Endovascular Surgery: Iri shisshigi

A cikin shekaru goma, endovascular tiyata ne m, kuma m, amma da hawan fara a cikin 50s na 20th karni.

A kadan tarihi

Yaren mutanen Sweden radiologist Sven Seldinger sanar da ra'ayin gabatar a cikin ruwa ganga, cewa shi ne, da bambanci wakili. Manufar na masanin kimiyyar ya kauce wa yanke. Kamar haka Ya zo da jirgin ruwa huda hanya musamman allura ta cikin fata.

Ya zo ta cikin allura kirtani, iya shiga cikin jirgin ruwa da iko da X-ray, da allura da aka kuranye da kirtani catheter sa. A bambanci wakili da aka amfani da catheter, sa'an nan na ɗauki hoto a kan X-ray fim. Kuma haka dai aka samu wani image da jirgin ruwa. A allura jagora catheter ne ainihin kayayyakin aiki, a endovascular tiyata da kuma amfani a yau. Yana da muhimmanci a lura da cewa ingancin da kayan aiki ne da key ga nasarar da aiki. Ga yadda ta samo asali endovascular tiyata na ciki carotid jijiya.

A na gaba mataki na ci gaba yana nufin 1964. Radiologist Charles Dotter gabatar da wani hanya domin fadada quntata jirgin ruwa ta amfani da wani inflatable balan-balan, wanda aka a haɗe zuwa karshen a cikin catheter. Wannan} ir} kammalã Swiss likitan zuciyar Andreas Gryunttsig. Ya sanya farko balan-balan angioplasty na zuciya jijiyoyi. A cikin shekaru goma, da filin da magani da kuma ta kãma masu kuzarin kawo cikas na ci gaba. Ya kamata a lura da taimako na gida manyan malaman a jijiyoyin bugun gini tiyata ne: Serbinenko FA, Rabkin I. H., Savelev V. S., Zingerman LS da sauransu.

Yau, endovascular tiyata ya daina zama wani matukin jirgi. Ya daidaitu dauka ta wuri, kuma an ci gaba.

Game da jijiyoyin bugun gini Surgery

Jijiyoyin bugun gini tiyata - yanki na magani, wanda ya hada da magani daga jini da kuma Lymph tasoshin. Mun yi amfani da hanyar na far matsayin operable da intravascular tiyata. Da farko, manufar da tiyata da aka bincike. Nasarori da kuma sakamakon da magani yarda ka kafa wararriyar yankin.

Minimally cin zali jinsunan nasa ne da zamani jijiyoyin bugun gini tiyata. Ingantaccen aiki intravascularly yiwu godiya ga m fasaha a magani, game da shi endovascular tiyata ne dauke da wani zaman kanta, musamman kunkuntar profile, wanda ya kama wuri da kuma sanya madadin zuwa gargajiya tiyata.

Kalmar "endovascular", wanda yake nufin "intravascular" daidai yayi dace da ƙayyadaddu. Shi ne a duniya Hanyar cewa shi ne m for daban-daban jijiyoyin bugun gini pathologies da intraorgan ducts.

The main iri

Endovascular Surgery hada rentgenohirurgii, interventional cardiology, interventional Radiology - wannan iri daga m baki, wanda yana da za'ayi a kan wani jirgin ruwa da jini via percutaneous damar iko radiation Dabarar.

Babban amfani da intravascular tiyata - wannan shiga tsakani ta hanyar kananan punctures a cikin fata da kuma X-ray iko da magudi.
Endovascular bincike da warkewa shisshigi da aka yi a asibitin da kuma bukatar kwanaki da dama na asibiti. abũbuwan amfãni:

• A kan talakawan, babu bukatar ga general maganin sa barci.
• Domin su runtse hadarin babu dole shisshigi operable, saboda haka ƙananan zafi, m fi idan aka kwatanta da na gargajiya tiyata.
• Iri endovascular shisshigi ne m kasafin kudin farashin.

Sau da yawa amfani endovascular hanya - a bincike angiography. Menene Center for Endovascular Surgery?

A takaita da jirgin ruwa sa shi dilatation ko stenting. Lokacin da wuce haddi da jini samar da wani sashin jiki (ƙari, angiodysplasia, da dai sauransu), ko mahaukaci jini ya kwarara (arteriovenous shunt, varicocele) tambaya jijiyoyin bugun gini embolization.
Idan gane asali pathological vasodilation - intravascular aneurysm dasa da ake amfani, wanda zame cikin aneurysm daga jini ya kwarara yankin.

hanya dubaru

Tare da girmamawa ga marasa lafiya da ganewar asali "portal hauhawar jini" (hawan jini a portal jannayẽnsa saboda da toshewa da jini ya kwarara ta cikin hanta) dubaru dabara amfani - An halitta hack "tashar" na jini ya kwarara daga portal jijiya a cikin hanta. Wannan rage portal jini, shi ne ya hana barazana ga rayuwa.

Idan akwai wani hadarin detachment na thrombus na ƙananan reshe jannayẽnsa tare da kara transporter su a cikin huhu jijiya, sa'an nan saita cava tace a matsayin prophylactic gwargwado.

yankin jiyyar cutar sankara

Regional jiyyar cutar sankara Hanyar amfani ga manufa allura a cikin wani sashin jiki, kamar jiko a m pancreatitis, ciwon daji jiyyar cutar sankara (catheter saka a cikin wani jijiya sa'an nan da miyagun ƙwayoyi ne allura kai tsaye a cikin waxannan cututtukan zuciya da sauransu). Gabatarwa a cikin jijiya da na jiyyar cutar sankara a hade tare da mai da bambanci matsakaici - himioembilizatsiya.

thrombolysis

Thrombosis jirgin ruwa ta amfani da yankin thrombolysis. Gabatar da catheter a cikin yanki na thrombosis, an gudanar da wani abu da dissolves a thrombus (thrombolytic) kai tsaye a cikin hearth thrombosis. Bisa wani thrombus partially ko gaba daya narkar da, game da shi, rage miyagun ƙwayoyi kashi tramboliticheskogo.

Wadannan endovascular dabaru ba a cika. A hakikanin na zamani rana ne irin wannan cewa endovascular tiyata yana da wani m, girma dabam dabam reshe na magani. Jerin daban-daban warkewa endovascular hanyoyin yana faɗaɗa.

Abin da za ka iya yi da taimakon X-ray?

Bincike a tasoshin, jijiyoyi ko jijiyoyinmu bayyana takaita, occlusion na jini, da mayar da hankali, da girman da fadada jirgin ruwa cuta, da kuma gane ciki na jini, ciwon daji tsari, da kuma more, cewa ba shi yiwuwa a gano wani Hanyar.

Endovascular tiyata sashen ke tsunduma a irin wannan bincike.
A hanya ne kullum da wadannan matakai. Don huda wani jijiya ko jijiyar da ake amfani da musamman allura - a cikin makwancin gwaiwa, hamata, kasa da clavicle ko wuyansa. Lankwasa roba tube - a catheter shiga cikin jirgin ruwa. Fluoroscopic shiriya taimaka wajen rike da catheter a cikin manufa jirgin ruwa.

Sa'an nan ciyar a cikin catheter bambanci matsakaici cewa shi ne bayyane a X-haskoki. A bambanci wakili, yada da batun a jijiyoyin bugun gini site, yin shi a shahararren X-ray masaƙa. A sakamakon binciken na kama wani X-ray ko video. X-ray endovascular tiyata don gane da daban-daban Pathology na tasoshin da kuma kayan ciki da shi ne irreplaceable Hanyar bincike.

Lokacin da hagiographic nazarin yiwu gajere zafi mai sãɓãwar launukansa a tsanani a cikin binciken yankin. Wani lokaci na zafi far da ake bukata.

samfurori angiograms

Saboda haka, yadda ta ke yi endovascular tiyata na carotid arteries? Overlapped tasoshin quntata ko rage ta gabatar da wani musamman balan-balan sa'an nan aka inflated shi a cikin lumen. Wannan hanya mayar da patency da jirgin ruwa ba ya bukatar faɗakar da mataki, duniya, kamar yadda zartar, domin kowane mutum tasoshin.

A vasoconstriction ciyar da catheter angiography yi don gane da matakin takaita da jirgin ruwa. Ta hanyar kunkuntar ko rufaffiyar ɓangare na jirgin ruwa ne da za'ayi kayan aiki - da shugaba. Sa'an nan da balan-balan catheter an ciyar, wanda overlaps da quntata rabo.

A balan-balan na shimfida quntata yankin. Dalilin da ƙuntatawa - wani jini gudan jini ko plaque, wanda aka rarraba gaba ɗaya kan dauke miƙa bango na jirgin ruwa. Next, da balan-balan aka deflated, game da shi, da warware matattarã rabo wanda aka mayar da su da cikakken jini ya kwarara.

Silinda kawar da m muhimmancin kula da maimaita angiography. Kuma rare endovascular tiyata na vertebral jijiya.

Tare da ineffectiveness na dilatation

Sau da yawa, bayan dilatation lura saura stenosis cewa ba ya tsoma baki tare da al'ada aiwatar da jini ya kwarara.

Idan dilatation m shawarar stent cewa tana goyon bayan a ciki da jirgin ruwa da kuma ba za su ba shi kunkuntar. A stent iya zama mai sãɓãwar launukansa a tsawon kuma diamita, a hanya daban-daban na shigarwa. A stent aka zaba akayi daban-daban. Don kwanan wata, duk mutum tasoshin samuwa ga endovascular jijiyoyin zuciya stent.

ƙarshe

Akwai daban-daban alamomi, idan ya daina jini ya kwarara ta cikin jirgin ruwa. Domin embolizirovaniya jirgin ruwa ne da za'ayi a cikin catheter. Yana da muhimmanci cewa catheter ya kamata a sanya don haka da cewa embolization abu ba ya fada a cikin sauran tasoshin. catheter ta hanyar da jirgin ruwa ya isar embolizing abu ko na'urar, kamar a karkace, roba (gelatin) barbashi sclerosant.