Catheter venous Central (CVC): he aha ia, he aha ia no a me ka mālama

Anter

• No ke aha ia
• Pehea e hana ai
• Nā ʻano o ke komo ʻana o ka venous central
• Mālama nui o ka catheter waena
• Nā pilikia i hiki

ʻO ka catheterization venous kikowaena, i ʻike ʻia ʻo CVC, kahi hana olakino i hana ʻia e kōkua ai i ka mālama ʻana i kekahi mau mea maʻi, keu hoʻi i nā hanana e like me ka pono o ka hoʻokomo ʻana i nā wai nui o nā wai i ke kahe o ke koko, hoʻohana i ke komo ʻana o ka venous no nā wā lōʻihi, no ka ʻoi aku ka maikaʻi o ka nānā ʻana i ka hemodynamic, a me ke kahe o ke koko a i ʻole ka meaʻai makua, no ka laʻana, e koi ana i ke komo palekana ʻana i nā kīʻaha koko.

ʻOi aku ka lōʻihi a me ka ākea o ka catheter venous kikowaena ma mua o nā catheters peripheral maʻamau i hoʻohana ʻia i nā aa o nā wahi e like me ka lima, a hoʻolālā ʻia e hoʻokomo ʻia i loko o nā uaua nui o ke kino, e like me ka subclavian, aia i ka thorax, ka jugular, Aia i ka ʻāʻī, a i ʻole ka femoral, aia i ka inguinal ʻāpana.

ʻO ka maʻamau, hōʻike pinepine ʻia kēia kaʻina hana i nā wahi mālama nui (ICU) a i ʻole nā ​​hanana pilikia, a pono e hana ʻia e ke kauka, e pili ana i kahi ʻenehana e koi ai i nā mea ʻokiʻoki a me nā pono pono ʻole. Ma hope o ke kau ʻia ʻana, pono pono ka mālama kahu hānai e nānā a pale i nā pilikia e like me nā maʻi a me ke kahe ʻana o ke kahe.

No ke aha ia

ʻO nā hōʻailona nui no ke komo ʻana o ka venous kikowaena:

• Hoʻomaʻamaʻa i ka mālama ʻana i ke komo ʻana o ka venous no nā wā lōʻihi, e pale ana i nā punctures he nui;
• Hoʻokomo i ka nui o nā wai a i ʻole nā ​​lāʻau, ʻaʻole i kākoʻo ʻia e nā hele ākea ākea peripheral maʻamau;
• Lawelawe i nā lāʻau i hiki ke hoʻonāukiuki ke loaʻa ka extravasation mai ke komo ʻana o ka venous peripheral, e like me vasopressors a i ʻole nā ​​hopena hypertonic o ka sodium a me ka calcium bicarbonate;
• E ʻae i ka nānā hemodynamic, e like me ke ana ʻana i ka puʻuwai venous a me ka hōʻiliʻili ʻana i nā mea koko
• Ke hana nei i ka hemodialysis, i nā hanana wikiwiki a i ʻole ke hoʻokumu ʻia o ka fistula arteriovenous iā ia iho. Hoʻomaopopo pehea ka hemodialysis e hana ai a ke kuhikuhi ʻia;
• Hana i ke koko a i ʻole nā ​​ʻāpana o ke koko transfusion;
• Hoʻomaʻamaʻa i ka hoʻomaʻamaʻa chemotherapy;
• E ʻae i ka meaʻai o nā mākua ke hānai ʻole ʻia ma o ka gastrointestinal tract i hiki ʻole.

Pono e hana i ka hana o ke kikowaena waena i kekahi mau hana akahele e hōʻemi ai i ka pilikia o nā pilikia. No laila, ʻaʻole hōʻike ʻia kēia kaʻina hana i nā hihia o ka maʻi a me nā deformities o ka pūnaewele e hou ʻia, nā loli i ke kāpili ʻana o ke koko a i ʻole inā he nui nā pilikia o ke kahe ʻana, koe wale nō nā hanana kūikawā i hōʻike ʻia e ke kauka.

Pehea e hana ai

No ka hana ʻana i ka catheterization venous kikowaena, pono pono e hoʻonohonoho i ke kanaka, ka mea maʻamau e moe ana ma ke kau. A laila, e hoʻomaopopo ke kauka i kahi kikoʻī o ka puncture, asepsis o ka ʻāina a hana ʻia ka ʻili a puni, e hoʻopau ana i ka foci o ka maʻi.

Eia hou, ua hana ke kauka a me ka hui i ka holoi lima lima akahele ʻana a lako pono ʻia me nā pono hana e hōʻemi ai i ka maʻi o ka maʻi, e like me nā mīkina lima, mask, pāpale, ʻaukā ʻoki kino a me nā drapes sterile.

ʻO ke ʻano hana i hoʻohana ʻia e hana i ka catheterization venous center i kapa ʻia ʻo Seldinger technique. I mea e hoʻokō ai, ma ka hoʻohui o nā pono pale, ka ʻeke a me nā pono o ke serum, anesthetic, steril gauze, scalpel a me ka pahu catheter kit, i loaʻa ka nila, alakaʻi, ka dilator a me ka catheter intravenous, pono e hoʻohana i nā pono. nila a me ka pae e hoʻopili i ka catheter i ka ʻili.

I kēia manawa, koho kekahi mau kauka e hoʻohana i ka ultrasound e alakaʻi i ka hoʻokomo ʻana o ka catheter a hoʻoliʻiliʻi i ka pilikia o nā pilikia.

He mea nui nō hoʻi e hoʻomanaʻo, ʻoiai he hana hoʻouka ia, pono e hoʻomaopopo a loaʻa ka ʻae o ka mea maʻi no kāna hana, koe wale nō inā pilikia nā pilikia a kokoke paha i ka make, ke hiki ʻole ke kamaʻilio.

Nā ʻano o ke komo ʻana o ka venous central

Hiki ke hana ʻia ka catheterization venous kikowaena ma nā ʻano he 3, e like me ke aa i koho ʻia e hou ʻia.

• Uku koko Subclavian;
• ʻO ka veins jugular kūloko;
• ʻO ke olonā wahine.

ʻO ke koho ʻana o ke ʻano o ke komo ʻana o ka venous e hana ʻia e ke kauka e like me ka ʻike, makemake a me nā ʻano o ka mea hoʻomanawanui, he maikaʻi nā mea āpau a loaʻa nā maikaʻi a me nā mea maikaʻi ʻole. ʻO kahi laʻana, i nā mea maʻi i loaʻa i ka ʻehaʻeha a i ʻole kahi e koi ʻia ai ka hoʻōla cardiopulmonary, ʻoi aku ka nui o ke aa o ka wahine, ʻoiai ke komo i loko o nā veins jugular a subclavian paha ʻaʻole e haumia.

E nānā i nā ʻano catheterization ʻē aʻe e pono ai.

Mālama nui o ka catheter waena

ʻO ka maʻamau, hoʻohana wale ʻia ka catheter venous kikowaena ma kahi haukapila, no ka mea pono e mālama pono ʻia, e pale ai i ke komo ʻana o nā microorganism i loko o ka copro, kahi e hiki ai i kahi maʻi nui a hoʻoweliweli i ke ola.

No laila, mālama pinepine ʻia ka CVC e ka kahu, nāna e mālama maʻamau e like me:

• E hana i ka ʻōlapa o ka catheter me ka paʻakai, e pale aku iā ia mai ka lilo ʻana i nā clots, no ka laʻana;
• Hoʻololi i ka lole waho, keu hoʻi inā he ʻano huna kāu;

I ka wā o ka mālama ʻana i ka catheter venous waena, he mea nui e holoi pinepine i kou mau lima a hoʻohana i kahi hana kuʻuna, ʻo ia hoʻi, pono ʻoe e hoʻopololei i ka CVC me ka hoʻohana ʻana i kahi māla sterile, a me nā mīkina lima sterile, ʻoiai inā e lawelawe wale ia. kekahi ʻano lāʻau.

Nā pilikia i hiki

Hiki i ke komo ʻana o ka venous Central ke kumu i kekahi mau pilikia e like me ke kahe ʻana o ke koko, ka ʻeha ʻana, ka maʻi, ka pūhaʻi pūpū, arrhythmia a i ʻole thrombosis venous.