Hemodialyse

Mu gukora hemodiaalyse, imashini isukura imyanda, umunyu n'amazi mu maraso yawe iyo impyiko zawe zitagishoboye gukora aka kazi neza. Hemodiaalyse (he-moe-die-AL-uh-sis) ni uburyo bumwe bwo kuvura ibibazo bikomeye by'impukiko kandi irashobora kugufasha gukomeza kubaho ubuzima buhamye nubwo impyiko zawe zidakorera neza.

Muganga wawe azagufasha kumenya igihe ukwiye gutangira hemodialyse hashingiwe ku bintu bitandukanye, birimo: Ubuzima bwawe muri rusange Imikorere y'impyiko Ibimenyetso n'ibibazo Ubuzima bwawe bwiza Ibitekerezo byawe bwite Ushobora kubona ibimenyetso n'ibibazo byo kunanirwa kw'impyiko (uremia), nko kubabara umutwe, kuruka, kubyimba cyangwa umunaniro. Muganga wawe akoresha igipimo cy'umuvuduko w'amaraso (eGFR) kugira ngo apime urwego rw'imikorere y'impyiko zawe. eGFR yawe ibarwa hakoreshejwe ibisubizo byo gupima creatinine mu maraso yawe, igitsina, imyaka n'ibindi bintu. Agaciro gasanzwe kagenda gahindagurika uko umuntu akura. Ubu buryo bwo gupima imikorere y'impyiko zawe bushobora kugufasha gutegura ubuvuzi bwawe, harimo nigihe cyo gutangira hemodialyse. Hemodialyse ishobora gufasha umubiri wawe kugenzura umuvuduko w'amaraso no kubungabunga ubusugire bw'amazi n'imyunyu y'ubutare itandukanye - nka potasiyumu na sodium - mu mubiri wawe. Ubusanzwe, hemodialyse itangira mbere yuko impyiko zawe zifunze kugeza aho ziteza ibibazo bikomeye bishobora kwica. Impamvu zisanzwe ziterwa no kunanirwa kw'impyiko harimo: Diabete Umuvuduko ukabije w'amaraso (hypertension) Kubyimba kw'impyiko (glomerulonephritis) Ububobere bw'impyiko (indwara y'impyiko nyinshi) Indwara z'impyiko zirakomoka Mu gihe kirekire gukoresha imiti idafite steroide cyangwa indi miti ishobora kwangiza impyiko Ariko kandi, impyiko zawe zishobora gufunga mu buryo butunguranye (indwara y'impyiko ikabije) nyuma y'uburwayi bukomeye, kubagwa bigoye, indwara y'umutima cyangwa ikindi kibazo gikomeye. Imiti imwe na imwe ishobora kandi gutera indwara y'impyiko. Bamwe mu bantu bafite indwara y'impyiko ikomeye kandi imaze igihe (indwara y'impyiko ikomeye) bashobora guhitamo kudatangira dialyse ahubwo bagahitamo inzira itandukanye. Ahubwo, bashobora guhitamo ubuvuzi bwo kuvura indwara, bwitwa kandi ubuvuzi bwo kuvura indwara cyangwa ubuvuzi bwo kwitaho. Ubu buvuzi burimo gucunga neza ibibazo by'indwara y'impyiko ikomeye, nko kuba amazi menshi mu mubiri, umuvuduko ukabije w'amaraso n'ubukonje bw'amaraso, hibandwa ku kuvura ibimenyetso bigira ingaruka ku buzima bwiza. Abandi bantu bashobora kuba abakandida bo kubagwa impyiko, aho gutangira dialyse. Baza itsinda ry'ubuvuzi bwawe kugira ngo umenye byinshi ku mahitamo yawe. Iki ni icyemezo cyawe bwite kuko inyungu za dialyse zishobora gutandukana, bitewe n'ibibazo byawe by'ubuzima.

Abenshi mu bantu bakeneye hemodialise bafite ibibazo bitandukanye by'ubuzima. Hemodialise irongera ubuzima kuri benshi, ariko igihe cyo kubaho ku bantu bayikeneye kikiri gito ugereranyije n'abaturage muri rusange. Nubwo ubuvuzi bwa hemodialise bushobora kuba ingirakamaro mu gusimbuza imikorere y'impyiko zimwe na zimwe zabuze, ushobora guhura n'ibibazo bimwe na bimwe bifitanye isano biri hepfo, nubwo atari bose bahura n'ibyo bibazo byose. Ikipe yawe ya dialyse irashobora kugufasha kubikemura. Igitutu cy'amaraso gito (hypotension). Kugwa k'igitutu cy'amaraso ni ingaruka zisanzwe za hemodialise. Igipimo gito cy'amaraso gishobora kujyana no guhumeka nabi, guhinda umubiri, gucika intege z'imitsi, isereri cyangwa kuruka. Gucika intege z'imitsi. Nubwo impamvu itaramenyekana, gucika intege z'imitsi mu gihe cya hemodialise ni ikintu gisanzwe. Rimwe na rimwe, ibyo bibazo bishobora kugabanywa binyuze mu guhindura amabwiriza ya hemodialise. Guhindura ifunguro n'umunyu hagati y'ubuvuzi bwa hemodialise bishobora kandi kugira uruhare mu gukumira ibimenyetso mu gihe cy'ubuvuzi. Kwiruka. Abantu benshi bakora hemodialise bafite uburibwe bw'uruhu, bukunda kuba bubi cyane mu gihe cyangwa nyuma gato y'ubuvuzi. Ibibazo byo kuryama. Abantu bakora hemodialise bakunze kugira ibibazo byo kuryama, rimwe na rimwe kubera guhagarika guhumeka mu gihe cyo kuryama (sleep apnea) cyangwa kubera kubabara, kudatuza cyangwa kugira amaguru adatuza. Anemia. Kudafite umubare uhagije w'utubuto tutukura mu maraso (anemia) ni ingaruka zisanzwe z'uburibwe bw'impyiko na hemodialise. Impyiko zangiritse zigabanya umusaruro w'ihormoni yitwa erythropoietin (uh-rith-roe-POI-uh-tin), ishishikariza imiterere y'utubuto tutukura. Imirire mike, imyororokere mibi y'ibyuma, ibizamini by'amaraso bikunze gukorwa, cyangwa gukuraho ibyuma na vitamine na hemodialise bishobora kandi gutera anemia. Indwara z'amagufa. Niba impyiko zawe zangiritse zitakibasha gutunganya vitamine D, ifasha mu gukuraho calcium, amagufa yawe ashobora kugenda asenyuka. Byongeye kandi, umusaruro mwinshi w'ihormoni ya parathyroid - ikibazo gisanzwe cy'uburibwe bw'impyiko - ushobora kurekura calcium mu magufa yawe. Hemodialise ishobora kuba mbi kuri ibyo bibazo binyuze mu gukuraho calcium nyinshi cyangwa nke. Igipimo cy'amaraso kiri hejuru (hypertension). Niba urya umunyu mwinshi cyangwa ukanywa amazi menshi, igipimo cy'amaraso kiri hejuru gishobora kuba kibi cyane kandi bigatuma ugira ibibazo by'umutima cyangwa stroke. Amazi menshi mu mubiri. Kubera ko amazi akurwa mu mubiri wawe mu gihe cya hemodialise, kunywa amazi menshi kurusha ibyateganijwe hagati y'ubuvuzi bwa hemodialise bishobora gutera ingaruka zikomeye, nko kunanirwa kw'umutima cyangwa gukusanya amazi mu bihaha (pulmonary edema). Kubyimba kw'urukuta rw'umutima (pericarditis). Hemodialise idahagije ishobora gutera kubyimba kw'urukuta rw'umutima, bishobora kubangamira ubushobozi bw'umutima bwo gutuma amaraso ajya mu bindi bice by'umubiri. Igipimo cy'ipotasiyumu kiri hejuru (hyperkalemia) cyangwa igipimo cy'ipotasiyumu kiri hasi (hypokalemia). Hemodialise ikuraho ipotasiyumu nyinshi, ari yo minerval ikurwa mu mubiri wawe n'impyiko. Niba ipotasiyumu nyinshi cyangwa nke ikurwaho mu gihe cya dialyse, umutima wawe ushobora gukora nabi cyangwa ugahagarara. Ingaruka ziterwa n'aho bakura amaraso. Ingaruka zikomeye - nko kwandura, gutomba cyangwa kubyimba kw'inkuta y'imitsi y'amaraso (aneurysm), cyangwa gufunga - bishobora kugira ingaruka ku mikorere ya hemodialise yawe. Kurikiza amabwiriza y'ikipe yawe ya dialyse ku buryo bwo kugenzura impinduka mu gice cyawe cyo gukura amaraso bishobora kugaragaza ikibazo. Amyloidosis. Amyloidosis ifitanye isano na dialyse (am-uh-loi-DO-sis) itera iyo poroteyine iri mu maraso ishyirwa ku magufa n'imitsi, bigatera ububabare, guhinda umubiri no gukusanya amazi mu magufa. Icyo kibazo gikunze kugaragara mu bantu bakoze hemodialise imyaka myinshi. Kugira agahinda. Impinduka mu mimerere y'amarangamutima ni ikintu gisanzwe mu bantu barwaye impyiko. Niba ugize agahinda cyangwa ubwoba nyuma yo gutangira hemodialise, vugana n'ikipe yawe y'ubuvuzi ku bijyanye n'uburyo bwiza bwo kuvura.

Itegurwa rya hemodialise ritangira ibyumweru cyangwa amezi menshi mbere y'ubuvuzi bwawe bwa mbere. Kugira ngo ubone uburyo bworoshye bwo kwinjira mu maraso yawe, umuganga azakora inzira yo kwinjira mu maraso. Ubu buryo butanga uburyo bwo gukuramo igipimo gito cy'amaraso mu mubiri wawe hanyuma ukabugarura kugira ngo igikorwa cya hemodialise gikore. Inzira yo kubaga ikeneye igihe kugira ngo ikire mbere y'uko utangira kuvurwa kwa hemodialise. Hari ubwoko butatu bw'inzira: Arteriovenous (AV) fistula. Arteriovenous (AV) fistula yakozwe n'ubuvuzi ni ugushaka kw'umutsi n'umusego, akenshi mu kuboko udakoresha kenshi. Ni bwo buryo bwiza bwo kwinjira kubera ingaruka n'umutekano. AV graft. Niba imitsi yawe ari mito cyane ku buryo udakora AV fistula, umuganga ashobora guhita akora inzira hagati y'umutsi n'umusego akoresheje umuyoboro woroshye, wa sintetike witwa graft. Central venous catheter. Niba ukeneye hemodialise yihutirwa, umuyoboro wa pulastike (catheter) ushobora gushyirwa mu musego munini wo mu ijosi ryawe. Catheter ni iy'igihe gito. Ni ingenzi cyane kwita ku gice cyinjira kugira ngo ugabanye ibyago by'indwara n'ibindi bibazo. Kurikiza amabwiriza y'itsinda ryawe ry'ubuvuzi ku bijyanye no kwita ku gice cyinjira.

Urashobora kubona hemodialyse mu kigo cyita ku ndwara z'impyiko, iwawe cyangwa mu bitaro. Akenshi ivuriro riba rihabwa bitewe n'imimerere yawe: Hemodialyse ikorerwa mu kigo. Abantu benshi bakora hemodialyse gatatu mu cyumweru, mu gihe cy'amasaha 3 kugeza kuri 5 buri cyanya. Hemodialyse ya buri munsi. Ibi bisobanura ko ivuriro riba rihabwa kenshi, ariko igihe gito - ubusanzwe bikorerwa mu rugo inshuro esheshatu cyangwa zirindwi mu cyumweru, hafi amasaha abiri buri gihe. Imashini za hemodialyse zoroheje zatumye hemodialyse yo mu rugo itakigoye, bityo, ufite amahugurwa yihariye n'umuntu uza kugufasha, ushobora gukora hemodialyse iwawe. Ushobora no gukora ubu buryo nijoro mu gihe utuye. Hariho ibigo byita ku ndwara z'impyiko biri hirya no hino muri Leta Zunze Ubumwe za Amerika no mu bindi bihugu bimwe na bimwe, kugira ngo ushobore kujya mu turere twinshi kandi ukomeze kubona hemodialyse yawe ku gihe. Itsinda ryita ku ndwara yawe rigushobora kugufasha gukora gahunda mu bindi bice, cyangwa ushobora kuvugana n'ikigo cyita ku ndwara z'impyiko aho ugiye. Tegura mbere kugira ngo ubone ubwicanyi buhari kandi habeho imyiteguro ikwiye.