He mea whakamataku te ngoikore o te whatukuhu, te 'ngoikore o te whatukuhu' rānei. He tokomaha te hunga e whakaaro ana i muri i tēnā, me haere rātou ki ngā hōhipera mō te toenga o ō rātou oranga kia horoia ō rātou toto. Engari i mōhio koe he tikanga dialysis motuhake ka taea e koe te mahi mai i te kāinga, me ō mahi o ia rā? Koinei te mea e kiia nei e mātou ko te Peritoneal Dialysis. I tēnei rā, ka kōrerohia e mātou tēnei mea mā te ngāwari, i roto i te huarahi e mārama ai koe.
He aha te tikanga o te Peritoneal Dialysis?
Whakaarohia ō whatukuhu hei tātari tino pai e rua. Ko tā rātou mahi matua he tātari i ngā para kore e hiahiatia me te wai taikaha mai i te toto. Ka kiia e tātou te wai e tātarihia ana he mimi. Engari ina kore e mahi ngā whatukuhu, kāore tēnei tātari e mahi tika. Kātahi ka tīmata te kohikohi o ngā para me ngā paitini ki roto i te toto. Ka kiia e tātou tēnei āhuatanga ko te "uremia". Ki te kore e rongoatia, ka tūpono pea tēnei ki te ora.
Koinei te wā e uru mai ai te maimoatanga dialysis. Ko te dialysis peritoneal tētahi o ngā momo dialysis. Engari ka puta he mea tino rerekē i tēnei. I tēnei, ka whakamahia e mātou he tātari taiao i roto i tō tinana hei horoi i ō toto. Ko te kiriuhi angiangi tēnā e karapoti ana i ngā whekau i roto i tō puku. I roto i te rongoā, ka kiia tēnei ko te peritoneum.
I mua i te tīmatanga o tēnei maimoatanga, ka whakahaerehia e te tākuta tētahi pokanga iti, ka whakaurua he ngongo angiangi, ngohengohe (catheter) mā roto i te kiri o tō puku. Kātahi, mā roto i te ngongo, ka tukuna he wai parakore motuhake (e kiia ana e mātou ko te "dialysate") ki roto i tō puku. I a tēnei wai e noho ana i roto i tō puku mō ētahi haora, ka mimiti te kiriuhi peritoneal i ngā hua para me te wai nui mai i te toto ki roto i tēnei wai. Kātahi, ka tangohia te wai kī tonu i te para mā roto i te ngongo kotahi, ā, ka tāpirihia anō he wai hou. Ka taea e koe te mahi i tēnei tikanga i te kāinga, i ētahi wā i te rā, i a koe e moe ana i te pō rānei.
E rua ngā tikanga matua mō tēnei.
E rua ngā huarahi matua e whakahaerehia ai te peritoneal dialysis. Ka taea e koe te whiriwhiri i te tikanga e pai ana ki a koe mā te kōrero ki tō tākuta.
| Tikanga maimoatanga | Me pēhea te mahi me ngā āhuatanga motuhake |
|---|---|
| Te Dialysis Peritoneal Haere Tonu (CAPD) (Tikanga mahi-ā-koe i te awatea) | Kāore he mīhini e whakamahia ana mō tēnei. Me whakawhiti e koe te wai i te 3-5 wā i te rā. E 30-40 meneti te roa i ia whakawhiti. I a koe e noho ana i roto i tō puku, ka taea e koe te mahi i tāu mahi. |
| Te Dialysis Peritoneal Aunoa (APD) (Tikanga mīhini mō te pō) | He mīhini iti tēnei (he 'hurihuri aunoa'). Ina honoa ki te mīhini i mua i tō haerenga ki te moe i te pō, ka werohia aunoatia e te mīhini te wai, ka tangohia hoki i ngā wā e hiahiatia ana puta noa i te pō. Ka oti te maimoatanga ina ara ake koe i te ata. He tokomaha te hunga e pai ake ana ki tēnei tikanga nā te mea kāore he aukati i te awatea. |
Engari he aha te take kāore i te tino rongonui ai tēnei tikanga?
Ahakoa ōna painga maha, he iti ake te whakamahinga i tēnei tikanga i te tikanga hemodialysis i te hōhipera. He maha ngā take mō tēnei:
- Te kore mōhio: He maha ngā tūroro, tae atu ki ngā kaimahi hauora i ētahi wā, kāore i te tino mōhio ki tēnei kōwhiringa.
- Te korenga o ngā kaimahi whakangungua: He torutoru noa ngā tākuta me ngā nēhi kua whiwhi whakangungu motuhake mō tēnei maimoatanga.
- Ngā raruraru e puta ake ana i roto i tētahi āhuatanga ohorere: Mēnā ka ngoikore ohorere ngā whatukuhu o te tangata, kāore i ngā hōhipera katoa ngā wāhi hei whakauru i tēnei ngongo (catheter). Mēnā he pēnei te āhua, me whakamahi i te hemodialysis, he mea ngāwari te tīmata.
- Te uaua ki te kimi i tētahi hei āwhina: He uaua ki ētahi tāngata te mahi ko rātou anake. I ēnei wā, he uaua pea te kimi i tētahi hei āwhina.
He aha ngā painga o tēnei tikanga?
Ko te painga nui o tēnei ko te herekoretanga me te whai wāhitanga ka riro i a koe. Kāore koe e hiahia ki te here i tō oranga ki te hōhipera.
- Te ngāwari me te ngāwari: Kāore koe e hiahia ki te haere ki te hōhipera. Ka taea e koe te mahi i tēnei i tētahi wāhi ma, ahakoa i te kāinga, i te mahi, i te wā e haereere ana rānei.
- Kāore he here nui mō te kai me te inu: He iti ake ngā here mō te kai me te inu i ērā atu tikanga dialysis. Nā te mea ka tangohia ngā para mai i te tinana tata ki ia rā, ka iti ake te nui o ngā para e kohia ana.
- Kāore he hiahia mō ngā ngira: I te wā e tangohia ana ngā ngira i te hōhipera, me whakamahi ngā ngira i ia wā. He mea tino whakamarie tēnei mō te tangata e wehi ana i ngā ngira.
Kāore ianei he ngoikoretanga, he mōrearea hoki?
Pērā i ngā maimoatanga hauora katoa, he tūponotanga me ngā ngoikoretanga kei reira, ā, he mea nui kia mōhio ki aua tūponotanga.
| Mōrearea / Huakore | Hei whakarāpopototanga... |
|---|---|
| Peritonitis | Koinei te mōrearea tino kitea. Ka taea e ngā huakita te tomo ki te arai peritoneum o te puku mā te ngongo, mā te paru rānei, ka puta he mate. He mea nui kia tino tupato ki te horoi. |
| Hernia | Ka puta he hernia nā te pēhanga e hangaia ana i te wā e whakakīia ana te puku e te wai. |
| Te pikinga o te taumaha | Nā te mea kei roto i te wai e whakamahia ana te huka (dextrose), ka taea e te tinana te mimiti i ētahi o aua huka, ā, ka piki ake te taumaha i te roanga o te wā. |
| Te kore whai hua o te maimoatanga | I muri i ngā tau o tēnei maimoatanga, ka pāngia ētahi tāngata e te ngoikore o te mahi a te kiriuhi peritoneal, ā, me huri pea ki tētahi atu tikanga dialysis. |
| Me mahi i ia rā | He mea tēnei e tika ana kia mahia i ia rā. Tērā pea he mahi uaua ki ētahi. |
Āta karohia ēnei mea.
Mena kei runga koe i te peritoneal dialysis, kia tūpato ki ēnei mea:
- Kaua e whakamahi i ngā rongoā pēnei i ngā rongoā anti-inflammatory kore-steroidal (NSAID) e kino ana ki ngā whatukuhu me te kore e kōrero ki tō tākuta.
- Kaua e kaukau i roto i ngā wai kāore i te hauota pērā i ngā roto, ngā awa, me ngā roto, ā, kaua hoki e rumakina ki roto i ngā kaukau wera. He nui ake te tūponotanga ka uru mai ngā huakita ki roto i ēnei. Heoi, kāore he raruraru ki te kaukau i ia rā.
Āhea koe me toro atu ki te tākuta tonu?
Mena kei te whiwhi koe i tēnei maimoatanga, ā, ka pāngia koe e tētahi o ngā tohu e whai ake nei:Kaua e warewarehia.
- Te mamae nui o te puku, te pupuhi rānei
- Ki te mea kei te pāngia koe e te kirika
- Mena he tere te tere o te manawa (tachycardia)
- Te uaua ki te manawa (dyspnea)
- Whakapairuaki me te ruaki
- Mena he kapua te wai e ringihia ana e koe i tō puku, he rerekē rānei te tae i te mea noa (he tohu pea tēnei nō te mate)
- Ngā tohu o te toto toto iti (hypotension), pērā i te whanoke me te māuiui
Ki te kite koe i tētahi o ēnei tohu, waea atu ki tō tākuta, ki tō whare hauora rānei i taua wā tonu. Mēnā rānei, haere ki te Tari Whawhati Tata (ETU) o te hōhipera e tata ana.
Hei whakamutunga, me whakatau tahi kōrua ko tō tākuta mēnā ko te Peritoneal Dialysis, ko te Hemodialysis rānei te mea pai mōu. Me whai whakaaro ki tō āhua hauora, ki tō momo noho, me ō hiahia katoa kia taea ai te whakatau pai.
Karere Tangohia ki te Kāinga
- He tikanga maimoatanga tino whai hua te peritoneal dialysis ka taea te mahi ki te kāinga me te nui ake o te wātea mō ngā tūroro e pāngia ana e te ngoikore o te whatukuhu.
- Ko te horoi te mea tuatahi i roto i tēnei maimoatanga. Horoia ō ringaringa i ngā wā katoa, ā, me mahi i tēnei i roto i tētahi taiao ma. Ka āwhina tēnei ki te ārai i ngā mate kino pērā i te Peritonitis.
- Kia mārama ki ngā painga, ngā ngoikoretanga, me ngā mōrearea o tēnei tikanga. Mēnā he āwangawanga āu, kaua e mangere ki te kōrero ki tō tākuta.
- Me rapu tonu i ngā tohutohu a tō tākuta hei whiriwhiri i te tikanga dialysis e pai ana mōu.
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