I-Catheter e-Latex kunye ne-Silicone: Yini okuyisifiso kuzo?

Iziriski zezikhathu zase-Latex: Ukugcina kwe-Latex, ukufaka amaphakathi, nokuhlwa kokungahlanjwa

Ubukhulu bezinkinga zokugcina kwe-Latex nokuthi kuyakwenza kanjani ukukhetha izikhathu

Amakatheteri e-latex ethu yokunakekela kwenza isiphelo esikhululekile sokubona ukuthi sithiwe ngokuphathwa kwesithunzi. Umkhondo wokuzilungiselela wabonisa ukuthi ubuninzi be-4.32% be-lateks alergi phakathi kwebankambo zokusebenza emzimbeni—lokhu kubonisa ukuthi abantu bakhululekile ngokuphathwa kwesithunzi—futhi ubuninzi obungaphezu kwe-72% kubagruphi obukhulu obukhululekile, njengoba babekhona abantu abanemphakathi yase-spina bifida noma abanenqubo eziningi. Izindlela zokubonwa kwezinhloso zokuhlanjwa kufana nokubonwa kokuhlaza kwezinyawo, kuya ku- anaphylaxis okubangela ubudlela, ikakhulu lapho amaproteni e-latex ayisuka kwezinyawo zokubonwa lapho akhuluma nezinyawo zokubonwa ngokwesikhathi sokusebenzisa ngokwesikhathi eside. Ngokuba umlando wokubonwa kwezinhloso kungenzeka kubhekwe ngokuphelele noma kungabonakali, ukuvikela ngokuphambili kuyisidingo: izinkokhelo ezingenakho i-latex—ikakhulu i-silicone yomzimbeni—kufanele kubheke kakhulu ngokwesikhathi sonke sokusebenzisa amakatheteri ngaphandle kokuthi kubhekwe ngokuphelele, ikakhulu lapho kusenokwesikhathi sokugcina noma kusenokwesikhathi sokugcina okungafanele ukuthi kubhekwe ngokuphelele, lapho ukuthi kusenokwesikhathi sokugcina noma kusenokwesikhathi sokugcina kuyisidingo esingafanele ukuthi kubhekwe ngokuphelele.

Ukubadala kwezinto zokusebenza nokubadala kwezinto zokusebenza ngokwesikhathi sokusebenzisa ngokwesikhathi eside

Ama-latex catheters athinteka kalula ekuwohlokeni kobuso nasekugqokeni ngenxa yesakhiwo sawo esincane esingajwayelekile nesinama-porous. Lokhu kuhlanganisa indawo kwenza amabhaktheriya agcine ekwazi ukuhlangana futhi akhiqize amafilimu omzimbaokwenzeka cishe engxenyeni yabasebenzisi be-catheter isikhathi esidefuthi kwakha indawo evumayo yamagciwane akhiqiza i-ureaze afana ne- I-Proteus mirabilis . Lezi zinambuzane zenza umchamo ube ne-alkali, zikhiphe amakristalu e-magnesium ammonium phosphate (struvite) anamathela ebusweni be-catheter. Ukwakheka okuvelayo kungavimbela ukugeleza, kubangele ukuquleka kwe-bladder, futhi kubangele ukubanjwa komchamoizinkinga ezihlobene ngqo nokuzwela kwezinto. Lokhu kuhlanganiswa kwezinto kunomthelela omkhulu engozini yansuku zonke engu-37% yokutheleleka komgudu womchamo okuhlobene ne-catheter (CAUTI), okuqinisa ukuthi ukukhethwa kwezinto akuyona into eyenzeka ngengozi kodwa kunomphumela we-pathophysiological.

Izinzuzo Zesibambo SaseSilicone: Ukuhambisana Kwezinto Eziphilayo, Ukumelana Ne-Biofilm, Nokungaguquguquki

Ukwehliswa kokudumba kwe-urothelial kanye nokusabela kwezicubu nge-silicone

I-silicone esezingeni lezokwelapha inokuhambisana okuhle kakhulu kwezinto eziphilayo, okuqinisekiswe yi-USP Class VI ne-ISO 10993 yokuxhumana ne-mucosal. Umphezulu wayo onamanzi, ogudile, futhi ongenawo amakhemikhali awumelana nokumuncwa kwamaprotheni futhi unciphisa ukusabela komzimba wangaphandle ngokungafani ne-latex, edala ukuvuvukala kwe-urothelial okulinganisekayo. I-silicone igcina isakhiwo sayo singashintshashintshi emchameni ngokuhamba kwesikhathi, ingakhombisi ukuchitheka kwezinto ezikhishwayo noma ukuguguleka komhlaba, ngisho nangemva kokuhlanzwa okuphindaphindiwe. Ukuqina kwayo kunciphisa ukulimala kokufakwa futhi kugcine ukuqina kwe-mucosal ngesikhathi sokuhlala isikhathi eside, okwenza kube impahla esekelwa ubufakazi yokukhetha izinhlelo zokusebenza ezandisiwe.

Izinga eliphansi le-CAUTI elihlobene nokuncishiswa kokuqina kwamagciwane ezindaweni ze-silicone

Ukumelana kwe-silicone nokwakhiwa kwamakoloni amagciwane kuyisici esiyinhloko sokwehla kwe-CAUTI. Umphezulu wayo ogudile, ongenama-porous uvimbela kokubili ukunamathela kokuqala kweplanktonic nokuvuthwa kwe-biofilm okulandelayoukuphazamisa isinyathelo sokuqala esibucayi ekubangeleni izifo. Ngokungafani ne-latex, i-silicone ayiwohloki uma kunosawoti womchamo noma ama-enzyme, igcina izakhiwo zayo zokulwa nokunamathela phakathi nesikhathi sokuma. Idatha yomtholampilo ihlanganisa njalo ama-silicone catheters nomthwalo we-biofilm, ukufakwa, kanye ne-UTIs enezimpawu ezincishisiwe kubasebenzisi besikhathi esideesekela indima yayo njengento eyisisekelo yamasu okuvimbela i-CAUTI.

Uhlaka Lwesinqumo Sokwelashwa: Ukufanisa Izinto Zokuthambisa Nezidingo Zesiguli Nesikhathi

Ukukhetha imateriali yokucatheterisa yomzimba oyidingekile kufuneka kubhekwe ukugxila kwezinto ezingaphambili zokuphatha umuntu, isikhathi esisizakwenzeka kusuka kumcatheter, nokuthembeka kwemithombo yomateriali. Kumaqala okuncane (<30 izinsuku) kubantu abangaphansi kokuphatha, abanegama elilungile ngokuthi akabikho ukuphatha kwe-latex, imicatheter yelatex ingayasebenza kahle—kepha kuphela emva kokubhekwa kwezinto ezingaphambili ngendlela engekhoyo. Ngaphezu kwalokho, isilikon iyi-standard-yo-kusebenza kumaqala okude (>30 izinsuku) okuzakwenzeka kumzimba, ukuphatha kwe-neurogenic bladder, ukuphatha okuphinda kuyabonwa kwe-CAUTI, noma yikuphi indlela ekhona kwenziwa ukubuka kwe-mucosal ngaphezu kwe-30 izinsuku—kubhekana nezindlela zokubaluleka kwe-FDA zokubaluleka kwe-biocompatibility yezinto zocwaningo lwe-Class II. Isimo sokukhetha esihlukene kufuneka sibheke isimo sokuphatha, isimo sokuphatha kwezinkambo, izinkinga zokubuka kwezinye izinto, nokubaluleka kwemateriali—akasibhekwe njengamazwi angafani, kepha njengamazwi amathathu okuhlanganisa ukubaluleka kwezinto eziningi zokuphatha kwezinto ezinye.

Umbiko wokusebenza kwezinhlayiya zokusebenza: Ukubhekwa kwezinto ezingaphambili, iziqalekiso zokuguqula, nemicatheter engavamile kwe-latex

Ukubhekwa kwezinto ezingaphambili kwe-latex ngaphambi kokucatheterisa

Ukusebenzisa indlela yokuhlola eshiyekile, efanayo, kuyadingeka ukuthi kube lona ukuqinisekisa abantu abanemiphumela emphakathini phambi kokukhetha isikhombisa. Abasemthwini kufanele bafunde ngokuphindeleka kwabalozi, amaglovi, amadhamu wokubhala, noma amakondomu—kodwa futhi izinkinga ezincinci njengezinkinga zokuphindeleka kwezinye izindawo ziyakwazisa ukuthi kufanele sibe nomlando. Izinhlangano eziphakathi kwezinye izinhlangano eziphakathi—njengabantu abanamaphakathi okusha, izinhlangano zokuzalwa zokugcina umsila, noma izikhathi eziningi (≥3) zokwenza izilungiselelo zokuzimela—kufanele zibekwe ngokuzenzakalela ukukhathazwa kwe-latex. Ithabeli engezansi ibonisa ukuthi kuzimelela kanjani ukuthi kubekwe imiphumela yokuqinisekisa:

Ukuguqula kusuka ku-latex ku-silicone ngokuphakanyiswa kahle kubantu abanemiphumela emnyenyeni noma abasebenzisa ngokuphakade

Ukuguqula okuhlanganisa kuyisisekelo sokuxhumana phakathi kwezinkumbulo zase-nursing, wezinkumbulo zase-urology, nezinkumbulo zokudala izinto. Qalani ngokubheka ukusebenzisa i-catheter njengamanje futhi uvumise abantu abanenqumo yase-latex noma abanekhetho yokusebenzisa ngokuphakade. Yenza okuqukethwe kwezindawo eziphakeme (isibhalo: ICU, izindawo zokugcina amasiko wase-spinal cord) lapho iziphumo zokuchitha ziyisikhundla esikhulu kakhulu. Nika izindlela zokufunda abantu abasebenzisa i-catheter yase-silicone—kufaka izinto ezinye zokufaka i-balloon noma ukufaka i-catheter—ukuze kuvunyelwe ukusebenzisa ngokuphelele nokuphelele. Faka lokhu kwezindlela zokuvikela abantu abanenqumo yase-CAUTI ukuze kuvunyelwe indlela yokusebenzisa futhi kuvikeleke.

Imibuzo Evame Ukubuzwa

Izinto ziziphi ezibalulekile zokubulungiswa okubhekwa ngokwesilatex?

Izicatheter zesilatex zinakha imiphumela emibi njengezinkinga zokuphatha izilatex, ukubadala kwesithunzi, ukubambisana kwebakteria, nokukhanya kwezinkumbu, konke okhuza ukuthi abantu bakhululekile kwezinkinga eziphambili kwezicatheter.

Ngubani ubukhulu bakho besilikonikhi ekusebenzeni kwezicatheter ngeminyaka?

Isilikonikhi sibuyiselwa ekusebenzeni ngeminyaka ngokwakho ukuthi kuyasebenza kahle ngezinhlobo zezinto ezihlukene, isalayi esihlanu esingasiza ukubambisana kwebakteria, nokuthi akabadi kusukela kwezinkinga zokubadala kwesithunzi nokuthi kuzobadala kwezinkinga zokuphatha izilatex.

Ngubani indlela yokuchaza ukuthi umuntu uyaphatha izilatex phambi kokusika izicatheter?

Abasemthwini bakhethe amaprotokholi okuchaza okufanayo, okufundisa ngamaphuzu okuphatha izilatex futhi ukubona izinkinga eziphambili kwezinhluvo ezikhulu.

Kuziziphi izindlela zokwenza uma umuntu uyaphatha izilatex?

Abantu abaphambili kakhulu kufanele bakhohlwe izilatex zonke futhi bakhethe isilikonikhi noma izinye izinto ezingenasi izilatex ukuze bakhululekile kwezinkinga ezimbi.

Ngubani indlela yokuvuma ukuthi abasemthwini bakhethe izicatheter zesilatex kuye nesilikonikhi ngokushesha?

Ama-staff akufanele abe nesifundo ngokusebenzisa i-catheter, ukubhalisa ukusetshenziswa kwayo, nokulandela umsebenzi wokuguqula ngokuhambisana nezindlela zokukhupha izinkinga zokugqibela kwe-CAUTI ngokwenza ngempilo.