ʻO nā meaʻai no ka hemodialysis kidney a me ka maʻi diabetes e kāpae i ka hoʻohana ʻana i nā momona saturated a maʻalahi e hoʻokaʻawale i nā hāmeʻe. Ke holomua ka "maʻi ʻala", pili ka pili i nā ʻōnaehana āpau, e hoʻoulu ʻia i nā ʻano ʻeha like ʻole.
ʻO ka hopena maʻamau e hōʻike ʻia i ka hiki ʻole o ka pilikia papaleka, ʻo ia ke kumu nui o ka make i waena o nā mea maʻi. ʻIa ia e kū'ē i ke kua o ke nephropathy diabetic - renal dysfunction.
ʻO ka Diabetes mellitus kahi ala i hoʻopili ʻia me nā pilikia metabol. Ke hōʻiliʻili nā huahana metabolic a me nā mea momona i loko o ke koko o kahi kanaka olakino, kau mai ka pēpē me kāna filtration.
Eia naʻe, me ka maʻi maʻi, ka hana hewa ʻole o ka huakaʻi paʻa i alakaʻi i ka hōʻiliʻili o nā mea ʻona i loko o ke koko e hoʻopau i ka kino. No laila, kuhikuhi pinepine nā kauka i kahi kaʻina no ka hoʻomaʻemaʻe koko. Pehea e pili ai ka hemodialysis a me ka maʻi diabetes? He aha kāu ʻano meaʻai e makemake ai iaʻu? E hoʻāʻo kākou e nānā.
Nā Papa Pahu i ka maʻi Diabetes
ʻO ka papa hana ʻōnaehana ka ʻoi aku o nā mea he 100 tausani "glomeruli" - nā kānana kūikawā e hoʻokuʻu ana i ke koko mai nā huahana metabola a me nā mea pono ʻole.
Ke hele nei ke koko i nā kīʻaha liʻiliʻi o kēia mau kānana, e hoʻihoʻi ʻia nā mea ʻino mai nā keiki mai ka pala, a hoʻi ka wai a me nā mea nui e hoʻi i ka kahe. A laila, me ke kōkua o ka urethra, lawe ʻia nā huahana waiwai a pau mai ke kino.
Ma muli o ke ʻano maʻi o ka maʻi maʻamau e hoʻonui ʻia ka nui o ka glucose, hoʻonui loa i ka ukana ma luna o nā huina paʻa. E hoʻoneʻe i ke kō nui i ke kō mai ke kino, pono hou ka lolo, e like me ka hopena, ke piʻi ka paʻakikī o kēlā me kēia glomerulus.
ʻO kēlā me kēia mau papa hana neʻe i ka manawa e kaohi ai i ka helu o nā kānana ikaika, ka hopena no ka hoʻomaʻemaʻe ʻana i ke koko.
Me kahi papa lōʻihi o ka "maʻi ʻoluʻolu", ua hoʻonele ʻia nā keiki i ka ulu ʻana o ke akeʻa. ʻO kāna mau hiʻohiʻona nui:
- hōʻeha a me ka momona;
- nā huakini a me nā hopena paneʻi;
- ka pōkole o ka hanu me ka liʻiliʻi o ka hoʻāliʻi kino kino;
- ʻili;
- paila ʻaila;
- nā ume a me nā alohilohi o nā haʻahaʻa haʻahaʻa, maikaʻi loa i ka pō;
- maikaʻi maikaʻi loa mai ka waha waha;
- nāwaliwali a me ka coma.
Ke ulu nei kēia kūlana ma hope o nā makahiki he 15-20 i ka hana like ʻole o ka maʻi maʻi. No ka loiloi i ka hana o nā kuhi, hiki i ke kauka ke kuhikuhi i kahi urine a i ʻole ka hoʻāʻo ʻia no ka creatinine a i ʻole he urine test no ka albumin a i ʻole microalbumin.
Ke hōʻoia nei i ka hoʻomohala ʻana, hiki i ke kauka ke kuhikuhi i kahi kaʻina hoʻomaʻemaʻe koko. ʻAe nui nā poʻe loea e hemodialysis no ka maʻi diabetes e pono ai ka mālama kūikawā. No laila, pono e loli nā mea maʻi i kahi regimen kūikawā o ka maʻi insulin - injections me insulins kanaka. ʻO ka mea nui o kēia hoʻomaʻamaʻaʻana e hoʻopau i nā inikini o kahi hormone o ka manawa maʻamau i ke kakahiaka.
Eia kekahi, ʻaʻole pono mākou e poina e pili ana i ka mālama mau ʻana i ka glycemia i mea e pale ai i nā hopena ʻē aʻe.
ʻO ke ʻano nui o ke kaʻina hemodialysis
ʻO Hemodialysis kahi hana hoʻomaʻemaʻe koko extrarenal.
Hoʻopili i kahi paahana kūikawā i ke koko o ka mea maʻi ma o ka membrane, no laila hoʻomaʻemaʻe ia i nā meaʻokoʻa a me nā wai. No laila, kapa pinepine ʻia ka ʻaoʻao i kapa ʻia he "hina maoli."
ʻO ka pilikino o ka hana o ka hāmeʻa e like me kēia. Komo ke koko mai kahi vein, a i ka hoʻomaka ʻana ke ʻano o kona hoʻomaʻemaʻe.
Ma kekahi ʻaoʻao o ka membrane kūikawā, kahe o ke koko, a ma ka ʻaoʻao ʻē aʻe, dialysate (hoʻonā). Loaʻa ia nā mea i hoʻokaʻawale i ka wai nui a me nā meaʻala. Koho ʻia kona ʻano no kēlā me kēia hoʻomanawanui.
"Nā huaʻōlelo kūloko" loaʻa kēia i nā hana:
- Hoʻopau i nā huahana decay. Pono e hoʻomaopopo ʻia ma loko o ke koko o ka mea maʻi e hoʻomehana ai i ka pilikia o ka papalū, kahi mākaʻikaʻi overestimated o nā toxins, protein, urea a me nā mea ʻē aʻe i ʻike ʻia. Eia nō naʻe, ʻaʻohe mea maoli i loko o ka dialysate. Wahi a nā kānāwai o ka hoʻokaʻawale ʻana, nā ʻāpana āpau mai nā wai wai me ko lākou hoʻonaninani kiʻekiʻe i ka wai me ka hoʻohaʻahaʻa haʻahaʻa.
- Hoʻopau i ka wai nui. Loaʻa kēia ma ka ultrafiltration. Mahalo i ka pae, hele mai ke koko i ka kānana ma lalo o ke kaomi, a i loko o ka laha e loaʻa i ka dialysate, he haʻahaʻa ka paʻu. No ka mea nui ka ʻokoʻa o ke kaomi, ua hele ka nui o ke kahe i loko o ka hopena dialysis. Mālama kēia hana i ka hōʻā ʻana o nā māmā, ka lolo a me nā ʻāpana, a wehe hoʻi i ka wai e hōʻuluʻulu ai a puni ka naʻau.
- Nā maʻamau maʻamau pH. Ke hoʻomau nei i ka kaulike acid-base, ʻike ʻia kahi kīkohu o ka paʻakai sodium bicarbonate i loko o ka hopena dialysis. Komo ʻia ia i loko o ka plasma, a laila i loko o nā ʻāpana koko ʻulaʻula, e hoʻomaikaʻi ana i ke koko me nā kumu.
- Hoʻohālike i nā pae electrolyte. I mea e hoka ʻole ai i ke koko o nā mea pono e like me Mg, K, Na a me Cl, loaʻa lākou i ka helu like me ka hapa o ka dialysate. No laila, lilo ka nui o nā electrolytes i ka hoʻonā, a naʻu ʻia ka ʻike i kā lākou ʻike.
- Kāohi i ka hoʻomohala ʻana o ka embolism ea. Hoʻomaopopo kēia hana ma ka loaʻa ʻana o ka "hau kalika" ma ka pahu, e hoʻihoʻi ana i ke koko i ka ulia. Me ke kahe ʻana o ke koko, e hoʻāā ʻia kahi paʻakikī (mai 500 a 600 mm Hg). Hāpai ke kāʻei i nā ʻōmuku hau a pale iā lākou mai ke komo koko.
Eia kekahi, ʻo ka hoʻohana ʻana o ka pēpē aipū e pale ai i ka hoʻokumu ʻana o nā māka koko.
Mahalo i ka heparin, kahi i mālama ʻia e hoʻohana nei i kahi pākeke, ʻaʻole i ʻike ʻia ka pilina koko.
Hemodialysis: hōʻailona hōʻailona a me nā contraindications
Hoʻolaha ʻia kēia hana ma nā manawa 2-3 i 7 mau lā.
Ma hope o ka nānā ʻana i ka hemodialysis, ua hoʻoholo ʻia ka nui o ka hopena o ka filtration koko.
Ke hoʻokō ʻia nei ke kaʻina hana i ʻekolu mau manawa i ka hebedoma, a laila aia kēia hōʻailona ma ka liʻiliʻi o 65%. Inā hana ʻia ka hemodialysis i ʻelua manawa i ka hebedoma, a laila pono ka nui o ka huina o ka hoʻomaʻemaʻe e pili ana i 90%.
Pono e hoʻokō ʻia ka maʻi Hemodialysis ma hope o ka hoʻoholo ʻana i ka maʻi a me ka ʻae ʻana o ke kauka i hele mai. Ua kuhikuhi ʻia ke kaʻina hoʻomaʻemaʻe koko i kēia mau hihia:
- ma ka huehue o ka hana pohihihi i hopena ʻia mai ka maʻi glomerulonephritis, pyelonephritis a me ka hana ʻana o ka ʻāpana urinary;
- ma kahi paʻa ʻole;
- me nā mea e make ai ka lāʻau (antibiotics, sulfonamides, nā mea moe, nā mea hana a me nā mea ʻē aʻe);
- me ka hānai me nā mea poʻi (pale toadstool a arsenic);
- me ka huakini me ka methyl alkohol a i ʻole ethylene glycol i loko o ka waiʻona;
- me ka hyperhydration (nui ka wai ma ke kino);
- me ka hoʻomoʻona me nā lāʻau lapaʻau narcotic (morphine a heroin paha);
- i ka hihia o ka eaʻole ma loko o ka manaʻo o ka electrolyte ma muli o ke kaʻi ʻana o ka wahie, cystic fibrosis, dehydration, Burns, peritonitis a hoʻokiʻekiʻe nui paha ke kino.
Eia nō naʻe, ʻaʻole pono ia ka hoʻohana ʻana i kahi "hina pilikino" i ke alo o kekahi o kēia mau ala. ʻO ka maʻi maʻi maʻi a i ʻole mea maʻi paha me kahi pae kūlohelohe maʻamau e kuhikuhi ʻia i hemodialysis inā:
- ʻO ka nui o kēlā me kēia lā o ka urine excreted i liʻiliʻi ma lalo o 0,5 lita.
- Hana nā kauka i kā lākou hana ma o 10-15% wale nei a hoʻomaʻemaʻe i ke koko ma lalo o 200 ml i ka 1 minuke.
- ʻO ka ʻike urea i ka plasma koko ma mua o 35 mmol / L.
- ʻO ka nānā ʻana i ke koko o ka pāhare pālahalaha ʻoi aku o 6 mmol / l.
- ʻOi aku ka bicarbonate koko ma mua o 20 mmol / L.
- ʻO ka mea hana Plasma he loaʻa ka 1 mmol / L.
- ʻO ka pīpī o ka puʻuwai, ka ʻōpū, a me ka lolo ʻaʻole hiki ke hōʻoki ʻia me ka lāʻau lapaʻau.
No kekahi mau māhele o ka poʻe maʻi, hiki i ka hemodialysis. ʻAʻole ʻae ʻia ia e hoʻohana i kahi pono no ka kānana ʻana i ke koko i kēia mau mea:
- i ka wā e hele ai ka maʻi;
- me ka hoʻomohala ʻana o nā pathologies noʻonoʻo (schizophrenia, psychosis a epilepsy);
- me ka ulu mau ʻana o ka hoʻokahe koko;
- ma hope o kahi hōʻeha a i ʻole kaʻaila myocardial;
- me nā mea maʻi ʻino;
- me ka puʻuwai hema;
- me ka maʻi pākōkī a me ka maʻi maʻi;
- me nā maʻi koko (leukemia a me ka anemia aplastic);
Eia kekahi, ʻaʻole i hoʻohana ʻia ka hemodialysis i nā makahiki he 80 o ka makahiki.
ʻO nā hiʻohiʻona o ka meaʻaiʻai i ka maʻi diabetes a me ka hemodialysis
ʻO kahi maʻi maʻi hānai me ke akeʻa e pono e kūkā i kahi kauka e pili ana i ka papaʻai.
ʻO kahi meaʻaiʻai, me ka mālama ʻana i ke kiʻekiʻe o ke kō, ka hele a me ka ʻole o nā ʻōpiopio, ʻo ka lōʻihi o ka lāʻau lapaʻau, kaupaona a me nā makahiki, e hoʻomohala ana i kahi hoʻolālā meaʻai.
Ke hoʻomau nei i nā pae glucose maʻamau a pale i ka emi ʻana o ka hana ʻana, pono ka mea maʻi i nā ʻōlelo a pau a ke kauka hele mai.
ʻO nā ʻōlelo nui o ke olakino no ka hemodialysis a me ka "maʻi ʻoluʻolu" penei:
- Hoʻonui i nā kōʻai protein i 1,2 g no 1 kg o ka paona o ke kino. Loaʻa ka mea i loko o nā hua, ka iʻa momona haʻahaʻa, nā ʻiʻo a me nā huahana momona.
- ʻAʻole pono ka nui o ka nui o ka huahana i hoʻopau ʻia ma mua o 2500 kcal. Penei ke hoʻike ʻia o nā kūlohelohe kūlohelohe.
- Hoʻopili i ka wai hoʻokeo. I nā lela i waena o nā kaʻina hoʻomaʻemaʻe koko, ʻaʻole ia e pāpā ʻia ma mua o 5% o ka wai o ka puna e ka nui o ka mea maʻi.
Hoʻololi ka meaʻai maikaʻi i ka momona o ka momona. No laila, pono ʻoe e haʻalele i ka puaʻa, keiki hipa, mackerel, tuna, herring, sardines a me ka salmon. Eia kekahi, ʻaʻole hiki iā ʻoe ke ʻai i nā lau i hoʻonui ʻia me ka waila oxalic (rhubarb, spinach, celery, radish, ʻākala ʻala a me ka ʻāpala). Pono ʻoe e poina e pili ana i nā sausages, sausages, nā ʻiʻo i poki ʻia a me ka meaʻai ʻai. ʻĀnō, a, ʻoiaʻiʻo hoʻi, hōʻole i nā kumuwaiwai o nā haʻalulu hoʻālaʻuwā, ʻo ia ka, ke kō, ke kōkeke, ka palaka a me nā mea ʻoluʻolu ʻē aʻe.
Akā, pono ʻoe e ʻai i nā huaʻai ʻole e like me ka mau melemele, nā ʻalala ʻōmaʻomaʻo, nā pākolo, nā lemona a me nā mea hou aʻe. Hoʻonani i ka mea ʻai me nā lau ʻai (mau ʻōmala, kukama) a me nā cereal olakino (bale, buckwheat a me ka oatmeal).
ʻAe ʻia e hoʻopau i ka ʻiʻo a me ka iʻa (veal, moa, hake) a me nā huahana wai skim.
Kina helu 7 no ka hemodialysis
Kahi ia meaʻai no ka maʻi diabetes-dependant e hoʻohana ʻia no hemodialysis e kaulike i ka mea e mālama ai i ka pono a pale i ka hoʻomohala ʻana o nā ʻaoʻao ʻaoʻao ma muli o ke kaʻina hana filtration koko.
ʻO ka pinepine, kapa ʻia kaʻai # 7 i kapa ʻia "renal."
ʻO kāna kumu nui nui, ʻo ia ka mea e kaupalena i ka ʻai o kēlā me kēia lā ka paʻakai, ka protein a me ka wai.
Nui nā ʻano o nā kīʻaha, akā pau nā mea āpau i ka hoʻohana ʻana i nā meaʻai me ka pāmaona, a me nā kīʻaha me nā ʻike paʻakai. Eia nō naʻe, ua ʻae ʻia kekahi mau mea ʻala a me nā ʻihi e uku no ka nele o ka paʻakai.
E like me ka mea ʻaina 7, e ʻae ʻia nā meaʻai a me nā kīʻaha:
- nā hua a me nā lau i hoʻohui ʻia me ka hoʻohui o nā ʻuala, kumala, pāhala, pata, ka ʻona (kaʻa ʻū a ʻū ʻia paha);
- berena, popo a me na pancakes me ka ole paakai;
- pipi momona haʻahaʻa, puaʻa hoʻōla, veal, 'ōpala, pihi, moa (hiki ke ʻū ʻia a hoʻolapalapa paha);
- nā iʻa momona haʻahaʻa i loko o ka hoʻolapalapa lā, laila hiki iā ʻoe ke hoʻomāmā iki ʻole i kā iʻa;
- vinaigrette me ka ʻole paakai, nā māla mai nā hua hou a me nā lau;
- ʻano a me nā mea ʻala - ʻōmato, ka pahu, ka hua a me ka aniani huaʻai, kanemona, suka;
- hua pālua maloʻo ʻelua i ka lā, ma ke ʻano o ka omelets, yolks ma ka hana ʻana i nā pā;
- hua ʻaihue ʻole ʻia e like me ka peach, ka ʻona, ka lemona, nā ʻalala ʻōmaʻomaʻo;
- nā palaoa - palaoa, palaoa;
- waiū, ʻona wai, kaʻaila paʻakai, keʻa oki, nā pāʻai curd, ʻo ka wai i hoʻomoʻi ʻia, kefir a me ka yogurt;
- tiʻa ʻole honu, nā wai ʻona ʻole, decoction o rose hips;
- aila ʻaila.
Ma kahi o ka nānā ponoʻana i nā meaʻai kūikawā, pono ia i nā hana hou me ka hoʻomaha maikaʻi. ʻO ke kaumaha koʻikoʻi kekahi mea nui i ka hana o ke aʻalolo a me ke kōpaʻa koko.
I ka wā o kaʻai, pono ka poʻe maʻi e hahai i nā ʻōlelo a pau a ke kauka e pale ai i nā hōʻeha. I kēia hihia, ua pāpā ikaika ʻia ka lāʻau lapaʻau ponoʻī, no ka mea hiki i ka mea maʻi ke hōʻeha wale iā ia iho.
ʻO ke wikiō i kēia ʻatikala e kikoʻī i ka hana o nā palaka ma ka maʻi diabetes.
