#金属支架在难治性输尿管狭窄的应用.ppt

* * Universa? Firm 输尿管硬支架 温控材质 AQ亲水涂层 放置容易，舒适度高 体内留置一年 单圈或多圈 RPN : UFH-624 Universa? Firm多圈支架 Graduation markers Tether Pigtail straightener Size Length on Stent Radiopaque tip on pusher RPN : UFH-600 Filiform 黑硅胶支架 材质柔软 12个月留置期 增强显影 RPN : 133624 输尿管切开支架 预防输尿管狭窄 用于内切开的输尿管引流 部分无侧孔，防止组织内向性生长 Disposable 2 part troca 套管针 Used to access to the renal pelvis 用于建立经皮通道 Stylet is removed to introduce wire guide 套管针 EchoTip 头端 RPN : 090020-ET ? 经皮肾造瘘猪尾/菊花引流管 080006～12系列 Malecot（菊花头）经皮肾造瘘套装 谢谢 Coiled tight enough to prevent ingrowth yet urine can flow through it. Minimal encrustration due to material used. 12 months indwelling. The only double pigtail metallic stent in the market. * * Tapered tip dilates from 6fr to 10fr. * * Prior to S-Curve the urologists uses metal dilators which are straight and is traumatic. Now sizes of 22fr,24fr, 26fr are available individually. Shapes like the male urethra. AQ for smoother passage and tray is designed for hydration. * * Good access wires. 逆行性尿路造影的具体方法是通过膀胱镜输尿管导管逆行插入输尿管，然后注入造影剂使患侧尿路显影，因而不受肾功能的影响，可以显示肾盂、肾盏、输尿管形态，结石的位置和尿路梗阻等情况。插入输尿管导管后，先拍尿路平片，然后再经导管缓慢注入造影剂，直至尿路完全显影。造影剂浓度不宜过高，以12%—30%为宜。造影过程应尽可能在X线动态观察下进行，以便动态了解结石的位置、尿路的梗阻情况以及整个造影全过程。如果输尿管导管不能通过结石进入近端输尿管时，导管应后退离开结石约1cm左右再注入造影剂。输尿管导管以下显示不理想时，可一边缓慢后退输尿管导管，一边注入造影剂。 在造影过程中，不能过量注入造影剂，因为肾内压力过高时，往往会出现肾盂淋巴、肾盂窦、肾盂静脉的造影剂“反流”现象而影响诊断，别可能导致尿路感染扩散。逆行性尿路造影的缺点是不能了解肾脏功能情况，并可能导致肾脏或输尿管损伤及泌尿系感染，严重的输尿管水肿还可能引起尿闭而出现急性梗阻性肾衰。由于其属于创伤性检查方法，因此不宜作为常规的检查手段，仅在尿路严重梗阻或肾功能不全的患者以及怀疑有透过X线的结石时，作进一步的鉴别诊断应用。 * Good access wires. * * Advantages of Double Flexible Wire Guide “The double floppy ended guide wires protect the working channel during passage of the endoscope into the upper urinary tract. In particular, in the actively deflecting portion and in the hand piece of the flexible endoscope there is acute angulation of the working channel. If the guide wire being back loaded into the endoscope is stiff, there is a chance of perforation. This will result in leakage of irrigant into the fiber optic compartme