Ukunyuswa kwengcinezelo yegazi akuyona inkxalabo engaqhelekanga ngexesha le-hemodialysis. Kwimeko yezokwelapha, i- intra-dialytic hypotension. Ingaba yinkinga ebuthathakayo ekukhokelela ukuba izigulane ezingaphumeleli zezintso azifumaneki ngokwaneleyo nge-dialysis ngenxa yokupheliswa ngokukhawuleza kwonyango. Ingakhokelela ekugqibeleni uketshezi kwamanzi kwizilwanyana, esiyazi ukuba zidibene nomngcipheko ophezulu wokufa.
Izinto zobungozi
Ezinye izigulane zinokuthi zibone ukuhlaselwa kwamanzi emanzini kwixinzelelo lwegazi ngexesha lokudityaniswa kwe-dialysis. Nangona iimbono zam zingenakwanela njengobungqina bonyango olwamkelekileyo, ukuhlaziywa ngokukhawuleza kweencwadi kubonisa ukuba ezinye izigulane ziyakwazi ukubona ukunyuka kwegazi.
- Izigulane ezindala
- Izigulane eziye zadwelisa ixesha elide
- Abantu abanesifo sikashukela bavame ukuba ngumngcipheko ophezulu
- Izigulane
- Izigulane ezigqithiseleyo
- Izigulana zidinga inani eliphezulu lokukhutshwa kwamanzi, okanye i-ultrafiltration, ngenxa yemali ephezulu ye-dialytic weight gain
- Izigulane ezinobunzima obunzima kakhulu.
- Ukuthatha imishanguzo yonyango yegazi ngaphambi kokuba i-dialysis iyakwandisa umngcipheko
- Ukutya ngexesha le-dialysis yinto eyaziwayo yengozi
Ingxoxo malunga nokuba kutheni ezi zigulane zibeka ingozi ephezulu ngaphandle kweli nqaku. Izizathu ziyakwazi ukuhluka kwizifo zesifo se-diabetics (ukuzimela kwe-autonomic neuropathy), ukususwa ngokukhawuleza kwamanzi ngexesha le-dialysis (ezinokuthi zenziwe kwizigulane ezineenzuzo eziphezulu eziphezulu zentengo ye-dialytic).
Oku akubandakanyi izinto eziqhelekileyo kodwa ezingaphezulu kwezona zinto ezinzulu zokwehla kwengcinezelo yegazi ezinokuthi zenzeke ngexesha le-dialysis ezibandakanya izinto ezinjengezifo, kunye neengxaki ngentliziyo enjengeengqumbo ezingavamile okanye nokuhlaselwa kwentliziyo.
Izimpawu kunye neMpawu
Inxalenye ecacileyo kukuba i-intradialytic hypotension iya kubonakala ngathi ihlawule ngokukhawuleza kwixinzelelo legazi.
Nangona kunjalo, izigulane ziya kuhlala zikhalaza ngeentlanzi, iintlungu zomva okanye intlungu yesifuba, iintloko, ukunyuka komzimba, njl njll. Uphawu lwe-vagal nerve stimulation luyakwazi ukubonwa kwaye luya kufakwa njengelungu.
Thintelo
Intradialytic hypotension ingaba nzima kakhulu ukunyanga, ngokukodwa kwizigulane ezineengxaki ezininzi ezikhankanywe ngasentla. Ngako oko, ngaphandle kokuthi zonke izinto ezibangelwa umngcipheko ziya kufuneka ziqwalaselwe ngabanye. Ezinye iziphakamiso ezinokusebenza zi:
- Gwema ukutya ngexesha le-dialysis
- Gwema ukuthatha imishanguzo yonyango yegazi ngaphambi kokuba udialysis, okanye ucinge ixesha lokutshintsha
- Kunceda ukungabi niselo okhulu phakathi kokunyanga kwe-dialysis; Ngoko ke inzuzo ephantsi-dialtic gain gain. Umbane ongaphantsi ofuna ukususwa kuwe, kulula ngakumbi kwinkqubo yakho yokujikeleza ukugcina uxinzelelo lwegazi.
- I-nephrologist yakho inokumisela i-dialysis ngokuhlukileyo, ngexabiso eliphezulu le-sodium. Iinkcukacha zezi zinto zingaphezu kweli nqaku.
- Ukuba le miqathango ihluleka, khuluma ne-nephrologist yakho malunga nokwandisa ubunzima obumileyo
Ukuba kubonakala ngathi isigulane sithobela ngokufanelekileyo imimiselo enqamlekileyo yombane, kwaye akukho mnye umngcipheko okhankanywe ngasentla apha, kunokubaluleka ukujonga intliziyo yesigulane.
Iingxaki kunye nomsebenzi wentliziyo azikho isizathu esingaqhelekanga sokuhlaselwa kwexinzelelo lwegazi, kwaye isigulane sinokuzuza ngokufumana i-echocardiogram. Kule meko, ukubona i-cardiologist ingaba yinto efanelekileyo.
Iyeza elithi midodrine lisetyenziswe njengesigqibo sokugqibela. Yaye ukuba akukho nto isebenzayo kwaye ingxaki iphindaphindiweyo, qwalasela umtshini kwi-diitoneal dialysis okanye kwikhaya le-hemodialysis.
Unyango
Ngokuqhelekileyo, kuya kunikwa ixabiso elincinci lokuhambisa amanzi. Oku kungabandakanya umbane oqhelekileyo oqhelekileyo onosawoti owenziwe kwi-bolus encinci ye-250 ml okanye njalo. Ngokuqhelekileyo, abasebenzi be-dialysis baya kunciphisa okanye bayeke ukukhishwa kwamanzi ngokugqithiseleyo kulo xesha, kwaye unakho ukuhlaliswa kwindawo ethile ukunyusa ukuhamba kwegazi ukuya kwingqondo, ebizwa ngokuba yi-Trendelenburg isikhundla (ukusetyenziswa okubangela ukuba kukho) .