【Zotsutsana】

1) Kusayenerera kwa maganizo kapena thupi pa opaleshoni pazochitika zonse

2) Kutuluka magazi kwambiri ndi matenda otsekeka kwa magazi.

3) Chiwerengero cha maselo oyera m'magazi chochepera 3×109/L

4) Kusamvana ndi zinthu zotsutsana

5) Kuphatikiza ndi matenda aakulu osatha otsekeka m'mapapo.

6) Odwala omwe akudziwika kapena akuganiziridwa kuti ali ndi vuto la ziwengo ku zinthu zomwe zili mu phukusi la chipangizocho.

7) Kupezeka kapena kukayikira kuti pali matenda okhudzana ndi chipangizo, mabakiteriya kapena sepsis.

8) Kuchiza ndi radiotherapy pamalo omwe akufunika kuikidwa.

9) Kujambula kapena kubaya mankhwala oletsa kutupa.

 

【Manufacturedate】 Onani chizindikiro cha malonda

 

【Tsiku Lotha Ntchito】 Onani chizindikiro cha malonda

 

【Njira yogwiritsira ntchito】

1. Konzani chipangizo cholumikizira chomwe chingalowe m'malo mwake ndipo onani ngati tsiku lotha ntchito ladutsa; chotsani phukusi lamkati ndikuwona ngati phukusilo lawonongeka.
2. Muyenera kugwiritsa ntchito njira zopewera kuwononga tizilombo toyambitsa matenda kuti mudule phukusi lamkati ndikuchotsa mankhwalawo kuti mukonzekere kugwiritsa ntchito.
3. Kugwiritsa ntchito zipangizo zolumikizira madoko zomwe zimayikidwa m'thupi kumafotokozedwa padera pa chitsanzo chilichonse motere.

 

MtunduⅠ

1. Kuyesa kutsuka, kutulutsa mpweya, ndi kutayikira kwa madzi

Gwiritsani ntchito syringe (singano ya chipangizo cholowetsamo mankhwala) kuti muboole chipangizo cholowetsamo mankhwala ndikubaya 5mL-10mL ya saline ya physiological kuti mutulutse mpando wa jakisoni ndi catheter lumen ndikuchotsa. Ngati palibe kapena madzi pang'onopang'ono apezeka, pindani kumapeto kwa catheter (kutali) ndi dzanja kuti mutsegule malo otumizira mankhwala; kenako pindani kutseka kumapeto kwa catheter, pitirizani kukankhira saline (kupanikizika kosapitirira 200kPa), yang'anani ngati pali kutuluka kwa madzi kuchokera pampando wa jakisoni ndi kulumikizana kwa catheter, pambuyo pa zonse. Zonse zitayenda bwino, catheter ingagwiritsidwe ntchito.

1. Kuchotsa ndi kulumikiza

Malinga ndi kafukufuku wa mkati mwa opaleshoni, ikani catheter (kutha kwa mankhwala) mu mtsempha woyenerera wa magazi malinga ndi komwe chotupacho chili, ndipo gwiritsani ntchito suture zosayamwa kuti mulumikize bwino catheter ku mtsempha. Catheter iyenera kumangidwa bwino (njira ziwiri kapena kuposerapo) ndikukonzedwa.

1. mankhwala a chemotherapy ndi kutseka

Mankhwala a chemotherapy omwe amaperekedwa pa opaleshoni amatha kubayidwa kamodzi motsatira dongosolo la chithandizo; Ndikofunikira kuti mpando wa jakisoni ndi catheter lumen zitsukidwe ndi 6-8 mL ya saline ya thupi, kutsatiridwa ndi 3 mL ~ 5 mL. Kenako catheter imatsekedwa ndi 3mL mpaka 5 mL ya saline ya heparin pa 100U/mL mpaka 200U/mL.

1. Kukhazikitsa mpando wa jakisoni

Chidebe cha cystic cha subcutaneous chimapangidwa pamalo othandizira, omwe ali pamtunda wa 0.5 cm mpaka 1 cm kuchokera pamwamba pa khungu, ndipo mpando wa jakisoni umayikidwa m'chidebecho ndikukhazikika, ndipo khungu limakulungidwa pambuyo pa hemostasis yolimba. Ngati catheter ndi yayitali kwambiri, ikhoza kuzunguliridwa kukhala bwalo kumapeto kwa proximal ndikukhazikika bwino.

 

MtunduⅡ

1. Kutsuka ndi kutulutsa mpweya

Gwiritsani ntchito syringe (singano ya chipangizo cholumikizira chomwe chimayikidwa) kuti mulowetse saline mu mpando wa jakisoni ndi catheter motsatana kuti mutulutse ndi kuchotsa mpweya mu lumen, ndikuwona ngati madzi otulutsira mpweya ali osalala.

2. Kuchotsa ndi kulumikiza

4. Kuyesa kutayikira

4. Mukamaliza kulumikiza, pindani ndi kutseka katheta kumbuyo kwa cholumikizira chotseka ndipo pitirizani kubaya saline mu mpando wa jakisoni ndi sirinji (singano yopangira chipangizo chotumizira mankhwala) (kupanikizika kopitirira 200kPa). (kupanikizika kosapitirira 200kPa), yang'anani ngati pali kutuluka kwa madzi kuchokera mu chotchingira jakisoni ndi katheta.

kulumikizana, ndipo gwiritsani ntchito pokhapokha ngati zonse zili bwino.

5. Chemotherapy, chubu chotsekera

Mankhwala a chemotherapy omwe amaperekedwa pa opaleshoni amatha kubayidwa kamodzi motsatira dongosolo la chithandizo; tikulimbikitsidwa kutsukanso maziko a jakisoni ndi catheter lumen ndi 6-8mL ya saline ya physiological, kenako gwiritsani ntchito 3mL-5mL ya saline ya physiological.

Kenako catheter imatsekedwa ndi 3mL mpaka 5mL ya heparin saline pa 100U/mL mpaka 200U/mL.

6. Kukhazikitsa mpando wa jakisoni

Chidebe cha cystic chopangidwa pansi pa khungu chinapangidwa pamalo othandizira, 0.5 cm mpaka 1 cm kuchokera pamwamba pa khungu, ndipo mpando wobayira unayikidwa m'chidebecho n'kukhazikika, ndipo khungu linakulungidwa pambuyo poti magazi achepa kwambiri.

 

Mtundu Ⅲ

Sirinji (singano yapadera ya chipangizo cholumikizira chomwe chimayikidwa) idagwiritsidwa ntchito poikamo saline wamba wa 10mL ~ 20mL mu chipangizo choperekera mankhwala chomwe chimayikidwa kuti chitulutse mpando wa jakisoni ndi m'mimba mwa catheter, ndikuchotsa mpweya womwe uli m'mimba, ndikuwona ngati madziwo anali osasokoneza.

2. Kuchotsa ndi kulumikiza

Malinga ndi kafukufuku wa mkati mwa opaleshoni, ikani catheter m'mbali mwa khoma la m'mimba, ndipo gawo lotseguka la kumapeto kwa catheter yoperekera mankhwala liyenera kulowa m'mimba ndikukhala pafupi ndi cholinga cha chotupa momwe mungathere. Sankhani mfundo 2-3 kuti mulumikize ndikukonza catheter.

3. mankhwala a chemotherapy, chubu chotsekera

Mankhwala a chemotherapy omwe amaperekedwa pa opaleshoni amatha kubayidwa kamodzi motsatira dongosolo la chithandizo, kenako chubucho chimatsekedwa ndi 3mL~5mL ya 100U/mL~200U/mL heparin saline.

4. Kukhazikitsa mpando wa jakisoni

Chidebe cha cystic chopangidwa pansi pa khungu chinapangidwa pamalo othandizira, 0.5 cm mpaka 1 cm kuchokera pamwamba pa khungu, ndipo mpando wobayira unayikidwa m'chidebecho n'kukhazikika, ndipo khungu linakulungidwa pambuyo poti magazi achepa kwambiri.

Kulowetsedwa ndi chisamaliro cha mankhwala

A.Kugwiritsa ntchito mankhwala osokoneza bongo, kusankha bwino malo oti muikepo jakisoni musanayikepo jakisoni, komanso kuyeretsa malo oti muyikepo jakisoni mosamala.B. Mukabaya jakisoni, gwiritsani ntchito singano pa chipangizo cholowetsamo mankhwala, sirinji ya 10 mL kapena kuposerapo, ndi chala chakumanzere cholunjika chikukhudza malo obowoledwa ndi chala chachikulu chikukankhira khungu pamene chikukoka mpando wobayira jakisoni, ndi dzanja lamanja likugwirizira sirinji molunjika mu singano, kupewa kugwedezeka kapena kuzungulira, ndi kubaya pang'onopang'ono saline 5 mL ~ 10 mL pamene pali kumva ngati ikugwa ndipo nsonga ya singano ikakhudza pansi pa mpando wobayira jakisoni, ndikuwona ngati njira yoperekera mankhwala ndi yosalala (ngati si yosalala, choyamba muyenera kuwona ngati singano yatsekedwa). Yang'anani ngati pali kukwera kulikonse kwa khungu lozungulira mukakankhira.

C. Kankhirani mankhwala a chemotherapeutic pang'onopang'ono mutatsimikizira kuti palibe cholakwika. Pakukankhira, samalani kuti muwone ngati khungu lozungulira lili lokwezeka kapena lofiirira, komanso ngati pali kupweteka kwapafupi. Mankhwala akakankhira, ayenera kusungidwa kwa masekondi 15 mpaka 30.

D. Mukamaliza jakisoni iliyonse, tikulimbikitsidwa kutsuka mpando wa jakisoni ndi catheter lumen ndi 6 ~ 8mL ya saline ya physiological, kenako kutseka catheter ndi 3mL ~ 5mL ya 100U/mL ~ 200U/mL ya saline ya heparin, ndipo 0.5mL yomaliza ya saline ya heparin ikabayidwa, mankhwalawa ayenera kukankhidwira pamene akubwerera m'mbuyo, kuti njira yobweretsera mankhwala idzazidwe ndi saline ya heparin kuti mankhwala asapangike komanso magazi azitsekeka mu catheter. Catheter iyenera kutsukidwa ndi saline ya heparin kamodzi pa milungu iwiri iliyonse panthawi ya chemotherapy.

E. Mukamaliza jakisoni, thirani mankhwala ophera tizilombo toyambitsa matenda pa diso la singano, phimbani ndi bandeji yoyera, ndipo samalani kuti malo apafupi akhale oyera komanso ouma kuti mupewe matenda pamalo obowoledwa.

F. Samalani momwe wodwalayo amachitira akalandira mankhwala ndipo yang'anirani mosamala pamene mukupereka mankhwala.

 

【Chenjezo, chenjezo ndi zinthu zosonyeza malingaliro oipa】

1. Mankhwalawa amayeretsedwa ndi ethylene oxide ndipo amagwira ntchito kwa zaka zitatu.
2. Chonde werengani buku la malangizo musanagwiritse ntchito kuti muwonetsetse kuti kugwiritsa ntchito kwake kuli kotetezeka.
3. Kugwiritsa ntchito mankhwalawa kuyenera kutsatira zofunikira za malamulo ndi malamulo oyenera a zachipatala, ndipo kuyika, kugwiritsa ntchito ndi kuchotsa zipangizozi kuyenera kukhala kwa madokotala ovomerezeka okha. Kuyika, kugwiritsa ntchito ndi kuchotsa zipangizozi kuli kwa madokotala ovomerezeka okha, ndipo chisamaliro cha pambuyo pa opaleshoni chiyenera kuchitidwa ndi ogwira ntchito zachipatala oyenerera.
4. Njira yonse iyenera kuchitidwa pansi pa vuto la aseptic.
5. Yang'anani tsiku lotha ntchito la mankhwala ndi phukusi lamkati kuti muwone ngati lawonongeka musanachite opaleshoni.
6. Mukagwiritsa ntchito, mankhwalawa angayambitse zoopsa zamoyo. Chonde tsatirani njira zamankhwala zovomerezeka ndi malamulo ndi malangizo onse okhudzana ndi kusamalira ndi kuchiza.
7. Musagwiritse ntchito mphamvu zambiri mukalowetsa chubu ndipo ikani mtsempha wamagazi molondola komanso mwachangu kuti mupewe kutsekeka kwa mitsempha. Ngati kulowetsa chubu kuli kovuta, gwiritsani ntchito zala zanu kutembenuza catheter kuchokera mbali imodzi kupita ina pamene mukulowetsa chubu.
8. Kutalika kwa catheter yomwe imayikidwa m'thupi kuyenera kukhala koyenera, yayitali kwambiri ndi yosavuta kupindika pang'onopang'ono, zomwe zimapangitsa kuti mpweya ukhale wochepa, yochepa kwambiri ndi pamene wodwala akuchita zachiwawa zomwe zingathe kutuluka m'chombo. Ngati catheter ndi yochepa kwambiri, ikhoza kutuluka m'chombocho wodwalayo akasuntha mwamphamvu.
9. Catheter iyenera kulowetsedwa m'chombocho ndi ma ligature opitilira awiri komanso kulimba koyenera kuti zitsimikizire kuti mankhwala alowetsedwa bwino komanso kuti catheter isagwe.
10. Ngati chipangizo cholumikizira chomwe chimayikidwa m'thupi ndi cha mtundu wachiwiri, kulumikizana pakati pa catheter ndi mpando wobayira jakisoni kuyenera kukhala kolimba. Ngati jakisoni wa mankhwala opangidwa panthawi ya opaleshoni sikofunikira, jakisoni wanthawi zonse wa saline uyenera kugwiritsidwa ntchito kuti utsimikizire musanakoke khungu.
11. Polekanitsa malo obisika pansi pa khungu, yeretsani magazi kuti asapangike, madzi asamaundane kapena matenda ena pambuyo pa opaleshoni; chotsekera cha vesicular chiyenera kupewa mpando wobayira jakisoni.
12. Magulu a α-cyanoacrylate achipatala amatha kuwononga zinthu zoyambira jakisoni; musagwiritse ntchito magulu a α-cyanoacrylate achipatala pochiza kudula kwa opaleshoni mozungulira maziko a jakisoni. Musagwiritse ntchito magulu a α-cyanoacrylate achipatala pochiza kudula kwa opaleshoni mozungulira maziko a jakisoni.
13. Samalani kwambiri kuti musatuluke madzi mu catheter chifukwa cha kuvulala mwangozi ndi zida zochitira opaleshoni.
14. Mukaboola, singano iyenera kuyikidwa moyimirira, sirinji yokhala ndi mphamvu ya 10mL kapena kuposerapo iyenera kugwiritsidwa ntchito, mankhwalawo ayenera kubayidwa pang'onopang'ono, ndipo singano iyenera kuchotsedwa pambuyo popuma pang'ono. Kukankhira kwa mphamvu sikuyenera kupitirira 200kPa.
15. Gwiritsani ntchito singano zapadera zokha pa zipangizo zotumizira mankhwala zomwe zingabzalidwe.
16. Ngati pakufunika kulowetsedwa kwa nthawi yayitali kapena kusintha mankhwala, ndikofunikira kugwiritsa ntchito chipangizo chopatsira mankhwala chomwe chingagwiritsidwe ntchito kamodzi kokha chokhala ndi singano yapadera yolowetsedwa kapena chogwirira, kuti muchepetse kuchuluka kwa mabowo ndikuchepetsa kukhudzidwa kwa wodwalayo.
17. Chepetsani kuchuluka kwa mabowo, chepetsani kuwonongeka kwa minofu ya wodwalayo ndi ziwalo zotanuka zomwe zimatseka zokha. Panthawi yosiya jakisoni wa mankhwala, jakisoni wa anticoagulant amafunika kamodzi pa milungu iwiri iliyonse.
18. Chogulitsachi ndi chogwiritsidwa ntchito kamodzi kokha, chopanda poizoni, chosawononga pyrogenic, chowonongeka mutachigwiritsa ntchito, kugwiritsanso ntchito n'koletsedwa kotheratu.
19. Ngati phukusi lamkati lawonongeka kapena tsiku lotha ntchito ladutsa, chonde libwezeni kwa wopanga kuti alitaye.
20. Chiwerengero cha mabowo a jekeseni iliyonse sichiyenera kupitirira 2000 (22Ga). 21.
21. Kuchuluka kocheperako kwa madzi osambira ndi 6ml