輸尿管鏡手術是通過一細長的窺鏡,經尿道、膀胱、輸尿管扣進入0.2至0.5cm直徑的輸尿管,在直視下或借助電視監視系統,可以很清晰地觀察到輸尿管內的病變,如有結石、腫瘤等,對輸尿管疾病進行診斷與治療。下面
內窺鏡設備維修人員來講講手術操作中輸尿管鏡的正確與操作要點。
Ureteroscopic surgery is to enter the ureter with a diameter of 0.2 to 0.5 cm through the urethra, bladder and ureteral buckle through a slender endoscope. Under direct vision or with the help of a television monitoring system, the pathological changes in the ureter can be clearly observed, such as stones, tumors, etc., to diagnose and treat ureteral diseases. The following endoscopic equipment maintenance personnel will talk about the correct operation of ureteroscope and key points of operation.
避免碰撞軟鏡:拿取及退還軟鏡時,須小心謹慎,放置穩妥,避免碰撞,受壓及墜落于地。
Avoid collision with the soft mirror: Take and return the soft mirror carefully and place it securely to avoid collision, compression and falling to the ground.
專人操作使用:因術者的使用經驗以及操作的持續時間是導致輸尿管軟鏡損傷的主要因素,為確保軟鏡的正常使用,避免因操作不熟練造成軟鏡的損傷,我們規定輸尿管軟鏡只能由具有操作經驗的結石組手術醫生專人使用,其他醫療組不能使用,如有需要,須由結石組醫生操作。
Specially assigned person for operation: The use experience of the operator and the duration of the operation are the main factors leading to the damage of the flexible ureteroscope. In order to ensure the normal use of the flexible ureteroscope and avoid the damage of the flexible ureteroscope caused by unskilled operation, we stipulate that the flexible ureteroscope can only be used by the specially assigned person of the surgeon in the calculus group with operation experience, and cannot be used by other medical groups. If necessary, it must be operated by the surgeon in the calculus group.
術中使用輸尿管擴張鞘便于軟鏡置入:對確定用輸尿管軟鏡碎石手術的患者,術前2周常規在膀胱鏡室留置輸尿管支架管,對輸尿管進行被動擴張,有利于術中順利放置軟鏡擴張鞘,便于軟鏡置入。
During the operation, the ureteral dilation sheath is used to facilitate the placement of the flexible endoscope: For patients who are determined to use the flexible ureteroscope for lithotripsy, the ureteral stent tube is routinely placed in the cystoscope room 2 weeks before the operation to passively dilate the ureter, which is conducive to the smooth placement of the flexible ureteroscope dilation sheath during the operation and the placement of the flexible ureteroscope.
輸尿管軟鏡碎石手術中,輸尿管擴張鞘的使用可明顯改善碎石視野,保證沖洗速度,降低腎盂內壓,減少鏡體軸線轉動阻力,減少鏡體反復進出輸尿管而可能趙成的黏膜損傷,縮短手術時間并提高碎石成功率,減少輸尿管軟鏡的損耗。
During ureteroscopic lithotripsy, the use of ureteral dilating sheath can significantly improve the lithotripsy field of vision, ensure the flushing speed, reduce the internal pressure of the renal pelvis, reduce the rotation resistance of the lens body axis, reduce the mucosal damage of Zhao Cheng caused by repeated access of the lens body to the ureter, shorten the operation time, improve the success rate of lithotripsy, and reduce the loss of ureteroscopic lithotripsy.
正確置入鈥激光光纖、導石籃等附件:有研究認為,軟鏡的主要損害原因是由于一些工具,如光纖、取石鉗等通過工作通道造成軟鏡的損傷。因此置入光纖時須使輸尿管軟鏡保持伸直狀態,光纖頂端應保持外伸超出輸尿管軟鏡2~3mm。
Correct placement of holmium laser optical fiber, stone guide basket and other accessories: some studies believe that the main cause of damage to the soft mirror is that some tools, such as optical fiber, stone forceps, cause damage to the soft mirror through the working channel. Therefore, the flexible ureteroscope must be kept straight when the optical fiber is inserted, and the top of the optical fiber should be kept extended beyond the flexible ureteroscope by 2-3 mm.
As one of the important equipment of modern clinical medicine, the maintenance of ureteroscope is also particularly important. More work needs to be done before and after the use of ureteroscope for inspection and cleaning. More relevant information can be found on our website http://m.thefunfoodfactory.com Consult!