【Ibibazo bibuzanya

1) Kutabasha kubagwa mu buryo bw'imitekerereze cyangwa umubiri muri rusange

2) Kuva amaraso menshi no kuvura amaraso mu nda.

3) Umubare w'uturemangingo tw'amaraso tw'umweru uri munsi ya 3×109/L

4) Kurwara ubwivumbure ku binyabutabire bitandukanya ibintu

5) Bivanze n'indwara ikomeye idakira y'ibihaha.

6) Abarwayi bazwi cyangwa bakekwaho ubwivumbure ku bikoresho biri mu gikoresho.

7) Kuba hari cyangwa hakekwa ko hari ubwandu buterwa n'ibikoresho, bagiteri cyangwa sepsis.

8) Gukoresha imirasire aho byagenewe gushyirwa.

9) Gufata amashusho cyangwa gutera imiti itera indwara.

 

【Itariki yo gukora】 Reba icyapa cy'ibicuruzwa

 

【Itariki izarangiriraho】 Reba icyapa cy'ibicuruzwa

 

【Uburyo bwo gukoresha】

1. Tegura igikoresho gishobora gushyirwamo hanyuma urebe niba itariki ntarengwa yarenze; ​​kuramo ipaki y'imbere hanyuma urebe niba ipaki yangiritse.
2. Ugomba gukoresha uburyo bwo gufunga kugira ngo uce agapaki k'imbere hanyuma ukuremo icyo gikoresho kugira ngo gikoreshwe.
3. Imikoreshereze y'ibikoresho bishobora gushyirwamo umuyoboro isobanurwa ukwayo kuri buri gishushanyo ku buryo bukurikira.

 

UbwokoⅠ

1. Gupima amazi yo mu mazi, aho umwuka usohoka, no gupima aho amazi asohoka

Koresha seringe (urushinge rwo gushyiramo igikoresho gishobora gushyirwamo) kugira ngo utobore igikoresho gishobora gushyirwamo hanyuma ushyiremo 5mL-10mL ya saline physiological kugira ngo wogeshe intebe y'inshinge na catheter lumen hanyuma uvanemo. Niba nta mazi cyangwa amazi agenda buhoro, zunguza impera y'umuti wa catheter (impera ya kure) n'intoki kugira ngo ufungure aho umuti ujyanwa; hanyuma uzinge impera y'umuti wa catheter, komeza gusunika saline (umuvuduko utarenze 200kPa), urebe niba hari amazi ava mu ntebe y'inshinge n'aho catheter ihurira, nyuma y'uko byose bibaye bisanzwe, catheter irashobora gukoreshwa.

1. Gufunga no gufunga

Dukurikije iperereza ryakozwe mu gihe cyo kubaga, shyiramo katheteri (igice cyo gutanga imiti) mu muyoboro w'amaraso ujyanye na yo ukurikije aho ikibyimba kiri, hanyuma ukoreshe imisumari idapfa gukururwa kugira ngo ushyire katheteri mu muyoboro neza. Katheteri igomba kuba ihambiriwe neza (inyuzwamo ebyiri cyangwa zirenga) kandi ikosorwe.

1. imiti igabanya ubukana no gufunga

Umuti wa chimiotherapie wo mu gihe cyo kubagwa ushobora guterwa rimwe hakurikijwe gahunda yo kuvura; ni byiza ko icyicaro cy’urushinge n’urumuri rwa catheter bisukurwa na mL 6-8 za saline physiological, hanyuma hagakurikiraho 3 mL ~ 5 mL. Hanyuma catheter ifunze na 3mL kugeza kuri 5 mL za saline ya heparin kuri 100U / mL kugeza 200U / mL.

1. Gushyiraho intebe iterwamo inshinge

Umwobo w’uruti rw’umura ukozwe munsi y’uruhu ukorerwa ahantu ho gushyigikirwa, uri hagati ya cm 0.5 na cm 1 uvuye ku ruhu, hanyuma intebe yo guterwamo ishyirwa mu mwobo hanyuma igakomezwa, hanyuma uruhu rugasukwa nyuma yo kuva amaraso mu buryo bukabije. Iyo catheter ari ndende cyane, ishobora gupfundikirwa mu ruziga ku mpera ya hafi hanyuma igakomezwa neza.

 

UbwokoⅡ

1. Gusukura no gusohora umwuka

Koresha seringe (urushinge rwo gushyiramo igikoresho gishyirwamo) kugira ngo ushyiremo saline mu ntebe y’igishingwa na catheter kugira ngo woge kandi ukuremo umwuka uri muri lumen, kandi urebe niba amazi ayobora ari meza.

2. Gufunga no gufunga

4. Ikizamini cyo gusohora amazi

4. Nyuma yo guhuza, funga katheta iri inyuma y'agakoresho ko gufunga hanyuma ukomeze gutera saline mu ntebe y'inshinge ukoresheje seringe (urushinge rwo gushyiramo imiti) (umuvuduko urenze 200kPa). (umuvuduko utarenze 200kPa), reba niba hari amazi ava mu gice cy'inshinge na katheta.

guhuza, kandi ikoreshwe gusa nyuma yuko byose bibaye ibisanzwe.

5. Ubumenyi bwa Chimiotherapie, umuyoboro wo gufunga

Umuti wa chimiotherapie wo mu gihe cyo kubagwa ushobora guterwa rimwe hakurikijwe gahunda yo kuvura; ni byiza kongera gusukura igice cy’urushinge n’urushinge rwa catheter ukoresheje 6 ~ 8 mL bya saline physiological, hanyuma ugakoresha 3 mL ~ 5 mL bya saline physiological.

Hanyuma catheter ifunze na 3mL kugeza kuri 5mL ya heparin saline kuri 100U/mL kugeza 200U/mL.

6. Gushyiraho intebe iterwamo inshinge

Umwobo w’uruti rw’umura wakozwe ahantu ho gushyigikirwa, kuva kuri cm 0.5 kugeza kuri cm 1 uvuye ku ruhu, maze intebe yo guterwamo ishyirwa mu mwobo irakomezwa, maze uruhu rurasukwa nyuma yo kuva amaraso mu buryo bukabije.

 

Ubwoko Ⅲ

Ishinge (urushinge rwihariye rw'igikoresho gishobora gushyirwamo) rwakoreshejwe mu gutera umunyu usanzwe wa 10mL ~ 20mL mu gikoresho gishyirwamo imiti kugira ngo hongerwe intebe y'igishinge n'umwobo wa catheter, kandi hakureho umwuka uri mu mwobo, kandi harebwe niba amazi atarimo kubangamira.

2. Gufunga no gufunga

Dukurikije ubushakashatsi bwakozwe mu gihe cyo kubaga, shyiramo katheteri ku rukuta rw'inda, hanyuma igice gifunguye cy'impera y'imiti itangwa na katheteri kigomba kwinjira mu nda kandi kikaba hafi y'aho ikibyimba giherereye. Hitamo amanota 2-3 yo gushyiramo katheteri no kuyishyiraho.

3. imiti igabanya ubukana, umuyoboro wo gufunga

Umuti wa chimiotherapie wo mu gihe cyo kubagwa ushobora guterwa rimwe hakurikijwe gahunda yo kuvura, hanyuma umuyoboro ugafungwa na 3mL ~ 5mL ya 100U / mL ~ 200U / mL heparin saline.

4. Gushyiraho intebe iterwamo inshinge

Umwobo w’uruti rw’umura wakozwe ahantu ho gushyigikirwa, kuva kuri cm 0.5 kugeza kuri cm 1 uvuye ku ruhu, maze intebe yo guterwamo ishyirwa mu mwobo irakomezwa, maze uruhu rurasukwa nyuma yo kuva amaraso mu buryo bukabije.

Gutera no kwita ku miti

A.Gukoresha uburyo bwo kwirinda gusa ibisebe, guhitamo neza aho intebe y’inshinge iherereye mbere yo kuyitera, no kuyica burundu aho inshinge igeze.B. Mu gihe utera inshinge, koresha urushinge rwo gushyiramo icyuma gishyirwamo, seringe ya 10 mL cyangwa irenga, urutoki rw'ibumoso rukora aho inshinge yatobowe n'igikumwe gikomeza uruhu mu gihe ushyiraho intebe, ukuboko kw'iburyo gufata seringe mu buryo buhagaze mu rushinge, wirinde kunyeganyega cyangwa kuzunguruka, hanyuma ushyiremo saline buhoro buhoro 5 mL ~ 10 mL iyo hari ikintu cyo kugwa hanyuma agasongero k'urushinge kagakora hasi ku ntebe, hanyuma urebe niba uburyo bwo gutanga imiti burimo uburinganire (niba butari bwiza, ugomba kubanza kureba niba urushinge rwarafunze). Reba niba hari uruhu rukikije ruri hejuru iyo urimo gusunika.

C. Suka umuti wa chimiotherapeutic buhoro buhoro nyuma yo kwemeza ko nta kosa ririmo. Mu gihe cyo gusunika, witondere kureba niba uruhu rukikije ruri hejuru cyangwa rwirabura, kandi niba hari ububabare bwo mu gace utuyemo. Nyuma yo gusunika umuti, ugomba kubikwa mu gihe cy'iminota 15 kugeza 30.

D. Nyuma ya buri guterwa inshinge, ni byiza ko woza intebe y’urushinge n’umuyoboro wa catheter ukoresheje 6 ~ 8mL ya saline physiological, hanyuma ugafunga catheter ukoresheje 3mL ~ 5mL ya 100U / mL ~ 200U / mL ya saline ya heparin, kandi iyo 0.5mL ya nyuma ya saline ya heparin itewe, umuti ugomba gusunikwa mu gihe usubira inyuma, kugira ngo sisitemu yo gushyiramo umuti yuzuremo saline ya heparin kugira ngo hirindwe ko imiti ihinduka kandi amaraso agafungana muri catheter. Catheter igomba kozwamo saline ya heparin rimwe mu byumweru 2 mu gihe cy’imiti ya chemotherapy.

E. Nyuma yo guterwa inshinge, shyira umuti wica udukoko mu jisho ry'urushinge, utwikire umuti wica udukoko, kandi witondere gukomeza kugira isuku n'umusemburo w'aho hantu kugira ngo wirinde kwandura aho wapfumuwe.

F. Witondere uko umurwayi abyitwaramo nyuma yo guhabwa umuti kandi ukurikirane neza igihe aterwa umuti.

 

【Icyitonderwa, umuburo n'ibikubiyemo bigamije kubangamira abandi】

1. Uyu muti uterwa umuti wica udukoko na ethylene oxide kandi umara imyaka itatu.
2. Mbere yo gukoresha, soma amabwiriza kugira ngo urebe neza ko ikoreshwa ari ryiza.
3. Gukoresha iki gikoresho bigomba kubahiriza ibisabwa n'amategeko agenga imikorere n'amabwiriza agenga urwego rw'ubuvuzi, kandi gushyiramo, gukoresha no gukuramo ibi bikoresho bigomba kugengwa n'abaganga bemewe gusa. Gushyiramo, gukoresha no gukuramo ibi bikoresho ni abaganga bemewe gusa, kandi ubuvuzi nyuma yo kuvura bugomba gukorwa n'abaganga babishoboye.
4. Igikorwa cyose kigomba gukorwa mu gihe cy’ubudahangarwa bw’amazi.
5. Mbere yo gukora, banza urebe itariki ntarengwa y'uko ibicuruzwa birangira ndetse n'aho bipfunyitse imbere kugira ngo urebe niba byangiritse.
6. Nyuma yo gukoresha, iki gicuruzwa gishobora guteza ingaruka mbi ku buzima bw'abantu. Nyamuneka kurikiza ubuvuzi bwemewe n'amategeko n'amabwiriza yose agenga uburyo bwo kugikoresha no kuvura.
7. Ntugakoreshe imbaraga nyinshi mu gihe cyo gushyiramo umuyoboro w'amaraso mu miyoboro y'amaraso kandi winjize umutsi w'amaraso neza kandi vuba kugira ngo wirinde ko imitsi ikomeza kugabanuka. Niba gushyiramo umuyoboro bigoye, koresha intoki zawe kugira ngo uhindukize catheter uhereye ku ruhande ujya ku rundi mu gihe ushyiramo umuyoboro w'amaraso.
8. Uburebure bwa catheter ishyirwa mu mubiri bugomba kuba bukwiye, burebure cyane bworoshye kuzunguruka mu nguni, bigatuma umwuka mubi uhumeka, bugufi cyane ni igihe ibikorwa by'urugomo by'umurwayi bishobora kuva mu muyoboro. Iyo catheter ari ngufi cyane, ishobora kuva mu muyoboro iyo umurwayi yihuta cyane.
9. Catheter igomba gushyirwa mu muyoboro ifite imigozi irenga ibiri kandi ifashe neza kugira ngo umuti utererwe neza kandi wirinde ko catheter inyerera.
10. Niba igikoresho gishobora gushyirwamo ari ubwoko bwa kabiri, isano iri hagati ya catheter n'intebe yo guterwamo inshinge igomba kuba ikomeye. Niba bidakenewe gutera imiti mu gihe cyo kubagwa, gutera imiti isanzwe ya saline bigomba gukoreshwa kugira ngo byemezwe mbere yo gukurura uruhu.
11. Mu gutandukanya agace ko munsi y'umubiri, hagomba gukorwa isuku yo mu nda kugira ngo hirindwe ko habaho ihungabana ry'amaraso, amazi yiyongera cyangwa kwandura indwara nyuma yo kubagwa; umushongi wo mu nda ugomba kwirinda intebe yo guterwamo inshinge.
12. Kole zo kwa muganga za α-cyanoacrylate zishobora kwangiza ibikoresho by'ibanze by'inshinge; ntugakoreshe kole zo kwa muganga za α-cyanoacrylate mu gihe uvura inshinge zo kubaga zikikije inshinge. Ntugakoreshe kole zo kwa muganga za α-cyanoacrylate mu gihe uvura inshinge zo kubaga zikikije inshinge.
13. Koresha ubwitonzi bukabije kugira ngo wirinde ko catheter iva bitewe n'impanuka yatewe n'ibikoresho byo kubaga.
14. Mu gihe cyo gutobora, urushinge rugomba gushyirwamo uhagaze, hagakoreshwa seringe ifite ubushobozi bwa 10mL cyangwa irenga, umuti ugaterwa buhoro buhoro, kandi urushinge rugomba gukurwamo nyuma yo guhagarara gato. Umuvuduko wo gusunika ntugomba kurenga 200kPa.
15. Koresha gusa inshinge zidasanzwe ku bikoresho byo gutanga imiti bishobora gushyirwa mu mubiri.
16. Iyo bikenewe ko umuntu ahabwa imiti myinshi cyangwa ayisimbura, ni byiza gukoresha igikoresho gikoreshwa rimwe cyo kuyiteramo imiti gifite urushinge rwihariye rwo kuyiteramo cyangwa agati, kugira ngo ugabanye umubare w'ibitoborwa no kugabanya ingaruka ku murwayi.
17. Gabanya umubare w'udusimba two gupfunyika, gabanya kwangirika kw'imitsi y'umurwayi n'ibice byayo byifunga. Mu gihe cyo guhagarika gutera umuti, gutera umuti ugabanya amaraso biba ngombwa rimwe mu byumweru bibiri.
18. Iki gicuruzwa ni ikintu gikoreshwa rimwe gusa, kidafite ubusembwa, kidatera indwara, cyangiritse nyuma yo gukoreshwa, kongera gukoreshwa birabujijwe cyane.
19. Niba ipaki y'imbere yangiritse cyangwa itariki ntarengwa y'uko ibicuruzwa bizarangiriraho yarenze, nyamuneka ubisubize ku wabikoze kugira ngo abijugunye.
20. Umubare w'udupfundo kuri buri gice cy'inshinge ntugomba kurenga 2000 (22Ga). 21.
21. Ingano ntoya yo gusohora amazi ni 6ml