Endovascular Surgery: Iintlobo zongenelelo

Kule minyaka ilishumi idluleyo, utyando endovascular iyasebenza kwaye ethandwa, kodwa nezinyuko yayo kwi-50 kwinkulungwane yama-20.

A incinane

ray Swedish ucinge ngephonografi Seldinger wavakalisa ingcamango yokwazisa kwi isikhongozeli elulwelo, oko kukuthi, i-arhente umahluko. Injongo yale sisazinzulu yaba ukunqanda cut. Ngaloo ndlela kufikile inkqubo inqanawa okuhlatywa inaliti ekhethekileyo ngesikhumba.

Weza ngokusebenzisa umtya yenaliti, zingene isitya ngokulawula X-ray, inaliti leyo ezisusiweyo yaye kufakelwe string catheter. Iarhente umahluko esisetyenziswe catheter, ngoko ndathatha nomfanekiso bhanya X-ray. Ngaloo yayifunyenwe umfanekiso benqanawa. Le catheter sikhokelo inaliti zizixhobo ezisisiseko kutyando endovascular wasebenzisa namhlanje. Kubalulekile ukuqaphela ukuba umgangatho isixhobo ngundoqo impumelelo nokusebenza. Nantsi indlela eqale endovascular utyando kwemithambo carotid lwangaphakathi.

Inqanaba elilandelayo lophuhliso ibhekisela 1964. Ray Charles Dotter laqalisa indlela ukuze kwandiswe isitya iingqameko usebenzisa ibhaloni sawa, nto leyo sakuncanyathiselwa kwisiphelo kwi catheter. Le ezintsha lugqibelele cardiologist Swiss Andreas Gryunttsig. Wenza ibhaloni angioplasty yokuqala kwemithambo intliziyo. Kule minyaka ilishumi ezayo, intsimi amayeza afumanana nemiba yophuhliso. kufuneka phawule igalelo izikhanyiso basekuhlaleni kutyando semithambo zezi: Serbinenko NBA, Rabkin I. H., savelev V. S., Zingerman LS kunye nabanye.

Namhlanje, utyando endovascular Uyekile ukwenza uvavanyo. Yena uye ngokuqinileyo indawo yayo kwaye luqhuba.

About Loqhaqho

utyando semithambo - indawo yamayeza, ebandakanya unyango igazi nkovu nempahla. Sisebenzisa indlela unyango njengoko utyando operable kunye intravascular. Ekuqaleni, injongo yale tyando diagnostic. Impumelelo kunye neziphumo zonyango ukuba kumiswe indawo eyahlukileyo.

eziphilayo kancinane invasive bobabo tyando olujikeleza mihla. ukusebenza kakuhle intravascularly Bulelani kangangoko iteknoloji ezintsha amayeza, utyando ngaloo endovascular kuthathwa ezimeleyo, ekhethekileyo iprofayili emxinwa, apho wathatha indawo yayo kwaye wenza enye ukuya utyando bemveli.

Igama elithi "endovascular", gama elo elithetha "intravascular" kanye ekwafanekisa le nkcukacha. Yindlela iphela oko kusebenza ezimbi ezahlukeneyo nemithambo kunye imibhobho intraorgan.

Eyona eziphambili ze

Endovascular Surgery iquka rentgenohirurgii, nezifo zentliziyo interventional, radiology interventional - oku iindidi yokungenelela ngotyando, oluqhutywa phezu isitya igazi nge ukufikelela percutaneous ukulawula radiation umfanekiso.

Eyona inzuzo zotyando intravascular - olu ngenelelo ngoncedo ngokusebenzisa ukuhlatywa ezincinane esikhumbeni kunye X-ray kolawulo lwe ukuphululwa.
ungenelelo Endovascular zokuxilonga nezinyangayo yayidlalwa eklinikhi kwaye ifuna iintsuku eziliqela esibhedlele. eziluncedo:

• Kwi-avareji, akukho mfuneko yokuba Ukubulawa jikelele.
• Ukuze ukunciphisa ingozi yokuba ukungabikho ngoncedo eziyimfuneko operable, iintlungu ngenxa yoko libe phantsi, kwimo ezikhawulezayo kuthelekiswa utyando zoqobo.
• Iintlobo zokungenelela endovascular kukho amaxabiso mali nomtsalane.

Kudla kusetyenziswa inkqubo endovascular - a angiography diagnostic. Yintoni i-Centre for Surgery Endovascular?

Licuthe isitya kube dilatation okanye stenting. Xa igazi excess yeziko (ithumba, angiodysplasia, njalo-njalo) okanye ukuhamba kwegazi engaqhelekanga (shunt arteriovenous, varicocele) isicelo embolization nemithambo.
Ukuba nokuxilonga vasodilation zophendlo lwezifo - isetyenziswa intravascular kwemithambo lenkohlakalo, leyo aliquki kwemithambo ukusuka kwindawo flow kwegazi.

indlela TIPS

Ngokubhekiselele izigulane unesifo "lwegazi portal" (high blood pressure kwi vein portal ngenxa nezithintelo yokumpompoza kwegazi ngokusebenzisa kwesibindi) TIPS ubuchule - idaliwe lomnqweno yimfumba 'channel' yokumpompoza kwegazi ukusuka vein Portal esibindini. Oku kunciphisa uxinzelelo lwegazi portal, oko kuyathintelwa esisongela ubomi.

Ukuba kukho umngcipheko lamabutho thrombus lomzimba umthambo elisezantsi kunye umthuthi ngokubhekele kulo pulmonary, zibekele filter cava njengenyathelo umbala.

chemotherapy zengingqi

indlela chemotherapy Regional esetyenziselwa inaliti ekujoliswe kulo ibe organ, ezifana ukumnika kwi pancreatitis etsolo, umhlaza Chemotherapy (catheter Kufakwe ibe umthambo kwaye ngoko ichiza lesitofu ngqo kwi-organ unesifo). Intshayelelo kwi kwemithambo nechemotherapy zidityaniswe ngeoli umahluko eliphakathi - himioembilizatsiya.

thrombolysis

isitya thrombosis usebenzisa thrombolysis lwengingqi. Ukwazisa catheter kummandla ka thrombosis, ilawulwa into ethe iyachithakala a thrombus (thrombolytic) ngqo kwi thrombosis ezonka. Apho thrombus itshitshisiwe ngokungaphelelanga okanye ngokupheleleyo, nto leyo eye yanciphisa tramboliticheskogo idosi iziyobisi.

Ezi ubuchule endovascular azikho ngokupheleleyo. Zenene lanamhlanje abantu abanjalo ukuba utyando endovascular ine ezintsha, ukukhula ngokucacileyo sebe lezamayeza. Uluhlu kweenkqubo ezahlukeneyo zonyango endovascular uyakhula.

Into onokuyenza ngoncedo lwe X-ray?

Uphando kweenqanawa, yegazi okanye imithambo utyhila exineneyo, occlusion kwemithambo yegazi, ugxininiso, ubungakanani semithambo ukwanda, uze uchonge ukopha ngaphakathi, inkqubo ithumba, kwaye ngakumbi, ukuba akunakwenzeka ukuchonga nayiphi na enye indlela.

isebe utyando Endovascular inxaxheba kuphando olunjalo.
Inkqubo ithatha amanyathelo ilandelayo. Ukuze kwenzakalani i kwemithambo okanye umthambo kusetyenziswa yenaliti ezikhethekileyo - kule nasemiphakathweni, kwekhwapha, ngaphantsi clavicle okanye entanyeni. ityhubhu yeplastiki ukugoba - a catheter ukungena kulo isitya. isikhokelo Fluoroscopic kunceda ukubamba catheter empahleni target.

Emva koko kufakwa le catheter umehluko medium ukuba obonakalayo-X-reyi. Iarhente koko, ukusasazwa lwezifundo isiza semithambo, eyenza i X-ray umqadi abadumileyo. Isiphumo phando sitsala i X-ray okanye ividiyo. X-reyi endovascular utyando ukuchonga ngezifo ezahlukeneyo kwimikhumbi kunye izibilini yi indlela ekungenakufumaneka uphando.

Xa ukufunda hagiographic of kunokwenzeka intlungu elifutshane elide ngegalelo lazo kule ndawo yophando. Ngamanye amaxesha unyango iintlungu efunekayo.

iisampulu angiograms

Ngoko ke, njani loo nto ukwenza utyando endovascular kwemithambo carotid? iinqanawa kwakudibana iingqameko okanye kuncitshiswa ngokuthi unike ibhaloni ekhethekileyo ngoko ke olunyuswe kuyo le mithambo. Le nkqubo ibuyisela lowo awufuni patency benqanawa ukuxhokonxa inyathelo, i-jikelele, njengokuba kufanelekile, ngokuba naziphi na iimpahla zabantu.

Le vasoconstriction wondla catheter angiography ukwenza ukuchonga inqanaba licuthe le nqanawa. Ngokusebenzisa yinxalenye emxinwa okanye oluvaliweyo inqanawa wenziwe isixhobo - umqhubi. Emva koko ke catheter ibhaluni ondliwa, leyo esilala isahlulo iingqameko.

Ibhaluni iyavuleka uyasetyenziswa ekuvuleni indawo. Isizathu sokuba isithintelo - ihlwili legazi okanye nebhodi, ezo asasazwa ngokufanayo phezu kodonga waneka kakhulu le nqanawa. Okulandelayo, ibhaluni leyo kumiyo, ngaloo ndlela ekhulula isitya isabelo ubuyiselwa ukuhamba kwegazi ngokupheleleyo.

Isilinda ususa dynamics ezintle esweni angiography ngokuphindaphindiweyo. utyando Kwakhona ethandwayo endovascular kwemithambo vertebral.

Ngenxa kwawo of dilatation

Amaxesha amaninzi, emva dilatation waphawula stenosis eyintsalela ukuba akuyiphazamisi inkqubo eqhelekileyo yokumpompoza kwegazi.

Ukuba dilatation stent okunikezelwe angabi exhasa ngaphakathi inqanawa yaye akayi umnike elimxinwa. Xa stent ibe ubude enyuse ububanzi, indlela eyahlukileyo yofakelo. Le stent sikhethwe ngamnye. Ukuza kuthi ga ngoku, zonke iimpahla zabantu ekhoyo stent endovascular sentliziyo.

isiphelo

Kukho izikhokelo ezahlukeneyo, xa uyeke ukuhamba kwegazi ngokusebenzisa isitya. Kuba embolizirovaniya isikepe oluqhutywa catheter yakhe. Kubalulekile ukuba catheter kufuneka zibekwe ukuze izinto embolization angaweli kwezinye iimpahla. catheter nge isitya esadluliselwa embolizing into okanye isixhobo, ezifana uwele, iplastiki (gelatin) yamasuntswana sclerosant.