Igazi elilahlwayo liyinyumbahemodialysis catheterkunye nezixhobo Ezilahlwayo zinyumbahemodialysis catheterisakhiwo sokusebenza kwemveliso kunye nokubunjwa le mveliso iqulethwe ngesicatshulwa esithambileyo, isihlalo sokudibanisa, i-tube yokwandisa kunye ne-cone socket; I-catheter yenziwe nge-polyurethane yonyango kunye ne-polycarbonate. Ingumngxuma omnye, umngxuma ophindwe kabini kunye necatheter yomngxuma emithathu. Le mveliso isetyenziselwa i-hemodialysis kunye ne-infusion. Iinkcazo zemodeli yecango ephindwe kabini, imingxuma emithathu
Umbhobho wetonela kunye nejacket yedacron
Ngokuguga koluntu, uxinzelelo lwegazi oluphezulu, isifo seswekile, isifo senhliziyo (i-CHD) kunye nezigulana zokusilela kwezintso zanda, imeko yemithambo ihlwempuzekileyo, i-autogenous arteriovenous yangaphakathi i-fistula ephezulu kakhulu yeengxaki, ichaphazela kakhulu isiphumo sonyango lwe-dialysis kunye nomgangatho wobomi. , ngoko thatha i-polyester ibhanti ye-tunnel catheter okanye i-catheter ixesha elide, isetyenziswe ngokubanzi kwihlabathi, inzuzo yayo kukuba: I-catheter ine-biocompatibility efanelekileyo, kwaye i-catheter inokulungiswa ngokuqinileyo nesikhumba. Umkhono wayo wepolyester unokwenza umqobo webhaktheriya evaliweyo kwitonela engaphantsi kwe-subcutaneous, ukunciphisa ukwenzeka kokusuleleka kunye nokwandisa kakhulu ixesha lokusetyenziswa.
Ukusetyenziswa kunye nokugcinwa kwee-catheters ze-hemodialysis
1. Ukonga kunye novavanyo lwee-catheters
1. Isikhumba seCatheter
Ngaphambi nangemva kokusetyenziswa ngalunye, ukubonakala kwesikhumba sesikhumba kwindawo ye-intubation kufuneka kuhlolwe ubomvu, ukukhutshwa, ukunyameka, ukuphuma kwegazi kunye nokukhupha, njl. Ukuba i-catheter yesikhashana, jonga ukulungiswa kwenaliti ye-suture. Ukuba yicatheter yexesha elide, jonga ukuba i-CAFF itsaliwe okanye iphumile.
2. Ilungu langaphandle lecatheter
Ingaba kukho ukuphuka okanye ukuphuka, iqondo le-patency ye-lumen, ukuba kufunyenwe ukuhamba kwegazi okwaneleyo, kufuneka kuxelwe kugqirha ngexesha, kwaye i-thrombus kunye ne-fibrin sheath formation kwi-catheter kufuneka igqitywe nge-ultrasound, imaging kunye ne-fibrin sheath formation. ezinye iindlela.
3. Iimpawu zesigulana
Ingaba iimpawu kunye neqondo lomkhuhlane, ukubanda, iintlungu kunye nezinye izikhalazo zokungakhululeki.
2. Inkqubo yokusebenza yoqhagamshelo
1. Ukulungiselela
(1) Umatshini we-dialysis ugqithise ukuzijonga, umbhobho we-dialysis uhlanjululwe kwangaphambili kwaye ukwimeko yokulinda.
(2) Ukulungiselela: inqwelo yonyango okanye i-tray yonyango, amanqaku e-disinfection (iodophor okanye i-chlorhexidine), amanqaku anyumba (i-towel yonyango, i-gauze, i-syringe, iiglavu zokucoca, njl.).
(3) Isigulana kufuneka sibekwe kwindawo ekhululekile, kwaye isigulane esine-intubation yentamo kufuneka sigqoke imaski ukuveza indawo yokungena.
2. Inkqubo
(1) Vula isinxibo sangaphandle se-catheter ye-venous esembindini.
(2) Nxiba iiglavu.
(3) Vula i-1/4 yecala letawuli yonyango oyinyumba kwaye uyibeke phantsi kwe-catheter ye-lumen ephindwe kabini yomthambo ophakathi.
(4) I-Screw disinfection ye-catheter protection cap, umlomo we-catheter kunye ne-catheter clamp ngamaxesha e-2 ngokulandelelanayo.
5 Beka i-catheter entsholongwane kwi-1/2 yecala elingenazintsholongwane kwitawuli yonyango.
(6) Ukubulala iintsholongwane emlonyeni kwakhona phambi kokuba usebenze.
(7) I-2mL ye-intracatheter yokutywina isisombululo se-heparin yampontshwa ngasemva nge-2-5ml yesirinji kwaye yatyhalelwa kwi-gauze.
(8) Khangela ukuba kukho amahlwili kwi-gauze. Ukuba kukho amahlwili, khupha i-1ml kwakhona kwaye utyhale inaliti. Umgama phakathi kwesitofu kunye ne-gauze mkhulu kune-10cm.
(9) Emva kokugqiba ukuba i-catheter ayivalelekanga, qhagamshela umthambo wemithambo kunye nemibhobho ye-extracorporeal circulation ukuze umisele ukujikeleza kwe-extracorporeal.
3. Qeda umsebenzi wokutywina ityhubhu emva kwe-dialysis
(1) Emva konyango kunye nokubuya kwegazi, qinisa intambo yecatheter, bulala iintsholongwane kwijoyinti ye-catheter ye-arteriovenous, uze ukhuphe umdibaniso wombhobho ojikelezayo.
(2) Ukubulala iintsholongwane kwi-inlet ye-artery kunye ne-vein ye-catheter ngokulandelelana, kwaye utyhale i-10ml ye-saline yesiqhelo yokuhlamba i-catheter ngendlela ye-pulse. Emva kokuqwalaselwa kwamehlo, kwakungekho ntsalela yegazi kwindawo eveziweyo ye-catheter, tyhala i-anticoagulant yokutywina ulwelo ngepellet njengoko uyalelwe ngugqirha. (3) Sebenzisa ikepusi yeheparin engasebenziyo ukuvala ukuvuleka kombhobho we-arteriovenous kunye nemigangatho ephindwe kabini yeyasuyasu elingenazintsholongwane ukuyisonga. Ilungisiwe.
3. Ukutshintsha ukunxiba kwi-catheter ye-venous ephakathi
1. Jonga ukuba ilokhwe yomile, igazi namabala.
2. Nxiba iiglavu.
3. Vula isinxibo kwaye ukhangele ukuba kukho ukopha, ukukhupha, ukubomvu kunye nokudumba, ukonakala kwesikhumba kunye nokuchithwa kwe-suture kwindawo apho i-catheter ye-venous ephakathi ibekwe khona.
4. Thatha i-iodophor cotton swab kwaye uyijikelezise ngaxeshanye ukuze ubulale iintsholongwane kwindawo apho ityhubhu ifakwe khona. Uluhlu lwe-disinfecting luyi-8-10cm.
5. Ncamathisela isilonda esikhumbeni kwindawo apho ityhubhu ibekwe khona, kwaye ubonise ixesha lokutshintsha ukunxiba. Ukusetyenziswa kunye nokugcinwa kwee-catheters
1. Ukonga kunye novavanyo lwee-catheters
1. Isikhumba seCatheter
Ngaphambi nangemva kokusetyenziswa ngalunye, ukubonakala kwesikhumba sesikhumba kwindawo ye-intubation kufuneka kuhlolwe ubomvu, ukukhutshwa, ukunyameka, ukuphuma kwegazi kunye nokukhupha, njl. Ukuba i-catheter yesikhashana, jonga ukulungiswa kwenaliti ye-suture. Ukuba yicatheter yexesha elide, jonga ukuba i-CAFF itsaliwe okanye iphumile.
2. Ilungu langaphandle lecatheter
Ingaba kukho ukuphuka okanye ukuphuka, iqondo le-patency ye-lumen, ukuba kufunyenwe ukuhamba kwegazi okwaneleyo, kufuneka kuxelwe kugqirha ngexesha, kwaye i-thrombus kunye ne-fibrin sheath formation kwi-catheter kufuneka igqitywe nge-ultrasound, imaging kunye ne-fibrin sheath formation. ezinye iindlela.
3. Iimpawu zesigulana
Ingaba iimpawu kunye neqondo lomkhuhlane, ukubanda, iintlungu kunye nezinye izikhalazo zokungakhululeki.
2. Inkqubo yokusebenza yoqhagamshelo
1. Ukulungiselela
(1) Umatshini we-dialysis ugqithise ukuzijonga, umbhobho we-dialysis uhlanjululwe kwangaphambili kwaye ukwimeko yokulinda.
(2) Ukulungiselela: inqwelo yonyango okanye i-tray yonyango, amanqaku e-disinfection (iodophor okanye i-chlorhexidine), amanqaku anyumba (i-towel yonyango, i-gauze, i-syringe, iiglavu zokucoca, njl.).
(3) Isigulana kufuneka sibekwe kwindawo ekhululekile, kwaye isigulane esine-intubation yentamo kufuneka sigqoke imaski ukuveza indawo yokungena.
2. Inkqubo
(1) Vula isinxibo sangaphandle se-catheter ye-venous esembindini.
(2) Nxiba iiglavu.
(3) Vula i-1/4 yecala letawuli yonyango oyinyumba kwaye uyibeke phantsi kwe-catheter ye-lumen ephindwe kabini yomthambo ophakathi.
(4) I-Screw disinfection ye-catheter protection cap, umlomo we-catheter kunye ne-catheter clamp ngamaxesha e-2 ngokulandelelanayo.
5 Beka i-catheter entsholongwane kwi-1/2 yecala elingenazintsholongwane kwitawuli yonyango.
(6) Ukubulala iintsholongwane emlonyeni kwakhona phambi kokuba usebenze.
(7) I-2mL ye-intracatheter yokutywina isisombululo se-heparin yampontshwa ngasemva nge-2-5ml yesirinji kwaye yatyhalelwa kwi-gauze.
(8) Khangela ukuba kukho amahlwili kwi-gauze. Ukuba kukho amahlwili, khupha i-1ml kwakhona kwaye utyhale inaliti. Umgama phakathi kwesitofu kunye ne-gauze mkhulu kune-10cm.
(9) Emva kokugqiba ukuba i-catheter ayivalelekanga, qhagamshela umthambo wemithambo kunye nemibhobho ye-extracorporeal circulation ukuze umisele ukujikeleza kwe-extracorporeal.
3. Qeda umsebenzi wokutywina ityhubhu emva kwe-dialysis
(1) Emva konyango kunye nokubuya kwegazi, qinisa intambo yecatheter, bulala iintsholongwane kwijoyinti ye-catheter ye-arteriovenous, uze ukhuphe umdibaniso wombhobho ojikelezayo.
(2) Ukubulala iintsholongwane kwi-inlet ye-artery kunye ne-vein ye-catheter ngokulandelelana, kwaye utyhale i-10ml ye-saline yesiqhelo yokuhlamba i-catheter ngendlela ye-pulse. Emva kokuqwalaselwa kwamehlo, kwakungekho ntsalela yegazi kwindawo eveziweyo ye-catheter, tyhala i-anticoagulant yokutywina ulwelo ngepellet njengoko uyalelwe ngugqirha. (3) Sebenzisa ikepusi yeheparin engasebenziyo ukuvala ukuvuleka kombhobho we-arteriovenous kunye nemigangatho ephindwe kabini yeyasuyasu elingenazintsholongwane ukuyisonga. Ilungisiwe.
3. Ukutshintsha ukunxiba kwi-catheter ye-venous ephakathi
1. Jonga ukuba ilokhwe yomile, igazi namabala.
2. Nxiba iiglavu.
3. Vula isinxibo kwaye ukhangele ukuba kukho ukopha, ukukhupha, ukubomvu kunye nokudumba, ukonakala kwesikhumba kunye nokuchithwa kwe-suture kwindawo apho i-catheter ye-venous ephakathi ibekwe khona.
4. Thatha i-iodophor cotton swab kwaye uyijikelezise ngaxeshanye ukuze ubulale iintsholongwane kwindawo apho ityhubhu ifakwe khona. Uluhlu lwe-disinfecting luyi-8-10cm.
5. Ncamathisela isilonda esikhumbeni kwindawo apho ityhubhu ibekwe khona, kwaye ubonise ixesha lokutshintsha ukunxiba.
Ixesha lokuposa: Feb-25-2022