Intshayelelo
Izibane zoqhaqho zidlala indima ebaluleke kakhulu kwimpilo yanamhlanje, esebenza njengeeecons ezikhanyayo ezikhokelela kwiinkqubo ezibuthathaka nezintsonkothileyo ezindisa ubomi. Ezi zibane zikhethekileyo ziyilelwe kakuhle ukuba zihlangabezane neemfuno ezizodwa zemontiya eyahlukeneyo, iqinisekisa ubumboniso ofanelekileyo kunye nokuchaneka. Ukusuka kwi-microsurgegies entsonkothileyo efuna ukuchaneka kwe-microscopic kwimisebenzi enkulu, yokusindisa ubomi kumaziko ahlabayo, amaziko oqhanqapho kufuneka enze kwaye enze ngokungagungqiyo. Kweli nqaku, siza kuphonononga iimfuno ezithile kunye nokusetyenziswa kwezixhobo zeklinikhi yezibane zotyando kwiisethingi ezahlukeneyo, ukuphalaza ukukhanya ngendlela ezi zibalulekileyo zosulelo kunye nokhathalelo lwesigulana.
II. Iimfuno ezisisiseko zezibane zotyando
A. Ukukhanyisa ubunzulu kunye nokufana
Eyona mfuno iphambili kwizibane zoqhaqho kukubonelela ngobukhulu obukhanyisiweyo. Kwilungiselelo loqhawulo-mtshato oluqhelekileyo, ukuqaqamba kokukhanya kufuneka ufikelele kwinqanaba elivumela oogqirha ukuba babone iinkcukacha ezintle zendawo yokuhlinzwa. Oku kuhlala kuthetha ubukhulu beeshumi zamashumi amawaka amawaka angaphezu kwekhulu lamawaka, kuxhomekeke kubunzima benkqubo. Umzekelo, kwimicrosimurigies ene-microsurggeggegs efana ne-Ophthalmic okanye iinkqubo ze-neurosurrurical, apho oogqirha basebenza kwizakhiwo zomzuzu, ubukhulu obuphezulu bubalulekile. Ukufakwa kokukhanya kubalulekile. Isibane esingalinganiyo sinokwenza iindawo zesithunzi okanye ukuvezwa, kukhokelela ekutolikeni gwenxa kwentsimi yoqhaqho. Uyilo oluphambili lwezinto ezikhethiweyo, kubandakanya ilensi yamanye kwaye icengqele kwaye ihluthwe, iqashwe ukuqinisekisa ukuba ukukhanya kuyasasazwa ngokulinganayo kwindawo yonke, ukunciphisa nayiphi na into engekhoyo.
B. Iqondo lobushushu lemibala kunye nombala onikezela ngesalathiso
Iqondo lokushisa lemibala lidlala indima ebalulekileyo ekuhambeni. Iqondo lokushisa lemibala kuluhlu lwe-4000k ukuya kwi-5000K likhethwa ngokubanzi njengoko liyifana nokukhanya kwendalo. Oku kunceda oogqirha ukuze baqonde imibala yokwenyani yezicubu kunye namalungu, oko kubalulekile ukuze kuxilongwe ngokuchanekileyo kunye nonyango. Umzekelo, kugqirha wentliziyo, amandla okwahlula umbala wenqanawa yegazi kunye nezicubu ezingqongileyo zinokuthetha umahluko phakathi kwenkqubo ephumeleleyo kunye nenkqubo yokulalanisa. Isalathiso sombala I-CRINI engama-90 okanye ngaphezulu ithathwa njengezibane zotyando zanamhlanje, ezivumayo zonyango ukwenza izigqibo ezichanekileyo ngokusekwe kwizicubu ezibonakalayo ezibonelelwe zizicubu ezichongiweyo.
C. Isiphumo esingenazithunzi
Umxholo wokukhanya kotyando ngaphandle komhlaba usekwe kumgaqo wemithombo yokukhanya emininzi ekhanyisa indawo yoqhaqho. Ngokubeka ngobuchule kwiqela leebhulorho ezinkulu okanye ii-LED kwiNtloko yeSetyhula okanye i-Polygonal Lamp, amathunzi atyhilwe ngezandla zikagqirha, izixhobo, okanye umzimba wesigulana uncitshisiwe. Izibongozo ezikhethekileyo kunye nezikhokelo zokukhanya zifakiwe ukuba zilandele kwaye zidibanise imiqadi yokukhanya, iqinisekisa ukuba naziphi na izithunzi ezinokubakho zizaliswe kukukhanya. Oku kubaluleke kakhulu kwiinkqubo apho kuchanekile khona, ezifana nonyango lwe-orthoric apho ulungelelwaniso lwe-subplants okanye ukususwa kweziqwengana zethambo kufuna imbono engafakwanga.
D. Ukuphuma kobushushu kunye nokukhanya okubandayo
Iinkqubo zoqhaqho zinokuba zide, kwaye ukuphuma okugqithisileyo kobushushu kwizibane zoqhaqho zinokuba nefuthe eliyingozi. Inokubangela ukungaphumeleli kwiqela lotyando, kukhokelela kwinkohliso kunye nokuphazamiseka okunokubakho. Okubaluleke ngakumbi, ubushushu bunokuba nefuthena nesigulana, ngakumbi kwiinkqubo ezibuthathaka apho zinokuchaphazela ukuphilisa inxeba okanye ukonakalisa izicubu ezijikeleze izicubu. Izibane zoqhaqho zanamhlanje zisebenzisa itekhnoloji yokukhanya ebandayo, iinkqubo ezisekwe kwi-LED, ezivelisa ubushushu obukhulu xa kuthelekiswa ne-halogn okanye i-incandescent bubbs. Ezi mithombo zindayo zenziwe nje kuphela ukuba zinciphise umthwalo we-thermal kwigumbi lokusebenza kodwa zikwandisa ukhuseleko kunye nentuthuzelo iyonke yendawo yotyando.
III. IIMFUNO ZOQOQOSHO KOKUGQIBELA KWIINGXAKI ZOKUGQIBELA
A. utyando ngokubanzi
Utyando ngokubanzi lubandakanya uluhlu olubanzi lweenkqubo, ukusuka kwi-prendestomues yesiqhelo ukuya kwi utyando olunzima. Kwezi meko, izibane zoqhaqho kufuneka zinikele ibhalansi phakathi kokukhanyisela kunye nokukwazi ukugxila kwiindawo ezithile. Ngexesha lendawo yokuqala kunye nesigaba sokuhlola, intsimi enokukhanya eqaqambileyo, esasaziweyo ibalulekile ekuboneni indawo yotyando. Njengoko utyando uqhubeka kwaye ugqirha utyando lungade lufikelele kwizicubu, ukukwazi ukuhlengahlengisa ubungakanani bokukhanya kwaye ugxininiso lubalulekile. Umzekelo, kugqirha wokulungisa i-hernia, ugqirha wotyando kufuneka ahlukanisa ngokucacileyo iingqengqelo zodonga lwesisu, ezifuna ukukhanya okuqinileyo ukuze ube nobunzulu obungafaniyo ukuqaqambisa ukungafani kunye nombala. Ukongeza, uzinzo lomthombo wokukhanya ubalulekile, njengoko nayiphi na i-fiker okanye intshukumo inokuphazamisa uxinzelelo lukagqirha ngexesha lenkqubo yokutya.
B. I-Neurosurgery
I-neurosurgery ifuna igalelo eliphezulu lokuchaneka, elihlala lisebenza kwizakhiwo njengokuthambisa njengezimilo nje ezimbalwa ngobukhulu. Izibane zoqhaqho kule ntsimi kufuneka zibonelele nge-ultra-fighlity yokuqaqamba okukhulu ukuze ungene kwinzulu kwi-cranial cavity kunye nemithambo yemizuzu ye-nerve kunye nemithambo yentsholongwane. Isalathiso sombala ophezulu sibalulekile ekuphumeni ngokuchanekileyo phakathi kwezicubu eziqhelekileyo nezingaqhelekanga, njengokwahluka kombala kunokubonisa utshintsho olubalulekileyo kwimeko yesigulana. Umzekelo, ngexesha lohlaselo lwethumba lengqondo, ugqirha ohlelayo uxhomekeke ekukhanyisweni kwe-subgical ukuba atyhile ngokucacileyo i-tumar margins, enokunganyaniseki ngaphandle kokukhanya okuqinisekileyo. Ukuncitshiswa komtshiswa ubushushu, iindlela zokupholisa okuqhubela phambili zifakwe kwiloyiki yokukhanya, njengoko ubushushu obugqithisileyo bunokuyonakalisa i-tissies ejikelezileyo kwaye kukhokelele kwiingxaki zendawo.
C. Ophthalmic utyando
Unyango lwe-Ophthalmic lusebenza kwelinye lawona manyango abuthathaka kwaye inamachaphaza omzimba emzimbeni womntu. Eyona gushana kancinane okanye ukukhanyisela okungahambelani kunokubangela ukonakaliswa komongo wesigulana. Izibane zoqhaqho ze-Ophthalmimis kufuneka zikhuphe ukukhanya okuthambileyo, ezifanayo ezikhululekileyo kwilitha elinzima. Oku kufezekiswa ngokulinganayo kunye nezihluzi ezisasaza ngokulinganayo ukukhanya kwaye zinciphise amandla ayo kwinqanaba elikhululekile kwiliso. Utyandori otyatyanga okanye iinkqubo zokubuyiselwa kwe-retinal, ukukhanya kufuneka kunikezelwe ukukhanyisa okuzinzileyo kunye nombumbi ovumela ugqirha ukuze asebenzise izixhobo ze-microscopic ngaphakathi kweliso. Nakuphi na utshintsho olukhawulezileyo kubungakanani bokukhanya okanye ubushushu bemibala kunokuphazamisa i-surgen kagqirha otyhidiweyo kwaye ubekekeze umbono onesigulana.
D. Utyando lwe-Orthopedic
Unyango lwe-Orthoric lubandakanya ukusebenza namathambo, ukufakwa, kwaye kudla ngokufuna ukufikelela okunzulu kwinkqubo yeMgubo yeMorcyskeletal. Izibane zoqhaqho kule ndawo kufuneka zibe namandla omeleleyo angena nzulu zokufikelela kubunzulu bentsimi yoqhaqho, ngakumbi iinkqubo zokuhamba ngokutshintshwa okanye utyando lwe-spinal. Ubunzulu obukhulu bokukhanya kuyimfuneko ukuqinisekisa ukuba ugqirha ugqirha unokubukela ngokucacileyo uphawu lokufakwa kunye nokunyaniseka kwethambo. Ii-angles eziguqukayo kunye neentloko ezikhanyayo ezininzi zihlala zisetyenziselwa ukuphelisa izithunzi kwaye zinike ukhanyiso olubanzi kwiimbono ezahlukeneyo. Kwi-spinal utyando, umzekelo, iqela elikhutshelweyo kufuneka libe nembono ecacileyo ye-vertebrae kunye nokubekwa kwezikrweqe kunye neentonga, ezifuna ukukhanya kwe-roomet enokuziqhelanisa ne-spine kwaye zinike ukukhanyiselwa okungaguqukiyo kuyo yonke le nkqubo.
E. Utyando oluhlaselweyo
Ukuhlinzwa kancinci kancinci, kubandakanya iinkqubo ze-laparoscopic kunye ne-endoscopic, ihambe iguqukele kumhlaba oqingqiweyo. Ezi ndlela zixhomekeke kwisithuba esincinci kunye nokusetyenziswa kwezixhobo ezizodwa kunye neekhamera. Izibane zoqhaqho ezihlanjisiweyo ezihlaselweyo kufuneka zenziwe ukuncedisa ukuncedisa ezi teknoloji. Ukukhanya okuphezulu kuyacelwa ukuba woyise ukufunxa ukukhanya kwaye ukonakalisa okwenzeka ngaphakathi kweingca zomzimba. I-beam emxinwa igxile ukuba izakhono zibalulekile ekukhaleni phambili apho ifuneka khona, ngaphandle kokukhanyisa iindawo ezingeyomfuneko. Ukongeza, izibane kufuneka zilungelelaniswe neenkqubo zokulinganisa i-endoscopic ukubonelela ngamava abonakalayo angenamthungo kugqirha wotyando. Kwi-Laparoscopic Cholecystectomyy, ukukhanya okukhuselekileyo kufuneka kusebenze ngokuhamba kwe-laparoscope ukuqinisekisa ukuba i-gallbladder kunye nezakhiwo ezijikelezileyo zibonakala ngokucacileyo, zivumela ugqirha onesigulana esincinci.
Iv. Imeko yesicelo sekliniki ngaphaya kwegumbi lokusebenza
Ngelixa amagumbi okusebenza angummandla ophambili kwizibane zoqhankqalazo, isixhobo sabo salela ngaphaya kwezi ndawo zinikezelweyo. Kwimeko ezahlukeneyo zonyango, isidingo sokukhanyisa ngokuchanekileyo ngexesha lenkqubo kunye neemviwo zibalulekile, kwaye nezibane zoqhawulo-mali zilungelelaniswe ukuze zihlangabezane neemfuno ezahlukeneyo.
A. amaSebe kaxakeka
Kwindawo ekhawulezayo ekhawulezileyo nengalindelekanga yamasebe kaxakeka, ukufikelela ngokukhawuleza kokukhanya okusebenzayo kubalulekile. Xa ujongene nezigulana ezigudileyo, ukubala imizuzwana, kunye nezibane zoqhawulo-mali kufuneka zithunyelwe ngokukhawuleza ukuba zibonelele ngokukhawuleza indawo yokulimala. Imobile kunye ne-ceriling swilical izibane zokukhanya okunokutshintsha kunye nokugxila kusetyenziswa. Umzekelo, kwiimeko zelitha okanye iqhekeza eliqaqambileyo, ukukhanya kufuneka kulungiswe ukuqaqambisa imiphetho yenxeba kunye neziqwengana zethambo, kuvumela amagqirha angxamisekileyo ukuba ahlole umda wonyango kunye nokuqalisa unyango olufanelekileyo ngokukhawuleza. Ukuguquguquka komgangatho wokubeka ukukhanya kwii-angles ezininzi kubalulekile, njengoko izigulana zinokufika kwizikhundla ezahlukeneyo, kwaye iqela lezonyango kufuneka lihlengahlengise ukhanyiso kwiimfuno zabo ezithile.
B. Iiyunithi zononophelo ezinzulu (i-ICUS)
I-ICUS yendlu izigulana ezigula kakhulu ezinokufuna iinkqubo zebhedi nangaliphi na ixesha. Izibane zoqhaqho kwezi zinto zisebenza ngenjongo ezimbini: Ukubonelela ngokukhanyisela unyamezelo lwezigulana, ezinje ngoncedo lokunxiba kunye nokufakelwa kwenxeba, kunye nongenelelo olungxamisekileyo. Izibane kufuneka zinikezele ngokuthambileyo kodwa ukukhangela okwaneleyo okungaphazamisi imeko yesigulana esele ibuthathaka. Amaqondo obushushu ombala oguqukayo anokuba yingenelo, avumela abasebenzi bezonyango ukuba batshintshe phakathi kokuthuthuzela izigulana ngexesha lokuthuthuzela kunye nokuphola, ukuthoba okukhohlakeleyo xa kupholile. Ukongeza, uyilo lwe-compact kunye nolwazelelo lwezibane zotyando ze-ICU zenza ukuba zibekwe ecaleni kwebhedi yesigulana ngaphandle kokuthintela izixhobo zonyango ezijikelezileyo kunye neendawo zokubeka iliso.
C. Iiklinikhi zamazinyo
Inkqubo yamazinyo ifuna iseti eyahlukileyo yeemfuno zokukhanyisa. I-Oral Cavity yindawo evaliweyo, kwaye oogqirha bamazinyo kufuneka bagxile kwiinkcukacha zemizuzu ngaphakathi. Izibane zoqhaqho kwiiklinikhi zamazinyo kufuneka zibe ne-beam emxinwa ukwalathisa ukukhanya ngokuthe ngqo apho kuyafuneka khona, njengakwindawo ethile okanye kwindawo ye-gum. Isalathiso sombala esiphezulu sibalulekile ukuba sihluleke ngokuchanekileyo phakathi kwezicubu zezakhono ezisempilweni nezinesifo. Umzekelo, kunyango lweengcambu, ugqirha wamazinyo uxhomekeke ekukhanyeni ukuze ube nomfanekiso ngqondweni weecasi kunye nazo naziphi na iimpawu zosulelo. Umgaqo wokukhanya kufuneka uhlengahlengiswe ukuphakama kunye ne-engile yokulungiselela indawo yokusebenza kwamazinyo kunye nokuma kancinci kwesigulana. Ezinye izibane zoqhankqalazo zangoku zibandakanya iilensi zokukhulisa ukongeza ukubonakala kwezakhiwo ezifanelekileyo zamazinyo, ekuqinisekiseni unyango oluchanekileyo nolusebenzayo.
V. Ukuhambela phambili kwezobuchwephesha kunye neendlela zexesha elizayo
Intsimi yokuhlinqwa iyabonakala, iqhutywa ngokuhambela phambili kwezobugcisa. Ezi zicelo zinokuphucula kuphela ukusebenza kwezibane zoqhaqho kodwa ziphinde ziguqule indlela eqhutywa yindlela eqhutywayo, ekhokelela kwiziphumo eziphuculweyo kunye namava ohlelo.
A. ITekhnoloji ye-LED kunye nefuthe layo
Itekhnoloji yokukhanya ekhanyayo (itekhnoloji ye-LED) ivele njengomdlalo otshintsha umdlalo kwizibane zoqhaqho. I-LED inika izibonelelo ezininzi ngaphezulu kwe-heard okanye i-incandescent bubs. Okokuqala, zisebenza kakhulu, zisebenzisa amandla amancinci kakhulu ngelixa zibonelela ngokuthelekiswa okanye ukuthambeka okuphezulu. Oku akunciphisi iindleko zombane kwizibhedlele kodwa ikwanegalelo kwimeko ezinzileyo yezempilo. Okwesibini, ii-LEDs zinobomi obukhethekileyo, zihlala zingaphaya kweeyure ezingama-50 000, zinciphisa kakhulu imvano-bume bebhalbhu. Oku kubaluleke kakhulu kumagumbi okusebenza apho iinkqubo zotyando ezingaphazanyiswanga ngumgangatho, ukunciphisa umngcipheko wokuphazamiseka ngenxa yokusilela okukhanyisayo. Ukongeza, ii-LED zinokulawulwa ngokuchanekileyo ukuba zikhuphe iqondo lobushushu kunye nobunzulu, zivumela oogqirha ukuba benze ngokwezifiso iimeko zenkqubo nganye. Umzekelo, kwi-Laparoscopic utyandelwa, apho ilizwe elibonakalayo lilinganiselwe kwaye imfuneko yokwahlulahlula i-tismount, oogqirha banokuhlengahlengisa izibane ezikhokelayo ze-APT ukuya kwi-Coundges ePhakamileyo kunye nemithambo yegazi.
B. Iinkqubo zokulawula ubuchule
Iinkqubo zokulawula ubuchule ziya kuba yinxalenye yezibane zotyando zangoku. Ezi nkqubo zisebenzisa i-deasors ze-Adved Advars, i-MicroProcessor, kunye netekhnoloji yonxibelelwano yokubonelela ngeendlela. Izakhono zomsebenzi ezikude zenza oogqirha okanye abasebenzi kwigumbi lokusebenza ukuze zilungelelanise useto lokukhanya, njengokukhanya, ukugxila kunye nobushushu bombala, ngaphandle kokuchukumisa umbala. Oku kuluncedo ngakumbi ngexesha lotyando oluntsonkothileyo apho ukulungiswa kufuneka kugcinwe, kwaye nayiphi na intshukumo inokuba sisiphazamiso. Umzekelo, kwiinkqubo ze-neurosurrical, apho umntu othuthuzelayo onokuba nemiphumo ebalulekileyo, amandla okulawula izibane ezingxamiseko zinika isisombululo esingenamthungo esingenamthungo. Amanqaku aSebenzayo ngokuzenzekelayo kunye nokuSebenza ngokuQhelekileyo ukuQiniseka ukuphucula usakhiwo kwezi nkqubo. Ngokuziqonda iimeko zokukhanya ezihle kwigumbi lokusebenza kunye nendawo yokuhlinqwa, inkqubo yokulawula inokutshintsha ngokuzenzekelayo ukuthamba okukhanyayo ukubonelela ngokukhanya okufanelekileyo apho kuyafuneka khona, ukunciphisa ilitha kunye namathunzi. Ezinye iinkqubo eziqhubela phambili zikwadibanisa ukusebenza kwezwi, ukuvumela oogqirha ukuba bakhuphe imiyalelo ngamazwi, bakhulule izandla zabo kwimisebenzi ebuthathaka.
C. Ukudityaniswa neenkqubo zokucinga kunye neenkqubo zokuhamba
Ikamva lokuhlinya i-subgings ilele kwindawo yayo engenamthungo kunye neenkqubo zokuhamba kunye nokuhamba. Njengoko utyando oluhlaselayo oluhlaselayo kunye nerobhothi lufumana udumo, isidingo solwazi olubonakalayo oluhambelanayo lubalulekile. Izibane zoqhaqho ngoku ziyilelwe ukusebenza ngokuhambelana neekhamera ze-endoscopic, oomatshini bokuhambahamba kwe-Fluoroscopy, kunye neenkqubo zokuhamba. Ngokudibanisa ezi teknoloji, izibane zoqhaqho zinokubonelela ngee-cumes zexesha lokwenyani kwaye zigqithise ngqo kwintsimi yoqhaqho. Umzekelo, kwi-Ortoperies utyandeji, ukukhanya okuthe tyaba kunokwenza umfanekiso obonakalayo wokubekwa endaweni yendawo yokubekwa kwesigulana kumzimba wesigulana, ukuvumela ugqirha ukuba alungelelanise ngokuchanekileyo ithambo ngokungqongileyo. Oku kudityaniswa akuphuculi nje ukuchaneka kotyando kodwa kunciphisa umthwalo wengqondo kugqirha wotyando, ngoku onokuthembela kumboniso obonakalayo ocacileyo ukwenza izigqibo ezinolwazi. Ukongeza, ukudityaniswa kwezibane zoqhaqho ngengcinga kunye neenkqubo zokuhamba zenza ukuba isikhokelo esingcono sokujonga, ngakumbi kwiinkqubo apho i-Aatomy ekujolise kuyo kunzima ukuyibona, njengalo utyando oluthile. Intsimi yoqhaqho ekhanyisiweyo inokuphakanyiswa ngolwazi olufanelekileyo lwe-Aatomical, ekwandiseni ukuzithemba kukagqirha kunye nokuchaneka kuyo yonke le nkqubo.
VI. Ukuqukumbela
Izibane zoqhaqho zingaphezulu kwemithombo yokukhanya elula kwicandelo lezonyango; Zizixhobo ezingathandekiyo ezixhasa impumelelo kwiinkqubo zotyando kunye nononophelo lwesigulana. Ukusuka kwiimfuno ezifunwayo zezinto ezahlukeneyo zonyango lwezonyango zekliniki ezahlukeneyo, ezi zibane ziye zavela ukuze zifezekise iimfuno eziguqukayo zonyango lwanamhlanje. Njengoko itekhnoloji iyaqhubeka ukuqhubela phambili, sinokulindela izisombululo ezinobunkunkqele ngakumbi utyando oluya kuphucula ukuqhubela phambili ukuchaneka, kwaye ekugqibeleni ukuphucula iziphumo zomonde. Uhambo lwezinto ezintsha ekubonakaliseni ukukhanya okuqhubekayo, kwaye ifuthe layo kwikamva lezeminyango ayinasiphelo.
