Na ọgwụgwọ colonoscopic, nsogbu ndị nnọchiteanya bụ perforation na ọbara ọgbụgba.
Perforation na-ezo aka na steeti nke oghere ahụ na-ejikọta ya na oghere ahụ n'ihi ntụpọ anụ ahụ zuru oke, na ọnụnọ nke ikuku efu na nyocha X-ray adịghị emetụta nkọwa ya.
Mgbe a na-ekpuchi akụkụ nke ntụpọ anụ ahụ zuru oke na enweghị nkwurịta okwu n'efu na oghere ahụ, a na-akpọ ya perforation. A kọwapụtaghị nkọwa ọbara ọgbụgba nke ọma, ndụmọdụ ndị dị ugbu a gụnyere mbelata hemoglobin karịa 2 g/dL ma ọ bụ mkpa mmịnye.
A na-akọwakarị ọbara ọgbụgba mgbe ịwachara ahụ dị ka ọnọdụ ọbara dị ịrịba ama na stool mgbe a wachara ya ahụ nke chọrọ ọgwụgwọ hemostatic ma ọ bụ mmịnye ọbara.
Mmetụta nke ihe mberede ndị a na-adịgasị iche site na ọgwụgwọ:
Ọnụọgụ mkpesa:
Polypectomy: 0.05%
Endoscopic mucosal resection (EMR): 0.58% ~ 0.8%
Ngwa Endoscopic emetụtara:Polypectomy ọnyà
Ngwa Endoscopic emetụtara:Ihe nkiri Hemostatic
Ngwa Endoscopic emetụtara: Sclerotherapy agịga
Mgbasa nke endoscopic submucosal (ESD): 2% ~ 14%
Ngwa Endoscopic emetụtara:Mma ESD
Ngwa Endoscopic emetụtara: Enwere ike ịtụfu yaMma ESD
Ọnụọgụ ọbara ọgbụgba gachara:
Polypectomy: 1.6%
EMR: 1.1% ~ 1.7%
ESD: 0.7% ~ 3.1%
1. Otu esi emeso perforation
Ebe ọ bụ na mgbidi nke nnukwu eriri afọ dị ntakịrị karịa nke afọ, ihe ize ndụ nke perforation dị elu. A chọrọ nkwadebe nke ọma tupu ịwa ahụ iji merie ohere nke perforation.
Akpachara anya n'ime ime:
Gbaa mbọ hụ na endoscope na-arụ ọrụ nke ọma. Họrọ endoscopes kwesịrị ekwesị, ngwa ọgwụgwọ, mmiri ịgba ntụtụ, na akụrụngwa ikuku carbon dioxide dabere na ọnọdụ, morphology, na ogo fibrosis nke etuto ahụ.
Nlekọta nke perforation intraoperative:
Mmechi ozugbo: N'agbanyeghị ebe ọ nọ, a na-ahọrọ obere vidiyo maka mmechi (ike nkwanye: ọkwa 1, ọkwa akaebe: C). N'ime ESD, mgbe ụfọdụ, a ga-ebu ụzọ kpochapụ ebe gbara ya gburugburu ka ọ ghara itinye aka na ọrụ ncha.
Tissue, hụ na ohere ọrụ zuru ezu tupu imechi.
Nleba anya mgbe arụchara ọrụ ahụ: Ọ bụrụ na enwere ike mechie perforation ahụ kpamkpam, enwere ike izere ịwa ahụ site na naanị ọgwụgwọ nje na ibu ọnụ.
Mkpebi ịwa ahụ: A na-ekpebi mkpa maka ịwa ahụ dabere na nchikota nke mgbaàmà abdominal, nsonaazụ nyocha ọbara, na eserese kama ikuku efu nke egosiri na CT naanị.
Ọgwụgwọ akụkụ pụrụ iche:
Isi ikewa dị ala agaghị eme ka ọnya afọ n'ihi njirimara anatomical ya, mana ọ nwere ike ịkpata ya
Pelvic perforation, pụtara dị ka retroperitoneal, mediastinal, ma ọ bụ subcutaneous emphysema.
Mkpachapụ anya:
Imechi ọnya mgbe ịwachara ahụ nwere ike igbochi nsogbu ruo n'ókè ụfọdụ, mana ọ naghị eme ya
Enwere ihe akaebe zuru oke iji gosi na ọ dị irè n'igbochi perforation na-egbu oge.
2. Nzaghachi maka Ọbara
Nlekọta ọbara ọgbụgba intraoperative:
Jiri okpomọkụ coagulation ma ọ bụhemostatic clipsịkwụsị ọbara ọgbụgba.
Obere arịa na-agba ọbara:
In EMR, enwere ike iji ọnụ ọnyà ahụ mee ka coagulation ọkụ.
Na ESD, enwere ike iji n'ọnụ mma eletrik kpọtụrụ coagulation thermal ma ọ bụ hemostatic forceps iji kwụsị ọbara ọgbụgba.
Nnukwu ọbara ọgbụgba: Jiri hemostatic forceps, mana jikwaa oke coagulation ka ịzenarị perforation na-egbu oge.
Mgbochi nke ọbara ọgbụgba mgbe ịwachara ahụ:
Mwepụ ọnya mgbe EMR gasịrị:
Nnyocha e mere egosiwo na iji hemostatic clamps maka mgbochi coagulation enweghị mmetụta dị ịrịba ama na ọnụ ọgụgụ ọbara ọgbụgba na-aga n'ihu, ma e nwere usoro na-ebelata. Mgbochi mgbochi na-enwe mmetụta dị nta na obere ọnya, ma ọ dị irè maka nnukwu ọnya ma ọ bụ ndị ọrịa nwere nnukwu ihe ize ndụ nke ọbara ọgbụgba (dị ka ndị na-anata ọgwụgwọ antithrombotic).
Mpụpụ ọnya mgbe ESD gasịrị:
A na-agbachikwa arịa ọbara ndị ahụ ekpughere, na enwere ike iji vidiyo hemostatic iji gbochie njide nke nnukwu arịa ọbara.
Mara:
Maka EMR nke obere ọnya, a naghị atụ aro ọgwụgwọ mgbochi oge niile, mana maka nnukwu ọnya ma ọ bụ ndị ọrịa nwere nnukwu ihe ize ndụ, mgbochi mgbochi na-aga n'ihu nwere mmetụta ụfọdụ (ike nkwanye: Ọkwa 2, ọkwa akaebe: C).
Perforation na ọbara ọgbụgba bụ nsogbu nkịtị nke endoscopy colorectal.
Ịme usoro mgbochi kwesịrị ekwesị na ọgwụgwọ maka ọnọdụ dị iche iche nwere ike ibelata ọrịa nke oge ụfọdụ ma melite nchekwa ndị ọrịa.
Anyị, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., bụ emeputa na China ọkachamara na endoscopic consumables, dị kabiopsy forceps, hemoclippolyp ọnyà,sclerotherapy agịga, ịgba catheter, cytology brushes, ndumodu, nkata eweghachite okwute, imi biliary drainage catheter,ureteral ohere n'ọbọ na urethra ohere n'ọbọ na suction wdg. nke a na-ejikarị eme ihe na EMR,ESD, ERCP. Ngwaahịa anyị bụ CE asambodo, na osisi anyị bụ ISO asambodo. Ebupụla ngwongwo anyị na Europe, North America, Middle East na akụkụ nke Eshia, na-enwetakwa ndị ahịa nke nnabata na otuto!
Oge nzipu: Eprel-18-2025