Ungawukhetha Kanjani Umshini Wekhwalithi Ephezulu We-Hemodialysis

Ezigulini ezine-end-stage renal disease (ESRD), i-hemodialysis iyindlela yokwelapha ephephile nephumelelayo. Ngesikhathi sokwelashwa, igazi ne-dialysate kuthintana ne-dialyzer (izinso zokwenziwa) ngolwelwesi olungena kancane, okuvumela ukushintshana kwezinto eziqhutshwa ama-concentration gradients. Umshini we-hemodialysis udlala indima ebalulekile ekuhlanzeni igazi ngokususa udoti we-metabolic kanye nama-electrolyte amaningi ngenkathi wethula i-calcium ion ne-bicarbonate kusuka ku-dialysate iye egazini. Kulesi sihloko, sizohlola izinto eziyisisekelo zemishini ye-hemodialysis futhi siqondise indlela yokukhetha idivayisi yekhwalithi ephezulu ukwenza ukwelashwa kukhululeke kakhudlwana.

 

Ukuqonda Imishini Ye-Hemodialysis

 

Imishini yokuhlaziya i-hemodialysis ngokuvamile inezinhlelo ezimbili eziyinhloko: uhlelo lokulawula igazi kanye nesistimu yokuqapha igaziuhlelo lokuhlinzeka nge-dialysate. Uhlelo lwegazi lunesibopho sokulawula ukujikeleza kwegazi ngaphandle kwe-extracorporeal futhi uhlelo lwe-dialysate lulungisa isisombululo se-dialysis esifanelekayo ngokuxuba ukugxilisa ingqondo.s kanye namanzi e-RO futhi athuthe isixazululo ku-dialyzer. Ku-hemodialyzer, i-dialysate yenza i-solute diffusion, ukungena, kanyei-ultrafiltration nesiguli's nge-membrane ekwazi ukungena kancane, futhi okwamanje, igazi lokuhlanza lizobuyela esigulini's umzimba ngohlelo lokulawula igazi kanye nohlelo lwe-dialysate lukhipha uketshezi olubi. Le nqubo yokugibela ibhayisikili eqhubekayo ihlanza igazi ngokuphumelelayo.

 

Ngokuvamile, uhlelo lokuqapha igazi luhlanganisa iphampu yegazi, iphampu ye-heparin, ukuqapha kwe-arterial kanye ne-venous pressure, kanye nohlelo lokuthola umoya. Izingxenye ezibalulekile zesistimu yokuhlinzeka nge-dialysis yisistimu yokulawula izinga lokushisa, uhlelo lokuxuba, uhlelo lwe-degas, uhlelo lokuqapha i-conductivity, ukuqapha kwe-ultrafiltration, ukutholwa kokuvuza kwegazi, njalonjalo.

 

Izinhlobo ezimbili eziyinhloko zemishini esetshenziswa ku-hemodialysis umshini ojwayelekile we-hemodialysis (HD) kanye nomshini we-hemodiafiltration (HDF).Imishini ye-HDF kusetshenziswa ama-dialyzer ane-flux ephezulu kunikeza inqubo yokuhlunga ethuthuke kakhudlwana--ukusabalalisa kanye nokuguquguquka ukuze kuthuthukiswe ukukhishwa kwama-molecule amakhulu nezinto ezinobuthi futhi kugcwalise ama-ion abalulekile ngokufaka umsebenzi wokuphakela esikhundleni.

 

Kuyaqapheleka ukuthi indawo engaphezulu ye-membrane ye-dialyzer kufanele icatshangelwe esigulini'isimo esiqondile, okuhlanganisa isisindo, ubudala, isimo senhliziyo, nokufinyelela kwemithambo lapho ukhetha ama-dialyzer. Hlala uthintana nodokotela'isiphakamiso sochwepheshe sokunquma i-dialyzer efanelekile.

 

Ukukhetha Umshini Ofanele We-Hemodialysis

 

Ukuphepha nokunemba yizinto eziza kuqala. Nazi ezinye izici ezibalulekile okufanele zicatshangelwe:

 

1. Izici Zokuphepha

Umshini oqeqeshiwe we-hemodialysis kufanele ube nokuqapha okuqinile kokuphepha kanye nezinhlelo ze-alamu. Lawa masistimu kufanele azwele ngokwanele ukuze abone noma yiziphi izimo ezingavamile futhi anikeze izexwayiso ezinembile kubaqhubi.

 

Ukuqapha kwesikhathi sangempela ukuqapha okuqhubekayo komfutho we-arterial kanye ne-venous, amazinga okugeleza, neminye imingcele ebalulekile ngesikhathi sokuhlanza. Izaziso zamasistimu e-alamu ngezindaba ezinjengomoya osezindaweni zegazi zeqe umfutho wegazi, noma amazinga okucwenga angalungile.

 

1. Ukunemba kokusebenza

Ukunemba komshini kuthinta ukusebenza kahle kokwelashwa futhi ngokuvamile kuhlolwa izici ezilandelayo :

 

Isilinganiso sokuhlunga: umshini kufanele ulawule ngokunembile uketshezi olukhishwe esigulini.

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

Ukulawula izinga lokushisa: umshini kufanele ulondoloze i-dialysate ekushiseni okuphephile nokunethezekile.

 

3. Isixhumi esibonakalayo Esisebenziseka kalula

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

 

4. Isondlo kanye Nokwesekwa

Cabangela umthamo wokusekela kwezobuchwepheshe kanye nezinsizakalo zokunakekela umshini okhethiwe umkhiqizi. Ukwesekwa okuthembekile kungaqinisekisa ukuthi noma yiziphi izinkinga zilungiswa ngokushesha, kuncishiswe ukuphazamiseka ekwelashweni.

 

5. Ukuhambisana Namazinga

Umshini we-hemodialysis kufanele uhambisane nezindinganiso ezifanele zokuphepha nekhwalithi ezibekwe yimizimba elawulayo. Lokhu kuthobela kubalulekile ekuqinisekiseni ukuphepha kwesiguli kanye nokwelashwa okusebenzayo.

 

UkuncintisanaHi-emodialysisMachines kanye noMkhiqizi

 

Imodeli yomshini we-hemodialysis i-W-T2008-B eyenziwe ngu-Chengdu Wesley ihlanganisa iqembu'cishe iminyaka engamashumi amathathu yesipiliyoni sembonini nokuqanjwa kabusha kwezobuchwepheshe. Umshini uklanyelwe ukusetshenziswa ezinyunithi zezokwelapha futhi uthole isitifiketi se-CE, esinobuchwepheshe obuphambili, ukuzinza, isiguli's ukuphepha nokunethezeka, kanye nokusebenza kalula kwabasebenzi bezokwelapha. Inamaphampu amabili kanye negumbi elinembile lebhalansi ye-supply-and-return-liquid, idizayini eyingqayizivele yokuqinisekisa ukunemba kwe-ultrafiltration. Izingxenye ezibalulekile zomshini zingeniswa zivela eYurophu nase-US, njengama-solenoid valves aqinisekisa ukulawulwa okunembile kokuvula nokuvala iziteshi, kanye nesiqinisekiso sama-chips.ing ukuqapha okunembile nokuqoqwa kwedatha.

 

Uhlelo oluthuthukisiwe lokuvikela ukuphepha

 

Umshini uthola okubiliuhlelo lokuqapha nokuvikela umoya, uketshezi izinga kanye namabhamuza detectors, okungase kuvimbele ngempumelelo umoya osegazini ukuze ungene emzimbeni wesiguli ukumisa izingozi air embolism. Ukwengeza, umshini ufakwe amaphuzu amabili wokuqapha izinga lokushisa kanye namaphoyinti amabili wokuqhuba, ukuqinisekisa ikhwalithi ye-dialysate. is igcinwe kukho konke ukwelashwa. Isistimu ye-alamu ehlakaniphile ihlinzeka ngempendulo yesikhathi sangempela kunoma yikuphi ukungahambi kahle phakathi ne-dialysis. Ii-alamu ye-acousto-optic ixwayisa opharetha ukuthi baphendule ngokushesha kunoma yiziphi izinkinga, okuthuthukisa ukuphepha kwesiguli nokusebenza ngempumelelo kokwelashwa.

 

Ngokusekelwe kusisekelo se-W-T2008-B, umshini we-W-T6008S hemodiafiltration wengeza isiqaphi somfutho wegazi, izihlungi ze-endotoxin, ne-Bi-Cart njengokucushwa okujwayelekile. Ingashintsha kalula phakathi kwezindlela ze-HDF ne-HD ngesikhathi sokwelashwa. Faka ama-dialyzer ane-flux ephezulu, asiza ukukhishwa kwama-molecule amakhulu egazini, umshini uthuthukisa ukusebenza kahle kanye nokunethezeka kokwelashwa.