(1). Dabaru na asali Dabaru na asali na EMR sune kamar haka:
Jerin dabarun
①A yi allurar maganin allurar gida a ƙasa da raunin.
②Sanya tarkon a kusa da raunin.
③Ana ɗaure tarkon don kama da kuma shake raunin.
④ Ci gaba da ƙara matse tarkon yayin da ake amfani da wutar lantarki don yanke raunin.
⑤Dawo da samfurin da aka cire.
(2). Nasihu
1. Nasihu don zaɓar wurin da jiki yake da kuma sanya endoscope
Domin kuwa raunin yana buƙatar a yi masa magani yayin da hoton gaba ɗaya yake a bayyane, yanayin majiyyacin yana da matuƙar muhimmanci. Yi ƙoƙarin karkatar da na'urar hangen nesa ta yadda raunin zai kasance kusa da buɗewar biopsy forceps, wato, daga ƙarfe 5 zuwa 7 a kan allon.
Kafin a yi magani, sai a wanke ragowar da kuma yawan launin da ke ciki sannan a cire su ta hanyar tsotsa.
Misali, idan aka cire wani rauni a cikin babban hanjin sigmoid a matsayin gefen hagu ko kuma a matsayin gefen hagu na decubitus, samfurin sau da yawa zai koma zuwa babban hanjin da ke saukowa, wanda hakan ke sa ya yi wuya a dawo da shi, don haka matsayin gefen dama na decubitus ya fi kyau don cire shi.
Haka kuma, daga mahangar murmurewa daga samfurin, an fi son a yanke raunukan hanji ta gefen hagu na gefen hagu.
2. Nasihu don allurar gida
Ana iya allurar allurar gida mai kauri a ƙaramin matsin lamba, amma ba ta da kaifi sosai kuma ramin allurar ya yi yawa, don haka marubucin ya yi amfani da allurar allurar gida mai ƙarfin 25G.
Ba ƙari ba ne a ce nasarar ko gazawar EMR ya dogara ne akan allurar gida.
Ga ƙananan raunuka, ana yin huda daga gefen duburar raunin zuwa ƙasa da raunin.
Ga raunuka a ɓangaren da aka lanƙwasa ko kuma a kan naɗewa, idan an yi allurar gida daga gefen dubura, a mafi yawan lokuta raunukan ba su bayyana ba saboda suna fuskantar gefen baki, don haka ya kamata a fara allurar gida daga gefen baki.
Muhimmanci ga Masu Aikin Endoscopy
Idan ruwa ya zube, ko kuma akwai juriya sosai yayin allura, ko kuma babu juriya lokacin da ruwa ya shiga amma babu kumburi, dole ne a dakatar da allurar kuma a sanar da mai aiki game da yanayin a kan lokaci don tattauna matakan da za a ɗauka don magance matsalar.
Yawan allurar da ake buƙata, mafi kyau.
Dabara ita ce a ci gaba da yin allura gwargwadon iko ta hanyar hudawa ɗaya har sai an cire dukkan raunin.
3. Nasihu don zaɓar tarko
Idan tarkon yana kama da dogon oval, za a iya haɗa mucosa na yau da kullun a gefen rauni a bakin da dubura cikin sauƙi kuma ba tare da wata matsala ba.
Tarkon ya fi dacewa ya yi kama da zagaye, yana da sauƙin buɗewa a gefe, ba shi da sauƙin zamewa, kuma yana da ɗan tauri don matsawa kan raunin don kama raunin.
Ya kamata a daidaita girman tarkon da girman raunin.
Tarkon Jurewar Polypectomy
Misalai na EMR
a. Hoton farin haske
Rauni mai girman mm 25 tare da wani ɓangare na tsakiya mai ɗan raguwa.
b. Hotunan ɗaukar hoto na ƙunƙuntaccen madauri (NBI)
c. Fesa indigo carmine don faɗaɗa hoton
An gano cewa ramukan da aka lura da su ta hanyar lura ta al'ada a zahiri ramuka ne tsakanin ganyaye.
d. Babban hoton fenti mai launin lu'ulu'u mai launin shuɗi
Tsarin ramin buɗewar bututun glandular a gefen raunin shine nau'in IV.
e. Babban hoton fenti mai launin lu'ulu'u mai launin shuɗi
a tsakiyar raunin akwai VI, ɗan rashin daidaituwa, kuma ba a sami wata alama ta shigar ciki ta cikin mucosa ba.
f. Allurar gida
An yi huda da allurar gida a tsakiyar raunin, wanda ya haifar da kumburi mai kyau.
g. Buɗe tarko
Danna kan tarko a bangon hanji don buɗe tarkon.
h. Rufe tarko
Rufe tarkon ka kama raunin.
i.Power akan cirewa
Ba a sami wani rami, zubar jini ko ƙari da ya rage ba.
j. Daidaita samfurin
An haɗa samfurin da aka cire a kan takardar roba.
Ganewar cutar ta ƙarshe:Ciwon daji na intramucosal (Tis)
4. Nasihu don aikin tarko
Ana sanya ƙarshen tarko a hankali a kan mucosa na baki na raunin, sannan a buɗe a hankali sannan a matse tushen tarko a gefen duburar raunin. Domin hana yankewar gefe ya zama tabbatacce, ya kamata a saka ƙaramin adadin mucosa na yau da kullun.
Ya kamata a lura cewa idan ba a iya ganin ƙarshen tarko ba, yana yiwuwa an saka mucosa na yau da kullun fiye da yadda ake tsammani. Bayan an matse tarko sosai, a tura kuma a ja hannun riga na waje na tarkon don lura da motsi na raunin. Idan aka saka shi cikin layin tsoka, motsi na tarkon zai ragu.
Nasihu don cire wutar lantarki
Kada a danna tarkon a bangon hanji, amma a ɗan ɗaga raunin don a cire shi. Haɗarin jinkirin hudawa ba shi da yawa lokacin amfani da tiyatar lantarki, amma yana iya haifar da zubar jini a lokacin tiyata (da wuri bayan an cire).
Fitar da ta yi sauri sosai na iya haifar da zubar jini, yayin da fitar da ta yi jinkiri sosai na iya haifar da jinkiri a huda. Idan majiyyaci ya ji zafi, ko kuma mataimakin ya ji cewa nama yana da laushi kamar roba kuma yana da wahalar yankewa, akwai yiwuwar nama yana cikin layin tsoka, kuma ya kamata a dakatar da fitar nan take.
Muhimmanci ga Masu Aikin Endoscopy
Idan likitan endoscope ya ji cewa nama yana da roba kamar roba kuma yana da wahalar yankewa, ya kamata ya sanar da mai aikin nan da nan don tattauna matakan da za a ɗauka don magance matsalar.
Nasihu don Sharding EMR
Ga manyan raunuka, wani lokacin yana da aminci a yi tiyatar cire sassan jiki maimakon tiyatar cire sassan jiki gaba ɗaya. Duk da haka, idan aka sami ƙarin sassan jiki, to akwai yuwuwar sake dawowar sassan jiki. Ko da tare da EMR mai rauni, ya kamata a yi tiyatar cire sassan jiki da farko gwargwadon iko tare da babban tarko don rage yawan sassan jiki.
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Na'urar ɗaukar hoto ta biopsy:
https://www.zrhendoscopy.com/single-use-endoscopic-tissue-biopsy-forceps-with-graduation-product/
Hemoclip
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tarkon polyp
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allurar sclerotherapy
https://www.zrhendoscopy.com/gastroenterology-accessories-endoscopic-sclerotherapy-injection-needle-product/
Fesa catheter
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gogewar cytology
https://www.zrhendoscopy.com/endoscopy-accessories-disposable-endoscopic-cytology-brush-for-gastrointestinal-tract-product/
Jagorar waya
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Kwandon ɗaukar dutse
https://www.zrhendoscopy.com/ercp-instrument-gallstone-stone-retrieval-basket-for-endoscopy-product/
catheter na magudanar ruwa ta hanci
https://www.zrhendoscopy.com/medical-instrument-disposable-nasal-biliary-drainage-catheter-for-ercp-operation-product/
EMR
https://www.zrhendoscopy.com/emresd/
ESD
https://www.zrhendoscopy.com/emresd/
ERCP
https://www.zrhendoscopy.com/ercp/
Lokacin Saƙo: Fabrairu-13-2025