Ibisobanuro ku ikoreshwa rya katheteri ya hemodialysis idafite umwanda hamwe na katheteri ya hemodialysis y'igihe kirekire.

Amaraso akoreshwa mu kujugunyamo imiti idafite uburibwekatheteri ya hemodialysisn'ibikoresho. Ikoreshwa mu gukuramo imiti idafite ubusembwakatheteri ya hemodialysisImiterere n'imiterere y'umusaruro Iki gicuruzwa kigizwe n'umutwe woroshye, intebe ihuza, umuyoboro wo kwagura n'agace k'inyuma; Catheter ikozwe muri polyurethane na polycarbonate. Ni umwobo umwe, umwobo ubiri na catheter eshatu. Iki gicuruzwa gikoreshwa mu buvuzi mu gupima no gutera. Ibisobanuro by'icyitegererezo: umwobo ubiri, umwobo utatu
Umuyoboro w'amazi wo mu muyoboro ufite ikoti rya dacron

Kubera gusaza kw'abaturage, umuvuduko ukabije w'amaraso, diyabete, indwara z'umutima (CHD) hamwe n'abarwayi barwaye impyiko, imitsi y'amaraso iba mibi, indwara zo mu miyoboro y'amaraso ziterwa n'imitsi ziyongera cyane, indwara zo mu mitsi ziterwa n'imitsi ziterwa n'imitsi zigaragara mu buryo bwimbitse, zigira ingaruka zikomeye ku murwayi ku ngaruka zo kuvurwa na dialyse n'ubuzima bwe, bityo fata catheter cyangwa catheter yo mu muyoboro wa polyester igihe kirekire, imaze igihe kinini ikoreshwa ku isi, inyungu yayo ni: Catheter ifite ubushobozi bwo guhuza neza umubiri, kandi catheter ishobora gufatirwa neza n'uruhu. Agakoresho kayo ka polyester gashobora gukora umuyoboro ufunze wa bagiteri mu muyoboro uri munsi y'umubiri, bikagabanya ubwandu no kongera igihe cyo kuyikoresha.
Gukoresha no kubungabunga catheters za hemodialysis

1. Kwakira no gusuzuma catheters

1. Aho gusohora uruhu rwa catheter

Mbere na nyuma ya buri ikoreshwa, ishusho y'uruhu aho uruhu rusohokera igomba gusuzumwa niba hari umutuku, isohoka ry'amaraso, ububabare, kuva amaraso no gusohora amaraso, nibindi. Niba ari catheter y'igihe gito, reba aho urushinge rw'umushongi ruhagaze. Niba ari catheter y'igihe kirekire, reba niba CAFF yakuwe cyangwa yavuye.

2. Ingingo yo hanze ya catheter

Haba hari guturika cyangwa kwangirika, urwego rw'ubugari bw'amaraso, niba amaraso adatembera neza, bigomba kumenyeshwa muganga ku gihe, kandi imiterere y'amaraso mu gitereko cya thrombus na fibrin muri catheter igomba kugaragazwa hakoreshejwe ultrasound, isuzuma n'ubundi buryo.

3. Ibimenyetso by'umurwayi

Niba ibimenyetso n'ingano y'umuriro, ubukonje, ububabare n'ibindi bibazo by'ububabare.

2. Uburyo bwo gukora ihuza

1. Kwitegura

(1) Imashini ya dialysis yatsinze isuzuma ryayo, umuyoboro wa dialysis wabanje gusukurwa kandi uri mu gihe cyo gutegereza.

(2) Gutegura: Igare ryo kuvura cyangwa isahani yo kuvura, ibikoresho byo kwica udukoko (iyodofori cyangwa chlorhexidine), ibikoresho byanduye (igitambaro cyo kuvura, agatambaro k'isuku, seringe, uturindantoki two gusukura, nibindi).

(3) Umurwayi agomba gushyirwa mu mwanya mwiza wo kuryama, kandi umurwayi ufite ijosi ryo kuryama agomba kwambara agapfukamunwa kugira ngo agaragaze umwanya wo kuryamamo.

2. Uburyo bwo gukora

(1) Fungura agapfundikizo k'inyuma ka catheter yo hagati mu mitsi.

(2) Ambara uturindantoki.

(3) Fungura 1/4 cy'igitambaro cyo kuvura gikozwe mu buryo bwa "sterile" hanyuma ukishyire munsi ya catheter ifite lumen ebyiri y'umutsi wo hagati.

(4) Gusukura umupfundikizo wo kurinda catheter, umunwa wa catheter n'agakingirizo ka catheter inshuro 2 zikurikirana.

(5) Reba neza ko agakoresho ka catheter gahambiriwe, ukureho akabuto, hanyuma ugate. Shyira catheter yangiritse ku ruhande rwa 1/2 rw'igitambaro cyo kuvuriramo.

(6) Ongera usukemo udukoko mu muyoboro mbere yo kuwukoresha.

(7) Umuti wa heparin ufunga intracatheter wa 2mL wasubijwemo ukoresheje seringe ya 2-5ml hanyuma ushyirwa kuri gauze.

(8) Reba niba hari uduce duto ku gatambaro. Niba hari uduce duto, ongera ukuremo 1ml hanyuma ushyiremo urushinge. Intera iri hagati y'urushinge n'agatambaro ni ndende cyane kurusha 10cm.

(9) Nyuma yo kubona ko catheter idakingiye, huza imiyoboro y'amaraso n'imitsi ijyana amaraso hanze y'umubiri kugira ngo ushyireho uburyo amaraso azenguruka hanze y'umubiri.

3. Guhagarika igikorwa cyo kuziba imiyoboro y'amazi nyuma yo gusukura amaraso

(1) Nyuma yo kuvurwa no kugaruka kw'amaraso, fata agakoresho ka catheter, ushyireho imiti yica udukoko ku gice cya catheter ifata imitsi, hanyuma uvane igice n'umuyoboro w'amaraso uzenguruka amaraso.

(2) Sukura umwuka uva mu mitsi n'imitsi ya catheter, hanyuma usukemo 10ml ya saline isanzwe kugira ngo woze catheter ukoresheje uburyo bwo gutera. Nyuma yo kwitegereza amaso, nta maraso yari yasigaye mu gice cya catheter cyagaragaye, kanda amazi afunga agabanya amaraso ukoresheje agace k'amaraso nk'uko muganga yabigutegetse. (3) Koresha agapfundikizo ka heparin gasukuye kugira ngo ufunge umwobo w'imitsi n'uduce tubiri tw'agatambaro gasukuye kugira ngo upfundike. Byarakosowe.

3. Guhindura impuzandengo ya catheter yo mu mitsi yo hagati

1. Reba niba ifuro ryumye, rifite amaraso n'ibizinga.

2. Ambara uturindantoki.

3. Fungura agapfundikizo hanyuma urebe niba hari amaraso, ubushyuhe, gutukura no kubyimba, kwangirika k'uruhu no gushonga kw'imitsi aho catheter yo hagati mu mitsi ishyizwe.

4. Fata agatambaro k'ipamba ka iodophor hanyuma ukazungurutse ukurikije icyerekezo cy'isaha kugira ngo usuke umuti aho umuyoboro washyizwe. Intera yo gusukura umuti ni cm 8-10.

5. Shyira agapfundikizo k'igikomere ku ruhu aho umuyoboro ushyizwe, kandi werekane igihe cyo guhindura agapfundikizo. Ikoreshwa n'isukura rya catheter

1. Kwakira no gusuzuma catheters

1. Aho gusohora uruhu rwa catheter

Mbere na nyuma ya buri ikoreshwa, ishusho y'uruhu aho uruhu rusohokera igomba gusuzumwa niba hari umutuku, isohoka ry'amaraso, ububabare, kuva amaraso no gusohora amaraso, nibindi. Niba ari catheter y'igihe gito, reba aho urushinge rw'umushongi ruhagaze. Niba ari catheter y'igihe kirekire, reba niba CAFF yakuwe cyangwa yavuye.

2. Ingingo yo hanze ya catheter

Haba hari guturika cyangwa kwangirika, urwego rw'ubugari bw'amaraso, niba amaraso adatembera neza, bigomba kumenyeshwa muganga ku gihe, kandi imiterere y'amaraso mu gitereko cya thrombus na fibrin muri catheter igomba kugaragazwa hakoreshejwe ultrasound, isuzuma n'ubundi buryo.

3. Ibimenyetso by'umurwayi

Niba ibimenyetso n'ingano y'umuriro, ubukonje, ububabare n'ibindi bibazo by'ububabare.

2. Uburyo bwo gukora ihuza

1. Kwitegura

(1) Imashini ya dialysis yatsinze isuzuma ryayo, umuyoboro wa dialysis wabanje gusukurwa kandi uri mu gihe cyo gutegereza.

(2) Gutegura: Igare ryo kuvura cyangwa isahani yo kuvura, ibikoresho byo kwica udukoko (iyodofori cyangwa chlorhexidine), ibikoresho byanduye (igitambaro cyo kuvura, agatambaro k'isuku, seringe, uturindantoki two gusukura, nibindi).

(3) Umurwayi agomba gushyirwa mu mwanya mwiza wo kuryama, kandi umurwayi ufite ijosi ryo kuryama agomba kwambara agapfukamunwa kugira ngo agaragaze umwanya wo kuryamamo.

2. Uburyo bwo gukora

(1) Fungura agapfundikizo k'inyuma ka catheter yo hagati mu mitsi.

(2) Ambara uturindantoki.

(3) Fungura 1/4 cy'igitambaro cyo kuvura gikozwe mu buryo bwa "sterile" hanyuma ukishyire munsi ya catheter ifite lumen ebyiri y'umutsi wo hagati.

(4) Gusukura umupfundikizo wo kurinda catheter, umunwa wa catheter n'agakingirizo ka catheter inshuro 2 zikurikirana.

(5) Reba neza ko agakoresho ka catheter gahambiriwe, ukureho akabuto, hanyuma ugate. Shyira catheter yangiritse ku ruhande rwa 1/2 rw'igitambaro cyo kuvuriramo.

(6) Ongera usukemo udukoko mu muyoboro mbere yo kuwukoresha.

(7) Umuti wa heparin ufunga intracatheter wa 2mL wasubijwemo ukoresheje seringe ya 2-5ml hanyuma ushyirwa kuri gauze.

(8) Reba niba hari uduce duto ku gatambaro. Niba hari uduce duto, ongera ukuremo 1ml hanyuma ushyiremo urushinge. Intera iri hagati y'urushinge n'agatambaro ni ndende cyane kurusha 10cm.

(9) Nyuma yo kubona ko catheter idakingiye, huza imiyoboro y'amaraso n'imitsi ijyana amaraso hanze y'umubiri kugira ngo ushyireho uburyo amaraso azenguruka hanze y'umubiri.

3. Guhagarika igikorwa cyo kuziba imiyoboro y'amazi nyuma yo gusukura amaraso

(1) Nyuma yo kuvurwa no kugaruka kw'amaraso, fata agakoresho ka catheter, ushyireho imiti yica udukoko ku gice cya catheter ifata imitsi, hanyuma uvane igice n'umuyoboro w'amaraso uzenguruka amaraso.

(2) Sukura umwuka uva mu mitsi n'imitsi ya catheter, hanyuma usukemo 10ml ya saline isanzwe kugira ngo woze catheter ukoresheje uburyo bwo gutera. Nyuma yo kwitegereza amaso, nta maraso yari yasigaye mu gice cya catheter cyagaragaye, kanda amazi afunga agabanya amaraso ukoresheje agace k'amaraso nk'uko muganga yabigutegetse. (3) Koresha agapfundikizo ka heparin gasukuye kugira ngo ufunge umwobo w'imitsi n'uduce tubiri tw'agatambaro gasukuye kugira ngo upfundike. Byarakosowe.

3. Guhindura impuzandengo ya catheter yo mu mitsi yo hagati

1. Reba niba ifuro ryumye, rifite amaraso n'ibizinga.

2. Ambara uturindantoki.

3. Fungura agapfundikizo hanyuma urebe niba hari amaraso, ubushyuhe, gutukura no kubyimba, kwangirika k'uruhu no gushonga kw'imitsi aho catheter yo hagati mu mitsi ishyizwe.

4. Fata agatambaro k'ipamba ka iodophor hanyuma ukazungurutse ukurikije icyerekezo cy'isaha kugira ngo usuke umuti aho umuyoboro washyizwe. Intera yo gusukura umuti ni cm 8-10.

5. Shyira agapfundikizo k'igikomere ku ruhu aho umuyoboro ushyizwe, kandi werekane igihe cyo guhindura agapfundikizo.