Ropa rinoraswa risina utachionakatheta yekuchenesa ropauye zvishongedzo Zvinoraswa zvisina utachionakatheta yekuchenesa ropaMagadzirirwo nemagadzirirwo echigadzirwa ichi chigadzirwa ichi chakagadzirwa nemuromo wakapfava, chigaro chinobatanidza, chubhu yekuwedzera uye soketi yekoni; Catheter iyi yakagadzirwa nepolyurethane yekurapa nepolycarbonate. Igomba rimwe chete, gomba rakapetwa kaviri uye catheter ine gomba nhatu. Chigadzirwa ichi chinoshandiswa mukurapa kwe hemodialysis uye infusion. Magadzirirwo emuenzaniso: gomba rakapetwa kaviri, gomba rakapetwa katatu
Mugero wemugero une jaketi redacron
Nekukwegura kwevanhu, BP, chirwere cheshuga, chirwere chemwoyo (CHD) pamwe nevarwere vanotadza kushanda zvakanaka kweitsvo, mamiriro etsinga dzeropa asina kunaka, fistula yemukati ye arteriovenous iri kuwedzera zvakanyanya, kukanganisa zvakanyanya kurapwa kwemurwere ne dialysis uye hupenyu hwakanaka, saka tora catheter yebhandi repolyester tunnel kana catheter kwenguva yakareba, yave ichishandiswa zvakanyanya munyika, mukana wayo ndewekuti: Catheter ine biocompatibility yakanaka, uye catheter inogona kugadziriswa zvakasimba neganda. Mupendero wayo wepolyester unogona kugadzira chipingamupinyi chebhakitiriya chakavharwa mu subcutaneous tunnel, zvichideredza kuitika kwehutachiona uye kuwedzera nguva yekushandisa.
Kushandisa uye kuchengetedza macatheter e hemodialysis
1. Kurapwa uye kuongororwa kwemacatheter
1. Nzira yekubuditsa ganda reCatheter
Usati washandisa uye mushure mekushandisa, chitarisiko cheganda panzvimbo inopinzwa dumbu chinofanira kuongororwa kuti chionekwe kuti chakatsvuka here, chinobuda here, chakanyorova, chinobuda ropa here uye chakabuda here, nezvimwewo. Kana iri katheta yenguva pfupi, tarisa kuti tsono yekurumwa yakagadzika sei. Kana iri katheta yenguva refu, tarisa kana CAFF yakadhonzwa kana kuti yabuda.
2. Chipfundo chekunze chekatheta
Kunyangwe paine kuputika kana kuputsika, mwero we patency ye lumen, kana ropa risina kuyerera zvakakwana, zvinofanira kuziviswa kuna chiremba nenguva, uye kuumbwa kwe thrombus ne fibrin sheath mu catheter kunofanira kutsanangurwa ne ultrasound, imaging nedzimwe nzira.
3. Zviratidzo zvevarwere
Ingava zviratidzo uye mwero wefivha, dzihwa, kurwadziwa nezvimwe zvichemo zvekusagadzikana.
2. Maitiro ekushanda kwekubatanidza
1. Kugadzirira
(1) Muchina we dialysis wapasa bvunzo yekuzviongorora, pombi ye dialysis yakashambidzwa kare uye iri mumamiriro ekumirira.
(2) Kugadzirira: ngoro yekurapa kana tireyi yekurapa, zvinhu zvekuuraya utachiona (iodophor kana chlorhexidine), zvinhu zvisina utachiona (tauro rekurapa, gauze, sirinji, magirovhosi ekuchenesa, nezvimwewo).
(3) Murwere anofanira kuiswa panzvimbo yakasununguka akarara, uye murwere ane mutsipa unobata machubhu anofanira kupfeka chifukidzo kuti aratidze nzvimbo yacho.
2. Maitiro
(1) Vhura chikamu chekunze che catheter yepakati petsinga.
(2) Pfeka magirovhosi.
(3) Vhura chidimbu chimwe muzvina chejira rekurapa risina utachiona woriisa pasi pekatheta ine double-lumen yetsinga yepakati.
(4) Kubvisa utachiona pachivharo chekudzivirira catheter, muromo wecatheter uye chibatiso checatheter kaviri zvichiteerana.
(5) Tarisa kuti catheter clamp yakabatidzwa here, bvisa nati, woirasa. Isa catheter yakacheneswa padivi rehafu rejira rekurapa risina utachiona.
(6) Bvisa utachiona mumuromo usati washandisa mushonga.
(7) 2mL intracatheter sealing heparin solution yakapombwa zvakare nesirinji ye2-5ml ndokusundirwa pagauze.
(8) Tarisa kana paine madota pagauze. Kana paine madota, bvisa 1ml zvakare wobva wadzvanya jekiseni. Daro riri pakati pejekiseni negauze rakakura kupfuura 10cm.
(9) Mushure mekuona kuti catheter haina kuvharwa, batanidza tsinga dzeropa netsinga dzeropa kuti usimbise kutenderera kweropa kunze kwemuviri.
3. Pedzisa kushanda kwekuvhara chubhu mushure mekuchenesa ganda (dialysis).
(1) Mushure mekurapwa uye ropa radzoka, sunga chibatiso checatheter, bvisa mushonga wekuuraya utachiona pajoini yecatheter ine arteriovenous, uye bvisa joini nepaipi inotenderera.
(2) Bvisa utachiona mutsinga yeropa netsinga yekatheta zvakateerana, wobva wadzvanya 10ml yesaline yakajairwa kuti usuke katheta nenzira yekurova kwemoyo. Mushure mekutarisa nemaziso, hapana ropa rakasara muchikamu chekatheta chakaburitswa, dzvanya mvura inovhara ropa nepellet sezvakarairwa nachiremba. (3) Shandisa chivharo cheheparin chisina utachiona kuvhara muromo wechubhu ye arteriovenous uye zvidimbu zviviri zvegauze isina utachiona kuti uiputire. Yakagadziriswa.
3. Kuchinja jira re catheter yepakati petsinga
1. Tarisa kana jira racho rakaoma, rine ropa uye rine mavara.
2. Pfeka magirovhosi.
3. Vhura jira rekuisa jira wotarisa kana paine kubuda ropa, kubuda kweropa, kutsvuka uye kuzvimba, kukuvara kweganda uye kusukwa kwetsvina panzvimbo pakaiswa catheter yepakati petsinga.
4. Tora swab yedonje ye iodophor woitenderedza uchitenderera wachi kuti uuraye hutachiona panzvimbo yakaiswa chubhu. Hurefu hwehutachiona i8-10cm.
5. Namatira chipfeko cheparonda paganda panzvimbo yakaiswa chubhu, uye ratidza nguva yekuchinja chipfeko. Kushandisa uye kuchengetedza macatheter
1. Kurapwa uye kuongororwa kwemacatheter
1. Nzira yekubuditsa ganda reCatheter
Usati washandisa uye mushure mekushandisa, chitarisiko cheganda panzvimbo inopinzwa dumbu chinofanira kuongororwa kuti chionekwe kuti chakatsvuka here, chinobuda here, chakanyorova, chinobuda ropa here uye chakabuda here, nezvimwewo. Kana iri katheta yenguva pfupi, tarisa kuti tsono yekurumwa yakagadzika sei. Kana iri katheta yenguva refu, tarisa kana CAFF yakadhonzwa kana kuti yabuda.
2. Chipfundo chekunze chekatheta
Kunyangwe paine kuputika kana kuputsika, mwero we patency ye lumen, kana ropa risina kuyerera zvakakwana, zvinofanira kuziviswa kuna chiremba nenguva, uye kuumbwa kwe thrombus ne fibrin sheath mu catheter kunofanira kutsanangurwa ne ultrasound, imaging nedzimwe nzira.
3. Zviratidzo zvevarwere
Ingava zviratidzo uye mwero wefivha, dzihwa, kurwadziwa nezvimwe zvichemo zvekusagadzikana.
2. Maitiro ekushanda kwekubatanidza
1. Kugadzirira
(1) Muchina we dialysis wapasa bvunzo yekuzviongorora, pombi ye dialysis yakashambidzwa kare uye iri mumamiriro ekumirira.
(2) Kugadzirira: ngoro yekurapa kana tireyi yekurapa, zvinhu zvekuuraya utachiona (iodophor kana chlorhexidine), zvinhu zvisina utachiona (tauro rekurapa, gauze, sirinji, magirovhosi ekuchenesa, nezvimwewo).
(3) Murwere anofanira kuiswa panzvimbo yakasununguka akarara, uye murwere ane mutsipa unobata machubhu anofanira kupfeka chifukidzo kuti aratidze nzvimbo yacho.
2. Maitiro
(1) Vhura chikamu chekunze che catheter yepakati petsinga.
(2) Pfeka magirovhosi.
(3) Vhura chidimbu chimwe muzvina chejira rekurapa risina utachiona woriisa pasi pekatheta ine double-lumen yetsinga yepakati.
(4) Kubvisa utachiona pachivharo chekudzivirira catheter, muromo wecatheter uye chibatiso checatheter kaviri zvichiteerana.
(5) Tarisa kuti catheter clamp yakabatidzwa here, bvisa nati, woirasa. Isa catheter yakacheneswa padivi rehafu rejira rekurapa risina utachiona.
(6) Bvisa utachiona mumuromo usati washandisa mushonga.
(7) 2mL intracatheter sealing heparin solution yakapombwa zvakare nesirinji ye2-5ml ndokusundirwa pagauze.
(8) Tarisa kana paine madota pagauze. Kana paine madota, bvisa 1ml zvakare wobva wadzvanya jekiseni. Daro riri pakati pejekiseni negauze rakakura kupfuura 10cm.
(9) Mushure mekuona kuti catheter haina kuvharwa, batanidza tsinga dzeropa netsinga dzeropa kuti usimbise kutenderera kweropa kunze kwemuviri.
3. Pedzisa kushanda kwekuvhara chubhu mushure mekuchenesa ganda (dialysis).
(1) Mushure mekurapwa uye ropa radzoka, sunga chibatiso checatheter, bvisa mushonga wekuuraya utachiona pajoini yecatheter ine arteriovenous, uye bvisa joini nepaipi inotenderera.
(2) Bvisa utachiona mutsinga yeropa netsinga yekatheta zvakateerana, wobva wadzvanya 10ml yesaline yakajairwa kuti usuke katheta nenzira yekurova kwemoyo. Mushure mekutarisa nemaziso, hapana ropa rakasara muchikamu chekatheta chakaburitswa, dzvanya mvura inovhara ropa nepellet sezvakarairwa nachiremba. (3) Shandisa chivharo cheheparin chisina utachiona kuvhara muromo wechubhu ye arteriovenous uye zvidimbu zviviri zvegauze isina utachiona kuti uiputire. Yakagadziriswa.
3. Kuchinja jira re catheter yepakati petsinga
1. Tarisa kana jira racho rakaoma, rine ropa uye rine mavara.
2. Pfeka magirovhosi.
3. Vhura jira rekuisa jira wotarisa kana paine kubuda ropa, kubuda kweropa, kutsvuka uye kuzvimba, kukuvara kweganda uye kusukwa kwetsvina panzvimbo pakaiswa catheter yepakati petsinga.
4. Tora swab yedonje ye iodophor woitenderedza uchitenderera wachi kuti uuraye hutachiona panzvimbo yakaiswa chubhu. Hurefu hwehutachiona i8-10cm.
5. Namatira chipfeko cheparonda paganda panzvimbo yakaiswa chubhu, uye ratidza nguva yekuchinja chipfeko.
Nguva yekutumira: Kukadzi-25-2022