I-Catheter ye-Venous esembindini: IsiKhokelo esiBalulekileyo

A I-Central Venous Catheter (CVC), eyaziwa ngokuba ngumgca we-venous ephakathi, i-tube eguquguqukayo efakwe kwi-vein enkulu ekhokelela entliziyweni. Okuisixhobo sonyangoidlala indima ebalulekileyo ekunikezeni amayeza, ulwelo, kunye nezondlo ngqo egazini, kunye nokubeka iliso kwiiparamitha ezahlukeneyo zempilo. I-catheters ye-venous esembindini ibalulekile ekulawuleni abaguli abanezigulo ezinzima, abo bafumana unyango oluntsonkothileyo, okanye abantu abafuna unyango lwexesha elide. Kweli nqaku, siza kuphonononga injongo ye-catheters ye-venous ephakathi, iintlobo ezahlukeneyo, inkqubo echaphazelekayo ekufakeni kwabo, kunye neengxaki ezinokuthi zibe khona.

Injongo yeeCatheter zeVenous esembindini

I-catheters ye-venous esembindini isetyenziselwa izizathu ezahlukeneyo zonyango, kubandakanya:

Ulawulo lwamayeza:Amayeza athile, anje ngechemotherapy okanye amayeza okubulala iintsholongwane, anokuba nzima kakhulu kwimithambo yeperipheral. I-CVC ivumela ukuhanjiswa okukhuselekileyo kwala mayeza ngokuthe ngqo kwi-vein enkulu, ukunciphisa umngcipheko wokucaphuka kwe-vein.

Unyango lwexesha elide lwe-IV:Izigulane ezifuna unyango olude lwe-intravenous (IV), kubandakanywa i-antibiotics, ulawulo lweentlungu, okanye isondlo (njengesondlo esipheleleyo se-parenteral), inzuzo kumgca we-venous central, onika ukufikelela okuzinzile nokuthembekileyo.

Ulwelo kunye noLawulo lweMveliso yeGazi:Kwiimeko ezingxamisekileyo okanye zokunyamekela, i-CVC yenza ukulawulwa ngokukhawuleza kwamanzi, iimveliso zegazi, okanye i-plasma, enokusindisa ubomi kwiimeko ezinzima.

Iisampulu zeGazi kunye nokuBeka iliso:I-catheters ye-venous esembindini yenza kube lula ukuthatha iisampulu zegazi rhoqo ngaphandle kweenaliti eziphindaphindiweyo. Zikwaluncedo nasekubekeni iliso kuxinzelelo lwe-venous ephakathi, ukunika ulwazi malunga nesimo sentliziyo yesigulane.

I-Dialysis okanye iApheresis:Kwizigulane ezinokungaphumeleli kwezintso okanye ezo zidinga i-apheresis, uhlobo olukhethekileyo lwe-CVC lunokusetyenziswa ukufikelela kwigazi lonyango lwe-dialysis.

 

Iintlobo zeIiCatheters zeVenus esembindini

Kukho iintlobo ezininzi ze-catheter ye-venous ephakathi, nganye yenzelwe iinjongo ezithile kunye nobude bexesha:

Umgca we-PICC (Umda oFakelwe uMbindi weCatheter):

Umgca we-PICC ngumtya omde, obhityileyo ofakwe kwi-vein engalweni, ngokuqhelekileyo i-basilic okanye i-cephalic vein, kwaye ifakwe kwi-vein ephakathi kufuphi nentliziyo. Iqhele ukusetyenziswa kunyango oluphakathi ukuya kwixesha elide, ukusuka kwiiveki ukuya kwiinyanga.
Imigca yePICC kulula ukuyibeka kwaye uyisuse, nto leyo eyenza ibe lolona khetho lukhethwayo kunyango oluthatha ixesha elide olungadingi kufakelo lotyando.

IiCatheters ezingafakwanga:

Ezi zifakwe ngokuthe ngqo kwi-vein enkulu entanyeni (i-jugular yangaphakathi), isifuba (i-subclavian), okanye i-groin (i-femoral) kwaye ngokuqhelekileyo isetyenziselwa iinjongo zexesha elifutshane, ngokuqhelekileyo kukhathalelo olunzima okanye kwiimeko ezingxamisekileyo.
Ii-CVC ezingezizo ii-tunnels azilungele ukusetyenziswa ixesha elide ngenxa yomngcipheko ophezulu wosulelo kwaye zidla ngokususwa xa imeko yesigulane izinzile.
I-Tunneled Catheters:

I-catheter ene-tunnel ifakwe kwi-vein ephakathi kodwa ihanjiswa kwitonela engaphantsi kwe-cutaneous ngaphambi kokuba ifike kwindawo yokungena esikhumbeni. Itonela inceda ekunciphiseni umngcipheko wosulelo, ibenze bafanelekele ukusetyenziswa ixesha elide, njengakwizigulane ezifuna ukutsalwa kwegazi rhoqo okanye ichemotherapy eqhubekayo.
Ezi catheter zihlala zine-cuff ekhuthaza ukukhula kwezicubu, ukukhusela i-catheter endaweni.

Izibuko Ezimiliselweyo (I-Port-a-Cath):

Izibuko elimiliselweyo sisixhobo esincinci, esingqukuva esibekwe phantsi kwesikhumba, ngokuqhelekileyo esifubeni. I-catheter ibaleka ukusuka kwizibuko ukuya kumthambo ophakathi. Amazibuko asetyenziselwa unyango oluphakathi kwexesha elide njengechemotherapy, njengoko ephantsi kwesikhumba ngokupheleleyo kwaye anomngcipheko ophantsi wosulelo.
Izigulane zikhetha izibuko zokunakekelwa kwexesha elide ngenxa yokuba zincinci kwaye zifuna kuphela intonga yenaliti ngexesha lokusetyenziswa ngalunye.

Inkqubo yeCatheter yeVenous esembindini
Ukufakwa kwe-catheter ye-venous ephakathi yinkqubo yonyango eyahluka ngokuxhomekeke kuhlobo lwe-catheter ebekwe. Nantsi isishwankathelo senkqubo:

1. Ukulungiselela:

Ngaphambi kwenkqubo, imbali yonyango yesigulane ihlaziywa, kwaye imvume ifunyenwe. Isisombululo se-antiseptic sisetyenziswe kwindawo yokufakela ukunciphisa ingozi yokusuleleka.
I-anesthetic yasekuhlaleni okanye ukuthomalalisa kunokwenziwa ukuze kuqinisekiswe ukukhululeka kwesigulana.
2. Ukubekwa kweCatheter:

Ukusebenzisa isikhokelo se-ultrasound okanye iimpawu ze-anatomical, ugqirha ufaka i-catheter kwi-vein efanelekileyo. Kwimeko yomgca we-PICC, i-catheter ifakwe kwi-peripheral vein engalweni. Kwezinye iintlobo, iindawo zokufikelela ezisembindini ezifana ne-subclavian okanye i-jugular veins yangaphakathi isetyenziswa.
I-catheter iqhubela phambili ide ifike kwindawo efunwayo, ngokuqhelekileyo i-vena cava ephezulu kufuphi nentliziyo. I-X-reyi okanye i-fluoroscopy isoloko isenziwa ukuqinisekisa indawo yecatheter.
3. Ukukhusela iCatheter:

Emva kokuba i-catheter ifakwe ngokufanelekileyo, ikhuselwe nge-sutures, i-adhesive, okanye i-dressing ekhethekileyo. I-catheter enetonela inokuba ne-cuff yokukhusela ngakumbi isixhobo.
Indawo yofakelo iyanxitywa, kwaye i-catheter ithotywa ngesaline ukuqinisekisa ukuba isebenza ngokuchanekileyo.
4. Ukhathalelo lwasemva:

Ukhathalelo olululo kunye nokutshintsha indlela yokunxiba rhoqo kubalulekile ukuze kuthintelwe usulelo. Izigulane kunye nabanonopheli baqeqeshwa ngendlela yokunyamekela i-catheter ekhaya xa kuyimfuneko.
Iingxaki ezinokuthi zibekho
Ngelixa i-catheter ye-venous ephakathi zizixhobo ezixabisekileyo kukhathalelo lwezonyango, azikho ngaphandle kwemingcipheko. Ezinye iingxaki ezinokwenzeka ziquka:

1. Usulelo:

Eyona ngxaki ixhaphakileyo lusulelo kwindawo yofakelo okanye usulelo lomjelo wegazi (usulelo olunxulunyaniswa nomgca ophakathi wegazi, okanye i-CLABSI). Iindlela zobuchule ezingqongqo ngexesha lokufakwa kunye nokugcinwa ngononophelo kunokunciphisa lo mngcipheko.
2. Amahlwili egazi:

Ii-CVCs ngamanye amaxesha zinokubangela amahlule egazi kwi-vein. Izinto zokuthambisa igazi zinokumiselwa ukunciphisa lo mngcipheko.
3. Pneumothorax:

Ukugqobhozwa komphunga ngengozi kunokwenzeka ngexesha lokufakwa, ngakumbi ngeecatheter ezingafakwanga kwitonela ezibekwe kwindawo yesifuba. Oku kukhokelela ekuweni komphunga, nto leyo efuna ungenelelo olukhawulezileyo lonyango.
4. Ukungasebenzi kakuhle kweCatheter:

I-catheter inokuthi ivalwe, ikhutshwe, okanye ikhutshwe, echaphazela umsebenzi wayo. Ukugungxulwa rhoqo kunye nokuphatha ngendlela eyiyo kunokuthintela le miba.
5. Ukopha:

Kukho umngcipheko wokuphuma kwegazi ngexesha lenkqubo, ngakumbi ukuba isigulane sinokuphazamiseka kwe-clotting. Ubuchule obufanelekileyo kunye nokhathalelo lwasemva kwenkqubo lunceda ukunciphisa lo mngcipheko.

 

Ukuqukumbela
I-Catheters ye-venous esembindini zizixhobo ezibalulekileyo kukhathalelo lwangoku lwezonyango, ezibonelela ngofikelelo oluthembekileyo lwe-venous kwiinjongo ezahlukeneyo zonyango kunye noxilongo. Nangona inkqubo yokufaka umgca we-venous ephakathi ilula ngokuthe ngqo, ifuna ubuchule kunye nokuphathwa ngononophelo ukunciphisa iingxaki. Ukuqonda iintlobo ze-CVCs kunye nokusetyenziswa kwazo okuthe ngqo kuvumela ababoneleli bezempilo ukuba bakhethe ukhetho olungcono kwiimfuno zesigulane ngasinye, ukuqinisekisa ukunakekelwa okusebenzayo kunye nokukhuselekileyo.