Indwara ya colon polyps nindwara zisanzwe kandi kenshi ziboneka mubuso rusange. Bavuga ku guhindagurika biruta mucosa yinyama. Mubisanzwe, colonoscopy ifite igipimo cyatangwa byibuze 10% kugeza 15%. Igipimo cy'igihe gito gikunze kwiyongera uko imyaka igendanwa. kuzamuka. Kubera ko kurenga kuri 90% bya kanseri yibara biterwa no guhindura nabi polyps, ubuvuzi rusange ni ugukora endoscopic sundoscopique akimara kuboneka.
Muri colonoscopy ya buri munsi, 80% kugeza kuri 90% ya polyps iri munsi ya cm 1. Kuri adnomatoous polyps cyangwa polyps ifite uburebure ≥ 5 mm (niba adnonomatous cyangwa atari), guhitamo endoscopic birasabwa. Ibishoboka bya micropolyps (uburebure bwa diameter ≤5mm) irimo ibice byigituba ni bike cyane (0 ~ 0, 0, 0, 0, 0,0%). Kuri micropolelys muri soko ya rectum na sigmoid, niba sogoscopiste ishobora kumenya neza ko atari ad abenootoous, ariko uko ibintu byavuzwe haruguru byashyizwe mubikorwa mubikorwa byubuvuzi mubushinwa.
Byongeye kandi, 5% ya polyps iringaniye cyangwa gukura kuruhande, hamwe na diameter ya cm irenze 2, hamwe cyangwa nta bice bibi. Muri iki gihe, bamwe bateye imbere tekinike yo gukuraho Polyp irakenewe, nkaEmrnaEsd. Reka turebe intambwe irambuye yo gukuraho Polyp.
Inzira yo kubaga
Umurwayi yarangije anesthesia mbere ya anesthesia, yashyizwe mumwanya wa Deubitus uhagaze, maze ahabwa anestnous yo muri propofole. Umuvuduko wamaraso, igipimo cy'umutima, electrocardiogram, no kuragura amaraso ya ogisijeni byakurikiranwe mugihe cyo kubagwa.
1 ubukonje / bishyushyeIngabo za biopsyKugabana
Birakwiriye gukuraho polyps nto ≤5mm, ariko hashobora kubaho ikibazo cyo gukuraho polyps 4 kugeza 5mm. Hashingiwe ku biopsy ubukonje, ikirere cya The Cyrmal kirashobora gukoresha inshuro nyinshi zigezweho zo kwita cyane ibikomere bisigaye kandi bikora hestasis ku gikomere. Ariko, hagomba kwitabwaho kugirango wirinde kwangirika kumwanya wa Serosa wurukuta rwinyama kubera electrocomagulation nyinshi.
Mugihe cyo gukora, umutwe winyuma wa polyp ugomba guterwa, uzamurwa neza (kugirango wirinde kwangiza urwego rwimitsi), kandi ukomeza intera ikwiye kuva kurukuta rwumuraro. Iyo Polyp Pedicle ahinduka umweru, hagarika electrocoagulation no guhambira ibisebe. Twabibutsa ko bitoroshye gukuraho kinini cyane polyp, bitabaye ibyo bizarangira igihe cyo gukwirakwiza no kongera ibyago byo kwangirika kwuzuye (Ishusho 1).
2 ubukonje / bishyushyeUmutego wa Polpocompyuburyo bwo gukuraho
Birakwiye ko yazamuye ibisingizo byubunini butandukanye i p, ubwoko bwa sp ubwoko bwa kanseri ya endoscopic. Hariho ubwoko bwinshi kandi sinzi neza) gusuzugura ibisebe. Kuri IP ntoya ya IP, uguhitamo umutego biroroshye. Imitego ikonje cyangwa ishyushye irashobora gukoreshwa mugushakisha. Mugihe cyo kugurira, uburebure bwa pedicle bugomba kuguma cyangwa intera runaka kuva kurukuta rwinyama mugihe ukomeza kuvana burundu. Nyuma yo gukomera umutego, bigomba guhungabanya umutego, witegereze niba hari ubwuzuzanyirize mu mara no gushyiramo hamwe kugirango wirinde kwangirika kurukuta rwinyuma.
Igishushanyo 1 Igishushanyo cya Schematic cyingufu za Hermal Biopsy, A mbere yo gukuraho imbaraga, b igikomere nyuma yo gukuraho FORPPS. CD: Ingamba zo mu bushyuheIngabo za biopsygukuraho. Niba polyp ari nini cyane, bizamura igihe cya electrocoagulation kandi bigatera ibyangiritse.
Igishushanyo 2 Igishushanyo cya Schematic cyumuhanda wubushyuhe buto bwa Ntoya I sp ubwoko
3 Emr
■ i P Ibikomere
Kuri minini i p ibibyimba, usibye kwirinda ibizaza haruguru, imitego yubushyuhe igomba gukoreshwa mugushaka. Mbere yo gutabarwa, inshinge zihagije zo muri Submucosal zigomba gukorwa munsi ya pedicle (metero 2 kugeza 10 za epinefirine zivanga mu murongo wa Epine 3,000. Ku buryo bwo gutahura Gukora loop ifunze kandi gutwika urukuta.
Igishushanyo 3 Igishushanyo cya Schematic cyaEmrKuvura ibikomere bya LP
Twabibutsa ko niba ubwoko bunini i p polyp ifite padicle yijimye, birashobora kuba birimo vasa nini, kandi bizava amaraso inyuma nyuma yo gukuraho. Mugihe cyo gutabwa, uburyo bwa coagulation-gukata-coagulation burashobora gukoreshwa mukugabanya ibyago byo kuva amaraso. Polyps nini irashobora guterwa ibice kugirango igabanye ingorane zo kubagwa, ariko ubu buryo ntabwo ifasha gusuzuma Pathologiya.
Ubwoko bwa Lla-C
Kuri ila-c ubwoko bwa Ila-C na bimwe ni ibikomere hamwe na diamesters nini, ugutana umutego birashobora gutera ibyangiritse byuzuye. Gutera submucosal byamazi birashobora kongera uburebure bwa lesion no kugabanya ingorane zumutego no gutabwa. Niba hari ukuba kubaga ni urujijo rwingenzi rwo kumenya niba Adenoma ari byiza cyangwa mabi kandi niba hari ibimenyetso byerekana imiti ya endoscopic. Ubu buryo burashobora kongera igipimo cyonyine cya Adenomas<2Cm muri diameter.
Igishushanyo 4Emrimbonerahamwe y'urugendo kugirango Ubwoko Il polyps
4 Esd
Kuri Adenomas hamwe na diameter nini kuruta 2cm bisaba igihe cyo guta igihe no gusinya nabi, kimwe na kanseri zimwe na zimwe zambere,EmrIbisigisigi cyangwa imyidagaduro igoye kubyifata,EsdKuvura birashobora gukorwa. Intambwe rusange ni:
1. Nyuma ya Endoscopic, imbibi za lesion zirasobanuwe neza kandi umuzenguruko ntirushobora kurangwa niba urubibi rwa lesion rusobanutse neza).
2. Gushora inyuma kugirango ibibyimba biragaragara.
3. Igice cyangwa kuzenguruka mucosa gushyira submucosa.
4. Kuraho ibice bihujwe hamwe na submucosa hanyuma usuzugure buhoro buhoro tissue irwaye.
5. Witegereze igikomere witonze kandi ufate inzabya zamaraso kugirango wirinde ingorane.
6. Nyuma yo gutunganya ingero zagaragaye, ohereza kubizamini bya pato.
Igishushanyo 5EsdKuvura ibisebe byinshi
INTEGO YO GUHA
Endoscopic Colon Colon Polyp Polyp isaba uburyo bukwiye bwo gutoranywa hashingiwe kubiranga Polyp, aho uherereye, urwego rwubuhanga, hamwe nubuhanga bwumukoresha, nibikoresho biriho. Muri icyo gihe, gukuraho Polyp nabyo bikurikira amahame Rusange, dukeneye gukurikiza byinshi bishoboka kugirango habeho gahunda yubuvuzi itekanye kandi ingirakamaro kandi abarwayi babyungukiramo.
1. Mbere yo gushiraho gahunda yo kuvura nurufunguzo rwo kurangiza neza kuvura polyp (cyane cyane polyps nini). Kuri polyps igoye, birakenewe guhitamo uburyo bujyanye mbere yo kuvura, kuvugana nabaforomo, anesthesiologiste nabandi bakozi mugihe gikwiye, kandi utegura ibikoresho byo kwivuza. Niba ibisabwa uruhushya, birashobora kuzura ukurikije ubuyobozi bwumuganga mukuru kugirango wirinde impanuka zitandukanye zo kubaga.
2. Kugumana "urwego rwubwisanzure" kumubiri windorerwamo mugihe cyo kuvura nicyo gisabwa kugirango tumenye neza ko ibikorwa bigamije. Iyo winjiye mu ndorerwamo, ukurikire cyane "uburyo bwo kubungabunga no kugabanya uburyo bwo kuvura" kugirango ukomeze umwanya wo kuvura muri leta yubuntu, bifasha kwivuza neza.
3. Icyerekezo cyiza gikora gituma inzira yo kuvura byoroshye kandi ifite umutekano. Amara y'umurwayi agomba gutegurwa neza mbere yo kuvurwa, umwanya w'umurwayi ugomba kugenwa mbere yo kubagwa, kandi polyps igomba kugaragara neza n'uburemere. Bikunze kuba byiza niba igisambo kirimo kuruhande rwamazi isigaye mu cyuho.
Twe, Jiagxi ZhuoluHhua Igikoresho cy'ubuvuzi Co, Ltd., ni uruganda mu Bushinwa rwihariye muri endoscopic ikoresha ibikoresha muri Endoscopic, nkaIngabo za biopsy, hemoclip, umutego wa polyp, Uruhu rwa sclerothethe, spray catheter, cytology brushes, kuyobora, Igitebo cya rene, Amashanyarazi ya Izurunibindi bikoreshwa cyane muriEmr, Esd, Ercp. Ibicuruzwa byacu ni byemewe, kandi ibimera byacu ni ISO yemewe. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika ya Ruguru, Uburasirazuba bwo hagati n'igice cya Aziya, kandi ibona cyane umukiriya kumenyekana no guhimbaza!
Igihe cya nyuma: Aug-02-2024