Nhanganyaya
Zviratidzo zvikuru zvemahemorrhoids iropa riri mutsvina, kurwadziwa kwetsvina, kudonha nekukwenya, nezvimwewo, izvo zvinokanganisa zvakanyanya hupenyu hwemunhu. Muzviitiko zvakakomba, zvinogona kukonzera mahemorrhoids ari muhudyu uye anemia isingaperi inokonzerwa neropa riri mutsvina. Parizvino, kurapwa kwakachengeteka kunonyanya kuenderana nemishonga, uye kurapwa kwekuvhiya kunodiwa muzviitiko zvakakomba.
Kurapa ne endoscopic inzira itsva yekurapa mumakore achangopfuura, iyo yakakodzera zvakanyanya kuzvipatara zvepasi. Nhasi, tichapfupikisa uye tichagadzirisa.
1. Kuongororwa kwekiriniki, chimiro chemuviri uye kurapwa kwekare kwehemorrhoids
Kuongororwa kweHemorrhoids
Kuongororwa kwemahemorrhoids kunonyanya kubva panhoroondo, kuongororwa, kuongororwa kwedhijitari rectal uye colonoscopy. Panyaya yenhoroondo yekurapa, zvakakosha kunzwisisa kurwadziwa kwemusana, ropa riri mutsvina, kubuda kwehemorrhoid uye kudzoserwa kweropa, nezvimwewo. Kuongorora kunonyanya kunzwisisa kuoneka kwemahemorrhoids, kana paine fistula yekubuda kweperianal, nezvimwewo, uye kuongororwa kwedhijitari rectal kunofanirwa kunzwisisa kuomarara kwemusana uye kana paine nguva refu. Colonoscopy inofanira kuziva zvimwe zvirwere zvakaita semabundu, ulcerative colitis, nezvimwewo zvinokonzera kubuda ropa. Kupatsanura uye kuyera mahemorrhoids.
Kune mhando nhatu dzemahemorrhoids: internal hemorrhoids, external hemorrhoids, uye mixed hemorrhoids.
Mamota: Mamota Emukati, Ekunze, uye Akasanganiswa
Mamota anogona kuiswa muzvikamu zveI, II, III, uye IV. Anoiswa muzvikamu zvichienderana nekuzara kweropa, kubuda kweropa uye kudzoka kwaro.
Zviratidzo zvekurapa ne endoscopic ndezve grade I, II, uye III internal hemorrhoids, nepo grade IV internal hemorrhoids, external hemorrhoids, uye mixed hemorrhoids zviri contraindicated pakurapa ne endoscopic. Mutsetse unoparadzanisa pakati pekurapa ne endoscopic ndiwo dentate line.
Kuumbwa kwemaHemorrhoids
Mutsetse wemusana, mutsetse wedentate, anal pad, uye hemorrhoids ipfungwa dzinofanirwa kuzivikanwa nevanoongorora endoscopies. Kuzivikanwa kwe endoscopic kunoda ruzivo rwakati. Mutsetse wedentate ndiwo musanganiswa we anal squamous epithelium ne columnar epithelium, uye nzvimbo yekuchinja pakati pemutsetse wemusana ne dentate yakafukidzwa ne columnar epithelium asi isingapinzwe mumuviri. Saka, kurapwa kwe endoscopic kunobva pamutsetse wedentate. Kurapa kwe endoscopic kunogona kuitwa mukati memutsetse wedentate, uye kurapwa kwe endoscopic hakugone kuitwa kunze kwemutsetse wedentate.
Mufananidzo 1.Kuonekwa kwepamberi kwemutsetse wemazino uri pasi pe endoscope. Museve weyero unonongedzera kumutsetse wemazino wakakombama, museve muchena unonongedzera kukoramu yemusana ne network yayo yeropa refu, uye museve mutsvuku unonongedzera kuvharuvhu yemusana.
1A:mufananidzo wechiedza chichena;1B:Mifananidzo yeNarrowband Light
Mufananidzo 2Kutarisa chidimbu chemusana (museve mutsvuku) uye mugumo wezasi wechikamu chemusana (museve muchena) uchishandisa maikorosikopu
Mufananidzo 3Kuonekwa kwepapilla yekumashure nepamaikorosikopu (museve weyero)
Mufananidzo 4.Mutsetse wemusana nemutsetse wemazino zvakaonekwa ne reverse endoscopy. Museve weyero wakananga kumutsetse wemazino, uye museve mutema wakananga kumutsetse wemazino.
Pfungwa dze anal papilla ne anal column dzinoshandiswa zvakanyanya mukuvhiyiwa kweanorectal uye hadzizodzokororwi pano.
Kurapa kwekare kwehemorrhoids:Kune mishonga yekuchengetedza masero uye yekuvhiya. Kurapa kwekuchengetedza masero kunosanganisira kushandisa mushonga weperianal uye kugeza ne sitz, uye nzira dzekuvhiya dzinosanganisira kubviswa kwehemorrhoid uye kubviswa kwe stapled (PPH). Nekuti kurapwa kwekuvhiya kwakajairika, mhedzisiro yacho yakadzikama, uye njodzi yacho idiki, murwere anofanira kugara muchipatara kwemazuva 3-5.
2. Kurapwa kweEndoscopic kweHemorrhoids dzemukati
Musiyano uripo pakati pekurapa kwemukati mehemorrhoids ne endoscopic uye kurapwa kweEGV:
Chinangwa chekurapa varices ye esophagogastric ne endoscopic imidziyo yeropa ine varicose, uye chinangwa chekurapa hemorrhoids yemukati hachisi midziyo yeropa iri nyore, asi hemorrhoids inoumbwa netsinga dzeropa nematishu akabatana. Kurapa hemorrhoids ndekwekuderedza zviratidzo, kusimudza jira rinodzika, uye kudzivirira matambudziko akadai se anal stenosis inokonzerwa nekunyangarika kwehemorrhoids (pfungwa yekuti "kuuraya zvese" inowanzoitika kune anal stenosis).
Chinangwa chekurapa ne endoscopic: Kuderedza kana kubvisa zviratidzo, kwete kubvisa mamota.
Kurapa kweEndoscopic kunosanganisirakurapwa kwesclerotherapyuyekubatanidzwa kwebhendi.
Pakuongorora nekurapa mamota emukati memuviri, colonoscopy inoshandiswa pakuongororwa, uye gastroscope inokurudzirwa pakurapa. Pamusoro pezvo, zvichienderana nemamiriro chaiwo echipatara chimwe nechimwe, unogona kusarudza kurapwa kwekunze kana kuti kwemukati memuviri.
①Sclerotherapy (inobatsirwa nechivharo chinoonekera pachena)
Chinhu chinobvisa sclerosing injection ye lauryl alcohol, uye injection ye lauryl alcohol inogona kushandiswawo. Zvakakoshawo kushandisa submucosal injection ye methylene blue sechinhu chisipo kuti unzwisise mafambiro emvura uye kufukidza kwayo.
Chinangwa chechivharo chakajeka ndechekuwedzera nzvimbo yekuona. Tsono yejekiseni inogona kusarudzwa kubva patsono dzakajairika dzejekiseni remucosal. Kazhinji, kureba kwetsono iyi i6mm. Vanachiremba vasina ruzivo rwakawanda vanofanira kuedza kudzivirira kushandisa jekiseni refu retsono, nekuti jekiseni refu retsono rinowanzo shandiswa jekiseni re ectopic uye jekiseni. Njodzi yakakura uye inotungamira kumapundu e perianal uye kuzvimba.
Nzvimbo yekubaiwa jekiseni inosarudzwa pamusoro pemuromo wemuromo wedentate line, uye nzvimbo yekubaiwa jekiseni iri pasi pehemorrhoid yakanangana nayo. Tsono inopinzwa pa30°~40° uchinyatsoona (kumberi kana kumashure) kwe endoscope, uye tsono inopinzwa zvakadzama pasi pehemorrhoid. Gadzira murwi wakaoma pasi pehemorrhoid, bvisa tsono paunenge uchibaya jekiseni, inenge 0.5~2mL, uye misa kubaiwa jekiseni kusvika hemorrhoid yakura uye yachena. Mushure mekunge kubaiwa jekiseni kwapera, tarisa kana paine kubuda ropa panzvimbo yekubaiwa jekiseni.
Kurapa ne endoscopic sclerotherapy kunosanganisira kubaya jekiseni repamberi nekubaya jekiseni regirazi rakapinzwa. Kazhinji, kubaya jekiseni regirazi rakapinzwa ndiyo nzira huru.
② kurapwa nebhandeji
Kazhinji, mudziyo wekubatanidza une maring akawanda unoshandiswa, usingapfuure maring manomwe. Kubatanidza kunoitwa pa1 kusvika 3 cm pamusoro pemutsetse wemazino, uye kusanganisa kunowanzo tangwa pedyo nemutsetse wemusana. Kunogona kuva kusanganisa tsinga dzeropa kana mucosal kana kusanganisa matinji. Kubatanidza mirror musono ndiyo nzira huru, kazhinji ka1-2, ine nguva yemwedzi mumwe chete.
Kurapa kwepashure pekuvhiyiwa: kutsanya hakudiwi mushure mekuvhiyiwa, kuchengetedza tsvina yakatsetseka, uye kudzivirira kugara kwenguva refu uye kushanda nesimba. Kushandisa mishonga inorwisa mabhakitiriya nguva dzose hakudiwi.
3. Mamiriro ezvinhu aripo iye zvino nematambudziko aripo ezvipatara zvepasi rose
Kare, nzvimbo huru yekurapa mamota yaive muchikamu cheanorectal. Kurapa kwesystemic muchikamu cheanorectal kunosanganisira mishonga inochengetedza hutano, jekiseni resclerotherapy, uye kurapwa kwekuvhiyiwa.
Vanachiremba vematumbu havana ruzivo rwakawanda mukuziva hunhu hwemuviri wemwana ari pasi pe endoscopy, uye zviratidzo zvekurapa ne endoscopic zvishoma (hemorrhoids dzemukati chete ndidzo dzinogona kurapwa). Kuvhiyiwa kunodiwawo kuti munhu apore zvakakwana, izvo zvave nguva yakaoma mukusimudzira chirongwa ichi.
Mukufunga, kurapwa kwemukati mehemorrhoids ne endoscopic kwakakodzera zvakanyanya kuzvipatara zvepuraimari, asi mukuita, hazvina kunyanya kufanana nekufungidzira.
Isu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., tinogadzira zvinhu muChina zvine chekuita ne endoscopic consumables, zvakaita sesimba re biopsy, hemoclip, musungo wepolyp, tsono yekurapa sclerotherapy, katheta yekupfapfaidza, mabhurashi e cytology, waya yekufambisa, tswanda yekutorwa kwematombo, katheta yekubuditsa mvura yemumhinonezvimwewo 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-11-2022