Mukufuna kudziwa zambiri za mayeso a ERCP (Endoscopic Retrograde Cholangiopancreatography)? Musachite mantha, tiyeni tikambirane!

Dokotala wanu akakuuzani kuti muyenera kuchita ERCP, mwina mumakhala ndi mafunso ambiri okhudza chomwe chimachitika, chifukwa chake chimachitidwa, ndipo kodi chidzapweteka. Ndizachilendo. Anthu ambiri amanjenjemera pang'ono akamva dzinalo. Koma ERCP si chinthu choopa. Ndi mayeso apamwamba kwambiri omwe amatha kuzindikira ndikuthandizira mavuto ena m'thupi lanu la biliary ndi pancreatic ducts. Chifukwa chake, tiyeni tikambirane za ERCP m'njira yosavuta lero, chabwino?

Kodi Endoscopic Retrograde Cholangiopancreatography (ERCP) ndi chiyani?

Dzina lalitali ili lingakupangitseni kumva chizungulire pang'ono, koma tiyeni tilifotokoze mwachidule kuti timvetse.

Mwachidule, ERCP ndi njira yapadera yomwe madokotala amagwiritsa ntchito poyang'ana mkati mwa ducts za bile ndi ducts za pancreatic . ducts izi zimakhala ndi ndulu ndi madzi a pancreatic, zomwe zimatithandiza kugaya chakudya chomwe timadya.

Tanthauzo la dzinali ndi ili:

• Endoscopic: Ichi chimagwiritsa ntchito chipangizo chotchedwa endoscope. Ndi chubu chopyapyala, chosinthasintha chokhala ndi kamera kakang'ono komanso kuwala mbali imodzi. Chimayikidwa kudzera pakamwa panu ndikuperekedwa kumtunda kwa matumbo anu (duodenum). Mudzapatsidwa mankhwala ochepetsa ululu kuti akuthandizeni kugona, kuti musamve kupweteka kulikonse.
• Kubwezeretsa: Mu ichi, chubu china chaching'ono chimayikidwa kudzera mu endoscope ndipo madzi apadera (utoto wosiyana) amalowetsedwa mu ducts za bile ndi ducts za pancreatic. "Retrograde" amatanthauza "kubwerera m'mbuyo" chifukwa madziwo amalowetsedwa mosiyana ndi momwe amayendera nthawi zambiri.
• Cholangiopancreatography: Izi zikutanthauza zithunzi zomwe zajambulidwa. "Cholangio" zikutanthauza zokhudzana ndi ducts ya ndulu. "Pancreato" zikutanthauza zokhudzana ndi kapamba. "Graphy" zikutanthauza kujambula zithunzi.

Chifukwa chake, utoto wosiyanitsa umapangitsa kuti duct yanu ya bile ndi duct ya pancreatic iwonekere bwino pazithunzi za X-ray. Izi zimathandiza madokotala kuwona ngati pali chilichonse chomwe chikutseka duct iyi - monga miyala ya ndulu, zotupa, kapena kuchepa kwa duct chifukwa cha zipsera . Gawo labwino kwambiri ndilakuti mavuto ena amatha kuchiritsidwa pomwepo, kudzera mu endoscope.

Kodi ndi nthawi ziti pamene ERCP imafunika?

Dokotala wanu angakupatseni ERCP ngati akukayikira kuti pali vuto ndi dongosolo lanu la biliary. Mwachitsanzo:

• Ngati muli ndi ululu wosaneneka m'mimba , kapena ngati muli ndi biliary colic.
• Ngati pali vuto lomwe kutuluka kwa ndulu kwatsekedwa kapena pali zizindikiro za kutuluka kwa ndulu, mwachitsanzo jaundice .

Kuyezetsa kwa ERCP kungathandize kuzindikira ndikuchiza mavuto omwe amakhudza njira zanu zotulutsira ndulu, monga:

• Kutupa kwa ndulu (cholangitis) ndi matenda ena okhudzana nayo.
• Kuchepa kwa njira zotulutsira ndulu chifukwa cha zipsera (kuchepa kwa ndulu) .
• Kutsekeka kwa miyala mu duct ya ndulu yodziwika bwino .
• Kutupa kwa kapamba komwe kumachitika chifukwa cha miyala (gallstone pancreatitis) .
• Zotupa kapena khansa ya m'mitsempha ya ndulu.
• Kutuluka kwa duct ya bile kapena ngozi zina.

Kodi ERCP imagwira ntchito bwanji?

ERCP imaphatikiza njira ziwiri zazikulu: endoscopy ndi fluoroscopy . Fluoroscopy ili ngati kusuntha zithunzi za X-ray. Taganizirani ngati kanema wa X-ray.

Kuyeza kumeneku kumathandiza dokotala kuona momwe madzi apadera (utoto wosiyana) amayendera kudzera m'mitsempha yanu ya ndulu ndi m'mitsempha ya pancreatic. Kungasonyeze bwino kutuluka kapena kutsekeka kulikonse.

Endoscope ndi yomwe imalola dokotala (endoscopist) kufika pamalopo. Utoto wosiyana umabayidwa kudzera mu izi. Komanso, ngati vuto lapezeka, zida zazing'ono zitha kuyikidwa kudzera mu endoscope iyi kuti zichiritsidwe.

Ndani amachita ERCP?

ERCP nthawi zambiri imachitidwa ndi dokotala wa gastroenterologist . Madokotala awa ndi akatswiri pochiza matenda am'mimba ndi m'matumbo. Amaphunzitsidwanso kuchita endoscopy. Amaphunzitsidwanso njira zochizira endoscopy zomwe zingagwiritsidwe ntchito m'malo mwa opaleshoni yaying'ono.

Kodi mumakonzekera bwanji ERCP?

Dokotala wanu adzakupatsani malangizo enaake oti mutsatire musanachite ERCP yanu. Kawirikawiri, awa ndi awa:

• Muyenera kusiya kusuta fodya, kudya, kutafuna chingamu, ndi kumwa china chilichonse kupatula madzi maola asanu ndi atatu musanayesedwe .
• Muyenera kuuza dokotala wanu za matenda ena aliwonse omwe muli nawo komanso mankhwala aliwonse omwe mukumwa . Mankhwala ena, monga ochepetsa magazi, angafunike kuyimitsidwa kwa masiku angapo mayeso asanachitike.
• Uzani dokotala wanu ngati munakhalapo ndi vuto la utoto wosiyana kapena mankhwala oletsa ululu omwe munagwiritsa ntchito panthawi yoyezetsa.
• Muyenera kukonza galimoto kuti mupite kunyumba mukamaliza mayeso, chifukwa zimatenga pafupifupi maola 24 kuti zotsatira za mankhwala oletsa ululu zithe kwathunthu. Chifukwa chake, simudzatha kuyendetsa galimoto.

Kodi chimachitika ndi chiyani panthawi ya mayeso a ERCP?

ERCP ndi njira yochizira odwala osapita kuchipatala . Izi zikutanthauza kuti mutha kupita kunyumba tsiku lomwelo. Njirayi nthawi zambiri imatenga ola limodzi kapena awiri.

Mudzapatsidwa mankhwala omwe amaperekedwa mumtsempha (kudzera mu ``IV```) kuti akupangitseni kugona (kugona tulo tofa nato) . Mungakhale muli mtulo waukulu, kapena simunadzuke mokwanira. Komabe, simudzakumbukira mayesowo.

Pa gawo la matenda, dokotala adzachita izi:

• Ngati mukufuna, mutha kugwiritsa ntchito mankhwala oletsa ululu amadzimadzi kuti muchepetse kupweteka kwa pakhosi.
• Endoscope imayikidwa kudzera pakamwa ndipo imadutsa mosamala kudzera m'mero ​​ndi m'mimba kupita kumtunda kwa matumbo ang'onoang'ono (duodenum). Zithunzi zomwe zimawonedwa kuchokera ku kamera ya endoscope zimawonetsedwa pazenera.
• Mukaonera mavidiyo amenewo, mutha kupeza potseguka pa duct ya bile ndi pancreatic duct mkati mwa matumbo ang'onoang'ono.
• Chubu china chaching'ono chimayikidwa kudzera mu catheter mu endoscope ndikulowa m'malo otseguka.
• Utoto wosiyana umalowetsedwa m'mitsempha kudzera mu chubu chaching'ono chimenecho.
• Kenako, pogwiritsa ntchito ukadaulo wa fluoroscopy, makanema a X-ray amatengedwa kuti awone momwe madziwo amayendera kudzera m'machubu. Mu fluoroscopy, ma X-ray amatulutsidwa mwachangu. Izi zimaonedwa kuti ndi kuchuluka kotetezeka kwa ma radiation.
• Zithunzizi zimagwiritsidwa ntchito pofufuza mavuto aliwonse omwe ali ndi mapaipi - kutsekeka, kutupa, kutuluka madzi, ndi zina zotero.

Tangoganizirani izi, zili ngati kuyika kamera mu payipi, kutumiza madzi amitundu yosiyanasiyana kudzera mmenemo, ndikupeza komwe yatsekeka ndi komwe ikutuluka.

Tsopano, ngati dokotala apeza vuto lililonse panthawi yowunikayi, adzayesa kuwachiza poika zida zazing'ono kudzera mu endoscope. Dokotala amene akuchita endoscopy akhoza kuchita zinthu monga:

• Kuphwanya ndi kuchotsa miyala ya ndulu.
• Kuchotsa zotupa kapena kutenga chitsanzo cha minofu (biopsy). (Akatenga biopsy, amatumizidwa ku labu kuti akaone ngati ndi khansa kapena ayi.)
• Kukulitsa kapena kutambasula mitsempha yamagazi yopapatiza kapena yopapatiza.
• Kuyika chinthu chaching'ono chonga chubu (stent) mkati mwa chotengera kuti chikhale chotseguka.
• Kukonza malo otayikira kapena kuvulala mu chitoliro.
• Kuchotsa mphuno (sphincterotomy) ndi kudula pang'ono komwe kumachitika mu minofu yozungulira potulukira payipi kuti ikule. (Izi zimathandiza kuti ndulu ndi madzi a kapamba azituluka mosavuta.)

Kodi mungayembekezere chiyani pambuyo pa ERCP?

Mukamaliza mayeso, mudzasungidwa kuchipatala kapena kuchipatala kwa ola limodzi kapena awiri, mpaka zotsatira za mankhwala oletsa ululu zitatha. Kenako munthu amene anabwera kudzakutengani akhoza kukutengerani kunyumba. Mungamve ngati muli ndi tulo pang'ono, mukutopa kapena muli ndi malo tsiku limenelo.

Kusamva bwino pang'ono ngati kumeneku kungachitike kwa tsiku limodzi kapena awiri mutamaliza mayeso:

• Kupweteka pakhosi ndi kuvutika kumeza: Endoscope ingayambitse kupweteka pakhosi. Ndi bwino kumwa zakumwa kapena zakudya zofewa mpaka zitachira.
• Kutupa m'mimba kapena kupweteka kwa mpweya: Pamene endoscope yaikidwa, mpweya pang'ono umalowetsedwa mu GI tract kuti muwone bwino. Ichi ndi chomwe chimayambitsa kusasangalala kumeneku. Kumachepa pakapita kanthawi (mpweya ukangotulutsidwa).
• Nseru: Izi zitha kukhala zotsatira zoyipa za mankhwala oletsa ululu. Zimathanso tsiku lotsatira.

Kodi zoopsa za ERCP ndi ziti?

Mavuto amapezeka pafupifupi 5% mpaka 10% ya njira za ERCP. Chiwopsezochi chimadalira matenda omwe mudakumana nawo kale komanso mtundu wa chithandizo chomwe mumalandira panthawi ya ERCP. Dokotala wanu adzakambirana nanu izi pasadakhale. Mavuto omwe angakhalepo ndi awa:

• Kuipa kwa mankhwala ochepetsa ululu: Izi zingayambitse mavuto a mtima ndi mapapo mwa anthu omwe ali ndi matenda a m'mapapo kapena a mtima omwe analipo kale.
• Kusamvana ndi utoto wosiyana: Ngati izi zitachitika, dokotala adzakupatsani mankhwala mwamsanga kuti asiye kuoneka ngati wachilendo.
• Kuvulala kwa njira yanu ya m'mimba kuchokera ku endoscope: Izi zingayambitse kutuluka magazi mkati kapena, pazochitika zazikulu, dzenje.
• Kutuluka kwa ndulu chifukwa cha kuvulala kwa ndulu yodutsa magazi chifukwa cha zida zoyezera magazi.
• Matenda m'thupi lanu la biliary: Pofuna kupewa izi, dokotala wanu angakupatseni maantibayotiki pasadakhale.
• Njirayi ingayambitse kuyabwa ndi kutupa kwa kapamba (pancreatitis). Imeneyi ndi vuto lofala kwambiri pambuyo pa ERCP.

Ngati muli ndi pakati panthawi yoyezetsa, chiopsezo cha kuvulala kwa mwana wosabadwayo chifukwa cha kuwala komwe kumatuluka panthawi ya fluoroscopy ndi chochepa, koma pali chiopsezo chochepa. Dokotala wanu adzakufunsani pasadakhale ngati pali kuthekera kuti mungakhale ndi pakati. Ngati ndi choncho, dokotala wanu adzayesa kusintha nthawi yoyezetsa kapena kuchepetsa kukhudzana ndi kuwala ngati pakufunika.

Kodi zimatenga nthawi yayitali bwanji kuti mudziwe zotsatira za mayeso?

Ngati simunagone chifukwa cha mankhwala oletsa ululu,Dokotala (endoscopist) amene anachita ERCP ayenera kukulankhulani nthawi yomweyo za mayesowo. Iye adzakuuzani zomwe zapezeka komanso zomwe zingachitike. Ngati mwatenga chitsanzo cha minofu (biopsy), zingatenge milungu ingapo kuti zotsatira zake zibwerere.

Ngati ERCP yanu siipeza chilichonse, mungafunike kuyesedwa mtundu wina. Ngati mayesowo sanathetse vuto lanu, kapena ngati zotsatira za biopsy zatsimikizira vuto latsopano, mungafunike kupatsidwa mtundu wina wa chithandizo. Dokotala wanu adzakambirana nanu zomwe mungachite kenako.

Kodi muyenera kuyimbira dokotala liti?

Ngati mukukumana ndi zizindikiro zazikulu kapena zachilendo izi mutalandira ERCP, imbani dokotala nthawi yomweyo:

• Kupweteka kwambiri m'mimba kapena kudzimbidwa.
• Kupweteka pachifuwa kapena kuvutika kupuma.
• Malungo, kusanza, kapena zizindikiro zina za matenda.
• Kutuluka magazi m'thupi kapena kutuluka ndowe zakuda, zotayirira.

Kodi kusiyana pakati pa ERCP ndi endoscopy yokhazikika ndi kotani?

ERCP ndi njira yapamwamba kwambiri yofufuzira matenda a m'mimba. Njira yodziwika bwino yofufuzira matenda a m'mimba (EGD) imangoyang'ana njira yanu yapamwamba ya m'mimba. Izi zikutanthauza kuti imangoyang'ana m'mero, m'mimba, ndi gawo loyamba la matumbo ang'onoang'ono.

Koma mu ERCP, njira ina yowonjezera imagwiritsidwa ntchito limodzi ndi endoscope yokhazikika - kutanthauza chubu chachiwiri (catheter) chomwe chimalowa mkati mwa chubu choyamba - ichi ndi chomwe chimafika m'mitsempha yanu ya biliary.

Kukulitsa kwa endoscope kakang'ono kumeneku kumalola dokotala kuchiza ma duct anu mwachindunji. Njira yokhayo yochizira endoscopic yomwe ingachiritse ma duct mwachindunji mwanjira iyi ndi `ERCP`. Ngakhale njira zina zochizira endoscopic monga `MRCP` (magnetic resonance cholangiopancreatography) ndi `EUS` (endoscopic ultrasound) zimatha kuwona ma duct anu a bile ndi ma duct a pancreatic, sizimapereka mwayi woterewu wochizira.

Kodi ERCP ndi opaleshoni yaikulu?

ERCP si opaleshoni monga momwe timaganizira nthawi zambiri. Si chinthu chomwe chimadula khungu ndikulowa m'ziwalo zomwe zili mkati mwa thupi. ERCP ndi njira yowunikira. Zimatanthauza kuti imalowa m'thupi kudzera m'malo otseguka mwachilengedwe - pakhosi.

Komabe, pochita ERCP, dokotala amatha kuchita opaleshoni ina kudzera mu endoscope. Nthawi zina madokotala amatchula njira izi zomwe zimachitika kudzera mu endoscope kuti opaleshoni ya endoscopic . Izi ndi njira zochitira opaleshoni chifukwa zimaphatikizapo kudula ndi kusoka mkati mwa thupi. Komabe, nthawi zambiri izi zimakhala zazing'ono, ndipo sizili zoopsa kwambiri ndipo zimakhala ndi nthawi yochepa yochira kuposa opaleshoni yachikhalidwe.

Kodi ERCP imachitidwa pa matenda a kapamba?

Inde, ngati dokotala wanu akuganiza kuti pali chinachake chomwe chikutseka duct yanu ya ndulu kapena duct ya pancreatic, akhoza kuyitanitsa ERCP. Miyala ya ndulu yomwe imamatirira m'duct ndi chifukwa chachikulu cha kapamba wa pachimake. Ngati zimenezo zitachitika, mungafunike ERCP kuti muchotse kutsekekako.

Ngati muli ndi matenda a kapamba osatha, kutupako kungayambitse kuti minyewa ya kapamba yanu ikhale ndi zipsera komanso kupapatiza (strictures). Pazochitika zotere, ERCP ingathandize kukulitsa minyewa kapena kuyika stent kuti ikhale yotseguka. Izi zimathandiza kuti madzi a kapamba apitirize kuyenda kudzera m'misewu.

Kumbukirani chinthu chofunika kwambiri (Uthenga Wopita Nawo Kunyumba)

ERCP (Endoscopic Retrograde Cholangiopancreatography) ndi njira yodziwira matenda yomwe ingagwiritsidwenso ntchito pochiza matendawa nthawi yomweyo ngati pakufunika kutero. Ngakhale kuti ndi yoopsa pang'ono kuposa njira yodziwira matenda nthawi zonse, siivulaza kwambiri kuposa opaleshoni yayikulu. Ingagwiritsidwenso ntchito pozindikira ndikuchiza matendawa nthawi yomweyo.

Anthu ambiri amatha kuchita mayesowa mosavuta, ndipo ali ndi ubwino wambiri. Chifukwa chake, ngati dokotala akulangizani ERCP, musaope kulankhula naye za izi, ndikufunsa mafunso anu onse. Zidzakuthandizani kupanga zisankho zabwino kwambiri zokhudza thanzi lanu!

ERCP , endoscopy, ndulu, kapamba, miyala, jaundice, kugaya chakudya