I-dialysis yakho ye-fistula okanye i-catheter ingaba ngumthombo weengxaki ezinxulumene ne-dialysis
Ukuze enze i-hemodialysis kwisigulane, enye imfuneko yindlela yokufumana igazi kwisigulane kumatshini we-dialysis. Oku kubizwa ngokuba " ukufikelela ". Usenokuba uvile ngemigangatho efana ne-graft, fistula, kunye ne-catheters. Zonke ezi ziintlobo ezahlukeneyo zokufikelela kwi-dialysis ezingasetyenziselwa ukudibanisa isigulane . Iinkcukacha malunga nalezi zixhobo ezahlukeneyo zokudibanisa zifakwe apha .
Eli nqaku liza kuthetha kuphela ngeengxaki ezinokuthi zihlobene nokufikelela 'kwisigulana se-dialysis. Le nxalenye yoluhlu lwamacandelo abandakanya iingxaki ze-dialysis (amanye amanqaku apha apha apha ).
IGAFAFT / FISTULA STENOSIS
Igama elithi stenosis lithetha ukunciphisa. Zombini iibrafti kunye ne-fistula zingahlakulela ukucutha kwe-lumen zazo ngezizathu ezahlukahlukeneyo (ezinokuthi zixhomekeke kwizizathu zokugonywa ngexesha lokubekwa, kwindlela eyafikelela ngayo kwi-dialysis). Abasebenzi be-Dialysis baya kuhlola i-graft / i-fistula phambi kwonyango kwaye bajonge iimpawu ze-stenosis:
- Ngokuxhomekeke kwendawo yokuhlala ngayo, ukufikelela kufanele kube yindoda enamandla , okanye nokuba negazi elihle .
- Ukukhupha okanye ukubetha kwengalo apho ukufikelela khona kungabonwa.
- Uxinzelelo ekungeneni luya kutshintsha kwaye luya kubonakaliswa kwi-alamu yomshishini we-dialysis.
- Ixesha lokuphuma kwegazi emva kokupheliswa kwonyango luphawu olufanayo.
- Unokubona ukuba ukusebenza kwe-dialysis kungahla ngenxa yokufikelela " ukuphindaphinda ". Ukuphindaphinda kwenzeka ntoni ekufikeleleni xa igazi eliphathwayo libuyiselwa kumatshini we-dialysis kwisigulane, ixubusha kunye negazi elisendleleni ukusuka kwisigulane ukuya kumatshini, ngaloo ndlela kudala ukungasebenzi kakuhle kunyango. Oku kuya kubakhokelela ekumanyanisweni kwemilinganiselo ye-dialysis ne-adequacy.
- Ukuba i-stenosis ivumelekile ukuba iqhubeke ixesha elide kakhulu, iya kubakhokelela ekwakheni i-blood clot kweso siza okanye ixhomeke kuyo, ebizwa ngokuba yi "thrombus".
IGAFAFT / FISTULA THROMBOSIS
Igama le- thrombosis libhekisela kwi-clot yegazi. Iyakhula ngaphakathi kwee-graftysis, i-fistula, okanye i-catheters ngezizathu ezahlukahlukeneyo, kodwa isizathu esivakalayo sokuthi i-thrombus ifom isimo se-stenosis. Emva kokuba i-thrombus yenzeke kwi-dialysis yokungena, i-dialysis ebonakalayo inokuba yinto engenakwenzeka kude kube yinkinga. Zonke iimpawu ezingentla zingenzeka kwiimeko zokufikelela kwi-thrombosis.
UKUPHATHISWA KWE-DIALYSIS UKUFUMA UKUFUMANA OKANYE OKWENKQUBO
Emva kokuba ukrokrelwa kweklinikhi kuphakanyiswe malunga nalezi ngxaki ezincike kwiimpawu ezikhankanywe ngasentla, i-nephrologist yakho ingakuthetha kwi-surgeon ye-vascular okanye isikhungo sokucinga. Uphando oluthile lunokukunceda ukuqinisekisa ukuxilongwa:
- I-ultrasound yokufikelela ingabonisa iimpawu ze-stenosis / thrombosis
- Ukuxilongwa ke kunjalo kudla ngokuqinisekileyo ngokufaka idayi ekhethekileyo kwindawo yokufikelela kunye nemifanekiso ethathwa, njenge-x-ray. Inqubo ibizwa ngokuba yi- fistulogram kwaye oku kuya kubonisa indawo ye-stenosis okanye i-thrombosis kakhulu
UKUHLAWULWA KWE-DIALYSIS UKUFUMA UKUFUMANA OKANYE OKUQHELEKILEYO
Unyango luphathwa ngonyango olwenziwe nge-nephrologists okanye oogqirha bezilwanyana.
I-interventionalist izakufaka i-catheter ekufikeleleni, kwaye uzame ukwandisa isigaba esincinci, inqubo ebizwa ngokuba yi-angioplasty yokuguqulela i-percutaneous. Ukuba i-clot yegazi ifunyenwe, ingasuswa ngamachiza okanye ngomatshini, inkqubo ebizwa ngokuthi i-thrombectomy. Ukuba kubonakala ngathi le ndlela encinci ye-invasive ayiyi kusebenza, ukulungiswa kocwangco kungafuneka.
IINGXELO ZEMISEBENZI EZIQHELEKILEYO KWI-DIALYSIS CATHETERS
Njengoko ndikhankanywe kweli nqaku , i-dialysis catheters yindlela encinci yokukhetha i-hemodialysis ngezizathu ezifanelekileyo. Baphatha umngcipheko ophezulu wokusuleleka, kwaye ngaphandle kokuba kukho isizathu esingafanelekanga (okanye ukuba sisiphumo esiphuthumayo), akukho si gulane kufuneka siqale i-dialysis nge-catheter.
Emva kokufakiwe, i-catheters ingase isebenze ngokufanelekileyo ukusuka ekuhambeni, into ebizwa ngokuba yi -cathéter yangaphambili , kwaye ngokuqhelekileyo ngenxa yokunyanzeliswa kwecatheter kwi-vein. I-catheter kule meko ngamanye amaxesha inokusetyenziswa kwaye iphinde ibekwe ukuba isebenze, okanye kufuneka iguquke.
Kwamanye amaxesha, i-catheter esebenze kakuhle iiveki ukuya kwiinyanga iyakyeka ukusebenza, kwaye oku kungabonakalisa ukubunjwa kwegazi ngaphakathi okanye ngeenxa zonke. Le thrombus iyakufuna unyango, mhlawumbi isebenzisa imithi yokukhupha i-thrombolytic, okanye i-catheter idinga ukutshintshwa. Kungenxa yengozi yokuba i-dialysis catheters "ivalwe" ngemithi ye-antiticoagulant emva kokusetyenziswa ukukhusela ukuma kwegazi.