ESD mashandiro ane taboo kuti aitwe zvisina tsarukano kana zvisina tsarukano.
Nzira dzakasiyana dzinoshandiswa kune zvikamu zvakasiyana. Zvikamu zvikuru ndeye esophagus, dumbu, uye colorectum. Dumbu rakakamurwa kuita antrum, prepyloric nharaunda, gastric angle, gastric fundus, uye yakakura curvature yegastric body. Iyo colorectum yakakamurwa kuita colon uye rectum. Pakati pavo, ESD yeantrum yakakura curvature maronda chikamu chekupinda-chikamu, nepo ESD yegastric angle, cardia, uye kurudyi colon maronda zvakanyanya kuoma.
The general musimboti kufunga yakaderera giravhiti chinhu uye kutanga nechikamu chakaoma uye ipapo chikamu nyore. Tanga incision uye kubvisa kubva panzvimbo yakaderera yegiravhiti. Panguva yekubvisa, kubvisa kunofanirawo kutanga kubva pane zvakanyanya kuoma. Esophageal ESD inogona kuitwa ne push-type incision. Kutungamira kwekucheka uye kubvisa maronda emudumbu kunofanirwa kugadzirwa pachine nguva. Maronda ari mugastric angle, kushoma curvature yegastric body, uye prepyloric nzvimbo inogona kuburitswa nekudhonza. Tunnel tekinoroji uye nzira yehomwe zvese zviri chikamu cheiyo ESD zano. ESD-yakatorwa matekinoroji anosanganisira ESTD, EFTR, ESE, POEM, etc. Aya matekinoroji zvakare matekinoroji anongobuda mushure mekunge hunyanzvi hweESD hwanyatsogona. Saka ESD ndiyo nheyo.
2. ESD maitiro ekushanda
ESD oparesheni ruzivo ruzivo pasi pekutungamirwa kweiyo hombe zano.
Operational Details
Iwo maoparesheni anosanganisira kumaka, jekiseni, peeling, nezvimwe.
Pane manomano maviri: rimwe ndiro banga rinodzoreka richinhonga pasi pechiono chakananga (shandisa banga risingaoni kunhonga zvishoma sezvinobvira), uye rimwe racho nderekudzorwa kwekugadzirisa kwemiganhu nemasangano madiki.
Kuisa mazita uye jekiseni
Electrocoagulation marking inoshandiswa kumaka. Kazhinji, muganhu wekukuvadza (2-5 mm kunze) unoshandiswa sechiratidzo. Kumaka kunogona kuitwa poindi nepoint kana kubva kuhombe kusvika kudiki. Pakupedzisira, nguva iri pakati pezvikamu zviviri zvekumaka inofanira kunge iri mukati me5 mm, uye inofanira kuonekwa kana endoscope iri pedyo nemunda wekuona.
Kunzvimbo inotevera yakamaka. Jekiseni rinobva pamaitiro emunhu. Mushure mekuisa jekiseni mukati me submucosal layer, tsono yacho inofanira kubviswa zvishoma uye yozobayiwa zvakare kuti ive nechokwadi chekuti chironda chinosimudzwa kusvika paurefu hwakakwana kuitira kunotevera kuchekwa uye kupepeta.
Cheka
Incision, zvimwe zvikamu zvakachekwa kubva kure kusvika pedyo kana kubva pedyo kusvika kure (push cutting), maererano nemaitiro evanhu uye zvikamu zvakananga, zvakakoshawo kucheka kubva pasi pesimba regiravhiti kutanga. Kucheka kunosanganisira kudzika kusati kwacheka uye kwakadzika kusati kwacheka. Iyo pre-kucheka inofanirwa kuve "yakarurama" uye "yakakwana". Kudzika kwekucheka kunofanirwa kukwana kusati kwaitwa kuvhiya kwepeel kunotevera. Zvakadai sekutora banga uye kumisa hwindo rengirozi. Achipinda pahwindo rengirozi,
ESD inoreva kuwana nzira inoshanda. Asi muchokwadi, haisi yese ESD inogona kupinda muWindow yeNgirozi. Mazhinji madiki-enzvimbo maronda uye akakosha maronda ESD haagone kupinda muWindow yeNgirozi. Panguva ino, inonyanya kuenderana nekushanda kwebanga rakanatswa.
Peel off: Bvisa chikamu chakaoma-kubata-kutanga. Paunenge uchibvisa chikamu che submucosal, inofanira kuitwa kubva kumativi ose kusvika pakati, ichigadzira "kiyi" yakaita V. Iyo yakadzika yeperipheral pre-cut inofanira kukwana, kana zvisina kudaro zviri nyore kubvisa kunze kwemuganhu. Iyo shoma yasara yenyama, yakakura dhigirii yerusununguko. Izvo zvinodikanwa kudzora banga kuti ucheke tishu zvakananga, kunyanya yekupedzisira tishu. Kana kutonga kusina kunaka, zviri nyore kucheka zvakanyanya kana zvishoma.
Mabatiro egirazi
Pane nzira mbiri dzekubata ESD chiyero, ese ari maviri anodzora chiyero chemuviri, mapfundo, uye mukati-uye-kunze accessories. Kune nzira mbiri: "kuruboshwe-kuruboshwe + zvishongedzo" uye "maoko maviri kune maoko mana". Nheyo yakakosha yekubata chiyero ndeyekuchengetedza nzvimbo yekushanda yakagadzikana uye inodzoreka. Parizvino, iyo-mawoko maviri kusvika mana-ruoko nzira ine zvirinani kudzora chiyero kugadzikana uye inonyanya kushandiswa. Chete kana chiyero chagadzikana chinogona kuratidzwa kushanda kwematishu madiki + flaps kubatwa zvirinani.
Chete negirazi rakanaka rekubata nzira rinogona kudzora banga. Iyo nzira yekunhonga banga inogona kudzora zvirinani kutungamira, chinangwa ndechekugara kure nemhasuru uye kucheka iyo inonangwa tishu. Paunenge uchigadzira ESD submucosal incision, zvinodikanwa kucheka padhuze nemhasuru layer, kudzika kwetishu incision yakakwana, uye zviri nyore kumisa kubuda ropa. Chinhu chinonyanya kukosha ndechekuona kuti iyo incision haina kudzika zvakanyanya kana kuburikidza, uye nzira yekunhonga banga ndiyo hunyanzvi hunyanzvi panguva ino.
Kudzora kwekuona
Kutungamira kwekutungamira kunoratidzwa zvakare mukuratidzwa uye kutonga kwendima yekuona. Pamusoro pekutenderedza knob nemuviri welens, zvivharo zvinoonekera uye zvishongedzo zvinoshandiswawo kuratidza munda wekuona kana matishu anotangwa, kunyanya simba diki rinoshandiswa kuratidza nekusimudza matishu madiki, inova diki diki deformation.
Dzora chinhambwe chemunda wekuona. Chete kana nzvimbo yekuona ichichengetwa iri chinhambwe chakakodzera ndipo inogona kushandiswa uye kudzorwa. Kana iri kure zvakanyanya kana padyo zvakanyanya, zvichave zvakaoma kudzora banga zvakatsiga. Mafambiro akajeka angaita seasina kufamba, asi matishu atove ane inherent deformation simba. Ichi ndicho chikonzero ESD ichifanira kushandisa chinhambwe chakakodzera uye deformation yakakodzera.
Izvo zviri pamusoro apa, kubata lens, uye munda wekutarisa wekutarisa ndizvo zvikuru zviri mukati ESD "lens control".
Isu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., inogadzira muChina inyanzvi mune endoscopic consumables, senge biopsy forceps, hemoclip, polyp snare, sclerotherapy tsono, pfapfaidzo catheter, cytology mabhurashi, gwara, dombo rekudzoreredza tswanda, mhino yekuwana sheteriath, drainage yekupinda mumhino kuyamwa nezvimwewo izvo zvinonyanya kushandiswa 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: Jul-14-2025