Arteriotomy, Farsamooyinka tolida aasaasiga ah

• In had iyo jeer la mariyo heparin xididka ka hor inta aan la isticmaalin xididdada dhiigga (marka laga reebo bukaanka oo leh taariikh heparin oo uu ku dhacay thrombopenia (HIT)
• Si loo fahmo farqiga muhiimka ah ee u dhexeeya aaladaha 'qabsashada' (tusaale ahaan qalabka xinjirowga dhiigga ee DeBakey iyo qalabka Overholt)
• Si sax ah loogu mariyo qabsatooyinka halbowlaha (fiiro gaar ah u yeelo jihada lakabyada kalsiyum-ka)
• Si sax ah loogu sameeyo arteriotomy (maqaarka madaxa ee lambarka 11 (kor u kaca!) iyo maqasyada Potts)
• Si sax ah u maareyso qalabka lagu xiro si looga fogaado waxyeelada soo gaarta derbiyada halbowlaha (ha isku cadaadin)
• Si si sax ah loogu meeleeyo irbadda meesha cirbadda lagu hayo (badanaa 1/3 ilaa 2/3; 30° hore)
• In la qaato qalabka iyo booska jirka iyo gacmaha oo leh qaab ergonomic ah
• Si sax ah loogu tolo derbiyada halbowlaha (jihada toosan)
• Si sax ah loogu toosiyo tolmada: laga bilaabogudaha dibaddahalbowlayaasha iyo qulqulka (si looga fogaado kala-goynta);dibadda gudahagudaha qalabka ilkaha lagu dhaqo (iyo, haddii loo baahdo, halbowlayaasha u socda qulqulka
• In aan waligaa lagu qaban tolmada qalabka (way dhaawacmi kartaa ama way jabi kartaa)
• Inaad mar walba jiido derbiga halbowlaha (si looga fogaado taabashada qulqulka dhiigga ee unugyada isku xira ee adventitial)
• Si aad u fahamto faa'iidooyinka iyo khasaarooyinka tolmada go'doonsan iyo tolmada socodsiinta
• Si loo fahmo meelaynta ugu habboon ee tolmada ee tolmada socota si loo hubiyo tolmo adag (jihada hore ee tolmada kasta, masaafada ugu gaaban ee u dhaxaysa tolmada gudaha iyo dibadda)
• Kaaliye ahaan: meesha lagu hayo tolmo si loo sugo xariiqda tolmada, iska ilaali wareegyada tolmada harsan laakiin sii fursad ku filan tolmada xigta (45% ilaa 55%)
• Kaaliye ahaan: in tolmada loo jiido jihada tolmada, oo aan loo jiidin gadaal (si looga fogaado saameynta xarigga boorsada
• Kaaliye ahaan: in dhakhtarka qalliinka marka hore la qabsado unugyadaka horjiidista tolka (si looga fogaado dhiigbaxa godadka tolka)
• Inaad had iyo jeer biyo raaciso ka hor inta aan la xidhin, la xidhin oo la furo ka hor inta aan la xidhin

1. 2x arteriotomies oo wareegsan / 2x ah oo wareegsan. Xidh labada arteriotomies labadaba farsamooyin: tolmo go'doonsan iyo kuwa socda, siday u kala horreeyaan
2. Maareynta derbiga halbowlaha: qabso adventitia oo keliya adigoo isticmaalaya qalabkaaga
3. Qaboojinta saxda ah ee halbowlaha: fiiro gaar ah u yeelo huurada, isticmaal qaboojiyaha xididdada dhiigga, hagaaji xoogga qaboojiyaha, ha ilaawin inaad siiso heparin ka hor intaadan qaboojin!
4. Arteriotomy: u isticmaal daab madax-xanuun ah Lambarka 11, jeexitaan qaloocsan oo haya daab kor
5. Kordhi arteriotomy adigoo isticmaalaya maqas Potts ah
6. Ku qabashada halbowlaha adigoo isticmaalaya qalabka lagu tolo: ha tuujin intima, isticmaal qalabka lagu tolo si aad uga hortagto, kaliya ku qabo adventitia
7. Si sax ah u qabo qalabka cirbadda lagu qaado
8. Meesha saxda ah ee irbadda
9. Tol dhammaan lakabka derbiga adigoo isticmaalaya tolmo toosan (ma jiraan tolmo tangential ah)
10. Jihada tolmada gudaha iyo dibadda (derbiyada halbowlaha si looga fogaado kala-goynta)
11. Isdhexgalka irbadda, hayaha irbadda iyo qalabka lagu xidho: soo qaado irbadda, qorshee tolmada xigta

Xakamaynta bartilmaameedyada waxbarashada

• Nooca
• Joogtada ah ee tolmada
• Adkaanshaha tolmada