Umuyoboro muremure wasal, akenshi uhwanye nkuko Hfnc, yahindutse ibuye rifatirwa mubuvuzi bwa kijyambere. Iyi mico Umuvumo wa Nasal Tanga intambwe ikomeye muburyo gakondo, gutanga inkunga yongerewe imbaraga kubarwayi bafite ibibazo bitandukanye byubuhumekero. Niba uri umunyamwuga wubuzima, umuyobozi wamasoko nka Mark Thompson muri Amerika, cyangwa umuntu ufite uruhare munzu yubuvuzi, gusobanukirwa Hfnc ni ngombwa. Iyi ngingo igamije gushushanya Umuyoboro mwinshi wa Nasal Ubuvuzi, gukora ubushakashatsi ku buryo bwacyo, inyungu, porogaramu, n'ibyo ugomba gusuzuma mugihe uhinga izo sisitemu zingenzi. Nka Allen, ukomoka ku isosiyete ikoresha mu bicuruzwa bikoreshwa mu Bushinwa mu Bushinwa, nabonye ubwanjye icyifuzo gisaba imbere Hfnc ibicuruzwa. Tuzakuraho impamvu ibi Amazuru yo hejuru Ikoranabuhanga ntirirenze ubundi buryo; akenshi ni amahitamo meza yo kunoza ogisijeni kandi ihumure ryihangane, cyane cyane mubihe bya Kunanirwa kw'ubuhumekero. Iki gice gikwiye umwanya wawe kuko kimenagura amakuru akomeye muburyo bworoshye bwo gutekerezwa, gushushanya muburyo bwo gusobanukirwa no gukora ibikorwa, amaherezo bigufasha gufata ibyemezo byuzuye kuri ubu buzima Ubuvuzi bwa Oxyjen.
1.
Umuyoboro mwinshi wa Nasal (Hfnc) Ubuvuzi nuburyo buhanitse bwo gushyigikira ubuhumekero butanga a urujya n'uruza y'umwuka / ogisijeni kuvanga umurwayi, mubisanzwe binyuze muri kabuhariwe Amazuru cyangwa kanulae. Bitandukanye na gakondo NASAL ogisijeni Sisitemu, Hfnc irashobora gutanga gaze kuri igipimo Ibyo bikunze kurenza umurwayi gutemba ibisabwa. Iri ni itandukaniro ryingenzi. Bitekerezeho muri ubu buryo: Niba umurwayi ahumeka kandi byimbitse, hashobora gutanga ogisijeni bihagije kugirango ibone ibyo bakeneye, biganisha Kwishora mu kirere kandi ntateganijwe Fio2 (agace ka ogisijeni wahumetswe). Hfnc sisitemu, ariko, irashobora gutanga igipimo Kugera kuri litiro 60 kumunota cyangwa no hejuru kubantu bakuru, tanga isoko rihamye kandi ryizewe.
The Hfnc Sisitemu isanzwe igizwe nibice bitatu byingenzi: Air / ogisijeni blender kugirango igenzure Fio2, ihuriro ryo gushyuha kandi ubushuhe gaze, hamwe numuzunguruko ushyushye utanga gaze yagenwe kumurwayi binyuze kuri a Umuyoboro wa Nasal. Ubushobozi bwo ubushuhe kandi shyushya gaze ni ngombwa kugirango uhumurize kwihangana no kwihanganira, cyane cyane kuri igipimo kinini. Iyi nzira irinda gukama inzira nyabagendwa Mucosa, ishobora kuba ikibazo gikomeye cyo kutangirika, Amazuru yo hejuru gaze. The Gukoresha HFNC iragenda ikomeza kugaragara muburyo butandukanye, kuva ishami ryihutirwa kuri Kwitaho cyane Igice (ICU), kubacunga abarwayi bafite ubwoko butandukanye bwa umubabaro w'ubuhumekero. Twebwe, nkabakora, twibande kuremwa neza kandi neza Ibishushanyo bya Nasal, nkacu Byakozwe PVC NASL OXYGEEN CANNULULA TUBE KUBANA N'UMUNTU, yagenewe guhitamo gutanga ibi Ubuvuzi bwa HFNC.
Uburyo busobanutse bwa Hfnc bikubiyemo ibirenze gutanga hejuru gutembera kwa ogisijeni. Ifasha mukaraba nasopharyngeal umwanya wapfuye, kugabanya imirimo yo guhumeka, gutanga umubare muto Umuvuduko w'indege, kandi ushishikarize neza Fio2. Uku guhuza Hfnc igikoresho cyingenzi kuri Ubuvuzi bwa Oxyjen, cyane cyane abarwayi bafite ubugari ibibazo byo guhumeka. The igipimo na Fio2 Irashobora kwigenga. Kwemerera abaganga guhuza ubuvuzi kubikenewe byumuntu ku giti cye. Gutanga gushika gukurikiranwa Fio2 ni inyungu nini, nkuko bigabanya Kugabanuka kwa Oxygen Kuva mu kirere.
2. HFNC itandukaniye he na sisitemu isanzwe ya ogisijeni?
Gakondo cyangwa ogisijeni isanzwe Sisitemu yo kuvura, nka kashe ya kamere cyangwa masike yo mumaso, mubisanzwe itanga ogisijeni hepfo igipimo, mubisanzwe litiro 6 kumunota kuri kanseri kandi wenda 10-15 l / min kuri masike. Mugihe ibi ari byiza kuri hypoxemia yoroheje, bafite aho bigarukira. Itandukaniro ryibanze iri muri igipimo ubwayo. Hfnc Gutera gaze kuri Ibipimo bigenda birenga impinga y'umurwayi Uruganda ruhute, akenshi kuva kuri 20 kugeza kuri 60 l / min, cyangwa birenze. Ibi bivuze Hfnc Sisitemu itanga byinshi, niba atari byose, ya gaze yumurwayi, biganisha ku buryo buhoraho kandi bugahanuwe Fio2. Hamwe na sisitemu isanzwe, umurwayi akunze guhumeka mubyumba binini hamwe na ogisijeni yinyongera, igabanya ogisijeni yatanzwe kandi ikora Fio2 impinduka kandi akenshi iri munsi ugereranije. Ibi Kwishora mu kirere ni ikibazo gikomeye Hfnc INTEGO.
Irindi tandukaniro rikomeye ni imiterere ya gaze yahumetswe. Hfnc sisitemu yagenewe gushyuha kandi ubushuhe gaze kugeza ubushyuhe bwumubiri (hafi 37 ° C) hamwe nubushuhe 100%. Ibi ni ngombwa kuko gutanga gaze yumye, ikonje kuri igipimo kinini irashobora kwangiza inzira nyabagendwa Mucosa, bitera kutamererwa neza, kubangamira mu mutego wo kwemererwa, no kongeramo akazi ko guhumeka. Ogisijeni isanzwe Sisitemu, cyane cyane hejuru yimiterere inyuze muri masike, akenshi utanga ogisijeni nziza, yumye, ishobora kwihanganira nabi mugihe kinini. The gushyuha no gushukwa gaze kuva an Hfnc Igikoresho kigutezimbere ihumure ryihangana no kubahiriza, nikibazo cyo gutsinda Ubuvuzi bwa Oxyjen. Iyi mikorere yonyine ikora Hfnc amahitamo ahitamo kuri benshi abarwayi bafite ubuhumekero ibibazo.
Byongeye kandi, Hfnc itanga inyungu zinyongera za physiologiologiya zidakunze kugaragara hamwe na sisitemu yoroheje. Ibi birimo kubura nasopharyngeal Umwanya wa Anatomique, itezimbere imikorere ya guhumeka, hamwe nigisekuru cyurwego rworoheje rwibyiza Umuvuduko w'indege (Pap), zirashobora gufasha gushakisha alveoli no kunoza ogisijeni. Mugihe atari umusimbura guhumeka nabi (NIV) cyangwa guhumeka gutera ibibazo byose, Hfnc Ikirahure, gitanga inkunga nyinshi kuruta ogisijeni nkeya ariko kuba bike kandi muri rusange byihanganira masike ya NIV. The Gukoresha Ibikoresho Byinshi Byagenda Byinshi byerekana iterambere rikomeye muri Sisitemu yo gutanga ogisijeni, kwimuka birenze ogisijeni yoroshye ya ogisijeni yo gushyigikira ubuhumekero.
3. Ni ubuhe buryo bw'ingenzi bw'imiterere ya physiologique yo gukoresha imiyoboro yo hejuru ya kashel?
The Gukoresha HFNC Nzana inyungu nyinshi za physiologiya zigira uruhare mubikorwa byayo mugucunga umubabaro wubuhumekeme. Imwe mu ingenzi cyane ni ukugabanya nasopharyngeal umwanya wapfuye. Bikomeza urujya n'uruza ya gaze neza yakuweho karuboni ya dioxyde (CO2) kuva hejuru inzira nyabagendwa Mugihe cyo guhumeka. Ibi bivuze ko hamwe na buri mwuka ukurikira, umurwayi ahumeka gaze hamwe na CO2 yo hepfo hamwe na ogisijeni yo hejuru ya ogisijeni, ikora guhumeka gukora neza. Uku gushidikanya Umwanya wa Anatomique irashobora kugabanya kugabanuka muri Igipimo cy'ubuhumekero kandi muri rusange akazi ko guhumeka, niyihe ntego yibanze mukuvura abarwayi bafite ikibazo cyubuhumekero bukabije.
Icya kabiri, Hfnc irashobora kubyara umubare muto Umuvuduko w'indege (Pap). Mugihe urwego rwa pap ruhinduka kandi biterwa na igipimo Kandi niba umunwa wumurwayi ufunguye cyangwa ufunze, ndetse no kwiyongera kwiyoroshya birashobora kuba ingirakamaro. Iyi gakoko karashobora gufasha stent ifunguye hejuru inzira nyabagendwa, gereranya ibiryo kuri Atelekeasis (Gusenyuka kw'ibiluro), no kunoza Ibihaha byanyuma. Izi ngaruka zigira ingaruka nziza ogisijeni kandi birashobora gufasha cyane cyane abarwayi bafite ibihe nkibi Kunanirwa kw'ubuhumekero. Gutanga Fio2 kuri igipimo kinini kandi yemeza kandi ko umurwayi yakiriye kwibanda kuri ogisijeni, kugabanya ihindagurika biterwa nimpinduka muburyo bwo guhumeka cyangwa Kwishora mu kirere.
Hanyuma, ubusunike buhebuje butangwa na Hfnc sisitemu ntabwo ari ihumure gusa; Ifite inyungu zifatika za physiologiya kuri inzira nyabagendwa. Neza Ubushuhe Bwinshi Gazi ifasha kubika imikorere isanzwe ya ruscalator yinzu yi mucociliary, ni ngombwa mugukuraho ururenda ruva mubihaha. Ibi birashobora gukumira ingwate yinyamanswa, kugabanya ibyago byo kwandura, no gukomeza inzira nyabagendwa PANTECY. Ubushyuhe nubushuhe birabuza kandi kurakara no kurakara ibice byamazuru no hepfo inzira nyabagendwa, biganisha ku kwihangana neza no kubahiriza Uwiteka Ubuvuzi bwa Oxyjen. Uku kwihanganirana ni ikintu cyingenzi mugutsinda kwa Ubuvuzi bwa HFNC, cyane cyane iyo inkunga yigihe kirekire. Nkumukora, twumva akamaro k'izo nyungu, itwara ibyo twiyemeje gutanga umusaruro mwinshi kuri Hfnc.
4. Kuki ubuhegu neza ari ngombwa cyane muburyo bwo kuvura busa?
Uburyo bwiza bwo guhitamo ntabwo ari "byiza-kuri-" kugira "ibintu muri Amazuru yo hejuru kuvura; Ni ngombwa rwose kumutekano wacyo nu munsi. Iyo utanze gaze kuri a igipimo kinini, say 30 to 60 liters per minute, directly into the nasal passages, if that gas is cold and dry, it can rapidly strip moisture and heat from the inzira nyabagendwa Mucosa. Ibi birashobora kuganisha kubibazo byifashe: Gutwika, imikorere ya ciliare ya cyiliary (umusatsi muto wo gukuraho urusaku na imyanda muri inzira nyabagendwa), ururenda rwinshi, gucundura kwandura, ndetse no kuva amaraso. Abarwayi bazabona ibintu bikabije, nko gukama ibyumba, ububabare, no gutwika, bigatuma badashobora kwihanganira Uwiteka Ubuvuzi bwa HFNC igihe kirekire. Kubwibyo, ubushobozi bwo ubushuhe no gushyuha gaze neza ni imfuruka ya Hfnc.
Hfnc Sisitemu igamije gutanga gaze ishyushye kugeza 37 ° C (ubushyuhe bwumubiri) kandi bwuzuyemo imyuka y'amazi (hafi ya 100% ugereranije). Iyi mimics isanzwe yimiterere yindege ibaho hejuru inzira nyabagendwa. Mugutanga ibi gushyuha no gushukwa gaze, Hfnc irinda Uwiteka inzira nyabagendwa Epithelium, ikomeza icyemezo gisanzwe cyo kwiyubarwa, kandi kikangisha cyane ihumure ryihangana no kwihanganirana. Ibi bituma abarwayi bakira inyungu zuzuye za igipimo kinini kandi byateganijwe Fio2 igihe kinini, gikunze gukenerwa mubihe nka Kunanirwa kw'ubuhumekero. Ihumure ryateye imbere naryo rigabanya umutima wumurwayi kandi akazi ko guhumeka, kuko batarwana no gukangura.
Kuva kumurongo wo gukora, kwemeza ko sisitemu yo gusuzugura Hfnc Ibikoresho byizewe kandi bifite akamaro ni byinshi. Ibi birimo igishushanyo mbonera ubwacyo, igituba gishyushye kibuza Ibishushanyo bya Nasal). Ubucuku bubi burashobora guhakana inyungu nyinshi za Hfnc ndetse ikanabitera ingaruka. Mubyambayeho kuri Uruganda rwibikoresho byumwuga - Zhongxing, dushyira imbere ibikoresho nibishushanyo bishyigikira gaze nziza. Kubatanga ubuzima, ni ngombwa kwemeza ko Hfnc Sisitemu irashyirwaho neza kandi ko Urugereko rwa humite rwuzuye kandi rukora neza. Uku kwitondera amakuru arambuye bigize ingaruka nini ku gisubizo cyihangana hamwe nitsinzi rusange ya Imbere ya Nasal Cannula ogisijeni.
5. Gusobanukirwa igipimo cyurumba: Nigute bigira ingaruka kuri HFNC.
The igipimo ni impande zose zisobanura cyane Hfnc Kuvura no gukina uruhare runini mu mibereho yayo. Imwe mu ngaruka z'ibanze za a igipimo kinini nubushobozi bwayo bwo guhura cyangwa kurenza impinga yumurwayi gutemba ibisabwa. Mu murwayi umubabaro w'ubuhumekero, ibyabo gutemba irashobora kuba hejuru cyane (urugero, 30-120 l / min). Niba yatanzwe igipimo kuva mubikoresho bya ogisijeni biri munsi yibi, umurwayi azamenya neza mubyumba umwuka, biganisha kuri Kugabanuka kwa Oxygen no gutangazwa Fio2. Hfnc sisitemu, mugutanga igipimo Mubisanzwe kugeza kuri 60 l / min (kandi rimwe na rimwe hejuru mubikoresho byihariye), birashobora kugabanya iki cyumba cyo kwikorera ikirere, kwemeza ko bihamye kandi byizewe byateganijwe Fio2. Ibi ni ngombwa kugirango ugire akamaro ogisijeni.
Birenze guhura gusa inspiratory Icyifuzo, The igipimo kinini bigira uruhare mu gutakaza nasopharyngeal umwanya wapfuye. Umugezi uhoraho wa gaze nshya usukura gaze gakomeye ya CO2 kuva hejuru inzira nyabagendwa (Farynx na cavity cavity). Kugabanya umwanya wapfuye bivuze ko buri mwuka urimo umubare munini wa gaze ya ogisiji, utezimbere imikorere ya alveolar guhumeka kandi birashoboka kugabanya Igipimo cy'ubuhumekero na akazi ko guhumeka. Hejuru igipimo, muri rusange, ibyo birababaje cyane birahinduka, kugeza aho runaka. Ubu buryo bufite akamaro cyane abarwayi bafite ubugari Ibisabwa guhumeka aho guhanahana gaze neza.
Byongeye kandi, the igipimo in Hfnc bigira uruhare mu gisekuru cyiza Umuvuduko w'indege (Pap). Mugihe uyu muvuduko wiyoroshya (mubisanzwe 1-5 cmh2o) kandi biratandukanye hamwe na anatomiya yihangana, yihangana, kandi niba umunwa ufunguye cyangwa ufunze, birashobora kugira ingaruka nziza. Ibi birimo guterana hejuru inzira nyabagendwa, kwiyongera Ibihaha byanyuma, kandi birashoboka ko yinjije Alveoli yaguye. Guhitamo igipimo is therefore a key clinical decision, often started at a moderate level (e.g., 30-40 L/min) and titrated based on the patient’s response, comfort, ogisijeni imiterere, na akazi ko guhumeka. Guhindura igipimo ni inzira nziza muri Gucunga Impuhwe Zikaba hamwe Hfnc.
6. Ni ryari ubuvuzi bwigihe kinini bwa canxjen ogisijeni busanzwe busabwa abarwayi?
Umuyoboro muremure birasabwa kugirango ugenda rwiyongera aho abarwayi bakeneye inkunga nyinshi zubuhumekero kuruta ogisijeni isanzwe Ubuvuzi burashobora gutanga, ariko bushobora kutazakenera, cyangwa burashobora komerwa muburyo, uburyo butera inkunga. Ikimenyetso cyambere ni Kunanirwa kw'ibihuru birakabije (Ahrf). Nibintu bisanzwe Kwitaho cyane igenamiterere aho abarwayi barwana no gukomeza bihagije ogisijeni nubwo ogisijeni isanzwe. HFNC YEREKANA kunoza ogisijeni, gabanya Igipimo cy'ubuhumekero, no kugabanya Dyspnea muriyi abarwayi bafite imyuka ikaze. Ubushakashatsi bwasohotse mubinyamakuru nka Kunegura med na Ubuvuzi bukomeye yakoresheje ingaruka zo hejuru ya kashe ya kasal Muri aba baturage, akenshi birashoboka.
Ikindi gice cyingenzi kuri Gukoresha HFNC ni mubihe byanyuma. Abarwayi bonsa kuva muri imashini ya mashini iri kuri ibyago byinshi yo kurwara ibihumekero. Hfnc Irashobora gukoreshwa nkigipimo cyiza cyangwa nkumuti wa post-extatutution umubabaro w'ubuhumekero. The Ingaruka zo Gufata Ijwi rirenga-Ikarari inkunga yagereranijwe na ogisijeni isanzwe ndetse guhumeka nabi, hamwe ninyigisho zimwe zivuga inyungu mugukumira inyungu, cyane cyane mumatsinda amwe amwe. Kurugero, the gutondekanya hejuru-yihuta kandi ya kansel cannula vs impaka zisanzwe ogisijeni zirakomeje, ariko Hfnc akenshi itanga ihumure ryiza kandi byizewe Fio2.
Birenze ibyo, Hfnc ikoresha kandi abarwayi bafite uburyo bworoheje bwa Kunanirwa kw'ubuhumekero, ababana "ntibakora amabwiriza" (DNI) basaba ko bashyigikiye ubuhumekero bwo guhumurizwa, no muri stive yo muburyo bwo kubungabunga ogisijeni. Biranabona kandi uruhare mu matekagaciro nka Kopd ExpricBations (nubwo NIV ikunze kuba umurongo wa mbere hano) no mu barwayi b'abana. Ibisobanuro bya Hfnc, uburyo bwo gukoresha, no kwihangana bihangana bigira uruhare mugusaba ibyagutse. Intego yaho ni ugutanga bihagije Ubuvuzi bwa Oxyjen no gushyigikira mugihe ugabanya akazi ko guhumeka no kwirinda kwiyongera kubipimo byinshi bitera niba bishoboka. Guhitamo gukoresha Ubuvuzi bwa HFNC Ugomba guhora ushingiye ku isuzuma ryitondewe ryitondewe kubyo umuntu akeneye ndetse na pathologiya.
7. HFNC irashobora gufasha kugabanya gukenera guhumeka gutera ibukanishi?
Iki nikibazo gikomeye hamwe nubuso bwingenzi bwubushakashatsi nu nyungu zubuvuzi. Ubushobozi bwa Hfnc Kugirango ugabanye gukenera guhumeka gutera imbere (IMV), hamwe nibibazo byayo bifitanye isano na Ventilator-bifitanye isano na soumoniya, nimwe mubyifuzo byayo bishimishije. Kubihugu bimwe byihangana, cyane cyane abafite Kunanirwa kw'ubuhumekero, ibimenyetso byerekana ko Hfnc irashobora kugabanya igipimo cy'imituba iyo ugereranije nubuvuzi busanzwe bwa ogisijeni kandi, rimwe na rimwe, ndetse guhumeka nabi (NIV). Ubushobozi bwa Hfnc Gutanga ihamye Fio2, gabanya umwanya wapfuye, tanga peep, kandi ugabanye Uwiteka akazi ko guhumeka Bose batanga umusanzu muriki gihe ubushobozi.
Ibigeragezo byinshi by'amavuriro byakoze iperereza ku ruhare rwa Hfnc mu gukumira inyungu. Mugihe ibisubizo bishobora gutandukana bitewe nitsinda ryihariye ryabarwayi nuburemere bwabo Kunanirwa kw'ubuhumekero, ubushakashatsi bwinshi bwerekanye inzira nziza. Kurugero, muri abarwayi bafite ubuhumekero bukabije Ibisabwa, Gutangiza hakiri kare Hfnc irashobora kubiramya no gukumira kurushaho kwangirika ko ibintu byakenerwa. Ni ngombwa kumenya ko Hfnc ntabwo ari imyanda; Niba umurwayi Igipimo cy'ubuhumekero cyananiwe kunoza cyangwa ibyabo ogisijeni akomeje gukomera nubwo ufite byiza Ubuvuzi bwa HFNC, noneho kwiyongera kugera IMV birashobora gucyakenewe. Hfnc itanga Gushyigikira, kugura umwanya kubandi bavugiye kugirango bakurikire cyangwa kumiterere yibanze yo gukemura.
Ariko, intsinzi ya Hfnc Muguhindura inversing hinges kumahitamo akwiye no gukurikirana hafi. Ntabwo bikwiriye abarwayi bafite intege nke zo guhumeka hypercapnic (aho niv ishobora kuba nziza) cyangwa abayobye byihuse cyangwa badashobora kurinda ibyabo inzira nyabagendwa. Ariko kuri benshi abarwayi bafite intege nke z'ubuhumekero, cyane cyane muburyo bwa hypoxemic, Hfnc itanga uburyo bwagaciro, buto. Mugutezimbere ogisijeni no kugabanya imihangayiko ya physiologique yo guhumeka, Ubuvuzi bwa HFNC Irashobora gufasha abarwayi kwirinda ingaruka no kutamererwa neza. Ibi bituma bigira igikoresho gikomeye muri Gucunga Impuhwe Zikaba muri Kwitaho cyane gushiraho no hanze.
8. Ni izihe nyungu zifatika za HFNC mu igenamigambi ritandukanye no gutanga ogisijeni?
Hfnc itanga inyungu nyinshi zifatika zagize uruhare mu kwakirwa kwayo mu bidukikije bitandukanye, uhereye mubyumba byihutirwa muri WESTER KANDI Kwitaho cyane Ibice. Imwe mu ingirakamaro cyane inoza ihumure ryo kwihangana no kwihanganira ugereranije n'ubundi buryo bwo gushyigikirwa, cyane cyane guhumeka nabi (NIV) masike. Niv Masks irashobora gukomera, itera ibisebe byigitutu mumaso, kandi bikagora abarwayi kurya, kunywa, cyangwa kuvugana. Hfnc, yatanzwe akoresheje byoroshye Amazuru, muri rusange biratoroshye cyane. Iyi ihumure ryiza rirashobora kuganisha kubwumvikane neza Ubuvuzi bwa Oxyjen, ni ngombwa kugirango utsinde. Abarwayi barashobora kuvuga, kurya, no kunywa byoroshye mugihe bakira Hfnc, kuzamura uburambe bwabo muri rusange nubufatanye no kuvurwa.
Izindi nyungu zifatika nuburyo bworoshye bwo gusaba no gucunga ugereranije nabapfumu. Mugihe Hfnc sisitemu ni nziza ibikoresho byo gutembera, muri rusange bazoroha gushyiraho no gucunga abakozi b'abaforomo. Imigaragarire iragoye, kandi iganisha igipimo na Fio2 ni. Ubu buryo bworoshye bwo gukoresha burashobora kuba ingirakamaro cyane muburyo bwuzuye igenamiterere cyangwa ahantu hashobora kuba idafite amahugurwa yihariye yo kuvura ubuhumekero. Byongeye kandi, kuko Hfnc itanga imbaraga kandi zizewe agace ka ogisijeni wahumetswe, byoroshya Gutanga ogisijeni no gukurikirana. Abaganga barashobora kwizera ko umurwayi arimo ahabwa urwego rwavuzwe na ogisijeni, kugabanya gushidikanya bifitanye isano Kugabanuka kwa Oxygen bigaragara na sisitemu isanzwe.
Ibisobanuro bya Hfnc yongeraho kandi inyungu zayo zifatika. Irashobora gukoreshwa kubarwayi benshi, kuva abarwayi bakuru n'abana kubafite ubukana butandukanye bwa umubabaro w'ubuhumekero. Ikora nk'ikiraro cyiza hagati ya ogisijeni yo hasi no mu mbuga nyinshi zitera. Kurugero, irashobora gukoreshwa kubarwayi batarwaye bihagije kuri NIV cyangwa kwikunda ariko bakeneye inkunga nyinshi kuruta bisanzwe Umuyoboro wa Nasal irashobora gutanga. IYI GUSOBANURA Hfnc Ikintu cyingenzi muburyo bwo guhambirana inkunga yubuhumekero. The kugabanuka gukora akazi kandi itezimbere ogisijeni Itanga irashobora kuganisha ku bitaro bigufi bigumaho kandi umusaruro mwiza kuri abarwayi, gukora Ikibuga kinini cya kasal cannula gishyigikira guhitamo neza kandi neza.
9. Kuva hasi yacu: Guharanira ubuziranenge muri kazul cannulae kuri Hfnc
Nka Allen, uhagarariye uruganda rufite imirongo irindwi yumusaruro mu Bushinwa, ndashobora kukubwira ko gukora ibijyanye no gukora ibicuruzwa bikoreshwa, cyane cyane ababisanzwe bameze Hfnc, bisaba ubwitange butajegajega. Iyo bigeze Ibishushanyo bya Nasal byagenewe Umuyoboro mwinshi wa Nasal kuvura, ibintu byinshi biratangaje. Ibikoresho bigomba kuba byiciro byubuvuzi, biocompble, kandi byoroshye guhumuriza kwihangana, cyane cyane ko Amazuru barimo guhura na Mucosa yoroheje mugihe kinini. Twibanze kubikoresho bitanga nkacu Sterile kandis ogisijeni cannula neonatal 2mm icyiciro cya II Ubuvuzi hamwe nibitekerezo ku isonga. Igishushanyo mbonera ubwacyo nacyo kiranebwa - bakeneye guhuza neza kandi neza badateje igitutu kidakwiye, mugihe gikomeje gukora neza Gutanga ogisijeni kuri igipimo kinini.
Ubunyangamugayo bwa byose Hfnc Umuzunguruko, harimo na tubing nabahuza, ni ngombwa. Igomba gushobora gukemura amashyi menshi, Ubushuhe Bwinshi gaze udahunze, gutemba, cyangwa gutera inkunga birenze urugero. Sterlity, aho bisabwa (nubwo benshi Hfnc Imikino y'abarwayi irasukuye aho guswera, bitewe na sisitemu na protocole yaho), niyindi ntabyuka. Gahunda yacu yo gukora ikurikiza amahame mvukirwa nka ISO 13485, kandi ibicuruzwa byacu bikunze gukora ibimenyetso, aribyo bipimo ngenderwaho byerekana ubuziranenge no kubahiriza abayobozi ba Mark Thompson bashakisha. Turabyumva abarwayi bafite ubugari ibibazo byubuhumekero, kwizerwa kwikintu cyose kimwe Ubuvuzi bwa HFNC ni ngombwa.
Byongeye kandi, guhuzagura mu musaruro ni urufunguzo. Buri cyiciro cya Ibishushanyo bya Nasal cyangwa izindi Hfnc Ibigize bigomba kuba byujuje ubuziranenge bumwe. Ibi bikubiyemo kugenzura ubuziranenge bukomeye mubyiciro byinshi byumusaruro, uhereye kumafaranga fatizo kubizamini byanyuma. Dushora imari mu ikoranabuhanga rishingiye ku ikoranabuhanga mu bijyanye no kwemeza ko buri Hfnc Ibicuruzwa bivuye mu kigo cyacu, haba byoroshye Umuyoboro wa Nasal cyangwa igice kitoroshye cya ogisijeni yo kuvura ogisijeni Gufasha, gukora nkuko byari byitezwe. Uku kwiyegurira ubuziranenge nuburyo twubaka ikizere nabakiriya bacu b2b - ibitaro, amavuriro, nubutegetsi bwubuvuzi kwisi yose batwishingikiriza kandi bafite akamaro ogisijeni ndende Sisitemu yo gutanga. Ibi byibanda kumiterere bigera nurwego rwacu rwose, harimo Gusukura kwa muganga guhuza tube 1.8mm hamwe na YanKuer, guharanira imikorere yizewe mu bicuruzwa byacu byose.
10. Ibitekerezo by'ingenzi byo gutanga amasoko: Gutererana sisitemu yizewe na HFNC
Kubashinzwe amasoko nka Mark Thompson muri Amerika, cyangwa umuntu wese ushinzwe gukuramo Hfnc Sisitemu no Gukoresha Ibitaro, amavuriro, cyangwa amashyirahamwe yubuzima, ibitekerezo byinshi byingenzi bizakina. Iya mbere, nta gushidikanya, ni Ubwishingizi bwiza nubujurire bushinzwe kugenzura. Ugomba kwemeza ko Hfnc ibikoresho nibigize, cyane cyane Ibishushanyo bya Nasal n'imizunguruko, guhuza amahame yubuvuzi. Shakisha ibyemezo nka ISO 13485, GC biranga, na FDA bihumanya aho bishoboka. Nkumutungo, twumva ibisabwa no kwemeza ibicuruzwa byacu, nkacu Hfnc-kubaho NASAL ogisijeni Cannula, yujuje ibipimo ngenderwaho ku isi. Kugenzura izi mpamyabumenyi hamwe nuwabikoze cyangwa binyuze muri cheque ya gatatu-yindirimbo nintambwe ikomeye.
Icya kabiri, tekereza kuri imikorere n'ibiranga ya Hfnc Sisitemu. Iratanga intera nini igipimo kandi birasobanutse Fio2 kugenzura? Ni sisitemu ya luidemic kandi yizewe mubushobozi bwayo ubushuhe gaze? Tuvuge iki ku mahitamo y'abarwayi - hari ingano zitandukanye za Amazuru kuboneka kugirango uhuze abarwayi batandukanye, kuva abarwayi bakuru n'abana? Umukoresha-Ubucuti Abakozi bavuriro nabo ni ngombwa - uburyo bworoshye igikoresho Gushiraho, gukora, no kugira isuku? Ibi bintu bigira ingaruka muburyo bukomeye bwa Ubuvuzi bwa HFNC Kandi akazi ku batanga ubuzima. The max ubushobozi, ukuri kwa Igipimo cyo gutembera Gutanga, nubushobozi bwa sisitemu bwo kubungabunga Umuvuduko w'indege ni ibintu byose bya tekinike kugirango usuzume.
Hanyuma, Utanga isoko n'inkunga ni ngombwa. Ukeneye utanga isoko ushobora kwemeza urunigi ruhamye, cyane cyane kubigize bimwe na bimwe bya Hfnc Sisitemu. Ni ibihe bihe byabo biri hagati? Ni ubuhe buryo bwabo bwo gukora ku gihe cyo gutanga igihe? Kurenga ibikoresho, tekereza ku nkunga nyuma yo kugurisha, amikoro, hamwe na garanti yatanzwe. Guhangana numukoresha uzwi cyangwa ukwirakwije wumva kamere ikomeye ya Ubuvuzi bwa Oxyjen n'ibicuruzwa kuri Kunanirwa kw'ubuhumekero irashobora gukumira umutwe benshi. Igiciro buri gihe ni ikintu, ariko kigomba kubanganiza ubuziranenge, kwizerwa, hamwe na rusange agaciro Hfnc Sisitemu izana ubuvuzi. Kurugero, uhenze cyane ariko wizewe cyane Umuyoboro mwinshi wa Nasal ibyo biteza imbere ibisubizo byo kwihangana no kugabanya ibyago byo kugorana cyangwa igipimo cy'imituba itanga agaciro keza. Kubaka umubano ukomeye nabatanga ibicuruzwa bitwara ibintu byabo nibikorwa byiza kuri Hfnc kandi bifitanye isano Sisitemu yo gutanga ogisijeni ni urufunguzo Ubuvuzi bukomeye na Kumenyera Amashami.
Urufunguzo rukwiranye hejuru-yizuru (Hfnc) yo kuvura:
- HFNC itanga ibipimo byimbitse byumuyaga ushyushye kandi ushutswe, Kurenga ibisabwa byibasiwe nabarwayi kuri Fio2 ihamye.
- Imyitozo yingenzi zirimo gushidikanya kwa Nasopharyngeal Umwanya wapfuye, igisekuru c'igitutu cyiza cya murwanyi, kandi gihamye cya Fio2.
- Ubushuhe bwiza ni ngombwa Kubwihumure ryihangane, ubuzima bwintambara, hamwe no kwihanganira HFNC.
- Igipimo cyurupfu kigira ingaruka kuri Fio2, umwanya wapfuye, no gukora guhumeka.
- HFNC yerekanwa kunanirwa kw'ubuhumekero, inkunga nyuma yo kuzamura, nibindi bisabwa bisaba kuvura ogisijeni.
- Irashobora kugabanya ikenerwa gukenera Ventilation mu barwayi batoranijwe neza bafite ubuhumekero bukabije.
- Inyungu zifatika zirimo kunoza ihumure ryibarura, koroshya ikoreshwa, no muburyo butandukanye hakurya yubuvuzi butandukanye.
- Inganda nziza yo gukora ibice bya HFNC, cyane cyane imiyoboro ya kazu, ni ngombwa Kubwumutekano nuburyo bwiza, bisaba kubahiriza amahame yo kwiga.
- Amasoko agomba kwibanda ku bwiza, kubahiriza amategeko, imikorere yimikorere, no gutanga inguzanyo mugihe sisitemu ya HFNC.
Ubushakashatsi bwa Hfnc Yerekana uruhare rukomeye mubuvuzi bwa kijyambere. Nkumukora, twe kuri Zhongxing twishimiye gutanga umusanzu muri iki gice dutanga amafaranga menshi yubuvuzi bwisumbuye ashyigikira akamaro Umuyoboro mwinshi wa Nasal Kuvura, gufasha kunonosora ogisijeni Kandi umusaruro wihangana kwisi yose.
Igihe cya nyuma: Gicurasi-20-2025