Unoda kuziva zvakawanda nezve ERCP (Endoscopic Retrograde Cholangiopancreatography) bvunzo here? Usatya, ngatitaurei!

Kana chiremba wako akakuudza kuti unofanira kuvhiyiwa ERCP, ungangove uine mibvunzo yakawanda pamusoro pekuti chii, kuti inoitirwa sei, uye icharwadza here. Izvozvo zvakajairika. Vanhu vazhinji vanotya zvishoma pavanonzwa zita racho. Asi ERCP haisi yekutya. Ichokwadi kuti bvunzo yepamusoro inogona kuona uye dzimwe nguva kurapa mamwe matambudziko mu biliary system yako uye pancreatic ducts. Saka, ngatitaurei nezve ERCP nenzira iri nyore nhasi, zvakanaka here?

Chii chinonzi Endoscopic Retrograde Cholangiopancreatography (ERCP)?

Zita iri refu rinogona kuita kuti unzwe dzungu zvishoma, asi ngatiritsanangure tinzwisise.

Zvichitaurwa zviri nyore, ERCP inzira yakakosha inoshandiswa navanachiremba kuti vaongorore mukati memigero yenyu ye bile nepancreas . Migero iyi ine bile nemuto wepancreatic, izvo zvinotibatsira kugaya chikafu chatinodya.

Heino zvinoreva zita iri:

• Endoscopic: Izvi zvinoshandisa mudziyo unonzi endoscope. Ichubhu yakatetepa, inochinjika ine kamera diki uye chiedza kune rimwe divi. Inopinzwa nemuromo wako yoendeswa kuchikamu chepamusoro cheura hwako (duodenum). Uchapihwa mushonga wekunyaradza kuti ukwanise kurara, saka hauzonzwi kusagadzikana.
• Kudzoreredza: Muizvi, imwe chubhu diki inopinzwa kuburikidza ne endoscope uye mvura chaiyo (dhayi yekuenzanisa) inopinzwa mu ducts dze bile ne pancreatic ducts. "Retrograde" zvinoreva "kudzokera kumashure" nekuti mvura inopinzwa nenzira yakatarisana neyainowanzo yerera.
• Cholangiopancreatography: Izvi zvinoreva mifananidzo yakatorwa. "Cholangio" zvinoreva zvine chekuita neducts ye bile. "Pancreato" zvinoreva zvine chekuita nepancreas. "Graphy" zvinoreva kutora mifananidzo.

Saka, dhayi remhando ye contrast rinoita kuti ducts dze bile nepancreatic ducts zvionekwe zvakajeka pamifananidzo yeX-ray. Izvi zvinobvumira vanachiremba kuona kana paine chimwe chinhu chinovhara ducts idzi - zvakaita sematombo emunduru, bundu, kana kutetepa kweducts nekuda kwemavanga . Chinhu chakanakisa ndechekuti mamwe ematambudziko aya anogona kurapwa ipapo ipapo, kuburikidza ne endoscope.

Muzviitiko zvipi panodiwa ERCP?

Chiremba wako anogona kuraira ERCP kana vachifungidzira kuti pane dambudziko nehurongwa hwenyu hwenyongo. Semuenzaniso:

• Kana uine kurwadziwa kusingatsananguriki mudumbu , kana kuti une biliary colic.
• Kana paine dambudziko rekuti kubuda kwenyongori kwakavharika kana kuti paine zviratidzo zvekubuda kwenyongori, semuenzaniso jaundice .

Kuongororwa kweERCP kunogona kubatsira kuongorora nekurapa matambudziko anowanzoitika anokanganisa ducts dze bile, akadai se:

• Kuzvimba kwenzira dzemudumbu (cholangitis) uye hutachiona hunoenderana nazvo.
• Kutetepa kwenzira dzemudumbu nekuda kwemavanga (nyongo) .
• Kuvharika kwematombo mumugero wenyongo .
• Kuzvimba kwepancreas kunokonzerwa nematombo (gallstone pancreatitis) .
• Mamota kana kenza yemutsinga dzenyongo.
• Kubuda kwemutsinga dzemudumbu kana dzimwe tsaona.

ERCP inoshanda sei?

ERCP inosanganisa nzira mbiri huru: endoscopy ne fluoroscopy . Fluoroscopy yakafanana nekufambisa mifananidzo yeX-ray. Funga nezvayo sevhidhiyo yeX-ray.

Kuongororwa uku kunoita kuti chiremba aone kuti mvura chaiyo (contrast dye) inofamba sei nemumaburi enyongori nemumapazi epancreatic. Izvi zvinogona kuratidza pachena chero kubuda kwemvura kana kuvharika.

Endoscope ndiyo inobvumira chiremba (endoscopist) kusvika panzvimbo iyi. Dhayi rekuenzanisa rinopinzwa kuburikidza neizvi. Uyewo, kana paine dambudziko, zvishandiso zvidiki zvinogona kuiswa kuburikidza ne endoscope iyi kuti zvirirwe.

Ndiani anoita ERCP?

ERCP inowanzoitwa nachiremba wezvekudya . Vanachiremba ava inyanzvi mukurapa zvirwere zvemudumbu nezviri mukati medumbu. Vakadzidziswawo kuita endoscopy. Vakadzidziswawo maitiro e endoscopic anogona kushandiswa panzvimbo pekuvhiyiwa kudiki.

Unogadzirira sei ERCP?

Chiremba wako achakupa mimwe mirairo chaiyo yekutevera usati waenda kuERCP. Kazhinji, iyi inosanganisira:

• Unofanira kurega kusvuta, kudya, kutsenga chingamu, uye kunwa chero chinhu chisiri mvura maawa masere bvunzo isati yaitwa .
• Unofanira kuudza chiremba wako nezvezvimwe zvirwere zvaunazvo uye chero mishonga yauri kutora . Mimwe mishonga, yakaita semishonga inobvisa ropa mumuviri, ingangoda kumira kwemazuva mashoma bvunzo isati yaitwa.
• Udza chiremba wako kana wakambova neallergy ne contrast dye kana anesthesia yakashandiswa panguva yebvunzo.
• Uchafanira kuronga mota yekuenda kumba mushure mekuongororwa, sezvo zvinotora maawa angangoita makumi maviri nemana kuti mhedzisiro yeanesthetic ipere zvachose. Saka, hauzokwanisi kutyaira.

Chii chinoitika panguva yekuongororwa kweERCP?

ERCP inzira yekuvhiyiwa kunze kwechipatara . Izvi zvinoreva kuti unogona kuenda kumba zuva rimwe chete. Maitiro acho anowanzo tora awa imwe chete kana maviri.

Uchapihwa mushonga unopinzwa mutsinga (kuburikidza ne "IV"`) kuti unzwe hope (wakarara) . Ungave wakarara zvakanyanya, kana kuti ungave usina kumuka. Zvisinei, hauzoyeuki bvunzo yacho.

Munguva yekuongorora chirwere, chiremba achaita zvinotevera:

• Kana uchida, mushonga wemvura unonyaradza marwadzo unogona kuiswa kuderedza marwadzo pahuro.
• Endoscope inopinzwa nemuromo yobva yapfuudzwa nekungwarira nepagurokuro nedumbu ichipinda muchikamu chepamusoro cheura hudiki (duodenum). Mifananidzo inoonekwa kubva pakamera ye endoscope inoratidzwa pachiratidziro.
• Nekuona mavhidhiyo iwayo, unogona kuwana kuvhurika kwemugero wenyongo negwenzi repancreas mukati meura diki.
• Imwe chubhu diki inopinzwa kuburikidza necatheter mu endoscope uye muburi.
• Dhayi remhando ye contrast rinopinzwa mumidziyo yeropa kuburikidza nechubhu diki iyoyo.
• Zvadaro, vachishandisa tekinoroji yefluoroscopy, mavhidhiyo eX-ray anotorwa kuti vaone kuti mvura yacho inofamba sei nemumachubhu. Mu fluoroscopy, maX-ray anoburitswa nekukasira. Izvi zvinoonekwa sehuwandu hwakachengeteka hwemwaranzi.
• Mifananidzo iyi inoshandiswa kutarisa kana paine matambudziko nemapaipi - kuvharika, kuzvimba, kudonha kwemvura, nezvimwewo.

Fungidzira izvi, zvakafanana nekuisa kamera mupombi, wotumira mvura ine mavara mairi, wobva waona kwayakavharika uye kwairi kubuda.

Zvino, kana chiremba akawana chero matambudziko panguva yekuongororwa uku, achaedza kurapa nekupinza midziyo midiki kuburikidza ne endoscope. Chiremba anoita endoscopy anogona kuita zvinhu zvakaita se:

• Kupwanya nekubvisa matombo emunduru.
• Kubvisa bundu kana kutora sampuro yenyama (biopsy). (Kana biopsy ikatorwa, inotumirwa kurabhoritari kuti ionekwe kana iri kenza kana kwete.)
• Kutambanudza kana kutambanudza tsinga dzeropa dzakatetepa kana dzakamanikana.
• Kuisa chinhu chidiki chakaita sechubhu (stent) mukati memudziyo kuti ugare wakavhurika.
• Kugadzirisa pakadonha mvura kana kukuvara mupombi.
• Kuvhiyiwa kwesphincterotomy kuchekwa kudiki kunoitirwa mutsandanyama yakatenderedza muromo wemugero kuti ukure. (Izvi zvinobatsira kuti nyongo nejusi repancreas zvibude zviri nyore.)

Chii chaungatarisira mushure meERCP?

Mushure mekuongororwa, muchachengetwa muchipatara kana kunzvimbo yekurapa kweinenge awa imwe kana maviri, kusvika migumisiro yeanesthesia yapera. Ipapo munhu akauya kuzokutorai anogona kukuendesai kumba. Munogona kunzwa hope shoma, kuchema kana kuti kushaya nzvimbo zuva iroro.

Kusagadzikana kudiki kwakadai kunogona kuitika kwezuva rimwe kana maviri mushure mekuongororwa:

• Huro inorwadza uye kuoma kumedza: Endoscope inogona kukonzera kurwadziwa pahuro. Zvakanaka kunwa zvinwiwa kana chikafu chakapfava kusvika zvapora.
• Kurwadziwa kwedumbu kana gasi: Kana endoscope yaiswa, mweya mudiki unofuridzirwa mudumbu kuti munhu aone zviri nani. Izvi ndizvo zvinokonzera kusagadzikana uku. Uchadzikira mushure mechinguva (kana mweya wangoburitswa).
• Kusvotwa: Izvi zvinogona kunge zviri mhedzisiro yekunzwa kuda kurutsa. Zvinoperawo pazuva rinotevera.

Ndezvipi njodzi dzeERCP?

Matambudziko anoitika muinenge 5% kusvika 10% yemaitiro eERCP. Njodzi iyi inoenderana nemamiriro ako ehutano agara aripo uye rudzi rwekurapwa kwaunowana panguva yeERCP. Chiremba wako achakurukura newe izvi pachine nguva. Matambudziko anogona kusanganisira:

• Kusagadzikana kwemushonga unonyaradza: Izvi zvinogona kukonzera matambudziko emwoyo nemapapu kuvanhu vane chirwere chemapapu kana chemwoyo.
• Kurwara nedhayi yemhando ye contrast: Kana izvi zvikaitika, chiremba achakurumidza kukupa mushonga wekumisa kurwara.
• Kukuvara kwenzira yako yekugaya chikafu kubva pa endoscope: Izvi zvinogona kukonzera kubuda ropa mukati medumbu kana, muzviitiko zvakakomba, buri.
• Kubuda kwenyongo nekuda kwekukuvara kwenzira dzenyongo kunokonzerwa nemidziyo ye endoscopic.
• Utachiona mudumbu rako: Kuti udzivise izvi, chiremba wako anogona kukupa mishonga inorwisa mabhakitiriya nguva isati yasvika.
• Maitiro aya anogona kukonzera kutsamwa uye kuzvimba kwepancreas (pancreatitis). Iri ndiro dambudziko rinowanzoitika mushure meERCP.

Kana uine pamuviri panguva yekuongororwa, njodzi yekukuvadzwa kwemwana ari mudumbu nekuda kwemwaranzi inoburitswa panguva ye fluoroscopy idiki, asi pane njodzi diki. Chiremba wako achakubvunza pachine nguva kana paine mukana wekuti ungave nepamuviri. Kana zvakadaro, chiremba wako achaedza kuronga nguva yekuongororwa kana kuderedza mukana wekuti upinzwe nemwaranzi kana zvichidikanwa.

Zvinotora nguva yakareba sei kuti uzive mhedzisiro yebvunzo?

Kana usati wabatwa nehope nekuda kweanesthesia,Chiremba (endoscopist) akaita ERCP anofanira kukwanisa kutaura newe nezvebvunzo nekukasika. Achakuudza zvakawanikwa uye zvingaitwa nezvazvo. Kana sampuli yenyama (biopsy) ikatorwa, zvinogona kutora mavhiki akati wandei kuti mhinduro dzidzoke.

Kana ERCP yako isina kuwana chero chinhu, ungangoda kuita imwe mhando yebvunzo. Kana bvunzo ikasagadzirisa dambudziko rako, kana kana zvabuda mu biopsy zvikaratidza dambudziko idzva, ungangoda kuita imwe mhando yekurapwa. Chiremba wako achataura newe nezve zvekuita zvinotevera.

Unofanira kufonera chiremba rini?

Kana ukaona chimwe chezviratidzo izvi zvakakomba kana zvisingawanzoitiki mushure meERCP, fonera chiremba wako nekukasika:

• Kurwadziwa kwakanyanya mudumbu kana kuzvimba.
• Kurwadziwa pachipfuva kana kufema zvakaoma.
• Fivha, kurutsa, kana zvimwe zviratidzo zvehutachiona.
• Kubuda ropa mutsvina kana tsvina nhema, kana kuti tarry.

Ndeupi musiyano uripo pakati peERCP ne endoscopy yenguva dzose?

ERCP inzira yepamusoro ye endoscopy. Nzira yakajairika ye esophagogastroduodenoscopy (EGD) inongotarisa nzira yako yepamusoro yekugaya chikafu. Izvi zvinoreva kuti inongotarisa gumbo, dumbu, uye chikamu chekutanga cheura hudiki.

Asi muERCP, imwe extension inoshandiswa pamwe chete ne endoscope yenguva dzose - kureva, chubhu yechipiri (catheter) inopinda mukati mechubhu yekutanga - iyi ndiyo inosvika mumachubhu ako enyongori.

Iyi mini endoscope extension inobvumira chiremba kurapa maducts ako zvakananga. Nzira chete ye endoscopic inogona kurapa maducts zvakananga nenzira iyi ndeye `ERCP`. Kunyange zvazvo dzimwe nzira dze endoscopic dzakadai se `MRCP` (magnetic resonance cholangiopancreatography) uye `EUS` (endoscopic ultrasound) dzichigona kuona maducts ako e bile nepancreatic ducts, hadzipi mukana wekurapa maducts aya.

ERCP kuvhiyiwa kukuru here?

ERCP haisi kuvhiyiwa sezvatinowanzofunga nezvayo. Haisi chinhu chinocheka nepaganda chopinda munhengo dziri mukati memuviri. ERCP inzira ye endoscopic. Zvinoreva kuti inopinda mumuviri nepaburi rechisikigo - muchiitiko ichi, pahuro.

Zvisinei, pakuita ERCP, chiremba anogona kuita mamwe maitiro ekuvhiya achishandisa endoscope. Dzimwe nguva vanachiremba vanoti maitiro aya anoitwa kuburikidza ne endoscope kuvhiya kwe endoscopic . Aya maitiro ekuvhiya nekuti anosanganisira kucheka nekusona mukati memuviri. Zvisinei, aya maitiro madiki, uye haana njodzi yakawanda uye ane nguva pfupi yekupora pane kuvhiya kwechinyakare.

ERCP inoitirwa here pancreatitis?

Ehe, kana chiremba wako achifunga kuti pane chiri kuvharira ducts dzenyongo kana ducts dzepancreas, anogona kukuraira ERCP. Matombo enyongo anonamira muducts ndiwo anonyanya kukonzera chirwere chepancreatitis. Kana izvozvo zvikaitika, ungangoda ERCP kuti ubvise closure yacho.

Kana uine chirwere chepancreatitis chisingaperi, kuzvimba uku kunogona kukonzera kuti migero yepancreatitis yako ive nemavanga uye itete (strictures). Muzviitiko zvakadaro, ERCP inogona kubatsira kuwedzera migero kana kuisa stent kuti irambe yakavhurika. Izvi zvinobatsira kuti muto wepancreatitis urambe uchiyerera nemumigero.

Yeuka chinhu chinonyanya kukosha (Mharidzo Yekuenda Kumba)

ERCP (Endoscopic Retrograde Cholangiopancreatography) ibvunzo yekuongorora chirwere inogona kushandiswawo kurapa chirwere ipapo ipapo kana zvichidikanwa. Kunyangwe ichinyanya kukuvadza kupfuura bvunzo yenguva dzose yemifananidzo, haina kukuvadza zvakanyanya pane kuvhiyiwa kukuru. Inogona zvakare kushandiswa kuongorora nekurapa chirwere panguva imwe chete.

Vanhu vazhinji vanogona kuita bvunzo iyi pasina dambudziko guru, uye ine mabhenefiti akawanda. Saka, kana chiremba akakukurudzira kuti uwane ERCP, usatya kutaura naye nezvazvo, uye kubvunza mibvunzo yako yese. Izvi zvichakubatsira kuita sarudzo dzakanakisa nezvehutano hwako!

ERCP , endoscopy, ducts ye bile, pancreas, matombo, jaundice, kugaya chikafu