Njira yosokoneza ya endoscopy yachipatala muzochitika zadzidzidzi komanso chisamaliro chovuta komanso chithandizo

1, njira zopulumutsa moyo pachimake magazi m`mimba

(1) Endoscopic Immediate Hemostasis System

Hemospray hemostatic powder spray:

Mfundo yaukadaulo: Titanate tinthu tating'onoting'ono timapanga chotchinga pamakina pamtunda, ndikuyimitsa magazi mkati mwa masekondi 30.

Deta yachipatala: Mlingo wowongolera magazi a jet ya Forrest Ia grade ndi 92%, yomwe ili mwachangu kuwirikiza katatu kuposa titaniyamu wamba.

Over The Scope Clip (OTSC):

Kapangidwe ka Chimbalangondo Chachimbalangondo: Tsekani zilonda zoboola ndi mainchesi 3cm (monga Dieulafoy lesion), ndikutulutsanso magazi osakwana 5%.

(2) Kuneneratu kwachiwopsezo cha AI

Real time visual algorithm:

Monga Cosmo AI's BLEED Score, chigoli cha Rockall chimawerengedwa zokha pazithunzi za endoscopic kuti ziwongolere chithandizo patsogolo.

2, Chithandizo chochepa kwambiri chazovuta zapamsewu

(1) ECMO pamodzi ndi bronchoscopy

Kupambana kwaukadaulo:

Portable ECMO (monga Cardiohelp) imagwiritsidwa ntchito kusunga oxygenation ndikuchita bronchoalveolar lavage (BAL) kuchotsa mapulagi a COVID-19.

Phindu lachipatala: Kutsimikizika kwa chitetezo chogwira ntchito kwa odwala omwe ali ndi PaO ₂/FiO ₂<100mmHg (Lancet Respir Med 2023).

(2) Cryoprobe airway recanalization

Ukadaulo wozizira kwambiri:

-40 ℃ low-temperature probe (monga ERBE CRYO2) amagwiritsidwa ntchito kuziziritsa zotupa zam'mlengalenga, ndi kuchuluka kwa magazi <10ml (poyerekeza ndi electrocautery>200ml).

3, Endoscopic kulowererapo kwa kapamba

(1) Kuwonongeka motsogozedwa ndi Endoscopic kwa minofu ya necrotic (EUS-NEC)

Zaukadaulo:

(2) Njira yosalekeza ya peritoneal lavage

Kuyika kwa endoscopic kwa catheter yothirira:

Motsogozedwa ndi endoscopy yanjira ziwiri, mulingo wa amylase mumadzi otsekemera amawunikidwa munthawi yeniyeni.

4, Endoscopic ntchito mu zoopsa chithandizo mwadzidzidzi

(1) Emergency hemostasis kudzera mu thoracoscopy

Khomo limodzi lolimba la thoracoscopy:

Yang'anani pachifuwa ndi chocheka cha 5mm, gwiritsani ntchito electrocoagulation kuti musiye kutuluka magazi, ndipo pewani thoracotomy (monga Storz 26003BA).

Ntchito yachipatala yankhondo: nthawi yoletsa kutaya magazi m'bwalo lankhondo yachepetsedwa kukhala mphindi 15.

(2) Duodenoscopy yochizira kuvulala kwa biliary thirakiti

ERCP kuchotsa mwala mwadzidzidzi + stent:

Kuyika kwachitsulo chophimbidwa bwino chachitsulo panthawi ya opaleshoni ya kuphulika kwa ndulu wamba kumakhala ndi kupambana kwa 98%.

5, Njira yosokoneza pakuwunika kwa ICU pabedi

(1) Transnasal endoscopic kuyika kwa m'mimba kutaya chubu

Ukadaulo wa navigation wa Electromagnetic:

Cortrak ® Dongosolo limawonetsa njira ya catheter mu nthawi yeniyeni, ndipo kuchuluka kwa njira yolowera mwangozi mwangozi kumakhazikitsidwanso mpaka zero.

Kuyerekeza kwa mawonekedwe a X-ray: Nthawi yogwirira ntchito yachepetsedwa kuchoka pa maola awiri kufika pa mphindi 20.

(2) Micro cystoscopy yowunikira ntchito yaimpso

10Fr electronic cystoscope:

Kuwunika mosalekeza mkhalidwe wa aimpso papillary ischemia wa odwala omwe akudwala kwambiri (monga sepsis zokhudzana AKI).

6. Mayendedwe aukadaulo amtsogolo

(1) Nano hemostatic endoscope:

Magnetic nanoparticles onyamula thrombin, maginito amawongolera embolization yolondola (nthawi yoyesera hemostasis yanyama <10 masekondi).

(2) Holographic AR navigation:

Microsoft HoloLens 2 imapanga makonzedwe atatu-dimensional pa malo osweka mtima.

(3) Zowonongeka za airway stent:

The polycaprolactone material scaffold iyenera kuyamwa mkati mwa masabata a 4 kupewa kuchotsedwa kwachiwiri.

Table Yofananira ya Phindu Lachipatala

Malingaliro okhazikitsa njira

Dipatimenti ya Emergency: Imabwera muyezo ndi Hemofray + OTSC "Hemostasis Kit".

Trauma Center: Pangani chipinda chopangira hybrid (CT + endoscopic integration).

Cholinga cha kafukufuku: Kupanga njira yopopera mankhwala ya trauma bio adhesive endoscopic.

Ukadaulo uwu ukukankhira endoscopy yadzidzidzi kuti ikhale pachimake cha chithandizo cha "golden hour" kudzera m'njira zitatu zazikulu: "kuyankha kwa mphindi, kuwonongeka kwina kowonjezera, komanso kuteteza thupi". Zikuyembekezeka kuti pofika chaka cha 2027, 50% ya maopaleshoni otsegula m'mimba / thoracic mwadzidzidzi adzasinthidwa ndi endoscopy.