I-catheter ye-venous esembindini (i-CVC): iyintoni, yeyantoni kwaye iyakhathala

Umxholo

• Yenzelwe ntoni
• Kwenziwa njani
• Iindidi zofikelelo oluphakathi lwemithambo
• Unonophelo ngokubanzi lwe-catheter esembindini
• Iingxaki ezinokwenzeka

I-catheterization ye-venous esembindini, ekwabizwa ngokuba yi-CVC, yinkqubo yonyango eyenziwayo ukulungiselela unyango kwezinye izigulana, ngakumbi kwiimeko ezinje ngemfuno yokufakwa kakhulu kumanzi kwigazi, ukusetyenziswa kokungena kwemithambo yegazi ixesha elide, ukubeka esweni okungcono kwe-hemodynamic, kunye nokufakwa kwegazi okanye isondlo se-parenteral, umzekelo, efuna ukufikelela ngokukhuselekileyo kwimithambo yegazi.

I-catheter ye-venous esembindini inde kwaye ibanzi kunee-catheters eziqhelekileyo ezisetyenziswa kwimithambo yeendawo ezinje ngengalo, kwaye ziyilelwe ukwaziswa kwimithambo emikhulu yomzimba, njenge-subclavian, ebekwe kwisifuba, i-jugular, ibekwe entanyeni, okanye ebusetyhini, ebekwe kwingingqi ye-inguinal.

Ngokubanzi, le nkqubo ihlala ibonakaliswa kwiindawo zononophelo olunzulu (ICU) okanye kwiimeko ezingxamisekileyo, kwaye kufuneka yenziwe ngugqirha, kulandela inkqubo efuna izinto zotyando kunye nezixhobo ezingasebenzi. Emva kokubekwa, kubalulekile ukuba ube nokhathalelo lokujonga kunye nokuthintela iingxaki ezinjengosulelo okanye ukopha.

Yenzelwe ntoni

Iimpawu eziphambili zokungena kwe-venous zibandakanya:

• Ukuququzelela ukugcinwa kokungena kwe-venous ixesha elide, ukunqanda ukubhoboza okuninzi;
• Ukufakela izixa ezikhulu zolwelo okanye amayeza, angaxhaswayo kukungena okuqhelekileyo kwemithambo;
• Ukulawula amayeza anokubangela ukucaphuka xa i-extravasation ivela kulwakhiwo olungena kwimithambo, njenge-vasopressors okanye izisombululo zehypertonic ze-sodium ne-calcium bicarbonate;
• Vumela ukubekwa kweliso kwi-hemodynamic, njengokulinganisa uxinzelelo lwe-venous esembindini kunye nokuqokelela iisampulu zegazi;
• Ukwenza i-hemodialysis, kwiimeko ezingxamisekileyo okanye xa i-arteriovenous fistula ingekazinzi. Qonda ukuba yenziwa njani i-hemodialysis kwaye iboniswa nini;
• Yenza utofelo-gazi okanye izinto zegazi;
• Ukuququzelela unyango lwe-chemotherapy;
• Vumela isondlo sabazali xa usondla nge-gastrointestinal tract ayinakwenzeka.

Ukusebenza kokungena kwe-venous kufuneka kuthathe amanyathelo okuthintela umngcipheko weengxaki. Ke, le nkqubo ayiboniswanga kwimeko yosulelo okanye ukukhubazeka kwesiza ukuba kuhlatywe, utshintsho ekunqandeni igazi okanye xa kukho imingcipheko yokopha, ngaphandle kweemeko ezizodwa eziboniswe ngugqirha.

Kwenziwa njani

Ukusebenza kwe-catheterization ye-venous central, kufuneka ubeke umntu, oqhele ukulala kwi-stretcher. Emva koko, ugqirha uya kuchonga indawo ngqo yokuhlatywa, i-asepsis yommandla kunye nolusu olujikelezileyo lwenziwa, ukuphelisa isifo.

Ukongeza, ugqirha kunye neqela kufuneka ukuba benze ukuhlamba izandla ngononophelo kwaye baxhotyiswa ngezixhobo ezinciphisa umngcipheko wosulelo, ezinje ngeeglavu ezingenazintsholongwane, imaski, umnqwazi, ingubo yotyando kunye needrapes ezingenazintsholongwane.

Inkqubo esetyenziswa kakhulu ekwenzeni i-catheterization ye-venous ibizwa ngokuba yi-Seldinger. Ukwenza oku, ukongeza kwizixhobo zokukhusela, ibhegi kunye nezixhobo ze-serum, i-anesthetic, i-gauze engenazintsholongwane, i-scalpel kunye ne-central catheter kit, equlethe inaliti, i-guidewire, i-dilator kunye ne-catheter efakwa ngaphakathi. inaliti kunye nomsonto wokuncamathisela i-catheter kulusu.

Okwangoku, abanye oogqirha bakhetha ukusebenzisa i-ultrasound ukukhokela ukufakwa kwe-catheter kunye nokunciphisa umngcipheko weengxaki.

Kukwabalulekile ukukhumbula ukuba, njengenkqubo yokungenelela, kubalulekile ukwazisa kunye nokufumana imvume yesigulana ngokusebenza kwayo, ngaphandle kwaxa kukho imeko kaxakeka okanye ingozi yokufa esondeleyo, xa unxibelelwano lungenakwenzeka.

Iindidi zofikelelo oluphakathi lwemithambo

I-catheterization esembindini yemithambo inokwenziwa ngeendlela ezi-3, ngokutsho komthambo okhethwe ukuba ugqobhozwe:

• Umthambo we-Subclavia;
• Umthambo wangaphakathi wejugular;
• Umthambo wabasetyhini.

Ukhetho lohlobo lokufikelela kwimithambo yegazi lwenziwa ngugqirha ngokwamava, ukhetho kunye neempawu zesigulana, zonke ezisebenzayo kwaye zinenzuzo kunye nezinto ezingalunganga. Umzekelo, kwizigulana eziye zane-traacic trauma okanye apho kufuneka khona ukuvuselelwa kwe-cardiopulmonary, ukubethelwa kwethambo lobufazi kubonisiwe ngakumbi, ngelixa ukufikelela kwimithambo ye-jugular okanye ye-subclavia kunqabile ukuba kungcoliswe.

Jonga ezinye iintlobo zokwenza i-catheterization ezinokufuneka.

Unonophelo ngokubanzi lwe-catheter esembindini

Ngokwesiqhelo, i-catheter ye-venous esembindini isetyenziswa kuphela kwisibhedlele, njengoko kufuneka inyanyekelwe ngokuchanekileyo, ukuthintela ukungena kwamagciwane kwi-copro, enokubangela usulelo olubi kwaye ibeke ubomi emngciphekweni.

Ke, i-CVC ihlala ikhathalelwa ngumongikazi, ekufuneka enononophelo oluqhelekileyo olunjengolu:

• Ukwenza ifayile ukugungxula itafile enetyuwa, ukuthintela ukuba ingagcwaliseki ngamahlwili, umzekelo;
• Guqula ukunxiba kwangaphandle, ngakumbi ukuba unayo nayiphi na imfihlo;

Ngexesha lokunyamekela i-catheter ye-venous esembindini, kubalulekile ukuba uhlale uhlamba izandla zakho kuqala kwaye usebenzise ubuchule obungenabungozi, oko kukuthi, kuya kufuneka usebenzise i-CVC usebenzisa intsimi eyinyumba, kunye neiglavu ezingenazintsholongwane, nokuba yeyokulawula uhlobo oluthile lwamayeza.

Iingxaki ezinokwenzeka

Ukufikelela okuphakathi kwe-venous kunokubangela ezinye iingxaki njengokuphuma kwegazi, ukugruzuka, usulelo, ukugqobhoza kwemiphunga, i-arrhythmia okanye i-venous thrombosis.