Arteriotomy, Dabaru na asali na dinki

• A riƙa shafa maganin heparin a cikin jijiya a koyaushe kafin a yi amfani da shi wajen ɗaure jijiyoyin jini (sai dai idan mara lafiya yana da tarihin cutar heparin da ta haifar da thrombopenia (HIT))
• Domin fahimtar muhimman bambance-bambance tsakanin na'urorin 'mannewa' (misali mannewar jijiyoyin jini ta DeBakey da mannewar Overholt)
• Don amfani da maƙallan jijiya daidai (a kula da yanayin plaques ɗin da aka haɗa da calcified)
• Don yin aikin arteriotomy daidai (Na'urar yankewa ta Nr. 11 (sama!) da almakashi na Potts)
• Don sarrafa forceps yadda ya kamata don guje wa lalacewar bangon jijiyoyin jini (kar a matse)
• Don sanya allura daidai a cikin abin riƙe allura (yawanci 1/3 zuwa 2/3; 30° gaba)
• Don ɗaukar ma'aunin ergonomic na kayan aiki da matsayin jiki da makamai
• Don dinka daidai ta bangon jijiyoyin jini (alkiblar tsaye)
• Don daidaita dinki daidai: dagadaga ciki zuwa wajea cikin jijiyoyin jini da kuma zuwa ga fitar ruwa (don guje wa rabuwar);waje a cikia cikin prostheses (kuma, idan ya cancanta, a cikin jijiyoyin jini zuwa ga kwararar ruwa
• Kada a taɓa kama dinki da kayan aiki (zai iya lalacewa ko ya karye)
• Koyaushe a kan bangon jijiya (don guje wa hulɗar jini da kyallen haɗin gwiwa masu tasowa)
• Don fahimtar fa'idodi da rashin amfanin dinkin da aka katse idan aka kwatanta da dinkin da aka yi amfani da shi wajen gudanar da shi
• Don fahimtar wurin da aka sanya dinkin a cikin dinkin da ke gudana don tabbatar da dinkin da ya matse (alkiblar gaba ta kowane dinki, mafi ƙarancin tazara tsakanin dinkin da kuma fitar da shi)
• A matsayin mataimaki: inda za a riƙe dinki don ɗaure layin dinki, a guji madaukai na sauran dinki amma a ba da isasshen sassauci don dinki na gaba (ƙa'idar kashi 45 zuwa 55%)
• A matsayin mataimaki: a ja dinkin zuwa ga dinkin, ba wai a mayar da shi baya ba (don guje wa tasirin igiyar jaka
• A matsayin mataimaki: don barin likitan fiɗa ya daidaita kyallen takarda da farkokafinjan dinki (don gujewa zubar jini a ramin dinki)
• Don wankewa da kuma wankewa kafin a rufe, a shafa da kuma a cire tarkace

1. 2x transverse / 2x lengthy arteriotomies. Rufe duka arteriotomies ɗin ta amfani da dabarun biyu: dinki mai katsewa da kuma wanda ke gudana, bi da bi
2. Gudanar da bangon jijiya: kama adventitia kawai da forceps ɗinku
3. Daidaita matsewar jijiya: kula da plaque, amfani da matsewar jijiyoyin jini, daidaita ƙarfin matsewar, kar a manta da ba da heparin kafin matsewa!
4. Arteriotomy: yi amfani da shi azaman ruwan wukake na scalpel Nr 11, yankewa a kan wuka yana riƙe da ruwan wukake sama
5. Faɗaɗa arteriotomy ta amfani da almakashi na Potts
6. Gudanar da jijiyoyin jini da forceps: kar a matse intima, yi amfani da forceps a matsayin martani yayin dinki, riƙe adventitia kawai
7. Riƙe maƙallin allura daidai
8. Matsayin allura daidai
9. Dinka dukkan layukan bango da dinkin da aka daidaita (ba tare da dinkin da aka tanada ba)
10. Alkiblar dinki daga ciki zuwa waje (a bangon jijiyoyin jini don guje wa rabawa)
11. Hulɗa tsakanin allura, mai riƙe allura da forceps: ɗaukar allura, tsara dinki na gaba

Sarrafa manufofin ilmantarwa

• Juyin Juya Hali
• Daidaito na stitches
• Matsewar dinki