Endoscopic Retrograde Cholangiopancreatography (ERCP) yog ib qho tseem ceeb ntawm kev kuaj mob thiab kho cov txheej txheem siv los tswj ntau yam kab mob hepatobiliary thiab pancreatic. Lub hauv paus rau txoj kev vam meej ntawm ERCP yog kev ua haujlwm zoo ntawm cov kua tsib thiab cov kab mob pancreatic, ib txoj haujlwm ua tau los ntawm kev siv cov ntawv qhia-xaim.
Dab tsi yog Guide-wire?
Nws yog ib qho kev sib tw, hloov tau yooj yim cov cuab yeej tseem ceeb rau kev tshawb nrhiav qhov nyuaj ntawm lub cev ntawm cov kab mob biliary thiab pancreatic thaum ERCP. Lawv tuaj nyob rau hauv ntau hom, txhua tus tsim los ua kom tau raws li cov txheej txheem tshwj xeeb. Peb lub hom phiaj tseem ceeb ntawm cov ntawv qhia-xaim uas feem ntau siv hauv ERCP suav nrog:
* Hlau Caij nplooj ntoos hlav hom: Cov lus qhia-xaim no muaj cov tub ntxhais sab hauv ib puag ncig los ntawm txheej txheej caij nplooj ntoos hlav. Thaum muab fluoroscopic visibility zoo heev, lawv yog cov tawv tawv thiab nquag kinking. Yog li ntawd, lawv cov kev siv tau poob qis vim kev nce qib hauv kev qhia-wire technology.
*Yas Insulated hom: Cov ntawv qhia-xaim no muaj cov tub ntxhais muaj zog hlau uas muaj nyob hauv Teflon sheath. Lawv muab cov kev hloov pauv zoo tshaj plaws thiab kev nkag mus zoo, ua rau lawv nyiam xaiv rau feem ntau cov txheej txheem ERCP. Lawv cov khoom zoo heev rwb thaiv tsev tso cai rau kev siv kev nyab xeeb thaum electrocautery.
*Hom Hydrophilic Coated: Cov ntawv qhia-xaim no yog coated nrog ib qho tshwj xeeb hydrophilic polymer uas ua tau nplua mias thaum raug dej los yog dej hauv lub cev. Cov txheej no txhim kho lawv cov peev xwm navigational, tshwj xeeb tshaj yog nyob rau hauv cov qauv anatomical nyuaj lossis nruj.
Yuav Ua Li Cas Master Insertion Techniques?
Cov txheej txheem ERCP ua tiav pob khawm raws li qhov tseeb tso ntawm cov lus qhia-xaim rau hauv qhov xav tau biliary lossis pancreatic ducts. Nov yog qee cov tswv yim tseem ceeb rau kev paub cov lus qhia-hlau ntxig:
1. Visualization thiab Planning: Ua ntej tso, ua tib zoo ua tib zoo saib lub cev ntawm lub biliary thiab pancreatic systems siv fluoroscopy. Npaj cov trajectory ntawm cov lus qhia-hlau ntxig kom txo tau qhov kev pheej hmoo ntawm kev raug mob thiab ua kom zoo tshaj qhov kev taw qhia.
2. Kev xaiv hom: Xaiv hom kev taw qhia tsim nyog raws li tus neeg mob lub cev thiab qhov nyuaj ntawm cov txheej txheem. Yas insulated ib qho yog ntau yam thiab haum rau feem ntau, thaum hydrophilic coated hom muaj kev txhim kho maneuverability hauv cov xwm txheej nyuaj.
3. Atraumatic Insertion: Ntxig nws maj mam thiab atraumatically, tsis txhob muaj zog heev uas yuav ua rau ductal raug mob los yog perforation. Siv cov lus qhia fluoroscopic los xyuas kom meej qhov chaw nyob rau hauv lub ductal system.
4. Kev siv cov txuj ci tshwj xeeb: Hauv cov xwm txheej nyuaj los yog kev hloov pauv ntawm lub cev, siv cov tswv yim tshwj xeeb xws li ua ntej khoov nws lub ntsis los yog siv lub kaum sab xis catheters kom yooj yim navigation.
Tom qab txheej txheem Kev Tswj Xyuas Kev Qhia-wires
Thaum cov txheej txheem ERCP ua tiav, kev tswj xyuas cov ntawv qhia-xaim kom zoo yog qhov tseem ceeb kom ntseeg tau tias lawv muaj kev nyab xeeb thiab muaj txiaj ntsig rau kev siv yav tom ntej. Ua raws li cov kauj ruam no rau kev tswj xyuas tom qab txheej txheem:
* Ntxuav: Ua kom huv si los ntawm kev ntub dej hauv dej thiab maj mam so nrog daim txhuam cev. Rau lub caij nplooj ntoos hlav hlau ib, siv ultrasonic tu kom tshem tawm cov khib nyiab los ntawm cov coil interstices.
* Kev tua kab mob: Muab cov ntaub ntawv ntxuav-xaim hauv 2% glutaraldehyde tov rau yam tsawg 30 feeb kom ua tiav cov tshuaj tua kab mob zoo. Yaug nws nrog dej ntws tom qab kom tshem tawm cov tshuaj tua kab mob seem.
* Kev tshuaj xyuas thiab kho: Ua tib zoo tshuaj xyuas nws rau txhua qhov kev puas tsuaj, xws li kinks, tawg, lossis tev ntawm txheej. Kho txhua qhov khoov lossis deformities kom ntseeg tau tias cov ntawv qhia-hlau txoj kev ua haujlwm zoo thiab ua haujlwm zoo.
* Ntim thiab Sterilization: Coil nws kom huv si thiab muab tso rau hauv lub hnab kom tsis muaj menyuam. Siv cov roj ethylene oxide sterilization kom ua tiav cov tshuaj tua kab mob thaum khaws cia cov lus qhia-hlau txoj kev ncaj ncees.
* Kev pov tseg: pov tseg ntawm kev siv ib zaug, raws li cov txheej txheem hauv tsev kho mob pov tseg kom tsis txhob muaj kab mob sib kis thiab ua kom cov neeg mob muaj kev nyab xeeb.
