Endoscopic Sclerotherapy (EVS) chikamu 1

1) Nheyo ye endoscopic sclerotherapy (EVS):

Jekiseni remutsinga: mushonga we sclerosing unokonzera kuzvimba kwakatenderedza tsinga, unoomesa tsinga dzeropa uye unovhara kufamba kweropa;

Kubaiwa jekiseni reropa mutsinga: kunokonzera kuzvimba kwetsinga kusingaparare zvichikonzera thrombosis.

2) Zviratidzo zveEVS:

(1) Kuputika kweEV kwakanyanya uye kubuda ropa;

(2) Vanhu vane nhoroondo yekuputika kweEV nekubuda ropa; (3) Vanhu vane EV inodzoka mushure mekuvhiyiwa; (4) Vanhu vasina kukodzera kurapwa kwekuvhiyiwa.

3) Zvinorambidzwa kushandisa EVS:

(1) Zvakafanana nekuongorora gastroscopy;

(2) Hepatic encephalopathy danho rechipiri zvichikwira;

(3) Varwere vane chirwere chakakomba chechiropa neitsvo, vane ascites yakawanda, uye jaundice yakanyanya.

4) Matanho ekudzivirira mashandiro

MuChina, unogona kusarudza lauromacrol. Kune mitsipa mikuru yeropa, sarudza jekiseni remukati meropa. Huwandu hwejekiseni hunowanzova 10~15mL. Kune mitsipa midiki yeropa, unogona kusarudza jekiseni reparavascular. Edza kudzivirira kubaya jekiseni panzvimbo dzakasiyana-siyana panzvimbo imwe chete (zvichida maronda anogona kuitika zvichikonzera kuvharwa kwegurokuro). Kana kufema kukakanganiswa panguva yekuvhiyiwa, chivharo chakajeka chinogona kuwedzerwa kugastroscope. Kune dzimwe nyika, bharumu rinowanzoiswa kugastroscope. Zvakakosha kudzidza kubva.

5) Kutarisirwa kweEVS mushure mekuvhiyiwa

(1) Usadye kana kunwa kwemaawa masere mushure mekuvhiyiwa uye zvishoma nezvishoma tangazve kudya zvine mvura;

(2) Shandisa huwandu hwakakodzera hwemishonga inorwisa mabhakitiriya kudzivirira hutachiona; (3) Shandisa mishonga inoderedza kumanikidzwa kwepazasi peganda kana zvakakodzera.

6) Kosi yekurapa yeEVS

Kurapwa kwe sclerotherapy kakawanda kunodiwa kusvika tsinga dzakakuvara dzanyangarika kana kuti dzanyangarika, nechikamu chevhiki imwe chete pakati pekurapwa kwega kwega; gastroscopy ichaongororwa mwedzi mumwe, mwedzi mitatu, mwedzi mitanhatu, uye gore rimwe chete mushure mekupera kwekurapwa.

 7) Matambudziko eEVS

(1) Matambudziko anowanzoitika: ectopic embolism, ulcer yegurokuro, nezvimwewo, uye

Zviri nyore kukonzera ropa kubuda kana kubuda ropa kubva muburi retsono kana tsono ikaburitswa.

(2) Matambudziko emunharaunda: maronda, kubuda ropa, stenosis, kutadza kufamba zvakanaka kwegurokuro, odynophagia, maronda. Matambudziko emunharaunda anosanganisira mediastinitis, kubooka, pleural effusion, uye portal hypertension gastropathy ine njodzi yakawedzera yekubuda ropa.

(3) Matambudziko emuviri: sepsis, aspiration pneumonia, hypoxia, bacterial peritonitis inongoerekana yaitika, uye portal vein thrombosis.

Kusunga mitsipa yeropa iri muropa (EVL)

1) Zviratidzo zveEVL:Zvakafanana neEVS.

2) Zvinorambidzwa neEVL:

(1) Zvimwe zvinopesana nekushandiswa kwegastroscopy;

(2) EV inoperekedzwa neGV iri pachena;

(3) pamwe chete nekushanda zvisina kunaka kwechiropa neitsvo, kuwanda kweascites, jaundice

Ronda rinouraya uye kurapwa kwazvino kwe multiple sclerotherapy kana mitsipa midiki yevaricose

Kutora Dzinza raHan serinenge riri pedyo neduofu zvinoreva kuti vanhu veHua vachakwanisa kufamba vakasununguka, kana kuti mitsipa nemapfupa zvichatambanudzirwa kumadokero.

Na.

3) Maitiro ekushanda

Kusanganisira kusungirirwa kwebvudzi rimwe chete, kusungirirwa kwebvudzi rakawanda, uye kusungirirwa kwetambo yenylon.

Nheyo: Kuvhara kufamba kweropa mutsinga dzakakuvara uye kupa emergency hemostasis → venous thrombosis panzvimbo yakasungirirwa → tissue necrosis → fibrosis → kunyangarika kwetsinga dzakakuvara.

(2) Kuchenjerera

Kune varices dzepagurokuro dzine mwero kusvika dzakakomba, tsinga yega yega yevaricose inosungirirwa mudenga kubva pasi kuenda kumusoro. Chinosungirirwa chinofanira kunge chiri pedyo nepanosungirirwa tsinga yevaricose, kuitira kuti tsinga yega yega ive yakasungirirwa zvakakwana uye yakasungirirwa zvakanyanya. Edza kufukidza tsinga yega yega yevaricose pane anopfuura mapoinzi matatu.