MAWU OYAMBA
Mu chisamaliro chaumoyo chamakono,Doko la Chemo(Implantable port kapena Port-a-Cath), ngati njira yokhazikikachipangizo cholumikizira mitsempha yamagazi, imagwiritsidwa ntchito kwambiri kwa odwala omwe amafunikira kulowetsedwa pafupipafupi, mankhwala a chemotherapy, kuikidwa magazi kapena chithandizo cha zakudya. Sikuti imangowonjezera moyo wa odwala, komanso imachepetsa ululu wobwerezabwereza komanso chiopsezo cha matenda. M'nkhaniyi, tifufuza tanthauzo, tsatanetsatane, kapangidwe kake, mitundu, zabwino komanso momwe mungasankhire yoyenera kuti ikuthandizeni kumvetsetsa bwino chipangizo chofunikira ichi chachipatala.
I. Kodi Chemo Port ndi chiyani?
Doko la Chemo, lomwe limadziwikanso kutiPort-a-Cathkapena cholumikizira cha infusion, ndi chipangizo chachipatala chomwe chimayikidwa pansi pa khungu kuti chithandizire chithandizo cha mtsempha kwa nthawi yayitali. Chimakhala ndi chosungira chaching'ono (cholumikizira) cholumikizidwa ndi catheter chomwe chimayikidwa mumtsempha waukulu, nthawi zambiri m'chifuwa. Cholumikiziracho chimalola kuti munthu azitha kulandira mankhwala mosavuta, chemotherapy, kulowetsa madzi m'thupi, komanso kutulutsa magazi, zomwe zimapangitsa kuti pasakhale kufunikira kogwiritsa ntchito singano mobwerezabwereza.
Doko la chemo nthawi zambiri limapangidwa ndi zinthu zogwirizana ndi zamoyo monga titaniyamu kapena pulasitiki yokhala ndi silicone septum yodzitsekera yokha. Akatswiri azaumoyo amatha kulowa padoko pogwiritsa ntchito njira yapadera.singano ya Huber yopanda coring, kuchepetsa kusasangalala komanso kuchepetsa chiopsezo cha matenda poyerekeza ndi ma IV catheter achikhalidwe.
Ntchito zazikulu za madoko a chemo ndi izi:
1. kulowetsedwa kwa mankhwala a chemotherapy kwa nthawi yayitali
2. chithandizo cha zakudya zopatsa thanzi
3. Kuthira magazi pafupipafupi kapena kusonkhanitsa magazi
4. mankhwala opha tizilombo toyambitsa matenda
5. kuchepetsa ululu
Mafotokozedwe ndi kapangidwe ka doko la Chemo (Port-a-Cath)
1. Mafotokozedwe
Mafotokozedwe a madoko a Chemo nthawi zambiri amagawidwa m'magulu motsatira izi:
- Kukula: m'mimba mwake mwa mpando wothira jakisoni nthawi zambiri amakhala masentimita 2-3 ndipo makulidwe ake ndi pafupifupi sentimita imodzi
- Kuchuluka: kuchuluka kwa lumen ya mpando wobayira nthawi zambiri kumakhala 0.5-1.5 mL
- Kukula kwa catheter: kukula komwe kumagwiritsidwa ntchito kwambiri ndi 6-10 French
- Kutalika kwa catheter: 20-90 cm kutengera malo oikiramo.
2. Zigawo za kapangidwe kake
Doko lotha kuikidwa m'thupi limapangidwa makamaka ndi zigawo zotsatirazi:
1. Mpando wothira jakisoni:
- Yopangidwa ndi titaniyamu kapena pulasitiki
– Diaphragm ya silikoni pamwamba, yomwe imatha kupirira kupyozedwa kwa mabala opitilira 2000.
- Pansi pake pali cholumikizira cha catheter
2. Choyezera:
- Yopangidwa ndi silicone kapena polyurethane
- Mphamvu zoletsa magazi kutuluka magazi komanso zoletsa matenda
- Ikhoza kukhala ndi kapangidwe ka chivundikiro kumapeto.
3. Chipangizo chokonzera:
- Amagwiritsidwa ntchito pomangirira chogwirira jakisoni ndi catheter
- Zimaletsa kusamuka ndi kusuntha
Mitundu ya madoko obzalidwa (Madoko a Chemo)
Malinga ndi njira zosiyanasiyana zogawa, madoko obzalidwa akhoza kugawidwa m'magulu otsatirawa:
1. Kugawa m'magulu malinga ndi zinthu
- Zogwirira jekeseni wa aloyi wa titaniyamu:
- Ubwino: mphamvu zambiri, zogwirizana ndi MRI
– Zoyipa: Mtengo wokwera
- Zogwirira jakisoni za pulasitiki:
- Ubwino: mtengo wotsika, kulemera kopepuka
- Kuipa: MRI yosagwirizana ndi MRI
2. Ma catheter amagawidwa m'magulu malinga ndi komwe kuli kumapeto kwa catheter.
- Mtundu wa mitsempha yapakati:
- Catheter imathera mu vena cava yapamwamba
- Yoyenera mikhalidwe yambiri.
- Mtundu wa Mitsempha Yozungulira:
- Catheter imathera m'mitsempha ya m'mphepete mwa thupi.
- Yoyenera kugwiritsidwa ntchito kwakanthawi kochepa
3. Ndi Ntchito
- Lumen imodzi:
- Kupeza chithandizo chamankhwala nthawi zonse ndi kamodzi kokha
- Lumen Yawiri:
- Njira ziwiri zodziyimira pawokha zoperekera mankhwala osiyanasiyana nthawi imodzi.
Ubwino wa madoko obzalidwa m'thupi (Chemo Ports)
1. Kugwiritsa ntchito kwa nthawi yayitali:
- Ingasiyidwe pamalo pake kwa zaka zingapo, kuchepetsa kubowola mobwerezabwereza
- Yoyenera odwala omwe akufunika chithandizo cha nthawi yayitali
2. Chiopsezo chochepa cha matenda:
- Kuikidwa kwathunthu m'thupi, kuchepetsa mwayi woti matenda atengeke
- Chiŵerengero cha matenda chotsika kwambiri poyerekeza ndi ma catheter a m'mitsempha ya m'mphepete mwa thupi
3. Moyo wabwino:
- Palibe kusokoneza zochita za tsiku ndi tsiku, mukhoza kusamba nthawi zonse
- Zachinsinsi zokhala ndi mawonekedwe obisika
4. Kuchepetsa mavuto:
- Kuchepetsa chiopsezo cha phlebitis, kumwa mankhwala osokoneza bongo, ndi zina zotero.
- Kuchepetsa kuwonongeka kwa mitsempha yamagazi
5. Zachuma:
- Mtengo wotsika wogwiritsa ntchito kwa nthawi yayitali kuposa kugwiritsa ntchito catheter mobwerezabwereza
- Chepetsani nthawi yogonera m'chipatala ndi ndalama zina zokhudzana nazo
6. Zosowa zochepa zosamalira
- Mosiyana ndi mizere yapakati yakunja, madoko obzalidwa m'mizere safuna kusintha ndi kusamalira pafupipafupi.
7. Kupereka mankhwala bwino
- Zimathandiza kuti mitsempha ifike mwachindunji ku mitsempha ikuluikulu, zimathandiza kuti mankhwala ayambe kuyamwa komanso kuchepetsa kuyabwa kwa mitsempha.
V. Momwe mungasankhire doko loyenera loti likhazikitsidwe (Madoko a Chemo)
Kusankha doko loyenera kwambiri loti likhazikitsidwe kumadalira zinthu zingapo:
- Matenda:
- Madoko a single-lumen ndi okwanira pa mankhwala ochiritsira okhazikika, pomwe madoko a double-lumen ndi abwino kwa odwala omwe amafunika kupatsidwa mankhwala nthawi imodzi.
- Ma doko obayira jakisoni wamagetsi amalimbikitsidwa kwa odwala omwe amajambula zithunzi zosiyanitsa nthawi zambiri.
- Kugwirizana kwa Zinthu ndi MRI:
- Odwala omwe ali ndi vuto la zitsulo ayenera kusankha ma pulasitiki.
- Madoko a titanium ogwirizana ndi MRI ndi omwe amakondedwa ndi odwala omwe amafunika kujambula zithunzi nthawi zonse.
- Kukula kwa Doko ndi Malo ake:
- Ganizirani kukula kwa thupi la wodwalayo ndi malo omwe akufuna kuti aikepo doko (chifuwa vs. mkono).
- Madoko ang'onoang'ono angakhale abwino kwa odwala ana kapena anthu omwe ali ndi mafuta ochepa m'thupi.
- Kuchuluka kwa Kagwiritsidwe Ntchito:
- Ngati magazi atengedwa pafupipafupi kapena kulowetsedwa m'magazi kumafunika, njira yolumikizira magazi awiri kapena mphamvu ndiyothandiza.
- Malangizo a Wopereka Chithandizo cha Zaumoyo:
- Kufunsana ndi dokotala kapena katswiri wa oncologist kumatsimikizira kuti mtundu wa port ukugwirizana ndi dongosolo la chithandizo cha wodwalayo komanso moyo wake.
VI. Zoyenera kuganizira pogula doko lotha kulowetsedwa (Madoko a Chemo)
1.Mtundu ndi wopanga
Sankhani opanga odalirika omwe ali ndi satifiketi ya FDA, CE, kapena ISO13485 kuti muwonetsetse kuti ndi abwino komanso otetezeka.
2. Kugwirizana kwa zamoyo
Onetsetsani kuti zipangizo zomwe zagwiritsidwa ntchito (titaniyamu, silikoni, kapena pulasitiki) zimagwirizana ndi chilengedwe ndipo zimachepetsa chiopsezo cha ziwengo.
3. Kusabereka ndi kulongedza
Doko liyenera kutsukidwa kale ndi kutsekedwa m'mabokosi osaphwanyidwa kuti lichepetse chiopsezo cha matenda.
4. Kuwonekera ndi kuzindikira doko
Madoko ena amabwera ndi zizindikiro zozindikiritsa kapena zinthu zina zojambulidwa ndi ma radiopaque kuti zidziwike mosavuta panthawi yojambula zithunzi.
5. Kugwirizana kwa Singano
Onetsetsani kuti doko likugwirizana ndi singano za Huber zomwe zimadziwika bwino kuti zifike mosavuta komanso motetezeka.
6. Mitengo ndi kugwiritsa ntchito bwino ndalama
Ngakhale kuti bajeti ikhoza kukhala yocheperako, ganizirani za ubwino ndi kulimba kuti mupewe kusintha kapena mavuto pafupipafupi.
7.Ndemanga za ogwiritsa ntchito ndi ndemanga zachipatala
Ganizirani ndemanga kuchokera kwa akatswiri azaumoyo pa kudalirika ndi magwiridwe antchito a mitundu yosiyanasiyana ya ma port.
8. Thandizo pa maphunziro:
Onetsetsani kuti wogulitsa akupereka maphunziro aukadaulo pa momwe angagwiritsire ntchito chinthucho.
Mvetsetsani malangizo osamalira zinthu ndi kuthetsa mavuto.
Zinthu zomwe zimapezeka mu doko lotha kuikidwa (Chemo Ports) zomwe zimaperekedwa ndi Shanghai Teamstand Corporation
Chikwama cha capsular chokhala ndi mawonekedwe owoneka bwino kutsogolo chimalola kudula pang'ono.
Doko la mfundo zitatu lokhala ndi kapangidwe ka ming'alu ya sutural limapangitsa kuti likhale lolimba.
Choko cholumikizira chopingasa kupinda.
Khomo la polysulfone ndi lopepuka, lokhala ndi kumverera kwa thupi lachilendo.
Zosavuta kuziyika. Zosavuta kusamalira.
Cholinga chake ndi kuchepetsa kuchuluka kwa mavuto.
MR Conditional mpaka 3-Tesla.
Chizindikiro cha 8.5F Radiopaque CT choikidwa mu port septum kuti chiwonekere pansi pa x-ray.
Imalola jakisoni wamagetsi mpaka 5mL/sec ndi 300psi pressure rating.
Imagwirizana ndi singano zonse zamagetsi.
Chizindikiro cha CT cha Radiopaque chomwe chimayikidwa mu port septum kuti chiwonekere pansi pa x-ray.
Mapeto
Monga katswiri wotsogolachipangizo chachipatala, madoko oti akhazikitsidwe(Madoko a Chemo)kupereka yankho lotetezeka komanso losavuta kwa odwala omwe akufuna chithandizo cham'mitsempha kwa nthawi yayitali. Pomvetsetsa zofunikira, kapangidwe, mitundu ndi ubwino wa madoko olowetsamo mankhwala, odwala ndi magulu azaumoyo amatha kusankha bwino. Kuganizira bwino zosowa za odwala, mtundu wa malonda ndi ntchito yogulitsa panthawi yogula ndikugwiritsa ntchito kudzathandiza kuonetsetsa zotsatira za chithandizo ndi chitetezo cha odwala. Pamene ukadaulo wazachipatala ukupitilira patsogolo, kapangidwe ndi magwiridwe antchito a madoko olowetsedwamo mankhwala adzapitiliza kukonzedwa kuti wodwala akhale ndi chidziwitso chabwino.
Mukagula doko lopachikidwa (Chemo Ports), onetsetsani kuti likukwaniritsa miyezo yachitetezo, limagwirizana ndi zinthu zachilengedwe, komanso likugwirizana ndi zowonjezera zofunika. Mukasankha bwino komanso mosamala, doko lopachikidwa (chemo ports) lingathandize kwambiri kukhala ndi moyo wabwino kwa odwala omwe akufuna kugwiritsa ntchito nthawi yayitali ya IV.
Potsatira malangizo onsewa, odwala ndi akatswiri azachipatala amatha kupanga zisankho zolondola zokhudza njira yoyenera kwambiri yopatsirana (Chemo port) kuti alandire chithandizo cham'mitsempha kwa nthawi yayitali.
Nthawi yotumizidwa: Marichi-31-2025