I-PICC
Ividiyo
Imininingwane Yomkhiqizo
UKUBUKEZWA KONKE
I-CATHTONG ™ II PICC Catheter yenzelwe ukufinyelela okufushane noma isikhathi eside kwe-peripheral ohlelweni lwe-venous olumaphakathi ukuze kufakwe, ukwelashwa nge-intravenous, isampula yegazi, umjovo wamandla wemidiya ehlukile, ukuphathwa koketshezi, imithi kanye nezakhamzimba, futhi ivumela i-venous ephakathi. ukuqapha ingcindezi.I-CATHTONG™ II PICC Catheter ikhonjiswe isikhathi sokuhlala esifushane noma esikhulu kunezinsuku ezingama-30.
UMJOVO WAMANDLA
I-CATHTONG™ II Catheter iklanywe ngekhono Lokujova Amandla.Umjovo Wamandla uvumela umjovo wemidiya yokuqhathanisa ngenani elingu-5.0 mL/sec.Lesi sici sivumela ulayini we-PICC ukuthi usetshenziselwe I-Contrast-Enhanced CT (CECT) Imaging.
I-DUAL LUmen DESIGN
Umklamo we-lumen okabili uvumela ukusetshenziswa kwezinhlobo ezimbili zokwelapha ngasikhathi sinye ngaphandle kokuthi kufakwe ama-catheter amaningi.Ukwengeza, i-CATHTONG™ II ihlanganisa amadayamitha e-lumen ahlukahlukene ukuze inikeze izinhlobonhlobo zamazinga okugeleza.
Izici
| · | Ukuhlonza Okulula |
| Amalebula acacile kuma-clamp kanye ne-extension tube avumela ukuhlonza kalula izinga lokugeleza eliphezulu namandla omjovo wamandla | |
| · | Izimpawu |
| Imaka njalo ngo-1 cm eduze komzimba we-catheter | |
| · | Ukuguquguquka |
| Idizayini ye-lumen ekabili ivumela idivayisi eyodwa ukuthi isetshenziselwe izindlela zokwelapha eziningi | |
| · | Kuyalungiseka |
| Umzimba ongu-55 cm ungasikwa ube ubude obufunayo | |
| · | Amandla Nokuqina |
| Umzimba we-catheter owenziwe nge-polyurethane |
I-PICC
Ipharamitha
| I-SKU/REF | Lumen | Usayizi we-Catheter | I-Gravity Flow Rate | Ukucindezela okuphezulu | Isilinganiso sokugeleza esiphezulu | Amavolumu Wokuqala | Usayizi we-Lumen Gauge |
| 4141121 | Awushadile | 4Fr | 15.5 ml/min | awu 244p | 5.0 mL/umzuzwana | <0.6 ml | 18 Ga |
| 5252121 | Okukabili | 5Fr | 8 ml/min | awu 245p | 5.0 mL/umzuzwana | <0.5 ml | 18 Ga |
IKHITHI YE-PICC IHLANGANISA
• Ulayini we-PICC
• Idivayisi Yokuqinisa Ikhathetha
• Ulwazi Oluzosetshenziswa (IFU)
• I-IV Catheter w/ Inalithi
• I-Scalpel, ukuphepha
• Inaliti Yesethulo
• Ukufinyelela Okuncane nge-Dilatorer
• I-Guidewire
• I-MicroClave®
Mayelana ne-PICC
Uma usebenzisa i-PICC, kufanele uqaphele ukuthi unganyakazi izingalo zakho kakhulu noma ngamandla kakhulu ngesikhathi usetshenziswa ukuze uvimbele i-catheter ukuthi ingawi noma iphuke;ngaphezu kwalokho, shayela ishubhu futhi ushintshe ulwelwesi kanye ngesonto (ngunesi), bese uzama ukusebenzisa ishawa ukugeza.I-membrane evulekile kufanele ishintshwe ngesikhathi ukuze kuvinjwe i-catheter ukuthi ingavinjelwa noma ukutheleleka kwesikhumba nemithambo yegazi endaweni lapho i-catheter ibekwe khona.Uma i-PICC inakekelwa kahle, ngokuvamile ingasetshenziswa isikhathi esingaphezu konyaka ongu-1, okwanele ukuyigcina kuze kube sekupheleni kwe-chemotherapy.
1. Ukukhetha imithambo
Ama-catheter e-PICC avame ukufakwa emithanjeni ebizayo ye-cubital fossa, i-median cubital vein, kanye ne-cephalic vein.I-catheter ifakwa ngqo ku-vena cava ephakeme.Kudingeka ukhethe isitsha segazi esinokuguquguquka okuhle nokubonakala.
2. Izinkomba ze-PICC intubation
(1) Labo abadinga ukujova emthanjeni isikhathi eside, kodwa isimo somthambo ophumela ngaphandle sibi futhi akulula ukubhoboza ngempumelelo;
(2) Kuyadingeka ukufaka ngokuphindaphindiwe izidakamizwa ezivuselelayo, njengezidakamizwa ze-chemotherapy;
(3) Ukufakwa kwesikhathi eside kwezidakamizwa ezinokungena okuphezulu noma i-viscosity ephezulu, njengoshukela ophezulu, i-emulsion yamafutha, ama-amino acid, njll.;
(4) Labo abadinga ukusebenzisa ingcindezi noma amaphampu acindezelwe ukuze bafakwe ngokushesha, njengamaphampu okufakelwa;
(5) Ukumpontshelwa ngokuphindaphindiwe kwemikhiqizo yegazi, njengegazi lilonke, i<em>plasma, ama<em>platelet, njll.;
(6) Labo abadinga ukuhlolwa kwegazi ngemithambo eminingi ngosuku.
3. I-contraindications ye-PICC catheterization
(1) Isimo somzimba wesiguli asikwazi ukumelana nokuhlinza, njengesithiyo se-blood coagulation mechanism, futhi labo abangenaso izivikeli mzimba kufanele bakusebenzise ngokuqapha;
(2) Labo abaziwayo noma okusolakala ukuthi abaguliswa yizingxenye eziqukethwe ku-catheter;
(3) Umlando we-radiotherapy endaweni ehleliwe yokufaka intubation esikhathini esidlule;
(4) Umlando odlule we-phlebitis kanye ne-venous thrombosis, umlando wokuhlukumezeka, nomlando wokuhlinzwa kwe-vascular endaweni ehleliwe ye-intubation;
(5) Izici zezicubu zendawo ezithinta ukuzinza noma ukuqina kwe-catheter.
4. Indlela yokusebenza
Isiguli sithatha isikhundla se-supine futhi silinganisa ubude besiguli kusukela endaweni yokubhoboza kuya ku-vena cava ephakeme nge-tape yokulinganisa.Ngokuvamile 45 ~ 48cm.Ngemuva kokuthi indawo yokubhoboza ikhethiwe, i-tourniquet iyaboshwa futhi ivame ukukhishwa amagciwane.I-PICC catheter puncture ye-venous yenziwa ngokulandela imiyalelo, futhi igcinwa ngokuvumelana nesimo sesiguli.Ubude be-catheter, ifilimu ye-X-ray ngemva kokubhoboza, ingasetshenziswa ngemva kokuqinisekisa ukuthi ikwi-vena cava ephakeme.
Izinzuzo ze-PICC
(1) Ngenxa yokuthi indawo yokubhoboza isemthanjeni ongaphandle we-peripheral lapho kufakwa i-PICC, ngeke kube nezinkinga ezisongela ukuphila njenge-pneumothorax yegazi, ukubhobozwa kwemithambo emikhulu yegazi, ukutheleleka, ukujula komoya, njll., kanye nokukhetha kwemithambo yegazi. inkulu, futhi izinga lokuphumelela lokubhoboza liphezulu.Ukunyakaza kwezitho endaweni yokubhoboza akukhawulelwe.
(2) Kunganciphisa ubuhlungu obubangelwa iziguli ngenxa ye-venipuncture ephindaphindiwe, indlela yokusebenza ilula futhi ilula, futhi ayinqunyelwe isikhathi nendawo, futhi ingasetshenziswa ngokuqondile esigcemeni.
(3) Impahla ye-catheter ye-PICC yenziwe nge-polyurethane ekhethekile, inokuhambisana okuhle nokuhambisana ne-histocompatibility.I-catheter ithambile kakhulu futhi akufanele iphuke.Ingashiywa emzimbeni izinyanga eziyisi-6 kuya onyakeni ongu-1.Imikhuba yempilo yeziguli ngemuva kokufakwa kwe-catheterization empeleni ngeke ithinteke.
(4) Ngenxa yokuthi i-catheter ingangena ngokuqondile ku-vena cava ephakeme, lapho ukugeleza kwegazi kukhulu, inganciphisa ngokushesha umfutho we-osmotic owuketshezi noma ubuhlungu bezicubu zendawo, i-necrosis, ne-phlebitis ebangelwa izidakamizwa ze-chemotherapy.
Iziguli ezisheshe zifakwe i-intubation ngeke zithole ukulimala kwe-venous ngesikhathi sokwelashwa ngamakhemikhali, nokuqinisekisa ukuthi kunomucu omuhle we-venous ngesikhathi se-chemotherapy futhi ukwelashwa ngamakhemikhali kungaqedwa ngempumelelo.Sesiphenduke indlela elula, ephephile, esheshayo nesebenzayo yokungena emthanjeni ukuze kusekelwe ukudla okunomsoco okufakwe emthanjeni kanye nemithi ezigulini ezigula kakhulu kanye nezelashwa ngamakhemikhali.
Lahla ukuvinjelwa
Uma ipayipi le-PICC livinjwe kungaqondile, indlela yokucindezela engemihle ingasetshenziswa ukujova i-urokinase exutshiwe engu-5000u/ml, 0.5ml kulume ye-PICC, hlala imizuzu engu-15-20 bese uhoxiswa ngesirinji.Uma igazi likhishwa, kusho ukuthi i-thrombosis iphumelele.Uma kungekho gazi elikhishiwe, lokhu kuhlinzwa okungenhla kungaphindaphindwa ngokuphindaphindiwe ukuze kwenziwe i-urokinase ihlale ku-catheter isikhathi esithile kuze kube yilapho kukhishwa igazi.Kumele kuqashelwe ukuthi inani eliphelele le-urokinase akufanele lidlule i-15000u.Ngemuva kokuthi i-catheter ingavimbekile, khipha u-5ml wegazi ukuze uqinisekise ukuthi yonke imithi namahlule kuyakhishwa.
Ukugcinwa okujwayelekile
Ukugqoka kufanele kushintshwe amahora angu-24 okuqala.Ngemva kokuba isilonda saphola kahle futhi kungekho kutheleleka noma ukopha, shintsha ingubo njalo ezinsukwini ezingu-7.Uma isilonda sixega futhi siswakama, sishintshe noma nini.Uma indawo yokubhoboza inobomvu, ukuqubuka, ukuphuma, ukungezwani komzimba nezinye izimo ezingavamile, isikhathi sokugqoka singafinyezwa, futhi izinguquko zendawo kufanele zibhekwe ngokuqhubekayo.Yenza ngokuqinile ukusebenza kwe-aseptic ngaso sonke isikhathi lapho ukugqoka kushintshwa.Ifilimu kufanele isuswe kusukela phansi kuya phezulu, futhi kufanele kuqashelwe ukulungisa i-catheter ukuze ivimbele ukuthi ingawi.Rekhoda idethi ngemva kokushintsha.Lapho izingane zigeza, bopha indawo yokubhoboza ngepulasitiki, bese ushintsha okokugqoka ngemva kokugeza.
Ngaphambi kokusebenzisa ukumnika kwe-PICC, sebenzisa i-iodophor cotton swab ukuze usule ikepisi ye-heparin imizuzwana engu-30.Ngaphambi nangemuva kokwelashwa ngokufakwa emthanjeni, sebenzisa isirinji engekho ngaphansi kuka-10ml ukuze udonse usawoti ojwayelekile ukuze ugeze ilume.Ngemuva kokumpontshelwa koketshezi olunezinga eliphezulu lokugxilisa ingqondo njengemikhiqizo yegazi kanye nezixazululo zezakhi zomzimba, ukushaywa kwe-pulse kweshubhu ngo-20ml we-saline evamile.Uma izinga lokumnika lihamba kancane noma isikhathi eside, ishubhu kufanele ligezwe ngosawoti ovamile phakathi nokusetshenziswa ukuze kuvinjwe ishubhu ukuthi livinjwe.