Amatye amancinci e-urethra anganyangwa ngononophelo okanye i-extracorporeal shock wave lithotripsy, kodwa amatye anobubanzi obukhulu, ngakumbi amatye athintelayo, afuna ungenelelo lotyando kwangoko.
Ngenxa yendawo ekhethekileyo yamatye aphezulu e-urethra, banokungafikeleleki nge-ureteroscope eqinile, kwaye amatye anokunyuka ngokulula ukuya kwi-renal pelvis ngexesha le-lithotripsy. I-Percutaneous nephrolithotomy yonyusa umngcipheko wokuphuma kwegazi ezintso xa kusekwa umjelo.
Ukunyuka kwe-ureteroscopy eguquguqukayo kuye kwasombulula ngempumelelo ezi ngxaki zingentla. Ingena kwi-ureter kunye ne-renal pelvis ngokusebenzisa i-orifice eqhelekileyo yomzimba womntu. Ikhuselekile, iyasebenza, ayivaleli kancinci, inokopha kancinci, iintlungu zincinci kumguli, kunye nesantya esiphezulu esingenamatye. Ngoku sele ibe yindlela esetyenziswa ngokuqhelekileyo yotyando ukunyanga amatye angaphezulu kwe-urethra.
Ukuvela kweUkungena kwi-ureral sheathiye yanciphisa kakhulu ubunzima be-flexible ureteroscopic lithotripsy. Nangona kunjalo, ngokunyuka kwenani leemeko zonyango, iingxaki zayo ziye zatsala ingqalelo ngokuthe ngcembe. Iingxaki ezifana nokugqobhoza kwe-urethra kunye nokuqina kwe-ureter zixhaphakile. Oku kulandelayo zizinto ezintathu eziphambili ezikhokelela kukuqina kwe-urethra kunye nokugqobhoza.
1. Ikhosi yesifo, i-diameter yamatye, impembelelo yamatye
Izigulane ezinexesha elide lokugula zivame ukuba namatye amakhulu, kwaye amatye amakhulu ahlala kwi-ureter ixesha elide ukwenza ukuvalelwa. Amatye kwindawo yempembelelo acinezela i-mucosa ye-ureter, okubangela ukungonelanga kwegazi lendawo, i-ischemia ye-mucosal, ukudumba kunye nokwakheka komnxeba, okuhambelana ngokusondeleyo nokwakhiwa kwe-urethra.
2. Ukulimala kwe-Ureter
I-ureteroscope eguquguqukayo kulula ukugoba, kwaye i-sheath yokufikelela kwi-ureter kufuneka ifakwe phambi kwe-lithotripsy. Ukufakwa kwe-channel sheath akwenziwanga phantsi kombono othe ngqo, ngoko ke akunakuphepheka ukuba i-mucosa ye-urethra iya konakaliswa okanye ikhutshwe ngenxa yokugoba kwe-ureter okanye i-lumen encinci ngexesha lokufakwa kwe-sheath.
Ukongezelela, ukwenzela ukuxhasa i-ureter kunye nokukhupha i-perfusion fluid ukunciphisa uxinzelelo kwi-pelvis ye-renal, i-channel sheath nge-F12 / 14 idla ngokukhethwa, enokubangela ukuba i-channel sheath icinezele ngokuthe ngqo udonga lwe-ureter. Ukuba ubuchule bogqirha bukhulile kwaye ixesha lokusebenza lide, ixesha lokunyanzeliswa kwe-channel sheath eludongeni lwe-ureter liya kwandiswa kwinqanaba elithile, kwaye umngcipheko wokulimala kwe-ischemic kudonga lwe-ureter uya kuba mkhulu.
3. Umonakalo we-laser weHolmium
Ukuqhekeka kwamatye e-holmium laser ikakhulu kuxhomekeke kwimpembelelo ye-photothermal, ebangela ukuba ilitye lithathe ngokuthe ngqo amandla e-laser kwaye linyuse ubushushu bendawo ukufezekisa injongo yokuqhekeka kwamatye. Nangona ubunzulu bemitha ye-thermal ngexesha lenkqubo yokutyumza igrabile yi-0.5-1.0 mm kuphela, umphumo ogqithisayo obangelwa kukutyumzwa kwegrabile ngokuqhubekayo akunakulinganiswa.
Amanqaku aphambili okufaka i-sheath yokufikelela kwi-ureral zezi zilandelayo:
1. Kukho ingqiqo ecacileyo yokuphumelela xa ufaka kwi-ureter, kwaye ivakalelwa xa inyuka kwi-ureter. Ukuba ukufakela kunzima, unokujiwuzisa ucingo lwesikhokelo ngasemva naphambili ukujonga ukuba ngaba ucingo lwesikhokelo luya ngaphakathi nangaphandle ngokutyibilikayo, ukuze uqonde ukuba isingxobo setshaneli siqhubela phambili kwicala locingo lwesikhokelo, njengokuthi Ukuba kukho ukuchasana okucacileyo, ulwalathiso lwe-sheathing kufuneka luhlengahlengiswe;
Isingxobo setshaneli esibekwe ngempumelelo silungisiwe kwaye asiyi kungena kwaye siphume ngokuthanda. Ukuba i-channel sheath iphuma ngokucacileyo, ithetha ukuba ihlanganiswe kwi-bladder kwaye ucingo lwesikhokelo luye lwaphuma kwi-ureter kwaye lufuna ukuphinda lubekwe;
3. Iishethi zeshaneli ye-Ureter zineenkcazo ezahlukeneyo. Izigulane zamadoda zisebenzisa imodeli ende ye-45 cm, kwaye izigulane zabasetyhini okanye ezifutshane zisebenzisa imodeli ye-35 cm ubude. Ukuba i-sheath yeshaneli ifakwe, inokudlula kuphela ekuvulekeni kwe-urethra okanye ayikwazi ukuya kwinqanaba eliphezulu. Isikhundla, izigulane zamadoda zingasebenzisa i-35 cm yokwazisa i-sheath, okanye itshintshe kwi-14F okanye i-fascial expansion sheath ukukhusela i-ureteroscope eguquguqukayo ekubeni ingakwazi ukunyuka kwi-pelvis ye-renal;
Musa ukubeka isingxobo setshaneli kwinqanaba elinye. Shiya i-10 cm ngaphandle kwe-orifice ye-urethral ukukhusela umonakalo kwi-mucosa ye-urethral okanye i-renal parenchyma kwi-UPJ. Emva kokufaka i-scope flexible, indawo ye-sheath yeshaneli inokulungiswa kwakhona phantsi kombono othe ngqo.
Thina, i-Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ngumvelisi e-China ogxile kwizinto ezityiwayo ze-endoscopic, ezifanai-biopsy forceps, i-hemoclip, polyp umgibe, inaliti ye-sclerotherapy, fafaza i-catheter, iibrashi zecytology, guidewire, ibhasikithi yokubuyiswa kwamatye, i-catheter ye-biliary drainage yeempumlonjl ezisetyenziswa ngokubanzi kwiI-EMR, ESD, I-ERCP. Iimveliso zethu ziqinisekisiwe nge-CE, kwaye izityalo zethu ziqinisekisiwe nge-ISO. Impahla yethu ithunyelwe eYurophu, kuMntla Melika, kuMbindi Mpuma kunye nenxalenye yeAsia, kwaye ifumana ngokubanzi umthengi wokuqatshelwa kunye nendumiso!
Ixesha lokuposa: Sep-11-2024