Central Venous Catheter: An Essential Guide

A Central Venous Catheter (CVC), inozivikanwawo semutsara wepakati we venous, ichubhu inochinjika inoiswa mutsinga huru inoenda kumoyo. Izvimudziyo wekurapainoita basa rakakosha mukupa mishonga, zvinwiwa, uye zvinovaka muviri zvakananga muropa, pamwe nekutarisa zvakasiyana-siyana zvehutano. Central venous catheters yakakosha pakubata varwere vane hurwere hwakanyanya, avo vari kurapwa zvakaomarara, kana vanhu vanoda kwenguva refu intravenous therapies. Muchikamu chino, tichaongorora chinangwa chepakati venous catheter, mhando dzakasiyana, maitiro anobatanidzwa mukuiswa kwavo, uye zvinogona kunetsa.

Chinangwa cheCentral Venous Catheters

Central venous catheters anoshandiswa kune zvakasiyana zvikonzero zvekurapa, zvinosanganisira:

Kutarisira Mishonga:Mimwe mishonga, yakadai sechemotherapy mishonga kana mishonga inorwisa mabhakitiriya, inogona kunge yakanyanya kuomarara kune peripheral veins. A CVC inobvumira kuendeswa kwakachengeteka kwemishonga iyi zvakananga mutsinga yakakura, kuderedza dambudziko rekutsamwa kwevheji.

Yenguva refu IV Therapy:Varwere vanoda kwenguva yakareba intravenous (IV) therapy, kusanganisira mishonga inorwisa mabhakitiriya, marwadzo ekugadzirisa, kana kudya (kufanana nehuwandu hwekudya kwevabereki), vanobatsirwa nemutsara wepakati wepakati, unopa kugadzikana uye kutendeseka kuwana.

Fluid uye Ropa Chigadzirwa Kuronga:Mumamiriro ekukurumidzira kana ekuchengetedza kwakanyanya, CVC inogonesa kukurumidza kutonga kwemvura, zvigadzirwa zveropa, kana plasma, iyo inogona kuponesa hupenyu mumamiriro ezvinhu akaoma.

Ropa Sampling uye Monitoring:Central venous catheter inogonesa kutorwa kweropa kakawanda pasina kudzokororwa tsono. Izvo zvakare zvinobatsira pakutarisa yepakati venous pressure, ichipa manzwisisiro muchimiro chemoyo chemurwere.

Dialysis kana Apheresis:Mune varwere vane itsvo kutadza kana avo vanoda apheresis, rudzi rwakakosha rweCVC runogona kushandiswa kuwana ropa rekurapa dialysis.

 

Mhando dzeCentral Venous Catheters

Kune akati wandei marudzi epakati venous catheters, imwe neimwe yakagadzirirwa zvinangwa uye nguva:

PICC Mutsetse (Peripherally Inserted Central Catheter):

Mutsara wePICC itambo refu, yakatetepa inopinzwa nemutsinga muruwoko, kazhinji iyo basilic kana cephalic vein, uye yakarukwa kune yepakati tsinga padyo nemoyo. Inowanzoshandiswa pakurapa kwepakati kusvika kwenguva refu, kubva kumavhiki kusvika kumwedzi.
Mitsetse yePICC iri nyore kuisa nekubvisa, zvichiita kuti ive sarudzo yakasarudzika yekurapa kwenguva refu iyo isingade kuiswa kwekuvhiya.

Non-tunneled Catheters:

Izvi zvinoiswa zvakananga mutsinga huru mumutsipa (mukati jugular), chifuva (subclavian), kana groin (femoral) uye inowanzoshandiswa kune zvinangwa zvenguva pfupi, kazhinji mukutarisira kwakanyanya kana mamiriro ekukurumidzira.
Non-tunneled CVCs haisi yakanakira kushandiswa kwenguva refu nekuda kwengozi yepamusoro yehutachiona uye inowanzobviswa kana mamiriro emurwere agadzikana.
Tunneled Catheters:

Makateta ane tunneled anopinzwa mutsinga yepakati asi anofambiswa nemukoto we subcutaneous asati asvika panopindwa paganda. Mugero uyu unobatsira kuderedza njodzi yekutapukirwa, uchiita kuti ive yakakodzera kushandiswa kwenguva refu, senge muvarwere vanoda kugara vachitorwa ropa kana chemotherapy inoenderera.
Aya ma catheter anowanzo aine cuff inokurudzira kukura kwetishu, kuchengetedza catheter munzvimbo.

Zviteshi Zvakasimwa (Port-a-Cath):

Chiteshi chakasimwa chinhu chidiki, chakatenderera chinoiswa pasi peganda, kazhinji muchipfuva. Catheter inomhanya kubva pachiteshi ichienda kune yepakati tsinga. MaPorts anoshandiswa kurapwa kwenguva refu senge chemotherapy, sezvo ari pasi peganda uye aine njodzi yakaderera yekutapukirwa.
Varwere vanosarudza zviteshi zvekuchengetedza kwenguva refu nekuti havanyanyi kubvongodza uye vanongoda tsono kamuti panguva yega yega yekushandisa.

Central Venous Catheter Procedure
Kuiswa kwepakati venous catheter inzira yekurapa inosiyana zvichienderana nerudzi rwecatheter iri kuiswa. Heino mhedziso yemaitiro acho:

1. Kugadzirira:

Kusati kwaitwa, nhoroondo yezvehutano yemurwere inoongororwa, uye kubvumirwa kunowanikwa. Mushonga wekuuraya utachiona unoshandiswa panzvimbo yekuisa kuti kuderedze njodzi yehutachiona.
Nharaunda yemunharaunda kana sedation inogona kupihwa kuti murwere anzwe kugadzikana.
2. Catheter Kuiswa:

Achishandisa ultrasound kutungamira kana anatomical landmarks, chiremba anoisa catheter mutsinga yakakodzera. Kana iri mutsara wePICC, catheter inopinzwa kuburikidza neperipheral vein muruoko. Kune mamwe marudzi, nzvimbo dzepakati dzekuwana senge subclavian kana yemukati jugular veins inoshandiswa.
Iyo catheter inofambiswa kusvika yasvika panzvimbo inodiwa, kazhinji iyo yepamusoro vena cava pedyo nemoyo. X-ray kana fluoroscopy inowanzoitwa kuti ione nzvimbo ye catheter.
3. Kuchengetedza Catheter:

Kana iyo catheter yaiswa zvakanaka, inochengetedzwa ne sutures, adhesive, kana yakakosha kupfeka. Tunneled catheter inogona kunge iine cuff yekuwedzera kuchengetedza mudziyo.
Nzvimbo yekuisirwa inobva yapfekwa, uye catheter inogezwa nesaline kuti ive nechokwadi chekuti iri kushanda nemazvo.
4. Aftercare:

Kuchengetedzwa kwakafanira uye kuchinja mapfekero nguva dzose kwakakosha kudzivirira utachiona. Varwere nevatarisiri vanodzidziswa kuti vangachengeta sei catheter kumba kana zvichidiwa.
Zvinogona Kunetsa
Nepo epakati venous catheter ari maturusi akakosha mukurapa, haana njodzi. Mamwe matambudziko anogona kuitika anosanganisira:

1. Utachiona:

Dambudziko rinonyanya kunetsa ndere kutapukirwa panzvimbo inoiswa kana utachiona hweropa (central line-associated bloodstream infection, kana CLABSI). Nzira dzakasimba dzakasimba panguva yekuisa uye kunyatsogadzirisa zvinogona kuderedza njodzi iyi.
2. Magwara eRopa:

CVCs dzimwe nguva inogona kukonzera kuvhara ropa mutsinga. Zvinoderedza ropa zvinogona kunyorerwa kuderedza njodzi iyi.
3. Pneumothorax:

Kubaya netsaona kwemapapu kunogona kuitika panguva yekuiswa, kunyanya nema catheter asina-tunneled akaiswa munzvimbo yechipfuva. Izvi zvinoguma nemapapu akadonha, izvo zvinoda kupindira kwechiremba nekukurumidza.
4. Kusashanda kweCatheter:

Iyo catheter inogona kuvharika, kinked, kana kubviswa, zvichikanganisa basa rayo. Kugara uchigeza uye kubata kwakakodzera kunogona kudzivirira nyaya idzi.
5. Kubuda ropa:

Pane ngozi yekubuda ropa panguva yekuitwa, kunyanya kana murwere ane zvirwere zvekuvhara. Tekinoroji yakakodzera uye kuchengetwa kwemashure kunobatsira kuderedza njodzi iyi.

 

Mhedziso
Central venous catheter ndiwo akakosha maturusi mukurapa kwemazuva ano, achipa yakavimbika venous kuwana kune akasiyana ekurapa uye kuongororwa zvinangwa. Nepo maitirwo ekuisa mutsara wepakati akati chechetere, zvinoda hunyanzvi uye kubata nekungwarira kuderedza matambudziko. Kunzwisisa mhando dzeCVCs uye mashandisiro awo chaiwo anobvumira vatapi vehutano kuti vasarudze yakanakisa sarudzo yezvinodiwa nemurwere wega wega, kuve nechokwadi chekuchengetedza uye kuchengetedzeka.