Kev qhia cov tshuaj rau hauv tib neeg cov hlab ntshav los ntawm kev txhaj tshuaj txhaj tshuaj tau ntev tau ua ib qho kev coj ua. Ua tsaug rau qhov kev tswj hwm ntawm cov tshuaj no, kev kho mob sai sai tau ua tiav. Cov hlab ntsha tawg, nrog rau lawv cov phab ntsa tsis muaj zog, ua rau nws nyuaj rau txhaj. Nyob rau hauv xws li mob, tus kws kho mob siv ib txoj kev xws li venesection - qhov no yog qhib lub lumen ntawm cov hlab ntsha los ntawm incision. Cov txheej txheem yog ua raws li kev ua kom tsis muaj menyuam.
Kev qhia
Venesection yog qhov nthuav tawm thiab tshem tawm ntawm phab ntsa venous rau kev kho mob lossis kev tshawb nrhiav kev kuaj mob. Ntau zaus rau cov txheej txheem no, cov hlab ntsha raug xaiv nyob rau hauv thaj tsam ntawm kev sib txuas ntawm cov pob txha ntawm sab ceg nrog ko taw lossis hauv lub luj tshib khoov.
Nws tau qhia ntawm:
- nyias lossis tsis pom cov leeg ntawm daim tawv nqaij ntawm cov menyuam yaus thiab cov neeg rog;
- vasospasm;
- qhia cov as-ham rau hauv lub cev los ntawm kev txhaj tshuaj intravenous;
- xav tau kev txhaj tshuaj ntev ntev ntawm cov tshuaj.
Cov txheej txheem yog contraindicated nyob rau hauv lub xub ntiag ntawm daim tawv nqaij, purulent pob nyob rau hauvthaj tsam ntawm qhov kev txiav txim siab, nrog rau thrombosis.
Toolkit
Daim ntawv teev cov cuab yeej rau venesection yog raws li nram no:
- riam phais;
- clamps kom txhob los ntshav;
- anatomical thiab phais tweezers;
- txiab nrog nyias lub puab tsaig;
- needle tuav;
- ntse hooks;
- koob txhaj tshuaj lossis qhov tso quav;
- koob tshuaj loog;
Ntxiv rau, cov txheej txheem yuav tsum:
- 50 ml 0.25-0.5% novocaine tov;
- phuam da dej;
- hnab looj tes roj hmab;
- khoom hnav;
- gauze pads thiab pob.
Kev npaj cov khoom siv venesection yog lub luag haujlwm ntawm tus kws saib xyuas mob hnyav. Tom qab txhua tus txheej txheem, nws yuav tsum tau npaj cov hnav khaub ncaws tshiab, yaug thiab tshuaj tua kab mob, thiab tom qab ntawd qhuav lawv thiab qhwv lawv hauv ib daim ntawv huv thiab muab tso rau hauv ib lub thawv rau kev ua kom tsis muaj menyuam (hauv ib qho tshwj xeeb los yog hauv ib qho autoclave).
Ib txheej ntawm cov cuab yeej rau venesection yuav tsum tau npaj ua ntej. Feem ntau, cov txheej txheem yog xav tau rau cov neeg mob hnyav, thiab kev npaj thiab kev ua ub no coj tus tsov ntxhuav feem ntawm lub sijhawm.
Technique
Ua ntej kev phais ntawm tus ceg ceg saum qhov chaw txiav qhov xav tausiv ib tug tourniquet. Cov tawv nqaij yog wiped nrog cawv thiab ib tug cawv daws ntawm iodine. Qhov chaw ua haujlwm yog them nrog daim ntawv tsis muaj menyuam lossis phuam.
Tom qab novocaine tshuaj loog, 3-4 cm ntawm daim tawv nqaij raug txiav nrog rab riam phais thiab raws cov leeg. Siv ob lub forceps, cov hlab ntsha yog ua tib zoo cais tawm ntawm cov ntaub so ntswg subcutaneous. Ob txoj xov nws tus kheej-absorbable yog coj los rau hauv nws. Ib qho yog txav me ntsis ntxiv, qhwv thiab siv los ua tus tuav. Qhov thib ob yog coj los ze zog rau qhov chaw, ntxhov siab, tab sis tsis khi. Tom qab ntawd ib txoj hlab ntsha raug txiav hauv thaj tsam ntawm ob txoj xov. Cov hlab ntsha yog txiav obliquely los ntawm 1/2 txoj kab uas hla. Tom qab ntawd ib rab koob (cannula) yog muab tso rau hauv nws lub lumen, tsau thiab khi nws nrog ib tug thib ob ligature. Qhov kawg ntawm cov xov yog nqa tawm. Ib txoj kab drip puv yog txuas rau lub catheter. Lub hauv paus ntawm lub catheter thiab thaj tsam ntawm lub raj roj hmab uas nyob ib sab ntawm nws yog txuas rau ntawm daim tawv nqaij nrog ib tug nplaum plaster. Lub qhov txhab raug sutured.
Lub cannula raug tshem tawm raws li hauv qab no: cov nplaum plaster yog tev tawm, cov xov knot yog unraveled nyob rau hauv qhov chaw yam tsis tau tshem tawm cov sutures ntawm daim tawv nqaij, rab koob (cannula) raug tshem tawm. Lub Upper kawg ntawm cov hlab ntsha yog khi los ntawm nruj lub catgut, qhov kawg ntawm lub protruding xov yog txiav tawm. Yog hais tias lub qhov txhab tsis kaw, ib tug ntxiv suture yog siv, thiab ces ib tug siab bandage. Cov hlua khi raug tshem tawm hnub 7 - 8.
Venesection yog tus txheej txheem thiab muaj kev nyab xeeb zoo, tab sis tsuas yog tus kws tshuaj tshuaj loog-resuscitator yuav tsum ua nws.
Kev nyuaj siab
Thaum lub sijhawm ua haujlwm, muaj teeb meem xws li los ntshav thiab kev puas tsuaj rau cov hlab ntsha nyob ib puag ncig. Ib me ntsis tom qab, hauv qab noqhov tshwm sim:
- thrombosis;
- phlebitis;
- thaiv ntawm cannula;
- mob mob.
Cov teeb meem ntawm venesection feem ntau yuav zam yog tias cov txheej txheem ua los ntawm cov neeg ua haujlwm kho mob tsim nyog.
Zoo kawg
Yog tias tsim nyog venesection, qhov taw qhia thiab qhov tshwm sim uas muaj peev xwm ua tau thaum nws siv yog raug ntsuas los ntawm tus kws kho mob koom. Txawm li cas los xij, nrog rau kev ua raws li cov txheej txheem no thiab kev kho mob kom raug, nws tso cai rau koj nkag mus rau cov leeg tsis zoo rau lub sijhawm ntev.
