Mālama i kou komo vascular no ka hemodialysis

Loaʻa iā ʻoe kahi komo vascular no ka hemodialysis. Mālama maikaʻi ʻana i kāu komo ʻana e kōkua ia e hoʻolōʻihi i ka lōʻihi.

E hāhai i nā ʻōlelo aʻoaʻo a kāu kahu mālama ola e pili ana i ka mālama ʻana i kou komo ʻana i ka home. E hoʻohana i ka ʻike ma lalo i mea hoʻomanaʻo.

ʻO kahi komo vascular kahi puka i hana ʻia i kou ʻili a me kou kīʻaha koko i ka wā o ka hana pōkole. Ke loaʻa ʻoe i ka dialysis, kahe kou koko mai ke komo i loko o ka mīkini hemodialysis. Ma hope o ka kānana ʻana o kou koko i ka mīkini, kahe hou ia i ke komo i loko o kou kino.

Aia he 3 ʻano nui o ke kōkua vascular no ka hemodialysis. Hōʻike ʻia kēia mau mea penei.

Fistula: Ua humuhumu ʻia kahi aʻa i loko o kou forearm a i ʻole ka lima luna i kahi aa koko kokoke.

• ʻAe kēia e hoʻokomo i nā nila i loko o ke aa no ka mālama dialysis.
• Lawe kahi fistula mai 4 a 6 mau wiki e hōʻola a makua ma mua o ka mākaukau e hoʻohana.

Pākuʻi: Hoʻopili ʻia kahi aʻa a me kahi aa i kou lima e kahi kīwī pelekikena U-ma lalo o ka ʻili.

• Hoʻokomo ʻia nā nila i loko o ke kuhi ke loaʻa kahi dialysis iā ʻoe.
• Hiki ke mākaukau kahi hoʻopili e hoʻohana i 2 a 4 mau pule.

Pōpō puʻupuʻu waena: Hoʻokomo ʻia kahi ʻōmole palupalu palupalu (catheter) ma lalo o kou ʻili a waiho ʻia i kahi aa i kou ʻāʻī, umauma, a i ʻole kou ʻūlū. Mai laila aku, hele ka paipu i kahi aa waena e alakaʻi ai i kou puʻuwai.

• Mākaukau kahi catheter venous kikowaena e hoʻohana koke.
• Hoʻohana wale ʻia ia no kekahi mau pule a mau mahina paha.

Hiki paha iā ʻoe ke ʻulaʻula iki a ʻū paha a puni kāu pūnaewele komo i nā lā mua. Inā loaʻa iā ʻoe kahi fistula a i ʻole graft:

• Prop i kou lima ma nā uluna a mālama i kou kuʻe lima e hoʻemi i ka pehu.
• Hiki iā ʻoe ke hoʻohana i kou lima ma hope o kou hoʻi ʻana i ka hale mai ke ʻoki kino. Akā, mai hāpai aʻe ma mua o 10 mau paona (lb) a i ʻole 4.5 kilokilo (kg), e pili ana i ke kaupaona o kahi galani waiū.

Ka mālama ʻana i ka lole (bandage):

• Inā he graft a fistula paha kāu, e hoʻomaloʻo i ka ʻaʻahu no nā lā 2 mua. Hiki iā ʻoe ke ʻauʻau a ʻauʻau paha e like me ka maʻamau ma hope o ka hemo ʻana o ka lole.
• Inā loaʻa iā ʻoe kahi catheter venous waena, pono ʻoe e mālama maloʻo i ke kapa i nā manawa āpau. Uhi iā ia me ka ea ke ʻauʻau ʻoe. Mai ʻauʻau, hele i ka ʻauʻau, a pulu i loko o kahi ipu wela. Mai ʻae i kekahi e huki i ke koko mai kāu catheter.

ʻOi aku ka nui o nā grafts a me nā catheters ma mua o nā fistula e lilo i maʻi. ʻO nā ʻōuli o ka maʻi ka ʻulaʻula, ka pehu ʻana, ka ʻeha, ka ʻeha, ka mehana, ka pā a puni ka pūnaewele, a me ke kuni.

Hiki i nā kahe koko ke hana a ālai i ke kahe o ke koko ma o ka pūnaewele komo. ʻOi aku ka ʻoi aku o nā grafts a me nā catheters ma mua o nā fistula e ʻōpala.

Hiki i nā kīʻaha koko i kāu graft a i ʻole fistula ke lilo i kahiki a hoʻolohi i ke kahe o ke koko ma o ke komo ʻana. Kapa ʻia kēia stenosis.

Ma muli o kēia mau kulekele e kōkua iā ʻoe e hōʻalo i ka maʻi, ke koko koko, a me nā pilikia ʻē aʻe i ke kōkua o ke vascular.

• Holoi mau i kou mau lima me ke kopa a me ka wai mehana ma mua a ma hope o ka hoʻopā ʻana i kou komo. E hoʻomaʻemaʻe i ka wahi a puni i ke komo me ke kopa antibacterial a i ʻole ka ʻānai ʻana i ka waiʻona ma mua o kāu mālama dialysis.
• E hōʻoia i ke kahe (i kapa ʻia hoʻi ka pīhoihoi) i kou hiki i kēlā me kēia lā. E hōʻike kāu mea hāʻawi iā ʻoe pehea.
• Hoʻololi kahi e hele ai ke kui kele i kāu fistula a i ʻole graft no kēlā me kēia lapaʻau dialysis.
• Mai hoʻokuʻu i kekahi i kou kaomi koko, e hoʻomaka i kahi IV (laina intravenous), a huki i ke koko mai kou lima komo.
• Mai hoʻokuʻu i kekahi e huki i ke koko mai kāu catheter venna kikowaena
• Mai hiamoe ma kou lima komo.
• Mai lawe i kahi ʻoi aku ma mua o 10 lb (4.5 kg) me kou lima komo.
• Mai hoʻokomo i kahi wati, nā mea hoʻonaninani, a i ʻole nā ​​lole paʻa ma luna o kāu pūnaewele.
• E akahele o kuʻi a ʻokiʻoki paha i kou komo ʻana.
• E hoʻohana wale i kou komo ʻana no ka dialysis.

Kāhea koke i kāu mea hāʻawi inā ʻike ʻoe i kekahi o kēia mau pilikia.

• Kahe ʻana mai kāu pūnaewele vascular access
• Nā hōʻailona o ka maʻi, e like me ka ʻulaʻula, ka pehu ʻana, ka ʻeha, ka ʻeha, ka mehana, a me ka pā a puni ka pūnaewele
• ʻO ke kuni 100.3 ° F (38.0 ° C) a ʻoi aku paha
• Lohi ke kahe (thrill) i kāu graft a i ʻole fistula a i ʻole ʻaʻole ʻoe e ʻike iki
• ʻO ka lima kahi e waiho ai kāu pahu lūlū a pehu a me ka lima ma kēlā ʻaoʻao ke anuanu
• Anuanu kou lima, palu a palupalu paha

Fistula Arteriovenous; A-V fistula; Hoʻohui A-V; Pahu komo Tunneled

ʻO Kern WV. Nā maʻi āpau e pili ana i nā laina intravascular a me nā grafts. I: Cohen J, Powderly WG, Opal SM, hua pā. Nā maʻi laha. ʻEhā ed. Piladelapia, PA: Elsevier; 2017: chap 48.

Pūnaewele Institute of Diabetes a me Digestive a me nā maʻi maʻi puʻuwai. Hemodialisis. www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/hemodialysis. Hoʻohou Ianuali 2018. Loaʻa iā Pepeluali 1, 2021.

ʻO Jeun JY, Young B, Depner TA, Chin AA. Hemodialisis. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. ʻO Brenner a me Rector's The Kidney. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 63.

• Dialysis