(1). Nga tikanga taketake Ko nga tikanga taketake o te EMR e whai ake nei:
Te raupapa o nga tikanga
①Tukuhia te wairewa werohanga o te rohe kei raro tonu i te whiu.
②Whakanohoia te mahanga ki te taha o te mate.
③Kua whakakikitia te mahanga kia mau ki te wero i te mate.
④Me whakamau tonu te mahanga i te wa e tono hiko ana ki te tapahi i te mate.
⑤Tikina te tauira kua tohua.
(2). Tohutohu
1.Tips mo te kowhiringa tuunga tinana me te tuunga endoscope
Na te mea me rongoa te whiu i te wa e kitea ana te ahua katoa, he mea nui te tuunga o te manawanui. Me ngana ki te kopikopiko i te whanui kia noho tata ai te whiu ki te whakatuwheratanga o nga maihao biopsy, ara, mai i te 5 ki te 7 karaka i runga i te mata.
I mua i te maimoatanga, me horoi te toenga me te nui o te poaka ka tangohia ma te momi.
Hei tauira, ki te tangohia he whiu i roto i te koroni sigmoid proximal i roto i te tuunga decubitus taha taha maui ranei, ka neke te tauira ki te koroni heke, he uaua ki te tiki mai, no reira he pai ake te tuunga decubitus taha taha matau mo te tapahi.
Waihoki, mai i te tirohanga o te whakaora tauira, he pai ake te tuunga decubitus taha taha maui mo te tangohanga o nga reinga o te koroni whakawhiti.
2.Tips mo nga werohanga rohe
Ka taea te werohia he ngira werohanga o te rohe ki te iti ake te pehanga, engari kaore i te koi, he nui rawa te kohao ngira, no reira ka whakamahia e te kaituhi he ngira werohanga rohe 25G.
Ehara i te mea whakahiato te kii ko te angitu me te kore o te EMR e whakawhirinaki nui ana ki nga werohanga a-rohe.
Mo nga whiu iti, ka werohia mai i te taha whakaeneene o te whiu ki raro noa iho i te whiu.
Mo nga whiu kei roto i te wahanga kopikopiko, puta noa ranei i nga kopa, mena ka mahia te werohanga rohe mai i te taha whero, i te nuinga o te waa ka kore e marama nga whiu na te mea kei te anga atu ki te taha waha, na reira me timata te werohanga rohe mai i te taha waha.
Nga mea nui mo nga Kaitoi Endoscopy
Mena ka pakaru te wai, ka nui te parenga i te wa e werohia ana, karekau he parenga ka uru mai te wai engari karekau he pupuhi, me mutu te werohia, me whakamohio atu ki te kaiwhakahaere mo te ahuatanga i te wa tika ki te matapaki i nga mahi aukati.
Ko te nui ake o te rōrahi werohanga, ko te pai ake.
Ko te mahi he ki tonu i te werohanga i nga mea e taea ana ma te wero kotahi kia hiki ra ano te whiu katoa.
3.Aki mo te whiriwhiri mahanga
Mena he ahua oval te ahua o te mahanga, ka ngawari te whakauru o te mucosa o te waha whiu me nga taha o te nono.
Ko te mahanga he tata porowhita, he ngawari ki te whakatuwhera i te taha, kaore e ngawari ki te paheke, he pakeke hoki ki te pehi i te whiu kia mau ai te whiu.
Ko te rahi o te mahanga me whakarite ki te rahi o te whiu.
Mahanga Polypectomy Tukua
Ko nga tauira o EMR
a. Whakaahua marama ma
He rewharewha momo IIa 25 mm me te wahi o te puku pouri.
b. Ko nga whakaahua whakaata roopu kuiti (NBI).
c. Te rehu indigo carmine hei whakanui ake i te ahua
I kitea ko nga paheketanga i kitea e te tirohanga tikanga he riu i waenga i nga rau.
d. Ko te ahua nui o te paninga puru karaihe
Ko te ahua o te rua o te whakatuwheratanga o te ngongo ngongo i te taha o te whiu he momo IV.
e. Ko te ahua nui o te paninga puru karaihe
i te pokapū o te whiu ko VI, paku kopikopiko, a karekau i kitea te whakaurunga o te submucosal.
f. Werohanga rohe
Ko te werohanga me te werohanga o te rohe i mahia ki waenganui o te whiu, ka puta he pai te pupuhi.
g. Whakatuwheratia te mahanga
Pēhia te pito o te mahanga ki te pakitara o te kopirua hei whakatuwhera i te mahanga.
h. Katia te mahanga
Katia te mahanga ka mau ki te reinga.
i.Te mana tango
Karekau i kitea he poka, he toto, he puku toenga ranei.
j. Te whakatika tauira
I whakapiria te tauira tohanga ki te pepa rapa.
Te tātari pathological whakamutunga:mate pukupuku intramucosal (Tis)
4.Tips mo te mahi mahanga
Ka ata whakanohoia te pito o te mahanga ki te mucosa waha o te whiu, ka ata whakatuwherahia, ka pehia te pakiaka mahanga ki te taha whero o te whiu. Kia kore ai e pai te werohanga taha taha, me whakauru he iti o te mucosa noa.
Me tohu, ki te kore e kitea te pito o te mahanga, tera pea he nui ake te mucosa noa kua whakauruhia atu i te mea i whakaarohia. I muri i te tino whakakikitia o te mahanga, panaia ka toia te ringaringa o waho o te mahanga kia kite i te nekeneke o te whiu. Mena ka whakauruhia ki roto i te paparanga uaua, ka iti ake te neke o te whiu.
Nga tohutohu mo te tango hiko
Kaua e pehia te mahanga ki te pakitara o te whekau, engari whakanekehia paku te reinga mo te tangohanga. He iti te tupono o te whakaroa i te poka i te wa e whakamahi ana i te tangohanga hiko, engari he pai ki te whakaheke toto.
Ko te tango i te tere rawa ka whakaheke toto, ko te tango i te puhoi ka roa pea te kohao. Mena ka mamae te turoro, ka whakaaro ranei te kaiawhina he rapa te kiko penei i te rapa me te uaua ki te tapahi, tera pea ka uru te kiko ki roto i te paparanga uaua, ka mutu tonu te tangohanga.
Nga mea nui mo nga Kaitoi Endoscopy
Mena ka whakaaro te tohunga endoscopist he rapa te kiko ka rite ki te rapa me te uaua ki te tapahi, me whakamohio tonu ia ki te kaiwhakahaere ki te matapaki i nga mahi aukati.
Tohutohu mo te Sharding EMR
Mo nga whiu nui ake, i etahi wa he pai ake te tango i tetahi waahanga iti, kaua ki te tango i nga waahanga katoa i te wa kotahi. Heoi, ka nui ake nga waahanga, ka nui ake te tupono ka hoki ano te toenga o te rohe. Ahakoa te iti o te EMR, me mahi nga wehenga tuatahi ki te rahi me te mahanga nui hei whakaiti i te maha o nga waahanga.
Ko matou, ko Jiangxi Zhuoruihua Medical Instrument Co., Ltd., he kaihanga i Haina e whai hua ana ki nga taonga endoscopic, penei i te biopsy forceps, hemoclip, polyp snare, sclerotherapy ngira, rehu catheter, cytology brushes, guidewire, kohatu tiki kete, nasal biliary drainage catheter etc. Ko o tatou hua he tohu CE, a ko o tatou tipu he tohu ISO. Kua tukuna atu a maatau taonga ki Uropi, Amerika Te Tai Tokerau, Middle East me tetahi waahanga o Ahia, a ka whiwhi whanui te kaihoko o te whakanui me te whakanui!
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Hemoclip
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mahanga polyp
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ngira sclerotherapy
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Rehu catheter
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paraihe cytology
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Waea Aratohu
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kete tiki kohatu
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nasal biliary drainage 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/
Wā tuku: Feb-13-2025