Intshayelelo
Kunyango lweklinikhi, i-plethora yezixhobo eziphambili kunye neetekhnoloji ivele, idlala indima ebaluleke kakhulu ekomelezeni ukusebenza nokuchaneka kweenkqubo zonyango. Phakathi kwezi, iyunithi ye-electrosugecal, eyaziwa ngokuba yi-electrototome, ibonakale njengesixhobo esifanelekileyo sefuthe elibanzi lemigangatho ebanzi kwiindlela zonyango kunye nezonyango.
I-electrototome iye yaba yinxalenye yegumbi lokusebenza kunye namaziko onyango akwihlabathi. Iguqulile indlela yotyando, ihambisa izibonelelo ezininzi kwiindlela zoqhaqho. Umzekelo, kwixesha elidlulileyo, oogqirha bahlala bejamelene nemiceli mngeni enjalo ilahleko engaphezulu ngexesha lokusebenza, enokukhokelela kwiingxaki kunye namaxesha okubuyisela ixesha elide kwizigulana. Ukufika kwe-elektrotime inciphile kakhulu lo mbandela.
Ngapha koko, i-electrototme yandise izinto ezinokwenzeka zokuhlinzwa kancinci. Iinkqubo ezingahlaseli ubuncinci zinxulunyaniswa neentlungu ezimbalwa, ukuhlala isibhedlele esifutshane, kunye nokubuyisa ngokukhawuleza izigulana. I-electrototome yenza oogqirha benza imisebenzi entsokothileyo kunye neziganeko ezincinci, ukunciphisa umothuko kumzimba wesigulana. Oku kungekuphela nje izibonelelo zesigulana ngokubhekisele ekuvuseleleni ngokwasemzimbeni kodwa ikwanempembelelo zoqoqosho, njengoko izibhedlele ezimfutshane zinokukhokelela kwiindleko ezisezantsi zempilo.
Njengoko isayensi yezonyango iyaqhubeka nokuvela, ukuqonda imigaqo-siseko yokusebenza, izicelo, kunye nengozi ezinokubakho kwi-elektroliyo kubalulekile ukuba zisebenze, izigulana, kunye nabo banomdla kwicandelo lezamayeza. Eli nqaku lijolise ekuqondeni ngokuqondakalayo i-elektroliyo kunyango lweklinikhi, izicelo zawo ezongezelelekileyo zonyango ezizodwa zonyango, ukuqwalaselwa kukhuseleko, kunye nethemba elizayo.
Umgaqo wokuSebenza owenzeyo
Iziseko zamandla ombane kuhlelo lotyando
Iimpukani ze-electrosujelical zisebenza kwimigaqo eyahlukeneyo eyahlukileyo kwizikali zemveli zemveli. I-scalpels yemveli ixhomekeke kwimiphetho ebukhali yokusika ngokwasemzimbeni izicubu, kakhulu ngathi kukutsiba ikhitshi ngokutya. Le ntshukumo inqumamayo ibangela ukuphazamiseka kwempahla yokugcina izicubu, kwaye imithambo yegazi yenziwa, ekhokelela ekwephangeni kangangokuba ihlala ifuna amanyathelo awongezelelekileyo e-Istimanis, njengokusetyenziswa kweearhente zentsimbi.
Ngokwahlukileyo, iimpuku ze-electrosururges zisebenzisa izixhobo eziphakamileyo-frequency enye yokutshintsha okwangoku. Ingcinga esisiseko kukuba xa kudlula umbane ophakathi, kule meko, izicubu zebhayoloji, ukuxhathisa kwezicubu kunokubangela ukuguqulwa kwamandla ombane. Esi siphumo se-shirmal sisitshixo sokusebenza kweYunithi ye-electrosugecal.
Iyunithi ye-electrosurustical (i-ESU) enika amandla iyunithi ye-electrosurgucgecal iqulethe i-frequencle ephezulu. Lo mvelisi uvelisa inye indlela yangoku nge-frequency eqhelekileyo kuluhlu lwamakhulu e-kilohertz (khz) kwi-megahertz ezininzi (MHz). Umzekelo, izixhobo ezininzi ezixhaphakileyo ze-electrosururical zisebenza kwi-frequements malunga ne-300 khz ukuya kwi-500 khz. Oku kuphezulu-frequency upy emva koko kusenziwa indawo yotyando nge-electrode ekhethekileyo, engumbane weyunithi ye-electrosgarical.
Xa i-frequency yangoku ifikelela kwizicubu, ukuxhathisa i-tishule kwimveliso yee-elektroni kubangela ukuba izicubu ziphakame. Njengoko iqondo lobushushu liyaphuma, amanzi ngaphakathi kweeseli zezicubu ziqala ukuphosa. Olu phuli lukhokelela kukwandiswa okukhawulezayo kweeseli, kubangele ukuba bakwazi ukuqhekeza kwaye kukhokelela ekunqumleleni izicubu. Eyona nto ibalulekileyo, iyunithi ye-electrosurustical 'itshisa ' ngokusebenzisa izicubu, kodwa ngendlela elawulwayo, njengoko amandla kunye nokusebenza kwangoku kuya kulungiswa ngokweemfuno zotyando.
Indima ye-frequency eyahlukeneyo
I-frequency yenxalenye yangoku ye-electrosurrugefical idlala indima ebalulekileyo ekumiseleni imisebenzi yayo ngexesha lotyando, oko kukuthi ukusika kunye nokuhamba.
Umsebenzi wokusika :
Ngomsebenzi wokusika, ukuphakama okuphezulu-frequency okuqhubekayo - i-wave yangoku ihlala isetyenziswa. Xa i-frequency yangoku isetyenziswa kwizicubu, i-oscimple yendawo yombane ibangela amasuntswana ahlawuliswe ngaphakathi kwi-tishu Le ntshukumo ivelisa ubushushu obuthambileyo, okhawulezayo ngokukhawuleza amanzi ngaphakathi kweeseli. Njengoko iiseli ziphuma ngenxa yokufumana amanzi ngokukhawuleza, izicubu zisikwe ngokufanelekileyo.
I-Right-Reep ePhakamileyo iqhubeka - i-Wave yangoku yokusika yenzelwe ukuvelisa ubushushu obuphezulu kwincam yeyunithi ye-electrosgastical. Oku kutshitshiswa okungafunekiyo kwenza ukuba i-tishu icocekile kwaye icocekile kwi-tishu. Isitshixo kukuba inani elaneleyo lamandla anikezelwe ngexesha elifutshane lokufumana iiseli ze-tissue. Umzekelo, kwinkqubo yotyando eqhelekileyo efana ne-incavetion yesikhumba, iyunithi ye-electrosugecal ibekwe kwimowudi ephezulu ye-tissume, ukunciphisa isixa se-tissue of mouncus of the okanye ukunciphisa umngcipheko wokukrazula okanye ukuqhutywa kwemiphetho yemveli.
Umsebenzi wokudibana :
Xa kufikwa kumba wokuhlangana, irejista eyahlukileyo kunye ne-wavesform yangoku iqeshiwe. Ukurhweba yinkqubo yokuphelisa ukopha ngokubangela iiprotein egazini kunye nezicubu ezijikelezileyo kwi-subture kwaye yenze into enjenge-clot. Oku kufezekiswa kusetyenziswa i-free-frequency, ityhutywe - i-wave okwangoku.
Ukutsalwa-ukuhambisa i-waked yangoku nge-fats emfutshane. Xa oku kutsalwa kudlula kwizicubu, kuvala izicubu ngendlela elawulwayo ethe tyaba ngokuthelekiswa ne-wave esetyenziselwa ukusika. Ubushushu obuvelisiweyo zanele ukuphelelwa ziiproteni egazini kunye nezicubu, kodwa akwanelanga ukubangela i-vaporid phumela ngokukhawuleza. Oku kudadayo bubangela iiproteni zokudibanisa, ukutywina ngokufanelekileyo kwimithambo yegazi elincinci kunye nokumisa ukopha. Umzekelo, ngexesha lokutyala apho kukho abophayo abancinci kumphezulu welungu, ugqirha ugqirha unokuvula iyunithi ye-electrosrulical kwimowudi ye-CAGS. I-frequency ityhutywe - i-wave yangoku iya kusetyenziswa kwingingqi eyopha, ibangela ukuba imithambo yegazi ibe kufutshane neyopha.
Iindidi zeempeni ze-electrosgarul
I-Monopolar I-electrosurulical
I-monoporical ye-electrosurulical yenye yezona ntlobo zisetyenziswa ziqhelekileyo kwiinkqubo zoqhaqho. I-Lottorly, iyunithi ye-electrosur ye-elektroniki iqulathe i-elektrode ye-handheld, eyinxalenye yotyando ngokuthe ngqo. Le electrode ixhunyiwe kwiyunithi ye-electrosurulical (ESU) ngentambo. U-Esu ngumthombo wamandla ovelisa i-frequal upolm yangoku.
Umgaqo wokuSebenza wecandelo le-elektrosor electrousical lusekwe kwisekethe yombane ngokupheleleyo. I-free-frequency yangoku ikhutshwa kwincam ye-elektrode ye-enctrode. Xa iqhekeza linxibelelana ne-tishu, ukugqitha okwangoku kwizicubu kwaye emva koko kubuyisela kwi-ESU ngokusebenzisa i-electrode ye-elektrode, idla ngokubizwa ngokuba yipali yokuphamba. Le phepha lokuphumla lihlala libekwe kwindawo enkulu yomzimba wesigulana, njengethanga okanye ngasemva. Injongo yepali yomhlaba kukubonelela indlela enyangekayo ye-ESU ukuze ibuyele kwi-EU, iqinisekisa ukuba ukusasazeka okukhoyo kwindawo enkulu yomzimba wesigulana, ukunciphisa umngcipheko wokutshisa kwinqanaba lokubuya.
Ngokwezicelo, i-monoporical ye-electrosurg isetyenziswe ngokubanzi kwiintlobo ezahlukeneyo utyando. Ngokuphathwa utyando ngokubanzi, zihlala zisetyenziswa ngokwenza inkqubela phambili ngexesha lokuqhutywa kweenkqubo ezifana ne-appendiestomies. Xa ususa iSihlomelo, ugqirha ongugqirha usebenzisa iyunithi ye-elektrosor ye-elektroniki ukwenza i-vemous yodonga lwesisu. Irejista ephakamileyo ye-Right ivumela igazi-elingaphantsi, njengoko ubushushu obuveliswe ngabanye bunokudibanisa imithambo yegazi elincinci ngaxeshanye, ukunciphisa isidingo samanyathelo ahlukeneyo abophayo.
Kwi-neurosurgery, i-monoporial ye-electrosurulical ikwasetyenziswa, nangona isilumkiso esikhulu ngenxa yemo yezicubu zendalo. Banokusetyenziselwa imisebenzi efana nezixhobo ezihlazisayo ezijikeleze i-tumor yengqondo. Amandla achanekileyo okusika kwe-monopolar kuqhawulwa ngonyango eyahlulahlula ngononophelo ithumba ukusuka kwi-turumus kwi-tuesture yengqondo esempilweni. Nangona kunjalo, iisetingi zaMandla kufuneka zihlengahlengiswe ngononophelo ukuthintela ukonakala kobushushu obugqithisileyo kwizimo zemozulu ezikufutshane.
Kutyando lweplastiki, ii-monoporical ze-electrosujeal zisetyenziselwa iinkqubo ezifana nendalo yekhusi. Umzekelo, ngexesha lotyando kwakhona, ugqirha wotyando unokusebenzisa iyunithi ye-elektrosor ye-elektroniki ukwenza iflewumu evela kwamanye amalungu omzimba, njengesisu. Ukukwazi ukusika kunye nokudibanisa kwangaxeshanye kunceda ekunciphiseni ukopha ngexesha lenkqubo ye-Flap, ebalulekileyo kwimpumelelo yokwakhiwa kwakhona.
I-Bipolar Electrosgalical
I-Bipolar Electrosurulical inoyilo olwahlukileyo kunye neseti yempawu ezibenza balungele iintlobo ezithile zotyando, ngakumbi ezo zifuna inqanaba eliphezulu. Ngolwakhiwo, iyunithi ye-elektroniki ye-bipolar inee-electrode ezimbini kufutshane nomnye kwincam. Ezi zixhobo zimbini zihlala zigcinwa ngaphakathi kwesixhobo esinye.
Umgaqo wokuSebenza owenziwe nge-bipolar we-electrosurudical uhlukile kwi-monopolar. Kwinkqubo ye-bipolar, irejista ephakamileyo yangoku ihamba kuphela phakathi kwee-elektroniki ezimbini ezisondeleyo kwincam yesixhobo. Xa iqhina lisetyenziswa kwi-tishu, ukuqhubeka ngoku kwizicubu ekunxibelelana ngazo zombini ii-elektroniki. Olu tshintsho lwangoku lwangoku luthetha ukuba iziphumo zokufudumeza kunye nezixhobo zivalelwe kwindawo phakathi kwezi zimbini. Ngenxa yoko, ubushushu obuvelisiweyo bujolise kakhulu kwaye bungaphantsi kokusasazeka kwizicubu ezijikelezileyo.
Isinye sezizathu eziphambili ze-elektrosurgical zikhethwa utyando oluchanekileyo kukukwazi kwabo ukubonelela ngolawulo lwe-tissule kunye nokusika. Kwi-Ophthalmic utyaries, umzekelo, apho izakhiwo zibuthathaka kakhulu, i-bipolar e-elektroninil ye-elektrosurul inokusetyenziselwa iinkqubo ezinjenge-IRIS. Ugqirha ugqirha unokusebenzisa i-biporar kilmen ukuba inqumle ngononophelo kwaye ihlabe izicubu kwindawo ye-IRIS ngaphandle kokubangela umonakalo kwiilensi ezikufuphi okanye ezinye izinto ezibalulekileyo. Ukufudumeza okwangoku kuqinisekisa ukuba ubungozi bomonakalo we-thermal kwizicubu ezibuthathaka zincitshisiwe.
Kwimicrosurggegers, ezinjengezo zibandakanya ukulungiswa kwemithambo yegazi elincinci okanye i-nerves, i-bipolar ye-elektrosical ikwabalulekile. Xa usenza i-rosurrugucal i-rosurg (ukukhulula kunye) yemithambo yegazi elincinci, isitshixo se-bipolar sinokusetyenziselwa ukuba sihlambe kakuhle nawaphi na abo baphembeleli ngaphandle kokuchaphazela ukuthembeka kweendonga zegazi okanye i-nerves ekufutshane. Ukukwazi ukulawula ngokuchanekileyo i-free kunye nobushushu kuvumela ugqirha ukuba asebenze kwintsimi encinci kwaye inobushushu, ukwandisa amathuba esiphumo esiphumeleleyo. Ukongeza, kuba okwangoku kuvalelwe phakathi kwee-electros ezimbini, akukho mfuneko yokuba kubekho i-pad yeenkqubo ezinkulu zendlela, eyenza lula ukuseta kolo utyando.
Izicelo zeklinikhi
Utyando ngokubanzi
Ngokuphathwa gadalala, iimpuku ze-electrosurulical zisetyenziswa ngokubanzi kwiinkqubo ezahlukeneyo, ukuhambisa izibonelelo ezahlukeneyo ezahlukeneyo.
I-Appendectomy :
I-Appendectomy yinkqubo eqhelekileyo yotyando yokususwa kwesihlomelo, esihlala sikhutshiwe okanye sosulelekile. Xa usebenzisa iyunithi ye-electrosugefical kwi-appendectomy, irejista ephakamileyo ivumela ukuba igazi-ukungcungcutheka okuncinci kwesihlomelo esivela kwizicubu ezijikelezileyo. Umzekelo, kwimeko ye-Laparoscopic Plendendestomy, i-monopolar okanye i-Bipolar I-elektrosigety isetyenziswe kwizibuko le-rocar. Umsebenzi wokusika wecandelo le-electrosurustical yenza ukuba ugqirha uza kukhawulezisa kwaye acoceke ngokutsha i-mesoppeloix, enemithambo yegazi ebonelela ngesihlomelo. Kwangelo xesha, umsebenzi we-COAGS tywina imithambo yegazi elincinci ngaphakathi kwe-mesoppelox, ukunciphisa umngcipheko wokwanda ngexesha lokusebenza. Oku kungekuphela nje ukuba intsimi yoqhaqho icace gca ukuba ugqirha wotyando kodwa ikwanciphisa ixesha lokusebenza liphela. Ngokwahlukileyo, iindlela zemveli zokusebenzisa i-scloalpel ukusika i-mesoappeix kwaye emva koko ukuhambisa inqanawa nganye yegazi lixesha elingaphezulu - lidla ngokukhupha ngaphezulu.
Cholecystectomy :
I-Cholecystectomy, ukususwa kwe-subgical ye-gellbladder, yenye indawo apho iimpeni ze-electrosuge play idlala indima ebalulekileyo. Kwi-cholecystectomyy evulekileyo, iyunithi ye-electrosugecal inokusetyenziselwa ukufumanisa izisulu zodonga, kubandakanya nolusu, izicubu ze-subcutaneal, kunye nemisipha. Njengoko kunqunyulwa kwezi tishu, ngaxeshanye imamela imithambo yegazi elincinci, ukunciphisa ilahleko yegazi. Ngexesha lokungaguquli kwe-gallbladder evela ebhedini yesibindi, amandla e-electrosurgerical ye-electrosgarical inceda ukutywina kwemithambo yegazi kunye ne-bile uqhagamshele i-gellbladder kwisiteli, ukunciphisa umngcipheko wokupheliswa kwendawo.
Kwi-Laparoscopic Cholecystectomyy, eyinkqubo engahlaseli encinci, iyunithi ye-electrosugecal ibaluleke nangakumbi. I-bipolar electrosulsurgefical idla ngokusetyenziswa ukuthoba i-createcry ye-cystic kunye ne-duct cyct. Ukuhamba kweendawo ezikhoyo kwi-bipolar kwizixhobo ze-bipolar kwi-bimporical ivumela ukucinywa kwe-bijoricise kunye nokusika kwezi zinto, ukunciphisa umngcipheko womonakalo we-bile kunye nezinye izinto ezibalulekileyo. Ukukwazi ukwenza ezi ntlobo ze-electrosurrugrical ngokusebenzisa izithuba ezincinci kuyinto ebalulekileyo, njengoko ikhokelela kwintlungu encinci, ukuhlala isibhedlele esifutshane, kunye namaxesha okubuyisela kwakhona kwizigulana ezithelekiswa notyando.
Utyando lweGynecological
Iimpeni ze-electrosurrugrical zifumene ukusetyenziswa kakhulu kwi-Gynecologies utyaries, evumelayo ngakumbi iinkqubo ezifanelekileyo kwaye ezifanelekileyo.
I-Hysterectomy ye-i-uterine Fibroids :
I-fibroids ye-uterine ayikho - ukukhula okumhlanileyo kwi-Utorus enokubangela iimpawu ezinjengokuya esikhathini, zibuhlungu, kunye nokungachumi. Xa usenza i-hysterectomy (isuswa yesibeleko) ukunyanga i-fibrodias enkulu okanye i-factomatic fibroids, iimpuku ze-elektrosige zingasetyenziswa ngeendlela ezininzi. Kwi-hysterectomy evulekileyo, iyunithi ye-electrosugecal isetyenziselwa ukwenza udonga lwesisu. Ngexesha lokugalelwa isibeleko ukusuka kwizicubu ezijikelezileyo, ezinje nge-bladder, i-rectum, kunye ne-pelvic esecaleni, imisebenzi yokusika i-electrosgalls kunye nemisebenzi ye-electrounical kunye nemisebenzi ye-elektroniki iyasebenza. Inganqunyulwa ngokuchanekileyo kwi-ligaments ye-terine, equkethe imithambo yegazi, ngelixa kwangaxeshanye itywine impahla ukuthintela ukopha. Oku kunciphisa isidingo sesakhiwo esibanzi semithambo yegazi, yenza lula inkqubo yoqhaqho.
Kwi-laparoscopic okanye irobhothi-incedisile i-hysterectomy, ezihamba kancinci, izixhobo ze-electrosurrucical, kuquka izixhobo ze-monoporiar kunye ne-bipolar eBipolar ezincinci, zisetyenziswa kakhulu nangakumbi. I-bipolar electrosursurlical ingenziwa ukuba iphazamise ngononophelo kwaye ihlabe imithambo yegazi ejikeleze isibeleko, iqinisekisa igazi elingaphantsi kwegazi lokususwa kwesibeleko sesibeleko se-uteris. Uhlobo oluncinci olungenasiphako lwezi nkqubo, lwenziwe ukuba lusebenzise i-elektrosicking ze-electrosurulical, iziphumo ezingaphantsi kwesigulana, isibhedlele esifutshane, kunye namaxesha okubuyela ngokukhawuleza.
Utyando lomlomo wesibeleko :
Kumbandela wesibeleko, njenge-loop-electrosurrucical nenkqubo yokuthambeka (i-leep) kunyango lwe-intplailical neoplasia (i-cin) okanye i-chin) okanye i-thelyvical polyps, iimpuku ze-elektrosgalces, izixhobo ze-electrosgalge zizixhobo ezikhethiweyo. Kwinkqubo ye-leep, i-lop yocingo elicekeceke iqhotyoshelwe kwiCandelo le-electrosurruelical liyasetyenziswa. I-Right-Roftency ePhezulu idlulile kwi-loop idala ubushushu, evumela ukungabinamsebenzi wezicubu zenkozeli engaqhelekanga. Le ndlela isebenza kakhulu ekususeni izicubu ezichetyiweyo ngelixa inciphisa umonakalo kwizicubu ezijikelezileyo.
Izifundo zibonise ukuba i-leep inezibonelelo ezininzi. Umzekelo, ineqondo eliphezulu lokuphumelela kwi-cin. Ixesha eliqhelekileyo lokusebenza lifutshane, ngokufuthi malunga nemizuzu emi-5 ukuya kweli-10. Ilahleko yegazi yegazi incinci, ihlala ingaphantsi kwe-10 ml. Ukongeza, umngcipheko weengxaki ezinje ngosulelo kunye nokopha kuphantsi. Emva kwenkqubo, isigulana sidla ngokuphinda siqhubeke nemisebenzi yesiqhelo ngokukhawuleza, kwaye ukulandela ixesha elide - ubonise inqanaba lokuphinda-phinda lezinto ezihlaziyiweyo. Elinye ingenelelo kukuba izicubu ezimdaka zinokuthunyelwa kuviwo oluchanekileyo lwe-pathological, ebaluleke kakhulu ekuqinisekiseni ubungakanani besi sifo nokukhokela unyango ukuba kukho imfuneko.
I-neurosurgery
Kwi-neurosurgery, ukusetyenziswa kweempuku ze-electrosurg kubaluleke kakhulu ngenxa yohlobo oluthathekileyo lwezicubu ze-neural kunye nemfuno yemisebenzi yotyando echanekileyo.
Xa ususa amathumba engqondo, iyunithi ye-electrosurgerical ivumela i-neurosurgeon ukuba ikhuphe ngocoselelo i-tumar kwi-turue yengqondo esempilweni. Iyunithi ye-elektrosor ye-electrourical inokusetyenziswa ngokuseto lwamandla asezantsi kakhulu ukunciphisa umngcipheko wokonzakala kwe-thermal kwizimo ezifanayo. I-frequency yangoku isetyenziselwa ukusika ngokuthe ngqo kwizicubu zethumba ngelixa kwangaxeshanye imanyano-nye imithambo yegazi elincinci ngaphakathi kwethumbu, ukunciphisa ukopha ukopha. Oku kubaluleke kakhulu kukungqubana okugqithisileyo kwingqondo kunokukhokelela kuxinzelelo lwe-intracrannial kunye nomonakalo kwizicubu zobuchopho ezingqonge.
Umzekelo, kwimeko ye-meningioma, oluhlobo oluqhelekileyo lwe-turumume ovela kwi-tunges (i-membras egubungela ubuchopho), i-elecrasurgeon isebenzisa iyunithi ye-electrosgarical ukuba ihlukane ngenyameko kumphezulu wobuchopho. Ukukwazi ukulawula ukusika kunye nokuhla kwe-geagely ngokuchanekileyo kunye neyunithi ye-electrosugecial kunceda ukugcina ubuchopho obuqhelekileyo bungaphezulu kangangoko kunokwenzeka. I-bipolar electrosursurcial isetyenziswa rhoqo kwi-neurosurgery, ingakumbi kwimisebenzi efuna ulawulo oluchanekileyo, olunjengokuhamba kwemitya yegazi elincinci kwindawo ebonakalayo. Ukuhamba kwezixhobo ezikhoyo ezikhoyo kwizixhobo ze-bipolar kuqinisekisa ukuba ubushushu buye bavalelwa kwindawo encinci, ukunciphisa umngcipheko wokubambisana komonakalo kwizicubu ezibuthathaka.
Izibonelelo ngeendlela zokuhlinzwa zemveli
I-hemanasis kwaye inciphise ilahleko yegazi
Esona sibonelelo sibalulekileyo se-electrosurrucgered kwizixhobo zotyando ngokwesiko ngamandla abo abonakalayo, okukhokelela ekunciphiseni kakhulu kwilahleko yegazi ngexesha lotyando. I-scalpels yemveli, xa isetyenziselwa ukusika izicubu, faka nje imithambo yegazi, ishiya ivulekile kwaye iyopha. Oku kuhlala kufuna ixesha elongezelelekileyo - amanyathelo athatyayo ukulawula ukopha, njengokutsala inqanawa nganye encinci yegazi okanye ukusebenzisa i-themonistatic.
Ngokwahlukileyo, iimpuku ze-elektrosgarege, ngokusebenzisa iziphumo zabo ze-shirmal, zinokudibanisa imithambo yegazi elincinci njengoko basike. Xa i-frequency yangoku igqitha kwizicubu, ubushushu obuveliswa bubuhlungu iiprotein zegazi kunye neendonga zenqanawa. Oku kudadayo kubangela ukuba igazi libe ligazi kunye nemithambo yegazi ukuya etywina. Umzekelo, kwinkqubo yotyando ngokubanzi efana nolusu - ukudalwa kwe-flap, i-scalpel yesintu inokufuna ugqirha wokuyeka kwaye usombulule amanqaku okomhlaba, onokuba baninzi. Ngeyunithi ye-electrosugecal, njengoko iyenza ukuba i-vem, imithambo yegazi encinci kulusu kunye nezicubu ze-subcutaneal zidibene ngaxeshanye. Oku akususi nje ilahleko yegazi kuphela ngexesha lokusebenza kodwa ikwabonelela ngentsimi ecacileyo yonyango. Isifundo esithelekisa ukusetyenziswa kwe-elektrososulces kunye ne-scalpels yemveli kwisisu esithile esisulungekileyo sifumanise ukuba ilahleko yegazi incitshisiwe malunga ne-30 - 40% xa usebenzisa iimpeni ze-elektroniki xa zisebenzisa iimpeni ze-elektroniki xa zisebenzisa iimpeni ze-electrosgarurge. Olu kuncitshiswa kwelahleko yegazi kubaluleke kakhulu njengokulahleka kwegazi kunokubangela ukuba iingxaki ezinjengeesile, ukothuka, kunye namaxesha okubuyela kwimeko yesigulana.
I-Precience I-Action kunye nokuDibanisa izicubu
Iimpeni ze-electrosurrugacal zibonelela ngenqanaba eliphezulu lokuchaneka kunye nokuhlaselwa kwezicubu, oluluphuculo olubonakalayo kwizixhobo zoqhaqho. I-scalpels yemveli inesenzo esikrwada kwi-microscopic inqanaba. Banokubangela ukhula kunye nomonakalo kwizicubu ezijikelezileyo ngenxa yamandla omatshini osetyenziswa ngexesha lokusika. Oku kunokuba yingxaki xa esebenza kwiindawo apho izicubu zibuthathaka okanye khona izakhiwo ezibaluleke kakhulu ekusondeleleni.
Kwelinye icala i-electrosurulical, kwelinye icala, sebenzisa umphumo olawulayo wokusika. Incam yecandelo le-electrosurrugecal linokuyilwa ukuba ibe nendawo encinci yomhlaba, ivumela ukusika ngokungqalileyo. Umzekelo, kwi-neurosurgery, xa ususa isisu esincinci esikufuphi nobuchule obukufuphi, ugqirha ongugqirha unokusebenzisa iyunithi ye-electrosgastical ene-electrode. I-frequentency yangoku ihlaziywa kwinqanaba elinqunyaziweyo ngokuchanekileyo nge-tumor tissure ngelixa inciphisa umonakalo we-thermal kwizicubu zobuchopho obusondeleyo. Ukukwazi ukulawula amandla kunye nerequency yecandelo le-electrosurrucec lenze ugqirha ohlelayo ukuba enze ukungavisisani kwe-tishu yezicubu ngokucocekileyo. Kwimicrosurggegers, efana nelezo zibandakanya ukulungiswa kwemithambo yegazi okanye i-nerves, i-biporical ye-elektrosurgecal inokusika ngokuchanekileyo kwaye icofe i-tissies kwintsimi encinci kakhulu, inciphisa umngcipheko womonakalo. Oku kuchaneka okungalunganga akuphuculi kuphela isiphumo soqhawulo-mtshato kodwa kunciphisa amathuba okubambisa i-post-passives ehambelana nomonakalo wezicubu.
Amaxesha amafutshane oSebenzayo
Ukusetyenziswa kweempuku zombane kunokukhokelela kumaxesha amafutshane okusebenza xa kuthelekiswa nezixhobo zoqhaqho ngokwesiko, eziluncedo kuzo zombini izigulana kunye neqela letyala. Njengoko bekutshiwo ngaphambili, iimpeni ze-electrosgargecal zingasika kwaye zidibane ngaxeshanye. Oku kuphelisa isidingo so utyando ukuba benze amanyathelo ahlukeneyo okusika aze alawule ukopha, njengoko kunjalo nge-scalpels yemveli.
Kwinkqubo yotyando entsonkothileyo njenge-hysterectomy, xa usebenzisa i-scalpel yemveli, ugqirha wotyando kufuneka anqumle ngononophelo kwizicubu ezahlukeneyo kunye ne-ligamon ejikeleze isibeleko kwaye emva koko sikhawuleze okanye sibethelele impahla nganye yegazi ukuthintela ukopha. Le nkqubo inokuthi yexesha-ukutya, ngakumbi xa ujongene nenani leenqanawa zegazi elincinci. Ngeyunithi ye-electrosugecal, ugqirha ongugqirha unokusika ngokukhawuleza kwizicubu ngelixa ethatha imithambo yegazi, enza uqwalasele inkqubo yoqhaqho. Izifundo zibonakalisile ukuba kwezinye iimeko, ukusetyenziswa kweempuku ze-electrosurg kunokunciphisa ixesha lokusebenza nge-20 - 30%. Amaxesha amafutshane okusebenza adityaniswa nomngcipheko oncitshisiweyo wezinto ezichaphazelekayo ezinxulumene ne-anesthesia ende. Ixesha elide isigulana siphantsi kwe-anesthesia, okukhulu emngciphekweni wokuphefumla kunye neengxaki zentliziyo. Ukongeza, amaxesha amafutshane okuphelisa kuthetha ukuba iqela elikhutshelwe i-subcen linokwenza iinkqubo ezingakumbi ngexesha elinikiweyo, okunokwenzeka okunokwandisa ukusebenza kwegumbi lokusebenza kunye nokunciphisa iindleko zokhathalelo lwempilo.
Ingozi ezinokubakho kunye neengxaki
Ukulimala kwe-thermal kwizicubu ezijikelezileyo
Ngaphandle kwezibonelelo ezininzi, ukusetyenziswa kweempuku ze-electrosurrucges kwiyeza leklinikhi ayinamngcipheko. Enye yeenkxalabo eziphambili kukulimala kwe-thermal kwizicubu ezijikelezileyo.
Xa iyunithi ye-electrosugecal isebenza, i-frequency ye-frequency yangoku ivelisa ubushushu ukuze unciphise kwaye udibanise izicubu. Nangona kunjalo, obu bushushu ngamanye amaxesha bunokusasazeka ngaphaya kwendawo ekujoliswe kuyo. Umzekelo, kwi-Laparoscopic utyandelwa, iyunithi ye-elektrosCulical ye-elektroniki, ukuba ayisetyenziswa ngononophelo, inokudlulisa ubushushu ngezixhobo ezincinci ze-laparoscopic kwaye zibangele ukonakala kwe-thebhus. Kungenxa yokuba ubushushu obuveliswe kwincam ye-electrode bunokuziphatha ecaleni kweshaft yesixhobo. Kwisifundo se-Laparoscopic Cholecystestetomy iimeko, safunyaniswa ukuba malunga ne-1 - 2% yamatyala, bekukho ukwenzakala okuncinci kwe-furnum ekufuphi neYunithi ye-Elellbladrust ngexesha lokungasebenzi kwe-Elellbladder.
Umngcipheko wokwenzakala kwe-thermal ikwanxulumene noseto lwemimandla yeyunithi ye-electrosgarical. Ukuba amandla aphezulu kakhulu, ubungakanani bobushushu buya kuba ngaphezulu, buyandisa amathuba okusasazeka kobushushu kwizicubu ezijikelezileyo. Ukongeza, ixesha lonxibelelwano phakathi kweyunithi ye-electrosugecal kunye netishu idlala indima. Ukunxibelelana ixesha elide kunye nezicubu kunokukhokelela ekutshintsheleni kobushushu obukhulu, kubangela ukonakala okuthe kratya.
Ukuthintela ukonzakala kwe-thermal kwizicubu ezijikelezileyo, amanyathelo aliqela anokuthathwa. Okokuqala, oogqirha bafuna ukuba baphiliswe kakuhle ekusebenziseni iimpeni ze-electrosurgecal. Kuya kufuneka baqonde ngokucacileyo iisetingi ezifanelekileyo zombane kwiintlobo ezahlukeneyo zezicubu kunye neenkqubo zotyando. Umzekelo, xa usebenza kwizicubu ezibuthathaka ezinjengesibindi okanye ingqondo, useto lwamacala asezantsi zihlala zifuneka ukuze zinciphise umngcipheko womonakalo we-thermal. Okwesibini, ukufundwa okufanelekileyo kwezixhobo ze-electrosurg kubalulekile. Ukufaka i-shafts yezixhobo ze-laparoscopic kunokuthintela ukwenziwa kobushushu kumalungu akufuphi. Ezinye iinkqubo eziphambili ze-electrosurulical nazo ziza neempawu ezibeka iliso kubushushu kwindawo yotyando. Ezi qondo lobushushu - iinkqubo zokubeka esweni zinokwazisa ugqirha kwi-surgeon ukuba i-tises ejikelezileyo iqala ukuphakama ngaphezulu kwenqanaba elikhuselekileyo, ivumela ugqirha uhlengahlengiso ngokukhawuleza.
Usulelo kunye nengozi yombane
Enye iseti yemingcipheko enxulumene nokusetyenziswa kweempuku ze-electrosurulical kukungabikho kosulelo kunye neengozi zombane.
Usulelo :
Ngexesha lotyando, ukusetyenziswa kweekhilomela ze-electrosurulical kungadala imeko enokunyusa umngcipheko wokosulelo. Ubushushu obuveliswe yiyunithi ye-electrosugecal bunokubangela ukonakala kwe-tishu, enokuphazamisa iindlela zokhuseleko lomzimba. Xa izicubu zonakaliswa bubushushu, inokuba nzima ngakumbi kwi-bactery casion. Umzekelo, ukuba indawo yoqhaqho ayicocekanga ngokufanelekileyo kwaye ibulale intsholongwane ngaphambi kokusebenzisa iyunithi ye-elektrosical, nayiphi na intsholongwane ekhoyo kulusu okanye kwindawo engqongileyo inokwaziswa kwizicubu ezonakeleyo. Ukongeza, izicubu ezivunyiweyo ezenziwa ngexesha lenkqubo ye-electrosurruge inokubonelela ngendawo entle yokukhula kwentsholongwane. Isifundo kwizifo zosulelo lwendawo yokuhlisela emva kweendlela zokusebenzisa i-electrosurusical zifumene ukuba iqondo losulelo lingaphezulu leendlela zokugcina izezosulelo zisebenzisa iindlela ezifanelekileyo, ngakumbi xa izenzo ezifanelekileyo zokulawula azilandelwa ngokungqongqo.
Ukunciphisa umngcipheko wokosuleleka, ukulungiselela ulusu olukhuselekileyo lolusu kubalulekile. Indawo yoqhaqho kufuneka icocwe ngokucokisekileyo kunye nezisombululo ezifanelekileyo ze-antiseptic zokunciphisa inani leebhaktiriya kubuso bolusu. Amanyathelo angenantlonelo anjengokusebenzisa izixhobo ze-elektrosocial kunye nokugcina intsimi enencasa nayo ibalulekile. Emva kotyando, ukhathalelo lwenxeba olufanelekileyo, kuquka notshintsho oluqhelekileyo lokunxiba kunye nokusetyenziswa kweentsholongwane xa kukho imfuneko, kunokunceda ukukhusela uphuhliso losulelo.
Ingozi yombane :
Ingozi yombane ikwayinkxalabo ebalulekileyo xa usebenzisa i-elektrosiged. Ezi ngozi zinokwenzeka ngenxa yezizathu ezahlukeneyo, ezinjengokusebenza ngaphandle kwezixhobo, ukuphakamisa okungafanelekanga, okanye impazamo yomsebenzi. Ukuba iyunithi ye-electrosugecal (i-ESU), inokuhambisa inani eligqithileyo langoku, elinokukhokelela ekutshiseni okanye lombane kwiqela lesigulana okanye iqela lonyango. Umzekelo, ukuhambisa amandla e-ESU e-ESU kunokubangela ukuguquguquka kwimveliso yangoku, okukhokelela kumbandela ophakamileyo.
Ukuphakama okungafanelekanga yenye unobangela oqhelekileyo weengozi zombane. Kwiinkqubo ze-monoporical ze-elektroniki, indlela efanelekileyo yokuphakamisa i-elektrode (i-pad) ibalulekile ekuqinisekiseni ukuba iMbuyiso yangoku ikhuselekile kwi-EU. Ukuba i-pad yokuthamba ayihambelani kakuhle emzimbeni wesigulana, okanye ukuba kukho ikhefu kwisekethe yokuphatha, okwangoku unokufumana indlela enye, enje ngamanye amalungu omzimba wesigulana okanye ukwenza umbane onokubangela ukutshiswa kombane. Ngamanye amaxesha, ukuba isigulana sinxibelelana nezinto ezisebenzayo kwigumbi lokusebenza, njengamacandelo etafile yetafile, kwaye umhlaba awukho, isigulana sisengozini yothuso lombane.
Ukulungisa ubungozi boMbane, ukugcinwa rhoqo kunye nokuhlolwa kwezixhobo ze-electrosgaulical kuyimfuneko. I-EU kufuneka ihlolwe nayiphi na imiqondiso yokunxiba kunye nokukrazula, kwaye izinto zombane kufuneka zivavanywe ukuqinisekisa ukusebenza ngokufanelekileyo. Abanini zithuthi kufuneka baqeqeshelwe ukuseta ngokuchanekileyo kwaye basebenzise izixhobo ze-elektrosical, kubandakanya nokuncamathiselwa okufanelekileyo kwepali yomhlaba. Ukongeza, igumbi lokusebenza kufuneka lixhotywe izixhobo ezifanelekileyo zokhuseleko zombane, ukuba ziphazamiseka kwifombo zefomati (i-GFCIIS), ezinokuyeka ngokukhawuleza, ukuvuza kombane okanye ukunciphisa umngcipheko weengozi zombane.
Uphuhliso lwexesha elizayo kunye nezinto ezintsha
Ukuhambela phambili kwezobuchwephesha kwi -electrosugelical yoyilo
Ikamva le-electrosurunical libambe isithembiso esikhulu malunga nokuhambela phambili kwezobuchwephesha. Inkalo enye yogxininiso kukuphuhliswa koyilo oluchanekileyo nolungelelwaniso lwe-electrode. Okwangoku, i-electrosrrodes ze-electrosurructical zisiseko kwiimilo zazo, zihlala zingenamagqabi okanye iingcebiso ezilula. Kwixesha elizayo, sinokulindela ukubona i-electrode ngejometri enzima. Umzekelo, ii-electrode zinokuyilwa kunye nezakhi ezincinci kwimiphezulu yazo. Ezi zakhiwo ezincinci zinokuphucula unxibelelwano kunye nezicubu kwindawo yemicroscopic, zivumela ukunqunyulwa okungathethekiyo kunye nokuhla komda. Isifundo kwicandelo lezenzululwazi lezayensi kunye nobunjineli bezonyango bubonisile ukuba ngokwenza iipateni zeNanoscale kumphezulu we-electrode kwi-elektrode, ekusebenzeni kwamandla kunokukhuselwa ukuya kuthi ga kwi-20 - 30%. Oku kunokukhokelela kwiinkqubo zoqhawulo-mvume kunye nokuchanekileyo.
Eminye inkalo yenkqubela phambili yetekhnoloji kukuphuculwa kweenkqubo zolawulo lwamandla kwiiyunithi ze-elektroniki. Iimpeni ze-electrosursul zexesha elizayo zinokuxhotyiswa ngamandla okwenyani- iindlela zokuhlengahlengiswa ngokusekwe kwingxelo yokufumana ingxelo yezicubu. Ukunyanzeliswa kwezicubu kunokwahluka kuxhomekeka kwizinto ezinje ngohlobo lwezicubu (amanqatha, umsipha, okanye ubukho besifo, kunye nenqanaba le-hydration. Iiyunithi ezikhoyo ze-elektrosical zihlala zixhomekeke kumanqanaba ombane angaphambi kokuseta, ezinokuthi zingabi kakhulu kuzo zonke iimeko zezicubu. Kwixesha elizayo, izinzwa ngaphakathi kweyunithi ye-electrosugefical inokuqhubeka ilinganisa i-tishu kwindawo yokunyanzela kwindawo yoqhaqho. Imveliso yamandla yecandelo le-electrosugefial liya kuthi emva koko lihlengahlengiswe ngokuzenzekelayo ngokoqobo-ixesha lokwenyani lokuqinisekisa ukuba inani elifanelekileyo lamandla lisiwe kwizicubu. Oku akuyi kuphucula nje ukusebenza ngokukuko kunye nokuhamba komhlambi kodwa kunciphisa umngcipheko womonakalo we-thermal kwizicubu ezijikelezileyo. Uphando lubonise ukuba amandla okwenyani olwame-lixesha-inkqubo yokuhlengahlengiswa isenokuba kukunciphisa isimo sezinto ezinxulumene ne-shirmal - iipesenti ezingama-60 kwezinye iinkqubo zotyando.
Ukudityaniswa nezinye iTekhnoloji yoNyango
Umdibaniso we-pilesururgecal ye-electrosururge kunye nenye itekhnoloji yoqhaqho ngumsimo onomdla onokubakho. Indawo enye ebonakalayo yindibaniselwano ngonyango lwerobhothi. Kwirobhothi-utyando oluncedisiweyo, ugqirha ugqirha ulawula iingalo zerobhothi ukwenza imisebenzi yoqhaqho. Ngokudibanisa iintshelo ze-electrosururgefical kwiinkqubo zerobhothi, ukuchaneka kunye nokuphelisa iingalo zerobhoti kunokudityaniswa kunye nezakhono zokusika kunye nokudibanisa kwamaqhina e-elektrosgalge. Umzekelo, kwirobhothi entsonkothileyo-incedisa i-prostatectomy, ingalo yerobhothi inokucwangciswa ngokuthe ngqo kwiyunithi ye-electrosugecal ejikeleze i-prostate gland. I-Right Refloctate yangoku evela kwiyunithi ye-electrosugecal inokuthi emva koko isetyenziselwe ukuthoba i-prostate ukusuka kwizicubu ezijikelezileyo ngelixa kwangaxeshanye imanyanisa imithambo yegazi. Oku kudityaniswa kunokukhokelela ekunciphiseni ilahleko yegazi, amaxesha amafutshane okusebenza, kunye nokugcinwa okungcono kwezakhiwo ezijikelezileyo, ekugqibeleni ukuphucula iziphumo zoqhako kwizigulana.
Umdibaniso weendlela zokuphambuka ezincinci, ezinjenge-laparoscopy kunye ne-endoscopy, kulindeleke ukuba ubone ukuphunyezwa ngakumbi. Kwi-Laparoscopic utyandele, iyunithi ye-electrosugecal okwangoku sisixhobo esibalulekileyo, kodwa inkqubela phambili yexesha elizayo inokwenza ukuba isebenze ngakumbi. Umzekelo, ukuphuculwa kweeflowe ze-electrosururged ezincinci nezingaguquguqukiyo ezinokuthi zifakwe ngokulula kwizibuko leTrocar e-Laparoscopy. Ezi phenyane zinokuyilwa ukuba nezakhono ezingcono zendlela, ukuvumela ugqirha wokufikelela kwaye asebenze kwiindawo ekunzima ukufikelela kuzo ngoku ukufikelela. E-Endoscopic utyandele, ukudityaniswa kweempuphu ze-electrosurrucrul kunokonza iinkqubo ezintsonkothileyo zokwenziwa e-gooscopic. Umzekelo, kunyango lwakwangoko - inqanaba le-gestrointentinal ye-gestrointel, iyunithi ye-EndosCosulical-Iyunithi ehlanganisiweyo inokusetyenziselwa ukuhambisa i-tishu yesicubu esijikelezileyo ngelixa inciphisa imfuno yeenkqubo ezivulekileyo ezivulekileyo ezivulekileyo. Oku kungakhokelela ekunciphiseni kwesigulana, ukuhlala isibhedlele esifutshane, kwaye ngokukhawuleza.
Ukuqukumbela
Ukuqukumbela, iYunithi ye-electrosugement ivele njengesixhobo sotshintsho kwimozulu yonyango lweklinikhi, kwaye ifikelela kude kakhulu nezenzo zonyango.
Ukujonga phambili, ikamva lamagqabantshintshi e-electrosurul luzele ngamathuba anomdla. Ukuhambela phambili kwezobuchwephesha kwi-elektrode yoyilo kunye neenkqubo zokulawula amandla zibambe isithembiso seenkqubo ezingakumbi kunye nezisebenzayo. Umdibaniso wezifiso ze-electrosururge kunye nolunye uhlobo lwetekhnoloji evelayo, ezinje ngotyando lwerobhothi kunye neendlela eziphambili zerobhothi kunye neendlela eziphezulu ezihlaselayo, kunokwenzeka ukuba zandise umda wegumbi lokusebenza.
Njengoko umhlaba wezamayeza uyaqhubeka ukuvela, iyunithi ye-electrosurgerem ngokungathandabuzekiyo iya kuhlala kwindawo ephambili yokuphambuka. Uphando oluqhubekayo kunye nophuhliso kule ndawo zibalulekile ekuqondeni ngokupheleleyo amandla akho, phucula ukhathalelo lwezigulana, kwaye uqhube ukuqhubela phambili kweendlela zokuza kwiminyaka ezayo.
