A cikin maganin colonoscopic, rikice-rikice na wakilci shine perforation da zub da jini.
Perforation yana nufin yanayin da rami ke da alaƙa da ramin jikin da yardar rai saboda ƙarancin nama mai kauri, kuma kasancewar iska mai kyauta akan gwajin X-ray baya shafar ma'anarsa.
Lokacin da gefen cikakkiyar lahani na nama ya rufe kuma babu sadarwar kyauta tare da rami na jiki, ana kiran shi perforation. Ba a bayyana ma'anar zub da jini da kyau ba, kuma shawarwarin na yanzu sun haɗa da raguwar haemoglobin fiye da 2 g/dL ko buƙatar ƙarin jini.
Yawan zubar jini na bayan tiyata ana bayyana shi azaman abin da ya faru na gagarumin jini a cikin stool bayan tiyata wanda ke buƙatar magani na jini ko ƙarin jini.
Abubuwan da ke faruwa na waɗannan abubuwan da suka faru na bazata sun bambanta tare da jiyya:
Ƙimar ɓarna:
Polypectomy: 0.05%
Endoscopic mucosal resection (EMR: 0.58% ~ 0.8%
Abubuwan Amfani Endoscopic masu alaƙa:Polypectomy Snare
Abubuwan Amfani Endoscopic masu alaƙa:Hemostatic Clips
Abubuwan Amfani Endoscopic masu alaƙa: Allurar Sclerotherapy
endoscopic submucosal dissection (ESD): 2% ~ 14%
Abubuwan Amfani Endoscopic masu alaƙa:Wukar ESD
Abubuwan Amfani Endoscopic masu alaƙa: Za'a iya zubarwaWukar ESD
Yawan zubar jini bayan tiyata:
Polypectomy: 1.6%
EMR: 1.1% ~ 1.7%
ESD: 0.7 ~ 3.1%
1. Yadda ake magance huda
Tun da bangon babban hanji ya fi na ciki, haɗarin perforation ya fi girma. Ana buƙatar isassun shirye-shirye kafin a yi aikin tiyata don magance yiwuwar ɓarna.
Kariyar kai:
Tabbatar da kyakkyawan aiki na endoscope. Zaɓi endoscopes da suka dace, kayan aikin jiyya, ruwan allura, da kayan isar da iskar gas na carbon dioxide bisa ga wuri, ilimin halittar jiki, da matakin fibrosis na ƙari.
Gudanar da perforation na ciki:
Rufewar nan da nan: Ko da kuwa wurin, an fi son shirye-shiryen bidiyo don rufewa (ƙarfin shawarar: matakin 1, matakin shaida: C). A cikin ESD, wani lokaci yankin da ke kewaye ya kamata a fara cirewa don guje wa tsoma baki tare da aikin bawon.
Nama, tabbatar da isasshen wurin aiki kafin rufewa.
Lura bayan tiyata: Idan za a iya rufe perforation gaba ɗaya, ana iya guje wa tiyata ta hanyar maganin rigakafi kawai da azumi.
Shawarar tiyata: An ƙayyade buƙatar tiyata bisa ga haɗuwa da alamun ciki, sakamakon gwajin jini, da kuma hoto maimakon gas ɗin kyauta da aka nuna akan CT kadai.
Maganin sassa na musamman:
Ƙarƙashin duburar ba zai haifar da huɗar ciki ba saboda halayensa na jiki, amma yana iya haifar da shi
Perforation na pelvic, bayyana a matsayin retroperitoneal, mediastinal, ko subcutaneous emphysema.
Matakan kariya:
Rufe raunin bayan tiyata na iya hana rikitarwa zuwa wani matsayi, amma ba haka ba
Akwai isassun shaidun da ke nuna cewa yana da tasiri wajen hana jinkirin huɗa.
2. Martani ga Jini
Gudanar da zubar jini na ciki:
Yi amfani da coagulation na zafi koshirye-shiryen hemostatica daina zubar jini.
Zubar da jini na ƙaramin jirgi:
In EMR, Za a iya amfani da tip ɗin tarkon don coagulation na thermal.
A cikin ESD, ana iya amfani da titin wuka na lantarki don tuntuɓar coagulation na thermal ko hemostatic forceps don dakatar da zubar jini.
Babban jini na jirgin ruwa: Yi amfani da karfin jini na jini, amma sarrafa kewayon coagulation don guje wa jinkirin huɗa.
Rigakafin zubar jini bayan tiyata:
Ciwon raunuka bayan EMR:
Nazarin ya nuna cewa yin amfani da maƙarƙashiya na hemostatic don rigakafin coagulation ba shi da wani tasiri mai mahimmanci akan yawan zubar da jini bayan tiyata, amma akwai yanayin raguwa. Ƙunƙarar rigakafi yana da iyakacin tasiri akan ƙananan raunuka, amma yana da tasiri ga manyan raunuka ko marasa lafiya da ke da haɗari na zubar da jini bayan tiyata (kamar wadanda ke karɓar maganin antithrombotic).
Ciwon raunuka bayan ESD:
Tasoshin jini da aka fallasa suna da coagulated, kuma ana iya amfani da shirye-shiryen hemostatic don hana matse manyan tasoshin jini.
Lura:
Don EMR na ƙananan raunuka, ba a ba da shawarar maganin rigakafi na yau da kullum ba, amma ga manyan cututtuka ko marasa lafiya masu haɗari, ƙwanƙwasa rigakafin bayan tiyata yana da wani tasiri (ƙarfin shawarar: Mataki na 2, matakin shaida: C).
Perforation da zub da jini matsaloli ne na gama gari na endoscopy na colorectal.
Ɗaukar matakan rigakafi da magani masu dacewa don yanayi daban-daban na iya rage yawan cututtukan cututtuka da kuma inganta lafiyar marasa lafiya.
Mu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., wani manufacturer ne a kasar Sin ƙware a cikin endoscopic consumables, kamarbiopsy forceps, hemoclip, tarkon polyp,allurar sclerotherapy, fesa catheter, cytology goge, jagora, kwandon dawo da dutse, hanci biliary drainage catheter,Kumburin samun kujerun fitsari da kumfa mai shiga fitsari tare da tsotsa da sauransu. wadanda ake amfani da su sosai a ciki EMR,ESD, ERCP. Samfuran mu suna da takardar shedar CE, kuma tsire-tsire namu suna da takaddun ISO. An fitar da kayanmu zuwa Turai, Arewacin Amurka, Gabas ta Tsakiya da wani yanki na Asiya, kuma suna samun abokin ciniki yabo da yabo!
Lokacin aikawa: Afrilu-18-2025