Kuvura amabuye akomeye ya ERCP

·Nyuma yo kubagwa kwa LC, imiterere y'umuyoboro w'indyo iba idasanzwe kandi umuyoboro w'indyo uragorama. Mu giheERCPIyo ikora, insinga iyobora "yoroshye kuyishyira hasi ariko ntiyoroshye kuyishyiraho" (iragwa ku bw'impanuka nyuma yo kuzamurwa), bityo iyo insinga iyobora imaze gushyirwaho, igomba kugumana kugira ngo hirindwe ko insinga iyobora igwa hanze y'umuyoboro w'inyongo.

·Mirizz syndrome ni ikibazo cy’imiterere y’umubiri kibura kandi kikirengagizwa byoroshye. Inyigo: Nyuma yo kubagwa LC, umurwayi ufite utubuye tw’imiyoboro ya cystic yakandagiye umuyoboro wa nyongo usanzwe, bitera Mirrizz syndrome. Ayo mabuye ntiyashoboraga gukurwaho hifashishijwe X-ray. Amaherezo, ikibazo cyakemutse nyuma yo gusuzuma no gukuraho hifashishijwe eyeMAX.

KuriERCPGukuraho amabuye y'igifu nyuma yo kubagwa Bi II, ikintu cy'ingenzi ni ukugera ku ibere unyuze mu icupa. Hari igihe bifata igihe kirekire (bisaba imitekerereze ikomeye) kugira ngo ugere ku ibere, kandi iyo umugozi udafashwe neza, ushobora gusohoka byoroshye.

③Ibindi bihe

Indwara yo mu bwoko bwa peripapillary diverticulum hamwe n'utubuye tw'imiyoboro y'amaraso ni ibisanzwe. Ingorane mu kubagwa muri iki gihe ni ibyago byo gukata ibere no kwaguka. Iyi ngaruka ni nyinshi ku mabere ari muri diverticulum, kandi ibyago byo ku mabere ari hafi ya diverticulum ni bike.

Muri iki gihe, ni ngombwa kandi gusobanukirwa urwego rwo kwaguka. Ihame rusange ryo kwaguka ni ukugabanya ibyangiritse bikenewe kugira ngo amabuye akurweho. Kwangirika guto bivuze ingaruka nke. Muri iki gihe, kwaguka kw'inyuma y'urubuto (CRE) rw'ibere rikikije diverticula muri rusange bikoreshwa mu kwirinda EST.

Abarwayi bafite indwara z'amaraso, imikorere y'umutima n'ibihaha badashobora kwihanganiraERCPcyangwa indwara z'umugongo zidashobora kwihanganira imiterere y'ibumoso igihe kirekire zigomba kwitabwaho no gusuzumwa iyo zihuye n'amabuye akomeye.

02 Imitekerereze yo guhangana n' "amabuye agoye"

Imitekerereze mibi iyo uhanganye n' "amabuye agoye": umururumba n'intsinzi, uburangare, agasuzuguro mbere yo gukora, nibindi.

·Umwina n'urukundo rw'ibintu bikomeye byagezweho

Iyo duhanganye n'amabuye yo mu miyoboro y'amaraso, cyane cyane ayo afite amabuye menshi, twifuza gukuraho amabuye yose. Ubu ni ubwoko bw' "umururumba" kandi ni intsinzi ikomeye.

Mu by’ukuri, ni byiza gufata icyuzuye n’icyanduye, ariko gufata icyuzuye uko byagenda kose ni "byiza cyane", ibyo bikaba bidafite umutekano kandi bizana ingorane nyinshi. Amabuye menshi yo mu miyoboro y’amaraso agomba gufatwa neza hashingiwe ku miterere y’umurwayi. Mu bihe byihariye, umuyoboro ugomba gushyirwaho cyangwa gukurwaho mu byiciro gusa.

Iyo amabuye manini yo mu miyoboro y'amaraso bigoye kuyakuraho by'agateganyo, "stent dissolving" ishobora kwitabwaho. Ntugahatire gukuraho amabuye manini, kandi ntukishyire mu kaga gakomeye.

·Kutagira amakenga

Ni ukuvuga ko kubaga mu buryo butarimo isesengura ryimbitse n'ubushakashatsi akenshi bituma amabuye ananirwa gukurwaho. Kubwibyo, imanza z'amabuye y'imiyoboro y'amaraso zigomba gusuzumwa neza mbere yo kubagwa, bigasuzumwa neza (bisaba ubushobozi bwoERCPabaganga basome amafoto), gufata ibyemezo witonze no gutegura gahunda zihutirwa bigomba gukorwa kugira ngo hirindwe gukuraho amabuye mu buryo butunguranye.

ItsindaERCPGahunda yo gukura amabuye igomba kuba iya siyansi, idafite aho ibogamiye, yuzuye, kandi ishobora kwihanganira isesengura n'ibitekerezo. Tugomba gukurikiza ihame ryo kongera inyungu z'umurwayi no kudahitamo kwihitiramo.

·agasuzuguro

Amabuye mato ari mu gice cyo hasi cy'umuyoboro w'inkondo y'umura byoroshye kwirengagiza. Iyo amabuye mato ahuye n'ibibazo by'imiterere mu gice cyo hasi cy'umuyoboro w'inkondo y'umura n'aho asohokera, bizagorana cyane kuyakuraho.

ERCPKuvura amabuye y'imiyoboro y'amaraso bifite ibintu byinshi bitandukanye kandi bifite ingaruka nyinshi. Biragoye kandi biteye akaga nk'uko cyangwa birutaERCPkuvura ibibyimba byo mu miyoboro y'amaraso. Kubwibyo, niba utabifata nk'ibisanzwe, uzisigira inzira ikwiye yo guhunga.

03 Uburyo bwo guhangana n' "amabuye agoye"

Mu gihe uhuye n'amabuye akomeye, hagomba gukorwa isuzuma ryimbitse ry'umurwayi, hakorwe kwagura guhagije,agaseke ko gukuramo amabuyehagomba gutoranywa kandi hagategurwa icyuma gipima amaraso, kandi hagakorwa gahunda y’uburyo bwo kuvura mbere na gahunda y’uburyo bwo kuvura.

Ubundi buryo, ibyiza n'ibibi bigomba gusuzumwa hashingiwe ku miterere y'umurwayi mbere yo gukomeza.

·Gutunganya ifungurwa

Ingano y'umwobo ishingiye ku miterere y'ibuye ry'ibanze n'umuyoboro w'inkondo y'umura. Muri rusange, gukata gato + kwaguka gukomeye (kuringaniye) bikoreshwa kugira ngo wongere umwobo. Mu gihe cya EST, ni ngombwa kwirinda imbere hanini n'imbere hato.

Iyo utamenyereye, biroroshye gukata "incision" "inini inyuma ariko imbere ikaba nto", ni ukuvuga ko ibere risa n'aho rinini inyuma, ariko nta incision iri imbere. Ibi bizatuma gukuraho ibuye binanirana.

Mu gihe cyo gukata EST, "shallow bow and slow incision" igomba gukoreshwa kugira ngo hirindwe gukata zipper. Gukata bigomba kuba byihuta nk'uko buri gukata. Imbunda ntigomba "guhagarara" mu gihe cyo gukata kugira ngo hirindwe ko ibere rishobora kubangamira no gutera pancreatitis.

·Gutunganya isuzuma ry'ibicuruzwa byo hasi no kohereza ibicuruzwa mu mahanga

Amabuye y’imiyoboro y’inkondo isanzwe asaba isuzuma ry’igice cyo hasi n’aho umuyoboro w’inkondo isanzwe usohoka. Ahantu hombi hagomba gusuzumwa. Uruvange rwa byombi rugena ibyago n’uburemere bw’igikorwa cyo gukata ibere.

·Uburyo bwo gupima ubushyuhe mu gihe cy’impanuka

Amabuye manini cyane kandi akomeye cyane n'amabuye adashobora gukurwaho agomba kuvurwa hifashishijwe uburyo bwo gupima ubutabazi bwihutirwa (emergency lithotripter).

Amabuye y’ibara ry’ibinure ashobora kuvunwa mo ibice, kandi amabuye menshi akomeye ya cholesterol na yo ashobora gukemurwa muri ubu buryo. Iyo igikoresho kidashobora kurekurwa nyuma yo kugikuramo, kandi lithotripter idashobora kumena amabuye, ni "ingorane" nyayo. Muri iki gihe, eyeMAX ishobora gukenerwa kugira ngo isuzume kandi ivure amabuye mu buryo butaziguye.

Icyitonderwa: Ntugakoreshe lithotripsy mu gice cyo hasi no mu nzira isohokamo umuyoboro w'amaraso usanzwe. Ntugakoreshe lithotripsy yuzuye mu gihe cyo gukoresha lithotripsy, ahubwo rekera umwanya wo kuyikoresha. Emergency lithotripsy ni ikibazo gikomeye. Mu gihe cyo gukoresha emergency lithotripsy, umurongo w'inyuma ushobora kuba udahuye n'umurongo w'amaraso ukoreshwa mu gukora imibonano mpuzabitsina, kandi umuvuduko ushobora kuba munini cyane ku buryo udashobora gutobora.

·Ibuye rishongesha stent

Niba ibuye ari rinini cyane kandi rigoye kurikuraho, ushobora gutekereza ku gushonga kw'ibumba - ni ukuvuga gushyiraho ibumba rya pulasitiki. Tegereza kugeza ibuye rigabanutse mbere yo gukuraho ibuye, amahirwe yo gutsinda azaba menshi cyane.

·Amabuye yo mu nda

Abaganga bakiri bato bafite uburambe buke ni byiza kudakora ubuvuzi bwa endoscopic ku mabuye yo mu miyoboro y’amaraso yo mu mwijima. Kubera ko amabuye yo muri aka gace ashobora kutabasha gufatwa cyangwa agashobora kwiruka cyane bigatuma adakomeza gukora, umuhanda ni mubi cyane kandi ufunganye.

·Amabuye y'imiyoboro y'inkondo y'umura ahujwe na diverticulum ya peripapillary

Ni ngombwa gusuzuma ibyago n'icyitegererezo cyo kwaguka. Ingaruka zo gutobora EST ziri hejuru cyane, bityo ubu uburyo bwo kwaguka kw'ibaluni ni bwo bwatoranyijwe. Ingano yo kwaguka igomba kuba ihagije kugira ngo ibuye rikureho. Uburyo bwo kwaguka bugomba kuba buhoro buhoro kandi intambwe ku yindi, kandi nta kwaguka gukomeye cyangwa kwaguka byemewe. Iseringi irakura uko ubyishakiye. Iyo habayeho kuva amaraso nyuma yo kwaguka, hakenewe ubuvuzi bukwiye.

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,Catheter yo gusohora amazi mu mazuru n'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!