Kupu Whakataki
Ko ngā tohu matua o te mate pukupuku ko te toto i roto i te tūtae, te mamae o te pona, te hinga me te mākūkū, me ētahi atu, e pā nui ana ki te kounga o te oranga. I ngā wā tino kino, ka puta he mate pukupuku mau tonu me te anemia mau tonu i puta mai i te toto i roto i te tūtae. I tēnei wā, ko te maimoatanga matatapu ko ngā rongoā te nuinga, ā, me mahi pokanga i ngā wā tino kino.
He tikanga maimoatanga hou te maimoatanga endoscopic i ngā tau tata nei, he pai ake mō ngā hōhipera taketake. I tēnei rā, ka whakarāpopototia e mātou, ka tātarihia hoki.
1. Te tātaritanga haumanu, te hanganga me te maimoatanga o mua o ngā hemorrhoids
Te Tātaritanga o ngā Pukupuku
Ko te tautuhi i ngā mate pukupuku ka ahu mai i te hītori, te tirotiro, te whakamātautau matihiko i te repe, me te colonoscopy. Mō te hītori hauora, me mārama ki te mamae o te repe, te toto i roto i te tūtae, te rere o te hemorrhoid me te whakahokinga mai, me ētahi atu. Ko te tirotiro te mea nui ko te āhua o ngā hemorrhoid, mēnā he fistula repe, he mumura perianal rānei, me ētahi atu, ā, me mārama ki te whakawhāititanga o te repe me te mēnā he induration. Me mōhio te Colonoscopy ki ētahi atu mate pēnei i te pukupuku, te ulcerative colitis, me ētahi atu e puta ai te toto. Te whakarōpūtanga me te whakarōpūtanga o ngā hemorrhoids
E toru ngā momo hemorrhoids: ko ngā hemorrhoids o roto, ko ngā hemorrhoids o waho, me ngā hemorrhoids whakauru.
Ngā Puku: Ngā Puku ā-roto, ā-waho, me ngā Puku whakauru
Ka taea te whakarōpū i ngā hemorrhoids ki ngā taumata I, II, III, me te IV. Ka whakarōpūtia i runga i te pupuhi, te rere o te hemorrhoids me te hokinga mai.
Ko ngā tohu mō te maimoatanga endoscopic ko ngā pukupuku ā-roto taumata I, II, me te III, ko ngā pukupuku ā-roto taumata IV, ngā pukupuku ā-waho, me ngā pukupuku whakauru he ārai mō te maimoatanga endoscopic. Ko te rārangi wehewehe i waenga i te maimoatanga endoscopic ko te rārangi dentate.
Te Anatomi o ngā Hemorrhoids
Ko te raina anal, te raina dentate, te papa anal, me ngā hemorrhoids he ariā me mōhio ngā endoscopist ki tēnei. Me whai wheako te tautuhi endoscopic. Ko te raina dentate te hononga o te epithelium squamous anal me te epithelium poutū, ā, ko te rohe whakawhiti i waenga i te raina anal me te raina dentate kua hipokina e te epithelium poutū engari kāore i te whakapūpūhia e te tinana. Nō reira, ko te maimoatanga endoscopic e hangai ana ki te raina dentate. Ka taea te mahi maimoatanga endoscopic i roto i te raina dentate, ā, kāore e taea te mahi maimoatanga endoscopic i waho o te raina dentate.
Pikitia 1.Ko te tirohanga o mua o te rārangi niho i raro i te endoscope. E tohu ana te pere kōwhai ki te rārangi niho porowhita ngokingoki, e tohu ana te pere mā ki te pou anal me tōna whatunga toto roa, ā, e tohu ana te pere whero ki te takirere anal.
1A:whakaahua mārama mā;1B:Whakaahua Mārama Whāiti
Pikitia 2Te mātakitaki i te papa o te ana (pere whero) me te pito o raro o te pou ana (pere mā) i te taha o te karuārai
Pikitia 3Te mātakitaki i te papilla anal i te taha o te karuārai (pere kōwhai)
Pikitia 4.I tirohia te rārangi ana me te rārangi niho mā te tirotiro whakamuri. E tohu ana te pere kōwhai ki te rārangi niho, ā, e tohu ana te pere pango ki te rārangi ana.
E whakamahia whānuitia ana ngā ariā o te papilla anal me te pou anal i roto i ngā mahi pokanga anorectal, ā, e kore e whakahuatia anō i konei.
Ko te maimoatanga matarohia o te hemorrhoids:Ko te nuinga o ngā maimoatanga ārai mate me ngā maimoatanga pokanga ko te whakamahi rongoā i te perianal me te kaukau noho, ā, ko ngā tikanga pokanga ko te tango i te hemorrhoidectomy me te tango i te stapled excision (PPH). Nā te mea he tawhito ake te maimoatanga pokanga, he pumau te pānga, ā, he iti te mōrearea, me noho te tūroro ki te hōhipera mō ngā rā 3-5.
2. Te rongoā endoscopic o ngā pukupuku o roto
Ko te rerekētanga i waenga i te maimoatanga endoscopic o ngā hemorrhoids o roto me te maimoatanga EGV:
Ko te whāinga matua o te maimoatanga endoscopic o ngā varices esophagogastric ko ngā oko toto varicose, ā, ko te whāinga matua o te maimoatanga hemorrhoid ā-roto ehara i te mea ko ngā oko toto noa iho, engari ko ngā hemorrhoids he mea tito mai i ngā oko toto me ngā kiko honohono. Ko te maimoatanga o ngā hemorrhoids he whakaora i ngā tohu, he hiki ake i te papa anal e neke ana ki raro, me te karo i ngā raruraru pēnei i te stenosis anal i puta mai i te ngaronga o ngā hemorrhoids (ko te kaupapa o te "whakamate i ngā mea katoa" ka pāngia e te stenosis anal).
Whāinga o te maimoatanga endoscopic: Hei whakamamae, hei whakakore rānei i ngā tohumate, ehara i te whakakore i ngā hemorrhoids.
Kei roto i te maimoatanga endoscopicte whakaora kiriuhimeherenga whitiki
Mō te tātaritanga me te rongoā i ngā mate pukupuku o roto, ka whakamahia te colonoscopy hei tirotiro, ā, ka tūtohutia te gastroscope hei rongoā. Hei tāpiri, i runga i te āhuatanga o ia hōhipera, ka taea e koe te whiriwhiri i te maimoatanga o waho, o roto rānei.
①Te whakaora kiri (me te āwhina o te taupoki mārama)
Ko te werohanga waipiro lauryl te mea whakapōrearea kiri, ā, ka taea hoki te whakamahi i te werohanga waipiro lauryl pahuka. Me whakamahi hoki i te werohanga kikorangi methylene i raro i te kiri hei mea ngaro kia mārama ai te ahunga rere me te kapi o te mea whakapōrearea kiri.
Ko te kaupapa o te taupoki mārama he whakawhānui i te tirohanga. Ka taea te whiriwhiri i te ngira werohanga mai i ngā ngira werohanga mucosal noa. Ko te roa o te ngira he 6mm. Me karo ngā tākuta kāore i te tino mātau ki te whakamahi i ngā ngira roa, nā te mea ka ngāwari te werohanga ectopic me te werohanga ki ngā ngira roa. He nui te mōrearea, ā, ka arahi ki ngā whewhe perianal me te mumura.
Ka tīpakohia te pūwāhi werohanga ki runga ake i te taha waha o te rārangi niho, ā, kei te pūtake o te hemorrhoid te tūranga ngira werohanga. Ka werohia te ngira ki te 30°~40° i raro i te tirohanga tika (mua, whakamuri rānei) o te endoscope, ā, ka werohia hohonu te ngira ki roto i te pūtake o te hemorrhoid. Hangaia he puranga mārō ki te pūtake o te hemorrhoid, tangohia te ngira i te wā e werohanga ana, tata ki te 0.5~2mL, ā, kati te werohanga kia nui, kia mā hoki te hemorrhoid. Kia mutu te werohanga, tirohia mēnā kei te toto te wāhi werohanga.
Kei roto i te endoscopic sclerotherapy te werohanga whakaata o mua me te werohanga whakaata hurihuri. Ko te tikanga whānui, ko te werohanga whakaata hurihuri te tikanga matua.
② maimoatanga takai
Ko te tikanga, ka whakamahia he taputapu here mowhiti maha, kaua e neke atu i te whitu ngā mowhiti. Ka mahia te here i te 1 ki te 3 cm i runga ake i te rārangi niho, ā, ka tīmata te here i te nuinga o te wā tata ki te rārangi anal. Ka taea te here toto, te here mucosal rānei, te here whakakotahi rānei. Ko te here whakaata hurihuri te tikanga matua, 1-2 ngā wā, me te wā okiokinga o te 1 marama pea.
Maimoatanga i mua i te pokanga: kāore e hiahiatia te nohopuku i muri i te pokanga, kia maeneene te tūtae, ā, karohia te noho roa me te mahi tinana taumaha. Kāore e hiahiatia te whakamahi noa i ngā paturopi.
3. Te āhua o nāianei me ngā raruraru o nāianei o ngā hōhipera taketake
I ngā wā o mua, ko te mahi matua mō te rongoā i ngā hemorrhoids ko te wāhanga anorectal. Ko te maimoatanga pūnaha i te wāhanga anorectal ko te rongoā tiaki, te werohanga sclerotherapy, me te maimoatanga pokanga.
Kāore i te tino mātau ngā tākuta tirotiro puku ki te tautuhi i te hanganga perianal i raro i te tirotiro endoscopic, ā, he iti noa ngā tohu mō te maimoatanga endoscopic (ko ngā hemorrhoids o roto anake ka taea te rongoā). Me mahi pokanga anō hoki kia ora katoa ai, kua noho hei wāhanga uaua tēnei i roto i te whanaketanga o te kaupapa.
I roto i te ariā, he tino pai te maimoatanga endoscopic o ngā pukupuku o roto mō ngā hōhipera tuatahi, engari i roto i te mahi, kāore i te rite te nui ki te mea i whakaarohia.
Ko mātou, ko Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., he kaihanga i Haina e tohunga ana ki ngā taonga endoscopic, pērā i tengā kukupa koiora, hemoclip, mahanga poripi, ngira whakaora kiriuhi, pūwero rehu, paraihe cytology, waea ārahi, kete tiki kohatu, te katitere whakaheke wai ihume ētahi atu e whakamahia whānuitia ana i roto iEMR, ESD, ERCPKua whai tiwhikete CE ā mātou hua, ā, kua whai tiwhikete ISO ā mātou whare hanga. Kua kaweakehia ā mātou taonga ki Ūropi, Amerika Te Raki, Te Rawhiti o Waenganui me tētahi wāhanga o Āhia, ā, kua whānuitia te mihi me te whakamoemiti a te kiritaki!
Te wā tuku: Hurae-11-2022