旋磨操作介绍

1BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally™旋磨操作介绍2BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally公司简介•公司总部设在美国马萨诸塞州波士顿地区的内提克市•全球共有约24,000名员工•业务遍及全球各个国家•作为全球医疗技术行业创新领导者，波士顿科学每年研发投入资金达8.86亿美金•在世界范围内拥有超过15,000项授权专利波士顿科学公司BostonScientific3BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally介绍内容•设备连接•操作技巧•“鸡尾酒”配方&常见问题•指引导管&磨头选择策略•旋磨的手法•消融技巧•消融时的反馈•交换过程4BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally设备连接Priortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.5BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally系统连接Priortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.A.连接供气管和氮气瓶,每台手术保证氮气瓶内压力至少为500PSI/3447.5kPa;经压力表输出到主机的压力保持在90-110PSI/620.55kPa-758.45kPaB.连接DyanaglideTM脚踏开关软管–绿管和蓝管接在主机背板上，粉色管接在主机前面板上C.主机接通电源打开开关D.连接推进器光纤接头E.连接推进器空气管F.将推进器盐水输入管和生理盐水袋连接并加压6BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally旋磨导管和推进器连接Priortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.旋磨导管和推进器连接好以后再移除磨头保护套7BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally系统测试（体外）•测试脚踏开关对系统的控制•调整磨头的转速磨头尺寸1.25-2.0mm2.15-2.5mm理想的转速160,000-180,000转/分150,000-170,000转/分注意:避免磨头接触毛巾，纱布，手套等8BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyD.R.A.W.–体外测试–Drip–盐水有无从推进器和磨头出滴出*–Rotate–磨头旋转且转速稳定**–Advancer–推进器把手可以自由移动–Wire–推进器尾部导丝可见，磨头旋转时导丝无法移动Priortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.*必须要有盐水注入的条件下才可操作旋磨推进器，用于冷却和润滑推进器。否则会造成推进器损坏**磨头高速旋转时使用推进器把手轻柔前后移动，不要使磨头保持在一个位置，否则会造成旋磨导丝损耗9BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally操作技巧Priortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.10BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally操作技巧——磨头位置•磨头送入导管之前，推进器把手请先固定在滑动槽中间•握住导丝时将磨头送入导管•当磨头接近病变区域近端时，松开推进器把手，慢慢回撤把手，使旋磨导管在导引导管内逐步伸展，解除前倾力•磨头转速•Smallburrs(1.25-2.0mm)160,000–180,000rpm•Largeburrs(≥2.15mm)140,000–160,000rpmPriortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.11BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally操作技巧——磨头移动•操作旋磨的时候需要前后来回移动磨头，建议距离3cm，遇到轻微阻力时可以再往前送•每次磨的时间不要超过30秒•整个旋磨手术操作时间不超过5分钟•根据需要选择磨头，磨头尺寸逐步增加.25mm递增.Priortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.重要提示！•磨头旋转时候必须前后移动•高速旋转时磨头固定在一处，会造成导丝损坏12BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally操作技巧——操作提示Priortouse,pleaseseethecomplete‘DirectionsForUse’formoreinformationonIndications,Contraindications,Warnings,Precautions,AdverseEventsandOperator’sInstructions.•Y阀不宜拧的太紧，避免造成磨头导管挤压损坏•磨头停止旋转时，不能停留在病变区域内或病变区域远端•旋磨消融时候不能调节转速•磨头不要和旋磨导丝的弹簧头端接触，防止导丝损坏或磨头卡住•磨头高速旋转时不宜停留在一处•磨头高速旋转时，前后移动动作轻柔•在导管内避免旋转磨头13BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally“鸡尾酒”配方&常见问题14BostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternallyBostonScientificConfidential--ForInternalUseOnly.DoNotCopy,DisplayorDistributeExternally“鸡尾酒”配方•500ml生理盐水•硝