可調(diào)壓腦積水分流管ppt課件

1、Aesculap. All it takes to operate.Aesculap NeurosurgeryMIETHKE proGAVAdjustable Hydrocephalus Shunt可調(diào)壓腦積水分流管 Aesculap. All it takes to operate.Aesculap NeurosurgeryMIETHKE proGAVAdjustable Unit可調(diào)壓部分Gravitational Unit重力抗虹吸部分 Aesculap. All it takes to operate.Aesculap Neurosurgery過度分流過度分流外界干擾下的不測調(diào)理外界干

2、擾下的不測調(diào)理需求在需求在X線透視形狀下驗(yàn)證線透視形狀下驗(yàn)證MRI檢查的平安性檢查的平安性操作操作閥門安裝位置的局限性閥門安裝位置的局限性調(diào)壓的范圍調(diào)壓的范圍International Shunt-expert Alfred Aschoff, MD,PhD, Neurosurgeon at 10th European Congress of Neurosurgery, Berlin, May 9t, 2019.可調(diào)壓腦積水分流系統(tǒng)存在的一些問題可調(diào)壓腦積水分流系統(tǒng)存在的一些問題 Aesculap. All it takes to operate.Aesculap Neurosurgery資料資

3、料競爭對手競爭對手:硅膠工藝硅膠工藝 Aesculap. All it takes to operate.Aesculap Neurosurgery資料資料我們的技術(shù)我們的技術(shù):Titanium Aesculap. All it takes to operate.Aesculap Neurosurgery 高質(zhì)量的鈦以及合成硅樹植高度的生物相容性長期的穩(wěn)定性,不會(huì)老化不受皮層壓力的影響良好的核磁兼容性資料資料 Aesculap. All it takes to operate.Aesculap Neurosurgery當(dāng)患者站立的時(shí)候當(dāng)患者站立的時(shí)候,呵呵斥過多的斥過多的CSF被引流被引流!對

4、患者呵斥的后果對患者呵斥的后果:過度分流過度分流 Aesculap. All it takes to operate.Aesculap NeurosurgeryproGAV處理的技術(shù)方案處理的技術(shù)方案:利用患者體位的變化利用患者體位的變化來平衡虹吸壓力來平衡虹吸壓力重力抗虹吸閥門重力抗虹吸閥門!過度分流過度分流 Aesculap. All it takes to operate.Aesculap Neurosurgery外界干擾下閥門被不測調(diào)理外界干擾下閥門被不測調(diào)理Literature:Schneider, Knauf, Nitsch Magdeburg, Germany (2019)Ele

5、ctromagnetic field hazards involving adjustable shunt valves in hydrocephalus“ Aesculap. All it takes to operate.Aesculap Neurosurgery外界干擾下閥門被不測調(diào)理外界干擾下閥門被不測調(diào)理Literature:Anderson, Walker, Viner, Kestle Salt Lake City, USA (2019)Adjustment and malfunction of a programmable valve after exposure to toy

6、magnets“ Aesculap. All it takes to operate.Aesculap NeurosurgeryproGAV處理的技術(shù)方案處理的技術(shù)方案:皮膚外可以使機(jī)械制動(dòng)閘解鎖皮膚外可以使機(jī)械制動(dòng)閘解鎖 SNSN外界干擾下閥門被不測調(diào)理外界干擾下閥門被不測調(diào)理 Aesculap. All it takes to operate.Aesculap NeurosurgeryNSSNSNSN外界干擾下閥門被不測調(diào)理外界干擾下閥門被不測調(diào)理 Aesculap. All it takes to operate.Aesculap NeurosurgerySNSNNSSN外界干擾下閥門被

7、不測調(diào)理外界干擾下閥門被不測調(diào)理 Aesculap. All it takes to operate.Aesculap Neurosurgery特別對于小兒病人特別對于小兒病人!對病人至關(guān)重要對病人至關(guān)重要(反復(fù)反復(fù)X-ray檢查呵斥輻射損害檢查呵斥輻射損害):X-ray 驗(yàn)證驗(yàn)證 Aesculap. All it takes to operate.Aesculap Neurosurgery時(shí)間和經(jīng)濟(jì)損失時(shí)間和經(jīng)濟(jì)損失對醫(yī)生也是至關(guān)重要對醫(yī)生也是至關(guān)重要:X-ray 驗(yàn)證驗(yàn)證 Aesculap. All it takes to operate.Aesculap NeurosurgeryproG

8、AV技術(shù)的處理方案技術(shù)的處理方案:只需求一支筆只需求一支筆!X-ray 驗(yàn)證驗(yàn)證 Aesculap. All it takes to operate.Aesculap Neurosurgery閥門開放壓力是如何被丈量的閥門開放壓力是如何被丈量的?1. 閥門的定位 Aesculap. All it takes to operate.Aesculap Neurosurgery刻度顯示部位對準(zhǔn)腦室端管方向2. 安放檢測工具WrongCorrect閥門開放壓力是如何被丈量的閥門開放壓力是如何被丈量的? Aesculap. All it takes to operate.Aesculap Neurosu

9、rgeryVentricle Cathether閥門開放壓力是如何被丈量的閥門開放壓力是如何被丈量的? Aesculap. All it takes to operate.Aesculap Neurosurgery閥門開放壓力是如何被丈量的閥門開放壓力是如何被丈量的? Aesculap. All it takes to operate.Aesculap Neurosurgery壓力識(shí)別標(biāo)尺壓力識(shí)別標(biāo)尺0 cmH2O20 cmH2O11 cmH2OMarker Aesculap. All it takes to operate.Aesculap Neurosurgery標(biāo)志標(biāo)志 Aesculap

10、. All it takes to operate.Aesculap NeurosurgeryScout view Aesculap. All it takes to operate.Aesculap Neurosurgery操作困難操作困難!Consequence for the adjustment:操作操作 Aesculap. All it takes to operate.Aesculap NeurosurgeryproGAV技術(shù)的處理方案技術(shù)的處理方案只需求用第二支筆來調(diào)理只需求用第二支筆來調(diào)理!操作操作 Aesculap. All it takes to operate.Aescu

11、lap Neurosurgery1. 調(diào)整壓力計(jì)的數(shù)值如何調(diào)整開放壓力如何調(diào)整開放壓力? Aesculap. All it takes to operate.Aesculap Neurosurgery2. 閥門定位如何調(diào)整開放壓力如何調(diào)整開放壓力? Aesculap. All it takes to operate.Aesculap Neurosurgery3.安放檢測工具如何調(diào)整開放壓力如何調(diào)整開放壓力? Aesculap. All it takes to operate.Aesculap Neurosurgery3.安放檢測工具如何調(diào)整開放壓力如何調(diào)整開放壓力? Aesculap. All

12、 it takes to operate.Aesculap Neurosurgery3.安放檢測工具如何調(diào)整開放壓力如何調(diào)整開放壓力? Aesculap. All it takes to operate.Aesculap NeurosurgeryIncorrectCorrect3.安放檢測工具如何調(diào)整開放壓力如何調(diào)整開放壓力? Aesculap. All it takes to operate.Aesculap NeurosurgeryVentricle Catheter如何調(diào)整開放壓力如何調(diào)整開放壓力? Aesculap. All it takes to operate.Aesculap N

13、eurosurgery如何發(fā)現(xiàn)埋在如何發(fā)現(xiàn)埋在皮下的閥門皮下的閥門?對調(diào)理器非常重要對調(diào)理器非常重要:閥門的定位閥門的定位 Aesculap. All it takes to operate.Aesculap NeurosurgeryproGAV技術(shù)的處理方案技術(shù)的處理方案:用一個(gè)磁性的羅盤即可做到無創(chuàng)的檢查用一個(gè)磁性的羅盤即可做到無創(chuàng)的檢查!閥門的定位閥門的定位 Aesculap. All it takes to operate.Aesculap Neurosurgery調(diào)理的跨度太大調(diào)理的跨度太大,無法細(xì)分無法細(xì)分!臨床治療過程必需面對的問題臨床治療過程必需面對的問題:壓力調(diào)整的范圍壓力調(diào)

14、整的范圍 Aesculap. All it takes to operate.Aesculap NeurosurgeryproGAV技術(shù)的處理方案技術(shù)的處理方案:在在0-200mmH2O的壓力范圍之的壓力范圍之內(nèi)可做到恣意內(nèi)可做到恣意覆蓋覆蓋壓力調(diào)整的范圍壓力調(diào)整的范圍 Aesculap. All it takes to operate.Aesculap NeurosurgeryCODMANProgrammable Valve (Hakim-Medos)可調(diào)壓閥門儲(chǔ)液囊 返流閥 Aesculap. All it takes to operate.Aesculap NeurosurgeryPro

15、grammable Valve (Hakim-Medos)轉(zhuǎn)子可以被磁場經(jīng)過皮膚進(jìn)展轉(zhuǎn)動(dòng),因此呵斥彈簧張力發(fā)生變化,從而導(dǎo)致閥門的開放壓力發(fā)生變化彈簧轉(zhuǎn)子近端閥體 Aesculap. All it takes to operate.Aesculap NeurosurgeryArgumentation Hakim-Medos(討論討論)可調(diào)壓力閥門,而不是可編程閥門當(dāng)體位發(fā)生變化之后(站立),閥門可以自動(dòng) 編程或調(diào)理嗎?平躺時(shí)壓力偏高,站立時(shí)壓力偏低假設(shè)患者是在平躺時(shí)設(shè)定壓力,那么當(dāng)其站 立時(shí)就會(huì)添加過度引流發(fā)生率 經(jīng)常發(fā)生病人要求調(diào)整壓力的情況 是件非常費(fèi)事的事 Aesculap. All i

16、t takes to operate.Aesculap NeurosurgeryArgumentation Hakim-Medos(討論討論)壓力程度的設(shè)定后確實(shí)認(rèn)只能經(jīng)過X攝片(is annoying for children) 甚至于最高的壓力設(shè)定值也不能補(bǔ)償流體靜力學(xué)壓力設(shè)定壓力被外界磁場所不測調(diào)理是不受控制的非常大的閥門昂貴任務(wù)過程卻類似于廉價(jià)的傳統(tǒng)微分壓力閥 (DPV) Aesculap. All it takes to operate.Aesculap NeurosurgeryCODMANSiphonGuard限制虹吸的安裝 (銜接于可調(diào)壓力閥門)只需一種單純的設(shè)計(jì),容易引起過度引

17、流或者分流缺乏該機(jī)械安裝非常容易發(fā)生梗阻 Aesculap. All it takes to operate.Aesculap NeurosurgeryMEDTRONIC - PS Medical Strata-Valve Aesculap. All it takes to operate.Aesculap NeurosurgeryStrata-Valve (PS-Medical) Strata-Valve 是一種可調(diào)壓抗虹吸閥門 (結(jié)合了可調(diào)壓力的膜閥和一個(gè)抗虹吸Delta閥門).ReservoirAdjustable Valve-ChamberDelta-chamber (correspo

18、nds to Anti-Siphon Device) Aesculap. All it takes to operate.Aesculap NeurosurgeryStrata-Valve (PS-Medical) Aesculap. All it takes to operate.Aesculap Neurosurgery1. 閥門用一個(gè)確認(rèn)位置的工具定位Strata-Valve (PS-Medical) Aesculap. All it takes to operate.Aesculap Neurosurgery1. 閥門用一個(gè)確認(rèn)位置的工具定位2. 用一個(gè)指示器確認(rèn)閥門的壓力Strata

19、-Valve (PS-Medical) Aesculap. All it takes to operate.Aesculap Neurosurgery1. 閥門用一個(gè)確認(rèn)位置的工具定位2. 用一個(gè)指示器確認(rèn)閥門的壓力3.用調(diào)壓工具設(shè)定新的壓力程度Strata-Valve (PS-Medical) Aesculap. All it takes to operate.Aesculap Neurosurgery1. 閥門用一個(gè)確認(rèn)位置的工具定位2. 用一個(gè)指示器確認(rèn)閥門的壓力3. 用調(diào)壓工具設(shè)定新的壓力程度Strata-Valve (PS-Medical) Aesculap. All it takes to operate.Aesculap Neurosurgery1. 閥門用一個(gè)確認(rèn)位置的工具定位2. 用一個(gè)指示器確認(rèn)閥門的壓力3. 用調(diào)壓工具設(shè)定新的壓力程度4. 用一個(gè)指示器驗(yàn)證新的閥門壓力Strata-Valve (PS-Medical) Aesculap. All it takes to operat