Selelekela
Matšoao a ka sehloohong a li-hemorrhoids ke mali a setulong, bohloko ba anal, ho oa le ho hlohlona, joalo-joalo, tse amang haholo boleng ba bophelo.Maemong a boima, e ka baka li-hemorrhoids tse koaletsoeng le khaello ea mali e sa foleng e bakoang ke mali ka setuloana.Hona joale, phekolo e tsitsitseng e itšetlehile haholo ka lithethefatsi, 'me phekolo ea ho buuoa e hlokahala maemong a boima.
Kalafo ea Endoscopic ke mokhoa o sa tsoa ntlafatsoa oa phekolo lilemong tsa morao tjena, o loketseng lipetlele tsa mahlahahlaha.Kajeno, re tla akaretsa le ho lokisa.
1. Tlhahlobo ea kliniki, anatomy le phekolo ea pele ea li-hemorrhoids
Tlhahlobo ea Li-Hemorrhoids
Tlhahlobo ea li-hemorrhoids e itšetlehile haholo ka histori, tlhahlobo, tlhahlobo ea rectal ea digital le colonoscopy.Mabapi le histori ea bongaka, hoa hlokahala ho utloisisa bohloko ba anal, mali ka setuloana, ho tsoa ha hemorrhoid le ho tsosolosoa, joalo-joalo Tlhahlobo e utloisisa haholo-holo ponahalo ea li-hemorrhoids, hore na ho na le fistula ea anal ea ho ruruha ha perianal, joalo-joalo, le rectal digital. tlhahlobo e hloka ho utloisisa ho tiea ha anus le hore na ho na le induration.Colonoscopy e hloka ho hlokomela mafu a mang a kang lihlahala, lefu la ho ruruha ha seso, joalo-joalo tse bakang mali.Ho hlophisoa le ho hlophisoa ha li-hemorrhoids
Ho na le mefuta e meraro ea li-hemorrhoids: li-hemorrhoids tse ka hare, li-hemorrhoids tse ka ntle, le li-hemorrhoids tse tsoakiloeng.
Li-Hemorrhoids: Li-Hemorrhoids tse ka hare, tsa ka ntle le tse tsoakaneng
Li-hemorrhoids li ka aroloa ka lihlopha tsa I, II, III, le IV.E hlophisitsoe ho latela tšubuhlellano, ho tsoa ha hemorrhoid le ho khutla.
Lipontšo tsa phekolo ea endoscopic ke li-hemorrhoids tsa ka hare tsa sehlopha sa I, II, le III, athe li-hemorrhoids tsa ka hare tsa sehlopha sa IV, li-hemorrhoids tsa ka ntle, le li-hemorrhoids tse tsoakiloeng ke li-contraindications bakeng sa phekolo ea endoscopic.Moeli o arolang lipakeng tsa kalafo ea endoscopic ke mohala oa meno.
Anatomy ea li-hemorrhoids
Anal line, dentate line, anal pad, le hemorrhoids ke likhopolo tseo litsebi tsa endoscopists li lokelang ho li tseba.Boitsebiso ba Endoscopic bo hloka boiphihlelo bo itseng.Mohala oa meno ke mateano a epithelium ea anal squamous epithelium le columnar epithelium, 'me sebaka sa phetoho pakeng tsa mothapo oa meno le dentate line se koahetsoe ke epithelium ea columnar empa e sa kenellehe ke' mele.Ka hona, kalafo ea endoscopic e thehiloe moleng oa meno.Kalafo ea Endoscopic e ka etsoa ka har'a mohala oa meno, 'me phekolo ea endoscopic e ke ke ea etsoa ka ntle ho moeli oa meno.
Setšoantšo sa 1. Pono e ka pele ea mohala oa meno tlas'a endoscope.Motsu o mosehla o supa moleng oa menono ea meno o sarolohileng, motsu o mosoeu o supa kholomong ea marako le marang-rang a eona a bolelele ba methapo, 'me motsu o mofubelu o supa phulumong ea marako.
1A: setšoantšo se khanyang se tšoeu;1B: Narrowband Light Imaging
Setšoantšo sa 2 Tlhokomelo ea lepheo la anal (motsu o mofubelu) le karolo e ka tlase ea kholumo ea anal (motsu o mosoeu) haufi le microscope.
Setšoantšo sa 3 Teko ea papilla ea anal haufi le microscope (motsu o mosehla)
Setšoantšo sa 4. Mohala oa anal le dentate line o ile oa hlokomeloa ke reverse endoscopy.Motsu o mosehla o supa mothalong oa meno, 'me motsu o motšo o supile mothalong oa thapo.
Likhopolo tsa anal papilla le anal column li sebelisoa haholo ho buuoa ka anorectal 'me li ke ke tsa phetoa mona.
Kalafo ea khale ea li-hemorrhoids: ho na le phekolo e thata haholo le phekolo ea ho buoa.Kalafo e sa lebelloang e kenyelletsa tšebeliso ea lithethefatsi perianal le bath ea sitz, 'me mekhoa ea ho buoa haholo-holo e kenyelletsa hemorrhoidectomy le stapled excision (PPH).Hobane kalafo ea ho buoa e le ea khale, phello e batla e tsitsitse, 'me kotsi e nyane, mokuli o hloka ho kena sepetlele matsatsi a 3-5.
2. Phekolo ea Endoscopic ea li-hemorrhoids tse ka hare
Phapang lipakeng tsa kalafo ea endoscopic ea li-hemorrhoids tsa kahare le kalafo ea EGV:
Sepheo sa phekolo ea endoscopic ea li-varicose tsa esophagogastric ke methapo ea mali ea varicose, 'me sepheo sa phekolo ea ka hare ea hemorrhoid ha se methapo ea mali e bonolo, empa li-hemorrhoids tse entsoeng ka methapo ea mali le lisele tse sebetsang.Kalafo ea li-hemorrhoids ke ho imolla matšoao, ho phahamisa lesela le thellang le thellang, le ho qoba mathata a kang anal stenosis e bakoang ke ho nyamela ha li-hemorrhoids (molao-motheo oa "ho bolaea ntho e 'ngoe le e' ngoe ka ntle" o atisa ho ba le stenosis ea anal).
Sepheo sa phekolo ea endoscopic: Ho imolla kapa ho felisa matšoao, eseng ho felisa li-hemorrhoids.
Kalafo ea Endoscopic e kenyelletsa sclerotherapy le band ligation.
Bakeng sa ho hlahlojoa le ho phekoloa ha li-hemorrhoids tse ka hare, colonoscopy e sebelisoa bakeng sa tlhahlobo, 'me gastroscope e buelloa bakeng sa phekolo.Ho phaella moo, ho ea ka boemo ba sebele ba sepetlele se seng le se seng, u ka khetha phekolo ea mokuli kapa ea bakuli.
① Sclerotherapy (e thusoa ke cap e bonaletsang)
Sehlahisoa sa sclerosing ke ente ea joala ea lauryl, mme ente ea joala ea foam lauryl le eona e ka sebelisoa.Hape hoa hlokahala ho sebelisa ente ea submucosal ea methylene blue e le moemeli ea sieo ho utloisisa tataiso ea phallo le tšireletso ea sclerosing agent.
Sepheo sa cap e hlakileng ke ho atolosa tšimo ea pono.Nale ea ente e ka khethoa ho tsoa ho linale tse tloaelehileng tsa ente ea mucosal.Ka kakaretso, bolelele ba nale ke 6mm.Lingaka tse se nang phihlelo haholo li lokela ho leka ho qoba ho sebelisa liente tse telele tsa nale, hobane liente tse telele tsa nale li na le monyetla oa ho entoa le ectopic.Kotsi e tebileng 'me e lebisa ho li-abscesses tsa perianal le ho ruruha.
Sebaka sa ente se khethiloe ka holim'a lehlakoreng la molomo la dentate line, 'me sebaka sa nale se fumaneha motheong oa sepheo sa hemorrhoid.Nale e kenngoa ka 30 ° ~ 40 ° tlas'a pono e tobileng (ka pele kapa e ka morao) ea endoscope, 'me nale e kenngoa ka botebo botlaaseng ba hemorrhoid.Theha qubu e thatafalitsoeng botlaaseng ba hemorrhoid, tlosa nale ha u ntse u enta, hoo e ka bang 0.5 ~ 2mL, 'me u emise ente ho fihlela hemorrhoid e fetoha e kholo le e tšoeu.Ka mor'a hore ente e felile, sheba hore na ho na le mali a tsoang sebakeng seo enteng ho sona.
Endoscopic sclerotherapy e kenyelletsa ente ea seipone se ka pele le ente ea seipone e senyehileng.Ka kakaretso, inverted seipone ente ke mokhoa o ka sehloohong.
② phekolo ea bandage
Ka kakaretso, ho sebelisoa lisebelisoa tse ngata tsa li-ring ligation, eseng tse fetang tse supileng.Khokahano e etsoa ho 1 ho 3 cm ka holim'a mohala oa meno, 'me hangata ho qaleha haufi le mola oa anal.E ka ba vascular ligation kapa mucosal ligation kapa ligation e kopantsoeng.Inverted seipone ligation ke mokhoa o ka sehloohong, hangata makhetlo a 1-2, ka nako e ka bang khoeli e le 'ngoe.
Phekolo ea Perioperative: ho itima lijo ha ho hlokahale ka mor'a ts'ebetso, boloka setulo se boreleli, 'me u qobe ho lula nako e telele le mosebetsi o boima oa' mele.Tšebeliso ea kamehla ea lithibela-mafu ha e hlokehe.
3. Maemo a hajoale le mathata a teng a lipetlele tsa mantlha
Nakong e fetileng, boemo bo ka sehloohong bakeng sa phekolo ea li-hemorrhoids e ne e le lefapheng la anorectal.Kalafo ea tsamaiso lefapheng la anorectal e kenyelletsa meriana e bolokang bophelo, ente ea sclerotherapy, le phekolo ea ho buuoa.
Li-endoscopists tsa ka mpeng ha li na boiphihlelo bo bongata mabapi le ho tsebahatsa perianal anatomy tlas'a endoscopy, 'me matšoao a kalafo ea endoscopic a fokotsehile (ke li-hemorrhoids tse ka hare feela tse ka phekoloang).Ho boetse ho hlokahala hore ho buuoe ho folisa ka ho feletseng, e leng ntho e fetohileng ntlha e thata ho nts'etsopele ea morero.
Ka khopolo, phekolo ea endoscopic ea li-hemorrhoids tsa ka hare e loketse ka ho khetheha lipetlele tsa mathomo, empa ha e le hantle, ha e tšoane le kamoo ho nahanoang kateng.
We, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ke moetsi oa China ea sebetsanang le lisebelisoa tsa endoscopic, joalo kabiopsy forceps, hemoclips, polyp leraba, sclerotherapy nale, fafatsa catheter, borashe ba cytology, guidewire, seroto sa ho khutlisa lejoe, nasal biliary drainage catheterjoalo-joalo tse sebelisoang haholo ho EMR, ESD, ERCP.Lihlahisoa tsa rona li netefalitsoe ke CE, 'me limela tsa rona li netefalitsoe ke ISO.Thepa ea rona e rometsoe Europe, Amerika Leboea, Bochabela bo Hare le karolo ea Asia, 'me e fumana ho pharaletseng moreki oa kananelo le thoriso!
Nako ea poso: Jul-11-2022