I. Chiyambi
Kulowetsedwa m'mitsempha kumakhala ngati mwala wapangodya wamankhwala amakono, omwe ndi njira yofunika kwambiri yoperekera mankhwala, zamadzimadzi, ndi michere m'magazi a wodwala. Imagwira ntchito yofunika kwambiri pazachipatala zosiyanasiyana, kuyambira pamankhwala okhazikika mpaka kuchitapo kanthu mwadzidzidzi. Komabe, njira yachikhalidwe yodalira mphamvu yokoka kuti ilowetsedwe kwa nthawi yayitali yakhala ikupereka zovuta pakuwongolera bwino kuthamanga kwa kuthamanga ndi kuchuluka kwake, zomwe zingachepetse mphamvu ndi chitetezo chamankhwala. Lowani pampu yolowetsera - chodabwitsa chaukadaulo chomwe chasintha kwambiri chithandizo chamtsempha. Nkhaniyi ikuwunikira zabwino zambiri komanso kufunikira kwake komwe mapampu olowetsedwa amabweretsa kuchipatala, ndikuwunika momwe amalimbikitsira chisamaliro cha odwala, kuwongolera kayendedwe kachipatala, ndikuthandizira kuti pakhale zotsatira zabwino zathanzi.
II. Mfundo Yogwira Ntchito ya Mapampu Olowetsedwa
A. Core Components
Pamtima pa mpope wolowetsedwa pali gulu lapamwamba la zigawo zomwe zimagwira ntchito mogwirizana. Dongosolo la microcomputer limagwira ntchito ngati 'ubongo,' womwe umayendetsa mbali zonse za kulowetsedwa. Imatanthauzira zolowa ndi ogwiritsa ntchito, imagwiritsa ntchito deta kuchokera ku masensa, ndikupereka malamulo olondola kuti pampu igwire ntchito molondola. Chipangizo cha mpope, kaya ndi makina oyendetsedwa ndi pisitoni kapena pampu ya peristaltic, imakhala ngati mphamvu, imapanga mphamvu yofunikira kuti madziwo apite patsogolo. Kuphatikizidwa ndi gulu la masensa - kuzindikira kuchuluka kwa kuthamanga, kuthamanga, ndi kukhalapo kwa thovu la mpweya - ndi alamu yomwe imayang'aniridwa kuti idziwitse ogwira ntchito zachipatala ku zolakwika zilizonse, zinthuzi zimagwirizanitsa kupanga zida zodalirika komanso zolephera.
B. Njira Yogwirira Ntchito
Kagwiridwe ka ntchito ka mpope wothira ndi wodabwitsa wa uinjiniya wolondola. Katswiri wazachipatala akakonza kuchuluka kwa kulowetsedwa komwe akufuna, makina a microcomputer amayamba kuchitapo kanthu. Imayendetsa mosamalitsa liwiro lomwe makina a pampu amagwirira ntchito, kulamula kutuluka kwamadzimadzi kudzera mu chubu. Mwachitsanzo, pachisamaliro chovuta kwambiri chomwe wodwala amafunikira kulowetsedwa kosasunthika kwa mankhwala amphamvu a vasoactive, mpope ukhoza kukhazikitsidwa kuti upereke minuscule koma voliyumu yeniyeni pamphindi, kusunga nthawi zonse ndi mankhwala ochizira mankhwala m'magazi. Mlingo wolondolawu sikuti umangowonjezera mphamvu yamankhwala komanso umachepetsa chiopsezo cha zovuta zomwe zingabwere chifukwa cha kusagwirizana kwa mlingo.
III. Ubwino wa Kulowetsedwa Pampu
A. Kulondola pa Kutumiza Kwamadzimadzi
Ubwino umodzi wodziwika bwino wa mapampu olowetsedwa wagona pakulondola kwake kosayerekezeka. Mosiyana ndi njira yanthawi zonse yothira motsogozedwa ndi mphamvu yokoka, pomwe kusinthasintha kwa madzi kumakhala kofala, mapampu amatha kuyenda mosasunthika modabwitsa. Mwachitsanzo, m'magawo osamalira odwala kwambiri akhanda, komwe makanda amafunikira mphindi zochepa koma kuchuluka kwake kwamankhwala, mapampu olowetsedwa amatha kuyesedwa kuti apereke madzi pamlingo wochepera 0.1 ml pa ola ndikulondola kwapakati pa ± 5% ya mtengo womwe wakhazikitsidwa. Mlingo wolondolawu umakhala wovuta kwambiri popereka mankhwala amphamvu ngati heparin kapena insulini, pomwe kusawerengeka pang'ono pa mlingo kungayambitse zotsatirapo zowopsa. Mu mankhwala amphamvu a chemotherapy, kupereka molondola komanso kosasinthasintha kwa mankhwala a cytotoxic sikungowonjezera mphamvu yochiritsa komanso kumachepetsa chiopsezo cha kumwa mochepa kapena mopitirira muyeso, kuteteza odwala ku zoopsa zomwe zingachitike.
B. Kuthetsa Kusiyanasiyana kwa Anthu
Zinthu zaumunthu zakhala zikuvutitsa kwa nthawi yayitali kulowetsedwa m'mitsempha. Kuyenda mosadziwa kwa odwala, monga kugudubuzika pabedi kapena kupindika mkono, kumatha kusokoneza kutuluka kwa kulowetsedwa, zomwe zimapangitsa kuti apereke mankhwala osokoneza bongo. Mapampu olowetsedwa amathetsa mavutowa. Machitidwe awo otsekedwa otsekedwa ndi njira zowonongeka zolimba zimatsimikizira kuti mlingo wa kulowetsedwa umakhalabe wosasinthika mosasamala kanthu za zochitika za thupi la wodwalayo. Kukhazikika kumeneku kumakhala kopindulitsa makamaka kwa odwala omwe ali ndi vuto loyenda kapena omwe sangathe kugwirizana mokwanira, monga odwala ana kapena okalamba. Pochotsa kusiyana kwa anthu, mapampu olowetsedwa amapereka njira yodalirika komanso yosasunthika yoyendetsera mankhwala osokoneza bongo, kupititsa patsogolo chitetezo chonse ndi chithandizo chamankhwala.
C. Kuchepetsa Ntchito Yachipatala
M'malo otanganidwa kwambiri m'chipinda chachipatala, anamwino amangokhalira kuchita zinthu zingapo. Mapampu olowetsedwa amatuluka ngati chothandizira, kuchepetsa kwambiri ntchito yawo. Ganizirani za chochitika chomwe namwino ali ndi udindo wosamalira odwala angapo, aliyense amafunikira mankhwala osiyanasiyana komanso kuchuluka kwa kulowetsedwa. Popanda mpope wothira, namwino angafunike kusintha pamanja kuchuluka kwa kudontha kulikonse, njira yowononga nthawi komanso yolakwika. Kubwera kwa mapampu olowetsedwa, anamwino amatha kukonza magawo omwe amafunikira kulowetsedwa ndikuwunikanso mbali zina zofunika kwambiri za chisamaliro cha odwala, monga kuyang'anira zizindikiro zofunika, kupereka chisamaliro chabala, kapena kusamalira zosowa za odwala. Izi sizimangowongolera momwe ntchito zikuyendera komanso zimachepetsa mwayi wolakwika wachipatala, zomwe zimapangitsa kuti pakhale zotsatira zabwino za odwala komanso kukhutira kwantchito pakati pa othandizira azaumoyo.
IV. Kufunika kwa Pampu Kulowetsedwa mu Kuchita Zachipatala
A. Kuwonetsetsa Kuchita Bwino kwa Ma Infusions Ovuta Kwambiri
Pankhani ya chisamaliro chovuta, kuperekedwa kwamankhwala moyenera komanso munthawi yake kumatha kukhala kusiyana pakati pa moyo ndi imfa. Mapampu olowetsedwa amawonekera ngati cholumikizira muzochitika zazikuluzikuluzi. Tengani mankhwala a vasopressor, mwachitsanzo. Odwala omwe ali ndi vuto la septic, komwe kukhala ndi kuthamanga kwa magazi kokwanira ndikofunikira, mapampu olowetsedwa amawongolera mosamala kulowetsedwa kwa mankhwala monga norepinephrine. Kuthekera kwa mpope kuti kukhalebe ndi mankhwala osasinthasintha m'magazi kumatsimikizira kuti kuthamanga kwa magazi kwa wodwalayo kumakhalabe kosasunthika, kuteteza moyo wa hypotensive episodes. Mofananamo, posamalira matenda a mtima, mankhwala osokoneza bongo monga amiodarone amafunika kuperekedwa molondola. Kusinthasintha pang'ono kwa kulowetsedwa kungathe kuwongolera bwino, mwina kulephera kukonza arrhythmia kapena kuyambitsa kusokoneza kwatsopano, koopsa kwa kayimbidwe ka mtima. Popereka njira yodalirika komanso yolondola yoperekera, mapampu olowetsedwa amapatsa mphamvu opereka chithandizo chamankhwala kuti ayendetse zinthu zovuta komanso zovutazi, kukulitsa mwayi wokhala ndi zotsatira zabwino za odwala.
B. Kukwaniritsa Zosowa Zapadera za Magulu Odwala Osauka
Odwala okalamba ndi makanda amaimira magulu awiri omwe ali ndi chiopsezo chapadera ponena za kulowetsedwa kwa mtsempha. Kukalamba nthawi zambiri kumabweretsa mitsempha yosalimba mwa okalamba, yomwe imakonda kulowetsa ndi kuwonongeka. Mapampu olowetsedwa, omwe amayendetsa bwino kwambiri madzimadzi, amachepetsa chiopsezo cha kuvulala kwa mitsempha. Mayendedwe awo osinthika amathandiziranso kuti magazi aziyenda pang'onopang'ono mwa okalamba, kuteteza kuchuluka kwa madzimadzi - mkhalidwe womwe ukhoza kukulitsa vuto la mtima kapena impso. Pankhani ya makanda, physiology yawo yofewa imafuna kulondola kwambiri. Ana akhanda, makamaka, amakhala ndi minyewa yaying'ono komanso kulolera pang'ono kusintha kwa kuchuluka kwa madzimadzi. Mapampu olowetsera amatha kusinthidwa kuti apereke ma voliyumu ochepa, monga ma micrograms pa kilogalamu pamphindi pamankhwala ena, kuwonetsetsa kuti mankhwalawa ndi othandiza komanso otetezeka. Mlingo woterewu umangoteteza thanzi la odwala omwe ali pachiwopsezo komanso umapereka mtendere wamalingaliro kwa omwe amawasamalira, podziwa kuti kulowetsedwa kumayendetsedwa mosamala.
C. Kuwongolera Chithandizo Chakudya Chakudya
Kwa odwala omwe satha kupeza chakudya chokwanira kudzera m'kamwa, chithandizo chamankhwala cholowa m'mitsempha chimakhala chamoyo. Zakudya zopatsa thanzi m'mimba ndi m'mimba zimafunikira kusamalidwa bwino pakuperekera zakudya. Mapampu olowetsedwa amagwira ntchito yofunika kwambiri pankhaniyi. Mayankho azakudya a makolo, okhala ndi ma amino acid ambiri, lipids, ndi shuga, amayenera kulowetsedwa mosamalitsa kuti apewe hyperglycemia kapena zovuta zina za kagayidwe kachakudya. Kulondola kwa mpope kumatsimikizira kuti kusakaniza kovuta kwa zakudya kumaperekedwa m'njira yomwe imatsanzira momwe thupi limayamwira mozama kwambiri. Muzakudya zam'mimba, komwe zakudya zamadzimadzi zimayambitsidwa kudzera mu chubu cha nasogastric kapena jejunostomy, mpope imayendetsa kayendedwe kake kuti zisadzadzanitse m'mimba. Izi ndizofunikira makamaka kwa odwala omwe achira maopaleshoni am'mimba kapena omwe ali ndi vuto loyenda m'matumbo. Pothandizira kuperekera zakudya zopatsa thanzi komanso zoyenera, mapampu olowetsedwa amathandizira kubwezeretsa mphamvu za odwala, kulimbikitsa machiritso a mabala, komanso kusintha kwabwino kwa matenda awo, kufulumizitsa ulendo wopita kuchira.
V. Zowona Zamtsogolo ndi Mapeto
Tikayang'ana zamtsogolo zaukadaulo wazachipatala, kusinthika kwa mapampu olowetsera kumakhala ndi lonjezo lalikulu. Kupita patsogolo komwe kumayembekezeredwa kumaphatikizapo kulumikizidwa kowonjezereka, ndi mapampu ophatikizidwa mosasunthika pamakina azidziwitso azachipatala. Izi zipangitsa kugawana zenizeni zenizeni pakati pa madipatimenti osiyanasiyana, kulola chisamaliro chokhazikika komanso chokwanira cha odwala. Mwachitsanzo, m'chipatala chachikulu chophunzitsira, madotolo omwe ali m'chipinda chosamalira odwala kwambiri amatha kuyang'anira patali ndikusintha magawo olowetsedwa m'maofesi awo kapena pomwe alibe, pomwe akatswiri azamankhwala amatha kulandira zidziwitso pompopompo za momwe angabweretsere mankhwala, kuwonetsetsa kubwezeretsedwanso munthawi yake.
Miniaturization ndi portability zilinso pafupi. Tangoganizani zochitika zomwe odwala omwe ali ndi matenda osachiritsika, monga omwe amafunikira chithandizo chanthawi yayitali cholowetsedwa m'nyumba ku matenda monga multiple sclerosis kapena cystic fibrosis, amatha kunyamula pampu yophatikizika, yovala. Chipangizochi sichingakhale chochenjera, choyenerera mosasamala m'miyoyo yawo ya tsiku ndi tsiku, komanso kukhala ndi zida zapamwamba zotetezera ndi mawonekedwe ogwiritsira ntchito, kupatsa mphamvu odwala kuti azitha kuyang'anira machitidwe awo a chithandizo ndi kudzilamulira kwakukulu.
Pomaliza, mpope wa kulowetsedwa watulukira ngati mphamvu yosinthira mankhwala amakono. Kulondola, kudalirika, ndi kusinthasintha kwake kwafotokozeranso miyezo ya chithandizo chamankhwala m'mitsempha. Pakupititsa patsogolo chitetezo cha odwala, kukhathamiritsa chithandizo chamankhwala, ndikuchepetsa kulemetsa kwa othandizira azachipatala, chakhala chida chofunikira kwambiri pazachipatala zosiyanasiyana. Pamene ukadaulo ukupitilirabe patsogolo, titha kuyembekezera kuti mapampu olowetsedwa apitirire kusinthika, kutsegulira mwayi watsopano wamankhwala osankhidwa payekha komanso kuwongolera kwaumoyo. Ndikoyenera kwa onse omwe akukhudzidwa nawo - kuyambira akatswiri azachipatala ndi ofufuza mpaka opanga mfundo ndi odwala - kukumbatira ndikuthandizira kupititsa patsogolo kumeneku, kuwonetsetsa kuti kuthekera konse kwaukadaulo wapampu wothira kumagwiritsidwa ntchito kuti apindule padziko lonse lapansi.
