Usoro nnweta Hemodialysis

Enwere ike ịnweta ohere iji nweta hemodialysis. Accessnweta bụ ebe ị na-enweta hemodialysis. N'iji nnweta ahụ, a ga-ewepụ ọbara n'ahụ gị, kpochaa ya site na igwe nkụkọ (akpọ dialyzer), wee laghachi n'ime ahụ gị.

A na-etinyekarị ohere ahụ na ogwe aka gị mana ọ nwekwara ike ịga n'ụkwụ gị. Ọ na-ewe izu ole na ole ruo ọnwa ole na ole iji nweta ohere dị njikere maka hemodialysis.

Dọkịta na-awa ga-etinye ohere. Enwere ụdị ụzọ atọ.

Fistula:

• Dọkịta na-awa ahụ na-esonyere akwara na akwara n'okpuru akpụkpọ ahụ.
• Ejikọtara akwara na akwara, ọtụtụ ọbara na-abanye n'ime akwara. Nke a na-eme ka akwara ahụ sie ike. Ntinye ogwu mkpuru n'ime akwara ike a di mfe maka hemodialysis.
• Ọrịa na-ewe izu 1 ruo 4 iji kee.

Nweta:

• Ọ bụrụ na ị nwere obere veins nke na - enweghị ike ịmịpụta na fistula, onye dọkịta na-awa ahụ na - ejikọ akwara na akwara na tube na - arụ ọrụ aka.
• Enwere ike itinye ntinye agịga n'ime ntụpọ maka hemodialysis.
• Aka nkedo na-ewe izu ụka atọ ma ọ bụ isii iji gwọọ.

Central venous catheter:

• Ọ bụrụ na ịchọrọ hemodialysis ozugbo ma ịnweghị oge ichere ka fistula ma ọ bụ aka ọrụ na-arụ ọrụ, dọkịta na-awa nwere ike itinye ya na catheter.
• A na-etinye catheter ahụ n'ime akwara olu, obi, ma ọ bụ ụkwụ elu.
• Igwe a na-adị nwa oge. Enwere ike iji ya maka ịrịa ọrịa mgbe ị na-eche ka fistula ma ọ bụ aka aka gwọọ gị.

Akụrụ na-eme ihe dị ka nzacha iji sachapụ mmiri mmiri na nsị si n'ọbara gị. Mgbe akụrụ gị kwụsịrị ịrụ ọrụ, a pụrụ iji dialysis mee ka ọbara gị dị ọcha. A na-emekarị ịrịa ọrịa ugboro atọ n'izu ma were ihe dị ka awa 3 ruo 4.

Na ụdị ohere ọ bụla, ị nwere ohere ibute ọrịa ma ọ bụ mkpụkọ ọbara. Ọ bụrụ na ọrịa ma ọ bụ mkpịsị ọbara na-etolite, ị ga-achọ ọgwụgwọ ma ọ bụ ịwa ahụ karịa iji dozie ya.

Dọkịta na-awa ahụ kpebiri ebe kachasị mma iji tinye ohere gị. Ezi uzo choro ezigbo obara. Enwere ike ime nyocha Doppler ultrasound ma ọ bụ nyocha ihe omimi iji chọpụta nrugharị ọbara na saịtị nwere ike ịnweta.

A na-emebukarị vaskụla dị ka usoro ụbọchị. Wards nwere ike ịla ụlọ ma emechaa. Jụọ dọkịta gị ma ọ bụrụ na ịchọrọ onye ga-ebugharị gị n'ụlọ.

Gwa onye dọkịta na-awa gị na onye na-ahụ maka ọgwụ anesthesiologist banyere ọgwụ nchịkwa maka usoro nnweta. Enwere nhọrọ abụọ:

• Onye na - ahụ maka ahụike gị nwere ike inye gị ọgwụ nke na - eme gị obere ụra na anestetiiki iji belata saịtị ahụ. Uwe akwa dị n'akụkụ ebe a ka ị ghara ilele usoro ahụ.
• Onye na-enye gị nwere ike inye gị ọgwụ mgbochi n’ozuzu ya ka ị na-ehi ụra n’oge usoro ahụ.

Nke a bụ ihe ị ga-atụ anya:

• Ga-enwe ụfọdụ mgbu na ọzịza na nnweta ozugbo ịwa ahụ. Debe ogwe aka gị na ohiri isi ma mee ka ikpere gị kwụ ọtọ iji belata ọzịza.
• Mee ka mbepụ ahụ kpọọ nkụ. Ọ bụrụ na etinyere catheter na-adịru nwa oge, B DOA mee ya mmiri. Fistula AV ma ọ bụ aka aka nwere ike ide mmiri 24 ruo 48 awa mgbe etinyechara ya.
• Ebula ihe ọ bụla karịrị 15 kilogram (kilogram 7).
• Emela ihe ike na ogwe aka site na nnweta.

Kpọọ dọkịta gị ma ọ bụrụ na ị nwere ihe ịrịba ama ọ bụla nke ọrịa:

• Mgbu, acha ọbara ọbara, ma ọ bụ ọzịza
• Drainage ma ọ bụ abu
• Ahụ ọkụ karịrị 101 ° F (38.3 ° C)

Ilekọta ohere gị ga - enyere gị aka idobe ya ogologo oge o kwere mee.

A fistula:

• Na-adịgide ruo ọtụtụ afọ
• O nwere ezigbo obara
• Nwere obere ihe ize ndụ maka ibute ọrịa ma ọ bụ ịkpụkọ

Akwara gị na akwara gị gwọọ mgbe agịga nke ọ bụla gafere maka hemodialysis.

Ihe nkedo anaghị adịte aka dị ka ọkpọ. Ọ nwere ike ịnwe afọ 1 ruo 3 na nlekọta kwesịrị ekwesị. Oghere si ntinye agịga na-etolite na ntụpọ. Akara aka nwere ihe egwu karịa ibute ọrịa fistula.

Akụrụ odida - ala ala - dialysis access; Renal ọdịda - adịghị ala ala - dialysis ohere; Adịghị ala ala gbasara akụrụ - dialysis access; Adịghị ala ala akụrụ - dialysis access; Adịghị ala ala gbasara akụrụ - dialysis access

Ebe nrụọrụ weebụ National Institute of Diabetes and Digestive and Kidney Disease. Hemodialysis. www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis. Emelitere Jenụwarị 2018. Nweta August 5, 2019.

Yeun JY, Young B, Depner TA, Chin AA. Hemodialysis. Na: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner na Rector nke akụrụ. Nke 11. Philadelphia, PA: Elsevier; 2020: isi 63.