Hemostatic: kev piav qhia thiab kev txheeb xyuas

Hemostatic clips yog siv los nres los ntshav los ntawm lawv yog ntes, thiab ib ntus compression ntawm ib tug los ntshav txog ntsha los yog lub hauv paus ntawm lub severed txog ntsha. Qhov ntau thiab tsawg ntawm cov cuab yeej muaj ib tug ob peb lub kaum os. Qhov no muaj ntau haiv neeg vim muaj cov hlab ntsha ntawm ntau ntau thiab tsawg los ntawm 1 mus rau 20 mm, thiab siv ntau yam kev kawm hemostasis. Me hlab ntsha severed thaum lub sij hawm kev lag luam, tuav clamp thiab ces clamping ligated saum toj no (sutured) hauv paus xov.

Hemostatic, uas yog siv los mus ib ntus tes hlab ntsha muaj sib txawv. Cov clamp yog tsim los nres lub los ntshav los ntawm qhov me me cov hlab ntsha, nws yuav raug mob rau ntawm lub kawg ntawm lub nkoj qab thus. Raws li ib tug txoj cai, nws yog ua los ntawm tawv cov ntaub ntawv. Clamps, uas kuj hu ua vascular, ua los ntawm cov elastic cov ntaub ntawv uas, vim cov nta ntawm lawv tsim. Lub npe ntawm cov cuab yeej yog tag nrho raws li lawv npaj siv. Nyob rau hauv ib qho xwm ceev, lawv yuav siv tau rau fixation ntawm napkins.

Txawm li cas los, peb yuav tsum nco ntsoov hais tias hemostatic clips, yam tsawg kawg ib zaug thov rau fixation ntawm napkins los yog paj rwb khoom thiab gauze, yuav tsis muaj lawm siv tau rau nws npaj lub hom phiaj. Qhov no yog vim lub deformation ntawm cov ua hauj lwm ib feem thiab txoj kev poob ntawm functionality. Nyob rau hauv lub neej yav tom ntej, lawv yuav tsum kos thiab tsuas yog siv rau kho cov khoom thiab napkins.

Yuav tsum muaj rau terminals

Hemostatic yuav tsum tau raws li cov cai nram no:

• Txhim khu kev qha fixation nyob rau thaum xaus ntawm cov hlab yuav tsis pub slippage.
• Nrog rov siv lawv tej khoom yuav tsum tsis txhob poob.
• Lub cuab tam yuav tsum yooj yim rau txuas thiab yuav qhib nyob rau hauv tus ntawm tus kws phais txhais tes.
• Lub locking mechanism yuav tsum securely kho lub puab tsaig, tiv thaiv inadvertent qhib. Ua li no, piv txwv li, tsim retainer nyob rau hauv daim ntawv ntawm racks.
  Thaum poob los ntawm ib qhov siab ntawm 1 Meter ntsuas yuav tsum tsis txhob nthawv qhib lub chaw ua hauj lwm nto, thiab pheej kaw thiab qhib ntawm lub puab tsaig yuav tsum tsis txhob ua rau lawv ncaj.
• Yuav tsum ua raws li cov kev cai ntawm ergonomics.
• Lightness, tsis suav lacerations uas tej zaum yuav tshwm sim nyob rau hauv lub ceeb thawj ntawm lub clips, yuam rau lub qhov txhab npoo.
• Peb yuav tsum tso cai rau cov kev siv ntawm electrocoagulator.
• Nws loj tsis los thaiv txheej txheem cej luam ntawm lub phais teb.
• Xaus ntawm lub cuab tam yuav tsum sib haum mus rau txoj kab uas hla ntawm cov hlab ntsha.

kev faib ntawm clamps

Hemostatic faib ua ob peb pab pawg:

1. Hemostatic clips muab ib ntus clamping receptacles ua ntej nyuam los yog kom tuav electrocoagulation (Notched hemostatic clip).

2. Vacular clamps, ib ntus siv ceev xwmphem cov ntshav txaus thiab cia los lub sam xeeb ntawm cov hlab (angiorrhaphy).

3. crushing clamps uas txhawb lub tsim ntawm thrombus nyob rau hauv cov hlab lumen tom qab ua ntawv thov cov clip.

tsim nta

Hemostatic clips yog muaj li ntawm qhov chaw uas muaj li nram no:

• Puab tsaig (puab tsaig).
• Tuam haujlwm txais nrog rings.
• Collapsible los yog lag ntseg tsev fuabtais.
• Racks.

Daim ntawv lub puab tsaig (puab tsaig)

1. Voos elongated, e.g., neurosurgical Halstead clamps.
2. Trapezoidal taw tes qhia, e.g., Billroth clamp.
3. Nrog Trapezoidal hniav, piv txwv li, ib tug Kocher clamp.
4. Dawb, piv txwv li, Pean Ncais.

Clips yuav muaj ncaj thiab nkhaus lub puab tsaig. Notches rau lub puab tsaig chaw pub ob transverse thiab oblique. Hemostatic ncais, nkhaus yog siv ntau heev.

Kocher clamp

Kocher clamp muaj cov hniav nyob rau thaum xaus. Lawv muaj nrees tsau nyob rau thaum xaus ntawm lub nkoj qab thus, raws li nyob rau kaw ntawm ib qho ntawm nws ib feem ntawm tus hniav clearance ntawm lwm ob.

Ua ntej qhov phais, tus kws phais yuav tsum tus kheej mus saib tus mob ntawm hemostatic clips (toothed, ncaj, nkhaus - tsis), vim hais tias:

• kev puas tsuaj rau cov hniav yuav ua rau racks samorazmykanie cuab tam, uas yog heev txaus ntshai thaum lub sij hawm tus ntoo khaub lig-clamping ntawm ib tug loj txog ntsha.
• skewed ua hauj lwm qhov chaw yuav tsis pub kom zoo tsis txhob muaj cov ntshav.

Clamps jaws txawv nyob rau hauv zoo lawm, qhov profile ntawm cov ua hauj lwm nto, lub hom phiaj thiab qhov luaj li cas ntawm cov seev.

hom clamps

Cov nram qab no hom ntawm clips:

1. hemostatic ncaj iav thiab ib tug ntev ntawm 15 mus rau 20 cm, los yog muaj ib tug releasable locking cov ntsia hlau, nrog ib tug oblique thais rau cov ua hauj lwm tej chaw ntawm lub puab tsaig. Lub xaus ntawm lub puab tsaig muaj hniav rau ntawm ib sab, ib tug thiab ob tug nyob rau lwm yam sab. Thaum lub kaw ntawm lub tsev fuabtais ib tug ntawm cov hniav yuav tsum poob ntawm lwm ob.

2. transverse thais, lawv yeej zoo tib yam Notched, tab sis cov ua hauj lwm nto muaj ib tug transverse tej. Ua los ntawm stainless steel, tus nto yog polished mus rau ib tug ci. Length los ntawm 16 mus rau 20 cm, yuav ncaj nraim los nkhaus.

3. Neurosurgical hemostat "yoov tshaj cum", khaub-ncaws nyias, ntev 15.5 cm, muaj ib tug locking ntsia hlau. Sponges nyob rau hauv ib tug longitudinal seem nyob rau hauv qhov zoo ntawm ib tug truncated lub khob hliav qab, nyob rau lawv cov ua hauj lwm nto yog ib tug nyias transverse notching. Qhov nkhaus los yog ncaj mas thiab horizontally. Mas siv rau hemostasis ntawm me me hlab ntsha thaum lub sij hawm neurosurgical cov txheej txheem.

4. Tus me nyuam ntawm cov "yoov tshaj cum" nyob rau hauv tus qauv zoo li tus yav dhau los, tiam sis yuav tau thinner lub puab tsaig. Length 12.5 cm, yog tseem ncaj thiab nkhaus. Tsim los rau cov angioplasty neeg arachnoid hlwb nyob rau hauv xyuas kev phais, kev ua hauj lwm nyob rau hauv lub parenchymal kabmob.

5. sib sib zog nqus mob plab, npaj rau hemostasis thiab leeg tshav nyuam nyob rau hauv tob heev. Lawv ntev yog 26 cm, lub paj rwb muaj ib tug ncaj los nkhaus zoo thiab ib tug luv luv ntev.

Clips ntawm lub "Yoov Tshaj Cum" kuj dais cov npe ntawm Halstead clips. Txawv zoo ua hauj lwm saum npoo av. изогнутый используется для новорожденных. Clip "Yoov Tshaj Cum" bent siv rau cov me nyuam mos. небольших сосудов в процессе нейрохирургических операций. Siv hemostasis me me hlab ntsha thaum lub sij hawm neurosurgical hauj lwm.

Clamp Billroth captures thiab squeezes cov hlab ntsha. Nws tau ua hauj lwm gripping lub puab tsaig thiab me me incision, thiab ib tug tapered nto rau sab nraum. Exciting lub puab tsaig nruab nrog incisions, ua nyob rau hauv tsawg cov ntaub so ntswg mob.

Clamp Popper yog ib tug ntev ncaj phais clamp, uas yog siv nyob rau hauv ib tug tsib zais zis lag luam.

Raws li cov clip yog thov?

Ua ntej lub lag luam tus kws phais yuav tsum tus kheej mus saib lub lag luam ntawm clamps. Qhov no yog tshwj xeeb tshaj yog muaj tseeb nrog loj cov hlab ntsha. Piv txwv li, overlapping phrenic-pais plab ligament, es, nws ncua mus rau sab laug pais plab leeg clamp uas yog cov, yog fraught khiav kawg ntawm cov hlab, uas yuav ua tau kom loj los ntshav.

Yuav ua li cas nakradyvat clips?

Lub dav ntawm lub feem ntawm lub mesentery (ligament) nrog cov hlab ntsha uas kuaj nyob rau ntawd, yuav tsum tau inversely xwm yeem mus rau nws thickness.

Nco ntsoov cov nram no:

- lub seem hauv paus ntawm ib tug loj loj yuav nekrozirovat uas yuav ua rau purulent o;

- tshwm sim ntawm ib tug loj deg hauv cheeb tsam deserozirovannoy yuav ua tau kom nplaum kab mob;

- Ligature, uas yog superimposed nyob rau tej roj, muaj peev xwm yuav cuam tshuam ntawm txhua lub sij hawm.

Thaum lub feem ntau tseem ceeb heev seem ntawm ligaments (lub mesentery), cov uas yuav tsis tau raug tshem tawm, ligatures thiab clips yuav tsum kom ib tug kws phais rau tshem qhov chaw ntawm lub mesentery kom lawv pab.

Excision ntawm lub ligament los yog ntawm lub mesentery ntawm lub clamps yog ua los ze zog mus rau lub cheeb tsam uas nyob. Lub volume ntawm qhov seem hauv paus yog zoo dua mus ua ib tug me ntsis ntau, nws yuav pab raws li ib tug guarantee hais tias lub neej puas yuav tsis tshwm sim ligatures.

Clamps thiab ligatures rau lub ligaments yog pom zoo kom thov tau ib me ntsis lub, raws li no tsub kom qhov ntim ntawm lub hauv paus ntoo, thiab qhov no muaj txhawb rau ib tug muaj zog fixation ligatures.

Muaj cov cai nram qab no, uas yuav tsum tau yuav tsum tau ua raws li:

1. qhov xaus ntawm lub ligatures tsis rub. Yog li ntawd lawv yuav rhuav tawm qhov kawg ntawm lub nkoj qab thus.

2. Saib kaum sab xis ntawm 40-50 degrees ntawm lub dav hlau ntawm txiab tuaj diluted Cooper thiab yarns.

3. Lub sab hniav ntawm tus txiab yog tsim nyog los so nyob rau hauv lub rooj sib txoos.

4. Tus txiav kawg ntawm lub Ligature yuav tsum tsis txhob ntau tshaj 1-2 hli.

Hemostats rau cov qhov txhab txwv

Yuav kom paub qhov txawv cov qhov txhab ntawm daim tawv nqaij, feem ntau yog siv Notched hemostatic clip kab (1160 hli ntev).

Lub ntiav txhab uas tsim nyog mus thov ncaj qha. Tab sis rau attaching lub gauze mus rau lub subcutaneous roj ntau haum rau nkhaus hemostats.

Cia ntawm phais seev

Cuab yeej muab cia rau hauv rhuab qhuav qhov chaw nyob rau ib tug kub ntawm 15-20 ° C. Nws yuav tsum tsis txhob yuav nyob rau hauv tib lub chav tsev nrog lawv tshuaj khub uas yuav ua rau xeb hlau (formalin, iodine, tshuaj zas dawb).

Cuab yeej tsim rau no siv raug nteg nyob rau hauv lub txee, thiab cov sorting rau lawv los ntawm hom thiab lo lus uas peb. Cov uas yog ua los ntawm cov hlau, thaum lub sij hawm tas mus li thauj los yog cia ua nruab nrab Vaseline los yog paraffin them. Yuav kom qhov no kawg roj av jelly yog melted mus rau ib tug kub ntawm 60-70 ° C, yog raus nyob rau hauv nws cov cuab yeej thiab ces qhwv nyob rau hauv loj hlob daim ntawv.

Nyeem cov cuab yeej yog tsis raug ntawm cov nram qab no ntaub ntawv: stainless steel, aluminium, tooj dag, bronze. Kev npaj cuab yeej rau grease: degrease thiab boil nyob rau hauv dej nrog dej qab zib thiab xab npum thiab dej, qhuav, ntsuam xyuas rau xeb, uas twb muaj lawm xeb tshem tawm los ntawm polishing. Ua cuab yeej tsuas nrog cov hnab looj tes yuav tsum tau nqa tawm, raws li potozhirovye ib co kua nplaum yuav ua tau kom tus kab xeb tsim.

Peb tau sib tham txog nyob rau hauv kom meej cov kev kho mob hemostatic clip, nws hom, cov kev cai ntawm kev siv thiab cia.