(1). Mekhoa ea mantlha Mekhoa ea mantlha ea EMR ke e latelang:
Tatelano ea mekhoa
①Enta tharollo ea ente ea lehae ka tlase ho leqeba.
② Beha leraba ho potoloha leqeba.
③Sefi se tiisitsoe hore se tšoare le ho thiba seso.
④Tsoela pele ho tiisa leraba ha u ntse u sebelisa motlakase ho khaola leqeba.
⑤Khutlisa mohlala o tsosolositsoeng.
(2). Malebela
1.Malebela a ho khetha boemo ba 'mele le boemo ba endoscope
Hobane leqeba le hloka ho phekoloa ha setšoantšo sohle se bonahala, boemo ba mokuli ke ba bohlokoa haholo. Leka ho sotha sebaka e le hore leqeba le be teng haufi le ho buloa ha matla a biopsy, ke hore, ho tloha ka 5 ho isa ho 7 hora skrineng.
Pele ho kalafo, masala le pigment e feteletseng e hloka ho hlatsuoa ebe e tlosoa ka ho monya.
Ka mohlala, haeba leqeba le ka har'a kolone ea proximal sigmoid le tlosoa setulong sa supine kapa se letšehali sa lateral decubitus, mohlala ona o atisa ho fallela karolong e theohelang, e leng ho etsang hore ho be thata ho e khutlisa, kahoo sebaka se nepahetseng sa lateral decubitus se molemo bakeng sa resection.
Ka mokhoa o ts'oanang, ho ea ka pono ea ho hlaphoheloa ha mohlala, sebaka se ka ho le letšehali sa lateral decubitus se khethoa bakeng sa ho tsosolosa maqeba a li-colon transverse.
2.Tips bakeng sa liente tsa lehae
Nale e teteaneng ea sebakeng seo e ka kenngoa ka khatello e tlaase, empa ha e bohale ka ho lekaneng 'me lesoba la nale le leholo haholo, kahoo mongoli o sebelisa nale ea 25G ea sebakeng seo.
Hase ho feteletsa litaba ho bolela hore katleho kapa ho hlōleha ha EMR ho itšetlehile haholo ka liente tsa sebaka seo.
Bakeng sa maqeba a manyenyane, ho phunngoa ho etsoa ho tloha ka lehlakoreng la seso ho ea tlase ho leqeba.
Bakeng sa maqeba karolong e kobehileng kapa ka mose ho mameno, haeba ente ea sebakeng seo e etsoa ho tloha lehlakoreng la anal, hangata liso ha li hlake hobane li shebane le lehlakore la molomo, kahoo ente ea sebakeng seo e lokela ho qalisoa ho tloha lehlakoreng la molomo.
Lintho tsa Bohlokoa bakeng sa Litsebi tsa Endoscopy
Haeba mokelikeli o tsoa, kapa ho na le khanyetso e kholo nakong ea ente, kapa ha ho na khanyetso ha mokelikeli o kena empa ho se na leqhubu le entsoeng, ente e tlameha ho emisoa 'me mosebeletsi o lokela ho tsebisoa ka boemo ka nako e loketseng ho buisana ka mehato ea ho hanyetsa.
Ha molumo oa ente e le ngata, ho ba betere.
Leqheka ke ho tsoela pele ho enta ka hohle kamoo ho ka khonehang ka ho phunya ha 'ngoe ho fihlela leqeba lohle le tlosoa.
3.Malebela a ho khetha leraba
Haeba leraba le le sebopehong sa oval e telele, mucosa e tloaelehileng molomong oa leqeba le mahlakoreng a anus e ka kenyelletsoa habonolo le ho sa hlokahale.
Leraba ka ho khetheha le batla le le chitja, le bulehe habonolo ka lehlakoreng le leng, ha le bonolo ho thelleha, 'me le na le bothata bo itseng ba ho hatella leqeba ho tšoara seso.
Boholo ba leraba bo lokela ho ikamahanya le boholo ba leqeba.
Leraba la Polypectomy le Lahloang
Mehlala ea EMR
a. Setšoantšo sa khanya e tšoeu
Leqeba la mofuta oa IIa oa 25 mm le karolo e bohareng e tepeletseng hanyane.
b. Litšoantšo tsa sehlopha sa Narrow band (NBI).
c. Ho fafatsa indigo carmine ho holisa setšoantšo
Ho ile ha sibolloa hore ho tetebela ho ileng ha lemohuoa ka mokhoa o tloaelehileng ha e le hantle e ne e le li-grooves pakeng tsa makhasi.
d. Setšoantšo se atolositsoeng sa mabala a kristale violet
Mokhoa oa mokoti oa ho buleha ha lesela la tšoelesa moeling oa leqeba e ne e le mofuta oa IV.
e. Setšoantšo se atolositsoeng sa mabala a kristale violet
bohareng ba leqeba e ne e le VI, e sa tloaeleha hanyenyane, 'me ha ho na ho kenella ha submucosal ho totobetseng.
f. Ente ea lehae
Ho phunya le ente ea sebakeng seo ho ile ha etsoa bohareng ba leqeba , e leng se ileng sa fella ka hore ho be le sekhahla se setle.
g. Bula leraba
Tobetsa ntlha ea leraba khahlanong le lebota la colon ho bula leraba.
h. Koala leraba
Koala leraba 'me u tšoare seso.
i.Matla a ho tlosa
Ha ho na ho phatloha, ho tsoa mali kapa hlahala e setseng e fumanoeng.
j. Ho lokisa mohlala
Setšoantšo se ntšitsoeng se ne se khomaretsoe letlapeng la rabara.
Tlhahlobo ea ho qetela ea pathological:intramucosal carcinoma (ts)
4.Malebela a ts'ebetso ea leraba
Leqheka la leraba le behoa ka bonolo holim'a mucosa ea molomo oa leqeba, ebe le buloa butle-butle 'me motso oa leraba o hatelloa khahlanong le lehlakoreng la mokokotlo oa leqeba. E le ho thibela sekhahla sa lateral hore se se ke sa e-ba se setle, ho lokela ho kenngoa palo e nyenyane ea mucosa e tloaelehileng.
Hoa lokela ho hlokomeloa hore ha ntlha ea leraba e ke ke ea bonoa, ho ka etsahala hore ebe mucosa e tloaelehileng e kentsoe ho feta kamoo ho neng ho lebeletsoe kateng. Ka mor'a hore leraba le tiisetsoe ka ho feletseng, sutumelletsa le ho hula letsoho le ka ntle la leraba ho shebella ho tsamaea ha leqeba. Haeba e kenngoa ka har'a lera la mesifa, ho tsamaea ha leqeba ho tla fokotseha.
Litlhahiso tsa electroresection
U se ke ua hatella leraba khahlanong le lebota la mala, empa phahamisa leqeba hanyenyane bakeng sa ho tsoa. Kotsi ea ho lieha ho phunya e fokotsehile ha ho sebelisoa electrosurgical resection , empa ho na le tšekamelo ea ho tsoa mali ka intraoperative (pele ka mor'a ho tsosolosa).
Ho phunya ka potlako haholo ho ka baka ho tsoa mali, ha ho fata butle haholo ho ka baka tieho ea ho phunya. Haeba mokuli a utloa bohloko, kapa mothusi a ikutloa hore lesela le rekere joaloka rabara ’me le thata ho seha, ho ka etsahala hore lesela le kenelle lera la mesifa, ’me ho ntšoa ho lokela ho emisoa hang-hang.
Lintho tsa Bohlokoa bakeng sa Litsebi tsa Endoscopy
Haeba setsebi sa endoscopist se na le maikutlo a hore lesela le rekere joalo ka rabara 'me le thata ho khaola, o lokela ho tsebisa motho ea sebetsang hang-hang hore a buisane ka mehato ea ho thibela.
Malebela a ho Sharding EMR
Bakeng sa liso tse kholoanyane, ka linako tse ling ho bolokehile ho etsa resection ea piecemeal ho e-na le ho qobella hang-hang resection. Leha ho le joalo, ha likotoana li ntse li le ngata, ho na le monyetla o moholo oa hore masala a ka hlaha sebakeng seo. Esita le ka EMR e nyenyane, li-resections tsa pele li lokela ho etsoa ka hohle kamoo ho ka khonehang ka leraba le leholo ho fokotsa palo ea likotoana.
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Nako ea poso: Feb-13-2025