Amatye amancinci e-ureteral anokunyangwa ngendlela egcina indalo okanye i-extracorporeal shock wave lithotripsy, kodwa amatye amakhulu, ingakumbi amatye athintelayo, afuna utyando lwangethuba.
Ngenxa yendawo ekhethekileyo amatye angaphezulu e-ureteral, asenokungafikeleleki nge-ureteroscope eqinileyo, kwaye amatye anokunyuka ngokulula aye kwi-renal pelvis ngexesha le-lithotripsy. I-Percutaneous nephrolithotomy inyusa umngcipheko wokopha kwezintso xa kumiselwa umjelo.
Ukwanda kwe-flexible ureteroscopy kusombulule ngempumelelo ezi ngxaki zingasentla. Ingena kwi-ureter nakwi-renal pelvis nge-orifice eqhelekileyo yomzimba womntu. Ikhuselekile, iyasebenza, ayingenisi kakhulu, ayophi kakhulu, ayiva ntlungu ingako kwisigulana, kwaye ayinamatye amaninzi. Ngoku sele iyindlela yotyando esetyenziswa kakhulu ukunyanga amatye aphezulu kwi-ureteral.
Ukuvela kweisingxobo sokufikelela kwi-ureteraliye yanciphisa kakhulu ubunzima be-ureteroscopic lithotripsy eguquguqukayo. Nangona kunjalo, ngokwanda kwenani lamatyala onyango, iingxaki zayo ziye zatsala ingqalelo kancinci kancinci. Iingxaki ezinje ngokugqobhoka kwe-ureteral kunye nokuqina kwe-ureteral zixhaphakile. Ezi zilandelayo zezona zinto zintathu ziphambili ezikhokelela ekuqineni kwe-ureteral kunye nokugqobhoka.
1. Indlela yesifo, ububanzi belitye, ukuchaphazeleka kwelitye
Izigulana ezinexesha elide lesifo zidla ngokuba namatye amakhulu, kwaye amatye amakhulu ahlala kwi-ureter ixesha elide ukuze enze ukuvalelwa entolongweni. Amatye kwindawo yokubethelwa acinezela i-mucosa ye-ureteral, nto leyo ebangela ukungoneli kwegazi lasekuhlaleni, i-mucosal ischemia, ukudumba kunye nokwakheka kwamanxeba, oku kunxulumene kakhulu nokwakheka kwe-ureteral stricture.
2. Ukulimala komchamo
I-ureteroscope eguquguqukayo kulula ukuyigoba, kwaye kufuneka kufakwe i-ureteral access sheath ngaphambi kokuba kufakwe i-lithotripsy. Ukufakwa kwe-channel sheath akwenziwa phantsi kombono othe ngqo, ngoko ke akunakuphepheka ukuba i-ureteral mucosa yonakale okanye igqobhoke ngenxa yokugoba kwe-ureter okanye i-lumen encinci ngexesha lokufakwa kwe-sheath.
Ukongeza, ukuze kuxhaswe i-ureter kwaye kukhutshwe ulwelo lokuphalaza ukuze kuncitshiswe uxinzelelo kwi-pelvis yezintso, kukhethwa i-channel sheath edlula kwi-F12/14, nto leyo enokubangela ukuba i-channel sheath icinezele ngqo udonga lwe-ureteral. Ukuba indlela kagqirha wotyando ayivuthwanga kwaye ixesha lotyando liyanda, ixesha lokucinezelwa kwe-channel sheath eludongeni lwe-ureteral liya kwanda ukuya kwinqanaba elithile, kwaye umngcipheko wokonakala kwe-ischemic eludongeni lwe-ureteral uya kuba mkhulu.
3. Umonakalo we-laser yeHolmium
Ukuqhekeka kwamatye kwe-laser ye-holmium kuxhomekeke kakhulu kwisiphumo sayo sobushushu belanga, esibangela ukuba ilitye lifunxe ngqo amandla e-laser kwaye lonyuse ubushushu bendawo ukuze kufezekiswe injongo yokuqhekeka kwamatye. Nangona ubunzulu bemitha yobushushu ngexesha lenkqubo yokutyumza ilitye buyi-0.5-1.0 mm kuphela, isiphumo sokugquma esibangelwa kukutyumza ilitye okuqhubekayo asinakuthelekelelwa.
Amanqaku aphambili okufakaisingxobo sokufikelela kwi-ureteralzezi zilandelayo:
1. Kukho ingqiqo ecacileyo yokuphuma xa ufaka kwi-ureter, kwaye ivakala ithambile xa inyuka kwi-ureter. Ukuba ukufakwa kunzima, ungajika ucingo olukhokelayo ubuye umva ukuze ubone ukuba ucingo olukhokelayo lungena luphume kakuhle na, ukuze ubone ukuba i-channel sheath iya phambili kwicala le-guide wire, njengokuthi Ukuba kukho ukumelana okucacileyo, kufuneka kulungiswe indlela yokubeka i-sheathing;
I-channel sheath ebekwe kakuhle izinzile kwaye ayizukungena iphume ngokuthanda kwayo. Ukuba i-channel sheath iphuma ngokucacileyo, oko kuthetha ukuba igobile kwisinyi kwaye ucingo olukhokelayo luphume kwi-ureter kwaye kufuneka lufakwe kwakhona;
3. Iishelufa zemisele yomchane zineenkcukacha ezahlukeneyo. Izigulana ezingamadoda zihlala zisebenzisa imodeli enobude obungama-45 cm, kwaye izigulana ezingamadoda ezibhinqileyo okanye ezimfutshane zisebenzisa imodeli enobude obungama-35 cm. Ukuba ishelufa yemisele ifakiwe, inokudlula kuphela kwindawo evulekileyo yomchane okanye ayinakukwazi ukunyuka iye kwinqanaba eliphezulu. Indawo, izigulana ezingamadoda zingasebenzisa ishelufa yokwazisa engama-35 cm, okanye zitshintshele kwishelufa yokwandisa i-fascial engama-14F okanye ebhityileyo ukuthintela i-ureteroscope eguquguqukayo ukuba ingakwazi ukunyuka iye kwi-renal pelvis;
Musa ukubeka ishelufu yemisele ngenyathelo elinye. Shiya i-10 cm ngaphandle kwe-urethral orifice ukuthintela umonakalo kwi-ureteral mucosa okanye kwi-renal parenchyma kwi-UPJ. Emva kokufaka i-flexible scope, indawo yeshelufu yemisele inokulungiswa kwakhona phantsi kokubona ngqo.
Thina, Jiangxi Zhuoruihua Medical Instrument Co.,Ltd., singumvelisi eTshayina ogxile kwizinto ezisetyenziswayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip, umgibe we-polyp, inaliti ye-sclerotherapy, i-catheter yokutshiza, iibhrashi ze-cytology, ucingo lwesikhokelo, ibhaskithi yokuqokelela amatye, i-catheter yokukhupha amanzi empumlweninjl. ezisetyenziswa kakhulu kwiI-EMR, I-ESD, I-ERCPKwayeUthotho lwe-Urology, njengeIsithambisi selitye seNitinol, IiForceps zeBiopsy ye-UrologicalkunyeIsingxobo sokufikelela kwi-UreteralkwayeIsikhokelo se-UrologyIimveliso zethu ziqinisekisiwe yi-CE, kwaye izityalo zethu ziqinisekisiwe yi-ISO. Iimpahla zethu zithunyelwe eYurophu, eMntla Melika, eMbindi Mpuma nakwinxalenye yeAsia, kwaye zifumana umthengi udumo nodumo!
Ixesha lokuthumela: Septemba-11-2024