Igazi elilahlwayo alinaluthoi-hemodialysis catheterkanye nezinsiza Ezilahlwayo oyinyumbai-hemodialysis catheterukwakheka kokusebenza komkhiqizo kanye nokubunjwa kwalo mkhiqizo wenziwe ithiphu elithambile, isihlalo sokuxhuma, ishubhu yokwandisa kanye nesokhethi yekhoni;I-catheter yenziwe nge-polyurethane yezokwelapha ne-polycarbonate.Kuyi-catheter eyodwa, i-catheter ye-catheter emithathu.Lo mkhiqizo usetshenziselwa ukwelapha i-hemodialysis kanye nokumnika.Imininingwane yemodeli yesikhala esiphindwe kabili, i-cavity emithathu
Ipayipi lomhubhe elinejakhethi ye-dacron
Ngokuguga komphakathi, umfutho wegazi ophakeme, isifo sikashukela, isifo senhliziyo (i-CHD) eneziguli ezihluleka kwezinso zanda, isimo se-vascular sibi, i-autogenous arteriovenous fistula yangaphakathi izigameko eziphakeme kakhulu zezinkinga, zithinta kakhulu umphumela wokwelapha we-dialysis kanye nekhwalithi yokuphila. , ngakho-ke thatha i-polyester belt tunnel catheter noma i-catheter isikhathi eside, isetshenziswe kabanzi emhlabeni, inzuzo yayo: I-catheter ine-biocompatibility enhle, futhi i-catheter ingalungiswa ngokuqinile ngesikhumba.Umkhono wayo we-polyester ungakha umgoqo ovaliwe webhaktheriya emhubheni ongaphansi kwesikhumba, unciphise ukwenzeka kokutheleleka futhi kwandise kakhulu isikhathi sokusebenzisa.
Ukusetshenziswa kanye nokugcinwa kwe-catheter ye-hemodialysis
1. Ubuhlengikazi kanye nokuhlolwa kwama-catheter
1. Isikhumba se-Catheter
Ngaphambi nangemva kokusetshenziswa ngakunye, ukubukeka kwesikhumba sesikhumba endaweni ye-intubation kufanele kuhlolwe ubomvu, ukufihla, ukuzwela, ukopha nokuphuma, njll. Uma kuyi-catheter yesikhashana, hlola ukulungiswa kwenaliti ye-suture.Uma kuyi-catheter yesikhathi eside, bheka ukuthi i-CAFF idonsiwe noma iphumile.
2. Ilunga langaphandle le-catheter
Kungakhathaliseki ukuthi kukhona ukuphuka noma ukuphuka, izinga le-patency ye-lumen, uma kutholakala ukugeleza kwegazi okwanele, kufanele kubikwe kudokotela ngesikhathi, futhi ukwakheka kwe-thrombus ne-fibrin sheath ku-catheter kufanele kunqunywe nge-ultrasound, imaging kanye ezinye izindlela.
3. Izimpawu zesiguli
Ukuthi izimpawu nezinga lomkhuhlane, ukugodola, ubuhlungu kanye nezinye izikhalazo zokungaphatheki kahle.
2. Inqubo yokusebenza yokuxhuma
1. Ukulungiselela
(1) Umshini we-dialysis uphumelele ukuzihlola, ipayipi le-dialysis seligezwe ngaphambili futhi lisesimweni sokulinda.
(2) Ukulungiselela: inqola yokwelapha noma ithreyi yokwelapha, izinto zokubulala amagciwane (iodophor noma i-chlorhexidine), izinto eziyinyumba (ithawula lokwelapha, i-gauze, isirinji, amagilavu okuhlanza, njll.).
(3) Isiguli kufanele sibekwe endaweni enethezekile ye-supine, futhi isiguli esine-intubation yentamo kufanele sigqoke imaski ukuze siveze indawo yokufaka intubation.
2. Inqubo
(1) Vula indwangu yangaphandle yombhobho we-venous catheter.
(2) Gqoka amagilavu.
(3) Vula u-1/4 ohlangothini lwethawula lokwelapha oyinyumba bese ulibeka ngaphansi kwe-double-lumen catheter yomthambo omaphakathi.
(4) Ukukhipha amagciwane ngesikulufu sekepisi lokuvikela i-catheter, umlomo we-catheter kanye ne-catheter clamp izikhathi ezi-2 ngokulandelanayo.
(5) Hlola ukuthi i-catheter clamp iboshiwe yini, khipha inati, bese ulilahla.Beka i-catheter eyinzalo ohlangothini lwe-1/2 oluyinyumba lwethawula lokwelapha.
(6) Khipha amagciwane umlomo wombhobho futhi ngaphambi kokuhlinzwa.
(7) Isixazululo se-heparin se-intracatheter esingu-2mL saphindiselwa emuva ngesipetu esingu-2-5ml sase siphushwa ku-gauze.
(8) Hlola ukuthi akhona yini amahlule ku-gauze.Uma kukhona amahlule, khipha u-1ml futhi bese uphusha umjovo.Ibanga phakathi komjovo ne-gauze likhulu kuno-10cm.
(9) Ngemva kokwahlulela ukuthi i-catheter ayivimbekile, xhuma imithambo yegazi kanye namapayipi emithanjeni okujikeleza okungaphandle komzimba ukuze kutholakale ukujikeleza kwe-extracorporeal.
3. Qeda ukusebenza kokuvalwa kweshubhu ngemva kokukhishwa kwe-dialysis
(1) Ngemva kokwelashwa nokubuya kwegazi, qinisa intambo ye-catheter, bulala amagciwane ejoyintini le-arteriovenous catheter, futhi unqamule ilunga nepayipi lokujikeleza.
(2) Khipha amagciwane umthambo womthambo kanye nomthambo we-catheter ngokulandelana, bese ucindezela u-10ml we-saline evamile ukuze ugeze i-catheter ngendlela ye-pulse.Ngemva kokubheka ngeso lenyama, kwakungekho nsalela yegazi engxenyeni eveziwe ye-catheter, phusha uketshezi lwe-anticoagulant sealing nge-pellet njengoba eyalelwe udokotela.(3) Sebenzisa ikepisi ye-heparin oyinyumba ukuze uvale ukuvuleka kweshubhu le-arteriovenous kanye nezingqimba ezimbili ze-gauze oyinyumba ukuyisonga.Kulungisiwe.
3. Ukushintsha kokugqoka kwe-catheter ye-venous emaphakathi
1. Hlola ukuthi ingubo yomile, igazi namabala.
2. Gqoka amagilavu.
3. Vula okokugqoka bese ubheka ukuthi akukho yini ukopha, ukuphuma kwamanzi, ububomvu nokuvuvukala, ukulimala kwesikhumba nokuchitheka komsele endaweni lapho kubekwe khona umthambo we-venous ophakathi.
4. Thatha i-iodophor cotton swab bese uyizungezisa ngokwewashi ukuze ukhiphe amagciwane endaweni lapho ishubhu lifakwe khona.Ububanzi be-disinfecting buyi-8-10cm.
5. Namathisela indwangu yesilonda esikhumbeni endaweni lapho ishubhu libekwe khona, futhi ubonise isikhathi sokushintsha ukugqokwa.Ukusetshenziswa kanye nokugcinwa kwe-catheter
1. Ubuhlengikazi kanye nokuhlolwa kwama-catheter
1. Isikhumba se-Catheter
Ngaphambi nangemva kokusetshenziswa ngakunye, ukubukeka kwesikhumba sesikhumba endaweni ye-intubation kufanele kuhlolwe ubomvu, ukufihla, ukuzwela, ukopha nokuphuma, njll. Uma kuyi-catheter yesikhashana, hlola ukulungiswa kwenaliti ye-suture.Uma kuyi-catheter yesikhathi eside, bheka ukuthi i-CAFF idonsiwe noma iphumile.
2. Ilunga langaphandle le-catheter
Kungakhathaliseki ukuthi kukhona ukuphuka noma ukuphuka, izinga le-patency ye-lumen, uma kutholakala ukugeleza kwegazi okwanele, kufanele kubikwe kudokotela ngesikhathi, futhi ukwakheka kwe-thrombus ne-fibrin sheath ku-catheter kufanele kunqunywe nge-ultrasound, imaging kanye ezinye izindlela.
3. Izimpawu zesiguli
Ukuthi izimpawu nezinga lomkhuhlane, ukugodola, ubuhlungu kanye nezinye izikhalazo zokungaphatheki kahle.
2. Inqubo yokusebenza yokuxhuma
1. Ukulungiselela
(1) Umshini we-dialysis uphumelele ukuzihlola, ipayipi le-dialysis seligezwe ngaphambili futhi lisesimweni sokulinda.
(2) Ukulungiselela: inqola yokwelapha noma ithreyi yokwelapha, izinto zokubulala amagciwane (iodophor noma i-chlorhexidine), izinto eziyinyumba (ithawula lokwelapha, i-gauze, isirinji, amagilavu okuhlanza, njll.).
(3) Isiguli kufanele sibekwe endaweni enethezekile ye-supine, futhi isiguli esine-intubation yentamo kufanele sigqoke imaski ukuze siveze indawo yokufaka intubation.
2. Inqubo
(1) Vula indwangu yangaphandle yombhobho we-venous catheter.
(2) Gqoka amagilavu.
(3) Vula u-1/4 ohlangothini lwethawula lokwelapha oyinyumba bese ulibeka ngaphansi kwe-double-lumen catheter yomthambo omaphakathi.
(4) Ukukhipha amagciwane ngesikulufu sekepisi lokuvikela i-catheter, umlomo we-catheter kanye ne-catheter clamp izikhathi ezi-2 ngokulandelanayo.
(5) Hlola ukuthi i-catheter clamp iboshiwe yini, khipha inati, bese ulilahla.Beka i-catheter eyinzalo ohlangothini lwe-1/2 oluyinyumba lwethawula lokwelapha.
(6) Khipha amagciwane umlomo wombhobho futhi ngaphambi kokuhlinzwa.
(7) Isixazululo se-heparin se-intracatheter esingu-2mL saphindiselwa emuva ngesipetu esingu-2-5ml sase siphushwa ku-gauze.
(8) Hlola ukuthi akhona yini amahlule ku-gauze.Uma kukhona amahlule, khipha u-1ml futhi bese uphusha umjovo.Ibanga phakathi komjovo ne-gauze likhulu kuno-10cm.
(9) Ngemva kokwahlulela ukuthi i-catheter ayivimbekile, xhuma imithambo yegazi kanye namapayipi emithanjeni okujikeleza okungaphandle komzimba ukuze kutholakale ukujikeleza kwe-extracorporeal.
3. Qeda ukusebenza kokuvalwa kweshubhu ngemva kokukhishwa kwe-dialysis
(1) Ngemva kokwelashwa nokubuya kwegazi, qinisa intambo ye-catheter, bulala amagciwane ejoyintini le-arteriovenous catheter, futhi unqamule ilunga nepayipi lokujikeleza.
(2) Khipha amagciwane umthambo womthambo kanye nomthambo we-catheter ngokulandelana, bese ucindezela u-10ml we-saline evamile ukuze ugeze i-catheter ngendlela ye-pulse.Ngemva kokubheka ngeso lenyama, kwakungekho nsalela yegazi engxenyeni eveziwe ye-catheter, phusha uketshezi lwe-anticoagulant sealing nge-pellet njengoba eyalelwe udokotela.(3) Sebenzisa ikepisi ye-heparin oyinyumba ukuze uvale ukuvuleka kweshubhu le-arteriovenous kanye nezingqimba ezimbili ze-gauze oyinyumba ukuyisonga.Kulungisiwe.
3. Ukushintsha kokugqoka kwe-catheter ye-venous emaphakathi
1. Hlola ukuthi ingubo yomile, igazi namabala.
2. Gqoka amagilavu.
3. Vula okokugqoka bese ubheka ukuthi akukho yini ukopha, ukuphuma kwamanzi, ububomvu nokuvuvukala, ukulimala kwesikhumba nokuchitheka komsele endaweni lapho kubekwe khona umthambo we-venous ophakathi.
4. Thatha i-iodophor cotton swab bese uyizungezisa ngokwewashi ukuze ukhiphe amagciwane endaweni lapho ishubhu lifakwe khona.Ububanzi be-disinfecting buyi-8-10cm.
5. Namathisela indwangu yesilonda esikhumbeni endaweni lapho ishubhu libekwe khona, futhi ubonise isikhathi sokushintsha ukugqokwa.
Isikhathi sokuthumela: Feb-25-2022