Matombo madiki ureter anogona kurapwa nekuchengetedza kana extracorporeal shock wave lithotripsy, asi matombo makuru-diameter, kunyanya matombo anodzivirira, anoda kupindira kwekuvhiya kwekutanga.
Nekuda kwenzvimbo yakakosha yematombo ekumusoro ureter, anogona kunge asingasvikike neyakaomarara ureteroscope, uye matombo anogona nyore kuenda kumusoro murenal pelvis panguva ye lithotripsy. Percutaneous nephrolithotomy inowedzera njodzi yekubuda ropa renal pakugadzira chiteshi.
Kukwira kweiyo flexible ureteroscopy kwakagadzirisa zvinobudirira matambudziko ari pamusoro. Inopinda mu ureter uye renal pelvis kuburikidza neyakajairika orifice yemuviri wemunhu. Yakachengeteka, inoshanda, haipindi zvishoma, ine kubuda ropa kushoma, marwadzo mashoma kumurwere, uye mwero wakakwira usina dombo. Ikozvino yave nzira inowanzoshandiswa yekuvhiya kurapa matombo ekumusoro ureter.
Kubuda kweureral access sheathyakaderedza zvakanyanya kuoma kwe flexible ureteroscopic lithotripsy. Zvisinei, nekuwedzera kwenhamba yezviitiko zvekurapa, zvinetso zvayo zvishoma nezvishoma zvakakwezva kutarisa. Matambudziko akadai sekuti ureter perforation uye ureteral stricture zvakajairika. Izvi zvinotevera zvinhu zvitatu zvakakura zvinotungamira kune urethra kuomeswa uye perforation.
1. Nzira yechirwere, dhayamita yebwe, kukanganiswa kwematombo
Varwere vane chirwere chakareba chechirwere vanowanzova nematombo makuru, uye matombo makuru anoramba ari mu ureter kwenguva yakareba kuti aite kuvharirwa. Matombo panzvimbo yekupindira anodzvinyirira ureteral mucosa, zvichikonzera kusakwana kweropa remunharaunda, mucosal ischemia, kuzvimba uye kugadzirwa kwevanga, izvo zvine hukama zvakanyanya nekuumbwa kweureteral stricture.
2. Kukuvara kweUreter
Iyo ureteroscope inochinjika iri nyore kukotama, uye ureteral access sheath inoda kuiswa pamberi lithotripsy. Kuiswa kwechannel sheath hakuitwe pasi pekuona kwakananga, saka hazvidzivirike kuti ureter mucosa ichakuvadzwa kana kubhoborwa nekuda kwekukotama kweiyo ureter kana nhete lumen panguva yekuiswa kwesheath.
Mukuwedzera, kuitira kuti utsigire ureter uye udere mvura yeperfusion kuti uderedze kudzvinyirira pa renal pelvis, chiteshi sheath kuburikidza neF12 / 14 inowanzosarudzwa, izvo zvingaita kuti chiteshi chevha chinyanye kumanikidzira rusvingo rwe ureter. Kana hunyanzvi hwechiremba wekuvhiya husina kukura uye nguva yekuvhiya yakarebeswa, iyo nguva yekumanikidza yemugero sheath pamadziro emadziro ichawedzerwa kune imwe nhanho, uye njodzi yekukuvadzwa ischemic kumadziro eureter ichave yakakura.
3. Holmium laser kukanganisa
Kutsemuka kwedombo kweholmium laser kunonyanya kutsamira pane yayo photothermal mhedzisiro, izvo zvinoita kuti dombo ritore zvakananga laser simba uye kuwedzera tembiricha yemuno kuzadzisa chinangwa chekutsemuka kwematombo. Kunyangwe kudzika kwemwaranzi yekupisa panguva yekupwanya matombo ingori 0.5-1.0 mm, iyo inopindirana mhedzisiro inokonzerwa nekuramba ichipwanya matombo haifungidzike.
Mapoinzi akakosha ekupinza ureral access sheath ndeaya anotevera:
1. Pane pfungwa iri pachena yekubudirira painopinza mu ureter, uye inonzwa inotsvedza kana ichikwira mu ureter. Kana kuiswa kwacho kwakaoma, unogona kutsveya waya yekutungamira nekudzoka kuti uone kana waya yekutungamira ichipinda nekubuda zvakanaka, kuitira kuti uone kana chiteshi chegedhi chiri kufambira mberi munzira yewaya yekutungamira, senge kana paine pachena kuramba, kutungamira kwesheathing kunoda kugadziriswa;
Iyo yakabudirira yakaiswa chiteshi sheath yakagadziriswa uye haipindi nekubuda pakuda. Kana iyo chiteshi sheath ichibuda pachena, zvinoreva kuti yakavharirwa mudundira uye waya inotungamira yakadonha kubva muureter uye inoda kuiswazve;
3. Ureter chiteshi sheaths ane zvirevo zvakasiyana. Varwere vechirume vanowanzo shandisa iyo 45 cm kureba modhi, uye vakadzi kana vapfupi varume varwere vanoshandisa iyo 35 cm kureba modhi. Kana iyo chiteshi sheath ikaiswa, inogona kungopfuura nepaburi reureral kana kuti haigone kukwira kumusoro. Nzvimbo, varwere vechirume vanogonawo kushandisa 35 cm kuunza sheath, kana kushandura kune 14F kana kunyange yakaonda fascial yekuwedzera sheath kudzivirira iyo inoshanduka ureteroscope kubva pakusakwanisa kukwira kune renal pelvis;
Usaise chiteshi sheath mune imwe nhanho. Siya masendimita gumi kunze kwemuburi weti urethral kudzivirira kukuvadzwa kweurterral mucosa kana renal parenchyma paUPJ. Mushure mekuisa iyo inochinjika scope, iyo chiteshi sheath chinzvimbo inogona kugadziridzwa zvakare pasi pechiratidzo chakananga.
Isu, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., inogadzira muChina inyanzvi mune endoscopic consumables, senge.biopsy forceps, hemoclip, polyp musungo, sclerotherapy tsono, pfapfaidza catheter, cytology brushes, guidewire, dombo rekudzosa tswanda, nasal biliary drainage catheteretc. ayo anoshandiswa zvakanyanya muEMR, ESD, ERCP. Zvigadzirwa zvedu ndezveEC Certified, uye zvidyarwa zvedu ISO certified. Zvinhu zvedu zvakatumirwa kuEurope, North America, Middle East uye chikamu cheAsia, uye zvakanyanya kuwana mutengi wekuzivikanwa nekurumbidzwa!
Nguva yekutumira: Sep-11-2024