Standard Monopolar Electrosurgical Unit:
Lub siab - zaus electrosurgical unit (los yog siab- zaus siv phais) yog ib qho khoom siv hluav taws xob tsim los hloov cov tshuab scalpels rau kev txiav cov ntaub so ntswg. Nws ua haujlwm los ntawm kev tsim lub siab - zaus, siab -voltage tam sim no ntawm qhov kawg ntawm cov khoom siv hluav taws xob; Thaum cov lus qhia no hu rau lub cev, nws ua kom sov cov ntaub so ntswg, yog li ua tiav cov kev sib cais thiab coagulation ntawm cov ntaub so ntswg lom kom ua tiav cov hom phiaj ntawm kev txiav thiab hemostasis. Nws siv lub tshuab hluav taws xob ua tiav los txiav thiab coagulate cov ntaub so ntswg; Qhov Circuit Court no muaj lub siab- lub tshuab hluav taws xob zaus nyob hauv chav tsev, tus neeg mob rov qab electrode (cov ntaub qhwv hauv av), txuas cables, thiab cov khoom siv hluav taws xob.
Daim duab yooj yim ntawm Electrosurgical Unit Operation
Hauv ntau daim ntawv thov, tam sim no ntws los ntawm cov khoom siv hluav taws xob thiab hluav taws xob los ntawm tus neeg mob lub cev, thiab tom qab ntawd rov qab mus rau lub tshuab hluav taws xob hluav taws xob los ntawm tus neeg mob rov qab electrode thiab nws cov txuas txuas.
Cov lus qhia siv:
· Tsis txhob teem lub hwj chim theem siab dhau lawm. Cov zis hluav taws xob tiag tiag sib txawv ntawm cov cuab yeej sib txawv, lossis txawm nyob hauv tib chav tsev, nyob ntawm nws cov kev ua haujlwm tshwj xeeb. Feem ntau, kev teeb tsa hluav taws xob rau electrosurgery (txiav) thiab electrocoagulation yuav tsum tsis pub tshaj 40 watts. Lub hauv paus ntsiab lus yog: teem lub hwj chim mus rau qhov tsawg kawg nkaus uas yuav tsum tau ua kom tiav cov txheej txheem. Txawm li cas los xij, thaum lub sijhawm phais cytoreductive rau kev mob qog noj ntshav ntawm zes qe menyuam-tshwj xeeb yog thaum hais txog kab mob siab hepatic metastases- qhov chaw electrocoagulation feem ntau yuav nce mus rau 100 watts kom ntseeg tau tias muaj txiaj ntsig zoo hauv cov ntaub so ntswg hauv siab.
· Ib qho electrosurgical electrode tsis yog ib qho kev siv scalpel. Lub hauv paus ntsiab lus ntawm electrosurgical txiav cia siab rau qhov incision tsim los ntawm hluav taws xob sparks uas tshwm sim los ntawm intermittent paug; Yog li ntawd, cov electrode yuav tsum tsis txhob raug kho los yog siv zoo li cov hniav txheem. Khaws qhov sib txawv me ntsis ntawm cov electrode thiab cov ntaub so ntswg, tso cai rau cov cim ntawm cov khoom sib xws, me me sparks. Tsis txhob nias lub electrode quab yuam tawm tsam cov ntaub so ntswg, vim qhov no tuaj yeem ua rau cov ntaub so ntswg raug mob.
· Cov ntaub so ntswg traction yog qhov tseem ceeb. Nws yog ib qho tseem ceeb uas yuav tsum nqa cov tawv nqaij ntawm lub kaum sab xis 45-degree los tsim kom muaj qhov chaw ua haujlwm sib txawv lossis dav hlau hauv cov ntaub so ntswg. Cov electrode yuav tsum tau coj los ntawm qhov chaw tsim no kom paub meej qhov pom thiab kev sib cais raws cov dav hlau anatomical.
· Tswj qhov ceev ntawm electrode txav. Tsiv qeeb heev tuaj yeem ua rau cov ntaub so ntswg puas; txav nrawm dhau yuav ua rau puas tsuaj rau cov qauv anatomical tseem ceeb.
· Siv electrocoagulation rau hemostasis. Feem ntau, siv hemostatic forceps los tuav thiab nqa lub nkoj -thiab tom qab ntawd siv cov electrode rau forceps-yields superior hemostatic.
· Hauv cov neeg mob uas muaj cov ntaub so ntswg subcutaneous adipose, txo qis kev siv lub tshuab electrosurgical kom tsis txhob muaj cov ntaub so ntswg liquefaction thiab necrosis, uas tuaj yeem cuam tshuam qhov txhab kho.
· Txij li thaum lub tsev electrosurgical exerts nws thawj cov nyhuv ntawm lub siab tshaj plaws hluav taws xob tsis kam (feem ntau yog qhov chaw tiv tauj), nws yog ib qho tseem ceeb kom ntseeg tau tias ib tug txhim khu kev qha kev twb kev txuas ntawm tus neeg mob rov qab electrode (ground pad) thiab daim tawv nqaij. Qhov chaw tiv tauj yuav tsum loj npaum li qhov ua tau kom tsis txhob kub hnyiab! · Tsis txhob sim txiav rau hauv ib qho excised specimen; txij li tsis muaj hluav taws xob Circuit Court tsim, lub cuab yeej yuav tsis hnov mob. Yog tias muaj qhov tshwm sim * puas * tshwm sim, nws txhais tau hais tias qhov tam sim no ntws los ntawm tus kws phais lawv tus kheej- thaum twg tus kws phais yuav tau txais hluav taws xob poob siab!
· Rau cov cheeb tsam uas muaj cov nqaij ntshiv nqaij -yog tias nws yuav tsum tau hloov cov leeg nqaij - siv hom electrocoagulation yuav ua rau los ntshav tsawg. Qhov no yog vim tias electrocoagulation txiav qeeb dua thiab siv qis dua tam sim no, tso cai rau lub sijhawm txaus rau cov leeg nqaij kom "char" thiab ua tiav hemostasis. Txawm li cas los xij, thaum lub ntim loj ntawm cov ntaub so ntswg yog clamped thiab electrocoagulation ua pov thawj tsis txaus los txo cov ntshav, hloov mus rau electrocautery (txiav) hom yuav ua rau cov txiaj ntsig zoo hemostatic.
· Thaum siv rab riam electrosurgical nyob rau hauv cov ntaub so ntswg sib sib zog nqus, thaum twg los tau, xaiv ib tug ntev - tuav cov cuab yeej nrog tsuas yog lub taub hau ntawm cov hniav; qhov no tiv thaiv cov hlau ncej los ntawm inadvertently ua puas nyob ib sab cov qauv, xws li cov hlab ntsha los yog cov hlab ntsha.
· Ceev faj kom tsis txhob raug mob ntawm daim tawv nqaij nrog cov riam electrosurgical. Qhov zoo tshaj plaws, cov ntaub so ntswg subcutaneous yuav tsum tsis txhob siv cov riam electrosurgical; Tsis tas li ntawd, siv cov pa scalpel los qhib cov txheej txheem subcutaneous, ua raws li qhov chaw electrocoagulation kom ua tiav hemostasis. Hauv thaj chaw anatomical uas los ntshav tsis xav tias yuav muaj ntau, cov riam electrosurgical yuav raug muab tso rau hauv kev pom zoo ntawm txiab txiab los yog ib qho scalpel.
· Thaum tshem cov khoom siv kho mob sab hauv, xyuas kom cov riam electrosurgical tsis tuaj yeem tiv nrog cov khoom cog lawv tus kheej. Qhov no yog ib qho tseem ceeb tshwj xeeb tshaj yog thaum phais txha caj qaum; Kev sib cuag ntawm lub zog hluav taws xob hluav taws xob thiab cov khoom siv kho mob txha caj qaum tuaj yeem ua rau lub cev dura mater, cov hauv paus paj hlwb, lossis tus txha caj qaum - muaj peev xwm ua rau muaj kev raug mob ntawm lub paj hlwb lossis txawm tias paraplegia.
· ** Tseem ceeb ceev faj: ** Monopolar electrosurgery yuav tsum * tsis * yuav tsum tau siv ncaj qha coagulate los yog transect cov hlab ntsha ntawm lub tsev menyuam los yog zes qe menyuam, vim qhov no muaj feem yuav ua rau hemorrhage. Yog tias los ntshav tshwm sim, qhov tshwm sim ntawm qhov ua tsis pom kev anatomical ua rau muaj qhov ua rau muaj kev raug mob tsis zoo rau cov qauv uas nyob ib sab, xws li cov ureters, zais zis, lossis cov hnyuv. Hloov chaw, cov hlab ntsha ntawm lub tsev menyuam thiab zes qe menyuam yuav tsum tau tswj xyuas los ntawm kev siv bipolar electrocoagulation los yog cov txheej txheem kev sib txuas ua ke.