Magazi otayika ndi osabalahemodialysis catheterndi Chalk Disposable wosabalahemodialysis catheterkapangidwe ka magwiridwe antchito ndi kapangidwe ka mankhwalawa amapangidwa ndi nsonga yofewa, mpando wolumikizira, chubu chowonjezera ndi socket ya cone; Catheter imapangidwa ndi polyurethane yachipatala ndi polycarbonate. Ndi kabowo kamodzi, kabowo kawiri ndi catheter atatu. Izi mankhwala ndi matenda ntchito hemodialysis ndi kulowetsedwa. Zofotokozera zachitsanzo ziwiri, patsekeke zitatu
Ngalande yokhala ndi jekete ya dacron
Ndi ukalamba wa anthu, kuthamanga kwa magazi, matenda a shuga, matenda a mtima (CHD) ndi odwala aimpso kulephera kuchuluka, mtima chikhalidwe ndi osauka, autogenous arteriovenous mkati fistula kwambiri kuchuluka kwa mavuto, kukhudza kwambiri mmene wodwalayo dialysis chithandizo ndi khalidwe la moyo. , kotero tengani catheter kapena catheter ya polyester lamba kwa nthawi yayitali, yakhala ikugwiritsidwa ntchito kwambiri padziko lapansi, ubwino wake ndi: Catheter ili ndi ubwino. biocompatibility, ndipo catheter ikhoza kukhazikitsidwa mwamphamvu ndi khungu. Manja ake a polyester amatha kupanga chotchinga chotseka cha bakiteriya mumsewu wa subcutaneous, kuchepetsa kupezeka kwa matenda ndikutalikitsa nthawi yogwiritsa ntchito.
Kugwiritsa ntchito ndi kukonza ma catheters a hemodialysis
1. Unamwino ndi kuunika kwa catheter
1. Chotuluka pakhungu la catheter
Musanagwiritse ntchito komanso mutatha kugwiritsa ntchito, mawonekedwe a chikopa cha khungu pa malo otsekemera ayenera kuyesedwa chifukwa cha redness, secretion, chifundo, kutuluka magazi ndi kutuluka, ndi zina zotero. Ngati ndi catheter yanthawi yayitali, yang'anani ngati CAFF yakokedwa kapena yotuluka.
2. Kulumikizana kwakunja kwa catheter
Kaya pali kuphulika kapena kusweka, mlingo wa patency wa lumen, ngati magazi osakwanira akupezeka, ayenera kuuzidwa kwa dokotala pakapita nthawi, ndipo mapangidwe a thrombus ndi fibrin sheath mu catheter ayenera kutsimikiziridwa ndi ultrasound, kujambula ndi kujambula. njira zina.
3. Zizindikiro za odwala
Kaya zizindikiro ndi mlingo wa malungo, kuzizira, ululu ndi zodandaula zina za kusapeza bwino.
2. Njira yolumikizirana
1. Kukonzekera
(1) Makina a dialysis adadziyesa okha, payipi ya dialysis idatsitsidwa kale ndipo ili pamalo oyimilira.
(2) Kukonzekera: ngolo mankhwala kapena thireyi mankhwala, mankhwala disinfection (iodophor kapena chlorhexidine), wosabala zinthu (mankhwala chopukutira, yopyapyala, syringe, kuyeretsa magolovesi, etc.).
(3) Wodwalayo ayenera kuikidwa pamalo omasuka, ndipo wodwala yemwe ali ndi intubation ya khosi ayenera kuvala chigoba kuti awonetse malo omwe ali ndi intubation.
2. Ndondomeko
(1) Tsegulani chovala chakunja cha catheter yapakati.
(2) Valani magolovesi.
(3) Tsegulani 1/4 mbali ya chopukutira chosabala ndikuchiyika pansi pa catheter ya lumen yapakati pa mtsempha wapakati.
(4) Kupha tizilombo toyambitsa matenda a catheter chitetezo kapu, catheter pakamwa ndi catheter clamp kwa 2 nthawi motsatana.
(5) Onetsetsani kuti chotsekereza katheta ndichotsekeredwa, chotsani mtedzawo, ndi kuutaya. Ikani catheter wosabala pa 1/2 mbali yosabala ya chopukutira.
(6) Pukutsaninso tizilombo toyambitsa matenda musanagwire ntchito.
(7) 2mL intracatheter yosindikiza heparin njira inapopedwa ndi syringe ya 2-5ml ndikukankhira pa yopyapyala.
(8) Onani ngati pali magazi pa gauze. Ngati pali magazi kuundana, chotsaninso 1ml ndikukankhira jekeseniyo. Mtunda pakati pa jakisoni ndi yopyapyala ndi wamkulu kuposa 10cm.
(9) Pambuyo poweruza kuti catheter ndi yosatsekeka, gwirizanitsani mapaipi a mitsempha ndi mitsempha ya extracorporeal circulation kuti mukhazikitse kutuluka kwa extracorporeal.
3. Kuthetsa ntchito yosindikiza chubu pambuyo dialysis
(1) Mukalandira chithandizo ndi kubwereranso magazi, sungani chotchinga cha catheter, thirani tizilombo tolowa m'malo olumikizirana mafupa, ndikudula cholumikiziracho ndi payipi yozungulira.
(2) Thirani mankhwala polowera mtsempha wa mtsempha ndi mtsempha wa katheta motsatira, ndipo kanikizani 10ml wasaline wamba kuti mutsuka katheta pogwiritsa ntchito kugunda kwa mtima. Pambuyo poyang'ana maso amaliseche, panalibe zotsalira za magazi mu gawo lowonekera la catheter, kukankhira anticoagulant kusindikiza madzi ndi pellet monga momwe adalangizira dokotala. (3) Gwiritsani ntchito chipewa cha heparin chosabala kuti mutseke potsegula chubu la arteriovenous chubu ndi zigawo ziwiri za gauze wosabala kuti mumangire. Zokhazikika.
3. Kusintha kwa kuvala kwa catheter yapakati ya venous
1. Yang'anani ngati chovalacho ndi chowuma, magazi ndi madontho.
2. Valani magolovesi.
3. Tsegulani chovalacho ndikuwona ngati pali magazi, kutuluka, kufiira ndi kutupa, kuwonongeka kwa khungu ndi kukhetsa kwa suture pamalo omwe catheter yapakati imayikidwa.
4. Tengani swab ya thonje ya iodophor ndikuzungulira mozungulira kuti muphe malo omwe chubu layikidwapo. Kutalika kwa disinfection ndi 8-10cm.
5. Mangani chovalacho pakhungu pamalo pomwe chubu layikidwa, ndikuwonetsa nthawi yosintha mavalidwe. Kugwiritsa ntchito ndi kukonza catheters
1. Unamwino ndi kuunika kwa catheter
1. Chotuluka pakhungu la catheter
Musanagwiritse ntchito komanso mutatha kugwiritsa ntchito, mawonekedwe a chikopa cha khungu pa malo otsekemera ayenera kuyesedwa chifukwa cha redness, secretion, chifundo, kutuluka magazi ndi kutuluka, ndi zina zotero. Ngati ndi catheter yanthawi yayitali, yang'anani ngati CAFF yakokedwa kapena yotuluka.
2. Kulumikizana kwakunja kwa catheter
Kaya pali kuphulika kapena kusweka, mlingo wa patency wa lumen, ngati magazi osakwanira akupezeka, ayenera kuuzidwa kwa dokotala pakapita nthawi, ndipo mapangidwe a thrombus ndi fibrin sheath mu catheter ayenera kutsimikiziridwa ndi ultrasound, kujambula ndi kujambula. njira zina.
3. Zizindikiro za odwala
Kaya zizindikiro ndi mlingo wa malungo, kuzizira, ululu ndi zodandaula zina za kusapeza bwino.
2. Njira yolumikizirana
1. Kukonzekera
(1) Makina a dialysis adadziyesa okha, payipi ya dialysis idatsitsidwa kale ndipo ili pamalo oyimilira.
(2) Kukonzekera: ngolo mankhwala kapena thireyi mankhwala, mankhwala disinfection (iodophor kapena chlorhexidine), wosabala zinthu (mankhwala chopukutira, yopyapyala, syringe, kuyeretsa magolovesi, etc.).
(3) Wodwalayo ayenera kuikidwa pamalo omasuka, ndipo wodwala yemwe ali ndi intubation ya khosi ayenera kuvala chigoba kuti awonetse malo omwe ali ndi intubation.
2. Ndondomeko
(1) Tsegulani chovala chakunja cha catheter yapakati.
(2) Valani magolovesi.
(3) Tsegulani 1/4 mbali ya chopukutira chosabala ndikuchiyika pansi pa catheter ya lumen yapakati pa mtsempha wapakati.
(4) Kupha tizilombo toyambitsa matenda a catheter chitetezo kapu, catheter pakamwa ndi catheter clamp kwa 2 nthawi motsatana.
(5) Onetsetsani kuti chotsekereza katheta ndichotsekeredwa, chotsani mtedzawo, ndi kuutaya. Ikani catheter wosabala pa 1/2 mbali yosabala ya chopukutira.
(6) Pukutsaninso tizilombo toyambitsa matenda musanagwire ntchito.
(7) 2mL intracatheter yosindikiza heparin njira inapopedwa ndi syringe ya 2-5ml ndikukankhira pa yopyapyala.
(8) Onani ngati pali magazi pa gauze. Ngati pali magazi kuundana, chotsaninso 1ml ndikukankhira jekeseniyo. Mtunda pakati pa jakisoni ndi yopyapyala ndi wamkulu kuposa 10cm.
(9) Pambuyo poweruza kuti catheter ndi yosatsekeka, gwirizanitsani mapaipi a mitsempha ndi mitsempha ya extracorporeal circulation kuti mukhazikitse kutuluka kwa extracorporeal.
3. Kuthetsa ntchito yosindikiza chubu pambuyo dialysis
(1) Mukalandira chithandizo ndi kubwereranso magazi, sungani chotchinga cha catheter, thirani tizilombo tolowa m'malo olumikizirana mafupa, ndikudula cholumikiziracho ndi payipi yozungulira.
(2) Thirani mankhwala polowera mtsempha wa mtsempha ndi mtsempha wa katheta motsatira, ndipo kanikizani 10ml wasaline wamba kuti mutsuka katheta pogwiritsa ntchito kugunda kwa mtima. Pambuyo poyang'ana maso amaliseche, panalibe zotsalira za magazi mu gawo lowonekera la catheter, kukankhira anticoagulant kusindikiza madzi ndi pellet monga momwe adalangizira dokotala. (3) Gwiritsani ntchito chipewa cha heparin chosabala kuti mutseke potsegula chubu la arteriovenous chubu ndi zigawo ziwiri za gauze wosabala kuti mumangire. Zokhazikika.
3. Kusintha kwa kuvala kwa catheter yapakati ya venous
1. Yang'anani ngati chovalacho ndi chowuma, magazi ndi madontho.
2. Valani magolovesi.
3. Tsegulani chovalacho ndikuwona ngati pali magazi, kutuluka, kufiira ndi kutupa, kuwonongeka kwa khungu ndi kukhetsa kwa suture pamalo omwe catheter yapakati imayikidwa.
4. Tengani swab ya thonje ya iodophor ndikuzungulira mozungulira kuti muphe malo omwe chubu layikidwapo. Kutalika kwa disinfection ndi 8-10cm.
5. Mangani chovalacho pakhungu pamalo pomwe chubu layikidwa, ndikuwonetsa nthawi yosintha mavalidwe.
Nthawi yotumiza: Feb-25-2022