Parenteral chikafu: chii icho, chii chaicho uye maitiro ekuchishandisa

Zvemukati

• Kana zvaratidzwa
• Maitiro ekugadzirisa kubata kwevabereki
• Chii chekutarisa panguva yekutonga
• Rudzi rwehutano hwevabereki
• Zvinogona kuitika
• 1. Nguva pfupi
• 2. Nguva yakareba

Parenteral, kana parenteral (PN) chikafu, inzira yekupa mishonga inoitwa yakanangana mutsinga, kana zvisingaite kuwana zvinovaka muviri kuburikidza nechikafu chakajairika. Nekudaro, rudzi urwu rwechikafu runoshandiswa kana munhu asisina gwara remudumbu, iro rinowanzoitika kune vanhu vari mune yakaoma mamiriro, senge mudumbu kana gomarara remudumbu padanho repamberi, semuenzaniso.

Kune maviri akakosha marudzi ehutano hwevabereki:

• Partial parenteral chikafu: chete mashoma marudzi ezvibereko uye mavitamini anoenderedzwa kuburikidza nemutsinga;
• Yese parenteral chikafu (TPN): mhando dzese dzezvikafu zvinovaka muviri uye mavhitaminzi anoshandiswa kuburikidza nemutsinga.

Kazhinji, vanhu vari kuita rudzi urwu rwechikafu vanobvumidzwawo kuchipatara kuti varambe vachiongorora hutano hwavo, zvisinei, zvinokwanisika kuti, mune dzimwe nguva, kudya kwevabereki kunoitwawo kumba uye, mune aya mamiriro, chiremba kana mukoti anofanirwa kutsanangura mabatiro aanogona kuita chikafu nenzira kwayo.

Kana zvaratidzwa

Parenteral chikafu chinoshandiswa kudzivirira kushaya zvinovaka muviri, kunyanya kune vanhu avo, nekuda kwechimwe chikonzero, vasina nzira inoshanda yemudumbu kana avo vanofanirwa kupa dumbu kana matumbo zororo.

Nechikonzero ichi, hutano hwevabereki hunoratidzwawo kana uchinwa zvekunwa, kunyangwe uine chubhu, haigone kuitwa pasi pemamiriro akakwana kweanopfuura mazuva mashanu kana manomwe.

Kuratidzwa kwerudzi urwu rwechikafu kunogonawo kuitwa munguva pfupi, kana ichiitwa kusvika kumwedzi mumwe, kana mukufamba kwenguva, zvichienderana nemamiriro emunhu wega wega:

Maitiro ekugadzirisa kubata kwevabereki

Kazhinji yenguva, chikafu chevabereki chinoitwa nevashandi vepachipatara, zvisinei, pazvinenge zvakakodzera kuita manejimendi kumba, zvakakosha kuti utange waongorora bhegi rezvikafu, uchiona kuti riri mukati merimwe zuva rekupera, bhegi rinoramba rakasimba uye rinochengetedza hunhu hwaro.

Zvino, mune kesi yekutonga kuburikidza neparipheriti catheter, mumwe anofanirwa kuteedzera nhanho-nhanho:

1. Shamba maoko ako nesipo nemvura;
2. Misa chero kumisikidzwa kweserum kana mushonga uri kupihwa kuburikidza nekateti;
3. Disinfect the serum system kubatana, uchishandisa isina kuchena doro swab;
4. Bvisa iyo serum system yaive panzvimbo;
5. Zvishoma nezvishoma jekiseni 20 mL yesaline;
6. Unganidza chirongwa chevabereki chekudya.

Maitiro ese aya anofanirwa kuitwa pachishandiswa zvinhu zvakaratidzwa nachiremba kana mukoti, pamwe nepombi yakaenzana yekuendesa inoona kuti chikafu chinopihwa panguva chaiyo uye nenguva yakatarwa nachiremba.

Iyi nhanho-nhanho inofanirwa zvakare kudzidziswa uye kudzidziswa nemukoti pachipatara, kubvisa chero kusahadzika uye kuona kuti matambudziko haamuke.

Chii chekutarisa panguva yekutonga

Paunenge uchipa chikafu chevabereki, zvakakosha kuongorora iyo catheter yekuisa saiti, kuongorora kuvepo kwekuzvimba, kutsvuka kana kurwadziwa. Kana chimwe chezviratidzo izvi chikaonekwa, zvinokurudzirwa kumisa kudya kwevabereki uye kuenda kuchipatara.

Rudzi rwehutano hwevabereki

Rudzi rwehutano hwevabereki hunogona kuverengerwa maererano nenzira yekutonga:

• Central parenteral chikafu: inogadzirwa kuburikidza nepakati venous catheter, inova chubhu diki inoiswa mukati mehombe caliber vein, senge vena cava, uye iyo inobvumidza kuiswa kweutachiona kwenguva inopfuura mazuva manomwe;
• Peripheral parenteral chikafu (NPP): Inoitwa kuburikidza neparipheral venous catheter, iyo inoiswa mune diki mutsinga yemuviri, kazhinji muruoko kana ruoko. Rudzi urwu runonyatsoratidzwa kana kudya kunochengetwa kwemazuva anosvika manomwe kana gumi, kana kana zvisingaite kuisa chepakati venous catheter.

Kuumbwa kwemabhegi anoshandiswa muhutano hwevabereki kunogona kusiyanisa maererano nenyaya imwe neimwe, asi inowanzo sanganisira mafuta, glucose uye amino acids, pamwe nemvura nemvura dzakasiyana siyana zvicherwa nemavhitamini.

Zvinogona kuitika

Zvinetso zvinogona kumuka nehutano hwevabereki zvakasiyana kwazvo uye, nekudaro, zvinogara zvichikosha kuteedzera ese marongero akaitwa nachiremba nevamwe vezvehutano.

Mhando huru dzematambudziko dzinogona kuiswa mumapoka zvinoenderana neyakareba nguva yeNN:

1. Nguva pfupi

Munguva pfupi, zvinetso zvinowanzoitika zvinosanganisira izvo zvinoenderana nekuiswa kwepakati venous catheter, senge pneumothorax, hydrothorax, kubuda kweropa kwemukati, kukuvara kwetsinga dzeruoko kana kukuvara mutsinga yeropa.

Uye zvakare, hutachiona hwecatheter ronda, kuzvimba kweropa mudziyo, kuvharirwa kwecatheter, thrombosis kana huwandu hwehutachiona nemavhairasi, mabhakitiriya kana fungi zvinogona kuitika.

Padanho remetaboli, matambudziko mazhinji anosanganisira shanduko mumashuga eropa, metabolic acidosis kana alkalosis, yakaderera yakakosha mafuta acids, shanduko muma electrolyte (sodium, potasium, calcium) uye inowedzera mu urea kana creatinine.

2. Nguva yakareba

Kana parenteral chikafu chinoshandiswa kwenguva yakareba, matambudziko makuru anosanganisira shanduko muropa uye vesicle, senge ine mafuta chiropa, cholecystitis uye portal fibrosis. Nechikonzero ichi, zvakajairika kuti munhu aratidze kuwedzera kwemakemikari echiropa mukuedzwa kweropa (transaminase, alkaline phosphatase, gamma-GT uye yakazara bilirubin).

Uye zvakare, mafuta acid uye kushomeka kwecarnitine, shanduko yemukati mezvirimwa uye atrophy yematumbo velocities uye mhasuru zvinogona kuitika.