【Ama-Contraindications】

1) Ukungafaneleki ngokwengqondo noma ngokomzimba ukuhlinzwa ezimweni ezijwayelekile

I-2) Izinkinga zokopha kakhulu kanye ne-coagulation.

3) Isibalo samangqamuzana egazi amhlophe ngaphansi kuka-3×109/L

4) I-Alejiki ukuqhathanisa imidiya

I-5) Kuhlanganiswe nesifo esibi esingapheli se-obstructive pulmonary.

6) Iziguli ezaziwayo noma ezisolwa ngokungezwani nezinto ezibonakalayo ephaketheni ledivayisi..

7) Ukuba khona noma izinsolo zokutheleleka okuhlobene nedivayisi, i-bacterium noma i-sepsis.

8) I-Radiotherapy endaweni okuhloswe ngayo ukufakwa.

9) Ukuthwebula izithombe noma umjovo wezidakamizwa ze-embolic.

 

【Usuku Lokukhiqiza】 Bona ilebula yomkhiqizo

 

【Usuku lokuphelelwa yisikhathi】 Bona ilebula yomkhiqizo

 

【Indlela yokusebenzisa】

1. Lungiselela idivayisi yembobo efakelwayo futhi uhlole ukuthi usuku lokuphelelwa yisikhathi lweqiwe yini; khipha iphakheji elingaphakathi bese uhlola ukuthi iphakheji ilonakele yini.
2. Kufanele usebenzise amasu ase-aseptic ukuze usike uvule iphakheji elingaphakathi bese ususa umkhiqizo ukuze ulungele ukusetshenziswa.
3. Ukusetshenziswa kwamadivaysi echweba afakelwayo kuchazwa ngokwehlukana kumodeli ngayinye ngale ndlela elandelayo.

 

UhloboⅠ

1. Ukushaywa umoya, ukuphuma, ukuhlola ukuvuza

Sebenzisa isirinji (inaliti yembobo efakelwayo) ukubhoboza idivayisi yembobo efakelwayo bese ujova u-5mL-10mL wosawoti womzimba ukuze usule isihlalo somjovo kanye ne-catheter lumen futhi ungafaki. Uma kungekho noma uketshezi olunensayo lutholakala, sonta isiphetho sokulethwa kwesidakamizwa se-catheter (i-distal end) ngesandla ukuze uvule imbobo yokulethwa kwezidakamizwa; bese i-Fold ivala ukuphela kokulethwa kwezidakamizwa kwe-catheter, qhubeka ucindezela u-saline (ukucindezela okungengaphezu kuka-200kPa), bheka ukuthi kukhona yini ukuvuza esihlalweni somjovo kanye noxhumo lwe-catheter, ngemva kwakho konke okuvamile Ngemva kokuba yonke into ijwayelekile, i-catheter ingasetshenziswa.

1. I-Cannulation kanye ne-ligation

Ngokophenyo lwe-intraoperative, faka i-catheter (ukuphela kokulethwa kwezidakamizwa) emkhunjini ohambisa igazi ohambelana nendawo yesimila, futhi usebenzise ama-sutures angenakumuncwa ukuze uhlanganise kahle i-catheter emkhunjini. I-catheter kufanele iboshwe kahle (amaphasi amabili noma ngaphezulu) futhi ilungiswe.

1. i-chemotherapy kanye nokubekwa uphawu

Umuthi we-chemotherapy we-intraoperative ungajovwa kanye ngokohlelo lokwelapha; kunconywa ukuthi isihlalo somjovo kanye ne-catheter lumen kugezwe ngo-6-8 mL we-physiological saline, kulandele u-3 mL~5 mL I-catheter ibe isivalwa ngo-3mL kuya ku-5mL we-heparin saline ku-100U/mL kuya ku-200U/mL.

1. Ukulungiswa kwesihlalo somjovo

I-subcutaneous cystic cavity yenziwa endaweni yokusekela, engu-0.5 cm kuya ku-1 cm ukusuka ebusweni besikhumba, futhi isihlalo somjovo sifakwa emgodini futhi silungiswe, futhi isikhumba siyathululwa ngemva kwe-hemostasis eqinile. Uma i-catheter iyinde kakhulu, ingasongelwa ibe yindingiliza ekugcineni okuseduze futhi ilungiswe kahle.

 

UhloboⅡ

1.Ukushaywa umoya nokukhipha umoya

Sebenzisa isirinji (inaliti yembobo efakelwayo) ukuze ujove usawoti esihlalweni somjovo kanye ne-catheter ngokulandelana ukuze ushaye futhi ukhiphe umoya kulume, futhi ubheke ukuthi uketshezi oluqhutshwayo lubushelelezi yini.

2. Ukukhanselwa nokuxhunywa

4. Ukuhlolwa kokuvuza

4. Ngemuva kokuthi ukuxhuma sekuqediwe, phinda futhi uvale i-catheter ngemuva kwesiqeshana sokukhiya bese uqhubeke ujova i-saline esihlalweni somjovo ngesirinji (inaliti yedivayisi yokulethwa kwezidakamizwa efakelwayo) (ingcindezi engaphezu kuka-200kPa). (ingcindezi engeqi ku-200kPa), bheka ukuthi akukho yini ukuvuza endaweni yomjovo kanye ne-catheter

uxhumano, futhi sebenzisa kuphela ngemva kokuba yonke into evamile.

5. I-Chemotherapy, ishubhu lokuvala

Umuthi we-chemotherapy we-intraoperative ungajovwa kanye ngokohlelo lokwelapha; kunconywa ukuthi usule isisekelo somjovo kanye ne-catheter lumen ngo-6~8mL we-physiological saline futhi, bese usebenzisa u-3mL~5mL we-physiological saline.

I-catheter ibe isivalwa ngo-3mL kuya ku-5mL we-heparin saline ku-100U/mL kuya ku-200U/mL.

6. Ukulungiswa kwesihlalo somjovo

I-subcutaneous cystic cavity yenziwa endaweni yokwesekwa, i-0.5 cm kuya ku-1 cm ukusuka ebusweni besikhumba, futhi isihlalo somjovo safakwa emgodini futhi salungiswa, futhi isikhumba sahlukunyezwa ngemva kwe-hemostasis eqinile.

 

Uhlobo Ⅲ

Isipetu (inaliti ekhethekile yedivayisi yembobo efakelwayo) yasetshenziselwa ukujova usawoti ovamile ongu-10mL ~ 20mL emshinini wokulethwa kwezidakamizwa ofakelwayo ukuze kugezwe isihlalo somjovo kanye nomgodi wecatheter, futhi kukhishwe umoya esikhaleni, futhi kubhekwe ukuthi uketshezi lukhona yini. wayengabonakali.

2. Ukukhanselwa nokuxhunywa

Ngokusho kokuhlolwa kwe-intraoperative, faka i-catheter eduze nodonga lwesisu, futhi ingxenye evulekile yokuphela kokulethwa kwezidakamizwa ye-catheter kufanele ingene emgodini wesisu futhi ibe seduze nethagethi yesimila ngangokunokwenzeka. Khetha amaphuzu angu-2-3 ukuze uhlanganise futhi ulungise i-catheter.

3. ukwelapha ngamakhemikhali, ishubhu lokuvala

Umuthi we-chemotherapy wangaphakathi kokuhlinza ungajovwa kanye ngokohlelo lokwelapha, bese ishubhu livalwa ngo-3mL~5mL ka-100U/mL~200U/mL we-heparin saline.

4. Ukulungiswa kwesihlalo somjovo

I-subcutaneous cystic cavity yenziwa endaweni yokwesekwa, i-0.5 cm kuya ku-1 cm ukusuka ebusweni besikhumba, futhi isihlalo somjovo safakwa emgodini futhi salungiswa, futhi isikhumba sahlukunyezwa ngemva kwe-hemostasis eqinile.

Ukumnika izidakamizwa nokunakekelwa

A.Ukusebenza okuqinile kwe-aseptic, ukukhetha okulungile kwendawo yesihlalo somjovo ngaphambi komjovo, kanye nokubulala amagciwane okuqinile kwendawo yomjovo.B. Lapho ujova, sebenzisa inaliti kudivayisi yembobo efakelwayo, isirinji engu-10 mL noma ngaphezulu, ngomunwe wenkomba wesandla sokunxele uthinta indawo yokubhoboza futhi isithupha siqinise isikhumba ngenkathi ulungisa isihlalo somjovo, ngesandla sokudla sibambe isirinji. iqonde yenaliti, igweme ukuzamazama noma ukuphenduka, futhi ijove kancane kancane usawoti ongu-5 mL~10 mL uma kunomuzwa wokuwa futhi ichopho lonaliti ngokulandelayo lithinta phansi kwesihlalo somjovo, futhi uhlole ukuthi uhlelo lokulethwa kwezidakamizwa lubushelelezi yini. (uma kungenabushelelezi, kufanele uqale uhlole ukuthi inaliti ivinjiwe). Qaphela ukuthi akukho yini ukuphakama kwesikhumba esizungezile lapho uphusha.

C. Phusha umuthi we-chemotherapeutic kancane ngemva kokuqinisekisa ukuthi alikho iphutha. Phakathi nenqubo yokusunduza, qaphela ukuthi isikhumba esizungezile siphakeme noma siphaphathekile, nokuthi ingabe kukhona ubuhlungu bendawo. Ngemuva kokuthi umuthi uphushiwe, kufanele ugcinwe i-15s ~ 30s.

D. Ngemuva komjovo ngamunye, kuyanconywa ukuthi usule isihlalo somjovo kanye ne-catheter lumen ngo-6~8mL we-physiological saline, bese uvala i-catheter ngo-3mL~5mL ka-100U/mL~200U/mL we-heparin saline, nalapho okokugcina. I-0.5mL ye-heparin saline ijovwe, umuthi kufanele uphushwe ngenkathi uhlehla, ukuze uhlelo lokwethulwa komuthi lugcwaliswe nge-heparin saline ukuvikela ukucwebezela kwezidakamizwa kanye nokuhlangana kwegazi ku-catheter. I-catheter kufanele igezwe nge-heparin saline kanye njalo emavikini ama-2 ngesikhathi sokwelashwa ngamakhemikhali.

E. Ngemva komjovo, bulala amagciwane esweni yenaliti ngesibulali magciwane sezokwelapha, ulimboze ngendwangu eyinyumba, futhi unake ukugcina indawo yasendaweni ihlanzekile futhi yomile ukuze uvimbele ukutheleleka endaweni yokubhoboza.

F. Naka indlela isiguli esisabela ngayo ngemva kokuphathwa kwezidakamizwa futhi ubhekisise ngesikhathi sokujova umuthi.

 

【Isexwayiso, isexwayiso nokuqukethwe okuyela ngasocansini】

1. Lo mkhiqizo ukhishwa inzalo nge-ethylene oxide futhi usebenza iminyaka emithathu.
2. Sicela ufunde incwadi yeziqondiso ngaphambi kokuyisebenzisa ukuze uqinisekise ukuphepha kokuyisebenzisa.
3. Ukusetshenziswa kwalo mkhiqizo kufanele kuhambisane nezidingo zamakhodi okusebenza afanelekile kanye nemithethonqubo yomkhakha wezokwelapha, futhi ukufakwa, ukusebenza nokususwa kwalezi zisetshenziswa kufanele kukhawulelwe kodokotela abagunyaziwe. ivinjelwe kodokotela abaqinisekisiwe, futhi ukunakekelwa kwe-post-tube kufanele kwenziwe ngabasebenzi bezokwelapha abaqeqeshiwe.
4. Yonke inqubo kufanele yenziwe ngaphansi kwezimo ze-aseptic.
5. Hlola usuku lokuphelelwa yisikhathi komkhiqizo kanye nephakheji yangaphakathi ukuze uthole umonakalo ngaphambi kwenqubo.
6. Ngemva kokusetshenziswa, umkhiqizo ungase ubangele izingozi zebhayoloji. Sicela ulandele inkambiso yezokwelapha eyamukelwe kanye nayo yonke imithetho efanele neziqondiso zokuphatha nokwelashwa.
7. Ungasebenzisi amandla amaningi ngesikhathi sokufakelwa bese ufaka umthambo ngokunembile futhi ngokushesha ukuze ugweme i-vasospasm. Uma i-intubation inzima, sebenzisa iminwe yakho ukuze uvule i-catheter ukusuka ohlangothini ukuya kwelinye ngenkathi ufaka ithubhu.
8. Ubude be-catheter ebekwe emzimbeni kufanele bufanele, ubude kakhulu kulula ukugoqa ube yi-engeli, okuholela ekungeneni komoya okuncane, kufushane kakhulu lapho imisebenzi yobudlova yesiguli inethuba lokuphuma emkhunjini. Uma i-catheter imfushane kakhulu, ingase iphume emkhunjini lapho isiguli sihamba ngamandla.
9. I-catheter kufanele ifakwe emkhunjini enezintambo ezingaphezu kwezimbili kanye nokuqiniswa okufanele ukuze kuqinisekiswe umjovo wezidakamizwa obushelelezi nokuvimbela i-catheter ukuthi ingasheleli.
10. Uma isisetshenziswa sembobo esifakelwayo siwuhlobo II, ukuxhumana phakathi kwe-catheter nesihlalo somjovo kufanele kuqine. Uma kungadingeki umjovo womuthi we-intraoperative, umjovo ojwayelekile wokuhlola usawoti we-saline kufanele usetshenziselwe ukuqinisekiswa ngaphambi kokuthunga isikhumba.
11. Lapho uhlukanisa indawo engaphansi, i-hemostasis eseduze kufanele yenziwe ukuze kugwenywe ukwakheka kwe-hematoma yendawo, ukuqoqwa kwamanzi noma ukutheleleka kwesibili ngemva kokuhlinzwa; i-vesicular suture kufanele igweme isihlalo somjovo.
12. Izinamathiselo zezokwelapha ze-α-cyanoacrylate zingabangela ukulimala kwesisekelo somjovo; ungasebenzisi izinamathiselo zezokwelapha ze-α-cyanoacrylate lapho welapha i-incision yokuhlinza ezungeze isisekelo somjovo. Ungasebenzisi izinamathiselo zezokwelapha ze-α-cyanoacrylate lapho usebenza nezimbobo zokuhlinzwa eduze kwesisekelo somjovo.
13. Sebenzisa ukuqapha okukhulu ukuze ugweme ukuvuza kwe-catheter ngenxa yokulimala ngengozi kwezinto zokuhlinza.
14. Lapho ubhoboza, inaliti kufanele ifakwe iqonde phezulu, isirinji enamandla angu-10mL noma ngaphezulu kufanele isetshenziswe, umuthi kufanele ujovwe kancane, futhi inaliti kufanele ihoxiswe ngemva kokumisa isikhashana. Ingcindezi yokuphusha akufanele ibe ngaphezu kuka-200kPa.
15. Sebenzisa kuphela izinaliti ezikhethekile zemishini yokulethwa kwezidakamizwa efakelwayo.
16. Uma ukumnika okude noma ukushintshwa kwezidakamizwa kudingekile, kuyafaneleka ukusebenzisa idivayisi yokulethwa kwezidakamizwa esetshenziswa kanye kanye enenaliti ekhethekile yokufaka ipayipi noma i-tee, ukuze kwehliswe inani lokubhoboza futhi kuncishiswe umthelela esigulini.
17. Yehlisa inani lama-punctures, unciphise ukulimala kwezicubu zesiguli kanye nezingxenye zokunwebeka zokuzivala. Ngesikhathi sokuyekiswa komjovo wezidakamizwa, umjovo we-anticoagulant uyadingeka kanye njalo emavikini amabili.
18. Lo mkhiqizo uwumkhiqizo osetshenziswa kanye, oyinyumba, ongeyona i-pyrogenic, ocekelwe phansi ngemva kokusetshenziswa, ukusetshenziswa kabusha akuvunyelwe ngokuphelele.
19. Uma iphakheji yangaphakathi yonakele noma usuku lokuphelelwa yisikhathi lomkhiqizo lweqiwe, sicela ulibuyisele kumkhiqizi ukuze lilahlwe.
20. Inani lama-puncture ebhulokhi ngalinye lomjovo akufanele lidlule ku-2000 (22Ga). 21.
21. Ivolumu encane yokuguquguquka yi-6ml