Kev siv tshuaj kho mob ntawm nickel-titanium nco alloys
Esophageal nruj. Cov tsos mob tseem ceeb ntawm benign thiab malignant esophageal strictures yog dysphagia. Nyob rau hauv cov xwm txheej hnyav, nws tuaj yeem ua rau muaj kev noj zaub mov tsis txaus lossis reflux thiab aspiration pneumonia. Cov kev kho mob yav dhau los muaj xws li kev phais, kev ua kom nruj, kev kho mob endoscopic (laser, microwave thiab kev phais hluav taws xob ntau zaus) thiab kev muab hlau stent. Cov kev kho mob no txhua tus muaj qee qhov zoo thiab qhov tsis zoo. Piv nrog rau lwm yam kev phais, endoscopic thiab hlau stent kev kho mob, NT-SMA yog corrosion-resistant, hnav-resistant thiab biocompatible. Nws kuj muaj lub cim xeeb zoo muaj nuj nqi; tsis tas yuav qhib kev phais; tsis tas yuav tsum tau nthuav dav heev. , qhov kev pheej hmoo ntawm perforation yog me me; lub zog rov qab los ntawm nickel-titanium nco alloy tuaj yeem tsim kev nthuav dav thiab maj mam nthuav dav ntawm cov ntaub so ntswg; thiab NT-SMA yog yooj yim dua tshem tawm thaum haus dej khov.
Hauv xyoo 1993, Dong Zongjun li al thawj zaug tau tshaj tawm txog kev siv cov nickel-titanium alloy esophageal txhawb nqa los kho 8 tus neeg mob benign esophageal nruj. Tsuas yog 3 kis ntawm qhov ntev-segment esophageal caws pliav stenosis los ntawm cov tshuaj lom neeg kub hnyiab, kev kho mob tsis zoo, thiab cov tsos mob ntawm lwm 5 tus neeg mob tau txo qis. Lub sijhawm soj ntsuam ntev tshaj plaws yog 11 lub hlis yam tsis muaj kev phiv tshuaj. Wu Xiong et al. siv nickel-titanium nco alloy ob lub tswb-lub qhov ncauj coiled raj stent los kho 9 tus neeg mob esophagogastric anastomotic stenosis tom qab esophageal cancer resection. Kev kuaj ntshav qabzib barium nqos tau pom tias barium tuaj yeem dhau los ntawm stent smoothly, thiab tsis muaj kev cuam tshuam thaum noj mov lossis zaub mov muag. Tsuas yog ib rooj plaub uas qhov anastomosis xoob thiab lub stent plam mus rau hauv lub plab thiab raug tshem tawm los ntawm gastroscopy, lwm yim kis tau ua raws li 5 mus rau 7 lub hlis. Lawv tuaj yeem noj chewed zaub mov zoo yam tsis muaj qhov tsis xis nyob, thiab lawv lub cev muaj zog tau zoo tuaj. Nws pom tias cov neeg mob uas siv cov stents loj dua muaj patency zoo dua li cov neeg mob uas siv cov stents me me rau noj.
Cov lus qhia rau kev tso kawm ntawm nickel-titanium nco alloy:
① Esophageal stricture thiab obstructive los ntawm esophageal cancer, thiab nruj tom qab radiotherapy rau esophageal cancer;
② esophageal stricture tshwm sim los ntawm lub cev los yog tshuaj hlawv;
③ Esophageal airway fistula, esophageal mediastinal fistula (siv membrane-coated NT-SMA stent). Contraindications:
① Mob plawv thiab ntsws tsis txaus;
② Cov neeg mob uas nqos tsis tau ntawm lawv tus kheej;
③ Qhov chaw stenosis siab dua qib xya ntawm lub ncauj tsev menyuam vertebra.
Tracheal stenosis tshwm sim los ntawm cov qog nqaij hlav; ntu stenosis ntev los yog muaj ntau yam stenosis; cov neeg mob uas muaj hnub nyoog laus los yog muaj kev noj qab haus huv tsis zoo tsis haum rau kev phais. Qhov tsis zoo ntawm kev tso T-tube yog qhov stent tsis tuaj yeem deform thiab nyuaj rau qhov chaw; nws yooj yim rau kev khiav tawm thiab kev puas tsuaj hauv zos; kev zais cia feem ntau tshwm sim; T-tube muaj qhov tsis yooj yim thiab tsis haum rau qis tracheal stenosis. NT-SMA zoo dua daws cov teeb meem saum toj no. Tom qab deformation, nws tuaj yeem muab tso rau hauv qhov chaw nqaim los ntawm cov kab noj hniav me me; tom qab reshaping, nws yog ze rau ntawm phab ntsa tracheal thiab tsau zoo; Nws muaj biocompatibility zoo thiab zoo rau tracheal mucosa. Tsis muaj kev puas tsuaj pom tseeb thiab tuaj yeem muab tso rau lub sijhawm ntev; Lub siab resilience tso cai rau nws hloov mus rau qhov khoov ntawm lub trachea thiab tuaj yeem muab tso rau hauv ntau ntu ntawm lub trachea. Xyoo 1993, Liu Yang et al. tso NT-SMA stents hauv 7 tus dev tom qab ua rau tracheal stenosis thiab saib lawv rau 2 mus rau 6 lub hlis. Cov txiaj ntsig tau pom tias cov stent tuaj yeem muab tso rau hauv granulated thiab caws pliav tracheal stenosis thaj chaw tsis ua rau muaj kev cuam tshuam loj heev lossis ua rau khaus khaus, thiab tsis muaj kev cuam tshuam los ntawm kev zais zais lossis cov ntaub so ntswg loj hlob. Qhov saum npoo ntawm stent yog du thiab huv, tsis muaj kev hloov pauv lossis deformation, qhia txog biocompatibility zoo. Raws li kev sim tsiaj, ib kis ntawm qhov mob hnyav tracheal stenosis thiab tracheal anastomotic stenosis tshwm sim los ntawm cov qog nqaij hlav tracheal siab heev tau kho, thiab cov txiaj ntsig kho tau zoo. Hauv kev sim tsiaj txhu los ntawm Pei Shigeng thiab lwm tus, NT-SMA stents tau muab tso rau hauv cov hlab ntsha thiab cov kab mob myocutaneous tau siv los kho cov kab mob hauv lub cev. Cov kev sim qhia tau hais tias NT-SMA stent muaj kev txhawb nqa zoo ntawm lub ntsws.
Cov lus qhia rau kev tso kawm ntawm nickel-titanium nco alloy:
① Tracheal stenosis tshwm sim los ntawm kev mob tracheal, bronchial, thyroid, esophageal lossis mediastinal qog, ua haujlwm tsis tau thiab xav tau lub neej txuas ntxiv;
②Tracheal phab ntsa vau tom qab laryngeal thiab tracheal reconstruction; ③ mob ntsws thiab bronchomalacia;
④ Cov neeg uas nws lub cev tsis tuaj yeem zam kev phais.
Vascular embolism. Xyoo 1974, Sokoloff et al. thawj zaug tau tshaj tawm txog kev kho mob zoo ntawm 2 mob ntawm epistaxis nrog percutaneous intra-arterial gelfoam embolization, tsim lub ntiaj teb tshiab ntawm kev kho mob epistaxis nrog angiography technology. Tom qab kev kho mob dav dav, cov pa angiography tau tsim rau hauv DSA, uas yog siv los ntawm ntau tus kws tshawb fawb rau kev ua haujlwm ua ntej ntawm epistaxis thiab lub taub hau thiab caj dab vascular hlav. Feem ntau siv embolization cov ntaub ntawv muaj xws li gelatin daim txhuam cev, polyethylene sponge, stainless hlau pob, thiab silica gel hais. Ua ntej, cov ntaub ntawv no raug txwv los ntawm lub caliber ntawm lub catheter thiab nyuaj rau tso tawm; thib ob, lawv nyuaj rau embolize cov hlab ntsha loj. Xyoo 1977, Simon et al. siv NT-SMA los ua lub lim dej thrombus thiab cog rau hauv qhov tsis zoo vena cava ntawm cov dev, thiab pom tias nws tsis muaj tshuaj lom lossis tsis zoo rau cov tsiaj. Xyoo 1992, Zhang Chuncai thiab lwm tus siv NT-SMA los ua cov khoom siv vascular embolization. Tom qab kev sim kev tshawb fawb ntawm embolization ntawm 39 lub hom phiaj hlab ntsha hauv 20 tus dev, lawv pom tias daim txhuam cev ntsaws ua los ntawm NT-SMA muaj:
① Tso tawm yooj yim thiab nyab xeeb;
② Cov nyhuv embolization yog ceev thiab txhim khu kev qha;
③ Tsim nyog rau embolization ntawm cov hlab ntsha loj dua;
④ Kev sim tau ua pov thawj tias kev sib koom ua ke ntawm NT-SMA zoo dua li cov hlau tsis muaj steel. NT-SMA tuaj yeem siv los ua cov khoom siv embolization zoo dua rau kev kho mob embolization. Ma Genshan et al kuj tau tshaj tawm tias NT-SMA endovascular stent muaj biocompatibility zoo thiab tsis muaj tshuaj lom lossis muaj kev phiv.
