Kana ukatora mushonga kwenguva yakareba, kunyanya kana uchifanira kuubaya mutsinga, zvinonetsa kuisa tsono mutsinga dzako zuva nezuva, handiti? Dzimwe nguva zvakaoma kuwana tsinga, uye kana ukaramba uchiisa tsono mutsinga dzako, unogona kudzikuvadza. Saka nhasi tiri kutaura nezvemuchina wakakosha unogona kubatsira varwere nevanachiremba mumamiriro ezvinhu akadai. Ndizvo zvatinodaidza kuti central line, kana kuti CVC.
Chii chaizvo chinonzi central line (CVC)?
Zvichitaurwa zviri nyore, mutsetse wepakati ichubhu yakatetepa, refu, inochinjika inopinzwa mutsinga huru mumuviri wako. Inowanzopinzwa mutsinga huru iri mumutsipa wako, pachipfuva, pahudyu, kana paruoko, uye rimwe divi rechubhu rinopinzwa mutsinga huru inotakura ropa kuenda kumoyo ('vena cava').
Funga nezvazvo se "mugwagwa mukuru" chaiwo unoiswa muropa rako. Kuburikidza ne "mugwagwa mukuru" uyu, vanachiremba nevanamukoti vanogona kuwana ropa rako zviri nyore.
Chikamu chinobuda chechubhu iyi chinogona kuva chemhando mbiri:
1. Sechikamu chehubhu: Ichi chikamu chinoonekwa kuburikidza neganda rako. Apa ndipo panobatanidzwa zvinhu zvakaita sechubhu yemunyu inokupa mushonga.
2. Sechivharo: Ichi chinhu chidiki, chakaenzana nemari, chinoiswa pasi peganda. Kuchekwa kudiki chete paganda ndiko kunoonekwa. Kana mushonga uchida kupihwa, tsono yakakosha inopinzwa nepaburi iroro uye muganda.
Chinhu chikuru chakanakira izvi ndechekuti kana wangoiisa, unogona kuita zvinhu zvakawanda sekutora mushonga, kuburitsa ropa, uye kuisa saline, pasina kumanikidzwa kuwana tsono nguva dzese kwenguva yakareba .
Ndeupi musiyano uripo pakati pemutsetse wepakati nekanula yenguva dzose (Peripheral IV)?
Pane misiyano mikuru mitatu pakati pecannula (inonziwo 'catheter') yatinowanzo pinda nayo muchipatara nepakati penzira iyi. Uchainzwisisa zviri nyore kana ukatarisa tafura iyi.
| Chikonzero chekuchinja | Mutsetse wepakati (CVC) | Cannula yakajairika (Peripheral IV) |
|---|---|---|
| Nzvimbo yekupinza mumuviri | Inobayiwa mutsinga huru, yakadzika iri mumutsipa, pachipfuva, pahudyu, kana paruoko rwepamusoro. | Kazhinji inopinzwa mutsinga diki inoonekwa pamusoro peganda, kazhinji paruoko kana paruoko. |
| Saizi nehurefu | Chubhu iyi yakareba uye yakakora. Inofanira kunge yakareba nekuti inofanira kusvika pedyo nemoyo. Dzimwe nguva kune ine machubhu maviri kana matatu (lumens). Aya anoshandiswa kupa mhando dzakasiyana dzemishonga panguva imwe chete. | Izvi zvipfupi uye zviri nyore kunzwisisa. Zvinongosvika padanho diki chete. |
| Nguva yazvinogona kuchengetwa mumuviri | Zvichienderana nerudzi rwayo, inogona kuchengetwa kwemavhiki, mwedzi, kana kunyange makore . | Kazhinji inofanira kuchinjwa mazuva mashoma ega ega . |
Ndiani anoda mutsetse uyu wepakati?
Vanachiremba vanowanzo sarudza kuisa mutsetse mukuru seizvi kana murwere achida kurapwa kwenguva refu. Semuenzaniso:
- Kune varwere vegomarara: Ramba uchipa mishonga yekurapa kenza.
- Kune varwere veitsvo: Kuongororwa kweropa kuti ropa richeneswe.
- Kune vanhu vanotora mishonga inorwisa mabhakitiriya inopinzwa mutsinga kwenguva yakareba: Mamwe hutachiona hwakakomba hunoda mavhiki ekurapa.
- Kune avo vanoda kutorwa ropa nguva nenguva: Vanhu vane matambudziko eropa vanofanira kutorwa ropa nguva nenguva.
- Kune avo vasingagoni kudya kuburikidza nekugaya: Vamwe varwere vanofanirwa kupihwa chikafu zvakananga mutsinga.
- Mumamiriro ekunze: Muzviitiko zvakaita se "hypovolemic shock" (kuvhunduka kweropa), apo mvura yakawanda kana ropa zvinofanirwa kupihwa pakarepo mushure metsaona huru.
- Kune avo vanorapwa vari kumba: Izvi zvinoita kuti zvive nyore kuwana mamwe marapirwo vari kumba.
Ndeapi marudzi emitsetse yepakati iripo?
Chiremba wako achasarudza rudzi rwakakunakira zvichienderana nemamiriro ako ehutano uye kuti unoda kuichengeta kwenguva yakareba sei. Kune mhando dzakawanda huru.
| Zita rekunyora | Tsananguro (Izvi zvinoshanda sei?) | Nguva inowanzo shandiswa |
|---|---|---|
| Catheter yepakati isina mugero | Iyi inobayiwa zvakananga mutsinga iri mumutsipa, pachipfuva, kana muhudyu. Inoshandiswa kana paine dambudziko uye kana paine zvinodiwa kwenguva pfupi. | Mavhiki asingasviki maviri |
| Mutsetse wePICC (Catheter yepakati yakaiswa padivi) | Izvi zvinopinzwa netsinga iri pamusoro peruoko zvoendeswa kumoyo. Sezvo zviri muruoko, zviri nyore kuita mabasa ezuva nezuva. | Kubva pamavhiki mashoma kusvika kumwedzi mishoma |
| Catheter yepakati yevenous ine mugero | Izvi zvinoitwa kuburikidza nekuvhiyiwa kudiki. Pane nzvimbo mbiri apo chubhu inopinzwa mutsinga uye painobuda neganda. Chubhu inobuda ne "tunnel" diki iri pasi peganda. Izvi zvinoderedza njodzi yekutapukirwa. (Muenzaniso: Broviac®, Hickman® ) | Kwemwedzi yakati wandei kana kupfuura |
| Chiteshi Chinoiswa Muganda (Chiteshi Chinoiswa Muganda) | Ichi chishandiso chakavanzwa pasi peganda. Chinoiswa kuburikidza nekuvhiyiwa kudiki. Hapana chinoonekwa kubva kunze. Tsono inoiswa pamusoro peganda chete kana mushonga uchida. Hapana chirambidzo pakugeza kana kushambira. (Muenzaniso: Port-a-Cath ) | Kwenguva refu, inopfuura mwedzi mitatu |
Unoisa sei mutsetse uyu wepakati?
Maitiro aya anoitwa nachiremba akadzidziswa basa iri. Maitiro acho anogona kusiyana zvishoma zvichienderana nerudzi rweCVC yaunayo.
Chii chinoitika mutsetse wepakati usati waiswa?
Chiremba wako achakutsanangurira maitiro acho, kusanganisira mabhenefiti nenjodzi. Ino inguva yakanaka yekubvunza chero mibvunzo yaungave nayo. Mvumo yako ichawanikwa. Kana paine emergency, panogona kunge pasina nguva yekukurukurirana uku. Uchaiswa panzvimbo (kazhinji wakarara pasi) uye wakabatana nevanoongorora kuti vaongorore kurova kwemoyo wako neBP.
Chii chinoitika kana ukapfeka izvi?
Kazhinji, uchapihwa mushonga unopedza kunzwa kurwadziwa kuitira kuti usazonzwa kurwadziwa. Unogonawo kurara (sedation). Maitiro acho anowanzoitwa seizvi:
1. Nzvimbo yeganda ichapinzwa tsono inocheneswa zvakanaka uye inopiswa mushonga wekuuraya utachiona.
2. Vanobaya mushonga wekuti nzvimbo yacho isashande zvakanaka.
3. Zvadaro, nerubatsiro rwe ultrasound scanner, tsinga yacho inenge yanyatsoonekwa uye tsono inopinzwa mairi.
4. Waya yakatetepa (waya yekufambisa) inopfuudzwa nepatsono yopinda mutsinga.
5. Nzvimbo yekuboorwa inokura zvishoma nebanga diki, uye mudziyo unonzi dilator unoshandiswa kugadzira nzvimbo yeCVC tube.
6. Zvadaro, chubhu yeCVC inopfuudzwa zvishoma nezvishoma pamusoro pewaya yopinda mutsinga, ichimira kana yasvika panzvimbo chaiyo pedyo nemoyo.
7. Pakupedzisira, chikamu chakavhurika chechubhu chinosungirirwa paganda uye bhandeji rinoiswa kuti nzvimbo yacho igare yakachena.
CVC negedhi zvakavharirwa mugomba zvinoiswa pachishandiswa nzira diki yekuvhiya. Kana iri gedhi, 'pocket' diki inogadzirwa pasi peganda, gedhi racho rinoiswa mukati, uye ganda rinosonerwa rakavharwa.
Chii chinoitika kana wapedza kuipfeka?
Kana nzira yacho yapera, X-ray yechipfuva ichatorwa kuti ive nechokwadi chekuti chubhu yeCVC iri panzvimbo chaiyo uye kuti hapana mamwe matambudziko aripo. Kana zvese zvakanaka, uchapihwa mirairo yekuti ungadzokera kumba riini uye kuti ungaitarisira sei kumba.
Ndezvipi zvakanakira kuiswa mutsetse wepakati?
- Inoderedza kuwanda kwekubaya netsono: Izvi zvinoderedza kukuvara kwetsinga dzako. Zvinobvisawo kutya nekusagadzikana kwekubaya netsono.
- Kurwadziwa kushoma: Mimwe mishonga inogona kukonzera kuzvimba nekurwadziwa mutsinga kana ikashandiswa ne cannula yenguva dzose. Kusanzwa zvakanaka uku kushoma kana uine CVC.
- Kushandiswa kwenguva refu: Vanhu vanorapwa nguva dzose havafanirwe kuchinja kanula zuva nezuva.
Pane njodzi dziripo here?
Sezvinoitwa chero nzira ipi zvayo yekurapa, kune dzimwe njodzi diki, asi idzi hadziwanzoitika.
Njodzi huru uye inowanzoonekwa ndeyekutapukirwa . Tinodaidza izvi kuti `(Catheter-Related Bloodstream Infection - CRBSI)`. Kana nzvimbo inobuda chubhu paganda isina kucheneswa, utachiona hunogona kupinda.
Pamusoro pezvo, kune mamwe matambudziko akawanda anogona kuitika panguva kana mushure mekuiswa kwemutsetse:
- Kubuda ropa.
- Kukuvara kwemapapu (pneumothorax).
- Kukuvadzwa kwetsinga kana mitsipa yeropa.
- Kugwamba kweropa mukati metsinga (thrombosis).
Chikwata chenyu chezvekurapa chichaita zvese zvavanogona kuderedza njodzi idzi, uye chinhu chakakosha chamungaita ndechekuchengetedza nzvimbo yeCVC yakachena uye kutevedzera mirairo yachiremba wenyu nokungwarira.
Paunofanira kufonera chiremba wako nekukasika
Kana ukaona chimwe chezviratidzo zviri pazasi uri kumba, unofanira kufonera chiremba wako nekukasika . Izvi zvinogona kunge zviri zviratidzo zvehutachiona.
| Zviratidzo zvengozi - teerera nekukurumidza | |
|---|---|
| - Kupindwa nechando. | - Marwadzo kana kurwadziwa panzvimbo inopinzwa CVC kana pedyo nayo. |
| - Kutsvuka kana mitsetse mitsvuku yakakomberedza ganda. | - Kuzvimba kweganda rakatenderedza kana kunzwa kudziya kana ukabatwa. |
| - Mvura yakaita semapundu yero kana yegirini iri kubuda. | - Kana chubhu yeCVC ichiita seyakabudikira (zvichireva kuti inogona kunge yakasununguka). |
Uyewo, kana CVC yako ikabuda zvachose netsaona, enda kuna chiremba nekukasika.
Mharidzo Yekuenda Nayo Kumba
- Mutsetse wepakati (CVC) chishandiso chakakosha zvikuru chinobatsira varwere kuwana kurapwa zviri nyore uye zvakachengeteka, zvichidzivirira kudiwa kwetsono dzezuva nezuva panguva yekurapwa kwenguva refu.
- Chiremba wako achasarudza rudzi rweCVC rwakakunakira zvichienderana nezvaunoda.
- Njodzi huru yeizvi ihutachiona, saka zvakakosha kuchengetedza ganda riri mukati nepakapoteredza CVC rakachena kwazvo.
- Kana ukaona zviratidzo zvehutachiona, zvakaita sefivha, kutsvuka, kuzvimba, kurwadziwa, kana kuti urwa, zivisa chiremba wako nekukasika.
- Kana muine mibvunzo kana kusava nechokwadi nezvenyaya iyi, musazeza kutaura nachiremba wenyu nezvazvo.
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