Yini i-Hemodialysis? Inhloso, Inqubo & Nemiphumela

I-Hemodialysis ukwelashwa kwezokwelapha okuhlambulula igazi lakho uma izinso zakho zingasakwazi ukukwenza kahle. Cabanga ngayo njengesinso sokwenziwa esihlunga imikhiqizo yemfucuza, amanzi amaningi, kanye nobuthi emgudwini wakho wegazi sisebenzisa umshini okhethekile nesihlungi.

Lokhu kwelashwa okusindisa impilo kuba ngesidingo lapho isifo sezinso esingamahlalakhona siqhubekela ekuhlulekeni kwezinso, okubuye kubizwe ngokuthi isifo sezinso esiphela. Ngenkathi umqondo wokuxhunywa emshinini ungase uzizwe ukhulu ekuqaleni, izigidi zabantu emhlabeni wonke ziphila impilo egcwele, enenjongo nge-hemodialysis.

Yini i-hemodialysis?

I-Hemodialysis ukwelashwa okuthatha indawo yezinso okwenza umsebenzi izinso zakho ezivame ukuwenza. Igazi lakho ligeleza ngamashubhu amancane liye emshinini we-dialysis, lapho lidlula khona esihlungini esikhethekile esibizwa nge-dialyzer.

I-dialyzer iqukethe izinkulungwane zemicu emincane esebenza njengesihlungo. Njengoba igazi lakho lihamba ngalezi zintambo, imikhiqizo yemfucuza kanye noketshezi olwengeziwe kudlula ngembrane ngenkathi amaseli akho egazi ahlanzekile namaprotheni abalulekile ehlala emgudwini wakho wegazi.

Igazi elihlanzekile libuye libuyele emzimbeni wakho ngelinye ishubhu. Le nqubo ivame ukuthatha amahora angu-3-5 futhi yenzeka kathathu ngesonto esikhungweni se-dialysis noma ngezinye izikhathi ekhaya.

Kungani kwenziwa i-hemodialysis?

I-Hemodialysis iba yisidingo lapho izinso zakho zilahlekelwa cishe ngama-85-90% womsebenzi wazo. Kuleli qophelo, umzimba wakho awukwazi ukukhipha ngempumelelo imikhiqizo yemfucuza, amanzi amaningi, futhi ugcine ibhalansi efanele yamakhemikhali egazini lakho.

Ngaphandle kwalolu kwelashwa, ubuthi obuyingozi bungazakha ohlelweni lwakho, okubangela izinkinga ezinkulu. Udokotela wakho uzoncoma i-hemodialysis lapho umsebenzi wakho wezinso wehla ezingeni lapho umzimba wakho ungasakwazi ukugcina impilo enhle uwedwa.

Izimo ezivame kakhulu eziholela ekudingeni i-hemodialysis zihlanganisa isifo sikashukela, umfutho wegazi ophezulu, isifo sezinso se-polycystic, kanye nezifo ze-autoimmune ezilimaza izinso ngokuhamba kwesikhathi.

Yini inqubo ye-hemodialysis?

Inqubo ye-hemodialysis ilandela inqubo eqaphelayo, yesinyathelo ngesinyathelo eyenzelwe ukuphepha kwakho nokunethezeka kwakho. Ngaphambi kokwelashwa kwakho kokuqala, uzodinga inqubo encane yokuhlinzwa ukuze udale ukufinyelela kwemithambo, okunikeza umshini we-dialysis indlela yokufinyelela ngqo emgudwini wakho wegazi.

Nakhu okwenzekayo ngesikhathi seseshini ngayinye ye-dialysis:

1. Ithimba lakho le-dialysis likuxhuma emshinini usebenzisa ukufinyelela kwakho kwemithambo
2. Igazi ligeleza emzimbeni wakho ngamashubhu liye ku-dialyzer
3. I-dialyzer ihlunga imfucuza, ubuthi, kanye noketshezi oluningi egazini lakho
4. Igazi elihlanzekile libuyela emzimbeni wakho ngamashubhu ahlukene
5. Le nqubo iyaqhubeka amahora angu-3-5 ngenkathi uphumula, ufunda, noma ubuka i-TV

Kuyo yonke le nqubo yokwelashwa, imishini iqapha umfutho wakho wegazi, izinga lokushaya kwenhliziyo, kanye nezinga lokususwa koketshezi. Ithimba lakho le-dialysis lihlala eduze ukuze liqinisekise ukuthi konke kuhamba kahle futhi lilungise izilungiselelo uma kudingeka.

Ungalungela kanjani i-hemodialysis yakho?

Ukulungiselela i-hemodialysis kuhilela ukulungela ngokomzimba nangokomzwelo. Ithimba lakho lokunakekelwa kwezempilo lizokuqondisa esinyathelweni ngasinye, kodwa ukuqonda okukulindele kungasiza ekudambiseni noma yikuphi ukukhathazeka.

Okokuqala, uzodinga ukuthi kwakhiwe ukufinyelela kwemithambo, okuvame ukwenziwa emasontweni ambalwa ngaphambi kokuqala i-dialysis. Lokhu kungase kube yi-arteriovenous fistula, i-graft, noma i-catheter yesikhashana evumela igazi ukuthi ligeleze liye futhi livela emshinini we-dialysis.

Ngaphambi kweseshini ngayinye yokwelashwa, kunezinto eziningana ongazenza ukuze ulungiselele:

• Thatha imithi yakho njengoba kunqunywe, ngaphandle uma udokotela wakho ekweluleka ngenye indlela
• Yidla ukudla okulula noma ukudla okulula ngaphambi kokwelashwa ukuvimbela ushukela ophansi wegazi
• Gqoka izingubo ezikhululekile, ezikhululekile ezinemikhono ezingaqoqwa kalula
• Letha ukuzijabulisa okufana nezincwadi, amaphilisi, noma umculo weseshini yamahora angu-3-5
• Gcina umkhondo wokuthi ungakanani uketshezi oluphuzayo phakathi kokwelashwa

Ithimba lakho le-dialysis lizokufundisa ngezinguquko zokudla ezingakusiza uzizwe ungcono futhi zenze ukwelashwa kuphumelele kakhulu. Le nqubo yokufundisa iyancipha futhi iyasekela, ikunikeza isikhathi sokuzivumelanisa.

Ungazifunda kanjani imiphumela yakho ye-hemodialysis?

Ukuqonda imiphumela yakho ye-dialysis kukusiza ukuthi ulandelele ukuthi ukwelashwa kusebenza kahle kangakanani. Ithimba lakho lezempilo lizochaza lezi zinombolo ngemininingwane, kodwa nazi izilinganiso ezibalulekile abaziqaphayo.

Isilinganiso esibaluleke kakhulu sibizwa ngokuthi i-Kt/V, ekhombisa ukuthi i-dialysis isusa ngempumelelo kangakanani udoti egazini lakho. I-Kt/V engu-1.2 noma ngaphezulu ikhombisa i-dialysis eyanele, nakuba okuhlosiwe kwakho kungase kwehluke ngokusekelwe ezidingweni zakho.

Ezinye izilinganiso ezibalulekile zihlanganisa:

• URR (Urea Reduction Ratio): Kufanele ibe ngu-65% noma ngaphezulu
• Izinga lokususwa koketshezi: Kungakanani amanzi amaningi asuswa ngesikhathi sokwelashwa
• Ushintsho lwengcindezi yegazi: Kuqashwe ngaphambi, ngesikhathi, nangemva kokwelashwa
• Amanani elebhu: Kubandakanya i-potassium, i-phosphorus, kanye namazinga e-hemoglobin

Ithimba lakho le-dialysis libukeza le miphumela njalo futhi lilungise uhlelo lwakho lokwelashwa njengoba kudingeka. Unganqikazi ukubuza imibuzo mayelana nokuthi lezi zinombolo zisho ukuthini empilweni yakho nenhlalakahle yakho.

Ungayithuthukisa kanjani ukwelashwa kwakho kwe-hemodialysis?

Ukwenza inzuzo enkulu ku-hemodialysis kuhilela ukusebenza eduze nethimba lakho lezempilo nokwenza izinguquko ezithile zokuphila. Izindaba ezinhle ukuthi izinguquko ezincane zingenza umehluko omkhulu endleleni ozizwa ngayo.

Ukulandela ukudla okubekiweyo kungenye yezinto ezibaluleke kakhulu ongazenza. Lokhu ngokuvamile kusho ukukhawulela i-sodium, i-potassium, i-phosphorus, kanye nokungeniswa kwamanzi phakathi kokwelashwa. Udokotela wakho wokudla uzokusiza ukuthi udale izinhlelo zokudla ezinomsoco futhi ezijabulisayo.

Ukuphuza imithi yakho ngqo njengoba kuchaziwe kubaluleke ngokulinganayo. Lokhu kungabandakanya izibopho ze-phosphate, imithi yokwehlisa umfutho wegazi, noma ukwelashwa kwe-anemia. Umuthi ngamunye usebenza ngenjongo ethile yokukugcina uphilile.

Ukuya njalo emaseshini e-dialysis kubalulekile. Ukweqa ukwelashwa noma ukuwanqamula ngaphambi kwesikhathi kungaholela ekwakhekeni okuyingozi kwama-toxin kanye noketshezi emzimbeni wakho. Uma unenkinga ngeshejuli, khuluma nethimba lakho ngezixazululo ezingenzeka.

Ziyini izici eziyingozi zokudinga i-hemodialysis?

Izimo eziningana nezici zingakhuphula ingozi yakho yokuthuthukisa ukuhluleka kwezinso okudinga i-hemodialysis. Ukuqonda lezi zici eziyingozi kungasiza ekutholakaleni kwasekuqaleni kanye nokuvimbela uma kungenzeka.

Isifo sikashukela siyimbangela ehamba phambili yokuhluleka kwezinso emazweni amaningi. Amazinga kashukela aphezulu egazini ngokuhamba kwesikhathi angalimaza imithambo emincane yegazi ezinso zakho, kancane kancane anciphise ikhono lazo lokuhlunga imfucuza ngempumelelo.

Izici eziyingozi ezivame kakhulu zihlanganisa:

• Isifo sikashukela (ikakhulukazi uma singalawulwa kahle)
• Umfutho wegazi ophezulu olimala imithambo yegazi ezinso
• Umlando womndeni wesifo sezinso
• Ubudala obungaphezu kwama-60, njengoba ukusebenza kwezinso kwehla ngokwemvelo
• Isifo senhliziyo nemithambo yegazi
• Ukukhuluphala ngokweqile
• Ukubhema

Izici eziyingozi ezingavamile kodwa ezibalulekile zihlanganisa izifo ze-autoimmune ezifana ne-lupus, isifo sezinso se-polycystic, kanye nemithi ethile engalimaza izinso ngokuhamba kwesikhathi. Abanye abantu bangase babe nezimo zofuzo ezithinta ukusebenza kwezinso.

Ziyini izinkinga ezingenzeka ze-hemodialysis?

Ngenkathi i-hemodialysis ngokuvamile iphephile futhi iyabekezeleleka, njenganoma yikuphi ukwelashwa kwezokwelapha, ingaba nemiphumela emibi ethile kanye nezinkinga. Iningi lalezi liyalawuleka ngokunakekelwa okufanele nokuqapha.

Imiphumela emibi evame kakhulu yenzeka ngesikhathi noma ngemva nje kokwelashwa futhi ngokuvamile iyathuthuka njengoba umzimba wakho uzivumela. Lokhu kuhlanganisa imisipha eqinile, isiyezi, isicanucanu, nokukhathala njengoba umzimba wakho uzivumela ekuguqukeni kwamanzi namakhemikhali.

Izinkinga ezingathi sína kodwa ezingavamile zingahlanganisa:

• Ukwehla kwegazi ngesikhathi sokwelashwa
• Ukutheleleka endaweni yokufinyelela
• Amaqhubu egazi ekufinyeleleni
• Ukushaya kwenhliziyo okungajwayelekile
• I-Air embolism (ayivamile kakhulu)

Izinkinga ezihlobene nokufinyelela zingase zidinge izinqubo ezengeziwe zokugcina noma ukushintsha ukufinyelela kwakho kwemithambo. Ithimba lakho le-dialysis liqapha lezi zinkinga futhi lithatha izinyathelo zokuzivimbela uma kungenzeka.

Izinkinga zesikhathi eside zingahlanganisa isifo samathambo, i-anemia, nezinkinga zenhliziyo nemithambo yegazi. Kodwa-ke, ngokwelashwa okufanele nokuphathwa kwendlela yokuphila, abantu abaningi banciphisa lezi zingozi futhi bagcine izinga elihle lempilo.

Kufanele ngibone nini udokotela mayelana ne-hemodialysis?

Uma usuvele use-hemodialysis, kufanele uthinte ithimba lakho lezempilo ngokushesha uma uhlangabezana nezimpawu ezithile zokuxwayisa. Lezi zingase zibonise izinkinga ezidinga ukunakwa ngokushesha.

Shayela isikhungo sakho se-dialysis noma udokotela ngokushesha uma uqaphela izimpawu zokutheleleka endaweni yakho yokufinyelela, njengobubomvu, ukufudumala, ukuvuvukala, noma ukukhipha. Umkhuhlane, ama-chills, noma ukuzizwa ungajwayelekile kufanele futhi kuqhubeke nokunakekelwa kwezokwelapha ngokushesha.

Ezinye izimo ezidinga ukunakekelwa okuphuthumayo zihlanganisa:

• Ukuphefumula kanzima okukhulu noma ubuhlungu besifuba
• Ukuphuma kwegazi okukhulu endaweni yakho yokufinyelela
• Izimpawu zamaqhubu egazi, njengokuvuvukala engalweni yakho noma emlenzeni
• Isicanucanu esikhulu, ukuhlanza, noma ukungakwazi ukugcina uketshezi phansi
• Ushintsho endaweni yakho yokufinyelela, njengokulahlekelwa umuzwa wokudlidliza

Kulabo abangakaqali ukuhlanza izinso, xoxa ngethuba nodokotela wakho wezinso uma uhlangabezana nezimpawu ezinjengokukhathala okuqhubekayo, ukuvuvukala, izinguquko ekuchameni, noma isicanucanu. Ukuhlela kusenesikhathi ukuhlanza izinso, uma kudingeka, kuholela emiphumeleni engcono.

Imibuzo evame ukubuzwa mayelana nokuhlanza izinso

Umbuzo 1. Ingabe ukuhlanza izinso kubuhlungu?

Ukuhlanza izinso ngokwako akubuhlungu, nakuba ungase uzwe ukungakhululeki lapho izinaliti zifakwa endaweni yakho yokufinyelela. Abantu abaningi bachaza lokhu njengokufana nokudonswa kwegazi noma ukuthola i-IV.

Ngesikhathi sokwelashwa, ungase uhlangabezane nama-cramps emisipha noma uzizwe ukhathele njengoba umzimba wakho ujwayela izinguquko zamanzi. Lezi zinzwa ngokuvamile ziyathuthuka njengoba ujwayela inqubo futhi ukwelashwa kwakho kulungiselelwa.

Umbuzo 2. Umuntu angaphila isikhathi esingakanani ekuhlanzeni izinso?

Abantu abaningi baphila iminyaka eminingi noma ngisho namashumi eminyaka ekuhlanzeni izinso, kuye ngempilo yabo yonke, ubudala, nokuthi balandela kahle kangakanani uhlelo lwabo lokwelashwa. Ezinye iziguli ziphila iminyaka engama-20 noma ngaphezulu ngokuhlanza izinso.

Ukwazi kwakho ukuphila kuncike ezintweni eziningi, okuhlanganisa izimo zakho zempilo ezingaphansi, ukuthi ukulawula kanjani ukudla kwakho nemithi, nokuthi ungumuntu ofanele ukufakelwa izinso.

Umbuzo 3. Ngingahamba ngenkathi ngikuhlanza izinso?

Yebo, ungahamba ngenkathi ukuhlanza izinso ngokuhlela okufanele. Izikhungo eziningi zokuhlanza izinso zinezinhlelo ezikuvumela ukuthi uthole ukwelashwa ezindaweni ezahlukene, okuhlanganisa nezindawo zokuvakasha.

Kuzodingeka ukuthi uhlele ukwelashwa lapho uya khona kusenesikhathi futhi uhlele nethimba lakho lokuhlanza izinso lasekhaya. Abanye abantu bafunda nokwenza ukuhlanza izinso ekhaya, okunganikeza ukuguquguquka okwengeziwe ekuhambeni.

Umbuzo 400 Ngingasebenza ngenkathi ngikuhlanza izinso?

Abantu abaningi baqhubeka nokusebenza ngenkathi bekuhlanza izinso, ikakhulukazi uma bengahlela amashejuli aguquguqukayo. Ezinye izikhungo zokuhlanza izinso zinikeza izikhathi zakusihlwa noma zasekuseni ukuze zivumelane namashejuli omsebenzi.

Ikhono lakho lokusebenza lincike ezidingweni zomsebenzi wakho, indlela ozizwa ngayo ngesikhathi nangemva kokwelashwa, kanye nempilo yakho iyonke. Abanye abantu basebenza isikhathi esigcwele, kanti abanye bangase badinge ukunciphisa amahora abo noma bashintshe uhlobo lomsebenzi wabo.

Q.5 Yini umehluko phakathi kwe-hemodialysis kanye ne-peritoneal dialysis?

I-Hemodialysis isebenzisa umshini ukuhlunga igazi lakho ngaphandle komzimba wakho, kanti i-peritoneal dialysis isebenzisa umugqa wesisu sakho (peritoneum) njengesihlungi semvelo ngaphakathi emzimbeni wakho.

I-Hemodialysis ngokuvamile yenziwa kathathu ngesonto esikhungweni, kanti i-peritoneal dialysis ivame ukwenziwa nsuku zonke ekhaya. Udokotela wakho wezinso uzokusiza ukuthi unqume ukuthi yiluphi uhlobo olungase lube ngcono ngendlela yakho yokuphila nezidingo zakho zezokwelapha.