最新INTERVENTIONAL RADIOLOGY介入影像学2-药学医学精品资料.ppt

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1、最新INTERVENTIONALRADIOLOGY介入影像学2-药学医学精品资料INTRODUCTIONInterventionalradiologistsaredoctorswhospecializeinminimallyinvasive,targetedtreatmentsthathavelessrisk,lesspainandlessrecoverytimecomparedtoopensurgery.Theyusetheirexperiencetomapouttheproceduretailoredtotheindividual

2、patienttotreatdiseasesatthesiteoftheillnessnonsurgically.InterventionalradiologyisarecognizedmedicalspecialtybytheAmericaBoardofMedicalSpecialties.INTRODUCTIONGOAL------->simplifytreatmentinawaythatminimizespatientdiscomfort,rendersgeneralanesthesiaunnecessary,lowersthe

3、incidenceofmorbidityandmortality,anddecreasesthelengthandcostofhospitalization.Specialprocedurescanreplacesurgery(embolizationofbleedingulcers).Otherscancomplementsurgery(postoperativeabscessdrainage).Certainprocedurescanbeusedinthemanagementofconditionsforwhichthereisn

4、osurgicalsolution(selectivechemotherapy).FNACandTrueCutCoreBiopsyIndicationsPresenceorabsenceofdisease.Natureofdisease(neoplastic,inflammatory,infectious).Extentofdisease.FNACandTrueCutCoreBiopsyContraindicationsAbnormalcoagulationprofile---Elevatedprothrombintime(PT).-

5、--Elevatedpartialthromboplastintime(PTT).---Depressedplateletcounts.---Lowprothrombinconcentration(PC).FNACandTrueCutCoreBiopsyPatientpreparationInformedconsent.Normalbleedingprofile.Startclearliquiddiet,thenightbeforetheprocedure.Anxiolyticagents(anxiouspatients,severe

6、lypainfulbiopsieslikebone,infants).Sterilizethepuncturesite,drapethesurroundingarea.FNACandTrueCutCoreBiopsyEquipmentFNAC-----spinalneedles(20–22Gauge)TrueCutCoreBiopsy-----truecutbiopsyneedle(unicut16G15cm),gunbiopsyneedle(speedybell18G20cm).123FNACandTrueCutCoreBiopsy

7、TechniqueUltrasoundorCTguided.Preciselesionsite.Applylocalanaesthetic(1%lidocaine)subcutaneous(TrueCutBiopsy).Insertneedleunderguidance.Cytopathologistatbiopsyprocedurecanminimizenumberofpasses.FNACandTrueCutCoreBiopsyComplicationsPainanddiscomfort.Hemorrhage(heamatoma)

8、.Pneumothorax(lungbiopsy).PERCUTANEOUSABSCESSDRAINAGEPercutaneousAbscessDrainagePatientpreparationNormalbleedi