Hōʻuluʻulu manaʻo o ka ʻike o ka mālama endoscopic o nā hemorrhoids kūloko

Hoʻolauna

ʻO nā hōʻailona nui o nā hemorrhoids he koko i loko o ka ʻōpala, ʻeha anal, hāʻule a me ka maneʻo, a pēlā aku, kahi e hoʻopilikia nui ai i ke ʻano o ke ola. I nā hihia koʻikoʻi, hiki iā ia ke hana i nā hemorrhoids i hoʻopaʻa ʻia a me ka anemia mau loa i hoʻokumu ʻia e ke koko i loko o ka ʻōpala. I kēia manawa, ʻo ka mālama conservative ke kumu nui o nā lāʻau lapaʻau, a pono ke ʻoki ʻana i nā hihia koʻikoʻi.

ʻO ka mālama ʻana i ka endoscopic kahi ʻano lapaʻau i hoʻomohala hou ʻia i nā makahiki i hala iho nei, ʻoi aku ka kūpono no nā haukapila kūloko. I kēia lā, e hōʻuluʻulu mākou a hoʻokaʻawale.

1. Ka hōʻoia ʻana o ke kino, ke ʻano o ke kino a me ka mālama mua ʻana i nā hemorrhoids

Ka ʻike ʻana i nā Hemorrhoids

ʻO ka ʻike ʻana i nā hemorrhoids e pili ana i ka mōʻaukala, ka nānā ʻana, ka hoʻokolokolo rectal digital a me ka colonoscopy. Ma ke ʻano o ka mōʻaukala lapaʻau, pono e hoʻomaopopo i ka ʻeha anal, ke koko i loko o ka ʻōpala, ka hoʻokuʻu ʻana o ka hemorrhoid a me ka hoʻihoʻi ʻana, a pēlā aku. Hoʻomaopopo nui ka nānā ʻana i ke ʻano o nā hemorrhoids, inā he fistula anal o ka mumū perianal, a pēlā aku, a pono e hoʻomaopopo i ka hoʻokolokolo rectal digital i ka paʻa o ka anus a inā he induration. Pono ka Colonoscopy e makaʻala i nā maʻi ʻē aʻe e like me nā tumors, ulcerative colitis, a me nā mea ʻē aʻe e hoʻoulu ai i ke kahe koko. Ka hoʻokaʻawale ʻana a me ka helu ʻana o nā hemorrhoids

ʻEkolu ʻano hemorrhoids: nā hemorrhoids kūloko, nā hemorrhoids waho, a me nā hemorrhoids hui ʻia.

Nā Hemorrhoids: Nā Hemorrhoids Kūloko, Waho, a me nā Hemorrhoids Hui Pū ʻia

Hiki ke hoʻokaʻawale ʻia nā hemorrhoids i nā papa I, II, III, a me IV. Hoʻokaʻawale ʻia ia e like me ke kū ʻana o ka ʻōpū, ka hoʻokuʻu ʻana o ka hemorrhoid a me ka hoʻi ʻana mai.

ʻO nā hōʻailona no ka mālama ʻana i ka endoscopic he mau hemorrhoids kūloko papa I, II, a me III, ʻoiai ʻo nā hemorrhoids kūloko papa IV, nā hemorrhoids waho, a me nā hemorrhoids hui ʻia he mau contraindications no ka mālama ʻana i ka endoscopic. ʻO ka laina hoʻokaʻawale ma waena o ka mālama ʻana i ka endoscopic ʻo ia ka laina dentate.

ʻAnotomy o nā Hemorrhoids

ʻO ka laina anal, ka laina dentate, ka anal pad, a me nā hemorrhoids he mau manaʻo e pono ai i nā endoscopist ke kamaʻāina. Pono ka ʻike endoscopic i kekahi ʻike. ʻO ka laina dentate ka hui ʻana o ka epithelium squamous anal a me ka epithelium columnar, a ua uhi ʻia ka ʻāpana hoʻololi ma waena o ka laina anal a me ka laina dentate e ka epithelium columnar akā ʻaʻole i hoʻopili ʻia e ke kino. No laila, ua hoʻokumu ʻia ka mālama ʻana endoscopic ma ka laina dentate. Hiki ke hana ʻia ka mālama ʻana endoscopic i loko o ka laina dentate, a ʻaʻole hiki ke hana ʻia ka mālama ʻana endoscopic ma waho o ka laina dentate.

Kiʻi 1.ʻO ka ʻike mua o ka laina dentate ma lalo o ka endoscope. Kuhikuhi ka pua melemele i ka laina dentate annular serrated, kuhikuhi ka pua keʻokeʻo i ke kolamu anal a me kāna pūnaewele vascular longitudinal, a kuhikuhi ka pua ʻulaʻula i ka valve anal.

1A:kiʻi kukui keʻokeʻo;1B:Kiʻi Mālamalama Narrowband

Kiʻi 2Ka nānā ʻana i ka ʻaoʻao anal (pua ʻulaʻula) a me ka ʻaoʻao haʻahaʻa o ke kolamu anal (pua keʻokeʻo) ma ke microscope

Kiʻi 3Ka nānā ʻana i ka papilla anal ma ke microscope (pua melemele)

Kiʻi 4.Ua nānā ʻia ka laina anal a me ka laina dentate e ka reverse endoscopy. Kuhikuhi ka pua melemele i ka laina dentate, a kuhikuhi ka pua ʻeleʻele i ka laina anal.

Hoʻohana nui ʻia nā manaʻo o ka anal papilla a me ke anal column i ke ʻoki kino anorectal a ʻaʻole e hana hou ʻia ma ʻaneʻi.

ʻO ka lāʻau lapaʻau maʻamau no nā hemorrhoids:ʻO ka hapa nui, aia nā lāʻau lapaʻau conservative a me ke ʻoki kino. ʻO ka lāʻau lapaʻau conservative e pili ana i ka noi perianal lāʻau a me ka ʻauʻau sitz, a ʻo nā kaʻina hana ʻoki kino e pili ana i ka hemorrhoidectomy a me ka stapled excision (PPH). No ka mea, ʻoi aku ka maʻamau o ka lāʻau lapaʻau ʻoki kino, ua paʻa ka hopena, a ua liʻiliʻi ka pilikia, pono ka mea maʻi e mālama ʻia i ka haukapila no 3-5 mau lā.

2. Ka mālama ʻana i nā hemorrhoids kūloko ma o ka endoscopic

ʻO ka ʻokoʻa ma waena o ka mālama endoscopic o nā hemorrhoids kūloko a me ka mālama ʻana o EGV:

ʻO ka pahuhopu o ka mālama endoscopic o nā varices esophagogastric ʻo ia nā kīʻaha koko varicose, a ʻo ka pahuhopu o ka mālama ʻana i ka hemorrhoid kūloko ʻaʻole ia he mau kīʻaha koko maʻalahi, akā ʻo nā hemorrhoids i haku ʻia me nā kīʻaha koko a me nā ʻiʻo pili. ʻO ka mālama ʻana i nā hemorrhoids, ʻo ia ka hōʻoluʻolu ʻana i nā hōʻailona, ​​​​​​e hāpai i ka pad anal e neʻe ana i lalo, a pale i nā pilikia e like me ka stenosis anal i hoʻokumu ʻia e ka nalo ʻana o nā hemorrhoids (ʻo ke kumumanaʻo o "pepehi ʻana i nā mea āpau" he mea maʻalahi ia i ka stenosis anal).

Pahuhopu o ka mālama endoscopic: E hōʻoluʻolu a hoʻopau paha i nā hōʻailona, ​​​​ʻaʻole e hoʻopau i nā hemorrhoids.

Hoʻokomo pū ʻia ka lāʻau lapaʻau endoscopicka lāʻau lapaʻau sclerotherapya mehoʻopaʻa ʻana i ke kāʻei.

No ka ʻike ʻana a me ka mālama ʻana i nā hemorrhoids kūloko, hoʻohana ʻia ka colonoscopy no ka hoʻokolokolo ʻana, a ua ʻōlelo ʻia ka gastroscope no ka mālama ʻana. Eia kekahi, e like me ke kūlana maoli o kēlā me kēia haukapila, hiki iā ʻoe ke koho i ka mālama ʻana ma waho a i ʻole ma loko.

①Sclerotherapy (kōkua ʻia e ka pāpale moakaka)

ʻO ka mea hoʻoheheʻe waiʻona lauryl ka injection, a hiki ke hoʻohana ʻia ka injection foam lauryl alcohol. Pono nō hoʻi e hoʻohana i ka injection submucosal o ka methylene blue ma ke ʻano he mea nalowale e hoʻomaopopo ai i ke kuhikuhi kahe a me ka uhi ʻana o ka mea hoʻoheheʻe waiʻona.

ʻO ke kumu o ka pāpale moakaka, ʻo ia ke hoʻonui i ke kahua o ka ʻike. Hiki ke koho ʻia ka nila inikini mai nā nila inikini mucosal maʻamau. Ma ke ʻano laulā, ʻo 6mm ka lōʻihi o ka nila. Pono nā kauka ʻaʻole i ʻike nui e hoʻāʻo e pale i ka hoʻohana ʻana i nā inikini nila lōʻihi, no ka mea, he maʻalahi nā inikini nila lōʻihi i ka inikini ectopic a me ka inikini. He pilikia nui a alakaʻi i nā abscesses perianal a me ka mumū.

Ua koho ʻia ke kiko o ka inikini ma luna o ka ʻaoʻao waha o ka laina niho, a aia ke kūlana o ke kui inikini ma ke kumu o ka hemorrhoid i manaʻo ʻia. Hoʻokomo ʻia ke kui ma 30°~40° ma lalo o ka ʻike pololei (mua a hope paha) o ka endoscope, a ua hoʻokomo hohonu ʻia ke kui i loko o ke kumu o ka hemorrhoid. E hana i puʻu paʻakikī ma ke kumu o ka hemorrhoid, e huki i ke kui i ka wā e inikini ana, ma kahi o 0.5~2mL, a hoʻōki i ka inikini a hiki i ka wā e nui a keʻokeʻo ai ka hemorrhoid. Ma hope o ka pau ʻana o ka inikini, e nānā inā he kahe koko ma kahi i inikini ʻia.

Hoʻokomo pū ʻia ka Endoscopic sclerotherapy i ka injection aniani mua a me ka injection aniani hoʻohuli. ʻO ka mea maʻamau, ʻo ka injection aniani hoʻohuli ke ʻano nui.

② ka mālama ʻana i ke kāʻei

ʻO ka maʻamau, hoʻohana ʻia kahi mea hoʻopaʻa apo he nui, ʻaʻole i ʻoi aku ma mua o ʻehiku mau apo ma ka nui. Hana ʻia ka hoʻopaʻa ʻana ma 1 a 3 cm ma luna o ka laina dentate, a hoʻomaka pinepine ʻia ka hoʻopaʻa ʻana ma kahi kokoke i ka laina anal. Hiki ke hoʻopaʻa ʻia ke koko a i ʻole ka hoʻopaʻa ʻana o ka mucosal a i ʻole ka hoʻopaʻa hui pū ʻia. ʻO ka hoʻopaʻa aniani i hoʻohuli ʻia ke ʻano nui, maʻamau 1-2 mau manawa, me kahi manawa o 1 mahina.

Lapaʻau perioperative: ʻaʻole koi ʻia ka hoʻokē ʻai ma hope o ke ʻoki ʻana, e mālama i ka noho laumania, a pale i ka noho lōʻihi a me ka hana kino kaumaha. ʻAʻole koi ʻia ka hoʻohana mau ʻana i nā antibiotics.

3. Ke kūlana o kēia manawa a me nā pilikia o nā haukapila kūloko

I ka wā ma mua, ʻo ke kūlana nui no ka mālama ʻana i nā hemorrhoids ma ka ʻāpana anorectal. ʻO ka mālama ʻōnaehana ma ka ʻāpana anorectal e komo pū ana me ka lāʻau lapaʻau conservative, ka injection sclerotherapy, a me ka mālama ʻoki kino.

ʻAʻole ʻike nui nā endoscopists Gastrointestinal i ka ʻike ʻana i ke anatomi perianal ma lalo o ka endoscopy, a ua kaupalena ʻia nā hōʻailona no ka mālama ʻana i ka endoscopic (hiki ke mālama ʻia nā hemorrhoids kūloko wale nō). Pono pū ke ʻoki ʻana e hoʻōla piha ai, kahi i lilo i wahi paʻakikī i ka hoʻomohala ʻana o ka papahana.

Ma ke kumumanaʻo, kūpono loa ka mālama endoscopic o nā hemorrhoids kūloko no nā haukapila mua, akā i ka hana maoli, ʻaʻole ia e like me ka mea i manaʻo ʻia.

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, ʻūpā polyp, nila sclerotherapy, ʻaukā pīpī, nā palaki cytology, uea alakaʻi, hīnaʻi kiʻi pōhaku, catheter hoʻokahe wai biliary ihua pēlā aku i hoʻohana nui ʻia maEMR, ESD, ERCPUa 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!