Isikhokelo esipheleleyo se-Chemo port (Port-a-Cath)- isixhobo esiluncedo kwi-chemotherapy

INTSHAYELELO

Kwezempilo zanamhlanje, iIzibuko leChemo(Izibuko elifakelweyo okanye iPort-a-Cath), njengexesha elideisixhobo sokufikelela kwimithambo, isetyenziswa ngokubanzi kwizigulane ezifuna ukunyuswa rhoqo, i-chemotherapy, utofelo-gazi okanye inkxaso yesondlo. Ayiphuculi kuphela umgangatho wobomi bezigulane, kodwa inciphisa intlungu yokuhlatywa ngokuphindaphindiweyo kunye nomngcipheko wosulelo. Kweli nqaku, siza kuhlolisisa inkcazo, iinkcukacha, isakhiwo, iintlobo, iinzuzo kunye nendlela yokukhetha okulungileyo ukukunceda uqonde ngokupheleleyo esi sixhobo sonyango esibalulekileyo.

I. Yintoni izibuko leChemo?

Izibuko leChemo, elaziwa ngokuba yiPort-a-Cathokanye i-infusion port, sisixhobo sonyango esibekwe phantsi kwesikhumba ukuququzelela unyango lwe-intravenous lwexesha elide. Iqukethe i-reservoir encinci (i-port) edibeneyo kwi-catheter efakwe kwi-vein enkulu, ngokuqhelekileyo esifubeni. Izibuko livumela ukufikelela ngokulula kulawulo lwamayeza, ichemotherapy, ukugalelwa ulwelo, kunye nokutsalwa kwegazi, ukuphelisa isidingo sokuphindaphindwa kweenaliti zeenaliti.

Izibuko le-chemo ngokuqhelekileyo lenziwe ngezinto ezihambelana ne-biocompatible ezifana ne-titanium okanye iplastiki ene-self-sealing silicone septum. Abasebenzi bezempilo banokufikelela kwizibuko besebenzisa i-specialinaliti non-coring Huber, ukunciphisa ukungonwabi kunye nokunciphisa imingcipheko yosulelo xa kuthelekiswa neecatheter zemveli ze-IV.

Usetyenziso oluphambili lwamazibuko ekhemo lubandakanya:

1. ukunyuswa kwamachiza e-chemotherapy yexesha elide

2. Inkxaso yesondlo sabazali

3. ukutofelwa rhoqo okanye ukuqokelela igazi

4. unyango lwe-antibiotic

5. ulawulo lweentlungu

Iinkcukacha kunye nolwakhiwo lwezibuko leChemo (iPort-a-Cath)

1. Iinkcukacha

Iimpawu zeChemo port zihlala zihlelwa ngokwezi parameters zilandelayo:

- Ubungakanani: ububanzi besihlalo sokutofa buhlala buziisentimitha ezi-2 ukuya kwezi-3 kwaye ubukhulu bumalunga nesentimitha enye.

- Umthamo: umthamo we-lumen yesitulo sokutofa ngokuqhelekileyo ngu-0.5-1.5 mL

- Ubungakanani beCatheter: ubukhulu obusetyenziswa ngokuqhelekileyo yi-6-10 French

- Ubude beCatheter: 20-90 cm ngokuxhomekeke kwindawo yofakelo.

2. Amacandelo esakhiwo

Izibuko elifakelwayo ikakhulu liqulunqwe zezi ndawo zilandelayo:

1. Isitulo sokutofa:

-Yenziwe nge-titanium alloy okanye iplastiki

-I-Silicone diaphragm phezulu, enokumelana ne-punctures engaphezu kwama-2000.

– Emazantsi anesango lokuqhagamshelwa kwecatheter

2. Ikhathetha:

-Yenziwe nge-silicone okanye i-polyurethane

-Iipropati ze-Antithrombotic kunye ne-anti-infective

-Inokuba noyilo lwe-flap ekugqibeleni.

3. Ukulungisa isixhobo:

– Isetyenziselwa ukukhusela isibambi sokutofa kunye necatheter

-Ithintela ukufuduswa kunye nokugxothwa

Iindidi zamazibuko afakelwayo (iizibuko zeChemo)

Ngokweendlela ezahlukeneyo zokwahlula, amazibuko afakelwayo anokwahlulwa ngokwezi ntlobo zilandelayo:

1. Ukuhlelwa ngokwezinto eziphathekayo

-Izibambi zenaliti ye-Titanium alloy:

-Izinto eziluncedo: amandla aphezulu, i-MRI iyahambelana

– Ukungalungi: ixabiso eliphezulu

-Izibambi zeplastiki zokutofa:

-Izinto eziluncedo: ixabiso eliphantsi, ubunzima obulula

-Ukungalungi: i-MRI encinci iyahambelana

2. Ii-Catheters zihlelwa ngendawo yesiphelo se-catheter.

- Uhlobo lwe-venous esembindini:

-I-Catheter iphela kwi-vena cava ephezulu

– Ifanelekile kwiimeko ezininzi.

-Udidi lweVein yoMda:

– I-Catheter iphela kwi-peripheral vein.

-Ifanelekile ukusetyenziswa kwexesha elifutshane

3. NgoMsebenzi

-Lumen enye:

– Ufikelelo olunye kunyango lwesiqhelo

-I-Lumen ephindwe kabini:

– Iitshaneli ezimbini ezizimeleyo zokufakwa ngaxeshanye kwamachiza ahlukeneyo.

Izinto eziluncedo kwizibuko elifakelwayo (iizibuko zeChemo)

1. Ukusetyenziswa kwexesha elide:

-Inokushiywa kwindawo iminyaka emininzi, ukunciphisa iipunctures eziphindaphindiweyo

– Ifanelekile izigulane ezifuna unyango lwexesha elide

2. Umngcipheko ophantsi wosulelo:

– Ifakwe ngokupheleleyo emzimbeni, inciphisa amathuba osulelo

– Lisezantsi kakhulu izinga losulelo xa kuthelekiswa neeperipheral venous catheters

3. Umgangatho wobomi obuphuculweyo:

- Akukho ukuphazamiseka kwimisebenzi yemihla ngemihla, unokuthatha ishawa ngokuqhelekileyo

-Imfihlo kunye nenkangeleko eyingqondi

4. Nciphisa iingxaki:

-Ukunciphisa umngcipheko we-phlebitis, i-extravasation yeziyobisi, njl.

– Ukunciphisa umonakalo wemithambo

5. Ezoqoqosho:

- Ixabiso eliphantsi lokusetyenziswa kwexesha elide kune-catheterization ephindaphindiweyo

– Nciphisa ixesha lokulaliswa esibhedlele kunye neendleko ezinxulumene noko

6. Iimfuno zokugcinwa okuphantsi

- Ngokungafaniyo nemigca esembindini yangaphandle, amazibuko afakelwayo afuna utshintsho oluncinci lokunxiba kunye nokhathalelo.

7. Ukuhanjiswa kweziyobisi okuphuculweyo

- Ukuqinisekisa ukufikelela ngokuthe ngqo kwimithambo emikhulu, ukuphucula ukufunxa amayeza kunye nokunciphisa ukucaphuka kwemithambo.

V. Unokukhetha njani izibuko elifakelweyo elifanelekileyo (Iizibuko zeChemo)

Ukukhetha elona zibuko lifanelekileyo lokumiliselwa kuxhomekeke kwizinto ezininzi:

1. Imeko yezonyango:
   • Amazibuko e-Single-lumen anele ichemotherapy eqhelekileyo, ngelixa amazibuko e-lumen kabini angcono kwizigulane ezifuna ukutonyulwa kweziyobisi ngaxeshanye.
   • Amazibuko atofwayo amandla ayacetyiswa kwizigulane ezithatha umfanekiso ophuculweyo owenziwe rhoqo.
2. Izinto kunye nokuhambelana kweMRI:
   • Izigulane ezine-allergies yesinyithi kufuneka zikhethe amazibuko eplastiki.
   • Izibuko ze-titanium ezihambelana ne-MRI zikhethwa kwizigulane ezifuna ukuskena kwemifanekiso rhoqo.
3. Ubungakanani bePort kunye nokuBekwa:
   • Qwalasela ubungakanani bomzimba wesigulana kunye nendawo enqwenelekayo yokubeka izibuko (isifuba vs. ingalo).
   • Amazibuko amancinci angakhethwa kwizigulane zabantwana okanye abantu abanamafutha aphantsi.
4. Ukusetyenziswa rhoqo:
   • Ukuba ukutsalwa kwegazi rhoqo okanye i-infusions iyadingeka, i-double-lumen okanye i-port-injectable port inenzuzo.
5. Ingcebiso yababoneleli ngezempilo:
   • Ukubonisana nogqirha okanye i-oncologist iqinisekisa ukuba uhlobo lwe-port luhambelana nesicwangciso sonyango lwesigulane kunye nendlela yokuphila.

VI. Iingqwalasela xa kuthengwa izibuko elifakelweyo (iChemo Ports)

1.Uphawu kunye nomvelisi

Khetha abavelisi abathembekileyo abane-FDA, i-CE, okanye izatifikethi ze-ISO13485 zokuqinisekisa umgangatho kunye nokhuseleko.

2.Biocompatibility

Qinisekisa ukuba izinto ezisetyenzisiweyo (i-titanium, i-silicone, okanye iplastiki) ziyahambelana ne-biocompatible kwaye zinciphisa umngcipheko wokungaguquki.

3.Inzala kunye nokupakishwa

Izibuko kufuneka lifakwe inzala kwangaphambili kwaye livalwe kwipakethe engaphazanyiswa ukuze kuncitshiswe iingozi zosulelo.

4.Ukubonakala kwePort kunye nokuchongwa

Ezinye izibuko ziza neziphawuli zokuchonga okanye iimpawu ezifakwe kwi-radiopaque ukuze ziqondwe lula ngexesha lokuskena kwemifanekiso.

5.Inaliti Ukuhambelana

Qinisekisa ukuba izibuko liyahambelana neenaliti eziqhelekileyo zeHuber zokufikelela lula nokukhuselekileyo.

6.Ixabiso kunye nokusebenza kakuhle kweendleko

Nangona kukho imiqobo yohlahlo lwabiwo-mali, beka phambili umgangatho kunye nokuqina ukuthintela ukutshintshwa rhoqo okanye iingxaki.

7.Uphononongo lwabasebenzisi kunye nengxelo yeklinikhi

Qwalasela impendulo evela kubasebenzi bezempilo ngokuthembeka kunye nokusebenza kweempawu zezibuko ezahlukeneyo.

8. Inkxaso yoqeqesho:

Qinisekisa ukuba umthengisi ubonelela ngoqeqesho lobungcali malunga nokusetyenziswa kwemveliso.

Qonda ukugcinwa kwemveliso kunye nezikhokelo zokusombulula ingxaki.

Iimpawu zezibuko elifakelwayo (iizibuko zeChemo) ezibonelelwa yiShanghai Teamstand Corporation

Isikhwama se-capsular esinoyilo olulungisiweyo lwangaphambili luvumela ukunqunyulwa okuncinci.

Izibuko leengongoma ezintathu ezinoyilo lwepore ye-sutural yenza ukuba izinze ngakumbi.

Uqhagamshelo oluchasene nokusonga.

Izibuko lepolysulfone likhaphukhaphu, linemvakalelo yomzimba wangaphandle.

Kulula ukuyifaka. Kulula ukuyigcina.

Yenzelwe ukunciphisa amazinga okuxakeka.

UMR Conditional ukuya kuthi ga kwi-3-Tesla.

I-8.5F imakishwa ye-Radiopaque CT efakwe kwi-port septum ukuze ibonakale phantsi kwe-x-reyi.

Ivumela iinaliti zamandla ukuya kuthi ga kwi-5mL/sec kunye ne-300psi yokukala uxinzelelo.

Iyahambelana nazo zonke iinaliti zamandla.

Ukumakishwa kwe-Radiopaque CT efakwe kwi-port septum ukuze ibonakale phantsi kwe-x-reyi.

Ukuqukumbela

Njengenkqubela phambiliisixhobo sonyango, amazibuko afakelwayo(Amazibuko eChemo)ukubonelela ngesisombululo esikhuselekileyo nesifanelekileyo kwizigulane ezifuna unyango lwe-intravenous lwexesha elide. Ngokuqonda iinkcukacha, ulwakhiwo, iintlobo kunye neenzuzo zamazibuko okufakelwa, izigulana kunye namaqela okhathalelo lwempilo anokwenza ukhetho olunolwazi ngakumbi. Ukuqwalaselwa kweemfuno zesigulane, umgangatho wemveliso kunye nenkonzo yomthengisi ngexesha lokuthenga kunye nokusetyenziswa kuya kunceda ukuqinisekisa iziphumo zonyango kunye nokhuseleko lwesigulane. Njengoko ubuchwephesha bezonyango buqhubela phambili, uyilo kunye nokusebenza kwamazibuko afakelwayo kuya kuqhubeka kulungiselelwa amava esigulane esingcono.

Xa kuthengwa i-port efakelwayo (i-Chemo Ports), qinisekisa ukuba ihlangabezana nemigangatho yokhuseleko, i-biocompatible, kwaye iyahambelana nezixhobo eziyimfuneko. Ngokukhetha okufanelekileyo kunye nokunyamekela, amachweba afakelwayo (izibuko ze-chemo) anokuphucula kakhulu umgangatho wobomi kwizigulane ezifuna ukufikelela kwe-IV okwandisiweyo.

Ngokulandela esi sikhokelo esibanzi, izigulane kunye neengcali zonyango zingenza izigqibo ezinolwazi malunga neyona ndawo ifanelekileyo yokufakela i-port (i-Chemo port) yonyango olude lwe-intravenous.