Izingozi Nokuvimbela Ukulahlekelwa Yigazi Ngaphandle Komzimba Ngesikhathi Sokuhlikihla Igazi
Sikubona njalo ku-dialysis—wonke umuntu ugxila emazingeni okukhishwa kwegazi kanye nokukhishwa koketshezi, kodwa sivame ukukhohlwa ngegazi elihleli khona lapho epayipini. Lokho kuyingozi yangempela, futhi akuncane. Ezigulini ezinesifo sezinso esingamahlalakhona, iningi lazo selivele line-anemia yezinso, ngakho-ke ngisho nokulahlekelwa igazi okwengeziwe ngesikhathi sokwelashwa kungabacindezela. Sikhuluma ngamamililitha angaba ngu-200 egazi elijikeleza ngesekethe yangaphandle komzimba njalo ngesikhathi esisodwa. Futhi uma kwakheka i-clot emigqeni, noma uma indawo yokubhoboza iqhubeka nokuphuma, noma inaliti iphuma ngengozi, khona-ke leyo hemoglobin iyehla, ukukhathala kanye nesiyezi kuya kuba kubi kakhulu, futhi sibeka ukucindezeleka okwengeziwe enhliziyweni. Ngakho-ke izinkinga zenhliziyo ziyanda. Nansi ingxenye eyesabekayo: uma singatholi ukunqamuka komugqa wemithambo ngesikhathi, isiguli singalahlekelwa igazi ngokushesha kangangokuthi singene ekushaqekeni kwe-hypovolemic ngemizuzu embalwa. Lokho akuyona inkolelo-leyo ingozi eyaziwayo okufanele sibhekane nayo ngqo.
Sibheke idatha yezokwelapha, futhi izizathu zincike kubantu abambalwa abaphindayo ukwenza amaphutha. Okokuqala, isekethe ayivalwanga ngokuphelele—ukuxhumana okuxekethile, amalunga anephutha, uma usho njalo. Okwesibili, inalithi yokubhoboza noma i-catheter ingaphuma, ikakhulukazi uma isiguli sihambahamba. Okwesithathu, sibona ukopha ngemva kokudonsa inalithi, kodwa kuphela ngoba ukucindezela akwenziwanga kahle. Bese kuba nenkinga yokujiya kwegazi: lapho senza i-dialysis engena-heparin, noma lapho inalithi ye-fistula idonsa kabi ngenxa yokugeleza okuncane, igazi liyama futhi kwakheke amahlule. Futhi ungakhohlwa ukuphatha ngokunganaki—njengokuvula imigqa ye-dialysis ngesikhathi esingafanele, noma indawo yokubhoboza ephumayo engeke ime. Kodwa futhi kufanele sivume ukuthi iziguli ngokwazo ziyimbangela—uma zishintsha kakhulu esihlalweni, inhloko yenalithi ingashayisa udonga lwemithambo yegazi, futhi lokho kuvimbela ukugeleza kwegazi, okubangela nokujiya kwegazi. Ngakho-ke kuyinhlanganisela yemishini, ubuchwepheshe, kanye nokuziphatha kwesiguli.
Ukuze kuxazululwe lezi zingozi, izikhungo zezokwelapha kanye neziguli kudingeka zakhe uhlelo lokuvikela olunezingqimba eziningi ndawonye.
Ngasohlangothini lwabaphathi, kumele baqinise ukulawulwa kwekhwalithi ye-dialysis, benze inqubo ngayinye ibe yifanayo, futhi bachaze izinqubo zokunakekela zesinyathelo ngasinye ngokuningiliziwe.
Ngasohlangothini lobuchwepheshe, kufanele basebenzise indlela yokuhlinza evaliwe ngokuphelele kanye nendlela yokubuyisela igazi kusukela ekuqaleni kuze kube sekupheleni, ngoba lokho kunciphisa ingozi yokutheleleka futhi kunciphisa amazinga okuphuma kwegazi. Futhi imishini yokudaya igazi kufanele ifakwe izinto zokubona ukuvuza kanye nezinye izinhlelo zokuxwayisa ukuze noma iyiphi inkinga ibonakale kusenesikhathi.
Ngasohlangothini lokuhlinzwa, abahlengikazi kufanele baqaphele kakhulu ukucindezeleka kwemigqa, ukushintsha kombala wegazi, kanye nama-alamu omshini, futhi bathathe isinyathelo ngokushesha uma bebona noma yiluphi uphawu lokujiya kwegazi. Badinga futhi ukulungisa izinaliti zokubhoboza ngokuqinile futhi batshele iziguli ukuthi zingadonsi noma zidonse imigqa yegazi ngesikhathi sokwelashwa.
Manje ake sixoxe ngomshini ngokwawo – unesistimu yokuvikela ukuvuza eyenza umsebenzi oqinile.
Ngaphansi kokugeleza okuphezulu kwe-dialysate, izinga lokuhluza igazi, kanye nezinga lokushintsha uketshezi (kuphela kwimodeli ye-W T6008S), umkhawulo omkhulu we-alamu wezinga lokuvuza lingu-≤0.35 mL/min (ne-HCT yegazi ku-32%). Futhi uma kutholakala ukuvuza, idivayisi ayihlali nje lapho - inikeza i-alamu elula kanye ne-alamu yomsindo, imise iphampu yegazi ngokushesha, futhi ivimbele i-dialysate ukuthi iye ku-dialyzer (noma isihlungi). Ku-W T6008S, ivimba futhi uketshezi olushintshayo ukuthi lungangeni egazini, futhi imisa nokuhluza igazi. Ngakho-ke lolu hlelo luthenga ithimba lezokwelapha isikhathi esengeziwe sokungenelela, futhi lokho kuyinzuzo yangempela yokuphepha.
Kuphela uma ulwazi ngezingozi ludlula kuzo zonke izixhumanisi lapho ingozi yokulahlekelwa igazi ngaphandle komzimba ingancishiswa khona ibe sezingeni eliphansi kakhulu, bese ukwelashwa nge-dialysis kuba okuphephile futhi okuqinisekisayo kuwo wonke umuntu.
Isikhathi sokuthunyelwe: Agasti-24-2026
