(1). Mekhoa ea motheo Mekhoa ea motheo ea EMR ke e latelang:
Tatellano ea mekhoa
①Kenya tharollo ea ente ea sebakeng seo ka tlase ho leqeba.
②Beha leraba ho potoloha seso.
③Leraba le tiisitswe ho tshwara le ho kgama seso.
④Tswela pele ho tiisa leraba ha o ntse o sebedisa motlakase ho kgaola seso.
⑤Lata sampole e kgethilweng.
(2). Malebela
1. Malebela a ho khetha boemo ba 'mele le ho beha endoscope
Kaha seso se hloka ho phekoloa ha setšoantšo sohle se ntse se bonahala, boemo ba mokuli bo bohlokoa haholo. Leka ho sotha sekoupo e le hore seso se be haufi le lesoba la biopsy forceps, ke hore, ho tloha ka hora ea bohlano ho isa ho ea bosupa skrineng.
Pele ho kalafo, masalla le pigment e feteletseng li hloka ho hlatsuoa ebe li tlosoa ka ho monya.
Mohlala, haeba seso se ka hare ho kolone e haufi ea sigmoid se tlosoa boemong ba ho tjamela kapa ho tloha ka lehlakoreng le letšehali la decubitus, sampole hangata e tla fallela kolone e theohelang, e leng se etsang hore ho be thata ho e ntša, kahoo boemo ba ho tloha ka lehlakoreng le letona la decubitus bo molemo bakeng sa ho buuoa hape.
Ka ho tšoanang, ho latela pono ea ho hlaphoheloa ha disampole, boemo ba decubitus bo ka lehlakoreng le letšehali bo khethoa bakeng sa ho sehoa ha liso tsa mala a ka holimo.
2. Malebela a ho enta sebakeng seo
Nalete e teteaneng ea ente ea sebakeng seo e ka entoa ka khatello e tlase, empa ha e bohale ka ho lekaneng 'me lesoba la nale le leholo haholo, kahoo mongoli o sebelisa nale ea ente ea sebakeng seo ea 25G.
Hase ho feteletsa taba ho bolela hore katleho kapa ho hloleha ha EMR ho itshetlehile haholo ka diente tsa sebakeng seo.
Bakeng sa diso tse nyane, ho phunngwa ho etswa ho tloha lehlakoreng la anal la diso ho ya tlase ho diso.
Bakeng sa diso karolong e kobehileng kapa ho pholletsa le mameno, haeba ente ya sebakeng seo e etswa ho tloha lehlakoreng la anal, maemong a mangata diso ha di hlaka hobane di shebile lehlakoreng la molomo, kahoo ente ya sebakeng seo e lokela ho qalwa ho tloha lehlakoreng la molomo.
Lintho tsa Bohlokoa bakeng sa Litsebi tsa Endoscopy
Haeba mokelikeli o dutla, kapa ho na le khanyetso e kgolo nakong ya ente, kapa ho se na khanyetso ha mokelikeli o kena empa ho se na le ho ruruha ho hlahang, ente e lokela ho emisoa mme mosebelisi o lokela ho tsebiswa ka boemo bona ka nako e nepahetseng ho buisana ka mehato ya ho e thibela.
Ha ente e le ngata, ho molemo.
Leqheka ke ho tswela pele ho enta ka hohle kamoo ho ka kgonehang ka ho phunya hanngwe ho fihlela seso sohle se tloswa.
3. Malebela a ho khetha leraba
Haeba leraba le le sebopehong sa oval e telele, mucosa e tloaelehileng molomong oa seso le mahlakoreng a anus e ka kenyelletsoa habonolo le ho sa hlokahale.
Sefi se ka ba se chitja, se bonolo ho buleha ka mahlakoreng, ha se bonolo ho thella, 'me se na le bothata bo itseng ba ho hatella seso ho utloisisa seso.
Boholo ba leraba bo lokela ho fetoloa ho latela boholo ba leqeba.
Leraba la Polypectomy le Lahloang
Mehlala ea EMR
a. Setšoantšo sa leseli le lesoeu
Seso sa mofuta oa IIa sa 25 mm se nang le karolo e bohareng e tepelletseng hanyane.
b. Litšoantšo tsa Narrow Band (NBI)
c. Ho fafatsa indigo carmine ho holisa setšoantšo
Ho ile ha sibolloa hore mapetso a neng a bonoa ka ho shebella ka mokhoa o tloaelehileng e ne e le likoti pakeng tsa makhasi.
d. Setšoantšo se atolositsoeng sa 'mala oa kristale violet
Sebopeho sa mokoti sa lesoba la mothapo wa tshwele pheletsong ya leqeba e ne e le mofuta wa IV.
e. Setšoantšo se atolositsoeng sa 'mala oa kristale violet
Bohareng ba leqeba ho ne ho e-na le VI, e sa tloaelehang hanyane, 'me ha hoa ka ha fumanoa ho kenella ha submucosal ho totobetseng.
f. Ente ea lehae
Ho ile ha etsoa ho phunya le ho enta sebakeng se itseng bohareng ba leqeba, e leng se ileng sa fella ka ho ruruha ho hoholo.
g. Bula leraba
Tobetsa ntlha ea leraba khahlanong le lebota la colon ho bula leraba.
h. Kwala leraba
Kwala leraba 'me u tšoare seso.
i. Matla a ho tlosa
Ha hoa ka ha fumanoa lesoba, ho tsoa mali kapa hlahala e setseng.
j. Ho lokisa mohlala
Sampole e ntšitsoeng e ne e khomaretsoe letlapeng la rabara.
Tlhahlobo ea ho qetela ea lefu la kelello:kankere ea ka hare ho mucosal (Tis)
4. Malebela a ho sebetsa ka leraba
Ntlha ea leraba e beoa ka bonolo holim'a mucosa ea molomo oa leraba, ebe e buloa butle-butle 'me motso oa leraba o hatelloa lehlakoreng la leraba. Ho thibela hore lehare le se ke la ba le letle, ho lokela ho kenngoa karolo e nyane ea leraba le tloaelehileng.
Ho lokela ho hlokomeloa hore ha ntlha ea leraba e sa bonahale, ho ka etsahala hore ebe mucosa e se e kentsoe ho feta kamoo ho neng ho lebelletsoe. Ka mor'a hore leraba le tiisetsoe ka botlalo, sutumelletsa le ho hula letsoho le ka ntle la leraba ho bona ho tsamaea ha leraba. Haeba le kentsoe ka har'a lera la mesifa, ho tsamaea ha leraba ho tla fokotseha.
Malebela a ho ntša motlakase ka electroresection
O se ke wa hatella leraba leboteng la mala, empa phahamisa leqeba hanyane bakeng sa ho sehuwa. Kotsi ya ho phunya leqeba e diehile e tlase ha o sebedisa resection ya electrosurgical, empa e na le monyetla wa ho tswa madi nakong ya opereishene (pele ka mora resection).
Ho seha ka potlako haholo ho ka baka ho tsoa mali, ha ho seha ka nako e telele haholo ho ka baka ho phunya ho liehang. Haeba mokuli a utloa bohloko, kapa mothusi a ikutloa hore lesapo lea thekesela joaloka rabara 'me ho thata ho le seha, ho ka etsahala hore lesapo le kenelle lera la mesifa, 'me ho seha ho lokela ho emisoa hang-hang.
Lintho tsa Bohlokoa bakeng sa Litsebi tsa Endoscopy
Haeba ngaka ea endoscopist e ikutloa hore lera le boreleli joaloka rabara 'me le thata ho le seha, e lokela ho tsebisa opereishene hang-hang ho buisana ka mehato ea ho e thibela.
Malebela a ho Sharding EMR
Bakeng sa diso tse kgolo, ka dinako tse ding ho bolokehile ho etsa ho kgaolwa ha karolo e itseng ya lesapo ho ena le ho kgaolwa ha karolo e itseng ka nako e le nngwe ka kgapeletso. Leha ho le jwalo, ha dikotwana di le ngata, monyetla wa hore karolo e setseng ya lesapo e kgutlele morao o eketseha. Esita le ka EMR e nyane, ho kgaolwa ha karolo ya pele ho lokela ho etswa ka boholo bo boholo ka ho fetisisa ka leraba le leholo ho fokotsa palo ya dikotwana.
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baskete ea ho lata majoe
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ERCP
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Nako ea poso: Hlakola-13-2025