(1). Basic matekiniki Maitiro ekutanga eEMR ndeaya anotevera:
Kutevedzana kwemaitiro
①Baya jekiseni remunzvimbo pazasi peronda.
②Isa musungo wakatenderedza chironda.
③Musungo unosimbiswa kuti ubate nekudzipa chironda chacho.
④Ramba wakaomesa musungo uchiisa magetsi kudzima chironda.
⑤Dzora mufananidzo wakaitwa.
(2). Mazano
1.Mazano ekusarudza nzvimbo yemuviri uye endoscope positioning
Nokuti chironda chacho chinoda kurapwa apo mufananidzo wose unoonekwa, nzvimbo yemurwere inokosha zvikuru. Edza kumonyanisa chiyero kuitira kuti ronda rive pedyo nekuvhurwa kwebiopsy forceps, ndiko kuti, kubva pa5 kusvika 7 o'clock pachiratidziri.
Usati warapwa, zvakasara uye pigment yakawandisa inoda kushambidzwa uye yozobviswa nekusveta.
Semuyenzaniso, kana chironda chiri muproximal sigmoid colon chikabviswa mu supine kana kuruboshwe lateral decubitus position, mufananidzo wacho unowanzo famba uchidzika necolon, zvichiita kuti zviome kudzosa , saka right lateral decubitus position iri nani pakuita resection.
Saizvozvovo, kubva pakuona kwemuenzaniso wekupora, iyo yekuruboshwe lateral decubitus chinzvimbo inosarudzwa kuti idzorerwezve ye transverse colon maronda.
2.Mazano emajekiseni emunharaunda
Ijekiseni gobvu remunharaunda rinogona kubaiwa nekudzvinyirirwa kwakaderera, asi harina kupinza zvakakwana uye buri retsono rakakurisa, saka munyori anoshandisa 25G yemuno jekiseni tsono.
Hakusi kuwedzeredza kutaura kuti kubudirira kana kukundikana kweEMR kunotsamira zvikuru pamajekiseni emunharaunda.
Pazvironda zvidiki, kubaya kunoitwa kubva kudivi rekumashure kweronda kusvika pazasi peronda.
Kune maronda ari muchikamu chakakombama kana mhiri kwakapetwa, kana jekiseni remunharaunda richiitwa kubva kudivi rekumashure, kazhinji maronda acho haanyatso kujeka nekuti akatarisana nemuromo, saka jekiseni remunharaunda rinofanira kutangwa kubva kudivi remuromo.
Zvinokosha zveEndoscopy Technicians
Kana mvura ikabuda kunze, kana paine kuramba kukuru panguva yejekiseni, kana pasina kuramba kana mvura ichipinda asi pasina bulge inogadzirwa, jekiseni rinofanirwa kumiswa uye mushandisi anofanira kuziviswa nezvemamiriro acho nenguva kuti akurukure matanho ekupikisa.
Iyo yakawanda jekiseni vhoriyamu, zviri nani.
Manomano ndeekuenderera mberi nekubaya jekiseni zvakanyanya sezvinobvira kuburikidza nekupinza kamwe chete kusvika ronda rose rasimudzwa.
3.Mazano ekusarudza musungo
Kana musungo wacho uri muchimiro cheovha yakareba, iyo yakajairika mucosa pamuromo wekukuvadzwa uye mativi eku anus inogona kuve nyore uye zvisina kufanira kubatanidzwa.
Musungo unokwanisa kuita kunge denderedzwa, nyore kuvhurika nechemberi, hausi nyore kutsvedza, uye une imwe kuoma kwekudzvanya pachironda kuti ubate chironda.
Hukuru hwemusungo hunofanira kuchinjirwa kuhukuru hwemaronda.
Disposable Polypectomy Snare
Mienzaniso yeEMR
a. Mufananidzo wechiedza chichena
A 25 mm mhando IIa lesion ine zvishoma yakaora mwoyo chikamu chepakati.
b. Narrow band imaging (NBI) mifananidzo
c. Kumwaya indigo carmine kuwedzera mufananidzo
Zvakaonekwa kuti kuora mwoyo kwakanzwisiswa nekutarisa kwakajairika kwaitova grooves pakati pemashizha.
d. Mufananidzo wakakura wekristaro violet staining
Iyo yegomba pateni yekuvhura kwegonhi kumucheto kwechironda yaive yemhando IV.
e. Mufananidzo wakakura wekristaro violet staining
pakati pechironda chaiva VI, zvishoma zvishoma, uye hapana pachena submucosal infiltration yakawanikwa.
f. Jekiseni remunharaunda
Kubaya uye jekiseni remunharaunda zvakaitwa pakati pechironda, zvichiita kuti pave nekuputika kwakanaka.
g. Vhura musungo
Dzvanya chinonongedza pamadziro ekoloni kuti uvhure musungo.
h. Vhara musungo
Vhara musungo uye ubate chironda.
i.Simba pakubvisa
Hapana kubuda, kubuda ropa kana bundu rekusarira rakawanikwa.
j. Kugadziriswa kwemuenzaniso
Muenzaniso wakachekwa wakasungirirwa papepa rerabha.
Pakupedzisira pathological kuongororwa:intramucosal carcinoma (Tis)
4.Mazano ekushandisa musungo
Musungo wemusungo unoiswa zvinyoro-nyoro pamuromo mucosa yechironda, wozovhurwa zvishoma nezvishoma uye mudzi wemusungo unodzvanywa kudivi rekumashure kwechironda. Kuti udzivise lateral incision kubva kune yakanaka, zvishoma zvishoma zvemazuva ose mucosa inofanira kuiswa.
Zvinofanira kucherechedzwa kuti kana muromo wemusungo haugone kuonekwa, zvinokwanisika kuti mucosa yakawanda yakajairwa yakaiswa pane inotarisirwa. Mushure mekunge musungo wanyatsosimbiswa, sundidzira uye dhonza ruoko rwekunze rwemusungo kuti uone kufamba kwechirwere. Kana iyo yakaiswa muscular layer, kufamba kwechirwere kuchaderedzwa.
Mazano e electroresection
Usadzvanyirire musungo pamadziro emukati, asi simudza zvishoma ronda rekubvisa. Ngozi yekunonoka kubhomba yakaderera kana uchishandisa electrosurgical resection, asi inowanzoitika kune intraoperative (kutanga mushure mekuvhiya) kubuda ropa.
Kucheka kunokurumidza kukonzeresa kubuda ropa, ukuwo kuchekwa kunonoke kukonzeresa kuboora kunonoke. Kana murwere achinzwa kurwadziwa, kana mubatsiri achinzwa kuti ganda rakatsetseka serabha uye rakaoma kucheka, zvingangoita kuti mutsara unobatanidzwa mumutsara wetsandanyama, uye kubvisa kunofanira kumiswa pakarepo.
Zvinokosha zveEndoscopy Technicians
Kana endoscopist ichinzwa kuti matishu ari elastic serabha uye yakaoma kucheka, anofanira kukurumidza kuzivisa mushandisi kuti akurukure matanho ekupikisa.
Mazano eShading EMR
Kune maronda mahombe, dzimwe nguva zvakachengeteka kuita chidimbu chesection pane kumanikidza zvese-kamwe-kamwe resection. Nekudaro, iyo yakawanda zvidimbu zviripo, inowedzera mukana wezvisaririra zvemunharaunda kudzokorora. Kunyangwe ne piecemeal EMR, kutanga kwekutanga kunofanirwa kuitwa zvakakura sezvinobvira nemusungo wakakura kuderedza nhamba yezvidimbu.
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Biopsy forceps:
https://www.zrhendoscopy.com/single-use-endoscopic-tissue-biopsy-forceps-with-graduation-product/
Hemoclip
https://www.zrhendoscopy.com/disposable-rotatable-endoscopic-hemoclip-for-gastroscopy-use-product/
polyp musungo
https://www.zrhendoscopy.com/disposable-endoscopic-resection-polypectomy-snare-for-gastroenterology-product/
sclerotherapy tsono
https://www.zrhendoscopy.com/gastroenterology-accessories-endoscopic-sclerotherapy-injection-needle-product/
Pfaya catheter
https://www.zrhendoscopy.com/ce-certified-disposable-endoscopic-spray-catheter-for-digestive-chromoendoscopy-product/
cytology brushes
https://www.zrhendoscopy.com/endoscopy-accessories-disposable-endoscopic-cytology-brush-for-gastrointestinal-tract-product/
dombo rekudzosa tswanda
https://www.zrhendoscopy.com/ercp-instrument-gallstone-stone-retrieval-basket-for-endoscopy-product/
nasal biliary drainage catheter
https://www.zrhendoscopy.com/medical-instrument-disposable-nasal-biliary-drainage-catheter-for-ercp-operation-product/
EMR
https://www.zrhendoscopy.com/emresd/
ESD
https://www.zrhendoscopy.com/emresd/
ERCP
https://www.zrhendoscopy.com/ercp/
Nguva yekutumira: Feb-13-2025