Emhlabeni wemishini yokubulala izinzwa, kunengxenye ethobekile kodwa ebucayi eyaziwa ngokuthi i-APL (Adjustable Pressure Limiting) valve.Lo mshini ongenakuzidla, ovame ukusetshenziswa odokotela ababulala izinzwa phakathi nezinqubo zezokwelapha, udlala indima ebalulekile ekuqinisekiseni ukuphepha nokusebenza ngempumelelo kokungena komoya kwesiguli.
Umgomo Wokusebenza we-APL Valve
I-valve ye-APL isebenza ngomgomo olula kodwa obalulekile.Ihlanganisa i-spring-loaded disk, futhi umsebenzi wayo uhlanganisa ukulungisa ukucindezela ngaphakathi kwesifunda sokuphefumula.Ngokuguqula i-knob, ukungezwani kwentwasahlobo futhi ngaleyo ndlela ukucindezela okufakwe kudiski kungashintshwa.I-valve ihlala ivaliwe kuze kube yilapho ukucindezela kumjikelezo wokuphefumula, omelelwa umcibisholo oluhlaza, kudlula amandla asetshenziswa entwasahlobo, aboniswa umcibisholo obomvana.Kulapho kuphela lapho i-valve ivuleka khona, ivumela igesi eningi noma ukucindezela ukubaleka.Igesi ekhishwe yi-valve ye-APL ngokuvamile iqondiswe ohlelweni lokulahla, ukuqinisekisa ukukhishwa okuphephile kwamagesi angaphezulu ekamelweni lokusebenza.
Izicelo ze-APL Valve
Ihlola Ubuqotho Bomshini Wokubulala Izinzwa
Ukusetshenziswa okukodwa okubalulekile kwevalvu ye-APL kuwukuqinisekisa ubuqotho bomshini wokubulala izinzwa.Izindlela ezehlukene zingasetshenziswa, kuye ngeziqondiso zomkhiqizi.Isibonelo, ngemva kokuxhuma umshini wokulalisa izinzwa endaweni yokuphefumula, umuntu angavala i-valve ye-APL, avale isixhumi esingu-Y sesekethe yokuphefumula, futhi alungise ukugeleza komoya-mpilo kanye ne-valve eshaywayo esheshayo ukuze azuze ukufundwa komfutho womoya ongu-30 cmH2O.Uma iphoyinti lihlala lizinzile okungenani imizuzwana eyi-10, lisho ubuqotho bomshini omuhle.Ngokufanayo, umuntu angahlola umshini ngokubeka i-valve ye-APL ku-70 cmH2O, avale ukugeleza komoya-mpilo, futhi afake i-flush esheshayo.Uma ukucindezela kuhlala ku-70 cmH2O, kubonisa uhlelo oluvalwe kahle.
Isimo Sokuphefumula Kwesiguli Okuzenzakalelayo
Ngesikhathi sokuphefumula kwesiguli okuzenzakalelayo, i-valve ye-APL kufanele ilungiswe ukuze ithi “0” noma “Spont.”Lezi zilungiselelo zivula ngokugcwele i-valve ye-APL, iqinisekisa ukuthi ingcindezi engaphakathi kwesekhethi yokuphefumula ihlala iseduze noziro.Lokhu kulungiselelwa kunciphisa iziguli ezengeziwe zokungazweli ebezingahlangabezana nazo lapho kukhishwa umoya okuzenzakalelayo.
Ukwethulwa Kokungenisa Komoya Okulawulwayo
Ukuze kungene umoya okwenziwa ngesandla, i-valve ye-APL ilungiswa endaweni efanele, ngokuvamile phakathi kuka-20-30 cmH2O.Lokhu kubalulekile njengoba umfutho womoya ophakeme kufanele ngokuvamile ugcinwe ungaphansi kuka-35 cmH₂O.Lapho unikeza umoya ocindezelayo omuhle ngokucindezela isikhwama sokuphefumula, uma ingcindezi ngesikhathi sokuphefumula idlula inani elimisiwe le-valve ye-APL, i-valve ye-APL iyavuleka, ivumele igesi eyeqile ukuba iphume.Lokhu kuqinisekisa ukuthi ukucindezela kuyalawulwa, kuvimbela ukulimala esigulini.
Ukugcinwa Kokuphefumula Kwemishini Ngesikhathi Sokuhlinzwa
Ngesikhathi sokufakwa komoya ngomshini, i-valve ye-APL empeleni idlulwa, futhi ukusetha kwayo kunomthelela omncane.Kodwa-ke, njengesexwayiso, kuwumkhuba ukulungisa i-valve ye-APL ukuze ibe “0” ngesikhathi sokulawula umshini kungenisa umoya.Lokhu kusiza ukushintshela ekulawuleni okwenziwa ngesandla ekupheleni kokuhlinzwa futhi kuvumela ukubhekwa kokuphefumula okuzenzakalelayo.
Ukunwetshwa kwamaphaphu ngaphansi kwe-Anesthesia
Uma ukwehla kwamandla emali emaphashini kudingekile ngesikhathi sokuhlinzwa, i-valve ye-APL isethwe enanini elithile, ngokuvamile eliphakathi kuka-20-30 cmH₂O, kuye ngokuthi ingcindezi ephakeme yokuphefumula edingekayo.Leli nani liqinisekisa ukwehla kwamandla emali okulawulwayo futhi ligwema ukucindezela okukhulu emaphashini esiguli.
Sengiphetha, nakuba i-valve ye-APL ingase ibonakale ingabonakali emhlabeni wemishini yokubulala izinzwa, indima yayo ibalulekile ngokungenakuphikwa.Isiza ekuphepheni kwesiguli, ekungeneni komoya kahle, kanye nempumelelo iyonke yezinqubo zezokwelapha.Ukuqonda ama-nuances we-valve ye-APL kanye nezinhlelo zokusebenza zayo ezihlukahlukene kubalulekile kuma-anesthetists kanye nabasebenzi bezempilo ukuze baqinisekise inhlalakahle yeziguli ezizinakekelayo.
