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دستگاه آنژیوگرافی

نویسنده :مازیار سلیمی
تاریخ:چهارشنبه 6 مرداد 1389-09:55 ب.ظ

دستگاه آنژیو گرافی

مفاهیم پایه
آنـژیـوگـرافـی از دو كلمـه آنـژیو به معنای رگ یا عروق و كلمه گرافی به معنای  نگاشتن  تشكیل شده است.

فیزیولوژی
بــیــمـــاریـهـــای قـلـــب و عـــروق از شـــایـــع تـــریـــن بیماری‌های قرن حاضر محسوب شده و نارسایی قلبی بزرگ ترین عامل مرگ و میر در جوامع صنعتی و نـیـمـه صـنعتی به حساب میآید. به دلیل اهمیت موضوع، ابزارها و روشهای مختلفی برای بررسی نحوه عملكرد قلب در پزشكی نوین ابداع شده كه از جمله آن ها می‌توان به رگ نگاری(Angiography) به كمك تصویربرداری اشعه X اشاره كرد. هدف در این روش به دست آوردن انواع مختلف و مكمل اطـــلاعـــات ســـاخــتــاری(Structural) و عـمـلـكــردی (Functional) از قـلـب است، به نحوی كه به كمك آن‌ها پزشك متخصص نه تنها توانایی تشخیص نوع بـیـمـاری قـلـبـی را داشـتـه بـاشـد، بـلـكـه بـتـواند بروز نارسایی قلبی احتمالی در آینده را نیز پیش بینی و از آن جلوگیری كند.
ایــن روش در درمـان بـیـمـاری تـصـلـب شـرایـیـن كاربرد بسیار گسترده ای دارد و در مقایسه با عمل جـراحی از مزایای متعدد از جمله درد بسیار كم ، كاهش خطر مرگ ومیر و اقتصادی بودن برخوردار است.
چگونه كار می كند
در آنـژیـوگـرافـی یـك كـاتتـر پـلاستیكـی نازك به داخـــل یـــك رگ بـــزرگ سـطـحـــی (نـظـیـــر شـــریــان فـمــورال‌،شــریــان بــراكـیــال، وریــد جــوگـولـر) وارد می‌شود و به سمت ناحیه هدف هدایت می شود. سـپــس مــاده حـاجـب یـد دار بـه داخـل رگ تـزریـق می‌شود(برای بیمارانی كه به مواد ید دار حساسیت دارند می توان از گاز  دی اكسیدكربن استفاده كرد.)
سپس پرتوهای ایكس از قسمت بالایی دستگاه سـی آرم بـه سمـت نـاحیـه هدف تابانده می شود و گیرنده هایی در قسمت پایین دستگاه سی آرم وجود دارد كه این پرتوها را جذب می كنند.
پس از این فرایند، تصویری واضح و دقیق از رگ و قسمت های مختلف آن بر روی عكس یا فیلم ظاهر مـی شـود. در هـنگام عكس‌برداری  به علت اینكه بافت عروقی بدن جزء نسج نرم بوده و تراكم كمی دارد بنابراین اشعه به راحتی از همه آن ها عبور كرده و بر روی فیلم نمی توان هیچ تصویری داشت. به هـمـیـن عـلـت جـهـت مـشـخـص كـردن ساختمان و وضعیت عروق بدن از موادی با عدد اتمی بالا مانند اوروگرافین و آمنیو پاك و غیره استفاده می كنند كه این مواد را اصطلاحا مواد حاجب گویند  و در لحظه عكس‌برداری این مواد را به داخل عروق هدایت كرده و همزمان عكس‌برداری انجام می شود.
كاربرد دستگاه
این روش تصویربرداری برای بیماری های زیر كاربرد دارد: 
تـصـلـب شرائین ، آنوریسم ، صدمات عروقی ‌، برای بررسی عروق كرونر ، برای بررسی عروقی كه خـون رسـانـی بـه تـومـور را بـه عهده دارند و احیانا مسدود كردن این عروق به منظور از بین بردن تومور و بالاخره برای بررسی خونریزی های داخلی.
تجهیزاتی كه بتواند وضعیت قلبی عروقی بیمار را بـه صـورت تـصویر گویا بر روی فیلم یا مانیتور به پزشك معالج گزارش كند می تواند در تشخیص و سـپـس درمـان ایـن گونه بیماران نقش بسیار تعیین كننده ایفا  كنند.
آنـــژیـــوگـــرافـــی رونــدی اســت كــه دقـیــق تــریــن اطلاعات ممكن از عروق را تهیه و قبل از عمل در اخـتـیــار پـزشـك جـراح قـرار مـی دهـد. بـر پـایـه ایـن اطـلاعات، جراح می تواند برخی از بیماری ها را بـدون نـیـاز بـه عـمـل جـراحـی بـاز، درمان كند و در صـورت نـیـاز بـه عـمـل جـراحـی باز، این اطلاعات جراح را در انجام سریع و دقیق این امر یاری رسانده و بهترین شرایط ایمنی را برای بیمار فراهم می كند.
مشخصات دستگاه
1- تخت كاتتر بارویه بدون كلاف )Frameless  (
2- ژنراتور مولد اشعه از نوع ولتاژ ثابت با قدرت 250 میلی آمپر، 150كیلو وات
3- ستون سقفی نگهدارنده سی آرم با ریل دوبل 
4- سی آرم زاویه صفر درجه ( رخ )
5- سی آرم زاویه 90 درجه ( نیم‌رخ )
6- لامپ تشدید كننده تصویر بدنه فلزی 9 اینچ 4 فیلد
7- تیوب مولد اشعه x با اندازه كانونی 5/0 و 1/0 ( 2 ست )
8- سیستم تصویری مدار بسته X-TV با دو مانیتور
9- دوربین سینه Cine   camera ()
10- انژكتور اتوماتیك مواد حاجب  
11- فیلم چنجر
12VTR -
13- یونیت شوك الكتریكی (Defibrillator unit )
14- دستگاه ظهور و ثبوت اتوماتیك فیلم 25 میلی متری
15- پروژكتور
16- Digital Subtraction Angiography(DSA)
17- تیوب مولد اشعه با اندازه كانونی 4/0 ، 8/0
18- آنالایزر سیستم قلبی
19- مولتی ایمیجر ( Multi Imager  )

منابع
[1]سالار تكی، دستگاه آنژیوگرافی
[2www.pezeshk.us]
[3www.prin.ir]




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