Zuciya-Huhu Machine: manufar da manufa na aiki

Zuciya-Huhu Machine - musamman da kayan likita abin da yake iya samar da mutum tafiyar matakai na rayuwa, idan zuciya ko huhu daina gaba daya, ko partially cika da ayyuka. A ra'ayin na da yiwuwar ya yi da "adana daga cikin rayayyun yanayin wani sashi na jiki" ya bayyana a cikin 1812, amma da farko m na'urar, wanda kunshi jini famfo inji da oxygenation, ya bayyana ne kawai a 1885.

A farko bude zuciya tiyata inda zuciya-huhu inji aka shiga tsakani, da aka gudanar a 1930. Tun daga nan, da dama asali dabaru amfani da aikace-aikace AIC: cardiopulmonary kewaye gaba daya da dukkan kwayoyin, a yankin, cikinsa da nazarin halittu ruwa da aka bayar tare da da wani sashin jiki ko site da kuma karin Sistem bambancin.

Features dabaru

Common wucin gadi wurare dabam dabam ne, musanyawa na cardiac tsoka aiki da iskar gas musayar a cikin huhu na musamman inji kayayyakin aiki, da kuma na'urorin. An yadu used a cardiac tiyata.

A yankin jini ya kwarara da aka kira wani musamman sashin jiki ko jiki sashi. Irin wannan hanya ake amfani wajen gabatar da gagarumin yawa na kwayoyi zuwa surkin jini kamuwa da cuta, ko malignancy.

Regionarnoe cardiopulmonary kewaye wani zaɓi da ake amfani da gajeren ayyukan a kan zuciya hade tare da m raguwa a jiki zafin jiki (hypothermia). Irin wannan tsari shine ake kira jijiyoyin zuciya carotid perfusion.

Features motocin

Modern zuciya-huhu inji, wanda yake da manufa na aiki da za a tattauna a kasa, dole ne hadu da wadannan bukatun:

• goyi bayan bukata matakin na minti girma jini wurare dabam dabam a cikin jiki na haƙuri.
• ingantaccen oxygenation a cikin abin da oxygen jikewa kamata a located a matakin ba kasa da 95% da kuma adadin carbon dioxide - 35-45 mm Hg. Mataki na ashirin da.;
• juz'i na cika inji shi ne ba fiye da 3 lita.
• da gaban da na'urar komawa haƙuri da jini a cikin Sistem madauki.
• kamata ba cuta da jini kamar yadda ya wuce ta tsarin abubuwa.
• abu domin yin sunadaran ya zama ba mai guba, motsa jiki da yiwuwar gudanar da wani disinfection da sterilization.

na'urar

Duk wani huhu inji hada da physiological (jijiya famfo, oxygenator, Sistem madauki) da kuma wani inji naúrar. Excreted haƙuri venous jini shiga oxygenator, inda shi da aka wadãtar da oxygen da kuma tsarkakewa na carbon dioxide, da kuma kara via wani jini tsotso shi baya a cikin jini.

Kafin jini ke baya, shi ya wuce ta musamman tace cewa kama thrombi, iska kumfa, alli guda daga bawul tsarin da kuma ta hanyar wani zafi Exchanger cewa tana goyon bayan da ake so zazzabi. Idan jini a cikin jiki ne a cikin kogo, shi ne ya aiko a cikin zuciya-huhu inji tare da wani musamman famfo.

Babban abubuwa

AIC yana da wadannan tsarin abubuwa:

1. Oxygenators. Akwai sunadaran a cikinsa na jini da aka wadãtar da oxygen ta kai tsaye lamba, kuma akwai wadanda inda hulda faruwa ne ta musamman membrane.
2. Farashinsa. Daban-daban bawul da valveless dangane da yadda da motsi na jini ya auku.
3. Heat Exchanger. Yana kula da yawan zafin jiki na jini da kuma jiki na haƙuri. Gyara na zazzabi daukan wuri da ruwa wanda wanke na'urar.
4. Ƙarin nodes. Wadannan sun hada da tarkuna, tankuna adanar cire daga rami ko madadin na jini.
5. Inji naúrar. Ya ƙunshi wani gidaje naúrar, da sassa masu motsi na oxygenator, inji for kayyade daban-daban sigogi, da gaggawa manual drive.

Zuciya-Huhu Machine HL 20 - daya daga cikin mafi kyau misalai. perfusion tsarin a cikin wannan inji gana da mafi matsayin da bukatun. Yana hadawa tsaro da kuma AMINCI, ingantattun bayanai tarin tsarin, sassauci da ikon daidaita zuwa wani magudi.

Shiri kuma na'urar sadarwa

Kafin amfani, tabbata a duba shiri na inji aiki. AIC (zuciya-huhu inji) dole ne suna da cikakken tsarki da kuma sterility na saman wanda kai tsaye tuntube tare da jini.

All tsarin abubuwa kunshe a cikin physiological naúrar, bi da tare da ƙuna ko wani babban taro na alkalis tare da kara da wanka da ruwa. Bayan sterilization. Bayan cikakken taro kuma cika da jini tsarin, shi an haɗa zuwa haƙuri a wani mataki na aiki.

Domin dawo da jini ga jiki ƙara yin amfani da damar via da femoral ko iliac jijiya, wani lokacin ta hanyar da hawa lakã. A nazarin halittu ruwa shiga cikin na'urar ta hanyar da vena cava drained. Kafin jini shigar da oxygenator ga mãsu haƙuri aka gudanar heparin (2-3 MG da kilogram jiki nauyi). Wannan marasa lafiya ne mai lafiya, damar yin amfani da jijiya tsarin ne da za'ayi kafin venous catheterization.

Maganin sa barci da kuma sa barci

A amfani da zuciya-huhu inji for ayyukan yana da wasu siffofin, don haka maganin sa barci da kuma rike a wannan lokaci shi ne daban-daban.

1. Multicomponent premedication.
2. A lokacin kafin perfusion bukatar wucin gadi iska tare da babban matsin Manuniya a kan wahayi da kuma exhalation.
3. A cikin tsawon perfusion anesthetics shiga jiki via da AIC. Gudanar da ventilator ne halin da ya karu matsa lamba a kan exhalation.
4. A posleperfuzionnom lokaci mayar hemodynamics bukata shafe tsawon inji iska.

pathophysiology

Lokacin amfani da zuciya-huhu inji jikin mutum shi ne a karkashin sabon abu yanayi. Iya ci gaba pathological halayen da za su gudanar perfusion kamar yadda retrograde jini ya kwarara a cikin lakã, rage matsa lamba a cikin cavities na zuciya, da rashin aikin na huhu wurare dabam dabam - yanayin da ba na hali na al'ada yanayin na jiki.

A lokacin da baki na wani mutum ne a cikin wani jihar kusa hemorrhagic buga. Yana auku ragewan jini da kuma duka gefe juriya. Karkashin al'ada hali, irin wannan dauki da aka dauke su m, amma a yanayi na yin amfani da AIC shi tsarè al'ada jini ya kwarara sabuntawa.

A sakamako ne da ci gaban hypoxia da kuma na rayuwa acidosis a cikin jini. Rigakafin rikitarwa dogara ne a kan kyautata na microcirculation, kawar da sabon abu na m jini redistribution.

zai yiwu rikitarwa

Babban rikitarwa ne:

• jijiyoyin bugun gini embolism wanda za a iya lalacewa ta hanyar wani blockage da jini clots, gas, sia, alli barbashi.
• hypoxia - na iya faruwa saboda kasa aiki oxygenator ko wani jini famfo, ta hanyar abin da jini dole gudãna daga ƙarƙashinsu baya a cikin jiki.
• hematological rikitarwa - jini incompatibility tsakanin haƙuri, kuma da mai bayarwa na kungiyar ko RH factor, wani haƙuri ta jiki dauki ga jiko na citrate jini traumatization na jini Kwayoyin a zuciya-huhu na'ura, coagulation cuta.

Wayoyi kullum hõre inganta rage yiwu rikitarwa a lokacin hanya. Modern bidi'a, fasaha da kuma sosai m likita tawagar - key zuwa nasara baki.