ISINGENISO
Ekunakekelweni kwezempilo kwanamuhla, iI-Chemo Port(Ichweba elifakelwayo noma i-Port-a-Cath), njengesikhathi esideidivayisi yokufinyelela kwemithambo, isetshenziswa kabanzi ezigulini ezidinga ukumnika njalo, ukwelashwa ngamakhemikhali, ukumpontshelwa igazi noma ukwesekwa kokudla okunomsoco. Akugcini nje ngokuthuthukisa izinga lempilo yeziguli, kodwa futhi kunciphisa ubuhlungu bokubhoboza okuphindaphindiwe kanye nengozi yokutheleleka. Kulesi sihloko, sizocubungula incazelo, imininingwane, isakhiwo, izinhlobo, izinzuzo kanye nendlela yokukhetha okulungile ukukusiza ukuthi uqonde ngokugcwele le divayisi yezokwelapha ebalulekile.
I. Liyini Imbobo Yekhemo?
Ichweba leChemo, elaziwa nangokuthi aPort-a-Cathnoma imbobo yokumnika, iyisisetshenziswa sezokwelapha esibekwe ngaphansi kwesikhumba ukuze kube lula ukwelapha ngokufakwa emthanjeni isikhathi eside. Iqukethe i-reservoir encane (ichweba) exhunywe ku-catheter efakwe emthanjeni omkhulu, ngokuvamile esifubeni. Ichweba livumela ukufinyelela okulula kokuphathwa kwemithi, ukwelashwa ngamakhemikhali, ukumnika uketshezi, nokudonsa igazi, okuqeda isidingo sezinti zezinaliti eziphindaphindiwe.
Itheku le-chemo ngokuvamile lenziwa ngezinto ezihambisana ne-biocompatible njenge-titanium noma ipulasitiki ene-septum ye-silicone ezivalayo. Ochwepheshe bezempilo bangangena echwebeni besebenzisa isipesheliinaliti ye-Huber engeyona i-coring, ukunciphisa ukungaphatheki kahle kanye nokunciphisa izingozi zokutheleleka uma kuqhathaniswa nama-catheter endabuko e-IV.
Ukusetshenziswa okuyinhloko kwamachweba we-chemo kufaka:
1. ukumnika izidakamizwa ze-chemotherapy zesikhathi eside
2. ukwesekwa komsoco kwabazali
3. ukumpontshelwa njalo noma ukuqoqwa kwegazi
4. ukwelashwa ngama-antibiotic
5. ukuphathwa kobuhlungu
Ukucaciswa nokwakheka kwechweba le-Chemo (Port-a-Cath)
1. Imininingwane
Ukucaciswa kwamachweba we-Chemo kuvame ukuhlukaniswa ngokuya ngamapharamitha alandelayo:
- Usayizi: ububanzi besihlalo somjovo ngokuvamile bungamasentimitha angu-2-3 futhi ugqinsi lungaba isentimitha elingu-1
- Umthamo: umthamo we-lumen yesihlalo somjovo uvamise ukuba ngu-0.5-1.5 mL
- Usayizi we-catheter: usayizi ovame ukusetshenziswa ngu-6-10 French
- Ubude be-catheter: 20-90 cm kuye ngendawo yokufakelwa.
2. Izingxenye zesakhiwo
Imbobo engatshalwa ngokuyinhloko yakhiwe izingxenye ezilandelayo:
1. Isihlalo somjovo:
- Yenziwe nge-titanium alloy noma ipulasitiki
- I-Silicone diaphragm phezulu, engamelana nama-puncture angaphezu kuka-2000.
– Phansi kunembobo yokuxhuma i-catheter
2. I-Catheter:
- Yenziwe nge-silicone noma i-polyurethane
- Izakhiwo ze-Antithrombotic kanye ne-anti-infective
– Ingase ibe ne-flap design ekugcineni.
3. Ukulungisa idivayisi:
- Isetshenziselwa ukuvikela isibambi somjovo kanye ne-catheter
- Ivimbela ukususwa kanye nokuxoshwa
Izinhlobo zamachweba angatshalwa (Chemo Ports)
Ngokuya ngezigaba ezahlukene zokuhlukanisa, izimbobo ezifakelwayo zingahlukaniswa zibe izinhlobo ezilandelayo:
1. Ukuhlukaniswa ngokwezinto ezibonakalayo
- Izibambi zomjovo we-Titanium alloy:
- Izinzuzo: amandla aphezulu, i-MRI iyahambisana
– Ukungalungi: Intengo ephakeme
- Izibambi zomjovo wePlastiki:
- Izinzuzo: intengo ephansi, isisindo esilula
- Ububi: i-MRI encane iyahambisana
2. Ama-catheter ahlukaniswa ngendawo yokuphela kwe-catheter.
- Uhlobo lwe-venous ephakathi:
- I-Catheter igcina ku-vena cava ephakeme
- Ifanele izimo eziningi.
- Uhlobo lwe-Peripheral Vein:
- I-Catheter igcina emthanjeni we-peripheral.
- Ifanele ukusetshenziswa kwesikhashana
3. Ngomsebenzi
- I-Lumen Eyodwa:
- Ukufinyelela okukodwa kokwelashwa okujwayelekile
- I-Double Lumen:
- Iziteshi ezimbili ezizimele zokumnika kanyekanye kwezidakamizwa ezahlukene.
Izinzuzo zechweba elifakelwayo (Amachweba weChemo)
1. Ukusetshenziswa isikhathi eside:
- Ingashiywa endaweni iminyaka eminingana, inciphisa ukubhoboza okuphindaphindiwe
– Ifanele iziguli ezidinga ukwelashwa isikhathi eside
2. Ingozi ephansi yokutheleleka:
– Kufakwe ngokugcwele emzimbeni, kunciphisa amathuba okutheleleka
- Izinga lokutheleleka liphansi ngokuphawulekayo uma liqhathaniswa nama-peripheral venous catheter
3. Izinga lempilo elithuthukisiwe:
- Akukho ukuphazamiseka emisebenzini yansuku zonke, kungathatha ukugeza ngokujwayelekile
- Ubumfihlo obunokubukeka okuhlakaniphile
4. Nciphisa izinkinga:
- Ukunciphisa ingozi ye-phlebitis, ukukhishwa kwezidakamizwa, njll.
– Yehlisa ukulimala kwemithambo
5. Ezomnotho:
- Izindleko eziphansi zokusetshenziswa kwesikhathi eside kunokuphindaphinda kwe-catheterization
- Yehlisa isikhathi sokulaliswa esibhedlela kanye nezindleko ezihlobene
6. Izidingo zokunakekela eziphansi
- Ngokungafani nemigqa emaphakathi yangaphandle, izimbobo ezifakelwayo zidinga izinguquko ezivamile zokugqoka nokunakekelwa.
7. Ukulethwa kwezidakamizwa okuthuthukisiwe
- Iqinisekisa ukufinyelela okuqondile emithanjeni emikhulu, ithuthukisa ukumuncwa kwemithi futhi inciphise ukucasuka kwemithambo.
V. Ungakhetha kanjani imbobo efanelekile efakekayo (Amachweba eChemo)
Ukukhetha imbobo efanelekile kakhulu engafakwa kuncike ezintweni ezimbalwa:
- Isimo Sezempilo:
- Izimbobo ezine-lumen eyodwa zanele ukwelashwa okujwayelekile ngamakhemikhali, kuyilapho izimbobo ezine-lumen ephindwe kabili zingcono ezigulini ezidinga ukuthakwa kwezidakamizwa ngasikhathi sinye.
- Izimbobo zokujova amandla ziyanconywa ezigulini ezenza izithombe ezithuthukisiwe ezithuthukisiwe.
- Ukuhambisana Kwezinto kanye ne-MRI:
- Iziguli ezingezwani nensimbi kufanele zikhethe izimbobo zepulasitiki.
- Izimbobo ze-titanium ezihambisana ne-MRI ziyakhethwa ezigulini ezidinga ukuskenwa kwesithombe okujwayelekile.
- Usayizi Wembobo kanye Nokubekwa:
- Cabangela usayizi womzimba wesiguli kanye nendawo efiselekayo yokubeka imbobo (isifuba ngokumelene nengalo).
- Amachweba amancane angase akhetheke ezigulini zezingane noma abantu abanamafutha aphansi emzimbeni.
- Imvamisa Yokusebenzisa:
- Uma ukudonsa kwegazi njalo noma ukumnika kuyadingeka, imbobo ene-lumen ephindwe kabili noma ejova amandla iyasiza.
- Izincomo Zomhlinzeki Wezempilo:
- Ukubonisana nodokotela noma i-oncologist kuqinisekisa ukuthi uhlobo lwechweba luhambisana nohlelo lokwelapha lwesiguli nendlela yokuphila.
VI. Okucatshangelwayo lapho uthenga ichweba elifakelwayo (Chemo Ports)
1.Ibhrendi nomkhiqizi
Khetha abakhiqizi abathembekile abanezitifiketi ze-FDA, CE, noma ISO13485 ukuze uqinisekise ikhwalithi nokuphepha.
2.I-Biocompatibility
Qinisekisa ukuthi izinto ezisetshenziswayo (i-titanium, i-silicone, noma ipulasitiki) ziyahambelana ne-bio futhi zinciphisa ubungozi bokungezwani komzimba.
3.Inyumba kanye nokupakishwa
Ichweba kufanele lifakwe inzalo ngaphambili futhi livalwe emaphaketheni angaphazanyiswa ukuze kuncishiswe izingozi zokutheleleka.
4.Ukubonakala kwembobo nokuhlonza
Ezinye izimbobo ziza nezimpawu zokuhlonza noma izici ze-radiopaque ezishumekiwe ukuze zibonakale kalula phakathi nokuskena kwezithombe.
5.Ukuhambisana Kwenaliti
Qinisekisa ukuthi ichweba lihambisana nezinaliti ze-Huber ezijwayelekile ukuze ufinyelele kalula futhi uvikelekile.
6.Intengo kanye nokusebenza kahle kwezindleko
Nakuba izithiyo zebhajethi zingase zibe khona, beka phambili ikhwalithi nokuqina ukuze uvimbele ukushintshwa okuvamile noma izinkinga.
7.Izibuyekezo zomsebenzisi kanye nempendulo yomtholampilo
Cabangela impendulo evela kochwepheshe bezokunakekelwa kwempilo ngokwethembeka nokusebenza kwemikhiqizo ehlukene yechweba.
8. Ukwesekwa kokuqeqeshwa:
Qinisekisa ukuthi umphakeli uhlinzeka ngokuqeqeshwa kochwepheshe mayelana nokusetshenziswa komkhiqizo.
Qonda ukunakekelwa komkhiqizo nemihlahlandlela yokuxazulula inkinga.
Izici zechweba elifakelwayo (i-Chemo Ports) elinikezwe i-Shanghai Teamstand Corporation
Isikhwama se-capsular esinomklamo oqondile we-front-end sivumela ukusika okuncane.
Imbobo enamaphuzu amathathu enomklamo wembotshana we-sutural iyenza izinze kakhudlwana.
Ilokhi yokuxhuma ephikisana nokugoqa.
Imbobo ye-polysulfone ilula, inomuzwa womzimba wangaphandle.
Kulula ukutshala. Kulula ukunakekela.
Ihloselwe ukunciphisa izilinganiso zezinkinga.
MR Conditional kufika ku-3-Tesla.
8.5F Ukumaka kwe-Radiopaque CT eshumekwe ku-port septum ukuze kubonakale ngaphansi kwe-x-ray.
Ivumela imijovo yamandla efika ku-5mL/sec kanye nesilinganiso sokucindezela esingu-300psi.
Ihambisana nazo zonke izinaliti zamandla.
Ukumakwa kwe-Radiopaque CT kushumekwe ku-port septum ukuze kubonakale ngaphansi kwe-x-ray.
Isiphetho
Njengomuntu othuthukileidivayisi yezokwelapha, amachweba angatshalwa(Chemo Ports)hlinzeka ngesixazululo esiphephile nesilungele iziguli ezidinga ukwelashwa ngokufakwa emthanjeni isikhathi eside. Ngokuqonda ukucaciswa, ukwakhiwa, izinhlobo kanye nezinzuzo zamachweba okumnika, iziguli namathimba okunakekelwa kwezempilo angenza izinqumo ezinolwazi. Ukucatshangelwa ngenxa yezidingo zesiguli, ikhwalithi yomkhiqizo kanye nesevisi yomthengisi ngesikhathi sokuthenga nokusebenzisa kuzosiza ukuqinisekisa imiphumela yokwelashwa nokuphepha kwesiguli. Njengoba ubuchwepheshe bezokwelapha buqhubeka nokuthuthuka, ukuklama nokusebenza kwezimbobo ezifakelwayo kuzoqhubeka nokuthuthukiswa ukuze kube nesipiliyoni esingcono sesiguli.
Lapho uthenga ichweba elifakelwayo (Izimbobo Ze-Chemo), qinisekisa ukuthi lihlangabezana nezindinganiso zokuphepha, liyahambisana nezinto eziphilayo, futhi liyahambisana nezinsiza ezidingekayo. Ngokukhetha nokunakekelwa okufanele, izimbobo ezifakelwayo (izimbobo ze-chemo) zingathuthukisa kakhulu izinga lempilo yeziguli ezidinga ukufinyelela okunwetshiwe kwe-IV.
Ngokulandela lo mhlahlandlela obanzi, iziguli kanye nochwepheshe bezokwelapha bangenza izinqumo ezinolwazi mayelana nechweba elifakelwayo elifaneleka kakhulu (ichweba le-Chemo) lokwelashwa ngokufakwa emthanjeni isikhathi eside.
Isikhathi sokuthumela: Mar-31-2025