Iyini i-Peritoneal Dialysis? Inhloso, Amazinga/Inqubo & Imiphumela

I-Peritoneal dialysis iyindlela enobumnene yokuhlanza igazi lakho uma izinso zakho zingakwazi ukwenza umsebenzi wazo ngendlela efanele. Esikhundleni sokusebenzisa umshini njenge-dialysis yendabuko, lokhu kwelashwa kusebenzisa umugqa wemvelo ngaphakathi kwesisu sakho obizwa ngokuthi i-peritoneum njengesihlungi. Uketshezi olukhethekile lugeleza esiswini sakho, lukhipha imfucuza namanzi engeziwe egazini lakho, bese lukhishelwa ngaphandle, luthatha ubuthi nalo.

Iyini i-peritoneal dialysis?

I-Peritoneal dialysis isebenza ngokuguqula isisu sakho sibe uhlelo lokuhlunga lwemvelo. I-peritoneum yakho iyi-membrane encane, ebushelelezi elayini umgodi wakho wesisu futhi emboza izitho zakho njengengubo yokuzivikela. Le membrane inemithambo yegazi emincane egeleza kuyo, okuyenza ilungele ukuhlunga imfucuza egazini lakho.

Ngesikhathi sokwelashwa, ithubhu elithambile elibizwa nge-catheter lihlala libekwe unomphela esiswini sakho. Uketshezi oluhlanzekile lwe-dialysis lugeleza ngale catheter lungene emgodini wakho wesisu, lapho luhlala khona amahora amaningana. Uketshezi lwenza njengozibuthe, lukhipha imikhiqizo yemfucuza namanzi amaningi egazini lakho ngembrane ye-peritoneal.

Ngemuva kokuthi inqubo yokuhlanza isiqediwe, ukhipha uketshezi olusetshenzisiwe ngale catheter efanayo. Le nqubo ibizwa ngokuthi ukushintshana, futhi abantu abaningi bayenza izikhathi ezi-3-4 nsuku zonke. Ukushintshana ngakunye kuthatha imizuzu engaba ngu-30-40, kukunikeza ukuguquguquka kokukwenza ekhaya, emsebenzini, noma ngabe uzizwa ukhululekile kuphi.

Kungani kwenziwa i-peritoneal dialysis?

I-Peritoneal dialysis iba yimpoqo lapho izinso zakho zilahlekelwa ikhono lazo lokuhlunga imfucuza noketshezi oluningi egazini lakho ngempumelelo. Lokhu kuvamile ukwenzeka lapho ukusebenza kwezinso kwehlela ngaphansi kuka-10-15% womthamo ojwayelekile. Ngaphandle kwalolu kwelashwa, ubuthi obuyingozi noketshezi luzokwakheka emzimbeni wakho, okuholela ezinkingeni ezinkulu zempilo.

Udkt wakho angase ancome ukuhlanjululwa kwegazi ngesisu uma unesifo sezinso esiphelile esibangelwa yisifo sikashukela, umfutho wegazi ophezulu, noma ezinye izimo zezinso. Ngokuvamile kukhethwa abantu abafuna ukuzimela okwengeziwe nokuguquguquka esimisweni sabo sokwelashwa uma kuqhathaniswa nokuhlanjululwa kwegazi ngesisu okwenziwa esikhungweni.

Lokhu kwelashwa kusebenza kahle kakhulu kubantu abasenza umchamo, abanobuchule obuhle bokusebenzisa izandla, futhi abakhetha ukuphatha ukunakekelwa kwabo ekhaya. Iziguli eziningi zikuthola kulungela kangcono izimiso zomsebenzi, imithwalo yemfanelo yomndeni, nezinhlelo zokuhamba ngoba ungenza ukushintshana noma yikuphi nempahla efanele.

Yini inqubo yokuhlanjululwa kwegazi ngesisu?

Inqubo yokuhlanjululwa kwegazi ngesisu iqala ngenqubo encane yokuhlinzwa ukufaka ikhathetha yakho. Le tube, cishe ingqongqo yomshini, ifakwa esiswini sakho ngokusikeka okuncane. Abantu abaningi bakwenza lokhu njengenqubo yeziguli eziphuthumayo futhi bangahamba ngosuku olufanayo.

Ikhathetha yakho idinga amasonto angu-2-3 ukuze iphole kahle ngaphambi kokuthi uqale ukwelashwa kokuhlanjululwa kwegazi. Ngesikhathi esifanayo, uzosebenza nomhlengikazi wokuhlanjululwa kwegazi ukuze ufunde ukuthi ungakwenza kanjani ukushintshana ngokuphepha futhi ubone izimpawu zokutheleleka noma ezinye izinkinga.

Ukushintshana ngakunye kulandela izinyathelo ezine ezilula eziba yinto ejwayelekile ngokuzijwayeza:

1. Khipha uketshezi lokuhlanjululwa kwegazi olusetshenzisiwe esiswini sakho esikhwameni sokuqoqa
2. Gcwalisa isisu sakho ngesisombululo sokuhlanjululwa kwegazi esisha, esingenazo izinto ezingcolile ngesikhathi sekhathetha
3. Vumela uketshezi luhlale esiswini sakho amahora angu-4-6 ngenkathi lihlambulula igazi lakho
4. Phinda inqubo ngokushintshana okusha

Yonke inqubo yokushintshana ithatha imizuzu engaba ngu-30-40 yesikhathi sokusebenza. Phakathi kokushintshana, ungaqhubeka nemisebenzi yakho ejwayelekile ngenkathi uketshezi lwenza umsebenzi walo wokuhlanza ngaphakathi esiswini sakho.

Ungalungiselela kanjani ukuhlanjululwa kwegazi ngesisu sakho?

Ukulungiselela i-peritoneal dialysis kuhilela izinyathelo zomzimba nezemfundo ukuqinisekisa ukuphepha kwakho nempumelelo yakho. Ithimba lakho lokunakekelwa kwezempilo lizokuqondisa ngokuqeqeshwa okubanzi okuvame ukuthatha amasonto angu-1-2 ukuqeda.

Ngaphambi kokuqala ukwelashwa, uzodinga izivivinyo eziningana zezokwelapha ukuze uqiniseke ukuthi i-peritoneal dialysis ikulungele. Lokhu kufaka phakathi izivivinyo zegazi ukuhlola ukusebenza kwezinso zakho, izifundo zokucabanga zesisu sakho, futhi ngezinye izikhathi ukuhlolwa okuncane ukubona ukuthi imembrane yakho ye-peritoneal ihlunga kahle kangakanani udoti.

Nakhu ongakulindela ngesikhathi sokulungiselela kwakho:

• Ukufunda ukugeza izandla ngendlela efanele kanye ne-sterile technique ukuvimbela izifo
• Ukuqeqeshwa ukuxhuma nokunqamula i-catheter yakho ngokuphepha
• Ukuqonda indlela yokukala nokurekhoda ukususwa kwamanzi akho
• Ukuqaphela izimpawu zokuxwayisa ezidinga ukunakekelwa kwezempilo ngokushesha
• Ukusetha indawo ehlanzekile, ezinikele ekhaya lakho ukuze utshintshane

Ithimba lakho le-dialysis lizoxoxa ngokudla kwakho, imithi, nokulungiswa kwendlela yokuphila. Abantu abaningi bangagcina imikhuba yokudla ejwayelekile, nakuba kungase kudingeke ukuthi uqaphele ukudla kwamaprotheni futhi ukhawulele ukudla okuthile okunama-phosphorus noma i-potassium ephezulu.

Ungazifunda kanjani imiphumela yakho ye-peritoneal dialysis?

Ukuqonda imiphumela yakho ye-peritoneal dialysis kukusiza ukuthi uhlale emgwaqeni ngezinhloso zakho zokwelashwa. Ithimba lakho lokunakekelwa kwezempilo liqapha izilinganiso ezimbalwa ezibalulekile ukuqinisekisa ukuthi ukwelashwa kwakho kusebenza ngempumelelo futhi kulungise imiyalelo yakho uma kudingeka.

Isilinganiso esibaluleke kakhulu yi-Kt/V ratio yakho, ekhombisa ukuthi ukwelashwa kwakho kukhipha kahle kangakanani imikhiqizo yodoti. Umgomo onempilo ngokuvamile uyi-1.7 noma ngaphezulu ngesonto uma uhlanganisa ukususwa kwe-dialysis yakho nanoma yimuphi umsebenzi wezinso osele ongase ube nawo.

Ithimba lakho lezokwelapha lizolandela lezi zinkomba ezibalulekile:

• Ukuvunywa kwe-Creatinine - kulinganisa ukuthi imikhiqizo yemfucuza isuswa kahle kangakanani
• Ukususwa kwamanzi - kuqinisekisa ukuthi ususa inani elifanele lamanzi amaningi
• Ukuhlolwa kokulinganiswa kwe-peritoneal - kuhlola ukuthi imembrane yakho ithutha ngokushesha kangakanani imfucuza
• Ukuthambekela kwengcindezi yegazi nesisindo - kubonisa ukulawulwa kokulinganiswa kwamanzi
• Amanani elebhu afana ne-potassium, i-phosphorus, kanye namazinga e-hemoglobin

Lezi zinombolo zibuyekezwa njalo ngenyanga ngesikhathi sokuvakasha kwakho emtholampilo. Umuthi wakho wokuhlanza igazi ungase ulungiswe ngokusekelwe kulezi ziphumo, okungasho ukushintsha amandla akho esixazululo, izikhathi zokuhlala, noma inani lokushintshana kwansuku zonke.

Ungayithuthukisa kanjani ukwelashwa kwakho kwe-peritoneal dialysis?

Ukwenza okuningi ekwelashweni kwakho kwe-peritoneal dialysis kuhilela ukulandela isimiso sakho esinqunyiwe ngokuqhubekayo nokugcina imikhuba emihle yempilo yonke. Izinqumo ezincane zansuku zonke zingenza umehluko omkhulu ekusebenzeni kahle kokwelashwa kwakho.

Ukunamathela esimisweni sakho sokushintshana kubalulekile ekugcineni ukususwa kwemfucuza okungaguquki. Ukweqa ukushintshana noma ukunciphisa izikhathi zokuhlala kungaholela ekwakhekeni kwama-toxin nokugcinwa kwamanzi. Uma udinga ukulungisa isikhathi ngezikhathi ezithile, sebenzisana nethimba lakho lezempilo ukuze uguqule isimiso sakho ngokuphepha.

Lezi zici zokuphila zingasiza ekuthuthukiseni ukusebenza kokwelashwa kwakho:

• Ukugcina ukudla okunomsoco okufanele ngokuphuza amaprotheni anele
Ukuhlala usebenza ngokomzimba ngaphakathi kwamazinga akho wamandla
• Ukuphatha ingcindezi yegazi noshukela wegazi uma unesifo sikashukela
• Ukuphuza imithi enqunyiwe ngokuqhubekayo
• Ukugcina indawo yakho yokuphuma kwe-catheter ihlanzekile futhi yomile
• Ukuya kuwo wonke ama-aphoyintimenti ezokwelapha ahleliwe

Ukwanela kwakho ukuhlanza igazi kungashintsha ngokuhamba kwesikhathi, ngakho ukuqapha njalo kusiza ukubamba noma yiziphi izinkinga ekuqaleni. Abanye abantu ekugcineni badinga ukushintshela ku-hemodialysis uma imembrane yabo ye-peritoneal iba ngaphansi kokusebenza ekuhlungeni imfucuza.

Ziyini izinto eziyingozi ezingabangela izinkinga ze-peritoneal dialysis?

Ngenkathi i-peritoneal dialysis ngokuvamile iphephile, izinto ezithile zingakhuphula ingozi yakho yezinkinga. Ukuqonda lezi zinto eziyingozi kukusiza wena nethimba lakho lezempilo ukuthi nithathe izinyathelo zokuvimbela futhi niqaphe ukwelashwa kwakho ngokucophelela.

Into eyingozi enkulu kakhulu ubuchwepheshe obungcolile obungahlelekile ngesikhathi sokushintshana, okungaholela ku-peritonitis - ukutheleleka kwembrane ye-peritoneal. Le nkinga enkulu ithinta cishe isiguli esingu-1 kwabangu-18 ngonyaka, kodwa ukuqeqeshwa okufanele kanye nobuchwepheshe obuqaphelayo kunganciphisa kakhulu le ngozi.

Izimo eziningana zezempilo nezinto zokuphila zingakhuphula ingozi yakho yezinkinga:

• Isifo sikashukela, ikakhulukazi ngokulawulwa koshukela okungahambi kahle
• Ukuhlinzwa kwesisu kwangaphambilini okwenza izicubu ezinamanxeba
• Isifo samathumbu esivuvukalayo noma ukuqunjelwa njalo
• Ukuvikeleka komzimba okubuthakathaka ngenxa yemithi noma ukugula
• Ukungabi namakhono okusebenza ngesandla noma izinkinga zombono ezithinta inqubo
• Ukuphila ezindaweni ezingenazo izindlu zangasese ezihle

Ubudala bodwa abukukhiphi ekwenzeni i-peritoneal dialysis, kodwa abadala bangase babhekane nezinselelo ezengeziwe ngokuqeqeshwa ngesandla noma ukukhumbula izinqubo eziyinkimbinkimbi. Ukusekelwa komndeni noma usizo lokunakekelwa ekhaya kungasiza ukunqoba lezi zithiyo ngokuphepha.

Ziyini izinkinga ezingenzeka ze-peritoneal dialysis?

Abantu abaningi benza kahle nge-peritoneal dialysis, kodwa njenganoma yikuphi ukwelashwa kwezokwelapha, izinkinga zingenzeka. Ukuqaphela izinkinga ezingaba khona kukusiza ukuthi uqaphele izimpawu zokuxwayisa kusenesikhathi futhi ufune ukwelashwa okusheshayo uma kudingeka.

I-Peritonitis iyinkinga enkulu kakhulu, eyenzeka lapho amagciwane engena emgodini wakho we-peritoneal futhi abangele ukutheleleka. Izimpawu zakuqala zihlanganisa uketshezi lwe-dialysis olungcolile, ubuhlungu besisu, umkhuhlane, nesicanucanu. Ngokwelashwa ngama-antibiotic ngokushesha, amacala amaningi axazululwa ngokuphelele, kodwa izifo ezinzima ngezinye izikhathi zingalimala imbrane yakho ye-peritoneal.

Ezinye izinkinga okufanele wazi ngazo zihlanganisa:

• Izifo ezihlobene ne-catheter ezizungeze indawo yokuphuma esikhumbeni sakho
• Ukuvaleka kwe-Catheter evela kuma-fibrin clots noma izinkinga zokuma
• Ukugcinwa kwamanzi uma ukwelashwa kwakho kungasusi amanzi amaningi
• Ama-Hernias avela ekucindezelweni kwesisu okwandisiwe ngesikhathi sokushintshana
• Ubuhlungu obungemuva obuvela esisindweni samanzi e-dialysis esiswini sakho
• Ukulahleka kancane komsebenzi we-peritoneal membrane ngokuhamba kwesikhathi

Izinkinga eziningi ziyelapheka uma zitholwe ngesikhathi. Ithimba lakho lezempilo lizokufundisa izimpawu zokuxwayisa okufanele uziqaphele futhi linikeze imiyalelo ecacile mayelana nokuthi ungabiza nini usizo. Ukuqokwa okuvamile kokuqapha kusiza ukuthola izinkinga ngaphambi kokuba zibe zimbi.

Kufanele ngibone nini udokotela ngezinkinga ze-peritoneal dialysis?

Ukwazi ukuthi ungathintana nini nethimba lakho lezempilo kungavimbela izinkinga ezincane ukuthi zingabi yizinkinga ezinkulu. Isikhungo sakho se-dialysis kufanele sikunikeze imininingwane yokuxhumana yamahora angama-24 ngezinkinga eziphuthumayo ezingeke zilinde kuze kube amahora ebhizinisi avamile.

Shayela udokotela wakho ngokushesha uma uqaphela uketshezi lwe-dialysis oluyizimvu oluphuma ngesikhathi sokushintshana, njengoba lokhu kuvame ukukhombisa i-peritonitis. Ezinye izimpawu eziphuthumayo zihlanganisa ubuhlungu obukhulu besisu, umkhuhlane ongaphezu kuka-100.4°F, noma izimpawu zokutheleleka kwe-catheter njengobubomvu, ukuvuvukala, noma i-pus ezungeze indawo yakho yokuphuma.

Xhumana nethimba lakho lezempilo ngokushesha ngezimpawu ezikhathazayo:

• Ukuhluleka ukukhipha uketshezi lwe-dialysis noma ukususwa okuncane koketshezi
• Ubuhlungu obungavamile besisu noma ukuqaqamba ngesikhathi sokushintshana
• Ukuzuza isisindo okungazelelwe noma ukuvuvukala emilenzeni yakho noma ebusweni bakho
• Isicanucanu esiqhubekayo, ukuhlanza, noma ukulahlekelwa isifiso sokudla
• Ukuphefumula kanzima noma ubuhlungu besifuba
• Umonakalo we-Catheter noma ukunqanyulwa ngengozi

Unganqikazi ukushaya ucingo ngemibuzo noma izinkathazo, ngisho noma zibonakala zincane. Ithimba lakho le-dialysis lingathanda ukubhekana nezinkinga ezincane ekuqaleni kunokubhekana nezinkinga ezinzima kamuva. Ukuxhumana njalo kusiza ekuqinisekiseni ukuthi ukwelashwa kwakho kuqhubeka ngendlela efanele.

Imibuzo evame ukubuzwa mayelana ne-peritoneal dialysis

Umbuzo 1: Ingabe i-peritoneal dialysis isebenza kahle njenge-hemodialysis?

I-Peritoneal dialysis ingasebenza kahle njenge-hemodialysis uma yenziwa ngendlela efanele futhi njalo. Ucwaningo lubonisa ukuthi amazinga okusinda ayafana phakathi kokwelashwa okubili, ikakhulukazi eminyakeni embalwa yokuqala. Okubalulekile ukulandela isimiso sakho esinqunyiwe nokugcina indlela enhle.

I-Peritoneal dialysis isebenza ngokuqhubekayo futhi ngobumnene, okutholakala abanye abantu kulula emzimbeni wabo kunokushintsha okusheshayo koketshezi kwe-hemodialysis. Kodwa-ke, ukusebenza kahle kuncike ezintweni ezinjengomsebenzi wakho osele wezinso, ukuthi imembrane yakho ye-peritoneal ihlunga kahle kangakanani imfucuza, kanye nekhono lakho lokwenza ukushintshana ngendlela efanele.

Umbuzo 2: Ngingahamba ngenkathi ngise-peritoneal dialysis?

Yebo, ungahamba nge-peritoneal dialysis, nakuba idinga ukuhlelwa kusengaphambili nokuxhumana nesikhungo sakho se-dialysis. Iziguli eziningi zithola le ndlela yokuguquguquka njengenye yezinzuzo ezinkulu ze-peritoneal dialysis uma kuqhathaniswa ne-hemodialysis esikhungweni.

Ithimba lakho le-dialysis lingahlela ukuthi izinto zilethwe lapho uya khona noma likusize ekutholeni izikhungo ze-dialysis ezinganikeza ukwesekwa ngesikhathi sohambo lwakho. Uzodinga ukupakisha izinto eziyinyumba ngokucophelela futhi ugcine isimiso sakho sokushintshana ngenkathi uhamba.

Umbuzo 3: Ngingahlala isikhathi esingakanani ku-peritoneal dialysis?

Abantu abaningi bangahlala ku-peritoneal dialysis iminyaka engu-5-7, nakuba abanye beqhubeka ngempumelelo isikhathi eside. Into enkulu ekhawulelayo ngokuvamile izinguquko ezinqala ku-membrane yakho ye-peritoneal ezenza ingasebenzi kahle ekuhlungeni imfucuza ngokuhamba kwesikhathi.

Iqembu lakho lezempilo liqapha ukusebenza kahle kokwelashwa kwakho njalo futhi lizoxoxa ngezinketho uma i-peritoneal dialysis iba ngaphansi kokwanele. Abanye abantu ekugcineni bashintshela ku-hemodialysis, kanti abanye bangase babe ngabazongenela ukufakelwa izinso.

Q4: Ingabe i-peritoneal dialysis izothinta ukudla kwami nesisindo sami?

I-Peritoneal dialysis ingathinta ukudla kwakho nesisindo ngezindlela eziningana. Isixazululo se-dialysis siqukethe ushukela omathintwa umzimba wakho, okungaholela ekuzuzeni isisindo futhi kunganciphisa indlala yakho ngesikhathi sokudla.

Abantu abaningi bathola ukuthi ukudla kwabo kuyathuthuka lapho beqala i-dialysis ngoba ukwakheka kwama-toxin kwakubenza bazizwe bengaphilile. Ukusebenza ne-renal dietitian kukusiza ukuthi ulinganise izidingo zakho zokudla ngenkathi ulawula noma yiziphi izinguquko zesimo somzimba ezivela ekwelashweni.

Q5: Ngingasebenza ngenkathi ngenza i-peritoneal dialysis?

Abantu abaningi bangaqhubeka nokusebenza ngenkathi be-peritoneal dialysis, ikakhulukazi uma bengahlela ukuhlela okuguquguqukayo kokushintshana. Ukuthuthwa kokwelashwa nesikhathi esifushane sokusebenza ngaso ngqo kwenza kube kuhambisana nezindawo eziningi zokusebenza.

Kungase kudingeke ukuthi uxoxe ngezindawo zokuhlala nomqashi wakho, njengokufinyelela endaweni ehlanzekile, eyimfihlo yokushintshana noma izikhathi zokuphumula eziguquguqukayo. Iziguli eziningi zithola ukuthi i-peritoneal dialysis zibavumela ukuthi bagcine amashejuli okusebenza ajwayelekile uma kuqhathaniswa ne-hemodialysis esikhungweni.