(1). Ubuhanga bwibanze Ubuhanga bwibanze bwa EMR nuburyo bukurikira:
Urukurikirane rwa tekinike
Injiza igisubizo cyaho cyo gutera inshinge munsi yindwara.
Shyira umutego ukikije igikomere.
Umutego urakomeye kugirango ufate kandi uhambire igikomere.
OntinKomeza gukaza umutego mugihe ukoresha amashanyarazi kugirango ucike igikomere.
Kuramo urugero rwakuweho.
(2). Inama
1.Inama zo guhitamo imyanya yumubiri hamwe na endoscope
Kuberako igikomere gikeneye kuvurwa mugihe ishusho yose igaragara, umwanya wumurwayi ni ngombwa cyane. Gerageza kugoreka urwego kugirango ibisebe biherereye hafi ya biopsy forceps ifungura, ni ukuvuga guhera saa kumi n'imwe kugeza saa moya kuri ecran.
Mbere yo kuvurwa, ibisigara hamwe na pigment irenze urugero bigomba gukaraba hanyuma bigakurwaho.
Kurugero, niba igikomere kiri hafi ya sigmoid colon yakuweho muri supine cyangwa ibumoso bwa decubitus, icyitegererezo akenshi kizimukira kumurongo wamanutse, bikagorana kugarura, bityo iburyo bwa decubitus iburyo nibyiza kubisubiramo.
Mu buryo nk'ubwo, duhereye ku buryo bwo kugarura ibintu, ibumoso bwa decubitus ihitamo gukundwa no kwangirika kw'imitsi ihindagurika.
2.Inama zo gutera inshinge
Urushinge rwinshi rwo gutera inshinge zirashobora guterwa kumuvuduko wo hasi, ariko ntirukarishye bihagije kandi umwobo wurushinge ni munini cyane, kubwibyo umwanditsi akoresha urushinge rwa 25G rwaho.
Ntabwo ari ugukabya kuvuga ko gutsinda cyangwa gutsindwa kwa EMR biterwa ahanini ninshinge zaho.
Kubikomere bito, gutobora bikorwa kuva kuruhande rwa anal kurwara kugeza munsi yindwara.
Kubikomere mu gice kigoramye cyangwa hejuru yubugingo, niba inshinge zaho zakozwe kuva kuruhande rwa anal, mubihe byinshi ibikomere ntibisobanutse neza kuko bireba uruhande rwumunwa, bityo inshinge zaho zigomba gutangirira kumunwa.
Ibyingenzi kubatekinisiye ba Endoscopi
Niba amazi asohotse, cyangwa hari ukurwanya gukomeye mugihe cyo gutera inshinge, cyangwa ntihabeho guhangana iyo amazi yinjiye ariko ntihabeho ibibyimba, inshinge igomba guhagarara kandi uyikoresha agomba kumenyeshwa uko byagenze mugihe gikwiye kugirango baganire kubirwanya.
Umubare munini wo gutera inshinge, nibyiza.
Amayeri nugukomeza gutera inshinge nyinshi zishoboka binyuze mumutwe umwe kugeza igihe igikomere cyose kizamuye.
3.Inama zo guhitamo umutego
Niba umutego uri muburyo bwa ova ndende, mucosa isanzwe kumunwa wangiritse no kumpande ya anus irashobora kubamo byoroshye kandi bitari ngombwa.
Umutego nibyiza ko uzenguruka, byoroshye gufungura kuruhande, ntabwo byoroshye kunyerera, kandi ufite ingorane zimwe zo gukanda kuri lesion kugirango ufate igikomere.
Ingano yumutego igomba guhuzwa nubunini bwa lesion.
Umutego wa Polypectomy
Ingero za EMR
a. Ishusho yera
Ubwoko bwa mm 25 ubwoko bwa IIa igikomere hamwe nigice cyo hagati cyihebye gato.
b. Amashusho mato yerekana amashusho (NBI)
c. Gutera indigo carmine kugirango yongere ishusho
Byagaragaye ko kwiheba byagaragaye kubireba bisanzwe mubyukuri byari ibiti hagati yamababi.
d. Ishusho nini ya kristu ya violet irangi
Urwobo rw'imiyoboro ya glandular ifungura ku nkombe ya lesion yari ubwoko bwa IV.
e. Ishusho nini ya kristu ya violet irangi
rwagati muri lesion yari VI, idasanzwe, kandi nta gucengeza kugaragara kwabonetse.
f. Gutera inshinge
Gutobora no gutera inshinge byakorewe hagati yindwara, bivamo umubyimba mwiza.
g. Fungura umutego
Kanda umutego hejuru y'urukuta rw'imbere kugirango ufungure umutego.
h. Funga umutego
Funga umutego hanyuma ufate igikomere.
i.Imbaraga zo gukuraho
Nta gutobora, kuva amaraso cyangwa ikibyimba gisigaye cyabonetse.
j. Kugaragaza neza
Urugero rwacukuwe rwometse ku rupapuro.
Isuzuma rya nyuma ry’indwara:kanseri ya intramucosal (Tis)
4.Inama zo gukora umutego
Umutego umutego ushyirwa witonze kuri mucosa yo mu kanwa ya lesion, hanyuma ugafungura buhoro buhoro hanyuma umuzi wumutego ugakanda kuruhande rwa anal. Kugirango wirinde gutembera kuruhande kuba mwiza, hagomba gushyirwamo agace gato ka mucosa.
Twabibutsa ko mugihe umutego wumutego udashobora kuboneka, birashoboka ko hashyizwemo mucosa isanzwe kuruta uko byari byitezwe. Umutego umaze gukomera rwose, kanda kandi ukurure amaboko yinyuma yumutego kugirango urebe uko igisebe kigenda. Niba byinjijwe mumitsi, kugenda kwa lesion bizagabanuka.
Inama za electroresection
Ntugakande umutego kurukuta rw'inda, ariko uzamure gato igikomere kugirango wongere. Ibyago byo gutinda gutobora ni bike mugihe ukoresheje imiti ya elegitoroniki, ariko ikunda kuva amaraso (hakiri kare nyuma yo kwangwa).
Gusohora byihuta cyane bishobora gutera kuva amaraso, mugihe gutinda bitinda cyane bishobora gutera gutinda gutinda. Niba umurwayi yumva ububabare, cyangwa umufasha akumva ko tissue yoroheje nka reberi kandi bigoye kuyikata, birashoboka ko tissue igira uruhare mumitsi, kandi gusohora bigomba guhita bihagarikwa.
Ibyingenzi kubatekinisiye ba Endoscopi
Niba endoscopiste yumva ko tissue yoroshye nka reberi kandi bigoye kuyikata, agomba guhita abimenyesha uyikoresha kugirango baganire kubirwanya.
Inama zo Gusangira EMR
Ku bisebe binini, rimwe na rimwe ni byiza gukora resececemale aho gukora ku gahato-icyarimwe. Nyamara, uko ibice byinshi bihari, niko bishoboka cyane ko byongeye kubaho. Ndetse hamwe na EMR icamo ibice, kubanza kubanza bigomba gukorwa binini bishoboka hamwe numutego munini kugirango ugabanye umubare wibice.
Twebwe, Jiangxi Zhuoruihua Medical Instrument Co., Ltd. Ibicuruzwa byacu byemewe na CE, kandi ibihingwa byacu byemewe na ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika y'Amajyaruguru, Uburasirazuba bwo hagati ndetse no muri Aziya, kandi bigera ku bakiriya bamenyekana kandi bashimwe!
Imbaraga za biopsy:
https://www.
umutego
https://www.
Shira catheter
https: //www.zrhendoscopy.com
cytology
https://www.
igitebo cyo kugarura amabuye
https://www.zrhendoscopy.com/impapuro
izuru rya biliary drainage catheter
https://www.
EMR
https://www.zrhendoscopy.com/emresd/
ESD
https://www.zrhendoscopy.com/emresd/
ERCP
https://www.zrhendoscopy.com/ercp/
Igihe cyo kohereza: Gashyantare-13-2025