Catheter yepakati yemutsinga
Zvimiro zveChigadzirwa
● Chibatiso chinofambiswa chinobvumira kuti chimire panzvimbo yakaboorwa pasinei nekudzika kwekatheta, izvo zvinoderedza kukuvara nekutsamwiswa panzvimbo yakaboorwa.
● Kuisa chiratidzo chekudzika kweropa kunobatsira pakuisa catheter yepakati petsinga kubva kurudyi kana kuruboshwe rwe subclavian kana jugular vein nemazvo.
● Muromo wakapfava unoderedza kukuvara kwetsinga dzeropa, zvichideredza kuputsika kwetsinga dzeropa, hemothorax uye cardiac tamponade.
● Lumen imwe chete, mbiri, katatu inowanikwa kuti usarudze.
Mirayiridzo yekushandisa
KUGADZIRA KWEMAITIRO PAKUTANGA
● Kuongororwa kweMurwere: Tarisa chiratidzo uye patency yetsinga (zvinokurudzirwa kushandisa ultrasound).
● Midziyo: Kit yeCVC isina utachiona (catheter, guidewire, dilator, sutures), muchina we ultrasound, machira asina utachiona, mushonga wekuuraya utachiona (chlorhexidine/doro), mushonga wekurwadziwa wemudumbu (1–2% lidocaine).
MAITIRO EKUISA
● Kuisa murwere panzvimbo yake uye kuvhiyiwa: Isa murwere muTrendelenburg (jugular/subclavian) kana akarara pasi (femoral), bvisa hutachiona paganda ne >0.5% chlorhexidine.
● Kupinda mutsinga: Shandisa nzira yeSeldinger inotungamirirwa neultrasound.
① Isa tsono, buritsa ropa kuti usimbise tsinga.
② Shandisa waya yekufambisa tambo, bvisa tsono.
③ Wedzera nzira yekupinda, fambisa katheta pamusoro pewaya.
④ Bvisa waya, simbisa kudzoka kweropa.
● Kuchengetedza & Kuisa Mbatya: Suture catheter + isa mbatya isina tsvina inoonekera. Simbisa kuti yaiswa sei uchishandisa CXR (tip iri paSVC/RA junction).
KUCHENGETEDZWA KWAKAPEREKWA MUSHURE KOKUBATIRWA
● Kushambadza: Heparinized saline (yekushandisa nguva nenguva). 0.9% saline (inoiswa nguva dzose).
● Kuchinja Mapfekero: Mazuva manomwe ega ega (akajeka) kana mazuva maviri (gauze).
● Kuongororwa Kwematambudziko: Pneumothorax, hutachiona, thrombosis.
Chikumbiro chechigadzirwa
● Kutarisirwa Kwakakosha: Kupa mishonga, mvura, kana mishonga inodzvinyirira ropa mumakamuri evarwere vanorwara zvakanyanya (ICUs).
● Kurapa nemakemikari: Kuendesa mishonga yemakemikari kana mimwe mishonga yenguva refu.
● Kudya Kwevabereki: Kupa rubatsiro rwezvekudya kune varwere vasingakwanise kudya.
● Kuchenesa ropa: Kunoshanda senzira yekukurumidza yekubvisa ropa kubva mutsinga dzeropa (semuenzaniso, CVC dzisina tunneled).
● Kuongororwa: Kuyera kumanikidzwa kwetsinga dzeropa (CVP) muvarwere vanorwara zvakanyanya.
Magadzirirwo uye Mamodheru
| Catheter yeLumen imwe chete | Catheter yeLumen mbiri | Catheter yeTriple Lumen | |||
| Nhamba yeChigadzirwa | Muenzaniso | Nhamba yeChigadzirwa | Muenzaniso | Nhamba yeChigadzirwa | Muenzaniso |
| 021001 | 20G | 022001 | 4F | 023002 | 5.5F |
| 021002 | 18G | 022002 | 5F | 023003 | 7F |
| 021003 | 16G | 022003 | 7F | 023004 | 8.5F |
| 021004 | 14G | 022004 | 8F | ||
Ruzivo rweChigadzirwa