Hemodialyse

Hemodialysis ni bumwe mu buryo bwo kuvura impyiko ku barwayi bafite impyiko zikomeye kandi zidakira.Itwara amaraso kuva mumubiri kugera hanze yumubiri kandi ikanyura muri dialyzer igizwe na fibre zitabarika.Amaraso hamwe numuti wa electrolyte (dialyse fluid) hamwe nubushuhe busa bwumubiri biri mumibiri yimbere kandi isohoka binyuze mukwirakwiza, ultrafiltration, na adsorption.Ihanahana ibintu hamwe nihame rya convection, ikuraho imyanda ya metabolike mumubiri, ikomeza electrolyte na aside-ishingiro;icyarimwe, ikuraho amazi arenze mumubiri, kandi inzira yose yo gusubiza amaraso yatunganijwe yitwa hemodialysis.

ihame

1. Ubwikorezi bwuzuye
(1) Gutatanya: Nuburyo bukuru bwo gukuraho solute muri HD.Umuti utwarwa kuva murwego rwo hejuru cyane ugana kuruhande rwo hasi cyane bitewe na gradient.Iyi phenomenon yitwa gutatanya.Ingufu zo gutwara ibintu zikwirakwiza zituruka kumyitwarire idasanzwe ya molekile ya solute cyangwa ibice ubwabyo (icyerekezo cya Brownian).
.Ntabwo byatewe nuburemere bwa molekuline ya solute hamwe nubunini bwacyo butandukanye, imbaraga zinyura muri membrane ni itandukaniro ryumuvuduko wa hydrostatike kumpande zombi za membrane, aricyo bita traction traction.
. , Endotoxine, nibindi).Ubuso bwa dialyse yibice byose byashizwemo nabi, kandi ingano yumuriro mubi hejuru ya membrane igena ingano ya poroteyine zamamajwe hamwe nuburyo butandukanye.Mugihe cyo kuvura indwara ya hemodialyse, poroteyine zimwe na zimwe zazamutse bidasanzwe, uburozi nibiyobyabwenge mumaraso byatoranijwe byamamaza hejuru ya dialyse ya dialyse, kugirango ibyo bintu bitera indwara bikurweho, kugirango bigere ku ntego yo kuvura.
2. Kohereza amazi
.Mugihe cya dialyse, ultrafiltration bivuga kugenda kwamazi kuva kumaraso kugera kuruhande rwa dialysate;muburyo bunyuranye, niba amazi yimutse avuye kuruhande rwa dialyse yerekeza kumaraso, byitwa reverse ultrafiltration.
(2) Ibintu bigira ingaruka kuri ultrafiltration: ① igipimo cyamazi cyamazi meza;Umuvuduko ukabije w'ikirere;Pressuretransmembrane igitutu;Co coefficient ya ultrafiltration.

Ibyerekana

1. Gukomeretsa impyiko.
2. Kunanirwa k'umutima guterwa no kurenza urugero cyangwa hypertension bigoye kugenzura ukoresheje ibiyobyabwenge.
3. Acideose ya metabolike ikabije na hyperkalemia bigoye gukosorwa.
4. Hypercalcemia, hypocalcemia na hyperphosphatemia.
5. Kunanirwa kw'impyiko zidakira hamwe no kubura amaraso bigoye gukosorwa.
6. Uremic neuropathie na encephalopathie.
7. Uremia pleurisy cyangwa pericarditis.
8. Kunanirwa kw'impyiko karande hamwe nimirire mibi ikabije.
9. Imikorere idasobanutse yumubiri cyangwa kugabanuka kumiterere rusange.
10. Ibiyobyabwenge cyangwa uburozi.

Kurwanya

1. Kuva amaraso munda cyangwa kwiyongera k'umuvuduko ukabije.
2. Guhungabana gukomeye bigoye gukosorwa nibiyobyabwenge.
3. Cardiomyopathie ikabije iherekejwe no kunanirwa k'umutima.
4. Uherekejwe nuburwayi bwo mumutwe ntashobora gufatanya kuvura hemodialyse.

Ibikoresho bya Hemodialyse

Ibikoresho bya hemodialyse birimo imashini ya hemodialyse, gutunganya amazi na dialyzer, bigizwe na sisitemu ya hemodialyse.
1. Imashini ya Hemodialysis
ni kimwe mu bikoresho bikoreshwa cyane mu kuvura amaraso.Nibikoresho bigoye cyane bya mechatronics, bigizwe nigikoresho cyo kugenzura itangwa rya dialyse hamwe nigikoresho cyo kugenzura ibintu bidasanzwe.
Sisitemu yo gutunganya amazi
Kubera ko amaraso yumurwayi mugice cya dialyse agomba guhura na dialyse nyinshi (120L) binyuze muri dialyse ya dialyse, kandi amazi yo mumazi yo mumijyi arimo ibintu bitandukanye, cyane cyane ibyuma biremereye, kimwe na disinfectant, endotoxine na bagiteri, guhura namaraso bizatera ibi Ibintu byinjira mumubiri.Kubwibyo, amazi ya robine agomba kuyungurura, gukuramo ibyuma, koroshya, gukora karubone ikora, hamwe na osose ihindagurika ikurikirana.Gusa amazi ya osmose arashobora gukoreshwa nkamazi yo kugabanura dialysate yibanze, kandi igikoresho cyo kuvura amazi ya robine nuburyo bwo gutunganya amazi.
3. Dialyzer
yitwa kandi "impyiko zimpimbano".Igizwe na fibre idafite akamaro ikozwe mubikoresho bya shimi, kandi buri fibre yuzuye ikwirakwizwa hamwe nu mwobo muto.Mugihe cya dialyse, amaraso atembera muri fibre yuzuye hanyuma dialyse ikagenda isubira inyuma binyuze muri fibre.Umuti n'amazi ya molekile ntoya mumazi ya hemodialyse bihanahana binyuze mumyobo mito kuri fibre.Igisubizo cya nyuma cyo guhana ni amaraso mumaraso.Uburozi bwa Uremia, electrolytite zimwe, n'amazi arenze urugero bivanwa muri dialyse, hamwe na bicarbonate na electrolytite muri dialyse byinjira mumaraso.Kugirango rero ugere ku ntego yo gukuraho uburozi, amazi, kubungabunga aside-ishingiro hamwe n’ibidukikije imbere.Ubuso bwuzuye bwa fibre yuzuye, umwanya wo guhanahana, bigena ubushobozi bwo gutambuka kwa molekile nto, kandi ingano yubunini bwa pore ya membrane igena ubushobozi bwo kunyura muri molekile nini nini nini.
4. Dialysate
Dialysate iboneka muguhindura dialyse yibintu birimo electrolytite na base hamwe namazi ya osmose ihindagurika, hanyuma igashiraho igisubizo cyegereye amaraso ya electrolyte kugirango igumane urwego rusanzwe rwa electrolyte, mugihe itanga umusingi kumubiri binyuze murwego rwo hejuru rwibanze, Kuri gukosora acide mu murwayi.Ibisanzwe bikoreshwa cyane bya dialyse ni bicarbonate, ariko kandi birimo aside aside ya acike.