Izimpawu Nezimpawu Zokuzibuka
I-extravasation yilapho imithi yokwelapha i- chemotherapy noma ezinye izidakamizwa zivuza ngaphandle kwe-vein noma esikhunjeni, okwenza kube khona ukusabela. E-chemotherapy, izidakamizwa zihlukaniswa zibe izigaba ezimbili ezibanzi ngokusekelwe emthonjeni onama tishu lapho zikhukhumeza-izidakamizwa kanye nezici.
I-Extravasation yama-Irritants
Imithi evuthayo yilabo abangela ukulimala okwesikhashana, okungokwenyama kwezicubu lapho bevuza.
Uma kunesidakamizwa esiphuthumayo semithi ephikisayo, uzobheka ububomvu, ukuvuvukala, ukuhlambalaza nokungahambi kahle esakhiweni se-intraveous (IV).
Uma enye yale mithi ivuza, umhlinzeki wakho wokunakekelwa kwempilo uyomisa lesi sidakamizwa, uqale i-IV emisha bese unikeza okunye okusele mithi ngesayithi elisha. Ukwelashwa kokunwetshwa kwemithi ecasulayo kugxile ekwenzeni isayithi lizwe sengathi likhululekile ngangokunokwenzeka. Umhlinzeki wakho wokunakekelwa kwezempilo angancoma imithi ebuhlungu, njengesiTylenol, futhi iphoqelele kakhulu njengoba kudingeka.
Ezinye izibonelo zokucasula okuvame ukunikezwa ekwelapheni i- leukemia ne- lymphoma zihlanganisa, i-cytarabine, i-bleomycin, i-epoposide ne-dacarbazine.
Ukwedlula ama-Vesicants
Ama-vesicants kukhona izidakamizwa ezingakwazi ukulimaza kakhulu izicubu uma zivuza ngaphandle kwe-vein. Kulokhu, uzophinde ubone ukubomvu nokuvuvukala, kodwa kungenzeka ukuthi ukungahambi kahle endaweni ye-IV kuzobonakala nakakhulu.
Ezinye zezimpawu ze-extravasation kungenzeka zingabonakali kuze kube amahora ambalwa ngemva kokuthi kwenzeke. Kuye ngesilinganiso semithi esetshenzisiwe, kungase kube khona ukuphuza, ukucubungula nokunyamala kwesikhumba ngaphezu kwesayithi. Kungenzeka ukuthi kuthathe izinsuku ezimbalwa ngaphambi kokuba umonakalo ogcwele we-tissue umonakalo ubonakale.
Ukubaluleka kwe-extravasation ebomvu kuxhomeke emthini othize, inani elikhishwe, ukuxilongwa kwezidakamizwa kanye nezenzo ezithathwe ngokushesha ngemuva kokususwa kwe-extravasation.
Umhlengikazi wakho noma udokotela uzoyeka lesi sidakamizwa futhi azame ukufisa imithi eminingi engayenza. Zizosebenzisa ukucindezeleka okufudumele noma okubandayo (kuye ngokuthi imithi) futhi kungahle kudingeke ukuthi ifake noma ijobe i-antidote ukuze kusize ukunciphisa umonakalo wesikhumba. Uma kukhona ubomvu, ithimba lakho lokunakekelwa kwezempilo lizohlonza indawo enomakaki ukuze bakwazi ukutshela ukuthi ngabe ngcono noma kubi. Njengomuthi othukuthele we-medication extravasation, umhlinzeki wakho wokunakekelwa kwezempilo kuzodingeka anikeze okusele kwe-chemotherapy ngokusebenzisa indawo entsha ye-IV.
Kungase kudingeke ubone udokotela ohlinzayo uma kukhona umonakalo ojulile wezicubu.
Izibonelo zezidakamizwa ezinobuthi zifaka i-vincristine, i-vinblastine, i-vinorelbine, idarubicin, i-doxorubicin, ne-daunorubicin.
Indima Yakho Ekuvimbeleni I-Extravasation
Nakuba abahlengikazi nodokotela abanikeza u-chemo baqeqeshwe ukuphatha lezi zidakamizwa, izingozi zingenzeka. Uma i-chemo yakho isengozini enkulu kakhulu yokulimala komzimba, udokotela wakho angase akhethe ukufaka i- catheter ye-venous central (CVC) . Ukunciphisa okuvela kuma-CVC, ngenkathi kusekhona, kungenzeka kakhulu.
Ngokwengxenye yakho, kunezinto ezimbalwa ongayenza ukuze uvimbele i-extravasation:
- Phatha isayithi lakho eliyinkimbinkimbi noma i-CVC ngokunakekelwa.
- Gwema ukuthinta indawo ye-IV noma ubhubhe ngesikhathi sokumnika kwakho.
- Vumela umhlengikazi noma udokotela wakho azi ngokushesha uma uqala ukuba nezibonakaliso zokushisa, ukushaya noma ukuzulazula eduze kwe-IV indawo yakho ngesikhathi sokumnika.
- Uma ubona noma yikuphi ukubomvu noma ukuvuvukala ngemuva kokushiya isikhungo somdlavuza, shayela udokotela wakho ngokushesha.
Isingatha phezulu
I-Chemotherapy extravasations ayimangalisa kakhulu. Ukuhlukaniswa kwezidakamizwa njengento enesisindo noma okucasulayo kuyosiza ekunqumeni inani lemonakalo elingabangela. Ngenkathi zonke izinyathelo zithathwa ukuze zivikelwe i-extravasation, kungenzeka isenzeke.
Umthwalo wakho njengesiguli ukuvumela umhlengikazi noma udokotela wakho ukuba wazi uma ubona noma yikuphi ushintsho kusayithi lakho lokufaka ngaphakathi ngesikhathi noma emva kwe-infusion ye-chemo.
Imithombo:
Goodman, M. Chemotherapy: Izimiso Zokuphatha. E-Yarbro, C., Frogge, M., Goodman, M., Groenwald, S. eds (2000) Ukunakekela Kansa : Izimiso Nezenzo 5th American Cancer Society, Jones noBartlett: Sudbury, MA.
JA Pérez Fidalgo, MD, futhi. al. "Ukulawulwa kwe-chemotherapy extravasation: Iziqondiso ze-ESMO-EONS Clinical Practice Guidelines." Amanothi we-Oncology Volume 23, Issue suppl 7, Pp. vii167-vii173.