I. Kugadzirira kwemurwere
1. Kunzwisisa nzvimbo, hunhu, saizi uye kubooka kwezvinhu zvekunze
Tora maX-ray kana maCT scans emutsipa, chipfuva, anteroposterior uye lateral views, kana dumbu sezvinodiwa kuti unzwisise nzvimbo, hunhu, chimiro, saizi, uye kuvapo kweboore remuviri wekunze, asi usaite barium swallow test.
2. Nguva yekutsanya nekunwa mvura
Kazhinji, varwere vanotsanya kwemaawa matanhatu kusvika masere kuti vabvise zviri mudumbu, uye nguva yekutsanya nekunwa mvura inogona kuzorora zvakakodzera kuti vaongororwe gastroscopy nekukurumidza.
3. Rubatsiro rweanesthesia
Vana, avo vane matambudziko epfungwa, avo vasingashande pamwe chete, kana avo vane mitumbi yekune dzimwe nyika yakavharirwa, mitumbi mikuru yekune dzimwe nyika, mitumbi yakawanda yekune dzimwe nyika, mitumbi yekune dzimwe nyika yakapinza, kana kuvhiyiwa kwe endoscopic kwakaoma kana kutora nguva yakareba vanofanira kuvhiyiwa pasi peanesthesia kana endotracheal intubation nerubatsiro rweanesthesia. Bvisa zvinhu zvekune dzimwe nyika.
II. Kugadzirira michina
1. Sarudzo yeEndoskopu
Mhando dzese dze gastroscopy dzinoonekwa mberi dziripo. Kana zvichifungidzirwa kuti zvakaoma kubvisa mutumbi wekunze kana kuti mutumbi wekunze wakakura, gastroscopy yekuvhiya ine mativi maviri inoshandiswa. Endoscopes ine dhayamita diki yekunze inogona kushandiswa kuvacheche nevana vadiki.
2. Kusarudzwa kweforceps
Zvinonyanya kuenderana nehukuru uye chimiro chemuviri wekunze. Zvishandiso zvinowanzoshandiswa zvinosanganisira biopsy forceps, snare, three-jaw forceps, flat forceps, foreign body forceps (makonzo-tooth forceps, jaw-mouth forceps), bhasikiti rekubvisa matombo, bhegi rekubvisa matombo, nezvimwewo.
Sarudzo yemudziyo inogona kusarudzwa zvichienderana nehukuru, chimiro, rudzi, nezvimwewo zvemuviri wekunze. Sekureva kwezvinyorwa, maforceps emazino egonzo ndiwo anonyanya kushandiswa. Mwero wekushandiswa kweforceps yemazino egonzo i24.0% ~ 46.6% yezvese zvinoshandiswa, uye mastraps anoumba 4.0% ~ 23.6%. Kazhinji zvinotendwa kuti mastraps akanakira mitumbi mirefu yakaita setsvimbo. Zvakadai sema thermometers, mabhurashi emazino, zvimiti zvebamboo, mapeni, zvipunu, nezvimwewo, uye nzvimbo yemugumo wakafukidzwa nesnare haifanirwe kudarika 1cm, zvikasadaro zvichave zvakaoma kubuda mucardia.
2.1 Mitumbi yekunze yakaita setsvimbo uye miviri yekunze yakaita sedenderedzwa
Kune zvinhu zvekunze zvakaita setsvimbo zvine pamusoro wakatsetseka uye dhayamita yekunze yakatetepa senge toothpicks, zviri nyore kusarudza tambo dzine shaya nhatu, tambo dzine mbeva, tambo dzakatsetseka, nezvimwewo; kune zvinhu zvekunze zvakatenderera (senge macores, magirazi, mabhatiri emabhatani, nezvimwewo), shandisa bhasikiti rekubvisa matombo kana bhegi rekubvisa matombo kuti ubvise. Zvakaoma kubvisa.
2.2 Miviri mirefu yakapinza yekunze, masumbu ezvekudya, uye matombo makuru mudumbu
Kune mitumbi mirefu yakapinza yekunze, denderedzwa refu remuviri wekunze rinofanira kunge rakafanana nedenderedzwa refu relumen, mugumo wakapinza kana mugumo wakavhurika wakatarisa pasi, uye uchidzoka uchipinza mweya. Kune mitumbi yekunze yakaita sedenderedzwa kana mitumbi yekunze ine maburi, zvakachengeteka kushandisa nzira yekubatanidza shinda kuti uibvise;
Pamasumbu echikafu nematombo makuru mudumbu, mafosi ekurumwa anogona kushandiswa kuapwanya uye obva abviswa nefosi dzeshaya nhatu kana musungo.
3. Midziyo yekudzivirira
Shandisai michina yekudzivirira zvakanyanya sezvinobvira pazvinhu zvisiri zvekunze zvakaoma kubvisa uye zvine njodzi. Parizvino, michina yekudzivirira inoshandiswa zvakanyanya inosanganisira zvivharo zvinoonekera, machubhu ekunze, uye zvivharo zvekudzivirira.
3.1 Chivharo chinoonekera
Munguva yekubvisa muviri wekunze, chivharo chinoonekera chinofanira kushandiswa kumagumo kwelenzi ye endoscopic zvakanyanya sezvinobvira kudzivirira mucosa kuti isakwekwe nemuviri wekunze, uye kuwedzera gumbo remudumbu kuderedza kuramba kunosangana nemuviri wekunze kana wabviswa. Zvinogonawo kubatsira kubata nekubvisa muviri wekunze, izvo zvinobatsira pakubvisa muviri wekunze.
Kune mitumbi yekunze yakaita semitsetse iri mudumbu remudumbu kumativi ese egurokuro, chivharo chinoonekera chinogona kushandiswa kusundidzira zvinyoro nyoro gurokuro kumucheto mumwe wedumbu rekunze kuitira kuti mugumo mumwe wemuviri wekunze ubude mumadziro edumbu remudumbu kudzivirira kubooka kwedumbu kunokonzerwa nekubviswa zvakananga.
Chivharo chinoonekera chinogonawo kupa nzvimbo yakakwana yekushanda kwechishandiso ichi, izvo zviri nyore kuona nekubvisa mitumbi yekunze muchikamu chakamanikana chemutsipa wegurokuro.
Panguva imwe chete, chivharo chinoonekera chinogona kushandisa kusveta chikafu zvisina simba kuti chibatsire kusveta masumbu echikafu uye kuita kuti chigadzirwe zvakanaka.
3.2 Kesi yekunze
Ukuwo ichidzivirira gumbo remudumbu nedumbu, chubhu yekunze inobatsira kubviswa kwemuviri murefu, wakapinza, uye wakawanda wekunze kwemuviri nekubvisa maburi echikafu, nokudaro ichideredza kuwanda kwematambudziko panguva yekubvisa muviri wekunze wemudumbu wepamusoro. Wedzera kuchengetedzeka uye kushanda zvakanaka kwekurapa.
Machubhu epamusoro haawanzo shandiswa kuvana nekuda kwenjodzi yekukuvadza gumbo panguva yekuiswa.
3.3 Chifukidziro chekudzivirira
Isa chifukidziro chekudzivirira chakatarira pasi kumucheto wepamberi pe endoscope. Mushure mekusunga chinhu chekunze, tenderedza chifukidziro chekudzivirira woputira chinhu chekunze paunenge uchibvisa endoscope kudzivirira zvinhu zvekunze.
Inosangana nemukati memudumbu uye inoita basa rekudzivirira.
4. Nzira dzekurapa mhando dzakasiyana dzemitumbi yekunze mudumbu repamusoro
4.1 Mashesi ezvekudya mugurokuro
Mishumo inoratidza kuti chikafu chidiki chiri mugurokuro chinogona kusundirwa zvinyoro nyoro mudumbu chosiyiwa kuti chibudiswe zviri zvega, izvo zviri nyore, zviri nyore uye zvisingawanzo kukonzera matambudziko. Munguva yekufambira mberi kwegastroscopy, inflation yakakodzera inogona kuiswa mugurokurokuro, asi vamwe varwere vanogona kunge vaine bundu remudumbu kana post-esophageal anastomotic stenosis (Mufananidzo 1). Kana paine kuramba uye ukasundidzira zvine simba, kudzvanya zvakanyanya kunowedzera njodzi yekuboorwa. Zvinokurudzirwa kushandisa bhasikiti rekubvisa matombo kana bhegi rekubvisa matombo kuti ubvise zvakananga muviri wekunze. Kana chikafu chikuru, unogona kushandisa forceps yemuviri wekunze, snares, nezvimwewo kuti uchipwanye usati wachipatsanura. Chibvise.
Mufananidzo 1 Mushure mekuvhiyiwa kwegomarara remudumbu, murwere akaperekedzwa nekubikira kwemudumbu uye kuchengetwa kwefood bolus.
4.2 Zvinhu zvipfupi uye zvisina kujeka zvekunze
Miviri mipfupi uye isina kusimba inogona kubviswa kuburikidza nekushandisa forceps yemuviri wekunze, misungo, matengu ekubvisa matombo, mabhegi ekubvisa matombo, nezvimwewo. (Mufananidzo 2). Kana muviri wekunze uri mugurokuro wakaoma kubvisa zvakananga, unogona kusundirwa mudumbu kuti ugadzirise nzvimbo yawo wobva waedza kuubvisa. Miviri mipfupi, isina kusimba ine dhayamita ye>2.5 cm mudumbu yakaoma kupfuura nepakati pe pylorus, uye endoscopic intervention inofanira kuitwa nekukurumidza sezvinobvira; kana miviri yekunze ine dhayamita diki mudumbu kana duodenum isingaratidze kukuvara kwemudumbu, inogona kumirira kubuda kwayo kwechisikigo. Kana ikaramba iripo kweanopfuura mavhiki 3-4 uye ichiri kukwanisa kubudiswa, inofanira kubviswa ne endoscopically.
Mufananidzo 2 Zvinhu zvepurasitiki zvekunze uye nzira dzekubvisa
4.3 Mitumbi yekunze kwenyika
Zvinhu zvekunze zvine hurefu hwe ≥6 cm (zvakaita se thermometers, mabhurashi emazino, zvimiti zvebamboo, mapeni, zvipunu, nezvimwewo) hazvisi nyore kubudiswa muzvinhu zvega, saka zvinowanzounganidzwa nebhasikiti remusungo kana dombo.
Musungo unogona kushandiswa kufukidza mugumo mumwe (kwete kupfuura 1 cm kubva kumugumo), woiswa muvharo rinoonekera kuti ubudiswe. Mudziyo wekunze we cannula unogona kushandiswawo kubata muviri wekunze wobva wadzokera zvakanaka mu cannula yekunze kudzivirira kukuvadza mucosa.
4.4 Zvinhu zvekunze zvakapinza
Zvinhu zvakapinza zvekune dzimwe nyika zvakaita semapfupa ehove, mapfupa ehuku, mazino ekugadzira, maburi emuti, matoothpicks, mapaper clips, razor blades, uye mapill tin box wrappers (Mufananidzo 3) zvinofanira kutarisirwa zvakakwana. Zvinhu zvakapinza zvekune dzimwe nyika zvinogona kukuvadza zviri nyore mucous membranes netsinga dzeropa uye zvinotungamira kumatambudziko akadai sekuboorwa kweropa zvinofanirwa kurapwa nokungwarira. Kutarisirwa kwe endoscopic nekukurumidza.
Mufananidzo 3 Mhando dzakasiyana dzezvinhu zvakapinza zvekune dzimwe nyika
Pakubvisa mitumbi yekunze yakapinza pasi pemugumoscope, zviri nyore kukwenya mucosa yemudumbu. Zvinokurudzirwa kushandisa chivharo chinopenya, chinogona kuburitsa pachena lumen uye kudzivirira kukwenya madziro. Edza kuunza mugumo wakagomara wemuviri wekunze pedyo nemugumo we lenzi ye endoscopic kuitira kuti mugumo mumwe wemuviri wekunze uiswe. Isa muvharo rinopenya, shandisa forceps yemuviri wekunze kana musungo kuti ubate muviri wekunze, wobva waedza kuchengetedza axis refu yemuviri wekunze yakafanana ne esophagus usati wabuda kubva pa scope. Miviri yekunze iri mune rimwe divi re esophagus inogona kubviswa nekuisa chivharo chinopenya kumucheto wepamberi we endoscope wopinda zvishoma nezvishoma mu esophageal inlet. Kune miviri yekunze iri mu esophageal cavity kumativi ese, mugumo usina kudzika unofanira kutanga wasunungurwa, kazhinji Padivi reproximal, dhonza rimwe mugumo, gadzirisa kutungamira kwechinhu chekunze kuitira kuti mugumo wemusoro ubatanidzwe muvharo rinopenya, wobva wabvisa. Kana mushure mekushandisa banga relaser kucheka muviri wekunze uri pakati, ruzivo rwedu nderokusunungura aortic arch kana divi remoyo kutanga, tobva tabvisa zvishoma nezvishoma.
a. Mazino emazino: Pakudya, pakukosora, kana pakutaurag, varwere vanogona kudonha netsaona kubva pamazino avo emazino, vozopinda mudumbu repamusoro vachimedza. Mazino emazino akapinza ane simbi kumativi ese ari maviri ari nyore kuaisa mumadziro edumbu, zvichiita kuti kubviswa kwacho kuve kwakaoma. Kune varwere vanokundikana kurapwa kwe endoscopic, zvishandiso zvakawanda zvekusunga zvinogona kushandiswa kuedza kubvisa pasi pe dual-channel endoscopy.
b. Makomba ezuva: Makomba ezuva anowanikwa mugurokuro anowanzova akapinza kumativi ese, izvo zvinogona kukonzera matambudziko akadai sekukuvadzwa kwemucosale, kubuda ropa, hutachiona hwemudumbu uye kubooka kwenguva pfupi, uye zvinofanirwa kurapwa nekurapwa kwe endoscopic nekukurumidza (Mufananidzo 4). Kana pasina kukuvara kwemudumbu, matombo mazhinji edate ari mudumbu kana duodenum anogona kuburitswa mukati memaawa makumi mana nemasere. Avo vasingakwanise kuburitswa nemazvo vanofanira kubviswa nekukurumidza sezvinobvira.
Mufananidzo 4: Musoro weJujube
Mushure memazuva mana, murwere akaonekwa aine muviri wekunze mune chimwe chipatara. CT yakaratidza muviri wekunze mugurokuro uine maburi. Matumbu ejujube akapinza kumativi ese akabviswa ne endoscopy uye gastroscopy yakaitwa zvakare. Zvakaonekwa kuti fistula yakaumbwa pamadziro egurokuro.
4.5 Zvinhu zvikuru zvekunze zvine mipendero mirefu nemipendero yakapinza (Mufananidzo 5)
a. Isa chubhu yekunze pasi pe endoscope: Isa gastroscope kubva pakati pechubhu yekunze, kuitira kuti mupendero wepazasi wechubhu yekunze uve pedyo nemupendero wepamusoro wechikamu chakakombama chegastroscope. Isa gastroscope nguva dzose pedyo nemuviri wekunze. Isa zvishandiso zvakakodzera kuburikidza nechubhu ye biopsy, senge snares, forceps yemuviri wekunze, nezvimwewo. Mushure mekubata chinhu chekunze, chiise muchubhu yekunze, uye mudziyo wese uchabuda pamwe chete negirazi.
b. Chifukidziro chekudzivirira cheganda remucous chakagadzirwa kumba: Shandisa chifukidziro chegunwe rerabha rekurapa kugadzira chifukidziro chekudzivirira che endoscope chakagadzirwa kumba. Chicheke nepakati pemudzi wechigunwe chegirovhosi kuita bharumu. Cheka buri diki pamunwe, wobva wapfuudza mugumo wemuviri wegirazi nepaburi diki. Shandisa rin'i diki yerabha kuti uigadzire iri 1.0cm kubva kumucheto wepamberi wegastroscope, woidzosera kumucheto wepamusoro wegastroscope, woitumira pamwe chete negastroscope kumuviri wekunze. Bata muviri wekunze wobva waubvisa pamwe chete negastroscope. Chifukidziro chichafamba zvakananga kumuviri wekunze nekuda kwekusagadzikana. Kana divi rikadzokera shure, richaputirwa nezvinhu zvekunze kuti ridzivirirwe.
Mufananidzo 5: Mapfupa ehove akapinza akabviswa ne endoscopically, nekukwenya mucosal
4.6 Zvinhu zvesimbi zvekunze kwenyika
Kuwedzera kune forceps dzechinyakare, simbi dzinogona kubviswa nekusveta ne magnetic foreign body forceps. Metallic foreign body ine njodzi kana yakaoma kubvisa inogona kurapwa ne endoscopically pasi pe X-ray fluoroscopy. Zvinokurudzirwa kushandisa bhasikiti rekubvisa matombo kana bhegi rekubvisa matombo.
Mari dzesimbi dzinowanikwa zvakanyanya pakati pemitumbi yekunze iri mudumbu revana (Mufananidzo 6). Kunyangwe mari zhinji dziri mugurokuro dzichigona kupfuudzwa nenzira yechisikigo, kurapwa kwe endoscopic kunokurudzirwa. Nekuti vana havashande pamwe chete, kubviswa kwemitumbi yekunze muvana kunoitwa zvakanaka pasi peanesthesia. Kana mari yacho yakaoma kubvisa, inogona kusundirwa mudumbu yozoburitswa. Kana pasina zviratidzo mudumbu, unogona kumirira kuti ibudiswe nenzira yechisikigo. Kana mari yacho ikaramba iripo kweanopfuura mavhiki matatu kusvika mana uye isina kuburitswa, inofanira kurapwa ne endoscopic.
Mufananidzo 6 Mari yesimbi yezvinhu zvekunze kwenyika
4.7 Zvinhu zvinoparadza zvekunze kwenyika
Mitumbi yekunze inoparadza inogona kukonzera kukuvara kwemudumbu kana kutoita kuti pave necrosis. Kurapwa nekukurumidza kunodiwa mushure mekuongororwa. Mabhatiri ndiwo anonyanya kukonzera kukuvara kwekunze uye anowanzoonekwa muvana vari pasi pemakore mashanu (Mufananidzo 7). Mushure mekukuvadza gumbo, anogona kukonzera stenosis yegumbo. Endoscopy inofanira kuongororwa mukati memavhiki mashoma. Kana stricture ikaitika, gumbo rinofanira kuvhurwa nekukurumidza.
Mufananidzo 7 Chinhu chekunze chiri mubhatiri, museve mutsvuku unoratidza nzvimbo yechinhu chekunze
4.8 Zvinhu zvekunze zvine magineti
Kana paine magineti akawanda kana magineti anowanikwa pamwe chete nesimbi mudumbu repamusoro, zvinhu izvi zvinokwezvana uye zvinodzvanya madziro edumbu, izvo zvinogona kukonzera ischemic necrosis, kuumbwa kwefistula, kubooka, kuvharika, peritonitis nezvimwe kukuvara kwakakomba mudumbu. , zvinoda kurapwa kwe endoscopic nekukurumidza. Zvinhu zvekunze zvine magineti zvinofanirawo kubviswa nekukurumidza sezvinobvira. Kuwedzera kune magineti akajairika, magineti anowanikwa anogona kubviswa achisvetwa ne magnetic foreign body forceps.
4.9 Miviri yekunze mudumbu
Mazhinji acho ma lighters, waya dzesimbi, zvipikiri, nezvimwewo zvinomedzwa nemaune nevasungwa. Miviri mizhinji yekunze yakareba uye yakakura, yakaoma kupfuura nepakati pe cardia, uye inogona kukwenya mucous membrane zviri nyore. Zvinokurudzirwa kushandisa makondomu pamwe chete ne forceps dzemazino egonzo kubvisa mitumbi yekunze uchiongororwa ne endoscopic. Kutanga, isa forceps dzemazino egonzo kumberi kwe endoscope kuburikidza ne endoscopic biopsy buri. Shandisa forceps dzemazino egonzo kuti ubate rin'i yerabha iri pasi pekondomu. Wobva wadzosera forceps dzemazino egonzo kuburi re biopsy kuitira kuti kureba kwekondomu kuonekwe kunze kweburi re biopsy. Deredza zvakanyanya sezvinobvira usingakanganisi nzvimbo yekuona, wobva waiisa mudumbu pamwe chete ne endoscope. Mushure mekuona muviri wekunze, isa muviri wekunze mukondomu. Kana zvakaoma kubvisa, isa kondomu mudumbu, uye shandisa forceps dzemazino egonzo kuti ubate muviri wekunze woiisa. Mukati mekondomu, shandisa pliers dzemazino egonzo kuti ubate kondomu woibvisa pamwe chete negirazi.
4.10 Matombo emudumbu
Magastrolith akakamurwa kuita magastrolith emuriwo, magastrolith emhuka, magastrolith anokonzerwa nemishonga uye magastrolith akasanganiswa. Magastrolith emuriwo ndiwo anonyanya kukonzerwa nekudya mapersimmons akawanda, hawthorns, winter dates, mapichisi, celery, kelp, uye coconut mudumbu musina chinhu. Zvinokonzereswa nezvimwe. Magastrolith emiti akadai sepersimmons, hawthorns, uye jujubes ane tannic acid, pectin, uye chingamu. Pasi pesimba re gastric acid, tannic acid protein isinganyunguduke mumvura inoumbwa, iyo inosunga kune pectin, chingamu, plant fiber, peel, uye core. Matombo emudumbu.
Matombo emudumbu anomanikidza madziro emudumbu uye anokurudzira kuwedzera kweacid yemudumbu, izvo zvinogona kukonzera kukurwa kwemucosal yemudumbu, maronda uye kutoboorwa. Matombo madiki, akapfava emudumbu anogona kunyungudutswa nesodium bicarbonate nemimwe mishonga uye obva abvumirwa kubudiswa ega.
Kune varwere vanokundikana kurapwa, kubviswa kwematombo e endoscopic ndiyo sarudzo yekutanga (Mufananidzo 8). Kune matombo emudumbu akaoma kubvisa zvakananga uchishandisa endoscopy nekuda kwehukuru hwawo, forceps yemuviri wekunze, snares, mabhasikiti ekubvisa matombo, nezvimwewo zvinogona kushandiswa kupwanya matombo zvakananga wozoabvisa; kune avo vane magadzirirwo akaomarara asingakwanise kupwanywa, kucheka matombo e endoscopic kunogona kufungwa nezvawo, Laser lithotripsy kana high-frequency electric lithotripsy kurapwa, kana dombo remudumbu riri pasi pe2cm mushure mekutyoka, shandisa three-claw forceps kana foreign body forceps kuti uribvise zvakanyanya sezvinobvira. Kungwarira kunofanira kutorwa kudzivirira matombo akakura kupfuura 2cm kuti asaburitswe mudumbu nemudumbu zvichikonzera kuvharika kwemudumbu.
Mufananidzo 8 Matombo mudumbu
4.11 Bhegi reMishonga
Kuputika kwebhegi remushonga kuchakonzera njodzi inouraya uye hazvibvumirwi kurapwa ne endoscopic. Varwere vasingakwanisi kubuda ropa ravo vega kana kuti vanofungidzirwa kuti vakaputika bhegi remushonga vanofanira kuvhiyiwa.
III. Matambudziko nekurapwa
Matambudziko emuviri wekunze ane chekuita nehunhu, chimiro, nguva yekugara uye mwero wekuvhiyiwa kwachiremba. Matambudziko makuru anosanganisira kukuvara kwemudumbu, kubuda ropa, uye hutachiona hwakaboorwa.
Kana mutumbi wekunze uri mudiki uye pasina kukuvara kuri pachena kweganda kana wabviswa, hazvidikanwi kuti munhu apinde muchipatara mushure mekuvhiyiwa, uye kudya kwakapfava kunogona kuteverwa mushure mekutsanya kwemaawa matanhatu.Kune varwere vane kukuvara kwemudumbu, glutamine granules, aluminium phosphate gel nezvimwe zvinodzivirira mucosal zvinogona kurapwa nezviratidzo. Kana zvichidikanwa, kutsanya uye kudya kunovaka muviri kunogona kupihwa.
Kune varwere vane kukuvara kuri pachena kwemucosal uye kubuda ropa, kurapwa kunogona kuitwa nekuona zvakananga kwe endoscopic, sekupfapfaidza ne ice-cold saline norepinephrine solution, kana endoscopic titanium clips kuvhara ronda.
Kune varwere vane CT vasati vavhiyiwa inoratidza kuti muviri wekunze wapinda mumadziro egurokuro mushure mekubviswa kwe endoscopic, kana muviri wekunze ukaramba uripo kwemaawa asingasviki makumi maviri nemana uye CT isingaonekwe kuti ibundu riri kunze kwegumbeze remudumbu, kurapwa kwe endoscopic kunogona kuitwa zvakananga. Mushure mekunge muviri wekunze wabviswa kuburikidza ne endoscope, titanium clip inoshandiswa kusungira rusvingo rwemukati megumbeze panzvimbo yakaboorwa, iyo inogona kumisa kubuda ropa uye kuvhara rusvingo rwemukati megumbeze panguva imwe chete. Chubhu yemudumbu nechubhu yekudyisa jejunal zvinoiswa pasi pekuona zvakananga kwe endoscope, uye murwere anoendeswa kuchipatara kuti arambe achirapwa. Kurapa kunosanganisira kurapwa kwezviratidzo zvakaita sekutsanya, kubvisa kumanikidzwa kwemudumbu, mishonga inorwisa mabhakitiriya uye kudya kunovaka muviri. Panguva imwe chete, zviratidzo zvakakosha zvakaita sekupisa kwemuviri zvinofanirwa kucherechedzwa zvakanyanya, uye kuitika kwematambudziko akadai semutsipa subcutaneous emphysema kana mediastinal emphysema kunofanirwa kuonekwa pazuva rechitatu mushure mekuvhiyiwa. Mushure mekunge iodine water angiography yaratidza kuti hapana kubuda kwemvura, kudya nekunwa zvinogona kubvumidzwa.
Kana muviri wekunze wakachengetwa kwemaawa anopfuura makumi maviri nemana, kana zviratidzo zvehutachiona zvakaita sefivha, dzihwa, uye huwandu hwakakwira hwemasero machena eropa zvikaitika, kana CT ikaratidza kuumbwa kwebundu riri kunze kwegurokuro, kana kana paine matambudziko akakomba, varwere vanofanira kutamisirwa kunovhiyiwa kuti varapwe nenguva.
IV. Kuchenjerera
(1) Kana muviri wekunze ukagara kwenguva yakareba mugurokuro, kuvhiyiwa kwacho kunowedzera kuoma uye matambudziko akawanda achaitika. Saka, kupindira kwe endoscopic nekukurumidza kunonyanya kukosha.
(2) Kana muviri wekunze uri mukuru, usina chimiro chakanaka kana kuti une mitsipa, kunyanya kana muviri wekunze uri pakati pegurokuro uye uri pedyo neaortic arch, uye zvakaoma kuubvisa ne endoscopic, usaubvise nechisimba. Zviri nani kutsvaga rubatsiro rwenyanzvi dzakasiyana-siyana uye kugadzirira kuvhiyiwa.
(3) Kushandisa zvine musoro zvishandiso zvekudzivirira gumbo kunogona kuderedza kuitika kwematambudziko.
Yedusimba rekubata rinoraswaInoshandiswa pamwe chete nema endoscope akapfava, ichipinda mumuviri wemunhu zvakaita senzira yekufema, gumbo, dumbu, ura nezvimwewo kuburikidza ne endoscope channel, kubata matishu, matombo nezvimwe zvinhu pamwe nekubvisa stent.
Nguva yekutumira: Ndira-26-2024