Miyala yaying'ono ya mkodzo imatha kuchiritsidwa mosamala kapena kunja kwa thupi, koma miyala yayikulu, makamaka miyala yotsekeka, imafunika opaleshoni yoyambirira.
Chifukwa cha malo apadera a miyala ya m'mwamba mwa mkodzo, sizingafikiredwe ndi ureteroscope yolimba, ndipo miyala imatha kukwera mosavuta m'chiuno cha impso panthawi ya lithotripsy. Percutaneous nephrolithotomy imawonjezera chiopsezo cha kutuluka magazi m'impso pokhazikitsa njira.
Kuwonjezeka kwa njira yosinthira ureteroscopy kwathetsa mavuto omwe ali pamwambapa. Imalowa mu ureter ndi impso kudzera m'malo abwinobwino a thupi la munthu. Ndi yotetezeka, yothandiza, yosavulaza kwambiri, ili ndi magazi ochepa, ululu wochepa kwa wodwalayo, komanso kuchuluka kwa miyala sikugwera. Tsopano yakhala njira yodziwika bwino yochitira opaleshoni pochiza miyala yam'mwamba ya ureter.
Kutuluka kwachidebe cholowera mu urethrayachepetsa kwambiri kuvutika kwa njira yosinthasintha ya ureteroscopic lithotripsy. Komabe, chifukwa cha kuchuluka kwa milandu yochizira, zovuta zake pang'onopang'ono zakopa chidwi. Mavuto monga kuboola kwa ureteral ndi stricture ya ureteral ndi ofala. Izi ndi zinthu zitatu zazikulu zomwe zimayambitsa stricture ndi bowo la ureteral.
1. Matenda, kukula kwa miyala, kukhudzidwa kwa miyala
Odwala omwe ali ndi matenda nthawi yayitali amakhala ndi miyala ikuluikulu, ndipo miyala ikuluikulu imakhalabe mu ureter kwa nthawi yayitali kuti ikhale m'ndende. Miyala yomwe ili pamalo okhudzidwa imafinya mucosa wa ureteral, zomwe zimapangitsa kuti magazi asakwanire m'deralo, kusokonekera kwa mucosal, kutupa ndi kupanga zipsera, zomwe zimagwirizana kwambiri ndi kupangika kwa ureteral stricture.
2. Kuvulala kwa mkodzo
Ureteroscope yosinthasintha ndi yosavuta kupindika, ndipo chivundikiro cha ureteral access sheath chiyenera kuyikidwa musanagwiritse ntchito lithotripsy. Kuyika chivundikiro cha channel sheath sikumachitika poyang'ana mwachindunji, kotero n'kosapeweka kuti mucosa wa ureteral udzawonongeka kapena kubowoka chifukwa cha kupindika kwa ureteral kapena lumen yopapatiza panthawi yoyika chivundikirocho.
Kuphatikiza apo, kuti athandizire ureter ndikutulutsa madzi otuluka kuti achepetse kupanikizika pa pelvis ya impso, nthawi zambiri amasankha channel sheath kudzera mu F12/14, zomwe zingapangitse kuti channel sheath ikanikize mwachindunji khoma la ureteral. Ngati njira ya dokotala wa opaleshoni si yokhwima ndipo nthawi yochita opaleshoni ikuchulukirachulukira, nthawi yokakamiza ya channel sheath pakhoma la ureteral idzawonjezeka mpaka pamlingo winawake, ndipo chiopsezo cha ischemic kuwonongeka kwa khoma la ureteral chidzakhala chachikulu.
3. Kuwonongeka kwa laser ya Holmium
Kugawikana kwa miyala ya holmium laser kumadalira kwambiri mphamvu yake yotentha, zomwe zimapangitsa kuti mwalawo utenge mphamvu ya laser mwachindunji ndikuwonjezera kutentha kwa m'deralo kuti ukwaniritse cholinga cha kugawikana kwa miyala. Ngakhale kuti kuya kwa kutentha kwa kutentha panthawi yophwanya miyala ndi 0.5-1.0 mm yokha, zotsatira zolumikizana zomwe zimachitika chifukwa cha kuphwanya miyala kosalekeza sizingayerekezeredwe.
Mfundo zazikulu zoyikachidebe cholowera mu urethrandi motere:
1. Pali kuonekeratu kwa kuphulika mukalowetsa mu ureter, ndipo imamveka yosalala ikakwera mu ureter. Ngati kulowetsako kuli kovuta, mutha kuzunguliza waya wotsogolera kumbuyo ndi kumbuyo kuti muwone ngati waya wotsogolera akulowa ndi kutuluka bwino, kuti mudziwe ngati chidebe cha channel chikupita patsogolo molunjika kwa waya wotsogolera, monga ngati pali kukana koonekeratu, njira yolumikizira sheathing iyenera kusinthidwa;
Chigoba cha njira choyikidwa bwino chimakhala chokhazikika bwino ndipo sichidzalowa ndi kutuluka nthawi iliyonse yomwe mukufuna. Ngati chigoba cha njira chituluka bwino, zikutanthauza kuti chakulungidwa mu chikhodzodzo ndipo waya wotsogolera watuluka kuchokera mu ureter ndipo uyenera kubwezeretsedwanso;
3. Zipolopolo za njira ya ureteral zimakhala ndi mawonekedwe osiyanasiyana. Odwala amuna nthawi zambiri amagwiritsa ntchito chitsanzo cha 45 cm kutalika, ndipo odwala akazi kapena afupiafupi amuna amagwiritsa ntchito chitsanzo cha 35 cm kutalika. Ngati chipolopolo cha njira chayikidwa, chimangodutsa m'malo otseguka a ureteral kapena sichingakwere pamwamba. Malo, odwala amuna angagwiritsenso ntchito chipolopolo cha 35 cm choyambitsa, kapena kusinthana ndi chipolopolo cha 14F kapena chopyapyala cha fascial expansion kuti alepheretse ureteroscope kukwera kupita ku renal pelvis;
Musayike chotchingira cha channel pang'onopang'ono. Siyani 10 cm kunja kwa chotsekera cha urethra kuti mupewe kuwonongeka kwa mucosa wa ureteral kapena renal parenchyma ku UPJ. Mukayika chotchingira chosinthasintha, malo a chotchingira cha channel amatha kusinthidwanso poyang'ana mwachindunji.
Ife, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., ndi opanga ku China omwe amagwira ntchito kwambiri pazinthu zogwiritsidwa ntchito m'ma endoscopic, mongamphamvu ya biopsy, hemoclip, msampha wa polyp, singano ya sclerotherapy, katheta wopopera, maburashi a cytology, waya wotsogolera, dengu lotengera miyala, katheta yotulutsira madzi m'mphunondi zina zotero zomwe zimagwiritsidwa ntchito kwambiri muEMR, ESD, ERCPNdipoMndandanda wa Urology, mongaChotsukira Miyala cha Nitinol, Mphamvu za Urological BiopsyndiChigoba cha Ureteral AccessndiBuku Lotsogolera la UrologyZogulitsa zathu zili ndi satifiketi ya CE, ndipo mafakitale athu ali ndi satifiketi ya ISO. Katundu wathu watumizidwa ku Europe, North America, Middle East ndi mbali ina ya Asia, ndipo makasitomala ambiri amalandira ulemu ndi kutamandidwa!
Nthawi yotumizira: Sep-11-2024