Hauv kev kho mob colonoscopic, cov teeb meem sawv cev yog perforation thiab los ntshav.
Perforation yog hais txog lub xeev uas cov kab noj hniav tau txuas mus rau hauv lub cev kab noj hniav vim muaj cov ntaub so ntswg puv, thiab muaj huab cua dawb ntawm kev kuaj X-ray tsis cuam tshuam rau nws cov ntsiab lus.
Thaum lub periphery ntawm tag nrho-thickness ntaub so ntswg tsis xws luag yog them thiab tsis muaj kev sib txuas lus dawb nrog lub cev kab noj hniav, nws yog hu ua perforation.
Lub ntsiab txhais ntawm los ntshav tsis zoo txhais; Cov lus pom zoo tam sim no suav nrog kev txo qis hauv hemoglobin ntau dua 2 g / dL lossis xav tau kev tso ntshav.
Postoperative los ntshav feem ntau txhais tau tias yog qhov tshwm sim ntawm cov ntshav tseem ceeb hauv cov quav tom qab kev phais uas yuav tsum tau kho hemostatic lossis ntshav.
Qhov xwm txheej ntawm cov xwm txheej xwm txheej no txawv nrog kev kho mob:
Perforation tus nqi:
Polypectomy: 0.05%
Endoscopic mucosal resection (EMR): 0.58% ~ 0.8%
Endoscopic submucosal dissection (ESD): 2% ~ 14%
Postoperative los ntshav tus nqi:
Polypectomy: 1.6%
EMRYog ': 1.1% ~ 1.7%
ESDYog ': 0.7% ~ 3.1
1. Yuav ua li cas nrog perforation
Txij li cov phab ntsa ntawm txoj hnyuv loj yog nyias dua li ntawm lub plab, qhov kev pheej hmoo ntawm perforation yog siab dua. Kev npaj tsim nyog yuav tsum tau ua ua ntej kev phais los daws qhov ua tau ntawm perforation.
Intraoperative ceev faj:
Xyuas kom zoo operability ntawm endoscope.
Xaiv qhov tsim nyog endoscopes, cov cuab yeej kho mob, cov tshuaj txhaj tshuaj thiab cov khoom siv roj carbon dioxide raws li qhov chaw, morphology thiab qib ntawm fibrosis ntawm cov qog.
Kev tswj ntawm intraoperative perforation:
Kev kaw tam sim no: Txawm hais tias qhov chaw nyob qhov twg, clip kaw yog txoj kev nyiam (kev pom zoo: Qib 1, qib pov thawj: C).
In ESD, txhawm rau kom tsis txhob cuam tshuam nrog kev ua haujlwm ntawm kev txiav tawm, cov ntaub so ntswg nyob ib puag ncig yuav tsum tau muab tshem tawm ua ntej kom muaj chaw ua haujlwm txaus ua ntej kaw.
Kev soj ntsuam tom qab: Yog tias qhov perforation tuaj yeem raug kaw tag nrho, kev phais yuav zam tau los ntawm kev kho tshuaj tua kab mob nkaus xwb thiab yoo mov.
Kev txiav txim siab phais: Qhov kev xav tau ntawm kev phais yog txiav txim siab raws li kev sib xyaw ua ke ntawm cov tsos mob plab, cov txiaj ntsig ntawm kev kuaj ntshav, thiab kev tshuaj ntsuam es tsis yog tsuas yog cov roj dawb uas pom hauv CT.
Kev kho tshwj xeeb qhov chaw:
Lub qhov quav hauv qab yuav tsis ua rau lub plab perforation vim nws cov yam ntxwv anatomical, tab sis nws yuav ua rau lub plab perforation, manifesting li retroperitoneal, mediastinal, los yog subcutaneous emphysema.
Cov kev ceev faj:
Kev kaw lub qhov txhab tom qab tuaj yeem tiv thaiv qhov teeb meem rau qee qhov, tab sis muaj pov thawj tsis txaus los qhia tias nws tuaj yeem tiv thaiv kev ncua qeeb.
2. Teb los ntshav
Kev tswj cov ntshav intraoperative:
Siv cov cua sov coagulation los yog hemostatic clips kom tsis txhob los ntshav.
Me me hlab ntsha los ntshav:
EMR, lub taub hau snare tuaj yeem siv rau thermal coagulation.
ESD, lub hau ntawm rab riam hluav taws xob tuaj yeem siv los tiv thaiv thermal coagulation lossis hemostatic forceps kom tsis txhob los ntshav.
Cov hlab ntsha loj los ntshav: Siv hemostatic forceps, tab sis tswj qhov ntau ntawm coagulation kom tsis txhob ncua perforation.
Kev tiv thaiv ntshav qab zib:
Qhov mob resection tom qabEMR :
Cov kev tshawb fawb tau pom tias kev siv cov hemostatic forceps rau kev tiv thaiv coagulation tsis muaj txiaj ntsig zoo rau cov ntshav tom qab phais, tab sis muaj qhov sib txawv ntawm qhov txo qis.
Prophylactic clipping muaj kev txwv tsis pub muaj qhov txhab me me, tab sis siv tau rau cov kab mob loj lossis cov neeg mob uas muaj kev pheej hmoo siab los ntshav tom qab (xws li cov neeg tau txais kev kho mob antithrombotic).
ESD, qhov txhab raug tshem tawm thiab cov hlab ntsha raug coagulated. Hemostatic clips kuj tseem siv tau los tiv thaiv cov hlab ntsha loj.
Nco tseg:
Rau EMR ntawm cov kab mob me, kev tiv thaiv kev kho mob niaj hnub tsis pom zoo, tab sis rau cov kab mob loj lossis cov neeg mob uas muaj kev pheej hmoo siab, kev tiv thaiv tom qab kev phais muaj qee yam cuam tshuam (kev pom zoo: Qib 2, qib pov thawj: C).
Perforation thiab los ntshav yog ib qho teeb meem ntawm kev kho qhov muag endoscopy.
Kev tiv thaiv thiab kev kho mob tsim nyog rau cov xwm txheej sib txawv tuaj yeem txo qhov tshwm sim ntawm cov kab mob sib kis thiab txhim kho cov neeg mob kev nyab xeeb.
Peb, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., yog cov chaw tsim khoom hauv Suav teb tshwj xeeb hauv cov khoom siv endoscopic, xws libiopsy forceps, hemoclip, polyp nuv, koob sclerotherapy, tshuaj tsuag catheter, cytology txhuam, phau ntawv qhia, pob zeb retrieval pob tawb,qhov ntswg biliary kua catheter,ureteral access sheath thiabureteral nkag sheath nrog suctionetc. uas yog dav siv nyob rau hauvEMR, ESD, ERCP. Peb cov khoom muaj ntawv pov thawj CE, thiab peb cov nroj tsuag tau ntawv pov thawj ISO. Peb cov khoom tau raug xa tawm mus rau Tebchaws Europe, North America, Middle East thiab ib feem ntawm Asia, thiab tau txais cov neeg siv khoom ntawm kev lees paub thiab qhuas!
Post lub sij hawm: May-23-2025