Multiparameter umonde esweni (ukuhlelwa kwabahloli) kunokubonelela ngolwazi lokuqala lweklinikhi kunye neentlobo ezahlukeneyoiimpawu ezibalulekileyo iiparamitha zokubeka iliso kwizigulane kunye nokuhlangula izigulane. Angokokusetyenziswa kweemonitha ezibhedlele,wndiyifundile loo ntoeisebe ngalinye leklinikhi alikwazi ukusebenzisa iliso kusetyenziso olukhethekileyo. Ngokukodwa, umqhubi omtsha akazi kakhulu malunga ne-monitor, okubangelwa iingxaki ezininzi ekusebenziseni iliso, kwaye akakwazi ukudlala ngokupheleleyo umsebenzi wesixhobo.Yonker izabeloiukusetyenziswa kunye nomgaqo wokusebenza weiiparamitha ezininzi esweni kumntu wonke.
Umntu obeka iliso kwisigulana unokubona into ebalulekileyo ebalulekileyoiimpawu iiparameters zezigulane ngexesha langempela, ngokuqhubekayo kunye nexesha elide, elinexabiso elibalulekileyo lekliniki. Kodwa kunye neselfowuni ephathekayo, ukusetyenziswa kwemoto, kuphucula kakhulu ukusetyenziswa rhoqo. Ngoku,iiparamitha ezininzi esweni isigulane siqhelekile, kwaye imisebenzi yayo ephambili ziquka ECG, uxinzelelo lwegazi, ubushushu, ukuphefumla,SpO2, I-ETCO2, IBP, ukuphuma kwentliziyo, njl.
1. Isakhiwo esisisiseko semonitha
Imonitha iqhele ukuqulunqwa yimodyuli yomzimba equlathe abenzi boluvo abahlukeneyo kunye nenkqubo yekhompyuter eyakhelweyo. Zonke iintlobo zeempawu ze-physiological ziguqulwa zibe yimiqondiso yombane ngamava, kwaye emva koko ithunyelwe kwikhompyutheni ukuze ibonise, ukugcinwa kunye nokulawula emva kokukhulisa kwangaphambili. Iparamitha ebanzi esebenzayo inokubeka iliso kwi-ecg, ukuphefumla, ubushushu, uxinzelelo lwegazi,SpO2 kunye nezinye iiparameters ngaxeshanye.
Modular isigulane eswenizisetyenziswa ngokubanzi kukhathalelo olukhulu. Ziqulunqwe ngeemodyuli zeparameter ye-physiological detachable detachable kunye nokubeka iliso kwimikhosi, kwaye inokuqulunqwa ngeemodyuli ezahlukeneyo ngokweemfuno ukuhlangabezana neemfuno ezizodwa.
2. The ukusetyenziswa kunye nomgaqo wokusebenza weiiparamitha ezininzi esweni
(1) Ukhathalelo lokuphefumla
Uninzi lwemilinganiselo yokuphefumla kwiiiparamitha ezininziesweni isigulanesebenzisa indlela ye-chest impedance. Ukunyakaza kwesifuba somzimba womntu kwinkqubo yokuphefumla kubangela ukuguqulwa kokumelana nomzimba, okuyi-0.1 ω ~ 3 ω, eyaziwa ngokuba yi-impedance yokuphefumula.
Imonitha ngokuqhelekileyo ithatha imiqondiso yotshintsho kwi-impedance yokuphefumula kwi-electrode efanayo ngokufaka i-current ekhuselekileyo ye-0.5 ukuya kwi-5mA kwi-sinusoidal carrier frequency ye-10 ukuya kwi-100kHz ngokusebenzisa i-electrode ezimbini IECG ukukhokela. I-wave waveform yokuphefumla inokuchazwa ngokwahluka kwe-impedance yokuphefumla, kwaye iiparameters zesantya sokuphefumla zinokukhutshwa.
Ukunyakaza kweThoracic kunye nokungaphefumli komzimba kuya kubangela utshintsho ekuchaseni umzimba. Xa ukuphindaphinda kolu tshintsho kufana nebhendi yokuphindaphinda yeamplifier yesitishi sokuphefumla, kunzima ukuba umntu obeke iliso abone ukuba yeyiphi na isignali yokuphefumla eqhelekileyo kwaye yeyiphi isiginali yokuphazamiseka kwentshukumo. Ngenxa yoko, imilinganiselo yokuphefumula isenokungachanekanga xa isigulane sineentshukumo eziqatha neziqhubekayo zomzimba.
(2) Ukujongwa kwengcinezelo yegazi (IBP).
Kolunye utyando olunzima, ujongo lwexesha lokwenyani loxinzelelo lwegazi lunexabiso leklinikhi elibaluleke kakhulu, ngoko ke kuyimfuneko ukwamkela itekhnoloji yokuhlola uxinzelelo lwegazi ukuyifezekisa. Umgaqo-siseko ngulo: okokuqala, i-catheter ifakwe kwimithambo yegazi yesayithi elilinganisiweyo nge-puncture. I-port yangaphandle ye-catheter ixhunywe ngokuthe ngqo kwi-sensor yoxinzelelo, kwaye i-saline eqhelekileyo ifakwe kwi-catheter.
Ngenxa yomsebenzi wokudlulisa uxinzelelo lwe-fluid, uxinzelelo lwe-intravascular luya kudluliselwa kwi-sensor yangaphandle yoxinzelelo nge-fluid kwi-catheter. Ngaloo ndlela, i-waveform eguquguqukayo yokutshintsha koxinzelelo kwimithambo yegazi inokufumaneka. Uxinzelelo lwe-Systolic, uxinzelelo lwe-diastolic kunye noxinzelelo lwentsingiselo lunokufumaneka ngeendlela ezithile zokubala.
Ingqalelo kufuneka ihlawulwe kumlinganiselo woxinzelelo lwegazi olungenayo: ekuqaleni kokubeka iliso, isixhobo kufuneka sihlengahlengiswe kwi-zero ekuqaleni; Ngethuba lenkqubo yokubeka iliso, inzwa yoxinzelelo kufuneka ihlale igcinwe kwinqanaba elifanayo nentliziyo. Ukuthintela ukujika kwe-catheter, i-catheter kufuneka ihlanjululwe ngeenaliti eziqhubekayo ze-heparin saline, ezinokuhamba okanye ziphume ngenxa yokunyakaza. Ngoko ke, i-catheter ifanele ilungiswe ngokuqinileyo kwaye ihlolwe ngononophelo, kwaye kufuneka kwenziwe uhlengahlengiso xa kuyimfuneko.
(3) Ukujongwa kobushushu
I-Thermistor ene-coefficient yeqondo lokushisa elibi lisetyenziswa ngokubanzi njengenzwa yobushushu kumlinganiselo wobushushu bemonitha. Iimonitha eziqhelekileyo zibonelela ngobushushu bomzimba omnye, kwaye izixhobo eziphezulu zibonelela ngamaqondo obushushu bomzimba amabini. Iintlobo zeprobe yeqondo lobushushu bomzimba zikwahlulwe ngokweprobe yomphezulu womzimba kunye neprobe yomgodi womzimba, ngokulandelelana isetyenziselwa ukujonga umphezulu womzimba kunye nobushushu bomgodi.
Xa kusenziwa umlinganiselo, umntu osebenzayo unokubeka iqondo lobushushu kulo naliphi na ilungu lomzimba wesigulana ngokwemfuno. Ngenxa yokuba iindawo ezahlukeneyo zomzimba womntu zinamaqondo obushushu ahlukeneyo, iqondo lobushushu elilinganiswa ngumhloli lixabiso leqondo lobushushu lenxalenye yomzimba wesigulane yokubeka iprobe, enokwahluka kwixabiso lobushushu lomlomo okanye lekhwapha.
WIsikhukukazi sithatha umlinganiselo weqondo lobushushu, kukho ingxaki yokulinganisa ubushushu phakathi kwendawo elinganisiweyo yomzimba wesigulane kunye nesixhobo soluvo esikwiprobe, oko kukuthi, xa iprobe ibekwa okokuqala, kuba isivamvo asikalungelelani ngokupheleleyo nobushushu besixhobo. umzimba womntu. Ngoko ke, iqondo lobushushu eliboniswayo ngeli xesha ayisiloqondo lokwenyani lobulungiseleli, kwaye kufuneka lifikelelwe emva kwexesha elithile ukuze lifike kwi-equilibrium ye-thermal phambi kokuba iqondo lokwenene libonakale. Kwakhona qaphela ukugcina uqhagamshelwano oluthembekileyo phakathi kwenzwa kunye nomphezulu womzimba. Ukuba kukho umsantsa phakathi kwenzwa kunye nolusu, ixabiso lokulinganisa linokuba liphantsi.
(4) Ukujongwa kwe-ECG
Umsebenzi we-electrochemical of "excitable cells" kwi-myocardium ubangela ukuba i-myocardium ibe yimincili yombane. Ibangela ukuba intliziyo ibambene ngoomatshini. Ukuvalwa kunye nesenzo sangoku esiveliswa yile nkqubo ye-excitatory yentliziyo igeleza kumqhubi womthamo womzimba kwaye isasazeka kwiindawo ezahlukeneyo zomzimba, okubangelwa utshintsho kwintlukwano yangoku phakathi kweendawo ezahlukeneyo zomzimba womntu.
Electrocardiogram ( I-ECG ) kukurekhoda ukungafani okunokwenzeka kwendawo yomzimba ngexesha langempela, kwaye ingcamango yokukhokela ibhekisela kwipatheni ye-waveform yokwahlukana okunokwenzeka phakathi kweendawo ezimbini okanye ngaphezulu komzimba womzimba womntu kunye nokuguqulwa komjikelezo wenhliziyo. Ezona zichaziweyo zokuqala Ⅰ, Ⅱ, Ⅲ iilothe ngokwezonyango zibizwa ngokuba zii-bipolar standard limb lead.
Kamva, i-pressurized unipolar lead lead yachazwa, i-aVR, i-aVL, i-aVF kunye ne-electrodeless chest ikhokelela i-V1, i-V2, i-V3, i-V4, i-V5, i-V6, ezi zikhokelo ze-ECG eziqhelekileyo ezisetyenziswa ngoku kwikliniki. Ngenxa yokuba intliziyo i-stereoscopic, i-lead waveform imele umsebenzi wombane kwindawo enye yentliziyo. Ezi zikhokelo ze-12 ziya kubonisa umsebenzi wombane kwiindawo ezahlukeneyo zokubonisa intliziyo ukusuka kwiindlela ezili-12, kwaye izilonda zeendawo ezahlukeneyo zentliziyo zinokufunyaniswa ngokupheleleyo.
Okwangoku, umatshini oqhelekileyo we-ECG osetyenziswa kwiiklinikhi ulinganisa i-waveform ye-ECG, kwaye i-electrodes yayo yomlenze ibekwe kwisandla kunye ne-ankle, ngelixa i-electrodes kwi-ECG yokubeka iliso ibekwe ngokulinganayo kwisifuba somgulane kunye nommandla wesisu, nangona ukubekwa. ezahlukeneyo, ziyalingana, kwaye inkcazelo yazo iyafana. Ngoko ke, ukuqhuba kwe-ECG kwi-monitor ihambelana nokukhokela kumatshini we-ECG, kwaye bane-polarity efanayo kunye ne-waveform.
Abahloli banokubeka iliso ngokubanzi i-3 okanye i-6 ekhokelela, banokubonisa ngaxeshanye i-waveform enye okanye zombini iinkokeli kwaye bakhuphe imilinganiselo yesantya sentliziyo ngohlalutyo lwamaza.. Piimonitha ezinamandla zinokubeka iliso kwii-12 ezikhokelayo, kwaye zinokuphinda zihlalutye i-waveform ukukhupha amacandelo e-ST kunye neziganeko ze-arrhythmia.
Okwangoku, iIECGi-waveform yokubekwa kweliso, isakhono sayo sokuxilongwa kwesakhiwo esifihlakeleyo asinamandla kakhulu, kuba injongo yokubeka iliso ikakhulu kukubeka iliso kwisingqi sentliziyo yesigulana ixesha elide kwaye ngexesha lokwenyani.. KodwaiIECGiziphumo zoviwo lomatshini zilinganiswa ngexesha elifutshane phantsi kweemeko ezithile. Ke ngoko, ububanzi bebhendi yeamplifier yezixhobo ezibini azifani. I-bandwidth yomshini we-ECG yi-0.05 ~ 80Hz, ngelixa i-bandwidth ye-monitor ngokubanzi i-1 ~ 25Hz. Umqondiso we-ECG luphawu olubuthathaka, oluchatshazelwa lula luphazamiseko lwangaphandle, kwaye ezinye iintlobo zokuphazamiseka kunzima kakhulu ukoyisa ezifana:
(a) Ukuphazamiseka kwentshukumo. Ukunyakaza komzimba wesigulane kuya kubangela utshintsho kwimiqondiso yombane entliziyweni. I-amplitude kunye nokuphindaphinda le ntshukumo, ukuba ngaphakathi kweIECGI-bandwidth ye-amplifier, isixhobo kunzima ukoyisa.
(b)Mukuphazamiseka kwe-yoelectric. Xa imisipha phantsi kwe-electrode ye-ECG ifakwe, isibonakaliso sokuphazamiseka kwe-EMG senziwa, kwaye isibonakaliso se-EMG siphazamisa umqondiso we-ECG, kwaye isibonakaliso sokuphazamiseka kwe-EMG sine-bandwidth ye-spectral efanayo kunye nesignali ye-ECG, ngoko ayikwazi ukucocwa ngokulula isihluzo.
(c) Ukuphazamiseka kwemela yombane esebenza ngamaza aphezulu. Xa i-high-frequency electrocution okanye i-electrocution isetyenziswa ngexesha lotyando, i-amplitude yesignali yombane eyenziwa ngamandla ombane eyongeziweyo kumzimba womntu bukhulu kakhulu kunophawu lwe-ECG, kunye necandelo le-frequency lityebile kakhulu, ukwenzela ukuba i-ECG. I-amplifier ifikelela kwindawo egcweleyo, kwaye i-ECG waveform ayikwazi ukubonwa. Phantse zonke iimonitha zangoku azinamandla ngokuchasene nophazamiso olunjalo. Ke ngoko, indawo yokubeka esweni i-anti-high frequency knife interference part ifuna kuphela ukuba imonitor ibuyele kwimeko yesiqhelo phakathi kwe-5s emva kokuba imela yombane ephezulu irhoxisiwe.
(d) Ukuphazamiseka koqhagamshelwano lwe-electrode. Nakuphi na ukuphazamiseka kwindlela yombane yombane ukusuka kumzimba womntu ukuya kwi-ECG amplifier kuya kubangela ingxolo enamandla enokuthi ifihle uphawu lwe-ECG, oluhlala lubangelwa ukudibanisa kakubi phakathi kwe-electrodes kunye nesikhumba. Ukukhuselwa kokuphazamiseka okunjalo kunqotshwa ngokuyinhloko ekusebenziseni iindlela, umsebenzisi kufuneka ahlolisise ngokucophelela indawo nganye rhoqo, kwaye isixhobo kufuneka sisekelwe ngokuthembekileyo, esingenakulungele ukulwa nokuphazamiseka, kodwa kubaluleke kakhulu, ukukhusela ukhuseleko lwezigulane. kunye nabaqhubi.
5. Azingeni ndawoesweni uxinzelelo lwegazi
Uxinzelelo lwegazi lubhekisa kuxinzelelo lwegazi kwiindonga zemithambo yegazi. Kwinkqubo yokufinyela ngakunye kunye nokuphumla kwentliziyo, uxinzelelo lokuhamba kwegazi kudonga lwemithambo yegazi luyatshintsha, kwaye uxinzelelo lwemithambo yegazi kunye nemithambo yegazi ye-venous yahlukile, kwaye uxinzelelo lwemithambo yegazi kwiindawo ezahlukeneyo lukwanjalo. ezahlukeneyo. Ngokweklinikhi, amaxabiso oxinzelelo lwexesha elihambelanayo le-systolic kunye ne-diastolic kwimithambo ye-arterial ekuphakameni okufanayo nengalo engaphezulu yomzimba womntu ihlala isetyenziselwa ukubonisa uxinzelelo lwegazi lomzimba womntu, olubizwa ngokuba yi-systolic blood pressure (okanye uxinzelelo lwegazi). ) kunye noxinzelelo lwe-diastolic (okanye uxinzelelo oluphantsi), ngokulandelanayo.
Uxinzelelo lwegazi lwe-arterial yomzimba luphawu oluguquguqukayo lwefiziyoloji. Inento eninzi yokwenza nemeko yengqondo yabantu, imeko yeemvakalelo, kunye nokuma kunye nesikhundla ngexesha lokulinganisa, ukubetha kwentliziyo kuyenyuka, uxinzelelo lwegazi lwe-diastolic luyenyuka, ukubetha kwentliziyo kuyehla, kwaye uxinzelelo lwegazi lwe-diastolic luyancipha. Njengoko inani lemivimbo entliziyweni linyuka, uxinzelelo lwegazi lwe-systolic luya kunyuka. Kunokuthiwa ukuba uxinzelelo lwegazi lwegazi kumjikelo ngamnye wentliziyo aluyi kufana ngokupheleleyo.
Indlela yokungcangcazela yindlela entsha yokulinganisa uxinzelelo lwegazi lwe-arterial non-invasive eyaphuhliswa kwiminyaka yee-70s,kwaye yayoUmgaqo kukusebenzisa i-cuff ukuvuthela kuxinzelelo oluthile xa imithambo yegazi ye-arterial ixinaniswe ngokupheleleyo kwaye ithintele ukuhamba kwegazi kwe-arterial, kwaye ngokuncipha koxinzelelo lwe-cuff, imithambo yegazi iya kubonisa inkqubo yokutshintsha ukusuka ekuthinteleni ngokupheleleyo → ukuvulwa ngokuthe ngcembe → ukuvula ngokupheleleyo.
Kule nkqubo, ekubeni i-pulse ye-arterial vascular wall iya kuvelisa amaza e-gas oscillation kwi-gas e-cuff, le wave ye-oscillation inembalelwano ecacileyo kunye noxinzelelo lwegazi lwe-systolic, uxinzelelo lwe-diastolic kunye noxinzelelo oluphakathi, kunye ne-systolic, intsingiselo kunye Uxinzelelo lwe-diastolic lwendawo elinganisiweyo inokufumaneka ngokulinganisa, ukurekhoda kunye nokuhlalutya amaza oxinzelelo oxinzelelo kwi-cuff ngexesha lenkqubo ye-deflation.
Isiseko sendlela ye-vibration kukufumana i-pulse rhoqo yoxinzelelo lwe-arterial. In inkqubo yokulinganisa eyona nto, ngenxa yokunyakaza kwesigulane okanye ukuphazamiseka kwangaphandle okuchaphazela ukutshintshwa koxinzelelo kwi-cuff, isixhobo asiyi kukwazi ukubona ukuguquguquka kwe-arterial rhoqo, ngoko kunokukhokelela ekungaphumeleli kokulinganisa.
Okwangoku, ezinye iimonitha ziye zamkela imilinganiselo yokuchasana nokuphazamiseka, njengokusetyenziswa kwe-ladder deflation method, nge-software ukumisela ngokuzenzekelayo ukuphazamiseka kunye namaza aqhelekileyo okubetha kwe-arterial, ukwenzela ukuba ube neqondo elithile lokuchasana nokuphazamiseka. Kodwa ukuba uphazamiseko lunzima kakhulu okanye luhlala ixesha elide, lo mgaqo wokuchasana nokuphazamiseka awukwazi ukwenza nantoni na. Ngoko ke, kwinkqubo yokujongwa kwengcinezelo yegazi engabonakaliyo, kuyimfuneko ukuzama ukuqinisekisa ukuba kukho imeko efanelekileyo yokuvavanya, kodwa kwakhona ingqalelo ekukhetheni ubungakanani be-cuff, ukubekwa kunye nokuqina kwe-bundle.
6. I-Arterial oxygen saturation ( SpO2 ) ukubeka iliso
Ioksijini yinto eyimfuneko kwimisebenzi yobomi. Iimolekyuli zeoksijini ezisebenzayo ezisegazini zithuthelwa kwiithishu kuwo wonke umzimba ngokubophelela kwi-hemoglobin (Hb) yenze ihemoglobin eneoksijini (HbO2). Ipharamitha esetyenziselwa ukubonisa umlinganiselo wehemoglobin eneoksijini egazini ibizwa ngokuba kukugcwala kweoksijini.
Umlinganiselo we-arterial saturation ye-oksijini engabonakaliyo isekelwe kwiimpawu zokufunxa i-hemoglobin kunye ne-hemoglobin ene-oksijini egazini, ngokusebenzisa amaza amabini ahlukeneyo okukhanya okubomvu (660nm) kunye nokukhanya kwe-infrared (940nm) ngokusebenzisa izicubu emva koko iguqulelwe kwiimpawu zombane. i-photoelectric receiver, ngelixa ikwasebenzisa amanye amacandelo kwizicubu, ezinje: ulusu, ithambo, izihlunu, igazi le-venous, njl. njl. , efunyenwe ngokucubungula isignali efunyenweyo.
Kuyabonakala ukuba le ndlela inokulinganisa kuphela ukugcwala kwe-oksijini yegazi kwi-arterial blood, kwaye imeko efunekayo yokulinganisa i-pulsating arterial blood flow. Ngokweklinikhi, inzwa ifakwe kwiindawo zezicubu kunye nokuhamba kwegazi kunye nobukhulu bezicubu ezingekho ngqindilili, njengeminwe, iinzwane, i-earlobes kunye nezinye iindawo. Nangona kunjalo, ukuba kukho ukunyakaza okunamandla kwinxalenye elinganisiweyo, kuya kuchaphazela ukutsalwa kwesi signali ye-pulsation eqhelekileyo kwaye ayikwazi ukulinganiswa.
Xa i-peripheral circulation yesigulane ihlupheke kakhulu, iya kukhokelela ekunciphiseni ukuhamba kwegazi kwi-arterial kwisayithi ekuza kulinganiswa ngayo, okukhokelela ekulinganisweni okungachanekanga. Xa ubushushu bomzimba bendawo yokulinganisa yesigulane esinokulahlekelwa kakhulu kwegazi liphantsi, ukuba kukho ukukhanya okuqinileyo okukhanya kwi-probe, kunokwenza ukusebenza kwesixhobo se-photoelectric receiver kuphambuka kuluhlu oluqhelekileyo, kubangele umlinganiselo ongachanekanga. Ngoko ke, ukukhanya okuqinileyo kufuneka kuphetshwe xa kusenziwa umlinganiselo.
7. Ukujongwa kwekhabhon dayokhsayidi yokuphefumla (PetCO2).
Ukuphefumla ikharbhon diokside sisalathisi esibalulekileyo kwizigulane ezine-anesthesia kunye nezigulana ezinezifo zesistim sokuphefumla. Umlinganiselo weCO2 ikakhulu usebenzisa indlela yokufunxa i-infrared; Oko kukuthi, ugxininiso olwahlukileyo lwe-CO2 lufunxa idigri ezahlukeneyo zokukhanya kwe-infrared. Kukho iindidi ezimbini zokubeka iliso kwi-CO2: i-mainstream kunye ne-sidestream.
Uhlobo oluqhelekileyo lubeka inzwa yegesi ngokuthe ngqo kumgudu wegesi wokuphefumla wesigulane. Ukuguqulwa koxinaniso lwe-CO2 kwigesi yokuphefumla iqhutywe ngokuthe ngqo, kwaye emva koko umqondiso wombane uthunyelwa kwi-monitor ukuze uhlalutye kunye nokucubungula ukufumana i-PetCO2 parameters. I-sensor ye-optical ye-side-flow ifakwe kwi-monitor, kwaye isampuli yegesi yokuphefumla isigulane ikhutshwe ngexesha langempela ngumbhobho wesampulu yegesi kwaye ithunyelwe kwi-monitor ye-CO2 yohlalutyo loxinaniso.
Xa siqhuba ukubeka iliso kwe-CO2, kufuneka sinikele ingqalelo kwezi ngxaki zilandelayo: Ekubeni i-CO2 inzwa i-sensor optical, kwinkqubo yokusetyenziswa, kuyimfuneko ukubeka ingqalelo ukuphepha ukungcola okunzulu kwenzwa efana ne-secretions yesigulane; Iimonitha ze-CO2 eziseSidestream zixhotyiswe ngokubanzi ngesahluli samanzi egesi ukususa ukufuma kwirhasi yokuphefumla. Ngalo lonke ixesha khangela ukuba isahluli samanzi egesi sisebenza ngokufanelekileyo; Ngaphandle koko, ukufuma kwigesi kuya kuchaphazela ukuchaneka komlinganiselo.
Umlinganiselo weeparamitha ezahlukeneyo uneziphene ekunzima ukuzoyisa. Nangona aba bahloli beneqondo eliphezulu lobukrelekrele, abanakukwazi ukuthatha indawo yabantu ngokupheleleyo okwangoku, kwaye aba basebenzi basafuneka ukuba bahlalutye, bagwebe kwaye bajongane nabo ngokuchanekileyo. Umsebenzi kufuneka ulumke, kwaye iziphumo zomlinganiselo kufuneka zigwetywe ngokuchanekileyo.
Ixesha lokuposa: Jun-10-2022
