Uma kukhulunywa ngokwelashwa kwe-hemodialysis okuphumelelayo, ukukhetha okulungilei-dialyzer ye-hemodialysis, futhiinaliti ye-dialyzerkubalulekile. Izidingo zesiguli ngasinye ziyahlukahluka, futhi abahlinzeki bezokwelapha kumele balinganise ngokucophelela izinhlobo ze-dialyzer kanyeUsayizi wezinaliti ze-AV fistulaukuqinisekisa imiphumela emihle yokwelapha. Kulesi sihloko, sizohlola izindlela ezahlukene zokwelaphaizinhlobo ze-dialyzer(ukuguquguquka okuphezulu, ukuguquguquka okuphakathi, ukuguquguquka okuphansi),amageyiji enali ye-dialyzer(15G, 16G, 17G), kanye nobudlelwano bazo namazinga okugeleza kwegazi, okukunikeza umbono ophelele walezi zixhobo zezokwelapha ezibalulekile.
Izinhlobo ze-Dialyzer
I-dialyzer ivame ukubizwa ngokuthi yizinso zokwenziwa. Ihlunga ukungcola kanye noketshezi oluningi oluvela egazini lapho izinso zingasakwazi ukwenza lo msebenzi ngempumelelo. Kunezinhlobo ezintathu eziyinhloko zalokhuama-dialyzer e-hemodialysisngokusekelwe ekungeneni kwamanzi kanye nokusebenza kahle: ukugeleza okuphezulu, ukugeleza okuphakathi, kanye nokugeleza okuphansi.
- Ama-Dialyzer e-Flux aphezulu: Lawa ma-dialyzer anezimbobo ezinkulu, okuvumela ukususwa okusheshayo kwama-molecule amancane naphakathi, kufaka phakathi ubuthi obukhulu obungenakuqedwa yi-dialyzer yendabuko ene-flux ephansi. Ama-membrane e-flux ephezulu avame ukuphumela ezikhathini zokwelashwa ezimfushane kanye nemiphumela engcono yesiguli, ikakhulukazi ekunciphiseni izinkinga zesikhathi eside.
- Ama-Dialyzer e-Flux aPhakathi: Zibekwe phakathi kwezinketho zokushintshashintsha okuphezulu nokuphansi, ama-dialyzer e-medium flux ahlinzeka ngokususwa okulinganiselwe kokubili ubuthi obuncane nobuphakathi besisindo sama-molecule. Zivame ukusetshenziswa lapho kunesidingo sokususa kahle ngaphandle kokufaka engcupheni yokulahlekelwa yi-albumin ngokweqile.
- Ama-Dialyzer Aphansi Okushintshashintshayo: Lawa ama-dialyzer esizukulwane esidala anezimbobo ezincane, ikakhulukazi ahlose ukuhlanzwa kwama-molecule amancane, njenge-urea ne-creatinine. Avame ukusetshenziswa ezigulini ezinezimo ezizinzile kanye nemithwalo ye-toxin ephansi.
Ukukhetha i-dialyzer efanele ye-hemodialysis kuncike esimweni sesiguli, ikhono lokufinyelela imithambo yegazi, kanye nemigomo yempilo iyonke.
Usayizi Wenaliti Ye-AV Fistula: 15G, 16G, kanye ne-17G
Inaliti ye-AV fistula ingenye into ebalulekileidivayisi yezokwelaphaku-hemodialysis. Izinaliti ziza ngama-gauge ahlukahlukene (G), ngalinye lifanele amazinga okugeleza kwegazi ahlukene kanye nezidingo zesiguli.
- Inaliti ye-Fistula ye-AV engu-15G: Njengoba inkulu ngobukhulu, inaliti ye-dialyzer engu-15G isekela amazinga aphezulu okugeleza kwegazi, ngokuvamile afinyelela ku-450 mL/min. Ilungele iziguli ezidinga i-dialysis esheshayo noma lezo ezine-vascular access eqinile.
- Inaliti ye-Fistula ye-AV engu-16G: Uma incane kancane, inaliti engu-16G ivame ukusetshenziswa futhi ingaphatha amazinga okugeleza kwegazi angaba ngu-300-400 mL/min. Zinikeza ibhalansi phakathi kokusebenza kahle kokugeleza kwegazi kanye nenduduzo yesiguli.
- Inaliti ye-Fistula ye-AV engu-17G: Incane kune-15G kanye ne-16G, inaliti ye-17G isetshenziselwa amazinga aphansi okugeleza kwegazi, cishe i-200-300 mL/min. Le naliti ingcono kakhulu ezigulini ezinemithambo ethambile noma ama-fistula amasha e-AV asakhula.
Ukukhetha i-AV fistula needle gauge efanele akuthinti nje kuphela ukusebenza kahle kokwelashwa kodwa futhi kuphazamisa nesikhathi esideukufinyelela kwemithambo yegaziimpilo. Ukusebenzisa inalithi enkulu kakhulu kune-fistula ebuthakathaka kungabangela umonakalo, kanti ukusebenzisa encane kakhulu kunganciphisa ukusebenza kahle kokwelashwa.
Izinga Lokugeleza Kwegazi Nokusebenza Kahle Kokuhlanzwa Kwegazi
Izinga lokugeleza kwegazi liyisici esibalulekile ekunqumeni ukwanele kwe-dialysis. Ngokuvamile, izinga lokugeleza kwegazi eliphezulu lithuthukisa ukususwa kobuthi, kodwa kumele lihambisane nekhono le-dialyzer kanye nosayizi wenalithi ye-AV fistula.
- Ama-Dialyzer e-Flux aphezulungokuvamile zidinga futhi zisekele amazinga aphezulu okugeleza kwegazi (kufika ku-450 mL/min), okwenza zihambisane nezinaliti ezingu-15G noma ezingu-16G.
- Ama-Dialyzer e-Flux aPhakathiingasebenza kahle ngesivinini sokugeleza kwegazi esimaphakathi (300-400 mL/min), ilungele izinaliti ezingu-16G.
- Ama-Dialyzer Aphansi Okushintshashintshayoivame ukusebenza ngezinga lokugeleza kwegazi eliphansi (200-300 mL/min), ihambisana kahle nezinaliti ezingu-17G.
Ukulinganisa okungalungile kungaholela ekungasebenzeni kahle kwe-dialysis, ukwanda kwezikhathi zokwelashwa, noma ukucindezeleka okungadingekile ekufinyeleleni kwemithambo yegazi.
Isiphetho
Ukuqonda ukusebenzisana phakathi kwezinhlobo ze-dialyzer ze-hemodialysis, ama-dialyzer needle gauges, kanye namazinga okugeleza kwegazi kubalulekile ekufinyeleleni imiphumela emihle ye-dialysis. Kungakhathaliseki ukuthi ukhetha phakathi kwe-high flux, medium flux, noma i-low flux dialyzers, noma ukhetha inaliti ye-15G, 16G, noma i-17G AV fistula efanele, isinqumo ngasinye sithinta ngqo impilo yesiguli.
Kwabahlinzeki bezempilo, ukuhlala unolwazi ngentuthuko yakamuva kumadivayisi ezokwelapha kuqinisekisa ukuthi iziguli zithola ukunakekelwa okungcono kakhulu. Inhlanganisela efanele ye-dialyzer nosayizi wenaliti ayithuthukisi nje kuphela ukusebenza kahle kwe-dialysis kodwa futhi ivikela ukufinyelela kwemithambo yegazi futhi ithuthukise ikhwalithi yokuphila kwesiguli.
Isikhathi sokuthunyelwe: Ephreli-27-2025