ʻĀpana 1 o ka Endoscopic Sclerotherapy (EVS)

1) Ke Kumumanaʻo o ka endoscopic sclerotherapy (EVS):

ʻO ka inikini intravascular: hoʻoulu ka mea sclerosing i ka mumū a puni nā veins, hoʻopaʻakikī i nā kīʻaha koko a ālai i ke kahe koko;

ʻIniki paravascular: hoʻoulu i kahi hopena mumū sterile i loko o nā aa koko e hoʻoulu ai i ka thrombosis.

2) Nā hōʻailona o EVS:

(1) Ka haki ʻana o ka EV a me ke kahe ʻana o ke koko;

(2) Nā kānaka me ka mōʻaukala o ka haki ʻana o ke koko o ka EV; (3) Nā kānaka me ka hoʻi hou ʻana o ka EV ma hope o ke ʻoki kino; (4) Nā kānaka i kūpono ʻole no ka mālama ʻoki kino.

3) Nā hōʻole o EVS:

(1) Ua like ia me ka gastroscopy;

(2) ʻO ka encephalopathy hepatic pae 2 a ʻoi aku;

(3) Nā maʻi me ka hana ʻino o ke akepaʻa a me nā puʻupaʻa, ka nui o ka ascites, a me ka jaundice koʻikoʻi.

4) Nā hana palekana

Ma Kina, hiki iā ʻoe ke koho i ka lauromacrol. No nā kīʻaha koko nui aʻe, e koho i ka inikini intravascular. ʻO ka nui o ka inikini he 10 ~ 15mL maʻamau. No nā kīʻaha koko liʻiliʻi, hiki iā ʻoe ke koho i ka inikini paravascular. E hoʻāʻo e pale i ka inikini ʻana ma nā wahi like ʻole ma ka mokulele hoʻokahi (hiki paha i nā ʻōpū ke alakaʻi i ka esophageal stricture). Inā pilikia ka hanu ʻana i ka wā o ke ʻoki ʻana, hiki ke hoʻohui ʻia kahi pāpale moakaka i ka gastroscope. Ma nā ʻāina ʻē, hoʻohui pinepine ʻia kahi balloon i ka gastroscope. He mea kūpono ke aʻo ʻia mai.

5) Ka mālama ʻana i ka EVS ma hope o ke ʻoki ʻana

(1) Mai ʻai a inu paha no 8 mau hola ma hope o ke ʻoki ʻana a hoʻomaka mālie i ka ʻai wai;

(2) E hoʻohana i nā nui kūpono o nā antibiotics e pale aku i ka maʻi; (3) E hoʻohana i nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke kaomi portal e like me ke kūpono.

6) Papa hana lapaʻau EVS

Pono ka sclerotherapy lehulehu a hiki i ka nalo ʻana o nā aʻa varicose a nalowale paha, me kahi manawa ma kahi o 1 pule ma waena o kēlā me kēia lāʻau lapaʻau; e nānā hou ʻia ka gastroscopy 1 mahina, 3 mahina, 6 mahina, a me 1 makahiki ma hope o ka pau ʻana o ka papa o ka lāʻau lapaʻau.

 7) Nā pilikia o EVS

(1) Nā pilikia maʻamau: embolism ectopic, ʻeha esophageal, a pēlā aku, a

He mea maʻalahi ke hoʻokahe i ke koko a i ʻole ke kahe ʻana o ke koko mai ka lua o ka nila ke huki ʻia i waho.

(2) Nā pilikia kūloko: nā ʻōpū, ke kahe koko, ka stenosis, ka hana ʻole o ka neʻe ʻana o ka esophageal, odynophagia, nā ʻokiʻoki. ʻO nā pilikia kūloko e pili ana i ka mediastinitis, perforation, pleural effusion, a me ka gastropathy hypertensive portal me ka hoʻonui ʻia o ka pilikia o ke kahe koko.

(3) Nā pilikia ʻōnaehana: sepsis, pneumonia aspiration, hypoxia, peritonitis bacterial spontaneous, a me ka thrombosis vein portal.

ʻO ka hoʻopaʻa ʻana o nā aʻa varicose endoscopic (EVL)

1) Nā hōʻailona no EVL:ʻO ia hoʻi me EVS.

2) Nā hōʻole o EVL:

(1) Nā contraindications like me ka gastroscopy;

(2) EV i hele pū ʻia me GV maopopo;

(3) hele pū me ka hana koʻikoʻi o ke akepaʻa a me nā puʻupaʻa, ka nui o nā ascites, jaundice

ʻO Gangrene a me nā lāʻau lapaʻau sclerotherapy lehulehu hou a i ʻole nā ​​​​​​veins varicose liʻiliʻi

ʻO ka lawe ʻana i ka Han Dynasty ma ke ʻano he kokoke-duofu, ʻo ia hoʻi, e hiki i ka poʻe Hua ke neʻe manuahi, a i ʻole e kīkoʻo ʻia nā aʻalolo a me nā pulse i ke komohana.

Ma o.

3) Pehea e hana ai

Me ka hoʻopaʻa ʻana o ka lauoho hoʻokahi, ka hoʻopaʻa ʻana o nā lauoho he nui, a me ka hoʻopaʻa ʻana o ke kaula nylon.

Kumumanaʻo: E ālai i ke kahe koko o nā aʻa varicose a hāʻawi i ka hemostasis ulia pōpilikia → thrombosis venous ma kahi ligation → necrosis tissue → fibrosis → nalo ʻana o nā aʻa varicose.

(2) Nā Mālama

No nā varices esophageal waena a koʻikoʻi paha, ua nakinaki ʻia kēlā me kēia aa varicose ma ke ʻano wili i luna mai lalo a luna. Pono ka ligator e kokoke loa i kahi kiko hoʻopaʻa o ka aa varicose, i hiki ai i kēlā me kēia kiko ke nakinaki piha a paʻa pono. E ho'āʻo e uhi i kēlā me kēia aa varicose ma mua o 3 mau kiko.