Hemostatic: incazelo kunye nohlaziyo

omfisha Hemostatic zisetyenziselwa ukunqanda ukopha kubo iya kuthinjwa, kunye ucinezelo inqanawa ukopha okanye isikhondo isitya yahlukana okwethutyana. Uluhlu lobungakanani ezo zixhobo kufuneka elinesibini ezimbalwa. Le yantlukwano ngenxa yobukho iimpahla ezohlukeneyo ngobukhulu ukusuka ku-1 ukuya ku-20 mm, kwaye usebenzisa iindlela hemostasis ezahlukeneyo. iimpahla Small Wazishiya ngexesha lokusebenza, ukubambelela uqinisa uze nokubotshwa ligated ngentla (sutured) ngomsonto isiphunzi.

Hemostatic, ezisetyenziswa songe okwexeshana iimpahla ukungaboni. Le kwesibambi yenzelwe ukunqanda ukopha evela imithambo yegazi ezincinane, ukulimaza ekupheleni isitya. Ngokuqhelekileyo, ukuba wenziwe ngezinto engqongqo. Yamasango, nto leyo nayo ngokuba semithambo, ezenziwe ngezinto ilastiki, ngenxa ezi mpawu icebo. Amagama ezi zixhobo iyavumelana ngokupheleleyo kunye nenjongo eziza kusetyenziselwa yona. Xa likaxakeka, ukuba zingasetyenziswa nitrogen kwamalweyile.

Noko ke, simele sikhumbule ukuba umboniso hemostatic, ubuncinane kanye isicelo nitrogen kwamalweyile okanye iibhola umqhaphu kunye igozi, ngaba akusayi kuba isetyenziselwa injongo eyenzelwe yona. Oku kubangelwa deformation kwenxalenye ukusebenza kunye nelahleko functionality. Kwixesha elizayo, kufuneka uphawule ize isetyenziswe kuphela ukulungisa iibhola kunye kwamalweyile.

Iimfuneko ezinjengeetheminali

Hemostatic kufuneka anelise ezi mfuno zilandelayo:

• nitrogen ezithembekileyo kwi ekupheleni isitya abayi kuvunyelwa slippage.
• Nokusebenzisa ngokuphindaphindiweyo ipropati yabo akufunekanga ilahleke.
• Isixhobo kufuneka kube lula ukuba ziqhagamshelane kunye kuvulwa phantsi kwempembelelo kwezandla ngoogqirha.
• Isixhobo kumise kufuneka aqiniswe ingalungiseka emihlathini, ukuvimbela lokuvula gwenxa azenziwanga ngabom. Ukuze wenze oku, umzekelo, isamba efanelekileyo ngohlobo nezinye izinto.
  Xa lehla ukusuka kubude 1 isixhobo imitha kufuneka bamane ukuvula wobuso, kwaye ngokuphindaphindiweyo lokuvala kunye nokuvulwa imihlathi akufunekanga ukuba nabo ngqo.
• Kufuneka bathobele imithetho ergonomics.
• Ndandifeketha na, ngaphandle nokopha ezingenzeka phantsi ubunzima umboniso, zamiselwa emiphethweni inxeba.
• Kufuneka uvumele ukusetyenziswa electrocoagulator.
• ubukhulu balo ukuba u ubenemboniselo yangaphezulu yazo yasendle yotyando.
• Igcina isixhobo kufuneka ne ubukhulu iimpahla.

ngezigaba yamasango

Hemostatic yahlulwe subgroups ezininzi:

1. omfisha Hemostatic ngokubonelela migqomo nokubotshwa okwethutyana phambi kokuba tubal okanye abeke abambelele electrocoagulation (notched iklip hemostatic).

2. anxulumene nemithambo yamasango, ukuyeka okwethutyana ukuhamba kwegazi kunye nokuvumela ukubuyisela isidima benqanawa (angiorrhaphy).

3. uwaphule yamasango ezikhuthaza akuseko thrombus kwi sayo isitya emva kokufaka ikliphu.

Iimpawu design

omfisha Hemostatic iqanjwa iindawo ezi zidweliswe apha ngezantsi:

• Imihlathi (imihlathi).
• Ephatha amakhonkco.
• inqaba lokukha okanye abangevayo.
• Ntsimbi zilapha phezulu.

Form imihlathi (imihlathi)

1. Oonxantathu side, umz, neurosurgical Halstead yamasango.
2. Trapezoidal wakhomba, umz, Billroth eligaqa.
3. Enamazinyo trapezoidal, umzekelo, kwesibambi Kocher.
4. Okweqanda, umzekelo, Pean forceps.

Umboniso unokuba emihlathini straight and ukugoba. Zingakhona phezu imiphezulu imihlathi ukuba zombini ezinqamlezayo kunye elibhalwe ngokumileyo. forceps Hemostatic, kujikwa isetyenziswa kakhulu rhoqo.

uqinisa Kocher

uqinisa Kocher uye amazinyo ekupheleni. ngokuqiniseka njo ekupheleni ngalo, njengoko e ukuvalwa enye inxalenye yayo kugqitywe izinyo phakathi kwezinye ezimbini.

Ngaphambi kokuba ahlinzwe, ugqirha kufuneka ngokobuqu khangela imeko omfisha hemostatic (unamazinyo, ngqo, kujikwa - Akukhathaliseki), ngokuba:

• umonakalo amazinyo kunokubangela amanqwanqwa isixhobo samorazmykanie, nto leyo eyingozi kakhulu ngexesha cross-nokubotshwa inqanawa enkulu.
• iindawo zokusebenza ekuzibandakanyeni akayi kuvumela ukuba ayeke ngempumelelo ukopha.

Yamasango imihlathi ezahluke ngokumila, iprofayili ye kumphezulu ukusebenza, injongo kunye nobukhulu izixhobo.

iintlobo yamasango

Ezi ndidi zilandelayo Umboniso:

1. gear hemostatic ngqo kunye ubude cm-15 ukuya ku-20, okanye utshixo Screw ngezikhonkwane, kunye inotshi elibhalwe ngokumileyo phezu iindawo zokusebenzela le imihlathi. Iziphelo imihlathi kufuneka kwamazinyo kwelinye icala, omnye amabini kwelinye icala. , Ukuvalwa enqabeni omnye kwamazinyo kufuneka kuwa phakathi kwezinye ezimbini.

2. notch ezinqamlezayo, ukuba ziyafana notched, kodwa umphezulu yokusebenza unalo ahlabayo ezinqamlezayo. Ezenziwe steel stainless, umphezulu njengebamba ukuya kukhanya. Ubude ukusuka cm-16 ukuya ku-20, inokuba ngqo okanye ukugoba.

3. hemostat "ingcongconi" Neurosurgical, ayisindi, ubude 15.5 cm, uye Screw lwekeyboard. Iziponji kwindawo longitudinal xa elimile cone thumbanails, kumphezulu wazo ukusebenza a notching ezinqamlezayo obhityileyo. Ekhoyo kujikwa okanye ethe nkqo kwaye tye. njengefama hemostasis iinqanawa ezincinane ngexesha iinkqubo neurosurgical.

4. Abantwana i "ingcongconi" kubume ngokufanayo edlulileyo, kodwa ke abe imihlathi thinner. Ubude 12.5 cm, nazo ngqo kunye ukugoba. Yenzelwe angioplasty umntu ubuchopho arachnoid kutyando ezingabantwana, ngokuba imisebenzi kwi amalungu parenchymal.

5. esiswini anzulu, zilungiselelwe hemostasis kunye tubal ezinemigca kwindawo amanxeba anzulu. ubude lwabo-26 cm, iziponji ukuba imile ngqo okanye ukugoba kunye nobude elifutshane.

Umboniso we "Mosquito" nawo amagama Halstead umboniso. Ezahlukeneyo indawo obuhle. изогнутый используется для новорожденных. Hlanganisa "Mosquito" ugobile esetyenziselwa kubelekwa. небольших сосудов в процессе нейрохирургических операций. Liphumeza imikhumbi ezincinane hemostasis ngexesha lomsebenzi neurosurgical.

Uqinisa Billroth libamba licudisa imithambo yegazi. Yena wayesebenza emihlathini ibambe kunye liqatywe amancinane, kwaye umphezulu tapered ngaphandle. imihlathi umdla zixhotyiswe ukusikwa, nto leyo izicwili ngaphantsi owenzakeleyo.

Uqinisa Popper i ngqo eligaqa elide zotyando, nto leyo lisetyenziswa umsebenzi inyongo lwesinye.

Njengoko ikliphu sifakwa?

Phambi kokuba umsebenzi ugqirha kufuneka ngokobuqu khangela ukusebenza yamasango. Oku kuyinyaniso ngakumbi imithambo ezinkulu. Umzekelo, ezimise lungu phrenic-esiswini, kunoko, nangabo ukuya ekhohlo esiswini uqinisa Umthambo leyo sinesiphene, kuba isiphelo ukubaleka lugcwele ezantsi enqanaweni, nto leyo enokukhokelela ukopha kakhulu.

Indlela nakradyvat omfisha?

Ububanzi isabelo mesentery (lungu) neempahla yahlolwa khona, kufuneka ube nobukhulu ngokomlinganiselo balo babulingana nesandla.

Khumbula ezi zinto zilandelayo:

- isiphunzi eliseleyo elimlinganiselo enkulu nekrozirovat ezingabangela ukuba ubovu komtshiso oko;

- isenzeko enkulu indawo umphezulu deserozirovannoy kunokukhokelela isifo enamathelayo;

- ligature, nto leyo enyanzeliswa phezu kwamanqatha bulk, ukuze kuphazamisekile naliphi na ixesha.

Ngelo macandelo abaluleke kakhulu kwemisipha (i mesentery), baya engafuduswayo, ezihlangene kunye iiklip kufuneka abeke ugqirha kumalungu ayinakususwa le mesentery ukunyanzelisa umncedisi zabo.

Ukusikwa kwi lungu okanye mesentery phakathi yamasango yenziwa kufutshane indawo isekhona. Umthamo we isiphunzi eseleyo Kungcono wenze kancinane ngakumbi, kuya kusebenza njengesiqinisekiso sokuba yokuwa akuyi kubakho ezihlangene.

Izibopho kunye ezihlangene phezu nemisipha kucetyiswa ukuba isicelo kwi imo yekona kancinane, njengoko oku kwandisa umthamo isiphunzi, yaye oku kwenza kube ezihlangene nitrogen ngamandla.

Kukho le migaqo ilandelayo, ekufuneka zilandelwe:

1. Kuba iziphelo ezihlangene abanduluka. Ngoko ke ndiziqhawule ekupheleni isitya.

2. Qaphela engile degrees 40-50 phakathi moya ka tikelo iincakuba sobisi Cooper and nebomvu.

3. I-blade esezantsi isikere kuyimfuneko ukuba kuhlala esikhungwini.

4. Isiphelo basinqumla khona ligature kufuneka ingadluli 1-2 mm.

Ezinqanda nezithintelo amanxeba

Ukuba sahlule inxeba nasesikhumbeni, ngokuqhelekileyo usebenzisa notched ikliphu hemostatic line (1160 mm ubude).

Amanxeba nzulu ezifanelekileyo ukuze isicelo ngqo. Kodwa kuqhotyoshelwe igozi ukuya amanqatha ongama zifaneleke ngakumbi xa ezinqanda kujikwa.

Ukugcinwa izixhobo zoqhaqho

Izixhobo egcinwe kwindawo eshushu eyomileyo kubushushu ka 15-20 ° C. Kufuneka ingabi kwigumbi efanayo kunye nabo izinto isibini esinokubangela umhlwa zesinyithi (formalin, ayodini, iblitshi).

Izixhobo eziyilelwe lo ukusetyenziswa zibekwe kwi iikhabhathi, kwaye ubeko kwabo uhlobo khona. Abo ezenziwe carbon ngentsimbi, ngexesha izithuthi eqhubekayo okanye ukugcinwa ukuqhubekekiswa vaseline cala okanye iparafini nesigqubuthelo. Kule petroleum ijeli isiphelo inyibilikiswa ukuya kwiqondo lobushushu 60-70 ° C, egxile kuyo izixhobo ze isongelwe ngephepha elenziwe.

izixhobo mnandi abekho phantsi kwezi zinto zilandelayo: insimbi, i-aluminiyamu, ixina, ubhedu. izixhobo amalungiselelo kuzithambisa: degrease uze uyithabathe, uyipheke emanzini ngesoda kunye ngesepha namanzi, yomile, ahlolwe ukuze irusi, umhlwa isuswe ngu ipolishi ekhoyo. izixhobo Iqhubekekisa kuphela iiglavu kufuneka wenziwe, njengoko nentwana potozhirovye kunokukhokelela irusi ukwakhiwa.

Siye sabona ngokweenkcukacha ikliphu hemostatic zonyango, iintlobo zayo, imithetho ukusetyenziswa kunye nokugcinwa.