Kua rongo koe i tētahi tākuta e kōrero ana mō tētahi raruraru whatukuhu i roto i tō whānau, i tētahi rānei o tō whanaunga? Ina rongo tātou i tētahi mea pēnei i te, "Kua ngoikore ngā whatukuhu e rua, ā, me mahi tātou i te dialysis," ka pā mai he mataku nui, he ohorere hoki. He aha rawa te dialysis? He mea tēnei hei wehi māu? Ka taea e koe te noho i tētahi oranga noa me tēnei maimoatanga? He maha pea āu pātai pēnei i roto i tō hinengaro. Kaua e manukanuka. I tēnei rā, ka kōrerohia e tātou tēnei mea me te tino māmā, i roto i tētahi huarahi ka tino mārama koe.
He aha te dialysis, i te whakarapopototanga?
Ki te kī māmā noa, he tikanga maimoatanga te dialysis e mahi hangai ana i ngā mahi e tika ana kia mahia e ō tātou whatukuhu ina kore e mahi tika.
Whakaarohia he wheketere nui tō tātou tinana. Kei te mahi ia pūtau o tēnei wheketere. Ka puta mai i tēnei mahi ngā momo para. He rite ō tātou whatukuhu ki te pūnaha tātari pai rawa atu o tēnei wheketere. Ko tā rātou mahi matua he tātari i ngā para koretake, ngā paitini, me te wai nui mai i te toto, ka tukuna atu i te tinana hei mimi. Ka tangohia ngā mea pēnei i te para hauota (urea) me ngā para mai i ngā uaua (creatinine) i tēnei ara.
Whakaarohia te aha ka tupu mēnā ka pakaru, ka mutu rānei te mahi a tēnei pūnaha tātari? Ka kohia ngā para katoa i puta i taua wheketere, ā, ka pōrearea te pūnaha katoa, kāore? Koinei te āhua, ina pāngia tātou e te ngoikore o te whatukuhu, ka tīmata te kohi o ngā paitini, ngā para, me ngā wai koretake ki roto i ō tātou toto. He tino morearea tēnei āhuatanga mō ō tātou oranga.
Koinā te mahi a te dialysis. Arā, ka mahi ia i te mahi horoi i te toto kāore e taea e ngā whatukuhu te mahi, mā te āwhina o tētahi mīhini, mā tētahi atu tikanga motuhake rānei. Pērā i te wā e pakaru ana tā tātou tātari wai i te kāinga, ka kawea mai e tātou he pounamu wai ma mai i te toa, ina kore ngā whatukuhu e mahi, ka horoia e tātou te toto mā te tukanga e kiia nei ko te dialysis.
Ko wai e hiahia ana ki te maimoatanga dialysis?
Ehara i te mea ko te hunga katoa e pāngia ana e te mate tākihi e hiahia ana ki te dialysis. E hiahiatia ana tēnei mō te hunga e pāngia ana e te mate tākihi wāhanga whakamutunga, te mate tākihi wāhanga whakamutunga rānei (ESKD).
E rima ngā wāhanga o te mate tākihi. I te wāhanga tuarima, kei te mahi ngā tākihi i raro iho i te 15% o tōna taumata noa. I tēnei wā, kāore e taea e te tinana te tango i ngā paitini e kohia ana i roto i te tinana. I taua wā, he mea tino tika te dialysis, te whakawhitinga tākihi rānei kia ora ai. Ka whiwhi ētahi tāngata i te maimoatanga dialysis i waenganui i aua wāhanga tae noa ki te whiwhinga i te whakawhitinga tākihi.
He aha ngā tino take o te ngoikore o te whatukuhu?
- Te toto toto tiketike: Ko te toto toto tiketike kāore e taea te whakahaere mō te wā roa te tino take o te kino o te whatukuhu.
- Mate huka:Ka pakaru ngā oko toto ngawari o ngā whatukuhu i ngā taumata huka toto tiketike nā te mate huka.
- Ngā mate pēnei i te Lupus: Ko ēnei ngā mate e whakaekea ai e te pūnaha ārai mate o te tinana ōna ake whekau.
- Ētahi atu take: I ētahi wā, ka pāngia te whatukuhu e te aituā ohorere, te mate kino rānei. Waihoki, ka pāngia ētahi tāngata e te mate whatukuhu, ahakoa kāore he take e taea te tautuhi.
He whakatau nui te tīmata i te dialysis. Engari ki te kore te tangata e pāngia ana e te ngoikore o te whatukuhu e te dialysis, ka pāngia rātou e te uremia (he puranga paitini i roto i te toto) ā, ka mate i roto i ngā rā, i ngā wiki rānei. Nō reira, he maimoatanga whakaora ora nui tēnei.
E rua ngā tikanga matua mō te dialysis:
Ina whakaaro tātou ki te dialysis, ko te mea anake e puta ake ana ki te hinengaro ko te tukanga horoi i te toto mā te hono atu ki tētahi mīhini nui. Engari e rua ngā tikanga matua o te dialysis. Me mārama noa tātou ki te rerekētanga i waenganui i ngā mea e rua.
1. Hemodialysis
2. Te Dialysis Peritoneal
Ka whakatau tō tākuta i ēnei tikanga e rua i muri i te whai whakaaro ki ngā āhuatanga pēnei i tō hauora me tō momo noho.
| Āhuatanga | Hemodialysis | Te Dialysis Peritoneal |
|---|---|---|
| Te wāhi mahi | He maha ngā wā ka mahia i roto i te hōhipera, i te pokapū dialysis rānei. | Ka taea e koe te mahi i a koe anō i te kāinga. |
| Tikanga | Ka tangohia te toto e te mīhini i te tinana, ka tātarihia mā roto i tētahi whatukuhu horihori (dialyzer), kātahi ka whakahokia te toto ma ki te tinana. | Ko te peritoneum, he kiriuhi i roto i te puku, he tātari taiao hei horoi i te toto. |
| Te wā me te auau | E 3-4 hāora te roa i te wā kotahi, e 3 rā i te wiki. | Ka mahia i ia rā, e 3-5 ngā wā i te rā (30-40 meneti ia wā), i te pō rānei i a koe e moe ana mā te whakamahi i tētahi mīhini. |
| Pokanga | I mua i te tīmatanga o te maimoatanga, me mahi he pokanga iti (fistula) hei whakanui ake i ngā uaua toto i te ringa. | Me mahi pokanga hei whakauru tūturu i tētahi ngongo ngohengohe (catheter) ki roto i te puku. |
He kōrero anō mō te hemodialysis
Koinei te tikanga dialysis e whakamahia whānuitia ana i te ao. Anei ngā mea ka tupu:
1. Te Whakarite: Nā te mea me tere te pupuhi toto o te mīhini dialysis, kāore e taea e ō tātou uaua noa te whakahaere. Nō reira, ka mahi te taote pokanga i tētahi pokanga iti, ka hono i te uaua toto me te uaua toto i tō ringa hei hanga i tētahi uaua toto nui, kaha (fistula). Koinei te mea e whakamahia ana hei tango me te whakahoki i te toto mō te dialysis.
2. Maimoatanga: Ina haere koe ki te pokapū dialysis, ka werohia e te nēhi ētahi ngira e rua ki roto i te oko toto kua hangaia. Ka tangohia e tētahi o aua ngira te toto i roto i tō tinana ka tukuna ki te mīhini dialysis. I a ia e haere ana mā roto i tētahi tātari horihori e kiia nei ko te dialyzer i roto i te mīhini, ka tangohia ngā para me te wai nui mai i te toto. Kātahi ka whakahokia te toto kua horoia ki tō tinana mā roto i tētahi atu ngira. E 3 ki te 4 hāora te roa o tēnei tukanga. I tēnei wā, ka taea e koe te noho ki runga i tētahi tūru me te mahi i tētahi mea pēnei i te pānui pukapuka, te mātaki pouaka whakaata rānei.
Ngā taipitopito mō te Peritoneal Dialysis
He rerekē tēnei tikanga. Kāore e whakamahia he mīhini nui. Engari, ka whakamahia he mea i roto i tō tātou tinana hei tātari.
1. Te Whakarite: I mua i te tīmatanga o tēnei maimoatanga, ka whakauruhia e te taote pokanga he ngongo ngohengohe tūturu (catheter) ki roto i tō puku, i runga ake i te mata o te kiri.
2. Maimoatanga: Ka ringihia he wai horoi motuhake e kiia nei ko te 'dialysate' ki roto i te kōhao puku mā roto i tēnei ngongo. He maha ngā uaua toto pai o te kiriuhi e kiia nei ko te 'peritoneum' e kapi ana i te pakitara o roto o te puku. Ina noho taua wai ki roto i te puku, ka mahi ia pērā i te aukume hei kukume i ngā hua para me te wai nui mai i te toto. I muri i ētahi haora, ka tangohia anō te wai kua kohia i roto i ngā hua para mā roto i taua ngongo anō ka tangohia. Ka kiia tēnei tukanga he 'whakawhitinga'.
E rua ngā huarahi hei mahi i tēnei:
- CAPD (Dialysis Peritoneal Haere Tonu):I tēnei āhuatanga, me whakawhiti e koe tēnei wai kia 3-5 ngā wā i te rā. Ina whakairihia he pēke wai kia teitei ake i tō pakihiwi, ka rere te wai ki roto i tō puku mā te kaha ā-papa. E 30-40 meneti pea te roa o tēnei.
- APD (Aunoa Peritoneal Dialysis): He mea watea tēnei mō te nuinga o te tangata. I mua i tō haerenga ki te moe i te pō, ka honoa koe ki tētahi mīhini iti. I a koe e moe ana, ka whakawhiti aunoa te mīhini i ngā wai i ngā wā maha puta noa i te pō.
Kei te pēhea te oranga me te dialysis? He āwangawanga kei a koe?
Koinei ētahi o ngā pātai nui e pā ana ki te tangata e tata ana ki te tīmata i te dialysis. Me titiro takitahi tātou ki ia pātai.
He mamae te dialysis?
- Hemodialysis: He iti noa te ngau ka pā mai ina werohia te ngira ki roto i te uaua. Whai muri i tēnā, kāore he mamae i te wā e rongoatia ana.
- Te dialysis peritoneal: Kāore he mamae i roto i tēnei. Heoi, i te mea ka whakakīia te puku e te wai, tera pea ka ahua kī tonu, ka taumaha hoki.
He aha ngā mōrearea o te maimoatanga dialysis?
Pērā i ngā maimoatanga hauora katoa, he mōrearea anō hoki kei te dialysis.
- I roto i te hemodialysis: Tērā pea ka pāngia te wāhi e puta ai te mate. Waihoki, ka ārai pea ngā toto toto i te uaua. I ētahi wā ka heke te toto toto. Kaua e manukanuka, he pūnaha haumaru ā ngā mīhini. Ki te he tetahi mea, ka tangi te whakaoho, ā, ka mutu te mīhini, nō reira kāore he kino nui.
- I roto i te dialysis peritoneal: Ko te mōrearea nui ko te peritonitis. Ka pā mai pea tēnei mena ka uru ngā iroriki ki te wāhi e whakaurua ana te ngongo. Nō reira, me tino ma te mahi i tēnei tukanga. Waihoki, i roto i te wā, ka ngoikore ngā uaua o te puku, ā, ka puta pea ngā hernia.
Ka pai ake anō ōku whatukuhu mā te dialysis?
He pātai tēnei e pātaihia ana e te tini. Ehara te dialysis i te rongoā mō te mate tākihi. Ka tangohia noa te mahi a ngā tākihi mō te wā poto. Ko te mate tākihi wāhanga whakamutunga (ESKD) he āhuatanga e kore e taea te whakakore. Nō reira, me dialysis mō te toenga o tō oranga tae noa ki te whiwhi koe i te whakawhitinga tākihi.
Kia pēhea te roa e ora ai te tangata e whiwhi ana i te dialysis?
Kāore he whakautu kotahi mō tēnei. He rerekē rawa i ia tangata, i ia tangata. He maha ngā āhuatanga e whakawhirinaki ana ki tēnei, pērā i tō tau, tō hauora whānui, me te mate i puta ai te ngoikore o te whatukuhu. Engari he tokomaha ngā tāngata, mā te maimoatanga tika me te whai i ngā tohutohu a tā rātou tākuta, ka ora harikoa mō ngā tau, tae atu ki ngā tekau tau.
Ka taea e au te mahi noa me te dialysis?
Ae rā, ka taea e koe.Ehara i te mea kua mutu tō oranga mā te dialysis. Ko te nuinga o te tangata ka mahi i ā rātou mahi o ia rā, ka tiaki i ō rātou whānau. Ka taea e koe te haereere. Mena kei raro koe i te hemodialysis, ka taea e koe te kōrero ki tētahi pokapū dialysis i tō rohe me te whakarite kia whiwhi koe i tō maimoatanga i reira. Mena kei raro koe i te peritoneal dialysis, he māmā ake nā te mea ka taea e koe te kawe i ō ake putea wai.
Kia tūpato ki ēnei tohu: Kōrero tonu atu ki tō tākuta
Mena kei te whiwhi koe i te maimoatanga dialysis, whakamōhio atu ki tō tākuta, ki tō pokapū maimoatanga rānei mēnā ka pāngia koe e tētahi o ngā tohu e whai ake nei.
| Tohu | Whakaahuatanga |
|---|---|
| Te uaua ki te mimi | Te whakaiti, te mutu rānei o te mimi. |
| Te toto toto iti | Pōuriuri, ngoikore, kikorangi ngā kanohi, he matewai rerekē. |
| Ngā tohu o te mate | Te kirika, te makariri, te ānini, te whero, te pupuhi, te pupuhi rānei i te wāhi i werohia ai te ngongo. |
| Mamae nui o te puku | He tohu pea tēnei nō te mate urutā, inā koa mō te hunga e tango ana i te peritoneal dialysis. |
| Whakapairuaki me te ruaki | Whakapairuaki, ruaki rānei kāore i te mārama. |
| Ngā tohu o te hernia | He pupuhi, he puku rerekē rānei i roto i te puku, i te uma rānei. |
Karere Tangohia ki te Kāinga
- He rongoā whakaora ora te dialysis mō te tangata e pāngia ana e te ngoikore o ōna whatukuhu. Kaua e wehi.
- E rua ngā momo matua o te dialysis (hemodialysis me te peritoneal dialysis). Ka taea e tō tākuta te āwhina i a koe ki te whiriwhiri i te tikanga e pai ana mō tō āhua noho me tō hauora.
- He maimoatanga mō te wā katoa tēnei (kia oti rā anō te whakawhitinga whatukuhu), engari ka taea tonu te noho ora tonu, ora tonu i te wā e whakamahia ana te dialysis.
- Ki te mea kei te whakahaerehia koe i te peritoneal dialysis , kia tino tupato ki te horoi. He mea tino nui kia tiakina koe i ngā mate urutā.
- Kia tika te whai i ngā tohutohu a tō tākuta mō tō kai, te wai e inuhia ana, me ngā rongoā.
- Kōrerotia mā te mahorahora ki tō tākuta mō ngā pātai, ngā āwangawanga rānei kei a koe. Kei te rite tonu rātou ki te āwhina i a koe.
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