Endoscopic Sclerotherapy (EVS) karolo ea 1

1) Molao-motheo oa endoscopic sclerotherapy (EVS):

Intravascular ente: sclerosing agent e baka ho ruruha ho pota-pota methapo, e thatafatsa methapo ea mali le ho thibela ho phalla ha mali;

Ente ea paravascular: e baka ts'ebetso e sa sebetseng ea ho ruruha methapong ho baka thrombosis.

2) Lipontšo tsa EVS:

(1) Ho phatloha ho hoholo ha EV le ho tsoa mali;

(2) Batho ba nang le histori ea ho phatloha ha EV le ho tsoa mali; (3) Batho ba nang le ho khutla ha EV ka mor'a ho buuoa; (4) Batho ba sa tšoaneleheng bakeng sa phekolo ea ho buuoa.

3) Contraindications tsa EVS:

(1) Ho tšoana le gastroscopy;

(2) Hepatic encephalopathy mohato oa 2 le ka holimo;

(3) Bakuli ba nang le ho se sebetse ho matla ha sebete le liphio, palo e ngata ea ascites, le jaundice e matla.

4) Litlhokomelo tsa ts'ebetso

China, o ka khetha lauromacrol. Bakeng sa methapo e meholo ea mali, khetha ente ea intravascular. Bophahamo ba ente hangata ke 10 ~ 15mL. Bakeng sa methapo e menyenyane ea mali, o ka khetha ente ea paravascular. Leka ho qoba ho enta lintlheng tse 'maloa tse fapaneng sefofaneng se le seng (mohlomong Liso li ka 'na tsa e-ba teng tse lebisang ho thibaneng ha 'metso). Haeba phefumoloho e ameha nakong ea ts'ebetso, sekoahelo se hlakileng se ka kenngoa ho gastroscope. Linaheng tsa linaheng tse ling, hangata balune e kenngoa ho gastroscope. Ke habohlokoa ho ithuta ho.

5) Tsamaiso ea postoperative ea EVS

(1) U se ke ua ja kapa ua noa lihora tse 8 ka mor'a ho buuoa 'me butle-butle u qale ho ja lijo tse metsi;

(2) Sebelisa tekanyo e loketseng ea lithibela-mafu ho thibela tšoaetso; (3) Sebelisa lithethefatsi tse theolang khatello ea portal ha ho loketse.

6) Koetliso ea phekolo ea EVS

Multiple sclerotherapy e hlokahala ho fihlela methapo ea varicose e nyamela kapa ha e le hantle e nyamela, ka nako e ka bang beke e le 'ngoe pakeng tsa phekolo e' ngoe le e 'ngoe; gastroscopy e tla hlahlojoa khoeli e le 'ngoe, likhoeli tse 3, likhoeli tse 6 le selemo se le seng ka mor'a ho fela ha phekolo.

 7) Mathata a EVS

(1) Mathata a tloaelehileng: ectopic embolism, esophageal ulcer, joalo-joalo, le

Ho bonolo ho etsa hore mali a phalle kapa a tšolohe ka lesoba la nale ha nalete e ntšoa.

(2) Mathata a sebakeng seo: liso, ho tsoa mali, stenosis, ho se sebetse hantle ha 'metso, odynophagia, maqeba. Mathata a tikoloho a kenyelletsa mediastinitis, perforation, pleural effusion, le portal hypertensive gastropathy e nang le kotsi e eketsehileng ea ho tsoa mali.

(3) Mathata a tsamaiso: sepsis, aspiration pneumonia, hypoxia, spontaneous bacterial peritonitis, le portal vein thrombosis.

Endoscopic varicose vein ligation(EVL)

1) Lipontšo tsa EVL:E tšoana le EVS.

2) Contraindications tsa EVL:

(1) Li-contraindication tse tšoanang le tsa gastroscopy;

(2) EV e tsamaeang le GV e hlakileng;

(3) ho tsamaisana le ho se sebetse ho matla ha sebete le liphio, bongata ba ascites, jaundice

Kalafo ea Gangrene le ea morao-rao ea multiple sclerotherapy kapa methapo e menyenyane ea varicose

Ho nka Leloko la Han e le haufi-duofu ho bolela hore batho ba Hua ba tla khona ho tsamaea ka bolokolohi, kapa li-tendon le li-pulses li tla otlolloa ka bophirimela.

Ka.

3) Mokhoa oa ho sebetsa

Ho kenyelletsa moriri o le mong oa ho kopanya, moriri o mongata oa moriri, le khoele ea nylon.

Molao-motheo: Thibela phallo ea mali ea methapo ea varicose 'me u fane ka hemostasis ea tšohanyetso → venous thrombosis sebakeng sa ligation → tissue necrosis → fibrosis → ho nyamela ha methapo ea varicose.

(2) Litlhokomelo

Bakeng sa methapo e leka-lekaneng ho ea ho e matla ea 'metso, mothapo o mong le o mong oa varicose o hokahantsoe ka mokhoa oa spiral ho ea holimo ho tloha tlase ho ea holimo. Ligator e lokela ho ba haufi ka hohle kamoo ho ka khonehang ho sepheo sa ligation ea mothapo oa varicose, e le hore ntlha e 'ngoe le e' ngoe e be le ligated ka ho feletseng le densely ligated. Leka ho koahela mothapo o mong le o mong oa varicose ka lintlha tse fetang 3.