Izinso zakho zifana nezihlungi ezimbili ezinkulu emzimbeni wethu. Umsebenzi oyinhloko wezinso ukuhlunga imfucuza engadingekile, enobuthi kanye noketshezi oluningi oluvela egazini. Kodwa uma lezi zinso zingasebenzi kahle ngenxa yezimo ezithile zezokwelapha, imfucuza inganqwabelana emzimbeni futhi ibangele izinkinga ezinkulu. Yilapho ukwelashwa okusindisa impilo okubizwa ngokuthi i-hemodialysis kuza khona ukusisiza.
Kalula nje, kuyini i-hemodialysis?
I-Hemodialysis uhlobo lokwelashwa nge-dialysis. Uma izinso zakho zingakwazi ukwenza umsebenzi wazo, kusetshenziswa umshini ukuhlanza igazi lakho. Kalula nje, isebenza njengezinso zokwenziwa.
Kule nqubo, umshini uthatha igazi elithile emzimbeni wakho, ulidlulise ngesihlungi esikhethekile (inso yokwenziwa) ukuze ulihlanze, bese ubuyisela igazi elihlanzekile emzimbeni wakho. Lokhu kususa izinto ezifana nemikhiqizo kadoti ene-nitrogen (urea), imikhiqizo kadoti emisipheni (creatinine), kanye nama-acid aqongelela egazini.
Lo mshini uhlanza kanjani igazi?
Cabanga nje, lobu ubuchwepheshe obumangalisayo kakhulu. Ingxenye eyinhloko yomshini we-hemodialysis yi -dialyzer . Lokhu yilokho esikubiza nangokuthi "izinso zokwenziwa."
Igazi lakho lidlula ezinkulungwaneni zamapayipi amahle kakhulu afana ne-mesh ngaphakathi kwale dialyzer. Bese kuthi, imfucuza kanye namanzi angaphezulu egazini kuvuza ngalezi mesh ezincane kuye ohlangothini oluhlukile. Kusetshenziswa uketshezi olukhethekile olubizwa ngokuthi i-dialysate ukuqoqa le mikhiqizo yemfucuza. Lolu ketshezi luqukethe amanzi, usawoti, kanye nama-electrolyte.
Igazi lakho, elihlanziwe futhi lasuswa emfucumfucwini, libuyiselwa emzimbeni wakho ngepayipi. Uketshezi lwe-dialysate, oluqoqe imfucumfucwini, lususwa ngumshini.
Yiziphi izinhlobo eziyinhloko zokwelapha nge-hemodialysis?
Kunezindlela ezimbili eziyinhloko zokwenza ukwelashwa kwe-hemodialysis. Ungaxoxa nodokotela wakho ukuthi iyiphi indlela engcono kakhulu kuwe.
| Indlela yokwelapha | Incazelo |
|---|---|
| I-hemodialysis ephakathi | Ukuze wenze lokhu, kuzodingeka uye esibhedlela noma esikhungweni esikhethekile ekuhlanzeni igazi. Ukwelashwa kwenziwa ngumhlengikazi oqeqeshiwe noma uchwepheshe. Ngokuvamile kuzodingeka uye cishe kathathu ngesonto, futhi iseshini ngayinye izothatha cishe amahora amathathu kuya kwamane. |
| Ekhaya (i-hemodialysis yasekhaya) | Lokhu kwelashwa kungenziwa ekhaya. Phakathi namasonto ambalwa, odokotela nabahlengikazi bazokufundisa ukuthi ungakwenza kanjani nokuthi ungabhekana kanjani nanoma yiziphi izinkinga ezincane ezingase zivele. Ngemva kwalokho, ungenza ukwelashwa ngokwakho ngendlela othanda ngayo. |
Ingabe zikhona izinhlobo ze-home hemodialysis?
Yebo, kunezinhlobo ezintathu eziyinhloko zokwelapha ekhaya.
1. Ukuhlanza i-hemodialysis okuvamile ekhaya: Kathathu ngesonto, amahora angu-3-4 isikhathi ngasinye.
2. Ukuhlanza i-hemodialysis yasekhaya okufushane nsuku zonke: Ubuchwepheshe obusha buvumela isikhathi sokwelashwa esifushane. Kwenziwa cishe izinsuku ezi-5-7 ngesonto, futhi kuthatha cishe amahora amabili ngeseshini ngayinye.
3. Ukuhlolwa kwe-hemodialysis yasekhaya ebusuku: Lokhu kwenziwa ebusuku ngenkathi ulele. Ukwelashwa kwenziwa amahora angu-6-8 ngesikhathi, cishe izinsuku ezingu-4-6 ngesonto. Le ndlela ivumela igazi ukuthi lihlanzwe isikhathi eside, ngakho-ke kususwa imfucuza eminingi emzimbeni.
Uzilungiselela kanjani ngaphambi kokwelashwa?
Ngaphambi kokuqala i-hemodialysis, udinga ukulungiselela amasonto ambalwa noma izinyanga ezimbalwa kusengaphambili. Into eyinhloko ukuthola indlela yokukhipha igazi kalula nangokushesha bese ulibuyisela emzimbeni ngesikhathi sokwelashwa. Lokhu kuhilela ukuhlinzwa okuncane.
- I-Arteriovenous fistula (AV fistula): Kule nqubo, udokotela ohlinzayo uxhuma umthambo kanye nomthambo engalweni yakho. Lena yindlela efanele kakhulu futhi ehlala isikhathi eside.
- Ukufakelwa kwemithambo yegazi (i-AV graft): Uma umthambo wakho nomthambo wakho kufushane kakhulu ukuba kuxhunywe ndawonye, udokotela ohlinzayo uzokuxhumanisa lokhu kokubili esebenzisa ipayipi elithambile nelingenalutho (i-graft).
Uma ukwelashwa kudingeka kuqalwe ngokushesha, ngezinye izikhathi ithubhu elithambile elibizwa ngokuthi i-catheter lingafakwa okwesikhashana emthanjeni omkhulu entanyeni, esifubeni, noma ethangeni.
Kubaluleke kakhulu: Indawo yakho ye-fistula noma i-graft kufanele iphathwe njengeso. Yiyo lapho ukwelashwa kwakho okusindisa impilo kunikezwa khona. Ngakho-ke, kubalulekile ukuvikela leyo ndawo ekuthelelekeni nasekulimeleni.
Ukuze uvikele i-fistula/i-graft yakho, khumbula lezi zinto:
- Ungalali unesisindo sakho ohlangothini lwengalo lapho kukhona khona i-fistula.
- Ungagqoki izingubo noma ubucwebe (izindandatho, amawashi) obuzobanjwa yileso sandla.
- Ungagqoki ibhande lesikhwama phezu kwaleyo ngalo.
- Ungalokothi uhlolwe umfutho wegazi (BP) noma ukhiphe igazi engalweni ene-fistula.
Ingabe udinga ukuqaphela kakhulu ngokudla neziphuzo?
Yebo impela. Ukudla okudlayo kuthinta ngqo impumelelo yokwelashwa nge-hemodialysis. Okunye ukudla kungandisa inani lemfucuza egazini, kubangele ukugcinwa kwamanzi, kwandise i-BP, futhi kwandise izinga lokushaya kwenhliziyo.
Ngaphambi kokuqala ukwelashwa, isazi sokudla kwezinso sizokwakha uhlelo lokudla olufanele wena. Ngokuvamile kuzodingeka unciphise ukudla okuqukethe okulandelayo:
| Izakhamzimba okufanele zikhawulelwe | Izingozi nezibonelo zokusebenzisa ngokweqile |
|---|---|
| I-Potassium | Ukushaya kwenhliziyo kungashesha ngendlela eyingozi. Isibonelo: ubhanana, u-avokhado, i-orenji, izithelo ezomisiwe, utamatisi. |
| I-Phosphorus | Amathambo angase aqhekeke futhi isikhumba singase silume. Isibonelo: ubisi nemikhiqizo yobisi, ushizi, inkukhu, inhlanzi ekheniwe, amasoseji, amalentili, amantongomane. |
| I-Sodium - usawoti | Umzimba udinga uketshezi olwengeziwe (ukoma okukhulu), ukuze kube nokugcinwa kwamanzi futhi i-BP ikhuphuke. Isibonelo: usawoti, amasoso afakwe ekudleni, ukudla okusheshayo, ukudla okusemathinini, ukudla okulula okunosawoti. |
Yimiphi imiphumela emibi kanye nezinkinga zokwelashwa?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunemiphumela emibi engaba khona kanye nezinkinga nge-hemodialysis. Kodwa asikho isidingo sokukhathazeka ngalokhu, njengoba ithimba lakho lezokwelapha lizohlala likuqapha ngalokhu.
Imiphumela emibi evamile engaba khona:
- Umfutho wegazi ophansi (i-Hypotension)
- Isicanucanu nokuhlanza
- Ukuzizwa unesizungu kanye nokuquleka (i-Syncope)
- Ubuhlungu besifuba noma umhlane
- Ikhanda elibuhlungu
- Ukuluma (Pruritus)
- Ukuqaqamba kwemisipha
- I-Restless legs syndrome (umuzwa wokungaphumuli emilenzeni)
Uma uhlangabezana nalezi zimpawu njalo, khuluma nodokotela wakho noma umhlengikazi. Zingalawulwa ngokushintsha ijubane lokwelashwa noma ukusebenzisa imithi ethile.
Izinkinga ezingaba khona ezihlobene ne-fistula/i-graft:
- Ukutheleleka (ubomvu, ukuvuvukala, ubuhlungu, umkhuhlane)
- Amahlule egazi
- Ukuvaleka ngenxa yezicubu zesilonda
Uma ubona into efana nale, kufanele ufune iseluleko sezokwelapha ngokushesha.
Ungaphila isikhathi esingakanani nge-hemodialysis?
Lokhu kuyinkinga kubantu abaningi. Isilinganiso sokuphila komuntu othola ukwelashwa nge-hemodialysis siyiminyaka emi-5-10. Kodwa-ke, lokhu kuyahlukahluka kumuntu nomuntu. Kunabantu abaphila iminyaka engama-20-30 noma ngaphezulu ngokudla okuhle, iseluleko sezokwelapha, kanye nekhwalithi yokuphila enhle kakhulu. Ngakho-ke, into ebaluleke kakhulu ukuhlala uqinile futhi uqhubeke nokwelashwa ngendlela efanele.
Umlayezo Wokuya Nawe Ekhaya
- I-Hemodialysis ayiyona into okufanele uyesabe. Iyindlela yokwelapha esebenza ezinso zakho futhi isindise impilo yakho.
- Landela imiyalelo enikezwe udokotela wakho kanye nochwepheshe wezokudla kahle. Ukulawula ukudla kubaluleke kakhulu.
- Nakekela kahle i-fistula noma i-graft yakho. Kufana nesango eliya empilweni yakho. Uma ubona noma yiziphi izinguquko (ubuhlungu, ukuvuvukala, ukubomvu), tshela udokotela wakho ngokushesha.
- Uma uzizwa ukhathazekile noma ukhathazekile, khuluma ngokukhululekile nomndeni wakho kanye nodokotela. Awuwedwa kulolu hambo.
- Kuvamile ukuzizwa ukhathele ngenxa yokwelashwa, kodwa uma kuqhubeka, yazisa ithimba lakho lezokwelapha.
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