Te Tātaritanga o te Uaua Waenga: He Aratohu Matua

A Te Kātene Uaua Waenga (CVC), e mōhiotia ana ko te raina uaua pokapū, he ngongo ngāwari e whakaurua ana ki roto i tētahi uaua nui e anga atu ana ki te ngākau. Ko tēneitaputapu hauoraHe mea nui te mahi a te catheter uaua pokapū ki te tuku tika i ngā rongoā, ngā wai, me ngā matūkai ki roto i te toto, me te aroturuki hoki i ngā āhuatanga hauora. He mea nui ngā catheter uaua pokapū mō te whakahaere i ngā tūroro e mate kino ana, te hunga e whiwhi ana i ngā maimoatanga uaua, te hunga rānei e hiahia ana ki ngā maimoatanga uaua mō te wā roa. I roto i tēnei tuhinga, ka tūhuratia e mātou te kaupapa o ngā catheter uaua pokapū, ngā momo rerekē, te tikanga e uru ana ki te whakaurunga, me ngā raruraru pea.

Te Kaupapa o ngā Catheters o te Uaua Waenga

He maha ngā take hauora e whakamahia ana ngā katitere uaua pokapū, tae atu ki:

Te Whakahaere i ngā Rongoā:Tērā pea he kaha rawa ētahi rongoā, pērā i ngā rongoā chemotherapy me ngā paturopi, mō ngā uaua ā-taha. Mā te CVC ka taea te tuku haumaru i ēnei rongoā ki roto i tētahi uaua nui ake, ka whakaiti i te tūponotanga o te mumura o te uaua.

Te Whakaora IV mō te Wā Roa:Ko ngā tūroro e hiahia ana ki te rongoā ā-uaua (IV) mō te wā roa, tae atu ki ngā paturopi, te whakahaere mamae, te kai totika rānei (pēnei i te kai parenteral katoa), ka whai hua mai i te raina uaua pokapū, e whakarato ana i te urunga pumau me te pono.

Te Whakahaere i te Wai me te Toto:I ngā wā ohorere, i ngā wā tiaki nui rānei, ka taea e te CVC te whakahaere tere i ngā wai, i ngā hua toto, i te plasma rānei, ā, ka taea e ēnei te whakaora i te ora i ngā wā tino kino.

Te Tātaritanga me te Aroturukitanga Toto:Mā ngā katitere uaua matua ka taea te tango toto i ngā wā katoa, me te kore e werohia ngā ngira. He pai hoki ēnei mō te aroturuki i te pēhanga uaua matua, hei whakarato māramatanga ki te āhua o te ngākau me te ngākau o te tūroro.

Te Dialysis, te Apheresis rānei:Mō ngā tūroro e pāngia ana e te ngoikore o te whatukuhu, e hiahia ana rānei ki te apheresis, ka taea te whakamahi i tētahi momo CVC motuhake hei uru atu ki te toto mō ngā maimoatanga dialysis.

 

Ngā momoNgā Kātetere Uaua Waenga

He maha ngā momo katitere uaua pokapū, ia momo kua hangaia mō ngā kaupapa me ngā roa motuhake:

Raina PICC (Te Kātene Waenga kua Whakauruhia ki te Taha):

He kātetere roa, angiangi te aho PICC ka whakaurua mā roto i tētahi uaua i te ringa, ko te uaua basilic, ko te uaua cephalic rānei te tikanga, ka mirohia ki tētahi uaua pokapū e tata ana ki te ngākau. He mea whakamahi noa mō ngā maimoatanga wā-waenga ki te wā roa, mai i ngā wiki ki ngā marama.
He tino ngāwari te whakanoho me te tango i ngā aho PICC, he mea pai ake mō ngā maimoatanga roa kāore e hiahiatia he pokanga.

Ngā Kātetere Kāore i te Tuwhera:

Ka whakaurua tika ēnei ki roto i tētahi uaua nui i te kaki (te uaua o roto), te uma (te uaua o raro), te uma rānei (te uaua o te hope) ā, he maha ngā wā ka whakamahia mō ngā mahi poto noa iho, i roto i ngā āhuatanga tiaki nui, i ngā āhuatanga ohorere rānei.
Kāore ngā CVC kāore i te whai rua i te pai mō te whakamahinga mō te wā roa nā te mea he nui ake te mōrearea o te mate, ā, ka tangohia i te nuinga o te wā ina tau te āhua o te tūroro.
Ngā Kātetere Kua Rungahia:

Ka whakaurua ngā katitere kua whakatōkia ki roto i te uaua pokapū, engari ka tukuna mā roto i te kauhanga i raro i te kiri i mua i te taenga ki te pūwāhi tomo ki te kiri. Ka āwhina te kauhanga ki te whakaiti i te mōrearea o te mate, kia pai ai mō te whakamahinga roa, pērā i ngā tūroro e hiahia ana ki te tango toto pinepine, ki te rongoā chemotherapy tonu rānei.
He maha ngā wā he poroporo kei roto i ēnei katitere hei akiaki i te tipu o te kiko, hei whakau i te katitere ki tōna wāhi.

Ngā Tauranga Whakatō (Port-a-Cath):

He taputapu porowhita iti te pūwero kua whakatōkia, ka whakatakotoria ki raro i te kiri, i roto i te uma te nuinga. Ka rere te catheter mai i te pūwero ki te uaua pokapū. Ka whakamahia ngā pūwero mō ngā maimoatanga wā roa pēnei i te chemotherapy, nā te mea kei raro katoa i te kiri, ā, he iti te mōrearea o te mate.
He pai ake ki ngā tūroro ngā tauranga mō te tiaki mō te wā roa nā te mea he iti ake te kitea, ā, he ngira anake e hiahiatia ana i ia whakamahinga.

Te Tukanga Tātari i te Catheter o te Uaua Waenga
He tikanga hauora te whakaurunga o te catheter uaua pokapū, e rerekē ana i runga i te momo catheter e whakatakotoria ana. Anei tētahi tirohanga whānui o te tukanga:

1. Te Whakarite:

I mua i te tikanga, ka arotakehia te hītori hauora o te tūroro, ā, ka whiwhi whakaaetanga. Ka pania he wai patu paturopi ki te wāhi i werohia ai hei whakaiti i te tūponotanga o te mate.
Tērā pea ka hoatu he rongoā whakamoe ā-rohe, he rongoā whakangāwari rānei hei whakamarie i te tūroro.
2. Te Whakatakotoranga o te Catheter:

Mā te whakamahi i te arataki ultrasound, i ngā tohu ā-tinana rānei, ka whakaurua e te tākuta te catheter ki roto i tētahi uaua e tika ana. Mēnā he aho PICC, ka whakaurua te catheter mā roto i tētahi uaua ā-taha i te ringa. Mō ētahi atu momo, ka whakamahia ngā pūwāhi urunga pokapū pērā i ngā uaua subclavian, ngā uaua jugular ā-roto rānei.
Ka nekehia te katitere kia tae rā anō ki te wāhi e hiahiatia ana, ko te nuinga ko te vena cava o runga e tata ana ki te ngākau. He maha ngā wā ka mahia he hihi-X, he fluoroscopy rānei hei manatoko i te tūranga o te katitere.
3. Te Whakamau i te Catheter:

Kia tika te whakanoho o te katitere, ka herea ki ngā tuitui, ki te piripiri, ki tētahi takai motuhake rānei. Tērā pea he poroporo kei roto i ngā katitere kua whakatōkia hei pupuri i te taputapu.
Kātahi ka whakakakahuhia te wāhi whakauru, ā, ka horoia te catheter ki te tote hei whakarite kei te tika te mahi.
4. Te tiaki i muri i te mahi:

He mea nui te tiaki tika me te whakawhiti kakahu auau hei ārai i te mate. Ka whakangungua ngā tūroro me ngā kaitiaki ki te tiaki i te catheter i te kāinga mēnā e tika ana.
Ngā raruraru pea
Ahakoa he taputapu tino nui ngā katitere uaua pokapū i roto i te tiaki hauora, ehara i te mea kāore he mōrearea. Ko ētahi o ngā raruraru ka pā mai ko:

1. Te mate urutā:

Ko te raruraru tino noa ko te mate i te wāhi i whakaurua ai te weronga, te mate rānei i te toto (central line-associated bloodstream infection, CLABSI rānei). Mā ngā tikanga tino parakore i te wā e whakaurua ana, me te tiaki tupato hoki, ka taea te whakaiti i tēnei mōrearea.
2. Ngā Pukupuku Toto:

Ka taea e ngā CVC te whakapūpū i te toto i roto i te uaua i ētahi wā. Tērā pea ka tohua he rongoā whakangāwari toto hei whakaiti i tēnei mōrearea.
3. Te pūkahukahu:

Ka taea te werohanga o te pukahukahu i te wā e whakaurua ana, inā koa me ngā katitere kāore i te whai rua e whakanohoia ana ki te uma. Ka hua ake tēnei i te hinga o te pukahukahu, me tere te wawaotanga hauora.
4. Te ngoikore o te kātene:

Tērā pea ka āraia, ka piko, ka tangohia rānei te katitere, ā, ka pāngia tana mahi. Mā te horoi auau me te whakahaere tika ka ārai i ēnei raruraru.
5. Te toto:

He tūponotanga kei te toto te toto i te wā e mahia ana, inā koa mēnā he mate totoka te tūroro. Mā te tikanga tika me te tiaki i muri i te tikanga ka āwhina i te whakaiti i tēnei tūponotanga.

 

Whakamutunga
He taputapu tino nui ngā katitere uaua pokapū i roto i te tiaki hauora hou, e tuku ana i te urunga pono ki roto i ngā uaua mō ngā momo kaupapa whakaora me te tātaritanga. Ahakoa he māmā noa te tikanga hei whakauru i te raina uaua pokapū, me whai tohungatanga me te whakahaere tupato hei whakaiti i ngā raruraru. Mā te mārama ki ngā momo CVC me ō rātou whakamahinga motuhake ka taea e ngā kaiwhakarato hauora te whiriwhiri i te kōwhiringa pai rawa atu mō ngā hiahia o ia tūroro, kia pai ai te tiaki me te haumaru.