深静脉置管的护理

深静脉置管的护理 深静脉穿刺置管术的护理体会 【关键词】 深静脉置管;护理 深静脉穿刺留置导管是重症监护中常用的操作技术之一,是危重、大手术及慢性消耗性疾病患者进行中心静脉压监测、输液、输血、血液透析和实施完全胃肠外营养最有效的途径之一〔1〕。由于其具有保留时间长、操作简单、输液种类广泛、导管弹性好等优点,目前已广泛应用于临床,但如果置管后护理不当，不但影响置管的继续使用，而且也给患者造成不必要的痛苦及经济损失，如何预防置管术后并发症的发生无疑对护理人员提出了越来越高的要求〔2〕。现结合病例谈一谈深静脉穿刺留置导管的护理体会。 1 临床 本组患者共11例，其中男5例，女6例，年龄21,75岁。 2 术前护理 (1)心理护理:由于危重患者无行为能力，家属对深静脉置管术缺乏了解，较难取得配合。因此，护士必须热情、主动，耐心细致地进行讲解，讲解置管的必要性和重要性，以消除家属的紧张和恐惧心理，配合医护人员完成操作过程。同时说明在穿刺过程中及术后有可能出现的并发症，让患者及家属做出选择。(2)在患者或家属同意做深静脉穿刺置管术的基础上，请他们在《深静脉穿刺置管术#协议#》上签字，使我们的护理工作做到有据可查，为深静脉穿刺的必要性、合理性提供依据。(3)用物准备:深静脉穿刺包1个、1%利多卡因5 ml、肝素稀释液(浓度为25 u/ml)，无菌手套2副，无菌纱布，消毒用碘伏、棉签等，3 M透明敷贴、肝素帽、5 ml注射器。(4)协助患者按穿刺要求取正确卧位，是保证穿刺成功的重要因素。 3 术中护理 (1)熟悉穿刺置管部位静脉的解剖和走行方向，严格执行无菌技术操作 ，穿刺部位用碘伏消毒，避免在同一部位反复多次穿刺，以防医源性感染的发生。(2)严密观察病情变化:术中尽量给予关心、体贴及耐心细致地解释、指导。对个别躁动不安的要约束四肢，必要时可适当地应用小剂量镇静剂。(3)置管成功后见回血，证实部位正确后接上肝素帽，方可按输液导管输液，导管固定稳妥后，并要标上置管刻度，一般为14,18 cm。 4 术后护理 4.1 固定与消毒 用无菌透明贴膜或用BD无菌贴膜外固定，可有效防止导管移位，扭曲、受压及脱出，使患者活动感到便利，同时要避免因患者翻身或不自主动作导致管道接头脱落。注意观察穿刺点局部皮肤有无红、肿、热、痛、渗血及脓性分泌物等炎性反应，穿刺点定时消毒，无菌敷料隔日更换一次，夏季或高热多汗患者需每日更换，若被污染立即更换，同时用碘伏或75,酒 精消毒穿刺点周围皮肤，要注意局部保护。 4.2 预防气栓 空气栓塞是一种严重并发症，可以立即引起死亡，常发生于静脉压较低、输液时液体输完或导管接头脱落时。因此，一定要及时更换液体，并仔细检查输液系统的各个连接点，进行必要的妥善固定，使其不漏气、不易脱落〔3〕。在更换输液导管时应先关闭静脉留置管，确保导管各连接完善并无漏气现象后，再打开导管的阻断阀。 4.3 导管的护理 对静脉输液管道，24 h要更换，观察液体滴注是否通畅，导管有否扭曲、受压，连接有无漏液现象，进针部有无皮下水肿、疼痛。对接头处使用的三通阀或肝素帽，发现松动或脱落，立即去除，严格消毒后更换新的三通阀或肝素帽。对接头处的各项操作如进行输液、给药及输液泵衔接操作时，严格遵守无菌操作，防止医源性感染发生。对输注静脉高营养液患者，输液过程中，加强巡视，输注完毕后，用生理盐水冲洗管腔或重新更换新的输液管后，再输入其他液体。 4.4 监测中心静脉压 利用深静脉置管监测中心静脉压时，特别加强患者及家属的心理护理，增强心理的安全感。较长时间监测CVP时，应每24 h用生理盐水配置的稀肝素液5 ml(30 u)冲洗导管，以保持测压系统通畅和减少感染发生率。 4.5 深静脉置管的重要性 深静脉置管是血透患者的生命线，应该专管专用，透析期间不要用导管输液、采血，注意防止交叉感染及血行感染，延长使用时间，血透结束后，先将双腔导管内血液用生理盐水每侧10 ml快速冲净，再用肝素盐水正压封管，下次在透前将保留的肝素盐水抽出。 4.6 治疗结束决定拔除导管时，先消毒局部皮肤，拔出导管，再消毒局部，用无菌纱布压迫穿刺点约5 min，防止发生血肿，并覆盖无菌敷料，以保护局部，防止感染，必要时剪下导管末端送检。 5 小结 经此处理，全部病例均未出现空气栓塞、穿刺点局部皮肤感染等并发症及出现堵管现象。因此，在护理工作中，护士应熟练掌握深静脉穿刺置管的无菌操作技术，熟悉深静脉穿刺置管可能出现的并发症。加强责任心，细心观察，仔细护理，发现问题及时，及时处理才能做好深静脉穿刺置管的护理工作。 【参考文献】 1 董薇.深静脉置管的临床应用及护理进展.第四军医大学吉林军医学院学报，2003，25(2):113-115. 2 周萍.深静脉留置导管并发症的观察与护理.广东医学院学报，2003，21(2):194-195. 3 雷娜.深静脉留置管的护理.职业卫生与应急救援，2004，22(2):85. ?cooling at the time 55 ter cooling of about 50 degrees Celsius in the medium. Agar slant medium should be taken out immediately after sterilization,Blood, body fluids and antibiotics and the aseptic technique extraction and joined in af ium using low temperature sterilization. r or intermittent sterilization sterilization, again using aseptic technique and quantitative increases in media. Gelatin medr hot ingredients, such as sugar, separate into 20% or a more concentrated solution to filteIn a variety of preparation methods, in the absence of special provisions, you can use this method of sterilization. Some fea sterilization method of 15 minutes. steamsterilization to determine the final pH of the medium used. 8, sterile medium 121 c can be used for medium and high pressure salts, lactose and neutral Red. Bile salts inhibit the intestinal bacteria other than ... In a small jar, with the media and on. Such as macconkey medium commonly used in food testing is one example. It contains bileeosin methylene blue medium is the identification of a common medium. Medium has a double function selection and identificati-l pathogenic bacteria of dairy productsFor example, to check the water and the presence of intestinar dirt bucket or sink should be collected within the specified container. 9. waste, especially in the strong acid and strong the residue of inflammable and easy explosive substance (such as sodium metal, white phosphorus, the match head) must not poumperature. 8. bath operation should be carefully heated, constantly measured with a thermometer, that the temperatures do not exceed oil te-well as in high temperature heating equipment such as gas, water, electricity ... Pour into glass bottle. 7. use oilre as often are quite toxic, corrosive, flammable and explosive chemical direct contact often use of fragile glass and porcelain waol to room temperature. Laboratory safety and protection in the fifth section, laboratory safety in the chemical laboratory, and cog water unless otherwise specified, refers to the purification of water. The pH check the water, means a new boiling water shall prevail. Four, testin? ? 2 ?emperature has significant influence on test results, except where otherwise provided, 25 ure; tption titration liquid volume (ML) of poor for calculation. 4. test temperature, does not indicate the means at room temperation", Department refers to by for try products by consumption titration liquid of volume (ML) and blank test in the by consumorrecty with method operation proceeds of results; content determination in the of "and will titration of results with blank test c", Department refers to in not added for try products or to equivalent solvent alternative for try liquid of situation Xia, bk testtake dosage by check items Xia measuring have of dry weightlessness (or water, or solvent) deduction. 3. test in the of "blane, should take without dry (or not to water, or not to solvent) of for try products for test, and will calculation in the of constantprovides outsid?All media at 36 ? 1 And determine the final pH. by culture medium contamination, should be discarded. ration done, should be carefully examined again, if cracks are found, water immersion, abnormal color, cotton was picked out , placed into proper falls to natural coagulation. 9, medium quality tests each batch of medium prepa?60 -annot directly down to the tank should bebase c2 深静脉置管的护理 留置导管的护理 ?妥善固定和密切观察。置管后应给予妥善固定，必要时用线将导管缝于皮肤上，穿刺处给予加压包扎24小时，定时巡视，注意观察穿刺处有无渗血，导管有无回血、滑脱，敷贴是否脱落等等，如出现相关问题应及时给予处理。如无特殊，常规第一个24小时更换敷料，以后隔日更换敷料1次;揭去敷料时应顺着导管的方向往上撕，以免将导管拔出。嘱患者穿脱衣服时动作尽量轻柔，行PICC者要避免置管肢体过度活动，行颈内静脉或锁骨下静脉置管的，要避免头部过度扭转，以免将留管导管拔出;每次洗澡或洗头时应避免弄湿敷贴，如不慎弄湿要报告护士及时给予更换。?严格无菌操作规程。置管期间注意保持穿刺部位干燥、清洁，穿刺部位及周围皮肤应每次用2,碘伏或碘酊、75,酒精消毒1次，并盖以无菌敷料。连续输液者，应每日更换输液器1次。肝素帽至少每周更换1次，预防感染发生。?正确封管。每次用药后一般要用2%肝素钠稀释液5 ml正压封管，不输液时每天也都要封管，并夹管，以防堵塞。采用可来福帽因有抗凝作用，既可以封管，也可以不封管;封管时用注射器抽生理盐水0.5~1 ml，针筒顺时针扭转90?即可注入，注入后逆时针旋转90?退出即可。 并发症的观察及护理 ?空气栓塞。这是最为严重也最容易发生的并发症。输液时护士应加强巡视，及时更换液体，以免药液滴尽后空气进入血管，引起空气栓塞。同时，向病人及家属交代有关注意事项，取得病人的合作。本组无一例发生空气栓塞。?感染。由于抗癌药在杀伤或抑制肿瘤细胞的同时，对机体正常组织细胞也有损伤作用，使机体抵抗力下降，加上化疗药抑制骨髓，更容易发生感染。如不严格执行无菌操作，穿刺处会出现红、肿、痛等局部感染，甚至出现全身感染。本组均严格执行无菌操作，无一例感染发生。?出血。严密观察穿刺部位的敷贴有无出血、局部有无肿胀、疼痛等。由于长期留置导管，肝素封管次数较多，加上有些病人的肝脏功能差，凝血功能低下，可能引起穿刺处出血或渗血，应定期检查出、凝血时间和血液黏稠度，并密切观察局部皮肤、黏膜有无瘀点、瘀斑，牙龈有无出血，避免摔伤,1,。消毒穿刺处时切不可强行将结痂脱掉，以免引起出血。本组有1例肝脏功能差，穿刺处经常出血或渗血，给予及时更换和加压包扎，并报告医生，给予保肝、护肝及促凝血治疗后，无继续渗血和出血现象。?导管堵塞。造成导管堵塞的原因较为复杂，通常与静脉高营养输液后导管冲洗不彻底，或封管液选择、用量以及推注速度选择不当，或病人的凝血机制异常等有关。肿瘤患者的血液大多呈高凝状态。因此，在静脉高营养输液或化疗后应彻底冲洗管道，每次输液完毕应正确封管，要根据病人的具体情况，选择合适的封管液及用量，并注意推注速度不可过快。本组有3例发生导管堵塞，其中PICC 2例，锁骨下静脉置管1例;1例是负压封管引起堵塞，1例是血液高凝患者，所用的封管液过少引起，另1例是使用静脉高营养输液后导管冲洗不彻底引起。此3例后经重新置管后继续化疗。?静脉炎。这是PICC置管后最常见的并发症，而在其余3种置管中比较少见。静脉炎多为机械性静脉炎，其症状为穿刺部位血管红、肿、热、痛，触诊时静脉如绳索般硬、滚、滑、无弹性。本组有2例出现机械性静脉炎，给 3 予拔管后，局部用多功能微波照射治疗5,7天后症状消失，并再给予患者行颈内静脉和锁骨下静脉穿刺置管后继续化疗。?导管脱落。较为常见。因置管时间长，而化疗患者均能下床走动，加上患者出汗后所用的敷料和胶布粘得不稳，容易引起导管脱落。本组有2例发生导管脱落，我们在常规消毒下重新穿刺置管并继续化疗。化疗结束或不需要留置导管后，给予拔管，拔管前用碘伏消毒穿刺点后拔出导管，用无菌敷贴覆盖导管入口处并压迫5,10 min左右，并交代病人穿刺处近两日暂时避免碰水，以免引起感染。次日可摘下敷贴，拔管后穿刺口愈合好。 护理体会 通过实践和观察，发现PICC可避免中心静脉穿刺所带来的危险及并发症，与颈内静脉穿刺、锁骨下静脉穿刺、股静脉穿刺比较，因为PICC不是盲穿而是直视，所以操作更方便、更易于掌握，护士可独立完成，大大降低了护理人员因反复穿刺产生的无效工作，提高了工作效率。因此，临床上我们首选PICC术进行化疗。但如果患者的贵要静脉或肘正中静脉没有弹性，血管细小、血管已硬化或有静脉窦者，我们就选择颈内静脉穿刺或锁骨下静脉穿刺置管，否则穿刺难送管，不易成功;如果患者因癌症所致出现颈部淋巴结肿大或上腔静脉综合征者，我们就选择股静脉置管进行化疗，以免出现药液不滴或不畅现象。如无特殊的禁忌证，我们建议采用深静脉置管为病人进行化疗。因为一般的头皮针仅能留4~6小时、浅静脉留置针能保留3~5天，而深静脉置管后能留3~6周甚至半年以上。深静脉置管术在本组化疗的临床护理中虽也出现一些并发症，但经及时发现和处理后未影响化疗。深静脉置管化疗不仅可以避免浅静脉用药时的频繁穿刺、药物容易外渗、易引起静脉炎等，可以使导管通畅无回血、无血栓形成，能减轻化疗药物对局部血管的刺激，药物吸收快，疗效好，副作用小;而且可长期连续小剂量用药，维持恒定的血药浓度，减轻患者恶心、呕吐等症状。避免患者因化疗所带来的痛苦，而不至于放弃或中断化疗。在肿瘤化疗中，与浅静脉穿刺相比，深静脉置管术有不可比拟的优点，值得临床推广使用。 ium using low temperature sterilization. r or intermittent sterilization sterilization, again using aseptic technique and quantitative increases in media. Gelatin medr hot ingredients, such as sugar, separate into 20% or a more concentrated solution to filteIn a variety of preparation methods, in the absence of special provisions, you can use this method of sterilization. Some fea sterilization method of 15 minutes. steamsterilization to determine the final pH of the medium used. 8, sterile medium 121 c can be used for medium and high pressure salts, lactose and neutral Red. Bile salts inhibit the intestinal bacteria other than ... In a small jar, with the media and on. Such as macconkey medium commonly used in food testing is one example. It contains bileeosin methylene blue medium is the identification of a common medium. Medium has a double function selection and identificati-l pathogenic bacteria of dairy productsFor example, to check the water and the presence of intestinar dirt bucket or sink should be collected within the specified container. 9. waste, especially in the strong acid and strong the residue of inflammable and easy explosive substance (such as sodium metal, white phosphorus, the match head) must not poumperature. 8. bath operation should be carefully heated, constantly measured with a thermometer, that the temperatures do not exceed oil te-well as in high temperature heating equipment such as gas, water, electricity ... Pour into glass bottle. 7. use oilre as often are quite toxic, corrosive, flammable and explosive chemical direct contact often use of fragile glass and porcelain waol to room temperature. Laboratory safety and protection in the fifth section, laboratory safety in the chemical laboratory, and cog water unless otherwise specified, refers to the purification of water. The pH check the water, means a new boiling water shall prevail. Four, testin? ? 2 ?emperature has significant influence on test results, except where otherwise provided, 25 ure; tption titration liquid volume (ML) of poor for calculation. 4. test temperature, does not indicate the means at room temperation", Department refers to by for try products by consumption titration liquid of volume (ML) and blank test in the by consumorrecty with method operation proceeds of results; content determination in the of "and will titration of results with blank test c", Department refers to in not added for try products or to equivalent solvent alternative for try liquid of situation Xia, bk testtake dosage by check items Xia measuring have of dry weightlessness (or water, or solvent) deduction. 3. test in the of "blane, should take without dry (or not to water, or not to solvent) of for try products for test, and will calculation in the of constantprovides outsid?All media at 36 ? 1 And determine the final pH. by culture medium contamination, should be discarded. ration done, should be carefully examined again, if cracks are found, water immersion, abnormal color, cotton was picked out , placed into proper falls to natural coagulation. 9, medium quality tests each batch of medium prepa?60 -?cooling at the time 55 ter cooling of about 50 degrees Celsius in the medium. Agar slant medium should be taken out immediately after sterilization,Blood, body fluids and antibiotics and the aseptic technique extraction and joined in af annot directly down to the tank should bebase c4 深静脉置管术的临床应用及护理要点 深静脉置管术由于保留时间长、操作简便、输液种类广泛、导管弹性好，以及能在短时间内建立安全、迅速、可靠的血管通路，所以在临床输血、补液、完全胃肠外营养(TPN)、中心静脉压监测(CVP)、危重患者抢救等方面被广泛应用，并且在血液透析、化疗、排除体腔积液等方面取得了良好效果，现就其临床应用及护理要点综述如下。 1 临床应用 [医 学教 育网 搜集 整理] 1.1 输液补血 由于其具有快速、有效的特点，同时能减轻因反复穿刺而带来的痛苦，减少了护士工作量，提高了护理工作效率，特别是采用多腔静脉插管，一次建立多路静脉通路，管腔分割，有利于不同成分液体同时输入，避免了药物配伍禁忌。 1.2 肿瘤患者化疗 大剂量多药物综合化疗应用及反复多次穿刺直接刺激血管而发生静脉炎、药物外渗，对肿瘤患者采用深静脉置管输入化疗药物，减轻了化疗药物对血管的刺激，使静脉炎及渗漏的发生率降低，保证了化疗的顺利实施。 1.3 完全胃肠外营养(TPN) 深静脉置管与周围静脉穿刺比较可输入高浓度葡萄糖、氨基酸、脂肪乳，具有留置时间长、输注速度快、减少静脉炎发生等优点。 1.4 中心静脉压监测(CVP) CVP是判断患者血容量及右心房功能的重要指标，在容量输注过程中，CVP可作为判断心脏对液体负荷的安全指标，在临床工作中，常依据动脉压高低、脉压大小、尿量以及临床症状、体征，结合CVP变化对病情做出判断，以采取相应措施。 1.5 建立临时、永久快速血透通路 慢性肾衰竭患者因组织间水肿，外围静脉穿刺困难，采用深静脉留置双腔导管方 法，能有效建立临时危症透析通路，具有血流充分、操作方便、易于固定、并发症少等优点，是常用安全有效的紧急通路。 [医 学教 育网 搜集 整理] 1.6 引流胸腔积液 胸腔积液是晚期肿瘤患者常见的并发症，其生成速度快且难以控制，需反复穿刺抽液，不仅给操作者带来困难，也给患者增加痛苦。留置导管质地柔软、组织相容性好、刺激小、操作简单，可减轻反复穿刺给患者带来痛苦，亦可根据病情控制引流速度，并可多次胸腔内直接给药。采用深静脉置管技术定期引流胸腔积液，腔内注入化疗药物，即达到控制胸腔积液目的，又避免了常规胸腔反复穿刺的缺点。 1.7 用于血流动力学监测和心脏临时起搏 深静脉留置导管可沿导管插入漂浮导管进行血流动力学监测，可直接测定各部位的压力及计算心脏指数(CI)和肺毛细血管嵌压(PCWP)，协助临床诊治。主要用于各种心脏病并发心功能不全患者。并在心脏停搏或高度房室传导阻滞患者，可沿套管插入临时起搏器进行心脏临时起搏，以挽救患者生命。 2 置管方法 导管选择有单腔、双腔、多腔导管。常规备皮、消毒手术野、铺无菌巾，静脉穿刺成功后，置入导引钢丝，应用皮肤扩张器，扩张皮肤、皮下组织后，置入静脉留置导管适当深度，退出导引钢丝，缝合静脉留置管，即可应用于临床。 5 3 置管方式 常用置管方式有右颈内静脉穿刺置管、锁骨下静脉穿刺置管、股静脉穿刺置管，三种置管方式各有利弊，应根据患者具体情况来选择，不宜硬性要求，置入单腔导管首选锁骨下静脉，容易固定，患者舒适方便，其次为颈内静脉。置入双腔导管，因导管粗、留置时间长，易压迫损伤血管，首选颈内静脉和股静脉。颈内静脉导管位于中心循环，药物起效快并可测CVP，相对安全，并发症少。锁骨下静脉不易插漂浮导管，常为颈内静脉穿刺困难时选用。股静脉用于各种危重患者的抢救，可在短时间内建立维持时间较长的静脉通路，适于休克衰竭状态及浅静脉穿刺困难时抢救输液，但不宜行TPN疗法，易受腹压的影响，不适应CVP的监测，下肢血运障碍者不宜采用。有气管切开时不宜选颈内静脉，有下肢活动受限、长期卧床不宜选择股静脉，有精神障碍或行为失控者慎选股静脉。 4 不同临床应用的护理要点 对静脉输液管道，24h更换[1].对接头处使用的三通阀或肝素帽，发现松动或脱落，立即去除，严格消毒后更换新的三通阀或肝素帽。对接头处的各项操作如进行输液、给药、抽血及输液泵衔接操作时，严格遵守无菌操作，防止医源性感染发生。对输注静脉高营养液患者[2]，输液过程中，加强巡视，输注完毕后，用生理盐水冲洗管腔或重新更换新的输液管后，再输入其他液体。 深静脉置管治疗胸腔积液时，在穿刺及引流中，严格执行无菌技术操作。每次引流胸腔积液结束后，应常规消毒导管与引流袋连接处，每周更换肝素帽1次[3]，封好、固定。接引流袋引流或注射化疗药物时，应避免进入空气，严密观察留置管的连接与固定处，防止气胸发生。引流袋切不可高于穿刺点，防止逆行感染。 深静脉置管是血透患者生命线，应该专管专用[4]，透析期间不要用导管输液、采血，注意防止交叉感染及血行感染，延长使用时间，血透结束后，先将双腔导管内血液用生理盐水每侧10ml快速冲净，再用肝素盐水正压封管，下次在透前将保留的肝素盐水抽出。 利用深静脉置管监测中心静脉压时，特别加强患者及家属的心理护理，增强心理的安全感。较长时间监测CVP时，应每24h用生理盐水配置的稀肝素液5ml(30u)冲洗导管，以保持测压系统通畅和减少感染发生率，防止导管端周围形成纤维蛋白鞘。 深静脉置管术是简便、安全、有效的临床护理技术，在临床的抢救、治疗中应用广泛，大大减少了护士工作量，有效地提高了危重症患者的抢救成功率。 [医 学教 育网 搜集 整理] 【参考文献】 1 杨小艳，武礼琴，杜丽.深静脉置管相关护理.农垦医学，2003，25(5):381-382. 2 郑晓明，王新磊.深静脉置管行全胃肠外营养护理体会.哈尔滨医药，2001，21(1):81-82. 3 王丽，张晓华.深静脉置管术在肺癌胸腔积液引流中应用.实用肿瘤学杂志，2001，15(3):221-222. 4 夏峰，谢燕.血透患者深静脉置管的护理体会.透析与人工器官，2001，12(12):37-38. , placed into proper falls to natural coagulation. 9, medium quality tests each batch of medium prepa?60 -?cooling at the time 55 ter cooling of about 50 degrees Celsius in the medium. Agar slant medium should be taken out immediately after sterilization,Blood, body fluids and antibiotics and the aseptic technique extraction and joined in af ium using low temperature sterilization. r or intermittent sterilization sterilization, again using aseptic technique and quantitative increases in media. Gelatin medr hot ingredients, such as sugar, separate into 20% or a more concentrated solution to filteIn a variety of preparation methods, in the absence of special provisions, you can use this method of sterilization. Some fea sterilization method of 15 minutes. steamsterilization to determine the final pH of the medium used. 8, sterile medium 121 c can be used for medium and high pressure salts, lactose and neutral Red. Bile salts inhibit the intestinal bacteria other than ... In a small jar, with the media and on. Such as macconkey medium commonly used in food testing is one example. It contains bileeosin methylene blue medium is the identification of a common medium. Medium has a double function selection and identificati-l pathogenic bacteria of dairy productsFor example, to check the water and the presence of intestinar dirt bucket or sink should be collected within the specified container. 9. waste, especially in the strong acid and strong the residue of inflammable and easy explosive substance (such as sodium metal, white phosphorus, the match head) must not poumperature. 8. bath operation should be carefully heated, constantly measured with a thermometer, that the temperatures do not exceed oil te-well as in high temperature heating equipment such as gas, water, electricity ... Pour into glass bottle. 7. use oilre as often are quite toxic, corrosive, flammable and explosive chemical direct contact often use of fragile glass and porcelain waol to room temperature. Laboratory safety and protection in the fifth section, laboratory safety in the chemical laboratory, and cog water unless otherwise specified, refers to the purification of water. The pH check the water, means a new boiling water shall prevail. Four, testin? ? 2 ?emperature has significant influence on test results, except where otherwise provided, 25 ure; tption titration liquid volume (ML) of poor for calculation. 4. test temperature, does not indicate the means at room temperation", Department refers to by for try products by consumption titration liquid of volume (ML) and blank test in the by consumorrecty with method operation proceeds of results; content determination in the of "and will titration of results with blank test c", Department refers to in not added for try products or to equivalent solvent alternative for try liquid of situation Xia, bk testtake dosage by check items Xia measuring have of dry weightlessness (or water, or solvent) deduction. 3. test in the of "blane, should take without dry (or not to water, or not to solvent) of for try products for test, and will calculation in the of constantprovides outsid?All media at 36 ? 1 And determine the final pH. by culture medium contamination, should be discarded. ration done, should be carefully examined again, if cracks are found, water immersion, abnormal color, cotton was picked out annot directly down to the tank should bebase c6