Hagati ya Catheter Hagati: Igitabo Cyingenzi

A Catheter yo hagati (CVC), bizwi kandi nk'umurongo wo hagati wamaraso, ni umuyoboro woroshye winjijwe mumitsi minini iganisha kumutima. Ibiibikoresho by'ubuvuziigira uruhare runini mu gutanga imiti, amazi, nintungamubiri mu maraso, ndetse no gukurikirana ibipimo bitandukanye byubuzima. Catheters yo hagati yimitsi ningirakamaro mugucunga abarwayi bafite uburwayi bukomeye, abavurwa bigoye, cyangwa abantu bakeneye ubuvuzi bwigihe kirekire. Muri iki kiganiro, tuzasesengura intego ya catheters yo hagati yimitsi, ubwoko butandukanye, uburyo bugira uruhare mugushyiramo, nibishobora kuvuka.

Intego ya Catheters yo hagati

Catheters yo hagati yimitsi ikoreshwa kubwimpamvu zitandukanye zubuvuzi, harimo:

Ubuyobozi bw'imiti:Imiti imwe n'imwe, nk'imiti ya chimiotherapie cyangwa antibiotike, irashobora kuba ikaze cyane ku mitsi ya peripheri. CVC yemerera gutanga iyi miti neza mumitsi minini, bikagabanya ibyago byo kurakara.

Ubuvuzi bw'igihe kirekire IV:Abarwayi bakeneye kuvura igihe kirekire (IV), harimo antibiyotike, gucunga ububabare, cyangwa imirire (nk'imirire yuzuye y'ababyeyi), bungukirwa n'umurongo wo hagati w’imitsi, utanga uburyo buhamye kandi bwizewe.

Ubuyobozi bwibicuruzwa byamazi namaraso:Mugihe cyihutirwa cyangwa cyitaweho cyane, CVC ituma imiyoborere yihuse yamazi, ibikomoka kumaraso, cyangwa plasma, bishobora kurokora ubuzima mubihe bikomeye.

Gutoranya Amaraso no Gukurikirana:Catheters yo hagati yorohereza gutoranya amaraso nta nkoni zisubiramo. Zifite akamaro kandi mugukurikirana umuvuduko wamaraso hagati, zitanga ubushishozi kumitsi yumutima nimiyoboro yumurwayi.

Dialysis cyangwa Apheresis:Ku barwayi bafite impyiko cyangwa bakeneye aperesi, ubwoko bwihariye bwa CVC burashobora gukoreshwa kugirango babone amaraso kugirango bavure dialyse.

 

Ubwoko bwaCatheters yo hagati

Hariho ubwoko bwinshi bwimitsi yo hagati, buri kimwe cyagenewe intego nigihe cyigihe:

Umurongo wa PICC (Byinjijwemo Catheter Hagati):

Umurongo wa PICC ni ndende ndende, yoroheje yinjizwa mu mitsi mu kuboko, ubusanzwe umutsi wa basilic cyangwa cephalic, hanyuma ugahuzwa nu muyoboro wo hagati hafi yumutima. Bikunze gukoreshwa mubuvuzi buciriritse cyangwa burigihe, kuva kumyumweru kugeza kumezi.
Imirongo ya PICC iroroshye gushira no kuyikuraho, bigatuma bahitamo uburyo bwo kuvura igihe kirekire bidasaba kubaga.

Catheters idafite umurongo:

Ibi byinjizwa muburyo butaziguye mu ijosi (jugular y'imbere), igituza (subclavian), cyangwa igituba (femorale) kandi mubisanzwe bikoreshwa mubikorwa byigihe gito, mubisanzwe mubuvuzi bukomeye cyangwa mubihe byihutirwa.
CVC idafite umurongo ntago ari nziza yo kuyikoresha igihe kirekire kubera ibyago byinshi byo kwandura kandi mubisanzwe ikurwaho iyo umurwayi ameze neza.
Catheters yubatswe:

Catheters ya tunel yinjizwa mumitsi yo hagati ariko ikanyuzwa mumurongo wubutaka mbere yo kugera aho yinjira kuruhu. Umuyoboro ufasha kugabanya ibyago byo kwandura, bigatuma ukoreshwa igihe kirekire, nko mubarwayi bakeneye kuvoma amaraso kenshi cyangwa chimiotherapie ikomeje.
Iyi catheters ikunze kugira cuff ishishikarizwa gukura kwinyama, kurinda catheter mu mwanya.

Ibyambu byatewe (Port-a-Cath):

Icyambu cyatewe ni igikoresho gito, kizengurutse gishyizwe munsi yuruhu, mubisanzwe mugituza. Catheter yiruka ku cyambu igana mu mitsi yo hagati. Ibyambu bikoreshwa mu kuvura igihe kirekire nka chimiotherapie, kuko biri munsi yuruhu kandi bifite ibyago bike byo kwandura.
Abarwayi bahitamo ibyambu kugirango babitaho igihe kirekire kuko ntibibangamira kandi bisaba gusa inkoni y'urushinge muri buri gihe cyo gukoresha.

Gahunda yo hagati ya Catheter yo hagati
Kwinjiza catheteri yo hagati ni inzira yubuvuzi itandukana bitewe nubwoko bwa catheteri yashyizwe. Dore rusange muri rusange inzira:

1. Gutegura:

Mbere yuburyo bukurikizwa, amateka yubuvuzi bwumurwayi arasubirwamo, kandi uruhushya rukaboneka. Umuti urwanya antiseptike ukoreshwa kurubuga rwinjizwamo kugirango ugabanye ibyago byo kwandura.
Anesthetic yaho cyangwa sedation irashobora gutangwa kugirango umurwayi ahumurizwe.
2. Gushyira Catheter:

Ukoresheje ultrasound ubuyobozi cyangwa ibimenyetso byerekana ibimenyetso, umuganga yinjiza catheter mumitsi ikwiye. Kubireba umurongo wa PICC, catheter yinjizwa binyuze mumitsi ya peripheri mumaboko. Kubundi bwoko, uburyo bwo kugera hagati nka subclavian cyangwa imbere imbere yimitsi ikoreshwa.
Catheter iratera imbere kugeza igeze ahantu hifuzwa, mubisanzwe vena cava isumba umutima. X-ray cyangwa fluoroscopi ikorwa kenshi kugirango igenzure aho catheter ihagaze.
3. Kurinda Catheter:

Iyo catheter imaze gushyirwaho neza, iba ifite umutekano hamwe na suture, ifata, cyangwa imyambarire idasanzwe. Catheters ya tunel irashobora kugira cuff kugirango irusheho kurinda igikoresho.
Urubuga rwinjizwamo noneho rwambarwa, kandi catheter isukwa saline kugirango irebe ko ikora neza.
4. Nyuma yo kwitabwaho:

Kwitaho neza no guhindura imyambarire ni ngombwa kugirango wirinde kwandura. Abarwayi n'abarezi bahuguwe ku buryo bwo kwita kuri catheter murugo nibiba ngombwa.
Ibishobora kubaho
Nubwo catheters yo hagati yimitsi ari ibikoresho byingirakamaro mubuvuzi, ntabwo bifite ingaruka. Bimwe mubishobora kugorana harimo:

1. Kwandura:

Ingorane zikunze kugaragara cyane ni kwandura ahashyizwemo cyangwa kwandura amaraso (kwanduza umurongo wo hagati ujyanye n'amaraso, cyangwa CLABSI). Ubuhanga bukomeye bwa sterile mugihe cyo gushiramo no kubungabunga neza birashobora kugabanya ibi byago.
2. Amaraso:

CVC irashobora rimwe na rimwe gutera amaraso mu mitsi. Amaraso yameneka arashobora gutegekwa kugabanya ibi byago.
3. Pneumothorax:

Gutobora ku buryo butunguranye ibihaha birashobora kugaragara mugihe cyo gushiramo, cyane cyane hamwe na cathete idafite umurongo ushyizwe mu gituza. Ibi bivamo ibihaha byaguye, bisaba kwihutira kwivuza.
4. Imikorere ya Catheter:

Catheter irashobora guhagarikwa, gukubitwa, cyangwa gutandukana, bigira ingaruka kumikorere yayo. Gusukura buri gihe no gufata neza birashobora gukumira ibyo bibazo.
5. Amaraso:

Hariho ibyago byo kuva amaraso mugihe gikwiye, cyane cyane iyo umurwayi afite ibibazo byo kwambara. Tekinike ikwiye hamwe nubuvuzi bukurikira bifasha kugabanya ibi byago.

 

Umwanzuro
Catheters yo hagati ni ibikoresho byingenzi mubuvuzi bugezweho, butanga uburyo bwizewe bwamaraso kubwuburyo butandukanye bwo kuvura no gusuzuma. Mugihe uburyo bwo gushyiramo umurongo wamaraso hagati ugereranije byoroshye, bisaba ubuhanga no gufata neza kugirango ugabanye ibibazo. Gusobanukirwa ubwoko bwa CVC nuburyo bukoreshwa byihariye bituma abashinzwe ubuzima bahitamo uburyo bwiza kuri buri murwayi akeneye, bigatuma ubuvuzi bwiza kandi butekanye.