I-Essential Dialysis 101
Uma izinso zakho ziqala ukuhluleka , uzovame ukuhamba ngezinyathelo eziqhubekayo zokulahlekelwa kwezinso zezinso. Lezi zigaba zihlukaniswa kusukela esigabeni 1 ukuya ku-5 sesifo esingenasifo sezinso (CKD). Isigaba sesi-5 sibi kakhulu lapho abantu abaningi bengadinga i-dialysis noma ukufakelwa kwezinso. Akuwona wonke umuntu oqala ngesifo sezinso ezincane (isigaba 1-3), uzoqhubeka esiteji sesi-5.
Isifo sezinso sifaka uhlu oludala lokuhlanza izinkinga. Esikhathini sokuqala se-CKD, lezi zinkinga ngokuvamile zilashwa ngokuphathwa kwezokwelapha. Okokuthi, amaphilisi kufanele akwanele ukuphatha izinkinga ezifana nomfutho wegazi ophezulu, electrolyte engavamile, ukuvuvukala noma i-edema (okulindeleke ukuba kwenzeke ku-CKD). Kodwa-ke, ekugcineni, uma kwenzeka okwenzeka ekuthuthukeni kwesifo sezinso esiphezulu, noma isigaba sesi-5 se-CKD, lezi zinkinga ziqala kanzima futhi zilukhuni ukuphatha nabaphathi bezokwelapha bodwa. Ngalesi sikhathi, akufanele uthole ukufakelwa kwezinso (noma uma ungafanelanga), uzovame ukudinga i-dialysis. Ngakho ake sikhulume ngemibuzo embalwa eyisisekelo iziguli eziningi ezizobe nazo mayelana ne-dialysis.
Kuyini i-dialysis?
I-Dialysis iyindlela yokufaka esikhundleni sezinye izinso zezinso. Izinso zenza imisebenzi eminingi ebalulekile emzimbeni, ngaphandle nje kokwenza "umchamo." Ngifake le mininingwane ngokuningiliziwe kwenye indawo , kodwa nansi isifinyeto esifushane:
- Izinso zilawula futhi zigcine izinga lawo wonke ama-electrolyte afana ne-sodium, i-potassium, njll ngaphakathi kwezinga elibalulekile empilweni evamile
- Zilawula umthamo wamanzi egazini lakho, ngakho-ke ukuhlushwa kwegazi lakho.
- Ikhiqiza ihomoni ebalulekile ukwenza amangqamuzana egazi abomvu, okuthiwa "i-erythropoietin"
- Baqinisekisa ukuthi amathambo akho ahlala enempilo ngokukhiqiza uhlobo lwevithamini D
- Zilahla i-asidi excess, eyakhiwe ekusetshenzisweni komzimba okujwayelekile, ngaphandle kwistimu yakho
- Okubaluleke kakhulu, zilawula ukucindezeleka kwegazi
I-Dialysis izama ukufaka enye indawo, kodwa hhayi yonke yale misebenzi.
I-dialysis yenziwa kanjani? Yiziphi izinhlobo ze-dialysis?
Indlela i-dialysis eyenziwa ngayo ixhomeke kuhlobo lwe-dialysis. Inqubo eyodwa (okuyinto ejwayelekile kunazo zonke esebenza e-US) ibizwa ngokuthi i- hemodialysis . I-Hemo igama lesiGreki elisetshenziselwa igazi. Ngakho "i-dialysis yegazi" yilapho igazi lesiguli lisuswa "ekufinyeleleni kwe-dialysis" futhi lisakazwa ngomshini onomfanekiso olingisa umsebenzi wokuhlunga kwezinso. Uma igazi lihamba ngalesi sihlungi (esibizwa ngokuthi i-dialyzer), igazi elihlanzekile libuyiselwa esigulini. I-Hemodialysis ivame ukwenza "isikhungo se-dialysis" ( ngaphakathi-hemodialysis ), lapho kuvame ukuqhutshwa cishe kathathu ngesonto, amahora amathathu kuya kwamane (lokhu kuncike esayizi lesiguli). Kodwa-ke, kungenzeka ukuthi enze i-hemodialysis ekhaya. Lokhu kubizwa ngokuthi i- home hemodialysis . Le nqubo ingenziwa njalo kaningi njengezikhathi ezinhlanu kuya kweziyisikhombisa ngesonto, kepha iseshwana ngasinye siba mfushane emahoreni amabili kuya amane ngalunye.
Olunye uhlobo lwe-dialysis olwenziwa ekhaya lubizwa nge- peritoneal dialysis . I-Peritoneum ibhekisela emgodini wesisu. Kulesi simiso, i-catheter engunaphakade ifakwa ku-peritoneum yesiguli ngodonga lwesisu. I-dialysis ehlanzekile isetshenziselwa ukungena ku-peritoneum, futhi lokhu okuketshezi kuhlale khona amahoreni ambalwa lapho kuhlanza khona igazi lezinyosi. Khona-ke, lokhu ketshezi olucwengekile lukhipha, futhi kusetshenzwa amanzi amaningi ahlanzekile. Lo mjikelezo uphindwa izikhathi ezimbalwa (ngokuvamile ebusuku ngisebenzisa umshini obizwa nge "cycler"), futhi ekuseni, isiguli sizikhiphela esitokisini bese sithatha ikhala.
Kuyini ukufinyelela kwe-dialysis?
Ukutholakala kwe-dialysis noma ukuhamba nge-shunt yisayithi lapho izinaliti ezimbili zifakiwe lapho umuntu ethola i-hemodialysis (iziguli ezitholakala nge-peritoneal dialysis ngeke zine-shunt enjalo, kodwa kunalokho i-catheter ehlala unomphela esiswini sayo). Enye yezinaliti e-shunt izosakaza igazi emzimbeni kumshini we-dialysis, kanti enye izoyiphatha igazi elihlanzekile emshinini kuya kwesiguli.
I-shunt ngokwayo ingumxhumanisi ophakathi kwe-artery ne-vein. Ubekwa udokotela ohlinzayo, ongase asebenzise umvuthwandaba wakho ukudala lokhu kuxhumano (lokhu kubizwa ngokuthi i- fistula ) noma angasebenzisa ithubhu yokufakelwa ukuze enze lokhu kuxhumano (lokhu kubizwa ngokuthi ukuhlanganiswa ).
Ingabe i-dialysis ingenziwa ekhaya?
Yebo! Kokubili i-dialysis ye-peritoneal ne-hemodialysis yekhaya ingenziwa yiziguli ngokwabo ekhaya. Umhlengikazi wakho nomhlengikazi we-dialysis uzokuqeqesha amasonto ambalwa ukuthi ungakwenza kanjani lokhu. Uma usukhululekile ukwenza lokho, kuzokuvumela ukuba uyenze induduzo yendlu yakho.
Uzobe usadingeka ukuthi ubonwe kanye ngenyanga ngenyanga yi-nephrologist yakho, futhi uzoba nomhlengikazi we-nephrologist kanye nomhlengikazi we-dialysis atholakale ekucingweni kokuxazulula izinkinga. Abahlengikazi be-Dialysis bavame ukuhlela ukuvakashelwa ekhaya lakho uma kwenzeka into engakwazi ukunakekelwa efonini.
Yimuphi uhlobo lwe-dialysis "oluhle kakhulu"?
Kusukela ekuboneni kwezokwelapha, akukho sifundo esiye sabonisa ukuthi noma iyiphi indlela yokuziphatha ingaba ngcono kunezinye. Kungaphezulu kokukhetha kokuphila. I-dialysis yasemakhaya ivame ukukhetha iziguli ezinekhono lokuzinakekela, zisebenza kahle, azifuni ukuba "ziboshwe phansi" esikhungweni se-dialysis, noma zifuna ukuhamba njalo. Ukuzimela okuza ne-dialysis ekhaya kukunika amandla futhi kusho okuningi kuziguli eziningi. Ibuye ithuthukise ikhwalithi yokuphila njengoba ungenzi ukuhamba ngamasonto amathathu ukuya esikhungweni se-dialysis. Kodwa-ke, "ngamandla amakhulu kuza umthwalo omkhulu" njengoba udinga ukuthatha ubunikazi bempilo yakho ngezinga elikhulu!