Toto parakore whakakorekorete katitere hemodialysisme ngā taputapu parakore maka-korete katitere hemodialysishanganga mahi hua me te hanganga he mea tito tēnei hua i te pito ngohengohe, he nohoanga hono, he ngongo toronga me te kōne kōne; he mea hanga te catheter ki te polyurethane hauora me te polycarbonate. He kōhao kotahi, he kōhao takirua, he catheter kōhao toru. Ka whakamahia haumanu tēnei hua mō te hemodialysis me te werohanga. Ngā Whakatakotoranga tauira kōhao takirua, kōhao toru
He paipa kauhanga me te koti dacron
I te kaumātuatanga o te hapori, te toto toto tiketike, te mate huka, te mate ngakau (CHD) me te ngoikore o te whatukuhu, te ngoikore o te āhua o ngā oko toto, te pikinga ake o ngā raruraru o te fistula arteriovenous ā-roto, ā, ka pā kino ki te hua o te maimoatanga dialysis me te kounga o te oranga o te tūroro, nō reira, kua roa te whakamahi i te catheter whitiki polyester, te catheter rānei, kua whānuitia te whakamahinga puta noa i te ao, ko tōna painga: He pai te hototahitanga o te catheter, ā, ka taea te piri pūmau ki te kiri. Ka taea e tōna ringaringa polyester te hanga i tētahi arai huakita kati i roto i te kauhanga kiri raro, ka whakaiti i te putanga mai o te mate, ka roa ake te wā whakamahi.
Te whakamahinga me te tiaki i ngā catheter hemodialysis
1. Te atawhai me te aromatawai i ngā katitere
1. Putanga kiri catheter
I mua atu, ā, i muri i ia whakamahinga, me arotake te āhua o te putanga kiri i te wāhi e whakauruhia ana te ngongo mō te whero, te tukunga, te ngawari, te toto me te wai, me ētahi atu. Mena he catheter rangitahi, tirohia te piri o te ngira tuitui. Mena he catheter roa, tirohia mēnā kua toia, kua pūwero rānei te CAFF.
2. Hononga o waho o te catheter
Ahakoa he pakaru, he whati rānei, me whakaatu ki te tākuta te nui o te āheinga o te oko toto, me te kore e ranea te rere o te toto, ā, me whakatau te hanganga o ngā thrombus me te pukupuku fibrin i roto i te catheter mā te ultrasound, te whakaahua me ētahi atu tikanga.
3. Ngā tohu a te tūroro
Ahakoa ngā tohu me te nui o te kirika, te makariri, te mamae me ētahi atu amuamu o te kore whakamarie.
2. Te tukanga whakahaere hononga
1. Te Whakarite
(1) Kua paahitia e te mīhini tātaritanga te tirotiro-ā-unoa, kua horoia te paipa tātaritanga i mua, ā, kei te tū tonu.
(2) Te Whakarite: te kāreti maimoatanga, te paepae maimoatanga rānei, ngā taputapu patu huakita (iodophor, chlorhexidine rānei), ngā taputapu parakore (te tauera maimoatanga, te kākahu, te pūwero, ngā karapu horoi, me ētahi atu).
(3) Me whakatakoto te tūroro ki tētahi tūranga takoto pai, ā, me mau te tūroro e werohia ana te ngongo ki tōna kaki i tētahi kopare hei whakaatu i te tūranga werohia.
2. Tukanga
(1) Whakatuwheratia te takai o waho o te catheter uaua pokapū.
(2) Mauria ngā karapu.
(3) Whakatuwheratia te 1/4 taha o te tauera maimoatanga parakore ka whakanoho ki raro i te catheter rua-lumen o te uaua pokapū.
(4) Whakapangia te taupoki tiaki katitere, te waha katitere me te rawhi katitere e te tīwiri, kia rua ngā wā.
(5) Tirohia mēnā kua mau te rawhi o te katitere, tangohia te nati, ka maka atu. Whakatakotoria te katitere kua whakahoromatatia ki te taha 1/2 o te tauera maimoatanga.
(6) Horoia anō te pūwero i mua i te whakamahinga.
(7) I pūhia anō te 2mL o te otinga heparin hiri i roto i te catheter ki te ngira 2-5ml, ā, i panaia ki runga i te kāpia.
(8) Tirohia mēnā he totoka kei runga i te kākahu. Mēnā he totoka, tangohia anō te 1ml ka pēhi i te werohanga. Neke atu i te 10cm te tawhiti i waenganui i te werohanga me te kākahu.
(9) Whai muri i te whakatau kāore he arai o te katitere, honoa ngā paipa toto o te uaua me te uaua o waho o te tinana hei whakatū i te tohanga toto o waho o te tinana.
3. Whakamutua te mahi hiri o te ngongo i muri i te dialysis
(1) I muri i te maimoatanga me te hokinga mai o te toto, whakapirihia te whakapiri o te catheter, horoia te hononga catheter arteriovenous, ka momotu i te hononga ki te paipa tohanga toto.
(2) Whakakorehia te pūaha o te uaua me te uaua o te catheter, ka pēhi i te 10ml o te tote noa hei horoi i te catheter mā te tikanga pā. I muri i te tirotiro kanohi tahanga, kāore he toenga toto i te wāhanga e kitea ana o te catheter, pēhia te wai hiri ārai toto mā te pirepire e ai ki ngā tohutohu a te tākuta. (3) Whakamahia he taupoki heparin parakore hei hiri i te whakatuwheratanga o te ngongo arteriovenous me ngā paparanga takirua o te kākahu parakore hei takai. Kua oti te whakapūmau.
3. Te whakawhiti i te takai o te catheter uaua pokapū
1. Tirohia mēnā kua maroke te takai, mēnā he toto, he paru rānei.
2. Mauria ngā karapu.
3. Whakatuwheratia te takai ka tirohia mēnā he toto, he wai, he whero me te pupuhi, he kino te kiri me te marere o te tuitui i te wāhi i whakatakotoria ai te catheter uaua pokapū.
4. Tangohia he miro iodophor ka hurihia kia tika ki te taha matau hei patu i te wāhi i whakaurua ai te ngongo. Ko te awhe patu he 8-10cm.
5. Whakapirihia te takai patunga ki te kiri i te wāhi i whakatakotoria ai te ngongo, ā, tohua te wā whakawhiti takai. Te whakamahinga me te tiaki i ngā catheter
1. Te atawhai me te aromatawai i ngā katitere
1. Putanga kiri catheter
I mua atu, ā, i muri i ia whakamahinga, me arotake te āhua o te putanga kiri i te wāhi e whakauruhia ana te ngongo mō te whero, te tukunga, te ngawari, te toto me te wai, me ētahi atu. Mena he catheter rangitahi, tirohia te piri o te ngira tuitui. Mena he catheter roa, tirohia mēnā kua toia, kua pūwero rānei te CAFF.
2. Hononga o waho o te catheter
Ahakoa he pakaru, he whati rānei, me whakaatu ki te tākuta te nui o te āheinga o te oko toto, me te kore e ranea te rere o te toto, ā, me whakatau te hanganga o ngā thrombus me te pukupuku fibrin i roto i te catheter mā te ultrasound, te whakaahua me ētahi atu tikanga.
3. Ngā tohu a te tūroro
Ahakoa ngā tohu me te nui o te kirika, te makariri, te mamae me ētahi atu amuamu o te kore whakamarie.
2. Te tukanga whakahaere hononga
1. Te Whakarite
(1) Kua paahitia e te mīhini tātaritanga te tirotiro-ā-unoa, kua horoia te paipa tātaritanga i mua, ā, kei te tū tonu.
(2) Te Whakarite: te kāreti maimoatanga, te paepae maimoatanga rānei, ngā taputapu patu huakita (iodophor, chlorhexidine rānei), ngā taputapu parakore (te tauera maimoatanga, te kākahu, te pūwero, ngā karapu horoi, me ētahi atu).
(3) Me whakatakoto te tūroro ki tētahi tūranga takoto pai, ā, me mau te tūroro e werohia ana te ngongo ki tōna kaki i tētahi kopare hei whakaatu i te tūranga werohia.
2. Tukanga
(1) Whakatuwheratia te takai o waho o te catheter uaua pokapū.
(2) Mauria ngā karapu.
(3) Whakatuwheratia te 1/4 taha o te tauera maimoatanga parakore ka whakanoho ki raro i te catheter rua-lumen o te uaua pokapū.
(4) Whakapangia te taupoki tiaki katitere, te waha katitere me te rawhi katitere e te tīwiri, kia rua ngā wā.
(5) Tirohia mēnā kua mau te rawhi o te katitere, tangohia te nati, ka maka atu. Whakatakotoria te katitere kua whakahoromatatia ki te taha 1/2 o te tauera maimoatanga.
(6) Horoia anō te pūwero i mua i te whakamahinga.
(7) I pūhia anō te 2mL o te otinga heparin hiri i roto i te catheter ki te ngira 2-5ml, ā, i panaia ki runga i te kāpia.
(8) Tirohia mēnā he totoka kei runga i te kākahu. Mēnā he totoka, tangohia anō te 1ml ka pēhi i te werohanga. Neke atu i te 10cm te tawhiti i waenganui i te werohanga me te kākahu.
(9) Whai muri i te whakatau kāore he arai o te katitere, honoa ngā paipa toto o te uaua me te uaua o waho o te tinana hei whakatū i te tohanga toto o waho o te tinana.
3. Whakamutua te mahi hiri o te ngongo i muri i te dialysis
(1) I muri i te maimoatanga me te hokinga mai o te toto, whakapirihia te whakapiri o te catheter, horoia te hononga catheter arteriovenous, ka momotu i te hononga ki te paipa tohanga toto.
(2) Whakakorehia te pūaha o te uaua me te uaua o te catheter, ka pēhi i te 10ml o te tote noa hei horoi i te catheter mā te tikanga pā. I muri i te tirotiro kanohi tahanga, kāore he toenga toto i te wāhanga e kitea ana o te catheter, pēhia te wai hiri ārai toto mā te pirepire e ai ki ngā tohutohu a te tākuta. (3) Whakamahia he taupoki heparin parakore hei hiri i te whakatuwheratanga o te ngongo arteriovenous me ngā paparanga takirua o te kākahu parakore hei takai. Kua oti te whakapūmau.
3. Te whakawhiti i te takai o te catheter uaua pokapū
1. Tirohia mēnā kua maroke te takai, mēnā he toto, he paru rānei.
2. Mauria ngā karapu.
3. Whakatuwheratia te takai ka tirohia mēnā he toto, he wai, he whero me te pupuhi, he kino te kiri me te marere o te tuitui i te wāhi i whakatakotoria ai te catheter uaua pokapū.
4. Tangohia he miro iodophor ka hurihia kia tika ki te taha matau hei patu i te wāhi i whakaurua ai te ngongo. Ko te awhe patu he 8-10cm.
5. Whakapirihia te takai patunga ki te kiri i te wāhi i whakatakotoria ai te ngongo, ā, tohua te wā whakawhiti takai.
Te wā tuku: 25-Pepuere-2022