Endovascular Opaleshoni: Mitundu ya zikunena

M'zaka khumi zapitazo, endovascular opaleshoni ntchito ndi otchuka, koma chitunda ake anayamba mu 50s kwa zaka za m'ma 20.

A mbiri pang'ono

Swedish radiologist Sven Seldinger analengeza lingaliro la kuyambitsa mu chidebe madzi, ndiko kusiyana wothandizira. Cholinga cha wasayansi anali kupewa odulidwa. Choncho wabwera ndondomeko chotengera puncture singano wapadera kudzera pakhungu.

Iye anadza kupyolera chingwe singano, ozama mu chotengera ndi kulamulira X-ray, singano chikutha ndi chingwe catheter mayikidwe. Kusiyana wothandizila amatanthauzabe catheter, ndiye ine ndinatenga chithunzi cha X-ray filimu. Choncho chinapezeka fano la chotengeracho. The singano kalozera catheter ndi zipangizo zofunika opaleshoni endovascular ndi ntchito lero. Nkofunika kudziwa kuti khalidwe la chida ndi chinsinsi cha chipambano cha ntchito. Apa mmene zinayambira endovascular opaleshoni ya mtsempha wamagazi mkati carotid.

Siteji yotsatira chitukuko amatanthauza 1964. Radiologist Charles Dotter anayambitsa njira ya kuwonjezera chotengera mwapang'ono ntchito zibaluni kufufuma, amene zaikidwa kumapeto mu catheter lapansi. Izi luso angwiro Swiss cardiologist Andreas Gryunttsig. Iye anapanga woyamba zibaluni angioplasty ya mitsempha mtima. Mu zaka khumi zotsatira, munda wa mankhwala ndipo anamupeza mphamvu ya chitukuko. Tikumbukenso chopereka zounikira m opaleshoni mtima ndi: Serbinenko FA, Rabkin I. H., Savelev V. S., Zingerman LS ndi ena.

Lero, opaleshoni endovascular watha kukhala woyendetsa. Iye anatsimikiza chinachitika ake ndipo akuchita.

Za mtima Opaleshoni

Mtima opaleshoni - m'dera la mankhwala, womwenso mankhwala a magazi ndi ziwiya lymph. Tigwiritsa ntchito njira mankhwala monga opaleshoni operable ndi intravascular. Poyamba, cholinga opaleshoni anali matenda. Zikayenda ndi zotsatira za mankhwala analola kukhazikitsa malo osiyana.

mitundu asang'ambe wa opaleshoni amakono mtima. Imayenera ntchito intravascularly zotheka chifukwa cha umisiri wotsogola mankhwala, potero endovascular opaleshoni imatengedwa wodziimira apadera yopapatiza mbiri, yomwe inatenga malo ake ndipo anapanga njira kuti opaleshoni chikhalidwe.

Mawu akuti "endovascular" kutanthauza "intravascular" ndendende limafanana limatchula lapansi. Ndi njira chilengedwe kuti ntchito kwa pathologies zosiyanasiyana mtima ndi ducts intraorgan.

The mitundu ikuluikulu ya

Endovascular Opaleshoni zikuphatikizapo rentgenohirurgii, interventional cardiology, interventional Radiology - izi mitundu ya alowererepo opaleshoni, yomwe ikuchitika pa magazi chotengera kudzera mwayi percutaneous kulamulira kulingalira cheza.

Ubwino waukulu wa opaleshoni intravascular - phukusi kudzera punctures ting'onoting'ono pakhungu ndi X-ray ulamuliro wa mpheto lapansi.
Endovascular zikunena matenda ndi achire ankachiritsa kuchipatala ndipo amafuna masiku angapo m'chipatala. ubwino:

• Pafupifupi palibe kufunika kwa mankhwala ochititsa dzanzi ambiri.
• Kuti chiopsezo pakalibe zikunena zofunika kuchepetsa operable, chifukwa m'munsi ululu, mofulumira konzanso poyerekeza opaleshoni zachikhalidwe.
• Mitundu ya zikunena endovascular ndi wokongola bajeti mitengo.

Nthawi zambiri ntchito endovascular ndondomeko - ndi matenda angiography. Kodi Center kwa Endovascular Opaleshoni?

The kuchepetsa chotengera kuti akhale dilatation kapena stenting. Pamene owonjezera magazi kundipatsako kwa chiwalo (chotupa angiodysplasia, etc.) kapena nthenda yotaya magazi (arteriovenous shunt, varicocele) ntchito mtima embolization.
Ngati matenda pathological vasodilation - intravascular aneurysm kumezanitsa ntchito, zomwe silikuphatikiza aneurysm m'dera magazi.

Methodology ZOTHANDIZA

Mokhudzana ndi odwala ndi matenda a "oopsa zipata" (kuthamanga kwa magazi mu mtsempha zipata chifukwa cha kutsekeka kwa magazi kudzera chiwindi) MUNGACHITE njira ntchito - analenga kuthyolako "njira" kwa magazi kuchokera mu mtsempha zipata mu chiwindi. Izi amachepetsa zipata magazi, izo kupewedwa moyo pachiswe.

Ngati pali chiopsezo detachment wa thrombus a m'munsi nthambi mtsempha ndi transporter zina iwo mu mtsempha wamagazi ndi m'mapapo mwanga, ndiye anapereka Zosefera cava ngati muyeso prophylactic.

Morning dera

Regional mankhwala amphamvu njira ntchito chandamale kulowetsa limba ndi, monga kulowetsedwa mu kapamba pachimake, khansa Morning (catheter anaikapo mu mtsempha wamagazi ndipo kenako mankhwala jekeseni mwachindunji mu limba matenda). Chiyambi mu mtsempha wamagazi mankhwala amphamvu osakaniza ndi mafuta Mosiyana sing'anga - himioembilizatsiya.

thrombolysis

Thrombosis chotengera ntchito thrombolysis dera. Powapatsa catheter mu dera thrombosis, ndi kutumikiridwa mankhwala kuti amasungunula ndi thrombus (thrombolytic) mwachindunji mu thrombosis ndi moto. Umene thrombus ndi pang'ono kapena kwathunthu kotero, potero kuchepetsa tramboliticheskogo mlingo mankhwala.

njira izi endovascular sali mu zonse. Zenizeni za tsiku masiku ano ngati kuti endovascular opaleshoni ali ndi nzeru, kukula exponentially nthambi ya mankhwala. Mndandanda wa njira zosiyanasiyana achire endovascular zambiri.

Zimene mungachite mothandizidwa ndi X-ray?

Research ziwiya, mitsempha kapena mitsempha limasonyeza kuchepetsa, occlusion Mitsempha, cholinga, kukula kwa matenda kuwonjezeka chotengera, ndi kuzindikira magazi mkati, ndondomeko chotupa, ndi zina zambiri, kuti n'zosatheka kudziwa njira ina iliyonse.

Endovascular dipatimenti opaleshoni chinkhoswe kafukufuku amenewa.
Ndondomeko zambiri zinthu zotsatirazi. Kuti puncture mtsempha wamagazi kapena mtsempha ntchito singano wapadera - mu groin ndi, armpit, m'munsimu clavicle kapena m'khosi. Yokhota kumapeto pulasitiki chubu - ndi catheter kudutsa mu chotengeracho. malangizo Fluoroscopic amathandiza kusunga catheter mu chandamale chotengeracho.

Ndiye zimalowa ndi catheter Mosiyana sing'anga kuti ndi kuonekera X-ray. Kusiyana wothandizira, kufalitsa nkhani malo mtima, kulipangitsa kukhala otchuka X-ray mtengo. The chifukwa cha phunziroli analanda ndi X-ray kapena kanema. X-ray endovascular opaleshoni kudziwa kudwala osiyana ziwiya ndi ziwalo ndipo ndi njira irreplaceable kafukufuku.

Pamene hagiographic kuphunzira zotheka ululu yochepa ya osiyanasiyana mwamphamvu m'dera kuphunzira. Nthawi zina mankhwala ululu chofunika.

zitsanzo angiograms

Kotero, momwe anachita endovascular opaleshoni ya mitsempha carotid? ziwiya Overlapped mwapang'ono kapena yafupika mwa kuyambitsa zibaluni wapadera ndiye ndi mpweya mu lumen wa. njirayi imatsitsimula patency chombocho sayenera zotheka, chilengedwe, monga applicable, zotengera munthu aliyense.

The vasoconstriction kudyetsedwa catheter angiography kuchita kudziwa mlingo wa kuchepetsa a chotengeracho. Kudzera gawo yopapatiza kapena chatsekedwa chombocho ikuchitika chida - kondakitala. Ndiye zibaluni catheter akudyetsedwa, amene overlaps gawo mwapang'ono.

The zibaluni zambiri m'dera mwapang'ono. Chifukwa chiletso - nthinthi magazi kapena zolengeza, omwe amafalitsidwa uniformly pa khoma kwambiri anatambasula chombocho. Kenako, zibaluni ndi ataphwetsedwa, potero anamasulidwa cholandirira gawo lomwe wabwezeretsedwa ku mtsinje zonse magazi.

Cylinder amachotsa mphamvu zabwino kuunikira angiography mobwerezabwereza. Umakopa endovascular opaleshoni ya mtsempha wamagazi ndi vertebral.

Ndi kupanda dilatation

Nthawi zambiri, pambuyo dilatation anati yotsalira stenosis yomwe sikusokoneza ndi ndondomeko wabwinobwino wa magazi.

Ngati dilatation osamveka analimbikitsa stent zothandiza mkati chotengera ndi sudzapereka iye yopapatiza. Mu stent ukhale wa kusinthasintha m'litali ndi awiri, njira ina unsembe. The stent amasankhidwa payekha. Pakali pano, ziwiya zonse anthu kupezeka kwa endovascular inatsekeratu stent.

Pomaliza

Pali zizindikiro zosiyanasiyana, polekera magazi kudzera chotengeracho. Chifukwa chotengera embolizirovaniya ikuchitika catheter wake. Nkofunika kuti catheter ndi adzaikidwe kuti embolization zakuthupi si kugwa mu ziwiya zina. catheter kudzera chotengeracho zoperekedwa embolizing mankhwala kapena chipangizo, monga mwauzimu, pulasitiki (gelatin) tinthu sclerosant.