【Contraindications】

1) Mupfungwa kana muviri kusakodzera kuvhiyiwa mumamiriro ezvinhu

2) Kubuda ropa kwakanyanya uye coagulation kusagadzikana.

3) Sero jena reropa risingasviki 3 × 109/L

4) Allergic kusiyanisa midhiya

5) Yakasanganiswa nechirwere chakasimba chisingaperi chinobstructive pulmonary.

6) Varwere vane vanozivikanwa kana vanofungidzirwa allergy kune zvinhu zviri mumudziyo wepakeji..

7) Kuvapo kana kufungidzira kwehutachiona-hune hutachiona, bacteraemia kana sepsis.

8) Radiotherapy panzvimbo yekuda kuiswa.

9) Kufananidza kana jekiseni remishonga embolic.

 

【Manufacturedate】 Ona chigadzirwa label

 

【Expirydate】 Ona chigadzirwa label

 

【Nzira yekushandisa】

1. Gadzirira mudziyo unogoneka wechiteshi uye tarisa kana zuva rekupera rakapfuura; bvisa pasuru yemukati uye tarisa kana pasuru yacho yakuvadzwa.
2. Unofanira kushandisa aseptic matekiniki kucheka kuvhura yemukati pasuru uye kubvisa chigadzirwa kugadzirira kushandisa.
3. Iko kushandiswa kwemidziyo inoiswa pachiteshi inotsanangurwa zvakasiyana kune yega yega modhi sezvinotevera.

 

TypeⅠ

1. Flushing, venting, leak test

Shandisa jekiseni (tsono yemudziyo unosimira pachiteshi) kubaya mudziyo unosimira pachiteshi uye jekiseni 5mL-10mL yesaline yemuviri kugezesa chigaro chejekiseni uye catheter lumen uye kusabvisa. Kana pasina kana mvura inononoka inowanikwa, shandura kuguma kwemishonga yekatheter (distal end) neruoko kuti uzarure chiteshi chekutakura zvinodhaka; ipapo Fold yakavhara kuguma kwekutengesa kwemishonga ye catheter, ramba uchisundira saline (kudzvinyirira kusingapfuuri 200kPa), cherechedza kana pane kubuda kubva pachigaro chejekiseni uye catheter connection, mushure mezvose zvakajairika Mushure mokunge zvinhu zvose zvakajairika, catheter inogona kushandiswa.

1. Cannulation uye ligation

Zvinoenderana nekuferefetwa kwemukati, isa iyo catheter (kuburitsa zvinodhaka kupera) mumudziyo unoenderana wekupa ropa zvinoenderana nenzvimbo yebundu, uye shandisa isingabatike sutures kuti inyatso sunga catheter kumudziyo. Iyo catheter inofanirwa kusungirirwa zvakanaka (mbiri kana kupfuura kupfuura) uye yakagadziriswa.

1. chemotherapy uye kuvhara

Intraoperative chemotherapy drug inogona kubaiwa kamwe maererano nechirongwa chekurapa; zvinokurudzirwa kuti chigaro chejekiseni uye catheter lumen zvigezwe ne 6-8 mL ye physiological saline, ichiteverwa ne 3 mL ~ 5 mL Catheter inobva yavharwa ne 3mL kusvika 5mL ye heparin saline pa 100U / mL kusvika 200U / mL.

1. Jekiseni chigaro kugadzirisa

A subcutaneous cystic cavity inogadzirwa panzvimbo yerutsigiro, iri 0.5 cm kusvika 1 cm kubva paganda repamusoro, uye chigaro chejekiseni chinoiswa mugomba uye chakagadziriswa, uye ganda rinoshongedzwa mushure mekuoma hemostasis. Kana iyo catheter yakarebesa, inogona kusungirirwa kuita denderedzwa kumagumo ekupedzisira uye yakagadziriswa nemazvo.

 

TypeⅡ

1.Kufefetedza nekuburitsa mweya

Shandisa jekiseni (tsono yemudziyo unopinzwa pachiteshi) kubaya saline muchigaro chejekiseni nekatheta zvakateerana kupuruzira nekubvisa mweya uri mulumen, uye tarisa kuti conduction fluid yakatsetseka.

2. Cannulation uye ligation

4. Leak test

4. Mushure mekunge kubatanidzwa kwapera, peta uye uvhare catheter kuseri kwekuvhara clip uye ramba uchiisa saline muchigaro chejekiseni nejekiseni (tsono yeimplantable drug delivery device) (pressure over 200kPa). (kudzvanya kusingadarike 200kPa), tarisa kana paine kubuda kubva mujekiseni block uye catheter

kubatanidza, uye shandisa chete mushure mekunge zvese zvakajairika.

5. Chemotherapy, kuvhara chubhu

Intraoperative chemotherapy drug inogona kubaiwa kamwe maererano nechirongwa chekurapa; zvinokurudzirwa kugezesa gasi rejekiseni uye catheter lumen ine 6 ~ 8mL ye physiological saline zvakare, uyezve kushandisa 3mL ~ 5mL ye physiological saline.

Catheter inobva yavharwa ne3mL kusvika 5mL yeheparin saline pa100U/mL kusvika 200U/mL.

6. Kugadzirisa chigaro chejekiseni

A subcutaneous cystic cavity yakasikwa panzvimbo yekutsigira, 0.5 cm kusvika 1 cm kubva pamusoro peganda, uye chigaro chejekiseni chakaiswa mugomba uye chakagadziriswa, uye ganda rakaiswa sutured mushure mekuoma kwehemostasis.

 

Type Ⅲ

Jekiseni (tsono inokosha yemudziyo unosimwa pachiteshi) yakashandiswa kubaya 10mL ~ 20mL yakajairika saline mumudziyo unoisirwa mushonga wekuendesa zvinodhaka kukwesha chigaro chejekiseni uye mhango yecatheter, uye kubvisa mweya mugomba, uye kuona kana mvura yacho. yakanga isingaonekwi.

2. Cannulation uye ligation

Zvinoenderana nekuongorora kwe intraoperative, isa catheter pamadziro edumbu, uye iyo yakavhurika chikamu chekupera kwemishonga yekuburitsa catheter inofanira kupinda mudumbu remukati uye kuve pedyo nebundu rakananga sezvinobvira. Sarudza 2-3 mapoinzi ekubatanidza uye kugadzirisa iyo catheter.

3. chemotherapy, kuvhara chubhu

Intraoperative chemotherapy drug inogona kubaiwa kamwe maererano nechirongwa chekurapa, uye ipapo chubhu inonamwa ne3mL ~ 5mL ye100U/mL ~ 200U/mL heparin saline.

4. Kugadzirisa chigaro chejekiseni

A subcutaneous cystic cavity yakasikwa panzvimbo yekutsigira, 0.5 cm kusvika 1 cm kubva pamusoro peganda, uye chigaro chejekiseni chakaiswa mugomba uye chakagadziriswa, uye ganda rakaiswa sutured mushure mekuoma kwehemostasis.

Mishonga infusion uye kutarisirwa

A.Yakanyanya aseptic oparesheni, kusarudzwa kwakaringana kwenzvimbo yechigaro chejekiseni pamberi pejekiseni, uye kuuraya utachiona kwakasimba kwenzvimbo yejekiseni.B. Pakuisa jekiseni, shandisa tsono yemudziyo unopinzwa pachiteshi, jekiseni re10 mL kana kudarika, nechigunwe cheruboshwe chinobata panobaya uye chigunwe chichisimbisa ganda paunenge uchigadzira chigaro chejekiseni, neruoko rwerudyi rwakabata sirinji. zvakadzika mutsono, kudzivisa kuzununguka kana kutenderera, uye zvishoma nezvishoma kubaya saline 5 mL ~ 10 mL kana paine pfungwa yekudonha uye muromo wetsono unobva wabata pasi pechigaro chejekiseni, uye tarisa kana chirongwa chekuendesa zvinodhaka chiri kutsetseka. (kana isina kutsvedzerera, unofanira kutanga watarisa kana tsono yakavharwa). Tarisa kana paine kukwirira kweganda rakatenderedza paunenge uchisunda.

C. Sunda mushonga wekemotherapeutic zvishoma nezvishoma mushure mekuratidza kuti hapana kukanganisa. Munguva yekusundidzira, teerera kuti uone kana ganda rakapoteredza rakasimudzwa kana kuti rakachenuruka, uye kana kune marwadzo emunharaunda. Mushure mekunge mushonga wasundirwa, unofanirwa kuchengetwa kwe15s ~ 30s.

D. Mushure mejekiseni rega rega, zvinokurudzirwa kugezesa chigaro chejekiseni uye catheter lumen ine 6 ~ 8mL ye physiological saline, uye wobva wasimbisa catheter ne 3mL ~ 5mL ye 100U/mL ~ 200U/mL ye heparin saline, uye kana yekupedzisira. 0.5mL yeheparin saline inobayiwa, mushonga unofanirwa kusundidzirwa uchidzokera shure, kuitira kuti mushonga wekusuma mushonga uzadzwe neheparin saline kudzivirira crystallization yezvinodhaka uye kugadzika kweropa mucatheter. Iyo catheter inofanirwa kugezwa neheparin saline kamwe chete kwemavhiki maviri mukati menguva yechemotherapy.

E. Mushure mekubaya jekiseni, urayai utachiona paziso retsono nemishonga inouraya utachiona, vharai nemapfekero asina utachiona, uye teererai kuchengetedza nzvimbo yemunharaunda yakachena uye yakaoma kudzivirira utachiona panzvimbo inobaya.

F. Nyatsocherechedza kuita kwemurwere mushure mekushandisa zvinodhaka uye nyatsocherechedza panguva yejekiseni rezvinodhaka.

 

【Yambiro, yambiro uye zvinokurudzira zvemukati】

1. Ichi chigadzirwa chinoitwa sterilized ne ethylene oxide uye inoshanda kwemakore matatu.
2. Ndokumbira uverenge bhuku rekuraira usati washandisa kuti uve nechokwadi chekuchengetedzwa kwekushandisa.
3. Kushandiswa kwechigadzirwa ichi kunofanira kuenderana nezvinodiwa zvemitemo yakakodzera yekudzidzira uye mitemo yebazi rezvokurapa, uye kuiswa, kushanda uye kubviswa kwezvigadziri izvi kunofanira kungoitwa kune vanachiremba vane ruzivo.Kuiswa, kushanda uye kubviswa kwezvigadziri izvi ndezvi inongogumira kune vanachiremba vane mbiri, uye post-tube kutarisirwa kunofanira kuitwa nevanorapa vanokwanisa.
4. Iyo yese nzira inofanirwa kuitwa pasi pemamiriro easeptic.
5. Tarisa zuva rekupera kwechigadzirwa uye yemukati kurongedza kwekukuvara kusati kwaitwa.
6. Mushure mekushandisa, chigadzirwa chinogona kukonzera biological njodzi. Ndokumbira uteedzere maitiro ekurapa anogamuchirwa uye mitemo yese yakakodzera uye mirau yekubata nekurapwa.
7. Usashandise simba rakawandisa panguva yekupinza uye isa arteri nenzira kwayo uye nekukurumidza kudzivirira vasospasm. Kana intubation yakaoma, shandisa zvigunwe zvako kushandura catheter kubva kune rumwe rutivi uchiisa chubhu.
8. Kureba kwecatheter yakaiswa mumuviri kunofanirwa kuve kwakakodzera, kurebesa kuri nyore kupeta mukona, zvichikonzera kushaikwa kwemhepo, kupfupika ndiko apo murwere mabasa echisimba ane mukana wekubvisa kubva mumudziyo. Kana iyo catheter ipfupi, inogona kubuda mumudziyo apo murwere anofamba nesimba.
9. Iyo catheter inofanirwa kuisirwa mumudziyo neanopfuura maviri ligature uye kusimba kwakakodzera kuti ive nechokwadi chejekiseni rakatsetseka rezvinodhaka uye kudzivirira catheter kubva pakutsvedza.
10. Kana iyo inosimwa chiteshi chengarava iri mhando II, kubatana pakati pecatheter nechigaro chejekiseni kunofanirwa kuve kwakasimba. Kana jekiseni remushonga rinoitwa intraoperative risingadiwi, jekiseni rejekiseni resaline rakajairwa rinofanira kushandiswa kusimbisa risati rasveta ganda.
11. Pakuparadzanisa nzvimbo ye subcutaneous, kuvhara hemostasis kunofanira kuitwa kudzivirira kuumbwa kwehematoma yemunharaunda, kuunganidza kwemvura kana chirwere chechipiri mushure mekuvhiyiwa; iyo vesicular suture inofanira kudzivisa chigaro chejekiseni.
12. α-cyanoacrylate mishonga yekunamatira inogona kukonzera kukanganisa kune jekiseni base zvinhu; usashandise α- cyanoacrylate zvekunamira zvekurapa paunenge uchibata yekuvhiya incision yakatenderedza chigadziko chejekiseni. Usashandise α-cyanoacrylate mishonga yekunamatira kana uchibata nekuvhiya incisions kumativi ejekiseni base.
13. Shandisa kungwarira kwakanyanya kudzivirira kubuda kwecatheter nekuda kwekukuvara netsaona kubva kune zvekuvhiya.
14. Pakubaya, tsono yacho inofanira kuiswa pasi, sirinji ine simba re 10mL kana kupfuura inofanira kushandiswa, mushonga unofanirwa kubaiwa zvishoma nezvishoma, uye tsono inofanira kubviswa mushure mechinguva chiduku. Kusundidzira hakufanire kudarika 200kPa.
15. Shandisa tsono dzakakosha chete dzemidziyo inoisirwa mishonga yekuendesa zvinodhaka.
16. Kana kuwedzeredzwa kwenguva refu kana kutsiviwa kwezvinodhaka kuchidikanwa, zvakafanira kushandisa imwe-inoshandiswa inoisirwa zvinodhaka dhizaini ine hosi yakakosha infusion tsono kana tee, kuitira kudzikisa huwandu hwepuncture uye kuderedza kukanganisa kumurwere.
17. Deredza huwandu hwepunctures, kuderedza kukuvadzwa kwemhasuru yemurwere uye kuzvivhara-chisimbiso zvikamu zve elastic. Munguva yekuregedzwa kwejekiseni rezvinodhaka, jekiseni reanticoagulant rinodiwa kamwe chete mavhiki maviri ega ega.
18. Ichi chigadzirwa chinoshandiswa kamwe chete, chisingaiti, chisiri chepyrogenic chigadzirwa, chakaparadzwa mushure mekushandiswa, kushandiswa zvakare kunorambidzwa zvachose.
19. Kana iyo yemukati pasuru yakakuvadzwa kana zuva rekupera kwechigadzirwa rapfuura, ndapota ridzosere kumugadziri kuti araswe.
20. Huwandu hwepunctures yega yega jekiseni block haifanire kudarika 2000 (22Ga). 21.
21. Iyo shoma yekugezesa vhoriyamu i6ml