Ukucindezeleka kwegazi akuyona inkinga engavamile phakathi ne-hemodialysis. Encwadini yezokwelapha, i- intra-dialytic hypotension. Kungaba yinkinga ekhubazayo evame ukuholela ezigulini ezihlulekayo zezinso ukungatholi ngokwanele i-dialysis ngenxa yokuphela kokuphulukiswa kwemithi. Kungabangela futhi uketshezi oluthe xaxa kwesokunxele ezigulini, esiyazi ukuthi zihlobene nengozi ephezulu yokufa.
Izingozi Zezingozi
Iziguli ezithile zivame ukubona amaconsi anciphazelayo emzimbeni wegazi ngesikhathi se-dialysis. Ngenkathi ukubuka kwami kunganele njengobunye bezokwelapha ezamukelekayo, ukubuyekezwa okusheshayo kwezincwadi kwembula ukuthi iziguli ezithile zingase zibone ukucindezeleka kwegazi.
- Iziguli ezindala
- Iziguli ezise-dialysis isikhathi eside
- Abantu abayisifo sikashukela bavame ukuba yingozi enkulu
- Iziguli zesifazane
- Iziguli ezikhulu kakhulu
- Iziguli zidinga inani eliphakeme ngokweqile lokususwa kwamanzi, noma i-ultrafiltration, ngenxa yemali ephezulu ye-inter-dialytic weight gain
- Iziguli ezinomzimba ophansi kakhulu omile.
- Ukuthatha imithi yengcindezi yegazi ngaphambi nje kokuba i-dialysis ikhulise ingozi
- Ukudla ngesikhathi se-dialysis kuyinto eyaziwayo engozini
Ingxoxo mayelana nokuthi kungani lezi ziguli zibeka ingozi enkulu engaphezu kwalesi sihloko. Izizathu zingase zihluke ezifweni zesifo se-diabetes (i-autonomic neuropathy), ukuze kususwe ngokushesha uketshezi ngesikhathi se-dialysis (okungenzeka kwenziwe ezigulini ezinesisindo esiphakeme se-inter-dialytic).
Lokhu futhi akubandakanyi izimbangela ezingavamile kodwa eziyingozi kakhulu ezithinta ukucindezeleka kwegazi okungenzeka phakathi kwe-dialysis okubandakanya izinto ezinjengezifo, nezinkinga ngenhliziyo njengengqikithi engavamile noma ukuhlasela kwenhliziyo.
Izimpawu Nezibonakaliso
Ingxenye ecacile yukuthi i-hypotension ye-intradialytic izobonakalisa njengokwehla ngokushesha kwegazi.
Kodwa-ke, iziguli zivame ukukhononda ngezinhlungu, ubuhlungu bomhlane noma ubuhlungu besifuba, izinsizwa, ikhanda elikhanyayo, njll. Izimpawu ze-vagal nerve stimulation zingase zibonwe futhi zivame ukuletha njenge-yawning.
Ukuvimbela
I-hypotension ye-Intradialytic ingaba yinselelo enhle yokwelapha, ikakhulukazi ezigulini ezinezici eziningi ezingozini ezishiwo ngenhla. Ngakho-ke, akusho ukuthi zonke izici eziyingozi ezingadingeka ukuba zibhekiswe ngabanye. Ezinye iziphakamiso ezingase zisebenze ziyi:
- Gwema ukudla phakathi ne-dialysis
- Gwema ukuthatha imishanguzo yengcindezi yegazi ngaphambi nje kokuba u-dialysis, noma ucabangele ukushintsha izikhathi
- Kuyasiza ukungatholi isisindo esiningi phakathi kokwelapha okulandelanayo kwe-dialysis; ngakho-ke ukunciphisa umzimba ophansi-dialytic kuyasiza. Uketshezi oluncane oludinga ukususwa kuwe, kulula kakhulu uhlelo lwakho lokujikeleza ukugcina ukucindezelwa kwegazi.
- Isazi sakho sezinzwa singase sinikeze i-dialysis ehlukile, ngenani eliphakeme le-sodium. Imininingwane yalokhu ingaphezu kwalesi sihloko.
- Uma lezi zinyathelo zingaphumeleli, khuluma nomfelandazi wakho wezinzwa mayelana nokwandisa isisindo sakho esomile
Uma kubonakala sengathi isiguli sivumelana ngokuvumelana nomthetho oqokelwe uketshezi, futhi akukho nezinye izici eziyingozi ezibalwe ngenhla ezikhona, kungase kudingeke ukuhlola inhliziyo yesiguli.
Izinkinga ngomsebenzi wenhliziyo akuyona imbangela engavamile yokwehla kwegazi, kanti isiguli singase sizuze ekutholeni i-echocardiogram. Kulesi simo, ukubona i-cardiologist kungaba umbono omuhle.
Imithi ebizwa ngokuthi i-midodrine ivame ukusetshenziswa njengendlela yokugcina. Futhi uma kungekho okunye okusebenzayo futhi inkinga iphindaphinda, cabangela ushintsho ku-dialysis peritoneal noma i-home hemodialysis.
Ukwelapha
Ngokujwayelekile, uzonikezwa amancane amanzi okugcoba ngaphakathi kulezi zimo. Lokhu kungafaka umthamo ovamile ofana nosawoti ovamile owenziwe nge-bolus encane ka 250ml noma ngaphezulu. Ngokuvamile, abasebenzi be-dialysis bayonciphisa noma bayeke ngisho nokususwa okukhipha amanzi okuvela kuwe ngokuphelele phakathi nalesi sikhathi, futhi ungase ubuyekezwe endaweni ethile ukukhulisa ukugeleza kwegazi ebuchosheni, okubizwa ngokuthi isikhundla se-Trendelenburg (okusetshenziselwa ukuthi kuyadingeka) .