Kwizigulane ezine-end-stage renal disease (ESRD), i-hemodialysis yindlela yonyango ekhuselekileyo nesebenzayo. Ngexesha lonyango, igazi kunye ne-dialysate zidibana ne-dialyzer (intso yokufakelwa) nge-membrane e-semi-permeable, evumela ukutshintshiselwa kwezinto eziqhutywa yi-concentration gradients. Umatshini we-hemodialysis udlala indima ebalulekileyo ekucoceni igazi ngokususa inkunkuma ye-metabolic kunye ne-electrolytes engaphezulu ngelixa ungenisa i-calcium ion kunye ne-bicarbonate ukusuka kwi-dialysate ukuya egazini. Kweli nqaku, siza kuphonononga izinto ezisisiseko koomatshini be-hemodialysis kwaye sikhokele indlela yokukhetha isixhobo esikumgangatho ophezulu ukwenza unyango lube lula.

 

Ukuqonda oomatshini beHemodialysis

Oomatshini be-Hemodialysis badla ngokuba neenkqubo ezimbini eziphambili: inkqubo yokulawula igazi kunye nenkqubo yokubonelela nge-dialysate. Inkqubo yegazi inoxanduva lokulawula ukujikeleza kwegazi kwi-extracorporeal kunye nenkqubo ye-dialysate ilungiselela isisombululo esifanelekileyo se-dialysis ngokuxuba i-concentrates kunye ne-RO yamanzi kunye nokuthutha isisombululo kwi-dialyzer. Kwi-hemodialyzer, i-dialysate yenza i-solute diffusion, ukungena, kunye ne-ultrafiltration ngegazi lesigulana nge-membrane ene-semi-permeable, kwaye okwangoku, igazi lokucoca liya kubuyela kumzimba wesigulane ngenkqubo yokulawula igazi kunye nenkqubo ye-dialysate ikhupha inkunkuma. Le nkqubo yebhayisikile eqhubekayo icoca ngokufanelekileyo igazi.

Ngokuqhelekileyo, inkqubo yokulawula igazi ibandakanya impompo yegazi, impompo ye-heparin, i-arterial kunye ne-venous monitoring pressure, kunye nenkqubo yokubona umoya. Amacandelo aphambili enkqubo yokubonelela nge-dialysis yinkqubo yokulawula ukushisa, inkqubo yokuxuba, inkqubo ye-degas, inkqubo yokubeka iliso ye-conductivity, i-ultrafiltration monitoring, ukufunyanwa kwegazi, njalo njalo.

Iintlobo ezimbini eziphambili zoomatshini ezisetyenziswa kwi-hemodialysis zisemgangathweniumatshini we-hemodialysis (HD).kwaye iumatshini we-hemodiafiltration (HDF).. Oomatshini abasebenzisa iHDFi-dialyzers ephezulubonelela ngenkqubo yokuhluza ehambele phambili ngakumbi--ukusasazwa kunye nokuhanjiswa ukomeleza ukususwa kweeathom ezinkulu kunye nezinto eziyityhefu kunye nokuzalisa ii-ion ezibalulekileyo ngokufaka umsebenzi wonikezelo endaweni.

Kuyafaneleka ukuba uqaphele ukuba indawo ye-membrane yendawo ye-dialyzer kufuneka ithathelwe ingqalelo kwimeko ethile yesigulane, kubandakanywa ubunzima, ubudala, imeko yenhliziyo, kunye nokufikelela kwi-vascular xa ukhetha i-dialyzers. Soloko udibana nengcebiso kagqirha ukuze ufumanisei-dialyzer efanelekileyo.

 

Ukukhetha umatshini ofanelekileyo weHemodialysis

Ukhuseleko kunye nokuchaneka zizinto eziphambili eziphambili. Nantsi imiba ephambili ekufuneka iqwalaselwe:

1. Iimpawu zoKhuseleko

Umatshini ofanelekileyo we-hemodialysis kufuneka ube nokubeka iliso olomeleleyo kunye neenkqubo ze-alamu. Ezi nkqubo kufuneka zibe novakalelo ngokwaneleyo ukuze zibone naziphi na iimeko ezingaqhelekanga kwaye zinike izilumkiso ezichanekileyo kubaqhubi.

Ukubeka iliso ngexesha langempela kukubeka iliso okuqhubekayo koxinzelelo lwe-arterial kunye ne-venous, amazinga okuhamba, kunye nezinye iiparameters ezibalulekileyo ngexesha le-dialysis. Izilumkiso ze-alam zemiba efana nomoya kwimizila yegazi igqithise uxinzelelo lwegazi, okanye amazinga angachanekanga okucoca.

 2. Ukuchaneka komsebenzi

Ukuchaneka komatshini kuchaphazela ukusebenza konyango kwaye ngokuqhelekileyo kuvavanywa ngale miba ilandelayo :

Umlinganiselo we-Ultrafiltration: umatshini kufuneka ulawule ngokuchanekileyo ulwelo olususwe kwisigulane.

Ukujongwa kokuziphatha: ukuqinisekisa ukuba i-dialysate ikugxininiso oluchanekileyo lwe-electrolyte.

Ukulawula ubushushu: umatshini kufuneka ugcine i-dialysate kwindawo ekhuselekileyo kunye nekhululekile.

 3. IsiNxulumanisi esinoMsebenzi

Ujongano olusebenziseka lula lunokuphucula kakhulu amava kuzo zombini izigulane kunye nabaqhubi. Khangela oomatshini abanolawulo olucacileyo kunye neziboniso ezicacileyo ezenza kube lula ukubeka iliso kwiiparamitha zonyango.

4. Ukugcinwa kunye neNkxaso

Qwalasela umthamo weenkonzo zenkxaso yobugcisa kunye nokugcinwa komenzi womatshini okhethiweyo. Inkxaso ethembekileyo inokuqinisekisa ukuba nayiphi na imiba ishukuxwa ngokukhawuleza, ukunciphisa ukuphazamiseka kunyango.

 5. Ukuthotyelwa kweMigangatho

Umatshini we-hemodialysis kufuneka uhambelane nokhuseleko olufanelekileyo kunye nemigangatho esemgangathweni ebekwe ngamaqumrhu alawulayo. Oku kuthobela kubalulekile ekuqinisekiseni ukhuseleko lwesigulane kunye nonyango olusebenzayo.

 

Oomatshini boKhuphiswano beHemodialysis kunye noMvelisi

Iimodeli yomatshini we-hemodialysis W-T2008-Byenziwe nguChengdu Wesleyidibanisa phantse iminyaka engamashumi amathathu yeqela lamava oshishino kunye nobuchule obutsha. Umatshini wenzelwe ukusetyenziswa kwiiyunithi zonyango kwaye ufumene isatifikethi se-CE, kunye nobuchwepheshe obuphezulu, uzinzo, ukhuseleko lwesigulane kunye nentuthuzelo, kunye nokulula ukusebenza kwabasebenzi bezonyango. Ineempompo ezimbini kunye negumbi elichanekileyo lokubonelela kunye nokubuyiswa kwe-liquid-balance, idizayini ekhethekileyo yokuqinisekisa ukuchaneka kwe-ultrafiltration. Amacandelo aphambili omatshini athunyelwa kumazwe aseYurophu nase-US, njengama-valve e-solenoid aqinisekisa ulawulo oluchanekileyo lokuvula nokuvala amajelo, kunye nee-chips eziqinisekisa ukubeka iliso ngokuchanekileyo kunye nokuqokelela idatha.

 

Ikwinqanaba eliphezulu ukhuseleko lokhuseleko inkqubo

Umatshini wamkela inkqubo yokuhlola kunye nokukhusela umoya ombini, inqanaba lolwelo kunye ne-bubble detectors, ezinokuthintela ngokufanelekileyo umoya ojikelezayo wegazi ukuba ungene emzimbeni wesigulana ukumisa iingozi ze-air embolism. Ukongezelela, umatshini uxhotyiswe ngamanqaku amabini okubeka iliso kwiqondo lokushisa kunye namanqaku amabini okuqhuba, ukuqinisekisa ukuba umgangatho we-dialysate ugcinwa kulo lonke unyango. Inkqubo ye-alamu ekrelekrele ibonelela ngengxelo yexesha langempela kuyo nayiphi na into engaqhelekanga ngexesha le-dialysis. I-alamu ye-acousto-optic ilumkisa abaqhubi ukuba baphendule ngokukhawuleza kuyo nayiphi na imiba, ukuphucula ukhuseleko lwesigulane kunye nokusebenza kakuhle kwonyango.

Ngokusekelwe kwisiseko se-W-T2008-B, iW-T6008S umatshini wokucoca i-hemodiafiltrationyongeza imonitha yoxinzelelo lwegazi, izihluzi ze-endotoxin, kunye ne-Bi-Cart njengolungelelwaniso oluqhelekileyo. Iyakwazi ukutshintsha ngokulula phakathi kwe-HDF kunye neendlela ze-HD ngexesha lonyango. Faka kunye ne-dialyzers ephezulu, eququzelela ukususwa kweeamolekyu ezinkulu kwigazi, umatshini uphucula ukusebenza kakuhle kunye nentuthuzelo yonyango.