Tsarin catheter na tsakiya (CVC): menene menene, menene don shi da kulawa

Wadatacce

• Menene don
• Yaya ake yi
• Ire-iren hanyoyin samun iska
• Babban kulawa na babban catheter
• Matsaloli da ka iya faruwa

Cutar sankara ta tsakiya, wanda aka fi sani da CVC, hanya ce ta likita da aka yi don sauƙaƙe maganin wasu majiyyata, musamman ma a yanayi irin su buƙatar yin ɗimbin ruwa mai yawa a cikin jijiyoyin jini, yin amfani da damar samun jini na tsawon lokaci, don mafi kyawun kulawa na hemodynamic, da kuma shigar jini ko abinci mai gina jiki na iyaye, misali, yana buƙatar samun damar zuwa hanyoyin jini mafi aminci.

Babban catheter na tsakiya ya fi fadi da fadi fiye da yadda ake amfani da catheters na gefe wanda ake amfani da shi a jijiyoyin wurare kamar hannu, kuma an tsara su ne don a shigar dasu cikin jijiyoyin jiki masu girma, kamar subclavian, wanda yake a cikin kirji, mai jugular, wanda yake a cikin wuya, ko na mata, wanda yake a yankin inguinal.

Gabaɗaya, wannan hanya yawanci ana nuna ta a cikin yanayin kulawa mai ƙarfi (ICU) ko kuma a cikin yanayi na gaggawa, kuma dole ne likita ya yi ta, bin dabarun da ke buƙatar kayan aikin tiyata da kayan aiki marasa amfani. Bayan sanya shi, ya zama dole a sami kulawar jinya don kiyayewa da hana rikice-rikice kamar cututtuka ko zubar jini.

Menene don

Manyan alamomi don samun damar shiga tsakiyar sun hada da:

• Taimakawa wajen kula da magudanar jini mai tsayi na dogon lokaci, tare da guje wa huɗa da yawa;
• Sanya ruwa mai yawa ko magunguna, waɗanda ba su da goyan bayan hanyoyin samun jini na gefe;
• Gudanar da magunguna waɗanda zasu iya haifar da ɓacin rai yayin fitowar ruwa daga haɗuwa da jijiyoyin jini, kamar vasopressors ko mafita na hypertonic na sodium da calcium bicarbonate;
• Bada damar kulawa da yanayin jini, kamar auna matsin lamba na tsakiya da tattara samfuran jini;
• Yin aikin hawan jini, cikin yanayi na gaggawa ko lokacin da cutar yoyon fitsari ba ta riga ta kafa kanta ba. Fahimci yadda ake yin hemodialysis da lokacin da aka nuna shi;
• Yi jini ko abubuwan da ke cikin jini;
• Sauƙaƙe jiyyar cutar sankara;
• Bada izinin abinci mai gina jiki na iyaye lokacin ciyarwa ta hanyar hanyar hanji ba zai yiwu ba.

Aikin babbar hanyar shiga jini dole ne ya dauki wasu matakan kariya don rage haɗarin rikitarwa. Don haka, ba a nuna wannan aikin a yanayin kamuwa da cuta ko nakasar shafin don a huda shi, canje-canje a daskarewar jini ko lokacin da akwai mummunan haɗarin zubar jini, sai dai a yanayi na musamman da likita ya nuna.

Yaya ake yi

Don yin aikin kitsen tsakiyar jijiyoyin jini, ya zama dole a sanya mutum, wanda yawanci yake kwance akan gadon daukar marasa lafiya. Bayan haka, likitan zai gano ainihin wurin da huda yake, asepsis na yankin da fatar da ke kewaye da ita ana yin ta, kawar da maganin kamuwa da cuta.

Bugu da kari, dole ne likitan da tawaga sun yi wanka da hannu sosai kuma sun kasance suna da kayan aiki da ke rage haɗarin kamuwa da cuta, kamar safofin hannu marasa tsabta, abin rufe fuska, huluna, rigar tiyata da labule marasa tsabta.

Dabarar da aka fi amfani da ita don aiwatar da jijiyoyin jini a ciki ana kiranta fasahar Seldinger. Don aiwatar da ita, ban da kayan kariya, jaka da kayan aikin magani, maganin sa maye, gauran bakararre, fatar kan mutum da kitsen catheter na tsakiya, wanda ya ƙunshi allura, jagorar jagora, dilator da igiyar ruwa, dole ne ayi amfani dasu azaman kayan aiki. allura da zare don haɗa catheter zuwa fata.

A halin yanzu, wasu likitocin sun zaɓi amfani da duban dan tayi don jagorantar shigar da catheter da rage haɗarin rikitarwa.

Har ila yau yana da mahimmanci a tuna cewa, tunda hanya ce ta mamayewa, ya zama dole a sanar da kuma samun izinin mara lafiya don aikinsa, sai dai idan akwai wani yanayi na gaggawa ko kuma barazanar mutuwa, lokacin da sadarwa ba ta yiwu ba.

Ire-iren hanyoyin samun iska

Za a iya yin amfani da ƙwayoyin cuta ta tsakiya ta hanyoyi 3, gwargwadon jijiyar da aka zaɓa don hudawa:

• Jijiyoyin Subclavian;
• Jijiyoyin jijiyoyin ciki;
• Jijiyoyin mata.

Likitan ne yake zaban nau'ikan hanyar samun damar shiga cikin jini gwargwadon gogewa, fifiko da halayen mara lafiyar, dukkansu suna da inganci kuma suna da fa'ida da rashin amfani. Misali, a cikin marassa lafiyar da suka sami rauni a thoracic ko kuma a wacce ake bukatar tayar da jijiyoyin jiki, hujin jijiya na jijiyoyin mata ya fi nunawa, yayin da ake samun damar shiga ta jijiyoyin jini ko na subclavian.

Duba sauran nau'ikan catheterization wanda za'a iya buƙata.

Babban kulawa na babban catheter

A ka'ida, ana amfani da babbar mashin din a cikin asibiti kawai, saboda ana bukatar kulawa sosai, don hana shigowar ƙananan ƙwayoyin cuta a cikin copro, wanda zai iya haifar da kamuwa da cuta mai tsanani kuma saka rayuwa cikin haɗari.

Don haka, yawanci ma'aikacin kula ne ke kulawa da CVC, wanda dole ne ya sami kulawa na yau da kullun kamar:

• Don yin ja ruwa na catheter tare da salin, don hana shi toshewa da daskararre, misali;
• Canja suturar waje, musamman idan kana da kowane irin sirri;

A yayin duk wani kulawa da babban mashin din, yana da mahimmanci koyaushe ka fara wanke hannayenka kuma kayi amfani da dabarar bakararre, ma'ana, dole ne ka sarrafa CVC ta amfani da filin bakararre, haka kuma safofin hannu marasa tsabta, koda kuwa kawai don gudanarwa ne wasu irin magunguna.

Matsaloli da ka iya faruwa

Samun tsakiyar jijiyoyin jiki na iya haifar da wasu matsaloli kamar zub da jini, rauni, kamuwa da cuta, cutar huhu, arrhythmia ko thrombosis na jini.