Zowopsa, matenda ndi matenda a impso kulephereka opaleshoni
Pokonzekera kuchitidwa opaleshoni, anthu ambiri saganiza kuti akhoza kukhala ndi vuto lalikulu kapena loopsya. Tsoka ilo, anthu ena amakhala ndi mavuto aakulu pamene akuchira, ndipo chimodzi mwa izo ndi kulephera kwa mphuno. Kuopsa kwa opaleshoni kumasiyana pakati pa odwala ndi odwala, malingana ndi msinkhu wawo, thanzi lawo ndi mtundu wa matenda awo.
Kuperewera kwachabe ndi mankhwala a impso kulephera, ndipo amatanthauza kuti impso sizikhoza kugwira ntchito bwino kuti zisawononge magazi bwinobwino. Mawu akuti kulephera kwa nsomba ndi mawu omwe amagwiritsidwa ntchito kwambiri panthawiyi, koma mumamva kuti matenda a impso ovuta (AKI) amadziwika bwino.
Kulephera kwa Impso Pambuyo Opaleshoni
Impso zimagwira ntchito kuchotsa zonyansa m'magazi. Amatsanulira magazi mu thupi la munthu kangapo patsiku, kuchotsa madzi ochulukirapo ndi zinyalala kuchokera ku magazi ndikusandutsa mkodzo.
Munthu akakhala ndi vuto la impso kwa nthawi yoyamba, amakhala ndi vuto la impso lopweteka, kutanthauza kuti ndi vuto ladzidzidzi ndipo akhoza kukonzekera. Kuperewera kwamtunda ndilo mawu oti impso zomwe zawonongeka kotheratu.
Kuopsa kwake kwa impso kulephera kumayesedwa makamaka ndi ma laboratory zotsatira za mphutsi yaphanzi yomwe imaphatikizapo creatinine, komanso zotsatira zina zabubu kuphatikizapo BUN, GFR, ndi ufulu wa creatinine.
Kulephera kwa impso kumapezeka pamene mlingo wa mlengi ndi 1.5 nthawi yomwe mlingo amayamba kulenga ngati impso zikugwira ntchito nthawi yoyesedwa.
Mlingo wa creatinine wosachepera 1.2 milligrams per deciliter ndi wofunikira kwa amuna, ndipo osachepera 1.1 ali ndi thanzi la amayi.
Mwachitsanzo, mwamuna yemwe ali ndi creatinine ya .8 mg / dl opaleshoni isanakwane nthawi zonse.
Ngati anali ndi 1.6 mlonda pambuyo pa opaleshoni tsiku lotsatira, adzipeza kuti ali ndi vuto lopweteka kwambiri. Matendawa amatha kupangidwanso pogwiritsa ntchito mkodzo. Mitsempha ya mitsempha yochepa kuposa maola mililita 55 a mkodzo pa kilogalamu ya kulemera kwa thupi pa ora yomwe imatenga maola asanu ndi limodzi kapena kuposerapo imasonyeza kuvulaza kwakukulu kwa impso.
Nthawi zina vutoli limathetsedwa mosavuta ndi kuwonjezeka kwa madzi, zomwe zimawonjezera mkodzo ndikulola impso kugwira ntchito bwino. Kwa ena, impso zawonongeka ndipo sizigwira ntchito moyenera monga momwe zidachitira opaleshoni isanakwane. Mwachimwemwe kwa anthu ambiri, impso zowonongeka nthawi zambiri zimagwira ntchito mokwanira kuti thupi likhale labwino.
Pa milandu yovuta, impso sangathe kufotokoza magazi, ndipo sangathe kupanga mkodzo. Kulephera kukhetsa mkodzo ndi vuto lalikulu ndipo mankhwala ayenera kuchitidwa mwamsanga ngati zikuchitika pamene akuchira kunyumba.
Mavuto Ambiri a Impso Pambuyo Opaleshoni
Dialysis Patatha Opaleshoni
Dialysis imachitika pamene impso sizigwira ntchito bwino kuti thupi likhale louziridwa. Palibe mlingo umodzi wa creatinine umene umasonyeza kuti dialysis iyenera kuchitidwa, zina zimanena kuti creatinine wa 8 ayenera kutsogolera ku dialysis, ena amati 10.
Komabe, ena amanena kuti mlingo wa chilengedwe ndi gawo limodzi lokha, ndipo zizindikiro zomwe wodwala akukumana nazo ziyenera kutsogolera chithandizo kuposa zotsatira za laboratori.
Kodi Dialysis N'chiyani?
Dialysis ndi mankhwala omwe amachititsa ntchito zomwe impso sizikwanitsa kuchita: kusamba kwa magazi kuchotsa poizoni, electrolytes, ndi madzi owonjezera. Pa dialysis, mtundu wawukulu wa mtundu wa IV umayikidwa muziwiya zamagazi. Magazi amatuluka kunja kwa thupi kuchokera pa tsamba la IVlo kudzera mu chubu, ndipo makina a dialysis amatsanulira magazi ndikubwezeretsa ku thupi. Ntchitoyi imatenga maola anayi kapena asanu ndipo imakhala katatu pa sabata kapena kuposa, malinga ndi zosowa za munthu aliyense.
Dokotala yemwe amatha kupaleshoni impso, wotchedwa nephrologist, amadziwongolera makina a dialysis kuphatikizapo kuchuluka kwa madzi okwanira ayenera kuchotsedwa m'thupi.
Zowopsa za Kulephera kwa Impso Pambuyo Opaleshoni
Chidziŵitso chimodzi chodziwika chifukwa cha matenda a impso pambuyo pa dialysis akuchitidwa opaleshoni yamtima kapena opaleshoni yambiri (njira yomwe imachitika pamitsinje ya magazi). Mitunduyi imatha kuonjezera chiopsezo chachikulu chokhala ndi vuto la impso lomwe liri lokwanira kwambiri kuti likhale ndi mankhwala odwala dialyse, mwina kwa nthawi yayitali kapena nthawi yayitali.
Kutsogoleredwa kwa impso musanachite opaleshoni ndichinthu choopsa kwambiri. Anthu amene ali ndi vuto la impso kale amakhala owonongeka kwambiri atatha opaleshoni.
Odwala achikulire amatha kuvulaza matenda a impso kusiyana ndi wodwala wamng'ono, pamene odwala omwe ali ocheperako amakhala ndi thanzi lisanayambe. Odwala omwe ali ndi kuthamanga kwa magazi, matenda a mtima ndi shuga amakhala pachiopsezo chachikulu.
Kuchuluka kwa mpweya wa magazi m'magazi kwa nthawi yaitali kungawononge impso. Kuvulala koopsa, kuwonongeka kwakukulu kwa magazi, kuthamanga kwa magazi kwa nthawi yaitali, ndi kukulitsa matenda akuluakulu otchedwa septic shock asanayambe, pakapita kapena pakatha opaleshoni ingathe kuwonjezera mwayi wa dialysis pambuyo pa opaleshoni.
Kupanga matenda akuluakulu a mkodzo pambuyo poti opaleshoni, ngati osatulutsidwa kapena matenda sakuvomerezedwa ndi mankhwala, akhoza kuwonongeka kwa impso.
Kawirikawiri, wodwala / wochulukirapo wamuvulaza nthawi yomweyo opaleshoni itangoyamba kumene, ndipo pakapita masiku akutsatila, zimakhala zovuta kuti awonongeke ndi impso.
Kulimbana Kwambiri Kwambiri ndi Dialysis Yakale
Kwa opaleshoni ambiri opaleshoni omwe amavutika ndi impso, dialysis siyenela, ndipo vuto likhoza kuthetsa kapena kusintha bwino kuti pakhale thanzi labwino.
Kwa anthu omwe amavutika ndi impso pambuyo pa opaleshoni ndipo amafunika dialysis, vuto ndi lovuta, ndipo ntchito ya impso imakula bwino kuti dialysis siidali nthawi yayitali. Matenda amtundu uwu amatchedwa Kusalidwa Kwachisawawa, kapena ARF.
Kwa ena, kuwonongeka kwa impso ndi kosatha ndipo ndi kovuta kuti dialysis ikhale yofunikira. Kwa anthuwa, vutoli ndi losalekeza ndipo lidzafuna dialyse pokhapokha atapezekanso kupsyinjika kwa impso . Magazini yotereyi imatchedwa Matenda Otchedwa Stage Renal Disease (ESRD) kapena kulephera kwa chiwindi.
> Chitsime:
> Impso Zikuluzikulu Pambuyo Opaleshoni Yambiri Yamimba: A Retrospective Cohort Analysis. Kafukufuku Wopanda Thandizo Ndiponso Zochita. http://www.hindawi.com/journals/ccrp/2014/132175