Hemostatic: hōʻikeʻano a me ka hōʻike manaʻo

Hemostatic pakalōlō i hoʻohana kahe ana ke koko ma ia ua lawe pio ia ana, a me ka? Aiaiiuie mīkini'opihia o ke kahe ana ke koko moku a me ke kumu o ka moku hookaawale ae. I ka laulā o ka nui like 'ole o kēia mau mea paahana mai he mau kakini. Kēia 'ano ku i ke alo o na moku o kekahi mau nui like' ole mai ka 1 a hiki i 20 mm o, a me ka hoʻohana 'ana i kūpono like hemostasis. Small moku hookaawale ae i hana, loaʻa mea'ūmiʻi, a laila ka hopuʻana ligated ma luna (sutured) kumu pae.

Hemostatic, a e hoʻohana ai i ka manawa E'ō'ū moku i oko ao. Ka mea'ūmiʻi ua papahana e hooki aku i ke kahe ana ke koko, mai na moku uuku koko, ka mea hiki iki i ka hope o ka moku. E like me ka rula, ka mea, ua i mai oʻoʻoleʻa mea. Clamps, i mea i kapaia vascular, i ka laholio mea, ma muli o ia mau hiʻona o ko lākou mau manao. Nā inoa o kēia mau mea paahana mea oo pahuhopu nei me kā lākou Manao iho la ia ana. Ma ka ulia pōpilikia, ka mea hiki ke hoʻohana 'ia no fixation o kahei.

Eia naʻe, ua pono hoomanao i hemostatic pakalōlō, ma ka liʻiliʻi loa koke pili no ka fixation o kahei a pulupulu kala a me gauze, hiki hou ke hoʻohana 'ia no kona Manao iho la ia mea. Keia mea aie a hiki i ka deformation o ka hana 'ana, a me ka poho o ka functionality. I ka wā e hiki mai, ka mea, e hōʻailona, a hoʻohana 'ia wale no ka hoʻopunipuni nā kala a me kahei.

Olelo no ka maʻi

Hemostatic pono halawai pu me ke kēia mau koi:

• Ike loea fixation ma ka hope o ka moku, e ole e ae slippage.
• Me ka puana 'ana o ko lākou waiwai e ole e nalowale.
• Ke koʻi lipi ma Pono e oluolu e kuhikihi ana mai, a e wehe ma lalo o ka aoao o ko ka surgeon ka lima.
• Ka lakaʻano papa hana pono ia a paa koho i ka mau a, pale inadvertent puka. E hana i kēia, no ka laʻana, pono kahu i loko o ka palapala ana i hoowalania iho ai i.
  I ka panina a me ka weheʻana o nā ā, Nākulukulu nō, mai ke kiekie mai o 1 mika kani pono ole spontaneously wehe i ka hanaʻili, a me ka pinepine ae la oia e ole i ia mau mea pololei.
• Pono e hoʻokō ai me na rula o ka ergonomics.
• He lauwili anei, Ma waho aʻeo ka lacerations i kānāwai ma lalo o ke kau paona ana o ka pakalōlō, kau ma luna o kaʻeha lua penei.
• Mākou e ae i ka pono o ka electrocoagulator.
• Kona nui,ʻaʻole e aeie hōʻuluʻulu manaʻo o ka meaʻoki lāʻau lapaʻau kula.
• Ke Aloha i ka mea kökua ka pono hoʻopili like i ke anawaena o ka moku.

Mea Maluna o clamps

Hemostatic māheleʻia i loko o kekahi mau subgroups:

1. Hemostatic pakalōlō ka hoʻolako '? Aiaiiuie ka hopuʻana wahi ma mua ligation a hoʻokō i paa electrocoagulation (notched hemostatic Clip).

2. Vascular clamps, hulina i noho koko a me ka hele 'ana o ka pono o ka moku (angiorrhaphy) e hoihoi mai.

3. palaoa clamps i ka paipai i ke kahua o ka thrombus i loko o ka moku lumen ma hope ana i ka Clip.

mea i manao ai Hiʻona

Hemostatic pakalōlō i haku o nā māhele a i ma lalo iho:

• Ā (ā).
• Mea e paʻa ai i nā apo.
• Collapsible a kuli kākela.
• I hoowalania iho ai.

Palapala ā (ā)

1. Triangular elongated, e laʻa me, neurosurgical Halstead clamps.
2. Trapezoidal kuhikuhi, e laʻa me, Billroth mea'ūmiʻi.
3. Me ka trapezoidal niho, no kekahi laʻana, he Kocher mea'ūmiʻi.
4. Ka'ololaha, no ka laʻana, Pean forceps.

Clips hiki i pololei a me ka uma ā. Notches ma ka iwi ā surfaces aeia nā transverse a me kēlā. Hemostatic forceps, uma ua hoʻohana loa pinepine ana.

Kocher mea'ūmiʻi

Kocher mea'ūmiʻi i mau niho i ka hopena. Ka mea, i paa paa ma ka hope o ka moku, e like me ma ka panina o kekahi o kona hapa o ka nihoʻae ma waena o ka mea'ē aʻeʻelua.

Mamua o kaʻoki kino, ka surgeon e kino e kaha i keʻano o hemostatic pakalōlō (kuʻi, pololei, Hālawa - 'aʻole i mea), no ka mea,:

• poino i na niho hiki i hoowalania iho ai i samorazmykanie mea paahana, i mea pilikia loa i kea-ka hopuʻana o ka moku nui.
• skewed hana wahi e ole ae i ka pono hooki i ke kahe ana ke koko.

Clamps ā oko in shape, ka holoʻokoʻa o ka hanaʻili, manao a me ka nui o na mea hana.

'ano o nā clamps

ʻO kēia mau 'ano o ka pakalōlō:

1. hemostatic kauoha kapa, a me ka lōʻihi o 15 a hiki i 20 knm, a i ka releasable laka hoʻohewa, a me ka kēlā notch ma luna o ka hana surfaces o na ā. Na welau o na ā i niho ma kekahiʻaoʻao, hoʻokahi aʻelua ma ka kekahiʻaoʻao. I ka panina o ka hale kākela kekahi o na niho e haule ma waena o ka mea'ē aʻeʻelua.

2. transverse notch, ka mea i'ālike notched, akā, i ka hana 'ilikai i ka transverse ana. I ka kuhiliʻole kila, i ka ili Ua anaiia i ka alohi mai. Lōʻihi mai ka 16 a hiki i 20 knm, hiki e pololei paha uma.

3. Neurosurgical hemostat "mosquito", Lightweight, lōʻihi 15,5 knm, i ka laka hoʻohewa. Ka huahuakai i ka pauku lonikū i loko o ke kinona o ka truncatedʻohana, ma kā lākou mau hana ili honua o ka lahilahi transverse notching. Available Hālawa a pololei hoʻopapakū a horizontally. ʻano nui i hoʻohana no ka hemostasis o ka moku liʻiliʻi ma neurosurgical kaʻina hana.

4. O na keiki a ka "mosquito" ma ka 'ole i' ano like me ka mea mua, akā, i thinner ā. Lōʻihi 12,5 knm, e hoi pololei a me ka uma. Papahana no ka angioplasty kanaka arachnoid lolo ma pediatricʻoki kino, no ka ana ma ka parenchymal nā loko.

5. Deep abdominal, manao no ka hemostasis a vascular ligation i ka eha hohonu. Lākou lōʻihi o 26 knm, ka huahuakai i pololei ole uma i ke ÿano, a me ka pōkole loa.

Clips o ka "Mosquito" i lawe ai i na inoa o Halstead pakalōlō. Okoa ke olonā hanaʻili. изогнутый используется для новорожденных. Clip "Mosquito" kūlou ihola ia no nā pēpē. небольших сосудов в процессе нейрохирургических операций. Mea lapaʻau hemostasis moku uuku iloko o neurosurgical hana.

Mea'ūmiʻi Billroth ka hopuʻia a me ka mole ipu koko. He Ua hana pūliki pono aʻelaʻo ā a me ka meaʻuʻuku incision, a me ka tapered ili ma luna o ka waho. Pīhoihoi ā i hoʻolako pono me incisions, kūpono i emi'aʻaʻa poino.

Mea'ūmiʻi Popper mea he lōʻihi pololeiʻoki lāʻau lapaʻau mea'ūmiʻi, a ua hoʻohana 'ia i loko o ke au bladder hana.

E like me ka Clip ua noi ia?

Ma mua o ka hana i ka surgeon e kino e kaha i ka hana o clamps. He oi loa oiaio me ka nui arteries. No ka laʻana, overlapping phrenic-gastric ligament, e aho, ka mea kŰlń ao i ka hema gastric artery mea'ūmiʻi i mea hemahema, Ua fraught pakele hope o ka moku, a hiki alakai i ka mea kahe ana ke koko.

Pehea e nakradyvat pakalōlō?

Ka laula o ka hapa o ka mesentery (ligament) me na moku e i ho'āʻo malaila, e e inversely hapaʻauhau i kona mānoanoa.

E hoʻomanaʻo i nā kēia:

- ka iʻa wale o ka nui nui i koe, hiki nekrozirovat i hiki i purulent li nui;

- hanana o ka nuiʻilikai āpana deserozirovannoy ke alakai i ka lina maʻi;

- ligature, i ua superimposed ma ka bulk momona, hiki ke Nyos i kekahi manawa.

Ma ka loa noho pilikia pauku o ligaments (ka mesentery), i ka poe i e ole e wehe, ligatures a me ka pakalōlō e hoʻokō i kekahi surgeon i weheʻia māhele o ka mesentery hoʻokō i kā lākou mau kumu.

Excision o ka ligament paha o ka mesentery ma waena o nā clamps ua i kokoke i ka wahi i koe. Ka buke o na kumu i koe mea maikaʻi, e hana i kekahi wahi hou aku, ka mea e malama aku ai i ke kumu hoʻomalu i ka hālāwai hope e ole ana ligatures.

Clamps a ligatures ma luna o nā ligaments ua? Aeiiaiaoaony e pili i ka hōʻemi iki huina, e like me keia maoli ka buke o ke kumu, a me keia ka poʻea pau i ka ikaika fixation ligatures.

Aia nō i ka keia mau rula, i pono ia e hahai:

1. No ka welau o na ligatures e huki. No laila, ka mea hiki ke haehae aku i ka hope o ka moku.

2. E hoʻomanaʻo huina o 40-50 degere ma waena o ka pelane o nā'ūpā kōmi 'nāu kekahi Cooper a me nā huakaʻi.

3. Ka lalo huhui o nā'ūpā mea pono e hoomaha i loko o kaʻaha kanaka.

4. Ka oki hope o ka ligature pono i oi aku mamua o 1-2 mm o.

Hemostats no ka eha he kapu

E hoomaopopo i ka eha mai o kaʻili, IeAUPIIe, IAa IO hoʻohana notched hemostatic Clip laina (1160 mm o lōʻihi).

Ke kai kohola eha he kūpono e pili 'ana. Akā, no ka hoʻopili i ka gauze i ka subcutaneous momona e oi pono no uma hemostats.

Waho pūnaewele oʻoki lāʻau lapaʻau mea hana

Mea Hana 'hūnā i wela maloo wahi ma ka wela o 15-20 ° C. Ka mea pono ole ia i loko o ka hookahi lumi me ia waiwai paʻa i hiki i ka popopo o ke hooheheeia (formalin, iodine, Hekikai).

Mea Hana 'ia no keia hana i waiho mai i loko o ka cupboards, a me ka ka hoʻomaopopoʻana iā lākou ma ke' ano a me ka mākaʻikaʻi. O na mea i hanaia o ka kalapona kila, iloko o ke ana amo a waho pūnaewele hoʻokō ''ākilikai vaseline a paraffin uhi. No keia hopenaʻaila kā jelly ua maule i ka wela o 60-70 ° C, ua bapetizo i loko o laila i ka hana, a laila, ua wahiia i ke mahuahua pepa.

Lubricant hana i ole malalo o na kēia mau pono hana: kuhiliʻole kila, Aluminum, keleawe, he keleawe. E hoomakaukau ai i na mea paahana e oil: degrease, a hoʻolapalapa i ka wai me ka soda a me ke kopa a me ka wai, maloʻo, nānā 'ia ai no ka lepo, na ka popo wehe ma ka anaiia. Aaioee hana wale me Loan e halihaliia oia iwaho, me potozhirovye ko läkou 'ke alakai i ka lepo ho okumu.

Ua kūkā mākou i loko o au mamuli o ka 'inikua hemostatic clip, kona ano, rula o ka pono a me ka pūnaewele.