【Crantrandication】

1) Udindo wamaganizidwe kapena ungwiro wa opaleshoni m'malo onse

2) Kutaya magazi kwambiri komanso magazi ophatikizika.

3) Kholo loyera la magazi lochepera 3 × 109 / l

4) kusanjana kusiyanasiyana

5) Kuphatikizidwa ndi matenda owopsa a m'mapapo.

6) Odwala omwe ali ndi vuto lodziwika kapena loganiziridwa ku ziweto zomwe zili phukusi la chipangizocho ..

7) Kukhalapo kapena kukayikira matenda okhudzana ndi chipangizo, bacteremia kapena sepsis.

8) radiotherarapy pamalo omwe mukufuna.

9) Kuganiza kapena jekeseni wa mankhwala osokoneza bongo.

 

【Zopanga】 Onani zilembo zamalonda

 

【Incrodate】 Onani zilembo zamalonda

 

【Njira yogwiritsira ntchito】

1. Konzani chida chofiyira ndikuyang'ana ngati tsiku lomaliza latha; Chotsani phukusi la mkati ndikuyang'ana ngati phukusi likuwonongeka.
2. Muyenera kugwiritsa ntchito njira zosinthira ku Aseptic kuti muchepetse phukusi lanu ndikuchotsa zomwe mungagwiritse ntchito.
3. Kugwiritsa ntchito zida zokhala ndi doko kumafotokozedwa mosiyana ndi mtundu uliwonse motere.

 

Lembani

1. Kutulutsa, kulowa, kuyesedwa kwa Dzuwa

Gwiritsani ntchito syringe (singano ya dokotala wowoneka bwino) kuti mupange chida chowoneka bwino komanso jekeseni 5ml-10ml wa mchere wazovuta kuti atulutse utoni wa jakisoni ndi Cheheter Lumen. Ngati ayi kapena madzi osachedwa amapezeka, kupotoza mankhwala osokoneza bongo a catheter (kumapeto kwa dzanja) ndi dzanja kuti mutsegule dokotala wothandizirana; Kenako pindani kutseka mankhwala operekera mankhwala a Catheter, pitilizani kukankha saline (kusapanikizika osati zopitilira 200Kpa), osawona ngati pali cholembera chilichonse, Catheter angagwiritsidwe ntchito.

1. Kukonzekera ndi ligawi

Malinga ndi kufufuza kolowera, ikani catheter (kumapeto kwa mankhwala osokoneza bongo) m'magazi ogwirizira malinga ndi komwe kuli kotupa, ndikugwiritsa ntchito zosatheka kukhomera bwino catheter kupita ku chotengera. Catheter ayenera kudulidwa bwino (kawiri kapena kupitilira apo) ndikukhazikika.

1. chemotherapy ndi kusindikiza

Mankhwala osokoneza bongo a chemotherapy amatha kulowetsedwa kamodzi malinga ndi dongosolo la mankhwala; Ndikulimbikitsidwa kuti umpando wa jakitala ndi mphaka zopangidwa ndi 6-8 ml ya anthu ozungulira mchere, omwe amatsatiridwa ndi 3 ml ya chikondwerero cha heparin saline ku 100U / ml.

1. Kukhazikika kwa Invicetion

Patseke lam'mphepete mwa msewuwo zimapangidwa kumalo othandizira, komwe ndi 0,5 masentimita mpaka 1 masentimita kuchokera pakhungu ndikukhazikika, ndipo khungu limakhazikika, ndipo khungu limasinthidwa pambuyo pa hemostasis. Ngati catheter ndi motalika kwambiri, itha kuphatikizidwa mu bwalo kumapeto kwenikweni ndikukhazikika moyenera.

 

Lembani

1.Kugwiritsa ntchito

Gwiritsani ntchito syringe (singano ya dokotala wowoneka bwino) kuyika mchere wa jakisoni ndi catheter moyenera kuti atuluke ndikuchotsa mpweya mu lumen, ndikuwona ngati madzi ophatikizirawo ndi osalala.

2. Kukongoletsa ndi Chipilala

4. Mayeso

4. Pambuyo pa kulumikizidwa kwatha, pindani ndi kutseka catheter kumbuyo kwa curning ndi syringe ya inchi ndi syringe yoperekera mankhwala osokoneza bongo). .

kulumikizana, ndikugwiritsa ntchito pokhapokha ngati zonse zili bwinobwino.

5. Chemotherapy, kusindikiza chubu

Mankhwala osokoneza bongo a chemotherapy amatha kulowetsedwa kamodzi malinga ndi dongosolo la mankhwala; Ndikulimbikitsidwa kuti muchepetse utoto ndi mitater lumen ndi 6 ~ 8ml ya osakhazikika mchere, kenako gwiritsani ntchito 3ml ~ 5ml ya osambira mchere.

Chathero amasindikizidwa ndi 3ml mpaka 5ml wa heparin saline ku 100U / ml to 200U / ml.

6. Kukhazikika kwa Itani

Chovala chopanda matope chinapangidwa pamalo othandizira, 0,5 masentimita mpaka 1 masentimita kuchokera pakhungu, ndipo mpando wa jekeseni udayikidwa m'khola ndikukhazikika, ndipo khungu limasinthidwa pambuyo pa hemostasis.

 

Lembani ⅲ

Syringe (singano yapadera ya doko lolowera) idagwiritsidwa ntchito kuvala 10ml ~ 20ml mchere wabwino kwambiri kuti utulutse mankhwala a jakisoni ndikuchotsa mlengalenga, ndikuwona ngati madziwo sanali osatsegula.

2. Kukongoletsa ndi Chipilala

Malinga ndi kupezeredwa kopitilira muyeso, ikani catheter pakhoma lam'mimba, ndipo gawo lotseguka la kutha kwa mankhwala a catheter kuyenera kulowa m'mimba ndikukhala pafupi ndi chotupa chomwe chingatheke. Sankhani 2-3 poimitsa ndikukonza catheter.

3. Chemotherapy, kugwaliza chubu

Mankhwala osokoneza bongo amatha kubayidwa kamodzi molingana ndi dongosolo la chithandizo, kenako chubu chimasindikizidwa ndi 3ml ~ 5ml wa 100U / ml ~ 200u / ml heparin saline.

4..

Chovala chopanda matope chinapangidwa pamalo othandizira, 0,5 masentimita mpaka 1 masentimita kuchokera pakhungu, ndipo mpando wa jekeseni udayikidwa m'khola ndikukhazikika, ndipo khungu limasinthidwa pambuyo pa hemostasis.

Kulowetsedwa kwa mankhwala ndi kusamalira

A.Kugwira ntchito mosamala kwambiri, kusankha koyenera kwa malo a jakisoni asana jakisoni, komanso kuperewera kwa malo a jekeseni.B. Mukayika jakisoni, gwiritsani ntchito singano ya doko lolowera, syringe ya 10 ml kapena kupitirira, ndikusintha pang'onopang'ono sayini Pambuyo pake zimakhudza pansi pampando wa jakisoni, ndikuwona ngati njira yobweretsera mankhwala ndi yosalala (ngati siyosalala, mungayang'ane kaye ngati singano yatsekedwa). Yang'anani ngati pali malo okwezeka a khungu lozungulira pokankha.

C. Kanikizani mankhwala a chemotherapeutic pang'onopang'ono mutatsimikizira kuti palibe cholakwika. Panthawi yokankhira, samalani kuwona ngati khungu lozungulira limakwezedwa kapena lotuwa, ndipo ngati pali zowawa zakomweko. Mankhwala atakankhidwira, iyenera kusungidwa kwa 15s ~ 30s.

D. Pambuyo jekeseni iliyonse, tikulimbikitsidwa kuti muchepetse mawonekedwe a jekeseni ndi 6 ~ 8ml wa osakhazikika ndi 3.5ml pomwe madzi a heparin sarnine, kuti mankhwalawa abwerezedwa Heparin saline kuti aletse mankhwala ozungulira a mankhwala a crystallization ndi kuphatikizika kwa magazi mu catheter. Catheter amayenera kuwikitsidwa ndi heparin saline kamodzi pa masabata awiri aliwonse nthawi ya chemotherapy.

E. Pambuyo pa jekeseni, polowetsa singano yazisitino yamankhwala ndi mankhwala ophera tizilombo, yizani ndi kuvala kosatsukira, ndipo samalani kuti dera likhale loyera komanso louma kuti muchepetse matenda osokoneza bongo.

F. Samalani ndi zomwe wodwala akuchita pambuyo makonzedwe a mankhwala osokoneza bongo ndikuwonetsetsa panthawi yamankhwala.

 

Chenjezo, Chenjezo ndi Zomwe Zili Zambiri】

1. Izi sizimadulidwa ndi ethylene oxide ndipo ndizovomerezeka kwa zaka zitatu.
2. Chonde werengani buku la malangizo musanagwiritse ntchito kuti muwonetsetse chitetezo.
3. Kugwiritsa ntchito mankhwalawa kumayenera kutsatira zofunikira za madokotala oyenera, ndipo kulowetsa, kugwira ntchito ndi kuchotsa madokotala ovomerezeka.
4. Njira yonse iyenera kuchitidwa pansi pa ziphuphu.
5. Onani tsiku lomaliza la malonda ndi phukusi lamkati la kuwonongeka pamaso pa njirayi.
6. Mukatha kugwiritsidwa ntchito, malonda atha kuyambitsa zoopsa zachilengedwe. Chonde tsatirani zovomerezeka zamankhwala ndi malamulo onse oyenera ndi chithandizo chamankhwala komanso chithandizo.
7. Osagwiritsa ntchito mphamvu zambiri pakanthawi zina ndikuyika mtsemphawo molondola komanso mwachangu kupewa vasoslospasm. Ngati intubation ndi yovuta, gwiritsani zala zanu kuti musinthe catheter kuchokera mbali mpaka pokhazikitsa chubu.
8. Kutalika kwa catheter yoyikidwa m'thupi kuyenera kukhala koyenera, motalika ndikosavuta kupindika, ndikupangitsa kuti mpweya wabwino ukhale wosawuka, womwe umakhala ngati wodwalayo ali ndi mwayi wochotsa chiwiya. Ngati catheter ndi yochepa kwambiri, imatha kungochotsa chotengera pomwe wodwalayo asunthira mwamphamvu.
9. Catheter iyenera kuyikidwa mu chotengera chomwe chimakhala ndi zopitilira ziwiri komanso kulimba koyenera kuti zitsimikiziketse jakisoni wosalala komanso kupewa catheter kuti asachotse.
10. Ngati doko lokhala ndi doko lokhala ndi lii, kulumikizana pakati pa catheter ndi ukisoni uyenera kukhala wolimba. Ngati jakisoni wamankhwala osafunikira siofunikira, jakisoni wamba saline ayenera kugwiritsidwa ntchito kuti atsimikizire musanadye khungu.
11. Polekanitsa dera la subcutanele, kutseka ma hemistasis kuyenera kuchitidwa kuti apewe kupangidwa kwa hematoma, kudzikundikira kwa madzi kapena kachilombo kawiri pambuyo pa opareshoni; Kukwiya kwa vesicular muyenera kupewa kumpando jakisoni.
12. Zochita zachipatala zamankhwala zimatha kuwononga zida zapansi; Osagwiritsa ntchito α- cyanoacrylate azachipatala pochiritsa opaleshoni yozungulira jekeseni. Osagwiritsa ntchito α-cyanoacrylate azachipatala akamayendetsa opaleshoni yozungulira jekeseni.
13. Gwiritsani ntchito mosamala kwambiri kuti mupewe kutaya catheter chifukwa cha kuvulala mwangozi chifukwa cha zida zopangira opaleshoni.
14. Mukasunga, singano iyenera kuyikidwa molunjika, syringe yokhala ndi ma 10ml kapena zochulukirapo ziyenera kugwiritsidwa ntchito, mankhwalawa amayenera kuphatikizidwa pang'onopang'ono, ndipo singano iyenera kuchotsedwa pambuyo pa mpumulo waufupi. Kupanikizika kwa kukankha sikuyenera kupitirira 200kpa.
15. Ingogwiritsa ntchito singano zapadera za zida zophatikizira za mankhwala osokoneza bongo.
16. Mukakhala kwadzidzidzi kapena kulowetsedwa kwa mankhwala osokoneza bongo kumafunikira, ndikoyenera kugwiritsa ntchito chipangizo choperekera mankhwala osavomerezeka ndi mankhwala apadera a kulowetsedwa kapena tee, kuti muchepetse kuchuluka kwa puncture.
17. Chepetsani kuchuluka kwa ziwerengero, kuchepetsa kuwonongeka kwa minofu ya wodwalayo komanso ziwalo zolimba. Munthawi yosiya jakisoni wa mankhwala, jakisoni wa anticoagulant amafunikira kamodzi milungu iwiri iliyonse.
18. Izi ndizogwiritsa ntchito imodzi, zosabala, zomwe sizimapanga pyrogenic, zowonongedwa mutatha kugwiritsa ntchito, gwiritsani ntchito ndalama zimaletsedwa.
19. Ngati phukusi lamkati lawonongeka kapena tsiku lotha litatha litapitilira, chonde bweretsani kwa wopanga.
20. Chiwerengero cha manambala a jakisoni iliyonse sayenera kupitirira 2000 (22GA). 21.
21. Voliyumu yocheperako ndi 6ml