Ezigulini ezinesifo sezinso esisesigabeni sokugcina (ESRD), i-hemodialysis iyindlela yokwelapha ephephile nephumelelayo. Ngesikhathi sokwelashwa, igazi kanye ne-dialysate kuhlangana ne-dialyzer (izinso zokwenziwa) nge-membrane engena kancane, okuvumela ukushintshaniswa kwezinto eziqhutshwa yi-gradients yokuhlushwa. Umshini we-hemodialysis udlala indima ebalulekile ekuhlanzeni igazi ngokususa imfucuza ye-metabolic kanye nama-electrolyte amaningi ngenkathi wethula ama-ion e-calcium kanye ne-bicarbonate kusuka ku-dialysate egazini. Kulesi sihloko, sizohlola izisekelo zemishini ye-hemodialysis futhi siqondise ukuthi ungakhetha kanjani idivayisi esezingeni eliphezulu ukuze ukwelashwa kube lula kakhudlwana.

 

Ukuqonda Imishini Yokuhlanza Igazi

Imishini ye-hemodialysis ivame ukuba nezinhlelo ezimbili eziyinhloko: uhlelo lokulawula igazi kanye nohlelo lokuhlinzeka nge-dialysate. Uhlelo lwegazi lunesibopho sokulawula ukujikeleza kwegazi ngaphandle komzimba kanti uhlelo lwe-dialysate lulungiselela isisombululo se-dialysis esifanelekile ngokuxuba ama-concentrate namanzi e-RO bese luthutha isisombululo siye ku-dialyzer. Ku-hemodialyzer, i-dialysate yenza ukusabalala okuncibilikayo, ukungena, kanye nokuhlunga ngegazi lesiguli nge-membrane engena kancane, kanti okwamanje, igazi lokuhlanza lizobuyela emzimbeni wesiguli ngohlelo lokulawula igazi futhi uhlelo lwe-dialysate lukhipha uketshezi olungcolile. Le nqubo yokujikeleza eqhubekayo ihlanza igazi ngempumelelo.

Ngokuvamile, uhlelo lokuqapha igazi luhlanganisa iphampu yegazi, iphampu ye-heparin, ukuqapha ingcindezi yemithambo yegazi kanye nemithambo yegazi, kanye nohlelo lokuthola umoya. Izingxenye ezibalulekile zohlelo lokuhlinzeka nge-dialysis uhlelo lokulawula izinga lokushisa, uhlelo lokuxuba, uhlelo lwe-degas, uhlelo lokuqapha ukuhanjiswa kwegazi, ukuqapha ukuhlunga kwegazi ngokweqile, ukutholwa kokuvuza kwegazi, njalo njalo.

Izinhlobo ezimbili eziyinhloko zemishini esetshenziswa ku-hemodialysis ziyindinganisoumshini we-hemodialysis (HD)kanyeumshini wokuhlunga igazi (i-HDF)imishini ye-HDF esebenzisaama-dialyzer ahamba kahle kakhuluinikeza inqubo yokuhlunga ethuthuke kakhulu - ukusabalala kanye nokuguqulwa koketshezi ukuze kuthuthukiswe ukususwa kwama-molecule amakhulu nezinto ezinobuthi futhi kugcwaliswe ama-ion abalulekile ngokufaka esikhundleni umsebenzi wokunikeza.

Kubalulekile ukuqaphela ukuthi indawo engaphezulu kwe-membrane ye-dialyzer kufanele icatshangelwe esimweni esithile sesiguli, okuhlanganisa isisindo, ubudala, isimo senhliziyo, kanye nokufinyelela kwemithambo yegazi lapho ukhetha ama-dialyzer. Njalo xhumana nesiphakamiso sochwepheshe sikadokotela ukuze uthole ukuthi yini edingekayo.i-dialyzer efanele.

 

Ukukhetha Umshini Ofanele Wokuhlanza I-Hemodialysis

Ukuphepha nokunemba yizinto eziza kuqala. Nazi ezinye izinto ezibalulekile okufanele uzicabangele:

1. Izici Zokuphepha

Umshini wokuhlaziya igazi ofanelekayo kufanele ube nokuqapha ukuphepha okuqinile kanye nezinhlelo ze-alamu. Lezi zinhlelo kufanele zibe bucayi ngokwanele ukuthola noma yiziphi izimo ezingavamile futhi zinikeze izexwayiso ezinembile kubasebenzi.

Ukuqapha ngesikhathi sangempela ukuqapha okuqhubekayo kwengcindezi yemithambo yegazi neyemithambo yegazi, amazinga okugeleza kwegazi, kanye nezinye izilinganiso ezibalulekile ngesikhathi sokuhlanza igazi. Izexwayiso zesistimu ye-alamu ngezinkinga ezifana nomoya egazini odlule umfutho wegazi, noma amazinga okuhluza igazi angalungile.

 2. Ukunemba kokusebenza

Ukunemba komshini kuthinta ukusebenza kahle kokwelashwa futhi kuvame ukuhlolwa yizici ezilandelayo:

Izinga lokuhluzwa kwe-Ultra: umshini kufanele ulawule ngokunembile uketshezi olukhishwe esigulini.

Ukuqapha ukuhanjiswa kwamandla: ukuqinisekisa ukuthi i-dialysate isezingeni elifanele le-electrolyte.

Ukulawula izinga lokushisa: umshini kufanele ugcine i-dialysate ekushiseni okuphephile nokukhululekile.

 3. I-Interface Esebenziseka Kahle

Isixhumi esibonakalayo esisebenziseka kalula singathuthukisa kakhulu ulwazi lweziguli kanye nabasebenzi. Funa imishini enezilawuli ezinembile kanye nezibonisi ezicacile ezenza kube lula ukuqapha imingcele yokwelashwa.

4. Ukugcinwa Nokusekelwa

Cabanga ngamandla okusekelwa kobuchwepheshe kanye nezinsizakalo zokulungisa zomkhiqizi womshini okhethiwe. Ukusekelwa okuthembekile kungaqinisekisa ukuthi noma yiziphi izinkinga zixazululwa ngokushesha, kuncishiswe ukuphazamiseka kokwelashwa.

 5. Ukuhambisana Nezindinganiso

Umshini wokuhlanza igazi kumele uhambisane nezindinganiso zokuphepha ezifanele kanye nekhwalithi ezibekwe yizinhlangano ezilawulayo. Lokhu kuhambisana kubalulekile ekuqinisekiseni ukuphepha kwesiguli kanye nokwelashwa okuphumelelayo.

 

Imishini Yokuhlaziya I-Hemodialysis Encintisanayo kanye Nomkhiqizi

Iimodeli yomshini we-hemodialysis W-T2008-Bekhiqizwe yi-UChengdu Wesleyihlanganisa ulwazi lweqembu lweminyaka ecishe ibe ngamashumi amathathu embonini kanye nokusungula ubuchwepheshe. Lo mshini wenzelwe ukusetshenziswa emayunithi ezokwelapha futhi uthole isitifiketi se-CE, ngobuchwepheshe obuthuthukisiwe, ukuzinza, ukuphepha nenduduzo yesiguli, kanye nokusebenza okulula kwabasebenzi bezokwelapha. Unamaphampu amabili kanye negumbi eliqondile lokunikeza nokubuyisela uketshezi, umklamo oyingqayizivele wokuqinisekisa ukunemba kokuhlunga. Izingxenye ezibalulekile zomshini zingeniswa zivela eYurophu nase-US, njenge-solenoid valves eqinisekisa ukulawula okunembile kokuvulwa nokuvalwa kweziteshi, kanye nama-chips aqinisekisa ukuqapha okunembile nokuqoqwa kwedatha.

 

Okuthuthukisiwe ukuvikela ukuphepha uhlelo

Lo mshini usebenzisa uhlelo lokuqapha nokuvikela umoya oluphindwe kabili, ama-level level kanye nama-bubble detector, angavimbela ngempumelelo umoya osegazini ukuthi ungene emzimbeni wesiguli ukuze kumiswe izingozi ze-air embolism. Ngaphezu kwalokho, umshini uhlonyiswe ngamaphuzu amabili okuqapha izinga lokushisa kanye namaphuzu amabili okuqhuba, okuqinisekisa ukuthi ikhwalithi ye-dialysate igcinwa kulo lonke ukwelashwa. Uhlelo lwe-alamu oluhlakaniphile lunikeza impendulo yesikhathi sangempela kunoma yikuphi ukukhubazeka ngesikhathi se-dialysis. I-alamu ye-acousto-optic ixwayisa opharetha ukuthi baphendule ngokushesha kunoma yiziphi izinkinga, okuthuthukisa ukuphepha kwesiguli kanye nokusebenza kahle kokwelashwa.

Ngokusekelwe esisekelweni se-W-T2008-B, iUmshini wokuhlunga igazi we-W-T6008SIngeza isiqaphi somfutho wegazi, izihlungi ze-endotoxin, kanye ne-Bi-Cart njengezilungiselelo ezijwayelekile. Ingashintsha kalula phakathi kwezindlela ze-HDF ne-HD ngesikhathi sokwelashwa. Faka nge-dialyzers ephezulu, evumela ukususwa kwama-molecule amakhulu egazini, umshini uthuthukisa ukusebenza kahle kanye nenduduzo yokwelashwa.