Ukuba ugqirha wakho uphakamise i-chemotherapy port kwi- chemotherapy , oko kuthetha ukuthini oku? Ziziphi iingxaki kunye nokuxhamla kwechweba xa kuthelekiswa nezinye iindlela zokufikelela ezifana nomgca we-intravenous (IV) okanye umgca wePICC?
Makhe sijonge ukuba nantoni na i-port iquka inzuzo (i-pros) kunye neempembelelo (inkunkuma) yokuba ne-port okanye i-port-o-cath, kunye nezindlela onokukwazi ukukhusela iingxaki ezifana nokusuleleka okanye ukuvinjelwa kwisango.
Iyintoni iPort for Chemotherapy?
Ichwephethi ye-chemotherapy (eyaziwa nangokuthi "i-port-a-path") isisityana esincinci esilungele phantsi kwesikhumba sakho ukuvumela ukuba lula ukufikelela kwigazi lakho.
Kusetyenziswa nini iPort?
Ichwethi ingasetyenziselwa ukuthabatha igazi kunye nokufumana iziyobisi zephemotherapy. Ingasetyenziselwa ukuba ufune ukudluliselwa kwamaseli obomvu okanye iiplatelet. Ngaphandle kwechweba, okanye umgca we-PICC, inaliti entsha (IV) iya ku funeka ibekwe rhoqo ngexesha unayo i-chemotherapy, kwaye imida ehlukeneyo ye-IV iya kufuneka ifakwe xa ufuna imithombo ye-IV okanye ukunyelwa igazi.
Chemotherapy
Ingaba ugqirha wakho uncoma ukuba ichweba lithembele kwizinto eziliqela. Amanye amayeza e-chemotherapy anganikwa kuphela kwi-port, njengoko iyakwenza ukuba ihanjiswe kwi-veiperal vein.
Ukuba uya kuba ne-infotheons ezininzi ze-chemotherapy (ezinye i-oncologists zincoma i-port ukuba uza kunceda unyango olungaphezulu kwezine), i-port ilula ngokulula ukufaka i-IV rhoqo.
Kwaye abanye abantu baneemithanjeni ezinzima kakhulu ukufikelela kuzo, ukwenza ichweba ingcono kunokuba ufake i-IV.
Ukuze wenze isigqibo esilungileyo kuwe, vumela ugqirha wakho ukuba ngaba ochwepheshe bafumene kulula okanye kunzima ukutala igazi okanye ukubeka i-IV esandleni sakho okanye ingalo esikhathini esidlulileyo. (Usenokuba uvile inkcazelo ye-tech ngokuthi "intonga elula" okanye "intonga elukhuni").
I-Port ifakiwe njani?
I-port isoloko ifakwe ngexesha lenkqubo yokucwangcisa enye enokuthi yenziwe nge-anesthetic yendawo. Uninzi lwamagqirha ukhetha ukuba i-port yakho ibekwe ubuncinane ngeveki enye ngaphambi kokuqala i-chemotherapy (ukuba kunokwenzeka) kwaye uphando lubonisa ukuba ukuba i-port yakho ibekwe ubuncinane iintsuku ezisibhozo ngaphambi kokunciphisa iyanciphisa umngcipheko weengxaki. Ukuba unomdla wokuqhathaniswa nomhlaza wakho, njengokwenza i- lobectomy yomdlavuza wamaphaphu okanye i-mastectomy yomhlaza wesifuba, ugqirha wakho unokufaka i-port ngexesha elinye uhlolo lwakho lwenziwa. Xa ichweba libekwe ngexesha lotyando, uya kuba sele unesifo esiphezulu se-anesthetic endaweni.
Ngethuba lokufakela, intsimbi encinci yeplastiki okanye iplastiki ifakwa phantsi kwesikhumba sakho nge-incch-or-two-long incision. Oku kunokufumaneka kwisifuba sakho esiphezulu okanye ngezinye izikhathi ingalo yakho engaphezulu. Eli thuba linamathele kwiphubhu ye-catheter edibeneyo kwenye yeemvumba ezinkulu entanyeni yakho, njenge-subclavian vein okanye i-vein jugular, kwaye iphelela eduze kwentliziyo yakho. Emva kokuba ichweba lakho libekwe ugqirha uya kwenza i-x-ray ukuqinisekisa ukuba isiphelo sakho siphethe kwindawo efanelekileyo.
Emva kokuba kufakwe ichweba, uya kuqaphela ukukhutshwa kancinane kwesikhumba sakho, phezu kwechweba.
Ngexesha legazi likhangela okanye i-chemotherapy infusions, umongikazi uza kufaka inaliti kwi-port yakho kwindawo ebizwa ngokuthi "i-septum," i-resealing rubber centre kwi-port yakho. Ekubeni ichweba liphantsi kwesikhumba sakho, uya kukwazi ukuhlamba kwaye udide ngaphandle kokukhathazeka malunga nokufumana isifo kwi-port yakho.
Iinzuzo kunye neNzuzo
Njengoko nayiphi na inkqubo yokucubungula, kukho izinto ezilungileyo kunye nokungalunganga ukuba kufakwe ichwephethi ye-chemotherapy. Kucingelwa ukuba ngaphezu kwezigidi ezi-5 izibuko zifakwa eMelika rhoqo ngonyaka, ngoko oogqirha bajwayelene kakhulu nenkqubo kwaye sele ifundwe kakuhle.
Iintlobo zokuba ichwephethi ye-chemotherapy ekusebenziseni i-IV yendabuko ziquka:
- Intuthuzelo enkulu: Inaliti enye inamathela kwesikhumba yinto efunekayo ukufikelela kwi-port yakho. Ngonyango lwe-IV kunye negazi lemveli ludonsa, ngamanye amaxesha amaninzi amaninzi aneenaliti ayadingeka ukuze athole umthambo omuhle, ngakumbi ukuba iimvini zakho zonakaliswe kwigazi eliphindaphindiweyo kunye neengcambu. (I-Chemotherapy inokudala utshintsho kwimvini yakho eyenza kube nzima kakhulu ukugqitywa ngenaliti.)
- Ukuphepha ukulibaziseka: Awuyikuphepha nje ukulibaziseka kokuba umongikazi uzame ukufumana umthombo omuhle ukuthabatha igazi okanye ukuhambisa i-chemotherapy, kodwa ukuba nechweba kunokunciphisa ixesha elifunekayo ukulungiselela isandla sakho okanye ingalo kwenkqubo.
- Ukunciphisa umngcipheko wokuba "u-extravasation:" Xa i-IV isetyenziswe, imishanguzo iyakwazi ukuvuza (i-extravasate) kwiifomthi ezungeze isandla sakho okanye ingalo. Ekubeni amayeza amaninzi e-chemotherapy enza ukuba izicubu zenzeke, i-port inganciphisa umngcipheko wokuvuvukala okuhlobene nokuvuza kwezi zonyango.
- Ukuhlamba okulula kunye nokubhukuda: Njengoko ichweba liphantsi kwesikhumba, unako ukuhlamba uze udide ngaphandle kokukhathazeka ngomngcipheko wosulelo.
Iingxaki ezingenzekayo zePhethiloli ye-Chemotherapy
Ingozi kunye neengxaki ezinxulumene nechwepthi ye-chemotherapy ziquka:
- Umngcipheko wenkqubo yokuqapha ukufaka ichweba: Nayiphi na inkqubo yokucoca inokuthi ithwale ingozi yokusuleleka. Iingxaki ezingaqhelekanga (ezo zenzeke ngaphantsi kweepesenti enye zabantu) zokufakelwa zingabandakanya ukuphuma kwamanzi (njengokuthi i-subclavian vein iyagqitywa) kunye ne- pneumothorax (ukuwa komphunga) ukuba umphunga wakho uphawulwe ngengozi ngexesha le nkqubo.
- Usuleleko: Umngcipheko wosulelo usuhluke kwizifundo kodwa awuqhelekanga. Ukuba i-port isifo, iyakudinga isuswe ize ishintshwe. Uphando luvavanya iindlela zokunciphisa umngcipheko, ngoko kubalulekile ukuthetha ne-oncologist yakho malunga nendlela yokuphatha kakuhle i-port yakho.
- I-Thrombosis: I-clot inokuthi ifake kwi-port okanye i-catheter, ibangela ukuba uyeke ukusebenza. Phakathi kwabangama-12 no-64 ekhulwini abantu abaphethe ichwethi ye-chemotherapy baya kuhlakulela i-thrombosis (clot) kwi-catheter (ngokuqhelekileyo kubangela isidingo sokuba ichweba ithathe indawo.)
- Iingxaki zengcingo ezibangele ukuba ichweba liyeke ukusebenza: Kwezinye iimeko, iingxaki zengqondo, ezifana nokunyakaza kwecatheter okanye ukuhlukana kweso sikhumba esikhumbeni, kunokubangela ukuba ichweba liyeke ukusebenza.
- Ukuncipha kumsebenzi: Nangona imisebenzi efana nokuhlamba nokubhukuda idla ngokufanelekileyo, i-oncologist yakho ingancoma ukuba ugcine ukuzivocavoca ukuze uqinise umzimba wakho okanye izixhobo kuze kube yilapho isango lakho lisuswe.
- Ukuqhaqhaqhaqha: Ngenxa yokunyanga komhlaza, inqabana evela kwisibuko yinto encinci. Kodwa abanye abantu banokufumana isiqhekeza esiphakameni sabo esiphazamisayo ngenxa yezizathu zokuzilungisa okanye ngenxa yokuba uyisimboli sokuba uye waphila nge-chemotherapy.
Ukukhusela izifo
Izifundo eziliqela kwiminyaka yamuva zijonge iindlela zokunciphisa umngcipheko we-bhakterial colonization kwi-port kunye nomngcipheko olandelayo wokusuleleka ( sepsis ). I-Sepsis yintsholongwane "yomzimba wonke" apho iibhaktheriya zikhona kwigazi kwaye zinokuba nzima kakhulu. Nangona kusetyenziswa ngokuqhelekileyo i-antibiotics akuzange kufunyanwe luncedo, ukuchukumisa i-catheter ene-antibiotics / i-solution ye-heparin kubonakala kunciphisa umngcipheko. Ukuhlanjululwa kwesikhumba akuzange kubonakale kunenzuzo ngeli xesha, kodwa ukusebenzisa izambatho ezifakwe kwii-antibiotics kunokunceda. Kuye kucatshangelwa ukuba ukukhusela ichweba ngendlela ngaphandle kwe-sutures (i-stitches) inokunciphisa umngcipheko wokusuleleka. Njengoko kuphawuliwe, le ngingqi yocwaningo olusebenzayo kwaye unokubuza i-oncologist yakho into ephakanyiswayo njengamanje.
Ingozi yeThrosis
Ukucima okanye i-thrombosis kwipropati iyinto eqhelekileyo kwaye isizathu esivame ukuba i-port ifune ukususwa kwaye iqhutyelwe indawo. Ngokukhawuleza ukuphosa i-port kunye ne-heparin kunye ne-saline ayibonakali ukwenza umdehluko omkhulu, kwaye ukunciphisa kuye kwaphawulwa ngokusebenzisa i-heparin ye-dose ephantsi (nangona yanda ukwanda kwamanzi). Abo bafumana ingozi enkulu kulabo abanembali ye-thrombosis ejulile kwixesha elidlulileyo. Indawo yokuphela kwenkathazo ingenza umehluko. Kodwa ke, umngcipheko we-thrombosis kwi-port incinci kakhulu ngaphantsi komgca wePICC.
Indlela ehluke ngayo kumgca wePICC
I-PICC imele "i-cathterter centered". Umgca wePICC uvame ukufakwa kwisigqubuthelo sokunyanga kwexesha elifutshane (umzekelo, ukwenzela ukuba kufumaneke ukufikelela kwiiveki ukuya kweyesithandathu kuphela). Imigca ye-PICC ifakwe kwisandla sakho kufuphi nesikhumba sakho (ngaphantsi) kwaye ungafihli ngokusondeza entliziyweni yakho njengendawo yesikhephe sechweba.
Indlela Ekususwe ngayo?
Xa wena kunye nodokotela wakho uyaqiniseka ukuba i-port yakho ayisasadingeki, inokuthi isuswe kwinkqubo elula yokuhlinzwa.
Yintoni Uya Kufuneka Uyazi Ukuba Unesondo?
Kuya kuba kubalulekile ukubuza ugqirha ukuba i-port yakho idinga nayiphi na inkathalo ekhethekileyo, njengokushushumbisa ngamachiza ukukunceda ukukhusela ama-clots ekwakheni.
Nini ukubiza uDokotela wakho
Ekubeni ukusuleleka kuyinkxalabo eqhelekileyo yokuba nechweba, qhagamshelana nogqirha wakho ukuba uhlakulela umkhuhlane okanye uqaphele nawuphi na ubomvu, ukuvuvukala, intlungu okanye umjelo phakathi kwechweba lakho.
> Imithombo:
> I-American Society of Clinic Oncology. Cancer.Net. 09/2016. http://www.cancer.net/kuvakalisa-coccer-care/how-cancer-treated/chemotherapy/catheters-and-ports-cancer-reatingment
> Heibl, C. et al. Iingxaki ezinxulumene nokusetyenziswa kwePort-a-Caths kwizigulane ezinesifo esibi okanye se-hematological: i-single-cent analysis analysis. I-European Journal yeCancer Care . 2010. 19 (5): 676-81.
> Madabhavi, I., Patel, A., Sarkar, M. et al. Isifundo Sokusetyenziswa kwe "PORT" I-Catheter kwizigulane ezineCarcer: I-Experience-Centre Centre. Ulwaphulo lwezonyango Ulwaphulo: i-Oncology . 2017. 11: 1179554917691031.
> Narducci, F. et al. Iinkqubo zokufikelela kwiindawo zokungena kwiindawo ezinobungozi kunye nemingcipheko yeengxaki: unyaka owodwa oza kufundelwa kwisikhungo somhlaza. I-European Journal ye-Oncology yokugulisa . 2011. 37 (10): 913-8.