Cov ntsiab lus ntawm kev paub txog kev kho mob endoscopic ntawm sab hauv hemorrhoids

Taw qhia

Cov tsos mob tseem ceeb ntawm hemorrhoids yog cov ntshav hauv cov quav, qhov quav mob, ntog thiab khaus, thiab lwm yam, uas cuam tshuam rau lub neej zoo.Hauv cov xwm txheej hnyav, nws tuaj yeem ua rau mob hemorrhoids thiab mob ntshav qab zib los ntawm cov ntshav hauv cov quav.Tam sim no, kev saib xyuas kev kho mob feem ntau yog los ntawm cov tshuaj, thiab kev kho mob phais yuav tsum tau ua rau mob hnyav.

Kev kho mob endoscopic yog ib txoj kev kho tshiab uas tau tsim nyob rau xyoo tas los no, uas tsim nyog rau cov tsev kho mob hauv paus.Niaj hnub no, peb yuav xaus thiab txheeb tawm.

1. Kev kuaj mob, kev kho lub cev thiab kev kho mob yav dhau los ntawm hemorrhoids

Kev kuaj mob hemorrhoids

Kev kuaj mob hemorrhoids feem ntau yog nyob ntawm keeb kwm, tshuaj ntsuam xyuas, kuaj lub qhov quav digital thiab colonoscopy.Hais txog keeb kwm kev kho mob, nws yog ib qho tsim nyog yuav tsum nkag siab qhov mob ntawm qhov quav, ntshav hauv cov quav, hemorrhoid tso tawm thiab rov ua dua, thiab lwm yam. Kev tshuaj xyuas feem ntau nkag siab txog cov tsos mob ntawm hemorrhoids, seb puas muaj qhov quav fistula ntawm perianal o, thiab lwm yam. kev ntsuam xyuas yuav tsum to taub qhov nruj ntawm lub qhov quav thiab seb puas muaj induration.Colonoscopy yuav tsum paub txog lwm yam kab mob xws li qog nqaij hlav, ulcerative colitis, thiab lwm yam uas ua rau los ntshav.Classification thiab grading ntawm hemorrhoids

Muaj peb hom hemorrhoids: internal hemorrhoids, sab nraud hemorrhoids, thiab hemorrhoids sib xyaw.

Hemorrhoids: Internal, External, thiab Mixed Hemorrhoids

Hemorrhoids tuaj yeem muab faib ua qib I, II, III, thiab IV.Nws yog graded raws li congestion, hemorrhoid tawm thiab rov qab.

Cov lus qhia rau kev kho mob endoscopic yog qib I, II, thiab III sab hauv hemorrhoids, thaum qib IV sab hauv hemorrhoids, sab nrauv hemorrhoids, thiab hemorrhoids sib xyaw yog contraindications rau kev kho mob endoscopic.Txoj kab sib faib ntawm kev kho mob endoscopic yog kab dentate.

Anatomy ntawm hemorrhoids

Cov kab hauv qhov quav, kab dentate, qhov quav qhov quav, thiab hemorrhoids yog cov ntsiab lus uas endoscopists yuav tsum paub txog.Kev txheeb xyuas endoscopic yuav tsum muaj qee qhov kev paub.Cov kab dentate yog qhov sib txuas ntawm lub qhov quav squamous epithelium thiab columnar epithelium, thiab qhov chaw hloov pauv ntawm qhov quav kab thiab kab dentate yog npog los ntawm columnar epithelium tab sis tsis innervated los ntawm lub cev.Yog li ntawd, kev kho mob endoscopic yog nyob ntawm txoj kab dentate.Kev kho mob endoscopic tuaj yeem ua tau nyob rau hauv kab dentate, thiab kev kho endoscopic tsis tuaj yeem ua sab nraum kab dentate.

Daim duab 1. Qhov pom ntawm lub ntsej muag ntawm txoj kab dentate nyob rau hauv lub endoscope.Cov xub daj taw qhia rau kab serrated annular dentate kab, lub xub dawb taw qhia rau ntawm lub qhov quav thiab nws txoj kab ntev vascular, thiab cov xub liab taw qhia rau lub qhov quav.

1A: dawb lub teeb duab;1B: Narrowband Light Imaging

Daim duab 2 Kev soj ntsuam ntawm qhov quav qhov quav (xub xub liab) thiab qis kawg ntawm lub qhov quav (dawb xub) raws lub tshuab ntsuas

Daim duab 3 Kev soj ntsuam ntawm qhov quav papilla raws lub tshuab tsom iav (daj xub)

Daim duab 4. Cov kab ntawm qhov quav thiab kab hniav tau pom los ntawm kev rov qab endoscopy.Cov xub daj taw qhia rau kab dentate, thiab tus xub dub taw qhia rau kab qhov quav.

Cov ntsiab lus ntawm qhov quav papilla thiab kab qhov quav tau siv dav hauv kev phais mob anorectal thiab yuav tsis rov ua dua ntawm no.

Cov kev kho mob classic ntawm hemorrhoids: muaj kev kho mob tshwj xeeb thiab kev phais mob.Kev saib xyuas kev kho mob suav nrog kev siv tshuaj perianal thiab sitz da dej, thiab cov txheej txheem phais feem ntau suav nrog hemorrhoidectomy thiab stapled excision (PPH).Vim tias kev kho mob phais yog ntau classic, cov nyhuv yog qhov ruaj khov, thiab qhov kev pheej hmoo me me, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob li 3-5 hnub.

2. Kev kho mob endoscopic ntawm sab hauv hemorrhoids

Qhov txawv ntawm endoscopic kev kho mob ntawm sab hauv hemorrhoids thiab EGV kev kho mob:

Lub hom phiaj ntawm kev kho mob endoscopic ntawm esophagogastric varices yog cov hlab ntsha varicose, thiab lub hom phiaj ntawm kev kho mob hauv hemorrhoid tsis yog cov hlab ntsha yooj yim, tab sis hemorrhoids uas muaj cov hlab ntsha thiab cov ntaub so ntswg.Kev kho mob hemorrhoids yog los txo cov tsos mob, nqa lub qhov quav qhov quav uas txav mus los, thiab tsis txhob muaj teeb meem xws li qhov quav stenosis los ntawm kev ploj ntawm hemorrhoids (lub hauv paus ntsiab lus ntawm "tua txhua yam tawm" yog qhov ua rau qhov quav stenosis).

Lub hom phiaj ntawm kev kho mob endoscopic: txhawm rau txo lossis tshem tawm cov tsos mob, tsis yog tshem tawm hemorrhoids.

Endoscopic kev kho mob suav nrog sclerotherapy thiab band ligation.

Rau kev kuaj mob thiab kev kho mob ntawm sab hauv hemorrhoids, colonoscopy yog siv los kuaj, thiab gastroscope raug pom zoo rau kev kho mob.Tsis tas li ntawd, raws li qhov xwm txheej tiag tiag ntawm txhua lub tsev kho mob, koj tuaj yeem xaiv tus neeg mob sab nraud lossis kho mob hauv tsev kho mob.

① Sclerotherapy (pab los ntawm pob tshab hau)

Tus neeg sawv cev sclerosing yog kev txhaj tshuaj lauryl cawv, thiab ua npuas ncauj lauryl cawv kuj siv tau.Nws tseem yuav tsum tau siv submucosal txhaj tshuaj ntawm methylene xiav ua tus neeg sawv cev uas ploj lawm kom nkag siab txog cov dej ntws thiab kev tiv thaiv ntawm tus neeg sawv cev sclerosing.

Lub hom phiaj ntawm lub pob tshab lub kaus mom yog txhawm rau nthuav dav qhov pom kev.Cov koob txhaj tshuaj tuaj yeem xaiv los ntawm cov koob txhaj tshuaj mucosal zoo tib yam.Feem ntau, qhov ntev ntawm rab koob yog 6 hli.Cov kws kho mob uas tsis muaj kev paub dhau los yuav tsum sim kom tsis txhob siv cov koob txhaj tshuaj ntev ntev, vim tias cov koob txhaj tshuaj ntev yuav ua rau ectopic txhaj thiab txhaj tshuaj.Sib sib zog nqus txaus ntshai thiab ua rau perianal abscesses thiab o.

Qhov taw qhia txhaj tshuaj yog xaiv saum lub qhov ncauj sab ntawm txoj kab dentate, thiab txoj hauj lwm koob txhaj tshuaj yog nyob ntawm lub hauv paus ntawm lub hom phiaj hemorrhoid.Lub koob yog muab tso rau ntawm 30 ° ~ 40 ° nyob rau hauv lub zeem muag ncaj qha (pem hauv ntej los yog rov qab) ntawm lub endoscope, thiab lub koob yog tob tob rau hauv lub hauv paus ntawm hemorrhoid.Ua ib pawg tawv tawv ntawm lub hauv paus ntawm hemorrhoid, tshem lub koob thaum txhaj, li 0.5 ~ 2mL, thiab nres qhov txhaj tshuaj kom txog thaum hemorrhoid loj thiab dawb.Tom qab txhaj tshuaj tas lawm, saib seb puas muaj los ntshav ntawm qhov chaw txhaj tshuaj.

Endoscopic sclerotherapy muaj xws li kev txhaj tshuaj rau pem hauv ntej daim iav thiab inverted daim iav txhaj tshuaj.Feem ntau, inverted daim iav txhaj tshuaj yog txoj hauv kev tseem ceeb.

② kev kho mob ntaub qhwv

Feem ntau, ntau lub nplhaib sib txuas yog siv, tsis pub ntau tshaj xya lub nplhaib feem ntau.Lub ligation yog ua nyob rau ntawm 1 mus rau 3 cm saum toj no txoj kab dentate, thiab cov ligation feem ntau pib nyob ze ntawm lub qhov quav kab.Nws tuaj yeem yog vascular ligation lossis mucosal ligation lossis ua ke ligation.Inverted daim iav ligation yog txoj hauv kev tseem ceeb, feem ntau yog 1-2 zaug, nrog rau qhov sib txawv ntawm 1 hli.

Kev kho mob perioperative: tsis tas yuav yoo mov tom qab kev ua haujlwm, tswj cov quav kom du, thiab tsis txhob zaum ntev thiab ua haujlwm hnyav.Tsis tas yuav siv tshuaj tua kab mob niaj hnub.

3. Cov xwm txheej tam sim no thiab cov teeb meem uas twb muaj lawm ntawm cov tsev kho mob hauv paus

Yav dhau los, txoj haujlwm tseem ceeb rau kev kho mob hemorrhoids yog nyob rau hauv lub tuam tsev anorectal.Kev kho mob hauv lub tuam tsev kho mob anorectal suav nrog kev siv tshuaj kho mob, kev txhaj tshuaj sclerotherapy, thiab kev kho mob phais.

Gastrointestinal endoscopists tsis muaj kev paub dhau los hauv kev txheeb xyuas ntawm perianal anatomy nyob rau hauv endoscopy, thiab cov lus qhia rau kev kho mob endoscopic raug txwv (tsuas yog cov hemorrhoids sab hauv tuaj yeem kho tau).Kev phais kuj tseem yuav tsum tau ua kom rov zoo tag nrho, uas tau dhau los ua qhov nyuaj hauv kev txhim kho qhov project.

Nyob rau hauv txoj kev xav, endoscopic kev kho mob ntawm sab hauv hemorrhoids yog tshwj xeeb tshaj yog haum rau thawj tsev kho mob, tab sis nyob rau hauv kev xyaum, nws tsis yog ntau npaum li xav.

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 catheterthiab lwm yam uas tau siv dav hauv EMR, 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!