【Contraindications】

1) Ukungafanelanga kwengqondo okanye ngokomzimba utyando kwiimeko eziqhelekileyo

2) Ukopha okukhulu kunye nokuphazamiseka kwe-coagulation.

3) Ukubalwa kweeseli ezimhlophe zegazi ngaphantsi kwe-3 × 109 / L

4) Ukwalana nemidiya yokuchasana

I-5) Idibaniswe nesifo esibi esingapheliyo se-pulmonary obstructive.

6) Izigulana ezaziwayo okanye ezikrokrelekayo zokwaliwa kwizinto ezikwipakethe yesixhobo..

7) Ubukho okanye ukukrokra kwentsholongwane enxulumene nesixhobo, i-bacteraemia okanye i-sepsis.

8) I-Radiotherapy kwindawo yokufakwa okujoliswe kuyo.

9) Ukufanekisa okanye ukutofa kweziyobisi ze-embolic.

 

【Ukwenziwa komhla】 Bona ileyibhile yemveliso

 

【Umhla wokuphelelwa yisikhathi】 Bona ileyibhile yemveliso

 

【Indlela yokusetyenziswa】

1. Lungisa isixhobo se-port esifakelwayo kwaye ukhangele ukuba umhla wokuphelelwa kwexesha ugqithisiwe; susa ipakethe yangaphakathi kwaye ujonge ukuba ipakethe yonakele.
2. Kufuneka usebenzise ubuchule be-aseptic ukusika uvule iphakheji yangaphakathi kwaye ususe imveliso ukulungiselela ukusetyenziswa.
3. Ukusetyenziswa kwezixhobo zezibuko ezifakelwayo zichazwe ngokwahlukeneyo kumzekelo ngamnye ngolu hlobo lulandelayo.

 

UhloboⅠ

1. Ukugungxula, ukukhupha umoya, uvavanyo lokuvuza

Sebenzisa isirinji (inaliti yesixhobo sezibuko esifakelwayo) ukugqobhoza isixhobo sezibuko esifakelwayo kunye nokutofa i-5mL-10mL yesaline yomzimba ukugungxula isitulo sokutofa kunye nelumen yecatheter kwaye ungabandakanyi. Ukuba akukho okanye ulwelo olucothayo lufunyenwe, jija isiphelo sokuhanjiswa kwechiza kwi-catheter (isiphelo esikude) ngesandla ukuvula izibuko lokuhanjiswa kweziyobisi; emva koko i-Fold ivalwe ukuphela kokunikezelwa kweziyobisi kwi-catheter, qhubeka utyhala i-saline (uxinzelelo olungekho ngaphezu kwe-200kPa), jonga ukuba kukho ukuvuza kwisihlalo sokutofa kunye nokudibanisa kwe-catheter, emva kokuba yonke into eqhelekileyo Emva kokuba yonke into iqhelekile, i-catheter ingasetyenziswa.

1. I-Cannulation kunye ne-ligation

Ngokutsho kophando lwe-intraoperative, faka i-catheter (isiphelo sokuhanjiswa kweziyobisi) kwisitya sokuhambisa igazi esihambelanayo ngokwendawo ye-tumor, kwaye usebenzise i-sutures engabonakaliyo ukuze udibanise kakuhle i-catheter kwisitya. I-catheter kufuneka ifakwe ngokufanelekileyo (iipasi ezimbini okanye ngaphezulu) kwaye zilungiswe.

1. ichemotherapy kunye nokutywinwa

Iyeza lechemotherapy esetyenziswa kwi-intraoperative linokutofwa kube kanye ngokwesicwangciso sonyango; kucetyiswa ukuba isihlalo sokutofa kunye ne-catheter lumen ihlanjwe nge-6-8 mL ye-saline ye-physiological, ilandelwa yi-3 mL ~ 5 mL I-catheter ivalwe nge-3mL ukuya kwi-5mL ye-heparin saline kwi-100U / mL ukuya kwi-200U / mL.

1. Ukulungiswa kwesihlalo sokutofa

I-subcutaneous cystic cavity yenziwa kwindawo yokuxhasa, eyi-0.5 cm ukuya kwi-1 cm ukusuka ebusweni besikhumba, kwaye isihlalo sokujova sifakwe kwi-cavity kwaye sigxininiswe, kwaye ulusu lufakwe emva kwe-hemostasis eqinile. Ukuba i-catheter inde kakhulu, inokudityaniswa kwisangqa kwisiphelo esisondeleyo kwaye ilungiswe ngokufanelekileyo.

 

UhloboⅡ

1.Ukugungxula nokukhupha umoya

Sebenzisa isirinji (inaliti yesixhobo sokungena esifakelwayo) ukufaka ityuwa kwisitulo sokutofa nakwicatheter ngokulandelelanayo ukugungxula nokukhupha umoya kwilumen, kwaye ujonge ukuba ulwelo oluqhutywayo lugudileyo.

2. I-Cannulation kunye ne-ligation

4. Uvavanyo lokuvuza

4. Emva kokuba uqhagamshelo lugqityiwe, songa kwaye uvale i-catheter ngasemva kwekliphu yokutshixa kwaye uqhubeke nokutofa i-saline kwisihlalo sokutofa ngesirinji (inaliti yesixhobo sokuhambisa iziyobisi esifakelwayo) (uxinzelelo olungaphezulu kwe-200kPa). (uxinzelelo olungekho ngaphezulu kwe-200kPa), jonga ukuba kukho ukuvuza kwibhloko yesitofu kunye necatheter

uxhumano, kwaye sebenzisa kuphela emva kokuba yonke into iqhelekile.

5. I-Chemotherapy, ityhubhu yokutywina

Iyeza lechemotherapy esetyenziswa kwi-intraoperative linokutofwa kube kanye ngokwesicwangciso sonyango; kucetyiswa ukugungxula isiseko sokutofa kunye ne-catheter lumen nge-6 ~ 8mL ye-saline ye-physiological kwakhona, kwaye emva koko usebenzise i-3mL ~ 5mL ye-physiological saline.

I-catheter ivalwe nge-3mL ukuya kwi-5mL ye-heparin saline kwi-100U / mL ukuya kwi-200U / mL.

6. Ukulungiswa kwesihlalo sokutofa

I-subcutaneous cystic cavity yenziwa kwindawo yokuxhasa, i-0.5 cm ukuya kwi-1 cm ukusuka ebusweni besikhumba, kwaye isihlalo sokutofa safakwa kwi-cavity kwaye silungisiwe, kwaye ulusu lwaxutywa emva kwe-hemostasis eqinile.

 

Uhlobo Ⅲ

Isirinji (inaliti ekhethekileyo yesixhobo sezibuko esifakelwayo) yasetyenziselwa ukutofa i-10mL ~ 20mL yetyuwa eqhelekileyo kwisixhobo sokuhambisa ichiza esifakelwayo ukugungxula isitulo sokutofa kunye nomngxuma wecatheter, nokususa umoya kumngxuma, kwaye ujonge ukuba ulwelo. ebengabonakali.

2. I-Cannulation kunye ne-ligation

Ngokutsho kokuphononongwa kwe-intraoperative, faka i-catheter ecaleni kodonga lwesisu, kwaye inxalenye evulekileyo yokunikezelwa kweziyobisi ekupheleni kwe-catheter kufuneka ingene kwi-catheter yesisu kwaye isondele kwithagethi ye-tumor ngokunokwenzeka. Khetha amanqaku angama-2-3 ukuze udibanise kwaye ulungise i-catheter.

3. ichemotherapy, ityhubhu yokutywina

I-Intraoperative chemotherapy drug inokutofwa kanye ngokwesicwangciso sonyango, kwaye ityhubhu ivalwe nge-3mL ~ 5mL ye-100U / mL ~ 200U / mL ye-heparin saline.

4. Ukulungiswa kwesihlalo sokutofa

I-subcutaneous cystic cavity yenziwa kwindawo yokuxhasa, i-0.5 cm ukuya kwi-1 cm ukusuka ebusweni besikhumba, kwaye isihlalo sokutofa safakwa kwi-cavity kwaye silungisiwe, kwaye ulusu lwaxutywa emva kwe-hemostasis eqinile.

Ukufakwa kweziyobisi kunye nokunyamekela

A.Ukusebenza ngokungqongqo kwe-aseptic, ukhetho oluchanekileyo lwendawo yesitulo sokutofa phambi kokutofa, kunye nokubulala iintsholongwane kwindawo yokutofa.B. Xa utofa, sebenzisa inaliti kwisixhobo sezibuko esifakelwayo, isirinji ye-10 mL okanye ngaphezulu, ngomnwe wesandla sasekhohlo obambe indawo yokuhlatywa kunye nobhontsi ucinezela ulusu ngelixa ulungisa isihlalo sokutofa, ngesandla sasekunene sibambe isirinji. ngokuthe nkqo kwinaliti, ukunqanda ukungcangcazela okanye ukujikeleziswa, kwaye ngokucotha ukutofa ityuwa yetyuwa 5 mL~10 mL xa kukho imvakalelo yokuwa kwaye incam yenaliti ichukumisa umzantsi wesihlalo sokutofa, kwaye ujonge ukuba inkqubo yokuhanjiswa kwechiza igudile. (ukuba ayigudi, kufuneka uqale ujonge ukuba inaliti ivaliwe). Jonga ukuba kukho nakuphi na ukuphakama kwesikhumba esijikelezileyo xa utyhala.

C. Lityhale iyeza le-chemotherapeutic kancinane emva kokuqinisekisa ukuba akukho mpazamo. Ngethuba lenkqubo yokutyhala, qaphela ukuba ulusu olujikelezileyo luphakanyisiwe okanye luphaphathekile, nokuba kukho intlungu yendawo. Emva kokuba iyeza lityhaliwe, kufuneka ligcinwe i-15s ~ 30s.

D. Emva kwesitofu ngasinye, kuyacetyiswa ukuba ugungxule isihlalo sokutofa kunye ne-catheter lumen nge-6 ~ 8mL ye-saline ye-physiological, kwaye emva koko utywine i-catheter nge-3mL ~ 5mL ye-100U / mL ~ 200U / ml ye-heparin saline, kwaye xa okokugqibela. I-0.5mL ye-heparin saline iyatofwa, iyeza kufuneka lityhalwe ngelixa lihlehla, ukuze inkqubo yokuqaliswa kweziyobisi izaliswe nge-heparin saline ukukhusela i-crystallization ye-chiza kunye ne-coagulation yegazi kwi-catheter. I-catheter kufuneka ihlanjwe nge-heparin saline kanye kwiiveki ezi-2 ngexesha le-chemotherapy.

E. Emva kokutofwa, bulala iintsholongwane kwiliso lenaliti ngesibulali-ntsholongwane sonyango, uligqume ngesinxibo esingenazintsholongwane, kwaye unike ingqwalasela yokugcina indawo yasekuhlaleni icocekile kwaye yomile ukuthintela usulelo kwindawo yokuhlatywa.

F. Nika ingqalelo kwindlela isigulane esisabela ngayo emva kokulawulwa kweziyobisi kwaye uqwalasele ngenyameko ngexesha lokutofa kweziyobisi.

 

【Isilumkiso, isilumkiso kunye nomxholo ocebisayo】

1. Le mveliso inzala nge-ethylene oxide kwaye isebenza iminyaka emithathu.
2. Nceda ufunde incwadana yemiyalelo ngaphambi kokusetyenziswa ukuqinisekisa ukhuseleko lokusetyenziswa.
3. Ukusetyenziswa kwale mveliso kufuneka kuhambelane neemfuno zeekhowudi ezifanelekileyo zokusebenza kunye nemimiselo yecandelo lezonyango, kunye nokufakwa, ukusebenza kunye nokususwa kwezi zixhobo kufuneka kuthintelwe oogqirha abaqinisekisiweyo.Ukufakwa, ukusebenza kunye nokususwa kwezi zixhobo ziyimfuneko ivinjelwe oogqirha abaqinisekisiweyo, kwaye ukunakekelwa kwe-post-tube kufuneka kwenziwe ngabasebenzi bezonyango abaqeqeshiweyo.
4. Yonke inkqubo kufuneka yenziwe phantsi kweemeko ze-aseptic.
5. Khangela umhla wokuphelelwa kwemveliso kunye nokupakishwa kwangaphakathi ngomonakalo phambi kwenkqubo.
6. Emva kokusetyenziswa, imveliso inokubangela iingozi zebhayoloji. Nceda ulandele inkqubo yonyango eyamkelekileyo kunye nayo yonke imithetho efanelekileyo kunye nemimiselo yokuphatha kunye nonyango.
7. Ungasebenzisi amandla amaninzi ngexesha lokungena kwaye ufake umthambo ngokuchanekileyo kwaye ngokukhawuleza ugweme i-vasospasm. Ukuba intubation inzima, sebenzisa iminwe yakho ukuguqula i-catheter ukusuka kwelinye icala ukuya kwelinye ngelixa ufaka ityhubhu.
8. Ubude be-catheter ebekwe emzimbeni kufuneka bufaneleke, ixesha elide kulula ukugoba kwi-angle, kubangele ukungena komoya okungahambi kakuhle, kufutshane kakhulu xa imisebenzi yobundlobongela yesigulane inethuba lokukhupha kwinqanawa. Ukuba i-catheter imfutshane kakhulu, inokukhupha kwisitya xa isigulane sihamba ngamandla.
9. I-catheter kufuneka ifakwe kwisitya kunye ne-ligatures engaphezulu kwesibini kunye nokuqina okufanelekileyo ukuqinisekisa inaliti yeziyobisi egudileyo kunye nokuthintela umbhobho ukuba ungatyibiliki.
10. Ukuba isixhobo sezibuko esifakelwayo siluhlobo lwe-II, uqhagamshelwano phakathi kwecatheter kunye nesihlalo sokutofa kufuneka luqine. Ukuba isitofu sechiza lotyando alifuneki, inaliti yovavanyo lwe-saline eqhelekileyo kufuneka isetyenziswe ukuze kuqinisekiswe phambi kokuba kufakwe i-suturing ulusu.
11. Xa ukwahlula indawo engaphantsi kwe-subcutaneous, i-hemostasis esondeleyo kufuneka yenziwe ukuphepha ukubunjwa kwe-hematoma yendawo, ukuqokelela kwamanzi okanye ukusuleleka kwesibini emva kokuhlinzwa; i-vesicular suture kufuneka iphephe isihlalo sokutofa.
12. I-α-cyanoacrylate i-adhesives yonyango inokubangela umonakalo kwisiseko se-injection; musa ukusebenzisa i-α- cyanoacrylate adhesives zonyango xa unyanga utyando lotyando olujikeleze isiseko sokutofa. Musa ukusebenzisa i-α-cyanoacrylate i-adhesives yonyango xa ujongene nezithintelo zotyando malunga nesiseko senaliti.
13. Sebenzisa ngononophelo olukhulu ukuphepha ukuvuza kwe-catheter ngenxa yokwenzakala ngengozi kwizixhobo zotyando.
14. Xa uhlatywa, inaliti kufuneka ifakwe ngokuthe nkqo, isirinji enomthamo we-10mL okanye ngaphezulu kufuneka isetyenziswe, iyeza kufuneka litofwe ngokucothayo, kwaye inaliti kufuneka irhoxiswe emva kokunqumama okufutshane. Uxinzelelo lokutyhala akufuneki ludlule kwi-200kPa.
15. Sebenzisa kuphela iinaliti ezikhethekileyo kwizixhobo zokuhambisa amayeza afakelweyo.
16. Xa ukufakwa ixesha elide okanye ukutshintshwa kweziyobisi kuyadingeka, kuyafaneleka ukusebenzisa isixhobo esisodwa sokunikezelwa kweziyobisi kunye ne-hose ekhethekileyo yokufaka inaliti okanye i-tee, ukwenzela ukunciphisa inani le-punctures kunye nokunciphisa impembelelo kwisigulane.
17. Ukunciphisa inani le-punctures, ukunciphisa umonakalo kwimisipha yesigulane kunye ne-self-sealing elastic parts. Ngexesha lokuyeka ukutofa, inaliti ye-anticoagulant iyafuneka kanye kwiiveki ezimbini.
18. Le mveliso isetyenziselwa enye, inyumba, imveliso engeyiyo i-pyrogenic, itshatyalaliswe emva kokusetyenziswa, ukusetyenziswa kwakhona kunqatshelwe ngokungqongqo.
19. Ukuba ipakethe yangaphakathi yonakele okanye umhla wokuphelelwa kwemveliso ugqithisiwe, nceda uyibuyisele kumenzi ukuze ichithwe.
20. Inani leepunctures kwibhloko nganye yesitofu akufanele lidlule kwi-2000 (22Ga). 21.
21. Ubuncinane bomthamo wokugungxula yi-6ml