Icatheter yocatheter yomkhulu yesilicone noma yelatex? Izinkinga eziphambili

Ukuthi kubhekwe ngokuphambuka kwezibophelelo nokuvikela kwabantu: Kungani icatheter yesilicone yomkhulu iyathandwa kubantu abanemiphumela yelatex

Ukuthi kubhekwe ngokuphambuka kwezibophelelo zelatex kanye nezingcingo zokuphambuka kwezinkinga zokusha/zokudala kwezempilo zomkhulu

Ukuthanda kwe-latex kubangela ukuthi abantu abaningi kakhulu (1–6%) baphila ngokuthanda kwe-latex, kodwa ukuthanda kwe-latex kungafika kuma-8–12% phakathi kwebhodhi yezempilo futhi kungafika kumagama amaningi kakhulu (kungenzeka kubhaliwe kuma-60%) phakathi kwabantu obabiliwe ngokuthi bane-spina bifida (CDC, 2020). Kuzo zizindaba zezempilo zomlomo—lapho kubhekwa kwe-latex kufana nezincwadi zokugcina izandla nezicathulo kuyisibonelo esikhulu—ukuthanda kwe-latex kuyisibonelo esikhulu. Noma kuphela isicathulo esisodwa sase-latex singabangela ukuthi kubhekwe ngokuthanda kwe-latex kahle, kusukela kwezinkinga zokugcina izandla nesifuba, kuya kuma-urinary tract infection eyinkulu. Ukubhekwa kwe-latex kusukela kwezinsuku ziningi kubangela izinkinga eziningi: ukuthi izinyawo ziyasihlwa kakhulu, ukuthi kubhekwe ngokuthanda kwe-latex kahle, nokuthi kubhekwe ngokuthanda kwe-latex kahle kungabangela ukuthi kubhekwe ngokuthanda kwe-latex kahle. Ngoba izinkinga ziyasihlwa kakhulu ngokuthanda kwe-latex kanye nezinkinga zezempilo zomlomo, ukuthanda kwe-latex kusukela kwezicathulo kuyisibonelo esingasihlwa kakhulu. Abasemthethweni baya kufuna ukuthi babheke ngokuthanda kwe-latex kabefore ukuthi bavale isicathulo—ngokuphelele kubantu obabiliwe ngokuthi bane-spina bifida, abanenqubo eziningi, abanenqubo yezimpilo, noma abanenqubo yezimpilo.

Icatheter yomkhulu yesilicone yokugcina isibonelo esingapheliyo sokubuyela kwezinye izinto ezisemthwakathini

Izicatheter zokugcina umlilo zase-silicone ziyisisekelo sokungafani nesithakazelo: isibonelo sakho sokuqinisa, esingasolwa ngamaphrothini, sikhupha izinkomo zokungafani nesithakazelo zase-natural rubber latex (NRL) ozikhethekile kuzo ukuthi zihlangele amaphethiwe ase-IgE. Ukungafani nesithakazelo kwe-silicone kuyisisekelo esingasolwa kakhulu, okwenza kwe-silicone ukuba yinketho enzima kakhulu, enziwe ngokubonakalisa, yokukhetha abantu abanomthwalo wokungafani nesithakazelo kwe-latex. Ngaphezu kwalokho kokukhathazeka kwesithakazelo, ukuthakazelwa kwe-silicone kunciphisa ukukhathazeka kwezinhlobo zokusebenza futhi ukuthwasa kwezinyawo zokugcina umlilo, okunciphisa imiphumela yezindlela zokugcina umlilo zokuhlanza kwe-urethra nokuthwasa kwezindlela zokugcina umlilo zokuhlukanisa ngokuphambili. Izindlela zokusebenza kwezincwadi zokusebenza—kufaka ezincwadi zase-CDC nezincwadi zase-European Association of Urology—zizimiselela ukusebenzisa izicatheter zase-silicone kubantu abanomthwalo wokungafani nesithakazelo kwe-latex noma abanomthwalo wokungafani nesithakazelo. Ngokuphambili, izindawo zokusebenza zizimiselela ukusebenzisa i-silicone njengokuzimiselela konke okusebenzayo kwezicatheter zokugcina umlilo ukuze zikhulule ukuthi baphinde baphinde bakhathazekile. Lokhu kucabanga ngokuphambili akukho kuphinde kuphinde kwe-anaphylaxis ekusheshisaneni kodwa kunciphisa futhi imiphumela yezindlela zokugcina umlilo zokuhlukanisa ngokuphambili okuzimelela ukuthi kubhekwe kabusha futhi kubhekwe kakhulu imali yezincwadi zokusebenza.

Ukuqonda Kwemithombo: Ukuzimela, Ukuthanda Kwemithombo Kwezinhloso Zokusebenza Kwesibonelo, Nokukhathazeka Kwemithombo Yokuqondwa

Ukuzimela Okubhekene Nokuchaza Kwesilicone Ngaphandle Kwesilinga Sokuzimela Kwelatex Kwezinhloso Zokusebenza Kwesibonelo

Ukuzimela okubhekene nokuchaza kwesilicone kwezinhloso zokusebenza kwezibonelo kuyisibonelo sokusebenza: kuzimela ngokuchaza kwesibonelo, kusiza ukuthi kuzimelwe ngokuphelele ngezinhloso zokusebenza zokugcina izibonelo. Lokhu kuzimela okuphelele kuzimisa amapointi amancane okuzimela kwezinhloso zokusebenza zokugcina izibonelo—kunciphisa ukungcoliswa kwezinhloso, ukuthwasa okuncane, nokuthwasa okulandelayo kwezinhloso. Ngaphandle kwalokho, izinhloso zokusebenza zelatex zizimela ngokuchaza kwesibonelo, zikhubaza ukuzimela kwezinhloso zokusebenza kwezibonelo futhi zihlula ukuthwasa okuphelele. Izifundo zibonisa ukuthi amafosha akhulu asezingeni lokufaka nokuhlamuka kwezibonelo emva kokufakwa kwezinhloso zokusebenza zesiSilicone, kubonisa ukuthi abantu bakhuluma ngokuphelele futhi kunciphisa ukuthwasa kwezinhloso zokusebenza. Lokhu kuzimela okuphelele nokuzimela okuphelele kuyisibonelo sokuthanda kwemithombo kwezinhloso zokusebenza—futhi kusiza ngokuphelele ukuthi kubhekene nokuthanda kwemithombo kwezinhloso zokusebenza kwezibonelo.

Ukuhambisana okuphezulu kwe-encrustation futhi ukubaluleka kwezikhathi ezide zokubeka kwe-silicone urinary catheter

Ukubeka kwe-encrustation—okwenzelwa ngokufakwa kwe-crystal calcium ne-magnesium phosphate—yindlela eyinkimbinkimbi yokublockiswa kwe-catheter nokuguqulwa kabusha. Isurface esihlanu sika-silicone, esingaphansi kwezinye izinto, sibhindela ukubamba kwe-crystal kwanasekuqaleni futhi sibeka isikhathi eside sokusobala kwe-biofilm, okuyindlela eyinkimbinkimbi yokuphila kwe-encrustation. Kukhona ukulinganisa kweminyaka yezikhathi eziyisikhombisa ukuthi i-silicone catheters zifakwa amagaramu angu-0.8 yencrustation ngeminyaka yezikhathi eziyisikhombisa ngokulinganisa ne-latex devices ozifakwa amagaramu angu-2.5 (Journal of Urology, 2021). Lokhu kucabanga okungaphezu kokubaluleka kwe-urinary drainage, ukuncamuka okuncane, futhi ukuncamuka okuncane kwezidingo zokuguqula ngokuzimisa. Ngakho-ke, i-silicone catheters ziyabuyisa ubuhle bokusebenza—kuxhumana nokuvumela ukudluliswa kwe-urine ngokungafani futhi kubeka isikhathi eside sokubeka ngokungafani.

Isimo Sokuziphatha Kweminyaka: Ukuchazela Icatheter Material Ngezinkinga Zokusebenza Nezikhathi

Ukukhetha imithombo kufanele kubhekwe ngokwesikhathi sokuhlala, isimo sokucinga ngokuthi umuntu uyathola ukuthi kuyakwenzeka ukuthi aqonde amadonga, nokuthi izindlela zokuvikela ezisemzini ziyasebenza njani. Ngokusebenzisa ngokufutshane (ngapansi kwamahora angu-24 noma ukusebenzisa ngokuphindaphinda), ukuthi i-latex ingakhethwa yizakhiwa uma kuthiwe ngokucacile ukuthi umuntu akayiqondi i-latex—kepha isibhakabhaka sakho sisebenza njengomkhakha wokuthi amadonga ayagcina ngokushesha, okuzimisa ukuthi akusizo kakhulu. Ngokusebenzisa ngokude (amahora angu-24 kuze kumazinsuku angu-30) noma kudala ngokude kakhulu (>30 days) ekuseni, i-silicone yisiqu esihle. Ukuthi iyasivikela ukuthi amadonga ayagcina, ukuthi ayinakho ukuthi amadonga ayagcina ngokushesha, nokuthi iyathola ubukhulu bokuthi ibe yisikhathi sokugcina ngokushesha kuyabonakala ngokuthi kunezinkinga ezincane zokuthi amadonga ayagcina, ukuthi amadonga ayagcina ngokushesha, nokuthi kuthiwe ukuthi kunezinkinga zokuthi amadonga ayagcina ngokushesha. Ngokubona ukuthi kunezinkinga ezinkulu zokuthi kunezinkinga—kubanzi ukuthi kunezinkinga zokuthi kufuneka kubuyiselwe ngokungafanele, ukuthi kubuyiselwe ngokungafanele, nokuthi kunezinkinga zokuthi amadonga ayagcina ngokushesha—ukuthi kubuyiselwe i-silicone ngokungafanele uma kubuyiselwe ngokungafanele, noma uma kubuyiselwe ngokungafanele uma kunezinkinga zokuthi amadonga ayagcina ngokushesha, kuyabonakala ngokuthi kuyisiqu esihle, nokuthi kuyisiqu esihle sokuthi kubuyiselwe ngokungafanele.

Ukuthi kunezinkinga zokuthi amadonga ayagcina: Ukuthi kunezinkinga zokuthi amadonga ayagcina ngokushesha nokuthi kunezinkinga zokuthi amadonga ayagcina ngokushesha kwi-silicone noma i-latex

Ukuhambisana kwezinye zezinye zokugcina, ukubambisana kwebhaktiria, nokuthi kwakho inkimbinkimbi yokuthi izikhathi zokugcina zezinye zezinye zokugcina ziyabhekwa ngokuphelele ngezikhathi ezincane ngokusebenzisa izikhathi zokugcina zesiSilicone

Izikhathi zokugcina zezinye zezinye zokugcina (CAUTI) zihlanganisa ngokuphelele ~30% yezikhathi zokugcina zezinye zezinye zokugcina kwezindawo zokuhlela abantu, nangokuphelele ~75% yezikhathi zokugcina zezinye zezinye zokugcina zezindawo zokuhlela abantu zihlanganisa nezikhathi zokugcina zezinye zezinye zokugcina. Izinqumo zezinye zezinye zokugcina ziyabhekwa ngokuphelele ngokuphambuka kweminye yezibhaktiria: isilicone sikhona ngokuphambuka kwezinye zezinye zokugcina, futhi isikhondlo sakho singasivumeli ukubambisana kwezinye zezinye zokugcina ngokuphambuka kwezinye zezinye zokugcina Escherichia coli ,Pseudomonas aeruginosa , futhi kwezinye izinhlobo zezibhaktria zokugqibela kwizithelo—kungafani nesifunda sezilathe esingaphansi kwezilwane, esingaphansi kwezilwane zokufihla. Nakuba umfanekiso woku-2016 owabonisa isilikon esihlukene nesilikon esisondelwe kuzilathe akabonisi ukulinganana okuphathelene nokubhekana kwezikhathi ezincinci, ubuchwepheshe bezempilo bakhombisa ngokuvamile ukuthi isilikon esihlukene sibhekise kakhulu ekugcineni kwezinkundla kanye nokunciphisa ukuthwasa kwezithelo zokugqibela kwizithelo, okubonisa ukuthi kunezinkinga eziphansi kwezibhaktria zokugqibela kwezikhathi ezide kanye nezinkinga eziphansi kwezinkinga zokugqibela kwizithelo zokugqibela kwizithelo. Lezi zinkinga ezihlukene—ezibhekise kumfanekiso wokusebenza kwezinto kanye nokuboniswa kwezimpilo—zibonisa ukuthi isilikon sibhekise kakhulu njengomkhakha wokusebenza kwezinkinga zokugqibela kwizithelo zokugqibela kwizithelo.

Imibuzo Evame Ukubuzwa

Kungani isilikon sezithelo zokugqibela zisayishwa kunezilathe?

Izithelo zokugqibela zesilikon ziyisilikon esingasindwa, zicimisa ukuthwasa kwezinkinga zokugqibela kwizithelo, futhi zinamalungelo amaningi njengezimalungelo emfanekiso wokusebenza kwezinto, ukunciphisa ukuthwasa kwezithelo zokugqibela kwizithelo, nokubhekisa kakhulu ekugcineni kwezinkundla, okwenza kubo baba yizithelo ezihlukene kwezikhathi ezide.

Abani abanemphakathi omkhulu wezinkinga zokugqibela kwizithelo zokugqibela kwizithelo?

Abantu abanemiphumela yokuqondwa kwe-spina bifida, izingxenye zokusebenza kwe-latex, noma abasebenza emaphathini, bakhula kakhulu ukuthi bafanele ngokusebenzisa i-catheters zelatex.

I-catheters zesilicone zinconywa ukuthi zihlala kuncipha isivumelwano se-CAUTI?

Yebo, isibonelo sesilicone sikhuphile ukuthi sifanele kubhekana nezinkampani zokugcina nokwenza i-biofilm, futhi lokhu kusiza ekunciphiseni isivumelwano se-CAUTI kulatex catheters.

Kungasemkho i-catheters zelatex kuzo zizinhlobo ezithile?

I-catheters zelatex zingasetyenziswa kuzo izikhathi ezincinci uma kubhekwe ngokuphelele ukuthi akukho isibonelo sokufanele kwe-latex, kodwa isibonelo sakho sikhuphile ukuthi asisizo kuzo izikhathi ezide.