Colonoscopy: Gudanar da rikitarwa

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 ba shi da sadarwar kyauta tare da rami na jiki, ana kiran shi perforation.
Ma'anar zubar da jini ba a bayyana shi da kyau ba; Shawarwari 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%
endoscopic submucosal dissection (ESD): 2% ~ 14%
Yawan zubar jini bayan tiyata:
Polypectomy: 1.6%
EMR1.1% ~ 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 masu dacewa, kayan aikin jiyya, ruwan allura da kayan isar da iskar gas na carbon dioxide bisa ga wurin wuri, ilimin halittar jiki da matakin fibrosis na ƙari.
Gudanar da perforation na ciki:
Rufewar nan da nan: Ko da kuwa wurin, rufewar shirin ita ce hanyar da aka fi so (ƙarfin shawarar: Mataki na 1, matakin shaida: C).

In ESD, don kaucewa tsangwama tare da aikin rarrabawa, ya kamata a fara fara rarraba kayan da ke kewaye don 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 kawai akan gas kyauta da aka nuna akan CT.
Maganin sassa na musamman:
Ƙarƙashin duburar ba zai haifar da huɗar ciki ba saboda halayensa na jiki, amma yana iya haifar da huɗar ƙashin ƙugu, wanda ke bayyana a matsayin retroperitoneal, mediastinal, ko emphysema na subcutaneous.
Matakan kariya:
Rufe rauni bayan tiyata na iya hana rikitarwa zuwa wani ɗan lokaci, amma babu isassun shaidun da ke nuna cewa zai iya hana jinkirin huɗa.

2. Martani ga Jini
Gudanar da zubar jini na ciki:
Yi amfani da coagulation na zafi ko shirye-shiryen hemostatic don dakatar da zubar jini.
Zubar da jini na ƙaramin jirgi:
EMR, Za a iya amfani da tip ɗin tarkon don coagulation na thermal.
ESD, Za a iya amfani da tip na wuka na lantarki don tuntuɓar maɗauran zafin jiki ko ƙarfin hemostatic 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 bayanEMR :
Nazarin ya nuna cewa yin amfani da magungunan hemostatic don rigakafin coagulation ba shi da wani tasiri mai mahimmanci akan yawan zubar jini bayan tiyata, amma akwai yanayin raguwa.
Prophylactic clipping 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).
ESD, an cire raunin kuma an kwantar da jijiyoyin jini da aka fallasa. Hakanan za'a iya amfani da shirye-shiryen hemostatic don hana matse manyan hanyoyin 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 rigakafi na baya 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, polyp tarko, allurar sclerotherapy, fesa catheter,cytology goge, jagora, kwandon dawo da dutse, hanci biliary drainage catheter,urethra samun kumfakumaKumburin shiga urethra tare da tsotsada sauransu wadanda ake amfani da su sosai a cikiEMR, 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!