(1). Nā ʻano hana kumu Eia nā ʻano hana kumu o EMR:
Kaʻina o nā ʻano hana
①E hoʻokomo i ka hopena inikini kūloko ma lalo pono o ka ʻeha.
②E kau i ke kaula a puni ka ʻeha.
③Ua hoʻopaʻa ʻia ka pahele e hopu a ʻūlū i ka ʻeha.
④E hoʻomau i ka hoʻopaʻa ʻana i ke pahele me ka hoʻopili ʻana i ka uila e ʻoki ai i ka ʻeha.
⑤E kiʻi i ka hāpana i ʻoki ʻia.
(2). Nā Manaʻo Kōkua
1.Nā ʻōlelo aʻoaʻo no ke koho ʻana i ke kūlana o ke kino a me ke kau ʻana o ka endoscope
No ka mea, pono e mālama ʻia ka ʻeha i ka wā e ʻike ʻia ai ke kiʻi holoʻokoʻa, he mea nui loa ke kūlana o ka mea maʻi. E ho'āʻo e hoʻohuli i ka scope i loaʻa ai ka ʻeha ma kahi kokoke i ka puka o ka biopsy forceps, ʻo ia hoʻi, mai ka hola 5 a i ka hola 7 ma ka pale.
Ma mua o ka mālama ʻana, pono e holoi ʻia ke koena a me ka pigment keu a laila wehe ʻia ma ka omo ʻana.
No ka laʻana, inā e wehe ʻia kahi ʻeha ma ka colon sigmoid proximal ma ke kūlana supine a i ʻole ke kūlana decubitus ʻaoʻao hema, e neʻe pinepine ka hāpana i ka colon descending, e paʻakikī ai ke kiʻi hou ʻia, no laila ʻoi aku ka maikaʻi o ke kūlana decubitus ʻaoʻao ʻākau no ka resection.
Pēlā nō, mai ka manaʻo o ka hoʻōla ʻana o ka hāpana, ʻoi aku ka makemake ʻia o ke kūlana decubitus ʻaoʻao hema no ka ʻoki ʻana i nā ʻeha transverse colon.
2. Nā ʻōlelo aʻoaʻo no nā inikini kūloko
Hiki ke hoʻokomo ʻia kahi nila inikini kūloko mānoanoa ma ke kaomi haʻahaʻa, akā ʻaʻole lawa ka ʻoi a ua nui loa ka lua o ka nila, no laila hoʻohana ka mea kākau i kahi nila inikini kūloko 25G.
ʻAʻole ia he hoʻonui ke ʻōlelo ʻana ʻo ka holomua a i ʻole ka hāʻule ʻana o EMR e hilinaʻi nui ʻia i nā inikini kūloko.
No nā ʻeha liʻiliʻi, hana ʻia ke hou ʻana mai ka ʻaoʻao anal o ka ʻeha a i lalo pono o ka ʻeha.
No nā ʻeha ma ka ʻāpana kūlou a i ʻole ma nā pelu, inā hana ʻia ka inikini kūloko mai ka ʻaoʻao anal, i ka hapanui o nā hihia, lilo nā ʻeha i mea maopopo ʻole no ka mea e kū pono ana lākou i ka ʻaoʻao waha, no laila e hoʻomaka ka inikini kūloko mai ka ʻaoʻao waha.
Nā mea nui no nā loea Endoscopy
Inā kahe ka wai i waho, a i ʻole he kūʻē nui i ka wā o ka inikini ʻana, a i ʻole ʻaʻohe kūʻē i ke komo ʻana o ka wai akā ʻaʻohe puʻupuʻu i hana ʻia, pono e hoʻōki i ka inikini ʻana a pono e hoʻomaopopo ʻia ka mea hana i ke kūlana i ka manawa kūpono e kūkākūkā i nā hana kūʻē.
ʻOi aku ka nui o ka nui o ka injection, ʻoi aku ka maikaʻi.
ʻO ke ʻano hana, ʻo ia ka hoʻomau ʻana i ka hoʻokomo ʻana i ka nui o ka hiki ma o hoʻokahi puncture a hiki i ka wā e hāpai ʻia ai ka ʻeha holoʻokoʻa.
3. Nā ʻōlelo aʻoaʻo no ke koho ʻana i kahi pahele
Inā he ʻano oval elongated ke ʻano o ke pahele, hiki ke hoʻopili maʻalahi ʻia ka mucosa maʻamau ma ka waha o ka ʻeha a me nā ʻaoʻao anus me ke kumu ʻole.
ʻOi aku ka maikaʻi o ke ʻano poepoe o ka pahele, maʻalahi e wehe ma ka ʻaoʻao, ʻaʻole maʻalahi ke paheʻe, a he paʻakikī kona e kaomi ai ma luna o ka ʻeha e hopu ai i ka ʻeha.
Pono e hoʻopili ʻia ka nui o ka ʻūlū i ka nui o ka ʻili.
ʻO ka pahele Polypectomy hoʻolei ʻia
Nā hiʻohiʻona o EMR
a. Kiʻi kukui keʻokeʻo
He ʻeha ʻano IIa 25 mm me kahi ʻāpana waena i emi iki.
b. Nā kiʻi kiʻi ʻāpana haiki (NBI)
c. Ke pīpī ʻana i ka indigo carmine e hoʻonui i ke kiʻi
Ua ʻike ʻia ʻo nā lua i ʻike ʻia ma ka nānā ʻana maʻamau he mau ʻauwaʻa ma waena o nā lau.
d. Kiʻi i hoʻonui ʻia o ka hoʻoluʻu ʻana i ka poni kristal
ʻO ke ʻano o ka lua o ka wehe ʻana o ka ʻauwai glandular ma ka lihi o ka ʻeha he ʻano IV.
e. Kiʻi i hoʻonui ʻia o ka waihoʻoluʻu poni kristal
ma ke kikowaena o ka ʻeha ʻo VI, ʻano ʻē iki, a ʻaʻohe ʻike maopopo ʻia o ka infiltration submucosal.
f. Hoʻokomo kūloko
Ua hana ʻia ke hou ʻana a me ka inikini kūloko ma waenakonu o ka ʻeha, a ua hopena i kahi pehu maikaʻi.
g. E wehe i ka pahele
E kaomi i ka piko o ke pahele i ka paia o ke kolona e wehe ai i ke pahele.
h. E pani i ka pahele
E pani i ke kaula a hopu i ka ʻeha.
i. Hoʻā i ka wehe ʻana
ʻAʻohe perforation, kahe koko a i ʻole ke koena o ka puʻupuʻu i loaʻa.
j. Hoʻopaʻa ʻana i nā laʻana
Ua hoʻopili ʻia ka mea i ʻoki ʻia i kahi ʻāpana laholio.
Ka hōʻoia hope loa o ka pathology:ka maʻi ʻaʻai intramucosal (Tis)
4. Nā ʻōlelo aʻoaʻo no ka hana ʻana i ka pahele
Hoʻokomo mālie ʻia ka piko o ke pahele ma luna o ka mucosa waha o ka ʻeha, a laila wehe mālie ʻia a kaomi ʻia ke aʻa pahele i ka ʻaoʻao anal o ka ʻeha. I mea e pale ai i ka ʻoki ʻana o ka ʻaoʻao mai ka maikaʻi ʻana, pono e hoʻokomo ʻia kahi liʻiliʻi o ka mucosa maʻamau.
Pono e hoʻomaopopo ʻia i ka wā ʻaʻole ʻike ʻia ka piko o ke pahele, hiki paha i ka mucosa maʻamau i hoʻokomo ʻia ma mua o ka mea i manaʻo ʻia. Ma hope o ka hoʻopaʻa piha ʻia ʻana o ke pahele, e paʻi a huki i ka lima o waho o ke pahele e nānā i ka neʻe ʻana o ka ʻeha. Inā hoʻokomo ʻia i loko o ka papa ʻiʻo, e emi ana ka neʻe ʻana o ka ʻeha.
Nā ʻōlelo aʻoaʻo no ka electroresection
Mai kaomi i ke kaula i ka paia o ka ʻōpū, akā e hoʻokiʻekiʻe iki i ka ʻeha no ka ʻoki ʻana. He haʻahaʻa ka pilikia o ka perforation lohi i ka wā e hoʻohana ai i ka electrosurgical resection, akā he maʻalahi ia i ke kahe koko intraoperative (ma hope koke o ka ʻoki ʻana).
ʻO ka ʻoki ʻana i ka wikiwiki loa e hiki ke hoʻokahe i ke koko, ʻoiai ʻo ka ʻoki ʻana i ka lohi loa e hiki ai ke hoʻopaneʻe i ka perforation. Inā ʻeha ka mea maʻi, a manaʻo paha ke kōkua he palupalu ka ʻiʻo e like me ka laholio a paʻakikī ke ʻoki, he mea hiki paha ke pili ka ʻiʻo i ka papa ʻiʻo, a pono e hoʻōki koke ʻia ka ʻoki ʻana.
Nā mea nui no nā loea Endoscopy
Inā manaʻo ka endoscopist he palupalu ka ʻiʻo e like me ka laholio a paʻakikī ke ʻoki, pono ʻo ia e hoʻomaopopo koke i ka mea hana e kūkākūkā i nā hana kūʻē.
Nā Manaʻo no ka Sharding EMR
No nā ʻeha nui aʻe, ʻoi aku ka palekana i kekahi manawa ke hana i kahi ʻoki ʻāpana ma mua o ka ʻoki ʻana i hoʻokahi manawa. Eia nō naʻe, ʻo ka nui o nā ʻāpana, ʻoi aku ka nui o ka hiki ke hoʻi hou ʻana o ke koena kūloko. ʻOiai me ka EMR ʻāpana, pono e hana ʻia nā ʻoki mua e like me ka nui me ka hiki ke hoʻohana i kahi pahele nui e hōʻemi i ka helu o nā ʻāpana.
ʻO mākou, ʻo Jiangxi Zhuoruihua Medical Instrument Co., Ltd., he mea hana ma Kina e loea ana i nā mea hoʻopau endoscopic, e like me ka biopsy forceps, hemoclip, polyp snare, sclerotherapy needle, spray catheter, cytology brushes, guidewire, stone retrieval basket, nasal biliary drainage catheter etc. 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 lawe ʻia aku kā mākou waiwai i ʻEulopa, ʻAmelika ʻĀkau, Hikina Waena a me kekahi ʻāpana o ʻAsia, a ua loaʻa i ka mea kūʻai aku ka ʻike a me ka hoʻomaikaʻi ʻia!
Nā forceps biopsy:
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/
nila sclerotherapy
https://www.zrhendoscopy.com/gastroenterology-accessories-endoscopic-sclerotherapy-injection-needle-product/
ʻO ka catheter pīpī
https://www.zrhendoscopy.com/ce-certified-disposable-endoscopic-spray-catheter-for-digestive-chromoendoscopy-product/
nā palaki cytology
https://www.zrhendoscopy.com/endoscopy-accessories-disposable-endoscopic-cytology-brush-for-gastrointestinal-tract-product/
ʻUea alakaʻi
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/
catheter hoʻokahe wai biliary ihu
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: Pepeluali-13-2025