Endovascular Ukuhlinzwa: Izinhlobo ukungenelela

Phakathi neminyaka eyishumi edlule, ukuhlinzwa endovascular kusebenza futhi ethandwa, kodwa ukunyukela kuwo baqala in the 50s yekhulu lama-20.

Umlando omncane

radiologist Swedish Sven Seldinger wamemezela umbono yokwazisa emgqonyeni ketshezi, okungukuthi, i-ejenti ukuze kuvele umehluko. Inhloso usosayensi kwakumelwe agweme cut. Ngakho-ke ufikile inqubo isitsha wokubhoboza inaliti ekhethekile ngesikhumba.

Weza ngokusebenzisa string inaliti, engena phakathi isitsha ngokulawula ze-X ray, inaliti kuyinto ekhishiwe futhi kufakwe string ipayipi. I-ejenti Ngokuphambene lasetshenziswa the ipayipi ke ngathatha isithombe-X-ray ifilimu. Ngakho-ke etholwe isithombe bomkhumbi. I ipayipi inaliti Umhlahlandlela zingamathuluzi eziyisisekelo ekuhlinzeni endovascular futhi wasebenzisa namuhla. Kubalulekile ukwazi ukuthi izinga ithuluzi kuyisihluthulelo ekuphumeleleni kwalo msebenzi. Nansi indlela yokukwenza umsuka ukuhlinzwa endovascular yangaphakathi carotid Umthambo.

Isigaba esilandelayo sokuthuthuka libhekisela 1964. Radiologist Charles Dotter wasungula indlela ukunweba isitsha ayisesemikhulu Usebenzisa ibhaluni inflatable, okuyinto eziboshelwe ngasekugcineni ku ipayipi. Lokhu emisha phelelisa wenhliziyo Swiss Andreas Gryunttsig. Wenza ibhaluni angioplasty lokuqala imithambo yenhliziyo. Phakathi neminyaka eyishumi ezayo, emkhakheni wezokwelapha, yayifica Dynamics ukuthuthukiswa. Kufanele kuqashelwe okomnikelo izinkanyiso sendawo ukuhlinzwa semithambo yilezi: Serbinenko FA, Rabkin I. H., grishkovec V S., Zingerman LS nabanye.

Namuhla, ukuhlinzwa endovascular uyekile abe umshayeli. Uye ngokuqinile ezithathwe endaweni yalo futhi uthuthuka.

Mayelana Vascular Surgery

ukuhlinzwa Umhlinzi - indawo imithi, okubandakanya ekwelapheni igazi lymph izitsha. Sisebenzisa indlela yokwelapha njengoba ukuhlinzwa operable futhi intravascular. Ekuqaleni, injongo ukuhlinza kwakuvame zokuxilonga. Izimpumelelo kanye nemiphumela yokwelashwa bavunyelwe usethe endaweni ehlukile.

zinhlobo kancane koda kungokwalabo ukuhlinzwa yesimanje semithambo. ukusebenza ngokuyikho intravascularly Sibonga kungenzeka ukuba ubuchwepheshe ezintsha kwezokwelapha, ukuhlinzwa kanjalo endovascular kubhekwa ezimele, ezikhethekile iphrofayela ewumngcingo, eyaqala yayo futhi yenza okunye ukuhlinzwa bendabuko.

Igama elithi "endovascular", okusho ukuthi "intravascular" ncamashi oluhambisana imininingwane. Kuyinto indlela jikelele okungukuthi ezisebenzayo pathologies ezehlukene semithambo kanye Amapayipi intraorgan.

Izinhlobo ezinkulu

Endovascular Ukuhlinzwa kuhlanganisa rentgenohirurgii, nezenhliziyo interventional, Radiology interventional - lokhu izinhlobo kokungenela kuhlinzwa, okuyinto eyenziwa womkhumbi igazi nge ukufinyelela percutaneous ukulawula imaging ngemisebe.

Inzuzo enkulu ukuhlinzwa intravascular - lokhu kokungenela ngokusebenzisa punctures ezincane esikhumbeni futhi -X-ray control of the zokukhwabanisa.
ukungenelela Endovascular zokuxilonga nokwelapha yayidlalwa umtholampilo futhi adinga izinsuku ezimbalwa esibhedlela. izinzuzo:

• Ngokwesilinganiso, asikho isidingo ngoba ukubulawa kwezinzwa okuvamile.
• Ukuze wehlise ingozi ukungabi khona ukungenelela kudingekile operable, ubuhlungu ngenxa yalokho ephansi, ukuvuselelwa okusheshayo kuqhathaniswa ukuhlinzwa classical.
• Izinhlobo ukungenelela endovascular zinhle isabelomali zamanani.

Ngokuvamile wasebenzisa inqubo endovascular - a angiography zokuxilonga. Yini Centre for Kokuhlinza Endovascular?

I ukuvaleka isitsha ukwenza kube dilatation noma stenting. Lapho ngokweqile igazi supply uhlaka (isimila, angiodysplasia, njll) noma ebonisa ukuthi awuphilile engqondweni ukugeleza kwegazi (shunt arteriovenous, varicocele) zisebenza embolization semithambo.
Uma ukuxilonga vasodilation sokugembula - intravascular useshonile xhumelela isetshenziswa, okuyinto akufaki useshonile kusukela ukugeleza kwegazi ndawo.

Indlela Yokwenza AMACEBISO

Ngenhlonipho iziguli kwathiwa unesifo "umfutho wegazi ophakeme portal" (umfutho wegazi ophakeme esikhathini vein portal ngenxa ukuvimbela ukugeleza kwegazi ngokusebenzisa isibindi) AMACEBISO nqubo eyayisetshenziselwa - kudalwa Hack "isiteshi" wegazi ephuma vein portal esibindini. Lokhu kunciphisa portal blood pressure, it is kuvinjelwe ingozi kakhulu empilweni.

Uma kukhona ingozi lamabutho ka thrombus letincane esitho umthambo nge Transporter okwengeziwe ngabo esandleni Umthambo yamaphaphu, bese usetha izihlungi cava njengoba isilinganiso prophylactic.

ngelashwa nangemithi lesifunda

Regional nokwelashwa ngamakhemikhali indlela esetshenziselwa umjovo target ku uhlaka, ezifana ukumnika e pancreatitis acute, umdlavuza Ukwelashwa ngamakhemikhali (ipayipi ifakwe i Umthambo bese izidakamizwa is injected ngqo isitho onesifo). Isingeniso ku umfula ngamakhemikhali lihambisana uwoyela Ngokuphambene naphakathi - himioembilizatsiya.

thrombolysis

Thrombosis isitsha usebenzisa thrombolysis lesifunda. Kwethulwa ipayipi endaweni ka thrombosis, iqondiswa ikhemikhali ancibilikisa a thrombus (thrombolytic) ngokuqondile thrombosis kwemizi. Lapho a thrombus kancane noma ngokuphelele ziyoncibilika, ngaleyo ndlela sinciphise tramboliticheskogo izidakamizwa umthamo.

Lezi zindlela endovascular akuzona ngokugcwele. I namaqiniso kwanamuhla yokuthi ukuhlinzwa endovascular ine ezintsha, ezikhulayo exponentially legatsha wezokwelapha. Uhlu zokwelapha izinqubo ezahlukene endovascular yandisa.

Ongakwenza ngosizo-X-ray?

Ucwaningo imithambo yegazi noma ngemithambo lembula ukuvaleka, occlusion imithambo yegazi, focus, ubukhulu isifo ukunwetshwa isitsha, futhi ukukhomba ukopha zangaphakathi, inqubo isimila, nokuningi, ukholelwa ngokuqinile ukuthi akunakwenzeka ukuba abone iyiphi enye indlela.

umnyango ukuhlinzwa Endovascular waziphatha ucwaningo olunjalo.
Inqubo ngokuvamile izinyathelo ezilandelayo. Ukuze lubhoboze i Umthambo noma umthambo is wasebenzisa inaliti encanyana ekhethekile - e imbilapho, ikhwapha, ngezansi clavicle noma entanyeni. Lwalugobile plastic tube - ipayipi ukungena esikebheni. isiqondiso Fluoroscopic kusiza ukubamba ipayipi ku umkhumbi.

Khona-ke wasuthisa singene ipayipi Ngokuphambene naphakathi okuwukuthi ebonakalayo X-ray. I-ejenti Ngokuphambene, ukusakazwa kwezindaba kuncike isayithi semithambo, okwenza kube esivelele-X-ray uvumelanise. Umphumela cwaningo ithumba -X ray noma ividiyo. -X-ray ukuhlinzwa endovascular ukuhlonza zokugula ezahlukene izitsha kanye izibilini kuyindlela Irreplaceable zocwaningo.

Lapho isifundo hagiographic yezingozi nobuhlungu besikhashana okushiyashiyanayo ngamandla endaweni cwaningo. Ngezinye izikhathi yokwelapha ubuhlungu kuyadingeka.

amasampula angiograms

Ngakho, indlela ukuthi bahlinza endovascular kwemithambo yegazi carotid? izitsha ezidlulanayo ayisesemikhulu noma kwanciphisa ngokwethula ibhaluni ekhethekile ke is Ayihaba kuyo mafutha anciphisa isikhala esingaphakathi. Le nqubo, elikhishiwe kwezinye izinguqulo patency bomkhumbi akadingi ingayala isinyathelo, jikelele, njengoba kufanele, ngoba iyiphi izitsha womuntu.

I vasoconstriction fed ipayipi angiography ukwenza ukuhlonza ezingeni ukuvaleka bomkhumbi. Ngokusebenzisa ingxenye encane noma avaliwe isikepe eyenziwa ithuluzi - umqhubi. Khona-ke ipayipi ibhaluni sidla, okuyinto ligamanxa ingxenye ayisesemikhulu.

Ibhaluni wenabisa endaweni ayisesemikhulu. Isizathu sokuba izivimbelo - ihlule legazi noma uqwembe, okuyinto anikezwa nombala phezu kodonga kakhulu welulela bomkhumbi. Okulandelayo, ibhaluni is deflated, kanjalo wakhulula ayesisebenzisa ingxenye okuyinto babuyiselwe ukugeleza kwegazi egcwele.

Emqulwini kususa Dynamics omuhle waqashwa angiography okuphindaphindiwe. ukuhlinzwa Futhi okudume endovascular we Umthambo vertebral.

Nge ukwehluleka dilatation

Ngokuvamile, ngemva dilatation waphawula stenosis asalile ukuthi kungaphazamisi ngenqubo evamile ukugeleza kwegazi.

Uma dilatation ayizwakali stent letiphakanyisiwe esekela ngaphakathi isitsha futhi ngeke amnike emincane. Esikhathini stent kungenzeka ubude obuhlukahlukene futhi ububanzi, indlela ehlukile ukufakwa. I stent ikhethwa ngamunye. Kuze kube manje, nezitsha zonke womuntu etholakalayo endovascular stent yenhliziyo.

isiphetho

Kukhona izinkomba ezahlukene, lapho ukuyeka igazi ukugeleza ngokusebenzisa umkhumbi. Ukuze embolizirovaniya isikepe kwenziwe ipayipi yakhe. Kubalulekile ukuthi ipayipi kufanele libekwe ukuze impahla embolization ongawi ezinye izitsha. ipayipi ngokusebenzisa umkhumbi lidluliselwe embolizing into noma idivayisi, okufana Kuvunguza, plastic (gelatin) kuyizinhlayiyana sclerosant.