Li-Esophageal / Lipakete tsa ka mpeng li bakoa ke litlamorao tsa litlamorao tse mpe tsa khatello ea malikanyo ea portal mme e ka ba 95% e bakoang ke lisosa tse fapaneng. Boholo ba mali hangata bo akaretsang ho kenyelletsa malinyane a mangata le bakuli le phahameng, 'me bakuli ba nang le mapolanka a hophonyoha bakeng sa ho buuoa.
Ka ntlafatso le ts'ebeliso ea mahlale a lijo tsa lijo tsa lijo, kalafo e fapaneng e fetohile mali a tsoang ho Esophage / Tloastric Vastric. Haholo-holo e kenyelletsa andoscopic Sclerotherapy (evscopic e fapana ligation (evl) le endcopic tissue tissie tyction therapy (evht).
Andoscopic sclerotherapy (evs)
Karolo ea 1
1) Molao-motheo oa Endoscopic Sclerotherapy (Evs):
Ente ea intravascular: Moemeli oa sclerosing o baka ho ruruha ho potoloha methapo, ho thata hore mali a phalle, ebe a thibela phallo ea mali;
Ente ea paravascular ea paravascular: e baka karabelo e ruruhileng methapong ho baka thrombosis.
2) Matšoao a EVS:
(1) ho phatloha ho ho matla ho ho mamella le ho tsoa mali;
(2) Nalane e fetileng ea ho phatloha ho hotseng le ho tsoa mali;
(3) Bakuli ba nang le phetisetso ea Eva ka mor'a ho buuoa;
(4) ba sa lokelang kalafo ea ho buoa.
3) Contraindications ea Evs:
(1) likontiishene tse tšoanang e le gastroscopy;
(2) hepatic encephalopathy Mothati oa 2 kapa ka holimo;
.
4) Ts'ebetso ea Ts'ebetso
Chaena, u ka khetha Lauromacrol (ts'ebelisosclerotherapy nale. Bakeng sa methapo e meholo ea mali, khetha ente ea intravascular. Molumo oa enjene hangata ke 10 ho isa ho 15 ml. Bakeng sa likepe tse nyane tsa mali, u ka khetha ente ea Paraviscular. Leka ho qoba ho entoa libakeng tse fapaneng ka sefofane se tšoanang ka sefofaneng se le seng. Haeba phefumoloho e ameha nakong ea ts'ebetso, ho ka eketsoa cap ea pepeneneng e ka eketsoa gastroscope. Linaheng tse ling, balune hangata ba eketsoa ke lehong. Ho bohlokoa ho ithuta ho.
5) Phekolo ea maemo a evs
(1) Se ke oa ja kapa u noe lihora tse 8 kamora ho buuoa, 'me butle-butle qalella lijo;
(2) Sebelisa lithibela-mafu tse ngata ho thibela tšoaetso;
(3) Sebelisa lithethefatsi ho khatello ea maikutlo e porleng ha e loketse.
6) Thupelo ea kalafo ea kalafo
Ho hlokahala sclerothetherapy e hlokahalang ho fihlela methapo e fapaneng e nyamela kapa e nyamela, ka nako ea beke e le 'ngoe lipakeng tsa kalafo e ngoe le e ngoe; Pastroscopy e tla hlahlojoa hape khoeli e le 'ngoe, likhoeli tse 3, likhoeli tse 6, likhoeli tse 1, likhoeli tse 1 kamora ho fela ha tsela ea kalafo.
7) mathata a evs
(1) Likhopiso tse tloaelehileng: Esepic embolic, esophagaal ul
. Liphello tsa Setereke li kenyelletsa Moddlinotis, e sa feteng e sa feteng Medicfor
.
Endscopic Vaicy Vin Ligungation (Evl)
Karolo ea 2
1) Matšoao a EVL: a tšoana le avs.
2) Contraindications of Evl:
(1) likontiishene tse tšoanang e le gastroscopy;
(2) EV E tsamaeang le GV;
.
3) Mokhoa oa ho sebetsa
Ho kenyelletsa le ligation e le 'ngoe ea moriri, litheolelo tse ngata tsa moriri le lihape tsa nylon tsa nylon.
(1) Molao-motheo: thibela mali a pharalletseng a methapo ea kutlo le ho fana ka lisele tsa ka tsa moea
(2) Litlhokomelo
Bakeng sa ho leka-lekana ho mefuta e matla ea esophage, veiin e 'ngoe le e' ngoe e koahetsoe ka mokhoa o phahameng ea spiral ho tloha tlase ho tloha holimo. Sengator e lokela ho atamela haufi kamoo ho ka khonehang ho fihla sehlohlolong sa vain, e le hore ntlha e ngoe le e ngoe e lumetse ebile e lumetse ka botlalo. Leka ho koahela mofuta o mong le o mong oa vain ho feta lintlha tse fetang 3.
Ho nka libeke tse ka bang 1 ho isa ho tse peli bakeng sa necrosis hore motho a theohe ka mor'a ho qeta kerbage necrosis. Beke e le 'ngoe kamora ts'ebetso, liso tsa lehae li ka baka ho tsoa ha mali, sehlopha sa letlalo se oela,' me ho kuta ka methapo ea likhahla tse fapaneng. Evl o ka felisa methapo e fapaneng kapele mme e na le mathata a fokolang, empa likhama tse fapaneng li boetse li pheta. Karolo e ka lehlakoreng le phahameng;
Evl e ka thibela lifofane tsa maleho a leoatle le letšehali, esophalisaal vein, le Vena Cava. Leha ho le joalo, kamora hore mali a mali a maphele a koaetsoe, veinery verinary e tla eketseha, phallo ea mali e tla eketseha ha nako e ntse e tsamaea. Ka hona, hangata lilakane li khafetsa ho kopanya kalafo. Bophahamo ba likhama tse fapaneng tsa vaerate li lokela ho ba ka tlase ho 1.5 cm.
4) mathata a evl
(1) Ho tsoa mali ka bongata ka lebaka la liso tsa lehae tse ka bang beke ka mor'a ho buuoa;
.
(3) tšoaetso.
5) Tlhahlobo ea masene a evl
Selemong sa pele ka mor'a ho buoa ka sefofane ka mor'a ho buoa, sebete sa sebete, tloaelo, ts'ebetso ea mali, ts'ebetso ea mali, jj. E lokela ho hlahlojoa hape likhoeling tse 3 ho isa ho tse tšeletseng. Endoscopy e lokela ho hlahlojoa hape likhoeling tse ling le tse ling tse 3, ebe ho isa ho 0 ho isa ho likhoeli tse 12.
6) Evs vs evl
Ha ho bapisoa le sclerotherapy le ligation, ha ho phapang ea bohlokoa bophelong le litefiso tse ngata lipakeng tsa tse peli. Ho bakuli ba hlokang kalafo khafetsa, lihation li khothalelitsoe haholo. Ka linako tse ling liahelo le sclerotherapy le tsona li kopantsoe, tse ka ntlafatsang kalafo. Phello. Likarolong tsa naha, li-stents tsa tšepe tse koahetseng ka botlalo li sebelisetsoa ho emisa ho tsoa mali.
Li-andoscopic lishue glue enjec ajection (evht)
Karolo ea 3
Mokhoa ona o loketse bakeng sa mefuta e fapaneng ea gastric le esophagal madi oa sebopeho sa esophal.
1) Litekanyetso tsa Evht
2) Melemo ea evht: Seteishene sa vains se nyamela kapele, ho tsoa mali ha se tlase, ho tsoa mali ha se fokola, ho bonolo ho tsoa holimo 'me ho bonolo ho thehlahla.
3) Lintho tsa ho elelloa:
Ho Fandoscopic tissue glue ea ente kalafo ea ente, palo ea ente e tlameha ho lekana. Pososcopic Ultrasound e bapala karolo e ntle haholo kalafong ea methapo ea khale ea varicose le ho fokotsa kotsi ea ho tsoa mali.
Ho na le litlaleho tsa lingoliloeng tsa kantle ho naha hore li phatsima ka li-coils kapa cyanakaccreak tlasa tataiso ea litlolo tsa feshene. Kopo e tataisoang ka sefofane, endoscopic ultrasound - e leng liente tse ngata tse sa tsotelleng ebile li amana le liketsahalo tse fokolang tse mpe.
Rona.Li-Forces tsa Biopsy, Hemoclip, Polyp Snare, sclerotherapy nale, Spray catheter, Brushes Brushes, Ruta, Baskete ea ho khutlisa lejoe, Nasol Biliary Drainage Catheteretc. e sebelisoang haholo hoEMR, Esd, Ercp. Lihlahisoa tsa rona ke Cepideridedited, 'me lijalo tsa rona ke tsa netefalitsoe. Thepa ea rona e rometsoe Europe, Amerika Leboea, Mille Amerika Bochabela bo bohareng le karolo ea Asia, 'me u fumane moreki ka kamohelo le thoriso!
Nako ea poso: Aug-15-2024