Miyala yaying'ono ya mkodzo imatha kuthandizidwa mosamalitsa kapena extracorporeal shock wave lithotripsy, koma miyala yayikulu m'mimba mwake, makamaka miyala yotchinga, imafunikira kuchitidwa opaleshoni koyambirira.
Chifukwa cha malo apadera a miyala yam'mwamba ya urethra, sangathe kufikika ndi ureteroscope yolimba, ndipo miyala imatha kupita m'chiuno mwa aimpso panthawi ya lithotripsy. Percutaneous nephrolithotomy imawonjezera chiopsezo chotaya magazi aimpso pokhazikitsa njira.
Kuwonjezeka kwa ureteroscopy yosinthika kwathetsa bwino mavuto omwe ali pamwambawa. Imalowa mu ureter ndi aimpso chiuno kudzera m'matumbo abwinobwino a thupi la munthu. Ndizotetezeka, zogwira mtima, zowononga pang'ono, zimakhala ndi magazi ochepa, zimakhala zochepa kwa wodwala, komanso zimakhala zopanda miyala. Tsopano yakhala njira yodziwika bwino yopangira opaleshoni yochizira miyala yam'mimba yam'mimba.
Kuwonekera kwachotupa cha ureterwachepetsa kwambiri vuto la flexible ureteroscopic lithotripsy. Komabe, ndi kuwonjezeka kwa chiwerengero cha milandu ya chithandizo, zovuta zake zakhala zikukopa chidwi. Zovuta monga kuphulika kwa ureter ndi kukhwima kwa ureter ndizofala. Zotsatirazi ndi zifukwa zazikulu zitatu zomwe zimapangitsa kuti ureter ikhale yolimba komanso yoboola.
1. Njira ya matenda, kukula kwa miyala, kukhudza miyala
Odwala omwe ali ndi matenda a nthawi yayitali amakhala ndi miyala ikuluikulu, ndipo miyala ikuluikulu imakhalabe mu ureter kwa nthawi yayitali kuti ikhale yotsekera. Miyala pa malo impaction compress ndi ureteral mucosa, chifukwa chosakwanira m`deralo magazi, mucosal ischemia, kutupa ndi zipsera mapangidwe, amene ali pafupi ndi mapangidwe ureteral stricture.
2. Kuvulala kwa mkodzo
Ureteroscope wosinthika ndi wosavuta kupindika, ndipo sheath yolowera mkodzo iyenera kuyikidwa pamaso pa lithotripsy. Kuyika kwa sheath ya njira sikuchitidwa molunjika, choncho n'zosapeŵeka kuti ureter mucosa idzawonongeka kapena kuphulika chifukwa cha kupindika kwa ureter kapena lumen yopapatiza panthawi yoyika sheath.
Kuonjezera apo, pofuna kuthandizira ureter ndi kukhetsa madzi otsekemera kuti achepetse kuthamanga kwa pelvis yaimpso, kansalu kameneka kamene kamadutsa F12/14 nthawi zambiri amasankhidwa, zomwe zingapangitse kuti mtsinje wa ureter utseke. Ngati njira ya dokotalayo ndi yachibwana ndipo nthawi ya opaleshoniyo italika, nthawi yoponderezedwa ya sheath pakhoma la ureter idzawonjezeka mpaka kufika pamlingo wina, ndipo chiopsezo cha kuwonongeka kwa ischemic ku khoma la ureter chidzakhala chachikulu.
3. Holmium laser kuwonongeka
Kugawika kwa mwala wa laser holmium makamaka kumadalira mphamvu yake ya photothermal, yomwe imapangitsa kuti mwalawo utenge mphamvu ya laser ndikuwonjezera kutentha kwanuko kuti ukwaniritse cholinga chakugawikana kwa miyala. Ngakhale kuya kwa kutentha kwa ma radiation panthawi yakuphwanya miyala ndi 0.5-1.0 mm, kuphatikizikako komwe kumachitika chifukwa cha kuphwanya miyala kosalekeza sikungayerekezeke.
Mfundo zazikuluzikulu zoyika ureter access sheath ndi izi:
1. Pali chidziwitso chodziwikiratu cha kupambana pamene akulowetsa mu ureter, ndipo amamva bwino pamene akukwera mu ureter. Ngati kulowetsako kuli kovuta, mukhoza kugwedeza waya wolondolera kumbuyo ndi kutsogolo kuti muwone ngati waya wolondolerawo akulowa ndi kutuluka bwino, kuti muwone ngati chingwecho chikupita kutsogolo kwa waya wotsogolera, monga Ngati pali kukana koonekeratu, njira ya sheathing iyenera kusinthidwa;
Sheath yoyikidwa bwino ndi yokhazikika ndipo siyibwera ndi kutuluka mwakufuna. Ngati sheath ya ngalandeyo ituluka mwachiwonekere, zikutanthauza kuti yakulungidwa mu chikhodzodzo ndipo waya wowongolera watuluka kuchokera mu ureter ndipo uyenera kuyikidwanso;
3. Mitsempha ya mkodzo imakhala ndi mawonekedwe osiyanasiyana. Odwala amuna nthawi zambiri amagwiritsa ntchito chitsanzo cha 45 masentimita, ndipo odwala achikazi kapena achifupi amagwiritsa ntchito chitsanzo cha 35 cm. Ngati sheath ya tchanelo itayikidwa, imatha kungodutsa mumtsempha wa ureter kapena sungathe kupita kumtunda wapamwamba. Udindo, odwala amuna amatha kugwiritsanso ntchito 35 masentimita poyambitsa sheath, kapena kusinthana ndi 14F kapena ngakhale wowonda kwambiri fascial expansion sheath kuteteza ureteroscope wosinthika kuti asathe kukwera ku pelvis yaimpso;
Osayika sheath ya tchanelo mu sitepe imodzi. Siyani masentimita 10 kunja kwa khomo la mkodzo kuti muteteze kuwonongeka kwa mphuno ya mkodzo kapena renal parenchyma pa UPJ. Pambuyo poyika mawonekedwe osinthika, malo a sheath channel akhoza kusinthidwa kachiwiri pansi pa masomphenya achindunji.
Ife, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ndi opanga ku China okhazikika pazakudya zama endoscopic, mongabiopsy forceps, hemoclip, polyp msampha, sclerotherapy singano, kupopera catheter, maburashi a cytology, guidewire, dengu lochotsa miyala, catheter ya nasal biliary drainageetc. omwe amagwiritsidwa ntchito kwambiri muEMR, ESD, ERCP. Zogulitsa zathu ndi zovomerezeka za CE, ndipo zomera zathu ndi ISO. Katundu wathu watumizidwa ku Europe, North America, Middle East ndi gawo la Asia, ndipo amapeza makasitomala ambiri kuzindikira ndi kutamandidwa!
Nthawi yotumiza: Sep-11-2024