Kev lim ntshav lub raum yog txheej txheem uas pab koj lub cev tshem cov khoom pov tseg los ntawm cov ntshav thaum lub raum tsis ua haujlwm lawm. Qhov kawg ntawm lub raum tsis ua haujlwm tsis kuaj pom txog thaum koj poob ntawm 85 thiab 90% ntawm koj lub raum ua haujlwm. Lub raum tsis ua haujlwm feem ntau yog ib qho xwm txheej tas mus li, tab sis qee tus neeg tuaj yeem ntsib qhov ua tsis tiav los ntawm kev kis tus kab mob, uas yuav zoo dua thaum kis tau zoo. Muaj ob hom kev lim ntshav hauv lub raum: hemodialysis thiab lim ntshav peritoneal. Txhawm rau npaj rau kev lim ntshav koj yuav xav tau hloov pauv koj cov zaub mov noj, hloov kho koj cov tshuaj tiv thaiv, thiab kawm paub yuav tiv thaiv kev kis mob li cas.
Cov kauj ruam
Txoj Kev 1 ntawm 3: Hloov Txoj Kev Ua Neej
Kauj Ruam 1. Ua kom ntseeg tau tias koj cov tshuaj tiv thaiv tau hloov tshiab
Txawm hais tias koj tab tom siv kev lim ntshav peritoneal lossis hemodialysis, txhua tus neeg uas muaj lub raum tsis ua haujlwm kawg yuav tsum tau hloov kho nrog lawv cov tshuaj tiv thaiv kom txo tau qhov muaj peev xwm kis mob thiab mob.
- Kab mob hauv lub raum kawg cuam tshuam rau koj lub cev tiv thaiv kab mob. Cov neeg tuag yog siab txog li 20% hauv ib xyoos rau cov tib neeg uas tau mus kuaj ntshav thiab qhov ua rau loj yog kab mob plawv thiab kis kab mob. Kev ua haujlwm tsis zoo ntawm lub cev tiv thaiv kab mob los ntawm uremia, lossis ntau dua ntawm urea hauv cov ntshav.
- Tham nrog koj tus kws kho mob txog kev txhaj tshuaj tiv thaiv kab mob khaub thuas, kab mob siab A thiab B thiab txhaj tshuaj tiv thaiv kab mob pneumococcal rau mob ntsws kom pab tiv thaiv kab mob no.
Kauj Ruam 2. Txaus kom tsaug zog ntau hmo
Dialysis ua haujlwm tau zoo tshaj plaws thaum koj tau so zoo vim kev pw tsaug zog pab koj lub cev tshem tawm cov khoom pov tseg. Nco ntsoov tias koj tau pw yim teev txhua hmo los txhawb nqa kev tshem cov khoom pov tseg ntawm koj lub cev thiab lub paj hlwb.
Yog tias koj muaj teeb meem pw tsaug zog tom qab pib lim ntshav, qhia rau koj tus kws kho mob paub sai li sai tau
Kauj Ruam 3. Txhob haus luam yeeb
Kev haus luam yeeb ua rau koj suav cov qe ntshav dawb ntau ntxiv, ua rau lub cev muaj kev nyuaj siab tiv thaiv qhov mob thiab puas tsuaj los ntawm cov tshuaj. Nicotine tseem ua rau cov hlab ntshav qis, ua rau cov qib cov as -ham thiab cov pa oxygen nkag mus rau cov cell. Tar thiab lwm yam tshuaj tseem yuav ua rau lub cev tiv thaiv kab mob tsis zoo hauv kev tawm tsam kev kis mob. Qhov ntawd txhais tau tias koj yuav muaj feem yuav muaj mob ntau dua thiab muaj kev phom sij rau cov kab mob autoimmune.
Yog tias koj yog neeg haus luam yeeb, nrog koj tus kws kho mob tham txog kev pab kom txiav luam yeeb. Muaj ntau txoj haujlwm txiav luam yeeb dawb thiab lwm yam kev kho mob uas koj tus kws kho mob tuaj yeem qhia koj txog
Kauj Ruam 4. Ntxuav koj txhais tes ntau zaus
Nws yog ib qho tseem ceeb kom ntxuav koj txhais tes kom zoo ua ntej thiab tom qab ua zaub mov noj, tom qab siv chav dej, tom qab nyob rau pej xeem lossis tom qab kov koj lub qhov ntswg lossis tshuab koj lub qhov ntswg. Ntxuav koj txhais tes tom qab nrog lwm tus neeg lossis nrog leej twg muaj mob lossis zoo li mob. Ua li ntawd yuav pab tiv thaiv koj kom tsis txhob mob lossis tsim kev kis mob.
Kauj Ruam 5. Tswj koj cov ntshav siab los ntawm kev noj tshuaj, noj zaub mov zoo, thiab tawm dag zog
Koj cov ntshav siab yuav muaj kev phom sij rau koj lub cev tiv thaiv kab mob, uas tuaj yeem ua rau muaj teeb meem hnyav dua. Los ntawm kev tswj koj cov ntshav siab thiab txhawb koj lub cev tiv thaiv kab mob koj tuaj yeem txo koj txoj kev kis mob.
Ntshav siab yuav txo cov pa oxygen uas xa mus rau ob lub raum thiab lwm yam kabmob. Txawm hais tias koj lub raum ua tsis tiav, ntshav siab tuaj yeem cuam tshuam koj qhov muag thiab ua rau mob plawv
Kauj Ruam 6. Noj zaub mov kom zoo nrog txiv hmab txiv ntoo, zaub, thiab nqaij
Tej zaum koj yuav tsum tau hloov qee yam kev noj haus nyob ntawm koj tus mob. Txo koj cov carbohydrates thiab ntsev kom tsawg los txo cov khoom pov tseg uas tsim nyog yuav tsum tau muab tshem tawm los ntawm kev lim ntshav. Tham nrog koj tus kws kho mob txog kev noj zaub mov tshwj xeeb nws xav kom koj ua raws, raws li koj tus kheej cov kev xav tau kho mob.
- National Kidney Foundation pom zoo noj zaub mov muaj protein ntau uas muaj ntsev tsawg, potassium thiab phosphorus. Cov zaub mov ib txwm muaj protein ntau suav nrog taum thiab nqaij.
- Zam kev ua zaub mov noj raws li cov no feem ntau muaj sodium ntau.
- Txwv koj cov ntsev kom tsawg. Sim siv tshuaj ntsuab thiab txuj lom los txhim kho qhov tsw ntawm koj cov zaub mov.
- Tsis txhob noj cov zaub mov uas muaj cov poov tshuaj thiab phosphorus ntau, xws li cov nplooj ntsuab tsaus, txiv tsawb, avocados, taub dag, qos yaj ywm, yogurt, thiab ntses.
Kauj Ruam 7. Ua tib zoo saib xyuas koj cov kua dej
Koj tus kws kho mob yuav txiav txim siab muab koj tso rau hauv cov kua txwv tsis pub noj zaub mov thiab tseem tuaj yeem nug koj kom taug qab cov dej uas koj haus. Nco ntsoov tias koj tham txog koj tus kheej cov kev xav tau nrog koj tus kws kho mob.
Kauj Ruam 8. Nco ntsoov tias koj yuav tsum tau tos rau qhov chaw kuaj kab mob kom zoo ua ntej koj yuav pib lim ntshav
Qhov chaw kuaj kab mob yuav siv sijhawm li ob lub lis piam los kho ua ntej nws yuav raug siv rau kev lim ntshav. Tom qab qhov chaw kho tau zoo, koj yuav tau txais kev qhia paub yuav npaj koj li cas lub hnab lim dej hauv lub cev thiab tshuab, yuav ua li cas txuas thiab tshem tawm, yuav ua li cas muab cov kua tawm, thiab thaum mus nrhiav kev kho mob.
Kauj Ruam 9. Nrhiav pab pawg txhawb nqa koj los daws qhov kev hloov pauv
Pib kev lim ntshav xav tau kev hloov pauv lub neej tseem ceeb uas yuav nyuaj rau koj tus kheej. Xav txog koom nrog pab pawg txhawb nqa los pab koj daws qhov kev hloov pauv hauv koj lub neej los ntawm lub raum tsis ua haujlwm. Koj kuj tseem yuav tau txais txiaj ntsig los ntawm kev sab laj nrog kws kho mob, kws kho paj hlwb lossis tus xibhwb.
Txoj Kev 2 ntawm 3: Xav Txog Qhov Teeb Meem
Kauj Ruam 1. Xav txog qee qhov tsis xis nyob
Hemodialysis tsis yog txheej txheem mob. Txawm li cas los xij thaum lub sijhawm txheej txheem koj yuav hnov xeev siab thiab ntuav. Yog tias koj nkees nkees qhia rau koj tus kws saib xyuas neeg mob paub tias koj tuaj yeem siv tshuaj los txo qhov tsis xis nyob. Qhov no yuav nyob ntawm koj tus mob.
Lub sijhawm txheej txheem qee tus neeg pom tias lawv nkees thiab yuav tsaug zog. Qhov no tseem tuaj yeem pab daws qhov kev xeev siab. Nyob ntawm koj tus mob, koj kuj tseem yuav pom tias koj tuaj yeem nyeem ntawv xov xwm, ua haujlwm hauv koj lub computer lossis saib cov yeeb yam ntawm koj lub xov tooj. Vim tias koj lub sijhawm teem rau kev lim ntshav yuav nyob rau tib hnub thiab sijhawm txhua lub lim tiam, ntau tus neeg mob ua phooj ywg nrog lwm tus neeg nyob ntawd rau kev lim ntshav
Kauj Ruam 2. Ceev faj txog kev pheej hmoo plawv ntawm kev lim ntshav
Dialysis muaj peev xwm ua rau qee yam mob plawv loj. Cov teebmeem no suav nrog ntshav siab, ntshav siab, thiab pericarditis. Koj tus kws kho mob yuav tshuaj xyuas koj rau cov xwm txheej no, tab sis nws yog qhov zoo kom paub txog qhov txaus ntshai ib yam.
- Ntshav siab. Ntshav siab tsawg lossis hypotension, tuaj yeem yog qhov tshwm sim ntawm kev lim ntshav, tshwj xeeb tshaj yog rau cov neeg uas muaj ntshav qab zib. Qhov no tuaj yeem ua nrog mob plab, ntuav thiab ua tsis taus pa. Tshaj qhia qhov hnov cov tsos mob no rau koj tus kws saib xyuas kev lim ntshav tam sim ntawd tuaj yeem hloov pauv mus rau qhov teeb tsa ntawm koj li txheej txheem kev lim ntshav.
- Ua kom ntshav siab ntxiv. Noj ntsev ntau dhau los yog kua nruab nrab ntawm kev kho mob tuaj yeem ua rau koj cov ntshav siab thiab koj muaj feem yuav mob plawv, mob plawv thiab mob hlab ntsha tawg. Raws li koj tus kheej xav tau kev kho mob koj tus kws kho mob yuav qhia kom txwv sodium thiab dej kom tsawg.
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Pericarditis.
Yog tias hemodialysis tsis ua haujlwm zoo nws tuaj yeem ua rau mob pericarditis lossis mob ntawm daim nyias nyias uas nyob ib puag ncig lub plawv. Qhov no txo qis kev ua haujlwm ntawm cov leeg nqaij hauv plawv thiab tuaj yeem ua rau mob stroke lossis plawv nres.
Kauj Ruam 3. Nco ntsoov tias lub cev tsis xis nyob
Txawm hais tias kev lim ntshav tsis yog kev kho mob hnyav, nws yuav tsis xis nyob thaum xub thawj. Cov tsos mob xws li mob leeg thiab khaus khaus yog qhov tsis txaus siab thaum thiab tom qab hemodialysis.
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Mob leeg.
Txawm hais tias qhov laj thawj tseeb vim li cas thiaj tsis paub, kev hloov kho koj cov sodium kom tau txais ntawm thiab thaum kho tuaj yeem pab txo cov leeg nqaij.
- Cov tawv nqaij khaus. Nws yog ib qho ua rau cov tawv nqaij khaus thaum thiab tom qab hemodialysis.
Kauj Ruam 4. Qhia koj tus kws kho mob yog tias koj muaj teeb meem pw tom qab txheej txheem
Tham nrog koj tus kws kho mob yog tias koj muaj teeb meem pw tam sim tom qab hemodialysis. Tej zaum koj yuav muaj kev tsaug zog tsaug zog lossis ob txhais ceg tsis so los ntawm cov txheej txheem. Cov neeg uas siv kev lim ntshav peritoneal tsis pom muaj qhov tshwm sim zoo li no.
Kauj Ruam 5. Paub tias ntshav tsis txaus yog qhov tshwm sim muaj tshwm sim
Anemia yog ib qho tshwm sim tshwm sim ntawm ob lub raum tsis ua haujlwm thiab kev lim ntshav. Cov tshuaj erythropoietin yog lub luag haujlwm rau kev tsim cov qe ntshav liab tab sis tau ua hauv lub raum. Koj tus kws kho mob feem ntau yuav xav kom koj kuaj ntshav tas li txhawm rau txheeb xyuas koj cov qib hlau.
Tham nrog koj tus kws kho mob yog tias koj qaug zog, ua tsis taus pa, lossis ntseeg tias koj yuav muaj ntshav tsis txaus
Kauj Ruam 6. Qhia txog kev hloov pauv ntawm kev xav
Kev hloov pauv kev xav yog ib txwm muaj rau tib neeg hla kev lim ntshav, tab sis muaj kev kho mob los pab nrog cov kev mob tshwm sim no. Qhia koj tus kws kho mob tam sim yog tias koj ntsib kev tu siab, kev nyuaj siab, lossis lwm yam kev cuam tshuam kev hloov pauv.
- Kev hloov pauv hauv lub siab tuaj yeem cuam tshuam nrog kev hloov pauv biochemical los ntawm kev lim ntshav thiab lub raum tsis ua haujlwm lossis los ntawm kev paub dhau los.
- Pab pawg txhawb nqa thiab tawm tswv yim nrog tus kws kho mob lossis tus xibhwb tuaj yeem pab thaum qhov kev xav hloov pauv cuam tshuam nrog kev paub uas koj tab tom dhau mus thiab tsis yog los ntawm kev hloov pauv biochemical hauv koj cov ntshav.
Kauj Ruam 7. Xav txog qhov tshwm sim mus sij hawm ntev ntawm hemodialysis
Tom qab kwv yees li tsib xyoos ntawm kev lim ntshav, koj txoj kev pheej hmoo ntawm kev tsim amyloidosis nce. Thaum cov protein nyob hauv cov ntshav tau tso rau hauv cov pob qij txha thiab cov leeg nws ua rau mob, khov thiab ua kom cov kua nyob hauv thaj chaw sib koom ua ke.
Yog tias koj ntseeg tias koj tab tom ntsib cov tsos mob no, tham nrog koj cov kev xaiv nrog koj tus kws kho mob. Lawv yuav vam khom koj li kev ua haujlwm ntawm lub raum, kev noj qab haus huv tag nrho thiab daim ntawv sau tshuaj ntxuav ntshav
Txoj Kev 3 ntawm 3: Kawm Ntxiv Txog Kev Dialysis
Kauj Ruam 1. Paub txog cov tsos mob thiab ua rau lub raum tsis ua haujlwm
Thaum lub raum pib ua tsis tiav, cov tsos mob cuam tshuam nrog kev sib npaug ntawm cov kua dej, qhov sib npaug ntawm cov roj ntsha, tshem tawm cov khoom pov tseg, thiab tsim cov qe ntshav liab. Cov tsos mob thaum ntxov kuj tseem tuaj yeem ua rau lwm tus mob, uas tuaj yeem ua rau tsis meej pem. Yog tias koj tau ntsib cov tsos mob no thiab lawv tsis daws tau ob peb hnub lossis tsis zoo li yog lwm qhov laj thawj, mus ntsib kws kho mob. Cov tsos mob los saib xyuas suav nrog:
- Tsis qab los noj mov
- Kev xav ntawm kev qaug zog
- Mob taub hau
- Khaus, tawv nqaij qhuav
- Xeev siab
- Poob phaus (thaum koj tsis ua kom poob phaus)
Kauj Ruam 2. Saib xyuas tom qab cov tsos mob ntawm lub raum tsis ua haujlwm
Cov tsos mob tom qab tshwm sim thaum lub raum ua haujlwm tau zoo dua qub thiab lub raum tsis tuaj yeem lim cov khoom pov tseg los ntawm cov ntshav. Cov tsos mob ntawm lub raum tsis ua haujlwm tom qab suav nrog:
- Cov tawv nqaij hloov xim
- Kev tsaug zog lossis teeb meem nrog kev mloog zoo thiab xav
- Cov nqaij ntshiv thiab cramps
- Mob pob txha
- Ua npaws lossis o ntawm tes thiab taw
- Ntshav hauv cov quav
- Nquag hiccups
- Kev nqhis dej ntau dhau
- Amenorrhea (hauv poj niam, lub cev ntas nres)
- Teeb meem pw tsaug zog
- Ua tsis taus pa
- Ntuav (ntau zaus thaum sawv ntxov)
Kauj Ruam 3. Txheeb xyuas cov cim ntawm qhov kawg ntawm lub raum tsis ua haujlwm
Qhov kawg ntawm lub raum tsis ua haujlwm yog qhov tshwm sim ntawm kev puas tsuaj rau lub raum. Cov theem kawg hu ua End Stage Renal Disease lossis ESRD, uas lub raum tsis tuaj yeem lim cov khoom pov tseg txaus los ntawm cov ntshav. Txog tam sim no koj lub cev yuav xav tau kev lim ntshav lub raum lossis hloov pauv lub raum kom ua haujlwm tau zoo. Ob ntawm qhov laj thawj feem ntau uas ESRD txhim kho yog ntshav qab zib thiab ntshav siab lossis ntshav siab. Lwm yam mob uas yuav ua rau muaj peev xwm nce rau ESRD yog:
- Kev yug menyuam tsis zoo ntawm ob lub raum, xws li mob raum polycystic
- Kev raug mob rau lub raum
- Raum pob zeb thiab kis kab mob
- Teeb meem nrog cov hlab ntsha uas muab cov pa oxygen thiab cov as -ham rau lub raum
- Qee yam tshuaj siv los kho mob qog noj ntshav lossis mob tuaj yeem ua rau lub raum puas thiab ua rau tsis ua haujlwm
- Qee yam tshuaj lom
- Kab mob autoimmune xws li scleroderma lossis kab mob lupus erythematosus
- Reflux, lossis thaum tso zis rov qab los ntawm lub zais zis mus rau ob lub raum thiab ua rau lub cev puas tsuaj
- Lwm yam kab mob hauv lub raum
Kauj Ruam 4. Nug koj tus kws kho mob txog kev lim ntshav hauv plab
Peritoneal dialysis tsis xav tau cov tshuab loj, yog li koj tuaj yeem ua daim ntawv lim ntshav no tom tsev. Ua ntej koj tuaj yeem muaj kev lim ntshav peritoneal, tus kws phais yuav xav tso lub raj tshwj xeeb (raj) rau hauv koj lub plab kab noj hniav. Kev siv lub raj no, yuav tau siv cov tshuaj lim ntshav tshwj xeeb, hu ua dialysate, yuav muab coj los siv. Cov tshuaj no rub tawm cov khoom pov tseg los ntawm koj cov ntshav uas tom qab ntawd lim los ntawm cov ntaub so ntswg hauv koj lub plab. Muaj ob hom kev lim ntshav ib leeg ib leeg: Kev Mob Nkeeg Tsis Tu ncua Peritoneal Dialysis (CAPD) thiab Automated Peritoneal Dialysis (APD).
- Nruam Ambulatory Peritoneal Dialysis. Peb zaug ib hnub, koj yuav xa txog li ob quarts dej nkag rau hauv koj lub plab los ntawm koj lub plab plab. Qhov no yuav ua raws los ntawm ib hmo "nyob," piv txwv li cov kua dej uas tseem nyob hauv cov kab noj hniav peritoneal thaum hmo ntuj. Tom qab ntawd, cov dej yuav tsum tau ntws thiab muab pov tseg. Ob qho kev ntxig thiab tso dej yog ua tiav siv lub ntiajteb txawj nqus.
- Automated Peritoneal Dialysis. Thaum koj tsaug zog, lub tshuab ntawm cov dej ntws tawm hauv thiab tawm ntawm koj lub plab. Koj yuav siv sijhawm li 30 feeb los tham txog kev lim ntshav thiab tshuab ua ntej yuav mus pw. Thaum sawv ntxov nws tuaj yeem siv kwv yees li 10 feeb kom tshem lub tshuab thiab tshem tawm cov tshuaj. Koj yuav khaws cov ntxaij lim dej thiab xa rov qab mus rau qhov chaw lim ntshav txhua lub lim tiam, qhov uas koj yuav khaws lwm cov lim dej los siv rau lub lim tiam tom ntej.
Kauj Ruam 5. Tham nrog hemodialysis nrog koj tus kws kho mob
Hemodialysis yuav tsum tau ua tom tsev kho mob lossis chaw lim ntshav. Cov txheej txheem no siv cov tshuab tshwj xeeb los rub ntshav los ntawm koj lub cev, lim cov khoom pov tseg thiab xa cov ntshav rov los rau koj lub cev. Thaum lub sij hawm hemodialysis siv ob lub lim dej. Ib qho yuav lim koj cov ntshav rau cov khoom pov tseg thiab qhov thib ob yog siv los lim cov kua uas siv los ntxuav cov ntshav. Lub tshuab lim dej qee zaum hu ua dag lub raum lossis dialyzer. Ua ntej koj thawj zaug lim ntshav ib tus kws phais yuav tso qhov chaw nkag rau hauv koj lub cev. Muaj peb hom chaw nres nkoj uas yuav siv tau.
- Fistula. Lub fistula yog kev nkag los hauv kev phais los ntawm kev koom nrog cov leeg ntshav thiab leeg ntshav ntawm caj npab. Qhov kev nkag mus no muab ob leeg cov hlab ntshav thiab cov hlab ntshav rau lub tshuab.
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Cuam tshuam.
Tej zaum yuav siv txoj hlab ntshav nrog lub raj xa dej tuaj koom nrog cov hlab ntshav thiab cov leeg ntshav ntawm caj npab.
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Catheter. Ib lub raj tuaj yeem tso rau hauv cov hlab ntshav loj hauv koj lub caj dab yog tias xav tau kev nkag mus tam sim thaum lub raum tsis ua haujlwm. Tus catheter no tsis yog kev daws teeb meem tas mus li, tab sis siv rau ib ntus xwb.
Muaj ob hom catheters. Cov tsis siv qhov quav, uas yog siv rau ib ntus, yooj yim rau ntxig rau hauv lub caj dab (sab hauv jugular leeg), hauv qab pob txha caj dab (subclavian leeg) lossis hauv puab tais (leeg leeg). Cov kws kho qhov quav tau nkag los ntawm daim tawv nqaij thiab cov nqaij rog mus rau hauv cov hlab ntshav, feem ntau yog nyob hauv qab pob txha caj dab, thiab tuaj yeem siv los ua cov vascular ntev mus rau kev lim ntshav hauv cov neeg mob uas tsis tuaj yeem muaj lub qhov txhab lossis qhov txhab
