Umjovo wesimanje osezingeni eliphezulu usebenzisa imodi yokulawula uhlelo lwekhompyutha.Ifakwe amasethi amaningi ezinhlelo zomjovo wezigaba eziningi ezingabanjwa ngekhanda.Wonke amasyringe omjovo "angamasyringe alahlwayo alahlwayo aphezulu", futhi afakwe amashubhu axhumanisa umfutho, akwazi ukuskena futhi ajove umuthi ngesikhathi esisodwa.Inezinzuzo zokuzenzakalela okuphezulu nokunemba okuphezulu.Ingakwazi ukulungisa izinga lomjovo ngokuthanda kwayo ngokusho kwezingxenye ezahlukene kanye nezakhiwo ezahlukene ze-pathological.Ingakwazi ukujova ngokushesha i-ejenti yokuqhathanisa emithanjeni nasemithanjeni, esakazwa emithanjeni ehlukahlukene yegazi.Ngesikhathi esifanayo sokujova, ingenza ukuskena kwe-CTA ukuze kuthuthukiswe izinga lokuxilongwa kwezifo.
1. Indlela yokusebenza
Egunjini lokwelapha le-CT, sebenzisa isirinji engu-2ml ukuncela u-2ml wesisombululo se-0.9% se-NaCl, bese uxhuma i-catheter efakwa emthanjeni, sebenzisa i-G18-22 IV catheter ukuze uthole i-venipuncture, khetha imikhumbi ewugqinsi, eqondile kanye nenwebekayo yomthambo we-radial welunga eliphezulu. , i-basilic vein, kanye ne-median cubital vein njenge-IV catheter yokubhoboza, ilungise kahle ngemva kwempumelelo.Bese usebenzisa isirinji engu-2ml ukumunca u-1ml ka-0.1% we-meglumine diatrizoate ejenti yokuqhathanisa ngomjovo womjovo.Bheka imiphumela yokuhlolwa ngemva kwemizuzu engu-20, Ukusabela okungekuhle: akukho ukucinana kwesifuba kwesikhashana, isicanucanu, i-urticaria, i-rhinitis, nebala elivamile nezimpawu ezibalulekile kuzobekwa ekamelweni lokuhlola i-CT.Igumbi lokuhlola i-CT yi-Philips 16 row spiral CT, i-CT injector enengcindezi ephezulu yase-Shenzhen Antmed Co., Ltd., ejova umuthi i-Ossurol.(1) Ngaphambi kokusebenza, vula iswishi yamandla bese ufaka amasirinji alahlwayo omfutho ophezulu (amasirinji akabili).Isirinji A sihogela u-200ml wemidiya ye-iodofol, futhi isirinji B ihogela u-200ml ka-0.9% wesisombululo se-sodium chloride.Xhuma amasirinji amabili omjovo ngeshubhu yokuxhuma yezindlela ezintathu, khipha umoya kusisirinji kanye neshubhu, bese uxhuma ne-catheter efakwa emthanjeni yesiguli.Ngemva kokuba igazi selidonswe kahle futhi, beka ikhanda lomjovo phansi ukuze ulinde.(2) Ngokwesisindo esihlukile sesiguli kanye nezindawo zokuskena ezithuthukisiwe ezihlukene, uhlelo lokuthinta lwenziwa esikrinini se-LCD ukuze kusethwe inani eliphelele kanye nezinga lokugeleza lomjovo womjovo nomjovo we-saline wesirinji yomfutho ophezulu.Inani eliphelele lomjovo we-iodoform ngu-60-200 ml, inani eliphelele le-0.9% yesisombululo se-sodium chloride ngu-80-200 ml, kanti izinga lomjovo li-3 - 3.5 ml / s.Ngemva kokuqedwa kokuhlelwa, u-opharetha wokuskena uzokhipha umyalo wokuqala umjovo.Okokuqala, i-iodoform media iyajovwa, hlambulula futhi ngesisombululo se-sodium chloride esingu-0.9% kuze kuqedwe ukuskena.
I-Shenzhen Antmed Co., Ltd Umugqa womkhiqizo we-High Pressure Injector:
2. Ukulungiselela ngaphambi kokuskena kwe-CTA
Buza isiguli ukuthi sinawo yini umlando wokungezwani nezinye izidakamizwa, i-hyperthyroidism, umfutho wegazi ophakeme, isifo senhliziyo, isifo sikashukela, ukwehluleka kwezinso, umthamo wegazi okwanele, i-hypoalbuminemia nezinye izici eziyingozi kakhulu ze-angiography, futhi uchaze inhloso nendima yokuskena okuthuthukisiwe. esigulini nomndeni waso.Isiguli sidinga ukuba nesisu esingenalutho amahora angu-4 ngaphambi kokuhlolwa okuthuthukisiwe kokuskena, futhi labo abaye benza i-barium meal fluoroscopy izinsuku ezingu-3 kuya kwezingu-7 kodwa abangazange bakhiphe i-barium abavunyelwe ukuskena isisu kanye ne-pelvic.Lapho wenza ukuskena kwe-CTA kwesifuba nesisu, kuyadingeka ukubamba umoya wakho ukuze unciphise noma ugweme ukungewona ama-stratification nama-artifacts.Ukuqeqeshwa kokuphefumula kufanele kwenziwe kusenesikhathi futhi ucelwe ukuthi ubambe umoya wakho ekupheleni kokuphefumulelwa.
3. Yenza umsebenzi omuhle wokunakekelwa kwengqondo, futhi wethule ezigulini ukuthi ukucindezela komjovo wokujova umfutho ophezulu kukhulu kunokucindezela kokuphusha ngesandla, futhi isivinini siyashesha.Imithambo yegazi endaweni yomjovo ingase idilike, kubangele ukuvuza komuthi owuketshezi, ukuqunjelwa, ukuba ndikindiki, ubuhlungu, kanti eminye ingase ikhule ibe isilonda kanye ne-tissue necrosis.Okwesibili, lapho ujova umjovo wengcindezi ephezulu, kunengozi engaba khona yokuthi i-catheter yomjovo izowa, okuholela ekuvuzeni komuthi owuketshezi kanye nokulahlekelwa umthamo.Izisebenzi zabahlengikazi zesiguli nazo zaziswa ukuthi zingakhetha ngokucophelela umthambo ofanele, zisebenze ngokucophelela, futhi zikhethe uhlobo olufanele lwe-IV catheter ngokuvumelana nezimo zemithambo yesiguli.Lapho usebenzisa i-injector yokucindezela okuphezulu, ama-turnbuckles phakathi kwe-syringe barrel ne-piston bolt yayiqinile, ithubhu yokuxhuma yezindlela ezintathu yayixhunywe ngokuqinile nesirinji kanye nazo zonke izixhumanisi ze-catheter ye-IV, futhi ikhanda yenaliti lalilungiswe kahle.Khipha ukuthuthumela kwesiguli, thola ukubambisana, futhi ekugcineni ucele amalungu omndeni wesiguli ukuthi asayine ifomu lemvume enolwazi lokuskenwa kwe-CTA.
4. Izinyathelo zokuqapha ngesikhathi sokuhlolwa kwe-CTA
1).Ukuvimbela ukuvuza komuthi owuketshezi: lapho isithwebuli sihamba, ishubhu yokuxhuma akufanele incinywe noma idonswe, futhi ingxenye yokubhoboza akufanele ingqubuzane ukugwema ukuvuza komuthi owuketshezi.Ngemuva kokunqunywa kwesikhungo sokuskena, umhlengikazi kufanele ahlole ukubekwa kwenaliti ye-catheter emthanjeni futhi, ajove u-10~15ml wesisombululo se-sodium chloride engu-0.9% ngaphansi kwengcindezi emaphakathi ukuze abone ukuthi ibushelelezi, abuze isiguli futhi nganoma yisiphi. ukungaphatheki kahle okunjengobuhlungu bokuvuvukala nokushaya ngamandla, futhi unikeze ukwelulekwa ngokwengqondo ukuze ududuze isiguli ukuthi abasebenzi bezokwelapha bazokunaka kusukela ekuqaleni kuze kube sekupheleni kokuskena, ukuze bakwazi ukubhekana kalula nokuhlolwa futhi baqede ukungezwani nokwesaba.Ngesikhathi sokujova izidakamizwa, umhlengikazi kufanele abhekisise isimo sobuso besiguli, ukuvuza kwezidakamizwa, ukungezwani komzimba, njll. Uma kuba nengozi, umjovo nokuskena kufanele kuphazamiseke noma nini.
I-2) Vimbela umjovo womoya: Ukukhipha umoya okungalungile kuzoholela embolism yomoya.I-Air embolism iyinkinga enkulu ngesikhathi sokuskena i-CTA, engaholela ekufeni kweziguli.Qaphela ngesikhathi sokusebenza.Zonke izixhumi ezibonakalayo kufanele ziqiniswe ukuze zigweme ukuhlukana ngaphansi kwengcindezi ephezulu.Ngaphambi komjovo, umoya osezinjeni ezimbili, amashubhu axhumayo anezindlela ezintathu kanye nezinaliti ze-catheter kufanele zithululwe.Ngesikhathi sokujova, ikhanda lomjovo liya phansi, ukuze amabhamuza amancane antante emsileni wesirinji.Inani lomjovo lingaphansi kwenani lomuthi ohogeliwe kanye nesisombululo se-sodium chloride esingu-0.9%.I-1 ~ 2ml yomuthi owuketshezi kufanele ihlale kusirinji ukuvimbela umoya ukuthi ungacindezelwa emithanjeni yegazi yesiguli ngesikhathi sokujova umfutho ophakeme.
I-3) Ukuvimbela ukutheleleka esibhedlela: isiguli esisodwa, inaliti eyodwa kanye nesirinji eyodwa ephindwe kabili kufanele kufinyelelwe lapho kwenziwa ukuskena kwe-CTA, futhi isimiso sokusebenza oyinyumba kufanele silandelwe ngokuqinile.
4) Isaziso ngemuva kokuskena
a.Ngemva kokuskena, cela isiguli ukuthi siphumule ekamelweni lokubuka, gcina i-catheter efakwa emthanjeni imizuzu engu-15 ~ 30, bese uyikhipha ngemva kokungasabela okubi.Igumbi lokwelapha i-CT kumele lilungiswe nemithi yosizo lokuqala kanye nemishini yosizo lokuqala.Uma uzizwa ungaphilile, hamba kudokotela ngokushesha ukuze uvimbele ukuvela kwe-anaphylaxis ebambezelekile kanye nemiphumela emibi.Isiguli sabuye sayalwa ukuba siphuze amanzi amaningi ukuze sikhuthaze ukuphuma kwe-agent ehlukile ngokushesha ngangokunokwenzeka futhi sinciphise ukusabela okubi ezinso.
b.Ekuskeneni kwe-CTA, nakuba ukusetshenziswa komjovo wengcindezi ephezulu kunezingozi ezithile, kuphephile, kunokwethenjelwa futhi kungadlala indima yomtholampilo eyingqayizivele enezinyathelo zokuvimbela ezifanele zokugwema izingozi.Kuyisidingo sabahlengikazi besimanje be-CT room.Abasebenzi abahlengikazi egumbini le-CT kumele babe nesimo sengqondo esiqinile futhi esibucayi lapho besebenza.Kumele bahambisane nezinqubo zokusebenza zama-injection aphezulu ngesikhathi sokusebenza.Kumelwe bahlole ngokuphindaphindiwe izixhumanisi eziningi ezifana nokumunca izidakamizwa, i-exhaust, ukubhoboza kanye nokulungisa ukuze baqinisekise ukuthi zilungile.Umthamo womjovo, izinga lokugeleza kanye nesikhathi somjovo oqhubekayo kufanele kube nembayo.Ukuze kuqinisekiswe ukuthi iziguli ziqeda ngempumelelo ukuhlolwa kwe-CTA.Ukusetshenziswa komjovo wengcindezi ephezulu ekuhlolweni kwe-imaging kungathuthukisa ikhono lekhwalithi yezilonda ezincane kanye namacala ayinkimbinkimbi, ukunikeza odokotela ukuxilongwa kwesifo kanye nesisekelo sokuxilongwa okuhlukile, ukuthuthukisa ukunemba kokuxilongwa kwesifo, futhi kunikeze isisekelo sokwelashwa esinembe kakhudlwana sokuxilongwa nokwelashwa komtholampilo.
Ukuze uthole ulwazi olwengeziwe mayelana nemikhiqizo namasevisi ethu, sicela usithinte kuinfo@antmed.com.
Isikhathi sokuthumela: Oct-27-2022