Endovasal laser coagulation ntawm cov leeg

Cov txheej txheem:

Endovasal laser coagulation ntawm cov leeg
Endovasal laser coagulation ntawm cov leeg

Video: Endovasal laser coagulation ntawm cov leeg

Video: Endovasal laser coagulation ntawm cov leeg
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Cov ceg zoo nkauj yog tus npau suav ntawm txhua tus poj niam. Hmoov tsis zoo, ntau ntawm kev sib deev ncaj ncees tsim cov leeg varicose. Qhov no pathology tshwm sim tsis tau tsuas yog nyob rau hauv cov poj niam laus, tab sis kuj nyob rau hauv cov ntxhais hluas. Vim varicose leeg, ob txhais ceg poob lawv attractiveness. Tom qab tag nrho, bulging thiab tortuous veins tshwm rau lawv. Qhov no ua rau cov tsos ntawm complexes txog lawv cov tsos ntawm ntau tus poj niam.

Ntxiv rau qhov kev xav ntawm lub hlwb, varicose leeg kuj tseem ceeb rau kev noj qab haus huv ntawm lub cev. Nyob rau theem pib ntawm pathology, qaug zog ntawm ob txhais ceg tau sau tseg tom qab taug kev ntev, maj mam tsis xis nyob pib tshwm sim thaum so. Yog tias tus kab mob tsis kho, muaj kev pheej hmoo ntawm kev tsim thrombophlebitis. Qhov teeb meem no, dhau los, tuaj yeem ua rau txo qis ntawm cov ntshav mus rau qis qis, thiab txawm tias tuag vim mob txoj cai ventricular tsis ua haujlwm.

Cov tshuaj niaj hnub tau nce sai. Tau ntau xyoo, rau kev kho mob ntawm varicose leeg nquagcov txheej txheem laser yog siv. Lawv yuav luag tag hloov cov kev phais qhib. Ib txoj hauv kev kho mob yog endovasal laser coagulation ntawm varicose leeg. Cov lus teb rau cov txheej txheem no yog qhov zoo. Cov neeg mob uas tau txais kev kho mob qhia ntau yam txiaj ntsig ntawm cov txheej txheem.

endovasal laser coagulation
endovasal laser coagulation

Keeb kwm ntawm laser photocoagulation

thawj zaug siv lub tshuab laser rau kev kho mob vascular pathologies tau hais hauv xyoo 1981. Txoj kev tau ua raws li lub peev xwm ntawm lub cev nqaij daim tawv kom nqus tau lub teeb. Lub wavelength ntawm thawj lasers yog 577 nm. Nws tau pom tias raug rau lub teeb lub zog tuaj yeem ua rau xaiv kev puas tsuaj ntawm cov hlab ntsha ntawm daim tawv nqaij. Hauv kaum xyoo tom ntej no, ntau lub tshuab laser compact tau tsim.

Nyob rau hauv lub lig 90s, intravascular siv cov khoom tau hais thawj zaug. Rau kev kho cov hlab ntsha pathologies, diode lasers nrog lub wavelength ntawm 810 nm tau siv. Cov txiaj ntsig tau luam tawm xyoo 2001. Lub laser yog thawj zaug siv los kho cov kab mob saphenous zoo. Nyob nruab nrab ntawm 1996 thiab 2000, 252 intravascular kev ua haujlwm tau ua. Nyob rau hauv lub neej yav tom ntej, cov txheej txheem ntawm kev kho mob endovasal txhim kho. Nws muab tawm tias ua kom lub zog ntawm lub teeb ci tuaj yeem txo qhov kev pheej hmoo ntawm kev cuam tshuam ntawm intravascular.

endovasal coagulation siv rau dab tsi?

Endovasal laser coagulation yog ib txoj hauv kev kho cov leeg varicose. Nws yog siv los ua lwm txoj hauv kev phais thiab sclerotherapy. Yuav ua li casNws paub tias varicose leeg tshwm sim vim qhov ua haujlwm tsis zoo ntawm cov li qub. Vim qhov tseeb tias lawv tsis muaj zog dhau lub sijhawm, cov ntshav ntws mus ib txwm hloov. Nrog varicose leeg, txhua cov hlab ntsha tuaj yeem cuam tshuam. Vim qhov nyob tsis tu ncua ntawm ob txhais ceg, feem ntau muaj teeb meem nrog cov hlab ntsha loj thiab me saphenous nyob rau hauv qis extremities. Endovasal laser coagulation muaj nyob rau hauv sealing cov hlab ntsha cuam tshuam. Vim li ntawd, cov ntshav tsis tuaj yeem hla nws thiab maj mus rau hauv cov leeg noj qab haus huv.

endovasal laser coagulation ntawm varicose leeg xyuas
endovasal laser coagulation ntawm varicose leeg xyuas

Lub luag haujlwm ntawm laser txiav txim ntawm cov hlab ntsha

endovasal laser coagulation ntawm varicose leeg ua li cas? Txoj kev no yog ua raws li cov nyhuv thermal ntawm thermal zog ntawm endothelium. Lub ntsiab lus ntawm kev kho mob yog tias nyob rau hauv lub zog ntawm laser beams, ntshav thickens. Lub teeb fluxes absorbed los ntawm cov hlwb tshwj xeeb - erythrocytes. Vim li no, cov rays tau hloov mus rau hauv thermal zog. Laser exposure ua rau thermal hlawv ntawm endothelium, thiab cov npuas npuas tshwm nyob rau hauv cov ntshav. Ua tsaug rau cov txheej txheem no, ib qho txhaws tau tsim - thrombus. Nws obliterates lub lumen ntawm cov hlab ntsha. Yog li ntawd, lub nkoj yog glued ua ke, thiab tom qab ntawd kaw tag nrho. Ib xyoos tom qab, cov ntaub so ntswg sib txuas ntawm qhov chaw ntawm qhov hlawv.

endovasal laser coagulation ntawm varicose leeg
endovasal laser coagulation ntawm varicose leeg

Indications rau laser coagulation

Nws tsim nyog sau cia tias tsuas yog qee kis, endovasal laser coagulation ntawm cov leeg tau ua. Kev tshuaj xyuas tus neeg mob,kev txom nyem los ntawm varicose leeg, qhia tias txoj kev no tsis yog ib txwm tso cai. Muaj ntau cov lus qhia rau kev kho mob laser vascular. Cov no suav nrog cov xwm txheej hauv qab no:

  1. Kev nthuav dav ntawm cov kab mob saphenous loj hauv qhov ncauj ntawm thaj tsam li 1 cm lossis tsawg dua.
  2. Ib qho me me ntawm cov nkoj loj.
  3. Smooth course of the great or me me saphenous vein.
  4. Kev tsis txaus ntshav rau ob txhais ceg.

Endovasal laser coagulation ntawm varicose leeg kuj siv rau lwm yam. Txawm li cas los xij, ua ntej txiav txim siab ua txoj kev kho no, tus kws kho mob yuav tsum ntsuas qhov zoo thiab qhov tsis zoo. Yog hais tias ostium expansion ntawm cov hlab ntsha yog ntau tshaj 1 cm, coagulation yuav tsis muaj qhov xav tau. Qhov no yuav xav tau kev phais dua. Lub xub ntiag ntawm pathological khoov raws cov hlab ntsha kuj tsis suav hais tias yog ib qho contraindications. Qee zaum hauv qhov no, endovasal laser coagulation yog ua. Hauv qhov no, cov kws phais mob siv ob lub teeb qhia es tsis yog ib qho.

Yog tias muaj cov kab mob varicose ntau, txoj kev no tuaj yeem siv tau, txawm li cas los xij, raws li kev xyaum qhia, nws yuav tsis coj cov nyhuv xav tau. Endovasal laser coagulation yog txoj kev siv tau tshaj plaws ntawm kev kho mob hauv kev ua txhaum ntawm trophism ntawm sab ceg. Yog tias tsim nyog, txoj kev no tuaj yeem rov ua dua.

evlk endovasal laser coagulation tshuaj xyuas
evlk endovasal laser coagulation tshuaj xyuas

txiaj ntsig ntawm Endovasal Coagulation

Tshaj li 10 xyoo dhau los, laser vascular coagulation tau tsim nws tus kheej ua ib txoj hauv kev zoo tshaj plaws ntawm kev kho mob. Nws nquagyog siv nyob rau hauv txawv teb chaws thiab tau nkag mus rau hauv domestic tshuaj. EVLK (endovasal laser coagulation) muaj ntau qhov zoo dua li cov txheej txheem ntawm kev kho cov leeg varicose. Cov no suav nrog:

  1. Tsis muaj caws pliav tom qab qhov txheej txheem. Tsis zoo li kev phais qhib, laser coagulation yog ib txoj kev ua kom tsawg heev. Yog li ntawd, tom qab EVLT, tsis muaj hematomas thiab nti.
  2. Ua tshuaj loog hauv zos. Qhib vascular phais yog ib qho qhia rau kev siv tshuaj loog. Raws li koj paub, hom tshuaj loog no tsis tuaj yeem ua tau yog tias tus neeg mob muaj kab mob somatic hnyav. Tsis tas li ntawd, kev rov qab los ntawm tshuaj loog hauv zos yog sai dua thiab yooj yim dua.
  3. Tsis mob. Kev hnov mob tsis zoo thaum lub sijhawm ua haujlwm yog qhov tsis tuaj yeem los yog tsawg heev. Tib yam siv rau lub sijhawm ua haujlwm tom qab.
  4. Txuag kev muaj peev xwm ua haujlwm. Endovasal laser coagulation ntawm varicose hlab ntsha tuaj yeem ua rau ntawm tus neeg mob sab nraud. Cov txheej txheem tsis siv sijhawm ntev, yog li tus neeg mob rov qab ua haujlwm sai.
  5. Muaj peev xwm rov ua dua coagulation ntawm cov leeg.
  6. Tsawg muaj feem cuam tshuam.
  7. Qhov muaj peev xwm ntawm laser coagulation nyob rau hauv lub xub ntiag ntawm trophic ulcers nyob rau hauv qis extremities.

Qhov zoo ntawm cov txheej txheem kev kho mob no yog pom tseeb. Txawm li cas los xij, nws tsim nyog nco ntsoov tias muaj contraindications rau kev ua laser coagulation. Yog li ntawd, ua ntej txiav txim siab txog txoj kev kho mob, nws yog ib qho tsim nyog yuav tau ua qhov kev kuaj mobcov txheej txheem.

endovasal laser coagulation ntawm cov hlab ntsha tshuaj xyuas
endovasal laser coagulation ntawm cov hlab ntsha tshuaj xyuas

Contraindications rau txheej txheem

Contraindications rau intravascular laser coagulation tsis tuaj yeem tsis quav ntsej. Txawm hais tias tus neeg mob lub siab xav muaj zog, kev kho mob tsis tuaj yeem ua tiav hauv cov xwm txheej hauv qab no:

  1. ntshav ntshav muaj kev pheej hmoo ntawm thrombosis.
  2. Kab mob hauv cheeb tsam cuam tshuam.
  3. Pathology vim tus neeg mob tsis muaj peev xwm txav mus los. Ntawm lawv yog cov kab mob ntawm cov pob txha thiab pob qij txha, tuag tes tuag taw.
  4. Muaj cov txheej txheem mob hnyav hauv lub cev.
  5. Ischemic vascular kab mob ntawm qis extremities.
  6. Kev rog rog.

Lub xub ntiag ntawm inflammatory foci thiab kis kab mob yog suav hais tias tus txheeb ze contraindications rau laser coagulation. Nyob rau hauv xws li mob, manipulation yog nqa tawm tom qab kev kho mob ntawm tus mob pathology. Tsis tas li ntawd, cov txheeb ze contraindications muaj xws li: pronounced expansion thiab tortuosity ntawm saphenous leeg. Hauv qhov no, qhov kev txiav txim siab ua laser coagulation yog ua los ntawm tus kws kho mob tom qab kuaj ntxiv.

Npaj rau txheej txheem

Ua ntej laser coagulation, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas cov txheej txheem xws li kuaj ntshav thiab zis, coagulogram, ECG, kuaj kab mob HIV thiab kab mob siab. Cov kev tshwj xeeb muaj xws li ultrasound ntawm cov hlab ntsha ntawm qis extremities nrog dopplerography. Txoj kev tshawb no yuav pab ntsuam xyuas qhov mob ntawm lub li qub, thiab txheeb xyuas cov ntshav ncig tsis zoo.

Ua ntej lasercoagulation yuav tsum tau tshem ntawm cov plaub hau ntawm ceg. Ua ntej pib nrog cov txheej txheem, tus kws kho mob ua cov cim ntawm daim tawv nqaij. Nws yog ua raws li kev qhia ntawm ultrasound. Ua ntej tshaj plaws, tus kws kho mob sau qhov chaw ntawm reflux (rov qab ntws) ntawm cov ntshav hauv cov hlab ntsha loj lossis me me. Tom qab ntawd, qhov chaw nyob rau hauv uas lub puncture ntawm lub nkoj yog ua cim. Nws nyob ntawm 3-4 cm hauv qab ntawm thawj lub cim. Tom qab ntawd, tus kws phais mob kos tag nrho cov orifices ntawm cov ntshav ntws thiab varicose expansions.

Cov txheej txheem coagulation

Endovasal laser coagulation ntawm cov leeg ntawm cov leeg qis yog ua raws li kev siv tshuaj loog hauv zos. Tom qab tshuaj loog, cov hlab ntsha yog punctured siv lub catheter. Lub teeb qhia tau muab tso rau hauv lub nkoj. Lub laser yog qhia rau venous anastomosis. Tom qab ntawd, tumescent anesthesia yog ua - tshuaj loog nyob ib ncig ntawm lub pathological tsom. Rau lub hom phiaj no, ib tug saline tov nrog ntxiv ntawm lidocaine thiab adrenaline yog siv. Yog li, nws muaj peev xwm ua tiav tsis tsuas yog mob nyem, tab sis kuj tiv thaiv qhov kub hnyiab ntawm cov ntaub so ntswg noj qab haus huv.

Endovasal laser coagulation tshuaj xyuas
Endovasal laser coagulation tshuaj xyuas

Tom qab cov tshuaj loog tumescent, endovasal laser coagulation ntawm cov leeg tau ua. Raws li kev cuam tshuam ntawm lub teeb teeb, thaj chaw puas ntawm lub nkoj yog obliterated. Tom qab ntawd ib daim ntaub qhwv tshwj xeeb yog siv rau cov leeg. Compression stockings yuav tsum muab tso rau tam sim ntawd.

Rov qab tom qab laser coagulation

Lub sijhawm ntawm endovasal coagulation yog li 40 feeb. Tom qab cov txheej txheem laser, nws yuav tsum tau taug kev nyob ib ncig ntawm pawg ntseeg li 1 teev. Cestus neeg mob tuaj yeem tawm hauv tsev kho mob. Kev tswj xyuas ultrasound ntawm cov leeg ntawm cov leeg qis yog ua nyob rau hauv 2-3 hnub. Compression stockings yuav tsum tsis txhob muab tshem tawm rau 5 hnub. Nyob rau nruab hnub, lawv yuav tsum hnav tsawg kawg 2 lub hlis. Cov neeg mob yuav tsum tau taug kev thiab zam kev tawm dag zog hnyav. Nws tsis pom zoo kom zaum ntev thiab mus da dej, nrog rau da dej kub thawj lub hlis tom qab ua haujlwm.

Cov teeb meem dab tsi tuaj yeem tshwm sim?

Dab tsi yog qhov txaus ntshai ntawm EVLT (endovasal laser coagulation)? Kev tshuaj xyuas cov neeg mob qhia tias muaj teeb meem tom qab txoj kev kho mob no tshwm sim tsis tshua muaj tshwm sim. Cov no suav nrog:

  1. YThrombophlebitis.
  2. Paresthesia - ib qho tingling sensation raws cov leeg.
  3. Kab mob thiab necrosis ntawm lub nkoj.

Kev txav me me tsis xis nyob thiab qhov kev xav nruj yog qhov qub thiab yuav daws tau hauv 2-3 hnub. Tsis tas li ntawd, thawj hnub, qhov kub ntawm lub cev subfebrile tuaj yeem cuam tshuam.

evlk endovasal laser coagulation
evlk endovasal laser coagulation

Endovasal laser coagulation ntawm varicose leeg: tus neeg mob tshuaj xyuas

Kawm txog ntau qhov kev tshuaj xyuas ntawm cov neeg uas tau dhau los ntawm qhov kev cuam tshuam no, nws tsim nyog sau cia qhov ua tau zoo thiab ntau qhov zoo ntawm txoj kev tshaj li lwm txoj kev kho mob. Ntawm qhov tsis zoo ntawm laser coagulation, cov neeg mob qhia tus nqi siab ntawm cov txheej txheem thiab muaj peev xwm rov ua dua. Txhua tus poj niam uas tau ua tiav txoj haujlwm no nco ntsoov qhov tsis muaj qhov tsis zoo ntawm cov tawv nqaij ntawm ob txhais ceg.

Endovasal laser coagulation: kws kho mob tshuaj xyuas

poRaws li kws kho mob, endovasal coagulation ntawm cov hlab ntsha nrog ib tug laser yog ib tug ntawm cov zoo tshaj plaws txoj kev rau kho varicose leeg. Txawm hais tias tus nqi siab, nws yog qhov xav tau ntawm cov neeg mob. Txawm li cas los xij, cov kws kho mob tau taw qhia tias nyob rau hauv cov xwm txheej hnyav nws tsis pom zoo kom ua tiav endovasal coagulation.

Pom zoo: