I ka mālama ʻana i ka colonoscopic, ʻo ka hoʻopiʻi ʻana i ke kino he perforation a me ke koko.
ʻO ka perforation e pili ana i kahi mokuʻāina kahi i hoʻopili manuahi ʻia ai ka lua i ka lua o ke kino ma muli o kahi kīnā o ka ʻiʻo mānoanoa piha, a ʻo ka loaʻa ʻana o ka ea manuahi ma ka hoʻokolokolo X-ray ʻaʻole e pili i kāna wehewehe.
Ke uhi ʻia ka ʻaoʻao o ka ʻiʻo mānoanoa piha a ʻaʻohe kamaʻilio manuahi me ka lua o ke kino, ua kapa ʻia ʻo ia he perforation. ʻAʻole i wehewehe maikaʻi ʻia ka wehewehe ʻana o ke koko, a ʻo nā ʻōlelo aʻoaʻo o kēia manawa aia ka emi ʻana o ka hemoglobin ʻoi aku ma mua o 2 g/dL a i ʻole ka pono no ka hoʻololi ʻana.
Hoʻomaopopo pinepine ʻia ke koko ma hope o ka hana ʻana e like me ke ʻano o ke koko nui i loko o ka waihona ma hope o ke ʻoki ʻana e koi ai i ka mālama hemostatic a i ʻole ke kahe koko.
ʻOkoʻa ke ʻano o kēia mau hanana pilikia me ka mālama ʻana:
Ka helu ʻana:
Polypectomy: 0.05%
ʻO ka wehe ʻana o ka mucosal endoscopic (EMR): 0.58%~0.8%
Nā mea hoʻohana endoscopic pili:Pahele Polypectomy
Nā mea hoʻohana endoscopic pili:Hemostatic Clips
Nā mea hoʻohana endoscopic pili: Nīila Sclerotherapy
Endoscopic submucosal dissection (ESD): 2%~14%
Nā Mea Hoʻohana Endoscopic pili:Pahi ESD
Nā Mea Hoʻohana Endoscopic Pili: HoʻopauPahi ESD
Ka nui o ke koko postoperative:
Polypectomy: 1.6%
EMR: 1.1%~1.7%
ESD: 0.7%~3.1%
1. Pehea e hana ai me ka perforation
No ka mea ʻoi aku ka lahilahi o ka pā o ka ʻōpū nui ma mua o ka ʻōpū, ʻoi aku ka nui o ka pilikia o ka perforation. Pono ka hoʻomākaukau kūpono ma mua o ka ʻoki ʻana e hoʻoponopono ai i ka hiki o ka perforation.
ʻO nā hana mālama intraoperative:
E hōʻoia i ka hana maikaʻi o ka endoscope. E koho i nā endoscope kūpono, nā mea hana lapaʻau, nā wai hoʻoheheʻe, a me nā lako lawe kalapona kalapona e like me ka wahi, morphology, a me ke kiʻekiʻe o ka fibrosis o ka ʻōpū.
Ka mālama ʻana i ka perforation intraoperative:
Pani koke: ʻAʻohe o ka wahi, makemake ʻia nā kiʻi no ka pani ʻana (ikaika manaʻo: pae 1, pae hōʻike: C). I ka ESD, i kekahi manawa pono e ʻili mua ʻia ka wahi a puni i mea e pale ai i ka hana ʻili.
Tissue, e hōʻoia i ka lawa o ka wahi hana ma mua o ka pani ʻana.
Ka nānā ʻana ma hope o ka hana: Inā hiki ke pani piha ʻia ka perforation, hiki ke pale ʻia ke ʻoki ʻana me ka mālama antibiotic a me ka hoʻokē ʻai.
ʻO ka hoʻoholo o ka ʻokiʻoki: Hoʻoholo ʻia ka pono o ka ʻoki ʻana ma muli o ka hui pū ʻana o nā hōʻailona o ka ʻōpū, nā hopena hoʻāʻo koko, a me ke kiʻi ʻana ma mua o ke kinoea manuahi i hōʻike ʻia ma CT wale nō.
Hana ʻāpana kūikawā:
ʻAʻole hiki i ka rectum haʻahaʻa ke hoʻoheheʻe i ka ʻōpū ma muli o kona ʻano anatomical, akā hiki ke kumu
ʻO ka pelvic perforation, hōʻike ʻia e like me retroperitoneal, mediastinal, a i ʻole subcutaneous emphysema.
Nā mea e mālama ai:
ʻO ka pani ʻana i ka ʻeha ma hope o ke ʻoki ʻana hiki ke pale i nā pilikia i kekahi ʻano, akā ʻaʻole
Loaʻa nā hōʻike kūpono e hōʻike ai i ka maikaʻi o ka pale ʻana i ka hoʻopaneʻe ʻana.
2. Pane i ke koko
Ka mālama ʻana i ke koko intraoperative:
E hoʻohana i ka coagulation wela a i ʻolenā kiʻi hemostatice hooki i ke koko.
He koko liʻiliʻi.
In EMR, hiki ke hoʻohana ʻia ka snare tip no ka coagulation thermal.
Ma ESD, hiki ke hoʻohana ʻia ka piko o ka pahi uila e hoʻopili ai i ka coagulation thermal a i ʻole hemostatic forceps e hoʻōki i ke koko.
ʻO ke koko o ka moku nui: E hoʻohana i ka hemostatic forceps, akā e hoʻomalu i ka laulā o ka coagulation e pale i ka lohi ʻana i ka perforation.
Ka pale ʻana i ke koko postoperative:
ʻO ka wehe ʻana i ka ʻeha ma hope o EMR:
Ua hōʻike ʻia nā haʻawina ʻaʻohe hopena koʻikoʻi o ka hoʻohana ʻana i ka hemostatic clamps no ka coagulation preventive i ka nui o ke koko postoperative, akā aia ke ʻano i ka hōʻemi. He liʻiliʻi ka hopena o ka hoʻopaʻa ʻana i nā liʻi liʻiliʻi, akā maikaʻi no nā ʻeha nui a i ʻole nā mea maʻi i pilikia nui i ke kahe koko postoperative (e like me ka poʻe e loaʻa ana i ka antithrombotic therapy).
ʻO ka wehe ʻana i ka ʻeha ma hope o ESD:
Hoʻopili ʻia nā kīʻaha koko i hōʻike ʻia, a hiki ke hoʻohana ʻia nā clip hemostatic e pale ai i ka pipili ʻana o nā kīʻaha koko nui.
Nānā:
No ka EMR o nā ʻeha liʻiliʻi, ʻaʻole ʻōlelo ʻia ka mālama pale maʻamau, akā no nā ʻeha nui a i ʻole nā mea maʻi kiʻekiʻe, loaʻa kekahi hopena i ka hoʻopaʻa ʻana i ka postoperative (ikaika manaʻo: Papa 2, pae hōʻike: C).
ʻO ka perforation a me ke kahe ʻana 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 hiki ke hōʻemi pono i ka ulu ʻana o nā maʻi sporadic a hoʻomaikaʻi i ka palekana o ka maʻi.
ʻO mākou, ʻo Jiangxi Zhuoruihua Medical Instrument Co., Ltd., he mea hana ma Kina i mea kūikawā i nā mea endoscopic consumables, e like mebiopsy forceps, hemoclip, pahele polyp,nila sclerotherapy, pāpaʻi pāpaʻi, cytology brushes, uea alakaʻi, hīnaʻi kiʻi pōhaku, ihu biliary drain catheter, ureteral access sheath and ureteral access sheath with suction etc. i hoohana nui ia ma EMR,ESD, ERCP. Ua hōʻoia ʻia kā mākou huahana, a ua hōʻoia ʻia kā mākou mea kanu. Ua lawe ʻia kā mākou waiwai i ʻEulopa, ʻAmelika ʻAmelika, Middle East a me kahi hapa o Asia, a loaʻa nui i ka mea kūʻai aku o ka ʻike a me ka hoʻomaikaʻi!
Ka manawa hoʻouna: Apr-18-2025