【Contraindications】

1) Rashin dacewa da ilimin halin ɗan adam ko na jiki don tiyata a cikin yanayin gabaɗaya

2) Matsanancin zubar jini da ciwon jini.

3) Farin ƙwayoyin jini bai wuce 3×109/L ba

4) Rashin lafiyan kafofin watsa labaru

5) Haɗe tare da matsananciyar cututtuka na huhu.

6) Marasa lafiya da aka sani ko ake zargin rashin lafiyar kayan da ke cikin kunshin na'urar.

7) Kasancewa ko zato na kamuwa da cuta da ke da alaƙa da na'urar, bacteremia ko sepsis.

8) Radiotherapy a wurin da aka nufa da shi.

9) Hoto ko alluran magungunan embolic.

 

【Kwanin masana'anta】 Duba alamar samfur

 

【Karfewa】 Duba alamar samfur

 

【Hanyar aikace-aikace】

1. Shirya na'urar tashar jiragen ruwa da za a iya dasa kuma duba idan ranar karewa ta wuce; cire kunshin ciki kuma duba idan kunshin ya lalace.
2. Ya kamata a yi amfani da dabarun aseptic don yanke buɗaɗɗen ciki da cire samfurin don shirya amfani.
3. An kwatanta amfani da na'urorin tashar jiragen ruwa da za a iya dasa su daban don kowane samfurin kamar haka.

 

Nau'in Ⅰ

1. Fitowa, iska, gwajin zubewa

Yi amfani da sirinji (alura don na'urar tashar jiragen ruwa da za a iya dasa) don huda na'urar tashar tashar ruwa da allurar 5mL-10mL na salin physiological don zubar da kujerar allura da catheter lumen sannan a cire. Idan babu ruwa ko jinkirin da aka samu, karkatar da ƙarshen isar da magani na catheter (ƙarshen nesa) da hannu don buɗe tashar isar da magunguna; Sa'an nan Fold rufe da miyagun ƙwayoyi kawo karshen catheter, ci gaba da tura saline (matsa lamba ba fiye da 200kPa), duba ko akwai yayyo daga wurin allura da catheter dangane, bayan duk al'ada Bayan duk abin da yake al'ada, da catheter za a iya amfani da.

1. Cannulation da ligation

Dangane da binciken da aka yi a cikin ciki, saka catheter (ƙarshen isar da magani) a cikin madaidaicin jirgin ruwa gwargwadon wurin da ƙari yake, kuma a yi amfani da sutures waɗanda ba za su iya sha ba don haɗa catheter ɗin daidai ga jirgin. Katheter ya kamata a haɗa shi da kyau (fis biyu ko fiye) kuma a gyara shi.

1. chemotherapy da rufewa

Za a iya yin allurar maganin chemotherapy na ciki sau ɗaya bisa ga tsarin kulawa; ana bada shawarar cewa wurin zama na allura da lumen catheter ya zubar da 6-8 ml na salin ilimin lissafi, sannan 3 ml ~ 5 mL an rufe catheter tare da 3mL zuwa 5mL na saline na heparin a 100U/ml zuwa 200U/mL.

1. Gyaran wurin zama na allura

An halicci kogon cystic na subcutaneous a wurin tallafi, wanda ke tsakanin 0.5 cm zuwa 1 cm daga saman fata, kuma ana sanya kujerar allura a cikin rami kuma an gyara shi, kuma ana suture fata bayan tsananin hemostasis. Idan catheter ya yi tsayi da yawa, ana iya murɗa shi cikin da'irar a ƙarshen kusanci kuma a gyara shi da kyau.

 

Nau'in Ⅱ

1.Flushing da iska

Yi amfani da sirinji (alura don na'urar tashar tashar da za a iya dasa) don allurar saline a cikin kujerar allura da catheter bi da bi don juyewa da cire iska a cikin lumen, kuma duba ko ruwan tafiyar yana da santsi.

2. Cannulation da ligation

4. Gwajin zubewa

4. Bayan an gama haɗin gwiwa, ninka kuma rufe catheter a baya na shirin kullewa kuma ci gaba da allurar saline a cikin wurin allura tare da sirinji (alura don na'urar isar da magunguna) (matsi sama da 200kPa). (matsi bai wuce 200kPa ba), duba ko akwai yabo daga toshe allura da catheter

haɗi, kuma amfani kawai bayan komai ya zama al'ada.

5. Chemotherapy, bututun rufewa

Za a iya yin allurar maganin chemotherapy na ciki sau ɗaya bisa ga tsarin kulawa; Ana ba da shawarar sake zubar da tushen allura da lumen catheter tare da 6 ~ 8mL na saline na ilimin lissafi kuma, sannan a yi amfani da 3mL ~ 5mL na saline na ilimin lissafi.

Ana rufe catheter tare da 3ml zuwa 5mL na saline na heparin a 100U/ml zuwa 200U/ml.

6. Gyaran wurin zama na allura

An halicci kogon cystic na subcutaneous a wurin tallafi, 0.5 cm zuwa 1 cm daga saman fata, kuma an sanya wurin zama na allura a cikin rami kuma an gyara shi, kuma an dinke fata bayan tsananin hemostasis.

 

Nau'in Ⅲ

An yi amfani da sirinji (alura ta musamman don na'urar tashar tashar jiragen ruwa) don allurar saline na al'ada 10mL ~ 20mL a cikin na'urar da za a iya dasa magani don zubar da kujerar allura da kogon catheter, kuma a cire iska a cikin rami, kuma a lura ko ruwan ya fito. ya kasance mai ban tsoro.

2. Cannulation da ligation

Bisa ga binciken da aka yi a cikin ciki, saka catheter tare da bangon ciki, kuma sashin budewa na maganin maganin ƙarshen catheter ya kamata ya shiga cikin rami na ciki kuma ya kasance kusa da maƙasudin ƙwayar cuta kamar yadda zai yiwu. Zaɓi maki 2-3 don daidaitawa kuma gyara catheter.

3. chemotherapy, bututun rufewa

Za a iya yin allurar maganin chemotherapy na ciki sau ɗaya bisa ga tsarin jiyya, sannan a rufe bututu da 3mL ~ 5mL na 100U/ml ~ 200U/ml heparin saline.

4. Gyaran wurin zama na allura

An halicci kogon cystic na subcutaneous a wurin tallafi, 0.5 cm zuwa 1 cm daga saman fata, kuma an sanya wurin zama na allura a cikin rami kuma an gyara shi, kuma an dinke fata bayan tsananin hemostasis.

Jikowar ƙwayoyi da kulawa

A.Tsananin aikin aseptic, daidaitaccen zaɓi na wurin zama na allura kafin allura, da tsantsar ƙazantawar wurin allurar.B. Lokacin yin allura, yi amfani da allura don na'urar tashar tashar da za a dasa, sirinji na 10 ml ko fiye, tare da yatsan hannun hagu yana taɓa wurin huda kuma babban yatsan yatsa yana ɗaure fata yayin gyara wurin allurar, tare da hannun dama yana riƙe da sirinji. a tsaye a cikin allura, guje wa girgiza ko juyawa, da kuma allurar saline a hankali 5 ml ~ 10 ml lokacin da ake jin faɗuwa kuma tip ɗin allura daga baya ya taɓa ƙasan kujerar allura, sannan a duba ko tsarin isar da magani yana da santsi (idan ba santsi ba, ya kamata a fara bincika ko allurar ta toshe). Duba ko akwai wani tsayin fata da ke kewaye lokacin turawa.

C. Tura maganin chemotherapeutic a hankali bayan tabbatar da cewa babu kuskure. Yayin aiwatar da turawa, kula da hankali don lura ko fatar da ke kewaye tana da girma ko kodadde, da kuma ko akwai ciwon gida. Bayan an tura miyagun ƙwayoyi, ya kamata a ajiye shi don 15s ~ 30s.

D. Bayan kowace allura, ana ba da shawarar zubar da wurin allura da catheter lumen tare da 6 ~ 8mL na saline na ilimin lissafi, sannan a rufe catheter tare da 3mL ~ 5mL na 100U / ml ~ 200U / ml na saline na heparin, da kuma lokacin ƙarshe. 0.5mL na heparin saline an allura, yakamata a tura miyagun ƙwayoyi yayin ja da baya, don haka tsarin gabatarwar miyagun ƙwayoyi ya cika. heparin saline don hana crystallization miyagun ƙwayoyi da kuma coagulation jini a cikin catheter. Ya kamata a shayar da catheter tare da saline na heparin sau ɗaya kowane mako 2 yayin tazarar chemotherapy.

E. Bayan allurar, shafa idon allura da maganin kashe kwayoyin cuta, rufe shi da suturar da ba ta dace ba, sannan a kula da tsaftace wurin da bushewa don hana kamuwa da cuta a wurin huda.

F. Kula da halayen mai haƙuri bayan gudanar da miyagun ƙwayoyi kuma lura sosai yayin allurar miyagun ƙwayoyi.

 

【 Tsanaki, faɗakarwa da abun ciki mai ban sha'awa】

1. Wannan samfurin yana haifuwa ta hanyar ethylene oxide kuma yana aiki har tsawon shekaru uku.
2. Da fatan za a karanta littafin koyarwa kafin amfani don tabbatar da amincin amfani.
3. Yin amfani da wannan samfurin dole ne ya bi ka'idodin ƙa'idodin aiki da ƙa'idodin sashin likitanci, kuma shigar, aiki da cire waɗannan na'urori yakamata a iyakance ga ƙwararrun likitoci. Sakawa, aiki da cire waɗannan na'urori sune taƙaice ga ƙwararrun likitoci, kuma ƙwararrun ma'aikatan kiwon lafiya ya kamata su yi kulawar bayan-tube.
4. Dole ne a yi duk hanyar a ƙarƙashin yanayin aseptic.
5. Bincika ranar karewa samfurin da marufi na ciki don lalacewa kafin hanya.
6. Bayan amfani, samfurin na iya haifar da hatsarori na halitta. Da fatan za a bi aikin likita da aka yarda da shi da duk dokoki da ƙa'idodi masu dacewa don kulawa da magani.
7. Kada kayi amfani da karfi da yawa yayin shigar da jini kuma saka jijiya daidai da sauri don guje wa vasospasm. Idan intubation yana da wahala, yi amfani da yatsunsu don juya catheter daga gefe zuwa gefe yayin shigar da bututu.
8. Tsawon catheter da aka sanya a cikin jiki ya kamata ya dace, tsayi da yawa yana da sauƙi don murƙushewa a cikin wani kusurwa, yana haifar da rashin iska mai kyau, gajere ne lokacin da ayyukan tashin hankali na masu haƙuri suna da yiwuwar raguwa daga jirgin ruwa. Idan catheter ya yi gajere sosai, zai iya nitsewa daga cikin jirgin lokacin da majiyyaci ke motsawa da ƙarfi.
9. Ya kamata a shigar da catheter a cikin jirgin tare da ligatures fiye da biyu da matsewa da ya dace don tabbatar da allurar magani mai laushi da kuma hana catheter daga zamewa.
10. Idan na'urar tashar jiragen ruwa da za'a iya dasa ita ce nau'in II, haɗin tsakanin catheter da wurin zama na allura dole ne ya tabbata. Idan ba a buƙatar allurar ƙwayar cuta ta ciki, ya kamata a yi amfani da allurar gwajin salin na yau da kullun don tabbatarwa kafin sutu fata.
11. Lokacin raba yankin subcutaneous, ya kamata a yi hemostasis kusa don guje wa samuwar hematoma na gida, tarin ruwa ko kamuwa da cuta ta biyu bayan tiyata; suturar vesicular yakamata ya kauce wa wurin zama na allura.
12. α-cyanoacrylate adhesives na likita na iya haifar da lalacewa ga kayan tushe na allura; Kada a yi amfani da α-cyanoacrylate adhesives na likitanci lokacin da ake yin aikin tiyata a kusa da gindin allura. Kada a yi amfani da α-cyanoacrylate adhesives na likita lokacin da ake ma'amala da incision na tiyata a kusa da gindin allura.
13. Yi amfani da tsattsauran taka tsantsan don guje wa ɗibar catheter saboda rauni na bazata daga kayan aikin tiyata.
14. Lokacin huda, sai a sanya allurar a tsaye, a yi amfani da sirinji mai karfin 10mL ko fiye, sai a yi allurar a hankali, sannan a cire allurar bayan dan dakata. Matsalolin turawa bai kamata ya wuce 200kPa ba.
15. Yi amfani da allura na musamman don na'urorin isar da magunguna da za a dasa.
16. Lokacin da ake buƙatar jiko mai tsayi ko maye gurbin magani, yana da kyau a yi amfani da na'urar isar da magani mai amfani guda ɗaya tare da bututun allurar jiko na musamman ko te, don rage yawan huda da rage tasirin majiyyaci.
17. Rage adadin huda, rage lalacewar tsokar mai haƙuri da sassa na roba mai rufe kai. A lokacin dakatar da allurar miyagun ƙwayoyi, ana buƙatar allurar rigakafin jijiyoyi sau ɗaya kowane mako biyu.
18. Wannan samfurin samfurin guda ɗaya ne, bakararre, wanda ba na pyrogenic ba, an lalatar da shi bayan amfani, sake amfani da shi an haramta shi sosai.
19. Idan kunshin ciki ya lalace ko kwanan watan karewa samfurin ya wuce, da fatan za a mayar da shi ga masana'anta don zubarwa.
20. Adadin huda ga kowane shingen allura kada ya wuce 2000 (22Ga). 21.
21. Matsakaicin ƙarar ruwa shine 6ml