Nzira yekushanda ye stapler
Stapler ndiye wekutanga stapler munyika.Yakashandiswa kuita gastrointestinal anastomosis kweanoda kusvika zana.Yakanga isiri kutozosvikira 1978 iyo tubular stapler yakashandiswa zvakanyanya mukuvhiya kwedumbu.Iyo inowanzo kupatsanurwa kuita imwe-nguva kana akawanda ekushandisa staplers, kunze kwenyika kana epamba staplers.Imhando yemidziyo inoshandiswa mukurapa kutsiva yechinyakare Chinyorwa suture.Nekuda kwekuvandudzwa kwesainzi yemazuva ano uye tekinoroji uye kuvandudzwa kwehunyanzvi hwekugadzira, iyo stapler inoshandiswa mukiriniki maitiro ine zvakanakira zvemhando yakavimbika, kushandiswa kuri nyore, kusimba uye kusimba kwakakodzera.Kunyanya, ine zvakanakira kukurumidza suture, nyore kushanda uye mashoma mhedzisiro uye kuvhiya matambudziko.Iyo zvakare inogonesa kubviswa kwekutarisa kwekuvhiyiwa kwebundu kusinga gadziriswe munguva yakapfuura.
Stapler chigadzirwa chekurapa chinotsiva manual suture.Iyo huru yekushanda kwayo ndeye kushandisa titanium zvipikiri kuputsa kana anastomose tishu, iyo yakafanana neiyo stapler.Zvinoenderana neyakasiyana chiyero chekushandiswa, inogona kukamurwa kuita ganda stapler, digestive turakiti (esophagus, gastrointestinal, nezvimwewo) denderedzwa stapler, rectal stapler, denderedzwa hemorrhoid stapler, kudzingiswa stapler, vascular stapler, hernia stapler, mapapu ekucheka stapler, nezvimwe .
Kuenzaniswa neyechinyakare bhuku suture, chiridzwa suture chine zvinotevera zvakanakira:
1. nyore uye nyore kushanda, kuchengetedza kushanda nguva.
Kushandisa kamwe chete kudzivirira kutapukira.
Shandisa titanium chipikiri kana Stainless simbi chipikiri (skin stapler) kusona zvakasimba nepakati tightness.
Iine migumisiro shoma uye inogona kuderedza zvinobudirira matambudziko ekuvhiya.
Nzira yekushandisa ye stapler inotsanangurwa ne intestinal anastomosis.Iyo proximal intestine yeanastomosis yakashongedzwa nehomwe, yakaiswa muchigaro chembambo uye yakasimbiswa.Iyo stapler inoisirwa kubva kumagumo, yakaboorwa kunze kweiyo stapler centre, yakabatana nepakati tsvimbo yeproximal stapler pakatarisana nechigaro chembambo, inotenderedzwa padyo neiyo distal uye proximal intestinal madziro, uye chinhambwe pakati peiyo stapler pakatarisana nechigaro chechipikiri. uye chigadziko chinogadziriswa maererano nehupamhi hwemadziro emukati, Iyo inowanzoita 1.5 ~ 2.5cm kana kutenderera kwemaoko kwakaoma (kune chiratidzo chekusimba pamubati) kuti uvhure fuse;
Svina kuvhara anastomosis wrench zvakasimba, uye inzwi re "tinya" rinoreva kuti kucheka uye anastomosis kwapera.Usabuda mu stapler kwenguva pfupi.Tarisa kuti anastomosis inogutsa here uye kana mamwe matishu akadai semesentery akaiswa mairi.Mushure mekurapa kwakafanana, sunungura stapler uye zvinyoro nyoro kuiburitsa kubva kumucheto kuti utarise kana distal uye proximal bowel resection mhete dzakakwana.
Stapler precautions
(1) Usati wavhiyiwa, tarisa kana sikero yakabatana nechiyero che 0, kana gungano rakarurama, uye kana chidimbu chekusundira uye tantalum mbambo zvisipo.Washer yepurasitiki ichaiswa mumudziyo wetsono.
(2) Mugumo wakatyoka weura uchaitwa anastomosed unofanirwa kuve wakasununguka uye wakabviswa kweinenge 2 cm.
(3) Kupatsanurwa kwetsono kwechikwama tambo suture hakufaniri kudarika 0.5cm, uye mucheto uchave 2 ~ 3mm.Kunyanya matishu zviri nyore kuiswa mu stoma, zvichitadzisa anastomosis.Chenjerera kuti usasiya mucosa.
(4) Zvinoenderana nehupamhi hwemadziro emukati, nguva yacho inofanira kuva 1 ~ 2 cm.
(5) Tarisa dumbu, esophagus uye mamwe matissue ari padyo usati wapfura kudzivirira kuti vasapinde muanastomosis.
(6) Kucheka kuchave kwakakurumidza, uye kudzvinyirirwa kwekupedzisira kuchashandiswa kuita kuti mbambo ye seam iite "B" chimiro, kuitira kuti uedze kubudirira kweimwe nguva.Kana ichionekwa sechisina kururama, inogona kuchekwa zvakare.
(7) Buda pa stapler zvinyoro nyoro, uye tarisa kana nyama yakachekwa iri ring yakazara.
Nguva yekutumira: Jun-24-2022
