I.Kugadzirira kwevarwere
1. Nzwisisa nzvimbo, hunhu, ukuru uye kuboora kwezvinhu zvekunze
Tora pachena X-rays kana CT scans yemutsipa, chifuva, anteroposterior uye lateral maonero, kana dumbu sezvinodiwa kuti unzwisise nzvimbo, chimiro, chimiro, ukuru, uye kuvapo kwekuputika kwemuviri wekunze, asi usaite barium kumedza. kuongorora.
2. Nguva yekutsanya nemvura yekutsanya
Nguva nenguva, varwere vanotsanya kwemaawa matanhatu kusvika masere kuti vabudise zviri mukati memudumbu, uye nguva yekutsanya uye yekutsanya kwemvura inogona kuzorora zvakakodzera kune emergency gastroscopy.
3. Anesthesia rubatsiro
Vana, avo vane dambudziko repfungwa, vasina kubatana, kana avo vane miviri yekunze yakavharirwa, miviri mikuru yekunze, miviri yekunze yakawanda, miviri yekunze yakapinza, kana endoscopic operation yakaoma kana kutora nguva yakareba inofanira kuvhiyiwa pasi peanesthesia kana endotracheal. intubation nerubatsiro rweanesthesiologist.Bvisa zvinhu zvekunze.
II.Kugadzirira kwemidziyo
1. Endoscope kusarudzwa
Mhando dzose dzekutarisa mberi gastroscopy dziripo.Kana zvichifungidzirwa kuti zvakaoma kubvisa mutumbi wekunze kana mutumbi wekunze wakakura, kaviri-port surgical gastroscopy inoshandiswa.Endoscopes ine dhayamita diki yekunze inogona kushandiswa kune vacheche nevana vadiki.
2. Kusarudzwa kwemasimba
Kunyanya zvinoenderana nehukuru uye chimiro chemuviri wekunze.Zviridzwa zvinowanzo shandiswa zvinosanganisira biopsy forceps, musungo, matatu-shaya forceps, flat forceps, ekunze body forceps (makonzo-zino forceps, jaw-mouth forceps), basket rekubvisa dombo, dombo rekubvisa mambure bhegi, nezvimwe.
Kusarudzwa kwechiridzwa kunogona kusarudzwa zvichienderana nehukuru, chimiro, rudzi, nezvimwe zvemuviri wekunze.Maererano nezvinyorwa zvinyorwa, makonzo-mazino forceps ndiwo anonyanya kushandiswa.Chiyero chekushandiswa kwegonzo-zino forceps ndeye 24.0% ~ 46.6% yezviridzwa zvese zvinoshandiswa, uye misungo inotora 4.0% ~ 23.6%.Zvinowanzotendwa kuti misungo iri nani kune miviri yekunze yakaita setsvimbo yakareba.Zvakadai sema thermometers, mabhurashi emazino, bamboo chopsticks, mapeni, zvipunu, nezvimwewo, uye nzvimbo yekupedzisira yakafukidzwa nemusungo haifanire kudarika 1cm, zvikasadaro zvichave zvakaoma kubuda mucardia.
2.1 Mitumbi yekunze yakaita setsvimbo uye miviri yekunze yakatenderera
Kune zvinhu zvekunze zvakaita setsvimbo zvine nzvimbo yakatsetseka uye yakatetepa yekunze dhayamita senge mazino, zviri nyore kusarudza matatu-shaya pliers, makonzo-mazino pliers, flat pliers, nezvimwewo;kune spherical yekunze zvinhu (senge macores, girazi mabhora, mabhatani mabhatiri, etc.), shandisa dombo rekubvisa tswanda kana dombo rekubvisa mambure bhegi kuti uzvibvise Zvinetse kutsvedza.
2.2 Mitumbi mirefu yakapinza yekunze, matumbu ezvokudya, nematombo makuru mudumbu
Kune miviri mirefu yakapinza yekunze, iyo axis refu yemuviri wekune imwe nyika inofanirwa kuenderana neiyo longitudinal axis ye lumen, ine yakapinza magumo kana yakavhurika magumo yakatarisa pasi, uye ichibvisa uchibaya mhepo.Kune miviri yekunze yakaita serin'i kana mitumbi yekunze ine maburi, zvakachengeteka kushandisa nzira yekuabvisa;
Pazviputi zvechikafu nematombo akakura ari mudumbu, simba rekurumwa rinogona kushandiswa kuapwanya uye ozobviswa nechisimba cheshaya nhatu kana musungo.
3. Midziyo yekudzivirira
Shandisa zvidziviriro zvakanyanya sezvinobvira kune zvinhu zvekunze zvakaoma kubvisa uye zvine ngozi.Parizvino, zvidziviriro zvinowanzoshandiswa zvinosanganisira zvivharo zvinoonekera, machubhu ekunze, uye zvivharo zvekudzivirira.
3.1 Transparent cap
Munguva yekubviswa kwemuviri wekunze, chivharo chinoonekera chinofanirwa kushandiswa kumagumo endoscopic lens zvakanyanya sezvinobvira kudzivirira mucosa kubva pakukwenywa nemuviri wekunze, uye kuwedzera esophagus kuderedza kupikisa kunosangana kana muviri wekunze. inobviswa.Inogonawo kubatsira kusungirira uye kubvisa mutumbi wekunze, izvo zvinobatsira pakubviswa kwemuviri wekunze.buritsa panze.
Kune miviri yekunze yakamisikidzwa yakamisikidzwa mucosa kumativi ese egurokuro, chivharo chinoonekera chinogona kushandiswa kusundira esophageal mucosa zvinyoro nyoro kumucheto kumwe kwemuviri wekunze kuitira kuti imwe magumo emuviri wekunze abude pasophageal mucosal madziro kuenda. kudzivirira esophageal perforation inokonzerwa nekubviswa kwakananga.
Iyo yakajeka cap inogona kupawo nzvimbo yakakwana yekushanda kwechiridzwa, icho chiri nyore pakuona uye kubviswa kwemitumbi yekunze mune yakamanikana esophageal neck segment.
Panguva imwecheteyo, chivharo chakajeka chinogona kushandisa kudzvinyirirwa kwakashata kubatsira kubata chikafu chekudya uye kufambisa kunotevera kugadzirisa.
3.2 Chivharo chekunze
Nepo kudzivirira esophagus uye esophageal-gastric junction mucosa, yekunze chubhu inofambisa endoscopic kubviswa kwemitumbi yakareba, inopinza, uye yakawanda yekunze uye kubviswa kwezvikafu zvekudya, nekudaro kuderedza kuitika kwematambudziko panguva yekubvisa kwepamusoro kwedumbu rekunze.Wedzera kuchengetedzwa uye kubudirira kwekurapa.
Overtubes haawanzo kushandiswa muvana nekuda kwengozi yekukuvadza esophagus panguva yekuiswa.
3.3 Chivharo chekudzivirira
Isa chivharo chekudzivirira chakatarisa pasi kumucheto wepamberi we endoscope.Mushure mekuvhara chinhu chekunze, flip chivharo chekudzivirira uye kuputira chinhu chekunze paunenge uchibvisa endoscope kudzivirira zvinhu zvekunze.
Inouya inosangana ne mucous membrane yegumbo rekudya uye inoita basa rekudzivirira.
4. Kurapa nzira dzemhando dzakasiyana dzemitumbi yevatorwa munzvimbo yepamusoro yegumbo
4.1 Mazhinji echikafu musophagus
Mishumo inoratidza kuti zvidiki zvidiki zvekudya mugurokuro zvinogona kusundirwa mudumbu zvinyoro nyoro ndokusiiwa kuti zvibudiswe zvega, izvo zviri nyore, zviri nyore uye zvishoma zvingakonzeresa matambudziko.Munguva yekufambira mberi kwegastroscopy, inflation yakakodzera inogona kuunzwa mune esophageal lumen, asi vamwe varwere vanogona kuperekedzwa esophageal malignant tumors kana post-esophageal anastomotic stenosis (Mufananidzo 1).Kana paine kuramba uye ukasunda zvine chisimba, kushandisa kudzvanya kwakawandisa kunozowedzera njodzi yekuboora.Inokurudzirwa kushandisa dombo rekubvisa net basket kana dombo rekubvisa mambure bhegi kuti ubvise zvakananga muviri wekunze.Kana iyo bolus yechikafu yakakura, unogona kushandisa ekunze body forceps, misungo, nezvimwewo kuti uipenye usati waipatsanura.Ibudise.
Mufananidzo 1 Mushure mekuvhiyiwa kwegomarara resophageal, murwere aiperekedzwa esophageal stenosis uye chikafu chekuchengetedza bolus.
4.2 Zvipfupi uye zvakagomara zvinhu zvekunze
Mazhinji mapfupi uye akagomara miviri yekune dzimwe nyika inogona kubviswa kuburikidza nekunze kwemuviri masimba, misungo, mabhasikiti ekubvisa matombo, mabhegi ekubvisa mambure ematombo, nezvimwewo (Mufananidzo 2).Kana mutumbi wekunze uri mugurokuro wakaoma kubvisa zvakananga, unogona kusundidzirwa mudumbu kuti ugadzirise nzvimbo yayo uye woedza kuibvisa.Mitumbi mipfupi, isina kujeka yekunze ine dhayamita ye> 2.5 cm mudumbu yakanyanya kuoma kupfuura nepylorus, uye endoscopic kupindira kunofanira kuitwa nekukurumidza sezvinobvira;kana miviri yekunze ine madhayamita madiki mudumbu kana duodenum isingaratidzi kukuvadzwa kwemudumbu, vanogona kumirira kubuda kwavo kwechisikigo.Kana ikaramba ichigara kwemavhiki anopfuura 3-4 uye haigoni kubudiswa, inofanira kubviswa endoscopically.
Mufananidzo 2 Plastiki yekunze zvinhu uye nzira dzekubvisa
4.3 Mitumbi yekunze
Zvinhu zvekune dzimwe nyika zvine hurefu hwe ≥6 cm (zvakadai sema thermometers, mazino, zvimiti zve bamboo, mapeni, zvipunu, nezvimwewo) hazvisi nyore kubudiswa zvakasikwa, saka zvinowanzounganidzwa nemusungo kana bhasika rematombo.
Musungo unogona kushandiswa kuvhara imwe mugumo (kwete kupfuura 1 cm kubva kumagumo), uye kuiswa muvharo yakajeka kuti ibudise kunze.Chishandiso chekunze che cannula chinogona zvakare kushandiswa kubata mutumbi wekunze uye wozodzokera zvakanaka mu cannula yekunze kudzivirira kukuvadza mucosa.
4.4 Zvakapinza zvinhu zvekunze
Zvinhu zvakapinza zvekune dzimwe nyika zvakaita semapfupa ehove, mapfupa ehuku, mazino emazino, makomba edati, mazino, zvimedu zvemapepa, mareza, nemapepa emabhokisi emabhokisi emapiritsi (Mufananidzo 3) zvinofanirwa kutariswa zvakakwana.Zvakapinza zvinhu zvekune dzimwe nyika zvinogona kukuvadza zviri nyore mucous membranes uye tsinga uye zvinotungamira kumatambudziko senge perforation zvinofanirwa kurapwa nemazvo.Emergency endoscopic manejimendi.
Mufananidzo 3 Mhando dzakasiyana dzezvinhu zvakapinza zvekunze
Pakubvisa miviri yakapinza yekunze pasi pemagumooscope, zviri nyore kukwenya mucosa yemudumbu.Inokurudzirwa kushandisa chivharo chakajeka, chinogona kuburitsa pachena lumen uye kudzivirira kukwenya madziro.Edza kuunza magumo asina kujeka emuviri wekune imwe nyika pedyo nekumagumo endoscopic lens kuitira kuti imwe mugumo wemuviri wekunze uiswe Iise muvharo yakajeka, shandisa simba rekunze remuviri kana musungo kuti ubate muviri wekunze, uye ipapo. edza kuchengetedza longitudinal axis yekunze kwemuviri kuenderana nesophagus usati wabuda kubva pachiyero.Mitumbi yekunze yakamisikidzwa mune rimwe divi regurokuro inogona kubviswa nekuisa chivharo chakajeka kumucheto wepamberi we endoscope uye zvishoma nezvishoma kupinda paguroguro inlet.Kune mitumbi yekunze yakamisikidzwa mumhango yesophageal pamigumo yese, iyo isina kudzika yakamisikidzwa magumo inofanira kusunungurwa kutanga, kazhinji Padivi repamusoro, buritsa imwe magumo, gadzirisa mafambiro echinhu chekunze kuitira kuti musoro unopera ubatanidzwe mune yakajeka. chivharo, uye ubudise kunze.Kana mushure mekushandisa laser banga kucheka muviri wekunze pakati, chiitiko chedu ndechekusunungura aortic arch kana moyo parutivi kutanga, tozoibvisa mumatanho.
a.Dentures: Paunenge uchidya, uchikosora, kana kutaurag, varwere vanogona kudonha netsaona kubva pamazino avo, uye vobva vapinda mudumbu repamusoro nekumedza mafambiro.Mazino akapinza emazino ane simbi kumagumo ari nyore kuiswa mumadziro emudumbu, zvichiita kuti kubvisa kunetse.Kune varwere vanotadza kurapa kwakajairika endoscopic, akawanda clamping zviridzwa zvinogona kushandiswa kuyedza kubviswa pasi pehuviri-chiteshi endoscopy.
b.Date pits: Date makomba akaiswa mugurokuro anowanzo kupinza kumativi ese, izvo zvinogona kutungamirira kumatambudziko akadai semucosal damag.e, kubuda ropa, yeko suppurative utachiona uye perforation munguva pfupi, uye inofanira kurapwa nechimbichimbi endoscopic kurapwa (Figure 4).Kana pasina kukuvara kwepamuviri, mazhinji ematombo edete mudumbu kana duodenum anogona kuburitswa mukati memaawa makumi mana nemasere.Avo vasingagoni kubudiswa nenzira yakasikwa vanofanira kubviswa nokukurumidza sezvinobvira.
Mufananidzo 4 Jujube core
Mazuva mana gare gare, murwere akaonekwa aine muviri wekune imwe nyika mune chimwe chipatara.CT yakaratidza muviri wekune imwe nyika mugurokuro ine perforation.Iyo yakapinza jujube cores pamigumo yese yakabviswa pasi peendoscopy uye gastroscopy yakaitwa zvakare.Zvakaonekwa kuti fistula yakaumbwa pamadziro egurokuro.
4.5 Zvikuru zvekunze zvinhu zvine mipendero yakareba uye inopinza (Mufananidzo 5)
a.Isai chubhu yekunze pasi pe endoscope: Isai gastroscope kubva pakati pechubhu yekunze, kuitira kuti mupendero wepazasi wechubhu yekunze ive pedyo nechekumusoro kwechikamu chakakombama che gastroscope.Gara uchiisa gastroscope pedyo nemuviri wekunze.Isa zviridzwa zvakakodzera kuburikidza nechubhu yebiopsy, semisungo, simba rekunze rekunze, nezvimwewo. Mushure mekubata chinhu chekunze, chiise muchubhu yekunze, uye mudziyo wese uchabuda pamwe negirazi.
b.Homemade mucous membrane inodzivirira kavha: Shandisa chigunwe chivharo chekurapa rubber magurovhosi kugadzira endoscope yekumberi-yekupedzisira yekudzivirira kavha.Icheke pamwe nebevel rechigunwe chegirovhosi kuita chimiro chebhosvo.Cheka gomba diki pamunwe, uye pfuura kumucheto kwemberi kwemuviri wegirazi kuburikidza negomba diki.Shandisa mhete diki yerabha kuti uigadzirise 1.0cm kubva kumucheto wepamberi we gastroscope, uidzosere kumucheto wepamusoro we gastroscope, uye utumire pamwe chete ne gastroscope kune imwe nyika.Bata muviri wekunze uye wozoubvisa pamwe chete ne gastroscope.Iyo sleeve yekudzivirira inozogara ichienda kune yekunze muviri nekuda kwekupokana.Kana gwara rikadzoserwa shure, rinoputirwa nezvinhu zvekunze kuti ridzivirire.
Mufananidzo 5: Mabhonzo ehove akapinza akabviswa endoscopically, ane mucosal scratches
4.6 Metallic kunze kwenyika
Kuwedzera kune akajairwa forceps, simbi yekunze mitumbi inogona kubviswa nekukweva nemagineti yekunze body forceps.Metallic yekunze mitumbi ine ngozi kana yakaoma kubvisa inogona kurapwa endoscopically pasi peX-ray fluoroscopy.Inokurudzirwa kushandisa bhasikiti rekubvisa dombo kana bhegi rekubvisa mambure.
Mari dzesimbi dzinonyanya kuwanda pakati pemiviri yekune dzimwe nyika mudumbu revana (Mufananidzo 6).Kunyange zvazvo mari zhinji musophagus inogona kupfuudzwa nega, elective endoscopic treatment inokurudzirwa.Nemhaka yokuti vana vanobatana zvishoma, kubviswa kwe endoscopic kwemitumbi yekunze muvana kunonyatsoitwa pasi peanesthesia.Kana mari yacho yakaoma kubvisa, inogona kusundidzirwa mudumbu uye yozobudiswa kunze.Kana pasina zviratidzo mudumbu, unogona kumirira kuti ibudiswe zvakasikwa.Kana mari yacho ikasara kwemavhiki anopfuura 3-4 uye isina kudzingwa, inofanira kurapwa endoscopically.
Mufananidzo 6 Mari yesimbi yekunze zvinhu
4.7 Nyaya yekunze inoodza
Mitumbi yekunze inoparadza inogona kukonzeresa zviri nyore kukuvadzwa kwegumbo rekudya kana kunyange necrosis.Emergency endoscopic kurapwa inodiwa mushure mekuongororwa.Mabhatiri ndiwo anonyanya kuodza muviri wekunze uye anowanzoitika muvana vari pasi pemakore mashanu (Mufananidzo 7).Mushure mekukuvadza esophagus, vanogona kukonzera esophageal stenosis.Endoscopy inofanira kuongororwa mukati memavhiki mashoma.Kana kuomarara kwakaumbwa, esophagus inofanira kuderedzwa nekukurumidza sezvinobvira.
Mufananidzo 7 Chinhu chekunze mubhatiri, museve mutsvuku unoratidza nzvimbo yechinhu chekunze
4.8 Magnetic kunze kwenyika
Kana akawanda magineti ekunze ekunze kana magineti ekunze miviri yakasanganiswa nesimbi iripo mukumusoro gastrointestinal turakiti, zvinhu zvacho zvinokwezva mumwe nemumwe uye kudzvanya madziro emudumbu, izvo zvinogona kukonzeresa ischemic necrosis, fistula formation, perforation, obstruction, peritonitis. kumwe kukuvadzwa kwakakomba kwemudumbu., inoda kurapwa kwechimbichimbi endoscopic.Single magnetic ekunze zvinhu zvinofanirawo kubviswa nokukurumidza sezvinobvira.Kuwedzera kune akajairwa forceps, magineti ekunze mitumbi inogona kubviswa pasi pekusvetwa nemagineti ekunze muviri forceps.
4.9 Mitumbi yevatorwa mudumbu
Zvizhinji zvacho zvirerutsira, tambo dzesimbi, zvipikiri, nezvimwewo zvinomedzwa nemaune nevasungwa.Mitumbi yakawanda yekunze yakareba uye yakakura, yakaoma kupfuura nepakati pe cardia, uye inogona kukwenya zviri nyore mucous membrane.Zvinokurudzirwa kushandisa makondomu akasanganiswa ne rat-tooth forceps kubvisa miviri yekunze pasi pe endoscopic kuongororwa.Chekutanga, isa rat-zino forceps kumberi kwekupedzisira kwe endoscope kuburikidza ne endoscopic biopsy gomba.Shandisa simba rezino rembeva kusungirira mhete yerabha pazasi pekondomu.Wobva wadzora simba regonzo-zino kugomba rebiopsy kuitira kuti kureba kwekondomu kuonekwe kunze kwegomba rebiopsy.Ideredze zvakanyanya sezvinobvira pasina kukanganisa ndima yekuona, uye woiisa mugastric cavity pamwe chete ne endoscope.Mushure mekuziva muviri wekunze, isa muviri wekunze mukondomu.Kana zvanetsa kubvisa, isa kondomu mudumbu, uye shandisa simba remazino embeva kusungirira muviri wekunze wouisa mukati. Mukati mekondomu, shandisa mbambo dzemazino emakonzo kusungirira kondomu uye kuribvisa pamwe chete ne girazi.
4.10 Matombo emudumbu
Gastroliths yakakamurwa kuita yemiriwo gastroliths, mhuka gastroliths, zvinodhaka-induced gastroliths uye yakasanganiswa gastroliths.Vegetative gastroliths ndiyo yakajairika, inonyanya kukonzerwa nekudya huwandu hwakawanda hwepersimmons, hawthorns, mazuva echando, mapichisi, celery, kelp, uye coconuts padumbu risina chinhu.Zvinokonzerwa nezvimwe. Magastroliths emumiti akadai semapersimmons, hawthorns, nejujube ane tannic acid, pectin, uye chingamu.Pasi pekuita kwegastric acid, mvura-insoluble tannic acid protein inoumbwa, inosunga pectin, gum, plant fiber, peel, uye core.Matombo emudumbu.
Matombo emudumbu anoshandisa mechanical pressure pamadziro emudumbu uye anokurudzira kuwedzera gastric acid secretion, iyo inogona kukonzeresa zviri nyore gastric mucosal erosion, maronda uye kunyange perforation.Matombo madiki, akapfava emudumbu anogona kunyungudutswa nesodium bicarbonate nemimwe mishonga obva atenderwa kuti abudiswe zvawo.
Kune varwere vanokundikana kurapwa, endoscopic dombo kubviswa ndiyo yekutanga sarudzo (Mufananidzo 8).Kune gastric matombo akaoma kubvisa zvakananga pasi pe endoscopy nekuda kwehukuru hwavo hukuru, simba rekunze rekunze, misungo, mabhasikiti ekubvisa matombo, nezvimwewo zvinogona kushandiswa kupwanya matombo zvakananga uye wozoabvisa;kune avo vane kugadzirwa kwakaoma kusingagoni kupwanyika, endoscopic kucheka kwematombo kunogona kufungwa, Laser lithotripsy kana high-frequency electric lithotripsy treatment, kana gastric stone iri pasi pe2cm mushure mekuputsika, shandisa katatu-claw forceps kana kunze kwenyika forceps. kuibvisa zvakanyanya sezvinobvira.Kungwarira kunofanirwa kutorwa kudzivirira matombo akakura kudarika 2cm kuti asabudire mudumbu nemudumbu zvichikonzera kuvharika kweura.
Mufananidzo 8 Matombo mudumbu
4.11 Drug Bag
Kuputika kwebhegi remishonga kuchaisa njodzi inouraya uye inopesana ne endoscopic kurapwa.Varwere vasingakwanisi kubudisa muviri kana kuti vanofungidzirwa kuti vane bhegi rezvinodhaka rinoputika vanofanira kushingaira kuvhiyiwa.
III.Matambudziko uye kurapwa
Matambudziko emuviri wekunze ane hukama nehunhu, chimiro, nguva yekugara uye nhanho yekushanda kwechiremba.Matambudziko makuru anosanganisira esophageal mucosal kukuvara, kubuda ropa, uye kutapukira.
Kana muviri wekune imwe nyika uri muduku uye pasina kukuvara kwakajeka kwemucosal kana kubviswa, kuchipatara hakudiwi mushure mekushanda, uye kudya kwakapfava kunogona kuteverwa mushure mekutsanya kwemaawa matanhatu.Kune varwere vane esophageal mucosal kukuvara, glutamine granules, aluminium phosphate gel uye mamwe mucosal anodzivirira ejenti anogona kupihwa chiratidzo chekurapa.Kana zvichidikanwa, kutsanya uye peripheral nutrition inogona kupiwa.
Kune varwere vane pachena mucosal kukuvara uye kubuda ropa, kurapwa kunogona kuitwa pasi pekuona endoscopic yakananga, sekupfapfaidza ice-inotonhora saline norepinephrine solution, kana endoscopic titanium clips kuvhara ronda.
Kune varwere vane preoperative CT inoratidza kuti mutumbi wekunze wakapinda mumadziro esophageal mushure mekubviswa endoscopic., kana mutumbi wekunze ukaramba uripo kwemaawa asingasviki makumi maviri nemana uye CT inowana pasina kuumbwa kweabscess kunze kwesophageal lumen, endoscopic kurapwa inogona kuitwa zvakananga.Mushure mekunge mutumbi wekunze wabviswa kuburikidza ne endoscope, titanium clip inoshandiswa kubata madziro emukati mesophagus panzvimbo yekuboora, iyo inogona kumisa kubuda ropa uye kuvhara madziro emukati mesophagus panguva imwe chete.A gastric tube uye jejunal feeding tube inoiswa pasi pechiratidzo chakananga che endoscope, uye murwere ari muchipatara kuti arambe achirapwa.Kurapa kunosanganisira kurapa kwezviratidzo sekutsanya, decompression yemudumbu, mishonga inorwisa mabhakitiriya uye kudya kunovaka muviri.Panguva imwecheteyo, zviratidzo zvakakosha zvakadai sekushisa kwemuviri zvinofanira kunyatsocherechedza, uye kuitika kwezvinetso zvakadai semutsipa subcutaneous emphysema kana mediastinal emphysema inofanira kuonekwa pazuva rechitatu mushure mekuvhiyiwa.Mushure mokunge iodine mvura angiography inoratidza kuti hapana kubuda, kudya uye kunwa kunogona kubvumirwa.
Kana mutumbi wekunze wakachengetwa kweanopfuura maawa makumi maviri nemana, kana zviratidzo zvehutachiona zvakaita sefivha, kutonhora, uye zvakanyanya kukwirisa masero machena eropa zvikaitika, kana CT ichiratidza kuumbwa kweabscess extraluminal musophagus, kana kana matambudziko akakomba akaitika. , varwere vanofanira kuendeswa kunovhiyiwa kuti varapwe panguva yakakodzera.
IV.Zvekungwaririra
(1) Kana muviri wekune dzimwe nyika ukagara mugurokuro, ndipo panobva panyanya kuoma kuvhiya uye matambudziko anowedzera kuitika.Nokudaro, kupindira kwechimbichimbi endoscopic kunonyanya kukosha.
(2) Kana mutumbi wekunze wakakura, usingaenzaniswi muchimiro kana uine spikes, kunyanya kana mutumbi wekunze uri pakati pegurokuro uye padyo neaortic arch, uye zvakaoma kuibvisa endoscopically, usaidhonza nesimba. kunze.Zviri nani kutsvaga kubvunzana kwakasiyana-siyana uye kugadzirira kuvhiyiwa.
(3) Kushandisa zvine musoro kwesophageal kudzivirira zvishandiso kunogona kuderedza kuitika kwematambudziko.
Yeduzvinoraswa kubata simbaInoshandiswa pamwe chete neiyo endoscopes yakapfava, ichipinda mukati memuviri wemunhu mhango senge nzira yekufema, esophagus, dumbu, ura uye zvichingodaro kuburikidza ne endoscope chiteshi, kubata matishu, matombo uye kunze kwenyika pamwe nekuburitsa stents kunze.
Nguva yekutumira: Jan-26-2024