Ua like kou mau puʻupaʻa me ʻelua mau kānana nui i loko o ko kākou kino. ʻO ka hana nui o nā puʻupaʻa, ʻo ia ke kānana i nā huahana ʻawahia pono ʻole a me nā wai keu mai ke koko. Akā, i ka wā e hana pono ʻole ai kēia mau puʻupaʻa ma muli o kekahi mau kūlana olakino, hiki i nā huahana ʻōpala ke hōʻiliʻili i loko o ke kino a hoʻoulu i nā pilikia koʻikoʻi. Maanei kahi e kōkua mai ai ka lāʻau lapaʻau ola i kapa ʻia ʻo hemodialysis iā kākou.
I ka ʻōlelo maʻalahi, he aha ka hemodialysis?
He ʻano lapaʻau dialysis ka hemodialysis. Ke hiki ʻole i kou mau puʻupaʻa ke hana i kā lākou hana, hoʻohana ʻia kahi mīkini e hoʻomaʻemaʻe i kou koko. I ka ʻōlelo maʻalahi, hana ia e like me kahi puʻupaʻa hana.
Ma kēia kaʻina hana, lawe kahi mīkini i kekahi koko mai kou kino, hoʻoili iā ia ma o kahi kānana kūikawā (he puʻupaʻa hana) e hoʻomaʻemaʻe iā ia, a laila hoʻihoʻi i ke koko maʻemaʻe i kou kino. Hoʻopau kēia i nā mea e like me nā huahana ʻōpala nitrogenous (urea), nā huahana ʻōpala mai nā ʻiʻo (creatinine), a me nā waikawa e hōʻiliʻili ana i loko o ke koko.
Pehea e hoʻomaʻemaʻe ai kēia mīkini i ke koko?
E noʻonoʻo, he ʻenehana kupaianaha loa kēia. ʻO ka ʻāpana nui o ka mīkini hemodialysis ka dialyzer . ʻO kēia ka mea a mākou e kapa nei ʻo "artificial kidney."
Hele kou koko ma o nā tausani o nā ʻōmole lahilahi loa e like me ka mesh i loko o kēia dialyzer. A laila, kahe nā huahana ʻōpala a me ka wai keu i loko o ke koko ma o kēia mau mesh lahilahi i kahi ʻaoʻao ʻokoʻa. Hoʻohana ʻia kahi wai kūikawā i kapa ʻia ʻo dialysate e hōʻiliʻili i kēia mau huahana ʻōpala. Loaʻa i kēia wai ka wai, nā paʻakai, a me nā electrolytes.
ʻO kou koko, ka mea i hoʻomaʻemaʻe ʻia a hoʻoneʻe ʻia mai ka ʻōpala, e hoʻihoʻi ʻia i kou kino ma o kahi ʻōmole. ʻO ka wai dialysate, ka mea nāna i hōʻiliʻili i ka ʻōpala, e hoʻoneʻe ʻia e ka mīkini.
He aha nā ʻano nui o ka mālama ʻana i ka hemodialysis?
ʻElua ala nui e hana ai i ka mālama ʻana i ka hemodialysis. Hiki iā ʻoe ke kūkākūkā me kāu kauka i ke ʻano hana kūpono loa iā ʻoe.
| ʻAno lapaʻau | Wehewehena |
|---|---|
| Hemodialysis i loko o ke kikowaena | No kēia, pono ʻoe e hele i kahi haukapila a i ʻole ke kikowaena i loea i ka hemodialysis. Hana ʻia ka lāʻau lapaʻau e kahi kahu maʻi a loea paha i aʻo ʻia. ʻO ka maʻamau, pono ʻoe e hele ma kahi o ʻekolu manawa i ka pule, a ʻo kēlā me kēia kau e lawe ma kahi o 3-4 mau hola. |
| Ma ka home (Hemodialysis ma ka home) | Hiki ke hana ʻia kēia lāʻau lapaʻau ma ka home. I loko o kekahi mau pule, e aʻo aku nā kauka a me nā kahu maʻi iā ʻoe pehea e hana ai a pehea e hoʻoponopono ai i nā pilikia liʻiliʻi e kū mai ana. Ma hope o kēlā, hiki iā ʻoe ke hana i ka lāʻau lapaʻau iā ʻoe iho i kou manawa kūpono. |
Aia kekahi mau ʻano hemodialysis home?
ʻAe, ʻekolu mau ʻano nui o nā lāʻau lapaʻau ma ka home.
1. Hemodialysis maʻamau ma ka home: ʻEkolu manawa i ka pule, 3-4 hola i kēlā me kēia manawa.
2. Hemodialysis home pōkole i kēlā me kēia lā: ʻAe ka ʻenehana hou i nā manawa lapaʻau pōkole. Hana ʻia ia ma kahi o 5-7 mau lā o ka pule, a he ʻelua hola ka lōʻihi i kēlā me kēia kau.
3. Hemodialysis home nocturnal: Hana ʻia kēia i ka pō i kou hiamoe ʻana. Hana ʻia ka lāʻau no 6-8 mau hola i ka manawa, ma kahi o 4-6 mau lā o ka pule. ʻAe kēia ʻano hana i ka hoʻomaʻemaʻe ʻana i ke koko no kahi manawa lōʻihi, no laila e hoʻoneʻe ʻia nā huahana ʻōpala mai ke kino.
Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?
Ma mua o ka hoʻomaka ʻana i ka hemodialysis, pono ʻoe e hana i kekahi hoʻomākaukau i kekahi mau pule a i ʻole mau mahina ma mua. ʻO ka mea nui, ʻo ia ka loaʻa ʻana o kahi ala e hiki ai ke lawe koke a maʻalahi i ke koko a hoʻihoʻi i loko o ke kino i ka wā o ka mālama ʻana. Pili kēia i kahi ʻoki liʻiliʻi.
- ʻO ka fistula arteriovenous (AV fistula): Ma kēia kaʻina hana, hoʻopili ke kauka lapaʻau i kahi aʻa a me kahi aʻa koko i kou lima. ʻO kēia ke ʻano kūpono loa a lōʻihi hoʻi.
- ʻO ke kāpili ʻana o ke aʻa (AV graft): Inā pōkole loa kou aʻa a me kou aʻa e hoʻopili ʻia, e hoʻopili ke kauka lapaʻau i nā mea ʻelua me ka hoʻohana ʻana i kahi ʻōmole palupalu a hakahaka (graft).
Inā pono e hoʻomaka koke ʻia ka lāʻau lapaʻau, i kekahi manawa hiki ke hoʻokomo ʻia kahi ʻōmole palupalu i kapa ʻia he catheter i loko o kahi aʻa nui ma ka ʻāʻī, ka umauma, a i ʻole ka ʻūhā.
He mea nui loa: Pono e mālama ʻia kou fistula a i ʻole kahi graft e like me ka maka. Ma o ia mea e hāʻawi ʻia ai kāu lāʻau lapaʻau e hoʻōla ai i ke ola. No laila, he mea nui e pale i kēlā wahi mai ka maʻi a me ka ʻeha.
No ka pale ʻana i kāu fistula/graft, e hoʻomanaʻo i kēia mau mea:
- Mai hiamoe me kou kaumaha ma ka ʻaoʻao o ka lima kahi o ka fistula.
- Mai komo i nā lole a i ʻole nā mea hoʻonani (nā apo, nā wati) e paʻa ai i kēlā lima.
- Mai kau i ke kaula ʻeke ma luna o kēlā lima.
- Mai hoʻāʻo e nānā i kou koko (BP) a i ʻole e huki ʻia ke koko mai ka lima me ka fistula.
Pono anei ʻoe e makaʻala nui e pili ana i ka meaʻai a me ka mea inu?
ʻAe loa. Hoʻopilikia pololei ka meaʻai āu e ʻai ai i ka holomua o ka mālama ʻana i ka hemodialysis. Hiki i kekahi mau meaʻai ke hoʻonui i ka nui o ka ʻōpala i loko o ke koko, hoʻoulu i ka paʻa ʻana o ka wai, hoʻonui i ke koko kiʻekiʻe, a hoʻonui i ka helu o ka puʻuwai.
Ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau, e hana kahi meaʻai no nā puʻupaʻa i kahi papaʻai kūpono nou. Pono ʻoe e kaupalena i nā meaʻai i loaʻa i kēia mau mea:
| Nā meaʻai e kaupalena ʻia | Nā pilikia a me nā hiʻohiʻona o ka overdose |
|---|---|
| Potasiuma | Hiki i ka puʻuwai ke lilo i mea wikiwiki loa. Eia kekahi laʻana: maiʻa, ʻāpala, ʻalani, hua maloʻo, tōmato. |
| ʻO ka phosphorus | Hiki i nā iwi ke palupalu a hiki ke maneʻo ka ʻili. Eia kekahi laʻana: ka waiū a me nā huahana waiū, ka tīhi, ka moa, ka iʻa i loko o ka pahu, nā sausage, nā lentil, nā nati. |
| Paʻakai - sodium | Pono ke kino i nā wai hou aʻe (make wai nui), no laila hiki ke paʻa ka wai a hiki ke piʻi aʻe ke koko. Eia kekahi laʻana: paʻakai, nā mea ʻono i hoʻohui ʻia i ka meaʻai, ka meaʻai wikiwiki, ka meaʻai i loko o ka pahu, nā meaʻai māmā me ka paʻakai. |
He aha nā hopena ʻaoʻao a me nā pilikia o ka lāʻau lapaʻau?
E like me nā lāʻau lapaʻau āpau, aia kekahi mau hopena ʻaoʻao a me nā pilikia me ka hemodialysis. Akā, ʻaʻohe pono e hopohopo no kēia, no ka mea, e nānā mau ana kāu hui lapaʻau iā ʻoe no kēia.
Nā hopena ʻaoʻao maʻamau e hiki ke loaʻa:
- Ke koko haʻahaʻa (Hypotension)
- Ka luaʻi a me ka luaʻi
- ʻO ka poniuniu a me ka nāwaliwali (Syncope)
- ʻEha umauma a i ʻole ke kua
- ʻEha poʻo
- ʻĀnai (Pruritus)
- ʻEhaʻeha o nā ʻiʻo
- ʻO ka maʻi wāwae hoʻomaha (manaʻo o ka hoʻomaha ʻole i nā wāwae)
Inā ʻike pinepine ʻoe i kēia mau hōʻailona, e kamaʻilio me kāu kauka a kahu maʻi paha. Hiki ke hoʻomalu ʻia lākou ma ka hoʻololi ʻana i ka wikiwiki o ka lāʻau lapaʻau a i ʻole ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau.
Nā pilikia e pili ana me ka fistula/graft:
- Ka maʻi (ʻulaʻula, pehu, ʻeha, kuni)
- Nā ʻūpā koko
- Ka pale ʻana ma muli o ka ʻiʻo ʻeha
Inā ʻike ʻoe i kekahi mea e like me kēia, pono ʻoe e ʻimi koke i ke kōkua lapaʻau.
ʻEhia ka lōʻihi e hiki ai iā ʻoe ke ola me ka hemodialysis?
He pilikia kēia no nā kānaka he nui. ʻO ka awelika o ke ola o kekahi e mālama ʻia ana ma ka hemodialysis ma kahi o 5-10 mau makahiki. Eia nō naʻe, ʻokoʻa kēia mai kēlā kanaka a kēia kanaka. Aia kekahi poʻe e ola ana he 20-30 mau makahiki a ʻoi aku paha me ka ʻai maikaʻi, ka ʻōlelo aʻoaʻo lapaʻau, a me ke ʻano maikaʻi o ke ola. No laila, ʻo ka mea nui loa, ʻo ia ke noho ikaika a hoʻomau i ka mālama pono ʻana.
Leka Lawe-Home
- ʻAʻole he mea e makaʻu ai ka hemodialysis. He lāʻau ia e hana ana ma kou mau puʻupaʻa a hoʻopakele i kou ola.
- E hahai pono i nā ʻōlelo aʻoaʻo a kāu kauka a me ka meaʻai meaʻai. He mea nui loa ka kaohi ʻana i ka ʻai.
- E mālama pono i kāu fistula a i ʻole graft. Ua like ia me kahi puka i kou ola. Inā ʻike ʻoe i kekahi mau loli (ʻeha, pehu, ʻulaʻula), e haʻi koke i kāu kauka.
- Inā ʻoe e hopohopo nei a hopohopo paha, e kamaʻilio ākea me kou ʻohana a me ke kauka. ʻAʻole ʻoe hoʻokahi i kēia huakaʻi.
- He mea maʻamau ke luhi ma muli o ka lāʻau lapaʻau, akā inā hoʻomau ia, e hoʻomaopopo i kāu hui lapaʻau.
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