophageal inlet. Kune miviri yekune dzimwe nyika yakadzvanywa muEsophageal Cavity pamativi ese ari maviri, kazhinji pane imwe mugumo, gadzirisa iyo yekupera kweiyo iyo yekupera iyo inopera iri munzvimbo inoonekera, uye uibudise. Kana mushure mekushandisa banga laser kutema muviri wekunze pakati, ruzivo rwedu rwekusunungura iyo AORIC ARCHI kana yemoyo chikamu chekutanga, wozobvisa mumatanho.
a.dentures: Kana uchidya, kukosora, kana kutaurag, varwere vanogona kusaona netsaona kubva pamatambudziko avo, uye vozopinda mukati megakava rekumusoro nekumedza mafambiro. Kupinza madhiri ane masimbi magumo pamigumo miviri iri nyore kuti atsungirire mumadziro eaya turakiti rekugaya, achibvisa kuoma. Kune varwere vanotadza magungano enguva dzose endoscopic kurapwa, zviridzwa zvakawandisa zvinogona kushandiswa kuyedza kubviswa pasi pehukama-chiteshi.
B.Date makomba: mhanya makomba akanyorwa muEsophagus anowanzo kupinza pamigumo miviri, ayo anogona kutungamira kune matambudziko akadai saCoSOL DAMAGe, kubuda ropa, kutapurirana kwenyika kutapurirana uye kufungidzira munguva pfupi, uye kunofanirwa kurapwa ne emergency endoscopic kurapwa (Mufananidzo 4). Kana pasina kukuvara kwegastrointinginal, mazhinji ematombo emudumbu ari mudumbu kana duodenum anogona kubhururuka mukati memaawa makumi mana nemasere. Avo vasingakwanise kubviswa zvakasikwa vanofanirwa kubviswa nekukurumidza sezvinobvira.
Mufananidzo 4 Jujube Core
Mazuva mana gare gare, murwere akawanikwa aine mutumbi wekunze mune chimwe chipatara. Ct yakaratidza mutumbi wekunze mune esophagus ine parformation. Iyo inopinza jujube cores pamapeti ese ari maviri akabviswa pasi peEndoscopy uye gastroscopy yakaitwa zvakare. Yakaonekwa kuti fistula yakaumbwa pamadziro eiyophagus.
4.5 zvinhu zvakakura zvekunze zvine mishonga yakareba uye mipendero inopinza (Mufananidzo 5)
a. Isa iyo yekunze tube pasi pekupedzisira Nhungamiro inoisa gastroscope pad pedyo nemuviri wekunze. Isa zviridzwa zvakakodzera kuburikidza ne biopsy tube, senge misungo, etc. Yokunze muviri, eting iyo yekunze chinhu, uye chishandiso chose chinobuda pamwe negirazi.
b. Homemade mucous membrane anodzivirira chifukidzo: Shandisa chifukidzo chemagavha yekurapa yerabha kuti uite homemade endoscope pamberi-yekupedzisira yekudzivirira chifukidzo. Cheka iyo pamwe nejere yechigunwe mugwagwa weglove muchimiro chehwamanda. Cheka gomba diki pachigunwe, uye pfuudza kuguma kwemugumo wemugirazi muviri kuburikidza negomba diki. Shandisa chindori chidiki cheRabha kuti ugadzirise 1.0cm kure kubva kumagumo ekumusoro kweGastroscope, uzvidzore mumugumo wekumusoro wegastroscope, uye uitumire pamwe chete neye gastoroscope kune imwe nzvimbo yekune dzimwe nyika. Bata muviri wokunze wobva wadzitora pamwe chete negastroscope. Iyo yekudzivirira ngozi ichafamba ichitama yakananga kune imwe nzvimbo yekunze nekuda kwekurwisa. Kana kutungamirirwa kuchidzorwa, kuchaputirwa zvinhu zvekunze kuti udzivirirwe.
Mufananidzo 5: Mapfupa ehove anopinza akabviswa endoscopically, ne mucosal scratches
4.6 Simbi Yevatorwa Yokunze
Pamusoro peanoratidzwa masimba, masimbi ekunze miviri inogona kubviswa nekusayiswa nemagineti yekunze kwemuviri. Simbi dzekunze dzevatorwa dzakawanda dzine njodzi kana kuoma kubvisa inogona kurapwa magumo pasi pe x-ray fluoroscopy. Zvinokurudzirwa kushandisa bhasikiti iri kubviswa ibwe kana bhegi remabwe rinobvisa.
Mari yakajairika pakati pemiviri yekune dzimwe nyika muga turakiti yevana (Mufananidzo 6). Kunyangwe akawanda emari muEsophagus anogona kupfuudzwa nemasikirwo, kurapa kwesarudzo kweEndoscopic kunokurudzirwa. Nekuti vana havanyanyisi kubatana, endoscopic kubviswa kwemiviri yevatorwa muvana inoitwa zvakanaka pasi peanesthesia. Kana iyo mari yakaoma kubvisa, inogona kusundidzirwa mudumbu uye ikabva yabuda. Kana pasina zviratidzo mudumbu, unogona kumirira kuti ibviswe pachena. Kana iyo mari ichiramba ichisvika kwevhiki dzinopfuura 3-4 uye hadzi kudzingwa, inofanira kurapwa endoscopically.
Mufananidzo 6 Metal Metal Coin Kunze kwenyika
4.7 COTROSI YEMAHARA YEMAHARA
Corrosivengi nzvimbo dzekunze dzinogona kukonzera kukuvadza kune iyo yekugaya turakiti kana kunyange necrosis. Emergency endoscopic kurapwa kunodiwa mushure mekuongororwa. Mabhatiri ndiwo anowanzo kujairika muviri wekunze uye anowanzoitika muvana vari pasi pemakore mashanu (Mufananidzo 7). Mushure mekukudziridza esophagus, vanogona kukonzera enzhirel stenosis. Endoscopy inofanira kuongororwa mukati memavhiki mashoma. Kana mutserendende wakaumbwa, esophagus inofanira kunge ichisikwa nekukurumidza sezvinobvira.
Mufananidzo 7 Chekunze chinhu mubhatiri, museve mutsvuku anoratidza nzvimbo yechinhu chekunze
4.8 Magnetic Kunze kwenyika
Kana zviyero zvakawanda zvemagineti. Mhando dzekunze dzemaginhini dzakabatanidzwa nesimbi zviripo, izvo zvinokonzerwa neHourcemic Necrossion, iyo Fistration Kuumbwa, Kukuvadzwa, Kukuvara Kwakakura uye kumwe kukuvara kwakakura. , inoda emergency emercopic kurapwa. Zvimwe chete zvemagineti zvinhu zvekunze zvinofanirwa zvakare kubviswa nekukurumidza sezvinobvira. Pamusoro peanoratidzwa mashekeri, miviri yekune dzimwe nyika inogona kubviswa pasi pesimba nemagineti yekunze.
4.9 Mafambiro ekunze ari mudumbu
Vazhinji vacho vaivhenekera, waya yesimbi, zvipikiri, nezvimwewo zvakamiswa nemaune nevasungwa. Miviri yakawanda yekumwe mitezo yakareba uye yakakura, yakaoma kupfuudza mukiriya, uye inogona kukwenya nyore nyore mucous membrane. Zvinokurudzirwa kushandisa makondomu zvakasanganiswa neyekuzano-mazino ekubvisa miviri yekune dzimwe nyika pasi pekuongororwa kweDegoscopic. Kutanga, isa zino-zino-zino rakanyoreswa mumugumo wekupedzisira weEndoscope kuburikidza neye endoscopic biopsy gomba. Shandisa iyo rat-zino herthps kuti clamp iyo rabbar mhete pasi pekondomu. Zvadaro, dzora zino ratano-zino kune iyo biopsy gomba kuitira kuti kureba kwemakondomu kunofumurwa kunze kweiyo biopsy gomba. Kuderedza zvakanyanya sezvinobvira pasina kukanganisa munda wekuona, uye wozoisa mune gastric cavity pamwe ne endoscope. Mushure mekuwana muviri wekunze, isa muviri wekunze mukondomu. Kana zvakaoma kubvisa, kuisa kondomu mune gastom yemukati, uye shandisa mazino ezvekunze muviri wacho uye uise macondom.
4.10 matombo emudumbu
Gastroliths yakakamurwa kuita miriwo gastroliths, gastroliths, inodhonzwa zvinodhaka gastroliths uye gastdroliths. Zvirimwa zveGastliths zvinonyanya kuitika, kazhinji zvinokonzerwa nekudya huwandu hwendicho dzerutsi, dzinogara, misi yechando, mapeya, celyry, kelp, uye conconuts padumbu risina chinhu. Inokonzerwa neEtc 1 yakavakirwa gastroliths yakadai sePersimmons, hawthorns, uye jujubes ine tannic acid, petin, uye gamu. Pasi pechiitiko cheGastric acid, mvura-insoluble tannic acid protein, iyo inosungirwa petactin, gamu, chirimwa fiber, peel, uye musimboti. Matombo emudumbu.
Matombo egastric anowedzera kudzvinyirira pamadziro emudumbu uye kukurudzira yakawedzera gastric acid secretion, iyo inogona kukonzera kurira kwegastric mucosal, maronda uye kunyange kutsikisa. Diki, matombo akapfava anokwanisa kunyungudutswa neSodium Bicarbonate uye zvimwe zvinodhaka uye ndokubvumidzwa kuve nekubviswa pachena.
Kune varwere vanotadza kurapwa kurapwa, endoscopic dombo kubvisa sarudzo yekutanga (Mufananidzo 8). Kune matombo emagetsi akaoma kubvisa zvakananga pasi peEndoscopy nekuda kwehukuru hwavo, mauto ekunze emuviri, misungo, etc. Kune avo vane chimiro chakaoma chisingagoni kupwanywa, kutemwa kwemabwe anokwanisa kutariswa, Laser lithotripy kurapwa, kana dombo remagetsi rapfuura, shandisa mativi matatu-claw. Chenjera chinofanira kutorwa kuti udzivise mabwe akakura kupfuura 2CM kubva pakudzingwa mumatumbu emukati kuburikidza nedumbu uye zvichikonzera kubatwa kwemukati.
Mufananidzo 8 mabwe mudumbu
4.11 bhegi rezvinodhaka
Iko kubvutuka kwebhegi remishonga kuchaisa njodzi inouraya uye inokanganisa kurapwa kweEndoscopic. Varwere vasingakwanise kuburitsa zvakasikwa kana kuti avo vanofungidzirwa kuve nehombodo yemishonga inokosirwa vanofanira kushingairira kuvhiyiwa.
III. Zvinetso uye Kurapa
Zvinetso zvemuviri wekunze zvine chekuita nechimiro, chimiro, nguva yekugara uye chikamu chechiremba. Zvinetso chikuru chinosanganisira esopophaal kukuvara kwemubhadharo, kubuda ropa, uye hutachiona hwehutachiona.
Kana iyo yekune imwe nyika idiki uye hapana kana isina kubikwa mucosal kukuvara kana yatorwa, muchipatara hazvidiwe mushure mekuvhiya, uye chikafu chakapfava chinogona kuteverwa mushure mekutsanya kwemaawa matanhatu.Kune varwere vane Esophageal mucosal kukuvara. Kana zvichidikanwa, kutsanya uye kupararira hutano kunogona kupihwa.
Kune varwere vane vaoneki emuchagetsi kukuvara uye kubuda ropa.
Kune varwere vane ruzivo rweCT vanoratidza kuti mutumbi wekunze wakapinda mumadziro enguva yeEsophageal mushure mekubviswa kwekupedzisira, kana iyo yekune dzimwe nyika ichiramba isingasviki maawa makumi maviri nemana uye ct inowana kuumbwa kwekuisa kunze kwespophaal luemen, edoscopic kurapwa kunogona kuitwa zvakananga. Mushure mekunge mutumbi wekunze abviswa kuburikidza neEndoscope, Clip titanium inoshandiswa kuchinjisa rusvingo rwemukati rwesipopus panzvimbo yeiyo yefari, iyo inogona kumisa kubuda ropa uye kuvhara madziro emukati yeephagus panguva imwe chete. A gastric tube uye jejunal yekudyisa tube inoiswa pasi pechiratidzo chakananga yeEndoscope, uye murwere ari muchipatara kuti arambe achirapwa. Kurapa kunosanganisira kurapwa kwakadai sekutsanya, kushungurudzika kwegastrointing, mishonga inorwisa mabhakitiriya uye zvinovaka. Panguva imwecheteyo, zviratidzo zvakakosha senge tembiricha zvinofanirwa kunyatsoonekwa, uye kuitika kwemanzwiro akadai seyemurogiramu kana yemuteMpsina emapaya anofanira kucherechedzwa pazuva rechitatu mushure mekuvhiyiwa. Mushure mekunge Iodine mvura Angiography inoratidza kuti hapana kudzikisira, kudya uye kunwa kunogona kubvumidzwa.
Kana iyo yekune dzimwe nyika yachengetwa kweanopfuura maawa makumi maviri nemana, kana hutachiona hwehushe, uye ct zvakanyanyisa kugadzirwa kweiyo esophagus, kana kuti kana matambudziko akanyanya kuitika, varwere vanofanira kutamiswa kuti vabatwe pakurapwa nenzira yakakodzera.
Iv. Zvekungwaririra
. Naizvozvo, emergency endoscopic kupindira kunonyanya kukosha.
. Zviri nani kutsvaga kutaurirana muMizinda wepamusoro uye kugadzirira kwekuvhiyiwa.
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Edukuraswa kwehunyanzviInoshandiswa pamwe chete neyenzizi endoscopes, achipinda mumuviri wemunhu wemunhu seyekufevedzana, dumbu nezvimwe zvekuita nematehwe, kubatwa nematombo, matombo nenyaya uye zvekunze uye kutora matende.
Kutumira Nguva: Jan-26-2024