I-Central Venous Catheter: Isikhokelo Esibalulekileyo

A I-Central Venous Catheter (CVC), ekwaziwa ngokuba ngumgca wemithambo ephakathi, yityhubhu eguquguqukayo efakwa kumthambo omkhulu okhokelela entliziyweni.isixhobo sezonyangoidlala indima ebalulekileyo ekunikezeni amayeza, ulwelo, kunye nezondlo ngqo egazini, kunye nokujonga iiparameter ezahlukeneyo zempilo. Ii-catheter zemithambo ephakathi zibalulekile ekulawuleni izigulana ezinezifo ezinzima, abo bafumana unyango oluntsonkothileyo, okanye abantu abafuna unyango lwe-intravenous lwexesha elide. Kweli nqaku, siza kuhlola injongo yee-catheter zemithambo ephakathi, iintlobo ezahlukeneyo, inkqubo ebandakanyekayo ekufakweni kwazo, kunye neengxaki ezinokubakho.

Injongo yeeCatheters zeMingxunya Ephakathi

Ii-catheter zemithambo ephakathi zisetyenziselwa izizathu ezahlukeneyo zonyango, kuquka:

Ulawulo lwamayeza:Amayeza athile, afana namayeza e-chemotherapy okanye ii-antibiotics, anokuba yingozi kakhulu kwimithambo engaphandle. I-CVC ivumela ukuhanjiswa ngokukhuselekileyo kwala mayeza ngqo kumthambo omkhulu, nto leyo enciphisa umngcipheko wokurhawuzelelwa yimithambo.

Unyango lwe-IV lwexesha elide:Izigulana ezifuna unyango olude lwe-intravenous (IV), kuquka amayeza okubulala iintsholongwane, ulawulo lweentlungu, okanye isondlo (njengokutya okupheleleyo kwe-parenteral), ziyazuza kumgca ophakathi wemithambo yegazi, obonelela ngokufikelela okuzinzileyo nokuthembekileyo.

Ulawulo lweMveliso yoLwakhiwo kunye neGazi:Kwiimeko zongxamiseko okanye zokhathalelo olunzulu, i-CVC ivumela ukuhanjiswa ngokukhawuleza kolwelo, iimveliso zegazi, okanye i-plasma, nto leyo enokusindisa ubomi kwiimeko ezinzima.

Ukusampula Igazi Nokubeka Esweni:Ii-catheter zemithambo yegazi ephakathi zenza kube lula ukuthatha igazi rhoqo ngaphandle kweenaliti eziphindaphindiweyo. Zikwaluncedo ekujongeni uxinzelelo lwemithambo yegazi ephakathi, zibonelela ngolwazi malunga nesimo sentliziyo yesigulana.

I-Dialysis okanye i-Apheresis:Kwizigulane ezinengxaki yezintso okanye ezo zifuna i-apheresis, uhlobo oluthile lwe-CVC lunokusetyenziswa ukufikelela kwigazi ukuze kusetyenziswe unyango lwe-dialysis.

 

Iintlobo zeIiCatheters zeMithambo Ephakathi

Kukho iintlobo ezahlukeneyo zee-catheters zemithambo ephakathi, nganye yenzelwe iinjongo ezithile kunye nobude bexesha:

Umgca wePICC (I-Catheter Ephakathi Efakwe Ngaphakathi):

Umgca we-PICC yi-catheter ende, ebhityileyo efakwa ngomthambo osengalweni, ngesiqhelo umthambo we-basilic okanye we-cephalic, kwaye ifakwe kwi-central vein kufutshane nentliziyo. Isetyenziswa rhoqo kunyango lwexesha eliphakathi ukuya kwelide, ukusuka kwiiveki ukuya kwiinyanga.
Imigca yePICC kulula ukuyibeka nokuyisusa, nto leyo eyenza ukuba ibe lolona khetho lukhethwayo kunyango olude olungafuni ukufakwa ngotyando.

IiCatheters ezingafakwanga imisele:

Ezi zifakwa ngqo kumthambo omkhulu entanyeni (ngaphakathi kwentloko), esifubeni (i-subclavian), okanye emqolo (i-femoral) kwaye zihlala zisetyenziselwa iinjongo zexesha elifutshane, ngokuqhelekileyo kwiimeko zokhathalelo oluphezulu okanye ezingxamisekileyo.
Ii-CVC ezingafakwanga imisele azilungele ukusetyenziswa ixesha elide ngenxa yomngcipheko ophezulu wosulelo kwaye zihlala zisuswa xa imeko yesigulana izinzile.
IiCatheters ezinemijelo:

Ii-catheter ezinemijelo zifakwa kumthambo ophakathi kodwa zidluliselwa kwimijelo engaphantsi komhlaba ngaphambi kokuba zifikelele kwindawo yokungena eluswini. Le mijelo inceda ekunciphiseni umngcipheko wosulelo, nto leyo eyenza ukuba zilungele ukusetyenziswa ixesha elide, njengakwizigulana ezifuna ukutsalwa igazi rhoqo okanye unyango lwe-chemotherapy oluqhubekayo.
Ezi catheters zihlala zine cuff ekhuthaza ukukhula kwezicubu, iqinise i catheter endaweni yayo.

IiPorts ezifakwe kwi-Inplanted (Port-a-Cath):

I-port efakelweyo sisixhobo esincinci, esingqukuva esifakwa phantsi kwesikhumba, esidla ngokuba sesifubeni. I-catheter ihamba ukusuka kwi-port iye kumthambo ophakathi. I-ports zisetyenziselwa unyango oluhlala ixesha elide olufana ne-chemotherapy, njengoko ziphantsi kwesikhumba kwaye zinomngcipheko omncinci wosulelo.
Izigulana zikhetha iiports zokhathalelo lwexesha elide kuba aziphazamisi kangako kwaye zifuna inaliti kuphela ngexesha lokusetyenziswa ngakunye.

Inkqubo yeCatheter yeVenous Central
Ukufakwa kwe-catheter yemithambo ephakathi yinkqubo yezonyango eyahluka ngokuxhomekeke kuhlobo lwe-catheter efakwayo. Nantsi ingcaciso ngokubanzi yenkqubo:

1. Ukulungiselela:

Ngaphambi kwenkqubo, imbali yesigulane iyahlolwa, kwaye kufunyanwe imvume. Kufakwa isisombululo sokubulala iintsholongwane kwindawo efakwe kuyo ukuze kuncitshiswe umngcipheko wokosuleleka.
Kunokunikwa i-anesthetic yendawo okanye i-sedation ukuqinisekisa ukuba isigulane siyakhululeka.
2. Ukubekwa kweCatheter:

Esebenzisa isikhokelo se-ultrasound okanye iimpawu ze-anatomical, ugqirha ufaka i-catheter kumthambo ofanelekileyo. Kwimeko yomgca we-PICC, i-catheter ifakwa ngomthambo ongaphandle engalweni. Kwezinye iintlobo, kusetyenziswa iindawo zokufikelela eziphakathi ezifana ne-subclavian okanye i-internal jugular veins.
I-catheter iphuculwa ide ifikelele kwindawo efunekayo, idla ngokuba yi-vena cava ephezulu kufutshane nentliziyo. I-X-ray okanye i-fluoroscopy idla ngokwenziwa ukuqinisekisa indawo ye-catheter.
3. Ukukhusela iCatheter:

Nje ukuba i-catheter ibekwe kakuhle, iqiniswa nge-sutures, i-adhesive, okanye i-dressing ekhethekileyo. Ii-catheter ezifakwe kwi-tunnel zinokuba ne-cuff yokuqinisa isixhobo ngakumbi.
Emva koko indawo yokufaka iye yanxitywa, kwaye i-catheter ihlanjwa nge-saline ukuqinisekisa ukuba isebenza kakuhle.
4. Ukhathalelo emva kotyando:

Ukunyamekela ngokufanelekileyo kunye nokutshintsha rhoqo iimpahla kubalulekile ukuthintela usulelo. Izigulana kunye nabanakekeli baqeqeshwe ngendlela yokunyamekela i-catheter ekhaya ukuba kuyimfuneko.
Iingxaki ezinokubakho
Nangona ii-catheter zemithambo ephakathi zizixhobo ezixabisekileyo kunyango, azinazo iingozi. Ezinye zeengxaki ezinokubakho ziquka:

1. Usulelo:

Eyona ngxaki ixhaphakileyo kusulelo kwindawo yokufakwa okanye usulelo lwegazi (usulelo lwegazi olunxulumene nomgca ophakathi, okanye i-CLABSI). Iindlela ezingqongqo zokucoca ngexesha lokufakwa kunye nokugcinwa ngononophelo zinokunciphisa le ngozi.
2. Amahlwili egazi:

Ii-CVC ngamanye amaxesha zinokubangela ukuqhekeka kwegazi emthanjeni. Ii-blood thinners zinokunikwa ukuze kuncitshiswe le ngozi.
3. I-Pneumothorax:

Ukugqobhozwa ngengozi komphunga kunokwenzeka ngexesha lokufakwa, ingakumbi xa ii-catheter ezingafakwanga zibekwe kwindawo yesifuba. Oku kubangela ukuba umphunga udibane, nto leyo efuna ukungenelela ngokukhawuleza kwezonyango.
4. Ukungasebenzi kakuhle kweCatheter:

I-catheter isenokuvaleka, iqhekeke, okanye iphume, nto leyo echaphazela ukusebenza kwayo. Ukuhlamba rhoqo kunye nokuphathwa ngendlela efanelekileyo kunokuthintela ezi ngxaki.
5. Ukopha:

Kukho umngcipheko wokopha ngexesha lenkqubo, ingakumbi ukuba isigulana sinengxaki yokuqunjelwa kwegazi. Ubuchule obufanelekileyo kunye nonyango emva kwenkqubo kunceda ekunciphiseni lo mngcipheko.

 

Isiphelo
Ii-catheter zemithambo ephakathi zizixhobo ezibalulekileyo kunyango lwanamhlanje, zibonelela ngokufikelela okuthembekileyo kwimithambo kwiinjongo ezahlukeneyo zonyango kunye nokuxilonga. Nangona inkqubo yokufaka umgca wemithambo ephakathi ilula kakhulu, ifuna ubuchule kunye nokuphathwa ngononophelo ukunciphisa iingxaki. Ukuqonda iintlobo ze-CVC kunye nokusetyenziswa kwazo ngokukodwa kuvumela ababoneleli bezempilo ukuba bakhethe ukhetho olufanelekileyo kwiimfuno zesigulana ngasinye, ukuqinisekisa unyango olusebenzayo nolukhuselekileyo.