He rite ō whatukuhu ki ngā tātari tino pai e rua i roto i tō tātou tinana. Ko te mahi matua a ngā whatukuhu he tātari i ngā para koretake, paitini me ngā wai taikaha mai i te toto. Engari ki te kore ēnei whatukuhu e mahi tika nā ētahi āhuatanga hauora, ka taea e ngā para te kohikohi ki roto i te tinana, ka puta he raruraru nui. Koinei te wāhi e puta ai te maimoatanga whakaora ora e kiia nei ko te hemodialysis hei āwhina i a tātou.
He aha te tikanga o te hemodialysis?
He momo maimoatanga dialysis te hemodialysis. Ina kore e taea e ō whatukuhu te mahi i tā rātou mahi, ka whakamahia he mīhini hei horoi i ō toto. He māmā noa iho, he rite tana mahi ki te whatukuhu horihori.
I tēnei tikanga, ka tangohia e te mīhini ētahi toto mai i tō tinana, ka tukuna mā roto i tētahi tātari motuhake (he whatukuhu horihori) hei horoi, kātahi ka whakahokia te toto ma ki tō tinana. Ka tangohia e tēnei ngā mea pēnei i ngā para hauota (urea), ngā para mai i ngā uaua (creatinine), me ngā waikawa e kohia ana i roto i te toto.
Me pēhea te purenga o te toto e tēnei mīhini?
Whakaarohia, he hangarau tino mīharo tēnei. Ko te wāhanga matua o te mīhini hemodialysis ko te dialyzer . Koinei te mea e kiia nei e tātou ko te "whatukuhu horihori".
Ka rere ō toto mā roto i ngā mano tini o ngā ngongo angiangi, he rite ki te mata whatu, i roto i tēnei taputapu tātari toto. Kātahi ka turuturu ngā para me te wai nui i roto i te toto mā roto i ēnei mata whatu ki tētahi taha motuhake. Ka whakamahia he wai motuhake e kiia nei ko te dialysate hei kohi i ēnei para. Kei roto i tēnei wai he wai, he tote, me ngā electrolytes.
Ko ō toto, kua horoia, kua tangohia mai i te para, ka whakahokia ki tō tinana mā roto i tētahi ngongo. Ko te wai dialysate, nāna nei i kohi ngā para, ka tangohia e te mīhini.
He aha ngā momo matua o te maimoatanga hemodialysis?
E rua ngā huarahi matua hei whakahaere i te maimoatanga hemodialysis. Ka taea e koe te kōrero ki tō tākuta ko tēhea te tikanga pai rawa atu māu.
| Tikanga maimoatanga | Whakaahuatanga |
|---|---|
| Hemodialysis i roto i te pokapū | Mō tēnei, me haere koe ki tētahi hōhipera, ki tētahi pokapū rānei e tohunga ana ki te hemodialysis. Mā tētahi nēhi, mā tētahi tohunga hangarau rānei te maimoatanga e whakahaere. I te nuinga o te wā me haere koe ki reira e toru ngā wā i te wiki, ā, e 3-4 hāora te roa o ia wā. |
| I te kāinga (Hemodialysis kāinga) | Ka taea te mahi i tēnei maimoatanga i te kāinga. I roto i ētahi wiki, ka ako ngā tākuta me ngā nēhi i a koe me pēhea te mahi me te whakatau i ngā raruraru iti ka puta mai. Whai muri i tēnā, ka taea e koe te mahi i te maimoatanga i tō ake wā. |
He momo hemodialysis kāinga kei reira?
Āe, e toru ngā momo maimoatanga kāinga matua.
1. Hemodialysis kāinga tuku iho: E toru ngā wā i te wiki, 3-4 hāora ia wā.
2. He hemodialysis poto i te kāinga i ia rā: Mā te hangarau hou ka taea te whakapoto i ngā wā maimoatanga. E 5-7 ngā rā o te wiki e mahia ana, ā, e rua hāora te roa mō ia wā.
3. Hemodialysis kāinga i te pō: Ka mahia tēnei i te pō i a koe e moe ana. Ka mahia te maimoatanga mō ngā hāora 6-8 i ia wā, tata ki te 4-6 ngā rā o te wiki. Mā tēnei tikanga ka taea te horoi i te toto mō te wā roa, kia nui ake ai ngā para ka tangohia mai i te tinana.
Me pēhea te whakarite i mua i te maimoatanga?
I mua i te tīmatanga o te hemodialysis, me whakarite koe i ētahi wiki, i ētahi marama rānei i mua. Ko te mea nui ko te kimi i tētahi huarahi hei tango ngāwari me te tere i te toto ka whakahokia ki roto i te tinana i te wā e rongoatia ana. Ko te tikanga he pokanga iti tēnei.
- Te fistula arteriovenous (AV fistula): I tēnei tikanga, ka honoa e te taote pokanga te uaua me te uaua i roto i tō ringa. Koinei te tikanga tino pai, ā, he roa te wā e mau ana.
- Tārua Arteriovenous (tārua AV): Mena he poto rawa tō uaua me tō uaua ki te hono tetahi ki tetahi, ka hono te taote pokanga i a rāua mā te whakamahi i tētahi ngongo ngohengohe, tuwhera (tārua).
Mena me tīmata wawe te maimoatanga, i ētahi wā ka taea te whakauru i tētahi ngongo ngohengohe e kiia nei ko te catheter ki roto i tētahi uaua nui i te kaki, i te uma, i te huha rānei.
He mea tino nui: Me atawhai tō fistula, tō wāhi pokanga rānei, pērā i te kanohi. Mā roto i tēnei ka tukuna tō maimoatanga whakaora ora. Nō reira, he mea nui kia tiakina taua wāhi mai i te mate me te whara.
Hei tiaki i tō fistula/graft, kia maumahara ki ēnei mea:
- Kaua e moe me tō taumaha ki te taha o te ringa kei reira te fistula.
- Kaua e mau i ngā kākahu, i ngā whakapaipai rānei (ngā mowhiti, ngā wati) ka mau ki taua ringa.
- Kaua e mau i te whitiki putea ki runga i taua ringa.
- Kaua rawa e tirohia tō toto toto (BP), kaua hoki e tangohia he toto mai i te ringa kei reira te fistula.
Me tino tupato koe ki te kai me te inu?
Ae rawa. Ko te kai e kainga ana e koe ka pā tika ki te angitu o te maimoatanga hemodialysis. Ka taea e ētahi kai te whakanui ake i te nui o te para i roto i te toto, te pupuri wai, te whakanui ake i te toto toto, me te whakanui ake i te tere o te ngakau.
I mua i te tīmatanga o te maimoatanga, ka waihangahia e te tohunga kai tākihi he mahere kai e tika ana māu. Me whakawhāiti e koe ngā kai kei roto i ēnei:
| Ngā matūkai hei whakawhāiti | Ngā mōrearea me ngā tauira o te nui rawa o te horomanga |
|---|---|
| Pāhare pākawa | Ka tere rawa te tere o te manawa i roto i te tinana, ā, ka mōrearea rawa atu. Hei tauira: panana, āwōkātō, karaka, hua maroke, tōmato. |
| Whēkau | Ka pakarukaru pea ngā wheua, ā, ka mākūkū te kiri. Hei tauira: te miraka me ngā hua miraka, te tiihi, te heihei, te ika kēne, te hōtiti, te pīni, te nati. |
| Konutai - tote | Me nui ake te wai e hiahiatia ana e te tinana (te nui haere o te matewai), nō reira ka mau te wai, ka piki ake hoki te toto toto. Hei tauira: te tote, ngā ranu i tāpirihia ki te kai, te kai tere, te kai kēne, ngā kai tote. |
He aha ngā pānga taha me ngā raruraru o te maimoatanga?
Pērā i ngā maimoatanga hauora katoa, tera pea ētahi pānga taha me ngā raruraru o te hemodialysis. Engari kāore he take e manukanuka ai mō tēnei, nā te mea ka aroturuki tonu tō tīma hauora i a koe mō tēnei.
Ngā pānga taha noa pea:
- Te toto toto iti (hypotension)
- Whakapairuaki me te ruaki
- Te whanoke me te ngoikore (Syncope)
- Mamae o te uma, o te tuara rānei
- Ānini
- Mākūkū (Pruritus)
- Ngā mamae o te uaua
- Te mate waewae okioki (te ahua o te okiokinga o ngā waewae)
Ki te pāngia koe e ēnei tohu i ngā wā katoa, kōrero ki tō tākuta, ki tō nēhi rānei. Tērā pea ka taea te whakahaere mā te whakarerekē i te tere o te maimoatanga, mā te whakamahi rānei i ētahi rongoā.
Ngā raruraru pea e pā ana ki te fistula/graft:
- Mate pāwera (whero, pupuhi, mamae, kirika)
- Ngā toto totoka
- Te aukati nā te kiko whara
Ki te kite koe i tētahi mea pēnei, me rapu tohutohu hauora tonu koe.
Kia pēhea te roa ka taea e koe te ora me te hemodialysis?
He raruraru tēnei mō te tini o te tangata. Ko te roanga o te oranga mō te tangata e whiwhi ana i te maimoatanga hemodialysis he 5-10 tau. Heoi, he rerekē tēnei i ia tangata, i ia tangata. Tērā ētahi tāngata e ora ana mō te 20-30 tau, neke atu rānei, me te kai pai, te tohutohu hauora, me te kounga o te oranga. Nō reira, ko te mea nui ko te noho kaha me te haere tonu i te maimoatanga tika.
Karere Tangohia ki te Kāinga
- Ehara te hemodialysis i te mea hei wehi. He maimoatanga tēnei e mahi ana ki ō whatukuhu, ā, e whakaora ana i tō ora.
- Whāia ngā tohutohu a tō tākuta me tō tohunga kai. He mea tino nui te whakahaere i te kai.
- Kia tino tiakina tō fistula, tō graft rānei. He rite ki te kuaha ki tō oranga. Ki te kite koe i ētahi huringa (mamae, pupuhi, whero), kōrero tonu atu ki tō tākuta.
- Ki te mea kei te āwangawanga koe, kōrerotia ki tō whānau me te tākuta mō tēnei mea. Ehara i te mea ko koe anake i tēnei haerenga.
- He mea noa te ngenge i muri i te maimoatanga, engari ki te mau tonu, me whakamōhio atu ki tō tīma hauora.
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