Kulephera kwa impso? Tiyeni tikambirane za dialysis mwachidule

Kodi mudamvapo dokotala akulankhula za vuto la impso m'banja mwanu kapena wokondedwa wanu? Tikamva mawu akuti, "Impso zonse ziwiri zalephera, ndipo tsopano tiyenera kuchita dialysis," timamva mantha komanso kudabwa kwambiri. Kodi dialysis ndi chiyani kwenikweni? Kodi ichi ndi chinthu chooperadi? Kodi mungakhale moyo wabwinobwino ndi chithandizochi? Mwina muli ndi mafunso ambiri ngati awa m'maganizo mwanu. Musadandaule. Lero, tikambirana izi mosavuta, mwanjira yomwe mungamvetse bwino.

Mwachidule, kodi dialysis ndi chiyani?

Mwachidule, dialysis ndi njira yochizira yomwe imagwira ntchito yopangidwa ndi impso zathu pamene sizikugwira ntchito bwino.

Tangoganizani kuti thupi lathu ndi fakitale yayikulu. Selo lililonse mufakitale iyi likugwira ntchito. Ntchitoyi imapanga mitundu yosiyanasiyana ya zinyalala. Impso zathu zili ngati njira yabwino kwambiri yosefera mufakitale iyi. Ntchito yawo yayikulu ndikusefa zinyalala zosafunikira, poizoni, ndi madzi ochulukirapo m'magazi ndikuzitulutsa m'thupi ngati mkodzo. Zinthu monga zinyalala za nayitrogeni (urea) ndi zinyalala zochokera ku minofu (creatinine) zimachotsedwa motere.

Tsopano taganizirani zomwe zingachitike ngati makina osefera awa atawonongeka kapena atasiya kugwira ntchito? Zinyalala zonse zomwe zimapangidwa mufakitale imeneyo zingasonkhanitsidwe ndipo makina onse angasokonekere, sichoncho? Umu ndi momwe, pamene impso zathu zikulephera kugwira ntchito, poizoni, zinyalala, ndi madzi osafunikira amayamba kusonkhana m'magazi athu. Izi ndi zoopsa kwambiri pa miyoyo yathu.

Ndicho chimene dialysis imachita. Izi zikutanthauza kuti, imagwira ntchito yoyeretsa magazi omwe impso sizingathe kuchita, kaya pogwiritsa ntchito makina kapena njira ina yapadera. Monga momwe fyuluta yathu yamadzi ikasweka kunyumba, timabweretsa mabotolo oyera amadzi kuchokera kusitolo, impso zikalephera kugwira ntchito, timayeretsa magazi kudzera mu njira yotchedwa dialysis.

Ndani akufunika chithandizo cha dialysis?

Si aliyense amene ali ndi matenda a impso amene amafunika dialysis. Izi zimangofunika kwa anthu omwe ali ndi matenda a impso omwe ali kumapeto kwa nthawi, kapena matenda a impso omwe amafika kumapeto kwa nthawi (ESKD).

Kawirikawiri pali magawo asanu a matenda a impso. Pofika gawo lachisanu, impso zimagwira ntchito zosakwana 15% ya mulingo wawo wabwinobwino. Pakadali pano, thupi silingathenso kuchotsa poizoni womwe umasonkhana m'thupi lokha. Pa nthawi imeneyo, dialysis kapena impso zosamutsidwa zimakhala zofunikira kwambiri kuti munthu apulumuke. Anthu ena amalandira chithandizo cha dialysis pakati pa nthawiyi mpaka atapatsidwa impso zosamutsidwa.

Kodi zifukwa zazikulu zomwe zimayambitsa kulephera kwa impso ndi ziti?

• Kuthamanga kwa Magazi Kwambiri: Kuthamanga kwa magazi kwambiri komwe sikulamuliridwa kwa nthawi yayitali ndi chifukwa chachikulu chowonongera impso.
• Matenda a shuga:Kuchuluka kwa shuga m'magazi chifukwa cha matenda a shuga kumawononga mitsempha yamagazi yofooka m'impso.
• Matenda monga Lupus: Awa ndi matenda omwe chitetezo cha mthupi chimaukira ziwalo zake.
• Zina zomwe zimayambitsa: Nthawi zina, ngozi yadzidzidzi kapena matenda oopsa angayambitse kulephera kwa impso. Komanso, anthu ena amatha kudwala matenda a impso popanda chifukwa chodziwika.

Pali njira ziwiri zazikulu zoyeretsera magazi (dialysis):

Tikamaganizira za dialysis, chinthu chokhacho chomwe chimabwera m'maganizo ndi njira yoyeretsera magazi powalumikiza ku makina akuluakulu. Koma kwenikweni pali njira ziwiri zazikulu zoyeretsera magazi. Tiyeni timvetse kusiyana pakati pa ziwirizi.

1. Kuyeretsa magazi

2. Kutsegula m'mimba (peritoneal dialysis)

Dokotala wanu adzasankha njira ziwirizi ataganizira zinthu monga thanzi lanu komanso moyo wanu.

Zambiri zokhudza hemodialysis

Iyi ndi njira yodziwika kwambiri yoyezera magazi padziko lonse lapansi. Izi ndi zomwe zimachitika:

1. Kukonzekera: Popeza makina oyeretsera magazi amafunika kupompa magazi mwachangu, mitsempha yathu yachibadwa singathe kupirira. Chifukwa chake, dokotala wa opaleshoni adzachita opaleshoni yaying'ono ndikulumikiza mtsempha wamagazi ndi mtsempha m'dzanja lanu kuti apange mtsempha waukulu komanso wamphamvu wamagazi (fistula). Ichi ndi chomwe chimagwiritsidwa ntchito kutenga ndikubweza magazi kuti akayeretsedwe magazi.

2. Chithandizo: Mukapita ku malo oyeretsera magazi, namwino amaika singano ziwiri mu mtsempha wamagazi womwe wapangidwa. Mmodzi wa iwo amatulutsa magazi m'thupi lanu ndikutumiza ku makina oyeretsera magazi. Pamene akudutsa mu fyuluta yopangidwa yotchedwa dialyzer mkati mwa makinawo, zinyalala ndi madzi ochulukirapo zimachotsedwa m'magazi. Kenako magazi oyeretsedwa amabwezedwa m'thupi lanu kudzera mu singano ina. Izi zimatenga pafupifupi maola atatu mpaka anayi. Panthawiyi, mutha kukhala pampando ndikuchita zina monga kuwerenga buku kapena kuonera TV.

Zambiri zokhudza Peritoneal Dialysis

Njira iyi ndi yosiyana pang'ono. Siigwiritsa ntchito makina akuluakulu. M'malo mwake, imagwiritsa ntchito chinthu chomwe chili m'thupi lathu ngati fyuluta.

1. Kukonzekera: Chithandizochi chisanayambe, dokotala wa opaleshoni adzaika chubu chofewa (catheter) m'mimba mwanu, pamwamba pa khungu.

2. Chithandizo: Madzi oyeretsera apadera otchedwa 'dialysate' amathiridwa m'mimba kudzera mu chubu ichi. Nembanemba yotchedwa 'peritoneum' yomwe imaphimba khoma lamkati la mimba ili ndi mitsempha yambiri yamagazi yopyapyala. Madziwo akakhala m'mimba, amagwira ntchito ngati maginito kuti akoke zinyalala ndi madzi ochulukirapo kuchokera m'magazi. Patatha maola ochepa, madzi omwe asonkhana m'zinyalalazo amachotsedwanso kudzera mu chubu chomwecho ndikuchotsedwa. Njirayi imatchedwa 'kusinthana'.

Pali njira ziwiri zochitira izi:

• CAPD (Continuous Ambulatory Peritoneal Dialysis):Pankhaniyi, muyenera kusintha madzi awa pafupifupi katatu kapena kasanu patsiku. Chikwama chamadzi chikapachikidwa pamwamba pa phewa lanu, mphamvu yokoka imapangitsa madziwo kulowa m'mimba mwanu. Izi zimatenga pafupifupi mphindi 30-40.
• APD (Automated Peritoneal Dialysis): Izi ndizothandiza kwa anthu ambiri. Musanagone usiku, mumalumikizidwa ndi makina ang'onoang'ono. Mukagona, makinawo amasinthasintha madzi kangapo usiku wonse.

Kodi moyo uli bwanji ndi dialysis? Kodi pali nkhawa iliyonse?

Awa ndi ena mwa mafunso akuluakulu omwe munthu amene akufuna kuyamba dialysis amakumana nawo. Tiyeni tiyang'ane funso lililonse limodzi ndi limodzi.

Kodi dialysis imapweteka?

• Hemodialysis: Pamakhala kuluma pang'ono kokha singano ikalowetsedwa mumtsempha. Pambuyo pake, palibe ululu womwe umabwera panthawi ya chithandizo.
• Kutsegula m'mimba: Palibe ululu pamenepa. Komabe, madzi akamadzaza m'mimba, amatha kumva kudzaza pang'ono komanso kulemera.

Kodi zoopsa za chithandizo cha dialysis ndi ziti?

Monga chithandizo chilichonse chamankhwala, dialysis ili ndi zoopsa zina.

• Mu hemodialysis: Pali chiopsezo cha matenda pamalo olowera magazi. Komanso, magazi oundana amatha kutseka mtsempha wamagazi. Nthawi zina kuthamanga kwa magazi kumathanso kutsika. Koma musadandaule, makina ali ndi njira zotetezera. Ngati china chake chalakwika, alamu idzalira ndipo makinawo adzayima, kotero sipadzakhala kuwonongeka kwakukulu.
• Mu peritoneal dialysis: Chiwopsezo chachikulu ndi peritonitis. Izi zitha kuchitika ngati majeremusi alowa m'dera lomwe chubucho chalowetsedwa. Chifukwa chake, njirayi iyenera kuchitidwa mwaukhondo kwambiri. Komanso, pakapita nthawi, minofu ya m'mimba imatha kufooka ndipo hernias ikhoza kuchitika.

Kodi dialysis ingathandize impso zanga kukhala bwino?

Funso limene anthu ambiri amafunsa ndi ili. Kutsegula impso si mankhwala a matenda a impso. Kumangotenga ntchito ya impso kwakanthawi kochepa. Matenda a impso otsiriza (ESKD) ndi vuto lomwe silingathetsedwe. Chifukwa chake, kutsegula impso kumafunika moyo wanu wonse mpaka mutapatsidwa impso ina.

Kodi munthu amene ali pa dialysis angakhale ndi moyo kwa nthawi yayitali bwanji?

Palibe yankho limodzi pa izi. Zimasiyana kwambiri kuchokera kwa munthu ndi munthu. Zimatengera zinthu zambiri, monga msinkhu wanu, thanzi lanu lonse, komanso vuto lomwe limayambitsa kulephera kwa impso. Koma pali anthu ambiri omwe, akalandira chithandizo choyenera komanso kutsatira malangizo a dokotala wawo, amakhala mosangalala kwa zaka zambiri, ngakhale zaka zambiri.

Kodi ndingathe kugwira ntchito bwino ndi dialysis?

Inde mungathe.Kuchotsa magazi m'thupi (dialysis) sikutanthauza kuti moyo wanu watha. Anthu ambiri amachita zinthu zawo za tsiku ndi tsiku, kugwira ntchito zawo, komanso kusamalira mabanja awo. Mutha kuyendanso. Ngati muli pa hemodialysis, mutha kulankhula ndi malo oyeretsera magazi m'dera lanu ndikukonzekera kulandira chithandizo kumeneko. Ngati muli pa peritoneal dialysis, zimakhala zosavuta chifukwa mutha kunyamula matumba anu amadzimadzi.

Samalani ndi zizindikiro izi: Uzani dokotala wanu nthawi yomweyo

Ngati mukulandira chithandizo cha dialysis, dziwitsani dokotala wanu kapena malo ochizira matenda nthawi yomweyo ngati mukukumana ndi zizindikiro zotsatirazi.