1) Ụkpụrụ nke endoscopic sclerotherapy (EVS):
Ngwunye intravascular: onye na-ahụ maka sclerosing na-ebute mbufụt gburugburu veins, na-eme ka arịa ọbara sie ike ma na-egbochi eruba ọbara;
Ngwunye paravascular: na-ebute mmeghachi omume mkpali na-adịghị mma na veins na-ebute thrombosis.2) Ngosipụta nke EVS:
(1) Nnukwu mgbawa EV na ọbara ọgbụgba;
(2) Ndị nwere akụkọ ihe mere eme nke mgbawa EV na ọbara ọgbụgba;(3) Ndị nwere nlọghachi nke EV mgbe ịwachara ahụ;(4) Ndị na-adabaghị maka ọgwụgwọ ịwa ahụ.
3) Ihe mgbochi nke EVS:
(1) Dị ka gastroscopy;
(2) Hepatic encephalopathy ogbo 2 na n'elu;
(3) Ndị na-arịa ọrịa imeju na akụrụ na-arụ ọrụ siri ike, nnukwu ascites, na jaundice siri ike.
4) Akpachara anya ọrụ
Na China, ị nwere ike họrọ lauromacrol.Maka arịa ọbara buru ibu, họrọ injection intravascular.Olu injection bụ n'ozuzu 10 ~ 15ml.Maka obere arịa ọbara, ị nwere ike ịhọrọ injection paravascular.Gbalịa ka ị ghara ịgbanye ọgwụ n'ọtụtụ ebe dị iche iche n'otu ụgbọ elu (ikekwe ọnya nwere ike ime na-eduga n'ịgbachi esophageal).Ọ bụrụ na ọ na-emetụta iku ume n'oge a na-arụ ọrụ ahụ, enwere ike ịgbakwunye okpu nke ọma na gastroscope.Na mba ọzọ, a na-agbakwunye balloon na gastroscope.Ọ bara uru ịmụta na.
5) Nlekọta nke EVS mgbe arụchara ọrụ gasịrị
(1) erila ma ọ bụ ṅụọ ihe ọṅụṅụ ruo awa 8 mgbe ịwachara ahụ ma jiri nwayọọ nwayọọ maliteghachi nri mmiri mmiri;
(2) Jiri ọgwụ nje mee ihe kwesịrị ekwesị iji gbochie ọrịa;(3) Jiri ọgwụ na-ebelata nrụgide portal dị ka o kwesịrị.
6) Usoro ọgwụgwọ EVS
A na-achọ ọgwụgwọ ọtụtụ sclerotherapy ruo mgbe veins varicose ga-apụ n'anya ma ọ bụ na-apụ n'anya, na-ewe ihe dị ka otu izu n'etiti ọgwụgwọ ọ bụla;A ga-enyocha gastroscopy 1 ọnwa, ọnwa 3, ọnwa 6, na 1 afọ mgbe njedebe nke usoro ọgwụgwọ gasịrị.
7) Nsogbu nke EVS
(1) Nsogbu ndị a na-ahụkarị: ectopic embolism, ọnyá afọ esophageal, wdg, na
Ọ dị mfe ime ka ọbara na-agbapụta ma ọ bụ na-agbapụta ọbara site na oghere agịga mgbe a na-ewepụ agịga ahụ.
(2) Nsogbu mpaghara: ọnya, ọbara ọgbụgba, stenosis, nkwụsị nke motility nke esophageal, odynophagia, lacerations.Nsogbu mpaghara gụnyere mediastinitis, perforation, pleural effusion, na portal hypertensive gastropathy nwere nnukwu ohere nke ọbara ọgbụgba.
(3) Nsogbu sistemu: sepsis, oyi oyi oyi, hypoxia, peritonitis nje bacteria na-apụtaghị, na thrombosis portal vein.
Endoscopic varicose vein ligation (EVL)
(1) Ngosipụta maka EVL: Otu dị ka EVS.
(2) Ihe mgbochi nke EVL:
(1) Otu contraindications dị ka gastroscopy;
(2) EV tinyere GV doro anya;
(3) na-esonyere ya na imeju na imeju na-arụ ọrụ nke ọma, nnukwu ascites, jaundice
Gangrene na ọgwụgwọ sclerotherapy na-adịbeghị anya ma ọ bụ obere veins varicose
Iwere usoro eze Han dị ka nso-duofu pụtara na ndị Hua ga-enwe ike ịkwaga n'efu, ma ọ bụ a ga-agbatị akaị na akwara na ọdịda anyanwụ.
Site na.
3) Otu esi arụ ọrụ
Gụnyere otu ntutu isi, ọtụtụ ntutu isi, na eriri nylon.
Ụkpụrụ: Gbochie usoro ọbara nke varicose veins ma nye hemostasis mberede → venous thrombosis na saịtị ligation → anụ ahụ necrosis → fibrosis → mpụ nke veins varicose.
(2) Akpachara anya
Maka varices esophageal dị oke ma dị njọ, vein varicose ọ bụla na-ejikọta ya n'ụzọ gbagoro elu site na ala ruo n'elu.Njikọ ahụ kwesịrị ịdị nso dị ka o kwere mee na ebe a na-achọ ligation nke vein varicose, nke mere na isi ihe ọ bụla na-ejikọta ya na nke ọma.Gbalịa ikpuchi vein varicose ọ bụla karịa isi atọ.
Usoro EVL
Isi mmalite: Ọkà Okwu PPT
Ọ na-ewe ihe dị ka izu 1 ruo 2 maka necrosis ka ọ daa ma ọ bụrụ na bandeeji necrosis.Otu izu ka a wachara ya ahụ, ọnya mpaghara nwere ike ịkpata nnukwu ọbara ọgbụgba, eriri akpụkpọ ahụ na-adapụ, na ịcha ọbara nke varicose veins, wdg;
EVL nwere ike ikpochapụ veins varicose ngwa ngwa ma nwee nsogbu ole na ole, mana ọnụọgụ nlọghachi nke veins varicose dị elu;
EVL nwere ike igbochi ọbara ọgbụgba nke eriri afọ nke aka ekpe, vein esophageal, na vena cava, ma mgbe egbochichara venous ọbara nke esophageal, eriri afọ eriri afọ na perigastric venous plexus ga-abawanye, ọbara na-erugharị ga-abawanye, na nlọghachite ọnụ ọgụgụ. ga-abawanye ka oge na-aga, ya mere, a na-emekarị ka a na-achọgharị bandwit ugboro ugboro iji mee ka ọgwụgwọ ahụ sie ike.Dayameta nke varicose vein ligation kwesịrị ịbụ ihe na-erughị 1.5 cm.
4) Nsogbu nke EVL
(1) Nnukwu ọbara ọgbụgba n'ihi ọnya mpaghara ihe dịka otu izu mgbe a wachara ya ahụ;
(2) Ọbara ọgbụgba n'ime ime, mfu nke eriri akpụkpọ anụ, na ọbara ọgbụgba nke varicose veins kpatara;
(3) Ọrịa.
5) Nyochaa nyocha nke EVL gachara
N'afọ mbụ mgbe EVL gasịrị, ọrụ imeju na akụrụ, B-ultrasound, usoro ọbara, ọrụ coagulation, wdg kwesịrị nyochaa kwa ọnwa 3 ruo 6.A ga-enyocha endoscopy kwa ọnwa 3, mgbe ahụ kwa ọnwa 0 ruo 12.6) EVS vs EVL
E jiri ya tụnyere sclerotherapy na ligation, ọnụ ọgụgụ ọnwụ na nlọghachi azụ nke abụọ ahụ bụ.
Enweghị nnukwu ọdịiche dị na ọnụọgụ ọbara yana maka ndị ọrịa chọrọ ọgwụgwọ ugboro ugboro, a na-atụkarị aro ka a na-ekekọta bandeji.A na-ejikọta band ligation na sclerotherapy mgbe ụfọdụ iji meziwanye mmetụta ọgwụgwọ.Na mba ọzọ, a na-ejikwa stent metal kpuchie nke ọma iji kwụsị ọbara ọgbụgba.
NkeSclerotherapy agịgaA na-eji ZRHmed eme ihe maka Endoscopic Sclerotherapy (EVS) na Endoscopic varicose vein ligation (EVL).
Oge nzipu: Jan-08-2024