Te Whakamātautau i ngā Whakamāhi o te Catheter Foley Ā-Toru Huarahi

Ngā Tohu Ā-Hāpaiti Matua mō te Tātai Foley Ā-Toru Huinga

Ko te tātai Foley ā-toru huinga he rākau ā-hāpaiti kia whakamāhi ai te whakamātautau tonu i te pūkoro (CBI) i te taha o te whakamātautau i ngā wāhanga o te wāhanga. Ko te tuatoru o ngā huinga e whakamāhi ana i te wai whakamātautau kia rere mai ki roto i te pūkoro, i te wā anō nei ko te huinga matua mō te whakamātautau e whakamāhi ana kia whakamātautau ai ngā wāhanga, ngā toto, me ngā toto—whakamāmā i te whakamātautau o ngā toto me ngā whakamātautau o te whakamātautau o ngā hāpai i te tātai.

Ko te tohu ā-hāpaiti matua ko te hematuria tauā, te hematuria nui , ā, ina whakamāhinga i te whakamāhinga o te rākau o te prostate (TURP), i te whakamāhinga o ngā pūpū o te pōro (TURBT). Ko ngā toto kua rere mai i te wāhi i whakamāhinga ai te prostate, i te wāhi i whakamāhinga ai ngā pūpū, he hāngā i taea ai te whakamāngō i ngā kātihita o Foley, e whakapāngia ana i te whakamāngō o te whakamāhinga o te uru, i te whakamāngō o te pōro. Ko te whakamāhinga tonu i te ārai ā-toru-huinga he whakamāhinga i ngā toto, he whakamāhinga i ngā hāngā iti i mua i ō rātou whakamāngō i ngā pūrere, ā, he whakamāhinga i te whakamāngō kāore he whakamāhinga anō.

I waho i te tiaki i muri i te whakamāhinga, ko tēnei rākau he whakamāhinga i te hematuria mātua nui i te whānanga, i te whakamāhinga o ngā rākau whakamāngō toto, i te cystitis i te whakamāhinga i te rākau. . Ko te CBI he tautoko i te whakamātautau i te wāhi o te toto: ko te kōwhai kākāriki he tohu o te toto e rere ana, e hiahiatia ana te whakamāhinga ake; ā, ina whakamāhinga mai ki te kōwhai pango, ki te kōwhai mā, he tohu o te whakamāhinga. I ēnei wāhi o te mate pūpū, ko te pūrere mātua hoki he whakamāhinga i te whakamāhinga ā-wāhi o te pōro , pērā i te tuku i te mitomycin i muri i te TURBT—whakamātau kia tukuna te hāngā i te wāhi e tika ana, kāore he whakamātautau, me te kore o te whakamātautau mai i ngā wai uru kua whakawātea.

Kāore te kāteter ā-toru huarahi i te whakamārama hei whakamārama mō te whakamārama tonu i ngā rātā e kāore ana i te whakamārama i te hematuria tūturu, i ngā hāngā whakamārama, i ngā hāngā whakamārama. Ko te huarahi taupua he whakamārama ake i ngā wāhi e whakamārama ai ngā pākaitanga, ā, ko te whakamārama o ngā rātā e tika ana i mua i te whakamārama. I te whakamārama i te tika, i te whakamārama hoki, he iti ake te hiahia ki te whakamārama i ngā kāteter, ngā whakamārama anō, me ngā pānga—ka poto ake ngā wā o te noho i te whare o ngā rātā, ā, ka pai ake te whakamārama o ngā rātā.

Me pēhea te mahi o te Kāteter Foley ā-Toru Huarahi: Te Whakamārama o ngā wāhi, me ngā hāngā o te whakamārama

Ko te tātai o te catheter o Foley e toru ngā wāhi (lumens) e toru: he wāhi mō te whakawhitinga o ngā wāhi o te urinā me ngā wāhi o te wai whakamātautau, he wāhi tuarua mō te whakapūpū i te pōro (i tēnei wā, i te wai mātātahi 10–30 mL), ā, he wāhi tuatoru mātātahi mō te whakauru i te wai whakamātautau. Ko tēnei āhuatanga o ngā wāhi e toru e whakamārama ai te rere mai me te rere atu i te wā anō—ka taea te whakamātautau tonu i te puku o te urinā, kāore he hinga o te catheter, kāore hoki he whakapupūnga o te pā pressure.

Ko te saline mātātahi (sterile isotonic saline) te wai whakamātautau e whakamahinga ana i te nuinga o ngā wā. Ka rere mai ki roto i te puku o te urinā i raro i ngā āhuatanga o te pā pressure iti (i tēnei wā, <40 cm H₂O), ā, ko te wāhi whakawhitinga nui ake te rere mai i te wai whakamātautau, i ngā toto, i ngā pōro toto, i ngā rākau, i ngā rākau kāore he uara. Ko tēnei whakamauranga āhua e whakakaha ai te whakamātautau i ngā pōro toto, e whakamāmā ai te whakamātautau i ngā kōrero o te puku o te urinā, ā, e whakamāmā ai hoki te whakamātautau i te puku o te urinā—ko tēnei he mea matua i te wā o te whakamātau mai i ngā mahi pērā i te TURBT.

Kāore i te rite ki ngā kāteter āhua rua huinga tāwhai, ko te pūnaha āhua toru huinga e whakamāngai ana i te hāngā i te whakamātau i waenganui i te whakauru wai me te whakawhenua, ā, he iti ake ngā whāinga o ngā whāinga o ngā whakamātau me ngā whāinga o ngā mātua. Ko ngā āhua o te rere i te whakamātau kia rite ki ngā whāinga ā-hāpaitanga me te whāinga o te tangata—ā, he nui te whāinga i te 100–150 mL/i hō—ā, e whakamātau ana i runga i te mātao o te whakawhenua me te rahi, kāore i ngā whakamātau tuatoru.

Te whakamāhi i te Whakauru Wai Tōnu i te Kāteter Foley āhua Toru Huinga

Ko te whakauru wai tōnu (CBI) i te kāteter Foley āhua toru huinga he take matua o te whakamāhi i muri i te TURBT me te TURP hei whakamāreke i te whakauru o ngā toto me te whakamāna i te whānanga o te pōro. Ko te anga o te anga o te whakauru wai me te whakawhenua kāore he raru, ā, me whakamāreke te whakauru kia kāore he whānanga.

Te whakamārama i te wai whakauru, i te āhua o te rere, me te whakamāhi i te whakamātautau i tēnei wā

Whakamāhi i te saline isotonic hei rākau whakamātautau tuatahi; ka taea ngā wā iti te whakamāhi i te wai kaha, engari he rāngai te whakamāhi i te wai kaha i ngā wā roa, ā, he whakamārama o te whakamāhi i te hemolysis. Timatahia te rere i te 150–200 mL/i hāora, ā, whakamātua i te rere i ngā whāinga o te tae o te wāhi: ko te rere tonu o te kōwhai pango he tohu mō te whakapai ake i te rere, i te wāhi e whakamātua ana i te rere i te kōwhai māwhero iti, i te wai mā, he tohu mō te whakamātua i te rere i ngā wāhanga.

Tirohia te pūkoro whakamātautau i ngā wāhanga o ngā 30 meneti. Ko te pūkoro e tāwhai ana i te toru hāngai o te whāinga i te wāhanga o te hāora he tohu mō te rere tika. Ko ngā pakaru i te rere, i te rere kore, i te rere tonu i te rere mai, he tohu mō te whakamātautau i te whakamātautau, i te whakamātautau, i te whakamātautau o te pōro. Ko te whakamātautau tūmati, ko te whakamātautau i te rere (i te 60-mL syringe me te saline), kaua kāore he whakamātautau kaha, he whakamātautau kaha.

Te whakamātautau iti vs. te whakamātautau kaha i te whakamātautau i muri i te TURBT

Ko te whakamātautau i te wai mātātoko i te pāmahana iti (<40 cm H₂O) te tikanga e whakamāramatia ana i ngā whakamātau hei tikanga mātua mō te CBI tūmatanui. He iti ake ngā pākanga ki te kōpae o te pōhuri, he iti ake te whāia o te whakawātea, ā, he tautoko hoki i te whakaora o te kōpae. Me whakamātautau te wai mātātoko i te pāmahana teitei i ngā wā o te riri pēnei i te whakawātea o ngā toto, ā, me whakamātautau anō i ngā wā poto tonu—ā, he pai ake kia whakamātautau i raro i te ārahi o tēnei pūrākau o te urology—nā te nui ake o ngā pākanga ki te kōpae me ngā whāia o ngā whakamāmā. Ko ngā tikanga o ngā rōpū hāpori e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātātoko i te pāmahana iti i mua, ā, kia whakamātautau anō i te pāmahana i ngā wā e whakamārama ana i te whakamātautau i te wai mātā......

Ngā Whāia Matua me ngā Rautaki Whakamāmā e Whakamāramatia ana i ngā Whakamātau

Ahakoa he mea matua i ngā āhuatanga whānui kliniki āpihi, ko te tātai o te Foley e toru ngā huinga he raru mātātū hoki e hiahiatia ana te whakamārama, te whakamārama i runga i ngā tikanga. Ko ngā whānanga o ngā pāpātanga o te uru (CAUTI) tonu te raru mātātū—i hono mai ki te wā roa o te noho, ngā wehenga o te tikanga o te whakamārama, i ngā pūnaha o te whakamārama i whakamāmā. Ko ngā raru o te tātai ko te whakamāmā o te tātai (te mātātū i ngā toto), te whakamāmā o te pōro i te wā o te whakamāmā, ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā, i ngā whakamāmā o te pōro e whakamāmā ana i te whakamāmā......

Ko te whakamāmā i ngā raru i te āhua e whai ana i ngā whakamātautau he tīmatanga i te whakamāhi i ngā tikanga kia kaha tonu ki te whakauru i ngā taputapu kia mā, me ngā mahi whakamāhi i ngā pūnaha kīato, ā, ko ngā aratohu o te CDC me te SHEA ngā whakamāhi. Me whakamāhi ngā tikanga whakamāhi i ngā ringaringa i mua i te whakamāhi i tēnei mea, kaua e whakamāhi ngā whakawhitinga, me whakamāhi ngā whakarere i ngā huinga kia kaha kia kore ai te whakamāhi i ngā huinga. Me whakamāhi ngā whakamātautau i te wāhi o ngā wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te wāhi o te......

Whakakapihia te kāteter i ngā wā e 2 ki ngā wā e 4 i ia tau, ā, ko ngā whakamātautau o te rōpū e whakamārama ana i ngā whakamātautau—ka piki ake ngā wā roa i te whananga o ngā biofilm me te whāia o te rākau o te CAUTI. Me whakakore te whakauru mātua o te pōro; whakaurua anake ki te rōrahi e tātai ai te kaiwhakamahi (i tēnei wā, he rōrahi o ngā wā e 10 ki ngā wā e 30 mL) i te wai whakamārama. He matua te whakamārama i ngā kaimahi: me mōhio ngā kaimahi i te tīmatanga o ngā tohu o te mātātoko (te hāpene, te mamae i te wāhi i raro i te puku, te wāhi kōpū kōpū / te wāhi kōpū kōpū), te hinga o te āhua (te whakamutunga mātua o te wāhi kōpū, ngā kōpū kōpū kīato i te rākau), me te autonomic dysreflexia i ngā rōpū e whakamārama ana.

Ko ēnei whakamātautau—i whakapūmautia mai i ngā whakamātautau o te IDSA, o te AUA, me ngā whakamātautau o te CAUTI o te motu—e tautoko ana i te whakamāhi i te haerenga o te kāteter o te Foley i ngā āhua o te whakamāhi i te puku, i ngā āhua o te whakamāhi i te puku i muri i te whakamāhi i te puku.

FAQ

He aha te whāinga matua o te kāteter o te Foley e toru ngā ara?

Ko tēnei he whakamāhi mō te whakamāhi i te puku i te wā katoa (CBI) i te taha o te whakamāhi i te wāhi kōpū. Ko tēnei e āki ana i te whakamāhi i te kōpū kōpū me te whakamāhi i te rākau, īnā ko ngā āhua o te whakamāhi i te puku, i ngā āhua o te whakamāhi i te puku i muri i ngā whakamāhi i te puku rānei.

He aha te momo wai e whakamahinga ana mō te whakamātautau?

Ko te wai hāngā i te saline isotonic te whirinakitanga o mua mō te wai whakamātautau i tēnei, i tōna haumātua me tōna whaihua.

Me pēhea te whānanga i te pākūnga o te kāteter?

Ko ngā pakaru iti i te rōrahi o ngā wai hoki mai i te pūrākau, i te rāhui, i te kore o te whakamātautau i te wāhi e whakamātautau ana, he tohu o te pākūnga. Ko te whakamātautau māmā he hāngā e whakamāngai ai te wāhi e whakamātautau ana.

He aha ngā whakamātau e pā ana ki te whakamātautau ā-toru o Foley?

Ko ngā whakamātau matua ko ngā whakamātau o te rāhui o te kāteter (CAUTI), ngā pākūnga, ngā pākūnga o te pōro, me ngā pākūnga o te pūrākau. Ko te whakamārama tika me te whakamahi i ngā tikanga hāngā hei whakamāngai i ēnei whakamātau.

He aha te take i tēnei i whakamāramatia ai te whakamātautau iti-te-pā?

Ko te whakamātautau iti-te-pā (<40 cm H₂O) e whakamāmā ai ngā pākūnga o te pūrākau, ā, e tautoko ana i te whakaora o ngā kōpae o te pūrākau i te wā o te whakaora, i te wā i tēnei ko te whakamātautau pā-kaikaha anake e whakamahinga ana i ngā wā kiko-kiko.