Ingabe udokotela ukutshelile ukuthi ufake 'umugqa ophakathi'? (I-Central Venous Catheter) Ake sixoxe ngalokhu kalula.

Uma udokotela ekutshela ukuthi udinga ukufaka 'umugqa ophakathi', ungase wesabe kancane. Uma sizwa igama elithi 'umugqa', sicabanga nge-cannula ekunika usawoti ojwayelekile. Kodwa lokhu kuyinto ehlukile kancane, into ekhethekile. Kodwa asikho isizathu sokwesaba. Empeleni ikunikeza lula kakhulu. Namuhla, ake sithole ukuthi uyini ngempela umugqa ophakathi, noma i-CVC.

Kalula nje, uyini umugqa ophakathi (i-CVC)?

Umugqa ophakathi, noma i-Central Venous Catheter (CVC), iyithuluzi elikhethekile elisiza ekwelapheni izimo ezahlukene zezokwelapha. Lenziwe ngepayipi elincane kakhulu, eliguquguqukayo, elide. Leli payipi lifakwa emthanjeni emzimbeni wakho. Leli payipi libe selihamba phansi emthanjeni kuze kube yilapho elinye icala lisemthanjeni wegazi oyinhloko (i-vena cava) othwala igazi liye enhliziyweni yakho.

Esinye isiphetho sale tube singase siphume esikhumbeni sakho, ngokuvamile ngakwesokudla kwesifuba sakho. Ingxenye ephuma esikhumbeni sakho ibizwa ngokuthi 'i-hub'. Yilokhu ongakubona nokukuzwa. Ngezinye izikhathi esinye isiphetho singaphansi kwesikhumba sakho. Lokhu kubizwa ngokuthi 'i-port'. Khona-ke ungakuzwa njengesigaxa esincane ngaphansi kwesikhumba sakho, kodwa asibonakali kahle. Le 'hub' noma 'i-port' isetshenziselwa izinto ezifana nokukunikeza imithi nokuthatha igazi.

Uyini umehluko phakathi kwe-cannula evamile (i-Peripheral IV) kanye nomugqa ophakathi?

Sonke siyazi ukuthi kokubili i-cannula evamile (`(Peripheral IV)`) kanye nalo mugqa ophakathi kuyasetshenziswa ukunikeza ukwelashwa. Kodwa kunezinhlobo ezintathu zomehluko omkhulu phakathi kwalokhu okubili. Ake sibone ukuthi kuyini.

Ubani odinga umugqa ophakathi?

Lokhu kusiza abantu abanezinkinga zempilo ezahlukahlukene. Isibonelo:

• Thola ukwelashwa ngamakhemikhali isikhathi eside kweziguli ezinomdlavuza.
• Kulabo abahlanzwa igazi (`(Hemodialysis)`) ngenxa yezinkinga zezinso.
• Kulabo abadinga ukuthatha ama-antibiotic ngemithambo yegazi isikhathi eside.
• Kulabo abadinga ukudonswa igazi ukuze bahlolwe igazi njalo.
• Uma kwenzeka isimo esiphuthumayo (ukushaqeka kwe-hypovolemic), nikeza usawoti noma igazi ngokushesha.
• Thola iminikelo yegazi noma ama-platelet.
• Uma uhlelo lokugaya ukudla lungasebenzi kahle, nikeza ukudla okunomsoco ngqo ngomthambo.
• Kulabo abadinga ikhono lokuthola imithi efakwa emthanjeni ekhaya.

Yiziphi izinhlobo zemigqa ephakathi ezikhona?

Udokotela wakho uzokhetha uhlobo olukufanele ngokusekelwe ezidingweni zakho kanye nobude besikhathi ofuna ukwelashwa ngaso. Kunezinhlobo eziningana eziyinhloko.

• I-CVC Engenamhubhe: Lokhu kufanelekile ukusetshenziswa kwesikhathi esifushane (ngaphansi kwamasonto amabili). Kufakwa ngqo emthanjeni, njengasentanyeni noma esifubeni.
• Umugqa we-PICC (I-Peripherally Inserted Central Catheter): Lokhu kuvame ukusetshenziselwa ukusetshenziswa kwesikhashana. Kodwa-ke, akufakwe ngentamo noma esifubeni, kodwa ngengalo engenhla. Ukusuka lapho, ithubhu lifakwa bese lifakwa emthanjeni omkhulu eduze kwenhliziyo.
• I-CVC Ethungelwe Umhubhe: Lokhu kufanelekile ukusetshenziswa isikhathi eside (ngaphezu kwamasonto amabili). Lapha, kunebanga elincane phakathi kwalapho ithubhu ifakwa khona emthanjeni nalapho iphuma khona esikhumbeni. Phakathi nalesi sikhathi, ithubhu ingaphansi kwesikhumba .Kuhamba njengomhubhe. Lokhu kunciphisa ingozi yokutheleleka. I-Broviac®, i-Hickman® yimikhiqizo edumile yalolu hlobo.
• Imbobo engaphansi kwesikhumba (efakwe): Lena inketho engcono kakhulu yesikhathi eside kunezinyanga ezintathu . Lapha, akukho ngxenye yepayipi ebonakala ngesikhumba. Lonke ithuluzi lifakwa ngaphansi kwesikhumba ngokusika okuncane. Uma kudingeka umuthi, inaliti ekhethekile ifakwa 'embobo' ngaphansi kwesikhumba bese umuthi unikezwa. Lokhu kubizwa nangokuthi "iPort-a-Cath".

Iyini inqubo yokufaka lokhu?

Lokhu akuyona inqubo enkulu, ngakho ungesabi. Kwenziwa udokotela oqeqeshwe ngokukhethekile ngale njongo.

1. Okokuqala, hlanza kahle isikhumba lapho kuzofakwa khona umugqa.

2. Ngemuva kwalokho, indawo izobe ingasasebenzi kahle ukuze ungezwa ubuhlungu. Uma kudingeka, unganikwa umuthi wokudambisa omnene ukuze uhlale uzolile.

3. Okulandelayo, udokotela usebenzisa inaliti ukungena emthanjeni okukhulunywa ngawo. Umshini we-ultrasound ungasetshenziswa futhi ukuthola umthambo ngokunembile.

4. Intambo encane kakhulu (`(ucingo lokuqondisa)`) idlula ngenaliti bese ingena emthanjeni.

5. Ngemuva kwalokho, inaliti iyasuswa, kufakwa ithuluzi elincane (i-dilator) ukuze kudalwe isikhala sokufakwa komugqa, bese kuthi ipayipi lomugqa ophakathi lidlule kancane phezu kocingo bese lingena emthanjeni.

6. Uma isihloko sethubhu sesisendaweni efanele eduze kwenhliziyo, ucingo luyasuswa.

7. Ekugcineni, ingxenye eveziwe yomugqa iqiniswa ngesitishi esincane noma iplasta ekhethekile ukuze igweme ukuthi ingakhuhli esikhumbeni, bese kufakwa ibhandishi ukuze ihlale ihlanzekile.

Uma kufakwa i-CVC noma imbobo enomhubhe, ngaphezu kwalezi zinyathelo eziyisisekelo, kuzodingeka kwenziwe ukusikwa okuncane ukuze kudlule ithubhu ngaphansi kwesikhumba noma kubekwe imbobo.

Yiziphi izinkinga ezingaba khona (izingozi)?

Njenganoma iyiphi inqubo yezokwelapha, kunezingozi ezincane. Eyinhloko ingozi yokutheleleka . Lokhu kungaholela ekutheni amagciwane angene egazini ngomugqa (owaziwa nangokuthi ukutheleleka kwegazi okuhlobene ne-Catheter - i-CRBSI). Yingakho kubalulekile ukugcina indawo lapho umugqa ufakwe khona ihlanzekile kakhulu.

Ngaphezu kwalokho, akuvamile kakhulu ukuthi kube nokopha, ukulimala kwamaphaphu (i-pneumothorax), noma amahlule egazi (i-thrombosis). Kodwa odokotela bathatha zonke izinyathelo zokuphepha ukuvimbela lokhu ukuthi kungenzeki.

Kunini lapho udinga ukubonana nodokotela ngokushesha okukhulu?

Uma une-central line, kufanele uqaphele kakhulu ngezimpawu zokutheleleka. Uma unezinye zezimpawu ezilandelayo, kufanele ushayele udokotela wakho ucingo ngokushesha .

• Uma uthola umkhuhlane .
• Uma kukhona ubuhlungu, ukubomvu, noma ukuvuvukala lapho umugqa ubekwe khona.
• Uma isikhumba esikuleyo ndawo sizizwa sifudumele uma usithinta.
• Uma kuvela uketshezi olufana nobovu oluphuzi noma oluhlaza okotshani.
• Uma ingxenye yomugqa oveziwe ibukeka inde kunangaphambili (kungenzeka ukuthi iphuma ngaphakathi).

Uma ubona into efana nale, tshela udokotela wakho ngokushesha. Uma kuyisimo esiphuthumayo, iya e-Emergency Treatment Unit (ETU) yesibhedlela esiseduze.