ESDmabasa haatenderwi kuitwa zvisina tsarukano kana kuti zvisina musoro.
Nzira dzakasiyana dzinoshandiswa pazvikamu zvakasiyana. Zvikamu zvikuru igurokuro, dumbu, uye colorectum. Dumbu rakakamurwa kuita antrum, prepyloric area, gastric angle, gastric fundus, uye greater curvature yedumbu. Colorectum yakakamurwa kuita colon nerectum. Pakati pazvo,ESD ye antrum greater curvature lesionschikamu chepakutanga, nepo ESD yemaronda emudumbu, emwoyo, uye emuura wekurudyi ichinyanya kuoma.
Nheyo huru ndeyekufunga nezvechinhu chine simba shoma regiravhiti wotanga nechikamu chakaoma wozotanga nechikamu chiri nyore. Tanga kuchekwa uye kubvisa kubva panzvimbo ine simba shoma regiravhiti. Munguva yekubvisa, kubvisa kunofanirawo kutanga kubva pachikamu chakaoma zvikuru. ESD yeEsophageal inogona kuitwa nekucheka kwerudzi rwe push-type. Nzira yekucheka uye kubvisa maronda emudumbu inofanira kugadzirwa pachine nguva. Maronda ari mukona yemudumbu, kukotama kushoma kwemuviri wemudumbu, uye nzvimbo ye prepyloric zvinogona kuratidzwa nekudhonza. Tekinoroji yemugero uye nzira yepocket zvese zviri chikamu chehurongwa hweESD. Matekinoroji anobva kuESD anosanganisira ESTD, EFTR, ESE, POEM, nezvimwewo. Matekinoroji aya zvakare matekinoroji anobuda zvega mushure mekunge hunyanzvi hweESD hwanyatso shandiswa. Saka ESD ndiyo hwaro.
2. Ruzivo rwekushanda kweESD
ESDRuzivo rwekushanda ruzivo rwuri pasi pekutungamirirwa kwehurongwa hukuru.
Ruzivo rweMashandiro
Ruzivo rwekushanda runosanganisira kutara, kubaya jekiseni, kubvisa ganda, nezvimwewo.
Pane nzira mbiri dzekunyengera: imwe ndeyekusarudza mapanga nenzira inodzorwa uchishandisa nzira yekuona zvakananga (shandisa nzira yekusarudza mapanga usingaoni), uye imwe nzira yekusarudza miganhu nemasangano madiki.
Kunyora mazita uye jekiseni
Kuisa chiratidzo cheelectrocoagulation kunoshandiswa pakuisa chiratidzo. Kazhinji, muganhu wekukuvara (2-5 mm kunze) unoshandiswa sechiratidzo. Kuisa chiratidzo kunogona kuitwa nepfungwa imwe neimwe kana kubva pakukura kusvika kudiki. Pakupedzisira, nguva iri pakati pepfungwa mbiri dzekuisa chiratidzo inofanira kunge iri mukati me5 mm, uye inofanira kuonekwa kana endoscope iri pedyo nenzvimbo yekuona.
Kusvika panzvimbo inotevera yakatarwa. Jekiseni rinobva pane zvarinoita iwe pachako. Mushure mekubaya jekiseni muchikamu chemukati memucosal, tsono inofanira kubviswa zvishoma yozopinzwa zvakare kuitira kuti gonda rikwire kusvika pakakwirira zvakakwana kuti richekwe uye ribviswe.
Cheka
Kuchekwa kweganda, zvimwe zvikamu zvinochekwa kubva kure kusvika pedyo kana kubva pedyo kusvika kure (kusunda kucheka), zvichienderana netsika dzemunhu uye zvikamu zvacho, zvakakoshawo kucheka kubva panzvimbo yakaderera yegiravhiti kutanga. Kucheka kunosanganisira kucheka kushoma uye kucheka kwakadzika. Kucheka kunofanira kunge "kwakarurama" uye "kwakakwana". Kudzika kwekucheka kunofanira kukwana usati watanga kuvhiya. Sekutora banga uye kuisa hwindo rengirozi. Kana wangopinda muhwindo rengirozi,
ESD zvinoreva kuwana nzira inoshanda. Asi muchokwadi, havasi vese ESD vanogona kupinda muWindow yeAngel. Maronda mazhinji enzvimbo diki uye maronda akakosha ESD haagone kupinda muWindow yeAngel. Panguva ino, zvinonyanya kuenderana nekushanda kwebanga kwakanyatsogadzirwa.
Bvisa: Bvisa chikamu chakaoma kubata. Pakubvisa chikamu chemudumbu, chinofanira kuitwa kubva kumativi ese kusvika pakati, zvichiita "kiyi" yakaita seV. Kudzika kwekucheka kweperipheral kunofanirwa kukwana, zvikasadaro zviri nyore kubvisa kupfuura muganhu. Kana tissue yasara isina kusimba, rusununguko rwacho runowedzera. Zvakakosha kudzora banga kuti ucheke tissue zvakananga, kunyanya tissue yekupedzisira. Kana kudzora kusina kunaka, zviri nyore kucheka zvakanyanya kana zvishoma.
Maitiro ekubata girazi
Kune nzira mbiri dzekubata ESD scope, dzose dziri mbiri dzinodzora muviri wescope, maknob, uye zvishandiso zvinopinda nekubuda. Kune nzira mbiri: "kutungamira kuruboshwe + zvishandiso" uye "maoko maviri kusvika kumaoko mana". Nheyo huru yekubata scope ndeyekuchengetedza nzvimbo yekushanda yakagadzikana uye inodzorwa. Parizvino, nzira yekubata maoko maviri kusvika kumaoko mana ine kugadzikana kuri nani kwescope uye inoshandiswa zvakanyanya. Kana scope yagadzikana chete ndipo panogona kubatwa zviri nani mashandiro ekuona matishu madiki + maflaps.
Banga rinogona kudzorwa zviri nani kana nzira yakanaka yekubata girazi chete. Nzira yekusarudza banga inogona kudzora zviri nani divi, chinangwa ndechekugara kure nerukoko rwemhasuru uye kucheka nyama yaunoda. Paunenge uchigadziraESDKana kucheka kwemudumbu kuchiitwa submucosal, zvakakosha kucheka pedyo netsandanyama, kudzika kwekucheka kwenyama kwakakwana, uye zviri nyore kumisa kubuda ropa. Chinhu chakakosha ndechekuona kuti kucheka kwacho hakuna kudzika zvakanyanya kana kupfuura, uye nzira yekucheka mapanga ndiyo hunyanzvi hwakakosha panguva ino.
Kudzora kuona
Kudzora mafambiro echinhu kunoratidzwawo mukuratidzwa uye kutonga kwenzvimbo yekuona. Pamusoro pekutenderedza bhatani nemuviri welenzi, mavharo akajeka nezvimwe zvinoshandiswawo kuratidza nzvimbo yekuona kana tishu yakanangana nayo, kunyanya simba diki rinoshandiswa kuratidza nekusimudza tishu diki, inova shanduko diki yenyama.
Dzora daro renzvimbo yekuona. Kana nzvimbo yekuona yakachengetedzwa padaro rakakodzera ndipo panogona kushandiswa nekudzorwa. Kana iri kure zvakanyanya kana kuti iri pedyo zvakanyanya, zvichava zvakaoma kudzora banga zvakadzikama. Kufamba kwacho kungaita sekunge hapana kufamba, asi tissue yacho yatove nesimba rekuchinja. Ndosaka ESD ichifanira kushandisa daro rakakodzera uye kuchinja kwakakodzera.
Zvinhu zviri pamusoro apa, kubata lenzi, uye kutonga nzvimbo yekuona ndizvo zvikuru zviri mukatiESD"Kudzora lenzi".
Isu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., tinogadzira zvinhu muChina zvine chekuita ne endoscopic consumables, zvakaita sesimba re biopsys, hemoclip, musungo wepolyp, tsono yekurapa sclerotherapy, katheta yekupfapfaidza, mabhurashi e cytology, waya yekufambisa, tswanda yekutorwa kwematombo, katheta yekubuditsa mvura yemumhino,sheya yekupinda muuretiuyesheya yekupinda muureti ine kusvetanezvimwewo zvinoshandiswa zvakanyanya muEMR, ESD, ERCPZvigadzirwa zvedu zvakanyoreswa neCE, uye mafekitori edu akanyoreswa neISO. Zvinhu zvedu zvakatumirwa kuEurope, North America, Middle East nedzimwe nzvimbo dzeAsia, uye zviri kuita kuti mutengi azivikanwe uye arumbidzwe zvikuru!
Nguva yekutumira: Chikunguru-14-2025