Uwukhetha njani uMshini weHemodialysis okwiMgangatho oPhezulu

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 beHemodialysis badla ngokuba neenkqubo ezimbini eziphambili: inkqubo yolawulo lwegazi kunye nenkqubo yokuhlola igaziinkqubo yokubonelela nge-dialysate. Inkqubo yegazi inoxanduva lokulawula ukujikeleza kwegazi kwi-extracorporeal kwaye inkqubo ye-dialysate ilungisa isisombululo esifanelekileyo se-dialysis ngokuxuba ukugxila.s kunye ne-RO yamanzi kwaye ihambisa isisombululo kwi-dialyzer. Kwi-hemodialyzer, i-dialysate yenza i-solute diffusion, ukungena, kunyeukuhluza kunye nesigulana's nge-membrane ene-semi-permeable, kwaye okwangoku, igazi lokucoca liya kubuyela kwisigulana's umzimba ngenkqubo yolawulo lwegazi kunye nenkqubo ye-dialysate ikhupha ulwelo lwenkunkuma. 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 abasetyenziswa kwi-hemodialysis ngumatshini oqhelekileyo we-hemodialysis (HD) kunye nomatshini we-hemodiafiltration (HDF).oomatshini HDF kusetyenziswa ii-dialyzers eziguquguqukayo eziphezulu zibonelela ngenkqubo yokucoca ekwinqanaba eliphezulu--ukusasazwa kunye nokuhanjiswa ukomeleza ukususwa kweeathom ezinkulu kunye nezinto eziyityhefu kunye nokuzalisa ii-ion ezibalulekileyo ngokufaka umsebenzi wokubonelela.

 

Kuyafaneleka ukuba uqaphele ukuba indawo ye-membrane yendawo ye-dialyzer kufuneka ithathelwe ingqalelo kwisigulane's imeko ethile, kubandakanywa ubunzima, ubudala, imeko yentliziyo, kunye nokufikelela kwemithambo xa ukhetha i-dialyzers. Hlala udibana nogqirha's ingcebiso yobuchwephesha ukumisela i-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.

 

1. Ukuchaneka kokusebenza

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 komatshini okhethiweyo umenzi. 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.

 

UkhuphiswanoHi-emodialysisMachines kunye noMvelisi

 

Imodeli yomatshini we-hemodialysis W-T2008-B eyenziwe nguChengdu Wesley idibanisa iqela.'Phantse kumashumi amathathu eminyaka yamava oshishino kunye nokwenziwa kweteknoloji entsha. Umatshini wenzelwe ukusetyenziswa kwiiyunithi zonyango kwaye ufumene isatifikethi se-CE, ngeteknoloji ephezulu, ukuzinza, isigulane's ukhuseleko kunye nentuthuzelo, kunye nokusebenza lula kubasebenzi bezonyango. Ineempompo ezimbini kunye negumbi elichanekileyo lokubonelela kunye nokubuyiswa kwe-liquid-balance, idizayini ekhethekileyo yokuqinisekisa ukuchaneka kwe-ultrafiltration. Amacandelo aphambili omatshini angeniswa evela eYurophu nase-US, njengeevalvu ze-solenoid eziqinisekisa ulawulo oluchanekileyo lokuvula nokuvalwa kwamajelo, kunye nesiqinisekiso se-chips.nge ukubeka esweni okuchanekileyo kunye nokuqokelelwa kwedatha.

 

Inkqubo yokhuseleko oluphezulu

 

Umatshini uthatha ezimbiniinkqubo yokubeka iliso kunye nokukhusela umoya, ulwelo inqanaba kunye ne-bubble detectors, ezinokuthi zithintele ngokufanelekileyo umoya ojikelezayo wegazi ukuba ungene emzimbeni wesigulana ukumisa iingozi ze-air embolism. Ukongeza, umatshini uxhotyiswe ngamanqaku amabini okuhlola ubushushu kunye namanqaku amabini okuqhuba, ukuqinisekisa umgangatho we-dialysate. is igcinwe kulo lonke unyango. Inkqubo ye-alamu ekrelekrele ibonelela ngengxelo yexesha langempela kuyo nayiphi na into engaqhelekanga ngexesha le-dialysis. Iialam yeacousto-optic ilumkisa abaqhubi ukuba baphendule ngokukhawuleza kuyo nayiphi na imiba, ukuphucula ukhuseleko lwesigulane kunye nokusebenza kakuhle kwonyango.

 

Ngokusekelwe kwisiseko se-W-T2008-B, umatshini we-W-T6008S we-hemodiafiltration wongeza i-monitor ye-blood pressure, i-endotoxin filters, kunye ne-Bi-Cart njengemimiselo eqhelekileyo. 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.