Endoscopic Sclerotherapy (EVS) Kashi na 1

1) Ka'idar endoscopic sclerotherapy (EVS):

Allurar intravascular: wakili na sclerosing yana haifar da kumburi a kusa da veins, yana taurare hanyoyin jini kuma yana toshe kwararar jini;

Paravascular allura: yana haifar da kumburi mai kumburi a cikin jijiyoyi don haifar da thrombosis.2) Alamun EVS:

(1) Mummunan fashewar EV da zubar jini;

(2) Mutanen da ke da tarihin fashewar EV da zubar jini;(3) Mutanen da ke da maimaitawar EV bayan tiyata;(4) Mutanen da basu dace da aikin tiyata ba.

3) Contraindications na EVS:

(1) Daidai da gastroscopy;

(2) Hepatic encephalopathy mataki na 2 da sama;

(3) Marasa lafiya masu fama da ciwon hanta da koda, yawan ciwon ascites, da jaundice mai tsanani.

4) Kariyar aiki

A kasar Sin, zaku iya zabar lauromacrol.Don manyan hanyoyin jini, zaɓi allurar cikin jini.Yawan allurar gabaɗaya shine 10 ~ 15mL.Don ƙananan tasoshin jini, zaku iya zaɓar allurar paravascular.Yi ƙoƙarin guje wa yin allura a wurare daban-daban a kan jirgin sama ɗaya (wataƙila Ulcers na iya faruwa wanda zai haifar da takurawar esophageal).Idan numfashi ya shafi yayin aikin, ana iya ƙara hular haske a cikin gastroscope.A cikin ƙasashen waje, ana ƙara balloon a cikin gastroscope.Yana da daraja koyo daga.

5) Gudanar da aikin EVS bayan aiki

(1) Kada ku ci ko sha na tsawon sa'o'i 8 bayan tiyata kuma a hankali ci gaba da abinci mai ruwa;

(2) Yi amfani da adadin da ya dace na maganin rigakafi don hana kamuwa da cuta;(3) Yi amfani da magungunan da ke rage matsa lamba kamar yadda ya dace.

6) EVS magani hanya

Ana buƙatar sclerotherapy da yawa har sai veins na varicose ya ɓace ko kuma ya ɓace, tare da tazara na kusan mako 1 tsakanin kowane magani;Gastroscopy za a sake nazarin wata 1, watanni 3, watanni 6, da shekara 1 bayan ƙarshen aikin jiyya.

7) Matsalolin EVS

(1) Rikice-rikice na yau da kullun: ectopic embolism, ulcer na esophageal, da sauransu, da

Yana da sauƙi don haifar da zubar jini ko zubar jini daga ramin allura lokacin da aka ciro allurar.

(2) Rikicin gida: ulcers, zub da jini, stenosis, rashin aikin motsa jiki na esophageal, odynophagia, lacerations.Rikita-rikitar yanki sun haɗa da mediastinitis, perforation, pleural effusion, da portal hypertensive gastropathy tare da ƙara haɗarin zubar jini.

(3) Matsalolin tsarin: sepsis, buri ciwon huhu, hypoxia, kwatsam na kwayan cuta peritonitis, da portal vein thrombosis.

Endoscopic varicose vein ligation (EVL)

(1) Alamu ga EVL: Daidai da EVS.

(2) Contraindications na EVL:

(1) Irin contraindications kamar gastroscopy;

(2) EV tare da bayyane GV;

(3) tare da hanta mai tsanani da rashin aikin koda, yawan adadin ascites, jaundice

Gangrene da magungunan sclerotherapy da yawa na baya-bayan nan ko ƙananan jijiyoyin varicose

Ɗaukar daular Han a matsayin kusa-duofu yana nufin cewa mutanen Hua za su iya motsawa cikin 'yanci, ko kuma a shimfiɗa jijiyoyi da bugun jini zuwa yamma.

By.

3) Yadda ake aiki

Ciki har da ligation na gashi guda ɗaya, ligation ɗin gashi da yawa, da igiya na nylon.

Ka'ida: Toshe hanyoyin jini na varicose veins da samar da hemostasis gaggawa → venous thrombosis a ligation site → tissue necrosis → fibrosis → bacewar varicose veins.

(2) Hattara

Don matsakaita zuwa matsananciyar variceal na esophageal, kowace jijiyar varicose an haɗa shi a karkace zuwa sama daga ƙasa zuwa sama.Ya kamata ligator ya kasance kusa da wurin da ake nufi da jijiya ta varicose, ta yadda kowane batu ya kasance cikakke kuma an haɗa shi da yawa.Yi ƙoƙarin rufe kowace jijiyar varicose fiye da maki 3.