Mukurapa kwekolonioscopic, matambudziko anomiririra ari perforation uye kubuda ropa.
Perforation inoreva mamiriro umo mhango yakabatana zvakasununguka negomba remuviri nekuda kwekuremara kwakazara kwetishu, uye kuvepo kwemhepo yakasununguka paX-ray kuongororwa hakukanganisi tsananguro yayo.
Kana iyo periphery yekuzara-yakazara tishu defect yakavharwa uye pasina kusununguka kutaurirana nemuviri mhango, inonzi perforation. Tsanangudzo yekubuda ropa haina kunyatsotsanangurwa, uye zvino kurudziro zvinosanganisira kuderera kwehemoglobin inopfuura 2 g/dL kana kudiwa kwekuwedzerwa ropa.
Kubuda ropa kwepashure kunowanzotsanangurwa sekuitika kweropa rakakosha muchigaro mushure mekuvhiyiwa kunoda kurapwa kwehemostatic kana kuwedzerwa ropa.
Chiitiko chezviitiko izvi zvechiitiko chinosiyana nekurapa:
Perforation rate:
Polypectomy: 0.05%
Endoscopic mucosal resection (EMR0.58%~0.8%
Zvinoenderana Endoscopic Consumables:Polypectomy Snare
Zvinoenderana Endoscopic Consumables:Hemostastic Clips
Zvinoenderana Endoscopic Consumables: Sclerotherapy Tsono
Endoscopic submucosal dissection (ESD): 2% ~ 14%
Zvinoenderana Endoscopic Consumables:ESD Banga
Zvinoenderana Endoscopic Consumables: InoraswaESD Banga
Postoperative kubuda ropa:
Polypectomy: 1.6%
EMR: 1.1% ~ 1.7%
ESD: 0.7% ~ 3.1%
1. Nzira yekubata nayo nekuboora
Sezvo madziro emukati mahombe akaonda kupfuura iwo emudumbu, njodzi yekuputika yakakwira. Kugadzirira kwakakwana kunodiwa kusati kwavhiyiwa kuti utarise mukana wekuboora.
Intraoperative precautions:
Ita shuwa kushanda kwakanaka kweiyo endoscope. Sarudza akakodzera endoscopes, zviridzwa zvekurapa, zvinwiwa zvejekiseni, uye kabhoni dhaidhirodhi gasi rekutakura zvinhu zvinoenderana nenzvimbo, morphology, uye dhigirii refibrosis yebundu.
Management ye intraoperative perforation:
Kuvharwa kwekukurumidza: Pasinei nenzvimbo, zvimedu zvinosarudzwa kuti zvivharwe (kurudziro simba: nhanho 1, humbowo nhanho: C). MuESD, dzimwe nguva nzvimbo yakatenderedza inofanira kutanga yapepereswa kudzivirira kuvhiringa kuvhiya.
Tissue, simbisa nzvimbo yekushanda yakakwana usati wavhara.
Postoperative observation: Kana iyo perforation inogona kuvharwa zvachose, kuvhiyiwa kunogona kudziviswa chete nemishonga inorwisa mabhakitiriya uye kutsanya.
Chisarudzo chekuvhiya: Kudiwa kwekuvhiyiwa kunotarirwa zvichienderana nekubatanidzwa kwezviratidzo zvemudumbu, migumisiro yekuongorora ropa, uye kufungidzira pane gasi remahara rinoratidzwa paCT chete.
Special parts treatment:
Iyo yezasi rectum haizokonzere kupera kwedumbu nekuda kwehunhu hwayo, asi inogona kukonzera.
Pelvic perforation, inoratidzwa seretroperitoneal, mediastinal, kana subcutaneous emphysema.
Zvekungwaririra:
Kuvhara ronda mushure mekuvhiyiwa kunogona kudzivirira matambudziko kusvika pamwero wakati, asi hazviiti
Pane humbowo hwakakwana hunoratidza kuti hunoshanda mukudzivirira kunonoka kuboora.
2. Response to Bleeding
Kutungamira kwekubuda ropa kwe intraoperative:
Shandisa kupisa coagulation kanahemostatic clipskumisa kubuda ropa.
Mutsipa diki kubuda ropa:
In EMR, muromo wemusungo unogona kushandiswa kupisa kupisa.
MuESD, muromo webanga remagetsi unogona kushandiswa kubata thermal coagulation kana hemostatic forceps kumisa kubuda ropa.
Mutsipa wakakura kubuda ropa: Shandisa hemostatic forceps, asi dzora huwandu hweiyo coagulation kudzivirira kunonoka kupera.
Kudzivirira kubuda ropa mushure mekushanda:
Kubviswa kwemaronda mushure meEMR:
Zvidzidzo zvakaratidza kuti kushandiswa kwehemostatic clamps yekudzivirira kudonha hakuna mhedzisiro yakakosha pakubuda ropa kwepashure, asi pane maitiro ekuderedza. Kudzivirira kuvharidzira kune zvishoma pazvironda zvidiki, asi zvinoshanda kumaronda mahombe kana varwere vari panjodzi yekubuda ropa mushure mekuvhiyiwa (sevaya vanowana antithrombotic therapy).
Kubviswa kwemaronda mushure meESD:
Mitsipa yeropa yakafumurwa inobatanidzwa, uye hemostatic clips inogona kushandiswa kudzivirira kubata kwetsinga hombe dzeropa.
Cherechedza:
Kune EMR yezvipembenene zviduku, kurapa kwemaitiro ekudzivirira hazvikurudzirwi, asi kune zvipembenene zvakakura kana varwere vane ngozi yakawanda, postoperative kudzivirira clipping ine chimwe chiitiko (kukurudzira simba: Nhamba 2, uchapupu hwehutano: C).
Perforation uye kubuda ropa ndiwo matambudziko akajairika e colorectal endoscopy.
Kutora matanho akakodzera ekudzivirira uye ekurapa emamiriro akasiyana anogona kunyatso kudzikisa kuitika kwezvirwere zvesporadic uye kugadzirisa kuchengetedzwa kwevarwere.
Isu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., inogadzira muChina inyanzvi mune endoscopic consumables, senge.biopsy forceps, hemoclip, polyp musungo,sclerotherapy tsono, pfapfaidza catheter, cytology brushes, guidewire, dombo rekudzosa tswanda, nasal biliary drainage catheter, ureteral access sheath uye ureter yekupinda sheath ine kuyamwa etc. ayo anoshandiswa zvakanyanya mu EMR,ESD, ERCP. Zvigadzirwa zvedu ndezveEC Certified, uye zvidyarwa zvedu ISO certified. Zvinhu zvedu zvakatumirwa kuEurope, North America, Middle East uye chikamu cheAsia, uye zvakanyanya kuwana mutengi wekuzivikanwa nekurumbidzwa!
Nguva yekutumira: Kubvumbi-18-2025