Amadivaysi okufinyelela emithanjeni emaphakathi (i-CVAD) ama-catheter afakwa emthanjeni angahlala amasonto, izinyanga noma kwezinye izimo iminyaka. Kunezinhlobo ezahlukahlukene zama-CVAD, futhi leli khasi lizoxoxa ngamanye ajwayelekile onganginikeza wona. Asetshenziselwa ukuletha ukwelashwa kwakho ngqo emgudwini wegazi lakho (ngokusebenzisa emithanjeni) futhi ayindlela ehlukile yokuba ne-cannula.
Ama-CVAD afakwa ngezindlela ezahlukene, kodwa isiphetho se-catheter sihlale sisemthanjeni omkhulu ngaphezu kwenhliziyo yakho.
Okulandelayo ezinye zezizathu ongazicela, noma unikezwe i-CVAD.
- Uthola ukwelashwa isikhathi esingaphezu kwezinyanga ezi-3
- Kudingeka unikezwe imithi eminingi noma uketshezi ngesikhathi esifushane
- Unemithi engase ibangele ukulimala emithanjeni emincane
- Unenqubo ye-apheresis (efana nokuqoqa ama-stem cells)
- Unemithambo enzima ukungakwazi ukuyivala
- Uzesaba kakhulu izinaliti.
Izinhlobo zemishini yokufinyelela i-venous emaphakathi
- I-Peripherally Inserted Central Catheter (PICC)
- Ikhethetha Engashunqiwe (CVC)
- I-Tunneled Central Venous Catheter (Hickman)
- Imbobo Etshaliwe (I-Port-A-Cath)
ngenhla: I-peripherally inserted central catheter (PICC)
I-peripherally inserted central catheter (PICC)
Ulayini we-PICC iyishubhu elithambile, elincane, elide, elingenalutho (i-catheter) elifakwa emithanjeni enkulu engalweni yakho engenhla ngenhla nje kokugoba kwendololwane. Iphushwa phezulu ngomthambo ongaphakathi kwengalo yakho futhi ekugcineni kwayo ime emthanjeni omkhulu ngaphezu kwenhliziyo yakho.
Ulayini we-PICC ungafakwa (ufakwe), emnyangweni we-radiology, ithiyetha yokuhlinza, eduze kombhede wakho ngenkathi usesibhedlela, noma egumbini lokuhlinzwa. Cishe uzonikezwa i-anesthesia yendawo ngaphambi kokufaka i-PICC ukuze unciphise indawo, ngakho akufanele ube nobuhlungu. Imigqa ye-PICC ingafakwa udokotela wakho, umhlengikazi oqeqeshwe ngokukhethekile noma isazi se-radiologist, kuye ngezinqubomgomo esibhedlela sakho.
Ungacela imigqa ye-PICC, noma ungase unikezwe yona uma uthola ukwelashwa okulindeleke ukuthi kuthathe isikhathi esingaphezu kwesonto, kodwa ngaphansi kwezinyanga eziyisi-6. Uma ukwelashwa kwakho kulindeleke ukuthi kuthathe isikhathi esingaphezu kwezinyanga eziyisithupha kungase kunikezwe i-CVAD ehlukile.
Awukwazi ukubhukuda nge-PICC noma ufake i-PICC ngaphansi kwamanzi. Uzodinga futhi ukuyigcina imboziwe uma ushawa. Unesi wakho uzokwazi ukukunikeza ulwazi olwengeziwe mayelana nendlela yokuphatha nge-PICC ekhaya.
Ukuphathwa
- Uzodinga ukuthi i-PICC ilungiswe futhi izinkinga zishintshwe okungenani kanye ngesonto. Lokhu kuvame ukwenziwa egunjini lasemini noma ewodini uma usesibhedlela. Kwezinye izimo, umhlengikazi angase akwazi ukwenza ushintsho lokugqoka kanye nokuguquguquka ku-GP wangakini - nakuba lokhu akunikezwanga njalo futhi akubona bonke abahlengikazi abaqeqeshelwe ukuphatha ama-PICC.
- I-PICC yakho kuzodingeka ukuthi igezwe okungenani kanye ngesonto uma ungazange ube nomuthi noma olunye uketshezi kuyo.
- Uma ungasayidingi i-PICC, ingasuswa umhlengikazi oqeqeshiwe egunjini labanakekeli emini noma ewodini.
Idivayisi Yokufinyelela I-Venous Efakekayo Ngokuphelele (TIVAD)
Ithuluzi lokufinyelela le-venous elifakelwayo ngokuphelele (ngaphambilini elalibizwa ngokuthi i-port-a-cath) idivayisi efakwe ngaphansi kwesikhumba sakho ephaketheni elingaphansi kwesikhumba (elinamafutha). I-TIVAD ine-reservoir engazwakala ngaphansi kwesikhumba sakho. I-catheter ibe isifakwa komunye wemithambo yakho emikhulu. Isetshenziswa uma udinga imithi ngomjovo - emithanjeni yakho noma emithanjeni yegazi.
Kunini lapho i-TIVAD iyinketho enhle?
I-TIVAD ingumqondo omuhle uma uzobe uthola ukwelashwa isikhathi esingaphezu kwezinyanga ezintathu, noma uma ithimba lakho lezempilo linenkinga yokufaka i-cannula emthanjeni wakho. Uma udinga umuthi noma ukuhlolwa kwegazi, umhlengikazi wakho uzofaka inaliti esikhumbeni sakho nasesitokisini. Uzoba nendwangu encane phezu kwalokhu ngenkathi inenaliti. Uma umuthi usuqedile ukudlula, bazoyikhipha inaliti. Inalithi ingahlala izinsuku ezingafika kweziyisi-7.
Uma unenaliti ku-TIVAD kuthiwa kufinyelelwe. Uma ingekho inaliti ku-TIVAD kuba yehlile. Usengakwazi ukubhukuda futhi ushawe njengokujwayelekile uma i-TIVAD yakho iyekiswa, kodwa awukwazi ukubhukuda ngenkathi ifinyelelwa. Uzodinga futhi ukuyigcina imbozwe eshaweni ngenkathi ingena.
I-TIVAD ifakwa udokotela ohlinzayo noma i-radiologist engenele ngaphansi kwe-anesthesia noma i-sedation elula.
Ngokuvamile kuthatha izinsuku ezingu-7-10 ukuphulukisa. Uma ichweba lidinga ukusetshenziswa ngokushesha, udokotela ohlinzayo angakwazi ukufinyelela kulo futhi ashiye inaliti phakathi lapho ifakwa. Uma kungenjalo ingase ivuvukele kakhulu ukuba ingafinyelela isonto lonke.
Okuhlangenwe nakho kwesiguli nge-port-a-cath (TIVAD)
Izwa uVenuja ekhuluma ngolwazi lwakhe nge-TIVAD (port-a-cath) ngesikhathi esesibhedlela.
Ukuphathwa kwe-TIVAD
- Uma i-TIVAD idingeka ukuze ifinyeleleke, yenziwa ngenaliti ebizwa ngokuthi 'gripper' inaliti.
- Inalithi yokubamba ingahlala isonto elilodwa ngaphambi kokuthi ishintshwe
- Uma umjikelezo wakho wokwelapha usuqedile futhi inaliti yokubamba isusiwe (i-TIVAD yakho inqanyuliwe)
- Into engcono kakhulu ngechweba ukuthi lingakwazi ukuhlala iminyaka eminingi futhi uma inaliti yokubamba isusiwe akukho lutho olulenga ethekwini futhi isikhumba sakho siyayivikela ekuthelelekeni.
- Uma ichweba lisuswa, lena inqubo yokuhlinzwa (inqubo yosuku).
I-Non-tunneled central venous catheter (CVC)
I-Non-tunneled central venous catheter (CVCs) angama-catheter esikhathi esifushane futhi kufanele akhishwe ngokushesha lapho engasadingeki.
Ama-CVC angafakwanga angafakwa ku-subclavian, noma emithanjeni ye-jugular entanyeni yakho noma emithanjeni yesifazane ku-groin yakho - nakuba i-femoral vein isetshenziswa kakhulu ezinganeni. Kungakhathaliseki ukuthi imuphi umthambo i-CVC efakwa kuwo, ithiphu lokugcina libekwe ku-vena cava ephakeme noma ephansi - umthambo omkhulu ngaphezu kwenhliziyo yakho.
I-CVC ibanjwe endaweni yayo ngemithungo noma noma ibhande elikhethekile elinamathiselwe esikhumbeni sakho. Isithombe esingezansi sibonisa i-CVC engashuniwe enamalumens amathathu, agcinwe endaweni yawo ngemithungo.
Ukuphathwa
- Izingubo zokugqoka namakepisi emigqeni zidinga ukushintshwa okungenani kanye ngesonto
- I-lumen ngayinye yomugqa idinga ukushaywa kanye ngesonto
- Angasuswa kalula ngokukhishwa uma kungasekho ukusetshenziswa kwawo
Ipayipi elimaphakathi elifakwe ngama-cuffed-central (tc-CICC)
Ungase udinge i-catheter efakwe emhubheni efakwe phakathi nendawo (tc-CICC) uma uzothatha imithi efakwa emthanjeni isikhathi eside.
I-tc-CICC iyi-catheter yomugqa omaphakathi ebekwe ngakwesokudla sodonga lwesifuba sakho. Kuyi-catheter ethambile, encane, ende, engenalutho efakwa emthanjeni osesifubeni sakho futhi igcine ngomthambo omkhulu ngaphezu kwenhliziyo yakho.
Izinhlobo ze-tc-CICC
Izinhlobo eziyinhloko ze-tc-CICC ezisetshenziswa e-Australian ama-HICKMAN nama-Broviac. Zingaba i-lumen catheter eyodwa (1), kabili (2) noma kathathu (3). Isithombe esingenhla sibonisa ukuthi i-lumen ephindwe kabili i-HICKMAN ibukeka kanjani.
Lapho i-tc-CICC iqala ukufakwa, uzoba nemithungo ethile oyibambe endaweni kanye nesambatho ngaphezulu. Kukhona i-cuff encane ku-catheter ehlala ngaphansi kwesikhumba sakho, futhi isikhumba sakho sikhula ngaphezu kwale cuff senza umhubhe omncane ngaphansi kwesikhumba sakho. Uma umhubhe usuthuthuke kahle ungase udinge noma ungasakudingi okokugqoka ngaphezulu.
I-tc-CICC ifakwa udokotela ohlinzayo noma i-radiologist engenelele ngaphansi kwe-anesthesia noma i-sedation elula. Ngokuvamile kuzothatha izinsuku ezingu-7-10 ukuphulukisa.
Ukuphathwa
- Lokhu kuzoncika kumshwayilense wasesibhedlela olashwa kuso.
- Ngokuvamile zidinga ukushaywa kanye ngesonto.
- Ofeleba ekugcineni komugqa ngokuvamile badinga ukushintshwa okungenani kanye ngesonto
- Uma ungasayidingi i-tc-CICC yakho izosuswa. Udokotela wakho noma unesi uzokuhlola kanye nolayini ngaphambi kokuba ususwe ukuze athole indlela engcono yokuwususa. Ingasuswa eyunithi yokunakekela izingane, emnyangweni we-radiology noma ithiyetha yokuhlinza.
Uzoxhumana nini nodokotela wakho
Xhumana nodokotela noma unesi wakho uma une:
- Izinga lokushisa elingu-38 degrees noma ngaphezulu
- Ukuphelelwa umoya
- Ubuhlungu besifuba noma ukushaya kwenhliziyo okusheshayo
- Ububomvu, ubuhlungu, ukuvuvukala, ukopha, noma uketshezi oluvuzayo kusuka noma eduze kwe-CVAD yakho
- Ububomvu, ubuhlungu noma ukuvuvukala engalweni yakho, intamo, noma indawo yesifuba
- Ukulimala noma ukuphuka noma ukuhlukaniswa komugqa we-PICC noma umugqa we-CVC
- Ukuzwa ukusha noma ukuvuvukala eduze kwe-CVAD yakho ngesikhathi sokwelashwa kwakho, noma nganoma yisiphi isikhathi.
