I-catheter yaseVenous Centrac: Umhlahlandlela Obalulekile

A I-catheter yase-venous ephakathi (CVC), eyaziwa nangokuthi umugqa we-central venous, iyishubhu eguquguqukayo efakwe emthanjeni omkhulu oholela enhliziyweni. LeliIdivayisi yezokwelaphaUdlala indima ebalulekile ekuphatheni imishanguzo, uketshezi, kanye nezakhi zomzimba ngqo egazini, kanye nokuqapha amapharamitha ahlukahlukene ezempilo. Ama-catheters asemaphakathi aseCentral ibalulekile ekuphatheni iziguli ezinezifo ezinzima, labo abazokwelapha abayinkimbinkimbi, noma abantu abadinga izindlela zokwelapha ezihlala isikhathi eside. Kulesi sihloko, sizohlola inhloso yamaCentral Verous Catheter, izinhlobo ezahlukene, inqubo ehilelekile ekufakweni kwazo, kanye nezinkinga ezingaba khona.

Inhloso yama-careters asemaphakathi ase-venous

Ama-catheters asemaphakathi asemaphakathi asetshenziselwa izizathu ezahlukahlukene zokwelashwa, kufaka phakathi:

Ukuphathwa kwemithi:Imithi ethile, efana nezidakamizwa ze-chemotherapy noma ama-antibiotic, ingahle ibe nokhahlo kakhulu ngemithambo ye-peripheral. I-CVC ivumela ukulethwa okuphephile kwale mithi ibe ngqo emveni enkulu, kunciphisa ubungozi bokucasulwa kwethambo.

I-Long-term IV Yokwelapha:Iziguli ezidinga ukwelashwa isikhathi eside (iv), kufaka phakathi ama-antibiotic, ukuphathwa kwezinhlungu, noma umsoco (njengezomsoco (njengezomsoco zabazali), zisizakala kulayini oqinile futhi onokwethenjelwa.

Ukuphathwa komkhiqizo we-fluid kanye negazi:Ezimweni eziphuthumayo noma zokunakekelwa okuthe xaxa, i-CVC inika amandla ukuphathwa ngokushesha kwamanzi, imikhiqizo yegazi, noma i-plasma, engasindisa impilo ngezimo ezibucayi.

Isampula yegazi nokuqapha:Ama-caneters asemaphakathi aseCentral enza isampula yegazi njalo ngaphandle kwezinti eziphindaphindwayo. Ziyasiza futhi ngokubheka ingcindezi ephakathi ne-venous, ukuhlinzeka ngemininingwane ngesimo senhliziyo yesiguli.

I-dialysis noma i-apheresis:Ezigulini ezinokwehluleka kwezinso noma labo abadinga i-Arethesis, uhlobo olukhethekile lwe-CVC lungasetshenziswa ukufinyelela igazi le-Dialysis zokwelapha.

 

Izinhlobo zeAma-careters asemaphakathi aseCentral

Kunezinhlobo eziningi zama-catheters asezingeni eliphakeme, ngalinye eliklanyelwe izinhloso ezithile nezinkantolo ezikhethekile:

Umugqa wePicc (I-Peripharally efakwe enkabeni ye-catheter):

Umugqa we-PICC ungumgwaqo omude, omncane ofakwe ngethambo engalweni, imvamisa umthambo we-basilic noma we-cephalic, wawuthambekele emveni ophakathi nendawo eduze kwenhliziyo. Kuvame ukusetshenziselwa ukwelashwa okuphakathi nokwelashwa isikhathi eside, okusukela emavikini kuya ezinyangeni.
Imigqa ye-PICC ilula ukuyibeka futhi isuse, ibenze kube yikhethelo elithandwayo lezokwelapha ezinde ezingadingi ukufakwa okuhlisiwe.

Ama-catheters angewona amatende:

Lokhu kufakwe ngokuqondile emthanjeni omkhulu entanyeni (i-juugar yangaphakathi), isifuba (subclavian), noma i-groin (femoral) (femoral) (femoral) futhi kuvame ukusetshenziselwa ukunakekelwa okufushane noma ezimweni eziphuthumayo.
Ama-CVC angenawo amandla awalungele ukusetshenziswa kwesikhathi eside ngenxa yengozi ephezulu yokutheleleka futhi avame ukususwa uma isimo sesiguli sizinza.
Ama-caneter ethandwe

Ama-catheter anenhlonipho afakwa emthanjeni omkhulu kepha adluliswa emhubheni ongaphansi ngaphambi kokufinyelela iphuzu lokungena esikhunjeni. Umhubhe usiza ukunciphisa ubungozi bokutheleleka, okwenza balungele ukusetshenziswa kwesikhathi eside, njengasezigulini ezidinga ukudonswa kwegazi njalo noma okuqhubekayo kwe-chemotherapy.
Labo mathekathi bavame ukuba ne-cuff ekhuthaza ukukhula kwezicubu, evikela i-catheter endaweni.

Amachweba afakiwe (i-port-a-cath):

Ichweba elifakiwe liyithuluzi elincane, eliyindilinga elibekwe ngaphansi kwesikhumba, imvamisa esifubeni. I-catheter ihamba isuka ethekwini iye engxenyeni ephakathi. Amachweba asetshenziselwa ukwelashwa okwesikhathi eside okuphakathi okufana ne-chemotherapy, njengoba aphansi kwesikhumba futhi abe nengozi ephansi yokutheleleka.
Iziguli zithanda amachweba okunakekelwa kwesikhathi eside ngoba azinandaba kangako futhi zidinga kuphela induku yenaliti ngesikhathi sokusetshenziswa ngakunye.

Inqubo ephakathi nendawo ye-venous catheter
Ukufakwa kwe-catheter ephakathi nendawo ye-venous inqubo eyehluka ngokuya ngohlobo lwe-catheter ebekwe. Nakhu ukubuka konke okujwayelekile kwenqubo:

1. Ukulungiselela:

Ngaphambi kwenqubo, umlando wezokwelapha wesiguli uyabuyekezwa, futhi imvume iyatholakala. Isixazululo se-antiseptic sisetshenziselwa indawo yokufaka ukunciphisa ingozi yokutheleleka.
I-anesthetic yasendaweni noma i-sedation ingahle inikezwe ukuqinisekisa induduzo yesiguli.
2. Ukubekwa kwe-catheter:

Kusetshenziswa ukuholwa kwe-ultrasound noma izimpawu zomhlaba we-anatomical, udokotela ufaka i-catheter emthanjeni ofanele. Endabeni yomugqa we-picc, i-catheter ifakwa ngethambo elihlanzekile engalweni. Kwezinye izinhlobo, amaphuzu aphakathi nendawo afana nemithambo ye-subclavian noma yangaphakathi ye-jugur.
I-catheter ithuthukile kuze kube yilapho ifinyelela endaweni oyifunayo, imvamisa i-vena cava ephakeme eduze kwenhliziyo. I-x-ray noma i-fluoroscopy ivame ukwenziwa ukuqinisekisa isikhundla se-catheter.
3. Ukuvikela i-catheter:

Lapho i-catheter ibekwe kahle, ivikelekile ngama-suture, anamathela, noma ukugqoka okukhethekile. Ama-catheter anenhlonipho angaba ne-cuff ukuze aqhubeke avikeleke idivaysi.
Indawo yokufaka bese igqokwa, futhi i-catheter igcwele i-saline ukuqinisekisa ukuthi isebenza kahle.
4. Ngemuva kwalokhu:

Ukunakekelwa okufanele kanye nezinguquko ezijwayelekile zokugqoka zibalulekile ukuvikela ukutheleleka. Iziguli nabanakekeli baqeqeshelwa ukuthi bangayinakekela kanjani i-catheter ekhaya uma kudingeka.
Izinkinga ezingaba khona
Ngenkathi ama-canter venous cather amathuluzi agxile ekunakekelweni kwezokwelapha, awekho ngaphandle kwezingozi. Ezinye izinkinga ezithile zifaka:

1. Ukutheleleka:

Ingxabano evame kakhulu ukutheleleka endaweni yokufaka noma ukutheleleka kwegazi (ukutheleleka kwegazi eliphakathi nendawo, noma i-clabsi). Amasu aqinile anobuthayo ngesikhathi sokufakwa nokugcinwa ngokucophelela kunganciphisa le ngozi.
2. Clots yegazi:

Ama-CVC kwesinye isikhathi angadala ama-cloots egazi emthanjeni. Ukuncipha kwegazi kungachazwa ukunciphisa le ngozi.
3. I-Pneumothorax:

Ukubhoboza ngengozi kwamaphaphu kungenzeka ngesikhathi sokufaka, ikakhulukazi ngama-catheters angewona angewona amatende afakwe endaweni yesifuba. Lokhu kuphumela kuphaphu elibhidlikile, elidinga ukungenelela kwezokwelapha okusheshayo.
4. Ukungasebenzi kahle kwe-catheter:

I-catheter ingavinjwa, i-kinhlayo, noma ikhishwe, ithinta umsebenzi wayo. Ukugcwala okujwayelekile nokuphatha okufanele kungavimba lezi zinkinga.
I-5. Ukopha:

Kunobungozi bokopha ngesikhathi senqubo, ikakhulukazi uma isiguli sinenkinga yokuphazamiseka. Icebo elifanele kanye nokunakekelwa kwenqubo yezenqubo yezenqubo yokunciphisa ingozi.

 

Ukugcina
Ama-catheters asezingeni eliphakeme amadivaysi abalulekile ekunakekelweni kwezokwelapha kwanamuhla, enikeza ukufinyelela okuthembekile kwe-venous ngezinhloso ezahlukahlukene zokwelapha nezihlokwayo. Ngenkathi inqubo yokufaka umugqa ophakathi nendawo iqondile, idinga ubuchwepheshe nokusingatha ngokucophelela ukunciphisa izinkinga. Ukuqonda izinhlobo ze-CVCS kanye nokusetshenziswa kwazo okuthile kuvumela abahlinzeki bezokunakekelwa kwezempilo ukuthi bakhethe inketho engcono kakhulu yezidingo zesiguli ngasinye, baqinisekise ukunakekelwa okusebenzayo nokuphephile.