Ịdị ọcha nke ọbara enwere ike iwepụhemodialysis catheteryana ngwa enwere ike iwepu yahemodialysis catheternhazi arụmọrụ ngwaahịa na ihe mejupụtara ngwaahịa a bụ nke dị nro, oche njikọ, eriri ndọtị na oghere cone; A na-eji polyurethane ọgwụ na polycarbonate mee catheter. Ọ bụ otu oghere, oghere okpukpu abụọ na catheter oghere atọ. A na-eji ngwaahịa a eme ihe maka hemodialysis na infusion. Ụdị nkọwapụta oghere okpukpu abụọ, oghere atọ
Ọwara ọwara nwere jaket dacron
Site na ịka nká nke ọha mmadụ, ọbara mgbali elu, ọrịa shuga, ọrịa obi na-arịa ọrịa obi (CHD) na ndị ọrịa gbasara akụrụ na-abawanye, ọnọdụ vaskụla adịghị mma, autogenous arteriovenous internal fistula budata nnukwu nsogbu nke nsogbu, na-emetụta mmetụta ọgwụgwọ dialysis nke onye ọrịa na ndụ ndụ. , Ya mere, were polyester belt tunnel catheter ma ọ bụ catheter ruo ogologo oge, ejirila ya mee ihe n'ụwa, uru ya bụ: catheter nwere ezigbo bioacompatibility, na catheter nwere ike idozi ya na akpụkpọ ahụ. Aka uwe polyester ya nwere ike ịmepụta ihe mgbochi nje mechiri emechi na ọwara subcutaneous, na-ebelata ọnọdụ nke ọrịa na ogologo oge iji.
Iji na mmezi nke hemodialysis catheters
1. Nọọsụ na nyocha nke catheters
1. Catheter akpụkpọ anụ
Tupu na mgbe ejiri nke ọ bụla mee ihe, a ga-enyocha ọdịdị akpụkpọ anụ na saịtị intubation maka ọbara ọbara, nzuzo, nro, ọbara ọgbụgba na exudation, wdg Ọ bụrụ na ọ bụ catheter nwa oge, lelee nhazi nke agịga suture. Ọ bụrụ na ọ bụ catheter dị ogologo oge, lelee ma CAFF dọtara ma ọ bụ pụta.
2. Njikọ dị n'èzí nke catheter
Ma enwere mgbawa ma ọ bụ nkwụsịtụ, ogo nke patency nke lumen, ma ọ bụrụ na ahụghị ọbara na-ezughị ezu, a ga-akọrọ dọkịta ya n'oge, na thrombus na fibrin sheath formation na catheter kwesịrị ikpebi site na ultrasound, imaging na ụzọ ndị ọzọ.
3. Nrịbama ndị ọrịa
Ma mgbaàmà na ogo nke ahụ ọkụ, oyi, mgbu na mkpesa ndị ọzọ nke ahụ erughị ala.
2. Usoro ọrụ njikọ
1. Nkwadebe
(1) Igwe dialysis agafeela nyocha nke onwe, ọkpọkọ dialysis ebutela ụzọ ma dị na steeti njikere.
(2) Nkwadebe: ụgbọ ala ọgwụgwọ ma ọ bụ tray ọgwụgwọ, ihe disinfection (iodophor ma ọ bụ chlorhexidine), ihe na-adịghị mma (akwa nhicha, gauze, sirinji, nhicha mkpuchi, wdg).
(3) Ekwesịrị idobe onye ọrịa ahụ n'ọnọdụ dị mma, onye ọrịa nwere intubation olu kwesịrị iyi ihe mkpuchi iji kpughee ọnọdụ intubation.
2. Usoro
(1) Mepee uwe mpụta nke catheter etiti venous.
(2) Yiri uwe aka.
(3) Mepee akụkụ 1/4 nke towel ọgwụgwọ sterile ma tinye ya n'okpuru catheter okpukpu abụọ nke lumen nke etiti vein.
(4) Kpochie mkpochapụ nke mkpuchi mkpuchi catheter, ọnụ catheter na mpịachi catheter ugboro abụọ n'otu n'otu.
(5) Lelee na ihe mgbochi catheter na-akụchi, wepụ akị ahụ, tụfuo ya. Debe catheter igba ogwu n'akụkụ 1/2 na-adịghị mma nke towel ọgwụgwọ.
(6) Gbanyụọ nozzle ọzọ tupu arụ ọrụ.
(7) 2mL intracatheter sealing heparin solution ka ejiri sirinji 2-5ml gbagoro azụ ma tụba ya na gauze.
(8) Lelee ma enwere mkpụkọ na gauze. Ọ bụrụ na enwere mkpụkọ, wepụ 1ml ọzọ ma gbanye ntụtụ ahụ. Ebe dị n'etiti injection na gauze karịrị 10cm.
(9) Mgbe emechara ikpe na catheter adịghị egbochi, jikọọ akwara na akwara nke mgbasa nke extracorporeal iji guzobe mgbasa ozi extracorporeal.
3. Kwụsị ọrụ mkpuchi tube mgbe dialysis gasịrị
(1) Mgbe ọgwụgwọ ahụ gasịrị na nlọghachi ọbara, kụchie eriri catheter, kpochapụ nkwonkwo catheter arteriovenous, ma kwụpụ njikọ ahụ na pipeline mgbasa ozi.
(2) Wepu ihe ntinye nke akwara na akwara nke catheter n'otu n'otu, ma gbanye 10ml saline nkịtị ka ọ sachaa catheter site na usoro pulse. Mgbe nlebanya anya gba ọtọ, ọ nweghị ihe fọdụrụ n'ọbara adịghị n'akụkụ ekpughere nke catheter ahụ, jiri pellet tinye mmiri na-egbochi mgbochi ọrịa dịka onye dọkịta gwara ya. (3) Jiri okpu heparin na-adịghị mma mechie oghere nke tube arteriovenous yana akwa gauze na-adịghị mma nke okpukpu abụọ iji kechie ya. Edoziri.
3. Mgbanwe ejiji nke etiti venous catheter
1. Lelee ma uwe mwụda akọrọ, ọbara na ntụpọ.
2. Yiri uwe aka.
3. Mepee uwe ahụ wee lelee ma enwere ọbara ọgbụgba, ọpụpụ, ọbara ọbara na ọzịza, mmebi akpụkpọ ahụ na ịkwasa suture n'ebe etinyere catheter etiti venous.
4. Were iodophor owu swab wee tụgharịa ya n'akụkụ elekere iji kpochapụ ebe etinyere tube. Oke disinfecting bụ 8-10 cm.
5. Tapawa mgbakwasa ọnya na akpụkpọ ahụ n'ebe a na-etinye tube ahụ, ma gosi oge mgbanwe ejiji. Iji na mmezi nke catheters
1. Nọọsụ na nyocha nke catheters
1. Catheter akpụkpọ anụ
Tupu na mgbe ejiri nke ọ bụla mee ihe, a ga-enyocha ọdịdị akpụkpọ anụ na saịtị intubation maka ọbara ọbara, nzuzo, nro, ọbara ọgbụgba na exudation, wdg Ọ bụrụ na ọ bụ catheter nwa oge, lelee nhazi nke agịga suture. Ọ bụrụ na ọ bụ catheter dị ogologo oge, lelee ma CAFF dọtara ma ọ bụ pụta.
2. Njikọ dị n'èzí nke catheter
Ma enwere mgbawa ma ọ bụ nkwụsịtụ, ogo nke patency nke lumen, ma ọ bụrụ na ahụghị ọbara na-ezughị ezu, a ga-akọrọ dọkịta ya n'oge, na thrombus na fibrin sheath formation na catheter kwesịrị ikpebi site na ultrasound, imaging na ụzọ ndị ọzọ.
3. Nrịbama ndị ọrịa
Ma mgbaàmà na ogo nke ahụ ọkụ, oyi, mgbu na mkpesa ndị ọzọ nke ahụ erughị ala.
2. Usoro ọrụ njikọ
1. Nkwadebe
(1) Igwe dialysis agafeela nyocha nke onwe, ọkpọkọ dialysis ebutela ụzọ ma dị na steeti njikere.
(2) Nkwadebe: ụgbọ ala ọgwụgwọ ma ọ bụ tray ọgwụgwọ, ihe disinfection (iodophor ma ọ bụ chlorhexidine), ihe na-adịghị mma (akwa nhicha, gauze, sirinji, nhicha mkpuchi, wdg).
(3) Ekwesịrị idobe onye ọrịa ahụ n'ọnọdụ dị mma, onye ọrịa nwere intubation olu kwesịrị iyi ihe mkpuchi iji kpughee ọnọdụ intubation.
2. Usoro
(1) Mepee uwe mpụta nke catheter etiti venous.
(2) Yiri uwe aka.
(3) Mepee akụkụ 1/4 nke towel ọgwụgwọ sterile ma tinye ya n'okpuru catheter okpukpu abụọ nke lumen nke etiti vein.
(4) Kpochie mkpochapụ nke mkpuchi mkpuchi catheter, ọnụ catheter na mpịachi catheter ugboro abụọ n'otu n'otu.
(5) Lelee na ihe mgbochi catheter na-akụchi, wepụ akị ahụ, tụfuo ya. Debe catheter igba ogwu n'akụkụ 1/2 na-adịghị mma nke towel ọgwụgwọ.
(6) Gbanyụọ nozzle ọzọ tupu arụ ọrụ.
(7) 2mL intracatheter sealing heparin solution ka ejiri sirinji 2-5ml gbagoro azụ ma tụba ya na gauze.
(8) Lelee ma enwere mkpụkọ na gauze. Ọ bụrụ na enwere mkpụkọ, wepụ 1ml ọzọ ma gbanye ntụtụ ahụ. Ebe dị n'etiti injection na gauze karịrị 10cm.
(9) Mgbe emechara ikpe na catheter adịghị egbochi, jikọọ akwara na akwara nke mgbasa nke extracorporeal iji guzobe mgbasa ozi extracorporeal.
3. Kwụsị ọrụ mkpuchi tube mgbe dialysis gasịrị
(1) Mgbe ọgwụgwọ ahụ gasịrị na nlọghachi ọbara, kụchie eriri catheter, kpochapụ nkwonkwo catheter arteriovenous, ma kwụpụ njikọ ahụ na pipeline mgbasa ozi.
(2) Wepu ihe ntinye nke akwara na akwara nke catheter n'otu n'otu, ma gbanye 10ml saline nkịtị ka ọ sachaa catheter site na usoro pulse. Mgbe nlebanya anya gba ọtọ, ọ nweghị ihe fọdụrụ n'ọbara adịghị n'akụkụ ekpughere nke catheter ahụ, jiri pellet tinye mmiri na-egbochi mgbochi ọrịa dịka onye dọkịta gwara ya. (3) Jiri okpu heparin na-adịghị mma mechie oghere nke tube arteriovenous yana akwa gauze na-adịghị mma nke okpukpu abụọ iji kechie ya. Edoziri.
3. Mgbanwe ejiji nke etiti venous catheter
1. Lelee ma uwe mwụda akọrọ, ọbara na ntụpọ.
2. Yiri uwe aka.
3. Mepee uwe ahụ wee lelee ma enwere ọbara ọgbụgba, ọpụpụ, ọbara ọbara na ọzịza, mmebi akpụkpọ ahụ na ịkwasa suture n'ebe etinyere catheter etiti venous.
4. Were iodophor owu swab wee tụgharịa ya n'akụkụ elekere iji kpochapụ ebe etinyere tube. Oke disinfecting bụ 8-10 cm.
5. Tapawa mgbakwasa ọnya na akpụkpọ ahụ n'ebe a na-etinye tube ahụ, ma gosi oge mgbanwe ejiji.
Oge nzipu: Feb-25-2022