Chimiro chepasi rose chechirwere cheitsvo chisingaperi
Ongororo yeEpidemiological yakaratidza kuti chirwere cheitsvo chisingaperi chave chimwe chezvirwere zvikuru zvinotyisidzira hutano hwevanhu pasi rese.Mumakore achangopfuura, nhamba dzinoratidza kuti munyika dzakabudirira (dzakadai seUnited States neNetherlands), inenge 6.5% kusvika 10% yevanhu vakawanda vane madhigirii akasiyana ehosha yeitsvo, iyo nhamba yezvirwere zveitsvo muUnited States ine. yakapfuura mamiriyoni makumi maviri, uye zvipatara zvinorapa varwere veitsvo kusvika kune vanopfuura mamiriyoni e1 gore negore.Huwandu hwevarwere vane chirwere chekupedzisira chetsvina muChina huri kuwedzera zvakare, uye zvinotarisirwa kuti huwandu hwevarwere vane chirwere chekupedzisira chetsvo muChina huchapfuura mamirioni mana panosvika 2030.
Hemodialysis (HD) imwe yerenal replacement therapy kune varwere vane acute uye vasingaperi renal kukundikana.
Kugadzwa kweiyo inoshanda vascular kuwana ndicho chinodiwa chekufambira mberi kwakanaka kwehemodialysis.Hunhu hwekuwana vascular hunokanganisa zvakananga kunaka kwe dialysis uye hupenyu hwevarwere.Kushandiswa kwakakodzera uye kunyatsochengetedza kuchengetedzwa kwevascular access hakungorebesi hupenyu hwebasa rekuwana vascular, asiwo kuwedzera hupenyu hwevarwere vedialysis, saka kuwana vascular kunonzi "lifeline" yevarwere vedialysis.
Clinical application ye ultrasound muAVF
Nyanzvi dzevascular access group dzinotenda kuti AVF inofanira kunge iri sarudzo yekutanga yekuwana vascular.Nekuda kweiyo isingadzokerikezve, yakaganhurwa nhamba yemidziyo yevascular, uye haigone kutsiviwa zvachose, kuitira kuti kuwedzere hupenyu hwebasa remurwere kuwana, kushandiswa kwakagadziriswa uye kuchengetedza arteriovenous fistula, uye zvinobudirira kudzivirira puncture ine chekuita nematambudziko ndiwo matambudziko ayo zvakwezva pfungwa dzevarapi nevakoti.
Kugadzira preoperative vascular evaluation ye arteriovenous fistula (AVF)
1) Ingave mitsipa yeropa yakajairika: tortuosity, stenosis uye dilatation
2) kuti madziro emudziyo akatsetseka here, paine maungira e plaque, pakatyoka kana kuremara, uye kana paine kutsemuka
3) kana paine thrombi uye mamwe maungira mu lumen
4) Kana ruvara rwekuyerera kweropa kuzadza rwakakwana uye kana kutungamira uye kumhanya kwekuyerera kweropa zvisiri izvo.
5) Kuongororwa kweropa
Mufananidzo uyu unoratidza Muzvinafundo Gao Min achirapa murwere padivi pemubhedha
Kuongororwa kwemukati fistulas
Kubva pakagadzwa fistula yemukati yevarwere ndiyo danho rekutanga re "kutenderera kwenguva refu", AVF isati yashandisa ultrasonic kuyerwa kwevascular diameter uye kubuda kweropa zvakasununguka, pakuongorora fistula inogona, kuva nemitemo yakakura, kuyera kana varwere vane fistula muchipatara. data uchishandisa yakajairwa, ultrasound pasina mubvunzo ndiyo yakanyanya intuitive uye yakarurama nzira.
AVF monitoring: Ultrasound monitoring yakaitwa kamwe chete pamwedzi
1) Kuyerera kweropa
2) Dhayamita yemudziyo
3) Kana iyo anastomosis yakamanikana uye kana paine thrombosis (kana paine thrombosis, zvakakosha kuwedzera bharumu)
Kutonga kwakakura kweautogenous arteriovenous fistula
Kunyangwe inguva yakakurudzirwa yekutanga puncture, chinodiwa chinofanira kunge chiri mushure mekunge fistula yemukati yakura.
Zvinowanzotendwa kuti kukura kwefistula yemukati kunofanirwa kuzadzisa matatu "6" maitiro:
1) arteriovenous fistula kuyerera> 600ml/min (2019 Chinese nyanzvi kubvumirana pavascular kuwana hemodialysis:> 500 ml/min)
2) dhayamita yepuncture vein> 6mm (2019 Chinese nyanzvi kubvumirana pane vascular kuwana hemodialysis:> 5 mm)
3) Venous subcutaneous kudzika & LT;6mm, uye panofanira kunge paine tsinga yeropa inobaya yakaringana kuti isangane nekushandiswa kwehemodialysis.
Muzviitiko zvakawanda, arteriovenous fistula ine tsinga dzinonzwika uye kubvunda kwakanaka kunogona kubudirira kupinza mukati memavhiki mana kubva pakagadzwa.
Kuongorora uye kuchengetedza
Zvinonyanya kukosha kugara uchiongorora uye kutarisa zviratidzo zvekliniki zve arteriovenous fistula uye hemodialysis kukwana mushure mekushanda.
Kuongorora kwakanaka uye nzira dzekutarisa dzinosanganisira
① Svika kuongorora kuyerera kweropa: zvinokurudzirwa kutarisa kamwe chete pamwedzi;
② Kuongororwa kwepanyama: zvinokurudzirwa kuti dialysis yese inofanira kuongororwa, kusanganisira kuongorora, palpation uye auscultation;
③ Doppler ultrasound: inokurudzirwa kamwe chete pamwedzi mitatu;
④ Non-urea dilution nzira inokurudzirwa kuyera kudzokorodza kamwe chete pamwedzi mitatu;
⑤ Yakananga kana isina kunanga static venous pressure yekuona inokurudzirwa kamwe chete pamwedzi mitatu.
Kana autologous AVF isingagadzirwe, sarudzo yechipiri inofanira kunge iri graft yemukati fistula (AVG).Ingave iri yekumisikidza AVF kana AVG, ultrasound yakakosha pa preoperative kuongororwa kwetsinga dzeropa, intraoperative kutungamira kwepuncture, postoperative evaluation uye kugadzirisa.
PTA yakaitwa pasi pekutungamirirwa kwe ultrasound
Dambudziko risingadzivisiki re arteriovenous fistula is stenosis.Kufamba kwenguva refu kwekukurumidza kweropa kunogona kukonzera reactive hyperplasia ye venous intima yemukati fistula, zvichiita kuti vascular stenosis uye kusakwana kweropa kuyerera, kunokanganisa kushanda kwe dialysis, uye kutungamirira ku fistula occlusion, thrombosis uye kukundikana apo stenosis yakaoma.
Parizvino kuvhiyiwa kukuru kwekurapa kwemukati fistula stenosis ye ultrasound inotungamirwa arteriovenous fistula stenosis mu keratoplasty (PTA), bharumu yekuwedzera kurapwa neganda biopsy muvarwere vane fistula mutsinga yeropa, kupinda mu catheter balloon kuwedzera, mukutungamirwa kwe ultrasound vascular stenosis nzvimbo yekuwedzera, gadzirisa yakamanikana, kudzorera yakajairika tsinga yeropa dhayamita, kuitira kuti uwedzere hupenyu hwebasa revarwere vane arteriovenous mukati fistula.
PTA pasi pekutungamirirwa ne ultrasound, iri nyore, hapana kukuvara kwemwaranzi, hapana kukuvara kwemumiriri, inogona kuratidza uye vascular occlusion maronda akapoteredza mamiriro acho ezvinhu, iyo yakayerwa kuyerera kweropa parameters uye kuongorora kubuda kweropa, uye inogona kuva pakarepo mushure mekubudirira se vascular. kuwana hemodialysis, haidi catheter yenguva pfupi, ine yakachengeteka, inobudirira uye maitiro ekukuvara kudiki, kukurumidza kupora, kuderedza marwadzo emurwere, Iyo nzira yekugadzirisa iri nyore.
Clinical kushandiswa kweultrasound mukati mepakati venous catheterization
Usati wagadzira catheter yepakati, ultrasound inofanira kushandiswa kuongorora mamiriro emukati wejugular vein kana femoral vein, kunyanya kune varwere vane nhoroondo yekare intubation, uye ultrasound inofanira kushandiswa kutarisa vein stenosis kana kuvhara.Pasi pekutungamirirwa kwe ultrasound, ultrasound, se "ziso rechitatu" rechiremba, rinogona kuona zvakajeka uye zvechokwadi.
1) Ongorora dhayamita, kudzika uye patency yeiyo puncture vein
2) Iyo yekubaya tsono mumudziyo weropa inogona kuoneswa
3) Chaiyo-nguva kuratidzwa kwetrajectory yetsono mumudziyo weropa kudzivirira kukuvara kwemukati
4) Dzivisa kuitika kwematambudziko (accident artery puncture, hematoma formation kana pneumothorax)
5) Kuvandudza chiyero chekubudirira kwekutanga puncture
Kliniki yekushandisa ye ultrasound mu peritoneal dialysis catheterization
Peritoneal dialysis imhando yerenal replacement therapy, iyo inonyanya kushandisa mamiriro eiyo peritoneum kuita renal kutsiva kurapwa.Kuenzaniswa nehemodialysis, ine maitiro ekushanda nyore, self-dialysis uye yakanyanya kuchengetedzwa kwezvakasara renal basa.
Sarudzo yekuiswa kwe peritoneal dialysis catheter pamusoro pemuviri idanho rakakosha pakugadzwa kweubstructed peritoneal dialysis access.Kuti uchengetedze patency ye peritoneal dialysis drainage uye kuderedza kuitika kwecatheterization complications, zvinodikanwa kujairana nechimiro cheanatomical yeanterior abdominal wall uye sarudza iyo inonyanya kupinza poindi yeperitoneal dialysis catheter.
Percutaneous placement ye peritoneal dialysis catheter pasi pe ultrasound kutungamira ishoma invasive, ine mari, iri nyore kushanda, yakachengeteka zvakanyanya, intuitive uye yakavimbika.
SonoEye palmar ultrasonication yakashandiswa kuwana vascular kuwana
SonoEye ndeyekupedzisira-inotakurika uye idiki, haigare padivi pemubhedha, iri nyore kutarisa, inogona kubatana zvakananga nefoni kana piritsi, vhura iyo application chero nguva.
Mufananidzo uyu unoratidza Muzvinafundo Gao Min achirapa murwere padivi pemubhedha
Chison palm ultrasound ine mifananidzo yekuongorora uye ine hungwaru hwekuyeresa kuyerera kweropa, iyo inongozvivharira uye inopa kubuda kwekubuda kweropa.
Ultrasound-inotungamirirwa puncture yemukati fistula inogona kuvandudza zvakanyanya kubudirira kwekuputika uye kuderedza kuitika kwematambudziko akadai sehematoma uye pseudoaneurysm.
Tikugashirei kuti tibatane nesu kune zvimwe zvigadzirwa zvehunyanzvi zvekurapa uye ruzivo.
Contact Details
Icy Yi
Iyo kambani Amain Technology Co., Ltd.
Mob/WhatsApp: 008617360198769
E-mail: amain006@amaintech.com
Linkedin: 008617360198769
Nhare: 00862863918480
Nguva yekutumira: Nov-03-2022
