Uma udokotela wakho ekhuthaze ichwethi le-chemotherapy for chemotherapy , lokhu kusho ukuthini ngempela? Yiziphi izinzuzo nezindleko zechweba uma kuqhathaniswa nezinye izindlela zokufinyelela ezifana ne-intravenous (IV) line noma umugqa we-PICC?
Ake sibuke ukuthi yini enesibindi ehlanganisa izinzuzo (izinzuzo) kanye nokungalungile (ingozi) yokuba nechweba noma i-port-o-cath, nezindlela ongakwazi ngazo ukuvimbela izinkinga ezifana nokutheleleka noma ukuvinjelwa ichweba.
Iyini Port for Chemotherapy?
I-chemotherapy port (eyaziwa nangokuthi "i-port-a-cath") idivayisi encane efakwe ngaphansi kwesikhumba sakho ukuvumela ukufinyelela okulula egazini lakho legazi.
I-Port isetshenziswa nini?
Ichweba lingasetshenziselwa ukudweba igazi nokunika imithi yokwelapha i-chemotherapy. Ingasetshenziswa futhi uma udinga ukumpontshelwa kwamaseli abomvu noma amaplatelet. Ngaphandle kwechweba, noma umugqa we-PICC, inaliti entsha (IV) iyodingeka ibekwe njalo uma unayo i-chemotherapy, futhi imidwebo engu-IV ehlukene iyodinga ukufakwa uma udinga i-IV fluids noma igazi lokumpontshelwa igazi.
I-Chemotherapy
Kungakhathaliseki ukuthi udokotela wakho uncoma ukuthi ichweba lingaxhomeke ezintweni eziningana. Amanye imithi yokwelapha i-chemotherapy inganikezwa kuphela ngechweba, njengoba nayo ingabangela ukuba ihanjiswe emthonjeni we-peripheral.
Uma uzoba ne-infotheons eziningana ze-chemotherapy (ezinye ze-oncologists zincoma ichweba uma uzodla imithi engaphezu kwezine), ichweba ngokuvamile lilula kunokufaka i-IV njalo.
Futhi abanye abantu banezethameli ezilukhuni kakhulu ukufinyelela, okwenza ichweba kungcono ukwedlula ukubeka i-IV.
Ukuze wenze isinqumo esingcono kakhulu kuwe, vumela udokotela wakho wazi uma ochwepheshe bathole kulula noma kunzima ukudweba igazi noma ukubeka i-IV esandleni sakho noma ingalo esikhathini esidlule. (Kungenzeka ukuthi wezwe iphuzu le-tech ukuthi "uyintonga elula" noma "intambo elukhuni").
I-Port ifakiwe kanjani?
Ichweba livame ukufakwa ngesikhathi senqubo yokuhlinzwa efanayo yosuku olufanayo okungenziwa nge-anesthetic yendawo. Iningi odokotela bakhetha ukuthi ichweba lakho libeke okungenani isonto elilodwa ngaphambi kokuqala i-chemotherapy (uma kungenzeka) futhi ucwaningo lubonisa ukuthi ukuba nechweba lakho elibekwa okungenani izinsuku eziyisishiyagalombili ngaphambi kokuncipha kunciphisa ingozi yezinkinga. Uma unenqubo yokuhlinzwa yomdlavuza wakho, njenge- lobectomy yomdlavuza wamaphaphu noma isifo somdlavuza wesifo somdlavuza wesifuba, udokotela wakho ohlinzayo angase afake ichweba ngesikhathi esifanayo olunye uphenyo lwakho lwenziwe. Uma ichweba lifakwa ngesikhathi sokuhlinzwa, uzobe usuvele une-anesthetic jikelele endaweni.
Ngesikhathi sokufakwa, i-metal encane encane noma i-plastiki disc ifakwa ngaphansi kwesikhumba sakho ngokusebenzisa ukuchithwa kwe-inch-or-long-long. Lokhu kungahle kutholakale esifubeni sakho noma ngezinye izikhathi ingalo yakho engaphezulu. Leli port lihlanganiswe ne-tube catheter elifakwe kwenye yezimvalo ezinkulu eduze kwentamo yakho, njenge-veclavian vein noma i-vein jugular, bese iphela eduze kwenhliziyo yakho. Ngemuva kokuthi ichweba lakho libekwe udokotela wakho uzokwenza i-x-ray ukuze aqiniseke ukuthi ukuphela kwechweba lakho kusendaweni efanele.
Ngemuva kokufakwa kwechweba lakho, uzobona isikhumba esincane sesikhumba sakho, ngaphezu kwechweba.
Ngesikhathi igazi lidonsa noma i-chemotherapy infusions, umhlengikazi uzofaka inaliti esangweni lakho endaweni okuthiwa "i-septum," ukuvuselela isikhungo senjoloba kudoti lakho. Njengoba ichweba lingaphansi kwesikhumba sakho, uzokwazi ukugeza nokugeza ngaphandle kokukhathazeka ngokuthola ukutheleleka esangweni lakho.
Izinzuzo nezinzuzo
Njenganoma iyiphi inqubo yokuhlinza, kunezinzuzo zombili kanye nokungahambi kahle kokuthola i-chemotherapy port. Kucatshangwa ukuthi ama-port angaphezu kwezigidi ezingu-5 abekwe e-United States unyaka ngamunye, ngakho odokotela bayazi kahle inqubo futhi kuye kwafundwa kahle.
Izinzuzo zokuthola i-chemotherapy port ngokusebenzisa i-IV yendabuko zihlanganisa:
- Induduzo enkulu: Inaliti eyodwa inamathela esikhumbeni sakho ivame konke okudingekayo ukuze ufinyelele port yakho. Ngendlela yokwelashwa kwe-IV neyendabuko yegazi yendabuko, ngezinye izikhathi iningi lezinaliti zidingwa ukuze uthole imifino emihle, ikakhulukazi uma imithanjeni yakho ibhidlizwe ekudonseni kwegazi nokuphindaphindiwe okuphindaphindiwe. (I-Chemotherapy ingabangela ushintsho emithanjeni yakho eyenza kube nzima kakhulu ukugubha ngenaliti.)
- Ukugwema ukulibaleka: Akugcini nje ukuthi ugweme ukubambezeleka kokuba nomhlengikazi uzame ukuthola umuthi omuhle ukudweba igazi noma ukunikeza imithi yokwelashwa, kodwa ukuba nechweba kunganciphisa isikhathi esidingekayo ukulungisa isandla sakho noma ingalo yakho ngenqubo.
- Ukunciphisa ingozi ye "extravasation:" Uma i-IV isetshenzisiwe, imithi ingase ivuleke (i-extravasate) zibe izicubu ezizungezile isandla sakho noma ingalo. Njengoba imishanguzo eminingi ye-chemotherapy ibangela izicubu, ichweba linganciphisa ingozi yokuvuvukala-okuhlobene nokuvuza kwale mithi.
- Ukugeza okulula nokubhukuda: Njengoba ichweba lingaphansi kwesikhumba, ungakwazi ukugeza futhi ngisho nokubhukuda ngaphandle kokukhathazeka ngengozi yokutheleleka.
Izinkinga ezikhona ze-Chemotherapy Port
Izingozi ezingenzeka kanye nezinkinga ezihlobene nechwep chemotherapy zihlanganisa:
- Ingozi yenqubo yokuhlinza ukufaka ichweba: Noma iyiphi inqubo yokuhlinzeka ingaba nengozi yokutheleleka. Izinkinga ezingavamile (lezo ezenzeka ezingaphansi kwephesenti elilodwa labantu) zokufakelwa zingafaka ukuphuma (njengokungathi i-subclavia vein ikhonjiswe) kanye ne- pneumothorax (ukuwa kwamaphaphu) uma amaphaphu akho aphulwa ngephutha ngesikhathi senqubo.
- Ukutheleleka: Ingozi yokutheleleka ihlukahluka kwizifundo kodwa akuvamile. Uma ichweba litheleleka, kuzodingeka ukuthi lisuswe futhi lithathelwe indawo. Ucwaningo luhlola izindlela zokunciphisa le ngozi, ngakho-ke kubalulekile ukukhuluma ne-oncologist yakho mayelana nendlela yokuphatha kahle ichweba lakho.
- I-Thrombosis: I-clot ingase ibe yisechwebeni noma i-catheter, okwenza ukuba yeke ukusebenza. Phakathi kwamaphesenti angu-12 no-64 abantu abanechweba elibekwe i-chemotherapy kuzokwakhiwa i-thrombosis (clot) ku-catheter (ngokuvamile okwenza kube nesidingo sokuba leli dolobha lingene esikhundleni.)
- Izinkinga zemiklamo ezenza ukuba ichweba liyeke ukusebenza: Kwezinye izimo, izinkinga zemishini, njengokunyakaza kwe-catheter noma ukwehlukaniswa kwechweba esikhumbeni, kungabangela ukuba ichweba liyeke ukusebenza.
- Ukulinganiselwa komsebenzi: Nakuba imisebenzi efana nokugeza nokubhukuda ivame ukufaneleka, i-oncologist yakho ingancoma ukuyeka ukuvivinya umzimba ukuze uqinise umzimba wakho noma izingalo kuze kube yilapho isikhumbuzo sakho sisusiwe.
- Ukuhlukumeza: Ngenxa yokuthi kunomthelela omkhulu wokwelashwa komdlavuza, ubuhlungu obuvela echwebeni buyinto encane kakhulu. Kodwa abanye abantu bangase bathole isibazi esikhwameni esiphezulu sokuphazamisa izizathu zezimonyo noma ngoba uphawu lokuthi wake waphila nge-chemotherapy.
Ukuvimbela Izifo
Ucwaningo oluthile eminyakeni yamuva lubuke izindlela zokunciphisa ingozi ye-bacteria colonisation esangweni kanye nengozi elandelayo yokutheleleka ( sepsis ). I-Sepsis iyisifo sokuthi "umzimba wonke" ukutheleleka lapho amabhaktheriya akhona egazini futhi kungaba yingozi kakhulu. Nakuba ukusebenzisa njalo imithi elwa namagciwane akutholakali kusiza, ukususa ikhalatha ngesisombululo se-antibiotic / i-heparin kubonakala kunciphisa ingozi. Ukuhlanzwa kwesikhumba akuzange kubonakale kuzuzisa kakhulu ngalesi sikhathi, kodwa ukusebenzisa izigqoko ezifakwe izidakamizwa kungasiza. Kucatshangwa ukuthi ukuvikela ichweba ngendlela ngaphandle kwe-sutures (stitches) kunganciphisa ingozi yokutheleleka. Njengoba kuphawuliwe, lokhu kuyindawo yokucwaninga okusebenzayo futhi ungabuza i-oncologist yakho okwakunconywa njengamanje.
Ingozi ye-Thrombosis
Ukuvala noma ukuxhaphaza kudoti kuvamile futhi kuyisizathu esivame ukuthi ichweba lidingeke lisuswe futhi liphinde lithathwe esikhundleni. Ngokuvamile ukuqhuma ichweba nge-heparin ne-saline kubonakala kungenzi umehluko omkhulu, futhi ukuncipha kuye kwaphawulwa ngokusebenzisa i-heparin ye-dose ephansi (nakuba kwanda ukuphuma kwegazi). Labo abasengozini enkulu yibo abanomlando we-thrombosis ejulile ye-vein esikhathini esidlule. Indawo yokuphela kwe-catheter ingenza umehluko. Kodwa-ke, ingozi ye-thrombosis echwebeni ingaphansi kakhulu kunalokho kulayini we-PICC.
Indlela Ihluke Ngayo Emgqeni wePICC
I-PICC imelela "i-catheter ephakathi yangaphakathi." Umzila we-PICC uvame ukufakwa emthonjeni wokuphatha ukwedlula isikhathi (isibonelo, ukuze uthole ukufinyelela okuzodingeka amasonto ayisithupha kuphela). Imigqa ye-PICC ifakwe engalweni yakho eduze kwesikhumba sakho (ngezansi) futhi ungafinyeleli eduze nenhliziyo yakho njenge-catheter ye-port.
Ikususwa kanjani?
Uma wena nodokotela wakho niqiniseka ukuthi ichweba lakho alisadingeki, lingasuswa ngenqubo elula yokuhlinzeka.
Yini Okudingeka Uyazi Uma Unesikebhe?
Kubalulekile ukubuza udokotela wakho uma ichweba lakho lidinga ukunakekelwa okhethekile, njengokususa ngemithi ukuze usize ukuvimbela ama-clots ekwakheni.
Nini Ukubiza Udokotela Wakho
Njengoba ukutheleleka kuyinkimbinkimbi evame kakhulu yokuba nechweba, xhumana nodokotela wakho uma uhlakulela umkhuhlane noma uqaphele noma yikuphi ukubomvu, ukuvuvukala, ubuhlungu noma ukugeleza eduze kwechweba lakho.
> Imithombo:
> Society of American of Clinical Oncology. I-Cancer.Net. 09/2016. http://www.cancer.net/navigating-cancer-care/how-cancer-treated/chemotherapy/catheters-and-ports-cancer-treatment
> Heibl, C. et al. Izinkinga ezihlobene nokusetshenziswa kwe-Port-a-Cath ezigulini ezinesifo esibuhlungu noma se-hematological: ukuhlolwa okukodwa okuzoba khona. I-European Journal of Cancer Care . 2010. 19 (5): 676-81.
> Madabhavi, I., Patel, A., Sarkar, M. et al. Isifundo Sokusetshenziswa kwe "PORT" Cathterter in Iziguli Nge Cancer: A Experience-Centre Experience. I-Clinical Medicine Insights: I-Oncology . 2017. 11: 1179554917691031.
> Narducci, F. et al. Izindlela zokungena ezikhungweni zokungena ezibucayi ngokuphelele kanye nezinkinga ezibangelwa izinkinga: unyaka owodwa ozofunda esikhungweni somdlavuza. I-European Journal of Oncology Yokuhlinza . 2011. 37 (10): 913-8.