Imiterere yisi yose yindwara zimpyiko zidakira
Ubushakashatsi ku byorezo byerekanye ko indwara zimpyiko zidakira zabaye imwe mu ndwara zikomeye zibangamira ubuzima rusange ku isi.Mu myaka yashize, imibare yerekana ko mu bihugu byateye imbere (nka Amerika n'Ubuholandi), hafi 6.5% kugeza 10% by'abaturage muri rusange bafite impamyabumenyi zitandukanye z'indwara z'impyiko, muri zo umubare w'indwara z'impyiko muri Amerika zikaba zifite yarenze miliyoni 20, kandi ibitaro bivura abarwayi b'impyiko bagera kuri miliyoni imwe buri mwaka.Umubare w'abarwayi barwaye impyiko zo mu cyiciro cya nyuma mu Bushinwa nawo uragenda wiyongera, bikaba biteganijwe ko umubare w'abarwayi bafite impyiko zo mu cyiciro cya nyuma mu Bushinwa uzarenga miliyoni 4 mu 2030.
Hemodialysis (HD) ni bumwe mu buryo bwo kuvura impyiko ku barwayi bafite impyiko zikomeye kandi zidakira.
Gushiraho uburyo bwiza bwo kubona imiyoboro y'amaraso nicyo gisabwa kugirango iterambere ryorohewe rya hemodialyse.Ubwiza bwo kubona imiyoboro y'amaraso bugira ingaruka ku buryo butaziguye ireme rya dialyse n'ubuzima bw'abarwayi.Gukoresha neza no kurinda neza uburyo bwo kubona imiyoboro y'amaraso ntibishobora gusa kuramba kumurimo wo kubona imiyoboro y'amaraso, ariko kandi birashobora no kuramba mubuzima bw'abarwayi ba dialyse, bityo kwinjira mumitsi byitwa "ubuzima" bw'abarwayi ba dialyse.
Gukoresha ivuriro rya ultrasound muri AVF
Inzobere mu itsinda ryinjira mu mitsi zemeza ko AVF igomba guhitamo bwa mbere uburyo bwo kubona imitsi.Bitewe nubudasubirwaho, umubare muto wumutungo wamaraso, kandi ntushobora gusimburwa burundu, kugirango ubuzima bwumurimo burusheho kugera kumurwayi, gukoresha bisanzwe no gufata neza fistula arteriovenous, no kwirinda neza ibibazo biterwa no gutobora nibibazo aribyo bakwegereye abaganga n'abaforomo.
Gushiraho isuzuma ryamaraso mbere yo gutangira fistula ya arteriovenous (AVF)
1) Niba imiyoboro y'amaraso ari ibisanzwe: gutotezwa, stenosis no kwaguka
2) niba urukuta rw'ubwato rworoshye, niba hari plaque echo, niba haravunitse cyangwa inenge, kandi niba hari gutandukana
3) niba hari trombi nizindi echo muri lumen
4) Niba ibara ryamaraso yuzuye yuzuye kandi niba icyerekezo n'umuvuduko wamaraso bidasanzwe
5) Gusuzuma amaraso
Ishusho yerekana Porofeseri Gao Min avura umurwayi ku gitanda
Gukurikirana fistula y'imbere
Kubera ko hashyizweho fistula y'imbere kubarwayi nintambwe yambere y "urugendo rurerure", AVF mbere yo gukoresha ultrasonic gupima imitsi y'amaraso ya diameter hamwe n'amaraso asanzwe, mugihe usuzumye fistula ishobora, kugira ibipimo bikuze, kugirango bapime niba abarwayi bafite fistula muri amakuru ukoresheje ibisanzwe, ultrasound ntagushidikanya nuburyo bwimbitse kandi bwukuri.
Gukurikirana AVF: Gukurikirana Ultrasound byakozwe rimwe mu kwezi
1) Amaraso atemba
2) Diameter
3) Niba anastomose ari nto kandi niba hariho trombose (niba hariho trombose, birakenewe kongera ballon)
Urubanza rukuze rwa autogenous arteriovenous fistula
Hatitawe ku gihe cyagenwe cyo gutangira gucumita, icyangombwa kigomba kuba nyuma yuko fistula y'imbere imaze gukura.
Muri rusange abantu bemeza ko gukura kwa fistula y'imbere bigomba kuba byujuje ibintu bitatu “6 ″:
1) fistula ya arteriovenous> 600ml / min (2019 impuguke z’abashinwa zumvikanye ku bijyanye no kubona imitsi yo kuvura indwara ya hemodialyse:> 500 ml / min)
)
3) Ubujyakuzimu bw'imitsi & LT;6mm, kandi hagomba kubaho intera ihagije yimiyoboro yamaraso kugirango ihuze ikoreshwa rya hemodialyse.
Kenshi na kenshi, fistula ya arteriovenous ifite imitsi ishobora guhinda umushyitsi hamwe no guhinda umushyitsi birashobora gutobora neza mugihe cyibyumweru 4 bimaze gushingwa.
Isuzuma no kubungabunga
Ni ngombwa cyane gusuzuma buri gihe no kugenzura ibipimo ngenderwaho bya fistula ya arteriovenous na hemodialysis ihagije nyuma yo kubagwa.
Uburyo bwiza bwo gusuzuma no gukurikirana burimo
① Kugera kubikurikirana byamaraso: birasabwa gukurikirana rimwe mukwezi;
Examination Kwipimisha kumubiri: birasabwa ko buri dialyse igomba kugenzurwa, harimo kugenzura, palpation na auscultation;
Ult Doppler ultrasound: bisabwa rimwe mu mezi 3;
Method Uburyo butari bwo bwa urea burasabwa gupima gutunganya inshuro imwe mumezi 3;
Ection Kugaragaza umuvuduko utaziguye cyangwa utaziguye byerekana umuvuduko wamaraso birasabwa rimwe mumezi 3.
Iyo autologique AVF idashobora gushingwa, ihitamo rya kabiri rigomba kuba fistula y'imbere (AVG).Niba ari ugushiraho AVF cyangwa AVG, ultrasound ningirakamaro mugusuzuma mbere yo gutangira imiyoboro y'amaraso, kuyobora imikoranire idahwitse, gusuzuma nyuma yo kubagwa no kuyitaho.
PTA yakozwe iyobowe na ultrasound
Ingorane byanze bikunze fistula ya arteriovenous ni stenosis.Amaraso maremare yihuta cyane ashobora gutera hyperplasia yimitsi yimitsi yimbere ya fistula yimbere, biganisha kumitsi yimitsi no gutembera kwamaraso bidahagije, bigira ingaruka kumikorere ya dialyse, kandi biganisha kumutwe wa fistula, trombose no kunanirwa mugihe stenosis ikabije.
Kugeza ubu ibikorwa nyamukuru byo kuvura fistula stenosis imbere ya ultrasound iyobowe na arteriovenous fistula stenosis muri keratoplasty (PTA), kuvura imipira yo kuvura imipira na biopsy y'uruhu ku barwayi bafite fistula mu mitsi y'amaraso, mu kwaguka kwa ballon, iyobowe na ultrasound kugirango kwaguka kwamaraso kwaguka, gukosora ibice bigufi, kugarura diameter isanzwe yamaraso, kugirango wongere ubuzima bwumurwayi wabarwayi bafite fistula yimbere.
PTA iyobowe na ultrasound, iroroshye, nta kwangiza imirasire, nta kwangirika kwa agent, irashobora kwerekana no gukomeretsa kw'imitsi iva mu bihe, ibipimo byamaraso byapimwe kandi bigasuzuma imigendekere yamaraso, kandi birashobora guhita nyuma yo gutsinda nkamaraso. kugera kuri hemodialyse, ntukeneye catheter yigihe gito, hamwe numutekano, ukora neza nibiranga ihahamuka rito, gukira vuba, kugabanya ububabare bwumurwayi, Gahunda yo gutunganya iroroshye.
Gukoresha ivuriro rya ultrasound muri catheterisation yo hagati
Mbere yo gushyiraho catheteri yo hagati, ultrasound igomba gukoreshwa kugirango isuzume imiterere yimitsi yimbere yimbere cyangwa imitsi yumugore, cyane cyane kubarwayi bafite amateka yubushakashatsi bwabanje, kandi ultrasound igomba gukoreshwa kugirango harebwe niba imitsi itagaragara.Bayobowe na ultrasound, ultrasound, nk "ijisho rya gatatu" rya muganga, irashobora kubona neza kandi mubyukuri.
1) Suzuma diameter, ubujyakuzimu na patensiya y'imitsi
2) Urushinge rwacumuye mumitsi yamaraso rushobora kugaragara
3) Kwerekana mugihe nyacyo cyerekana inzira yinshinge mumitsi yamaraso kugirango wirinde gukomeretsa cyane
4) Irinde ko habaho ibibazo (gutembera kw'imitsi itunguranye, guterwa na hematoma cyangwa pneumothorax)
5) Kunoza intsinzi yikigereranyo cya mbere
Gukoresha ivuriro rya ultrasound muri peritoneal dialyse catheterisation
Indwara ya Peritoneyale ni ubwoko bwo kuvura impyiko, bukoresha cyane cyane imiterere ya peritoneum kugirango ikore imiti yo gusimbuza impyiko.Ugereranije na hemodialyse, ifite ibiranga imikorere yoroshye, kwikorera-dialyse no kurinda cyane imikorere yimpyiko zisigaye.
Guhitamo gushyira peritoneyale dialyse catheter hejuru yumubiri nintambwe yingenzi cyane mugushiraho uburyo bwa dialyse ya peritone itabujijwe.Kugirango ukomeze kwihanganira imiyoboro ya dialyse ya peritoneyale no kugabanya ibibaho byingutu za catheterisation, birakenewe ko tumenyera imiterere ya anatomique yurukuta rwimbere rwinda hanyuma ugahitamo ingingo yinjizwamo ikwiye ya catheter ya peritoneyale.
Gushyira muburyo butandukanye bwa peritoneal dialyse catheter iyobowe na ultrasound iratera cyane, ubukungu, byoroshye gukora, umutekano, intiti kandi wizewe.
SonoEye palmar ultrasonication yakoreshejwe muburyo bwo kubona imitsi
SonoEye ni ultra-portable kandi ntoya, ntabwo ifata umwanya wigitanda, biroroshye kugenzura, irashobora guhuzwa na terefone cyangwa tableti, fungura porogaramu igihe icyo aricyo cyose.
Ishusho yerekana Porofeseri Gao Min avura umurwayi ku gitanda
Chras palm ultrasound ifite amashusho yo kwisuzumisha kandi ifite ibikoresho byapimwe byubwenge bipima amaraso, bihita bifunga kandi bigatanga ibisubizo byamaraso.
Ultrasound-iyobowe na fistula y'imbere irashobora kuzamura cyane igipimo cyo gutsinda cyo gutobora no kugabanya indwara ziterwa na hematoma na pseudoaneurysm.
Murakaza neza kutwandikira kubicuruzwa byubuvuzi nubuhanga.
Menyesha Ibisobanuro
Yi Yi
Amain Technology Co., Ltd.
Mob / WhatsApp: 008617360198769
E-mail: amain006@amaintech.com
Linkedin: 008617360198769
Tel.: 00862863918480
Igihe cyo kohereza: Ugushyingo-03-2022
