Amabuye mato yinkari arashobora kuvurwa muburyo bwitondewe cyangwa lithotripsy ya extraitorporeal shock, ariko amabuye manini ya diameter, cyane cyane amabuye abangamira, bisaba kubagwa hakiri kare.
Bitewe n’ahantu hihariye h’amabuye yo hejuru yinkari, ntibishobora kugerwaho na ureteroskopi ikaze, kandi amabuye arashobora kuzamuka byoroshye mumyanya yimpyiko mugihe cya lithotripsy. Indwara ya nephrolithotomy yongerera ibyago byo kuva amaraso mugihe hashyizweho umuyoboro.
Kuzamuka kwa ureteroskopi yoroheje byakemuye neza ibibazo byavuzwe haruguru. Yinjira muri ureter na pelvis yimpyiko binyuze muri orifice isanzwe yumubiri wumuntu. Ni umutekano, ukora neza, utera cyane, ufite amaraso make, ububabare buke kumurwayi, nigipimo kinini kitagira amabuye. Ubu bimaze kuba uburyo bukoreshwa muburyo bwo kubaga kuvura amabuye yo hejuru.
Kugaragara kwaurureralyagabanije cyane ingorane za ureteroskopi yoroheje ya lithotripsy. Ariko, hamwe n’ubwiyongere bw’imibare y’ubuvuzi, ingorane zayo zagiye zikurura abantu buhoro buhoro. Ingorane nko gutobora ureteral no gukomera ureteral birasanzwe. Ibikurikira nimpamvu eshatu zingenzi zitera gukomera kwinkari no gutobora.
1. Inzira yindwara, diameter yamabuye, kutagira amabuye
Abarwayi bafite inzira ndende yindwara bakunda kugira amabuye manini, kandi amabuye manini aguma muri ureter igihe kirekire kugirango bafungwe. Amabuye ahabigenewe agabanya mucosa yinkari, bikaviramo gutanga amaraso adahagije, ischemia mucosal, inflammation hamwe ninkovu, bifitanye isano rya bugufi no gushiraho inkari.
2. Gukomeretsa mu mura
Ihinduramiterere ya ureteroskopi iroroshye kunama, kandi urwungano ngogozi rugomba kwinjizwa mbere ya lithotripsy. Kwinjiza umuyoboro wumuyoboro ntukorwa mubyerekezo bitaziguye, kubwibyo byanze bikunze ko mucosa yinkari yangiritse cyangwa igatoborwa bitewe no kunama kwa ureter cyangwa lumen ifunganye mugihe cyo gushyiramo sheath.
Byongeye kandi, kugirango ushyigikire ureteri no kumena amazi ya parufe kugirango ugabanye umuvuduko wimpyiko, ubusanzwe hatoragurwa umuyoboro unyuze kuri F12 / 14, ibyo bikaba bishobora gutuma umuyoboro wumuyoboro uhagarika urukuta rwinkari. Niba tekinike yo kubaga idakuze kandi igihe cyo kubaga kikaba kirekire, igihe cyo kwikuramo umuyoboro wumuyoboro wurukuta rwinkari ziziyongera ku rugero runaka, kandi ibyago byo kwangirika kwa ischemic kurukuta rwinkari bizaba byinshi.
3. Holmium laser yangiritse
Gutandukanya amabuye ya lazeri ya holmium ahanini bishingiye ku ngaruka zayo zifotora, bigatuma ibuye ryinjiza mu buryo butaziguye ingufu za lazeri no kongera ubushyuhe bwaho kugira ngo rigere ku ntego yo gucamo amabuye. Nubwo ubujyakuzimu bwumuriro mugihe cyo kumenagura amabuye ni mm 0,5-1.0 gusa, ingaruka zirenze urugero ziterwa no kumenagura amabuye ntagereranywa.
Ingingo z'ingenzi zo gushyiramo inkari zo kwinjira ni izi zikurikira:
1. Hariho imyumvire igaragara yo gutera imbere mugihe winjiye muri ureter, kandi ikumva neza iyo izamutse muri ureter. Niba gushiramo bigoye, urashobora kuzunguza insinga ziyobora inyuma no kureba niba insinga ziyobora zinjira kandi zisohoka neza, kugirango umenye niba umuyoboro wumuyoboro ugenda utera imbere mucyerekezo cyinsinga ziyobora, nka Niba ahari kwigaragaza kugaragara, icyerekezo cyo gukata gikeneye guhinduka;
Umuyoboro washyizwe muburyo bwiza urashizweho kandi ntuzinjira kandi ushakiye. Niba umuyoboro wumuyoboro usohotse bigaragara, bivuze ko ushyizwe mu ruhago kandi insinga iyobora yavuye muri ureter kandi igomba kongera gushyirwaho;
3. Umuyoboro wumuyoboro wa Ureteral ufite ibisobanuro bitandukanye. Abarwayi b'abagabo muri rusange bakoresha urugero rwa cm 45 z'uburebure, naho abarwayi b'igitsina gore cyangwa bagufi bakoresha urugero rwa cm 35 z'uburebure. Niba umuyoboro wumuyoboro winjijwe, urashobora kunyura mumyanya yinkari cyangwa ntushobora kuzamuka murwego rwo hejuru. Umwanya, abarwayi b'igitsina gabo barashobora kandi gukoresha cm 35 zerekana ibyatsi, cyangwa bagahinduka kuri 14F cyangwa ndetse no kwaguka kwagutse kwagutse kugirango birinde ureteroskopi yoroheje idashobora kuzamuka munda yimpyiko;
Ntugashyire umuyoboro wintambwe imwe. Kureka cm 10 hanze ya urethral orifice kugirango wirinde kwangirika mucosa yinkari cyangwa parenchyma yimpyiko kuri UPJ. Nyuma yo kwinjiza ibintu byoroshye, umuyoboro wumuyoboro urashobora guhindurwa ukundi muburyo butaziguye.
Twebwe, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., Ni uruganda mu Bushinwa ruzobereye mu gukoresha endoskopi, nkabiopsy imbaraga, hemoclip, umutego, inshinge, spray catheter, cytology, kuyobora, igitebo cyo kugarura amabuye, izuru rya biliary drainage catheternibindi bikoreshwa cyane muriEMR, ESD, ERCP. Ibicuruzwa byacu byemewe na CE, kandi ibihingwa byacu byemewe na ISO. Ibicuruzwa byacu byoherejwe mu Burayi, Amerika y'Amajyaruguru, Uburasirazuba bwo hagati ndetse no muri Aziya, kandi bigera ku bakiriya bamenyekana kandi bashimwe!
Igihe cyo kohereza: Nzeri-11-2024