He mea noa te mataku me te manukanuka ina kī mai tō tākuta kāore ō whatukuhu e mahi tika ana. Tērā pea kua kīia atu ki a koe me haere koe ki te dialysis. He maha ngā tāngata e manukanuka ana ina rongo rātou i ēnei kupu, ā, kāore e taea e rātou te whakaaro he aha te mea ka tupu. Engari ki te mārama tātou ki tēnei tikanga maimoatanga, ka mārama koe he tikanga tino nui tēnei ka taea te whakaora i tō ora. Nō reira, i tēnei rā ka kōrero tātou mō te hemodialysis i roto i ngā kupu māmā noa iho.
He aha te tikanga o te hemodialysis?
Whakaarohia ō whatukuhu hei tātari tino pai e rua i roto i tō tātou tinana. Ka tātarihia e rātou ngā para kore e hiahiatia, ngā paitini, me ngā wai taikaha mai i ō tātou toto, ka tukuna atu hei mimi. Engari ina āraia e te mate whatukuhu te mahi tika o tēnei mahi, ka tīmata te kohikohi o aua paitini ki roto i te tinana.
Ko te hemodialysis te tukanga horoi toto mā te whakamahi i tētahi mīhini e tango ana i ngā para hauota (urea), ngā para mai i ngā uaua (creatinine), me ngā waikawa mai i te toto, ā, ka whakahokia te toto kua horoia ki te tinana.
Me pēhea te purenga o te toto e tēnei mīhini?
He tātari motuhake tā tēnei mīhini hemodialysis. Ka kiia he 'dialyzer'. Ka kiia hoki e ētahi he 'whatukuhu hangai'. Ka haere te toto i tangohia mai i tō tinana ki roto i tēnei 'dialyzer'. I te rere o te toto mā roto i ngā ngongo angiangi rawa, he rite ki te mata whatu, ko ngā para me te wai nui anake i roto i te toto ka tātarihia ki waho.
Ka kohia ēnei para i roto i tētahi wai motuhake e kiia nei ko te 'dialysate'. He mea hanga tēnei i te wai, i ngā tote, me ngā electrolytes. Inaianei, ka tukuna te toto ma, kua tangohia ngā para katoa, ki tō tinana mā te mīhini. Ka tangohia te wai 'dialysate', kei roto ngā para, mai i te mīhini. Whakaarohia he rite ki tētahi tātari tī e tātari ana i ngā rau tī, ā, ko te tī anake ka taka ki roto i te kapu.
E rua ngā huarahi matua mō te mahi hemodialysis:
Ka taea e koe te kōrero ki tō tākuta me te whakatau ko tēhea tikanga te mea pai mōu.
| Tikanga maimoatanga | Whakaahuatanga |
|---|---|
| Hemodialysis e mahia ana i roto i te hōhipera, i te pokapū rānei (Hemodialysis i roto i te pokapū) | Koinei te tikanga tino noa. Me haere koe ki tētahi hōhipera motuhake, ki tētahi pokapū dialysis rānei mō tēnei. I reira, ka hoatu e tētahi nēhi, e tētahi tohunga hangarau rānei tēnei maimoatanga ki a koe. I te nuinga o te wā, me haere koe mō ngā rā e toru i te wiki. E 3-4 hāora te roa o ia wā. |
| Hemodialysis kāinga | I tēnei wā, ka taea e koe te mahi i tēnei maimoatanga i te kāinga. Engari i mua i ētahi wiki, i ētahi marama rānei, ka akona koe e te hōhipera me pēhea te mahi tika, me te aha hoki hei mahi mēnā he raruraru āu. Whai muri i tēnā, ka taea e koe te mahi i a koe anō i tō wā e pai ai. |
Kei reira anō ngā momo hemodialysis kāinga.
- Te hemodialysis kāinga tuku iho: I tēnei tikanga, ka mahia te maimoatanga e toru ngā rā o te wiki, mō ngā hāora e 3-4 i ia wā.
- He hemodialysis poto i te kāinga i ia rā: Ka taea tēnei te mahi mā te hangarau hou. Ka mahia tēnei i te 5-7 rā o te wiki, engari he poto noa te wā e pau ana, tata ki te rua hāora i ia wā.
- Hemodialysis kāinga i te pō: Ka mahia tēnei i te pō i a koe e moe ana. E 6-8 hāora te mahi a te mīhini i ia wā, tata ki te 4-6 rā i te wiki. Mā tēnei ka roa ake te horoi i te toto, ā, ka pai ake te tango i ngā para i ētahi atu tikanga.
Ko wai rā te tangata e hiahia ana ki tēnei maimoatanga?
Mena he mate whatukuhu kino tōu, e kiia nei ko te Mate Whatukuhu Wāhanga Mutunga (ESKD) , me tango e koe he hemodialysis. Waihoki, mō te tangata e tatari ana ki te whakawhitinga whatukuhu, he mea nui tēnei maimoatanga kia ora ai ia tae noa ki te whakawhitinga.
He mea nui kia mārama koe ki tēnei: Ehara te hemodialysis i te rongoā mō te mate tākihi. Ka āwhina noa i ō tākihi ki te mahi i ngā mahi e tika ana kia mahia, kia roa ake ai tō oranga.
Ka aha mēnā ka whakakahoretia te maimoatanga?
He kaupapa tairongo tēnei, engari me kōrero tātou mō tēnei. Mēnā ka whakatau tetahi kia kaua e tīmata te hemodialysis, ki te tīmata rānei, kātahi ka mutu, ka tīmata te kohikohi o ngā paitini i roto i te toto. Ka kiia tēnei mate he '(uremia)'. Engari, he mate kino tēnei mate. Ki te kore he maimoatanga, ka taea e koe te ora mō ētahi rā, wiki rānei.
He whakatau whaiaro tēnei. Heoi, i mua i te whakatau i tēnei momo whakatau, me kōrero koe ki tō tākuta me tō whānau mō ō āwangawanga, ō wehi, me ō kare ā-roto.
Me pēhea taku whakarite i mua i te maimoatanga?
I mua i te tīmatanga o te hemodialysis, i ētahi wiki, i te marama rānei i mua, me whakarite he iti noa te whakarite. Arā, me hanga he 'urunga' kia ngāwari ai te tango toto mai i te tinana, kia whakahokia mai ai ki te tinana i te wā e rongoatia ana. Me mahi he pokanga iti noa iho tēnei.
E rua ngā huarahi matua hei mahi i tēnei:
- AV fistula (Arteriovenous fistula - AV fistula): I tēnei, ka hono te taote pokanga i te uaua me te uaua i roto i tō ringa.
- Tārua Arteriovenous (tārua AV): Mena kāore i te roa te uaua me te uaua i roto i tō ringa hei hono, ka whakamahia e te taote pokanga he ngongo iti, ngohengohe (tārua) hei hono i a rāua.
Mā ēnei tikanga e rua ka hangaia he uaua toto kaha, ka māmā ake te werohanga ngira i te wā o te hemodialysis. Ka āwhina hoki tēnei i te tere o te rere o te toto.
Mena me tīmata ohorere te hemodialysis, ka whakauru pea tō tākuta i tētahi ngongo ngohengohe e kiia nei ko te catheter ki roto i tētahi uaua nui i tō kaki, i tō uma, i tō waewae rānei mō tētahi wā poto.
He mea tino nui kia tiakina tō urunga!
Me whakaaro ki tēnei taputapu urunga kua hangaia e koe me te mea he taonga nui. Mēnā ka pangia, ka pakaru rānei, e kore e taea te rongoā. Ko ngā tohu o te mate urutā ko:
- Mamae
- Te mamae i te wā e pēhi ana
- Pupuhi
- Te huringa tae (whero, hina, māwhero, parauri, mangu rānei)
- Kirika
Hei tiaki i te urunga atu, kia maumahara ki ēnei mea:
- Kaua e moe me te taha urunga e anga ana ki raro.
- Kaua e mau i ngā kākahu, i ngā whakapaipai rānei e mau ai taua ringa.
- Kaua e tukua te whitiki o te putea kia taka ki runga i te urunga.
- Kaua rawa e tukua kia tirohia te toto toto o tetahi, kia tangohia rānei te toto i te ringa e taea te uru atu.
Me huri rānei tō kai?
Āe, tino tika. Ko tāu e kai ana, e inu ana hoki, ka pā tika ki te angitu o te maimoatanga hemodialysis. Ko ētahi kai ka whakanui ake i ngā hua para i roto i te toto, te pupuri wai, te toto toto, me te tere o te ngakau. Nō reira, me kōrero koe ki tētahi tohunga kai whatukuhu hei whakawhanake i tētahi mahere kai e tika ana māu.
I te nuinga o te wā, me whakawhāiti e koe ngā kai me ngā inu kei roto ēnei mea.
| He aha hei whakawhāiti | Take me ngā tauira |
|---|---|
| Pāhare pākawa | Ki te piki ake ngā taumata pāhare pāporo, ka tere rawa atu te tere o te manawa. Tauira: Panana, āwōkātō, karaka, pea, hua maroke (tāte, karepe maroke), rīwai. |
| Whēkau | Ki te piki ake te whākōkī, ka ngoikore ngā wheua, ā, ka puta he ponana kiri. Tauira: te miraka me ngā kai miraka (miraka miraka, tīhi), heihei, hōtiti, kai kēne, pīni, kāhew. |
| Konutai - tote | Ki te nui rawa te tote e kai ana koe, ka nui ake tō matewai, ā, ka pupuri te wai i roto i tō tinana. Tauira: tote, ranu, ketchup, hupa kua tākaihia, nūru inamata, kai i hokona mai i te toa. |
He aha ngā mea ka tupu i te wā e rongoatia ana?
Ka werohia e te nēhi, e te tohunga hangarau rānei ngā ngira e rua ki roto i te urunga i hangaia i roto i tō ringa. Ka tangohia e te ngira kotahi te toto mai i tō tinana ka tukuna ki te mīhini. Kia horoia te toto e te dialyzer i roto i te mīhini, ka tukuna e te ngira tuarua te toto ma ki roto i tō tinana.
Ka aroturukihia e te mīhini tō toto toto i te roanga o te maimoatanga. Ka taea hoki e te mīhini te whakanui, te whakaiti rānei i te tere o te rere o te toto ina hiahiatia.
He mamae tēnei?
Ka pāngia koe e te ngau iti ina werohia ngā ngira e rua ki roto i tō urunga. Heoi, kāore koe e mamae mō ētahi haora i muri i te maimoatanga. He tokomaha te hunga e pānui pukapuka ana, e mātaki pouaka whakaata ana, e moe ana rānei i tēnei wā.
He aha i roa ai tēnei?
E rua ngā whatukuhu hauora e purea tonu ana te toto i ngā hāora 24 o te rā, ahakoa e moe ana koe. Kāore e taea e te mīhini hemodialysis te mahi i tēnā. Ka purea e ngā whatukuhu hauora te 140 rita o te toto i te rā. Engari he iti iho te whai huatanga o te maimoatanga hemodialysis. Koia te take me mahi mō te iti rawa 3-4 hāora i te wā kotahi.
I muri i te maimoatanga me ngā pānga taha pea
Kia oti te maimoatanga, ka tangohia ngā ngira, ka horoia te wāhi, ā, ka tāpirihia he pāreti. Whai muri i tēnā, ka taea e koe te hoki ki te kāinga pērā i ngā wā katoa.
He tokomaha te hunga e ngenge ana, e ngenge ana rānei i muri i te maimoatanga. Tērā pea ka roa tēnei mō ētahi haora. He mea noa tēnei. Engari ki te tino kore e pai tō āhua, me kōrero ki tō tākuta.
He maha atu anō ngā pānga taha ka pā mai i te hemodialysis. Kāore e pāngia te katoa e ēnei, engari he mea pai kia mōhio koe ki ēnei.
| Ngā pānga taha noa | |
|---|---|
| Te toto toto iti (hypotension) | Tērā pea ka pā te whanoke me te hemo o te kiri. |
| Ngā mamae o te uaua | Ka tino kitea pea tēnei i ngā waewae. |
| Whakapairuaki me te ruaki | He uaua tēnei ki ētahi tāngata. |
| Mākūkū (Pruritus) | Ka taea te whakaiti i tēnei mā te whakahaere i te taumata o te whākōkī i roto i te toto. |
| Te mamae o te upoko, te mamae o te uma, te tuara rānei | Ka puta anō hoki ēnei i ētahi wā. |
Kia pēhea te wā me toro atu ahau ki te tākuta?
Mena kei a koe tētahi o ngā tohu e whai ake nei, me whakamōhio tonu atu ki tō tākuta.
- Ngā tohu o te toto toto iti (pōuri, ngoikore (syncope))
- Whakapairuaki me te ruaki
- Ngā tohu o te mate pāwera i te wāhi e uru ana (pupuhi, whero, mamae, kirika)
- Mamae nui o te puku
Karere Tangohia ki te Kāinga
- He maimoatanga whakaora ora te hemodialysis e āwhina ana ki te pupuri i a koe kia ora ina ngoikore ō whatukuhu. Ehara i te rongoā.
- He mea tino nui te whakahaere i tō kai mā te whakamahi i tēnei maimoatanga.Me whai tonu i ngā tohutohu a tō tākuta me tō tohunga kai.
- Ko te urunga kua mahia e koe hei oranga mōu. Tiakina pai mai i ngā mate urutā me ngā aituā.
- He mea noa te ngenge i muri i te maimoatanga. Heoi, kaua e wehi ki te kōrero ki tō tākuta mō ngā mamae katoa e pā ana ki a koe.
- Kāore koe i te mokemoke i tēnei haerenga. Kei reira tō whānau, ō hoa, me ngā kaimahi hauora hei tautoko i a koe. Ko koe te tangata tino nui o tō rōpū hauora. Nō reira, me whakatau koe i ia whakatau me te whai whakaaro.
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