Swan-Ganz - ekunene catheterization yentliziyo

I-Swan-Ganz catheterization (ekwabizwa ngokuba yi-catheterization yentliziyo elungileyo okanye i-pulmonary artery catheterization) kukudlula kombhobho omncinci (catheter) kwicala lasekunene lentliziyo kunye nemithambo ekhokelela kwimiphunga. Kuyenziwa ukubeka esweni ukusebenza kwentliziyo kunye nokuhamba kwegazi kunye noxinzelelo ngaphakathi nasekujikelezeni kwentliziyo.

Uvavanyo lunokwenziwa ngelixa ulele embhedeni kwigumbi lokunyamekela (ICU) esibhedlele. Inokwenziwa nakwiinkqubo ezikhethekileyo ezinje ngelebhu yentliziyo yokuthambisa.

Phambi kokuba uvavanyo luqale, unganikwa iyeza (lokuthomalalisa) ukukunceda uphumle.

Uya kulala etafileni enephedi. Ugqirha wakho uya kwenza i-puncture kwi-vein kufutshane ne-groin okanye engalweni yakho, okanye entanyeni. Ityhubhu eguqukayo (i-catheter okanye i-sheath) ibekwa ngokugqobhoza. Ngamanye amaxesha, iya kubekwa emlenzeni wakho okanye engalweni. Uya kuba uvukile ngexesha lenkqubo.

I-catheter ende ifakiwe. Ishenxiswa ngononophelo kwigumbi eliphezulu lasekunene kwentliziyo. Imifanekiso yeX-reyi ingasetyenziselwa ukunceda umboneleli wezempilo ukuba abone apho icatheter kufuneka ibekwe khona.

Igazi linokususwa kwi-catheter. Eli gazi livavanywa ukulinganisa ubungakanani beoksijini egazini.

Ngexesha lenkqubo, isingqi sentliziyo yakho siyakujongwa rhoqo kusetyenziswa i-electrocardiogram (ECG).

Akufuneki utye okanye usele nantoni na kangangeeyure ezisi-8 phambi kokuba uvavanyo luqale. Kuya kufuneka uhlale esibhedlele ubusuku ngaphambi kovavanyo. Ngaphandle koko, uya kujonga esibhedlele ngentsasa yovavanyo.

Uya kunxiba ilokhwe yasesibhedlele. Kufuneka utyikitye ifom yemvume phambi kovavanyo.Umboneleli wakho uya kuchaza inkqubo kunye nomngcipheko wayo.

Unokunikwa iyeza lokukunceda uphumle ngaphambi kwenkqubo. Uya kuba uvukile kwaye ukwazi ukulandela imiyalelo ngexesha lovavanyo.

Unokuziva ungonwabanga xa i-IV ibekwa engalweni yakho. Unokuziva uxinzelelo kwindawo xa kufakwa i-catheter. Kubantu abagula kakhulu, i-catheter inokuhlala endaweni kangangeentsuku ezininzi.

Unokuziva ungonwabanga xa indawo ye-vein ine-anesthetic.

Inkqubo yenziwa ukuvavanya ukuba igazi lihamba njani (lijikeleza) kubantu abane:

• Uxinzelelo olungaqhelekanga kwimithambo yentliziyo
• Ukutsha
• Isifo sentliziyo
• Ukumelwa yintliziyo
• Isifo sezintso
• Ivalvu zentliziyo ezivuzayo
• Iingxaki zemiphunga
• Umothuko (uxinzelelo lwegazi oluphantsi kakhulu)

Kananjalo kunokwenziwa ukubeka esweni iingxaki zesifo sentliziyo. Ikwabonisa ukuba asebenza njani amayeza entliziyo.

I-Swan-Ganz catheterization inokusetyenziselwa ukufumanisa ukuhamba kwegazi okungaqhelekanga phakathi kweendawo ezimbini zentliziyo ezingadibananga.

Imiqathango enokuchongwa okanye kuvavanywa nge-Swan-Ganz catheterization ibandakanya:

• I-tamponade yentliziyo
• Isifo sentliziyo
• Uxinzelelo lwegazi
• Isithintelo okanye isifo se-cardiomyopathy

Iziphumo eziqhelekileyo zolu vavanyo zezi:

• Isalathiso senhliziyo yi-2.8 ukuya kwi-4.2 yeelitha ngomzuzu ngemitha nganye nganye (yommandla womzimba)
• Uxinzelelo lwe-pulmonary artery systolic uxinzelelo yi-17 ukuya kwi-32 yeemilimitha zemekyuri (mm Hg)
• Umthambo wePulmonary uthetha uxinzelelo yi-9 ukuya kwi-19 mm Hg
• Uxinzelelo lwe-diastolic ye-pulmonary yi-4 ukuya kwi-13 mm Hg
• Uxinzelelo lwe-capillary wedge pulmonary yi-4 ukuya kwi-12 mm Hg
• Uxinzelelo lwe-atrial olufanelekileyo ngu-0 ukuya ku-7 mm Hg

Iziphumo ezingaqhelekanga zinokubangelwa:

• Iingxaki zokuhamba kwegazi, ezinje ngokusilela kwentliziyo okanye ukothuka
• Isifo sentliziyo sentliziyo
• Isifo semiphunga
• Iingxaki zolwakhiwo ngentliziyo, ezinje ngokushiya kwisiphene se-atrial okanye se-ventricular septal defect

Umngcipheko wale nkqubo ubandakanya:

• Ukuthuthuzela malunga nendawo apho kwakufakwa khona i-catheter
• Ukwenzakala emthanjeni
• Ukubetha emiphungeni ukuba kusetyenziswa imithambo yentamo okanye yesifuba, ibangela ukuwa kwemiphunga (pneumothorax)

Iingxaki ezinqabileyo kakhulu zibandakanya:

• I-Cardiac arrhythmias efuna unyango
• I-tamponade yentliziyo
• I-Embolism ebangelwa ngamahlwili egazi kwincam yecatheter
• Usulelo
• Uxinzelelo lwegazi oluphantsi

I-catheterization yentliziyo elungileyo; Catheterization - intliziyo elungileyo

• Ukudityaniswa kwecatheterization ye-Swan Ganz

IHermann J. Catheterization yentliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 19.

I-Kapur NK, uSorajja P.I-hemodynamics ehlaselayo. Ku: Sorajja P, Lim MJ, Kern MJ, ii-eds. Incwadi kaKern's Catheterization Handbook. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 4.

IShreenivas SS, uLilly SM, uHerrmann HC. Ungenelelo kukothuka kwentliziyo. Ku: I-Topol EJ, iTeirstein PS, ii-eds. Incwadi yeNdlela yokuNgenelela kweCardiology. Ngomhla we-8. IPhiladelphia, PA: Elsevier; 2020: isahluko 22.