Impso "impso zopangira": zizindikiro, ndondomeko yowonongeka ndi ndemanga

Impso zimagwira ntchito yofunikira kwambiri m'thupi, chifukwa ndi thandizo lawo magazi amatsuka, madzi ochulukirapo amachotsedwa, ndipo kuchepetsa madzi amchere kumakhala kosavomerezeka. Kutha kwa kayendedwe ka thupili kumabweretsa kuledzera kwa thupi ndi imfa ya wodwalayo. Pofuna kupewa imfa ndi kupititsa patsogolo chitukuko cha munthu musanapangidwe opaleshoniyi, chipangizocho "chimagwiritsidwa ntchito".

Kodi hemodialysis ndi chiyani?

Chifukwa cha matenda osiyanasiyana, kuchuluka kwake kwa minofu yothandizira kumachepetsa kwambiri. Matendawa amatchedwa kuchepa kwa chiwindi. Pali zifukwa zina zomwe zimapangitsa kuti zipangidwe, makamaka monga:

• Pyelonephritis;
• Matenda a zamoyo;
• Kusokonekera kwa njira zamagetsi;
• Matenda a hematopoiesis.

Kulephera kuchepa kwa thupi kumapangitsa kuti thupi liledzere, kumabweretsa zokolola zamadzimadzi ndi poizoni m'magazi, komanso kuchotsa madzi osakwanira.

Pachifukwa ichi, kuikidwa kwa chiwalo ichi kumawonetsedwa, koma kuyembekezera kwa wopereka wabwino kungatenge nthawi yaitali, choncho, zipangizo zamagetsi zimagwiritsidwa ntchito. Hemodialysis imathandiza kupititsa patsogolo moyo wa wodwalayo, imapereka mpata wokhala ndi chikhalidwe chisanayambe kusuntha, komanso kukuthandizani kukhala ndi moyo wokhutira.

Mitundu yambiri yamagetsi

Kuchita hemodialysis sangakhale kokha kuchipatala, koma kunyumba, popeza pali zipangizo zing'onozing'ono zopangira kunyumba kapena kuvala kwamuyaya.

Kuchokera pamaganizo, zipangizo za "impso" zikusiyana ndi zida zina zamakono komanso chigawo chimodzi. Kuwonjezera apo, mlingo wa manufacturability ndi wofunika kwambiri, popeza mu zipangizo zamakono yankho limakonzedwa ndi zipangizo zokha malinga ndi zizindikiro zomwe zilipo.

Ndondomeko yoyendetsera bwino ndiyoyendetsa bwino kuchuluka kwa mphamvu kapena hemoglobini kusintha, ndiyeno kusintha ndondomeko yothetsera vutoli. Komabe, izi zikhoza kuchitidwa ndi zipangizo zamakono "impso yokonza" Dialog +, komanso zipangizo Gambra, Baxter-1550, zomwe amagwiritsidwa ntchito kuchipatala. Zomwe zingatheke kuti zitsanzo zamakono, makamaka zomwe zimagwiritsidwa ntchito kuvala pa lamba, zikuchepa kwambiri.

Zipangizo zachipatala

Zipangizo zamankhwala zamakono za hemodialysis ndi makompyuta othamanga kwambiri komanso otsika kwambiri omwe amapangidwa kuti apitirize kuyang'anitsitsa mkhalidwe wa wodwalayo komanso kusanthula zizindikiro. Fosenius "impso yoberekera" imagwiritsidwa ntchito ngati chipangizo chabwino komanso chogwira ntchito. Phindu lake lalikulu ndilo kuti otsatsa adzigwiritsa ntchito pulogalamu yamakono. Izi zimathandiza madokotala kupeŵa kuyang'anitsitsa nthawi zonse.

Impso "4008S" ingathe kuwerengera mlingo wa mankhwalawo, kuyang'anira mlingo, kuyang'anira mlingo wa hemoglobin, ndi kuyeza kuthamanga kwa magazi.

Zida zogwiritsa ntchito kunyumba

Panopa zipangizo zambiri zamasulidwa zogwiritsa ntchito kunyumba. Makina opangidwa ndi "impso" chaka chilichonse amatha kusintha malonda awo, ndipo masiku ano amavala lamba ndipo amalemera 4-7 kilograms. Pachifukwachi, hemodialysis ikuchitika tsiku ndi tsiku, ndipo nthawi ya ndondomekoyi ndi maola awiri ndi awiri. Madokotala ambiri amaona kuti njira imeneyi ndi yabwino kwambiri, choncho m'mayiko a ku Ulaya ndi wamba. Ngakhale kuti mtengo wa chipangizo cha "impso zopangira ntchito" chapakhomo ndi waukulu kwambiri (kuchokera pa $ 5,000), ambiri amakonda kugwiritsa ntchito mtundu woterewu.

Ubwino waukulu wa njirayi ndi monga chitetezo, komanso kumasuka kwa ntchito. Komabe, pali zovuta za chipangizocho, chomwe chikhoza kuwonedwa ndi mtengo wapatali, komanso kufunikira koyang'anira wodwala, makamaka poyamba.

Ntchito ya impso yokha

Chipangizocho "impso yokhazikika" imagwiritsidwa ntchito panthawi yomwe thupi lake limataya ntchito yake ndi 85-90%. Chigawochi chimathandiza:

• Chotsani urea kuchokera ku magazi;
• Kupititsa patsogolo njira zamagetsi;
• Chotsani madzi owonjezera;
• Kuti muyambe kusinthanitsa kazitsulo ka asidi;
• Pewani mapangidwe a magazi.

Kuphatikiza apo, zimathandiza kukwaniritsa magazi ndi mpweya, zomwe zimathandiza kuthetsa ubwino wa wodwalayo. Chifukwa cha zipangizo zamakono zamakono mukhoza kuchita hemodialysis nthawi iliyonse yabwino popanda kuchoka panyumba.

Momwe chipangizo chimagwirira ntchito

Mfundo yeniyeni ya "impso yokhazikika" imadalira kuti chipangizo chimatenga magazi kuchokera kwa wodwalayo, kuchiyeretsa ndikuchibwezeretsa. Pali chipangizo cha magulu atatu omwe amagwira ntchito zosiyanasiyana. Magazi opanga magazi ali ndi mapampu a kayendetsedwe ka kayendedwe kake, kayendedwe ka mpweya, ndi masensa omwe amayang'anira mlingo wa mavuto m'mitsempha ndi m'mitsempha. Chipangizo chothandizira kupeza njirayi chimaphatikizapo dongosolo lokusakaniza madzi ndi kuganizira. Ikuphatikizapo dongosolo loyendetsa msinkhu wa kusungunula ndi kuzindikira magazi mwa njira. Wojambulayo akuphatikizapo membrane ya hemodialysis.

Mu mawonekedwe ake, chipangizochi chingakhale mbale kapena capillary. Zipangizo zamagetsi zimadziwika ndi kuti ndizovuta kuthetsa kuchuluka kwa magazi, ndipo amachepetsa chiopsezo cha thrombosis.

Zipangizo zamakono zimagwiritsidwa ntchito chifukwa chakuti amagwiritsa ntchito nembanemba yomwe magazi amaperekedwa m'njira imodzi, ndipo njira yothetsera dialysate imabweretsedwa, yokonzekera kugwiritsa ntchito nthawi yaitali.

Gulu la asayansi mu 2010 linapanga chipangizo chimene chinayikidwa mu thupi la wodwalayo, ndipo kuchigwiritsira ntchito moyenera. Chipangizo choterocho ndi chokwanira ndipo sichimayambitsa vuto lililonse. Zimagwira ntchito chifukwa cha kuthamanga kwakukulu kwa magazi ndipo sizimasowa magetsi.

Mfundo yogwiritsira ntchito zipangizo

Malangizo a "impso" akugwirizanitsa ndi kuti akugwirizana ndi kayendedwe kabwino ka magazi, magazi amachokera ku chiwindi. Komabe, pali njira yothetsera dialysis yotsuka. Chifukwa chake, magazi amachotsa poizoni. Ndiye magazi oyeretsedwa amabwerera mmbuyo mu dongosolo lopweteka.

Dialysate imakonzedweratu pasadakhale, kulingalira makhalidwe a wodwala ndi matenda ake. Njira ya chipangizochi imayambitsa njira yothetsera vutoli, pogwiritsa ntchito madziwa osakaniza ndi makina otetezera malingana ndi magawo omwe alipo. Pambuyo pa ndondomeko yoyendetsedwa, ntchito yake imayesedwa malinga ndi magawo angapo.

Kutulutsa hemodialysis pa zipangizo "impso yokhazikika"

Kuyeretsa magazi kumapangidwa 2-4 pa mlungu. Pakati pa machitidwe ovuta, matendawa amasonyeza. Ndondomeko yokha imayang'aniridwa ndi dotolo-nephrologist kapena resuscitator ndipo ikhoza kutenga nthawi kuchokera maola awiri mpaka 7.

Hemodialysis imachitidwa kuchipatala kapena kuchipatala chokhala kuchipatala. Musanayambe ndondomekoyi, muyenera kuyembekezera wodwalayo kuti muwone kuchulukitsa kwa madzi okwanira omwe ayenera kuchotsedwa m'thupi, ndi kuyesa kutentha ndi kupanikizika. Kenaka wodwala akukhala pampando, dokotala amalowetsa catheter mkati mwa mitsempha ndipo amaigwiritsira ntchito. Magazi amalowa mu chipinda cha dialyzer, kenako amadutsa mu njira yowonongeka ndi kubwerera mu mawonekedwe oyeretsedwa kumbuyo kwa thupi. Zomwe zimayambitsa ndondomekoyi ndizokhazikika payekha kwa wodwala aliyense.

Panthawi ya hemodialysis, wodwalayo ayenera kukhala wodekha ndikugona. Pambuyo pake, mlingo wa urea umayesedwa.

Ndemanga za odwala ndi madokotala za njira ya hemodialysis ndi yosavuta. Ambiri amakhulupirira kuti ichi ndicho chipulumutso chokha pamene palibe kuthekera kwa kuikidwa kwa thupi. Madokotala amati chifukwa cha kuyambika kwa zipangizo zamakono, njirayi yakhala yotetezeka kwambiri, ndipo ndi kayendedwe kabwino, odwala akhoza kukhala zaka 20-30. Komabe, nkofunikanso kukhala ndi moyo wathanzi komanso zakudya.

Odwala ena amadziwa pambuyo potsatira njira zowonongeka, komanso kuwonjezeka kwa chikhalidwe. Madokotala amati thupi la munthu aliyense ndilokhakha, choncho musayembekezere zotsatira zofanana pa anthu osiyanasiyana.

Zisonyezo za njirayi

Impso "impso yokhazikika" imagwiritsidwa ntchito pazirombo, pamene palibe njira ina yowonetsera magazi kuchokera ku zowonongeka ndi poizoni. Zizindikiro zazikulu za ndondomekozi zikuphatikizapo:

• Kusakwanira kwapadera kosalekeza;
• Kusakwanira kwachilendo;
• Pyelonephritis;
• Kusamba thupi;
• Kupha poizoni ndi zinthu zoopsa;
• Kuphwanya poizoni ndi ethyl mowa.

Matenda onsewa sali chizindikiro choyeretsera kuyeretsedwa kwa magazi, choncho, musanayambe kukonzekera, m'pofunika kupititsa mayeso a magazi ndi mkodzo kuti mudziwe kuchuluka kwa zinthu zovulaza. Zingathenso kutchulidwa mu matenda a shuga, monga momwe shuga imayambira, zomwe zimapangitsa kuti wodwala azikhala ndi moyo wambiri.

Zotsutsana ndi njirayi

Hemodialysis imakhalanso ndi zotsutsana, zomwe ziyenera kuganiziridwa. Zotsutsana zikuphatikizapo zinthu monga:

• Matenda a magazi;
• Matenda a mtima;
• Kugonjetsa kachitidwe kakang'ono ndi matenda osiyanasiyana a m'maganizo;
• Matenda opatsirana;
• Chiwopsezo cha matenda oopsa;
• Chifuwa cha ziwalo zamkati;
• Matenda a zamoyo.

Kuonjezera apo, chimodzi mwazovomerezeka ndi zaka za wodwala zaka zoposa 80.

Kugwirizana ndi zakudya

Zotsatira za hemodialysis zimadalira kwambiri zakudya. Zikatero, kusagwirizana ndi zakudya kungayambitse vutoli. Zimaperekedwa payekha, chifukwa ndikofunikira kuganizira malingaliro a a nephrologist, cardiologist ndi endocrinologist. Mfundo zazikuluzikulu za zakudya ndi:

• Kuletsedwa kwa kugwiritsira ntchito mchere wamchere;
• Kuthetsa zakudya zomwe zili ndi potaziyamu kuchokera ku zakudya;
• Kutaya zakudya zomwe zimapangitsa kuti madzi asungidwe;
• Kuyeza kashiamu mu thupi;
• Kuchepetsa kumwa mankhwala okoma.

Ndifunikanso kuchepetsa kuchepa kwa madzi ndikuwunika kulemera kwake, monga momwe makilogalamu angapo amawonetsera zakudya zosagwirizana. Zogulitsazo ndizophika kapena zowonongeka. Chakudyacho chiyenera kugawanika komanso choyenera.

Zingakhale zovuta ndi zotsatirapo

Ndondomeko yothetsera kuyeretsedwa kwa magazi siyibwino monga momwe tingafunire. Impso zoberekera nthawi zina zimabweretsa zotsatira ngati:

• Kusamba kwa khungu pa malo olowa mu catheter;
• Pewani muyezo wa erythrocytes;
• Kupanikizika kwapanikizi;
• Kupweteka ndi kupweteka kwa minofu;
• Matenda ogona;
• Kuchepetsa mphamvu za fupa.

Palinso mavuto ena aakulu, monga kutupa kwa pulojekiti. Zidazi zingagwire ntchito, zomwe zimapangitsa kuti wodwalayo afe.