Xa ugqirha ekuxelela ukuba kufuneka ufake 'umgca ophakathi', usenokuba noloyiko oluncinci. Xa sisiva igama elithi 'umgca', sicinga nge-cannula ekunika i-saline eqhelekileyo. Kodwa le yinto eyahlukileyo kancinci, into ekhethekileyo. Kodwa akukho sizathu sokoyika. Ikunika lula kakhulu. Namhlanje, masifumanise ukuba yintoni kanye kanye umgca ophakathi, okanye i-CVC.
Kalula nje, yintoni umgca ophakathi (i-CVC)?
Umgca ophakathi, okanye iCentral Venous Catheter (CVC), sisixhobo esikhethekileyo esinceda ekunyangeni izifo ezahlukeneyo. Senziwe ngetyhubhu ebhityileyo, eguquguqukayo, nende. Le tyhubhu ifakwa kumthambo emzimbeni wakho. Emva koko le tyhubhu ihamba ngemithambo ide ibe semthanjeni wegazi oyintloko (i-vena cava) ethwala igazi entliziyweni yakho.
Esinye isiphelo sale tube sisenokuba siphuma eluswini lwakho, ngesiqhelo kwicala lasekunene lesifuba sakho. Inxalenye ephuma eluswini lwakho ibizwa ngokuba yi-'hub'. Yile nto unokuyibona kwaye uyive. Ngamanye amaxesha esinye isiphelo singaphantsi kolusu lwakho. Oku kubizwa ngokuba yi-'port'. Emva koko ungayiva njengeqhubu elincinci phantsi kolusu lwakho, kodwa ayibonakali kakuhle. Le 'hub' okanye 'port' isetyenziselwa izinto ezinjengokunika amayeza nokuthatha igazi.
Eyona nzuzo iphambili yoku kukuba oogqirha banokufikelela lula kwigazi lakho ngaphandle kokufaka iinaliti rhoqo. Ke ngoko, oku kuluncedo kakhulu kubantu abafuna ukuthatha amayeza ixesha elide, bafumane ityuwa, bathathe igazi, okanye banikele ngegazi.
Yintoni umahluko phakathi kwe-cannula eqhelekileyo (i-Peripheral IV) kunye nomgca ophakathi?
Sonke siyazi ukuba zombini i-cannula eqhelekileyo (`(Peripheral IV)`) kunye nalo mgca uphakathi zisetyenziselwa ukunika unyango. Kodwa kukho umahluko omkhulu phakathi kwezi zimbini. Masibone ukuba zeziphi.
| Isizathu sotshintsho | Umgca oPhakathi (Umgca oPhakathi/iCVC) | I-cannula eqhelekileyo (i-Peripheral IV) |
|---|---|---|
| Umthambo ongena emzimbeni | Kwiindawo ezifana nentamo, isifuba, kunye nemisipha yangaphakathiIfakwa kumthambo omkhulu nonzulu. | Ifakwa kumthambo omncinci okufutshane nolusu olukumphezulu wesandla okanye ingalo. |
| Ubungakanani | Inde, ityebile. Ngamanye amaxesha kukho iityhubhu ezingaphezu kwesinye (`(i-lumen ephindwe kabini/ezintathu)`) ezinokunika iintlobo ezahlukeneyo zamayeza ngaxeshanye. | Imfutshane, incinci, kwaye inetyhubhu enye. |
| Ixesha elinokugcinwa emzimbeni | Inokuhlala iiveki, iinyanga, mhlawumbi nangaphezulu. | Ngokwesiqhelo ihlala iintsuku ezimbalwa kuphela. Emva koko kufuneka itshintshwe. |
Ngubani ofuna umgca ophakathi?
Oku kunceda abantu abaneengxaki zempilo ezahlukeneyo. Umzekelo:
- Fumana unyango lwe-chemotherapy oluhlala ixesha elide kwizigulane ezinomhlaza.
- Kwabo bahlanjululwa ngegazi (`(Hemodialysis)`) ngenxa yeengxaki zezintso.
- Kwabo bafuna ukuthatha amayeza okubulala iintsholongwane ngemithambo ixesha elide.
- Kwabo bafuna ukutsalwa igazi rhoqo ukuze bahlolwe igazi.
- Kwimeko yongxamiseko (uxinzelelo oluphantsi kwe-hypovolemic), nika i-saline okanye igazi ngoko nangoko.
- Fumana iminikelo yegazi okanye iiplatelet.
- Xa inkqubo yokwetyisa ingasebenzi kakuhle, nika ukutya ngokuthe ngqo ngomthambo.
- Kwabo bafuna ukukwazi ukufumana amayeza emithanjeni ekhaya.
Ziziphi iintlobo zemigca ephakathi ezikhoyo?
Ugqirha wakho uza kukhetha uhlobo olukufaneleyo ngokweemfuno zakho kunye nobude bexesha ofuna ukufumana unyango. Kukho iintlobo ezininzi eziphambili.
- I-CVC engashukumiyo: Le ifanelekile ukusetyenziswa ixesha elifutshane (ngaphantsi kweeveki ezimbini). Ifakwa ngqo emthanjeni, njengasentanyeni okanye esifubeni.
- Umgca wePICC (iPeripherally Inserted Central Catheter): Le ikwasetyenziswa rhoqo kwixesha elifutshane. Nangona kunjalo, ayifakwa ngentamo okanye esifubeni, kodwa ngengalo engasentla. Ukusuka apho, ityhubhu ifakwa ize ifakwe kwimithambo emikhulu kufutshane nentliziyo.
- I-CVC efakwe kwi-tunneled: Le ifanelekile ukusetyenziswa ixesha elide (ngaphezu kweeveki ezimbini). Apha, kukho umgama omncinci phakathi kwendawo apho ityhubhu ifakwa khona emthanjeni nalapho iphuma khona eluswini. Ngeli xesha, ityhubhu ingaphantsi kwesikhumba .Ihamba njengomhubhe. Oku kunciphisa umngcipheko wosulelo. I-Broviac®, i-Hickman® ziimpawu ezidumileyo zolu hlobo.
- Isango elingaphantsi kwesikhumba (elifakwe ngaphakathi): Olu lolona khetho lulungileyo ixesha elide kuneenyanga ezintathu . Apha, akukho nxalenye yombhobho ibonakala ngesikhumba. Lonke isixhobo sifakwa phantsi kwesikhumba ngomqhekezo omncinci. Xa kufuneka amayeza, kufakwa inaliti ekhethekileyo 'kwisango' phantsi kwesikhumba kwaye amayeza anikwa. Oku kukwabizwa ngokuba yi-"Port-a-Cath".
Ithini inkqubo yokufaka oku?
Olu asilotyando lukhulu, ngoko ke ungoyiki. Lwenziwa ngugqirha ofumene uqeqesho olukhethekileyo ngale njongo.
1. Okokuqala, hlamba kakuhle ulusu apho umgca uza kusetyenziswa khona.
2. Emva koko, loo ndawo iya kuba nentlungu ukuze ungabi nantlungu. Ukuba kuyimfuneko, unganikwa isithomalalisi esithambileyo ukuze uhlale uzolile.
3. Emva koko, ugqirha usebenzisa inaliti ukungena kumthambo ochaphazelekayo. Umatshini we-ultrasound unokusetyenziswa ukufumana umthambo ngokuchanekileyo.
4. Intambo ecolekileyo kakhulu (`(ucingo olukhokelayo)`) idluliselwa ngenaliti ize ingene emthanjeni.
5. Emva koko, inaliti iyasuswa, kufakwa isixhobo esincinci (i-dilator) ukuze kudalwe indawo yomgca oza kufakwa, kwaye umbhobho womgca ophakathi udlula kancinci phezu kocingo uye emthanjeni.
6. Nje ukuba incam yombhobho ikwindawo efanelekileyo kufutshane nentliziyo, ucingo luyasuswa.
7. Okokugqibela, inxalenye evulekileyo yomgca iqiniswa nge-stitch encinci okanye i-plaster ekhethekileyo ukuthintela ukuba ingakhuhli eluswini, kwaye kufakwa ibhandeji ukuze ihlale icocekile.
Sithatha amanyathelo onke okuqinisekisa ukuba awuva ntlungu kulo lonke eli xesha, ngoko ke akukho sizathu sokoyika.
Ukuba kufakwa i-CVC okanye i-port ene-tunnel, ukongeza kula manyathelo asisiseko, kuya kufuneka kwenziwe i-incision encinci ukuze kudluliswe ityhubhu phantsi kwesikhumba okanye kubekwe i-port.
Ziziphi iingxaki (iingozi) ezinokubakho?
Njengakweminye inkqubo yezonyango, kukho iingozi ezincinci. Eyona iphambili kumngcipheko wokosuleleka . Oku kunokukhokelela ekubeni iintsholongwane zingene egazini ngomgca (owaziwa ngokuba yi-Catheter-related bloodstream infection - CBRSI). Yiyo loo nto kubalulekile ukugcina indawo apho umgca ufakwe khona icocekile kakhulu.
Ukongeza, kunqabile kakhulu ukuba kubekho ukopha, umonakalo emiphungeni (pneumothorax), okanye amahlwili egazi (thrombosis). Kodwa oogqirha bathatha amanyathelo onke okuthintela oku.
Kufuneka nini ubonane nogqirha ngokukhawuleza?
Ukuba une-central line, kufuneka ulumke kakhulu malunga neempawu zosulelo. Ukuba unezinye zeempawu ezilandelayo, kufuneka ufowunele ugqirha wakho ngoko nangoko .
- Ukuba ufumana umkhuhlane .
- Ukuba kukho intlungu, ubomvu, okanye ukudumba apho umgca ubekwe khona.
- Ukuba ulusu olukuloo ndawo luvakalelwa lufudumele xa uluchukumisa.
- Ukuba ulwelo olufana nobovu olumthubi okanye oluhlaza luphuma emgceni.
- Ukuba inxalenye yomgca ovezweyo ibonakala inde kunangaphambili (isenokuba iphuma ngaphakathi).
Ukuba ubona into efana nale, xelela ugqirha wakho ngokukhawuleza. Ukuba yingxamiseko, yiya kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele esikufutshane.
Umyalezo Wokuya Ekhaya
- Umgca ophakathi (i-CVC) yityhubhu ekhethekileyo ekunceda ufumane unyango lwexesha elide kwaye iphephe izinti zeenaliti rhoqo.
- Kukho iintlobo ezahlukeneyo zemigca ephakathi ngokweemfuno zakho. Ugqirha wakho uza kukhetha eyona ikulungeleyo.
- Akubuhlungu ukuyifaka. Sisoloko sithatha amanyathelo afunekayo ukuqinisekisa ukuba awuva ntlungu.
- Umngcipheko ophambili lusulelo, ngoko ke luxanduva lwakho ukugcina indawo apho umgca ufakwe khona icocekile kakhulu.
- Ukuba ubona iimpawu zosulelo ezifana nomkhuhlane, iintlungu, ukubomvu, okanye ukudumba, yazisa ugqirha wakho ngoko nangoko.
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