Izingozi ezinxulumene nokubekwa kunye nokusetyenziswa kwe-Central Lines
Umgca ophakathi ngumhlobo wekathetha ofakwe kwisivalo esikhulu esivumela ukuba amanzi amaninzi e-IV anikwe kwaye igazi litsalwe. Xa kuthelekiswa nomgca we-IV oqhelekileyo, umgca ophakathi ukhulu, unokuhlala kwindawo ede, unokukhulula umthamo omkhulu wamanzi kwaye uvumela igazi ukuba litsalwe kalula. Umgca ophakathi ungasetyenziselwa ukulinganisa isimo somthamo wamanzi, kunye nokunceda ukuba isigulane sitshatyalaliswe okanye sifike inani elaneleyo lokuncedisa imisebenzi yomzimba.
Umgca wePICC , uhlobo lokufikelela kwe-IV olunokugcinwa iiveki kunye neenyanga, alukho umgca ophakathi kodwa unokwabelana ngeempawu ezininzi ngale ndlela yokufikelela kwe-IV.
Kutheni Kuthetha Ukusetyenziswa Kwendawo Ephakathi?
Umgca ophakathi ungafakwa kwizizathu ezininzi. Umgca ophakathi unokuba neemeko ezi-5, eziyizibuko apho umbane ungangeniswa khona, igazi lingathathwa okanye imilinganiselo ingathathwa. Ukuba isigulane sidinga ukuhlaziywa kwamanzi, kuthetha ukuba kufuneka kunikwe umthamo omkhulu wamanzi amanzi, umgca ophakathi unokufakwa ukuba uvumele umbane uqhume ngokukhawuleza.
Imigca ephakathi ingasetyenziselwa ukudweba igazi. Kwezinye iimeko, ezimbini zezikhanyiso kumgca ophakathi zingasetyenziselwa ukwenza i-dialysis, kunye ne-lumen enye esetyenziselwa ukuthatha igazi kwi-system ye-vascular kunye nelinye i-lumen esetyenziselwa ukubuyisela igazi elidifiyali kumzimba. Kuba izigulana ezifuna igazi elidlulileyo liza kuthunyelwa kwibhubhoratri, umgca ophakathi uvumela igazi ukuba litsalwe ngaphandle "ngokunamathela" isigulane.
Omnye umsebenzi oyingqayizivele kwimigca ephambili yikhono lokulinganisa uxinzelelo oluphambili lwentlungu. Lo mlinganiselo unikezela iqela lokunakekelwa kwempilo kwinqanaba le-vascular, kwaye ukuba isigulane siye safumana amaninzi okanye amaninzi kakhulu.
Ukuba umgca wecala ngumgca we-Swann-Ganz, uhlobo lwe-pulmonary wedgeary can also be found, olungachaza ngokuthe ngqo ukuba i-atrium yekhohlo ekhoyo isebenza njani.
Kwiigulane ezinengxaki ezinzulu zenhliziyo okanye ukuhlinzwa kwentliziyo yakutshanje, olu lwazi lunokuba luncedo kakhulu.
Umgca ophakathi nawo ufanelekile xa unyango lwexesha elide lilindelwe, njengeeveki ze-IV zonyango lweyeza, okanye ukuba kufuneka ukuba unyango olunokuthi lunganikezwa nge-IV standard, njenge- chemotherapy .
Ukufakwa kweNgcaciso yoMgca
Ukuze kufakwe umgca ophakathi, isiguli kufuneka silale phantsi, kwaye indawo yomzimba apho umgca ophakathi uya kufakwa khona. Iimvumbo eziqhelekileyo ezisetyenziselwa ukubekwa komgca ophakathi ziyingqungquthela yangaphakathi entanyeni, i-subclavian vein kufuphi ne-clavicle, kunye ne-veinoral vein kwi-groin.
Isigulane sinxibekile, ngokuqhelekileyo sisuka entloko ukuya enontsheni, kunye nomgca ongezantsi. I-drape yiphepha elingamanzi elinomngxuma kulo mvume ukuvumela umntu ukuba abeke umgca ophakathi komgca. I-stereil drape ijoliswe ekuncedeni ukunciphisa umngcipheko wokusuleleka, kwaye uphando lubonise ukuba ukumboza umzimba wonke, kunokuba nje ummandla apho umgca ophakathi uza kufakwa khona, yinto efanelekileyo yokukhusela intsholongwane.
Emva kokuba isigulane sikhishwe, indawo yesikhumba ihlambulukile. Ukuba isigulane siphaphekile, indawo yesikhumba nayo ingadibaniswa ne- anesthetic yendawo .
Ukusebenzisa ubuqhetseba obunobumba, i-catheter engenayo ifakwe kwi-vein, ngokuqhelekileyo isebenzisa i-ultrasound ukufumana isitya segazi esifanelekileyo. I-cathtter yatshitshiswa endaweni, okanye ifowuni isetyenziselwa ukubamba i-catheter esaweni kwisiza sokufakwa.
Ummandla uphinde uhlambuluke kwakhona kunye ne-antiseptic kunye nokugqokisa okungenamafutha kufakwe kwisayithi yokufakela, kunye nezikhanyiso ezifumanekayo. Ukufakwa kwecatheter kufuneka kuqinisekiswe usebenzisa i-ray ngaphambi kokuba umda ophakathi ungasetyenziselwa, ukuphepha ukuphazamisa imichiza kwiimfucu okanye kwisitya esingalunganga segazi. Kwezinye iimeko, i-catheter ingaba kwisitya esifanelekileyo, kodwa kufuneka ulungelelaniso oluthile ngenxa yokuba i-catheter inokude kakhulu kwisikebhe okanye kungekudala.
I-Central Line-Associated Bloodstream Infection (CLABSI)
Enye yemingcipheko yokubeka umgca wendawo kunye nokusetyenziswa yintsholongwane yegazi. Ukukunceda ukukhusela izifo , iindlela ezifanelekileyo zenziwe ziphunyeziwe. Ezi zinto zibandakanya utshintsho olugugu olungaguqukiyo, ukusetyenziswa komzimba opheleleyo ongenamanzi ngexesha lokubekwa komgca, ukususa umgca ngokukhawuleza ukuba kungabalulekanga, kwaye kufaka kuphela imigca ephambili efunekayo.
Imigca ephakathi ikwafakwa ngaphezulu kwelinqeni xa kunokwenzeka ukunciphisa umngcipheko wosulelo. Amasayithi omzimba wesifazane anxulumene namazinga aphezulu okusuleleka. Ukugqoka okubekwe phezu kwesiza sokufakwa kufana ngokucacileyo, okuvumela iqela lokunakekelwa kwezempilo ukuba lihlolisise iimpawu zentsholongwane ngaphandle kokubhengeza indawo yokufaka indawo engaphezulu kunokuba iyimfuneko.
Izingozi zeNqila Ephakathi
Kukho iingozi ezinxulumene nokufakwa komgca ophakathi, omele ulinganiswe ngesidingo sesigulane somgca. Usulelo luyingozi enkulu yomda ophakathi, kunye nezinye iingozi ezibandakanya i-pneumothorax (iphofu epholileyo), ingakumbi ukuba umgca ophakathi ubeka kwi-subclavian vein, ephathekayo ngethubhu yesifuba xa kuyimfuneko.
Ngethuba lokufakela kwezinye iintlobo zemigca ephakathi, intliziyo ingashukunyiswa yinkqubo ngelixa umgca uhamba ngemida yegazi kufuphi nentliziyo, obangela ukuguqulwa kwisigqi senhliziyo. Oku kugqitywa ngokufakwa ngokufanelekileyo komgca kodwa kunokufuna imithi kubantu abathile abangaqabanga.
Enye inkcazo yokugqibela yimizila ephambili yindlela yokubumba emoyeni, imeko apho umoya ungena kwinkqubo ye-vascular kwaye uqala ukuhamba ngomzimba. Le meko, enzima kakhulu, nayo inqabile kwaye ikhuseleke kakhulu.
ILizwi Ku:
Umgca ophambili uncedo kakhulu xa isigulane sigula, kodwa akusiyo ingozi. Kwizigulane ezininzi, inzuzo yokungabikho "iintonga" ezininzi zegazi iyakhupha kwaye ukufikelela kwindawo ethembekileyo ye-IV kukhulu kunokuba kubekho ingozi efumaneka kulolu hlobo lokufikelela.
Kwezinye izigulane, umgca ophakathi wenza ukuba izibhedlele zibekezeleke ngakumbi, kanti ezinye zingakhathazeki ngegazi kwaye zikhetha ukukhusela iingxaki ezinokuthi zifikelele.
> Umthombo:
> Ephakathi > I-Line-Associated > I-Bloodstream Infection. KwiSebe lezeMpilo laseCalifornia.