【Contraindications】

1) Kare e tika ana a-hinengaro, a-tinana ranei mo te pokanga i roto i nga ahuatanga whanui

2) Te kaha o te toto me te mate o te toto.

3) He iti ake i te 3×109/L te tatau o te toto toto ma

4) He mate pāwera ki te pāpāho rerekē

5) Ka honoa ki te mate pukupuku obstructive pulmonary.

6) Ko nga turoro e mohio ana, e whakapaehia ana ranei he mate mate ki nga taonga kei roto i te kete taputapu.

7) Te aroaro, te whakapae ranei mo te mate e pa ana ki te taputapu, te bacteremia, te sepsis ranei.

8) Radiotherapy i te waahi e whakaarohia ana kia whakauruhia.

9) Te whakaahua, te werohanga ranei o nga raau taero embolic.

 

【Waihanga】 Tirohia te tapanga hua

 

【Rā paunga】 Tirohia te tapanga hua

 

【Tirohanga tono】

1. Whakapaia te taputapu tauranga implantable ka tirohia mena kua hipa te ra paunga;tangohia te kete o roto ka tirohia mena he kino te kete.
2. Me whakamahi tikanga aseptic ki te tapahi tuwhera te kete o roto me te tango i te hua mo te whakarite ki te whakamahi.
3. Ko te whakamahinga o nga taputapu tauranga whakauru ka whakaahuahia motuhake mo ia tauira e whai ake nei.

 

MomoⅠ

1. Te pupuhi, te hau, te whakamatautau turuturu

Whakamahia he syringe (ngira mo te taputapu tauranga whakauru) ki te werohia te taputapu tauranga whakato me te werohia te 5mL-10mL o te tote tinana hei horoi i te nohoanga werohanga me te lumen catheter me te whakakore.Ki te kore e kitea he wai puhoi ranei, whiria te pito tuku tarukino o te catheter (te pito tawhiti) ma te ringaringa hei whakatuwhera i te tauranga tuku tarukino;katahi ka katia te pito tuku tarukino o te catheter, toha tonu ki te tote (kaore e neke ake te pehanga i te 200kPa), tirohia mena he turuturu mai i te nohoanga werohia me te hononga catheter.

1. Cannulation and ligation

E ai ki te tirotiro i roto i nga mahi, whakauruhia te catheter (whakamutunga tuku rongoa) ki roto i te ipu tuku toto e rite ana ki te waahi o te puku, me te whakamahi i nga tui kore-absorbable hei hono tika i te catheter ki te oko.Me tika te here o te catheter (e rua, neke atu ranei nga paahi) ka whakatika.

1. chemotherapy me te hiri

Ka taea te werohia te tarukino chemotherapy i roto i te mahi kotahi i runga i te mahere maimoatanga;e taunaki ana kia horoia te nohoanga werohanga me te lumen catheter ki te 6-8 mL o te tote tinana, ka whai i te 3 mL~5 mL Ka hirihia te catheter ki te 3mL ki te 5mL o te saline heparin i te 100U/mL ki te 200U/mL.

1. Whakatikanga nohoanga werohanga

Ka hangaia he kohanga kirikiri subcutaneous ki te waahi tautoko, he 0.5 cm ki te 1 cm mai i te mata kiri, ka whakanohohia te nohoanga werohanga ki roto i te kohao me te whakatika, ka werohia te kiri i muri i te hemostasis tino.Mena he roa rawa te catheter, ka taea te porowhita ki te pito tata me te whakatika tika.

 

MomoⅡ

1. Te pupuhi me te hau

Whakamahia he syringe (ngira mo te taputapu tauranga whakauru) ki te werohia te tote ki roto i te nohoanga werohia me te catheter hei horoi me te tango i te hau i roto i te lumen, ka tirohia mena he maeneene te wai kawe.

2. Cannulation and ligation

4. Whakamatau turuturu

4. I muri i te otinga o te hononga, piuhia, katia te catheter ki te tuara o te topenga maukati, ka werohia te tote ki roto i te nohoanga werohia me te syringe (ngira mo te taputapu tuku tarukino whakauru) (te pehanga neke atu i te 200kPa).(kaua e neke ake te pehanga i te 200kPa), tirohia mena ka pakaru mai te paraka werohia me te catheter.

hononga, me te whakamahi i muri i te mea noa nga mea katoa.

5. Chemotherapy, ngongo hiri

Ka taea te werohia te tarukino chemotherapy i roto i te mahi kotahi i runga i te mahere maimoatanga;e tūtohu ana ki te horoi i te turanga werohanga me te catheter lumen ki te 6~8mL o te saline whaiaroaro, ka whakamahi i te 3mL~5mL o te tote tinana.

Ka hiritia te catheter ki te 3mL ki te 5mL o te saline heparin i te 100U/mL ki te 200U/mL.

6. Whakatika nohoanga werohanga

I hangaia he kohanga cystic subcutaneous i te waahi tautoko, 0.5 cm ki te 1 cm mai i te mata o te kiri, a ka whakanohoia te nohoanga werohanga ki roto i te kohanga me te whakatika, ka werohia te kiri i muri i te hemostasis tino.

 

Momo Ⅲ

I whakamahia he syringe (ngira motuhake mo te taputapu tauranga whakauru) ki te werohia te 10mL ~ 20mL saline noa ki roto i te taputapu tuku raau taero hei horoi i te nohoanga werohanga me te kohao o te catheter, me te tango i te hau i roto i te kohao, me te mataki mena te wai. he koretake.

2. Cannulation and ligation

E ai ki te tirotiro i roto i te mahi, whakauruhia te catheter i te taha o te pakitara puku, a ko te waahanga tuwhera o te mutunga o te tuku tarukino me uru ki roto i te kohao puku me te tata ki te taumata pukupuku ka taea.Kōwhiria kia 2-3 ngā tohu hei here me te whakatika i te catheter.

3. chemotherapy, ngongo hiri

Ka taea te werohia te tarukino chemotherapy Intraoperative kia rite ki te mahere maimoatanga, katahi ka hiri te ngongo ki te 3mL~5mL o te 100U/mL~200U/mL heparin saline.

4. Whakatika nohoanga werohanga

I hangaia he kohanga cystic subcutaneous i te waahi tautoko, 0.5 cm ki te 1 cm mai i te mata o te kiri, a ka whakanohoia te nohoanga werohanga ki roto i te kohanga me te whakatika, ka werohia te kiri i muri i te hemostasis tino.

Te whaowhia tarukino me te tiaki

A.Ko te mahi aseptiki, ko te kowhiringa tika o te waahi tuuru werohanga i mua i te werohanga, me te whakakino mate o te waahi werohanga.B. I te wa e werohia ana, whakamahia he ngira mo te taputapu tauranga whakauru, he syringe o te 10 mL neke atu ranei, me te ringa maui o te ringa maui e pa ana ki te waahi werohanga me te koromatua e whakakaha ana i te kiri i te wa e whakatika ana te nohoanga werohanga, me te ringa matau e pupuri ana i te syringe. poutū ki roto i te ngira, karohia te wiriwiri, te hurihuri ranei, ka werohia te tote 5 mL~10 mL ina kua taka te ahua ka pa te pito o te ngira ki raro o te nohoanga werohia, ka tirohia mena he maeneene te punaha tuku tarukino. (mehemea karekau he maeneene, me titiro tuatahi mena kua purua te ngira).Tirohia mehemea he pikinga o te kiri huri noa i te wa e pana ana.

C. Kia ata panaia te tarukino chemotherapeutic i muri i te whakau karekau he hapa.I te wa e pana ana, kia tupato ki te titiro mehemea kua piki te kiri, kua koma ranei, me te mamae o te rohe.I muri i te panaia o te tarukino, me pupuri mo te 15s~30s.

D. I muri i ia werohanga, ka tūtohuhia kia horoia te nohoanga werohanga me te catheter lumen ki te 6 ~ 8mL o te saline whaiaroaro, ka hiritia te catheter ki te 3mL ~ 5mL o te 100U / mL ~ 200U / mL o te heparin saline, a ka mutu Ka werohia te 0.5mL o te saline heparin, me pana te raau taero i te wa e hoki ana, kia whakakiia te punaha whakauru tarukino ki te heparin saline hei aukati i te whakamaaramatanga o te tarukino me te whakaheke toto i roto i te catheter.Me horoi te catheter ki te heparin saline kotahi ia 2 wiki i te wa o te chemotherapy.

E. I muri i te werohanga, whakawetohia te kanohi ngira ki te waipara hauora, hipokina ki te whakakakahu parakore, kia tupato kia ma, kia maroke te waahi o te rohe kia kore ai e pangia te mate ki te waahi wero.

F. Kia whai whakaaro ki te tauhohenga o te manawanui i muri i te whakahaerenga tarukino me te ata titiro i te wa e werohia ana te tarukino.

 

【Whakatupato, whakatupato me nga ihirangi whakaaro】

1. Ko tenei hua ka whakahoroa e te ethylene oxide ka whai mana mo nga tau e toru.
2. Tena panuihia te pukapuka tohutohu i mua i te whakamahi hei whakarite i te haumaru o te whakamahinga.
3. Ko te whakamahinga o tenei hua me tutuki ki nga whakaritenga o nga tikanga mahi me nga ture e pa ana ki te waahanga rongoa, me te whakauru, te mahi me te tango i enei taputapu me herea ki nga taakuta whaimana.Ko te whakauru, te mahi me te tango i enei taputapu he kua herea ki nga rata whaimana, me te tiaki i muri i te ngongo e nga kaimahi hauora whai mana.
4. Ko te tukanga katoa me mahi i raro i nga tikanga aseptic.
5. Tirohia te ra paunga o te hua me te putunga o roto mo te kino i mua i te mahi.
6. I muri i te whakamahinga, ka raru pea te hua mo te koiora.Me whai i nga mahi rongoa kua whakaaetia me nga ture me nga ture katoa e pa ana mo te whakahaere me te maimoatanga.
7. Kaua e kaha ki te whakamahi i te kaha i te wa e werohia ana, me te whakauru tika me te tere o te uaua ki te karo i te vasospasm.Mena he uaua te whakauru, whakamahia o maihao ki te huri i te ngongo mai i tetahi taha ki tetahi taha i te wa e whakauru ana i te ngongo.
8. Kia tika te roa o te catheter kua tuu ki roto i te tinana, he roa rawa te ngawari ki te kopiko ki te koki, ka hua mai he ngoikoretanga o te hau, he poto rawa te wa ka taea e nga mahi tutu te manawanui te wehe mai i te ipu.Mena he poto rawa te catheter, tera pea ka mawehe atu i te waka ina kaha te neke o te manawanui.
9. Me kuhu te catheter ki roto i te oko me te neke atu i te rua nga here me te here tika kia pai te werohanga tarukino me te kore e paheke te catheter.
10. Mena he momo II te taputapu tauranga whakauru, me mau te hononga i waenga i te catheter me te nohoanga werohanga.Ki te kore e hiahiatia te werohanga tarukino i roto i te mahi, me whakamahi te werohanga whakamatautau tote mo te whakau i mua i te werohanga i te kiri.
11. I te wa e wehea ana te waahi o raro o te kiri, me mahi he hemostasis tata kia kore ai te hanga o te hematoma o te rohe, te whakaemi wai, te mate tuarua ranei i muri i te pokanga;kia karohia te tuuru vesicular i te nohoanga werohanga.
12. Ka taea e nga taapiri rongoa α-cyanoacrylate te kino ki te papanga turanga werohanga;kaua e whakamahi i nga whakapiri rongoa α-cyanoacrylate i te wa e rongoa ana i te werohanga pokanga huri noa i te turanga werohanga.Kaua e whakamahi i nga whakapiri rongoa α-cyanoacrylate i te wa e pa ana ki nga werohanga huri noa i te turanga werohanga.
13. Kia tino tupato ki te karo i te turuturu o te catheter na te whara ohorere mai i nga taputapu pokanga.
14. I te wa e werohia ana, me kuhu poutū te ngira, me whakamahi he syringe 10mL neke atu ranei, me ata werohia te tarukino, me tango te ngira i muri i te okiokinga poto.Ko te pehanga pana kia kaua e neke ake i te 200kPa.
15. Me whakamahi noa i nga ngira motuhake mo nga taputapu tuku tarukino whakato.
16. Ina hiahiatia he whaowhia roa, he whakakapinga raau taero ranei, he mea tika ki te whakamahi i tetahi taputapu tuku tarukino whakauru kotahi me te ngira whaowhia motuhake, tee ranei, hei whakaiti i te maha o nga wero me te whakaiti i te paanga ki te manawanui.
17. Whakaitihia te maha o nga werohanga, whakaitihia te kino o te uaua o te manawanui me nga waahanga hiri-a-whaiaro.I te wa o te whakamutua o te werohanga tarukino, ka hiahiatia te werohanga anticoagulant kotahi ia rua wiki.
18. Ko tenei hua he hua kotahi-whakamahi, horomata, kore-pyrogenic, ka whakangaromia i muri i te whakamahinga, ka tino rahuitia te whakamahi ano.
19. Mena kua pakaru te kete o roto, kua hipa atu ranei te ra paunga o te hua, tena koa whakahoki mai ki te kaihanga mo te tuku.
20. Ko te maha o nga werohanga mo ia poraka werohia kaua e neke ake i te 2000 (22Ga).21.
21. Ko te 6ml te iti rawa o te ruri