Một số kinh nghiệm bảo dưỡng máy thận nhân tạo ở Khoa thận nhân tạo Bệnh viện Bạch Mai Hà Nội

T\., T\J VAN

Mpt so kinh nghiem bao difdng

may than nhan tao d Khoa Than

nhan tao Benh vien Bach Mai Ha Noi

KS. Nguyin NguySn Trudng*, TS.BSCC. NguySn Cao Luan*

MIy than nhan tao la loai miy hay

bio Idi vl rat dS hdng. DS dim bao

cho CO sd boat ddng on dinh, khoa

than nhan tao cua benh vien Bach

Mai da td chuc riSng mdt bd phan bao hinh vl sira

chira miy tai khoa, bao dam may bdng la sira chua

ngay, cd gang chua xong miy trong thdi gian sdm

nhat dS phuc vu ngudi benh. Tuy vay, da cd nhiing

liic ban than khoa ciing gap khd khan vi miy hdng

qui nhiSu, sira cbCi'a khdng kip do do kbdng du

may phuc vu ngudi benh. DS khac phuc dnh trang

thiSu miy, ngoli viec nang cao nang lire ciia bd

phan sua chira, khoa da thuc hien nhiSu bien phap

mang dnh bio dudng du phdng. Day la nhirng bien

phip rat cd y nghTa vi khi thuc hien khdng hS tdn

cong sua chua nhung gilm rat nhiSu sd miy bi

hong, qua dd gilm tai cho bd phan sua chGa miy.

Sau day II mpt sd bien phap hieu qua nhat, dugc

thuc hien tai khoa ehung tdi:

1. Dam bao noi dat may phai luon luon kho rao,

khong am uot

MIy than nhan tao II thiSt bi cd he thdng dien

tir rat phirc tap, lai ludn phai boat ddng trong mdi

trudng muoi vl nudc ciia dich Ige, nen rlt dl hu

hdng, die biet la khi thdi tiSt am udt. De dim bao

noi dat miy luon khd rIo, khoa da phai I^p dat

nhiSu miy dieu boa nhiet do cho phdng Igc mlu.

VS mua he van hinh theo chS do lam mit d nhiet

dp 270c - 28^0. Miia mua hoac nhung ngly am

udt van hinh theo chS dp hiit im. Thuc tS cho tbSy

nSu dam bao phdng dat miy ludn khd rIo thi chac

chan se khac phuc duge dnh trang hdng may hang

loat thudng xay ra vio miia mua hoac khi tinh

trang am udt keo dii.

* Khoa Thin nhin tao - Benh vien Bach Mai

2. Dam bao cho may than nhan tao co nguon

cung cap Olen du manh va on djnh

MIy than nhan tao cd cdng suat khi Idn

(khoing 2kw), nhung ddng dien tiSu thu lai lien

tuc tbay ddi theo boat ddng ciia bd ddt nong

(cdng suat khoang l,5kw). Trong khi dd he thdng

diSu khiSn ciia miy than nhan tao lai rat dS bio

Idi tham chi hu hdng nSu dien Ip ngudn thay ddi

qua nhiSu. Chinh vi vay khi tinh toan cdng suat

dien chg cle co sd than nhan tao can dam bao

mdi may cd dugc ngudn dien dn dinh vdi cdng

suat khoang 2kw. Qua kinb ngbiem boat dpng d

khoa than nhan tao benh vien Bach Mai chiing

toi thay nSu cdng suat ngudn cung cap dii manh

vl dn dinh, noi dat miy dam bao khd rIo thi co

thS gilm dugc khoang 50% nbirng hu hdng liSn

quan dSn he thdng diSu khien, qua dd gilm ding

kS nban cdng sira chira miy vl giam rat nbiSu chi

phi vat tu thay thS di ciing.

3. Lam sach may truac va sau mdi ca Ioc mau

MIy than nhin tao can phai ludn ludn sach.

MIy sach se gdp phan dam bao sy vd triing cho

phdng benh va ngudi benh, ddng thdi nang eao

tudi thg ciia miy. Trudc hole sau mdi ea lgc

mlu, phai thuc bien lau sach miy bang vai mSm

khd hole am theo thir tu tir trSn xudng. RiSng

cle bd phan dac biet ciia miy nhu min hinh

cham, min hinh tinh tbS Idng, bd cam biSn khi

trong mlu thi cd gang diing vai sgi bdng mSm va

am lau nhe nbing, trinh llm vd, xudc gay hdng

may. Ciing vdi viec lau sacb miy nhat thiSt phai

thuc hien rira miy theo chuang trinh da chgn de

tiet trung va llm sach he thdng dich cua may.

64 IY HOC LAM SANG So 44 (Thang 09/2009)