Ọkwa zuru ụwa ọnụ nke ọrịa akụrụ na-adịghị ala ala
Nnyocha ọrịa na-efe efe egosila na ọrịa akụrụ na-adịghị ala ala abụrụla otu n'ime ọrịa ndị na-eyi ahụike ọha egwu egwu n'ụwa niile.N'afọ ndị na-adịbeghị anya, ọnụ ọgụgụ na-egosi na na mba ndị mepere emepe (dị ka United States na Netherlands), ihe dị ka 6.5% ruo 10% nke ndị mmadụ n'ozuzu nwere ogo dị iche iche nke ọrịa akụrụ, nke ọnụ ọgụgụ nke ọrịa akụrụ na United States nwere. gafere nde 20, ụlọ ọgwụ na-agwọkwa ndị ọrịa akụrụ ihe ruru nde 1 kwa afọ.Ọnụ ọgụgụ ndị ọrịa na-arịa ọrịa gbasara akụrụ ngwụcha na China na-abawanye, a na-atụkwa anya na ọnụ ọgụgụ ndị ọrịa na-arịa ọrịa akụrụ na China ga-agafe nde 4 n'afọ 2030.
Hemodialysis (HD) bụ otu n'ime ọgwụgwọ nnọchi gbasara akụrụ maka ndị ọrịa nwere nnukwu akụrụ na-adịghị ala ala.
Ịmepụta ohere ịnweta vaskụla dị irè bụ ihe dị mkpa maka ọganihu dị mma nke hemodialysis.Ogo nke ịnweta vaskụla na-emetụta kpọmkwem ogo dialysis na ndụ ndị ọrịa.Iji ya mee ihe nke ọma na nlezianya nchebe nke ịnweta vaskụla nwere ike ọ bụghị naanị ịgbatị ndụ ọrụ nke ohere vaskụla, kamakwa ogologo ndụ nke ndị ọrịa dialysis, ya mere a na-akpọ ohere vaskụla "ndụ ndụ" nke ndị ọrịa dialysis.
Ngwa ụlọ ọgwụ nke ultrasound na AVF
Ndị ọkachamara nke vascular access group kwenyere na AVF kwesịrị ịbụ nhọrọ mbụ maka ịnweta vaskụla.N'ihi na ndị na-abụghị emeghari ohuru, ọnụ ọgụgụ dị nta nke vaskụla akụrụngwa, na enweghị ike dochie kpamkpam, iji jirichaa ndụ ọrụ nke onye ọrịa ohere, ọkọlọtọ ojiji na mmezi nke arteriovenous fistula, na n'ụzọ dị irè zere puncture metụtara nsogbu bụ nsogbu ndị na. adọtala ndị dọkịta na ndị nọọsụ anya.
Iji guzobe nyocha vaskụla vaskụla mbụ nke fistula arteriovenous (AVF)
1) Ma arịa ọbara bụ ihe nkịtị: tortuosity, stenosis na dilatation
2) ma mgbidi arịa ahụ ọ dị ire, ma ọ dị ihe mgbawa, ma ọ dị mgbaji ma ọ bụ ntụpọ, na ma ọ dị dissection.
3) ma enwere thrombi na nkwughachi ndị ọzọ na lumen
4) Ma agba agba agba agba agba agbachaala yana ma ntụzịaka na ọsọ nke ịgbasa ọbara adịghị mma
5) Ntụle nrịba ọbara
Foto a na-egosi Prọfesọ Gao Min na-agwọ onye ọrịa ahụ n'akụkụ akwa
Nleba anya nke fistulas dị n'ime
Ebe ọ bụ na nguzobe nke fistula dị n'ime maka ndị ọrịa bụ nzọụkwụ mbụ nke "ogologo njem", AVF tupu iji ultrasonic nha dayameta vaskụla vaskụla na eruba ọbara, mgbe ị na-enyocha fistula nwere ike inwe ụkpụrụ tozuru oke, iji tụọ ma ndị ọrịa nwere fistula na data site na iji ọkọlọtọ, ultrasound bụ ihe ịrụ ụka adịghị ya na usoro kachasị nghọta na nke ziri ezi.
Nyocha AVF: A na-eme nlekota ultrasound otu ugboro n'ọnwa
1) Ọbara eruba
2) dayameta ụgbọ mmiri
3) Ma anastomosis dị warara na ma enwere thrombosis (ọ bụrụ na enwere thrombosis, ọ dị mkpa ịbawanye balloon)
Ikpe tozuru oke nke autogenous arteriovenous fistula
N'agbanyeghị oge akwadoro ka ịmalite ntapu, ihe a ga-achọrịrị ga-abụ mgbe fistula dị n'ime tochara.
A na-ekwenyekarị na ntozu oke nke fistula dị n'ime kwesịrị iru usoro "6" atọ:
1) Ọkpụkpụ fistula arteriovenous> 600ml / min (2019 ndị ọkachamara ndị China kwenyere na ohere vaskụla maka hemodialysis:> 500 ml / min)
2) dayameta nke akwara oghere> 6mm (2019 ndị ọkachamara ndị China kwenyere na ohere vaskụla maka hemodialysis:> 5 mm)
3) Venous subcutaneous omimi & LT;6mm, na ekwesịrị inwe ebe dị anya n'oghere arịa ọbara zuru oke iji zute ojiji nke hemodialysis.
N'ọtụtụ ọnọdụ, fistulas arteriovenous nwere veins na-emetụ n'ahụ na ezigbo ịma jijiji nwere ike ịdaba nke ọma n'ime izu anọ nke nguzobe ha.
Ntụle na mmezi
Ọ dị ezigbo mkpa ka a na-enyocha ma nyochaa ụlọ ọgwụ na-egosi fistula arteriovenous na hemodialysis ezuru mgbe arụchara ọrụ ahụ.
Ezi ntule na ụzọ nlekota gụnyere
① Ịnweta nlekota nyocha ọbara: a na-atụ aro ka nyochaa otu ugboro n'ọnwa;
② Nnyocha anụ ahụ: a na-atụ aro ka enyocha dialysis ọ bụla, gụnyere nyocha, palpation na auscultation;
③ Doppler ultrasound: akwadoro otu ugboro kwa ọnwa 3;
④ A na-atụ aro usoro dilution na-abụghị urea iji tụọ imegharị ihe otu ugboro kwa ọnwa 3;
⑤ A na-atụ aro nchọpụta nrụgide venous ozugbo ma ọ bụ na-apụtaghị ìhè otu ugboro n'ọnwa atọ ọ bụla.
Mgbe enweghị ike ịmepụta AVF autologous, nhọrọ nke abụọ kwesịrị ịbụ graft internal fistula (AVG).Ma ọ bụ iji guzobe AVF ma ọ bụ AVG, ultrasound dị mkpa maka nyocha tupu ịwa ahụ nke arịa ọbara, nduzi intraoperative nke ntanye, nyocha na nrụzi ọrụ.
Emere PTA n'okpuru nduzi ultrasound
Ihe mgbagwoju anya nke fistula arteriovenous bụ stenosis.Ogologo ọbara na-agba ọsọ ogologo oge nwere ike ime ka hyperplasia na-arụ ọrụ nke venous intima nke fistula dị n'ime, na-eduga na vaskụla stenosis na ezughị ezu nke ọbara, na-emetụta mmetụta nke dialysis, na-eduga na nkwụsị nke fistula, thrombosis na ọdịda mgbe stenosis siri ike.
Ugbu a na mainstream ọrụ maka ọgwụgwọ nke esịtidem fistula stenosis maka ultrasound eduzi arteriovenous fistula stenosis na keratoplasty (PTA), balloon mgbasa ọgwụgwọ site akpụkpọ biopsy na ọrịa na fistula na ọbara arịa, n'ime catheter balloon mgbasa, na n'okpuru nduzi nke ultrasound maka. Mgbasa saịtị vaskụla stenosis, mezie akụkụ ndị dị warara, weghachi dayameta arịa ọbara nkịtị, ka ogologo ndụ ọrụ nke ndị ọrịa nwere fistula akwara akwara dị ogologo.
PTA n'okpuru eduzi ultrasound, bụ adaba, ọ dịghị radieshon mmebi, ọ dịghị iche gị n'ụlọnga mmebi, o nwere ike na-egosipụta na vaskụla occlusion ọnya gburugburu ọnọdụ, na tụrụ ọbara eruba kwa ma na-enyocha ọbara eruba, na pụrụ ozugbo ihe ịga nke ọma dị ka a vaskụla vaskụla. ịnweta maka hemodialysis, ọ dịghị mkpa katheter na-adịru nwa oge, nke nwere nchebe, dị irè na njirimara nke obere trauma, mgbake ngwa ngwa, belata ihe mgbu nke onye ọrịa, A na-eme ka usoro nhazi ahụ dị mfe.
Clinical ngwa nke ultrasound na Central venous catheterization
Tupu i guzobe catheter nke etiti, a ga-eji ultrasound chọpụta ọnọdụ nke akwara jugular dị n'ime ma ọ bụ vein femoral, karịsịa na ndị ọrịa nwere akụkọ ihe mere eme nke intubation gara aga, na ultrasound kwesịrị iji chọpụta maka stenosis vein ma ọ bụ nkwụsị.N'okpuru nduzi nke ultrasound, ultrasound, dị ka "anya nke atọ" nke dọkịta, nwere ike ịhụ nke ọma na n'ezie.
1) Nyochaa dayameta, omimi na patency nke akwara ntụpọ
2) Enwere ike iji anya nke uche hụ agịga mgbapu n'ime arịa ọbara
3) Ngosipụta oge nke trajectory nke agịga n'ime arịa ọbara iji zere mmerụ ahụ
4) Zere omume nke mgbagwoju anya (mkpọtụ akwara mberede, hematoma formation ma ọ bụ pneumothorax)
5) Iji meziwanye ọnụego ihe ịga nke ọma nke nkwụsị nke mbụ
Ngwa ụlọ ọgwụ nke ultrasound na peritoneal dialysis catheterization
dialysis peritoneal bụ ụdị ọgwụgwọ nnọchi gbasara akụrụ, nke na-ejikarị ọnọdụ nke peritoneum nke ya eme ihe iji mee ọgwụgwọ nnọchi akụrụ.E jiri ya tụnyere hemodialysis, ọ nwere njirimara nke ọrụ dị mfe, dialysis onwe ya na nchebe kachasị nke ọrụ gbasara akụrụ.
Nhọrọ nke ntinye nke peritoneal dialysis catheter n'elu ahụ bụ ihe dị oke mkpa n'ịmepụta ohere dialysis peritoneal na-enweghị mgbochi.Iji nọgide na-enwe patency nke peritoneal dialysis drainage na ibelata ihe omume nke catheterization nsogbu, ọ dị mkpa ka mara na anatomical Ọdịdị nke n'ihu afọ mgbidi na họrọ kasị kwesịrị ekwesị ntinye ntinye nke peritoneal dialysis catheter.
Ndobe nke peritoneal dialysis catheter n'okpuru nduzi ultrasound dị ntakịrị mkpasu iwe, akụ na ụba, dị mfe iji rụọ ọrụ, nchekwa karịa, nke nwere nghọta na ntụkwasị obi.
A na-eji SonoEye palmar ultrasonication mee ihe maka ịnweta vaskụla
SonoEye dị obere obere na obere, anaghị abanye n'akụkụ akwa, ọ dị mfe ịlele, enwere ike jikọọ ya na ekwentị ma ọ bụ mbadamba, mepee ngwa n'oge ọ bụla.
Foto a na-egosi Prọfesọ Gao Min na-agwọ onye ọrịa ahụ n'akụkụ akwa
Chison palm ultrasound nwere onyogho nyocha ma nwee ngwungwu nha ọbara nwere ọgụgụ isi, nke na-etinye envelopu ozugbo wee na-enye nsonaazụ ọbara ọgbụgba.
Ntupu nke ime fistula nke ultrasound na-eduzi nwere ike ime ka ọganihu nke ọma na-aga nke ọma ma belata nsogbu ndị dị ka hematoma na pseudoaneurysm.
Nabata ịkpọtụrụ anyị maka ngwaahịa ahụike ọkachamara na ihe ọmụma.
Nkọwa kọntaktị
Icy Yi
Ụgwọ nke ụlọ ọrụ Amain Technology Co., Ltd.
Mob/WhatsApp: 008617360198769
E-mail: amain006@amaintech.com
Njikọ: 008617360198769
Tel.: 00862863918480
Oge nzipu: Nov-03-2022
