雅培Perclose血管缝合器使用过程中常见问题及解决方法-推荐课件

连接线断裂--第二个常见的失败现象
• 连接线断裂:
– 连接口与针尖相连 – 无蓝色缝线相连 – 可以看到连接线的断裂处
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
蓝色缝线断裂
• 缝线:
– 线本身的问题 – 牵拉时张力过大
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
处理办法
• 处理方法
– 缝合器未完全撤出
• 更换新的缝合器
• Plunger withdrawal begins.
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
拔针时的绷紧时状态
• Plunger removed from device.
连接线断裂时的处理方法
• 具体方法
– 退出缝合器 – 更换新的缝合器
• 改进办法
– 拔针的最初阶段忌用力过猛
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
鞘的扭曲打折
Company Confidential © 2007 Abbott Laboratories
打折后的处理办法；减少打折的措施
• 处理办法
– 退出缝合器 – 换新的缝合器
• 如果确认穿刺部位血管钙化明显，无必要换新的缝合器 ，改手压
• 减少打折的措施
– 采用右手稳定缝合器，左手推进的方法
– 忌用力推送
• 如果确认穿刺部位血管钙化明显 ，无必要换新的缝合器，改手压
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
降低连接失败的关键步骤
• 打针时，左手扶稳缝合器至关重要
最常见的失败状况
– 连接失败
• 长针连接失败 • 短针连接失败
– 白色连接线断裂 – 鞘发生扭曲打折 – 蓝色缝线断裂 – 标记腔（透明塑料管）无喷血或血流不足
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
Company Confidential © 2007 Abbott Laboratories
总结
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
鞘打折
• 野蛮推进缝合器 – 肥胖的病人 – 病人穿刺周围瘢痕组织明 显
ProGlide Troubleshooting April 2007 LT2925875
标记腔不出血/血流缓慢
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
标记腔不出血/血流缓慢
• 原因
– 组织或血凝块 – 血管细 – 标记腔出口抵在了动脉壁上 – 低血压 – 缝合器没有进入股动脉
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
开脚后的状态
• Foot deployed.开脚
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
打针时的状态
• Depressing the plunger.打针
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
连接失败
• The tip(s) of the Needle(s) did not make contact with Cuff(s).针不能与线脚中的接口对接
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
长针
长针连接 口
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
Rail Suture 短针尖端 短针连接口
白色 连接 线
缝线的路径
Device prior to deployment 操作前状态
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
处理方法
• 方法
– 血管直径大于5mm – 回撤器械冲洗标记腔 – 观察病人血压
– 确保缝合器进入血管
ProGlide Troubleshooting April 2007 LT2925875
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
Device deployed, suture in place操作后状态
打针前的状态
• Device prior to deployment. 操作前状态
Company Confidential © 2007 Abbott Laboratories
缝合器完全撤出股动脉的状态
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
引起断裂的原因
– 连接线已经断裂 – 其他原因:
• 推进力量过大 • 操作快速顿挫现象 • 周围出现尖刺，造成缝合线的
损伤
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
线脚收回时的状态
• Lever is down, Foot is parked.
ProGlide Troubleshooting April 2007 LT2925875
– 缝合器撤出
• 手压
• 预防措施
– S.C.I.T. (Slow, constant, increasing tension)
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
连接线断裂
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
连接失败的外观
白色连 接线
连接口
短针脱扣；长针连接
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
长针脱扣；空针状态
连接失败后的解决办法
• 解决办法
– 退出缝合器 – 换新的缝合器
连接失败
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
连接失败是最常见的失败现象
• 只有长针短针都与其相对应的连接口对接后，才会使带有线结的 缝线穿过穿刺口两端的正常组织
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
蓝色缝线断裂
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
长针连接proglidetroubleshootingapril2007lt2925875companyconfidential2007abbottlaboratories连接失败后的解决办法解决办法退出缝合器换新的缝合器如果确认穿刺部位血管钙化明显无必要换新的缝合器改手压proglidetroubleshootingapril2007lt2925875companyconfidential2007abbottlaboratories降低连接失败的关键步骤打针时左手扶稳缝合器至关重要proglidetroubleshootingapril2007lt2925875companyconfidential2007abbottlaboratoriesproglidetroubleshootingapril2007lt2925875companyconfidential2007abbottlaboratories连接线断裂第二个常见的失败现象连接线断裂
Perclose ProGlide 使用过程中常见问题及解决方法
内容
• 最常见的5种操作失败状况 • 解决办法 • 减少失败的注意事项
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Laboratories
长短针与连接口连接
• Needles engage cuffs within foot.针脚连接
ProGlide Troubleshooting April 2007 LT2925875
Company Confidential © 2007 Abbott Labo