https://www.kidney.org/sites/default/files/Fistula%20Bulletin.pdf

Hauv kev kho hemodialysis, arteriovenous fistula(AVF) ua haujlwm raws li cov neeg mob lub cev lub cev, thiab kev nyab xeeb thiab kev ntseeg siab ntawm AVF cannulation koob uas puncture no vascular nkag pob khawm hauv paus ntawm lawv cov khoom siv raw. Kev xaiv cov khoom yog deb ntawm rudimentary hlau tshuaj ntsuam; Hloov chaw, nws tso siab rau cov kev suav ua vaj tse nruj heev uas khi rau biocompatibility, ntev -lub sij hawm nyob rau hauv -vivo kev nyab xeeb thiab kho tau zoo. Kev kho mob- qib stainless hlau sawv cev los ntawm Qib 304 thiab 316L tau hloov zuj zus mus rau hauv tus qauv kub tom qab rov ua dua kev kho mob thiab kev siv tshuab, nrog rau lawv cov hauv paus ntsiab lus kev tshawb fawb embodying cov qauv tsim qauv tswj hwm kev tsim khoom siv kho mob.

Ua ntej thiab qhov tseem ceeb tshaj plaws, cov ntaub ntawv xaiv yuav tsum tiv taus qhov hnyav hnyav ib puag ncig sab hauv thiab sab nraud tib neeg lub cev. Cov neeg mob ntshav qab zib tau txais cov cannulation txhua lub lim tiam, nthuav tawm AVF koob rov qab rau cov ntshav thiab cov kua dej nruab nrab; nruab nrab ntawm txoj kev kho mob, cov khoom siv tau ua kom tsis muaj menyuam ntawm qhov siab -kub siab -siab chav lossis ethylene oxide. Cov kev pabcuam zoo li no ua haujlwm tshwj xeeb rau kev tiv thaiv corrosion. Raws li classic austenitic stainless hlau, Qib 304 muab lub suab dav dav corrosion kuj. Los ntawm qhov sib piv, Qib 316L suav nrog molybdenum (Mo), muab qhov ua tau zoo tshaj plaws rau pitting thiab crevice corrosion, tshwj xeeb tshaj yog nyob rau hauv cov tshuaj chloride- nplua nuj nyob hauv lub cev. Cov lus "L" txhais tau hais tias ultra{10}} cov ntsiab lus carbon tsawg (tsawg dua lossis sib npaug li 0.03 wt%), uas ua rau muaj kev cuam tshuam kev cuam tshuam ntawm intergranular corrosion tshwm sim los ntawm carbide nag lossis daus raws cov ciam teb thaum lub sij hawm vuam los yog kev kho cua sov. Cov khoom muaj txiaj ntsig zoo no ua rau 316L qhov kev xaiv zoo tshaj plaws rau cov khoom siv kho mob uas raug ncua ntev lossis rov ua dua rau kev tawm dag zog lub cev, suav nrog ntev - cov khoom cog thiab siv cov twj siv hluav taws xob ntau zaus, tiv thaiv cov hlau ion leaching thiab deg defects tshwm sim los ntawm kev rov ua kom tsis muaj menyuam thiab kev siv tshuaj kho mob.

Thib ob, tailored mechanical zog ua lub cev lav rau kev ua haujlwm zoo cannulation thiab kev nplij siab ntawm tus neeg mob. AVF koob yuav tsum muaj cov phab ntsa tuab txaus thiab cov txheej txheem rigidity (hardness: HRC 30-40) kom tsis txhob shaft dabtsi yog khoov los yog tawg thaum puncture thiab extracorporeal ncig. Lub caij no, cov tubing tuaj yeem ua tau precision machined rau hauv geometrically refined ultra- cov lus qhia ntse rau kev nkag mus los ntawm cov nqaij mos thiab cov hlab ntsha, txo qis iatrogenic raug mob thiab cov txheej txheem mob. Tau txais txiaj ntsig zoo los ntawm qhov muaj zog tensile thiab kev ua haujlwm zoo- cov yam ntxwv hardening, kev kho mob stainless hlau tuaj yeem ua tiav rau hauv cov npoo ntse ntawm cov txheej txheem sib tsoo zoo xws li kev sib tsoo centerless thiab cylindrical sib tsoo. Lub bevel tiav khaws cia nws cov duab geometric nyob rau hauv rov qab puncture, stabilizing kev nkag mus rau hauv tus qauv ntau ntawm 50 txog 100 gram- quab yuam. Qhov sib npaug ntawm cov khoom siv dag zog, machinability thiab ntug tuav tsis tuaj yeem rov ua dua los ntawm cov khoom siv hlau zoo tib yam.

Thib peb, tag nrho biocompatibility thiab ua tiav traceability yog qhov yuav tsum tau ua ua ntej rau kev tswj hwm kev lag luam clearance. Kev ua raws li cov khoom siv txuas ntxiv tshaj qhov tsim nyog tshuaj muaj pes tsawg leeg. Kev ntsuam xyuas biocompatibility raws li ISO 10993 thoob ntiaj teb tus qauv series ua haujlwm raws li kev lees paub thoob ntiaj teb rau kev txheeb xyuas kev nyab xeeb ntawm kev nyab xeeb, suav nrog ntau tshaj kaum qhov kev ntsuas nruj xws li cytotoxicity, tawv nqaij rhiab heev, intracutaneous reactivity thiab mob toxicity los txiav txim qhov tsis zoo ntawm cov tshuaj lom neeg thaum cev xeeb tub. Tsis tas li ntawd, tag nrho cov menyuam txaj-rau- tas lawm- cov khoom traceability yog tswj hwm los ntawm thawj steel phaj Tshuag mus rau cov koob cannulation tiav. Cov neeg tsim khoom yuav tsum tau muab cov ntawv pov thawj Mill Certificate sau cov tshuaj lom neeg muaj pes tsawg leeg, cov yam ntxwv ntawm cov khoom siv thiab kev kho cua sov ntawm cov ntaub ntawv raw, nrog rau kev tsim kom muaj tag nrho traceability txuas cov khoom siv raw ntau rau cov lej ua tiav. Qhov kev xav tau no yog cov ntsiab lus tseem ceeb ntawm ISO 13485 kev tswj hwm kev kho mob cov cuab yeej zoo, ua kom muaj cov hauv paus puv - ua rau traceback rau txhua qhov tsis zoo.

Plaub, stainless hlau ua haujlwm raws li lub substrate ua rau kev tsim khoom ua haujlwm siab heev. Niaj hnub nimno AVF koob tsim loj hlob zuj zus ntxiv; tsib-axis laser txiav yog dav siv los tsim cov chaw nres nkoj sab nraud thiab cov kwj ntws zoo rau kev ua kom zoo hemodynamics thiab txo qis kev pheej hmoo ntawm thrombotic. Qhov kev ua tiav qib siab no xav tau cov laser zoo -cov khoom siv tau zoo. Qhov tseem ceeb ntawm cov hlau tsis muaj xws li laser absorptivity ntawm lub wavelengths, thermal conductivity thiab molten slag tsim dictate lub dimensional precision, ntug smoothness thiab tag nrho cov zoo ntawm laser - txiav apertures. Premium stainless hlau yields huv si, burr-dawb txiav profiles nrog tsawg tshav kub- cuam tshuam cheeb tsam tom qab laser ablation, tsim ib tug zoo tagnrho puag rau tom ntej electrochemical (electrolytic) polishing kom ua tau ultra- du, huv si sab hauv lumens.

Hauv cov ntsiab lus, qhia txog qib 304 lossis 316L stainless hlau rau AVF cannulation koob yog qhov kev txiav txim siab engineering hauv av hauv kev tshawb fawb corrosion, mechanical engineering, biomedicine thiab advanced manufacturing technology. Ntau dua li qhov tshwj xeeb zoo li qub, kev xaiv cov khoom siv hloov pauv nrog rau kev nce qib hauv metallurgy xws li siab - purity nqus melting thiab hloov chaw kho mob cov cai suav nrog kev thov kom txo qhov kev nkag mus. Cov qib stainless hlau no tsim cov pob txha hauv lub cev kom muaj kev nyab xeeb, ua haujlwm tau zoo thiab tus neeg mob- cov khoom lag luam AVF cannulation tus phooj ywg, ntsiag to nkag mus rau vascular thoob plaws txhua qhov kev sib kho hemodialysis thiab qhia txog lub ntsiab lus tseem ceeb hauv kev lag luam rau cov khoom siv kho mob:Cov ntaub ntawv qhia txog kev ua tau zoo, thiab kev ua tau zoo tiv thaiv tib neeg lub neej. Saib tom ntej, cov kev hloov kho saum npoo av tshiab xws li nanocoatings tuaj yeem ua rau cov hlau tsis muaj steel substrate nrog txhim kho cov tshuaj tiv thaiv kab mob, tshuaj tua kab mob lossis tus kheej -lubricating functionalities; Txawm li cas los xij, stainless hlau yuav nyob twj ywm irreplaceable raws li cov khoom siv tseem ceeb rau AVF koob rau yav tom ntej.