Iyo ufata imiti igihe kirekire, cyane cyane iyo ugomba kuyitera mu mitsi, birababaza cyane gushyira inshinge mu mitsi yawe buri munsi, si byo se? Hari igihe bigorana kubona umutsi, kandi iyo ukomeje gushyira inshinge mu mitsi yawe, ushobora kuyingiza. Uyu munsi rero turimo kuvuga ku gikoresho cyihariye gishobora gufasha cyane abarwayi ndetse n'abaganga mu bihe nk'ibi. Ibyo ni byo twita umurongo mukuru, cyangwa CVC.
Umurongo wo hagati (CVC) ni iki mu by'ukuri?
Mu magambo make, umurongo wo hagati ni umuyoboro muto cyane, muremure kandi woroshye winjizwa mu mutsi munini mu mubiri wawe. Akenshi winjizwa mu mutsi munini uri mu ijosi ryawe, mu gituza, mu nda, cyangwa mu kuboko, kandi impera y'umuyoboro ishyirwa mu mutsi mukuru ujyana amaraso mu mutima (`vena cava`).
Tekereza nk'umuhanda udasanzwe ushyirwa mu maraso yawe. Binyuze muri uyu 'muhanda', abaganga n'abaforomo bashobora kugera ku maraso yawe byoroshye.
Igice cy’iyi tube gishobora kuba amoko abiri:
1. Nk'igice cy'umubiri: Iki ni igice kigaragara binyuze mu ruhu rwawe. Aha niho ibintu nk'umuyoboro wa saline uguha imiti bihurizwa.
2. Nk'aho ari umuyoboro: Iki ni igikoresho gito, kingana n'igiceri, gishyirwa munsi y'uruhu. Ni agace gato k'uruhu gashobora gucikamo ibice. Iyo hakenewe imiti, urushinge rwihariye rushyirwa muri ako gace rugana ku ruhu.
Akamaro kanini k'ibi ni uko iyo ubishyizemo, ushobora gukora ibintu byinshi nko gufata umuti, gukuramo amaraso, no gutanga umuti uvanze n'amazi, utiriwe utera urushinge igihe kirekire .
Ni irihe tandukaniro riri hagati y'umurongo wo hagati n'umuyoboro usanzwe wa cannula (Peripheral IV)?
Hari itandukaniro ritatu rikomeye hagati ya cannula (izwi kandi nka 'catheter') dukunze kubona mu bitaro n'iyi central line. Uzabyumva byoroshye iyo urebye iyi mbonerahamwe.
| Impamvu y'impinduka | Umurongo wo hagati (CVC) | Kanula isanzwe (Peripheral IV) |
|---|---|---|
| Aho umuntu yinjiza mu mubiri | Iterwa mu mutsi munini kandi wimbitse mu ijosi, mu gituza, mu kibuno, cyangwa mu kuboko ko hejuru. | Ubusanzwe iterwa mu mutsi muto, ugaragara hejuru y'uruhu , mu kuboko cyangwa mu kiganza. |
| Ingano n'uburebure | Uyu muyoboro ni muremure cyane kandi unini. Ugomba kuba muremure kuko ugomba kujya hafi y'umutima. Hari igihe haba hari imiyoboro ibiri cyangwa itatu (lumens). Iyi miyoboro ikoreshwa mu gutanga ubwoko butandukanye bw'imiti icyarimwe. | Ibi ni bigufi kandi byoroheje. Bigera kure cyane mu mutsi. |
| Igihe gishobora kubikwa mu mubiri | Bitewe n'ubwoko, ishobora kubikwa mu byumweru, amezi, cyangwa se imyaka . | Ubusanzwe biba ngombwa ko bihindurwa buri minsi mike . |
Ni nde ukeneye uyu murongo wo hagati?
Abaganga bakunze gufata icyemezo cyo gushyiraho umurongo mukuru nk'uyu iyo umurwayi akeneye kuvurwa igihe kirekire. Urugero:
- Ku barwayi ba kanseri: Komeza gutanga imiti igabanya ubukana bw'indwara za kanseri.
- Ku barwayi b'impyiko: Hemodialysis kugira ngo amaraso yezwe neza.
- Ku bantu bafata imiti igabanya ubukana bw'imitsi mu mitsi igihe kirekire: Hari ubwandu bukomeye busaba imiti y'ibyumweru byinshi.
- Ku bantu bakeneye gukururwa amaraso kenshi: Abantu bafite ibibazo by'amaraso bagomba gupimwa amaraso buri gihe.
- Ku badashobora kurya binyuze mu buryo bw'igogora: Hari abarwayi bakeneye kugaburirwa mu mitsi.
- Mu gihe cy’impanuka: Mu bihe nk’ibijyanye no "guhungabana kw’amaraso mu buryo bukabije", iyo hakenewe gutangwa amazi menshi cyangwa amaraso ako kanya nyuma y’impanuka ikomeye.
- Ku bavurirwa mu rugo: Ibi bituma byoroha kuvurwa mu rugo.
Ni ubuhe bwoko bw'imirongo yo hagati iriho?
Muganga wawe azaguhitiramo ubwoko bukubereye bitewe n'uburwayi bwawe n'igihe wifuza kubugumana. Hari ubwoko bwinshi bw'ingenzi.
| Andika izina | Ibisobanuro (Ibi bikora bite?) | Igihe gisanzwe gikoreshwa |
|---|---|---|
| Catheter yo hagati y'imitsi idakoresha imiyoboro | Ibi bishyirwa mu mitsi mu ijosi, mu gituza, cyangwa mu kibuno. Bikoreshwa mu bihe byihutirwa no mu gihe gito. | Munsi y'ibyumweru 2 |
| Umurongo wa PICC (Catheter yo Hagati Ishyizwemo Peripheral) | Ibi bishyirwa mu mutsi uri mu kuboko ko hejuru hanyuma bigashyirwa mu mutima. Kubera ko biri mu kuboko, biroroha gato ku mirimo ya buri munsi. | Kuva ku byumweru bike kugeza ku mezi make |
| Catheter yo hagati y'imitsi iteretse mu muyoboro | Ibi bikorwa binyuze mu kubagwa gato. Hari ahantu habiri aho umuyoboro winjizwa mu mitsi n'aho usohoka mu ruhu. Umuyoboro usohoka unyuze mu "muyoboro" muto munsi y'uruhu. Ibi bigabanya ibyago byo kwandura. (Urugero: Broviac®, Hickman® ) | Mu gihe cy'amezi menshi cyangwa arenga |
| Umuyoboro wo munsi y'uruhu (Umuyoboro washyizwemo) | Iki ni igikoresho cyihishe munsi y'uruhu rwose. Gishyirwamo hakoreshejwe uburyo bwo kubaga buto. Nta kintu kigaragara inyuma. Urushinge rushyirwa hejuru y'uruhu gusa iyo hakenewe imiti. Nta mbogamizi zihari ku koga cyangwa koga. (Urugero: Port-a-Cath ) | Ku ikoreshwa ry'igihe kirekire cyane, rirenga amezi 3 |
Ushyiramo gute uyu murongo wo hagati?
Ubu buryo bukorwa na muganga wahawe amahugurwa yihariye kuri iyi ntego. Uburyo bushobora gutandukana gato bitewe n'ubwoko bwa CVC ufite.
Ni iki kibaho mbere yuko umurongo wo hagati ushyirwa?
Muganga wawe azagusobanurira uburyo bwo gukora, harimo ibyiza n'ingaruka. Iki ni igihe cyiza cyo kubaza ikibazo icyo ari cyo cyose ushobora kuba ufite. Uzemererwa uzakibona. Mu gihe cyihutirwa, hashobora kubura umwanya wo kuganira. Uzaba uhagaze (ubusanzwe uryamye) kandi ugahuzwa n'abashinzwe kugenzura umuvuduko w'umutima wawe n'umuvuduko w'amaraso.
Bigenda bite iyo wambaye ibi?
Akenshi, uzahabwa umuti ugabanya ububabare kugira ngo utazababara. Ushobora no gusinzira (gusinzira). Ubusanzwe uburyo bukorwa bukurikira:
1. Agace k'uruhu aho urushinge ruzashyirwa karasukurwa neza kandi kagaterwa imiti yica udukoko.
2. Batera umuti kugira ngo bashire ibisebe mu gace.
3. Hanyuma, hifashishijwe icyuma gipima imiterere y'umubiri (ultrasound scanner), umutsi uba uherereye neza hanyuma urushinge rugashyirwamo.
4. Insinga nto (umugozi uyobora) inyuzwa mu rushinge ikajya mu mutsi.
5. Aho bapfumuriye harushaho kwaguka gato hakoreshejwe icyuma gito, kandi igikoresho cyitwa dilator gikoreshwa kugira ngo umuyoboro wa CVC ushyirwemo umwanya.
6. Hanyuma, umuyoboro wa CVC unyura buhoro buhoro hejuru y'insinga ukajya mu mutsi, ugahagarara iyo ugeze aho ukwiye hafi y'umutima.
7. Amaherezo, igice cy’umuyoboro cyagaragaye gishyirwa ku ruhu hanyuma kigashyirwaho igitambaro kugira ngo aho hantu hakomeze kuba hasukuye.
CVC na port irimo tunnel bishyirwa hakoreshejwe uburyo bwo kubaga buto. Mu gihe cy'aho hantu hashyirwa, hakorwa "umufuka" muto munsi y'uruhu, port ishyirwa imbere, hanyuma uruhu rugafungwa.
Bigenda bite umaze kubyambara?
Nyuma yo kurangiza igikorwa, hazafatwa X-ray yo mu gituza kugira ngo harebwe neza ko umuyoboro wa CVC uri mu mwanya ukwiye kandi ko nta kindi kibazo kirimo. Niba byose bimeze neza, uzahabwa amabwiriza y'igihe ushobora gutaha n'uko wakwitaho uri mu rugo.
Ni izihe nyungu zo gushyiramo umurongo wo hagati?
- Bigabanya inshuro zo gukubitwa urushinge: Ibi bigabanya kwangirika kw'imitsi yawe. Bikuraho kandi ubwoba n'ububabare bwo gukubitwa urushinge.
- Ububabare buke: Imiti imwe ishobora gutera ububabare no kubyimba mu mitsi iyo itanzwe binyuze muri cannula isanzwe. Ubu bubabare buragabanuka cyane iyo urwaye CVC.
- Gukoreshwa igihe kirekire: Abantu bahabwa ubuvuzi buhoraho ntibakenera guhindura kanula buri munsi.
Ese hari ingaruka zishobora guterwa n'ibyo?
Nkuko bigenda ku buvuzi ubwo aribwo bwose, hari ingaruka nkeya, ariko izi ntizikunze kubaho cyane.
Ingaruka nyamukuru kandi ikunze kugaragara ni ukwandura . Ibi tubyita `(Infection ifitanye isano na Catheter-Related Bloodstream Infection - CRBSI)`. Iyo agace umuyoboro usohoka mu ruhu kadasukuye, mikorobe zishobora kwinjiramo.
Byongeye kandi, hari ibindi bibazo byinshi bishobora kuvuka mu gihe cyo gushyiraho umurongo cyangwa nyuma yawo:
- Kuva amaraso.
- Kwangirika kw'ibihaha (pneumothorax).
- Kwangirika kw'imitsi cyangwa imitsi.
- Kuziba kw'amaraso mu mitsi (thrombosis).
Itsinda ry’abaganga rizakora uko rishoboye kose kugira ngo rigabanye izi ngaruka, kandi ikintu cy’ingenzi ushobora gukora ku ruhande rwawe ni ugusukura aho CVC iherereye no gukurikiza amabwiriza ya muganga wawe witonze.
Igihe ugomba guhamagara muganga wawe ako kanya
Niba ubonye kimwe mu bimenyetso biri hepfo uri mu rugo, ugomba guhita uhamagara muganga wawe . Ibi bishobora kuba ibimenyetso by'ubwandu.
| Ibimenyetso by'ibyago - hita witondera | |
|---|---|
| - Umuriro. | - Ububabare cyangwa ububabare ahantu CVC ishyirwa cyangwa hafi yaho. |
| - Imirongo itukura cyangwa itukura ikikije uruhu. | - Kubyimba uruhu rukikije cyangwa kumva ushyushye iyo ubikozeho. |
| - Amazi asa n'ibibyimba by'umuhondo cyangwa icyatsi arimo kuva. | - Niba umuyoboro wa CVC usa n'aho usohoka (bivuze ko ushobora kuba urimo gucika). |
Nanone, niba CVC yawe ivuye burundu ku bw'impanuka, hita ubonana na muganga.
Ubutumwa bwo kujyana mu rugo
- Umurongo wo hagati (CVC) ni igikoresho cy'ingenzi cyane gifasha abarwayi kuvurwa byoroshye kandi mu mutekano, birinda gukenera inshinge za buri munsi mu gihe cy'ubuvuzi bw'igihe kirekire.
- Muganga wawe azagena ubwoko bwa CVC ikubereye akurikije ibyo ukeneye.
- Ingaruka nyamukuru z'ibi ni ukwandura, bityo ni ngombwa ko uruhu ruri muri CVC no hafi yayo rugira isuku cyane.
- Niba ubonye ibimenyetso by'ubwandu, nko kugira umuriro, gutukura, kubyimba, kubabara, cyangwa amashyira, bwira muganga wawe ako kanya.
- Niba ufite ikibazo cyangwa gushidikanya kuri ibi, vugana na muganga wawe kuri byo.
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