I.Banta Shiri
1
Aauki X-haskoki ko Ct na wuyansa, kirji, kereoposaitiRior, ko a cikin ra'ayoyi da yawa don fahimtar wurin, yanayi, sigogi, girma, da kuma kasancewarsu, girma, da kuma kasancewarsu, girma, da kuma kasancewarsu, girma, da kuma kasancewarsu, girma, da kuma kasancewarsu da ake buƙata na waje.
2. Azumi da lokacin azumi
A zahiri, marasa lafiya da sauri don awanni 6 zuwa 8 da ke cikin abubuwan ciki, da lokacin azumi da lokacin azumi na iya zama daidai da gaggawa gastroscopy.
3. Taimakon Abincin Kudi
Yara, waɗanda ke da rikice-rikicen tunani, waɗanda ba su da alaƙa, ko waɗanda ke da jikunan waje na ƙasashen waje, ko kuma abubuwan ƙasan ƙasashen waje tare da taimakon likitan dabbobi. Cire abubuwa na kasashen waje.
II. Kayan aiki
1. Zabi na Endoscope
Duk nau'ikan gastroscopy suna samuwa. Idan an kiyasta cewa yana da wuya a cire jikin kasashen waje ko jikin baƙi yana da yawa, ana amfani da gastroscopy sau biyu. Ana iya amfani da Endoscopes tare da ƙaramin diamita na waje don jarirai da yara ƙanana.
2. Zabi na karfi
Da farko ya dogara da girman da siffar jikin baƙi. Kayan aikin da aka yi amfani da su sun haɗa da kayan aikin biopsy, snare, ƙarfin ƙarfi, flower karfi, mud-hakoran da ƙarfi), Jawo-baki Provals Bag, da sauransu.
Za a iya ƙaddara zaɓin kayan aiki gwargwadon girman, siffar, nau'in, da sauransu na jikin baƙi. A cewar rahoton litattafan da aka ba da rahoto, ƙarfin hali-hakori sune mafi yawan amfani. Amfanin amfani da bera-haƙoshin haƙora shine 24.0% ~ 46.6% na dukkan kayan aikin da aka yi amfani da shi, da asusun snares na 4.0% ~ 23.6%. An yi imani da hakan gabaɗaya cewa tarkon sun fi kyau na jikin ƙasashen waje na Rod-mai haske. Kamar thermometers, haƙori, goge goge, ciyawar bamboƙa, pens, ciyawar ta rufe 1cm, in ba haka ba zai zama da wahala fita Cardia.
2.1 Rod-mai siffar jiki na ƙasashen waje da kuma jikin kasashen waje na Sahara
Don abubuwa na ƙasƙanci na ruwa mai santsi tare da santsi mai laushi da na bakin ciki na bakin ciki kamar su na 'yan doki uku, shirye-shiryen hancin hakori, da sauransu.; Don abubuwa na ƙasƙanci na Speical (kamar cores, gilashin kwalliya, batirin button ko jakar cire dutse ko kuma jakar cire dutse.
2.2 Dogayen jikin ƙasashen waje, cikar abinci, da manyan duwatsu a ciki
Don dogon tsawancin ƙasashen waje ya kamata a layi ɗaya a cikin sararin samaniya, tare da ƙarshen kaifi ko ƙarewa yayin da baje iska. Don jikin kasashen waje mai siffa ko kuma jikin kasashen waje da ramuka, yana da aminci don amfani da hanyar gado don cire su;
Don cluns abinci da manyan duwatsu a ciki, ana iya amfani da karfi don murkushe su sannan a cire su tare da ƙarfi uku ko snare.
3. Kayan aikin kariya
Yi amfani da na'urorin kariya gwargwadon yadda zai yiwu ga abubuwan ƙasashen waje waɗanda ke da wahalar cire kuma masu haɗari. A halin yanzu, ana amfani da na'urori masu kariya sun haɗa da haɗi mai tushe, shambura na waje, da kuma murfin kariya.
3.1
A lokacin cire cirewar jiki na waje, ya kamata a yi amfani da shi a ƙarshen lensencopic lens kamar yadda zai yiwu don hana mucosa daga jikin baƙi don rage juriya da aka ci karo da shi lokacin da aka cire jikin ƙasar waje. Hakanan zai iya taimakawa wajen matsa da kuma fitar da jikin kasashen waje, wanda yake da amfani ga cire jikin ƙasar waje. fitar.
Don tsintsaye-tsangwakin da ke tattare da tsararren ƙasashen waje wanda aka saka a cikin mucosa a duka iyakar esophagus na waje don guje wa esophageal munchageal muncheal don guje wa esophageal serval.
Hakanan za a iya samar da isasshen sarari don aikin kayan aikin, wanda ya dace da ganowa da kuma cire jikin ƙasashen waje a kunkuntar wuyan esophage.
A lokaci guda, motar da ba za ta iya amfani da madaidaiciyar tsotse ba don taimakawa ɗaukar abinci da abinci da sauƙaƙe aiki mai zuwa.
3.2 Casing na waje
Yayinda yake kare esophagus da kuma esophageal-ciki junc na waje mucosa, da kaifi, da kuma cire abubuwan da ake ciki, don haka ya rage abin da ya faru a cikin cire jikin gagarumin da aka cire kasashen waje. Kara aminci da tasiri na magani.
Ba a yawan amfani da gangara a cikin yara saboda haɗarin lalata ƙwayar esophus a yayin sakawa.
3.3 murfin kariya
Sanya murfin kariya a gaban ƙarshen ƙarshen ƙarshen. Bayan matsawa da abin da baƙon waje, jefa murfin kariya akan kuma kunsa abin da baƙon waje lokacin da ya janye maganin don guje wa abubuwan waje.
Ya zo cikin hulɗa tare da membrane na mucous na narkewar narkewa kuma yana taka rawar tsaro.
4. Hanyar kulawa don nau'ikan nau'ikan jikin kasashen waje a cikin gastrointestinal
4.1 talakawa na abinci a cikin Esophagus
Rahotanni sun ba da shawarar cewa yawancin ƙananan talakawa abinci a cikin esophagus za a iya tura a hankali cikin ciki, wanda yake mai sauƙi, dace don haifar da rikice-rikice. A lokacin aiwatar da ci gaban ci gaba na gastroscopy, ana iya gabatar da hauhawar farashin ci gaba a cikin lumen esophageal, amma ana iya samun cututtukan ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta ta hanyar esophageal. Idan akwai juriya kuma kuna tura da ƙarfi, da amfani da matsin lamba da yawa zai ƙara haɗarin yin huda. An bada shawara don amfani da kwandon cire dutse na dutse ko jakar cire dutse don cire jikin kasashen waje. Idan bolus abinci yana da girma, zaku iya amfani da ƙarfin lantarki, tarkon, da sauransu don daskare shi kafin rarrabawa. Fitar da shi.
Hoto na 1 Bayan tiyata ga cutar kansa ta hanyar esopophageal, mai haƙuri da ke tattare da raɗaɗaɗaɗaɗaɗar stretosis da kuma riƙewa da ke riƙe da Bolus abinci.
4.2 Short da kuma Blant Abubuwan kasashen waje
Za'a iya cire yawancin jikin ƙasashen waje da baƙin ƙarfe na ƙasashen waje, snares, cire kwanduna na dutse, da sauransu (Hoto na 2). Idan jikin kasashen waje a cikin esophagus yayi wuya a cire kai tsaye, ana iya tura shi cikin ciki don daidaita matsayin sa sannan kuma kokarin cire shi. Takaice, gawarwakin kasashen waje tare da diamita na> 2.5 cm a cikin ciki sun fi wuyar wucewa ta Pylorus, kuma yakamata a yi wani kamfani na Endoscopic da wuri-wuri; Idan jikin kasashen waje da ƙananan diamita a ciki ko Duodenum ba su nuna lalacewar ciki ba, suna iya jiran fitowar su ta halitta. Idan ya kasance fiye da makonni 3-4 kuma har yanzu ba za a fitar da shi ba, dole ne a cire shi avenoscopically.
Hoto na 2 Filastik Abun Gida da Hanyoyin Cire
4.3 Jikin waje
Abubuwa na ƙasƙanci tare da tsawon ≥6 cm (kamar thermerets, haƙori, choons, pens, choons, pens, choons, da sauransu) ba su da sauƙi a cire su ta halitta, don haka galibi ana tattara su da snare ko kwandon dutse.
Za'a iya amfani da tarko don rufe ƙarshen ƙarshen (ba fiye da 1 cm ba daga ƙarshen), kuma an sanya shi a cikin wani gangara cikin gaba ɗaya don fitar da shi. Hakanan ana iya amfani da na'urar cannula na waje don amfani da jikin ƙasar waje sannan kuma ya koma baya zuwa waje na ciki don gujewa lalata mucosa.
4.4 da kaifi na kasashen waje
Abubuwan da ke cikin kasashen waje kamar ƙasusuwa na kifi, ƙasusuwa na kaji, rami na zamani, karar tafaramin, da magunguna, ƙyallen takarda, ya kamata a ba da shi sosai. Abubuwa masu kaifi wadanda zasu iya lalata ƙwayar mucous da sauƙi kuma suna haifar da rikitarwa kamar su ya kamata a kula da su a hankali. Gudanar da Gaggawa na Gaggawa.
Hoto na 3 daban-daban na abubuwa masu kaifi
Lokacin cire kaifi na kasashen waje a karkashin karshenOscope, yana da sauki karye mucosa na narkewa. An ba da shawarar yin amfani da tushe mai tushe, wanda zai iya bin diddigin lumen kuma a guji lalata bango. Yi ƙoƙarin kawo ƙarshen ƙarshen jikin ƙasar waje don ƙarshen ruwan tabarau na waje, sannan a yi ƙoƙarin kiyaye ƙarshen jikin ƙasar waje ɗaya kafin a cire shi daga cikin ikon ƙasar. Abubuwan da ke cikin kasashen waje sun saka a gefe ɗaya na esophagus na iya cire shi ta hanyar sanya tushe a gaba na ƙarshen entoscope kuma a hankali yana shiga cikin allet ɗin esophageal. Ga gawawwakin kasashen waje da aka saka a cikin hanyar esophageal a duka biyun, da kuma m expeded ƙarshen, a gefe ɗaya a gefe ɗaya, kuma a fitar da shi. Ko bayan ta amfani da wuka na laser don yanke jikin baƙi a tsakiyar, kwarewarmu ita ce sassauta ƙungiyar Aortic ko gefen zuciya ta farko, sannan cire shi cikin matakai.
A.Dirates: Lokacin cin abinci, tari, ko maganaG, marasa lafiya na iya barin motsinsu na baya, sannan shigar da saman gastrointestinal na sama tare da hadiye motsi. Shawulu'u mai kaifi tare da karfe consps a duka iyakar suna da sauƙin zama wanda aka saka a bangon digve na narkewa, yin cirewa mai wahala. Ga marasa lafiya waɗanda suka kasa yin magani na al'ada na al'ada, ana iya amfani da kayan aikin maƙasudin abubuwa da yawa don ƙoƙari a cire cirewar a ƙarƙashin engoscopy na Dual.
B.Date rami: Ranar da Ranae, zub da jini, kamuwa da jini na gida da kuma tsari na ɗan gajeren lokaci, kuma ya kamata a kula da shi da magani na gaggawa na tushen gaggawa (Hoto na 4). Idan babu rauni na ciki, mafi yawan duwatsun da ke cikin ciki ko Duodenum za a iya gurbata tsakanin 48 hours. Wadanda ba za a iya kawar da su ta halitta da wuri-wuri ba.
Hoto na 4 Jujube Core
Kwana hudu bayan haka, an gano mai haƙuri tare da jikin kasashen waje a wani asibiti. CT ya nuna jikin baƙi a cikin esophagus tare da turare. An cire manyan abubuwan da aka kai a cikin ƙarshen duka a ƙarƙashin endoscopy kuma an sake yin gastroscoy kuma. An gano cewa an kafa Fistula a bango na esophagus.
4.5 manyan abubuwa na kasashen waje tare da gefuna masu tsayi da kaifi (Hoto 5)
a. Shigar da bututun waje a ƙarƙashin Odentoscope: Saka gastroscope daga tsakiyar bututun waje, saboda ƙananan gefen waje na bakin ciki na mai lankwasa na gastrucope. A zahiri sanya gastroscope kusa da jikin baƙi. Sanya kayan kida ta hanyar bututun biopsy, kamar tarko, ƙasashen waje Jikin ƙasashen waje, da sauransu bayan sun yi amfani da abin da ke waje, da duka na'urar za su fita tare da madubi.
b. Murfin adon gida na gida na gida: Yi amfani da babban yatsa na gunkin salama na roba don yin murfin gida mai kariya na gida. Yanke shi a tare da bevel na babban babban yatsa tushen babban filin hannu zuwa siffar ƙaho. Yanke karamin rami a yatsan, kuma ka wuce ƙarshen ƙarshen madubi na jikin. Yi amfani da karamin roba zobe don gyara shi 1.0cm nesa daga ƙarshen ƙarshen gastrupope, ya mayar da shi cikin babba na gastrucope, kuma aika tare da gastrencope zuwa ga ƙasar waje. Ansu rubuce-rubucen jikin baƙi sannan ya janye shi tare da gurmin abinci. A dabi'ar riga za ta motsa zuwa jikin kasashen waje saboda juriya. Idan an juyar da shugabanci, za a lullube shi a kusa da abubuwan kasashen waje don kariya.
Hoto na 5: An cire Sharfi Kish Kifi
4.6 na bunkasa bangaren kasa
Baya ga ƙarfi na al'ada na al'ada, ana iya cire jikin harkokin waje na ƙarfe tare da ƙarfin ƙasashen waje na Magnetic. Mumbin jikin kasashen waje waɗanda suka fi haɗari ko wahalar cire za a iya magance su a ƙarƙashin X-ray Fluoroscopy. An bada shawara don amfani da kwandon cire dutse ko jakar cire dutse.
Tsabar kudi sun fi kowa gama gari tsakanin jikin kasashen waje a cikin narkewa na yara (Hoto na 6). Kodayake yawancin tsabar kudi a cikin esophagus za a iya shayar da ta dabi'a, ana ba da shawarar maganin endoscopic magani. Saboda yara ba su da haɗin kai na hadin kai, cirewar HOTERSCOPICS na kasashen waje a cikin yara sun fi dacewa a karkashin maganin sa maye. Idan tsabar kudin yana da wuya a cire, ana iya tura shi cikin ciki sannan a fitar da shi. Idan babu alamun cutar a ciki, zaku iya jira a cire ta dabi'ance. Idan tsabar kudin ya kasance fiye da 3-4 makonni kuma ba a fitar da shi ba, dole ne a kula da shi engoscopically.
Hoto 6 tsabar kudi na sati
4.7 Mata na waje
Jikin kasashen waje marasa galihu suna iya haifar da lahani ga narkewar narkewa ko ma necrosis. Ana buƙatar maganin gaggawa na gaggawa bayan ganewar asali. Batura sune mafi yawan jikin kasashen waje na gama gari kuma sau da yawa suna faruwa a cikin yara 'yan kasa da shekaru 5 (Hoto na 7). Bayan lalata esophagus, suna iya haifar da sesophageal Stetosis. Dole ne a sake duba Endoscopy a cikin 'yan makonni. Idan an kafa matsaya, da esophabus ya kamata ya dushe da wuri-wuri.
Hoto na 7 Abun waje A Batirin, Red Arrow yana nuna wurin Abun waje
4.8 Magnetic Hukunci
Lokacin da aka haɗu da jikin ƙasashen waje da yawa ko kuma jikin ƙasashen magnetic ya haɗu da ƙarfe suna nan a cikin manyan gastrointesis, wanda zai iya haifar da ganuwar narkewa, wanda zai iya haifar da ganuwar narkewa, wanda zai iya haifar da ganuwar narkewa, wanda zai iya haifar da ganuwar narkewa, wanda zai iya haifar da ganuwar narkewa, wanda zai iya haifar da ganuwar narkewa, wanda zai iya haifar da junan su da kuma saiti, wutsiya, lalata, ƙarfin hali, peritonitis da sauran raunin jijiya. , buƙatar buƙatar magani na gaggawa. Hakanan za'a cire abubuwa guda na kasashen waje guda da wuri-wuri. Baya ga ƙarfi na al'ada na al'ada, ana iya cire jikin huhu da magnetic a ƙarƙashin tsotsa tare da ƙarfin ƙasar Magnetic.
4.9 jikin kasashen waje a ciki
Mafi yawansu yanã wayoyi, wayoyi na baƙin ƙarfe, ƙusoshi, da sauransu. Yawancin jikin kasashen waje suna da tsawo da babba, suna da wuyar wucewa ta Cardia, kuma suna iya sauƙaƙa membrane membrane. An bada shawara don amfani da kwaroron roba hade tare da fire-hors hiski don cire jikin kasashen waje a karkashin jarrabawar Endoscopic. Na farko, saka bera-haƙoran haƙora zuwa gaban ƙarshen ƙarshen rami ta hanyar rami na Endoscopic biopsy rami. Yi amfani da flaws ɗin haƙori zuwa matsa zobe roba a ƙasan kwaroron roba. Bayan haka, ya koma da fire-hork-haƙoran haƙora masu haƙora ga rami na biopsy saboda tsawon kwaroron roba ya fallasa a waje da rami na biopsy. Rage shi gwargwadon iko ba tare da shafar filin ra'ayi ba, sannan shigar da shi cikin rami mai zurfi tare da endoscope. Bayan gano jikin kasashen waje, sanya jikin kasashen waje cikin kwaroron roba. Idan yana da wuya a cire, sanya kwaroron roba a cikin rami na ciki, da kuma amfani da fage-haƙoran haƙora don matsawa kwaroron roba da kuma cire shi tare da madubi.
4.10 duwatsu
Gastoliths sun kasu zuwa ga gasterrith na kayan lambu, kwayoyin halittar dabbobi, gastalin gasterits miyagun ƙwayoyin cuta da kuma gauraye gasterits. Ciyawar gastoliths sune mafi yawanci, galibi lalacewa ta hanyar cin adadin fagesta, da kuma kwanakin hunturu, peach, seleri, Kelp, da kwakwa a kan komai a ciki. Abubuwan da ke haifar da cutar da ke haifar da shi kamar Pertimons, da kuma Jujubes suna da acid na tannin, pectin, da danko. A karkashin aikin na ciki na ciki, an kafa furotin ruwa-insolable ruwa, wanda ya danganta file, danko, ƙwaya, core. Duwatsun ciki.
Ruwan duwatsun hanji na hanji yana yin matsin lamba na hanji a jikin bango na ciki kuma ku ƙarfafa tsiro na ciki, wanda zai iya haifar da lalacewa mai lalata ciki, ulcers har ma da kuma turare. Ana iya narkar da ƙananan duwatsu mai laushi tare da sodium bicarbonate da sauran kwayoyi sannan a yarda su gurbata da kyau.
Ga marasa lafiya waɗanda suka kasa yin magani, cirewar dutse na Endosscopic shine farkon zaɓi (Hoto na 8). Don duwatsun na ciki waɗanda suke da wahala su cire kai tsaye a ƙarƙashin endoscopy saboda manyansu, jikinsu, snares, snares, cire kwanduna na dutse, sannan a iya cire kwanduna kai tsaye. Ga waɗanda suke da yanayin yanayin da ba za a iya la'akari da shi ba, ana iya ɗaukar yankan ƙwanƙwasawa ko kuma taɓake na ƙasa zuwa cire shi gwargwadon iko. Ya kamata a kula don hana duwatsu mafi girma fiye da 2cm daga shigar da hanji a cikin rami na ciki ta cikin ciki da kuma haifar da toshewar hanji.
Hoto 8 duwatsu a ciki
4.11 jakar
Rackure na jakar jakar zai haifar da hadarin m kuma shine wata matsala ce ta maganin endoscopic. Marasa lafiya waɗanda ba su da ikon yin sulhu na halitta ko waɗanda ake zargi da samun jakar jakar ƙwayoyin cuta ya kamata su yi aikin tiyata.
III. Rikicewa da magani
Abubuwan da rikice-rikice na jikin kasashen waje suna da alaƙa da yanayin, siffar, lokacin zama da matakin aikin likita. Babban rikice-rikice sun haɗa da raunin ƙwayar cututtukan ƙwayar cuta, zub da jini, da kamuwa da cuta.
Idan jikin kasashen waje karami ne kuma babu wata alama ta fuskar gamsai lokacin da aka fitar, ana buƙatar asibiti bayan aikin, da kuma abincin da taushi za'a iya bi bayan da azumi na awa 6.Ga marasa lafiya da cututtukan cututtukan cututtukan cututtukan zuciya, Grutamine Granules, Grutamine Granulate gel da sauran wakilan kariya na Mucosal za a iya ba da magani ta hanyar jiyya. Idan ya cancanta, azumi da keɓaɓɓun abinci zai iya bayarwa.
Ga marasa lafiya da lalacewa a bayyane, ana iya yin magani a ƙarƙashin wahayi kai tsaye kai tsaye, kamar feshin kankara mai sanyi mai sanyi, kamar kayan aikin titanium don rufe rauni.
Don marasa lafiya wanda abin ba ya nuna cewa jikin kasashen waje ya shiga bangon esophageal bayan cirewar Edososcopic, idan jikin kasashen waje ya kasance kasa da awanni 24 da CT ne ba batun ƙuruciya a wajen esophageal a waje ba. Bayan an cire jikin kasashen waje ta hanyar endoscope, ana amfani da clip ɗin titanium don matsa bangon ciki na esophagus kuma rufe zubar jini da rufe jini da rufe jini da rufe jini da rufe jini da rufe jini da esophagus a lokaci guda. An sanya bututu na ciki da bututun jejunal a ƙarƙashin wahayi kai tsaye na endosscope, kuma an yi haƙuri don ci gaba da jiyya. Jiyya ya haɗa da jiyya ta hanyar ruwa kamar azumi, gastrointestestal na ciki, maganin rigakafi da abinci mai gina jiki. A lokaci guda, alamu masu mahimmanci kamar zafin jiki dole ne a lura da shi a hankali, kuma faruwar rikice-rikice na subcutema ko emphaysema mai zurfi a rana ta uku bayan tiyata. Bayan tarin ruwan sha ya nuna cewa babu wani yadudduka, ci da sha.
Idan an riƙe jikin kasashen waje fiye da sa'o'i 24, idan alamun kamuwa da cuta kamar zazzabi ya faru, ya kamata a canja wurin da farin farin jini, ya kamata a tura masu haƙuri zuwa tiyata don jiyya a kan kari.
IV. Matakan kariya
(1) Da ya fi ƙarfin waje Jikin waje ya zauna a cikin esophagus, mafi wuya aikin zai zama kuma mafi rikitarwa zai faru. Sabili da haka, Gagarin Harkokin Gaggawa na Gaggawa yana buƙatar musamman.
(2) Idan jikin baƙi yana da girma, wanda ba tare da izini ba ko yana da spikes, musamman idan jikin ƙasashen Aortic, kuma yana da wuya a cire shi Esopscopically, Kada a tilasta cire shi. Zai fi kyau neman tattaunawa da shirye-shiryen tiyata.
(3) Amfani da na'urorin kariyar esophageal na iya rage faruwar rikice-rikice.
Namuzubar da ƙarfiAna amfani da shi a cikin haɗin kai tare da m enosscopes, shiga cikin rami na jikin mutum kamar yadda aka gano kyanki, da ciki da abin da ƙasƙanci suka fita.
Lokaci: Jan-26-024