Ukuqalisa
Endaweni yomuthi wanamuhla, ukuhlinzwa kwe-laparoscopic sekuvele njengendlela yezinguquko, ukuguqula kakhulu isimo sezinqubo zokuhlinzwa. Le ndlela yokuzihlasela kancane ithole isimemezelo esibanzi sokwengeza izinzuzo zayo eziningi ngokuhlinzwa okuvulekile kwendabuko. Ngokwenza ukufakwa okuncane esiswini, odokotela abahlinzayo bangafaka i-laparoscope - ishubhu elincanyana, eliguqukayo elifakwe ukukhanya nekhamera - kanye namathuluzi okuhlinza akhethekile. Lokhu kubavumela ukuba benze izinqubo eziyinkimbinkimbi ngokunemba okuthuthukisiwe, ukuncishiswa kwezicubu, kanye nokuncipha kwegazi okuncishisiwe. Iziguli zivame ukuhlangabezana nokuhlala esibhedlela, izikhathi zokutakula ngokushesha, kanye nokuthumela okuncane - Ubuhlungu bokusebenza, okuholela kwikhwalithi yempilo ethuthukisiwe ngesikhathi senqubo yokutakula. I-Laparoscopic Surgery ithole izinhlelo zokusebenza ezinhlobonhlobo zemikhakha yezokwelapha, kusuka ku-gynecology kanye nokuhlinzwa okujwayelekile kuya ku-Urology kanye nokuhlinzwa okumelelekayo, kube yingxenye ebalulekile yokuzijwayeza okuphakathi kwesimanje.
Ukugcwaliswa kwentuthuko kumasu we-laparoscopic yiyunithi ye-electrosurgical (eSU), esephenduke ithuluzi elisemqoka egumbini elisebenzayo. I-ESS isebenzisa okuphezulu kakhulu - imvamisa kagesi kagesi ukusika, ukuhlanganisa, noma izicubu ze-desiccate ngezindlela zokuhlinzwa. Lobu buchwepheshe bunika amandla odokotela abahlinzayo ukuthi bafinyelele i-hemostasis (ukulawulwa kokopha) ngempumelelo futhi benza ukuqondiswa kwezicubu ngokunemba okukhulu. Amandla wokulawula kahle amandla kagesi alethwe kwizicubu zenze i-ESS ibe yinto evamile ekuhlinzeni okuvulekile kanye ne-laparoscopic, okufaka isandla empumelelweni ephelele kanye nokuphepha kwezinqubo.
Kodwa-ke, naphezu kwezinzuzo eziphawuleka zokuhlinzwa kwama-laparoscopic kanye namayunithi we-electrosurgical, ukukhathazeka okukhulu kuqhamuke mayelana nokusetshenziswa kwe-eSUS ngesikhathi sezinqubo ze-laparoscopic: isizukulwane samagesi ayingozi. Lapho okuphezulu kakhulu - imvamisa kagesi kagesi ye-ES kuxhumana nezicubu, kungadala ukuhlukaniswa nokubola kwezinto eziphilayo, okuholele ekukhiqizweni kwengxube eyinkimbinkimbi yamagesi. Lawa magesi awalimazi kuphela esigulini esihlinzwa kodwa futhi abe yingozi enkulu empilweni nokuphepha kwabasebenzi bezokwelapha abakhona egumbini elisebenzayo.
Izingozi ezingaba khona zezempilo ezihambisana nalawa magesi ayingozi ziyehluka futhi zifinyelela kude. Esikhathini esifushane - ukubonwa kwalawa magesi kungadala ukucasuka emehlweni, ekhaleni naseqenjini lokuphefumula leziguli kanye nabahlinzeki bezokunakekelwa kwempilo. Isikhathi eside - Ukuvezwa okuphindaphindiwe kungakhulisa ubungozi bezindaba ezinkulu zezempilo, ezifana nezifo zokuphefumula, kufaka phakathi umdlavuza wamaphaphu, nezinye izinkinga zempilo ezihlelekile. Njengoba ukuhlinzwa kwe-laparoscopic kuyaqhubeka ukukhula ekudumeni nasekusetshenzisweni kwamayunithi we-electrosurgical kuhlangenwe nakho kwalawa magesi ayingozi, imiphumela yawo engahle ibe khona, nokuthi unganciphisa kanjani ubungozi babo sekubaluleke kakhulu emphakathini wezokwelapha. Lo mbhalo uhlose ukuhlola ngokuphelele lesi sihloko esibucayi, okhanyisela isayensi ngemuva kwesizukulwane segesi, amasu angaba nemithelela yezempilo, kanye namasu angaqashwa ukuze aqinisekise indawo ephephile yokuhlinzwa.
Izisekelo zokuhlinzwa kwe-laparoscopic kanye namayunithi we-electrosurgical
Ukuhlinzwa kweLaparoscopic: isimangaliso esincane esihlaselayo
Ukuhlinzwa kweLaparoscopic, owaziwa nangokuthi ukuhlinzwa okuncane okuhlaselayo noma ukuhlinzwa kwe-keyhole, kumelela i-screap ebalulekile phambili emkhakheni wamasu okuhlinza. Le nqubo iguqule indlela yokungenelela okuningi okuqhutshwa ngayo, enikeza iziguli izinzuzo eziningi eziqhathaniswa nezinto ezivulekile zendabuko - izindlela zokuhlinzwa.
Inqubo iqala ngokwakhiwa kokufakwa okuncane okuningana, imvamisa ingekho ngaphezu kwamamilimitha ambalwa kuya kumasentimitha ambalwa ubude, esiswini sesiguli. Ngokusebenzisa okukodwa kulokhu kufakwa, kufakwa i-laparoscope. Lesi sisebenzi sensimbi ethambile sihlome ngekhamera ephezulu - incazelo kanye nomthombo onamandla wokukhanya. Ikhamera idlulisela kwangempela - isikhathi, izithombe ezikhulisiwe zezitho zangaphakathi eziku-Monitor, ukuhlinzeka udokotela ohlinzayo nombono ocacile wesayithi lokuhlinzwa.
Odokotela abahlinzayo bese befaka izinsimbi ezikhethekile ze-laparoscopic ngokufakwa okusele. Lezi zinsimbi zenzelwe ukuba zinde, zibe mncane, futhi ziguquguquke, zivumela ukukhohlisa okuqondile ngaphakathi komzimba ngenkathi kunciphisa ukulimala kwezicubu ezizungezile. Ngosizo lwalawa mathuluzi, odokotela abahlinzayo bangenza izinqubo eziningi ezahlukahlukene, kufaka phakathi ukususwa kweGallbladder (Cholecysttectomy), i-applendectomy, ukulungiswa kwe-hernia, kanye nokuhlinzwa okuningi kwe-gynecological kanye nokobuzwe.
Enye yezinzuzo ezivelele kakhulu zokuhlinzwa kwe-laparoscopic ukuhlinza okuncishisiwe emzimbeni. Ukuvela okuncane kuholela ekulahlekelweni kwegazi okuncane ngesikhathi senqubo uma kuqhathaniswa nokuhlinzwa okuvulekile, lapho kwenziwa khona incist enkulu ukuze kudalulwe indawo yokuhlinzwa. Lokhu akupheli nje kuphela isidingo sokumpompela igazi kodwa futhi kunciphisa ubungozi bezinkinga ezihambisana nokukhipha ukopha ngokweqile. Ngokwengeziwe, ukufakwa okuncane kuholela eposini elingaphansi - izinhlungu zokusebenza zesiguli. Njengoba kunokuphazamiseka okuncane kwimisipha nezicubu, iziguli zivame ukudinga umuthi omncane wezinhlungu futhi zihlangabezana nenqubo yokubuyisa okuthe xaxa.
Isikhathi sokutakula okulandela ukuhlinzwa kweLaparoscopic nakho kufushane kakhulu. Iziguli zivame ukuqala kabusha imisebenzi evamile maduze, zivame ezinsukwini ezimbalwa kuya kwesonto, kuya ngobulukhuni benqubo. Lokhu kuqhathanise ukuhlinzwa okuvulekile, okungadinga amasonto okubuyisa kanye nesikhathi esinwetshiwe se-collalescence. Ukuhlala okufushane kwesibhedlela kungenye inzuzo, engagcini nje ngokunciphisa izindleko zokunakekelwa kwempilo kepha futhi ivumela iziguli ukuthi zibuyele empilweni yazo yansuku zonke ngokushesha okukhulu.
I-Laparoscopic Surgery ithole izicelo ezibanzi kwezindlela ezahlukahlukene zezokwelapha. Kwi-Gynecology, kuvame ukusetshenziselwa izinqubo ezifana ne-hysterectomy (ukususwa kwesibeletho), i-cystectomy ye-ovari), kanye nokwelashwa kwe-endometriosis. Ngokuhlinzwa okujwayelekile, kuqashwa ukususwa kweGallodder, kanye nokwelashwa ngezimo ezinjengezilonda ze-peptic kanye nezinhlobo ezithile zomdlavuza. I-Udologists isebenzisa amasu we-laparoscopic ngezinqubo ezifana ne-nephrectomy (ukususwa kwezinso) kanye ne-prostatectomy. Ukuguquguquka kwezingxabano kanye nokusebenza kahle kokuhlinzwa kwe-laparoscopic kuye kwakwenza kwaba ukukhetha okuthandwayo kokungenelela okuningi kokuhlinzwa noma nini lapho kungenzeka.
Amayunithi we-electrosurgical: ukunemba kwamandla ukuhlinzwa
Amayunithi we-electrosurgical (eSUS) amadivaysi wezokwelapha amancane adlala indima ebalulekile ezinhlosweni zanamuhla zokuhlinzwa, ikakhulukazi ekuhlinzweni kwe-laparoscopic. Lawa madivayisi asebenzisa izimiso zikagesi ukwenza imisebenzi ehlukahlukene ngesikhathi sokuhlinzwa, ngokuyinhloko ukusika izicubu kanye nokugqekeza.
Isimiso esiyisisekelo sokusebenza se-ESU sihilela isizukulwane sezimali eziphezulu kakhulu zikagesi. Lezi zindlela zivame ukusuka ku-300 khz kuya ku-5 mhz, ngaphezu kobubanzi obuvaliwe bezakhiwo (imvamisa 50 - 60 Hz). Lapho i-ESU icushiwe, imvamisa ephezulu - imvamisa yayisekela esizeni sokuhlinza ngokusebenzisa i-electrode ekhethekile, engaba ngesimo se-scalpel - njengengxenye yesandla esihlukile.
Lapho isetshenziselwa ukusika kwezicubu, imvamisa ephezulu - imvamisa yamanje ibangela ama-molecule wamanzi ngaphakathi kwezicubu ukuze aqhekeke ngokushesha. Lokhu ukudlidliza kwakha ukushisa, okuhlanganisa izicubu futhi kusike ngempumelelo. Inzuzo yale ndlela ukuthi ihlinzeka ukusika okuhlanzekile nokunembile. Ukushisa kwakhiqizwa nakho kuthola imithambo yegazi emincane njengoba izicubu zisikwa, zinciphisa ukopha ngesikhathi senqubo. Lokhu kuphambene nezindlela zokusika ezenziwa ngomshini, ezingadala ukopha okuningi futhi zidinga izinyathelo ezengeziwe zokufeza i-hemostasis.
Ukuze uthole ukugeleza, i-ESU iyalungiswa ukuletha iphethini ehlukile yamanje kagesi. Esikhundleni sokusika ngezicubu, okusetshenziselwa amanje kusetshenziselwa ukushisa izicubu ziye endaweni lapho amaprotheni emikhakheni yamaseli. Lokhu kudala ukuthi izicubu zibambeze, noma zigobe, zibopha uphawu emithanjeni yegazi nokumisa ukopha. I-ESUS ingahle isethwe emazingeni ahlukahlukene ama-Power kanye nama-WaveForms, avumela odokotela abahlinzayo ukuthi balawule ngokunembile inani lokushisa nokujula kokungena kwezicubu, kuya ngezidingo ezithile zokuhlinzwa.
Ekuhlinzweni kwe-laparoscopic, i-eSus ibaluleke ikakhulukazi. Amandla okwenza ukuqondiswa kwezicubu okuqondile futhi afinyelele ama-hemostasis asebenzayo ngokusebenzisa izinqubo ezincane zezinqubo ze-laparoscopic zibalulekile. Ngaphandle kokusebenzisa i-ESUS, kungaba yinselele enkulu ukulawula ukopha futhi wenze ukusikwa kwezicubu ezibucayi ngaphakathi kwesikhala esilinganiselwe sesisu sesisu. I-Esus inika amandla odokotela abahlinzayo ukuthi basebenze kahle, behlisa isikhathi sonke sokuhlinzwa. Lokhu akukuzuzisi kuphela isiguli ngokuya ngokunciphisa isikhathi ngaphansi kwe-anesthesia kodwa futhi kwehlisa ubungozi bezinkinga ezihambisana nezinqubo ezinde zokuhlinzwa.
Ngaphezu kwalokho, ukucaciswa okuhlinzekwa yi-ESUS ekuhlinzweni kwe-laparoscopic kuvumela ukususwa okunembe kakhudlwana kwezicubu ezinesifo ngenkathi kuvinjeze izicubu ezizungezile ezizungezile. Lokhu kubalulekile ekwenzeni izinqubo lapho ukulondolozwa komsebenzi ojwayelekile wesitho kubalulekile, njengokuhlinzwa okuthile komdlavuza. Ukusetshenziswa kwe-ESUS ngaleyo ndlela kube nomthelela omkhulu empumelelweni nasekuphepheni kokuhlinzwa kwe-laparoscopic, kubenza balithole ngendlela ejwayelekile futhi ebaluleke kakhulu ekusebenzeni kwanamuhla. Kodwa-ke, njengoba kushiwo ngaphambili, ukusetshenziswa kwe-ESUS ekuhlinzweni kwe-laparoscopic kubuye kuletha udaba lwesizukulwane esilimazayo segesi, esizohlola imininingwane ngezigaba ezilandelayo.
UGenesise Wamagesi Amabi
Imiphumela eshisayo kanye nokusabela kwamakhemikhali
Lapho iyunithi ye-electrosurgical icushiwe ngesikhathi sokuhlinzwa kwe-laparoscopic, kuvelisa uchungechunge oluyinkimbinkimbi lwemiphumela eshisayo kanye nokusabela kwamakhemikhali ngaphakathi kwezicubu zebhayoloji. Imvamisa ephakeme - imvamisa kagesi edlula lapho izicubu zikhiqiza ukushisa okukhulu. Lokhu kushisa kungumphumela wamandla kagesi aguqulwa abe amandla afudumele njengokuhlangana kwamanje ukumelana kwezicubu. Izinga lokushisa elisendaweni ye-electrode - ukusebenzisana kwezicubu kungakhuphuka ngokushesha kumazinga aphezulu kakhulu, kuvame ukwedlula i-100 ° C, futhi kwezinye izikhathi, ukufinyelela ama-degree angamakhulu amaningana.
Kula mazinga okushisa aphakeme, izicubu zikhulelwa ukubola okushisayo, ezaziwa nangokuthi i-pyrolysis. Amanzi ngaphakathi kwezicubu ngokushesha adopisha, okuwuphawu lokuqala olubonakalayo lomphumela we-thermal. Njengoba izinga lokushisa liqhubeka lenyuka, izingxenye eziphilayo zezicubu, njengamaprotheni, ama-lipid nama-carbohydrate, ziqala ukudiliza. Amaprotheni, akhiwa amaketanga amade ama-amino acid, aqala ukudelela abese ebola ngezingcezwana ezincane zamangqamuzana. Ama-Lipids, aqukethe ama-fatty acid kanye ne-glycerol, futhi abhekana nokuwohloka okushisayo, akhiqiza imikhiqizo ehlukahlukene yokuqhekeka. Ama-carbohydrate, njenge-glycogen egcinwe kumaseli, athinteka ngendlela efanayo, ephulwe phansi kushukela olula bese ebolile futhi.
Lezi zinqubo zokukhohlisa okushisayo zihambisana nobuningi bokuphendula kwamakhemikhali. Isibonelo, ukwephuka kwamaprotheni kungaholela ekwakhekeni kwe-nitrogen - okuqukethe amakhompiyutha. Lapho i-Amino - izinsalela ze-acid kuma-protein zifudumele, i-nitrogen - izibopho zekhabhoni zinamathele, okuholela ekukhishweni kwe-ammonia - njengezingxube nezinye i-nitrogen - equkethe ama-molecule. Ukuwohloka kwama-lipid kungakhiqiza ama-acid aguquguqukayo nama-Aldehydes. Lokhu kusabela kwamakhemikhali akuwona kuphela umphumela wePighter - Temperature Pyyrolysis kodwa futhi kuthonywa khona yi-oksijini esikhungweni sokuhlinza kanye nokwakhiwa okuthile kwezicubu eziphathwayo. Inhlanganisela yalezi zinqubo ezishisayo nezamakhemikhali yilokho ekugcineni okuholela esizukulwaneni samagesi ayingozi ngesikhathi sokuhlinzwa kwe-laparoscopic esebenzisa iyunithi ye-electrosurgical esebenzisa iyunithi ye-electrosurgical.
Amagesi ajwayelekile alimazayo akhiqizwayo
1. I-Carbon Moxide (CO)
1. I-carbon monoxide iyigesi engenamibala, engenaphunga, futhi enobuthi kakhulu ekhiqizwa kaningi ngesikhathi kusetshenziswa iyunithi ye-electrosurgical ekuhlinzweni kwe-laparoscopic. Ukwakheka kwe-CO kwenzeka ikakhulukazi ngenxa yokuhlanganiswa okungaphelele kwezinto eziphilayo ezicutshini. Lapho ama-prolysis aphezulu aphezulu, ama-lipids, nama-carbohydrate atholakala endaweni enomkhawulo wokutholakala komoya-mpilo (okungenzeka ukuthi kuvaliwe - ikhabhoni - equkethe amakhompiyutha ezicutshini awenziwanga ngokuphelele ku-carbon dioxide (). Esikhundleni salokho, bangama-oxidized ngokwengxenye kuphela, okuholela ekukhiqizweni kwe-Co.
1. Izingozi zezempilo ezihambisana no-CO zibalulekile. I-CO inobudlelwano obuphakeme kakhulu be-hemoglobin egazini kune-oxygen yenza. Lapho i-inhalid, ibopha i-hemoglobin ukwakha i-carboxhemoglobin, yehlisa umoya-mpilo - ukuthwala umthamo wegazi. Ngisho nokuchayeka kwezinga eliphansi - okukhona ku-CO kungadala amakhanda, isiyezi, isicanucanu nokukhathala. Ukuvezwa kwezinga isikhathi eside noma okuphezulu kungaholela kwizimpawu ezinzima kakhulu, kufaka phakathi ukudideka, ukulahleka kokwazi, kanye nasezimweni ezimbi kakhulu, ukufa. Ekamelweni elisebenzayo, bobabili isiguli kanye nabasebenzi bezokwelapha basengozini yokuvezwa uma umoya omncane kanye negesi - amasistimu wokukhipha awatholakali.
1. Hlela izinhlayiya
1. Intuthu ekhishwe ngesikhathi sezinqubo ze-electrosurgical iqukethe ingxube eyinkimbinkimbi yezinhlayiya eziqinile nezamanzi. Lezi zinhlayiya zakhiwa ngezinto ezahlukahlukene, kufaka phakathi izingcezwana zezicubu ze-chorroted, izindaba ezingezinhle, kanye namaphunga ancishisiwe avela ekuboshweni kwe-thermal kwezicubu. Ubukhulu balezi zinhlayiya bungasukela ku-micrometer ku-micrometer kuma-micrometer amaningana ubukhulu.
1. Lapho u-inhalid, lezi zinhlayiya zentuthu zingadala ukucasuka kwipheshana lokuphefumula. Bangakufaka emavesini amakhala, i-trachea namaphaphu, okuholele ekukhweneni, ukujuluka, kanye nomphimbo obuhlungu. Ngokuhamba kwesikhathi, ukuvezwa okuphindaphindiwe kulezi zinhlayiya kungandisa ingozi yokuthola izinkinga ezinkulu zokuphefumula, njenge-bronchitis engapheli kanye nomdlavuza wamaphaphu. Ngaphezu kwalokho, izinhlayiya ezibhemayo nazo zingaphatha ezinye izinto eziyingozi, njengamagciwane namagciwane akhona kwizicubu, ezingabeka engcupheni ethelelekile kubasebenzi bezokwelapha.
1. Amakhompiyutha e-turatile organic (ama-Vocs)
1. Kukhiqizwa izinhlobo eziningi zezinto eziguquguqukayo ze-organic eziguquguqukayo ngesikhathi kusetshenziswa iyunithi ye-electrosurgical. Lokhu kufaka i-benzene, i-formaldehyde, i-agralein, kanye nama-hydrocarbons ahlukahlukene. UBenzene uyi-carcinogen eyaziwayo. Ukuvezwa kwesikhathi eside - Ukuchayeka kwesikhathi ku-benzene kungalimaza umongo, okuholela ekwehleni kokukhiqizwa kwamangqamuzana abomvu egazi, amaseli amhlophe egazi, kanye namaplayiti owaziwa ngokuthi yi-aplamia ye-aplastic. Ingakhulisa nengozi yokuthuthukisa i-leukemia.
1. I-formaldehyde enye i-voc esebenzayo esebenzayo. Kuyimpunge - igesi enukezayo engadala ukucasuka emehlweni, ekhaleni nasekuqaleni komphimbo. Ukuchayeka isikhathi eside ku-formaldehyde kuhlobene nengozi eyandayo yokuthola izifo zokuphefumula, kufaka phakathi i-asthma, kanye nezinhlobo ezithile zomdlavuza, njengomdlavuza we-nasopharyngeal. Ngakolunye uhlangothi, i-agralein, iyinkampani ecasulayo kakhulu engadala usizi olukhulu lokuphefumula ngisho nokugxila okuphansi. Kungalimaza i-epithelium yokuphefumula futhi kuhlotshaniswa nezinkinga zokuphefumula isikhathi eside. Ukuba khona kwalezi zivota egumbini lokusebenza kwendawo esebenza kuyo kusongela kakhulu empilweni yethimba lokuhlinzwa kanye nesiguli, kugqamisa isidingo sezinyathelo ezisebenzayo zokunciphisa ubukhona bawo.
Umthelela empilweni
Ubungozi ezigulini
Ngesikhathi sokuhlinzwa kwe-laparoscopic, iziguli zivezwa ngokuqondile kumagesi ayingozi akhiqizwa iyunithi ye-electrosurgical. Ukuphefumula kwalawa magesi kungaba nemiphumela yesikhathi esisheshayo futhi ende - yempilo yabo.
Esikhathini esifushane - ithemu, izimpawu ezivame kakhulu ezitholwa yiziguli zihlobene nokucasuka okuphefumula. Ukuba khona kwezinhlayiyana, ama-compacts aguqukayo (ama-Vocs), nezinye izinto ezicasulayo endaweni yokuhlinzwa kungenza amehlo esiguli, ikhala nomphimbo ukuze acasuke. Lokhu kungaholela ekukhweneni, ukushushuluza, kanye nomphimbo obuhlungu. Ukucasulwa kwepheshana lokuphefumula nakho kungenza umuzwa wokuqina esifubeni kanye nokufushane komoya. Lezi zimpawu azidali nje ngenxa yokungakhululeki ngesikhathi sokuhlinzwa ngesikhathi sokwehlinzwa kodwa futhi singaphazamisa ukuphefumula kwesiguli, okukukhathaza okubucayi, ikakhulukazi lapho isiguli siphansi kwe-anesthesia.
Ngokuhamba kwesikhathi, ukubonwa okuphindaphindwayo noma okuphawulekayo noma okubalulekile kumagesi ayingozi kungaholela ezindabeni ezinkulu zezempilo. Enye yezinto ezikhathazayo ezinkulu yithuba lokulimala kwamaphaphu. Ukuphefumula kwezinhlayiya zentuthu emihle namavoloshi athile, njenge-benzene ne-formaldehyde, kungadala ukulimala kwezicubu ezintekenteke. Izinhlayiya ezincane zingangena ekujuleni kwi-alveoli, ama-sacs amancane omoya emaphashini lapho kwenzeka khona igesi. Lapho ese-alveoli, lezi zinhlayiya zingadala impendulo yokuvuvukala emaphashini. Ukuvuvukala okungapheli emaphashini kungaholela ekuthuthukisweni kwezimo ezinjengesifo esingama-pulmonary se-pulmonary (Copd), okubandakanya i-bronchitis engapheli ne-emphysema. I-Copd ibonakala ngobunzima bokuphefumula obuqhubekayo, ukukhwehlela, kanye nokukhiqizwa kwe-mucus ngokweqile, ukunciphisa kakhulu ikhwalithi yempilo yesiguli.
Ngaphezu kwalokho, uhlobo lwe-carcinogenic lwamanye amagesi, njenge-benzene, kubangela ubungozi obude bomdlavuza. Yize ubungozi obuqondile bokuthi umdlavuza osungula umdlavuza ngenxa yokuhlinzwa okukodwa kwe-laparoscopic kuphansi, umphumela wokuqothuka ngokuhamba kwesikhathi (ikakhulukazi iziguli ezingase zibe nezindlela eziningi zokuhlinzwa esikhathini sazo sonke) azinakunakwa. Ukuba khona kwe-benzene ekolweni lokuhlinzwa kungalimaza i-DNA emahlengweni amaphaphu, okuholela ekuguqukeni okungahle kube nomphumela ekuthuthukisweni komdlavuza wamaphaphu.
Izingozi kubasebenzi bezempilo
Abasebenzi bezokunakekelwa kwezempilo, okubandakanya odokotela abahlinzayo, abahlengikazi, kanye nama-anesthesiologists, nabo basengozini ngenxa yokuchayeka kwabo okujwayelekile nokuphindaphindiwe kumagesi ayingozi akhiqizwa ngesikhathi sokuhlinzwa okuyilimakile okwenziwe ngesikhathi sokuhlinzwa kwama-laparoscopic. Imvelo yegumbi elisebenzayo ivame ukuvalelwa, futhi uma umoya omncane nogesi - amasistimu wokukhishwa awekho endaweni, ukugcwaliseka kwalawa magesi ayingozi angakha ngokushesha.
Ukuchayeka isikhathi eside - ukuvezwa kwesikhathi kumagesi egumbini lokusebenza kwandisa ingozi yabasebenzi bezokunakekelwa kwempilo abasungula izifo zokuphefumula. Ukuphefumula okuqhubekayo kwezinhlayiya zentuthu nama-Voc kungaholela ekuthuthukisweni kwesifuba somoya. Uhlobo olucasulayo lwamagesi lungenza ukuthi imigwaqo yomoya ingenelwe futhi i-hypersensitive, okuholela ezimpawuni ezinjengokukhanya, ukuqina komoya. Abasebenzi bezokunakekelwa kwezempilo nabo bangaba sengozini ephezulu yokuthuthukisa i-bronchitis engapheli. Ukuchayeka okuphindaphindiwe ezintweni eziyingozi entuthuni yokuhlinzwa kungenza ukufakwa kwamashubhu e-bronchial ukuba kuhlaselwe futhi kucasule ukukhwehlela, ukukhiqizwa kokuphefumula okuphikelelayo, nokukhiqizwa kokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula, kanye nobunzima bokuphefumula.
Ingozi yomdlavuza nayo uyikhathalela kakhulu abasebenzi bezempilo. Ukuba khona kwamagesi e-carcinogenic afana ne-benzene kanye ne-formaldehyde emvelweni esebenzayo kusho ukuthi ngokuhamba kwesikhathi, ukuvezwa okuhlanganisiwe kungakhulisa amathuba umdlavuza athile. Ngaphezu komdlavuza wamaphaphu, izisebenzi zezempilo nazo zingaba sengozini ephezulu yokuthuthukisa umdlavuza wepheshana eliphakeme lokuphefumula, njengomdlavuza we-nasopharyngeal, ngenxa yokuxhumana ngqo kwama-carcinogens ngezicubu zamakhala nange-pharyngeal izicubu.
Ngaphezu kwalokho, ukuphefumula kwamagesi ayingozi kungaba nemiphumela emihle ngempilo yabasebenzi bezempilo. Ezinye zezinto ezisesimweni sokuhlinzwa, ezinjengezinsimbi ezisindayo ezingaba khona ngamanani alandelwayo ezicutshini ezifundwayo, zingangenwa egazini. Lapho esegazini, lezi zinto zingathinta izitho ezahlukahlukene nezinhlelo emzimbeni, okuholela ezinkingeni zemizwa, ukulimala kwezinso, nezinye izindaba zezempilo ezihlelekile. Imiphumela yethemu ende - yalokhu kudalulwa kusafundwa, kepha kuyacaca ukuthi ubungozi bezempilo kubasebenzi bezempilo babalulekile futhi badinga ukunakwa okukhulu kanye nezindlela zokuvimbela.
Ukutholwa nokuqapha
Izindlela zamanje zokutholwa
1. Izinzwa zegesi
1. Izinzwa zegesi zidlala indima ebalulekile ekutholeni amagesi ayingozi akhiqizwe ngesikhathi sokuhlinzwa kwe-laparoscopic. Kunezinhlobo eziningana zezinzwa zegesi ezisetshenziswayo, ngayinye inemigomo yayo ehlukile yokusebenza kanye nezinzuzo.
1. Izinzwa zegesi ye-Electrochemical : Lezi zinzwa zisebenza ngokususelwa emgomweni wokuphendula nge-electrochemical. Lapho igesi kwelitshe, njenge-carbon monoxide (co), ihlangana ne-electrodes ye-sensor, kwenzeke ukusabela kwe-electrochemical. Isibonelo, enzwa ye-Electrochemical Sensor, i-CO i-Oxidised ku-Electrode esebenzayo, futhi imiphumela yamanje kagesi ilingana nokuqoqwa kwendawo ezungezile. Lokhu kwamanje kulinganiswa futhi kuguqulwe kube yisiginali efundekayo, okuvumela ukunqunyelwa okunembile kokuhlushwa. Izinzwa ze-electrochemical zizwela kakhulu futhi zikhetha, zibenze bahle - balungele ukuthola amagesi athile ayingozi endaweni yokuhlinzwa. Banganikeza idatha yangempela - yesikhathi samazinga wegesi, okwenza ukuphendula ngokushesha uma kwenzeka ukugxila okuyingozi.
1. Izinzwa zegesi ezingenamkhawulo Isibonelo, ukuthola i-carbon dioxide () nezinye izindlela ze-hydrocarbons, inzwa ikhipha ukukhanya okukhanyayo. Lapho ukukhanya kudlula igesi - imvelo egcwalisiwe egumbini lokusebenza, amagesi ahlosiwe amunca imisebe ye-infrared kuma-wavelength awo acijile. Inzwa-ke ikala inani lokukhanya elidonswa noma lidluliselwa, futhi ngokusekelwe kulokhu kulinganiswa, kungakwazi ukubala ukugcwala kwegesi. Izinzwa ezingezinhlabezi azinalo - thintana futhi zibe nesikhathi sokuphila eside. Futhi zizinzile futhi zingasebenza ezinhlotsheni ezahlukahlukene zezemvelo, zibenze bathembeke ngokubheka okuqhubekayo kwamagesi ayingozi ngesikhathi sokuhlinzwa kwe-laparoscopic.
1. Ukukhishwa Kokubhema Nezinhlelo Zokuqapha
1. Izinhlelo zokukhishwa kwentuthu ziyingxenye ebalulekile yokuqapha igesi egumbini elisebenzayo. Lezi zinhlelo zenzelwe ukususa umusi waphusi kanye namagesi ayingozi akhiqizwe ngesikhathi sokusebenzisa iyunithi ye-electrosurgical.
1. Amadivayisi wokukhipha intuthu esebenzayo : Lawa madivayisi, afana nokumunca - Ukuthunyelwa okususelwa kubhemo, kuxhunywe ngokuqondile esizeni sokuhlinza. Basebenzisa indlela enamandla yokukhulisa ukudweba intuthu namagesi njengoba bekhiqizwa. Isibonelo, umphathi we-handheld Smothunzi angabekwa eduze kwensimbi ye-electrosurgical ngesikhathi sokuhlinzwa. Njengoba i-ES ikhiqiza intuthu, umfutho ngokushesha wamunca, ukuvimbela amagesi ekusakazeni imvelo yegumbi elisebenzayo. Ezinye izinto ezithuthukile zokukhishwa kwentuthu zihlanganiswe nemishini ye-laparoscopic uqobo, ukuqinisekisa ukuthi intuthu isuswa eduze komthombo ngangokunokwenzeka.
1. Izakhi zokuqapha ngaphakathi kwezinhlelo zokukhishwa kwentuthu : Ngaphezu kokukhishwa, lezi zinhlelo zivame ukuyakha - ezingxenyeni zokuhlola. Lokhu kungafaka izinzwa zegesi ezifana nalezo ezishiwo ngenhla. Isibonelo, uhlelo lokukhishwa kwentuthu lungaba ne-sensor ye-CO ehlanganiswe ngendlela yalo yokudla. Njengoba uhlelo lumunca intuthu, inzwa ilinganisa ukugxila kwentuthu entuthu engenayo. Uma ukugxila kudlula i-Pre - Setha izinga eliphephile, i-alamu ingabangelwa, ikwazise iqembu lokuhlinzwa ukuthatha isenzo esifanele, njengokukhulisa amandla okukhishwa noma ukuguqula inqubo yokuqeda ukunciphisa ukukhiqizwa kwegesi.
Ukubaluleka kokuqapha okujwayelekile
1. Ukuvikela impilo yeziguli
1. Ukuqapha njalo kokugxila kwamagesi ayingozi ngesikhathi sokuhlinzwa kwe-laparoscopic kubalulekile ekuvikeleni impilo yesiguli. Njengoba isiguli sivezwa ngokuqondile kumagesi asensimini yokuhlinza, ngisho nesifushane - ukubonakaliswa kwesikhathi kumazinga aphezulu amagesi ayingozi kungaba nemithelela emibi ngokushesha. Isibonelo, uma ukugcwala kwe-carbon monoxide (co) endaweni yokuhlinzwa akuqakwa futhi kufinyelela ezingeni eliyingozi, isiguli singathola ukwehla komoya-mpilo - ukuthwala umthamo wegazi. Lokhu kungaholela e-hypoxia, okungadala ukulimala kwezitho ezibalulekile ezifana nobuchopho, inhliziyo nezinso. Ngokubheka njalo ukugxila kwegesi, iqembu lokuhlinza lingaqinisekisa ukuthi isiguli asivezwanga amazinga amagesi ayingozi angadala izinkinga zempilo eziphakeme kakhulu.
1. I-Long - Izingozi Zempilo Ezithemu Yezempilo nazo zingancishiswa ngokuqapha njalo. Njengoba kushiwo ngaphambili, ukuvezwa kwamagesi athile afana ne-benzene kanye ne-formaldehyde ngokuhamba kwesikhathi kungakhulisa ubungozi bokuthuthukisa umdlavuza. Ngokugcina ukugxila kwegesi endaweni yokuhlinzwa ngaphakathi kwemingcele ephephile, ukuvezwa kwesiguli kulezi zinto ze-carcinogenic kuncishisiwe, kunciphisa ubungozi bezempilo obude obuhambisana nokuhlinzwa kwe-laparoscopic.
1. Qinisekisa ukuphepha kwabasebenzi bezempilo
1. Abasebenzi bezempilo egumbini lokusebenza basengozini yokuchayeka kaninginingi kumagesi ayingozi. Ukuqapha njalo kusiza ukuvikela impilo yabo. Ngokuhamba kwesikhathi, ukuvezwa okuqhubekayo kumagesi egumbini lokusebenza kungaholela ekuthuthukisweni kwezifo zokuphefumula ezinjenge-asthma, i-bronchitis engapheli, kanye nomdlavuza wamaphaphu. Ngokuqapha ukugxila kwegesi njalo, izikhungo zezokunakekelwa kwempilo zingathatha izindlela ezisebenzayo zokuthuthukisa umoya omncane noma zisebenzisa amasistimu wokukhipha. Isibonelo, uma ukuqapha kukhombisa ukuthi ukugcwaliswa kwezinto eziguquguqukayo ze-organic (ama-Vocs) ziphakeme ngokungaguquki, isibhedlela singatshala imali engcono - Ikhwalithi yomoya - Izinhlelo ze-Filtration noma zithuthukise intuthu ekhona. Lokhu kuqinisekisa ukuthi abasebenzi bezokunakekelwa kwezempilo abadalulwa amazinga ayingozi amagesi ayingozi ngesikhathi somsebenzi wabo, ukuvikela impilo yawo isikhathi eside futhi - ukuba khona.
1. Ukuqinisekiswa kwekhwalithi ngokuzijwayeza okuhlinzayo
1. Ukuqapha njalo kwamagesi ayingozi nakho kuyinto ebalulekile yokuqinisekiswa kwekhwalithi ngokuzijwayeza okuhlinzayo. Ivumela izibhedlela namaqembu okuhlinza ukuhlola ukusebenza kwezindlela zawo zokuphepha zamanje. Uma idatha yokuqapha ibonisa ukuthi ukugxila kwegesi kuguquguquko ngaphakathi kwebanga eliphephile, kukhombisa ukuthi ukungena komoya okukhona kanye negesi - Izinhlelo zokukhishwa zisebenza ngempumelelo. Ngakolunye uhlangothi, uma idatha iveza ukuthi ukugxila kusondela noma kudlula imikhawulo ephephile, kukhombisa isidingo sokwenza ngcono. Lokhu kungafaka ukuhlola ukusebenza kweyunithi ye-electrosurgical, kuhlola noma yikuphi ukuvuza kugesi - uhlelo lokukhishwa, noma ukuqinisekisa ukuthi umoya omncane wegumbi osebenzayo wanele. Ngokusebenzisa idatha yokuqapha ukwenza izinqumo ezinolwazi, amaqembu okuhlinza angathuthuka ngokuqhubekayo ukuphepha kwendawo yegumbi lokusebenza, athuthukise ikhwalithi ephelele yokunakekelwa kokuhlinzwa.
Amasu wokunciphisa
Izilawuli Zobunjiniyela
1. Ukuthuthukisa Idizayini ye-ESU
1. Abakhiqizi bamayunithi we-electrosurgical angadlala indima ebalulekile ekwehliseni isizukulwane samagesi ayingozi. Enye indlela yokwenza ngcono amandla - izindlela zokulethwa ze-ESUS. Isibonelo, ukuthuthukisa i-ESUS ngokulawulwa okunembile ngokwengeziwe ngaphezulu kwamanje kagesi kunganciphisa isizukulwane esishisa ngokweqile. Ngokulawula kahle inani lamandla ahanjiswe ezicubu, izinga lokushisa esigungwini - isikhombimsebenzisi se-electrode singalawulwa kangcono. Lokhu kunciphisa amathuba okudlula - ukufudumeza izicubu, ezincipha ubukhulu bokubola okushisayo kanye nokukhiqizwa kwamagesi ayingozi.
1. Enye into yokuthuthuka kwe-Esu Design ukusetshenziswa kwezinto ezithuthukisiwe ze-elektrofomu. Ezinye izinto ezintsha zingahle zibe nezinto ezingcono zokuvuselelwa kanye nokumelana, okuvumela ukudluliswa okusebenzayo kwamandla kagesi ngenkathi kunciphisa ukushisa - ukungcola okuhlobene kwezicubu. Ngokwengeziwe, ucwaningo lungagxila ekuthuthukiseni ama-elektrodi aklanyelwe ngokukhethekile ukunciphisa ukwakheka kwezicubu ezinamakhaza, njengoba izicubu ezishisiwe zingumthombo omkhulu wezinhlanzi ezilimazayo zamagesi namagesi.
1. Ukuthuthukisa Izinhlelo Zokunikeza Ukuthambekela
1. Ukuphefumula okwanele kubalulekile egumbini lokusebenza ukususa amagesi ayingozi akhiqizwa ngesikhathi sokuhlinzwa kwe-laparoscopic. Izinhlelo zomoya wendabuko zingathuthukiswa zibe yintsha. Isibonelo, ama-Laminar - Izinhlelo zomoya omncane zingafakwa. Lezi zinhlelo zakha ukugeleza komoya ongalingani, zihambisa umoya ongcolile ngaphandle kwegumbi elisebenzayo ngendlela ephumelelayo. Ngokugcina ukugeleza okuqhubekayo nokuhle - okuqondiswe komoya omusha, i-laminanami - izinhlelo zokugeleza kungavimba ukunqwabelana kwamagesi ayingozi endaweni yokuhlinzwa.
1. Ngaphezu kokuvutha umoya okujwayelekile, izinhlelo zokuphelelwa amandla endawo zingahlanganiswa ekusethweni okuhlinzwa. Lezi zinhlelo zenzelwe ukuthwebula intuthu kanye namagesi asemthonjeni, eduze kwensimbi ye-electrosurgical. Isibonelo, ukumunca - Idivaysi yokukhipha indawo esekelwe ekwakhiweni i-LAPAROSCOPE noma isendlalelo se-ESU. Lokhu kuqinisekisa ukuthi amagesi ayingozi asuswa ngokushesha nje lapho akhiqizwa khona, ngaphambi kokuba abe nethuba lokuhlakaza endaweni enkulu yegumbi lokusebenza. Ukulungiswa okujwayelekile nokuqapha kwalezi zinhlelo zokungena kanye nezinhlelo zokuphelelwa amandla zibalulekile nokuqinisekisa ukusebenza kwazo okuhle. Izihlungi ezinhlelweni kufanele zithathelwe indawo njalo ukuze zilondoloze ukusebenza kwazo ekususeni izinhlayiya namagesi alimazayo emoyeni.
Imishini yokuzivikela (i-PPE)
1. Ukubaluleka kwe-PPE yabasebenzi bezempilo
1. Abasebenzi bezempilo egumbini lokusebenza kufanele banikezwe futhi baqeqeshelwe kahle ukusebenzisa imishini yokuzivikela (i-PPE) ukunciphisa ukuvezwa kwabo kumagesi ayingozi. Enye yezingcezu ezibaluleke kakhulu ze-PPE iyi-repirator ephezulu kakhulu. Ama-respirators, anjenge-N95 noma ngaphezulu - I-Level Practiation - Ukuhlunga Uhlu Lokuhlunga, zenzelwe ukuhlunga izinhlayiya ezinhle, kubandakanya nalabo abakhona entuthuni yokuhlinzwa. Lezi zikhungi zikwazi ukunciphisa ngempumelelo ukuphefumula kwezinhlayiya zentuthu, amakhompiyutha ajwayelekile aphilayo, nezinye izinto eziyingozi emoyeni wegumbi lokusebenza.
1. Izihlangu zobuso nazo ziyingxenye ebalulekile ye-PPE. Banikeza ungqimba olwengeziwe lokuvikelwa ngokuvikela amehlo, ekhaleni kanye nomlomo kusuka ekuxhumaneni ngqo nentuthu yokuhlinzwa kanye nezikhala. Lokhu akusizi nje kuphela ukuvikela ukuphefumula kwamagesi ayingozi kepha futhi kuvikelekile ekulweni nakuwo abakhona abangenayo okungenzeka ukuthi abe khona emsikeni.
1. Ukusetshenziswa okufanele kwe-PPE
1. Ukusetshenziswa okufanele kwe-PPE kubalulekile ekusebenzeni kwayo. Abasebenzi bezokunakekelwa kwezempilo kufanele baqeqeshelwe ukuthi banganike kanjani kahle futhi badedele abaphefumuli babo. Ngaphambi kokubeka i-respirator, kubalulekile ukwenza i-fit - hlola. Lokhu kufaka ukumboza i-respirator ngezandla zombili nokuphefumula nokuphefumula ngokujulile. Uma ukuvuza komoya kutholwa ezungeze imiphetho ye-respirator, kufanele kulungiswe noma ithathelwe indawo ukuze kuqinisekiswe uphawu olufanele.
1. Izihlangu zobuso kufanele zigqoke kahle ukuhlinzeka ngokumboza okugcwele. Kufanele zilungiswe ukuze zilinganise kahle ekhanda futhi akufanele zifakwe lapho kuhlinzwa. Uma kwenzeka inkungu, anti - ingasetshenziswa izixazululo zenkungu. Ngaphezu kwalokho, i-PPE kufanele ithathelwe indawo njalo. Ama-respirators kufanele aguqulwe ngokuya ngezincomo zomkhiqizi, ikakhulukazi uma ziba manzi noma zilimele. Izihlangu zobuso kufanele zihlanzwe futhi zibulawe amagciwane phakathi kokuhlinzwa ukuvikela ukunqwabelana kwezingcola.
Imikhuba emihle kakhulu egumbini lokusebenza
1. Ukuhlanza njalo kanye nokunakekelwa
1. Ukugcina indawo yokuhlala esebenzayo kubalulekile ekunciphiseni ukuvezwa kwegesi okuyingozi. Izindawo ezisegumbini lokusebenza kufanele zihlanzwe njalo ukuze zisuse noma yiziphi izinsalela zezinto eziyingozi ezikhona entuthuni yokuhlinzwa. Lokhu kufaka phakathi ukuhlanza amatafula okuhlinza, imishini, nezitezi. Ukuhlanza njalo kusiza ukuvikela ukuphindiswa kwezinhlayiya ezingezo ezihlale ezindaweni eziphansi, kunciphisa ukugcwaliswa kwezinto eziyingozi emoyeni.
1. Iyunithi ye-electrosurgical uqobo kufanele igcinwe kahle. Ukuhlinzekwa njalo kwe-ESU kungaqinisekisa ukuthi isebenza ekusebenzeni kahle. Lokhu kufaka ukubheka noma yikuphi ukuxhumana okuxhunyiwe, okugqokwayo - ama-elekthrodi, noma ezinye izindaba zemishini. Umthombo - I-ES egcinwe kungenzeka mancane amathuba okuthi ikhiqize ukushisa ngokweqile noma ukungasebenzi kahle, okungaba nomthelela ekukhiqizweni kwamagesi ayingozi.
1. Inqubo yokulinganisa
1. Abahlinzayo bangadlala indima enkulu ekunciphiseni ukubhekana negesi eyingozi ngokusebenza kwamasu abo okuhlinza. Isibonelo, usebenzisa ukumiswa kwamandla okusebenzayo okuphansi kakhulu kuyunithi ye-electrosurgical kunganciphisa inani lokulimala kwezicubu kanye nokukhiqizwa kwegesi okwalandela. Ngokulawula ngokucophelela isikhathi sokusebenza kwe-ESU nesikhathi sokuxhumana nesicubu, odokotela abahlinzayo banganciphisa futhi ubukhulu bokubola okushisayo.
1. Omunye umkhuba obalulekile ukusebenzisa i-ESA ngamafuphi, aqhuma ama-incmsts kunokusebenza okuqhubekayo. Lokhu kuvumela izicubu ukuba ziphole phansi phakathi kokuqhuma, zinciphisa ukushisa okuphelele - ukulimala okuhlobene nezicubu kanye nesizukulwane samagesi ayingozi. Ngokwengeziwe, lapho kungenzeka, ezinye izindlela zokuhlinza ezikhiqiza intuthu negesi, njengokuhlakazeka kwe-ultrasonic, kungabhekwa. Lawa masu anganikeza ukusika okusebenzayo kwezicubu kanye nokugxuma ngenkathi kunciphisa ukukhiqizwa okuyingozi - imikhiqizo, okufaka isandla endaweni ephephile yokuhlinzwa eMpumalanga yazo zombili iziguli nabasebenzi bezempilo.
Ucwaningo kanye nemibono yesikhathi esizayo
Izifundo Eziqhubekayo
Njengamanje, kunezifundo ezimbalwa eziqhubekayo ezigxile ekubhekaneni nodaba lokuhlinzekwa kwegesi okuyingozi ngesikhathi sokuhlinzwa kwe-laparoscopic kusetshenziswa amayunithi we-electrosurgical. Indawo eyodwa yocwaningo igxile ekuthuthukisweni kwezinto zokwakha amanoveli we-electrosurgical electrosurgical electrosurgical. Ososayensi bahlola ukusetshenziswa kwama-polymers athuthukile kanye nama-nanomatadium anezindawo ezihlukile. Isibonelo, amanye ama-nanomatadi athile anekhono lokuthuthukisa ukusebenza kahle kokudluliswa kwamandla ngesikhathi se-electrosurgery ngenkathi kunciphisa inani lokushisa - ukulimala kwezicubu. Lokhu kungaholela ekunciphiseni esizukulwaneni samagesi ayingozi. Ocwaningweni lwakamuva, abacwaningi baphenya ukusetshenziswa kwekhabhoni - i-nanotube - ama-electrodes ahlanganisiwe. Imiphumela ikhombisile ukuthi la ma-electrodes angafinyelela ukusika okusebenzayo kwesicubu kanye nokugxuma ngesizukulwane esincane sokushisa uma kuqhathaniswa ne-elektrodi yendabuko, okubonisa ukuncishiswa okungenzeka kube yingozi.
Olunye umugqa wocwaningo luqondiswe ekuthuthukiseni ukwakheka kwama-electrosurgical amayunithi uqobo. Onjiniyela basebenza ekuthuthukiseni i-ESUS ngezinhlelo ezihlakaniphile zokulawula. Lezi ezintsha - Isizukulwane se-ESUS sizokwazi ukuguqula ngokuzenzakalelayo umphumela wamanje kagesi nokukhiqiza ngokusekelwe kuhlobo lwezicubu kanye nomsebenzi wokuhlinzwa osusondele. Ngokuvumelanisa ngokuqondile ukulethwa kwamandla, ubungozi bokudlula - ukufudumeza izicubu nokwanda kwamagesi amakhulu ngokweqile kungancishiswa. Isibonelo, amanye ama-prototypes ahlome ngezinzwa ezingabona ukungafani kwezicubu ngesikhathi sangempela. I-ESA yabe isiguqula izilungiselelo zayo ngokufanele ukuqinisekisa ukusebenza kahle kanye nesizukulwane esincane segesi.
Ngaphezu kwalokho, izifundo nazo zenziwa ekusetshenzisweni kweminye imithombo yamandla ye-electrosurgery. Abanye abacwaningi bahlola ukusetshenziswa kwama-lasers noma amandla e-ultrasonic njengezinye izindlela eziphezulu - imvamisa kagesi kagesi yamanje. Ama-Lasers, ngokwesibonelo, anganikeza ukubonwa kwezicubu okuqondile ngokusakazwa okungatheni okushisayo futhi kungenzeka kube yingozi ngo - imikhiqizo. Yize esaseziteshini zokuhlola, la mandla ahlukile - amadivaysi okuhlinza asuselwa kukhombisa ukwehlisa inkinga eyingozi ehlotshaniswa namayunithi wendabuko we-electrosurgical.
Umbono wokuhlinzwa okuphephile kwe-laparoscopic
Ikusasa lokuhlinzwa kwe-laparoscopic liphethe isithembiso esihle sokunciphisa ubungozi obuhambisana nesizukulwane esilimazayo segesi. Ngokuqamba ubuchwepheshe obuqhubekayo, singalindela ukubona intuthuko enkulu ekuphepheni kwalezi zinqubo.
Enye yentuthuko esemqoka esikhathini esizayo kungaba ukuthuthukiswa kwezinhlelo zokuhlinzwa ezihlanganiswe ngokuphelele. Lezi zinhlelo zingahlanganisa amayunithi we-electrosurgical athuthukile ngegesi esebenza kahle kakhulu - izinhlelo zokuhlanzwa kanye nezinhlelo zokuhlanza. Isibonelo, iyunithi ye-electrosurgical ingaxhunyaniswa ngqo esimweni - kwe - - I-art actempleator esebenzisa ubuchwepheshe obuthuthukile be-Filtration, njenge-nanoparticle - izihlungi ezisekelwe. Lezi zihlungi zizokwazi ukususa ngisho nezinhlayiya ezincane kakhulu namagesi anezinhlambululo ezivela endaweni yokuhlinza, eqinisekisa ukuthi kusondele - zero - isimo sengozi sazo zombili iziguli neqembu lokuhlinzwa.
Ngaphezu kwalokho, ngenqubekela phambili yobuhlakani bokufakelwa (AI) kanye nokufunda komshini, amarobhothi okuhlinza angadlala indima ebaluleke kakhulu ekuhlinzweni kwe-laparoscopic. Lawa marobhothi angahlelwa ukwenza izinqubo zokuhlinzwa ngokunemba okukhulu, usebenzisa inani elincane lamandla adingekayo ekukhohlisweni kwezicubu. I-AI - ama-algorithms anamandla angahlaziya izici zezicubu ngesikhathi sangempela - isikhathi futhi alungise indlela yokuhlinzwa ngokufanele, asheshe anciphise isizukulwane samagesi ayingozi.
Ngokuya ngokwelashwa, imihlahlandlela yezemihlahlandlela yesikhathi esizayo nezinhlelo zokuqeqeshwa odokotela abahlinzayo nazo zingagcizelelwa okukhulu ekunciphiseni ukugcwaliswa kwegesi. Odokotela abahlinzayo bangaqeqeshwa ukusebenzisa amasu amasha okuhlinza nemishini eyenzelwe ukunciphisa ukukhiqizwa kwamagesi ayingozi. Ukuqhubeka kwezifundo zemfundo yezokwelapha kungagxila ekutholakaleni kocwaningo kwakamuva kanye nemikhuba emihle kakhulu kule ndawo, ukuqinisekisa ukuthi abahlinzeki bezokunakekelwa kwezempilo baphumile - kuze kube - usuku ngezindlela eziphumelela kakhulu zokunciphisa ubungozi obuhambisana nesizukulwane segesi se-electrosurgical.
Ekuphetheni, ngenkathi udaba lokuhlinzekelwa yigesi elimazayo ngesikhathi sokuhlinzwa kwe-laparoscopic kusetshenziswa amayunithi we-electrosurgical ukukhathazeka okukhulu, ukucwaninga okuqhubekayo kanye nentuthuko yokuzijwayeza yezokwelapha kanye nezokwelapha kunikeza ithemba ngesimo sokuhlinzwa esiphephile. Ngokuhlanganisa izixazululo zobunjiniyela ezintsha, izinto ezithuthukile, kanye namasu okuhlinza athuthukisiwe, singabheka phambili esikhathini esizayo lapho ukuhlinzwa kwe-laparoscopic kungenziwa ngengozi encane empilweni nokuphepha kweziguli kanye nezisebenzi zezempilo.
Ukugcina
Ngamafuphi, ukusetshenziswa kwamayunithi we-electrosurgical ngesikhathi sokuhlinzwa kwe-laparoscopic, ngenkathi kunikezwa izinzuzo ezinkulu ngokuya ngokunemba okuhlobisile nokulawulwa kwe-hemostasis, kuvusa isizukulwane samagesi ayingozi. Lawa magesi, kufaka phakathi i-carbon monoxide, izinhlayiya ezibhemayo, kanye namakhompiyutha ajwayelekile ezinto eziphilayo, abeke usongo olukhulu empilweni yazo zombili iziguli nabasebenzi bezempilo.
Okufushane - isikhathi nesikhathi eside - ubungozi bezempilo obuhambisana nalawa magesi ayingozi akufanele bubukelwe phansi. Iziguli zingathola ukucasuka okusheshayo kokuphefumula ngesikhathi sokuhlinzwa ngesikhathi sokuhlinzwa, futhi ngokuhamba kwesikhathi - Run, sibhekane nengozi eyandayo yokuthola izifo zokuphefumula okungamahlalakhona. Abasebenzi bezokunakekelwa kwezempilo, ngenxa yokuvezwa kwabo okuphindaphindiwe emvelweni yegumbi lokusebenza, nabo basengozini yokuthola izinkinga zempilo yokuphefumula neyesihlelekile.
Izindlela zamanje zokutholwa, njengezinzwa zegesi nokukhishwa kwentuthu kanye nezinhlelo zokuhlola, zidlala indima ebalulekile ekuhlonzeni ubukhona kanye nokuqokwa kwalawa magesi ayingozi. Ukuqapha okujwayelekile kubalulekile hhayi ukuvikela impilo yeziguli kanye nezisebenzi zezempilo kodwa futhi nokuqinisekisa ikhwalithi ephelele yokuzijwayeza.
Amasu wokunciphisa, kufaka phakathi izilawuli zobunjiniyela ezifana nokwenza ngcono ukwakhiwa kwe-ESU kanye nokwenza ngcono izinhlelo zokuvikela umoya, kanye nokusetshenziswa kwemikhuba emihle kakhulu egumbini lokusebenza, konke kubalulekile ekunciphiseni izingozi ezihambisana nokuvezwa yingozi.
Ucwaningo oluqhubekayo luba nesithembiso esihle ngekusasa lokuhlinzwa kwe-laparoscopic. Ukuthuthukiswa kwezinto zokwakha inoveli, kwathuthukisa ukwakheka kwe-ES, kanye nokuhlolwa kweminye imithombo yamandla ye-electrosurgery anikeza ithemba lokunciphisa ukusekelwa yigesi eyingozi. Umbono wezinhlelo zokuhlinza ezihlanganiswe ngokuphelele nokusetshenziswa kwe-AI - amarobhothi okuhlinzwa anamandla angaphinde athuthukise ukuphepha kwezinqubo ze-laparoscopic.
Kubaluleke kakhulu ukuthi umphakathi wezokwelapha, okubandakanya odokotela abahlinzayo, ama-anesthesiologists, abahlengikazi, kanye nabakhiqizi bedivaysi yezokwelapha, bayakubona ukubaluleka kwalolu daba. Ngokusebenza ngokubambisana, ukusebenzisa izindlela ezidingekayo zokuvimbela, futhi uhlale unolwazi mayelana nokucwaninga kwakamuva kanye nentuthuko yezobuchwepheshe, singalwela ngekusasa lapho ukuhlinzwa kwe-laparoscopic kungenziwa ngengozi encane empilweni nokuphepha kwabo bonke abathintekayo. Ukuphepha kweziguli kanye nezisebenzi zezempilo egumbini lokusebenza kufanele zibe yinto ebaluleke kakhulu, futhi zibhekane nenkinga yokuhlinzekwa kwegesi okuyingozi ekuhlinzeni i-laparoscopic usebenzisa igxathu elibalulekile ekufezekiseni le nhloso.
