Mu 2020, COVID-19 ikukula. Posachedwapa, mitundu yosiyanasiyana ku India, Brazil, United Kingdom ndi mayiko ena atulukira, ndipo mafupipafupi a masinthidwe awonjezeka pang'onopang'ono kuchokera ku 0,1 pa chikwi kufika 1.3 pa chikwi. Mliri kumayiko ena ukadali wovuta, ndipo dzikolo silingachedwe ngakhale pang’ono. Odwala atatu adatsimikiziridwa ku Anhui pa 13-14. Mliriwu sunathe. Tiyenerabe kuziganizira mozama, kusamba m'manja pafupipafupi, kuvala masks ndikubaya katemera watsopano wa korona posachedwa.
Ndipo zikafika pa chithandizo choyamba kwa odwala omwe ali ndi COVID-19, ECMO nthawi zambiri imapezeka pamalo owopsa. Ndi chiyani?Mtengo wa ECMOndi extracorporeal membrane oxygenation therapy chida, chomwe chimadziwika kuti "mapapo opangira". Makina opangira mtima-mapapo ndi luso lothandizira moyo lomwe limagwiritsa ntchito chipangizo chapadera chopangira kukoka magazi kubwerera kumtima ndi mitsempha kunja kwa thupi, kuchita kusinthana kwa mpweya, kusintha kutentha ndi fyuluta, ndikubwezeretsanso mkati. Chifukwa chipangizo chapadera ichi chimalowa m'malo mwa mtima ndi mapapo a munthu, chimatchedwanso cardiopulmonary bypass amatchedwa makina opangira mtima-mapapo amatchedwa "mankhwala omaliza" kwa odwala omwe akudwala kwambiri chibayo chatsopano cha coronary.
Zida zoyambira zamakina a ECMO zikuphatikizapo:
(1) Pampu yamagazi: Pofuna kuyendetsa njira imodzi yokha ya magazi omwe ali ndi okosijeni kunja kwa thupi, amabwereranso ku mitsempha yamkati kuti alowe m'malo mwa gawo lalikulu la ntchito yotulutsa magazi a mtima.
(2) Chida chotulutsa magazi chokhala ndi okosijeni cha unidirectional.
(3) Oxygenator: Amatulutsa okosijeni m'magazi a venous, amatulutsa mpweya woipa, ndikusintha mapapo kuti asinthe mpweya.
(4) Thermostat: Chipangizo chomwe chimagwiritsa ntchito kutentha kwa madzi ozungulira komanso mbale zodzipatula zazitsulo zochepetsetsa zochepetsera kapena kuonjezera kutentha kwa magazi. Ikhoza kukhalapo ngati gawo losiyana, koma nthawi zambiri imaphatikizidwa ndi oxygenator.
(5) Zosefera: Chipangizo chopangidwa ndi chotchinga chojambulira chopangidwa ndi polima, choyikidwa mu payipi, chimagwiritsidwa ntchito kusefa zinthu zosiyanasiyana zoipitsa, tinthu, fumbi ndi tinthu tating'onoting'ono. , ili ndi mwayi wokwanira kusefa kwabwino kwa mpweya wabwino, kusefa kwabwino, kutsekereza fumbi, kotetezeka komanso kopanda poizoni, kopanda fungo. Imatha kusefa mitundu yosiyanasiyana ya tinthu, kuphatikiza mabakiteriya, ma virus ndi madontho amadzi. Mapangidwe a kabowo ndi apadera komanso ogawidwa mofanana, amatha kugwiritsidwa ntchito kangapo popanda kuyeretsa.
Chosefera cha HENGKO ECMO chochita kupangaimatha kuteteza mpweya wopumira wa wodwalayo ku kuipitsidwa ndi kachilomboka ndikuletsa tinthu tambiri ta fumbi kulowa mu makina ndikuwononga.
Mapapo opangira samangothandiza kupulumutsa odwala kwambiri omwe ali ndi chibayo chatsopano cha coronary komanso amakhala ndi ntchito zambiri zamankhwala ankhondo. Mwachitsanzo, US Air Force yakhazikitsa gulu lachipatala la Extracorporeal Membrane Oxygenation (ECMO), lomwe limatumizidwa kutsidya kwa nyanja kukagwira ntchito zosiyanasiyana zankhondo padziko lonse lapansi. Asilikali ndi gulu lankhondo lomwe limatsimikizira chitetezo cha dziko. Purezidenti Xi Jinping adatsindika mobwerezabwereza kuti "asilikali ali pankhondo." M'mawu ake pa Marichi 9 chaka chino, Purezidenti Xi Jinping adatsimikiza kuti zomwe zikuchitika mdziko langa ndizosakhazikika komanso zosatsimikizika. Kuchokera "kuwonjezeka" mpaka "kukulirapo", kuopsa kwa zomwe zikuchitika kumafuna nkhondo yaikulu. Kuchokera "kuwonjezeka" mpaka "kukulirapo", kuopsa kwa zomwe zikuchitika kumafuna nkhondo yaikulu. Choncho, kufunikira kwa mapapu ochita kupanga monga chitsimikizo chofunikira chachipatala cha chithandizo chamankhwala chankhondo kumawonekera.
Medtronic ku United States, McCoy ku Germany, Solin ku Germany, Terumo ku Japan, ndi Fresenius ku Germany, kupanga okhawo. Mtengo wa makina a mapapo ochita kupanga umafika mamiliyoni ambiri, ndipo zogwiritsidwa ntchito zimatumizidwanso kunja. Chifukwa cha mliri komanso zopinga zapadziko lonse lapansi ku China, kuitanitsa zinthu kuchokera kunja sikungowopsa komanso makampani ambiri akunja amayimitsa. Tumizani ku China. Kudalira katundu wochokera kunja kwa nthawi yaitali si chinthu chabwino. Monga imodzi mwamabizinesi aku China, zikhulupiriro zathu zimaphatikiza mzimu woyimirira pachilungamo cha dziko, kulimbikira kugwira ntchito molimbika, komanso kudzidalira kosalekeza. Pakafukufuku wozama wa gulu laukadaulo, mitundu yosiyanasiyana ya zosefera zomwe zimagwiritsidwa ntchito m'mapapo ochita kupanga zapangidwa, zomwe zikufanana ndi zopangidwa kuchokera ku Europe ndi United States, zomwe zimachepetsa mtengo wokonza zipatala ndi mabungwe azachipatala, ndikuthandizira chitukuko cha Makampani opanga zida zamankhwala apamwamba ku China.
ECMO ndiyothandiza kwambiri, komabe pali zovuta zina pakugwiritsira ntchito ECMO ku China. Mwachitsanzo, luso lamakono logwiritsidwa ntchito ndi ECMO ndilokwera kwambiri, zipangizozo ndizokwera mtengo, ndipo zipatala zochepa chabe zapakhomo zimakhala ndi chidziwitso chogwiritsa ntchito ECMO ndi chiwerengero cha milandu. Ndi zochepa za njira yophunzitsira ya ECMO.Mtengo wa ECMO ndi wokwera mtengo kwambiri, ndipo sizikukhudzana ndi kubwezeredwa kwa inshuwalansi yachipatala. Mtengo woti wodwala achite ECMO ndi pafupifupi 300,000 mpaka 400,000 yuan, zomwe mtengo wa zinthu zomwe zimagulitsidwa kunja zimakhalanso zotsika mtengo, ndi mtengo woyambira wa 40,000 mpaka 80,000 yuan.
Ngakhale kuti pali zovuta zambiri, tidzazigonjetsa. Ndi kupita patsogolo kwapadziko lonse komanso zopambana zazikulu za pulani yayikulu ya "Made in China 2025", imathandizira kukwezedwa kwazomwe amapanga. Timakhulupirira kuti ECMO yapakhomo idzalowa m'chipatala ndikulowa kuchipatala kuti apindule odwala m'tsogolomu.
Nthawi yotumiza: Jun-04-2021
