Mō ngā tūroro e pāngia ana e te mate whatukuhu mutunga-wāhanga (ESRD), he kōwhiringa maimoatanga haumaru, whai hua hoki te hemodialysis. I te wā e rongoatia ana, ka pā te toto me te dialysate ki te dialyzer (whatukuhu horihori) mā roto i te kiriuhi haurua-permeable, ka taea ai te whakawhiti i ngā matū e peia ana e ngā pikinga kukū. He mahi nui tā te mīhini hemodialysis ki te pure i te toto mā te tango i ngā para pākia me ngā electrolytes taikaha me te whakauru i ngā ion konupūmā me te paikāponate mai i te dialysate ki roto i te toto. I roto i tēnei tuhinga, ka tūhuratia e mātou ngā kaupapa matua o ngā mīhini hemodialysis, ā, ka ārahi i te whiriwhiri i tētahi taputapu kounga teitei kia pai ake ai te maimoatanga.

 

Te Mārama ki ngā Mīhini Hemodialysis

Ko ngā mīhini hemodialysis he tikanga e rua ngā pūnaha matua: te pūnaha aroturuki toto me te pūnaha tuku dialysate. Ko te pūnaha toto te kawenga mō te whakahaere i te tohanga toto i waho o te tinana, ā, ka whakarite te pūnaha dialysate i te otinga dialysis kua tohua mā te whakaranu i ngā kukū me te wai RO, ka kawe i te otinga ki te dialyzer. I roto i te hemodialyzer, ka mahi te dialysate i te tohatoha matū, te urunga, me te tātaritanga ultra me te toto o te tūroro mā roto i te kiriuhi haurua-permeable, ā, i taua wā, ka hoki te toto purenga ki te tinana o te tūroro mā te pūnaha whakahaere toto, ā, ka ringihia e te pūnaha dialysate te wai para. Mā tēnei tukanga huringa tonu ka horoia te toto.

I te nuinga o te wā, kei roto i te pūnaha aroturuki toto he papu toto, he papu heparin, he aroturuki pēhanga uaua me te uaua, me te pūnaha kimi hau. Ko ngā wāhanga matua o te pūnaha tuku dialysis he pūnaha whakahaere pāmahana, he pūnaha whakaranu, he pūnaha tango hau, he pūnaha aroturuki kawe hiko, he aroturuki tātaritanga ultra, he kimi turuturu toto, me ētahi atu.

Ko ngā momo mīhini matua e rua e whakamahia ana i roto i te hemodialysis ko te mīhini paerewamīhini hemodialysis (HD)me temīhini tātaritanga hemodia (HDF)Ngā mīhini HDF e whakamahi ana ingā dialyzers rere-teiteie tuku ana i tētahi tukanga tātari matatau ake - te horapa me te kawe hiko hei whakarei ake i te tango i ngā ngota nui me ngā matū paitini, me te whakakī anō i ngā katote nui mā te mahi tuku whakakapinga.

He mea tika kia mōhiotia ko te horahanga o te mata o te membrane o te dialyzer me whai whakaaro ki te āhuatanga motuhake o te tūroro, tae atu ki te taumaha, te tau, te āhua o te ngākau, me te urunga ki ngā oko toto i te wā e whiriwhiri ana i ngā dialyzer. Me kōrero tonu ki ngā tohutohu ngaio a te tākuta hei whakatau i tete mīhini tātari toto e tika ana.

 

Te Kōwhiri i tētahi Mīhini Hemodialysis Tika

Ko te haumaru me te tika ngā mea matua. Anei ētahi āhuatanga matua hei whakaaroaro:

1. Ngā Āhuatanga Haumaru

Me whai pūnaha aroturuki haumaru me te whakaoho pakari te mīhini hemodialysis whai tohu. Me tairongo ēnei pūnaha ki te kite i ngā āhuatanga rerekē, me te tuku whakatūpato tika ki ngā kaiwhakahaere.

Ko te aroturukitanga wā-tūturu ko te aroturuki tonu i te pēhanga o ngā uaua me ngā uaua, ngā tere rere, me ētahi atu tawhā nui i te wā o te dialysis. Ka whakatūpato ngā pūnaha whakaoho mō ngā take pēnei i te hau i roto i ngā raina toto kua nui ake te pēhanga toto, te tere tātaritanga hē rānei.

 2. Te tika o te mahi

Ka pā te tika o te mīhini ki te whai huatanga o te maimoatanga, ā, i te nuinga o te wā ka aromatawaihia e ēnei āhuatanga:

Te tere tātaritanga tino-rahi: me whakahaere tika e te mīhini te wai i tangohia mai i te tūroro.

Te aroturuki i te kawe ira: te whakarite kia tika te kukū o te irahiko o te dialysate.

Whakahaere pāmahana: me pupuri e te mīhini te pāmahana o te dialysate ki tētahi pāmahana haumaru, whakamarie hoki.

 3. Atanga Kaiwhakamahi-hoa

Ka taea e te atanga kaiwhakamahi-hoa te whakapai ake i te wheako mō ngā tūroro me ngā kaiwhakahaere. Rapua ngā mīhini he ngāwari ki te whakahaere me ngā whakaaturanga mārama hei āwhina i te aro turuki i ngā tawhā maimoatanga.

4. Te Tiaki me te Tautoko

Whakaarohia te kaha o te tautoko hangarau me ngā ratonga tiaki mō te kaihanga mīhini kua whiriwhiria. Mā te tautoko pono ka taea te whakarite kia tere te whakatika i ngā take katoa, kia iti ake ai ngā whakararuraru i te maimoatanga.

 5. Te Whakatutuki i ngā Paerewa

Me tutuki te mīhini hemodialysis i ngā paerewa haumaru me te kounga e tika ana kua whakatakotoria e ngā whakahaere ture. He mea nui tēnei tutukitanga kia pai ai te haumaru o te tūroro me te whai hua o te maimoatanga.

 

Ngā Mīhini me ngā Kaihanga Hemodialysis Whakataetae

Temīhini whakaheke toto tauira W-T2008-Bi hangaia eChengdu Wesleye whakauru ana i te tata ki te toru tekau tau o te wheako ahumahi me te auahatanga hangarau o te tīma. Kua hangaia te mīhini hei whakamahi i roto i ngā wāhanga hauora, ā, kua whiwhi i te tiwhikete CE, me te hangarau matatau, te pumau, te haumaru me te whakamarie o te tūroro, me te ngāwari o te whakahaere mō ngā kaimahi hauora. E rua ngā papu me te rūma taurite-tuku-me-whakahoki-wai tika, he hoahoa ahurei hei whakarite i te tika o te tātari ultra. Ko ngā wāhanga matua o te mīhini he mea kawemai mai i Ūropi me te US, pērā i ngā takirere solenoid e whakarite ana i te whakahaere tika o ngā awa e tuwhera ana me te kati ana, me ngā maramara e whakarite ana i te aroturukitanga tika me te kohikohi raraunga.

 

Matatau tiaki haumaru pūnaha

Kei te mīhini he pūnaha aroturuki me te tiaki hau takirua, he pūnaha kite taumata wai me te mirumiru, e āhei ai te ārai i te hau i roto i te tohanga toto kia kaua e tomo ki te tinana o te tūroro hei aukati i ngā aituā o te embolism hau. Hei tāpiri, e rua ngā pūwāhi aroturuki mō te pāmahana me ngā pūwāhi e rua mō te kawe hiko o te mīhini, kia mau tonu ai te kounga o te dialysate puta noa i te maimoatanga. Ka tukuna e te pūnaha whakaoho atamai he urupare wā-tūturu mō ngā āhuatanga rerekē i te wā dialysis. Ka whakatūpato te whakaoho acousto-whatu i ngā kaiwhakahaere kia tere te urupare ki ngā take katoa, kia pai ake ai te haumaru o te tūroro me te whai huatanga o te maimoatanga.

I runga i te turanga o te W-T2008-B, ko teMīhini tātari toto W-T6008Stāpirihia he aroturuki toto toto, he tātari endotoxin, me te Bi-Cart hei whirihoranga paerewa. Ka taea te whakawhiti ngāwari i waenga i ngā aratau HDF me HD i te wā e rongoatia ana. Tāutahia me ngā dialyzers rere-teitei, e āwhina ana i te tango i ngā ngota nui ake i te toto, ka whakarei ake te mīhini i te whai huatanga whānui me te whakamarie o te rongoā.