Yini i-Peripherally Inserted Central Catheter (PICC Line)? Injongo, Inqubo & Nemiphumela

Ulayini we-PICC uyishubhu elincanyana, eliguquguqukayo odokotela abalifaka ngomthambo engalweni yakho ukuze lifinyelele emithanjeni emikhulu eduze kwenhliziyo yakho. Cabanga ngayo njengomugqa okhethekile we-IV ongahlala endaweni yawo amasonto noma izinyanga, okwenza kube lula kakhulu ukuthola imithi nokwelashwa ngaphandle kokubhoboza izinaliti ngokuphindaphindiwe.

Lolu hlobo lwe-catheter emaphakathi lunikeza enye indlela ephephile, enethezekile kune-central lines yendabuko. Ngokungafani nezinye izinhlobo ze-catheter emaphakathi ezidinga ukufakwa eduze kwentamo yakho noma isifuba, imigqa ye-PICC isebenzisa indlela yemvelo yemithambo yengalo yakho ukuze ifinyelele endaweni efanayo.

Yini ulayini we-PICC?

Ulayini we-PICC yi-catheter ende, encane ehamba isuka emthanjeni engalweni yakho engenhla iye emithanjeni emikhulu eduze kwenhliziyo yakho. I-catheter ngokwayo yenziwe ngezinto ezithambile, ezihambisana nomzimba wakho ongazithwala isikhathi eside.

Ingxenye ethi "ifakwe emaphethelweni" isho ukuthi indawo yokungena ingomthambo ongaphambili engalweni yakho, kunokuthi ngqo emithanjeni emaphakathi esifubeni sakho noma entanyeni. Kodwa-ke, ithiphu igcina isendaweni emaphakathi, yingakho ibizwa ngokuthi i-catheter emaphakathi.

Imigqa ye-PICC ngokuvamile ilinganisa phakathi kuka-50 kuya ku-60 amasentimitha ubude. Zingaba neziteshi ezilodwa, ezimbili, noma ezintathu ezihlukene ezibizwa ngokuthi ama-lumens, okuvumela abahlinzeki bezempilo ukuthi banikeze imithi ehlukene ngasikhathi sinye ngaphandle kokuyixuba.

Kungani kwenziwa ulayini we-PICC?

Udokotela wakho angase ancome ulayini we-PICC uma udinga ukufinyelela ngemithambo isikhathi eside ukuze uthole ukwelashwa okungaba nzima noma okulimazayo ngemigqa evamile ye-IV. Lezi zinhlobo ze-catheter zivikela imithambo yakho emincane emithini ecasulayo ngenkathi zinikeza ukufinyelela okuthembekile.

Imigqa ye-PICC ivame ukusetshenziselwa ukwelashwa ngamakhemikhali, njengoba le mithi enamandla ingalimaza imithambo emincane ngokuhamba kwesikhathi. Zibalulekile futhi ekwelashweni ngama-antibiotic isikhathi eside, ikakhulukazi uma udinga ukwelashwa amasonto amaningana noma izinyanga.

Nawa amazwi ezokwelapha lapho imigqa ye-PICC ibonakala isiza kakhulu:

• Ukwelashwa ngamakhemikhali kanye nokunye ukwelashwa komdlavuza
• Ukwelashwa ngama-antibiotic isikhathi eside ngezifo ezinzima
• Ukwondla okuphelele kwangaphandle uma ungakwazi ukudla ngokujwayelekile
• Ukudonswa kwegazi okuvamile ukuze kuqashwe
• Ukuphathwa kwemithi ecasula imithambo emincane
• Izinqubo zokufakelwa kwamaseli esiqu
• Ukwelashwa okudinga ukuqashwa kwengcindezi yomthambo ophakathi nendawo

Ithimba lakho lezempilo lizohlola ngokucophelela ukuthi ngabe umugqa we-PICC uyindlela engcono kakhulu yohlelo lwakho lokwelashwa oluthile. Bacabangela izinto ezinjengobude bokwelashwa, uhlobo lwemithi, nesimo sakho sempilo esiphelele.

Yini inqubo yokufakwa komugqa we-PICC?

Ukufakwa komugqa we-PICC kuvame ukwenziwa njengenqubo yeziguli eziphuma ngaphandle ngabanakekeli abaqeqeshwe ngokukhethekile noma odokotela be-radiologists abangenelelayo. Le nqubo ivame ukuthatha imizuzu engaba ngu-30 kuya kwengu-60 futhi ingenziwa eceleni kombhede wakho noma egumbini elikhethekile lenqubo.

Ngaphambi kokuthi inqubo iqale, uzothola i-anesthetic yendawo ukuze uqede indawo yokufaka engalweni yakho engenhla. Iziguli eziningi zithola lokhu kukhululekile kakhulu kunalokho obekulindelekile ekuqaleni, zichaza ukuthi kufana nokudonswa kwegazi.

Nakhu okwenzekayo ngesikhathi senqubo yokufaka:

1. Ingalo yakho ihlanzwa futhi ifakwe izinto eziyinyumba
2. I-Ultrasound isiza ukuthola umthambo ongcono kakhulu wokufaka
3. I-anesthetic yendawo ifakwa ukuze iqede indawo
4. Inaliti encane idala ukufinyelela emthanjeni
5. I-catheter ye-PICC ifakwa ngomthambo iqonde enhliziyweni yakho
6. I-X-ray noma i-ultrasound iqinisekisa ukubekwa okufanele
7. I-catheter ivikelwe ngendwangu ekhethekile

Ngesikhathi sonke senqubo, ithimba lezempilo liqapha ukuqhubeka kwe-catheter lisebenzisa ubuchwepheshe bokuthwebula izithombe. Lokhu kuqinisekisa ukuthi i-catheter ifinyelela endaweni efanele eduze komnyango wenhliziyo yakho.

Uzoqhubeka uphapheme ngesikhathi sonke senqubo, futhi iziguli eziningi zimangala ukuthi isipiliyoni sizizwa silawuleka kanjani. Indawo yokufaka ingase izizwe ibuhlungu kancane usuku noma ezimbili ngemuva, kodwa ubuhlungu obukhulu abuvamile.

Ungalungiselela kanjani ukufakwa komugqa wakho we-PICC?

Ukulungiselela ukufakwa komugqa we-PICC kuhilela izinyathelo ezimbalwa ezilula ezisiza ukuqinisekisa ukuthi inqubo ihamba kahle. Ithimba lakho lezempilo lizohlinzeka ngemiyalelo ethile, kodwa ukulungiselela okuningi kugxila ekuvikeleni ukutheleleka nasekuqinisekiseni ukuthwebula izithombe okucacile.

Ungadla futhi uphuze ngokujwayelekile ngaphambi kwenqubo ngaphandle uma udokotela wakho ekunikeza imiyalelo ehlukile. Ngokungafani nezinqubo ezithile zezokwelapha, ukufakwa kwe-PICC ngokuvamile akudingi ukuzila ukudla.

Nakhu ukuthi ungalungiselela kanjani ngempumelelo ukuqokwa kwakho:

• Geza ngensipho elwa namagciwane ekuseni ngosuku lokufakwa
• Gqoka izingubo ezikhululekile ezinemikhono evulekile
• Susa ubucwebe ezingalweni zakho nasezandleni zakho
• Tshela ithimba lakho nganoma yikuphi ukungezwani komzimba noma imithi
• Lungiselela othile ukuthi akuqhubele ekhaya uma uthola ukuthuliswa
• Letha uhlu lwemithi yakho yamanje
• Hlala unamanzi kahle ezinsukwini ngaphambi kokufakwa

Udokotela wakho angase akucele ukuthi uyeke imithi ethile ngaphambi kwenqubo, ikakhulukazi ama-blood thinners. Ungalokothi uyeke imithi ngaphandle kwemiyalelo ecacile evela kumhlinzeki wakho wezempilo.

Kujwayelekile ngokuphelele ukuzwa ukukhathazeka ngaphambi kwenqubo. Iziguli eziningi zikuthola kuwusizo ukubuza imibuzo ngesikhathi sokubonisana kwazo ngaphambi kwenqubo ukuze zibhekane nanoma yikuphi ukukhathazeka.

Ungawafunda kanjani imiphumela yomugqa wakho we-PICC?

Imiphumela yomugqa we-PICC ngokuyinhloko ihlanganisa ukuqinisekisa ukubekwa okufanele nokusebenza kunokuchaza amanani ezinombolo njengeminye imivivinyo yezokwelapha. Ithimba lakho lokunakekelwa kwezempilo lisebenzisa izifundo zokucabanga ukuqinisekisa ukuthi ithiphu le-catheter lifinyelela endaweni efanele eduze kwenhliziyo yakho.

I-X-ray yesifuba ngokushesha ngemuva kokufakwa ikhombisa ukuthi ithiphu yomugqa we-PICC ihlezi endaweni efanele ngaphakathi kwe-superior vena cava noma i-atrium engakwesokudla. Lokhu kubekwa kuqinisekisa ukuthi imithi igeleza kahle ngaphakathi egazini lakho.

Ukubekwa kwe-PICC okuphumelelayo kusho izinto eziningana ezibalulekile ekunakekelweni kwakho:

• Ithiphu ye-catheter ifinyelela endaweni emaphakathi ehlosiwe
• Igazi ligeleza ngokukhululeka uma lidonswa ngomugqa
• Imithi inganikezwa ngaphandle kokumelana
• Akukho izinkinga ngokushesha ezinjengokopha noma i-pneumothorax ezenzekile
• Indawo yokufaka ibonakala ihlanzekile ngaphandle kwezimpawu zokulimala

Umnakekeli wakho uzokhombisa ukuthi umugqa we-PICC usebenza kanjani nokuthi ukusebenza okuvamile kubukeka kanjani. Uzoqeqeshwa ukuthi ubone izimpawu zokuthi konke kusebenza kahle uma kuqhathaniswa nalapho ungase udinge ukunakekelwa kwezempilo.

Ukuqapha okuqhubekayo kuhilela ukuhlola izinkinga ezinjengokutheleleka, amahlule egazi, noma ukungahambisani kwe-catheter. Ithimba lakho lokunakekelwa kwezempilo lizokufundisa izimpawu zokuxwayisa okufanele uzibheke ekhaya.

Ungawugcina kanjani umugqa wakho we-PICC?

Ukunakekelwa okufanele komugqa we-PICC kuvimbela ukutheleleka futhi kuqinisekisa ukuthi i-catheter yakho iyaqhubeka nokusebenza ngempumelelo kuyo yonke imithi yakho. Ithimba lakho lokunakekelwa kwezempilo lizohlinzeka ngemiyalelo enemininingwane ethile esimweni sakho nezidingo zokuphila.

Ukunakekelwa kwansuku zonke kugxila ekugcineni indawo yokufaka ihlanzekile futhi yomile ngenkathi kuvikelwa i-catheter ekulimaleni. Iningi leziguli livumelana nalezi zindlela ngokushesha futhi lizithola zilawuleka ngaphakathi kwemisebenzi yazo yansuku zonke.

Izinyathelo ezibalulekile zokulungisa zihlanganisa lezi zenzo ezibalulekile:

• Gcina indawo yokufaka yomile ngesikhathi sokugeza nokushawa
• Shintsha izindwangu zokugqoka ngokuya ngeshejuli yeqembu lakho lezempilo
• Geza i-catheter njalo ukuvimbela ukuba khona kwamahlule egazi
• Gwema imisebenzi engalimaza noma ekhumula i-catheter
• Qaphela izimpawu zokutheleleka njengobubomvu, ukuvuvukala, noma umkhuhlane
• Vikela i-catheter ngesikhathi sokulala nomsebenzi womzimba
• Landela imihlahlandlela yokuphatha imithi ngokucophelela

Umnakekeli wakho uzokufundisa wena noma umnakekeli wakho ukuthi angawenza kanjani imisebenzi yokunakekela edingekayo ngokuphepha. Ezinye iziguli zizizwa zikhululekile ukuphatha ukunakekelwa kwazo, kanti ezinye zikhetha ukuthi amalungu omndeni noma abahlengikazi bezempilo basekhaya bazisize.

Ukubhukuda nokucwiliswa emanzini kufanele kugwenywe ngaphandle uma udokotela wakho enikeza imvume ethile. Kodwa-ke, unga shawa ngokuphepha usebenzisa izembozo ezingangeni manzi ezenzelwe imigqa ye-PICC.

Ziyini izici eziyingozi zezinkinga zomugqa we-PICC?

Ezinye izici zingakhuphula ingozi yakho yokuba nezinkinga ngomugqa we-PICC, yize izinkinga ezingathi sína zihlala zingavamile. Ukuqonda lezi zici eziyingozi kusiza ithimba lakho lezempilo ukuthi lithathe izinyathelo zokuphepha ezifanele futhi likuqaphe eduze.

Umlando wakho wezokwelapha nesimo sakho sempilo samanje kuthonya ukuthi umzimba wakho ukubekezelela kangakanani i-catheter. Ezinye izimo zithinta ukuphulukiswa, ingozi yokutheleleka, noma ukujiya kwegazi, okuthinta ukuphepha komugqa we-PICC.

Izici eziyingozi ezivamile ezingakhuphula amazinga ezinkinga zihlanganisa:

• Isifo sikashukela noma ezinye izimo ezithinta ukusebenza komzimba
• Umlando wamahlule egazi noma izifo zokujiya kwegazi
• Izinkinga zangaphambilini ngama-catheter aphakathi
• Isifo sezinso noma ukujikeleza kwegazi okungahambi kahle
• Ukwelashwa komdlavuza okuvimbela ukusebenza komzimba
• Ubudala obuthuthukile noma ukuba buthaka
• Ukufakwa kwama-catheter amaningi ngaphambilini

Izinto ezingavamile kodwa eziyingozi kakhulu zihlanganisa izimo ezithile zofuzo ezithinta ukujiya kwegazi noma izifo zezicubu ezixhumene. Udokotela wakho uzobuyekeza umlando wakho wezokwelapha ophelele ngaphambi kokuncoma ukufakwa komugqa we-PICC.

Ukuba nezinto eziyingozi akusho ukuthi nakanjani uzobhekana nezinkinga. Kunalokho, ithimba lakho lezempilo lisebenzisa lolu lwazi ukuhlinzeka ngokuqapha okufanele kakhulu nokunakekelwa kokuvimbela isimo sakho.

Ziyini izinkinga ezingaba khona zemigqa ye-PICC?

Ngenkathi imigqa ye-PICC ivikelekile ngokuvamile, njenganoma iyiphi idivayisi yezokwelapha, ngezinye izikhathi ingabangela izinkinga. Izinkinga eziningi ziyalawuleka uma zitholwa ngesikhathi, yingakho ithimba lakho lezempilo likufundisa izimpawu zokuxwayisa okufanele uziqaphele.

Ukutheleleka kumelela inkinga evame kakhulu, eyenzeka cishe kuma-2-5% eziguli ezinemigqa ye-PICC. Lokhu kutheleleka kuvame ukuphendula kahle kuma-antibiotics, ikakhulukazi uma kwelashwa ngokushesha.

Nazi izinkinga eziyinhloko ezingenzeka, ezisohlwini kusuka kokuvamile kakhulu kuye kokungavamile kakhulu:

• Ukutheleleka endaweni yokufaka noma ukutheleleka kwegazi
• Amaqhubu egazi akheka ngaphakathi noma ngaphakathi kwe-catheter
• Ukungasebenzi kahle kwe-catheter noma ukuvaleka
• Ukususwa ngephutha kwe-catheter noma ukuthutha
• Ukuphuma kwegazi noma ukulimala endaweni yokufaka
• Umonakalo wemizwa ngesikhathi sokufakwa (akuvamile kakhulu)
• Ukuphazamiseka kwesigqi senhliziyo okuvela endaweni ye-catheter tip (akuvamile)

Izinkinga ezinzima njengokuphuma kwegazi okukhulu, i-pneumothorax, noma ukulimala kwemithambo emikhulu yegazi akuvamile kakhulu ngemigqa ye-PICC. Lolu hlu lwezokuphepha lwenza ukuthi zithandwe kunezinye izinhlobo ze-catheter emaphakathi ezigulini eziningi.

Ithimba lakho lezempilo liqapha izinkinga ngokuhlola njalo futhi likufundisa izimpawu zokuxwayisa ezidinga ukunakekelwa kwezokwelapha ngokushesha. Ukubona nokwelashwa ngesikhathi kuvimbela izinkinga eziningi ukuthi zingabi zimbi.

Kufanele ngibone nini udokotela ngezinkinga zomugqa we-PICC?

Ukwazi ukuthi ungaxhumana nini nethimba lakho lokunakekelwa kwezempilo mayelana nezinkinga zomugqa we-PICC kusiza ekuvikeleni izinkinga ezincane ukuthi zingabi yizinkinga ezinkulu. Ezinye izimpawu zidinga ukunakekelwa kwezempilo ngokushesha, kanti ezinye zingalinda amahora ebhizinisi avamile.

Themba imizwa yakho uma kukhona okungahambi kahle ngomugqa wakho we-PICC noma indawo yokufaka. Kungcono ngaso sonke isikhathi ukushaya ucingo futhi ube nezinkinga ezixazululwayo kunokulinda futhi ubeke engozini izinkinga.

Xhumana nomhlinzeki wakho wezempilo ngokushesha uma uhlangabezana nanoma yiziphi zalezi zimpawu eziphuthumayo:

• Umkhuhlane ongu-100.4°F (38°C) noma ngaphezulu
• Ubuhlungu obukhulu, ububomvu, noma ukuvuvukala endaweni yokufaka
• Ukuphuma kwegciwane noma ukuphuma okungavamile endaweni yokufaka
• Ubuhlungu besifuba noma ubunzima bokuphefumula
• Ukuvuvukala okungazelelwe engalweni yakho, entanyeni, noma ebusweni
• I-catheter ibonakala sengathi ihambile noma ikhishwe
• Ayikwazi ukukhipha noma ukudonsa igazi ku-catheter

Izimpawu ezingaphuthumi kangako ezisadinga ukuhlolwa kwezokwelapha zihlanganisa ubuhlungu obuncane, amanani amancane okuphuma okucacile, noma imibuzo mayelana nokuphathwa kwemithi. Lezi zinkinga ngokuvamile zingalinda amahora emtholampilo avamile.

Ithimba lakho lokunakekelwa kwezempilo likhetha ukuthi ushayele ucingo ngemibuzo kunokukhathazeka ngokungadingekile. Bayaqonda ukuthi ukunakekelwa komugqa we-PICC kungase kuzizwe kukhulu ekuqaleni futhi bafuna ukukusekela kuyo yonke imithi yakho.

Imibuzo evame ukubuzwa mayelana nemigqa ye-PICC

Q.1 Ingabe ukuhlolwa komugqa we-PICC kulungile ekwelashweni kwesikhathi eside?

Yebo, imigqa ye-PICC yenzelwe ngokuqondile ukufinyelela ngemithambo isikhathi eside futhi ingahlala ngokuphepha endaweni amasonto kuya ezinyangeni. Zifaneleka kakhulu ekwelashweni okweluliwe kunezintambo ze-IV ezivamile, ezivame ukuhlala izinsuku ezimbalwa kuphela.

Imigqa ye-PICC ingasebenza ngempumelelo izinyanga ezi-3-6 noma ngisho nangaphezulu uma inakekelwa kahle. Lokhu kubenza balungele ukwelashwa okufana nemijikelezo ye-chemotherapy, ukwelashwa ngama-antibiotic isikhathi eside, noma ukusekelwa kokudla okunomsoco okweluliwe.

Q.2 Ingabe ukuba nomugqa we-PICC kubangela umonakalo unomphela?

Imigqa ye-PICC ayivamile ukubangela umonakalo unomphela uma ifakwe futhi inakekelwa kahle. Iningi elikhulu leziguli lithola ukuphola okuphelele kwendawo yokufakwa ngemva kokususwa kwe-catheter, ngesibazi esincane kuphela esisele.

Ngokuvamile, ezinye iziguli zingase zithole imiphumela ehlala njalo efana nokuzwela kwemizwa noma ukulimala kwemithambo. Nokho, lezi zinkinga azivamile kakhulu ngemigqa ye-PICC uma ziqhathaniswa nezinye izinhlobo ze-catheter emaphakathi.

Q.3 Ngingakwazi yini ukuzivocavoca ngomugqa we-PICC endaweni?

Ukuzivocavoca okulula kuya kokulingene kuvamile ukuthi kwenzeke ngomugqa we-PICC, kodwa uzodinga ukugwema imisebenzi engalimaza noma ikhiphe i-catheter. Ukuhamba, ukwelula okulula, nokuphakamisa izinsimbi ezilula ngengalo yakho engeyona i-PICC kuvamile ukuthi kwamukeleke.

Gwema ezemidlalo zokuxhumana, ukuphakamisa izinto ezisindayo ngengalo ye-PICC, noma imisebenzi ebandakanya ukunyakaza kwengalo okuphindaphindiwe. Ithimba lakho lezempilo lizohlinzeka ngemihlahlandlela ethile yomsebenzi esekelwe ekwelashweni kwakho nasezidingweni zokuphila.

Q.4 Kubuhlungu kangakanani ukufakwa nokususwa komugqa we-PICC?

Iziguli eziningi zichaza ukufakwa kwe-PICC njengokufana nokudonswa kwegazi, ngokuphazamiseka okufushane kuphela ngesikhathi sokujova kwe-anesthetic yendawo. Inqubo ngokwayo ngokuvamile ayinabuhlungu, futhi noma yikuphi ukuba buhlungu ngemva kwalokho kuvamile ukuthi kulungiswe phakathi kwezinsuku eziyi-1-2.

Ukususwa kwe-PICC ngokuvamile kulula ngisho nokwedlula ukufakwa, okuvame ukuchazwa njengomuzwa wokudonsa okufushane. Yonke inqubo yokususwa ithatha imizuzu embalwa nje futhi ayidingi i-anesthetic.

Q.5 Kwenzekani uma umugqa wami we-PICC uthola ukutheleleka?

Ukutheleleka komugqa we-PICC kuvamile ukuthi kulashwe ngama-antibiotics, futhi iziguli eziningi zingagcina i-catheter yazo endaweni ngesikhathi sokwelashwa. Udokotela wakho uzonquma indlela engcono kakhulu esekelwe ohlotsheni nobukhulu bokutheleleka.

Kwezinye izimo, umugqa we-PICC ungase udinge ukususwa ukuze kususwe ukutheleleka ngokuphelele. Uma lokhu kwenzeka, i-catheter entsha ingafakwa kaningi uma ukutheleleka sekulungisiwe, okukuvumela ukuthi uqhubeke nokwelashwa okudingekayo.