1) Ihame rya endoskopi sclerotherapie (EVS):
Gutera imitsi y'amaraso: imiti ya sclerose itera uburibwe mu mitsi, igakomera imiyoboro y'amaraso ikabuza gutembera kw'amaraso;
Gutera paravaskulaire: bitera sterile inflammatory reaction mumitsi itera trombose.2) Ibimenyetso bya EVS:
(1) Guturika gukabije kwa EV no kuva amaraso;
(2) Abantu bafite amateka yo guturika no kuva amaraso;(3) Abantu bafite ibibazo bya EV nyuma yo kubagwa;(4) Abantu badakwiriye kuvurwa.
3) Kurwanya EVS:
(1) Kimwe na gastroscopi;
(2) Hepatic encephalopathie icyiciro cya 2 no hejuru;
(3) Abarwayi bafite umwijima mwinshi nimpyiko zidakora neza, asitite nyinshi, na jaundice ikabije.
4) Ibikorwa byo kwirinda
Mubushinwa, urashobora guhitamo lauromacrol.Ku miyoboro minini y'amaraso, hitamo inshinge.Ingano yo gutera inshinge muri rusange 10 ~ 15mL.Ku mitsi mito y'amaraso, urashobora guhitamo inshinge za paravascular.Gerageza kwirinda gutera inshinge ahantu hatandukanye ku ndege imwe (birashoboka ko Ulcers ishobora kubaho iganisha kuri esophageal).Niba guhumeka bigira ingaruka mugihe cyo kubaga, capa ibonerana irashobora kongerwaho gastroscope.Mu bihugu by'amahanga, ballon ikunze kongerwa muri gastroscope.Birakwiye ko twigiraho.
5) Ubuyobozi bwa nyuma yubuvuzi bwa EVS
(1) Ntukarye cyangwa unywe amasaha 8 nyuma yo kubagwa hanyuma buhoro buhoro usubukure ibiryo byamazi;
(2) Koresha antibiyotike ikwiye kugirango wirinde kwandura;(3) Koresha ibiyobyabwenge bigabanya umuvuduko wurubuga uko bikwiye.
6) Amasomo yo kuvura EVS
Sclerotherapie nyinshi irakenewe kugeza igihe imitsi ya varicose ibuze cyangwa ahanini ikabura, hamwe nigihe kingana nicyumweru 1 hagati yubuvuzi;gastroscopy izasubirwamo ukwezi 1, amezi 3, amezi 6, numwaka 1 nyuma yamasomo yo kuvura.
7) Ingorane za EVS
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Biroroshye gutera amaraso gutemba cyangwa gusuka amaraso ava mu mwobo w'urushinge iyo urushinge rusohotse.
.Ingorane zo mu karere zirimo mediastinitis, perforasi, pleural effusion, hamwe na portal hypertensive gastropathie ifite ibyago byinshi byo kuva amaraso.
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Endoscopic varicose vein ligation (EVL)
(1) Ibyerekana kuri EVL: Kimwe na EVS.
(2) Kurwanya EVL:
(1) Kurwanya kimwe na gastroscopi;
(2) EV iherekejwe na GV igaragara;
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Gangrene nubuvuzi bwinshi bwa sclerotherapy cyangwa imitsi mito ya varicose
Gufata Ingoma ya Han nka hafi-duofu bivuze ko abaturage ba Hua bazashobora kugenda mu bwisanzure, cyangwa imitsi na pulses bizaramburwa bigana iburengerazuba.
Na.
3) Uburyo bwo gukora
Harimo guhuza umusatsi umwe, guhuza imisatsi myinshi, hamwe na nylon umugozi.
Ihame: Hagarika umuvuduko wamaraso yimitsi ya varicose kandi utange hemostasis yihutirwa → trombose yimitsi ahabigenewe → tissue necrosis → fibrosis → kubura imitsi ya varicose.
(2) Kwirinda
Kuburyo butandukanye kandi bukabije Esophageal varices, buri mitsi ya varicose ihujwe muburyo buzunguruka hejuru kuva hejuru kugeza hejuru.Ligator igomba kuba yegeranye hashoboka kugera kuntego yo guhuza imiyoboro ya varicose, kugirango buri ngingo ihuze neza kandi ihujwe cyane.Gerageza gupfuka imitsi ya varicose kurenza ingingo 3.
Intambwe ya EVL
Inkomoko: Umuvugizi PPT
Bifata ibyumweru 1 kugeza kuri 2 kugirango nérosose igwe nyuma ya bande ya nérosose.Icyumweru kimwe nyuma yo kubagwa, ibisebe byaho bishobora gutera kuva amaraso menshi, uruhu rwuruhu ruragwa, no gukata imashini zikoresha imitsi ya varicose, nibindi.;
EVL irashobora kurandura imitsi ya varicose vuba kandi ifite ibibazo bike, ariko igipimo cyo kugaruka kwimitsi ya varicose ni kinini;
EVL irashobora guhagarika amaraso ava mumitsi yi bumoso, imitsi ya esophageal, na vena cava, ariko nyuma yo gutembera kw'amaraso yo mu maraso ya Esophageal, imitsi ya coronary gastrica na perigastric venine plexus izaguka, umuvuduko w'amaraso uziyongera, kandi umuvuduko wo kugaruka biziyongera mugihe, kubwibyo bikunze gusubirwamo bande isabwa kugirango ihuze imiti.Diameter ya varicose vein ligation igomba kuba munsi ya 1.5cm.
4) Ingorane za EVL
(1) Kuva amaraso menshi kubera ibisebe byaho nyuma yicyumweru 1 nyuma yo kubagwa;
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(3) Kwandura.
5) Isubiramo rya nyuma ya EVL
Mu mwaka wa mbere nyuma ya EVL, imikorere yumwijima nimpyiko, B-ultrasound, gahunda yamaraso, imikorere ya coagulation, nibindi bigomba gusubirwamo buri mezi 3 kugeza kuri 6.Endoscopi igomba gusubirwamo buri mezi 3, hanyuma buri mezi 0 kugeza 12.6) EVS vs EVL
Ugereranije na sclerotherapie na ligation, ibipimo bipfa no gusubiramo byombi ni
Nta tandukaniro rikomeye riri hagati yumuvuduko wamaraso kandi kubarwayi bakeneye kuvurwa inshuro nyinshi, birasabwa cyane.Band ligation na sclerotherapie rimwe na rimwe bihuzwa kugirango bigire ingaruka nziza yo kuvura.Mu mahanga, ibyuma bitwikiriye byuzuye nabyo bikoreshwa muguhagarika kuva amaraso.
UwitekaUrushinge rwa Sclerotherapykuva ZRHmed ikoreshwa kuri Endoscopic Sclerotherapy (EVS) na Endoscopic varicose vein ligation (EVL).
Igihe cyo kohereza: Mutarama-08-2024