I ka mālama ʻana o ka colonoscopy, ʻo nā pilikia maʻamau ka perforation a me ke kahe ʻana o ke koko.
ʻO ka perforation e pili ana i kahi kūlana kahi i pili pono ai ka lua i ka lua o ke kino ma muli o kahi kīnā ʻiʻo piha-mānoanoa, a ʻo ke alo o ka ea manuahi ma ka hoʻokolokolo X-ray ʻaʻole ia e hoʻopilikia i kona wehewehe ʻana.
Ke uhi ʻia ka ʻaoʻao o ke kīnā ʻiʻo mānoanoa piha a ʻaʻohe kamaʻilio manuahi me ke ana o ke kino, ua kapa ʻia ia he perforation. ʻAʻole i wehewehe pono ʻia ka wehewehe ʻana o ke kahe koko, a ʻo nā ʻōlelo paipai o kēia manawa e pili ana i ka emi ʻana o ka hemoglobin ma mua o 2 g/dL a i ʻole ka pono no ka hoʻoili ʻana.
ʻO ka maʻamau, ua wehewehe ʻia ke kahe koko ma hope o ke ʻoki ʻana ʻo ia ke ʻano o ke koko nui i loko o ka ʻōpala ma hope o ke ʻoki ʻana e pono ai ka mālama hemostatic a i ʻole ka hoʻoili koko.
ʻOkoʻa ka nui o kēia mau hanana ulia pōpilikia me ka mālama ʻana:
Ka helu o ka puka ʻana:
Polypectomy: 0.05%
ʻO ka ʻoki ʻana o ka mucosal endoscopic (EMR): 0.58%~0.8%
Nā mea hoʻopau Endoscopic pili:ʻO ka pahele Polypectomy
Nā mea hoʻopau Endoscopic pili:Nā ʻūpā hemostatic
Nā mea hoʻopau Endoscopic pili: Nila Sclerotherapy
ʻO ka hoʻokaʻawale ʻana o ka submucosal endoscopic (ESD): 2% ~ 14%
Nā mea hoʻopau Endoscopic pili:Pahi ESD
Nā mea hoʻopau Endoscopic pili: Hoʻolei ʻiaPahi ESD
Ka nui o ke kahe koko ma hope o ke ʻoki ʻana:
Polypectomy: 1.6%
EMR: 1.1%~1.7%
ESD: 0.7% ~ 3.1%
1. Pehea e hana ai me ka perforation
ʻOiai ʻoi aku ka lahilahi o ka paia o ka ʻōpū nui ma mua o ko ka ʻōpū, ʻoi aku ke kiʻekiʻe o ka pilikia o ka perforation. Pono ka hoʻomākaukau kūpono ma mua o ke ʻoki ʻana e hoʻoponopono ai i ka hiki ke perforation.
Nā hana palekana i loko o ke ʻoki kino:
E hōʻoia i ka hana maikaʻi o ka endoscope. E koho i nā endoscopes kūpono, nā mea hana lapaʻau, nā wai injection, a me nā lako lawe kinoea carbon dioxide e like me ka wahi, ke ʻano, a me ke kekelē o ka fibrosis o ka puʻupuʻu.
Ka mālama ʻana i ka perforation intraoperative:
Pani koke: Me ka nānā ʻole i kahi, makemake ʻia nā ʻūmiʻi no ka pani ʻana (ikaika manaʻo: pae 1, pae hōʻike: C). I ka ESD, i kekahi manawa pono e ʻili mua ʻia ka ʻāpana a puni e pale aku i ke keakea ʻana i ka hana ʻili.
ʻIʻo lole, e hōʻoia i ka lawa ʻana o ka wahi hana ma mua o ka pani ʻana.
Nānā ma hope o ke ʻoki ʻana: Inā hiki ke pani loa ʻia ka perforation, hiki ke pale ʻia ke ʻoki ʻana ma o ka mālama ʻana i nā lāʻau antibiotic a me ka hoʻokē ʻai wale nō.
Hoʻoholo ʻoki kino: Hoʻoholo ʻia ke koi no ke ʻoki kino ma muli o ka hui pū ʻana o nā hōʻailona o ka ʻōpū, nā hopena o nā hoʻāʻo koko, a me ke kiʻi ʻana ma mua o ke kinoea manuahi i hōʻike ʻia ma ka CT wale nō.
Ka mālama ʻana i nā ʻāpana kūikawā:
ʻAʻole e hoʻoulu ka rectum lalo i ka perforation obdominal ma muli o kona mau ʻano anatomical, akā hiki ke hana
ʻO ka perforation pelvic, i hōʻike ʻia e like me ka retroperitoneal, mediastinal, a i ʻole ka emphysema subcutaneous.
Nā Mālama:
ʻO ka pani ʻana i ka ʻeha ma hope o ke ʻoki ʻana e pale aku i nā pilikia i kekahi ʻano, akā ʻaʻole ia
Aia nā hōʻike kūpono e hōʻike ana he pono ia i ka pale ʻana i ka perforation lohi.
2. Pane i ke kahe koko
Ka mālama ʻana i ke kahe koko intraoperative:
E hoʻohana i ka coagulation wela a i ʻolenā ʻūmiʻi hemostatice hoʻōki i ke kahe ʻana o ke koko.
Ke kahe koko ʻana o nā kīʻaha koko liʻiliʻi:
In EMR, hiki ke hoʻohana ʻia ka piko o ke pahele no ka hoʻopili wela.
I ka ESD, hiki ke hoʻohana ʻia ka piko o ka pahi uila e hoʻopili ai i ka coagulation thermal a i ʻole nā forceps hemostatic e hoʻōki i ke kahe ʻana o ke koko.
Ke kahe ʻana o ke koko ma nā kīʻaha koko nui: E hoʻohana i nā forceps hemostatic, akā e kaohi i ka laulā o ke coagulation e pale aku i ka lohi o ka perforation.
Kāohi ʻana i ke kahe koko postoperative:
ʻO ka wehe ʻana o nā ʻeha ma hope o EMR:
Ua hōʻike ʻia nā haʻawina ʻaʻohe hopena koʻikoʻi o ka hoʻohana ʻana i nā clamps hemostatic no ka coagulation pale i ka nui o ke kahe koko postoperative, akā aia kahi ʻano e hōʻemi ai. He hopena palena ko ka clamping pale i nā ʻeha liʻiliʻi, akā he kūpono ia no nā ʻeha nui a i ʻole nā maʻi i ka pilikia nui o ke kahe koko postoperative (e like me ka poʻe e loaʻa ana i ka lāʻau antithrombotic).
ʻO ka ʻoki ʻana i nā ʻeha ma hope o ka ESD:
Hoʻopaʻa ʻia nā kīʻaha koko i hōʻike ʻia, a hiki ke hoʻohana ʻia nā ʻūmiʻi hemostatic e pale aku ai i ka hoʻopaʻa ʻana o nā kīʻaha koko nui.
Hoʻomaopopo:
No ka EMR o nā ʻeha liʻiliʻi, ʻaʻole ʻōlelo ʻia ka mālama pale maʻamau, akā no nā ʻeha nui a i ʻole nā maʻi pilikia kiʻekiʻe, loaʻa i ka ʻoki pale postoperative kahi hopena (ikaika ʻōlelo paipai: Pae 2, pae hōʻike: C).
ʻO ka perforation a me ke kahe ʻana o ke koko he mau pilikia maʻamau o ka endoscopy colorectal.
ʻO ka lawe ʻana i nā hana pale a me ka mālama kūpono no nā kūlana like ʻole e hiki ke hōʻemi pono i ka nui o nā maʻi sporadic a hoʻomaikaʻi i ka palekana o ka mea maʻi.
ʻO mākou, ʻo Jiangxi Zhuoruihua Medical Instrument Co., Ltd., he mea hana ma Kina e loea ana i nā mea hoʻopau endoscopic, e like menā forceps biopsy, hemoclip, pahele polyp,nila sclerotherapy, ʻaukā pīpī, nā palaki cytology, uea alakaʻi, hīnaʻi kiʻi pōhaku, catheter hoʻokahe wai biliary ihu, ka ʻūpā komo ureteral a me ka ʻūpā komo ureteral me ka omo a pēlā aku. nā mea i hoʻohana nui ʻia ma EMR,ESD, ERCP. Ua hōʻoia ʻia kā mākou huahana e CE, a ua hōʻoia ʻia kā mākou mau mea kanu e ISO. Ua hoʻokuʻu ʻia aku kā mākou waiwai i ʻEulopa, ʻAmelika ʻĀkau, Hikina Waena a me kekahi ʻāpana o ʻAsia, a ua loaʻa nui ka ʻike a me ka hoʻomaikaʻi ʻia e ka mea kūʻai aku!
Ka manawa hoʻouna: ʻApelila-18-2025