Catheter yo mu mitsi yo hagati: Ubuyobozi bw'ingenzi

A Catheter yo mu mitsi yo hagati (CVC), izwi kandi nk'umurongo wo hagati mu mitsi, ni umuyoboro woroshye winjizwa mu mutsi munini ugana ku mutima. Uyuigikoresho cy'ubuvuziIfite uruhare runini mu gutanga imiti, ibinyobwa, n'intungamubiri mu maraso, ndetse no kugenzura ibipimo bitandukanye by'ubuzima. Catheter zo mu mitsi yo hagati ni ingenzi mu kuvura abarwayi bafite indwara zikomeye, abavurwa mu buryo bugoye, cyangwa abantu bakeneye kuvurwa mu mitsi igihe kirekire. Muri iyi nkuru, turasuzuma intego ya catheter zo mu mitsi yo hagati, ubwoko butandukanye, uburyo zikoreshwa mu kuzishyiramo, n'ingorane zishobora kubaho.

Intego ya Catheters zo mu mitsi yo hagati

Catheter zo mu mitsi yo hagati zikoreshwa kubera impamvu zitandukanye z’ubuvuzi, harimo:

Gutanga imiti:Imiti imwe n'imwe, nk'imiti ya chimiotherapie cyangwa antibiyotike, ishobora kuba ikaze cyane ku mitsi yo mu mpande. CVC yemerera iyi miti kuyigeza mu mutsi mugari mu buryo bwizewe, bigabanya ibyago byo kubabara imitsi.

Ubuvuzi bw'igihe kirekire bwo kuvura hakoreshejwe imiyoboro ya IV:Abarwayi bakeneye kuvurwa mu mitsi igihe kirekire (IV), harimo imiti yica udukoko, kugabanya ububabare, cyangwa indyo yuzuye (nk'imirire y'ababyeyi), bungukirwa no gukoresha umurongo wo hagati w'imitsi, utanga uburyo buhamye kandi bwizewe bwo kugera ku barwayi.

Gutanga ibikoresho by'amazi n'ibikomoka ku maraso:Mu bihe byihutirwa cyangwa iby’ubuvuzi bw’inyongera, CVC ituma umuntu ahabwa amazi, ibikomoka ku maraso, cyangwa plasma vuba, ibyo bikaba bishobora kurokora ubuzima mu bihe bikomeye.

Gufata Amaraso no Kuyakurikirana:Catheter zo mu mitsi yo hagati zorohereza gupimwa amaraso kenshi nta ntera zikoreshwa mu gutera. Zifasha kandi kugenzura umuvuduko w'amaraso yo mu mitsi yo hagati, zigatanga ubumenyi ku miterere y'umutima n'imitsi y'umurwayi.

Dialysis cyangwa Apheresis:Ku barwayi bafite ikibazo cy'impyiko cyangwa abakeneye apheresis, ubwoko bwihariye bwa CVC bushobora gukoreshwa mu kugera ku maraso kugira ngo bavurwe dialyse.

 

Ubwoko bwaCatheters zo mu mitsi yo hagati

Hari ubwoko butandukanye bwa catheter zo mu mitsi yo hagati, buri bwoko bwagenewe intego runaka n'igihe runaka:

Umurongo wa PICC (Catheter yo Hagati Ishyizwemo Peripherally):

Umurongo wa PICC ni catheter ndende, ntoya yinjizwa mu mutsi wo mu kuboko, akenshi mu mutsi wa basilic cyangwa cephalic, hanyuma igashyirwa mu mutsi wo hagati hafi y'umutima. Ikunze gukoreshwa mu kuvura igihe giciriritse kugeza igihe kirekire, kuva ku byumweru kugeza ku mezi.
Imirongo ya PICC yoroshye kuyishyira no kuyikuraho, bigatuma iba amahitamo meza ku miti miremire idasaba kubagwa.

Catheters zidafite imiyoboro:

Ibi bishyirwa mu mutsi munini mu ijosi (imbere mu gatuza), mu gituza (subclavian), cyangwa mu nda (femoral) kandi bikunze gukoreshwa mu bikorwa by'igihe gito, akenshi mu gihe cy'ubuvuzi bwihutirwa cyangwa mu bihe byihutirwa.
Imiti ya CVC idakoresha imiyoboro ntabwo ari myiza gukoreshwa igihe kirekire bitewe n’uko ishobora kwandura indwara nyinshi kandi akenshi ikurwamo iyo umurwayi amaze kumererwa neza.
Catheters zo mu muyoboro:

Catheter zishyirwa mu miyoboro y'amaraso ijya mu miyoboro y'amaraso, ariko zinyuzwa mu muyoboro w'amaraso mbere yo kugera aho uruhu rwinjirira. Uyu muyoboro ufasha kugabanya ibyago byo kwandura, bigatuma uba ukwiriye gukoreshwa igihe kirekire, nko ku barwayi bakeneye gukurwa amaraso kenshi cyangwa guhabwa imiti igabanya ubukana bw'indwara z'imitsi.
Izi catheter akenshi ziba zifite agakoresho gatuma ingingo zikura, gatuma catheter ikomeza gukoreshwa.

Ibyambu byatewe (Port-a-Cath):

Umuyoboro washyizwemo ni igikoresho gito, gifite uruziga gishyirwa munsi y'uruhu, akenshi mu gituza. Catheter iva mu muyoboro ikagera mu mutsi wo hagati. Umuyoboro ukoreshwa mu kuvura igihe kirekire nka chimiotherapie, kuko uba uri munsi y'uruhu rwose kandi ukaba ufite ibyago bike byo kwandura.
Abarwayi bakunda kororerwa mu bitaro igihe kirekire kuko bitabangamira cyane kandi bakeneye inkoni y'urushinge gusa mu gihe cyose bakoreshwa.

Uburyo bwo gukora Catheter yo mu mitsi yo hagati
Gushyiramo catheter yo mu mitsi yo hagati ni uburyo bukoreshwa mu buvuzi butandukanye bitewe n'ubwoko bwa catheter ishyirwamo. Dore incamake rusange y'uburyo iyi nzira ikorwa:

1. Imyiteguro:

Mbere yo kubagwa, hasuzumwa amateka y'ubuzima bw'umurwayi, hagatangwa uburenganzira. Hashyirwa umuti wica udukoko aho washyizwe kugira ngo ugabanye ibyago byo kwandura.
Umuti ugabanya ububabare cyangwa umuti ugabanya ububabare ushobora gutangwa kugira ngo umurwayi agire ihumure.
2. Gushyiramo Catheter:

Akoresheje ubuyobozi bwa ultrasound cyangwa ibimenyetso by'imiterere y'umubiri, umuganga ashyira catheter mu mutsi ukwiye. Mu gihe cy'umurongo wa PICC, catheter ishyirwa mu mutsi unyura mu kuboko. Ku zindi bwoko, ahantu ho hagati nk'imitsi ya subclavian cyangwa imitsi yo mu mutwe imbere niho hakoreshwa.
Catheter iratera imbere kugeza igeze aho ishakiye, akenshi vena cava iri hafi y'umutima. Akenshi hakorwa X-ray cyangwa fluoroscopy kugira ngo harebwe aho catheter iri.
3. Gukingira Catheter:

Iyo catheter imaze gushyirwaho neza, ifatwa n'imisumari, kole cyangwa agapfundikizo kabugenewe. Catheters zifite umugozi zishobora kuba zifite agapfundikizo kugira ngo zikomeze gufata neza igikoresho.
Aho bashyiramo hashyirwamo imyenda, hanyuma catheter igasukwaho umunyu kugira ngo irebe ko ikora neza.
4. Kwita ku babyeyi nyuma yo kubyara:

Kwita ku buryo bukwiye no guhindura imyenda buri gihe ni ingenzi cyane kugira ngo hirindwe kwandura. Abarwayi n'ababitaho bahugurwa ku buryo bwo kwita kuri katheteri mu rugo mu gihe bibaye ngombwa.
Ingorane zishobora kubaho
Nubwo catheter zo mu mitsi yo hagati ari igikoresho cy'ingenzi mu buvuzi, nazo zifite ingaruka. Zimwe mu ngorane zishobora kubaho zirimo:

1. Kwandura indwara:

Ingorane ikunze kugaragara ni ukwandura aho umuntu yinjiriye cyangwa kwandura amaraso (indwara yo mu maraso ifitanye isano n'umurongo wa central line, cyangwa CLABSI). Uburyo bukomeye bwo gukoresha imiti igabanya ubukana mu gihe cyo kuyishyiramo no kuyibungabunga neza bushobora kugabanya iyi ngaruka.
2. Kuziba kw'amaraso:

Hari igihe imiti ya CVC ishobora gutera kubyimba kw'amaraso mu mitsi. Imiti igabanya amaraso ishobora gutangwa kugira ngo igabanye ibi byago.
3. Pneumothorax:

Gutobora ibihaha mu buryo butunguranye bishobora kubaho mu gihe cyo kubishyiramo, cyane cyane iyo utwuma tudafite imiyoboro dushyizwe mu gituza. Ibi bituma ibihaha bigwa, bigasaba ubufasha bwihuse bwa muganga.
4. Imikorere mibi ya Catheter:

Catheter ishobora kuziba, gucika cyangwa gusohoka, bigagira ingaruka ku mikorere yayo. Gusukura buri gihe no kuyikoresha neza bishobora gukumira ibi bibazo.
5. Kuva amaraso:

Hari ibyago byo kuva amaraso mu gihe cyo kubagwa, cyane cyane iyo umurwayi afite ibibazo byo kuvura amaraso. Uburyo bukwiye bwo gukora no kwita ku ndwara nyuma yo kubagwa bifasha kugabanya iyi ngaruka.

 

Umwanzuro
Catheter zo mu mitsi yo hagati ni ibikoresho by'ingenzi mu buvuzi bwa none, bitanga uburyo bwo kwinjira mu mitsi mu buryo bwizewe mu buryo butandukanye bwo kuvura no gusuzuma. Nubwo uburyo bwo gushyiramo umurongo wo hagati mu mitsi bworoshye, bisaba ubuhanga n'uburyo bwo kuyifata neza kugira ngo bigabanye ingorane. Gusobanukirwa ubwoko bwa CVC n'imikoreshereze yazo byihariye bituma abakora mu buvuzi bahitamo uburyo bwiza bujyanye n'ibyo buri murwayi akeneye, bakareba ko ubuvuzi bukwiye kandi bufite umutekano.