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Hng dn s dng

Thit b laser diode tr liu


MODEL: MINI-630/S

Nacenlas
H Ni 2013

phn I. gii thiu chung Thit b Laser Diode tr liu, Model: MINI 630/S, bc sng 635nm do Trung tm Cng ngh Laser (NACENLAS) nghin cu, ch to l h thit b a chc nng, c tc dng chng vim, lm thay i mt s ch s ca mu theo chiu hng tt khi b mc bnh mch mu, lm tng hot tnh ca cc cht xc tc v thay i mt s chc nng trn b mt hng cu khi b mt hng cu b bt thng, nng cao chc nng bm ca mng t bo, c th ci thin s lu thng mu v iu tit chc nng min dch ca t bo v c th. Phm vi ng dng: Cc loi bnh tim mch c tnh cht thiu mu nh: Bnh ng mch vnh, xut huyt no, tc mch mu no, cn au tht ngc, x cng ng mch no, cc di chng sau khi tai bin mch mu no, lon nhip tim, cao huyt p, i tho ng, vin phi hen ph qun, ri lon chc nng thn kinh vin a khp au u mt ng, chiu cc vt thng h, chm cu trong ng y... phn II. hng dn s dng my l/ Thng s k thut my : Bc sng bc x laser Ch pht laser Cng sut bc x laser. S knh pht Thi gian t t ng Ngun nui Cng sut tiu th iu kin lm vic m <80% Trng lng Kch thc ~ 635nm xung, lin tc 1-8mW 2 knh 1 99 pht AC 220V, 50-60Hz 25W max nhit <40C, 4kg 27 x 17 x 10cm

o cng sut ti u ra ca u pht tia, hin th trn mn LCD. ll/ Ph kin ca my: 2

1. u laser diode: 2. Cha kho my: 3. Dy ngun:

02 ci 02 ci 01 ci

S mt my
8 6 1 2 4 11

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(1) : Mn LCD hin th trng thi hot ng. (2) : Phm t ch hot ng. (3) : Phm t tn s xung pht. (4) : Phm tng cng sut (5) : Phm gim cng sut. (7) : Phm gim thi gian. (9) : Phm tt laser. in. (11): n bo trng thi pht tia laser th 1 (6) : Phm tng thi gian. (8) : Phm bt laser. (10): Kho ngun (12): Gic cm u laser

(13): Cng tc u ra laser th 1 th 2 (15): Cng tc u ra laser th 2 laser

(14): Gic cm u laser (16): Cng o cng sut

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QuY trnh vn hnh.


1. Khi ng: cm phch in ca my vo cm ca ngun in 220V/50Hz, vn cha kha ngun in chnh, mn hnh LCD sng bo c in, trn mn hnh hin tn hng sn xut v tn my. Cm 2 u laser diode vo hai gic 9 chn trn thn my. 2. t mc cng sut pht tia laser : mc cng sut mc nh khi bt my l 10, tng/gim cng sut pht tia bng cch nhn vo phm [POWER UP] / [POWER DOWN] tng ng, gi tr cng sut c chn s hin th v tr POWER VALUE trn mn LCD. My c 20 mc cng sut, t mc 1 n mc 20, bc thay i l 1. Mi mc cng sut tng ng vi mt gi tr cng sut. 3. Kim tra cng sut pht ra u pht tia bng cch a u pht tia laser vo cng o cng sut MEAS POWER trn thn my m. My t ng o cng sut v hin th gi tr o c trn mn LCD v tr MEAS POWER trn mt my . 4. t thi gian iu tr: gi tr thi gian mc nh khi bt my l 10 pht, nhn phm [ TIME UP] / [TIME DOWN ] tng/gim gi tr thi gian t iu tr, gi tr thi gian 4

t hin th ti v tr TIME, ht thi gian nh my t ng ngt (ht tia laser). Di thi gian hot ng l 1 -99 pht 5. Chn ch pht lin tc/xung lp li (CONT/REP): khi bt my ch hot ng t mc nh l lin tc (CONT), t li ch pht tia ngi vn hnh s dng nhn phm [ MODE ]. Mn hnh LCD s hin th tng ng vi cc ch lin tc/ xung lp li ti v tr MODE. 6. t tn s pht xung: ch pht l xung lp li, mun thay i tn s pht tia, nhn vo phm [ FREQ ] trn mt my la chn tn s pht xung thch hp, gi tr tn s pht s hin th trn mn LCD ti v tr FREQ. 7. Bt/tt tia laser: nhn phm [ START ] iu khin trng thi sn sng pht hai u ra. Mi gic cm u laser diode c mt cng tc ring, cng tc ny trng thi ON v phm [START] c bt, c tia laser u pht. Nhn phm [ STOP ] khi mun ngng pht tia laser 8. Lp kim laser vo u pht tia laser. 9. Tt my: sau khi iu tr xong chuyn tt c cc cng tc v trng thi ngh v rt phch cm in ra khi in ngun. phn III. quy trnh - k thut iu tr 1. Chun b bnh nhn 1.1. T th bnh nhn: Bnh nhn nm nga bnh thng, chn tnh mch bn tay no th di v tr chc tnh mch ni ln r v tin cho thao tc. 1.2. Trc khi iu tr cho bnh nhn i tiu tin v bnh nhn phi nm lu . 1.3. Gii thch r cho bnh nhn v mc ch iu tr v mt s cc triu chng c th xut hin trong khi iu tr nh: cm gic nng, ra m hi nhiu, hi hng phn cht t, bnh nhn yn tm iu tr s ht. 5

2. Chun b dng c: 2.1. Chun b my laser, lp dy dn vo my, lp kim quang c dit khun vo u pht tia. 2.2. Chun b kim chc tnh mch G22 (Catheter G22) hoc 20G cn it 1%, cn 70 o mt bm tim 5-10 ml 1dy ga r mt gi mm nh . 2.3. i vi bnh nhn sau khi iu tr xong cn truyn dch, phi chun b dch truyn sau khi iu tr laser xong th truyn ngay bng kim ni mch . 3. Cc thao tc k thut : 3.1. Cc tnh mch chn iu tr: - Tnh mch nn, tnh mch gia khu tay. - Tnh mch di n . - Tnh mch di da u - Tnh mch i . - Tnh mch chi di. (Ni chung s dng cc tnh mch ngoi bin ln iu tr .) Dng ngn tay d hng i ca tnh mch xc nh hng i, nng su ca tnh mch. Lt gi mm xung di v tr nh chc, buc ga r trc im nh chc pha trn 6 cm, s dng cn it 1-3% st trng sau st trng li bng cn 70o. Bo bnh nhn nm tay li cho tnh mch phng ln nu l tnh mch vng tay. 3.3. Khi chc tnh mch dng ngn tay ci tay tri cht pha di ch chc c nh tnh mch. Tay phi cm kim chc tnh mch hng mt vt ln trn, kim chc to vi mt da gc 20o , t pha trn ca tnh mch m qua da v lun vo tnh mch theo ng i ca chng nu ng c mu theo kim. Lc dng ngn tr v ci ca 6

tay tri gi catheter c nh ng thi tay phi rt bm kim ra, khi bnh nhn nh tay, tho dy ga r, a kim quang lun vo catheter, c nh bng bng dnh. 3.4. Bt cng tc pht laser ti u kim laser trong lng mch c trm tia chi pht ra. Thi gian iu tr t 15- 90 pht, cng sut pht ca u kim laser iu tr l: 2- 4 mW, s ngy iu tr 7-10 ngy. Ni chung sau mt liu trnh iu tr l c kt qu. Nu sau hai liu trnh iu tr m khng c biu hin tin trin th chuyn phng php khc tu tng loi bnh 3.5. Sau iu tr xong tt in my laser, rt Catheter, kim quang ra nu truyn dch ch rt kim quang cm lun dch truyn vo Catheter. 3.6. Kh khun kim quang, Catheter bng nc mui sinh l, sau ngm tip vo dung dch trit khun t nht 30 pht mi c dng li ln sau. 4. Mt s im cn ch : * Kim chiu laser cn gi cho nhn bng sch s m bo ng quy trnh dit khun, trnh ma st, khi khng dng cho vo hp c lp mt bo v ni kh ro, nu pht hin thy u kim hoc thn kim nt, sn si th thay kim mi. * My laser v u pht laser cng vi cc dng c k thut khc dng iu tr ni mch cn phi chp hnh nghim ngt quy trnh k thut bo qun, v khun, trnh nhim khun cho. * iu tr xong my ni kh ro trnh va p mnh, khi cn di chuyn phi nh nhng. Khi s dng my tt nht phi c n p v c dy ni t. * Khi tia laser ca u pht tia hay ti u kim laser b m, c th dng bng cn kh lau nh u cm vo my hay u ra ca dy quang hoc kim quang. 7

An ton v bo dng

Nghim cm chiu tia laser hoc tia phn x vo mt Khng bt laser khi cha ni t v my Cn c du hiu cnh gii theo quy nh quc t ni t my Khi cho pht laser, cn lun c nhn vin thng trc, trong trng hp xy ra s c, phi tt ngay ngun in v lin h vi cn b k thut c trch nhim sa cha. Gi gn thit b ni kh ro, trnh bi bn.

C ch tc dng ca bc x laser diode

Laser Diode

Qu trnh vim Hot ho chc nng ty th v cu trc khc ca t bo Kch thch chuyn ho Tng tiu th xy Hot ho t chc h hp Km hm k kh Kch thch h thng ADN - ARN - Prtt

Gin mch, kch thch tun hon, ri s co mch Phng ri lon vi tun hon, lm n nh vi tun hon n nh tnh thm thnh mch Gim ph n t chc To ra hng ro bch cu trung tnhv bch cu n nhn to

Tng hot tnh tng sinh ca t bo

Kch thch phn ng ca t chc lin kt


Tng nhanh v y mnh hnh thnh nguyn bo x (hng ro) trn c s bi tit cht kch thch pht trin

Kch thch qu trnh thc bo

phng nhim acid v bin i do lon d ng ti pht gim tc bin i tn thng To iu kin thun li ti to t chc

Kch thch to thnh t chc ht Tng sinh nguyn bo x trng thnh

Sn ra cht dit khun v cht kch thch pht trin

Kch thch tng sinh

Kch thch to ra hng ro nim mc nh gim ph n v gim ri lon vi tun hon

Kch thch to si colagen v t chc lin kt trng thnh trng thnh Kch thch v hon thin biu m ho 9 Tng nhanh ti to nim mc

ng dng laser Diode trong iu tr mt s bnh


STT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 Tn mt bnh Lo mt Vim b mi Vim tuyn l Vim kt mc mi Lot gic mc Lot gic mc sau m mng Nha chu vim Vim nim mc ming Vim khp thi dng hm Nht ng tai Vim ng tai ngoi lan to Vim Amidan cp mn Vim hng Vim mi d ng Vim sn vnh tai Vim l tuyn c t cung Vim m o Vim tuyn Bectolin Vim v, abces v Lot lon dng Vim b da thn kinh Eczema Zona Chng so li (sau m) Trng c Vt m nhim trng toc rng Vim nhim b mt: - Nht - Abces mng - Chn m - inh ru Vim xng bn tay phng nhim trng vt m Vim lot ng tiu ho: - Vim lot d dy t trng Mt cng sut mW/cm2 0,5 - 2 0,5 - 2 0,5 - 2 0,5 - 1 0,5 - 1 0,5 - 1 0,5 - 1 0,5 - 1 1-5 0,5 - 1 0,5 - 1 0,5 - 1 0,5 - 1 0,5 - 1 1-5 0,5 - 2 0,5 - 2 0,5 - 2 1-2 0,5 - 1 1-2 2-5 1-2 1 1-2 1-2 2 2 2 2 2 2 1,6 Thi gian chiu, pht 3-5 3-5 3-5 3-5 3-5 3-5 5 - 10 5 - 10 5 - 10 5 - 10 5 - 10 10 10 10 5 - 10 10 - 15 10 - 15 10 - 15 10 - 15 10 - 15 8 - 10 8 - 10 8 - 10 10 10 10 - 15 10 10 10 10 10 10 1 15 15 15 15 15 15 S ln chiu 4-5 7 - 10 7 - 10 7 - 10 12 12 15 15 15 5 - 10 10 - 15 7 - 10 7 - 10 7 - 10 7 - 10 10 - 15 10 - 15 10 - 15 10 - 15 20 - 25 20 20 20 20 20 20 7 7 7 7 7 - 15 - 15 - 15 - 15 - 15 20

28 29 30

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31 32

- Vim lot trc trng Thiu mu c tim Chm cu (theo huyt c truyn) - Chn thng (gim au) - au khp - H sn gin t sng - Thoi ho xng khp bin dng - Vim khp bin dng - Vim xng sau chn thng - Ct tu vim sau chn thng - Vim khp dng thp - au thn kinh s V - Lit dy thn kinh s VII - Chiu ln xoang cnh trong iu tr thiu mu c tim

1,6 0,4 - 0,6 100 - 130 100 - 130 100 - 130 100 - 130 100 - 130 100 - 130 100 - 130 100 - 130 100 - 130 100 - 130 100 - 130

1 2 pht/vng 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt 2 pht/huyt

3-4 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20 15 - 20

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