Izixhobo ze-Central venous access (CVAD) zii-catheter ze-intravenous ezinokuhlala kwindawo yazo iiveki, iinyanga okanye kwezinye iimeko iminyaka. Kukho iindidi ezahlukeneyo ze-CVADs, kwaye eli phepha liza kuxoxa ngezinye zezona ziqhelekileyo onokundinika zona. Zisetyenziselwa ukuhambisa unyango lwakho ngqo kumjelo wegazi lakho (emithanjeni) kwaye yenye indlela yokuba necannula.
I-CVADs ifakwe ngeendlela ezahlukeneyo, kodwa isiphelo se-catheter sihlala sihlala kwi-vein enkulu ngaphezu kwentliziyo yakho.
Ezi zilandelayo zezinye zezizathu onokuthi uzicele, okanye unokunikwa iCVAD.
- Ufumana unyango ngaphezulu kweenyanga ezi-3
- Kufuneka unikwe amayeza amaninzi okanye ulwelo ngexesha elifutshane
- Unamayeza anokuthi enze umonakalo kwimithambo emincinci
- Unenkqubo ye-apheresis (efana nokuqokelela iiseli zesiqu)
- Unemithambo enzima yokukwazi ukuyikhupha
- Uyoyika kakhulu iinaliti.
Iindidi zezixhobo zokufikelela kwi-venous esembindini
- I-Peripherally Inserted Central Catheter (PICC)
- ICatheter engafakwanga (CVC)
- I-Tunneled Central Venous Catheter (Hickman)
- Izibuko eliMkiweyo (iPort-A-Cath)
ngasentla: Icatheter ephakathi efakwe ecaleni (PICC)
Icatheter ephakathi efakwe ecaleni (PICC)
Umgca wePICC yityhubhu ethambileyo, encinci, ende, enomgongxo (catheter) efakwa kumthambo omkhulu kwingalo yakho engaphezulu kanye ngentla kwengqiniba. Ityhalwa ngobunono inyuke ngomthambo ongaphakathi kwengalo yakho kwaye isiphelo sayo sime kumthambo omkhulu kanye entla kwentliziyo yakho.
Umgca we-PICC unokufakwa (ufakwe), kwisebe le-radiology, ithiyetha yokusebenza, ecaleni kwebhedi yakho ngelixa usesibhedlele, okanye kwigumbi lokuhlinzwa. Uya kunikwa i-anesthesia yendawo ngaphambi kokuba ufake i-PICC ukuze unciphise indawo, ngoko akufanele ube nentlungu. Imigca ye-PICC inokufakwa ngugqirha wakho, umongikazi oqeqeshwe ngokukodwa okanye i-radiologist, ngokuxhomekeke kwimigaqo-nkqubo esibhedlele sakho.
Unokucela imigca ye-PICC, okanye unokunikezelwa kuwe ukuba unonyango ekulindeleke ukuba ihlale ngaphezu kweveki, kodwa ngaphantsi kweenyanga ezi-6. Ukuba ngaba unyango lwakho lulindeleke ukuba luhlale ngaphezu kweenyanga ezintandathu iCVAD eyahlukileyo inokunikwa.
Awukwazi ukuqubha ngePICC okanye ubeke iPICC ngaphantsi kwamanzi. Kananjalo kuya kufuneka uyigcine igqunyiwe xa uhlamba. Umongikazi wakho uya kuba nakho ukukunika ulwazi oluthe kratya malunga nendlela yokulawula kunye ne-PICC ekhaya.
ulawulo
- Kuya kufuneka ukuba i-PICC ilungiswe kwaye i-bungs iguqulwe kanye ngeveki. Oku kuqhele ukwenziwa kwiyunithi yosuku okanye ewodini ukuba usesibhedlele. Kwezinye iimeko, umongikazi unokukwazi ukwenza utshintsho kunye nokunxiba kunye ne-bung kwi-GP yendawo yakho - nangona oku kungabonelelwa ngesiqhelo kwaye ayingabo bonke abongikazi abaqeqeshelwa ukulawula ii-PICC.
- I-PICC yakho kuya kufuneka igungxulwe kanye ngeveki ukuba awukhange ube nalo naliphi na iyeza okanye olunye ulwelo kuyo.
- Ukuba ngaba awusayifuni i-PICC kwakhona, inokususwa ngumongikazi oqeqeshiweyo kwicandelo lokhathalelo lwasemini okanye kwiwadi.
IsiXhobo soFikelelo esiFakelwe ngokupheleleyo kwiVenus (TIVAD)
Isixhobo sofikelelo se-venous esifakelwayo ngokupheleleyo (esikade sasibizwa ngokuba yi-port-a-cath) sisixhobo esifakwe phantsi kwesikhumba sakho kwipokotho engaphantsi kwesikhumba (enamafutha). I-TIVAD inesisele esinokuviwa phantsi kwesikhumba sakho. I-catheter ifakwa kwenye yemithambo yakho emikhulu. Isetyenziswa xa ufuna amayeza ngokufakwa emithanjeni – emithanjeni okanye kumjelo wegazi.
Xa i-TIVAD ilukhetho olulungileyo?
I-TIVAD luluvo olulungileyo ukuba uza kuba nonyango ngaphezulu kweenyanga ezintathu, okanye ukuba iqela lakho lokhathalelo lwezempilo linenkathazo yokufaka i-cannula emithanjeni yakho. Xa kufuneka ufumane iyeza okanye uvavanyo lwegazi, umongikazi wakho uya kukufaka inaliti esikhumbeni sakho nakwindawo yokugcina amanzi. Uya kuba nelokhwe encinci phezu koku ngelixa inenaliti ngaphakathi. Xa iyeza ligqibile ukuphumela, baya kuyikhupha inaliti. Inaliti ingahlala ukuya kutsho kwiintsuku ezisi-7.
Xa unenaliti kwi-TIVAD kuthiwa ifikelelekile. Xa kungekho naliti kwi-TIVAD yi iphelile. Usenako ukuqubha kwaye uhlambe njengesiqhelo xa i-TIVAD yakho icinyiwe, kodwa awukwazi ukuqubha ngelixa ifikeleleka. Kuya kufuneka kwakhona ukuba uyigcine igqunyiwe kwishawari ngelixa ingena.
I-TIVAD ifakwe ngugqirha okanye i-radiologist engenelelayo phantsi kwe-anesthesia okanye i-sedation ekhanyayo.
Ngokuqhelekileyo kuthatha malunga neentsuku ezi-7-10 ukuphilisa. Ukuba izibuko lifuna ukusetyenziswa ngokukhawuleza, ugqirha wotyando angafikelela kulo kwaye alishiye inaliti xa lifakwa. Kungenjalo lisenokudumba kakhulu ukuba lingafikelela kwisithuba esingangeveki.
Amava esigulane nge-port-a-cath (TIVAD)
Mamela uVenuja ethetha ngamava akhe nge-TIVAD (port-a-cath) ngelixa esibhedlele.
Ulawulo lwe-TIVAD
- Xa i-TIVAD ifuneka ukuba ifikeleleke, yenziwa ngenaliti ebizwa ngokuba yinaliti 'yokubambisa'.
- Inaliti yokubamba inokuhlala iveki enye ngaphambi kokuba itshintshwe
- Nje ukuba umjikelo wakho wonyango ugqibile kwaye inaliti yokubamba isusiwe (i-TIVAD yakho iphelile)
- Eyona nto intle malunga nezibuko kukuba banokuhlala iminyaka emininzi kwaye nje ukuba inaliti yokubamba isusiwe akukho nto ixhonywe kwizibuko kwaye ulusu lwakho luyayikhusela kusulelo.
- Xa izibuko lisusiwe, le yinkqubo yotyando (inkqubo yosuku).
I-catheter ye-venous engafakwanga (CVC)
Ii-catheter ze-venous ezingenayo i-tunnel (CVCs) zii-catheter zexesha elifutshane kwaye kufuneka zisuswe ngokukhawuleza xa zingasafuneki.
Ii-CVC ezingabonakaliyo zinokuthi zifakwe kwi-subclavian, okanye i-jugular veins entanyeni yakho okanye kwi-femoral veins kwi-groin yakho - nangona i-femoral vein isetyenziswa ngokuqhelekileyo kubantwana. Kungakhathaliseki ukuba yiyiphi i-vein ye-CVC efakwe kuyo, isicatshulwa sokugqibela sibekwe kwi-vena cava ephezulu okanye engaphantsi - umthambo omkhulu ngaphezu kwentliziyo yakho.
I-CVC ibanjwe kwindawo kunye ne-stitches okanye okanye i-clamp ekhethekileyo eqhotyoshelwe esikhumbeni sakho. Umfanekiso ongezantsi ubonisa i-CVC engekho i-tunnel ene-lumens emithathu, ebanjwe kwindawo kunye nezititshi.
ulawulo
- Iingubo kunye neekepusi kwimigca kufuneka zitshintshwe ubuncinane kanye ngeveki
- Ilumen nganye yomgca kufuneka ihlanjwe kanye ngeveki
- Zinokususwa ngokulula ngokutsalwa ngaphandle xa kungasekho ukusetyenziswa kwazo
Umbhobho ofakwe i-cuffed-central catheter (tc-CICC)
Unokufuna i-tunneled cuffed – catheter ephakathi efakwe phakathi (tc-CICC) ukuba uya kumayeza emithanjeni ixesha elide.
I-tc-CICC yicatheter yomgca osembindini obekwe kwicala lasekunene lodonga lwesifuba sakho. Yicatheter ethambileyo, encinci, ende, evulekileyo efakwa kumthambo esifubeni sakho ize iphele kumthambo omkhulu kanye phezu kwentliziyo yakho.
Iintlobo ze-tc-CICC
Iintlobo eziphambili ze-tc-CICC ezisetyenziswa e-Australia yi-HICKMANs kunye ne-Broviacs. Zinokuba yinye (1), kabini (2) okanye kathathu (3) i-lumen catheter. Umfanekiso ongasentla ubonisa ukuba i-lumen ephindwe kabini i-HICKMAN ibonakala njani.
Xa i-tc-CICC ifakwa kuqala, uya kuba nemithungo oyibambe endaweni kunye nokunxiba ngaphezulu. Kukho i-cuff encinci kwi-catheter ehlala phantsi kwesikhumba sakho, kwaye ulusu lwakho lukhula ngaphezulu kwale cuff lwenza itonela encinci phantsi kwesikhumba sakho. Nje ukuba itonela liphuhliswe ngokufanelekileyo usenokufuna okanye ungasafuni ukunxitywa ngaphezulu.
I-tc-CICC ifakwe ngugqirha okanye i-radiologist yongenelelo phantsi kwe-anesthesia okanye i-sedation ekhanyayo. Ngokuqhelekileyo kuya kuthatha iintsuku ezi-7-10 ukuphilisa.
ulawulo
- Oku kuya kuxhomekeka kwipolisi yesibhedlele onyangwa kuso.
- Ngokuqhelekileyo kufuneka zigungxulwe ibe nye ngeveki.
- Iicaps ekupheleni komgca ngokubanzi kufuneka zitshintshwe ubuncinane kanye ngeveki
- Xa ungasayifuni i-tc-CICC yakho iya kususwa. Ugqirha wakho okanye umongikazi uya kukuvavanya kunye nomgca phambi kokuba ususwe ukufumanisa eyona ndlela ilungileyo yokuwususa. Inokususwa kwiyunithi yokhathalelo lwasemini, isebe leradiology okanye ithiyetha.
Uqhagamshelane nini nogqirha wakho
Qhagamshelana nogqirha wakho okanye umongikazi ukuba unayo:
- Ubushushu obungama-38 degrees okanye ngaphezulu
- Ukuqhawukelwa ngumphefumlo
- Intlungu yesifuba okanye ukubetha kwentliziyo ngokukhawuleza
- Ububomvu, intlungu, ukudumba, ukopha, okanye ukuvuza ulwelo olusuka okanye olujikeleze iCVAD yakho
- Ubomvu, intlungu okanye ukuvuvukala kwengalo yakho, intamo, okanye indawo yesifuba
- Umonakalo okanye ikhefu okanye ukwahlula kumgca wePICC okanye umgca weCVC
- Ukutshisa okanye ukudumba kwi-CVAD yakho ngexesha lonyango lwakho, okanye nangaliphi na ixesha.
