Koj lub raum zoo li ob lub lim dej zoo heev hauv peb lub cev. Lub luag haujlwm tseem ceeb ntawm lub raum yog lim cov khib nyiab tsis tsim nyog, cov khoom lom thiab cov kua dej ntau dhau ntawm cov ntshav. Tab sis thaum cov raum no tsis ua haujlwm zoo vim muaj qee yam mob, cov khoom pov tseg tuaj yeem sib sau ua ke hauv lub cev thiab ua rau muaj teeb meem loj. Qhov no yog qhov kev kho mob cawm siav hu ua hemodialysis los pab peb.
Hauv lwm lo lus, hemodialysis yog dab tsi?
Kev ntxuav ntshav yog ib hom kev kho mob ntxuav ntshav. Thaum koj lub raum ua tsis tau lawv txoj haujlwm, yuav siv lub tshuab los ntxuav koj cov ntshav. Hais yooj yim xwb, nws ua haujlwm zoo li lub raum cuav.
Hauv cov txheej txheem no, lub tshuab yuav siv cov ntshav los ntawm koj lub cev, xa nws mus rau hauv lub lim tshwj xeeb (lub raum cuav) los ntxuav nws, thiab tom qab ntawd xa cov ntshav huv rov qab mus rau koj lub cev. Qhov no tshem tawm cov khoom xws li cov khoom pov tseg nitrogen (urea), cov khoom pov tseg los ntawm cov leeg nqaij (creatinine), thiab cov kua qaub uas sib sau ua ke hauv cov ntshav.
Lub tshuab no ua li cas thiaj ntxuav tau cov ntshav?
Xav txog seb, qhov no yog ib qho thev naus laus zis zoo kawg nkaus. Lub ntsiab lus tseem ceeb ntawm lub tshuab hemodialysis yog lub dialyzer . Qhov no yog qhov peb hu ua "lub raum cuav."
Koj cov ntshav hla dhau ntau txhiab lub raj me me zoo li daim ntaub me me uas nyob hauv lub tshuab dialyzer no. Tom qab ntawd, cov khoom pov tseg thiab cov dej ntau dhau hauv cov ntshav yuav ntws los ntawm cov ntaub me me no mus rau ib sab sib cais. Ib qho kua tshwj xeeb hu ua dialysate siv los sau cov khoom pov tseg no. Cov kua no muaj dej, ntsev, thiab electrolytes.
Koj cov ntshav, uas tau ntxuav thiab tshem tawm cov khib nyiab, raug xa rov qab mus rau koj lub cev los ntawm ib lub raj. Cov kua dialysate, uas tau sau cov khib nyiab, raug tshem tawm los ntawm lub tshuab.
Cov hom kev kho mob hemodialysis tseem ceeb yog dab tsi?
Muaj ob txoj kev tseem ceeb los kho mob hemodialysis. Koj tuaj yeem tham nrog koj tus kws kho mob seb txoj kev twg zoo tshaj plaws rau koj.
| Txoj kev kho mob | Kev piav qhia |
|---|---|
| Kev ntxuav ntshav hauv nruab nrab | Ua li no, koj yuav tsum mus rau tsev kho mob lossis chaw uas tshwj xeeb hauv kev ntxuav ntshav. Kev kho mob yog ua los ntawm tus kws saib mob lossis tus kws kho mob uas tau kawm tiav. Feem ntau koj yuav tsum mus li peb zaug hauv ib lub lim tiam, thiab txhua zaus yuav siv sijhawm li 3-4 teev. |
| Nyob hauv tsev (Kev ntxuav ntshav hauv tsev) | Kev kho mob no ua tau hauv tsev. Hauv ob peb lub lis piam, cov kws kho mob thiab cov kws tu mob yuav qhia koj yuav ua li cas thiab yuav daws cov teeb meem me me uas yuav tshwm sim li cas. Tom qab ntawd, koj tuaj yeem ua kev kho mob koj tus kheej thaum twg koj xav tau. |
Puas muaj hom kev ntxuav ntshav hauv tsev?
Yog, muaj peb hom kev kho mob hauv tsev tseem ceeb.
1. Kev ntxuav ntshav hauv tsev ib txwm muaj: Peb zaug hauv ib lub lim tiam, 3-4 teev txhua zaus.
2. Kev ntxuav ntshav hauv tsev luv luv txhua hnub: Cov thev naus laus zis tshiab ua rau lub sijhawm kho mob luv dua. Nws ua li ntawm 5-7 hnub hauv ib lub lim tiam, thiab siv sijhawm li ob teev rau ib zaug.
3. Kev ntxuav ntshav hauv tsev thaum hmo ntuj: Qhov no ua thaum hmo ntuj thaum koj pw tsaug zog. Kev kho mob ua rau 6-8 teev ib zaug, kwv yees li 4-6 hnub hauv ib lub lim tiam. Txoj kev no tso cai rau cov ntshav kom huv si ntev dua, yog li ntawd cov khoom pov tseg ntau dua raug tshem tawm ntawm lub cev.
Koj npaj li cas ua ntej kev kho mob?
Ua ntej pib ua kev ntxuav ntshav, koj yuav tsum npaj ua ntej ob peb lub lis piam lossis ob peb lub hlis. Qhov tseem ceeb tshaj plaws yog nrhiav txoj hauv kev kom yooj yim thiab sai sai rho cov ntshav thiab muab nws rov qab rau hauv lub cev thaum lub sijhawm kho mob. Qhov no yuav tsum tau phais me me.
- Arteriovenous fistula (AV fistula): Hauv txoj kev phais no, tus kws phais yuav txuas cov hlab ntsha thiab cov leeg ntshav hauv koj txhais caj npab. Qhov no yog txoj kev tsim nyog tshaj plaws thiab kav ntev tshaj plaws.
- Arteriovenous graft (AV graft): Yog tias koj cov hlab ntsha thiab cov leeg ntshav luv dhau los txuas ua ke, tus kws phais yuav txuas ob qho tib si siv lub raj mos mos thiab khoob (graft).
Yog tias yuav tsum tau pib kho mob sai sai, qee zaum ib lub raj mos mos hu ua catheter tuaj yeem muab ntxig rau hauv cov leeg ntshav loj hauv caj dab, hauv siab, lossis ncej puab ib ntus.
Tseem ceeb heev: Koj qhov fistula lossis qhov chaw graft yuav tsum tau kho zoo li lub qhov muag. Nws yog los ntawm nws uas koj txoj kev kho mob cawm txoj sia tau xa tuaj. Yog li ntawd, nws yog ib qho tseem ceeb kom tiv thaiv thaj chaw ntawd ntawm kev kis kab mob thiab kev raug mob.
Yuav kom tiv thaiv koj lub qhov quav/qhov txhab, nco ntsoov cov no:
- Tsis txhob pw nrog koj qhov hnyav rau ntawm sab caj npab qhov chaw uas muaj qhov fistula.
- Tsis txhob hnav khaub ncaws lossis cov hniav nyiaj hniav kub (cov nplhaib, cov moos) uas yuav raug ntes hauv tes ntawd.
- Tsis txhob hnav txoj siv hnab hla caj npab ntawd.
- Tsis txhob ntsuas koj cov ntshav siab (BP) lossis rho ntshav ntawm caj npab uas muaj qhov fistula.
Koj puas yuav tsum tau ceev faj txog zaub mov thiab dej haus?
Muaj tseeb tiag. Cov khoom noj uas koj noj cuam tshuam ncaj qha rau kev ua tiav ntawm kev kho mob hemodialysis. Qee cov khoom noj tuaj yeem ua rau cov khib nyiab ntau ntxiv hauv cov ntshav, ua rau cov dej khaws cia, ua rau ntshav siab ntxiv, thiab ua rau lub plawv dhia ceev.
Ua ntej pib kho mob, tus kws kho mob raum yuav tsim ib txoj kev npaj zaub mov uas haum rau koj. Feem ntau koj yuav tsum txwv cov khoom noj uas muaj cov hauv qab no:
| Cov khoom noj khoom haus kom txwv | Kev Pheej Hmoo thiab Piv Txwv ntawm Kev Siv Tshuaj Ntau Dhau |
|---|---|
| Cov poov tshuaj | Lub plawv dhia ceev heev. Piv txwv li: txiv tsawb, txiv avocado, txiv kab ntxwv, txiv hmab txiv ntoo qhuav, txiv lws suav. |
| Phosphorus | Cov pob txha yuav tawg yooj yim thiab daim tawv nqaij yuav khaus. Piv txwv li: mis nyuj thiab cov khoom noj siv mis, cheese, nqaij qaib, ntses kaus poom, hnyuv ntxwm, taum pauv, txiv ntoo qhuav. |
| Sodium - ntsev | Lub cev xav tau dej ntau ntxiv (nqhis dej ntau ntxiv), yog li ntawd dej thiaj li khaws cia tau thiab ntshav siab tuaj yeem nce ntxiv. Piv txwv li: ntsev, cov kua ntses ntxiv rau hauv cov khoom noj, khoom noj ceev ceev, khoom noj hauv kaus poom, khoom noj txom ncauj uas muaj ntsev. |
Cov kev mob tshwm sim thiab cov teeb meem ntawm kev kho mob yog dab tsi?
Ib yam li kev kho mob twg los xij, muaj qee qhov kev phiv thiab teeb meem nrog kev ntxuav ntshav. Tab sis koj tsis tas yuav txhawj txog qhov no, vim koj pab neeg kho mob yuav saib xyuas koj tas li rau qhov no.
Cov kev mob tshwm sim feem ntau:
- Ntshav siab qis (Hypotension)
- Xeev siab thiab ntuav
- Kiv taub hau thiab tsaus muag (Syncope)
- Mob hauv siab los yog mob nraub qaum
- Mob taub hau
- Khaus (Pruritus)
- Mob nqaij ntshiv
- Mob ceg tsis so (mob ceg tsis so)
Yog koj muaj cov tsos mob no ntau zaus, nrog koj tus kws kho mob lossis tus nais tham. Tej zaum yuav tswj tau los ntawm kev hloov qhov ceev ntawm kev kho mob lossis siv qee yam tshuaj.
Tej yam teeb meem uas yuav tshwm sim nrog rau qhov fistula/graft:
- Kev kis kab mob (liab, o, mob, kub taub hau)
- Cov ntshav txhaws
- Kev txhaws vim yog cov nqaij caws pliav
Yog koj pom ib yam dab tsi zoo li no, koj yuav tsum nrhiav kev pab kho mob tam sim ntawd.
Koj tuaj yeem ua neej ntev npaum li cas nrog kev ntxuav ntshav?
Qhov no yog ib qho teeb meem rau ntau tus neeg. Lub neej nruab nrab ntawm ib tus neeg uas tau txais kev kho mob hemodialysis yog li 5-10 xyoo. Txawm li cas los xij, qhov no txawv ntawm ib tus neeg mus rau ib tus neeg. Muaj cov neeg uas nyob tau 20-30 xyoo lossis ntau dua nrog kev noj zaub mov zoo, kev qhia kho mob, thiab lub neej zoo heev. Yog li ntawd, qhov tseem ceeb tshaj plaws yog kom nyob ruaj khov thiab txuas ntxiv kev kho mob kom raug.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev ntxuav ntshav tsis yog ib yam dab tsi uas yuav tsum ntshai. Nws yog ib txoj kev kho mob uas ua haujlwm rau koj lub raum thiab cawm koj txoj sia.
- Ua raws li cov lus qhia uas koj tus kws kho mob thiab tus kws noj zaub mov muab. Kev tswj kev noj zaub mov yog qhov tseem ceeb heev.
- Ua tib zoo saib xyuas koj lub qhov quav lossis qhov chaw mos. Nws zoo li lub rooj vag rau koj lub neej. Yog tias koj pom muaj kev hloov pauv (mob, o, liab), qhia rau koj tus kws kho mob tam sim ntawd.
- Yog koj ntxhov siab lossis txhawj xeeb, tham nrog koj tsev neeg thiab kws kho mob yam tsis muaj laj thawj. Koj tsis yog tib tug neeg uas nyob hauv txoj kev no.
- Nws yog ib qho ib txwm muaj uas yuav xav tias nkees vim yog kev kho mob, tab sis yog tias nws tseem muaj, qhia rau koj pab neeg kho mob paub.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus