Mukatenga mankhwala kwa nthawi yayitali, makamaka mukayenera kuwabaya mumtsempha, zimakhala zokhumudwitsa kwambiri kuyika singano m'mitsempha yanu tsiku lililonse, sichoncho? Nthawi zina zimakhala zovuta kupeza mtsempha, ndipo ngati mupitiliza kuyika singano m'mitsempha yanu, mutha kuiwononga. Chifukwa chake lero tikulankhula za chipangizo chapadera chomwe chingathandize kwambiri odwala komanso madokotala omwe ali ndi vuto ngati ili. Ndicho chomwe timachitcha kuti central line, kapena CVC.
Kodi mzere wapakati (CVC) ndi chiyani kwenikweni?
Mwachidule, mzere wapakati ndi chubu chopyapyala kwambiri, chachitali, komanso chosinthasintha chomwe chimayikidwa mu mtsempha waukulu m'thupi lanu. Nthawi zambiri chimayikidwa mu mtsempha waukulu m'khosi mwanu, pachifuwa, m'mimba, kapena m'dzanja, ndipo mbali ina ya chubucho imalumikizidwa mu mtsempha waukulu womwe umanyamula magazi kupita kumtima ('vena cava').
Taganizirani ngati 'msewu waukulu' wapadera womwe umayikidwa m'magazi mwanu. Kudzera mu 'msewu waukulu' uwu, madokotala ndi anamwino amatha kupeza mosavuta magazi anu.
Gawo lotulukira la chubu ichi likhoza kukhala la mitundu iwiri:
1. Monga chitoliro: Apa ndi pomwe zinthu monga chubu cha saline chomwe chimakupatsirani mankhwala zimalumikizidwa.
2. Monga chotchingira: Ichi ndi chipangizo chaching'ono, chofanana ndi ndalama, chomwe chimayikidwa pansi pa khungu. Kung'ambika pang'ono pakhungu kokha ndikomwe kumaonekera. Mankhwala akafunika kuperekedwa, singano yapadera imayikidwa kudzera mu chong'ambikacho ndikulowa pakhungu.
Ubwino waukulu wa izi ndi wakuti mukangoyiyika, mutha kuchita zinthu zambiri monga kumwa mankhwala, kutulutsa magazi, ndikupereka saline, popanda kufunikira singano nthawi zonse kwa nthawi yayitali .
Kodi kusiyana pakati pa mzere wapakati ndi kanula wamba (Peripheral IV) ndi kotani?
Pali kusiyana kwakukulu kutatu pakati pa cannula (yomwe imatchedwanso 'catheter') yomwe nthawi zambiri timaipeza kuchipatala ndi mzere wapakati uwu. Mudzamvetsa mosavuta mukayang'ana tebulo ili.
| Chifukwa cha kusinthaku | Mzere Wapakati (CVC) | Cannula yachibadwa (Peripheral IV) |
|---|---|---|
| Malo olowetsera m'thupi | Imabayidwa mu mtsempha waukulu, wozama kwambiri pakhosi, pachifuwa, m'mimba, kapena m'dzanja lapamwamba. | Kawirikawiri imabayidwa mu mtsempha waung'ono womwe umawonekera pamwamba pa khungu, nthawi zambiri m'dzanja kapena m'dzanja. |
| Kukula ndi kutalika | Chubu ichi ndi chachitali kwambiri komanso chokhuthala. Chimafunika kukhala chachitali chifukwa chimayenera kufika pafupi ndi mtima. Nthawi zina pamakhala chomwe chili ndi machubu awiri kapena atatu (lumens). Izi zimagwiritsidwa ntchito popereka mitundu ingapo ya mankhwala nthawi imodzi. | Izi ndi zazifupi komanso zosaoneka bwino. Zimangopita pang'ono chabe m'mitsempha. |
| Nthawi yomwe ingasungidwe m'thupi | Kutengera mtundu wake, ukhoza kusungidwa kwa milungu, miyezi, kapena zaka . | Kawirikawiri imafunika kusinthidwa masiku angapo aliwonse . |
Ndani akufunikira mzere wapakati uwu?
Madokotala nthawi zambiri amasankha kuyika mzere wofunikira ngati uwu pamene wodwala akufunika chithandizo cha nthawi yayitali. Mwachitsanzo:
- Kwa odwala khansa: Pitirizani kupereka mankhwala a chemotherapy.
- Kwa odwala impso: Kuyeretsedwa kwa magazi (hemodialysis) kuti magazi ayeretsedwe.
- Kwa anthu omwe akumwa mankhwala opha majeremusi m'mitsempha kwa nthawi yayitali: Matenda ena oopsa amafunika milungu ingapo ya mankhwala.
- Kwa iwo omwe amafunikira kutengedwa magazi pafupipafupi: Anthu omwe ali ndi vuto la magazi ayenera kutengedwa magazi nthawi zonse.
- Kwa iwo omwe sangathe kudya kudzera m'mimba: Odwala ena amafunika kudyetsedwa mwachindunji m'mitsempha.
- Pakagwa ngozi: Pazochitika monga ``hypovolemic shock``, pamene madzi ambiri kapena magazi amafunika kuperekedwa nthawi yomweyo pambuyo pa ngozi yaikulu.
- Kwa iwo omwe amalandira chithandizo kunyumba: Izi zimapangitsa kuti zikhale zosavuta kulandira chithandizo kunyumba.
Kodi pali mitundu yanji ya mizere yapakati?
Dokotala wanu adzasankha mtundu womwe ukukuyenererani kutengera matenda anu komanso nthawi yomwe mukufuna kuusunga. Pali mitundu ingapo yayikulu.
| Dzina la mtundu | Kufotokozera (Kodi izi zimagwira ntchito bwanji?) | Nthawi zambiri imagwiritsidwa ntchito |
|---|---|---|
| Catheter ya Venous Yopanda Tunnel | Izi zimabayidwa mwachindunji mumtsempha wa m'khosi, pachifuwa, kapena m'mimba. Zimagwiritsidwa ntchito pazifukwa zadzidzidzi komanso pa zosowa za nthawi yochepa. | Masabata osakwana awiri |
| Mzere wa PICC (Catheter Yapakati Yoyikidwa Pambali) | Izi zimayikidwa kudzera mu mtsempha womwe uli pamwamba pa mkono ndikutumizidwa kumtima. Popeza zili m'dzanja, zimakhala zosavuta pang'ono pa zochita za tsiku ndi tsiku. | Kuyambira milungu ingapo mpaka miyezi ingapo |
| Catheter ya Venous Yapakati Yokhala ndi Tunneled | Izi zimachitika kudzera mu opaleshoni yaying'ono. Pali malo awiri omwe chubucho chimalowetsedwa mumtsempha ndi komwe chimatuluka pakhungu. Chubucho chimatuluka kudzera mu "ngalande" yaying'ono pansi pa khungu. Izi zimachepetsa chiopsezo cha matenda. (Chitsanzo: Broviac®, Hickman® ) | Kwa miyezi ingapo kapena kuposerapo |
| Doko Losanjikizidwa (Doko Loikidwa) | Ichi ndi chipangizo chomwe chimabisika pansi pa khungu. Chimayikidwa kudzera mu opaleshoni yaying'ono. Palibe chomwe chimawoneka kuchokera kunja. Singano imayikidwa pamwamba pa khungu pokhapokha ngati pakufunika mankhwala. Palibe choletsa kusamba kapena kusambira. (Chitsanzo: Port-a-Cath ) | Kugwiritsa ntchito kwa nthawi yayitali, kupitirira miyezi itatu |
Kodi mumayika bwanji mzere wapakati uwu?
Njirayi imachitika ndi dokotala amene waphunzitsidwa mwapadera pa izi. Njirayi ingasiyane pang'ono kutengera mtundu wa CVC yomwe muli nayo.
Kodi chimachitika ndi chiyani mzere wapakati usanayikidwe?
Dokotala wanu adzakufotokozerani za njirayi, kuphatikizapo ubwino ndi zoopsa zake. Ino ndi nthawi yabwino yofunsa mafunso aliwonse omwe mungakhale nawo. Chilolezo chanu chidzapezeka. Pakagwa mwadzidzidzi, sipangakhale nthawi yokambirana izi. Mudzakhala pamalo (nthawi zambiri mugona pansi) ndikulumikizidwa ndi oyang'anira kuti aziyang'anira kugunda kwa mtima wanu ndi kuthamanga kwa magazi.
Kodi chimachitika ndi chiyani mukavala izi?
Nthawi zambiri, mudzapatsidwa mankhwala oletsa kumva kupweteka kuti musamve kupweteka kulikonse. Muthanso kugonedwa (kugona). Njirayi nthawi zambiri imakhala motere:
1. Malo a khungu kumene singano idzalowetsedwa amatsukidwa bwino ndikutsukidwa ndi mankhwala ophera tizilombo toyambitsa matenda.
2. Amabaya mankhwala kuti achite dzanzi pamalopo.
3. Kenako, pogwiritsa ntchito ultrasound scanner, mtsempha umakhala pamalo oyenera ndipo singano imalowetsedwamo.
4. Waya woonda (waya wotsogolera) umadutsa mu singano ndikulowa mumtsempha.
5. Malo obowoledwawo amakulitsidwa pang'ono ndi tsamba laling'ono, ndipo chipangizo chotchedwa dilator chimagwiritsidwa ntchito kuti pakhale malo a chubu cha CVC.
6. Kenako, chubu cha CVC chimadutsa pang'onopang'ono pa waya ndikulowa mu mtsempha, ndikuyima ikafika pamalo oyenera pafupi ndi mtima.
7. Pomaliza, gawo lowonekera la chubu limakokedwa pakhungu ndipo bandeji imayikidwa kuti malowo akhale oyera.
CVC ndi chotchingira cholumikizidwa ndi ngalande zimayikidwa pogwiritsa ntchito njira yaying'ono yochitira opaleshoni. Pankhani ya chotchingira, 'thumba' laling'ono limapangidwa pansi pa khungu, chotchingiracho chimayikidwa mkati, ndipo khungu limasokedwa.
Kodi chimachitika n’chiyani mukachivala?
Pambuyo poti opaleshoniyo yatha, X-ray ya pachifuwa idzatengedwa kuti iwonetsetse kuti chubu cha CVC chili pamalo oyenera komanso kuti palibe mavuto ena. Ngati zonse zili bwino, mudzapatsidwa malangizo a nthawi yomwe mungapite kunyumba komanso momwe mungasamalire kunyumba.
Kodi ubwino wokhala ndi mzere wapakati ndi wotani?
- Amachepetsa kuchuluka kwa kubayidwa kwa singano: Izi zimachepetsa kuwonongeka kwa mitsempha yanu. Zimachotsanso mantha ndi kusasangalala kwa kubayidwa kwa singano.
- Kupweteka kochepa: Mankhwala ena angayambitse kutupa ndi kupweteka m'mitsempha akaperekedwa kudzera mu cannula wamba. Kusamva bwino kumeneku sikofala kwambiri ndi CVC.
- Kugwiritsa ntchito nthawi yayitali: Anthu omwe amalandira chithandizo chosalekeza safunika kusintha kanula tsiku lililonse.
Kodi pali zoopsa zilizonse zomwe zingachitike?
Monga momwe zimakhalira ndi njira iliyonse yachipatala, pali zoopsa zazing'ono, koma izi sizichitika kawirikawiri.
Chiwopsezo chachikulu komanso chofala kwambiri ndi matenda . Timachitcha `(Catheter-Related Bloodstream Infection - CRBSI)`. Ngati malo omwe chubucho chimatuluka pakhungu sali oyera, majeremusi amatha kulowa.
Kuphatikiza apo, pali mavuto ena angapo omwe angabuke panthawi yokonza kapena pambuyo pake:
- Kutuluka magazi.
- Kuwonongeka kwa mapapo (pneumothorax).
- Kuwonongeka kwa mitsempha kapena mitsempha.
- Kuundana kwa magazi mkati mwa mtsempha (thrombosis).
Gulu lanu lachipatala lidzachita zonse zomwe lingathe kuti lichepetse zoopsazi, ndipo chinthu chofunika kwambiri chomwe mungachite ndi kusunga malo a CVC aukhondo kwambiri ndikutsatira malangizo a dokotala wanu mosamala.
Nthawi yoyenera kuyimbira dokotala nthawi yomweyo
Ngati muwona zizindikiro zilizonse zomwe zili pansipa muli kunyumba, muyenera kuyimbira dokotala nthawi yomweyo . Izi zitha kukhala zizindikiro za matenda.
| Zizindikiro za zoopsa - samalani nthawi yomweyo | |
|---|---|
| - Malungo. | - Ululu kapena kupweteka pamalo oikira CVC kapena pafupi ndi malo oikira CVC. |
| - Mizere yofiira kapena yofiira yozungulira khungu. | - Kutupa kwa khungu lozungulira kapena kumva kutentha ukakhudza. |
| - Madzi achikasu kapena obiriwira ngati mafinya akutuluka. | - Ngati chubu cha CVC chikuoneka ngati chikutuluka (kutanthauza kuti chikhoza kumasuka). |
Komanso, ngati CVC yanu yatuluka mwangozi yonse, pitani kwa dokotala nthawi yomweyo.
Uthenga Wopita Nawo Kunyumba
- Mzere wapakati (CVC) ndi chipangizo chofunikira kwambiri chomwe chimathandiza odwala kulandira chithandizo mosavuta komanso mosamala, kupewa kufunika kogwiritsa ntchito singano tsiku lililonse panthawi ya chithandizo cha nthawi yayitali.
- Dokotala wanu adzasankha mtundu wa CVC womwe uli woyenera kwa inu kutengera zosowa zanu.
- Chiwopsezo chachikulu cha izi ndi matenda, kotero ndikofunikira kusunga khungu mkati ndi mozungulira CVC kukhala loyera kwambiri.
- Ngati muwona zizindikiro zilizonse za matenda, monga malungo, kufiira, kutupa, kupweteka, kapena mafinya, dziwitsani dokotala wanu nthawi yomweyo.
- Ngati muli ndi mafunso kapena kukayikira kulikonse pankhaniyi, musazengereze kulankhula ndi dokotala wanu za izi.
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