Ni iki cyitwa Dialysis ya Peritoneal? Intego, Uburyo bwo Gukora & Ibivamo

Dialysis ya Peritoneal ni uburyo bworoheje bwo gukora isuku mu maraso yawe igihe impyiko zawe zitabasha gukora akazi kazo neza. Mu mwanya wo gukoresha imashini nkuko bikorwa muri dialysis isanzwe, ubu buvuzi bukoresha uruhu rusanzwe ruri imbere mu nda yawe rwitwa peritoneum nk'urugero. Amazi yihariye atembera mu nda yawe, akuramo imyanda n'amazi y'inyongera mu maraso yawe, hanyuma akavanywamo, akajyana uburozi.

Ni iki cyitwa dialysis ya peritoneal?

Dialysis ya peritoneal ikora ihindura inda yawe ikaba sisitemu isanzwe yo gukora isuku. Peritoneum yawe ni uruhu ruto, rworoshye rutwikira umwanya wo mu nda yawe kandi rugatwikira ibice by'umubiri wawe nk'igitambaro kirinda. Uruhu rufite imitsi mito y'amaraso inyuramo, bituma ruba rwiza cyane mu gukora isuku mu maraso yawe.

Mugihe cy'ubuvuzi, agati gato kitwa catheter kaguma mu nda yawe. Amazi meza ya dialysis atembera muri iyi catheter akajya mu mwanya wo mu nda yawe, aho amara amasaha menshi. Aya mazi akora nk'imbaraga, akurura ibicuruzwa by'imyanda n'amazi y'inyongera mu maraso yawe binyuze muri membrane ya peritoneal.

Nyuma yo kurangiza isuku, uvana amazi yakoreshejwe hanze unyuze muri catheter imwe. Ubu buryo bwitwa guhinduranya, kandi abantu benshi babikora inshuro 3-4 ku munsi. Guhinduranya buri gihe bifata iminota 30-40, bikaguha umudendezo wo kubikorera mu rugo, ku kazi, cyangwa aho wumva wishimiye.

Kuki dialysis ya peritoneal ikorwa?

Dialysis ya peritoneal iba ngombwa igihe impyiko zawe zitakibasha gukora isuku mu myanda n'amazi y'inyongera mu maraso yawe neza. Ibi bikunda kubaho igihe imikorere y'impyiko imanuka munsi ya 10-15% y'ubushobozi busanzwe. Hatabayeho ubu buvuzi, uburozi bukomeye n'amazi byakwiyongera mu mubiri wawe, bigatuma ugira ibibazo bikomeye by'ubuzima.

Muganga wawe ashobora kugusaba gukoresha dialysis ya peritoneal niba urwaye indwara y'impyiko yo ku rwego rwa nyuma iterwa na diyabete, umuvuduko ukabije w'amaraso, cyangwa izindi ndwara z'impyiko. Akenshi ihitwamo n'abantu bifuza ubwigenge n'ubushobozi bwo guhindura gahunda y'imivurire yabo ugereranije na hemodialysis ikorerwa mu kigo.

Ubu buvuzi bukora neza cyane ku bantu bagikora inkari, bafite ubushobozi bwiza bwo gukoresha intoki, kandi bakunda kwita ku buzima bwabo mu rugo. Abarwayi benshi basanga bikwiranye neza n'amasaha y'akazi, inshingano z'umuryango, n'ingendo kuko ushobora gukora ivunjana ahantu hose ufite ibikoresho bikwiye.

Ni iki gikorerwa muri dialysis ya peritoneal?

Uburyo bwa dialysis ya peritoneal butangirana n'uburyo bwo kubaga buto bwo gushyira catheter yawe. Iyi tube, ifite ubukana nk'ubwa pencil, ishyirwa mu nda yawe binyuze mu gace gato. Abantu benshi babikora nk'uburyo bwo kuvurwa hanze y'ibitaro kandi bashobora gutaha umunsi umwe.

Catheter yawe ikeneye ibyumweru 2-3 kugira ngo ikire neza mbere yo gutangira imivurire ya dialysis. Muri iki gihe, uzakora hamwe n'umuforomo wa dialysis kugira ngo wige uburyo bwo gukora ivunjana neza kandi umenye ibimenyetso byo kwandura cyangwa izindi ngorane.

Ivunjana ryose rikora mu ntambwe enye zoroheje ziba akamenyero hamwe no gukora:

1. Kuvana amazi ya dialysis yakoreshejwe mu nda yawe mu gikapu cyo gukusanyiriza
2. Uzuza inda yawe n'umuti mushya, utarimo mikorobe wa dialysis unyuze muri catheter
3. Reka amazi agume mu nda yawe amasaha 4-6 mugihe asukura amaraso yawe
4. Subiramo uburyo hamwe n'ivunjana rishya

Uburyo bwose bwo kuvunjana bufata iminota 30-40 y'igihe cyo gukora. Hagati y'ivunjana, urashobora gukora ibikorwa byawe bisanzwe mugihe amazi akora akazi kayo ko gusukura imbere mu nda yawe.

Ni gute witegura dialysis yawe ya peritoneal?

Kwitegura dialysis ya peritoneal bikubiyemo intambwe zombi zo mu mubiri no mu burezi kugira ngo umutekano wawe n'intsinzi byizwe. Itsinda ryawe ry'ubuvuzi rizagufasha mu mahugurwa yuzuye asanzwe afata icyumweru kimwe cyangwa bibiri kugira ngo arangire.

Mbere yo gutangira kuvurwa, uzakenera ibizamini byinshi by'ubuvuzi kugira ngo wemeze ko dialysis ya peritoneal ikwiriye kuri wowe. Ibi bikubiyemo ibizamini by'amaraso kugira ngo barebe imikorere y'impyiko zawe, isesengura ry'amashusho y'inda yawe, rimwe na rimwe kandi ikizamini gito kugira ngo barebe uburyo urugingo rwawe rwa peritoneal rusesa imyanda.

Ibi nibyo ushobora kwitega mugihe cyo kwitegura:

• Kwigira uko bimesa intoki neza no gukoresha uburyo butuma ibintu bitandura kugirango birinde indwara
• Kumenyera guhuza no gutandukanya catheter yawe neza
• Gusobanukirwa uburyo bwo gupima no kwandika imyanda yawe ivanwaho
• Kumenya ibimenyetso byo kwitondera bisaba ubufasha bwihuse bw'ubuvuzi
• Gushyiraho ahantu hasukuye, hagenewe ibikorwa byo mu rugo rwawe

Itsinda ryawe rya dialysis rizaganira kandi ku mirire yawe, imiti, n'imibereho yawe. Abantu benshi bashobora kugumana imirire isanzwe, nubwo ushobora gukenera gukurikirana ibirimo poroteyine no kugabanya ibiryo bimwe birimo fosifore cyangwa potasiyumu.

Uburyo bwo gusoma ibisubizo byawe bya dialysis ya peritoneal?

Gusobanukirwa ibisubizo byawe bya dialysis ya peritoneal bifasha kuguma ku murongo w'intego zawe zo kuvurwa. Itsinda ryawe ry'ubuvuzi rikoresha ibipimo byinshi byingenzi kugirango rimenye neza ko kuvurwa kwawe bikora neza kandi bigahindura umuti wawe niba bibaye ngombwa.

Igipimo cyingenzi ni igipimo cyawe cya Kt/V, kigaragaza uburyo kuvurwa kwawe gukuraho imyanda neza. Intego nziza ni 1.7 cyangwa hejuru yicyumweru iyo uhuza gusukura kwawe kwa dialysis n'imikorere y'impyiko isigaye ushobora kuba ufite.

Itsinda ryawe ry'ubuvuzi rizakurikirana kandi ibi bimenyetso byingenzi:

• Uburyo bwo gukuramo creatinine - bupima uburyo ibintu byangiza bikurwamo neza
• Gukuramo amazi - byemeza ko ukuramo amazi menshi neza
• Igeragezwa ryo kuringaniza peritoneal - rigenzura uburyo urwungano rwawe rwohereza imyanda vuba
• Uburyo umuvuduko w'amaraso n'uburemere bihinduka - byerekana uburyo amazi agenzurwa
• Agaciro ka laboratori nk'urugero rwa potasiyumu, fosifore, na hemoglobin

Imibare yose isuzumwa buri kwezi mugihe cyo gusura ivuriro. Umuti wawe wa dialysis ushobora guhindurwa bitewe n'ibi bintu, bishobora gusobanura guhindura imbaraga z'umuti wawe, igihe cyo gutegereza, cyangwa umubare w'imikorere ya buri munsi.

Ni gute wakoresha neza uburyo bwawe bwa peritoneal dialysis?

Gukoresha neza uburyo bwawe bwa peritoneal dialysis bikubiyemo gukurikiza gahunda yawe yategetswe kandi ugakomeza kugira ubuzima bwiza muri rusange. Amahitamo mato ya buri munsi ashobora gutuma havuka itandukaniro rinini muburyo ubuvuzi bwawe bukora.

Gukurikiza gahunda yawe yo guhanahana ni ngombwa kugirango ukomeze gukuraho imyanda neza. Kureka guhanahana cyangwa kugabanya igihe cyo gutegereza bishobora gutuma imyanda yiyongera no kubika amazi. Niba ukeneye guhindura igihe rimwe na rimwe, korana n'ikipe yawe y'ubuzima kugirango uhindure gahunda yawe neza.

Ibi bintu by'imibereho birashobora gufasha kunoza imikorere y'ubuvuzi bwawe:

• Kugira imirire myiza hamwe no kurya poroteyine ihagije
• Gukora imyitozo ngororamubiri ukurikije imbaraga zawe
• Kugenzura umuvuduko w'amaraso n'isukari mu maraso niba urwaye diyabete
• Kunywa imiti yategetswe buri gihe
• Kugumisha ahantu catheter isohokera hasukuye kandi humye
• Kwitabira gahunda zose z'abaganga

Uburyo bwawe bwa dialysis bushobora guhinduka uko igihe gihita, bityo kugenzura buri gihe bifasha kumenya ibibazo byose hakiri kare. Abantu bamwe bakeneye guhindukira kuri hemodialysis niba urwungano rwabo rwa peritoneal rutagikora neza mu gukuramo imyanda.

Ni ibihe bintu bishobora gutera ingorane mu kuvura indwara zifata urwungano rw'inda (peritoneal dialysis)?

Nubwo peritoneal dialysis muri rusange ari nziza, ibintu bimwe na bimwe bishobora kongera ibyago byo kugira ingorane. Kumva ibyo bintu bishobora gutera ingorane bifasha wowe n'ikipe yawe y'ubuzima gufata ingamba zo kwirinda no gukurikirana imiti yawe neza.

Ikintu cy'ingenzi cyane cyongera ibyago ni ukutagira isuku ihagije mugihe cyo guhindura amazi, ibyo bishobora gutera peritonitis - indwara y'urwungano rw'inda. Iyi ngorane ikomeye ifata abarwayi nka 1 kuri 18 buri mwaka, ariko imyitozo ikwiriye n'uburyo bwo gukora neza bushobora kugabanya cyane ibyo byago.

Indwara nyinshi n'imibereho bishobora kongera ibyago byo kugira ingorane:

• Uburwayi bwa diyabete, cyane cyane iyo isukari yo mu maraso itagenzurwa neza
• Kubagwa mu nda kwabayeho mbere byateje inkovu
• Indwara zifata urwungano rw'igifu cyangwa guhora ugorwa n'ifunguro
• Urwungano rw'ubuzima rwarushijeho gucika intege biturutse ku miti cyangwa indwara
• Kutagira ubushobozi bwo gukoresha intoki neza cyangwa ibibazo by'amaso bigira ingaruka ku buryo bwo gukora
• Kubaho ahantu hatagira isuku ihagije

Imyaka yonyine ntigutera kutemererwa gukoresha peritoneal dialysis, ariko abantu bakuze bashobora guhura n'ibindi bibazo byo gukoresha intoki cyangwa kwibuka uburyo bukomeye bwo gukora. Ubufasha bw'umuryango cyangwa ubufasha bwo kwitabwaho mu rugo bushobora gufasha gutsinda izo mbogamizi mu buryo bwizewe.

Ni izihe ngorane zishoboka zo kuvura indwara zifata urwungano rw'inda (peritoneal dialysis)?

Abantu benshi babaho neza bakoresha peritoneal dialysis, ariko nk'uko bimeze ku miti iyo ari yo yose, ingorane zirashobora kubaho. Kumenya ibibazo bishoboka bifasha kumenya ibimenyetso byo kuburira hakiri kare no gushaka ubuvuzi bwihuse igihe bibaye ngombwa.

Peritonitis ni ingorane ikomeye cyane, ibaho iyo mikorobe yinjira mu rwungano rw'inda yawe ikaba yatera indwara. Ibimenyetso bya mbere birimo amazi yo kuvura afite urujijo, kuribwa mu nda, umuriro, no kuruka. Hamwe n'imiti y'antibiyotike yihuse, ibibazo byinshi birakira rwose, ariko indwara zikomeye rimwe na rimwe zishobora kwangiza urwungano rw'inda yawe.

Izindi ngorane ugomba kumenya zirimo:

• Udukoko duterwa na kateteri ahantu kateteri isohokera ku ruhu rwawe
• Kateteri yiziba biturutse ku gushyiraho amaraso cyangwa ibibazo byo gushyirwa ahantu hatari ho
• Kuguma kw'amazi mu mubiri niba imiti yawe itavanaho amazi ahagije y'ikirenga
• Hernias iterwa no kongera umuvuduko mu nda mugihe cyo guhinduranya
• Urubavu rwo hasi rubabara biturutse ku buzito bw'amazi ya diyarese mu nda yawe
• Guta buhoro buhoro imikorere y'uruhu rw'inda nyuma y'igihe runaka

Ingorane nyinshi ziravurwa igihe zamenyekanye hakiri kare. Itsinda ry'abaganga bazakwigisha ibimenyetso byo kwitondera kandi baguhe amabwiriza asobanutse y'igihe ugomba guhamagara kugira ngo ufashwe. Inama zo kugenzura buri gihe zifasha kumenya ibibazo mbere yuko biba bikomeye.

Ni ryari ngomba kubona umuganga kubera impungenge za diyarese ya peritoni?

Kumenya igihe wahamagara itsinda ry'abaganga bawe birashobora gukumira ibibazo bito kuba ingorane zikomeye. Ikigo cyawe cya diyarese kigomba kuguha amakuru yo guhamagara amasaha 24 ku byerekeye impungenge zihutirwa zitagomba gutegereza kugeza igihe cy'akazi gisanzwe.

Hamagara umuganga wawe ako kanya niba ubonye amazi ya diyarese afite urujijo asohoka mugihe cyo guhinduranya, kuko ibi akenshi byerekana peritonite. Izindi mpamvu zihutirwa zirimo kuribwa cyane mu nda, umuriro uri hejuru ya 100.4°F, cyangwa ibimenyetso byo kwandura kwa kateteri nk'ubutukura, kubyimba, cyangwa gusa umusonga ahantu kateteri isohokera.

Vugana n'itsinda ry'abaganga bawe vuba na bwangu kubera ibi bimenyetso biteye impungenge:

• Kugorana gusohora amazi ya diyarese cyangwa gukuraho amazi nabi
• Kuribwa mu nda cyangwa kuruka bidasanzwe mugihe cyo guhinduranya
• Kongera ibiro mu buryo butunguranye cyangwa kubyimba mu maguru yawe cyangwa mu maso
• Urugimbu rukomeye, kuruka, cyangwa kubura ubushake bwo kurya
• Kugufiha cyangwa kuribwa mu gituza
• Ukwangirika kwa kateteri cyangwa gukurwaho ku buryo butunguranye

Ntimugatindiganye guhamagara niba mufite ibibazo cyangwa impungenge, kabone niyo byaba bisa nk'ibitari iby'ingenzi. Itsinda ryanyu rishinzwe diyarese rishaka gukemura ibibazo bito hakiri kare kurusha uko ryahangana n'ingorane zikomeye nyuma. Imyifatire isanzwe ifasha kumenya neza ko imivurire yanyu ikora neza.

Ibikunze kubazwa kuri diyarese ya peritoni

Q1: Ese diyarese ya peritoni ikora neza nk'uko diyarese ya hemodiyarese ikora?

Diyarese ya peritoni ishobora gukora neza nk'uko hemodiyarese ikora iyo ikozwe neza kandi igakorwa buri gihe. Ubushakashatsi bwerekana ko urugero rwo kubaho rumeze kimwe hagati y'izo mvurire zombi, cyane cyane mu myaka mike ya mbere. Ikintu cy'ingenzi ni ukurikiza gahunda yanyu yategetswe kandi mugakoresha uburyo bwiza.

Diyarese ya peritoni ikora buri gihe kandi buhoro, ibyo abantu bamwe babona ko byoroshye ku mubiri wabo kurusha impinduka zihuse z'amazi za hemodiyarese. Ariko, imikorere yayo iterwa n'ibintu nk'imikorere y'impyiko zanyu zisigaye, uburyo urugingo rwanyu rwa peritoni rusesa imyanda neza, n'ubushobozi bwanyu bwo gukora impinduka neza.

Q2: Ese nshobora kugenda nkiri kuri diyarese ya peritoni?

Yego, urashobora kugenda ukoresha diyarese ya peritoni, nubwo bisaba gutegura mbere no guhuza ibikorwa n'ikigo cyanyu gishinzwe diyarese. Abarwayi benshi babona ko iyi mikorere yoroshye ari kimwe mu byiza bikomeye bya diyarese ya peritoni ugereranije na hemodiyarese ikorerwa mu kigo.

Itsinda ryanyu rishinzwe diyarese rishobora gutegura ko ibikoresho byoherezwa aho ujya cyangwa bakagufasha gushaka ibigo bya diyarese bishobora gutanga ubufasha mu rugendo rwawe. Uzaba ukeneye gupakira ibikoresho byera neza kandi ugakomeza gahunda yanyu y'impinduka mugihe uri mu rugendo.

Q3: Nshobora kumara igihe kingana iki kuri diyarese ya peritoni?

Abantu benshi bashobora kumara imyaka 5-7 kuri diyarese ya peritoni, nubwo bamwe bakomeza neza igihe kirekire cyane. Ikintu cy'ingenzi kibuza ni akenshi impinduka buhoro buhoro mu rugingo rwawe rwa peritoni zituma itagikora neza mu gusesa imyanda uko igihe kigenda.

Itsinda ryawe rishinzwe ubuzima rikurikirana imikorere y'imiti yawe buri gihe kandi rizaganira ku buryo bwo gufata icyemezo niba dialysis ya peritoneal itagikora neza. Abantu bamwe bageza igihe bagahindukirira hemodialysis, mu gihe abandi bashobora kuba abakandida bo gushyirwaho impyiko.

Q4: Ese dialysis ya peritoneal izagira ingaruka ku rwego rwanjye rwo kurya no kubyibuha?

Dialysis ya peritoneal ishobora kugira ingaruka ku rwego rwawe rwo kurya no kubyibuha mu buryo butandukanye. Umuti wa dialysis urimo isukari umubiri wawe winjiza, bishobora gutuma wongera ibiro kandi bikagabanya inzara yawe mu gihe cyo kurya.

Abantu benshi basanga ubushake bwabo bwo kurya burushaho gukomera iyo batangira dialysis kuko kwiyongera kw'uburozi byabateraga kumva batameze neza. Gukorana n'umuganga w'imirire w'impyiko bifasha kuringaniza ibyo ukeneye mu mirire mu gihe ucunga impinduka zose z'ibiro zituruka ku kuvurwa.

Q5: Nshobora gukora nkanakora dialysis ya peritoneal?

Abantu benshi barashobora gukomeza gukora bakoresha dialysis ya peritoneal, cyane cyane niba bashobora gutegura gahunda yoroshye yo guhinduranya. Ubushobozi bwo gukoresha ubuvuzi ahantu hose n'igihe gito cyo gukoresha intoki bituma bikwiranye n'ahantu henshi hakorerwa akazi.

Ushobora gukenera kuganira n'umukoresha wawe ku bijyanye n'ibyo wakora, nko kugira icyumba cyiza, cyihariye cyo guhinduranya cyangwa ibihe byoroshye byo kuruhuka. Abarwayi benshi basanga dialysis ya peritoneal ibafasha gukomeza gahunda zisanzwe zo gukora ugereranije na hemodialysis ikorerwa mu kigo.