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 isina kusununguka kutaurirana nemuviri mhango, inonzi perforation.
Tsanangudzo yekubuda ropa haina kunyatsotsanangurwa; zvinokurudzirwa zvino zvinosanganisira kuderera kwehemoglobin inopfuura 2 g/dL kana kuti 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 (EMR): 0.58% ~ 0.8%
Endoscopic submucosal dissection (ESD): 2% ~ 14%
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 pakarepo: Pasinei nenzvimbo, kuvharwa kwe clip ndiyo nzira yakasarudzika (kurudziro simba: Giredhi 1, humbowo nhanho: C).
In ESD, kuitira kuti urege kupindira nekushanda kwekuparadzanisa, mhuka dzakapoteredza dzinofanira kuparadzaniswa kutanga kuti dzive nechokwadi chokuti nzvimbo yekushanda yakakwana isati yavhara.
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 kwete chete pagasi remahara rinoratidzwa paCT.
Special parts treatment:
Iyo yezasi rectum haizokonzere kupera kwedumbu nekuda kwehunhu hwayo, asi inogona kukonzera pelvic perforation, ichiratidza seretroperitoneal, mediastinal, kana subcutaneous emphysema.
Zvekungwaririra:
Kuvharwa kwemaronda epashure kunogona kudzivirira matambudziko kusvika pamwero wakati, asi hapana humbowo hwakakwana hunoratidza kuti hunogona kudzivirira kunonoka kupera.
2. Response to Bleeding
Kugadziriswa kwekubuda ropa kwe intraoperative:
Shandisa heat coagulation kana hemostatic clips kumisa kubuda ropa.
Mutsipa diki kubuda ropa:
EMR, muromo wemusungo unogona kushandiswa kupisa kupisa.
ESD, 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:
Ronda resection mushureEMR :
Zvidzidzo zvakaratidza kuti kushandiswa kwehemostatic forceps yekudzivirira kuvharika hakuna mhedzisiro yakakosha pakubuda kweropa, asi pane maitiro ekuderera.
Prophylactic clipping ine mhedzisiro shoma pamaronda madiki, asi inoshanda kune maronda mahombe kana varwere vari panjodzi yekubuda ropa mushure mekuvhiyiwa (sevaya vanowana antithrombotic therapy).
ESD, ronda racho rinobviswa uye tsinga dzeropa dziri pachena dzinobatanidzwa. Hemostatic clips inogona zvakare kushandiswa kudzivirira kubata kwetsinga dzakakura 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,ureral access sheathuyeureral access sheath nekuyamwaetc. ayo anoshandiswa zvakanyanya muEMR, 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: May-24-2025