Kwizigulane ezinesifo sezintso esikwinqanaba lokugqibela (ESRD), i-hemodialysis yindlela yonyango ekhuselekileyo nesebenzayo. Ngexesha lonyango, igazi kunye ne-dialysate zidibana ne-dialyzer (izintso zokwenziwa) nge-membrane engena ngaphantsi, okuvumela ukutshintshiselana kwezinto eziqhutywa yi-concentration gradients. Umatshini we-hemodialysis udlala indima ebalulekileyo ekucoceni igazi ngokususa inkunkuma ye-metabolic kunye ne-electrolytes egqithisileyo ngelixa ungenisa i-calcium ions kunye ne-bicarbonate kwi-dialysate ukuya egazini. Kweli nqaku, siza kuhlola iziseko zoomatshini be-hemodialysis kwaye sinike isikhokelo sendlela yokukhetha isixhobo esikumgangatho ophezulu ukwenza unyango lube lula ngakumbi.

 

Ukuqonda iiMatshini zeHemodialysis

Iimashini ze-Hemodialysis zihlala zineenkqubo ezimbini eziphambili: inkqubo yokulawula igazi kunye nenkqubo yokubonelela nge-dialysate. Inkqubo yegazi inoxanduva lokulawula ukujikeleza kwegazi ngaphandle kwe-corporeal kwaye inkqubo ye-dialysate ilungiselela isisombululo se-dialysis esifanelekileyo ngokuxuba i-concentrate kunye namanzi e-RO kwaye ithuthe isisombululo siye kwi-dialyzer. Kwi-hemodialyzer, i-dialysate yenza ukusasazwa kwe-solute, ukungena, kunye nokucoca nge-ultrafiltration ngegazi lesigulana nge-membrane engena ngaphantsi, kwaye okwangoku, igazi lokucoca liya kubuyela emzimbeni wesigulana ngenkqubo yokulawula igazi kwaye inkqubo ye-dialysate ikhupha ulwelo olungcolileyo. Le nkqubo yokujikeleza rhoqo ihlambulula igazi ngempumelelo.

Ngokwesiqhelo, inkqubo yokujonga igazi iquka ipompo yegazi, ipompo ye-heparin, ukujonga uxinzelelo lwemithambo yegazi kunye nemithambo yegazi, kunye nenkqubo yokufumanisa umoya. Izinto ezibalulekileyo kwinkqubo yokubonelela nge-dialysis yinkqubo yokulawula ubushushu, inkqubo yokuxuba, inkqubo ye-degas, inkqubo yokujonga ukuhanjiswa kwegazi, ukujonga ukuhluza igazi nge-ultrafiltration, ukufumanisa ukuvuza kwegazi, njalo njalo.

Iintlobo ezimbini eziphambili zoomatshini abasetyenziswa kwi-hemodialysis zezona ziqhelekileyoumatshini we-hemodialysis (HD)kwaye iumatshini wokuhluza i-hemodiafil (HDF)oomatshini be-HDF abasebenzisaii-dialyzers eziphezuluinika inkqubo yokucoca ephucukileyo ngakumbi--ukusasazwa kunye nokuhanjiswa kwe-convection ukuphucula ukususwa kweemolekyuli ezinkulu kunye nezinto ezinobuthi kunye nokugcwalisa ii-ion ezibalulekileyo ngokutshintsha umsebenzi wokubonelela.

Kubalulekile ukuqaphela ukuba indawo yomphezulu we-dialyzer kufuneka iqwalaselwe kwimeko ethile yesigulana, kubandakanya ubunzima, ubudala, imeko yentliziyo, kunye nokufikelela kwimithambo yegazi xa ukhetha ii-dialyzer. Soloko uqhagamshelana nengcebiso yogqirha ukuze ubone ukuba yintoni na.i-dialyzer efanelekileyo.

 

Ukukhetha umatshini ofanelekileyo we-hemodialysis

Ukhuseleko kunye nokuchaneka zezona zinto ziphambili. Nazi ezinye zezinto ezibalulekileyo ekufuneka ziqwalaselwe:

1. Iimpawu zoKhuseleko

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

Ukubeka esweni ngexesha langempela kukubeka esweni rhoqo uxinzelelo lwemithambo yegazi kunye nolwemithambo yegazi, amazinga okuhamba kwegazi, kunye nezinye izinto ezibalulekileyo ngexesha le-dialysis. Iisilumkiso zeenkqubo ze-alamu ngemicimbi efana nomoya okwimigca yegazi udlule uxinzelelo lwegazi, okanye amazinga angachanekanga okuhluza igazi.

 2. Ukuchaneka kokusebenza

Ukuchaneka komatshini kuchaphazela ukusebenza kakuhle konyango kwaye kudla ngokuvavanywa ngokwezi zinto zilandelayo:

Izinga lokuhluzwa kwe-Ultra: umatshini kufuneka ulawule ngokuchanekileyo ulwelo olususiweyo kwisigulana.

Ukubeka esweni ukuhanjiswa kwamanzi: ukuqinisekisa ukuba i-dialysate ikwizinga elifanelekileyo le-electrolyte.

Ulawulo lobushushu: umatshini kufuneka agcine i-dialysate kubushushu obukhuselekileyo nobukhululekileyo.

 3. Ujongano Olusebenziseka Kakuhle

Ujongano olusebenziseka lula lunokuphucula kakhulu amava kwizigulane nakubasebenzi. Khangela oomatshini abanolawulo oluqondakalayo kunye neziboniso ezicacileyo ezenza kube lula ukujonga iiparameter zonyango.

4. Ukugcinwa kunye neNkxaso

Cinga ngamandla enkxaso yobugcisa kunye neenkonzo zokugcinwa komatshini kumenzi womatshini okhethiweyo. Inkxaso ethembekileyo inokuqinisekisa ukuba naziphi na iingxaki zisonjululwa ngokukhawuleza, nto leyo enciphisa ukuphazamiseka konyango.

 5. Ukuthobela iMigangatho

Umatshini we-hemodialysis kufuneka ulandele imigangatho yokhuseleko efanelekileyo kunye nomgangatho obekwe ziibhodi ezilawulayo. Oku kuthobela kubalulekile ukuqinisekisa ukhuseleko lwesigulana kunye nonyango olusebenzayo.

 

Oomatshini kunye noMvelisi weHemodialysis okhuphisanayo

Iimodeli yomatshini we-hemodialysis W-T2008-Byenziwe nguUChengdu Wesleyidibanisa amava eqela aphantse abe yiminyaka engamashumi amathathu kushishino kunye nophuhliso lwetekhnoloji. Lo matshini wenzelwe ukusetyenziswa kwiiyunithi zonyango kwaye ufumene isiqinisekiso se-CE, kunye netekhnoloji ephucukileyo, uzinzo, ukhuseleko kunye nentuthuzelo yesigulane, kunye nokusebenza okulula kwabasebenzi bezonyango. Uneepompo ezimbini kunye negumbi elichanekileyo lokubonelela kunye nokubuyisela ulwelo, uyilo olulodwa lokuqinisekisa ukuchaneka kwe-ultrafiltration. Izinto eziphambili zomatshini zingeniswa zivela eYurophu nase-US, ezifana neevalvu ze-solenoid eziqinisekisa ulawulo oluchanekileyo lokuvulwa nokuvalwa kweziteshi, kunye neetships eziqinisekisa ukujonga ngokuchanekileyo kunye nokuqokelelwa kwedatha.

 

Phambili ukhuseleko lokhuseleko inkqubo

Lo matshini usebenzisa inkqubo yokujonga nokukhusela umoya kabini, izixhobo zokubona umgangatho wolwelo kunye neebhamuza, ezinokuthintela ngokufanelekileyo umoya ohamba ngegazi ukuba ungangeni emzimbeni wesigulana ukuze kumiswe iingozi ze-air embolism. Ukongeza, lo matshini uxhotyiswe ngamanqaku amabini okujonga ubushushu kunye namanqaku amabini okuqhuba, ukuqinisekisa ukuba umgangatho we-dialysate ugcinwa kulo lonke unyango. Inkqubo ye-alamu ekrelekrele inika ingxelo ngexesha langempela kuyo nayiphi na ingxaki ngexesha le-dialysis. I-alamu ye-acousto-optic ilumkisa abaqhubi ukuba baphendule ngokukhawuleza kuyo nayiphi na imiba, nto leyo ephucula ukhuseleko lwesigulana kunye nokusebenza kakuhle konyango.

Ngokusekelwe kwisiseko se-W-T2008-B,Umatshini wokucoca i-hemodiafiltre we-W-T6008Syongeza isixhobo sokujonga uxinzelelo lwegazi, izihluzi ze-endotoxin, kunye neBi-Cart njengezinto eziqhelekileyo. Ingatshintsha ngokulula phakathi kweendlela ze-HDF kunye ne-HD ngexesha lonyango. Faka ngee-dialyzers eziphezulu, ezinceda ekususweni kweemolekyuli ezinkulu egazini, umatshini uphucula ukusebenza kakuhle kunye nentuthuzelo yonyango.