(1). Nā ʻenehana kumu ʻO nā ʻenehana kumu o EMR penei:
Ke kaʻina hana
①E hoʻokomo i ka hoʻonā ʻokoʻa kūloko ma lalo pono o ka lesion.
②E kau i ka pahele a puni ka lesion.
③ Hoʻopaʻa ʻia ka pahele no ka hopu ʻana i ka ʻeha.
④E hoʻomau i ka hoʻopaʻa ʻana i ka pahele me ka hoʻohana ʻana i ka uila e ʻoki i ka lesion.
⑤E kiʻi i ka mea hoʻohālike i koho ʻia.
(2). Manaʻo kōkua
1. Nā ʻōlelo aʻoaʻo no ke koho ʻana i ke kūlana kino a me ke kūlana endoscope
No ka mea e pono ke mālama ʻia ka lesion i ka wā e ʻike ʻia ai ke kiʻi holoʻokoʻa, he mea nui ke kūlana o ka mea maʻi. E ho'āʻo e wili i ka laulā i loaʻa ka lesion ma kahi kokoke i ka wehe ʻana o biopsy forceps, ʻo ia hoʻi, mai ka hola 5 a hiki i ka hola 7 ma ka pale.
Ma mua o ka hoʻomaʻamaʻa ʻana, pono e holoi ʻia ke koena a me ka puaʻa keu a laila hoʻoneʻe ʻia e ka hoʻomoe.
No ka laʻana, inā hoʻoneʻe ʻia kahi ʻeha ma ke kolonā sigmoid proximal ma ke kūlana decubitus ʻaoʻao hema a i ʻole, e neʻe pinepine ka specimen i ke kolone iho, e paʻakikī ke kiʻi, no laila ʻoi aku ka maikaʻi o ke kūlana decubitus ʻaoʻao ʻākau no ka wehe ʻana.
Pēlā nō, mai ka hiʻohiʻona o ka hoʻihoʻi ʻana i ka specimen, ʻoi aku ka maikaʻi o ke kūlana decubitus ʻaoʻao hema no ka wehe ʻana i nā ʻeha transverse colon.
2.Tips no nā injections kūloko
Hiki ke ho'oku'u 'ia ka nila mānoanoa ma kahi ha'aha'a ha'aha'a, akā 'a'ole lawa ka 'oi a nui loa ka puka nila, no laila, ho'ohana ka mea kākau i ka nila 25G kūloko.
ʻAʻole hoʻonui ka ʻōlelo ʻana i ka kūleʻa a i ʻole ka hāʻule ʻole o ka EMR e hilinaʻi nui ʻia i nā injections kūloko.
No nā ʻeha liʻiliʻi, hana ʻia ke kī mai ka ʻaoʻao anal o ka ʻeha a ma lalo pono o ka ʻeha.
No nā ʻeha ma ka ʻaoʻao ʻōniʻoniʻo a i ʻole ma ka ʻaoʻao o nā ʻāpana, inā hana ʻia ka hoʻoheheʻe kūloko mai ka ʻaoʻao anal, i ka nui o nā hihia, ʻaʻole maopopo nā lesions no ka mea e kū ana lākou i ka ʻaoʻao waha, no laila pono e hoʻomaka ʻia ka hoʻokele kūloko mai ka ʻaoʻao waha.
Nā mea nui no nā ʻenehana Endoscopy
Inā kahe ka wai, a i ʻole ke kūʻē nui ʻana i ka wā o ka injection, a i ʻole ʻaʻohe kūʻē i ka wā e komo ai ka wai akā ʻaʻohe bulge i hoʻokumu ʻia, pono e kāpae ʻia ka injection a pono e hoʻomaopopo ʻia ka mea hana i ke kūlana i ka manawa kūpono e kūkākūkā i nā countermeasures.
ʻOi aku ka nui o ka injection, ʻoi aku ka maikaʻi.
ʻO ka hana maʻalea e hoʻomau i ka hoʻokomo ʻana e like me ka mea hiki ma o ka pū hoʻokahi a hiki i ka hāpai ʻana o ka ʻeha holoʻokoʻa.
3. Nā ʻōlelo aʻoaʻo no ke koho ʻana i kahi pahele
Inā he ʻano oval elongated ka pahele, hiki ke maʻalahi a hoʻokomo ʻia ka mucosa maʻamau ma ka waha lesion a me nā ʻaoʻao anus.
ʻOi aku ka maikaʻi o ka pahele ʻaneʻane pōʻai, maʻalahi ke wehe ma ka ʻaoʻao, ʻaʻole maʻalahi ke paheʻe, a he ʻano paʻakikī ke kaomi ʻana i ka lesion e hopu ai i ka ʻeha.
Pono e hoʻololi i ka nui o ka pahele i ka nui o ka lesion.
Nahele Polypectomy Hoʻolele
Nā laʻana o EMR
a. Kiʻi māmā keʻokeʻo
He 25 mm ʻano IIa lesion me kahi ʻāpana kikowaena haʻahaʻa.
b. Narrow band imaging (NBI).
c. Ka pīpī ʻana i ka indigo carmine e hoʻonui i ke kiʻi
Ua ʻike ʻia ʻo nā puʻupuʻu i ʻike ʻia e ka nānā maʻamau, ʻo ia nā awāwa ma waena o nā lau.
d. Hoʻonui ʻia ke kiʻi o ka ʻulaʻula violet
ʻO ke ʻano o ka lua o ka ʻawaʻawa glandular e wehe ana ma ka ʻaoʻao o ka lesion he ʻano IV.
e. Hoʻonui ʻia ke kiʻi o ka ʻulaʻula violet
Aia ma ke kikowaena o ka lesion he VI, ʻaʻole maʻamau, ʻaʻole i ʻike ʻia kahi infiltration submucosal.
f. ʻImi kūloko
Ua hana ʻia ka puncture a me ka hoʻokele kūloko i ke kikowaena o ka lesion, i hopena i kahi puʻupuʻu maikaʻi.
g. E wehe i ka pahele
E kaomi i ka piko o ka snare i ka paia kolone e wehe ai i ka snare.
h. E pani i ka pahele
E pani i ka pahele a hopu i ka lesion.
i.Ka mana ma ka wehe
ʻAʻole i ʻike ʻia ka ʻūhā, ke koko a i ʻole ke koena tumo.
j. Hoʻopaʻa hōʻike
Ua hoʻopili ʻia ka mea hoʻoheheʻe ʻia i kahi ʻōpala.
ʻO ka hōʻailona pathological hope loa:ka maʻi maʻi maʻi intramucosal (Tis)
4. Nā ʻōlelo aʻoaʻo no ka hana ʻana
Hoʻokomo mālie ʻia ka piko o ka pahele ma ka waha o ka ʻeha, a laila wehe mālie ʻia a kaomi ʻia ke aʻa pahele ma ka ʻaoʻao anal o ka ʻeha. I mea e pale ai i ka ʻoki ʻana o ka ʻaoʻao mai ka maikaʻi, pono e hoʻokomo ʻia kahi liʻiliʻi o ka mucosa maʻamau.
Pono e hoʻomaopopo ʻia inā ʻaʻole ʻike ʻia ka piko o ka pahele, hiki ke hoʻokomo ʻia ka mucosa maʻamau ma mua o ka mea i manaʻo ʻia. Ma hope o ka hoʻopaʻa paʻa ʻia ʻana o ka pahele, e kaomi a huki i ka lima o waho o ka pahele e nānā i ka neʻe ʻana o ka ʻeha. Inā hoʻokomoʻia i loko o ka papa muscular, e ho'ēmiʻia ka mobility o ka lesion.
Nā ʻōlelo aʻoaʻo no ka wehe ʻana i ka uila
Mai kaomi i ka pahele i ka paia o ka ʻōpū, akā e hoʻokiʻekiʻe iki i ka lesion no ka wehe ʻana. He haʻahaʻa ka pilikia o ka lohi ʻana i ka perforation i ka wā e hoʻohana ai i ka electrosurgical resection, akā hiki ke maʻalahi i ke koko intraoperative (ma hope o ka wehe ʻana).
Hiki ke hoʻokahe koko ka ʻoki ʻana i ka wikiwiki loa, a ʻo ka hoʻokuʻu ʻana i ka lohi loa, hiki ke hoʻopaneʻe i ke kahe. Inā ʻeha ka mea maʻi, a manaʻo paha ke kōkua he elastic ka ʻiʻo e like me ka lāʻau a paʻakikī ke ʻoki ʻia, aia paha ke komo ʻana o ka ʻiʻo i loko o ka papa ʻiʻo, a e hoʻopau koke ʻia ka excision.
Nā mea nui no nā ʻenehana Endoscopy
Inā manaʻo ka endoscopist he elastic ka ʻiʻo e like me ka lāʻau a paʻakikī ke ʻoki ʻia, pono ʻo ia e haʻi koke i ka mea hana e kūkākūkā i nā mea kūʻē.
Manaʻo kōkua no ka Sharding EMR
No nā ʻeha nui, ʻoi aku ka palekana o ka hana ʻana i kahi ʻāpana ʻāpana ma mua o ka hoʻokaʻawale ʻana i ka manawa hoʻokahi. Eia naʻe, ʻoi aku ka nui o nā ʻāpana, ʻoi aku ka nui o ka hiki ke hoʻi hou i ke koena kūloko. ʻOiai me ka ʻāpana EMR, pono e hana ʻia nā ʻoki ʻoki mua e like me ka nui me ka pahele nui e hōʻemi i ka nui o nā ʻāpana.
ʻO mākou, ʻo Jiangxi Zhuoruihua Medical Instrument Co., Ltd., he mea hana ma Kina i mea kūikawā i ka endoscopic consumables, e like me biopsy forceps, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes, guidewire, stone retrieval basket, nasal biliary drainage catheter etc. 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!
Biopsy forceps:
https://www.zrhendoscopy.com/single-use-endoscopic-tissue-biopsy-forceps-with-graduation-product/
Hemoclip
https://www.zrhendoscopy.com/disposable-rotatable-endoscopic-hemoclip-for-gastroscopy-use-product/
pahele polyp
https://www.zrhendoscopy.com/disposable-endoscopic-resection-polypectomy-snare-for-gastroenterology-product/
nila sclerotherapy
https://www.zrhendoscopy.com/gastroenterology-accessories-endoscopic-sclerotherapy-injection-needle-product/
E kāpīpī i ka catheter
https://www.zrhendoscopy.com/ce-certified-disposable-endoscopic-spray-catheter-for-digestive-chromoendoscopy-product/
cytology brushes
https://www.zrhendoscopy.com/endoscopy-accessories-disposable-endoscopic-cytology-brush-for-gastrointestinal-tract-product/
uwao alakai
https://www.zrhendoscopy.com/gastrointestinal-endoscopic-ptfe-coated-ercp-hydrophilic-guidewire-product/
hīnaʻi kiʻi pōhaku
https://www.zrhendoscopy.com/ercp-instrument-gallstone-stone-retrieval-basket-for-endoscopy-product/
ihu biliary drain catheter
https://www.zrhendoscopy.com/medical-instrument-disposable-nasal-biliary-drainage-catheter-for-ercp-operation-product/
EMR
https://www.zrhendoscopy.com/emresd/
ESD
https://www.zrhendoscopy.com/emresd/
ERCP
https://www.zrhendoscopy.com/ercp/
Ka manawa hoʻouna: Feb-13-2025