【Iimeko ezichaseneyo】

1) Ukungafaneleki ngokwengqondo okanye ngokwasemzimbeni kotyando kwiimeko eziqhelekileyo

2) Ukopha kakhulu kunye neengxaki zokujiya kwegazi.

3) Inani leeseli ezimhlophe zegazi lingaphantsi kwe-3×109/L

4) I-allergy kwi-contrast media

5) Idityaniswe nesifo esingapheliyo esingapheliyo semiphunga.

6) Izigulane ezaziwayo okanye ezirhanelwayo ukuba zine-allergy kwizinto ezikwiphakheji yesixhobo.

7) Ukubakho okanye ukurhanelwa kosulelo olunxulumene nesixhobo, i-bacteriaemia okanye i-sepsis.

8) Unyango ngemisebe kwindawo efakelwe kuyo.

9) Ukufota okanye ukutofa iziyobisi ezibangela ukudumba.

 

【Umhla wokwenziwa】 Jonga ilebheli yemveliso

 

【Umhla wokuphelelwa】 Jonga ilebheli yemveliso

 

【Indlela yokusebenzisa】

1. Lungisa isixhobo sokufaka i-port esifakelwayo kwaye ujonge ukuba umhla wokuphelelwa udlulile na; susa iphakheji yangaphakathi kwaye ujonge ukuba iphakheji yonakele na.
2. Kufuneka usebenzise iindlela zokungabolisi ukusika iphakheji yangaphakathi kwaye ususe imveliso ukuze ilungele ukusetyenziswa.
3. Ukusetyenziswa kwezixhobo zezibuko ezifakelwayo kuchazwa ngokwahlukeneyo kwimodeli nganye ngolu hlobo lulandelayo.

 

UhloboⅠ

1. Uvavanyo lokucoca, lokukhupha umoya, lokuvuza

Sebenzisa isirinji (inaliti yesixhobo sokufaka i-implantable port device) ukugqobhoza isixhobo sokufaka i-implantable port uze ufake i-5mL-10mL ye-physiological saline ukuze uhlambe isihlalo sokufaka i-injection kunye ne-catheter lumen uze uyikhuphe. Ukuba akukho okanye ulwelo olucothayo olufunyenweyo, jika isiphelo sokuhambisa amayeza se-catheter (isiphelo esikude) ngesandla ukuze uvule i-port yokuhambisa amayeza; uze ugobe isiphelo sokuhambisa amayeza se-catheter, uqhubeke utyhala i-saline (uxinzelelo olungekho ngaphezulu kwe-200kPa), ujonge ukuba kukho ukuvuza okuvela kwisihlalo sokufaka i-injection kunye noqhagamshelo lwe-catheter, emva kokuba yonke into iqhelekile, i-catheter ingasetyenziswa.

1. Ukususwa kwe-cannulation kunye nokubotshwa

Ngokophando olwenziwe ngexesha lotyando, faka i-catheter (isiphelo sokuhanjiswa kwamayeza) kwimithambo yegazi ehambelanayo ngokwendawo yethumba, kwaye usebenzise imithungo engafunxwayo ukuze ubophe i-catheter ngokufanelekileyo kwimithambo. I-catheter kufuneka ibotshelelwe ngokufanelekileyo (iindlela ezimbini okanye ngaphezulu) kwaye ilungiswe.

1. i-chemotherapy kunye nokuvalwa

Iyeza le-chemotherapy elisetyenziswa ngexesha lotyando linokufakwa kanye ngokwesicwangciso sonyango; kucetyiswa ukuba isihlalo senaliti kunye ne-catheter lumen zihlanjwe nge-6-8 mL ye-physiological saline, kulandele i-3 mL ~ 5 mL. Emva koko i-catheter ivalwe nge-3mL ukuya kwi-5 mL ye-heparin saline kwi-100U/mL ukuya kwi-200U/mL.

1. Ukufakwa kwesihlalo ngenaliti

Umgodi we-cystic ongaphantsi kwesikhumba wenziwa kwindawo yokuxhasa, eyi-0.5 cm ukuya kwi-1 cm ukusuka kumphezulu wesikhumba, kwaye isihlalo sokufaka inaliti sibekwe ngaphakathi komgodi kwaye silungiswe, kwaye ulusu luthungelwa emva kokuphuma kwegazi okungqongqo. Ukuba i-catheter inde kakhulu, inokujijwa ibe sisangqa esiphelweni esikufutshane kwaye ilungiswe ngokufanelekileyo.

 

UhloboⅡ

1. Ukucoca nokukhupha umoya

Sebenzisa isirinji (inaliti yesixhobo sokufaka i-port esifakelweyo) ukufaka i-saline kwisitulo se-injection kunye ne-catheter ngokulandelelana ukuze ukhuphe umoya kwi-lumen, kwaye ujonge ukuba ulwelo lokuhambisa lugudile na.

2. Ukucima kunye nokubotshwa

4. Uvavanyo lokuvuza

4. Emva kokuba uqhagamshelo lugqityiwe, songa uze uvale i-catheter ngasemva kwe-lock clip uze uqhubeke nokufaka i-saline kwisihlalo se-injection ngesirinji (inaliti yesixhobo sokuhambisa amayeza esifakelwayo) (uxinzelelo olungaphezulu kwe-200kPa). (uxinzelelo olungaphezulu kwe-200kPa), jonga ukuba kukho ukuvuza okuvela kwi-injection block kunye ne-catheter.

uqhagamshelo, kwaye uyisebenzise kuphela emva kokuba yonke into iqhelekile.

5. Unyango ngamakhemikhali, ityhubhu yokutywina

Iyeza le-chemotherapy ngexesha lotyando lingafakwa kanye ngokwesicwangciso sonyango; kucetyiswa ukuba kuhlanjwe isiseko senaliti kunye ne-catheter lumen nge-6 ~ 8mL ye-physiological saline kwakhona, uze usebenzise i-3mL ~ 5mL ye-physiological saline.

Emva koko i-catheter ivalwa nge-3mL ukuya kwi-5mL ye-heparin saline kwi-100U/mL ukuya kwi-200U/mL.

6. Ukufakwa kwesihlalo ngenaliti

Kwenziwa umngxuma we-cystic ongaphantsi komhlaba kwindawo yokuxhasa, ukusuka kwi-0.5 cm ukuya kwi-1 cm ukusuka kumphezulu wesikhumba, kwaye isihlalo sokufaka inaliti safakwa kumngxuma saza salungiswa, kwaye ulusu lwathungwa emva kokuphela kwe-hemostasis engqongqo.

 

Uhlobo Ⅲ

Kusetyenziswe isirinji (inaliti ekhethekileyo yesixhobo sokufaka i-implantable port device) ukufaka i-10mL ~ 20mL yesaline eqhelekileyo kwisixhobo sokuhambisa amayeza esifakelwayo ukuze kuhlanjwe isihlalo se-injection kunye nomngxuma we-catheter, kususwe umoya okwi-injection, kujongwe ukuba ulwelo aluzange luphazamiseke na.

2. Ukucima kunye nokubotshwa

Ngokwengxelo yophando lwangaphakathi kotyando, faka i-catheter ecaleni kodonga lwesisu, kwaye inxalenye evulekileyo yesiphelo sokuhanjiswa kwamayeza kwi-catheter kufuneka ingene kwisisu kwaye isondele kakhulu kwindawo ekujoliswe kuyo ithumba. Khetha amanqaku ama-2-3 ukuze ubophe kwaye ulungise i-catheter.

3. i-chemotherapy, ityhubhu yokutywina

Iyeza le-chemotherapy ngexesha lotyando linokufakwa kanye ngokwesicwangciso sonyango, emva koko ityhubhu ivalwe nge-3mL~5mL ye-100U/mL~200U/mL ye-heparin saline.

4. Ukufakwa kwesihlalo ngenaliti

Kwenziwa umngxuma we-cystic ongaphantsi komhlaba kwindawo yokuxhasa, ukusuka kwi-0.5 cm ukuya kwi-1 cm ukusuka kumphezulu wesikhumba, kwaye isihlalo sokufaka inaliti safakwa kumngxuma saza salungiswa, kwaye ulusu lwathungwa emva kokuphela kwe-hemostasis engqongqo.

Ukufakwa kwamayeza kunye nokhathalelo

A.Ukusebenza ngokungqongqo okungasenabungozi, ukukhetha ngokuchanekileyo indawo yesihlalo sokujova ngaphambi kokujova, kunye nokubulala iintsholongwane kwindawo yokujova.B. Xa ufaka inaliti, sebenzisa inaliti kwisixhobo esifakelwayo, isirinji ye-10 mL nangaphezulu, umnwe wakho wesandla sasekhohlo uchukumisa indawo ebhobokileyo kunye nobhontsi uqinisa ulusu ngelixa ulungisa isihlalo senaliti, isandla sasekunene sibambe isirinji ngokuthe nkqo kwinaliti, siphephe ukushukuma okanye ukujikeleza, kwaye ufake i-saline kancinci i-5 mL ~ 10 mL xa kukho imvakalelo yokuwa kwaye incam yenaliti emva koko ichukumisa ezantsi kwesihlalo senaliti, kwaye ujonge ukuba inkqubo yokuhambisa amayeza ithambile na (ukuba ayithambile, kufuneka uqale ujonge ukuba inaliti ivaliwe). Jonga ukuba kukho ukuphakama kolusu olujikelezileyo xa utyhala.

C. Tyhala iyeza le-chemotherapy kancinci emva kokuqinisekisa ukuba akukho mpazamo. Ngexesha lenkqubo yokutyhala, qaphela ukuba ulusu olujikelezileyo luphezulu okanye luphaphathekile, kwaye nokuba kukho intlungu yendawo. Emva kokuba iyeza lityhaliwe, kufuneka ligcinwe imizuzwana eli-15 ukuya kwengama-30.

D. Emva kokufakwa kwenaliti nganye, kucetyiswa ukuba uhlambe isihlalo senaliti kunye ne-catheter lumen nge-6 ~ 8mL ye-physiological saline, uze uvale i-catheter nge-3mL ~ 5mL ye-100U/mL ~ 200U/mL ye-heparin saline, kwaye xa i-0.5mL yokugqibela ye-heparin saline ifakwa, iyeza kufuneka lityhalwe ngelixa libuyela umva, ukuze inkqubo yokungenisa iyeza izaliswe yi-heparin saline ukuthintela ukwakheka kwe-drug crystallization kunye nokuxinana kwegazi kwi-catheter. I-catheter kufuneka ihlanjwe nge-heparin saline kanye kwiiveki ezi-2 ngexesha le-chemotherapy.

E. Emva kokufaka inaliti, bulala iliso lenaliti ngesibulali-ntsholongwane sezonyango, uligqume ngebhandeji elingenazintsholongwane, kwaye uqaphele ukugcina indawo yasekuhlaleni icocekile kwaye yomile ukuthintela usulelo kwindawo ebhoboziweyo.

F. Nika ingqalelo kwindlela isigulane esisabela ngayo emva kokunikwa amayeza kwaye uqwalasele ngenyameko xa usifaka amayeza.

 

【Isilumkiso, isilumkiso kunye nomxholo ocebisayo】

1. Le mveliso ihlanjululwe nge-ethylene oxide kwaye isebenza iminyaka emithathu.
2. Nceda ufunde incwadi yemiyalelo ngaphambi kokuba uyisebenzise ukuqinisekisa ukhuseleko lokusetyenziswa kwayo.
3. Ukusetyenziswa kwale mveliso kufuneka kuhambelane neemfuno zeekhowudi ezifanelekileyo zokusebenza kunye nemigaqo yecandelo lezonyango, kwaye ukufakwa, ukusetyenziswa kunye nokususwa kwezi zixhobo kufuneka kuthintelwe koogqirha abaqinisekisiweyo. Ukufakwa, ukusetyenziswa kunye nokususwa kwezi zixhobo kuthintelwe koogqirha abaqinisekisiweyo, kwaye unyango emva kokuhlinzwa kufuneka lwenziwe ngabasebenzi bezonyango abafanelekileyo.
4. Lonke olu qwalaselo kufuneka lwenziwe phantsi kweemeko ezingasebenzi kakuhle.
5. Jonga umhla wokuphelelwa kwemveliso kunye nephakheji yangaphakathi ukuze ubone ukuba ayinamonakalo na ngaphambi kwenkqubo.
6. Emva kokusetyenziswa, imveliso inokubangela iingozi zebhayoloji. Nceda ulandele iindlela zonyango ezamkelekileyo kunye nayo yonke imithetho nemigaqo efanelekileyo yokuphatha kunye nonyango.
7. Musa ukusebenzisa amandla amaninzi ngexesha lokufaka ityhubhu kwaye faka umthambo ngokuchanekileyo nangokukhawuleza ukuze uphephe ukuxinana kwegazi. Ukuba ukufaka ityhubhu kunzima, sebenzisa iminwe yakho ukujika i-catheter ukusuka kwelinye icala ukuya kwelinye ngelixa ufaka ityhubhu.
8. Ubude be-catheter ebekwe emzimbeni kufuneka bufaneleke, bude kakhulu kulula ukubugoba bube yi-engile, nto leyo ebangela ukuba umoya ungangeni kakuhle, bufutshane kakhulu xa imisebenzi yobundlobongela yesigulana inokuphuma kwi-vessel. Ukuba i-catheter imfutshane kakhulu, inokuphuma kwi-vessel xa isigulana sishukuma ngamandla.
9. I-catheter kufuneka ifakwe kwisitya esinee-ligatures ezingaphezulu kwesibini kunye nokuqina okufanelekileyo ukuqinisekisa ukufakwa kweyeza okubushelelezi kunye nokuthintela i-catheter ukuba ingatyibiliki.
10. Ukuba isixhobo sokufaka i-port esifakelwayo siluhlobo lwesibini, unxibelelwano phakathi kwe-catheter kunye nesihlalo sokufaka inaliti kufuneka luqine. Ukuba akufuneki inaliti yeyeza ngexesha lotyando, kufuneka kusetyenziswe inaliti eqhelekileyo yovavanyo lwe-saline ukuze kuqinisekiswe ngaphambi kokuba kufakwe i-suture eluswini.
11. Xa kusahlulwa indawo engaphantsi kolusu, kufuneka kufakwe i-close hemostasis ukuze kuthintelwe ukwakheka kwe-hematoma yendawo, ukuqokelelana kolwelo okanye usulelo lwesibini emva kotyando; i-vesicular suture kufuneka ithintele isihlalo senaliti.
12. Izincamathelisi zonyango ze-α-cyanoacrylate zinokubangela umonakalo kwizinto ezisisiseko senaliti; musa ukusebenzisa izincamathelisi zonyango ze-α-cyanoacrylate xa unyanga utyando olujikeleze isiseko senaliti. Musa ukusebenzisa izincamathelisi zonyango ze-α-cyanoacrylate xa ujongana nezithinteli zotyando ezijikeleze isiseko senaliti.
13. Lumka kakhulu ukuze ungaphumi kwi-catheter ngenxa yokwenzakala ngengozi ngenxa yezixhobo zotyando.
14. Xa ubhoboza, inaliti mayifakwe ngokuthe nkqo, isirinji enomthamo we-10mL okanye ngaphezulu mayisetyenziswe, iyeza lifakwe kancinci, kwaye inaliti mayirhoxiswe emva kokuma kancinci. Uxinzelelo lokutyhala akufuneki ludlule kwi-200kPa.
15. Sebenzisa iinaliti ezikhethekileyo kuphela kwizixhobo zokuhambisa amayeza ezifakelwayo.
16. Xa kufuneka utyando olude okanye ukutshintshwa kwamayeza, kufanelekile ukusebenzisa isixhobo sokuhambisa amayeza esifakelwa kanye esinenaliti okanye i-tie ekhethekileyo yotyando, ukuze kuncitshiswe inani leemingxunya kunye nokunciphisa impembelelo kwisigulana.
17. Nciphisa inani leembobo, nciphisa umonakalo kwimisipha yesigulana kunye neendawo ezizivala ngokwazo. Ngexesha lokuyeka ukusebenzisa iyeza, kufuneka ufake i-anticoagulant kanye kwiiveki ezimbini.
18. Le mveliso yimveliso esetyenziswa kanye, engenazintsholongwane, engenabungozi, itshatyalalisiwe emva kokusetyenziswa, kwaye ukuphinda isetyenziswe akuvumelekanga ngokungqongqo.
19. Ukuba iphakheji yangaphakathi yonakele okanye umhla wokuphelelwa kwemveliso udlulile, nceda uyibuyisele kumenzi ukuze ilahlwe.
20. Inani lee-punctures kwi-injection block nganye akufuneki lidlule kwi-2000 (22Ga). 21.
21. Umthamo omncinci wokuhlamba yi-6ml