Ni iki cyitwa Hemodialysis? Impamvu, Uburyo & Ibivamo

Hemodialysis ni uburyo bwo kuvura mu buvuzi bukosora amaraso yawe igihe impyiko zawe zitagishoboye kubikora neza. Bitekereze nk'impyiko y'ubwenge isukura imyanda, amazi yarenze urugero, n'uburozi mu maraso yawe ikoresheje imashini yihariye n'urugero rwo kuyungurura.

Ubu buvuzi burokora ubuzima butangira gukenerwa igihe indwara ya kronike y'impyiko igera ku kunanirwa kw'impyiko, nanone yitwa indwara y'impyiko yo mu gihe cyanyuma. Nubwo igitekerezo cyo guhuzwa n'imashini gishobora kumvikana nk'ikintu kigoye mbere na mbere, abantu babarirwa muri za miriyoni ku isi hose babaho ubuzima bwuzuye kandi bufite icyo buvuze bakoresheje hemodialysis.

Ni iki cyitwa hemodialysis?

Hemodialysis ni uburyo bwo gusimbuza impyiko bukora akazi impyiko zawe zisanzwe zikora. Amaraso yawe anyura mu tuyunguruzo duto tujya muri mashini ya dialysis, aho anyura mu muyunguruzo wihariye witwa dialyzer.

Dialyzer ikubiyemo ibihumbi by'udufuka duto dukora nk'uruyunguruzo. Igihe amaraso yawe anyura muri utwo dufuka, imyanda n'amazi yarenze urugero binyura muri membrane mugihe uturemangingo tw'amaraso yawe asukuye na poroteyine z'ingenzi ziguma mu maraso yawe.

Amaso asukuye asubira mu mubiri wawe anyuze mu tuyunguruzo twundi. Ubu buryo busanzwe bufata amasaha 3-5 kandi bikorwa inshuro eshatu mu cyumweru kuri centre ya dialysis cyangwa rimwe na rimwe mu rugo.

Kuki hemodialysis ikorwa?

Hemodialysis iba ngombwa igihe impyiko zawe zitakigira imikorere ingana na 85-90%. Muri iki gihe, umubiri wawe ntushobora gukuraho neza imyanda, amazi yarenze urugero, no gukomeza uburinganire bukwiye bw'imiti mu maraso yawe.

Utabayeho ubu buvuzi, uburozi bukomeye bwakwiyongera mu mubiri wawe, bigatera ibibazo bikomeye. Muganga wawe azagusaba hemodialysis igihe imikorere y'impyiko zawe igabanutse ku rwego umubiri wawe utashobora kwitaho ubuzima bwiza wenyine.

Indwara zisanzwe zikunda gutuma umuntu akeneye hemodialysis zirimo diyabete, umuvuduko ukabije w'amaraso, indwara ya polycystic kidney, n'indwara ziterwa n'umubiri w'umuntu ubwawo zangiza impyiko uko imyaka igenda.

Ni iki gikorerwa muri hemodialysis?

Uburyo bwa hemodialysis bukurikiza uburyo bwitondewe, bukurikiza intambwe ku yindi bugamije umutekano wawe n'imibereho myiza. Mbere yo kuvurwa bwa mbere, uzakenera kubagwa gato kugira ngo habeho uburyo bwo kwinjira mu maraso, butuma imashini ya dialysis ibona uburyo bwo kugera mu maraso yawe.

Ibi nibyo bibaho muri buri gihe cyo kuvurwa:

1. Itsinda ryawe rya dialysis riguhuza n'imashini ukoresheje uburyo bwawe bwo kwinjira mu maraso
2. Amaraaso ava mu mubiri wawe anyura mu tuyunguruzo ajya muri dialyzer
3. Dialyzer yongera imyanda, uburozi, n'amazi arenze urugero mu maraso yawe
4. Amaraaso meza asubira mu mubiri wawe anyuze mu tuyunguruzo dutandukanye
5. Ubu buryo bukomeza mu masaha 3-5 mugihe uruhuka, usoma, cyangwa ureba televiziyo

Mugihe cyo kuvurwa, imashini zikurikirana umuvuduko w'amaraso yawe, umuvuduko w'umutima, n'umuvuduko wo gukuramo amazi. Itsinda ryawe rya dialysis riguma hafi kugirango ryemeze ko byose bigenda neza kandi rigahindura ibintu niba bibaye ngombwa.

Ni gute witegura hemodialysis yawe?

Kwitegura hemodialysis bikubiyemo kwitegura mu mubiri no mu mutwe. Itsinda ryawe ry'ubuvuzi rizagufasha mu ntambwe zose, ariko kumenya icyo witegura gishobora kugufasha kugabanya impungenge zose.

Mbere na mbere, uzakenera gukorerwa uburyo bwo kwinjira mu maraso, akenshi bikorwa mu byumweru byinshi mbere yo gutangira dialysis. Ibi bishobora kuba arteriovenous fistula, graft, cyangwa catheter y'agateganyo ituma amaraso atembera ajya no ava muri mashini ya dialysis.

Mbere ya buri gihe cyo kuvurwa, hari ibintu byinshi ushobora gukora kugirango witegure:

• Fata imiti yawe uko yategetswe, keretse muganga wawe abigushishijeho
• Fata ifunguro rito cyangwa agafunguro gato mbere yo kuvurwa kugirango wirinde isukari nkeya mu maraso
• Wambare imyenda yoroshye, yagutse ifite amaboko yoroshye gupfundika
• Zana ibishimisha nk'ibitabo, amatableti, cyangwa umuzika mu gihe cy'amasaha 3-5
• Ukurikirane amazi unywa hagati yo kuvurwa

Itsinda ryawe rya diyalisisi rizanakwigisha impinduka mu mirire zishobora kugufasha kumva neza no gutuma imiti ikora neza. Ubu burezi bukorwa buhoro buhoro kandi bufasha, buguha umwanya wo kumenyera.

Ni gute usoma ibisubizo byawe bya hemodiyalisi?

Kumenya ibisubizo byawe bya diyalisisi bifasha gukurikirana uburyo imiti ikora neza. Itsinda ryawe ryita ku buzima rizagusobanurira iyi mibare mu buryo burambuye, ariko aha hari ibipimo byingenzi bakurikirana.

Igipimo cyingenzi cyane cyitwa Kt/V, kigaragaza uburyo diyalisisi ikuraho imyanda mu maraso yawe. Kt/V ya 1.2 cyangwa hejuru yerekana diyalisisi ihagije, nubwo intego yawe ishobora kuba itandukanye bitewe n'ibyo ukeneye.

Ibindi bipimo byingenzi birimo:

• URR (Urea Reduction Ratio): Igomba kuba 65% cyangwa hejuru
• Igipimo cyo gukuraho amazi: Amazi menshi akurwaho mugihe cyo kuvurwa
• Impinduka za umuvuduko w'amaraso: Zikurikiranwa mbere, mugihe, na nyuma yo kuvurwa
• Agaciro ka laboratori: Harimo potasiyumu, fosifore, na hemoglobin

Itsinda ryawe rya diyalisisi risuzuma ibi bisubizo buri gihe kandi rigahindura gahunda yawe yo kuvurwa uko bikwiye. Ntukazuyaze kubaza ibibazo kubyerekeye icyo iyi mibare isobanura ku buzima bwawe.

Ni gute watezimbere imiti yawe ya hemodiyalisi?

Kugira ngo ubone inyungu nyinshi muri hemodiyalisi bikubiyemo gukorana bya hafi n'itsinda ryawe ryita ku buzima no gukora impinduka zimwe na zimwe mu mibereho yawe. Inkuru nziza ni uko impinduka nto zishobora gutuma umva neza.

Gukurikiza imirire wahawe ni kimwe mu bintu by'ingenzi ushobora gukora. Ibi bikunze gusobanura kugabanya umunyu wa sodium, potassium, phosphorus, n'amazi hagati y'imiti. Umuganga wawe w'imirire azagufasha gukora gahunda z'imirire ifite intungamubiri kandi iryoshye.

Gufata imiti yawe uko yategetswe ni ingenzi cyane. Iyi miti irimo imiti igabanya phosphate, imiti igabanya umuvuduko w'amaraso, cyangwa imiti ivura anemia. Buri muti ufite akamaro kayo mu kugufasha kugira ubuzima bwiza.

Kwitabira buri gihe amasomo ya dialysis ni ingenzi cyane. Kureka imiti cyangwa kuyigabanya bishobora gutera ubwiyongere bw'uburozi n'amazi mu mubiri wawe. Niba ufite ibibazo by'igihe, ganira n'ikipe yawe ku bisubizo bishoboka.

Ni ibihe bintu byongera ibyago byo gukenera hemodialysis?

Ibyiciro byinshi n'impamvu bishobora kongera ibyago byo kurwara impyiko zikaba zidakora neza bigasaba hemodialysis. Kumva ibi bintu byongera ibyago bishobora gufasha mu kubona hakiri kare no gukumira niba bishoboka.

Diabetes ni yo mpamvu ya mbere y'indwara y'impyiko mu bihugu byinshi. Urwego rwo hejuru rw'isukari mu maraso mu gihe kirekire rushobora kwangiza imitsi mito y'amaraso mu mpyiko zawe, bigatuma buhoro buhoro zidashobora gukora neza mu gukuramo imyanda.

Ibyago byinshi birimo:

• Diabetes (cyane cyane iyo itagenzurwa neza)
• Umuvuduko mwinshi w'amaraso wangiza imitsi y'amaraso y'impyiko
• Amateka y'umuryango y'indwara y'impyiko
• Imyaka irenga 60, kuko imikorere y'impyiko igabanuka mu buryo busanzwe
• Indwara z'umutima n'imitsi y'amaraso
• Ubunini bukabije
• Umunyonga

Ibyago bike ariko by'ingenzi birimo indwara ziterwa n'ubudahangarwa bw'umubiri nka lupus, indwara y'impyiko ya polycystic, n'imiti imwe n'imwe ishobora kwangiza impyiko mu gihe kirekire. Abantu bamwe bashobora no kugira indwara ziterwa n'imirerere zigira ingaruka ku mikorere y'impyiko.

Ni izihe ngaruka zishoboka za hemodialysis?

Mugihe hemodialysis ikunze kugenda neza kandi yihanganirwa, kimwe n'ubundi buvuzi, ishobora kugira ingaruka zimwe na zimwe n'ibibazo. Byinshi muri ibi bishobora gukemurwa no kwitabwaho neza no gukurikiranwa.

Ingaruka zikunze kugaragara zibaho mugihe cyangwa nyuma gato y'ubuvuzi kandi akenshi zikagenda neza uko umubiri wawe uhinduka. Ibi birimo kuribwa kw'imitsi, isereri, isesemi, no kunanirwa uko umubiri wawe uhinduka ku mazi n'imiti.

Ibibazo bikomeye ariko bidakunze kugaragara birimo:

• Umubyimba muke w'amaraso mugihe cy'ubuvuzi
• Udukoko ahantu habonetse
• Amabara y'amaraso ahantu habonetse
• Umutima utagenda neza
• Air embolism (gake cyane)

Ibibazo bijyanye n'ahantu habonetse bishobora gusaba uburyo bwo kongera kubungabunga cyangwa gusimbuza uburyo bwawe bwo kubona amaraso. Itsinda ryawe rya dialysis rikora igenzura ry'ibi bibazo kandi rifata ingamba zo kubikumira igihe bishoboka.

Ibibazo by'igihe kirekire birimo indwara z'amagufa, anemia, n'ibibazo by'umutima n'imitsi. Ariko, hamwe n'ubuvuzi bukwiye n'imibereho myiza, abantu benshi bagabanya ibi byago kandi bagakomeza ubuzima bwiza.

Ni ryari nkwiriye kubona umuganga kubera hemodialysis?

Niba umaze gukoresha hemodialysis, ugomba guhita uvugana n'ikipe yawe y'ubuvuzi niba ubona ibimenyetso bimwe na bimwe byo kwihanangiriza. Ibi bishobora kwerekana ibibazo bisaba kwitabwaho vuba.

Hamagara ikigo cyawe cya dialysis cyangwa umuganga ako kanya niba ubona ibimenyetso byo kwandura ahantu habonetse, nk'umutuku, ubushyuhe, kubyimba, cyangwa kuvamo amazi. Umuriro, ibikonjo, cyangwa kumva utameze neza cyane bigomba gutuma uhita ushakisha ubufasha bw'ubuvuzi.

Izindi mimerere isaba ubufasha bwihutirwa zirimo:

• Kugufi cyane cyangwa kuribwa mu gituza
• Kuva amaraso menshi ahantu habonetse
• Ibimenyetso by'amabara y'amaraso, nk'ukubyimba mu kuboko cyangwa ukuguru
• Isereri rikomeye, kuruka, cyangwa kutabasha gukomeza amazi
• Impinduka ahantu habonetse, nk'ukubura kumva umuvuduko

Ku bantu bataratera imitsi, ganira n'umuganga wawe w'impyiko niba ufite ibimenyetso nk'umunaniro udashira, kubyimba, impinduka mu kunyara, cyangwa isesemi. Gutegura hakiri kare gutera imitsi, niba bikenewe, bituma habaho ibisubizo byiza.

Ibibazo bikunze kubazwa ku bijyanye no guterwa imitsi

Q.1 Mbese guterwa imitsi birababaza?

Guterwa imitsi ubwabyo ntibibabaza, nubwo ushobora kumva utameze neza igihe inshinge zinjizwa ahantu hakorerwa imitsi. Abantu benshi basobanura ibi nk'ibisa no kuvurwa amaraso cyangwa guterwa urushinge.

Mugihe cyo kuvurwa, ushobora guhura no kuribwa kw'imitsi cyangwa ukumva unaniwe uko umubiri wawe uhinduka kubera impinduka z'amazi. Ibi byiyumvo mubisanzwe biragenda bigabanuka uko umenyera uburyo bwo kuvurwa kandi uburyo bwawe bwo kuvurwa bugashyirwa ku murongo.

Q.2 Umuntu ashobora kumara igihe kingana iki aterwa imitsi?

Abantu benshi bamara imyaka myinshi cyangwa ndetse n'imyaka mirongo baterwa imitsi, bitewe n'ubuzima bwabo muri rusange, imyaka yabo, n'uburyo bakurikiza gahunda yabo yo kuvurwa. Abantu bamwe barara imyaka 20 cyangwa irenga baterwa imitsi.

Uko uzabaho biterwa n'ibintu byinshi, harimo uburwayi bwawe bw'ibanze, uburyo ucunga imirire yawe n'imiti, niba wemerewe guhabwa impyiko.

Q.3 Nshobora kujya mu rugendo nterwa imitsi?

Yego, urashobora kujya mu rugendo nterwa imitsi hamwe no gutegura neza. Ibitaro byinshi byo guterwa imitsi bifite imiyoboro ituma wakirira ubuvuzi ahantu hatandukanye, harimo n'ahantu ho kuruhukira.

Bizakenera gutegura ubuvuzi ahantu ugiye mbere y'igihe kandi ufatanye n'ikipe yawe yo guterwa imitsi. Abantu bamwe kandi biga gutera imitsi mu rugo, bishobora gutanga umwanya wo kujya mu rugendo.

Q.400 Nshobora gukora nterwa imitsi?

Abantu benshi bakomeza gukora nterwa imitsi, cyane cyane niba bashobora gutegura gahunda zihinduka. Ibitaro bimwe na bimwe byo guterwa imitsi bitanga amasomo y'umugoroba cyangwa mu gitondo kare kugirango bihuze n'amasaha yo gukora.

Ubushobozi bwawe bwo gukora akazi buterwa n'ibisabwa by'akazi kawe, uko wumva umeze mu gihe cyo kuvurwa no nyuma yaho, ndetse n'ubuzima bwawe muri rusange. Abantu bamwe bakora amasaha yose, mu gihe abandi bashobora gukenera kugabanya amasaha yabo cyangwa guhindura ubwoko bw'akazi bakora.

Q.5 Ni iki gitandukanya hemodialysis na peritoneal dialysis?

Hemodialysis ikoresha imashini mu gushungura amaraso yawe hanze y'umubiri wawe, mu gihe peritoneal dialysis ikoresha uruhu rwo mu nda yawe (peritoneum) nk'ishungura risanzwe imbere mu mubiri wawe.

Hemodialysis ikunze gukorwa inshuro eshatu mu cyumweru ahantu habugenewe, mu gihe peritoneal dialysis ikunze gukorwa buri munsi mu rugo. Muganga wawe w'impyiko azagufasha gufata icyemezo cy'ubwoko bushobora kuba bwiza ku mibereho yawe na serivisi z'ubuvuzi ukeneye.