Michael Menna, DO, ndi dokotala wodziwika bwino yemwe amapita kuchipatala cha White Plains ku White Plains, New York.
Singano ya agulugufe ndi chipangizo chomwe chimagwiritsidwa ntchito kutulutsa magazi kuchokera mumtsempha kapena kupereka chithandizo chamtsempha (IV) kupita mumtsempha. Singano ya gulugufe imatchedwanso kulowetsedwa kwa mapiko kapena chipangizo cha scalp venous. Amakhala ndi singano yopyapyala kwambiri ya hypodermic, "mapiko" awiri osinthika, chubu chowoneka bwino komanso cholumikizira. Cholumikizira chitha kulumikizidwa ku chubu cha vacuum kapena thumba lotolera magazi, kapena pampopi yothira kapena thumba lachikwama lolowetsamo m'mitsempha kuti lipereke zakumwa kapena mankhwala. Mankhwalawa amathanso kuperekedwa mwachindunji ku cholumikizira kudzera pa syringe.
Singano za gulugufe zili ndi ubwino wina kuposa singano zowongoka. Mwachitsanzo, amalola kuyika bwino kwambiri, makamaka m'mitsempha yomwe imakhala yovuta kupeza. Komabe, siwosankha bwino pazochitika zilizonse.
Poyamba, singano ya gulugufe ikufanana ndi singano ya Huber, komanso ili ndi mapiko. Komabe, singano za Huber zimapindika pamadigiri 90 kuti zitha kuyikidwa bwino padoko lokhazikitsidwa ndi chemotherapy.
Madokotala a phlebotomy nthawi zambiri amagwiritsa ntchito singano zagulugufe kuti apeze zitsanzo za magazi kuti athe kuwerengera magazi athunthu (CBC), kuyezetsa cholesterol, kuyang'anira matenda a shuga, kuwunika kwa STD, ndi mayeso ena otengera magazi. Singano zimenezi zimagwiritsidwanso ntchito kwambiri m’malo osungira magazi anthu amene akufuna kupereka magazi.
Ngati mulibe madzi m'thupi ndipo simutha kumwa kapena kumwa madzi okwanira kuti muchepetse madzimadzi, singano zagulugufe zitha kugwiritsidwanso ntchito popereka madzi amtsempha. Angagwiritsidwenso ntchito popereka mankhwala (monga opha ululu) mwachindunji mumtsempha kapena pang'onopang'ono kubaya mankhwala a IV (monga chemotherapy kapena antibiotics) kudzera m'mitsempha.
Ngakhale singano za agulugufe zimatha kukhala m'mitsempha kwa masiku 5 mpaka 7 ngati zili zotetezedwa bwino, zimagwiritsidwa ntchito kwambiri pakulowetsedwa kwakanthawi kochepa.
Kulowetsedwa pafupipafupi kapena kosalekeza nthawi zambiri kumapezeka kudzera mumtsempha wokulirapo kudzera pamzere wapakati kapena mzere wapakati wa catheter (PICC).
Ngakhale singano zonse za agulugufe ndizofanana pamapangidwe, zimasiyanabe. Singano za agulugufe zimayesedwa m'mayunitsi a mafotokozedwe, kawirikawiri kukula kwake kuyambira 18 mpaka 27. Kukwera kwa ndondomekoyi, singanoyo imakhala yaying'ono.
Mwachitsanzo, singano ya 27-gauge ndiyomwe imagwiritsidwa ntchito kwambiri pobaya jakisoni wa insulin. Ngati jekeseni wamadzimadzi ndi wokhuthala kapena magazi akusonkhanitsidwa kuti atengedwe magazi, gwiritsani ntchito singano yaing'ono. Singano zambiri za agulugufe sizipitirira mamilimita 19.
Chipangizo cha IV kapena chotengera chosonkhanitsira chimalumikizidwa ndi chubu cholumikizidwa ndi singano, osati singano. Izi ndizothandiza chifukwa ngati mwathamangitsidwa kapena kugwetsedwa, mwayi wovulazidwa umachepa.
Kukula kwa chitoliro kumayambira 8 mainchesi mpaka 15 mainchesi (20 mpaka 35 cm). Chubu chachifupichi chimagwiritsidwa ntchito potulutsa magazi. Zazitali zimagwiritsidwa ntchito pamapulogalamu a IV ndipo zimatha kukhala ndi ma valve odzigudubuza kuti asinthe kuyenda. Machubu amathanso kukhala amitundu kuti namwino athe kusiyanitsa mzere womwe umagwiritsidwa ntchito pamene mizere ingapo imagwiritsidwa ntchito.
Zolumikizira mapini agulugufe zina zimakhala ndi doko la "amuna" lomwe limatha kulowetsedwa mu chubu cha vacuum. Zolumikizira zina zimakhala ndi madoko "achikazi" momwe ma syringe kapena machubu amatha kuyikidwamo.
Panthawi ya venipuncture (singanoyo imayikidwa mumtsempha), phlebotomist kapena namwino amamanga singano ya gulugufe ndi mapiko pakati pa chala chachikulu ndi chala cholozera. Chifukwa singano ya hypodermic ndi yaifupi ndipo mtunda wogwira ndi waufupi, kuyika kwa singano ya gulugufe kumakhala kolondola kwambiri kuposa singano yowongoka, ndipo singano yowongoka nthawi zambiri imagudubuzika kapena kugwedezeka chala.
Ikani singano yayifupi, yopyapyala mumtsempha pang'ono. Pambuyo poika, kuthamanga kwa venous kudzakakamiza magazi pang'ono mu chubu chowonekera, kutsimikizira kuti singano yayikidwa bwino. Singano ikakhazikika, mapiko atha kugwiritsidwanso ntchito kuti akhazikitse singanoyo ndikuletsa kugudubuza kapena kusuntha.
Chikagwiritsidwa ntchito (kutulutsa magazi kapena kupereka mankhwala), chipangizo chonsecho chidzatayidwa mu chidebe chotayira. Ndiye kukulunga puncture bala ndi bandeji.
Chifukwa cha kukula kwake kochepa (kocheperako kuposa ma catheter olowera m'mitsempha) komanso kapangidwe kake kozama, singano zagulugufe zimatha kulowa m'mitsempha yapakhungu pafupi ndi khungu. Izi sizimangopangitsa kuti zikhale zosavuta kugwiritsa ntchito, komanso zimawathandiza kuti alowe m'mitsempha yaing'ono kapena yopapatiza, monga makanda kapena okalamba.
Singano za butterfly ndizoyenera kwambiri kwa anthu omwe ali ndi mitsempha yaying'ono kapena kugwedeza (kugudubuza), ndipo amatha kulowetsedwa m'mitsempha yabwino ya manja, mapazi, zidendene kapena scalp.
Singano za butterfly ndizoyenera kwambiri kwa iwo omwe amazengereza singano, chifukwa ndizowopsa.
Singanozo zikachotsedwa, zimakhalanso zokayikitsa kuti zingayambitse magazi ambiri, kuwonongeka kwa mitsempha, kapena kugwa kwa mitsempha.
Mitundu yatsopano imakhala ndi loko yotsetsereka yomwe imangoyenda pamwamba pa singano ikachotsedwa mumtsempha, kuteteza kuvulala kwa singano ndikugwiritsanso ntchito singano zomwe zagwiritsidwa kale ntchito.
Ngati mwauzidwa kuti mitsempha yanu ndi yaing’ono ndipo munali ndi vuto lotulutsa magazi m’mbuyomu, mungaganize zopempha singano ya gulugufe.
Chifukwa cha kukula kwa singano, kuthamanga kwa magazi nthawi zambiri kumakhala kochedwa. Ngati munthu ali wofinyira kapena pangozi yomwe imafuna magazi ofulumira, izi zingayambitse mavuto m'malo osungira magazi. Pankhaniyi, kusankha kukula kwa singano ndiye chinsinsi.
Ngakhale ndi chizolowezi chotenga magazi, ngati magazi ambiri akufunika, kukula kwa singano kolakwika kungayambitse kutsekeka ndipo kumafuna kutulutsa magazi kachiwiri.
Popeza singano yomwe imagwiritsidwa ntchito kulowetsedwa imasiyidwa m'manja, osati catheter kapena waya wa PICC, singano ya gulugufe imatha kuwononga mtsempha ngati chipangizocho chikoka mwadzidzidzi. Ngakhale singano ya kukula koyenera ikagwiritsidwa ntchito, ngati siiyikidwa bwino, singanoyo imatha kutsekedwa panthawi ya chithandizo.
Lowani m'makalata athu a Daily Health Tips kuti mulandire malangizo atsiku ndi tsiku okuthandizani kukhala ndi moyo wathanzi.
Venipuncture njira. Mu: bata. 6. 2018:308-318. doi:10.1016/b978-0-323-40053-4.00024-x
Ohnishi H, Watanabe M, Watanabe T. Gulugufe singano amachepetsa kuvulala kwa mitsempha pa phlebotomy. Arch Pathol Lab Med. 2012;136(4):352. doi:10.5858/arpa.2011-0431-LE
Ialongo, C. ndi Bernardini, S. Phlebotomy, mlatho pakati pa labotale ndi wodwala. Biochem Med (Zagreb). 2016 February 15; 26(1):17-33. DOI: 10.11613/BM.2016.002.
Volovitz, A.; Bere, P.; Essex, D., etc. Poyerekeza ndi ma catheters olowera m'mitsempha, kugwiritsa ntchito singano za butterfly potengera magazi kumalumikizidwa ndi kuchepa kwakukulu kwa hemolysis. Msonkhano Wapachaka wa Academy of Academic Emergency Medicine; Atlanta, Georgia, USA; May 2013. DOI: 10.1111/acem.12245.
Nthawi yotumiza: Nov-10-2021
