I-cannula ehamba i-nilal canula, ihlala ishwankathelwe njenge Hfnc, iba lilitye lembombo kukhathalelo lokuphefumla lwanamhlanje. Oku kubuncinci I-Nasal Cannula Unyango Inika inyathelo elibalulekileyo ukusuka kwiindlela zemveli, libonelela ngenkxaso ephuculweyo kwizigulana ezinemiceli mngeni emininzi yokuphefumla. Ukuba uyingcali yezempilo, umphathi okhohlakeleyo njengophawu lwe-thompson e-USA, okanye umntu obandakanyekayo kwi-chain yolondolozo kwezonyango, ukuqonda Hfnc ibalulekile. Eli nqaku lijolise ekupheliseni i-romes ephezulu ye-cannula Unyango, ukuphonononga iindlela zalo, izibonelelo, ukusetyenziswa, kunye noko ukuqwalasela xa kufuneka xa kufuneka ezi nkqubo zibalulekileyo. Njenge-Allen, kwinkampani ekhethekileyo kwinkampani enokuthethwa kwezempilo e-China, ndiyibonile indibano yokukhula kwemfuno kunye nefuthe elihle lomgangatho Hfnc iimveliso. Siza kujonga ukuba kutheni le nto i-high ephezulu Itekhnoloji ingaphezulu kwendlela nje; Ihlala ilukhetho oluphezulu lokuphucula ioksijini kunye nokuthuthuzelwa ngomonde, ngakumbi kwiimeko ze Ukusilela kokuphefumla okukhulu. Esi siqwenga sililungelo lakho kuba iqhekeza ulwazi oluntsonkothileyo kwizinto ezingenamda ngokulula, ukuzoba ukusuka kokubini ekuqondeni kweklinikhi kunye nokwenza izigqibo, ekugqibeleni ukukunceda wenze izigqibo ezinobomi Unyango lweoksijini.
1. Ithini kanye kanye le ndlu ye-UNFnula ye-UNFNAN YASALD (HFNnc) kwaye isebenza njani?
Ukuhamba kwe-neasal ye-nasal Unyango luhlobo olunobuchule lwenkxaso yokuphefumla ehambisa i ukuhamba okuphezulu yomoya / ioksijini yokudibanisa kwisigulana, ngokuqhelekileyo ngokukhethekileyo I-Prongs ye-Nasal okanye i-cannulae. Ngokungafaniyo nokuhamba kwemveli ioksijini ye-nasal iinkqubo, Hfnc inokuhambisa igesi Ukuhamba kweereyithi Oko kuhlala kudlula i-gugus's ukuhamba okukhuthazayo imfuneko. Lo ngumsebenzi ophambili. Yicinge ngale ndlela: Ukuba isigulana siphefumla ngokukhawuleza nangokunzulu, i-cannula esemgangathweni isenokunganikezeli ioksijini eyaneleyo yokufezekisa iimfuno zabo, ezikhokelela kwi Ukufakwa komoya wegumbi kunye nokuchazwa kancinci Fio2 (iqhezu leoksijini ephefumlelweyo). Hfnc Iinkqubo, nangona kunjalo, zinokuhlangula Ukuhamba kweereyithi Ukuya kuthi ga kwiilitha ezingama-60 ngomzuzu okanye nangaphezulu kubantu abadala, qinisekisa ukuba ubonelelo lweoksijini olungafezekanga noluthembekileyo.
I Hfnc Inkqubo ihlala inamacandelo amathathu aphambili: I-air / shosten brander ukulawula i Fio2, i-hidifier ifudumele kwaye hlazisa irhasi, kunye nesiphaluka esishushu esihambisa igesi ye-proidef kwisigulana nge i-nasal cannula. Ukukwazi hlazisa kwaye ubushushu igesi kubalulekile ukuze ufumane intuthuzelo kunye nokunyamezelana, ngakumbi kwi amaqondo aphezulu okuhamba. Le nkqubo ithintela ukomisa i umoya I-MUCOSA, enokuba yimbambano ebalulekileyo ngaphandle kwe-ofisi engafakwanga, i-high ephezulu irhasi. I Ukusetyenziswa kwe-HFNC iyaqhubeka ixhaphakile kwiisethingi ezahlukeneyo, kwiSebe likaxakeka kwi Unonophelo oluBanzi Iyunithi (i-ICU), yokulawula izigulana ezineentlobo ezahlukeneyo ze Uxinzelelo lokuphefumla. Thina, njengabavelisi, gxila ekudalani kwaye kufanelekile i-nasal canulae, njengawethu I-PVC ye-PVC ye-PVC ye-Asnula ye-Cansula ye-Cannula yentsana kunye nomntu omdala, yenzelwe ukwenzela ukuhanjiswa koku I-HFND Unyango.
Indlela ye-FETIS Hfnc kubandakanya okungaphezulu kokuhambisa nje i-up Ukuhamba kweoksijini. Inceda ngokuhlamba i-nasopharyngel indawo efileyo, ukunciphisa umsebenzi wokuphefumla, ukubonelela ngesixa esincinci sezinto ezintle uxinzelelo lwe-Airway, kunye nokuqinisekisa ukuzinza ngakumbi Fio2. Indibaniselwano yenza Hfnc Isixhobo esixabisekileyo se Unyango lweoksijini, ngakumbi Izigulana ezinesidenge Imicimbi yokuphefumla. I umgangatho wohambo kwaye Fio2 Inokuqina ngokuqinileyo, ivumela abagqirha ukuba balayishe unyango kwiimfuno zomlingane ngamnye. Ukuhanjiswa okungaguqukiyo kokumiselwa Fio2 yinto ephambili, njengoko inciphisa I-OXYGEN RINIL ukusuka egumbini lokuphumla.
2. I-HFNnc yahluke njani kwiinkqubo ze-Oxygen zeoksijini?
Ngokwesiko okanye Ioksijini eqhelekileyo Iinkqubo zonyango, ezinjenge-cannulas eziqhelekileyo okanye iimaski zobuso ezilula, zihamba ngeoksijini esezantsi Ukuhamba kweereyithi, ihlala ikwiilitha ezi-6 ngomzuzu we-cannulas kwaye mhlawumbi i-10-15 l / imiz kwimaski. Ngelixa ezi zisebenza nge-hypoxemia ethambileyo, zinomda. Umahluko omkhulu ulele kwi umgangatho wohambo ngokwayo. Hfnc Ukuhambisa irhasi Ukuhamba kweereyithi ezigqithile Intaba yomguli Ixabiso lokuqhuba, ihlala isukela ukusuka kwi-20 ukuya kwi-60 l / min, okanye ngaphezulu. Oku kuthetha ukuba Hfnc Inkqubo ibonelela kakhulu, ukuba ayizizo zonke, zerhasi ephefumlelweyo yesigulana, ekhokelela ekuguqukayo kwaye kuyayinqanda Fio2. Ngeenkqubo eziqhelekileyo, isigulana sihlala siphefumla kwinani elibalulekileyo lomoya kunye neoksijini eyongeziweyo, ilahle ioksijini yeoksijini kunye nokwenza eyona nyani Fio2 Ukwahluka kwaye uhlala uphantsi kunenjongo. Le Ukufakwa komoya wegumbi ngumceli mngeni omkhulu ukuba Hfnc inciphisa ngokufanelekileyo.
Omnye umahluko obaluleke kakhulu kukujongana nemeko ephefumlelweyo. Hfnc Iinkqubo zenzelwe ubushushu kwaye hlazisa Irhasi ukuya kufutshane nobushushu bomzimba (i-37 ° C) kunye ne-100% yokufuma. Oku kubalulekile kuba ukuhambisa igesi eyomileyo, ebandayo amaqondo aphezulu okuhamba inokuyonakalisa i umoya I-MUCOSA, yenza ukungakhathazeki, iphazamise imvume ye-mucomeler, kwaye yandisa i Umsebenzi wokuphefumla. Ioksijini eqhelekileyo Iinkqubo, ngakumbi ngokuhambahamba kweemaski, zihlala zihambisa ioksitha, eyomileyo yeoksijini, enokuthathwa gadalala ixesha elide. I Ushushu kwaye uthobele irhasi evela Hfnc Isixhobo siphucula ukuthuthuzela isigulana kunye nokuthobela, nto leyo eyimfuneko ephumeleleyo Unyango lweoksijini. Eli nqaku lodwa lenza Hfnc ukhetho olukhethiweyo lwabaninzi izigulana ezinomtshato wokuphefumla Imiceli mngeni.
Ngapha koko, Hfnc ibonelela ngezibonelelo ezongeziweyo zomzimba ezingakhange zibonwe ngenkqubo yokuhamba kancinci. Oku kubandakanya ukuhlamba kweNasopharyngel indawo efileyo ye-Aatomical, ephucula ukusebenza kakuhle kwe umoya, kunye nesizukulwane senqanaba lokuthozama uxinzelelo lwe-Airway (I-PAP), enokukunceda ekufuneni i-alveli kwaye iphucule ioksijini. Ngelixa ungangeniswanga Umoya we-nonvievas (NIV) okanye umoya ohlaselweyo kuzo zonke iimeko, Hfnc Ibhlorho, inika inkxaso engaphezulu kuneoksijini ye-oxygen kwaye incinci kwaye incinci kwaye inyamezele i-maskis i-iv. I Ukusetyenziswa kwe-neasal ye-neal imele ukuqhubela phambili okukhulu ngaphakathi Inkqubo yokuhambisa ioksijini, ukuhambisa ngaphaya kwesongezelelo seoksijini elula kwinkxaso yokuphefumla esebenzayo.
3. Zeziphi izibonelelo eziphambili zomzimba zokusebenzisa i-cannula ye-nilal ye-nisa?
I Ukusetyenziswa kwe-HFNC Ukuzisa iinzuzo ezibalulekileyo zomzimba ezinegalelo ekusebenzeni kwalo kulawulo lokuphefumla. Enye yezona zinto zibalulekileyo kukuncitshiswa kwe-nasopharyngel indawo efileyo. Okuqhubekayo ukuhamba okuphezulu Irhasi iqhubela phambili i-carbon diokside (CO2) ukusuka phezulu umoya ngexesha lokuphelisa. Oku kuthetha ukuba ngomphefumlo ngamnye olandelayo, isigulana serhasi enoxinzelelo olusezantsi lwe-CO2 kunye ne-oxygen ephezulu yeoksijini, esenza umoya isebenza ngakumbi. Ukuhlamba kwe indawo efileyo ye-Aatomical inokukhokelela ekunciphiseni kwi Ixabiso lokuphefumla kwaye iyonke Umsebenzi wokuphefumla, eyona njongo iphambili ekunyangeni Izigulana ezinesifo sokuphefumla okukhulu.
Okwesibini, Hfnc inokuvelisa isixa esincinci sexabiso elifanelekileyo uxinzelelo lwe-Airway (I-PAP). Ngelixa inqanaba le-PAP liguquguquka kwaye lixhomekeke kwi umgangatho wohambo Kwaye nokuba umlomo wesigulana uvulekile okanye uvaliwe, nokuba kukhula oluthobekileyo kunokuba luncedo. Olu xinzelelo lunganceda ukuthoba i-vent ephezulu umoya, ukunciphisa i-thesticlis (i-lang yowa), kwaye iphucu Ivolumu yokuphela kwe-l ephezulu. Oku kunegalelo ngcono ioksijini kwaye kunokuba luncedo ngokukhethekileyo kwizigulana ezinemeko ezifana Ukusilela okuphefumla kweHypoxmatic. Ukuhanjiswa okungaguqukiyo kwe Fio2 kwi amaqondo aphezulu okuhamba Ukuqinisekisa ukuba isigulana sifumana uxinzelelo lweoksijini ecetywayo, ukunciphisa ukuguquguquka okubangelwa ziinguqu kwipateni yabo yokuphefumla okanye Ukufakwa komoya wegumbi.
Okokugqibela, ukuthobeka okuqinisekileyo kubonelelwe ngu Hfnc Iinkqubo azikho kwintuthuzelo nje; Inezibonelelo zezomzimba zomzimba umoya. Ngokufanelekileyo Ukuhamba okuphezulu okuphezulu Irhasi inceda ukugcina umsebenzi oqhelekileyo we-MUCEARMARENATORE, ebalulekileyo ekucaciseni imiphunga. Oku kungathintela ukugcinwa kweemfihlo, ukunciphisa umngcipheko wokosuleleka, kwaye ugcine umoya plitercy. Ubushushu kunye nokufuma kwakhona kuthintela ukomisa kunye nokucaphukisa iindinyana zempumlo kwaye zisezantsi umoya, ekhokelela ekunyamezeleni kakuhle kwisigulo kunye nokubambelela kwi Unyango lweoksijini. Olu xinzelelo luphuculweyo yinto ephambili kwimpumelelo ye I-HFND Unyango, ngakumbi xa kufuneka inkxaso yexesha elide. Njengomvelisi, siyakuqonda ukubaluleka kwezi zibonelelo, okuqhuba ukuzibophelela kwethu ekuveliseni iindlela eziphezulu eziphezulu Hfnc.
4. Kutheni kubalulekile ukufudumala ngokugqibeleleyo kubaluleke kakhulu kunyango oluphezulu?
Ukufudumala ngokugqibeleleyo ayisiyiyo nje "ukuba" i-high ephezulu Unyango; Ibaluleke kakhulu kukhuseleko lwayo kunye nokusebenza kakuhle. Xa uhambisa igesi kwi Ixabiso eliphezulu lokuhamba, Thetha iilitha ezingama-30 ukuya kwezingama-60 ukuya kwi-60 ngomzuzu, ngqo kwiindinyana zempumlo, ukuba irhasi iyabanda kwaye yomile, inokusitya ngokukhawuleza umswakama kunye nobushushu obukhawulezileyo umoya I-MUCOSA. Oku kunokukhokelela kwi-Contistraist Iingxaki: Ukuvuvukala, umsebenzi ongafakwanga kakuhle (iinwele ezincinci ezisusa i-mucus kunye nenkunkuma ngaphandle kwe umoya), amaqela atyhutyha amanzi, i-mucus clging, kunye nephalane. Izigulana ziya kufumana ukungonwabi kubaluleke kakhulu, ezinjengokwenza impumlo, iintlungu, kunye nemvakalelo evuthayo, ibenza bangathandeki ukuba banyamezele i I-HFND Unyango ixesha elide. Ke ngoko, ukukwazi hlazisa kwaye ubushushu ngerhasi yilitye lesiseko Hfnc.
Hfnc Iinkqubo zenzelwe ukuhambisa igesi ezishushu malunga ne-37 ° C (iqondo lobushushu lomzimba) kwaye lizaliswe ngumphunga wamanzi (kufutshane ne-100% yokufumanisa umswakama). Oku kulinganisa imeko yendalo yomoya okwenzeka ngaphambili umoya. Ngokubonelela ngale Ushushu kwaye uthobele irhasi, Hfnc ukhusela i umoya I-Epitium, igcina imvume yesiqhelo ye-mucocial, kwaye iphucula kakhulu intuthuzelo kunye nokunyamezelana. Oku kuvumela abaguli ukuba bafumane izibonelelo ezipheleleyo ze Ixabiso eliphezulu lokuhamba kwaye ndimiselwe Fio2 Ngexesha elininzi, elihlala liyimfuneko kwiimeko ezifana Ukusilela kokuphefumla okukhulu. Intuthuzelo ephuculweyo ikwanciphisa ukhathazeke isigulana kwaye Umsebenzi wokuphefumla, njengoko bengalwi ngokuchasene nokucaphukisa okucaphukisayo.
Ukusuka kwindawo yokuma yemveliso, ukuqinisekisa ukuba iinkqubo zokufudumala ngaphakathi Hfnc Izixhobo zinokuthenjwa kwaye ziyasebenza yinto enkulu. Oku kubandakanya uyilo lwe-fidifier ngokwayo, ityhubhu eshushu ebathintela ukuziphindezela ("Imvula") kwisekethe, kunye nomnxibelelanisi (i i-nasal canulae). Ukuthobeka kakubi kunokungakhathaleli uninzi lwezibonelelo ze Hfnc kwaye nokubangela ingozi. Ngamava am kwi Umvelisi wesixhobo sonyango lwezonyango - Zhongx, sibeka phambili izixhobo kunye nokuyilwa okuxhasa imeko yegesi efanelekileyo. Ababoneleli bezempilo, kubalulekile ukuqinisekisa ukuba Hfnc Inkqubo isetiwe ngokuchanekileyo kwaye igumbi lokuthobeka lizaliswe kwaye lisebenza ngokufanelekileyo. Olu ncedo kwiinkcukacha zenza umahluko omkhulu kwizifundo zesigulana kunye nempumelelo iphela ye Ukuhamba okuphezulu kwe-neasal ye-cannula yeoksijini.
5. Ukuqonda inqanaba lokuhamba: Ngaba ifuthe njani ukusebenza kweHFNnc?
I umgangatho wohambo Iphithiphithi inqaku elichaza kakhulu Hfnc Unyango kwaye udlala indima eninzi ekusebenzeni kwayo. Enye yeempembelelo eziphambili ze Ixabiso eliphezulu lokuhamba Ngaba amandla ayo okuhlangana okanye ngaphezulu kwencopho yesigulana ukuhamba okukhuthazayo imfuneko. Kwisigulana nge Uxinzelelo lokuphefumla, yabo ukuhamba okukhuthazayo Ingaphezulu kakhulu (E.G., 30-120 l / min). Ukuba ihanjisiwe umgangatho wohambo Ukusuka kwisixhobo seoksijini singaphantsi kwesi, isigulana siyakutsala ngokungathandabuzekiyo kumoya wegumbi, okhokelela kwi I-OXYGEN RINIL kunye nokungalindelekanga Fio2. Hfnc iinkqubo, ngokubonelela Ukuhamba kweereyithi Ngokwesiqhelo ukuya kuthi ga kwi-60 l / min (kwaye ngamanye amaxesha iphezulu kwizixhobo ezithile), inokunciphisa le gumbi lokufakwa komoya, ukuqinisekisa ukuhanjiswa okuzinzileyo nokunyaniseka kokuxhomekeka Fio2. Oku kubalulekile ukuba isebenze ioksijini.
Ngaphaya kwentlanganiso nje ukuphefumlelwa Ibango, i Ixabiso eliphezulu lokuhamba Inegalelo ekuhleni kweNasopharyngel indawo efileyo. Umjelo oqhubekayo wegesi entsha yerhasi i-CO2 etyebileyo evela phezulu umoya (Pharynx kunye ne-nasal cavity). Ukuncitshiswa kwe indawo efileyo kuthetha ukuba ukuphefumla ngalunye kuqukethe inani eliphezulu legesi yeoksijini, ukuphucula ukusebenza kwe-alveolar umoya kwaye inokubangela ukuba kuncitshiswe i Ixabiso lokuphefumla kwaye Umsebenzi wokuphefumla. Ngaphezulu umgangatho wohamboNgapha koko, ukuphumelela okusebenzayo kuya kuba, ukuya kwinqanaba elithile. Le nkqubo iluncedo ngakumbi Izigulana ezinesidenge Iimeko zokuphefumla apho kutshintshiselwano ngegesi ngokufanelekileyo.
Ngapha koko, i umgangatho wohambo ngaphakathi Hfnc Igalelo kwisizukulwana sesona silungileyo uxinzelelo lwe-Airway (I-PAP). Ngelixa le ngxilongo ithobekile (i-1-5 cmh25o) kwaye iyahluka ngokuhamba, i-amontoy yoguli, nokuba umlomo uvulekile okanye uvaliwe, isenokuba neziphumo zenu. Oku kubandakanya ukuthobela i-pronts ephezulu umoya, iyanda Ivolumu yokuphela kwe-l ephezulu, kwaye unokuqesha i-alveoli ewileyo. Ukhetho lwe umgangatho wohambo Ke sisigqibo esiphambili seklinikhi, sasiqala ukuqalisa kwinqanaba eliphakathi (E.G., 30-40 l / min) kunye neshumiselweyo ngokusekwe kwimpendulo yemeko yesigulana, intuthuzelo, ioksijini inqanaba, kwaye Umsebenzi wokuphefumla. Ukulungelelanisa i umgangatho wohambo yinkqubo eguqukayo kwi Ulawulo lokungaphumeleli kokuphefumla okukhulu nge Hfnc.
I-6. Iqala nini i-NUASNAL ye-ANULD OKSINGEN I-AKYGEN YOPHANDO KWABASEBENZI?
Ukuhamba okuphezulu kwe-nasal cannula (hfnc) ioksi yeoksijini Kucetyiswa ukuba kuluhlu olukhulayo lweemeko zeklinikhi apho abaguli bafuna inkxaso yokuphefumla ngakumbi kune Ioksijini eqhelekileyo Unyango lunokubonelela, kodwa lusenokungafuneki, okanye lunyuswe ukusuka, iindlela ezihlaselayo zenkxaso. Isalathiso esiyintloko Ukusilela okuphefumla kweHypoxmatic (Ahrf). Le yimeko eqhelekileyo ngaphakathi Unonophelo oluBanzi Useto Apho abaguli basokola ukuze balondolozwe ioksijini Ngaphandle kweoksijini yomgangatho. I-HFNC ibonisiwe ukuphucula ioksijini, ukunciphisa Ixabiso lokuphefumla, kwaye unciphisa i-dyspnea kwezi Izigulana ezinesifo sokuphefumla seHypoxmatic. Izifundo ezipapashwe kwiijenali ezinje Ukhathalelo olugxekayo med kwaye Unonophelo olunzulu Med uphonononge i Iziphumo zokuhamba kwe-nasal ephezulu Kwelixhebe, zihlala zilungele.
Enye indawo ephambili Ukusetyenziswa kwe-HFNC ikwixesha lokuphela kwexesha. Izigulana ezibosiweyo ezivela kwi-ventilation yoomatshini zikhona umngcipheko omkhulu ye-respiratory demforation. Hfnc inokusetyenziswa njengomlinganiso weprophylactic okanye njengonyango lokukhuphela emva Uxinzelelo lokuphefumla. I Iziphumo ze-PSTEXTubation ephezulu Inkxaso ithelekiswa neoksijini eqhelekileyo kwaye nkqu Umoya we-nonvievasAbanye bophononongo becebisa izibonelelo ekuthinteleni ubuntu, ngakumbi kwizinto ezithile zesigulana. Umzekelo, I-POSTEXIBUUTUP-SPOULA YOKUGQIBELA I-NSnula vs Ingxoxo ye-OXYHNGN ye-Oxejin iyaqhubeka, kodwa Hfnc ihlala inika intuthuzelo engcono kwaye ithembeke ngakumbi Fio2.
Ngaphaya kwezi, Hfnc ikwasetyenziswa kwizigulana ezinefomu ezityebileyo ze Ukusilela kokuphefumla okukhulu, abo bane-odolo "(i-DNI) abafuna inkxaso yokuphefumla eyaphuculweyo yentuthuzelo, kwaye kwi-sedation yenkqubo ukugcina ioksijini. Ikwafumana indima kwiimeko ezingapheliyo njengokwandisa iikopi (nangona i-NIV ihlala iqala nini) kunye nezigulana zabantwana. Ukusetyenziswa kwe Hfnc, IXESHA LOKUSETYENZISWA KOKUSETYENZISWA, NOKUTHENGA ITHENI UKUKHUSELEKA Igalelo kwizicelo zayo zandisayo. Injongo ihlala ibonelela ngokufanelekileyo Unyango lweoksijini kunye nenkxaso ngelixa unciphisa i Umsebenzi wokuphefumla kwaye ukuphepha ukunyuka kwamanyathelo ahlaselayo ukuba kunokwenzeka. Ukukhetha ukusebenzisa I-HFND Unyango kufuneka ihlale isekwe kuvavanyo lweklinikhi ngenyameko yeemfuno zomguli ngamnye kunye ne-patrology patrology.
7. Ngaba ingaba i-HFN inokukunceda ukunciphisa isidingo somoya wokuhlaselwa koomatshini?
Lo ngumbuzo obalulekileyo kunye nendawo ebalulekileyo yophando kunye nomdla wekliniki. Amandla Hfnc Ukunciphisa isidingo somoya ongenamhlanya-moya, kunye neengxaki zayo ezinxulumene ne-Ventilator-yenye yethemba elinomnandi kakhulu. Kwimigangatho ethile yesigulana, ngakumbi abo bane Ukusilela okuphefumla kweHypoxmatic, ubungqina bucebisa ukuba Hfnc inokwenzeka ngokwenene Inqanaba lokungena Xa kuthelekiswa nonyango lweoksijini lwe-shosygen kwaye, kwezinye iimeko, nkqu Umoya we-nonvievas (NIV). Amandla e Hfnc ukubonelela ngesita Fio2, ukunciphisa indawo efileyo, Nika ezinye i-POEE, kwaye ninciphise i Umsebenzi wokuphefumla Zonke zinegalelo koku.
Iimvavanyo ezininzi zeklinikhi ziye zaphanda ngendima ye Hfnc ekuthinteleni ukungathathi-thula. Ngelixa iziphumo zinokwahluka ngokuxhomekeka kwiqela elithile lesigulana kunye nobukrakra be Ukusilela kokuphefumla okukhulu, izifundo ezininzi zibonise imeko entle. Umzekelo, ngaphakathi Izigulana ezinesiphene seHypoxmatic iimeko, ukuqalwa kwangoko kwe Hfnc Unokuzinzisa kwaye kuthintele ukonakala okungaphezulu okufuneka intatheko. Kubalulekile ukuba uqaphele oko Hfnc ayisiyo pansacea; Ukuba isigulana Iqondo lokuphefumla liyasilela ukuphucula okanye yabo ioksijini iyaqhubeka isebenza mbi nangona ilungile I-HFND Unyango, ke ukunyuka ukuya kwi-IMV kusenokufuneka. Hfnc ibonelela Unyango oluxhasayo, ukuthenga ixesha lolunye unyango ukwenza ukusebenza okanye imeko yokusombulula.
Nangona kunjalo, impumelelo ye Hfnc Ukuthintela ukungathathi-hinges ngokukhetha ngokufanelekileyo isigulana kunye nokubekwa kweliso ekwenzeni. Ayilungelanga izigulana ezinokuphefumla okukhulu kwe-hypercapnic umoya. Kodwa uninzi Izigulana ezinokungaphumeleli, ngakumbi uhlobo lweHypoxmic, Hfnc inika ukhetho oluxabisekileyo, olungenaluthando oluncinci. Ngokuphucula ioksijini kunye nokunciphisa uxinzelelo lwendalo lokuphefumla, I-HFND Unyango inokunceda abaguli baphephe umngcipheko kunye nokunganyamezelwa kwentsusa. Oku kwenza ukuba kube sisixhobo esibalulekileyo kwi Ulawulo lokungaphumeleli kokuphefumla okukhulu kwi Unonophelo oluBanzi Ukuseta nangaphaya.
8. Zeziphi izibonelelo ezisebenzayo ze-HFNNS kwizicwangciso zeklinikhi eyahlukeneyo kunye nokuhanjiswa kweoksijini?
Hfnc inika iinzuzo ezininzi ezibe negalelo ekusebenzeni kwayo ngokuxhaphakileyo kwiimeko ezahlukeneyo zeklinikhi, kumagumbi kaxakeka kwiwadi ngokubanzi kwaye Unonophelo oluBanzi Iiyunithi. Enye yezona zinto zibalulekileyo kukuthuthuzelwa kwesigulana kunye nokunyamezelana xa kuthelekiswa nezinye iindlela zenkxaso yokuphefumla, ngakumbi Umoya we-nonvievas (NIV) Imaski. I-Niv Masisks zinokuqina, zibangele izilonda zobuso, kwaye zenze kube nzima ukuba abaguli batye, basele, okanye banxibelelane. Hfnc, inikelwe nge-sure I-Prongs ye-Nasal, ihlala inyamezeleke kakhulu. Olu thuthuzelo luphuculweyo lunokukhokelela ekuthobeleni kakuhle Unyango lweoksijini, eyona nto iyimfuneko kwimpumelelo yalo. Izigulana zinokuthetha, zitye, kwaye zisela ngokulula ngelixa zifumana Hfnc, ukuphucula amava abo ngokubanzi kunye nentsebenziswano nonyango.
Elinye iZibonelelo eziSebenzayo kukulula kwesicelo kunye nolawulo xa kuthelekiswa ne-verilators yoomatshini. Ngelixa Hfnc Iinkqubo zinobunkunkqele izixhobo zokuhamba, ngokukuko kulula ukuzimisela kwaye bakwazi ukulawula abasebenzi abahlengikazi. I-witsers ayinangxaki, kunye nengqwaba umgangatho wohambo kwaye Fio2 ngqo. Oku kuba lula ukusebenzisa kunokuba luncedo ngokukhethekileyo kwizicwangciso zeklinikhi okanye kwiindawo apho abasebenzi banokungafikeleli uqeqesho olukhethekileyo lonyango. Ngapha koko, kuba Hfnc ibonelela ngokuhambelana nenokuthenjwa iqhezu leoksijini ephefumlelweyo, yenza lula Ukuhanjiswa kweoksijini nokubeka iliso. Iiklinikhi zinokuqiniseka ngakumbi ukuba isigulana sifumana inqanaba elimiselweyo leoksijini, ukunciphisa ukungaqiniseki okunxulumene noko I-OXYGEN RINIL ibonwa ngeenkqubo eziqhelekileyo.
Ukusetyenziswa kwe Hfnc Yongeza nakwizinto zayo ezisebenzayo. Ingasetyenziselwa uluhlu olubanzi lwezigulana, ukusuka abantu abadala kunye nabaguli abasebenza ngenyanga Kwabo banobunzima obuqhelekileyo be Uxinzelelo lokuphefumla. Isebenza njengebhlorho ebalaseleyo phakathi kokuhamba kweoksijini ephantsi kunye nonyango oluhlaselayo. Umzekelo, inokusetyenziselwa izigulana ezingaguli kakhulu ze-NIV okanye iNgubano kodwa zifuna inkxaso engaphezulu kunomgangatho i-nasal cannula inokunikezela. Olu buqululi lwenza Hfnc Icandelo elixabisekileyo lendlela enesidima kwinkxaso yokuphefumla. I Ukuhla komsebenzi wokuphefumla kwaye iphuculwe ioksijini Inika kungakhokelela ekubeni sibe sesibhedlele esibhedlele esifutshane kunye neziphumo ezingcono ze Izigulana zokugcina, ukwenza Ukuhamba okuphezulu kwe-neasal cannula ukhetho olusebenzayo nolusebenzayo.
I-9. Kumgangatho wethu wefektri: Ukuqinisekisa umgangatho kwi-nasal canulae ye-HFNnc
Njenge-allen, emele umzi-mveliso ngemigca yesixhenxe yemveliso eTshayina, ndingakuxelela ukuba izinto ezenziwa kwezonyango, ngakumbi ezo zicelo zibalulekileyo Hfnc, ifuna ukuzibophelela okungagungqiyo kumgangatho. Xa kuziwa i-nasal canulae yenzelwe ngokukodwa i-romes ephezulu ye-cannula Unyango, izinto ezininzi zibaluleke kakhulu. Izixhobo kufuneka zibe libanga lezonyango, i-biompatid, kwaye zithambile ukuqinisekisa intuthuzelo yezigulana, ngakumbi oko I-Prongs ye-Nasal banxibelelana ngokuthe ngqo ne-mucosa ebuthathaka ye-MUCOSA malunga nexesha elongezelelweyo. Sigxila ekuveliseni izixhobo ezinjengethu I-Oxten ye-Assula ye-Inuntuunal 2mm IBAKALA 2mI II yezonyango Ngale nto iqwalasele ngaphambili. Uyilo lweeproxus ngokwazo lubalulekile- kufuneka lukhona ngovuyo kwaye ngokukhuselekileyo ngaphandle koxinzelelo olungafanelekanga, ngelixa uvumela ukuba usebenze Ukuhanjiswa kweoksijini kwi amaqondo aphezulu okuhamba.
Ingqibelelo ye Hfnc Isekethe, kubandakanya ityhubhu kunye neziqhobosiweyo, zibalulekile. Kuya kufuneka ukwazi ukuphatha ishushu, Ukuhamba okuphezulu okuphezulu Irhasi ngaphandle kokuchitha, ivuza, okanye ibangele ukuphiliswa kwe-proences. Ukungasebenzi, apho kufuneka (nangona abaninzi Hfnc Ukudibana kwesigulana kucocekile endaweni yokufumana i-suble, kuxhomekeka kwinkqubo kunye neeprotocol zengingqi, yenye into engeyako. Iinkqubo zethu zokwenza ukubambelela kwimigangatho yehlabathi yamazwe aphesheya efana ne-ISO 13485, kwaye iimveliso zethu zihlala zinokuthwala, zezona zimpawu ziphambili zoMgangatho, ukuthotyelwa kwabaphathi kunye nabaphathi bezinto ezithengiweyo njengoMark Thompson. Siyayiqonda loo nto Izigulana ezinesidenge Imicimbi yokuphefumla, ukuthembeka kwento nganye ye I-HFND Unyango ibalulekile.
Ngapha koko, ukungqinelana kwimveliso kubalulekile. Ibhendi nganye ye i-nasal canulae okanye enye Hfnc izinto kufuneka zihlangabezane nemigangatho ephezulu. Oku kubandakanya ukuqhutywa komgangatho ojikelezileyo kwinqanaba lamanqanaba amaninzi emveliso, ukusuka ekuhlolweni lwezinto ezikhuselweyo kwimveliso yokugqibela yemveliso. Sityala imali kwiTekhnoloji yoNcedo lweMveliso kunye noQeqesho kwabasebenzi ukuqinisekisa ukuba yonke Hfnc Imveliso ishiya indawo yethu, nokuba ilula i-nasal cannula okanye icandelo elinzima kakhulu le Unyango lweoksijini kunye nomoya ongenakuphikiswa Ukuqhubeka, kwenziwe njengoko kulindelwe. Oku kuzinikezela kumgangatho yindlela esakha ngayo ukuthembana nabathengi bethu B2B - izibhedlele, iikliniki, kunye nabasasazi kwezonyango kwihlabathi liphela abaxhomekeke ekukhuseleni kwaye basebenze ioksijini ephezulu yeoksijini iinkqubo zokuhambisa. Oku kugxila kumgangatho kwandiswa kuluhlu lwethu lonke, kubandakanya Ukunyanzelwa kwemeko yentlalo, ukuqinisekisa ukusebenza ngokuthembekileyo kuzo zonke izidlo zethu zonyango.
10. Ukuqwalaselwa okuphambili kokuthengwa kwempahla: Ukunyanzeliswa kweenkqubo ezinokuthenjwa zeHFN kunye nokubonelela
Kubaphathi abathengileyo njengoMark Thompson e-USA, okanye nabani na onoxanduva lokufumana Hfnc Iinkqubo kunye nezitrato zezibhedlele, iiklinikhi, okanye imibutho yezempilo, eziqwalaselwayo eziphambili zokudlala. Eyokuqala, ngokungathandabuzekiyo, yile Ukuqinisekiswa komgangatho kunye nokuthotyelwa komthetho. Kufuneka uqiniseke ukuba Hfnc izixhobo kunye nezinto zabo, ngakumbi i i-nasal canulae kunye nesekethe, zidibane nemigangatho engqongqo yezonyango. Jonga iziqinisekiso ezinjenge-ISO 13485, ukumakisha i-CE, kunye neFDA Njengomvelisi, siyaziqonda ezi mfuno kwaye siqinisekise iimveliso zethu, njengawethu Hfnc-Coticactive ioksijini ye-nasal I-cannulas, dibanisa ezi zixhobo zehlabathi. Ukuqinisekisa ngeziqinisekiso ngokuthe ngqo kumvelisi okanye ngetshekhi yeqela lesithathu elidumileyo linyathelo elibalulekileyo.
Okwesibini, qwalasela i intsebenzo kunye neempawu ye Hfnc Inkqubo. Ngaba inika uluhlu olubanzi lwe Ukuhamba kweereyithi kwaye ichanekile Fio2 Ulawulo? Ngaba inkqubo yokuthobeka isebenze ngokufanelekileyo kwaye inokuthenjwa kumandla ayo hlazisa Irhasi? Kuthekani malunga nokukhetha isigulana-ngaba kukho ubungakanani bo I-Prongs ye-Nasal iyafumaneka ukuze ilingane nezigulana ezahlukeneyo, ukusuka abantu abadala kunye nabaguli abasebenza ngenyanga? Umsebenzisi-ubuhlobo babasebenzi beklinikhi ikwabalulekile- indlela elula ngayo isixhobo sokuhamba Ukuseta, ukusebenza, kwaye ucoceke? Ezi zinto zichaphazela ngokuthe ngqo ukusebenza kwe I-HFND Unyango kunye nomthwalo womsebenzi kubaboneleli bezempilo. I Ukuhamba kwe-max amandla, ukuchaneka kwe Inqanaba lokuhamba kwegesi Ukuhanjiswa, kunye nokukwazi kwenkqubo yokugcina uxinzelelo lwe-Airway zonke izinto zobugcisa zikrexeza.
Okokugqibela, Ukuxhomekeka ekuthembeni kunye nenkxaso ibalulekile. Udinga umthengisi ukuba ngubani onokuqinisekisa i-chain yokubonelela, ingakumbi yezinto ezilahlayo ze Hfnc Inkqubo. Athini amaxesha abo akhokelayo? Ithini irekhodi labo lokuhambisa ixesha? Ngaphandle kwezinto, qwalasela inkxaso yasemva kwentengiso, izixhobo zoqeqesho kunye newaranti. Ukujongana nomenzi odumileyo okanye umhambisi oqonda imeko ephambili ye Unyango lweoksijini kunye neemveliso ze Ukusilela kokuphefumla okukhulu inokuthintela uninzi lwentloko. Ixabiso lihlala liyinto, kodwa kufuneka lilungelelaniswe ngokuchasene nomgangatho, ukuthembeka, kunye nexabiso elipheleleyo Hfnc Inkqubo izisa ukhathalelo lwesigulana. Umzekelo, kuyabiza kakhulu kodwa inokuthenjwa kakhulu i-romes ephezulu ye-cannula ephucula iziphumo zonyango kwaye inciphise umngcipheko weengxaki okanye Inqanaba lokungena inika ixabiso elingcono lexesha elide. Ukwakha ubudlelwane obuqinileyo nabathengisi ababonakalayo malunga nemveliso yabo yemveliso kunye nomgangatho ye Hfnc kwaye inxulumene Inkqubo yokuhambisa ioksijini isitshixo se Unonophelo olunzulu Med kwaye ukhathalelo olugxekayo amasebe.
I-theays ephambili kwi-subnila ye-cannula (HFNnc) yonyango:
- I-HFNNS inikezela ngeereyithi eziPhambili eziPhakamileyo zokuHamba kunye neDemidied Deaid / i-Oxevin, ngaphezulu kwemfuno yokukhuthaza isigulana sefio2.
- Iindlela eziphambili zibandakanya ukuhlamba indawo efileyo ye-Nason, Isizukulwane soxinzelelo olufanelekileyo
- Ukufudumala ngokugqibeleleyo kubalulekile Ukuthuthuzela isigulana, impilo yenqwelo moya, kunye nokunyamezelana kwe-HFN.
- Ukuhamba kwereyitha ifuthe lokuzinza nge-FIO2, ukucaciswa kwendawo efileyo, kunye nomsebenzi wokuphefumla.
- I-HFNC iboniswe ekungaphumleni kwe-hypoxmatic yokuphefumla, inkxaso yokuthweswa emva, kunye nezinye iimeko ezifuna unyango lweoksijini.
- Ingayinciphisa imfuneko yokufumana umoya ongenamhla kwizigulana ezifanelekileyo ezifanelekileyo ngokusilela kokuphefumla okukhulu.
- Iinzuzo ezisebenzayo zibandakanya ukuphuculwa kwentuthuzelo yesigulana, ukulungiselela ukusetyenziswa, kunye nokutshintsha kwizicwangciso ezahlukeneyo zeklinikhi.
- Ukutyunjwa komgangatho wezinto ze-HFNn, ngakumbi i-nasal cannulae, ibalulekile Ukhuseleko kunye nokusebenza kakuhle, ukufuna ukubambelela kwimilinganiselo yebanga lezonyango.
- Ukuthengwa kwempahla kufuneka kugxilwe kumgangatho womgangatho, ukuthotyelwa kwemigaqo, amanqaku okusebenza, kunye nokuxhomekeka kubaboneleli Xa ukhangela iinkqubo ze-HFN.
Olu vavanyo lwe Hfnc ibalaselisa indima yayo ebalulekileyo kwinkathalo yokuphefumla yanamhlanje. Njengomvelisi, thina e-Zhongxing sinebhongo ngokufaka isandla kule ntsimi ngokubonelela ngexabiso eliphezulu lonyango oluxhasayo i-romes ephezulu ye-cannula Unyango, lunceda ukuphucula ioksijini kunye nezigulana iziphumo kwihlabathi liphela.
Ixesha leposi: Meyi-20-2025