Intangiriro
Ibimenyetso by'ingenzi bya emorroide ni amaraso mu mwanda, ububabare bwo mu kibuno, kugwa no kuribwa, nibindi, bigira ingaruka zikomeye ku mibereho y'umuntu. Mu bihe bikomeye, bishobora gutera emorroide ifungiranye ndetse no kubura amaraso mu mwanda bidakira biterwa n'amaraso mu mwanda. Muri iki gihe, ubuvuzi busanzwe bushingiye ahanini ku miti, kandi kubagwa birakenewe mu bihe bikomeye.
Uburyo bwo kuvura hakoreshejwe endoskopi ni uburyo bushya bwo kuvura bwateguwe mu myaka ya vuba aha, kandi bukwiriye cyane mu bitaro by’ibanze. Uyu munsi, turasobanura muri make kandi tubikemure.
1. Gusuzuma indwara, imiterere y'umubiri n'uburyo bwo kuvura indwara z'ibibyimba mbere
Gusuzuma indwara ya Hemorrhoids
Gusuzuma indwara ya emoroyide bishingiye ahanini ku mateka, isuzuma, isuzuma rya digitale rectal na colonoscopy. Ku bijyanye n'amateka y'ubuzima, ni ngombwa gusobanukirwa ububabare bwo mu kibuno, amaraso mu mwanda, kuva amaraso mu nda no kongera kugaragara, nibindi. Isuzuma ahanini rireba uko emoroyide igaragara, niba hari fistula yo mu kibuno ifite ububyimbirwe bwa perianal, nibindi, kandi isuzuma rya digitale rectal rigomba gusobanukirwa uburyo anus ifunganye n'uko ikomeza. Colonoscopy igomba kumenya izindi ndwara nka kanseri, indwara yo mu gifu, nibindi bitera kuva amaraso. Ishyirwa mu byiciro no gushyira mu byiciro emoroyide.
Hari ubwoko butatu bwa hemorrhoids: hemorrhoids zo mu nda, hemorrhoids zo hanze, na hemorrhoids zivanze.
Hemorrhoids: Hemorrhoids z'imbere, iz'inyuma, n'izivanze
Ibibyimba bishobora gushyirwa mu byiciro bya I, II, III, na IV. Bishyirwa mu byiciro hakurikijwe ukwibyimba kw'ibibyimba, kuvamo ibibyimba n'igaruka ry'ibibyimba.
Ibimenyetso byo kuvura hifashishijwe endoskopi ni hemorrhoids zo mu rwego rwa I, II, na III, mu gihe hemorrhoids zo mu rwego rwa IV, hemorrhoids zo hanze, na hemorrhoids zivanze ari ibintu bibujijwe kuvura hifashishijwe endoskopi. Umurongo utandukanya ubuvuzi hifashishijwe endoskopi ni umurongo w'amenyo.
Imiterere ya Hemorrhoids
Umurongo w'ikibuno, umurongo w'amenyo, agapira k'ikibuno, na hemorrhoids ni ibintu abahanga mu by'ubuvuzi bw'indwara z'imitsi bagomba kumenya. Gupima endoskopi bisaba uburambe. Umurongo w'amenyo ni aho epithelium y'ikibuno ihurira n'igice cy'inyuma cy'ikibuno n'igice cy'inyuma cy'ikibuno, kandi agace k'impinduka hagati y'umurongo w'ikibuno n'umurongo w'amenyo gatwikiriwe n'igice cy'inyuma cy'ikibuno ariko ntabwo umubiri ubyinjizamo. Kubwibyo, ubuvuzi bw'inyuma bushingiye ku murongo w'amenyo. Ubuvuzi bw'inyuma bushobora gukorwa mu murongo w'amenyo, kandi ubuvuzi bw'inyuma ntibushobora gukorwa hanze y'umurongo w'amenyo.
Ishusho ya 1.Ishusho y'imbere y'umurongo w'amenyo munsi ya endoscope. Umwambi w'umuhondo werekana umurongo w'amenyo ufite utudomo twinshi, umwambi w'umweru werekana inkingi y'ikibuno n'urusobe rwayo rw'imitsi, naho umwambi utukura werekana valve y'ikibuno.
1A:ishusho y'urumuri rwera;1B:Ishusho y'urumuri rwa Narrowband
Igishushanyo cya 2Kwitegereza agace k'ikibuno (umwambi utukura) n'inkombe yo hasi y'inkingi y'ikibuno (umwambi wera) unyuze kuri mikorosikopi
Igishushanyo cya 3Kwitegereza agahu k'ikibuno ukoresheje mikorosikopi (umwambi w'umuhondo)
Ishusho ya 4.Umurongo w'ikibuno n'umurongo w'amenyo byagaragaye hakoreshejwe isuzuma rya reverse endoscopy. Umwambi w'umuhondo werekana umurongo w'amenyo, naho umwambi w'umukara werekana umurongo w'ikibuno.
Ibitekerezo bya anal papilla na anal column bikoreshwa cyane mu kubaga abana bato kandi ntibizongera kuvugwa hano.
Uburyo busanzwe bwo kuvura hemorrhoids:Hari ubuvuzi bushingiye ku buryo busanzwe n'ubuvuzi bwo kubaga. Ubuvuzi bushingiye ku buryo busanzwe burimo gukoresha imiti ikoreshwa mu gihe cy'izuba no kwiyuhagira mu buryo bwa sitz, naho uburyo bwo kubaga burimo kubagwa amaraso no gucibwamo ibice (PPH). Kubera ko kubaga ari ubuvuzi busanzwe, ingaruka ni nke, kandi ingaruka zikaba nke, umurwayi agomba kujya mu bitaro iminsi 3-5.
2. Kuvura indwara zo mu nda ziterwa na endoscope
Itandukaniro riri hagati yo kuvura hemorrhoids zo mu nda hakoreshejwe endoskopi n'ubuvuzi bwa EGV:
Intego yo kuvura varice zo mu kibuno ni imiyoboro y'amaraso iri mu nda, naho intego yo kuvura hemorrhoid zo mu nda si imiyoboro y'amaraso yoroshye, ahubwo ni hemorrhoids zigizwe n'imiyoboro y'amaraso n'ingingo zihuza. Kuvura hemorrhoids ni ukugabanya ibimenyetso, kuzamura agace k'ikibuno kamanuka, no kwirinda ingorane nka stenosis yo mu kibuno iterwa no kubura kwa hemorrhoids (ihame ryo "kwica byose" rikunze gutera stenosis yo mu kibuno).
Intego yo kuvura hakoreshejwe endoskopi: Kugabanya cyangwa gukuraho ibimenyetso, ntabwo ari ukugabanya hemorrhoids.
Ubuvuzi bwa endoscopic burimoubuvuzi bwa sclerotherapynaumugozi w'itsinda.
Mu gusuzuma no kuvura indwara ya hemorrhoids zo mu nda, hakoreshwa colonoscopy mu gusuzuma, naho gastroscope ikaba ari yo isabwa kuvura. Byongeye kandi, ukurikije uko ibitaro bihagaze, ushobora guhitamo ubuvuzi bwo hanze cyangwa ubuvuzi bwo mu nzu.
①Ubuvuzi bwa sclerotherapy (bufashijwe n'umupfundikizo ubonerana)
Uburyo bwo gutera sclerosing ni inshinge ya lauryl alcohol, kandi inshinge ya lauryl alcohol na yo irashobora gukoreshwa. Ni ngombwa kandi gukoresha inshinge ya methylene blue nk'ikintu kibura kugira ngo wumve icyerekezo cy'amazi n'uburyo akwirakwira.
Intego y'umupfundikizo ubonerana ni ukwagura ubushobozi bwo kureba. Urushinge rw'inshinge rushobora gutoranywa mu nshinge zisanzwe zo guterwa mu mucosa. Muri rusange, uburebure bw'urushinge ni mm 6. Abaganga badafite uburambe cyane bagomba kugerageza kwirinda gukoresha inshinge ndende, kuko inshinge ndende zo guterwa mu mfuruka y'amaraso zikunze guterwa no guterwa mu mfuruka y'amaraso. Ingaruka zikomeye kandi zigatera ibibyimba no kubyimba mu mfuruka y'amaraso.
Aho urushinge ruterwa hatoranywa hejuru y'uruhande rw'umunwa rw'umurongo w'amenyo, kandi aho urushinge rushyirwa ruherereye mu nsi y'amaraso aterwa. Urushinge rushyirwa kuri 30°~40° urebeye imbere cyangwa inyuma y'icyuma gipima amaraso, hanyuma urushinge rugashyirwa mu nsi y'amaraso aterwa. Kora ikirundo gikomeye ku nsi y'amaraso aterwa, ukuremo urushinge mu gihe utera urushinge, hafi 0.5~2mL, hanyuma uhagarike urushinge kugeza igihe amaraso aterwa rubaye runini kandi rwera. Nyuma yo gutera urushinge, reba niba hari amaraso ava aho uterwa urushinge.
Uburyo bwo kuvura indwara ya sclerotherapy hakoreshejwe endoscopic burimo gutera indorerwamo imbere no gutera indorerwamo ihinduriwe inyuma. Muri rusange, gutera indorerwamo ihinduriwe inyuma ni bwo buryo bw'ingenzi.
② uburyo bwo kuvura igitambaro
Muri rusange, hakoreshwa igikoresho cyo gufunga imikufi myinshi, kitarenze impeta zirindwi. Gufunga imikufi bikorwa kuri cm 1 kugeza kuri 3 hejuru y'umurongo w'amenyo, kandi gufunga imikufi akenshi bitangirira hafi y'umurongo w'ikibuno. Bishobora kuba ugufunga imitsi cyangwa gufunga mucosal cyangwa gufunganya. Gufunga indorerwamo mu buryo bwa "inverted mirror ligation" ni bwo buryo bw'ingenzi, akenshi inshuro 1-2, hamwe n'igihe cy'ukwezi kumwe.
Ubuvuzi bwo mu gihe cyo kubagwa: kwiyiriza ubusa ntibikenewe nyuma yo kubagwa, gukomeza kwituma neza, no kwirinda kwicara igihe kirekire no gukora imirimo ivunanye. Gukoresha imiti igabanya ubukana buri gihe ntabwo ari ngombwa.
3. Imiterere y'ibitaro by'ibanze n'ibibazo bihari ubu
Mu bihe byashize, uburyo bw'ingenzi bwo kuvura indwara zo mu nda bwari mu ishami rishinzwe kuvura indwara zo mu nda. Uburyo bwo kuvura indwara zo mu nda burimo imiti ikoreshwa mu kuvura indwara zo mu nda, gutera inshinge zo mu bwoko bwa sclerotherapy, no kubagwa.
Abaganga b’indwara zo mu nda ntabwo bafite uburambe bwinshi mu kumenya imiterere y’umubiri w’umwana hakoreshejwe endoskopi, kandi ibimenyetso byo kuvura endoskopi ni bike (hemorrhoids zo mu nda ni zo zishobora kuvurwa gusa). Kubagwa nabyo birakenewe kugira ngo umuntu akire neza, ibyo bikaba byarabaye ingorabahizi mu iterambere ry’umushinga.
Mu buryo bw’imitekerereze, kuvura indwara zo mu nda hakoreshejwe endoscopic birakwiriye cyane cyane mu bitaro by’ibanze, ariko mu by’ukuri, ntabwo ari byinshi nk’uko byatekerejwe.
Twebwe, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ni uruganda rukora ibikoresho byo mu Bushinwa byihariye mu gukoresha ibikoresho byo mu nda, nkaforceps za biopsy, hemoklip, umutego wa polyp, urushinge rwo kuvura sclerotherapy, katheteri itera umuti, uburoso bwa cytology, insinga y'ubuyobozi, agasanduku ko gukurura amabuye, katheteri itwara amazi mu mazurun'ibindi bikoreshwa cyane muriEMR, ESD, ERCPIbicuruzwa byacu bifite icyemezo cya CE, naho inganda zacu zifite icyemezo cya ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika ya Ruguru, Uburasirazuba bwo Hagati no mu gice kimwe cya Aziya, kandi birushaho kumenyekana no gushimwa n'abakiriya!
Igihe cyo kohereza: Nyakanga-11-2022