Hemostatic: nkọwa na reviews

Hemostatic mkpachị na-eji kwụsị ọbara na-agba site na ha na-weghaara, na-adịru nwa mkpakọ nke a na-agba ọbara arịa ma ọ bụ n'ogwe osisi ahụ gbubiri arịa. The nso nke nha nke a ngwaọrụ nwere a ole na ole na iri na abuo. Nke a di iche iche n'ihi ọnụnọ nke arịa dị iche iche nha site 1 20 mm, na eji dị iche iche usoro hemostasis. Obere arịa gbubiri n'oge ọrụ, adịgide mwekota na mgbe clamping ligated n'elu (sutured) ogwe eri.

Hemostatic, nke na-eji na-anọ nwa oge tuo arịa nwere iche. The mwekota e mere iji kwụsị ọbara na-agba si obere ọbara arịa, o nwere ike imerụ njedebe nke arịa. Dị ka a na-achị, ọ na-mere nke isiike ihe. Clamps, nke na-akpọ vaskụla, mere nke na-agbanwe ihe onwunwe, n'ihi ndị a na atụmatụ nke ha imewe. The aha nke a ngwaọrụ bụ n'ụzọ zuru ezu-agbanwe agbanwe na ha chọrọ iji. Na mberede, ha ga-eji na fixation nke akwa nhicha.

Otú ọ dị, anyị aghaghị icheta na hemostatic mkpachị, dịkarịa ala otu ugboro etinyere maka fixation nke akwa nhicha ma ọ bụ owu bọọlụ na fere fere, nwere ike agaghịkwa-eji maka ya bipụta ya, nzube. Nke a bụ n'ihi na deformation nke na-arụ ọrụ akụkụ na ọnwụ nke arụmọrụ. N'ọdịnihu, ha ga-akara na-eji nanị maka idozi bọọlụ na akwa nhicha.

Chọrọ maka ọnụ

Hemostatic ga izute ndị na-esonụ chọrọ:

• Pụrụ ịdabere fixation na njedebe nke arịa gaghị ekwe slippage.
• Na ugboro ugboro ojiji nke ihe onwunwe ha ga-agaghị efu.
• The ngwá ọrụ ga-adị mfe ịkpọtụrụ na-emeghe n'okpuru nduzi nke dọkịta na-awa aka.
• The kpochidoro usoro ga-ntukwasi-obi idozi jaws, na-egbochi inadvertent oghere. Iji mee nke a, n'ihi na ihe atụ, adabara retainer n'ụdị racks.
  Mgbe ama esịn si a elu nke 1 mita ngwá ga bụghị spontaneously ịmalite ọrụ elu, na ugboro ugboro na-emechi na mmeghe nke jaws ekwesịghị ime ka ha guzozie.
• Ga-esoriri na iwu nke ergonomics.
• Lightness, ewepu lacerations ahụ nwere ike ime n'okpuru arọ nke mkpachị, amanye na ọnya n'ọnụ ya.
• Anyị kwesịrị ekwe ojiji nke electrocoagulator.
• Ya size bụghị igbochi nnyocha nke ịwa ahụ ubi.
• Agwụ na ngwá ọrụ ga-ederịta akwụkwọ ozi na dayameta nke arịa.

nhazi ọkwa nke clamps

Hemostatic ekewa n'ime ọtụtụ subgroups:

1. Hemostatic mkpachị enye nwa oge clamping agbanye tupu ligation ma ọ bụ wetara jide electrocoagulation (notched hemostatic clip).

2. vaskụla clamps, na nwa oge ịkwụsị ọbara na-ekwe iweghachi ike n'ezi ihe nke arịa (angiorrhaphy).

3. ndinuak clamps na-akwalite guzobe thrombus na arịa lumen na etinye clip.

imewe Atụmatụ

Hemostatic mkpachị na-ekewet nke akụkụ nke na-depụtara n'okpuru:

• N'agba (jaws).
• Ejiri na yiri mgbaaka.
• Collapsible ma ọ bụ onye ntị chiri obí eze.
• Racks.

Ụdị jaws (jaws)

1. Zita elongated, e.g., neurosurgical Halstead clamps.
2. Trapezoidal kwuru, e.g., Billroth mwekota.
3. Na trapezoidal ezé, n'ihi na ihe atụ, a Kocher mwekota.
4. Oval ihe atụ, Pean forceps.

Obere vidiyo nwere ike ogologo na curved jaws. Notches n'agba ebupụta kwere ma transverse na oblique. Hemostatic forceps, curved na-eji ezi mgbe.

Kocher mwekota

Kocher mwekota nwere ezé na njedebe. Ha na-ike ofu na njedebe nke arịa, dị ka ná mmechi nke onye nke ya nke nha nha nwechapụ n'etiti abụọ ndị nke ọzọ.

Tupu usiakidem, ndị dọkịta na-awa kwesịrị onwe-elele ọnọdụ nke hemostatic mkpachị (toothed, ogologo, na curved - dịghị mkpa), n'ihi na:

• mmebi nke ezé nwere ike ime ka racks samorazmykanie ngwá ọrụ, nke dị nnọọ ize ndụ n'oge cross-clamping nke a nnukwu ite.
• skewed ọrụ akụkụ agaghị ekwe ka ihe n'ụzọ dị irè kwụsị ọbara ọgbụgba.

Clamps jaws dị iche na udi, profaịlụ nke na-arụ ọrụ n'elu, nzube na size nke ngwá.

ụdị clamps

Ndị na-esonụ ụdị nke Obere vidiyo:

1. hemostatic kpọmkwem gia na a ogologo nke 15 ruo 20 cm, ma ọ bụ nwere a releasable kpochidoro ịghasa, na ihe oblique notch na-arụ ọrụ na-ebupụta nke jaws. Na nsọtụ nke jaws nwere ezé dị n'otu akụkụ, otu na abụọ na n'akụkụ nke ọzọ. Ná mmechi nke nnukwu ụlọ onye nke ezé ga-ada n'etiti ndị ọzọ na abụọ.

2. transverse notch, ha yiri notched, ma na-arụ ọrụ n'elu nwere a transverse ọnwụ. Mere nke igwe anaghị agba nchara, na n'elu-egbu maramara ka a na-enwu. Ogologo si 16 20 cm, nwere ike ịbụ ogologo ma ọ bụ curved.

3. Neurosurgical hemostat "anwụnta", fechaa, ogologo 15,5 cm, nwere a kpochidoro ịghasa. Fom na a longitudinal ngalaba ke udi nke a truncated cone, na ha na-arụ ọrụ n'elu bụ a mkpa transverse notching. Dị curved ma ọ bụ ogologo ekwesị na ịgbasapụ. Tumadi eji maka hemostasis nke obere arịa n'oge neurosurgical usoro.

4. The ụmụ nke "anwụnta" na Ọdịdị yiri gara aga, ma nwere thinner jaws. Ogologo 12.5 cm, na-ọtọ na curved. Ezubere maka angioplasty onye arachnoid ụbụrụ ụmụaka usiakidem, maka arụmọrụ ke parenchymal akụkụ.

5. Deep abdominal, bu n'obi maka hemostasis na vaskụla ligation ke miri ọnyá. Ha ogologo bụ 26 cm, fom nwere a ogologo ma ọ bụ curved udi na a obere ogologo.

Obere vidiyo nke "anwụnta" ịgba aha Halstead Obere vidiyo. Dị iche iche mma na-arụ ọrụ n'elu. изогнутый используется для новорожденных. Clip "anwụnta" kpebisiri eji mụrụ ọhụrụ. небольших сосудов в процессе нейрохирургических операций. Implements hemostasis obere arịa n'oge neurosurgical arụmọrụ.

Mwekota Billroth were na squeezes ọbara arịa. Ọ na-arụ ọrụ oké ọgba jaws na obere mbepụ, na a tapered n'elu na n'èzí. Na-akpali akpali jaws onwem na mbepụ, dapụtara na obere anụ ahụ merụrụ ahụ.

Mwekota Popper bụ ogologo ogologo ịwa mwekota, nke na-eji na a ńsí eriri afo ọrụ.

Dị ka clip etinyere?

Tupu ọrụ ndị dọkịta na-awa kwesịrị onwe ịlele ọrụ clamps. Nke a bụ eziokwu karịsịa na nnukwu akwara. Ka ihe atụ, overlapping phrenic-gastric ọgọdọ, kama, ọ na-enye ekpe gastric akwara mwekota nke bụ ntụpọ, bụ fraught mgbapụ njedebe nke arịa, nke pụrụ ịkpata oké ọbara ọgbụgba.

Olee otú nakradyvat mkpachị?

The obosara nke òkè nke mesentery (ọgọdọ) na arịa na-anwale ya, kwesịrị inversely proportional ya ọkpụrụkpụ.

Cheta na-esonụ:

- fọdụrụ ogwe nke a nnukwu size nwere ike nekrozirovat na nwere ike ime ka purulent mbufụt;

- omume nke a buru ibu n'elu ebe deserozirovannoy pụrụ iduga nyagide ọrịa;

- ligature, nke a na karịrị na nnukwu abụba, nwere ike akwusila n'oge ọ bụla.

Na ihe ndị kasị oké egwu ngalaba nke akwara (na mesentery), na ndị na-agaghị apụ, ligatures na mkpachị ga wetara a dọkịta na-awa na mbughari akụkụ nke mesentery wetara ha nnyemaaka.

Excision nke ọgọdọ ma ọ bụ nke mesentery n'etiti clamps ka nso ka ebe na-adịgide. Olu nke fọdụrụ ogwe dị mma na-eme a obere ihe, ọ ga-eje ozi dị ka a nkwa na ndakpọ gaghị enwekwa ligatures.

Clamps na ligatures na akwara njikọ na-atụ aro ime na a nta n'akuku, dị ka a enwekwu olu nke ogwe, na nke a na-eme ka a siri ike fixation ligatures.

E nwere ndị na-esonụ iwu, nke mkpa a ga-agbaso:

1. N'ihi na nsọtụ nke ligatures bụghị sere. Ya mere ha nwere Gbapụtanụ njedebe nke arịa.

2. Leruo n'akuku nke 40-50 degrees n'etiti ụgbọelu nke mkpa pupụtara diluted Cooper na yarns.

3. The ala agụba nke mkpa dị mkpa iji zuru ike na nzukọ.

4. The ịkpụ njedebe nke ligature ga gafere 1-2 mm.

Hemostats maka ọnyá mgbochi

Ịmata ihe dị iche na ọnya si akpụkpọ, na-emekarị iji notched hemostatic clip akara (1160 mm ogologo).

The na-emighị emi ọnyá kwesịrị ekwesị itinye ozugbo. Ma n'ihi na attaching fere fere na subcutaneous abụba ndị ọzọ kwesịrị ekwesị n'ihi na curved hemostats.

Nchekwa nke ịwa ahụ ngwá

Tools echekwara na kpụ ọkụ n'ọnụ n'ebe kpọrọ nkụ na okpomọkụ nke 15-20 Celsius C. Ọ ga-abụ na otu n'ime ụlọ na ha bekee ụzọ nke nwere ike ime corrosion nke ọla (formalin, ayodiin, bleach).

Tools mere maka ojiji na-tọrọ ke cupboards, na sorting ha site ụdị na-aga. Ndị nke na-mere nke carbon ígwè, n'oge na-aga n'ihu iga ma ọ bụ nchekwa esichara-anọpụ iche vaseline ma ọ bụ paraffin kpuchie. Iji mezuo nke a mmanụ ala jelii na-gbazee ka okpomọkụ nke 60-70 Celsius C, na-mikpuru n'ime ya ngwá ọrụ na mgbe ahụ ọbọp ke we akwụkwọ.

Mmanu ngwaọrụ bụghị n'okpuru ndị na-esonụ ihe: igwe anaghị agba nchara, aluminum, ọla, na nke ọla. Nkwadebe ngwaọrụ teghị: degrease na obụpde na mmiri na soda na ncha na mmiri, a mịrị amị, nyochara maka nchara, ẹdude nchara wepụrụ polishing. Nhazi ngwaọrụ naanị na uwe a ga-rụrụ, dị ka potozhirovye metụtara pụrụ iduga nchara guzobere.

Anyị atụlewo zuru ezu banyere ọgwụ na ahụ ike hemostatic clip, ya ụdị, iwu nke were na nchekwa.