Yini Ongayilindela Ezinyathelweni Zokugcina Zokuhluleka Kwezinso?
Isifo sesifo sokuphela kwesifo sokuphela kwezinso yisifo sokugcina sesifo esingenasifo sezinso. Kulesi sigaba sokugcina, izinso azikwazi ukusebenza zodwa, okusho ukuthi umuntu udinga i- dialysis noma ukufakelwa kwezinso ukuze aphile. Ngenkathi ukufakelwa kuyisinqumo esihle njengoba sinikeza ukwelashwa, akuwona wonke umuntu ozobhapathizwa kulolu hlelo lokusebenza.
Noma kunjalo, kubalulekile ukuphawula ukuthi iningi labantu abanesifo esingenasifo sezinso asipheli ekudinga i-dialysis.
Lokhu kungenxa yokuthi, ngokunakekelwa kokuqala, umuntu angase aphuze lesi sifo.
Uma wena noma othandekayo esesimweni sokugcina sezinso zezinso, yini ongayilindela, futhi yini efana nokufa ngokuhluleka kwezinso?
Incazelo yezifo eziphilile zengqondo
Izinso zakho zokuhlunga imfucumfucu kanye namanzi ngaphandle kwegazi lakho. Uma umsebenzi wakho wezinso wehla, imfucuza iqoqa emzimbeni, futhi lokhu kudala imfucuza kungaholela ekugcineni kwezimpawu ezinjengezinhlanzi ezinzima nokuhlanza, ukulahlekelwa ukudla, nokuzizwa ugula futhi obuthakathaka jikelele.
Ukulahlekelwa kwesifo sezinso ezivamile kungase kwenzeke ngokuzumayo (okuthiwa isifo sofuba esiphuthumayo) noma ngaphezu kwezinyanga ezintathu noma ngaphezulu (okuthiwa isifo sengqondo esingapheliyo). Isifo esinzima sezinso sinamandla okuziphendulela ngokwazo. Kodwa uma isifo sezinso esingapheli, umsebenzi wezinso kancane kancane ukhula ngokuhamba kwesikhathi.
Kunezigaba ezinhlanu zesifo esingenasifo sezinso, nesigaba sesihlanu esimele isifo sezinso sokuphela kwesifo.
Ngamanye amazwi, ngaphandle kwesilinganiso sokusindisa ukuphila njengo-dialysis noma ukufakelwa kwezinso, umuntu uzofa kungakapheli isonto noma kunjalo.
Kubalulekile ukuqaphela ukuthi umsebenzi wezinso zomuntu uthambekela kancane kancane, nakuba izinga lapho izinso zisebenza khona futhi zishintsha kusukela kwesiteji esisodwa kuya kwesinye kuncike ezintweni eziningi (isibonelo, isimo sempilo esibhekene nesifo esibangela ukuba isifo sezinso sibe indawo yokuqala).
Kungathatha iminyaka eminingi noma amashumi eminyaka ngenxa yokungaphumeleli kwenqunu yokuqhubekela phambili esigabeni sokugcina sesifo.
Izimbangela
Kunezimbangela eziningi ezihlukahlukene zesifo esingenasifo sezinso; izifo ezimbili ezivame kakhulu yisifo sikashukela kanye nomfutho wegazi ophezulu.
Ezinye izimbangela zihlanganisa:
- I-Lupus (i-systemic lupus erythematosus)
- I-Nephrotic syndrome
- Isifo sezinso ze-Polycystic
- Izifo eziphindaphindiwe ze- urinary
- Ukuvinjelwa okwesikhathi eside emaphethini omchamo (isibonelo, kusuka kwesisu noma i-prostate gland ekhulisiwe emadodeni)
Kubalulekile kudokotela ukuhlola ukuthi "kungani" ngemuva kwesifo sakho sezinso ngoba angakwazi ukuphuza isifo sakho phansi. Isibonelo, uma umfutho wegazi ophakeme ungumlandu, udokotela wakho angase abe nobudlova ngokuqapha umfutho wegazi lakho futhi awugcine ngaphansi kohlobo olujwayelekile. Ngokufanayo, ukuphathwa ngokucophelela kwe-ushukela wegazi lakho uma unesifo sikashukela, kunganciphisa ukwehla kwezinso zakho.
Ukuxilongwa
Kukhona izivivinyo eziningi udokotela angase azenze ukuze ahlaziye kahle isifo sakho sezinso ezingapheli, kanti ezinye zalezi zivivinyo (isibonelo, ukuhlolwa kwegazi) zizophindwa kaningi, njengoba uqhubeka nesigaba sokugcina.
Izibonelo zokuhlolwa okuzokwenziwa udokotela wakho ukuxilongwa nokuqapha umsebenzi wakho wezinso kuhlanganisa:
- Ukuhlolwa kwegazi okulinganisa umsebenzi wakho wezinso (isibonelo, izinga le-BUN ne-creatinine) namazinga we-electrolyte (isibonelo, izinga lakho le-potassium)
- Ukuhlolwa kwe-Urine
- I-ultrasound yezinso zakho
- Ukuphikisana kwezinso zakho (inqubo lapho kuthathwa khona isampula encane yezinso zakho futhi ihlolwe ngaphansi kwe-microscope)
- CT scan of izinso zakho
Udokotela wakho uzophinde afune ukunquma izinga lakho lokuhlunga kwe-glomerular (GFR). Le nombolo ivumela udokotela wakho ukuba aqonde kangcono umsebenzi wakho wezinso futhi anqume isigaba sesifo sakho. I-GFR ibalwa kalula usebenzisa izinga lakho le-creatinine yegazi, yobudala, ubulili, nohlanga.
Nakuba ezinye zalezi zivivinyo ziqale ziyalwe udokotela noma umuthi wezokwelapha emndenini, umuntu onesifo sezinso ezingapheli ekugcineni ubhekiselwa kuchwepheshe wezinso okuthiwa i-nephrologist, ikakhulukazi njengoba eqhubeka nezigaba kamuva.
Empeleni, ucwaningo luye lwathola ukuthi labo abathunyelwa kwiphrofethi yezinkanyezi bahlala isikhathi eside kunabo abangaboni ochwepheshe.
I-nephrologist ingalandela ngokucophelela ukusebenza kwezinso zakho futhi ixoxe nawe ngezokwelapha uma izinso zakho zihluleka. Angakwazi futhi ukuqapha noma yikuphi ukucindezeleka okuvela ngenxa yesifo sakho sezinso, njenge-anemia noma isifo sefu.
Izimpawu
Njengoba nje ukuguqulwa kwesifo sezinso ezingapheli kuyashintsha, kunjalo futhi izimpawu ezihambisanayo. Ukwengeza, isikhathi umuntu aqala ngaso ukuzwa izimpawu zesifo sakhe sezinso asinqunyuli futhi asomile. Eqinisweni, abantu abaningi bazizwa belungile kuze kube yilapho isifo sabo sithuthukile. Lesi esinye sezizathu zokubona udokotela wakho njalo ukuhlolwa kwegazi.
Ezinye zezimpawu umuntu angase azizwe ezinesifo esingenasifo sezinso, ikakhulu njengoba ziqhubekela phambili esigabeni sokugcina, zibandakanya:
Ukulahlekelwa Kwamandla
Into yokuqala ongase uyiqaphele ukuzwa ukulala noma ukukhathala kunokujwayelekile. Amaphethini akho okulala angashintsha. Ungase ulale ngaphezulu emini noma ube nobunzima bokulala ebusuku. Ukukhathala okuhlobene nokuhluleka kwezinso kuhlukile kunokukhathala okuvamile. Ungase uzizwe ukhathele naphezu kobusuku obuhle bokulala noma indebe yekhofi.
Izinguquko Zengqondo
Ungase ubone ukudideka okuncane noma izinkinga ezigxila ekuqaleni ukuthi zingase zithuthuke ekudidiseni, ukukhathazeka , ukucasula noma ngisho nokudilizwa . Uma umuntu eqala ukwakhiwa kwemfucuza enamandla kusukela ekuhlulekeni kwezinso, ukuhlukunyezwa kanye ne-coma kungenzeka.
Ukuzizwa okungavamile
Imilenze engapheli, izinyawo ezivuthayo, noma ezinye izinkinga zengqondo zingathuthuka ngenxa yomkhiqizo omkhulu wokudoba emzimbeni. Eqinisweni, lapho lokhu kwenzeka, kungaba uphawu lokuthi i-dialysis idinga ngokuphuthumayo.
Izinguquko zeMisipha
Njengoba amaminerali akhiwe egazini, ungase ubone imisipha noma i-cramps, ikakhulukazi ebusuku.
Izinguquko Zesikhumba
Ukwakhiwa kwekhemikhali ebizwa ngokuthi i-urea egazini kungabangela isikhumba sakho ukuba sishaye, futhi ungase uhlakulele i powder emhlophe esikhumbeni sakho. Ukunambitheka kungavunyelwa ukulawula ama-creams noma ama-antihistamine, njenge-Benadryl (diphenhydramine ) .
Ukudla kwesisindo nesisindo
Ukudla kwakho kuyoncipha , futhi ungase ulahlekelwe isisindo. Ngaphandle kwalokho, ungase ube nesisindo njengoba umzimba wakho ugcina uketshezi oluthe xaxa.
Uma ungakhiqiza umchamo omningi kodwa usaqhubeka uphuza amanzi, ungase ubone ukuthi izinyawo zakho, imilenze, nezinyawo zakho zivuvukala, okuthiwa i-edema.
Ukungondleki kwesifo esingenasifo sinezinkinga ezinkulu, yingakho abantu bavame ukulandela ukudla okukhethekile ukuze balungise isimo sabo somsoco.
Izinguquko ku-Urination
Ungase udlule kancane noma ungabi namchamo nhlobo. Uma ngabe kunjalo kuwe, ukunciphisa inani lomkhuhlane ophuzayo lingase lithuthukise izinga lakho lokududuza ngokunciphisa inani lomkhuhlane owedlulele emzimbeni wakho.
Abanye bangase bathole izinguquko endleleni yabo yokucwenga njengokungena ngaphezulu, ukulahlekelwa ukulawulwa komchamo wabo (okuthiwa i-incontinence), noma ukuthuthukisa izifo ezingaphezulu kwamagciwane.
Ukukhubazeka ngokocansi
Abesifazane bavame ukuthuthukisa izinkinga zokuya esikhathini nokuya kwezinkinga zesifo esingenasifo ngesikhathi abantu behlakulela ukungasebenzi kahle kwe-erectile. Ngaphezu kwalokho, iningi labesifazane abafinyelela ekugcineni kwesifo sezinso bayeke ukuba nezikhathi.
Izinguquko eziphuthumayo
Ukwakhiwa kwe-acids egazini kungabangela ushintsho ekuphefumuleni, njengokuphefumula ngokushesha futhi okungapheli, kepha lezi zinguquko ngokuvamile azihlali kahle. Kodwa-ke, uketshezi lungakha emaphashini nasodongeni lwesifuba okwenza ukuphefumula nokuphefumula kwesifuba.
Ezinye izinguquko
Kunezinye izinkinga zezempilo ezihlobene nezifo ezingenasifo ezinsifo ezifana nesibalo segazi esincane, amapletletthi aphansi (okusiza ukuvala igazi lakho futhi kungaholela ekunciphiseni kalula), izinkinga zethambo, ukungondleki, ukushintshwa kwamanzi, kanye nokungajwayelekile kwe-electrolyte. Ukuphunga iphunga, ukuhlanza, kanye nezinselele ze-hiccups zingase zenzeke.
Ukwelapha
Ukwelashwa kwesifo sakho sezinso ezingapheli kuncike ekusebenzeni kwezinso zakho. Isibonelo, umuntu osezingeni eliphansi lesifo esingenasifo sezinso angakwazi ukuthatha isisu sokukhipha umkhuhlane owedlule. Ngakolunye uhlangothi, umuntu onesifo sezinso sokuphela kwesiguli esenza umchamo adinge i-dialysis ukususa uketshezi okwedlulele emzimbeni.
Udokotela wakho uzophinde aphathe noma yiziphi izinkinga ezihlobene nesifo sakho sezinso. Isibonelo, ungadinga imithi ye-anemia noma isidakamizwa ukuvimbela ukulahleka kwethambo.
Izigaba Zokugcina Zezifo Zezinso Zezintandokazi
Ngezinye izikhathi abantu bangaphila iminyaka eminingi ngosizo lwe-dialysis. Noma kunjalo, ngaphandle kwe-dialysis, noma uma umuntu ekhetha i-forego dialysis, ukufa ngokuvamile kwenzeka emavikini ambalwa. Njengama-toxins akha egazini (okubizwa ngokuthi uremia), umuntu uzoqala ukulala kakhulu kosuku. Angase abone izinto ezingekho, noma akhulume ngokukhuluma nabantu abafile esikhathini esidlule. Isikhumba sakhe singase sibe nemoto, futhi uzolahlekelwa yilamba. Umqondo wokoma ungase upheleke, nakuba ukwehluleka kwezinso kungabangela ukoma ngokweqile. Njengoba esondela ekufeni, angase avuleke kakhulu futhi athuthukise ukuphefumula okungavamile (ukuphefumula kwe- Cheyne-Stokes ). Lezi zimpawu zingase zingakhathazeki kakhulu kubantu abathandekayo, kodwa zingabonakali zingakhathazeki ngomuntu ofa. Njengoba esondela ekufeni, cishe uzongena e-coma. Ngalesi sikhathi, ukuchitha isikhathi naye nje kubalulekile. Sifunde ukuthi umuzwa wokuzwa umqondo wokugcina ukuhamba, ngakho ukukhuluma naye kungase kube yinduduzo enkulu.
Uma kuqhathaniswa nabantu ababulawa umdlavuza, labo ababulawa yisifo sokuphela kwezinso bezinso zitholakala ukuthi banamanani aphezulu okubhedlela kanye nemiyalelo embalwa yokuphela kokuphila. Kucatshangwa ukuthi abantu abanesifo sezinso zesigaba sesi-5 bangazuza ngokunakekela okungcono nokuhlela ekupheleni kokuphila. Uma othandekayo wakho ebhekene nalezi zigaba zokugcina, khuluma nodokotela wakhe mayelana nokunakekelwa kokunakekelwa kwezinhliziyo kanye nezinketho ezifana nokunakekelwa esibhedlela.
Izwi elivela
Uma unesifo esingenasifo sezinso, ungase ube nokukhathazeka ukucabanga ngekusasa. Hlala uqine futhi uqhubeke usebenza eduze nodokotela wakho. Ukuqapha ngokucophelela nokutholakala kokuqala kwezinso zezinso kubaluleke kakhulu ekuvikeleni izinso zakho.
Uma unesifo sezinso sokugcina futhi usu-dialysis noma usondelene kakhulu nokuqala i-dialysis, sicela uqiniseke ukuthi uxoxe ngemibuzo yakho yonke, izinkathazo, ukulindela, nezinhloso zokunakekelwa nodokotela wakho.
Kungakhathaliseki ukuthi ukhetha ukuba ne-dialysis, noma uma kungenjalo, khuluma nodokotela wakho mayelana nokunakekelwa kwe-palliative. Kubantu abanomdlavuza, lokhu kuvame ukwakhiwa ukuvakashelwa kwemitholampilo, futhi kwenziwa uhlelo oluhle. Ngokwehluleka kwezinso, kungadingeka ukuthi uqale le ngxoxo ukuze uthole ukwelashwa okungcono kakhulu futhi ube nekhwalithi engcono kakhulu yokuphila kanye nesikhathi esiningi osishiyile.
> Imithombo:
> Isikhungo Sikazwelonke Sesifo Sikashukela kanye Nezifo Zokugula Nezinso Zokugaya. Kuyini Isifo Sengqondo Esingajwayelekile? https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease
> Raghavan, D., noJ. Holley. Ukunakekelwa kokuqapha komuntu okhulile we-CKD Isiguli: Umhlahlandlela oSebenzayo. Ukuthuthuka kwezifo eziphilile ezinganeni . 2016. 23 (1): 51-6.
> Rosenberg, M. Sibutsetelo Ngokuphathwa Kwezifo Zesifo Esisifo Sabantu Abadala. UpToDate . Kubuyekezwe ngo-12/06/17.
> Wachterman, M., Lipsitz, S., Lorenz, K., et al. Ukwaziswa Okuphelile Kokuphila Kwabadala Abadinga Ukuphela Kwezinkinga Zokuqeda Izintambo: Ukuqhathaniswa Ne-Cancer. Journal of Pain and Symptom Management . 2017. 54 (6): 789-797.
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