Catheter ya Venous Yapakati: Buku Lofunika Kwambiri

A Catheter ya mtsempha wapakati (CVC), yomwe imadziwikanso kuti mzere wapakati wa mitsempha, ndi chubu chosinthasintha chomwe chimayikidwa mu mtsempha waukulu womwe umapita kumtima.chipangizo chachipatalaAmagwira ntchito yofunika kwambiri popereka mankhwala, madzi, ndi zakudya mwachindunji m'magazi, komanso poyang'anira magawo osiyanasiyana azaumoyo. Ma catheter apakati pa mitsempha ndi ofunikira pochiza odwala omwe ali ndi matenda aakulu, omwe akulandira chithandizo chovuta, kapena anthu omwe amafunikira chithandizo cha nthawi yayitali cha mtsempha. M'nkhaniyi, tifufuza cholinga cha ma catheter apakati pa mitsempha, mitundu yosiyanasiyana, njira yomwe imagwiritsidwira ntchito powaika, ndi zovuta zomwe zingachitike.

Cholinga cha Ma Catheter a Pakati pa Venous

Ma catheter apakati a mitsempha amagwiritsidwa ntchito pazifukwa zosiyanasiyana zachipatala, kuphatikizapo:

Kupereka Mankhwala:Mankhwala ena, monga mankhwala a chemotherapy kapena maantibayotiki, angakhale ovuta kwambiri pa mitsempha ya m'mphepete mwa thupi. CVC imalola kuti mankhwala awa aperekedwe mwachindunji mumtsempha waukulu, zomwe zimachepetsa chiopsezo cha kuyabwa kwa mitsempha.

Chithandizo cha Iv cha Nthawi Yaitali:Odwala omwe amafunikira chithandizo cha nthawi yayitali cha mtsempha (IV), kuphatikizapo maantibayotiki, kuchepetsa ululu, kapena zakudya zopatsa thanzi (monga zakudya zonse za parenteral), amapindula ndi mzere wapakati wa mitsempha, womwe umapereka mwayi wokhazikika komanso wodalirika.

Kuyang'anira Zamadzimadzi ndi Magazi:Pa nthawi yadzidzidzi kapena yosamalira odwala kwambiri, CVC imalola kupereka madzi, zinthu zamagazi, kapena plasma mwachangu, zomwe zingapulumutse moyo pazochitika zovuta kwambiri.

Kusankha Magazi ndi Kuwunika:Ma catheter apakati pa mitsempha amathandiza kutengedwa magazi pafupipafupi popanda singano mobwerezabwereza. Amathandizanso poyang'anira kuthamanga kwa magazi pakati pa mitsempha, kupereka chidziwitso cha momwe wodwala alili ndi matenda a mtima.

Dialysis kapena Apheresis:Kwa odwala omwe ali ndi vuto la impso kapena omwe akufunika apheresis, mtundu wapadera wa CVC ungagwiritsidwe ntchito kuti apeze magazi kuti alandire chithandizo cha dialysis.

 

Mitundu yaMa Catheters a Pakati pa Venous

Pali mitundu ingapo ya ma catheter apakati a mitsempha, iliyonse yopangidwira zolinga ndi nthawi yake:

Mzere wa PICC (Catheter Yapakati Yoyikidwa Pambali):

Mzere wa PICC ndi katheta wautali, woonda womwe umalowetsedwa kudzera m'mitsempha m'dzanja, nthawi zambiri mtsempha wa basilic kapena cephalic, ndipo umalumikizidwa ku mtsempha wapakati pafupi ndi mtima. Umagwiritsidwa ntchito kwambiri pochiza matenda apakati mpaka aatali, kuyambira milungu ingapo mpaka miyezi.
Mizere ya PICC ndi yosavuta kuyika ndi kuchotsa, zomwe zimapangitsa kuti ikhale njira yabwino kwambiri yochizira matenda omwe safuna kuchitidwa opaleshoni.

Ma Catheter Osagwiritsa Ntchito Mipata:

Izi zimayikidwa mwachindunji mumtsempha waukulu m'khosi (mkati mwa jugular), pachifuwa (subclavian), kapena m'mimba (femoral) ndipo nthawi zambiri zimagwiritsidwa ntchito pazifukwa zazifupi, nthawi zambiri pa chisamaliro chapadera kapena pazochitika zadzidzidzi.
Ma CVC osagwiritsidwa ntchito ndi ngalande si abwino kugwiritsidwa ntchito kwa nthawi yayitali chifukwa cha chiopsezo chachikulu cha matenda ndipo nthawi zambiri amachotsedwa wodwalayo akakhazikika.
Ma Catheter Opangidwa ndi Tunnel:

Ma catheter okhala ndi ngalande amaikidwa mu mtsempha wapakati koma amadutsa mu ngalande yapansi panthaka asanafike polowera pakhungu. Ngalandeyo imathandiza kuchepetsa chiopsezo cha matenda, zomwe zimapangitsa kuti ikhale yoyenera kugwiritsidwa ntchito kwa nthawi yayitali, monga kwa odwala omwe amafunika kutengedwa magazi pafupipafupi kapena chemotherapy nthawi zonse.
Ma catheter amenewa nthawi zambiri amakhala ndi cuff yomwe imalimbikitsa kukula kwa minofu, ndikusunga catheter pamalo pake.

Madoko Omwe Amaikidwa (Port-a-Cath):

Cholumikizira choikidwacho ndi chipangizo chaching'ono, chozungulira chomwe chimayikidwa pansi pa khungu, nthawi zambiri m'chifuwa. Catheter imayenda kuchokera pacholumikizira kupita ku mtsempha wapakati. Cholumikiziracho chimagwiritsidwa ntchito pochiza matenda a nthawi yayitali monga chemotherapy, chifukwa chimakhala pansi pa khungu lonse ndipo chili ndi chiopsezo chochepa cha matenda.
Odwala amakonda ma ports kuti asamalidwe kwa nthawi yayitali chifukwa samakhala obisika kwambiri ndipo amangofunika singano nthawi iliyonse akagwiritsidwa ntchito.

Ndondomeko ya Catheter ya Pakati pa Venous
Kuyika catheter yapakati pa mitsempha ndi njira yachipatala yomwe imasiyana malinga ndi mtundu wa catheter yomwe ikuyikidwa. Nayi chidule cha ndondomekoyi:

1. Kukonzekera:

Opaleshoni isanachitike, mbiri ya wodwalayo imawunikidwanso, ndipo chilolezo chimapezedwa. Mankhwala ophera tizilombo amapakidwa pamalo obayira kuti achepetse chiopsezo cha matenda.
Mankhwala oletsa ululu kapena oletsa ululu angaperekedwe kuti wodwalayo akhale womasuka.
2. Kuyika kwa Catheter:

Pogwiritsa ntchito malangizo a ultrasound kapena zizindikiro za thupi, dokotala amaika catheter mu mtsempha woyenera. Pankhani ya mzere wa PICC, catheter imayikidwa kudzera mu mtsempha wa m'mbali mwa mkono. Pa mitundu ina, malo olowera pakati monga mitsempha ya subclavian kapena mitsempha yamkati ya jugular imagwiritsidwa ntchito.
Katheta imayendetsedwa bwino mpaka itafika pamalo omwe mukufuna, nthawi zambiri vena cava yapamwamba pafupi ndi mtima. Nthawi zambiri amachitidwa X-ray kapena fluoroscopy kuti atsimikizire malo a katheta.
3. Kuteteza Catheter:

Katheta ikayikidwa bwino, imamangidwa ndi ma stur, zomatira, kapena chovala chapadera. Makatheta okhala ndi ngalande amatha kukhala ndi cuff kuti asunge chipangizocho.
Kenako malo oikiramo amaikidwa, ndipo catheter imatsukidwa ndi saline kuti iwonetsetse kuti ikugwira ntchito bwino.
4. Kusamalira pambuyo pa opaleshoni:

Kusamalira bwino komanso kusintha zovala nthawi zonse n'kofunika kwambiri kuti tipewe matenda. Odwala ndi osamalira odwala amaphunzitsidwa momwe angasamalire catheter kunyumba ngati pakufunika kutero.
Mavuto Omwe Angakhalepo
Ngakhale kuti ma catheter a m'mitsempha yapakati ndi zida zofunika kwambiri pa chisamaliro chamankhwala, ali ndi zoopsa zina. Mavuto ena omwe angakhalepo ndi awa:

1. Matenda:

Vuto lofala kwambiri ndi matenda omwe amabwera pamalo obayira kapena matenda a m'magazi (matenda a m'magazi ogwirizana ndi mzere wapakati, kapena CLABSI). Njira zolimba zoyeretsera panthawi yobayira komanso kusamalira mosamala zitha kuchepetsa chiopsezochi.
2. Magazi Oundana:

Mankhwala a CVC nthawi zina angayambitse magazi kuundana m'mitsempha. Mankhwala ochepetsa magazi angapatsidwe kuti achepetse chiopsezochi.
3. Nthenda ya m'mphuno:

Kuboola mapapo mwangozi kungachitike mukalowetsa, makamaka ndi ma catheter osalumikizidwa omwe amaikidwa pachifuwa. Izi zimapangitsa kuti mapapo agwe, zomwe zimafuna thandizo lachipatala mwachangu.
4. Kulephera kwa Catheter:

Katheta ikhoza kutsekeka, kuphwanyika, kapena kutuluka m'malo mwake, zomwe zingakhudze ntchito yake. Kusamba nthawi zonse ndi kugwiritsa ntchito bwino kungalepheretse mavutowa.
5. Kutuluka magazi:

Pali chiopsezo chotuluka magazi panthawi ya opaleshoniyi, makamaka ngati wodwalayo ali ndi vuto la magazi kuundana. Njira yoyenera komanso chisamaliro chochitidwa pambuyo pa opaleshoniyi zimathandiza kuchepetsa chiopsezochi.

 

Mapeto
Ma catheter apakati a mitsempha ndi zida zofunika kwambiri pa chisamaliro chamankhwala chamakono, zomwe zimapereka mwayi wodalirika wopezera mitsempha pazifukwa zosiyanasiyana zochiritsira komanso zodziwira matenda. Ngakhale njira yoyika mzere wapakati wa mitsempha ndi yosavuta, imafuna ukatswiri komanso kusamalira mosamala kuti muchepetse mavuto. Kumvetsetsa mitundu ya ma CVC ndi momwe amagwiritsidwira ntchito kumathandiza opereka chithandizo chamankhwala kusankha njira yabwino kwambiri yokhudzana ndi zosowa za wodwala aliyense, kuonetsetsa kuti chisamalirocho ndi chothandiza komanso chotetezeka.