Uqhaqho lokuTshintshela izintso-Iintlobo, Inkqubo, Iindleko eIndiya, imingcipheko, ukuBuyisa kunye neeNzuzo
Isibhedlele esisesona siGqibo seKindey Transplant eIndiya-izibhedlele zeApollo
Yintoni ukufakelwa kwezintso?
Ukufakelwa kwezintso yinkqubo yotyando ebandakanya ukubeka intso esempilweni evela kumnikeli ibe ngumntu onezintso ezingasasebenziyo kakuhle. Injongo ephambili yale nkqubo kukubuyisela ukusebenza kwezintso kwizigulane ezinesifo sokugqibela (ESRD) okanye isifo esibi kakhulu sesifo (CKD). Izintso zidlala indima ebalulekileyo ekuhluzeni inkunkuma kunye nolwelo oluphuma egazini, ukulawula uxinzelelo lwegazi, nokugcina ibhalansi ye-electrolyte. Xa izintso zingasebenzi, le misebenzi ibalulekileyo iyancipha, nto leyo ekhokelela ekudibaneni kwee-toxins emzimbeni, ezinokubeka ubomi esichengeni.
Ukutshintshwa kwezintso kunokuphucula kakhulu umgangatho wobomi kwizigulane, kubavumela ukuba babuyele kwimisebenzi eqhelekileyo kunye nokunciphisa imfuno dialysis, unyango olususa izinto ezimdaka egazini. Inkqubo inokwenziwa kusetyenziswa umntu onikelayo ophilayo okanye umntu onikelayo ongasekhoyo, kwaye ihlala ithathwa njengeyona ndlela yonyango yonyango kwizigulana ezinesifo sezintso esikwinqanaba eliphezulu.
Kutheni Kwenziwa uTshintsho Lwezintso?
Uqhaqho-fakelo lwezintso ngokuqhelekileyo luyacetyiswa kwizigulana ezibonisa iimpawu ze ukusilela kwezintso okanye bafunyenwe benezigulo eziphazamisa kakhulu ukusebenza kwezintso.
Iimpawu eziqhelekileyo ezinokukhokelela ekuqwalaselweni kokufakelwa kwezintso ziquka:
- Ukukhathala okungapheliyo kunye nobuthathaka
- Ukudumba emilenzeni, emaqatheni, okanye ezinyaweni ngenxa yokugcinwa kwamanzi
- Isihlunu kunye nokuhlanza
- Ukulahlekelwa ngumdla kunye nokunciphisa umzimba
- Ukurhawuzelelwa kunye nesikhumba esomileyo
- Utshintsho kwiipateni zokuchama, ezifana nokuncipha kokuphuma komchamo okanye umchamo omnyama
Isigqibo sokuqhubeka nokutshintshwa kwezintso ngokuqhelekileyo senziwe xa umsebenzi wezintso zesigulane uyancipha ukuya kwinqanaba elibalulekileyo, elidla ngokuboniswa yi-glomerular filtration rate (GFR) engaphantsi kwe-20 mL / min. Lo mgangatho wokusebenza kwezintso udla ngokudityaniswa:
- Iingozi zempilo ezibalulekileyo
- Iingxaki zentliziyo
- Ukwehliswa kwexesha lokuphila
Uqhaqho-fakelo lwezintso lukwaboniswa kwizigulana ezi:
- Bebekwi-dialysis ixesha elide kwaye bafumana iingxaki ezinxulumene nonyango
- Inokuthunyelwa kuvavanyo lokutshintshwa kwangaphambi kokuqala i-dialysis, ngakumbi ukuba banesifo sezintso esiqhubekayo ekulindeleke ukuba sibe mandundu.
Iimpawu zoTshintsho lwezintso
Iimeko ezininzi zeklinikhi kunye neziphumo zovavanyo zinokwenza isigulana sibe ngumviwa wofakelo lwezintso. Ezi ziquka:
- Isifo Sezintso (ESRD): Olu lolona phawu luqhelekileyo lofakelo lwezintso. Izigulana ezine-ESRD zilahlekelwe malunga ne-90% yokusebenza kwezintso kwaye zifuna i-dialysis okanye uqhaqho ukuze ziphile.
- Isifo sezintso eziNgapheliyo (CKD): Izigulane ezine advanced isifo esesigxina, ngakumbi abo bakwinqanaba lesi-4 nelesi-5, banokuvavanyelwa uqhaqho-fakelo. Oku kuquka abantu abaneemeko ezifana ne-nephropathy yesifo seswekile, umonakalo wezintso onxulumene noxinzelelo lwegazi, okanye isifo sezintso ze-polycystic.
- Ukwenzakala Kabukhali Kwezintso (AKI): Kwezinye iimeko, izigulana eziye zehla ngesiquphe nangokumandundu ekusebenzeni kwezintso ngenxa yeemeko ezinjengokuphelelwa ngamanzi emzimbeni, i-sepsis, okanye ubutyhefu beziyobisi banokuba ngabaviwa bofakelo-mzimba ukuba izintso zabo azichachanga kwaye baqhubela phambili kwisifo sezintso.
- Iziphene zezintso ezizalwayo: Ezinye izigulana zizalwa zinezinto ezingahambi kakuhle kwizintso nto leyo ekhokelela kukusilela kwezintso okungapheliyo. Aba bantu banokuqwalaselwa uqhaqho besebancinci.
- Isifo sezintso esiQondayo: Izigulane eziye zafumana izintso zangaphambili eziye zahluleka ngenxa yokugatywa okanye ezinye iingxaki zinokuthi zifanelekele ukutshintshwa kwesibini.
- Ezinye iimeko zonyango: Izifo ezithile ze-autoimmune, ezifana lupus or ivasculitis, kunokukhokelela kumonakalo wezintso kwaye kunokufuna ukutshintshwa ukuba izintso zichaphazeleka kakhulu.
Ngaphambi kokuba babekwe kuluhlu lokufakelwa, abaviwa bavavanywa ngokucokisekileyo, kubandakanywa novavanyo lwegazi, izifundo ze-imaging, kunye novavanyo lwempilo yabo yonke. Olu vavanyo lunceda ukugqiba ukufaneleka kwesigulane kwinkqubo kwaye ichonge nayiphi na ingozi enokubakho.
TIintlobo zoTshintsho lweZintso
Utyando lwezintso lunokwahlulwa ngokwesiseko somthombo wezintso zomnikeli. Iindidi eziphambili zimbini zezi:
UTshintsho lwezintso oluPhilayo lukaMnikeli:
Kulolu hlobo lokutshintshwa, intso enempilo isuswa kumnikeli ophilayo kwaye ifakwe kummkeli. Abanikeli abaphilayo banokuba zizalamane, abahlobo, okanye abantu abanobubele nabanqwenela ukunceda umntu osweleyo. Ufakelo lwabantu abaphilayo luhlala luneziphumo ezingcono xa kuthelekiswa nofakelo lomnikezeli ongasekhoyo, njengoko intso idla ngokusempilweni kwaye inobomi obude.
Ufakelo-zintso oMnikeli ongasekhoyo:
Olu hlobo lubandakanya ukufumana intso kumntu oswelekileyo obhalise njengomnikeli ngamalungu okanye usapho lwakhe luvume ukunikelwa ngamalungu emva kokufa. Ufakelo lomnikezeli oswelekileyo luxhaphake kakhulu kunokutshintshwa kwabanikeli abaphilayo, kodwa ixesha lokulinda izintso ezifanelekileyo linokuba lide ngenxa yokufumaneka okulinganiselweyo kwamalungu.
Zombini ezi ntlobo zoqhaqho-fakelo zineengenelo zazo neengcamango zazo, yaye ukhetho phakathi kwalo ngokufuthi luxhomekeke kwiimeko ezikhethekileyo zomguli, ukufumaneka kwabo banikelayo, nokungxamiseka kwemfuneko yofakelo.
Contraindications for Kidney Transplant
Ngelixa ukufakelwa kwezintso kunokusindisa ubomi, iimeko ezithile zinokwenza isigulana singafaneleki kwinkqubo. Ukuqonda ezi contraindications kubalulekile kuzo zombini izigulana kunye nababoneleli ngezempilo. Nazi ezinye izinto eziphambili ezinokuthi zithintele umntu ekufumaneni uqhaqho lwezintso:
- Usulelo olusebenzayo: Izigulane ezinezifo eziqhubekayo, ezifana nesifo sofuba okanye ukusuleleka kwebhaktheriya enzima, zingenakufaneleka ukutshintshwa kuze kube yilapho usulelo luphathwa ngokupheleleyo. Oku kungenxa yokuba amayeza e-immunosuppressive asetyenziswa emva kofakelo anokwenza usulelo lube mandundu.
- Cancer: Imbali yee-cancer ezithile, ngakumbi ezo zinobundlongondlongo okanye ezinomngcipheko omkhulu wokuphinda ziphinde, zinokuchaswa. Izigulana kufuneka zingabinawo umhlaza kangangexesha elithile, ngokwesiqhelo ubuncinci iminyaka emibini, phambi kokuba ziqwalaselwe uqhaqho-fakelo.
- Isifo senhliziyo esiMandundu: Izigulana ezinesifo senhliziyo esibalulekileyo okanye ezinye iimeko ezinzulu ze-cardiovascular may not be ngabaviwa abafanelekileyo. Uvandlakanyo olucokisekileyo lwentliziyo luhlala lufuneka ukuze kuhlolwe impilo yentliziyo phambi kokuba kuqhutyekwe noqhaqho-fakelo.
- Ubukhulu: Ukutyeba kakhulu kunokuba nzima utyando kunye nokuchacha. Izigulane ezine-body mass index (BMI) ngaphezu komda othile zingadinga ukunciphisa umzimba ngaphambi kokuba ziqwalaselwe ukutshintshwa.
- Ukuhlukunyezwa kwesiyobisi: Ukusetyenziswa kakubi kweziyobisi okusebenzayo, kubandakanywa utywala kunye neziyobisi, kunokukhupha isigulana. Ukuzibophelela ekuthobeni kubalulekile kwimpumelelo yofakelo kunye nempilo yesigulana iyonke.
- Ukungahambelani noNyango: Izigulane ezinembali yokungalandeli iingcebiso zonyango okanye izicwangciso zonyango zingabonwa njengezingafanelekanga. Ukubambelela kwiirejimeni zamayeza emva kokutshintshwa kubalulekile ekuthinteleni ukwaliwa kwamalungu.
- Imiba yezengqondo: Imiba yempilo yengqondo, ukungabikho kwenkxaso yoluntu, okanye iimeko zokuhlala ezingazinzanga zinokuchaphazela amandla esigulane okulawula ukhathalelo emva kokutshintshwa. Uvandlakanyo olubanzi lweemeko zengqondo yoluntu luhlala luqhutywa.
- Ezinye izifo ezingapheliyo: Iimeko ezifana nokungalawuleki Diabetes, isifo sesibindi, okanye isifo semiphunga sinokuyinzima inkqubo yokufakelwa. Imeko nganye ivavanywa ngabanye ukuze kufunyanwe iingozi ezibandakanyekileyo.
Ukuqonda ezi zithintelo kunceda izigulana kunye neentsapho zabo zibe nolindelo oluyinyani malunga nenkqubo yokufakelwa. Kubalulekile ukuba neengxoxo ezivulekileyo nababoneleli bezempilo ukuze baphonononge zonke iinketho kunye nokwenza izigqibo ezinolwazi.
ULungiselela njani uTshintsho lweZintso
Ukulungiselela uqhaqho-fakelo lwezintso kubandakanya amanyathelo aliqela okuqinisekisa esona siphumo silungileyo. Nasi isikhokelo malunga nokuba izigulane zinokulindela ntoni ngexesha lesigaba samalungiselelo:
- UVavanyo lokuqala: Inyathelo lokuqala luvandlakanyo olubanzi olwenziwa liqela lofakelo-mzimba, olubandakanya ii-nephrologists, oogqirha botyando, kunye nezinye iingcali. Olu vavanyo luvavanya impilo yesigulana iyonke, ukusebenza kwezintso, kunye nokufaneleka kofakelo.
- Uvavanyo lwezonyango: Izigulana ziya kuqhuba uthotho lweemvavanyo, kubandakanywa novavanyo lwegazi, izifundo zomfanekiso (njengoko Imitha yesandi or CT scans), kwaye mhlawumbi i-biopsy yezintso. Olu vavanyo lunceda ukufumanisa unobangela wokungaphumeleli kwezintso kunye nokuvavanya impilo yamanye amalungu.
- UVavanyo lweNgqondo: Uvavanyo lwempilo yengqondo luhlala luyinxalenye yenkqubo yamalungiselelo. Olu vavanyo lunceda ukuchonga nayiphi na imiba yengqondo okanye yentlalo enokuthi ichaphazele amandla esigulane okumelana nenkqubo yokufakelwa.
- Imfundo: Izigulana ziya kufumana imfundo malunga nenkqubo yoqhaqho, kubandakanywa nento onokuyilindela phambi, ngexesha, nasemva kotyando. Ukuqonda inkqubo kunye nokubaluleka kokhathalelo emva koqhaqho lokufakelwa kubalulekile.
- Ukuguqula indlela yokuphila: Abaguli banokucetyiswa ukuba benze utshintsho kwindlela yokuphila, njengokudla ukutya okunempilo, ukuyeka ukutshaya, kunye nokwandisa umthambo. Olu tshintsho lunokuphucula impilo yonke kwaye luphucule ukuchacha.
- Ukufumana uMnikeli: Ukuba isigulana asiyifumani intso ephilayo yomnikeli, baya kufakwa kuluhlu lokulinda kwizintso zomnikeli ongasekhoyo. Iqela lokutshintshela liya kuchaza indlela inkqubo yokudibanisa esebenza ngayo kunye nento onokuyilindela ngelixa ulindile.
- Amayeza aphambi koTshintsho: Izigulane kunokufuneka ziqale amayeza athile phambi kokuba uqhaqho-fakelo ukuze kulungiswe imizimba yazo kwizintso ezintsha. La mayeza anokunceda ukulawula iimeko zempilo ezikhoyo kunye nokunciphisa umngcipheko weengxaki.
- UCwangciso loTyando: Izigulana zifanele zilungiselele ukuthuthwa ukuya nokubuya esibhedlele ngosuku lotyando. Kukwabalulekile ukuba kubekho inkqubo yenkxaso ekhoyo yokhathalelo lwasemva kotyando, njengoko ukuchacha kunokuba ngumngeni.
- Imiyalelo yokuSebenza kwangaphambili: Izigulana ziya kufumana imiyalelo ecacileyo ngokuphathelele ukuzila ukutya, amayeza, nento emayizise esibhedlele. Ukulandela le miyalelo kubalulekile ukuze kwenziwe utyando olugudileyo.
Ngokuthatha la manyathelo okulungiselela, izigulana zinokomeleza amathuba azo oqhaqho lwezintso oluyimpumelelo kunye nokuchacha kakuhle.
Inkqubo yoTyelo lweZintso-Inyathelo ngeNyathelo
Ukuqonda inkqubo yokufakelwa kwezintso kunokunceda ukunciphisa ixhala kunye nokulungiselela izigulana oko kuzayo. Nantsi isishwankathelo senyathelo ngenyathelo lenkqubo:
- Ngaphambi kweNkqubo: Ngomhla wokutshintshwa, izigulane ziya kufika esibhedlele kwaye zikhangele. Baya kudibana neqela lotyando, eliya kuhlaziya inkqubo kwaye liphendule nayiphi na imibuzo yomzuzu wokugqibela. Umgca we-intravenous (IV) uya kuqaliswa ukulawula amayeza kunye nolwelo.
- Ukubulawa: Ngaphambi kokuba utyando luqale, izigulane ziya kufumana i-anesthesia jikelele, ziqinisekisa ukuba azikho zingqondweni kwaye azikho iintlungu ngexesha lenkqubo.
- Inkqubo yoTyando: Ugqirha wotyando uya kwenza isiko emazantsi esisu ukufikelela kwindawo yezintso. Izintso ezintsha, nokuba zivela kumntu ophilayo okanye ongasekhoyo, ziya kufakwa kumazantsi esisu, kwaye imithambo yegazi kunye ne-ureter (ityhubhu ehambisa umchamo ukusuka kwizintso ukuya kwisinyi) iya kudityaniswa.
- Ukubeka iliso: Kulo lonke utyando, iqela lezonyango liya kubeka iliso kwiimpawu ezibalulekileyo zesigulane kwaye liqinisekise ukuba yonke into ihamba kakuhle. Yonke inkqubo idla ngokuhlala phakathi kweeyure ezintathu ukuya kwezintlanu.
- Ukhathalelo lwasemva kokusebenza: Emva kokuhlinzwa, izigulane ziya kuhanjiswa kwindawo yokubuyisela apho ziya kujongwa ngokusondeleyo njengoko zivuka kwi-anesthesia. Ukulawulwa kweentlungu kuya kuqaliswa, kwaye izigulane ziya kufumana ulwelo kunye namayeza nge-IV.
- Ukuhlala esibhedlele: Uninzi lwezigulana ziya kuhlala esibhedlele malunga neentsuku ezintathu ukuya kwezisixhenxe, kuxhomekeke kwinkqubela phambili yazo yokuchacha. Ngeli xesha, ababoneleli bezempilo baya kubeka iliso ekusebenzeni kwezintso, balawule amayeza, kwaye baqinisekise ukuba akukho zingxaki.
- Ukuqeshwa kolandelo: Emva kokukhutshwa, izigulane ziya kuba nokuqeshwa ngokulandelelana rhoqo ukujonga ukusebenza kwezintso kunye nokulungelelanisa amayeza njengoko kufuneka. Uvavanyo lwegazi luya kwenziwa ukujonga iimpawu zokulahlwa okanye ukusuleleka.
- Ukhathalelo Lwexesha elide: Izigulane kuya kufuneka zithathe amayeza e-immunosuppressive ubomi babo bonke ukuze ukuthintela ukwaliwa kwamalungu. Ukubambelela kwi irejimeni yamayeza nokuzimasa ukuqeshwa kokulandelela ibalulekile kwi impumelelo yexesha elide.
Ngokuqonda inkqubo yesinyathelo-nge-nyathelo yokutshintshwa kwezintso, izigulane zinokuziva ngakumbi ilungisiwe kwaye yaziswa njengoko beqalisa oku uhambo olutshintsha ubomi.
Imingcipheko kunye neeNgxaki zokuTyelwa kwezintso
Njengayo nayiphi na inkqubo yotyando, ukufakelwa kwezintso kuza neengozi kunye neengxaki ezinokubakho. Kubalulekile ukuba izigulane zizazi ezi zinto ukuze zenze izigqibo ezinolwazi. Nalu uhlaziyo lwemingcipheko eqhelekileyo kunye nenqabileyo ehambelana nokufakelwa kwezintso:
Imingcipheko eqhelekileyo yokuTyelwa kwezintso:
- Uyala: Umzimba unokuqaphela intso entsha njengeyangaphandle kwaye uzame ukuyikhaba. Kungenxa yoko le nto amayeza e-immunosuppressive zibalulekile.
- Usulelo: Ukusetyenziswa kwe-immunosuppressants kwandisa umngcipheko wosulelo, ngakumbi kwithuba lokuqala emva kokusebenza.
- Ukuhlamba: Ukopha okuthile ngexesha okanye emva kotyando, kufuna ungenelelo olongezelelweyo.
- Amahlwili egazi: Kukho umngcipheko wokuphuhlisa iifutha zegazi emilenzeni okanye emiphungeni, ngakumbi ngexesha lokubuyisela.
Imingcipheko enqabileyo yokuTyelwa kwezintso:
- Ukusilela kwelungu: Kwiimeko ezinqabileyo, intso etshintshiweyo inokusilela, ifuna i-dialysis okanye enye i-transplant.
- Cancer: Ukusetyenziswa kwexesha elide amayeza e-immunosuppressive kunokunyusa umngcipheko wee-cancer ezithile, ezifana umdlavuza wesikhumba or lymphoma.
- Imiba yentliziyo: Izigulane zinokuba neengxaki zentliziyo, kuquka ukuhlaselwa yintliziyo or ukubetha, ngakumbi ukuba zineemeko esele zikho.
- I-Graft Versus Host Disease (GVHD): Nangona kunqabile kwizintso, le meko inokwenzeka xa iiseli zokhuselo lomzimba zomnikeli zihlasela umzimba womamkeli.
Iingqwalasela zexesha elide: Izigulana kufuneka ziphaphe ngempilo yazo kwaye zixele naziphi na iimpawu ezingaqhelekanga kumboneleli wabo wezempilo ngokukhawuleza. Ukulandelelanisa rhoqo kubalulekile ukubeka iliso ekusebenzeni kwezintso kunye nempilo yonke.
Ngelixa imingcipheko enxulumene nokufakelwa kwezintso inokuba malunga, uninzi lwezigulana ziyaqhubeka ziphila ubomi obunempilo, obunelisayo emva kokutshintshwa. Unxibelelwano oluvulekileyo kunye nababoneleli bezempilo kunye nokubambelela kwiingcebiso zonyango kunokunciphisa kakhulu le mingcipheko.
Ukuchacha emva koTshintsho lweZintso
Inkqubo yokubuyisela emva kokufakelwa kwezintso ibalulekile kwimpumelelo yenkqubo kunye nempilo yonke yesigulane. Ngokuqhelekileyo, ixesha lokubuyisela lingahlulwa libe ngamanqanaba amaninzi:
- Ixesha elikhawulezayo emva kokuSebenza (Iintsuku 1–3): Emva kotyando, izigulane zijongwa ngokusondeleyo esibhedlele ngeempawu zeengxaki. Eli xesha lihlala lihlala iintsuku ezi-3 ukuya kwezi-5, apho izigulane zinokuva iintlungu, ukukhathala, kunye nokudumba okuthile. Oogqirha baya kulawula iintlungu ngamayeza kwaye babeke iliso ekusebenzeni kwezintso ngovavanyo lwegazi.
- Ukukhutshwa esibhedlele (Iintsuku 4–7): Zakuba zizinzile, izigulane ziyakhutshwa esibhedlele. Baya kufumana imiyalelo kumayeza, kuquka i-immunosuppressants ukukhusela ukulahlwa kwamalungu. Kubalulekile ukulandela le miyalelo ngononophelo ukuqinisekisa ukuba izintso ezintsha zisebenza kakuhle.
- Inyanga yokuqala (Iiveki 1–4): Ngenyanga yokuqala ekhaya, izigulane kufuneka zigxininise ekuphumleni kunye nokusebenza ngokuthe ngcembe. Imisebenzi yokukhanya, njengokuhamba, inokunceda ukuphucula ukujikeleza kunye nokukhawuleza ukubuyiswa. Ukuqeshwa okulandelwa rhoqo kuyimfuneko ukubeka iliso ekusebenzeni kwezintso kunye nokulungelelanisa amayeza.
- Iinyanga ezintathu ukuya kwezintandathu: Uninzi lwezigulana zinokubuyela kwimisebenzi eqhelekileyo kwiinyanga ezi-3 ukuya kwezi-6, kodwa imidlalo enempembelelo ephezulu kunye nokuphakamisa okunzima kufuneka kugwenywe de isuswe ngugqirha. Izigulana kufuneka ziqhubeke nokuya kukhangelwa rhoqo ukuqinisekisa ukuba izintso zisebenza kakuhle.
- UBuyiselo Lwexesha elide (Iinyanga ezi-6 nangaphaya): Emva kweenyanga ezintandathu, izigulane ezininzi zichaza ukuphuculwa okuphawulekayo kumgangatho wobomi babo. Ngokufuthi banokubuyela emsebenzini baze baqhubeke nomsebenzi wabo wemihla ngemihla. Nangona kunjalo, ukhathalelo lokulandelela ubomi bonke lubalulekile ukubeka iliso kwimpilo yezintso kunye nokulawula amayeza.
Iingcebiso zoTshintsho lweZintso emva koNyango:
- Ukubambelela kunyango: Thatha onke amayeza amiselweyo njengoko kuyalelwe ukuthintela ukulahlwa nokulawula impilo.
- Utshintsho ekutyeni: Landela a ukutya kwezintso-friendly, ezinokubandakanya i-sodium ephantsi, i-potassium ephantsi, kunye nokutya okuphantsi kwe-phosphorus.
- Hydration: Hlala u-hydrated kakuhle, kodwa qhagamshelana nogqirha wakho malunga nokuthatha ulwelo.
- Ukuhlolwa rhoqo: Yiya kuzo zonke iindibano ezicwangcisiweyo zovavanyo lwegazi kunye nokuhlolwa kokusebenza kwezintso.
- Kuphephe ukosuleleka: Ziqhelise ucoceko kwaye uphephe iindawo ezixineneyo ukunciphisa umngcipheko wosulelo.
Iinzuzo zokuTyelwa kwezintso
Ufakelo lwezintso lubonelela ngeenzuzo ezininzi kwi-dialysis kunye nolunye unyango lwesigaba sokugqibela sesifo sezintso. Nalu uphuculo oluphambili lwezempilo kunye neziphumo zomgangatho wobomi ezinxulumene nokufakelwa kwezintso:
- Umgangatho woBomi obuphuculweyo: Izigulana ezininzi zinika ingxelo yophuculo olubalulekileyo kumgangatho wabo bonke wobomi emva kokutshintshwa. Bahlala bafumana amanqanaba okwandisa amandla, ukuphuculwa kwemeko, kunye nokubuyela kwimisebenzi yesiqhelo yemihla ngemihla.
- Iziphumo zeMpilo eziNgcono: Ukutshintshwa kwezintso ngokubanzi kukhokelela kwiziphumo ezingcono zezempilo zexesha elide xa kuthelekiswa ne-dialysis. Izigulane ezine-transplants zihlala zinomngcipheko omncinci wesifo senhliziyo kunye nezinye iingxaki ezinxulumene nesifo sezintso ezingapheliyo.
- Inkululeko kwiDiyalysis: Ukufakelwa kwezintso ngempumelelo kuphelisa imfuneko yeeseshoni ze-dialysis eziqhelekileyo, ezinokudla ixesha kunye nokukhupha umzimba. Le nkululeko isandul’ ukufunyanwa ivumela izigulana ukuba zibandakanyeke emsebenzini, kwizinto zokuzonwabisa nakwimicimbi yasekuhlaleni.
- Ukulindela Ubomi Obude: Uphononongo lubonisa ukuba abamkeli be-kidney transplant bahlala bephila ixesha elide kunabo bahlala kwi-dialysis. Ukutshintshwa kunokubuyisela ukusebenza kwezintso, ukuvumela ulawulo olungcono lwezempilo.
- Ukusebenza kwexabiso: Ngelixa iindleko zangaphambili zokufakelwa kwezintso zinokuba phezulu kune-dialysis, iindleko zexesha elide zihlala ziphantsi. Izigulana zonga kwiindleko ezinxulumene nonyango lwe-dialysis rhoqo kunye nokutyelela esibhedlele.
UkuTyelwa kwezintso vs. I-Dialysis: Ukuthelekiswa koKhetho loNyango lwe-ESRD
Kubantu abaneSifo Sokuphela Kwezintso (ESRD) apho iintso zingasasebenzi ngokufanelekileyo, ukhetho oluphambili lonyango lutshintsho lwezintso okanye i-dialysis. Inketho nganye inomahluko ohlukileyo ngokwenkqubo, impembelelo yendlela yokuphila, kunye neziphumo zexesha elide. Ukuqonda lo mahluko kubalulekile ukwenza isigqibo esinolwazi malunga nokulawula ukusilela kwezintso.
|
uphawu |
Ukutshintshwa kweentso |
Uhlalutyo lweHemodialysis |
I-Peritoneal Dialysis |
|---|---|---|---|
|
Ubungakanani bokusika |
Phakathi (amazantsi esisu ukwenzela ukufakelwa) |
Incinci (ye-AV fistula / uxhulumaniso okanye ukubeka umgca osembindini) |
Incinci (yokubekwa kwecatheter kwisisu) |
|
Ixesha lokubuyisela |
Ixesha elide (iiveki ukuya kwiinyanga zokubuyisela utyando kunye nohlengahlengiso lwe-immunosuppressant) |
Akukho ukuchacha ngotyando (kodwa ukuchacha okuqhubekayo kwiiseshoni) |
Akukho ukuchacha kotyando (kodwa ukubuyiswa okuqhubekayo kutshintshiselwano lwemihla ngemihla) |
|
Ukuhlala esibhedlele |
Ngokuqhelekileyo iintsuku ezi-3-7 emva kokuhlinzwa |
Iyahluka (isigulana esingalalanga seseshini yesiqhelo, isigulana sokufikelela ekudalweni okanye iingxaki) |
Iyahluka (isigulana esingalaliswanga soqeqesho, isigulana esilaliswayo sokubekwa kwecatheter okanye iingxaki) |
|
Inqanaba leentlungu |
Iintlungu eziphakathi zasemva kotyando (ezilawulwa ngamayeza) |
Ukwahluka (iintlungu zenaliti, ukubetha ngexesha leeseshoni, ukufikelela kwindawo yokungakhululeki) |
Ubuncinci (kwindawo ye-catheter, ukungaphatheki kakuhle kwesisu ngexesha lotshintshiselwano) |
|
Umngcipheko weengxaki |
Ukuchaswa, usulelo (ngenxa ye-immunosuppressants), ukopha, amahlule egazi, ukungaphumeleli kwamalungu, umhlaza (umngcipheko wexesha elide we-immunosuppressant), imiba yentliziyo |
Ukufikelela usulelo lwendawo, amahlwili egazi ekufikeleleni, i-hypotension (uxinzelelo lwegazi oluphantsi) ngexesha leeseshoni, ukuqaqanjelwa yimisipha, ukudinwa, umthwalo wentliziyo wexesha elide. |
I-Peritonitis (usulelo lwesisu), usulelo lwendawo ye-catheter, i-hernia, ukufumana ubunzima, ukulahleka kweprotheni |
|
Inkqubo yokuqala |
Uthatha indawo yezintso ezingasebenziyo kunye nezintso ezisebenzayo |
Igazi lihluzwa ngaphandle komzimba ngomatshini |
I-Peritoneal membrane ngaphakathi kwesisu isebenza njengesihluzi |
|
Impembelelo kwindlela yokuphila |
Uphuculo olubonakalayo; inkululeko kwi-dialysis; ukubuyela kwimisebenzi yesiqhelo enokwenzeka |
Ukutyelelwa rhoqo kweklinikhi (umzekelo, amaxesha ama-3 / ngeveki kwiiyure ze-3-5); izithintelo zokutya/zolwelo |
Utshintshiselwano lwemihla ngemihla ekhaya (ngesandla okanye ngokuzenzekelayo); ukuba bhetyebhetye kodwa kufuna uqeqesho; izithintelo zokutya/zolwelo |
|
Umsebenzi Wezintso |
Ibuyisela ukusebenza kwezintso ezikufutshane-eziqhelekileyo |
Ukutshintshwa ngokuyinxenye; ukuhluzwa okwenziweyo |
Ukutshintshwa ngokuyinxenye; ukuhluzwa okwenziweyo |
|
Imfuneko yee-Immunosuppressants |
Yobomi bonke |
Hayi |
Hayi |
|
Ixesha elide Outlook |
Ngokuqhelekileyo ubude bobomi obude kunye nomgangatho wobomi obungcono xa kuthelekiswa ne-dialysis |
Ubomi obuphantsi obulindelekileyo kunye nomgangatho wobomi xa kuthelekiswa nokutshintshwa |
Ubomi obuphantsi obulindelekileyo kunye nomgangatho wobomi xa kuthelekiswa nokutshintshwa |
|
ixabiso |
Iindleko eziphezulu zangaphambili, zihlala zithoba iindleko zexesha elide |
Iindleko eziphantsi zangaphambili, iindleko eziphezulu zexesha elide (unyango oluqhubekayo, izixhobo, ukutyelela ekliniki) |
Iindleko eziphantsi zangaphambili, iindleko eziqhubekayo (izibonelelo, uqeqesho, utyelelo lwaseklinikhi) |
Iindleko zokuTyelwa kwezintso eIndiya
Kwizibhedlele ze-Apollo, siyaqonda ukuba iindleko zibalulekile ingqalelo xa uceba ukutshintshwa kwezintso. I iindleko zofakelo lwezintso eIndiya ngokwesiqhelo iqala ukusuka R1,00,000 ukuya kwi-R2,50,000, kuxhomekeke kwizinto eziliqela.
Imiba Enefuthe kwiNdleko yoTshintsho lweZintso kwizibhedlele zeApollo
- Izibonelelo zesibhedlele kunye nobuGcisa: Njengomboneleli okhokelayo wokhathalelo lwempilo eIndiya, izibhedlele zeApollo zibonelela ngamaziko akumgangatho wehlabathi wotshintsho kunye namaqela onyango anamava kakhulu. Ukhathalelo lwethu oluphezulu kunye nobuchwepheshe buqinisekisa iziphumo ezilungileyo kwizigulane zethu, ezibonisa kumaxabiso.
- Indawo: Iindleko zinokwahluka kancinci ngokusekwe kwisixeko kunye nesebe lesibhedlele, kunye neendawo ezinkulu zemetropolitan ngamanye amaxesha zineendleko eziphezulu ngenxa yezinto zokusebenza.
- Uhlobo lwegumbi: Ukhetho phakathi kweewadi zabucala, ezizezabucala, okanye jikelele lunefuthe kwindleko yokufakelwa kolunye uhlobo.
- Iingxaki kunye Nokhathalelo olongezelelweyo: Kwimeko yazo naziphi na iingxaki ngexesha okanye emva kwenkqubo, unyango olongezelelweyo okanye ukuhlala ixesha elide esibhedlele kunokunyusa ixabiso lilonke.
Kwizibhedlele zeApollo, sibeka phambili unxibelelwano oluselubala kunye nezicwangciso zokhathalelo lomntu. Izibhedlele zeApollo sesona sibhedlele sibalaseleyo sofakelo lwezintso eIndiya ngenxa yobungcali bethu obuthembekileyo, amaziko ahambele phambili, kunye nokuzinikela kwiziphumo zesigulana. Sikhuthaza izigulane ezilindelekileyo ezifuna ukufakelwa kwezintso eIndiya ukuba ziqhagamshelane nathi ngokuthe ngqo ngolwazi oluthe kratya malunga neendleko zokutshintshwa kunye noncedo lokucwangciswa kwemali.
Ngezibhedlele ze-Apollo, ufumana ukufikelela kubuchwephesha obuthembekileyo, ukhathalelo olupheleleyo lwasemva, kunye nexabiso elibalaseleyo, okusenza sibe lolona khetho lukhethekileyo lofakelo lwezintso eIndiya.
Imibuzo ebuzwa qho
1. Loluphi utshintsho kwidayethi ekufuneka ndilwenzile phambi koTshintsho lweZintso?
Ngaphambi koTshintsho lweZintso, kubalulekile ukulandela ukutya okulungeleyo kwizintso. Oku kubandakanya ukunciphisa ukutya kwe-sodium, ukuphepha ukutya okuphezulu kwe-potassium, kunye nokuhlala u-hydrated. Qhagamshelana nengcali yezokutya ukuze ufumane iingcebiso ezizezakho.
2. Ndingakutya ukutya endikuthandayo emva koTshintsho Lwezintso?
Emva kokuTshintshwa kwezintso, unokuphinda ubuyisele ukutya okuthandayo, kodwa ukumodareyitha kubalulekile. Gxininisa kukutya okunokulinganisela okutyebileyo kwiziqhamo, imifuno, kunye neeprotheni ezibhityileyo ngelixa uphepha ukutya okuphezulu kwe-sodium kunye ne-potassium ephezulu.
3. Ubudala buchaphazela njani ukuchacha emva koTshintsho Lwezintso?
Ukuchacha emva koTshintsho Lwezintso kunokwahluka ngokweminyaka. Izigulana ezindala zinokuthatha ixesha elide ukuba ziphole kwaye zinokuba neengxaki ezininzi. Nangona kunjalo, izigulane ezininzi ezisele zikhulile zisenokuzuza kakhulu kwinkqubo.
4. Ingaba ukukhulelwa kukhuselekile emva koTshintsho Lwezintso?
Ukukhulelwa kunokukhuseleka emva koTshintsho Lwezintso, kodwa kubalulekile ukubonisana neqela lakho lezempilo. Baza kuvavanya impilo yakho kunye nomsebenzi wezintso zakho ezintsha phambi kokuba bacebise ngocwangciso-ntsapho.
5. Yintoni endifanele ndiyazi malunga noTyalo lweKidney kwiimeko zabantwana?
Izigulana zoTshintsho lweKidney kubantwana zihlala zineziphumo ezibalaseleyo. Inkqubo iyafana neyabantu abadala, kodwa abantwana banokufuna ingqalelo ekhethekileyo malunga nokukhula nophuhliso.
6. Ukutyeba kakhulu kukuchaphazela njani ukufaneleka kwam uTshintsho lweZintso?
Ukutyeba ngokugqithiseleyo kunokwenza kube nzima uTshintsho lweZintso. Inokunyusa imingcipheko yotyando kwaye ichaphazele ukuchacha. Ukunciphisa umzimba kunokucetyiswa ngaphambi kokuqwalasela ukutshintshwa.
7. Ndingalenza uTshintsho lweZintso ukuba ndinesifo seswekile?
Ewe, izigulana ezininzi ezinesifo seswekile ziphumelela uTshintsho lweZintso. Nangona kunjalo, ukulawulwa ngononophelo kwamanqanaba eswekile yegazi kubalulekile kwisiphumo esiyimpumelelo.
8. Kuthekani ukuba ndinoxinzelelo lwegazi phambi koTshintsho lweZintso lwam?
Uxinzelelo lwegazi luqhelekileyo phakathi kwezigulane ezinesifo sezintso. Kubalulekile ukulawula uxinzelelo lwegazi ngokufanelekileyo phambi nasemva koTshintsho lweZintso ukuqinisekisa ezona ziphumo zilungileyo.
9. Kuya kufuneka ukuba ndithathe ixesha elingakanani amayeza emva koTshintsho Lwezintso?
Emva koTshintsho lweZintso, kuya kufuneka uthathe amayeza e-immunosuppressive ubomi bonke ukuthintela ukwaliwa kwamalungu. Ukulandelela rhoqo kuya kunceda ukulawula la mayeza.
10. Zeziphi iimpawu zokulahlwa emva koTshintsho lweZintso?
Iimpawu zokulahlwa zingabandakanya umkhuhlane, intlungu kwindawo yofakelo, ukwehla komchamo, kunye nokudumba. Ukuba ufumana nayiphi na kwezi mpawu, qhagamshelana nomboneleli wakho wezempilo ngokukhawuleza.
11. Ndingahamba emva koTshintsho Lwezintso?
Ewe, unokuhamba emva koTshintsho lweKidney, kodwa kubalulekile ukudibana nogqirha wakho kuqala. Baza kunika isikhokelo kumayeza, ugonyo, kunye nezilumkiso zokuhamba.
12. Loluphi utshintsho kwindlela yokuphila ekufuneka ndiyenze emva koTshintsho lweZintso?
Emva koTshintsho lwezintso, gxininisa ekutyeni okunempilo, ukuzilolonga rhoqo, nokuphepha ukutshaya kunye notywala obugqithisileyo. Olu tshintsho lunokunceda ukugcina impilo yezintso kunye nokuphila kakuhle.
13. Kukangaphi ndifuna idinga lokulandelelwa emva koTshintsho Lwezintso?
Ekuqaleni, ukuqeshwa kokulandelela kuya kwenzeka rhoqo, rhoqo ngeveki okanye kabini ngeveki. Njengoko ixesha lihamba kwaye ukuba ukusebenza kwezintso zakho kuhlala kuzinzile, ukuqeshwa kunokwahlulwa kuzo zonke iinyanga ezimbalwa.
14. Yintoni izinga lempumelelo yoTshintsho lweZintso eIndiya?
Izinga lokuphumelela kwezintso eIndiya liphezulu ngokubanzi, kunye nezigulane ezininzi zifumana iziphumo ezilungileyo zexesha elide. Impumelelo ixhomekeke kwizinto ezifana nohlobo lwabaxhasi, impilo yesigulana, kunye nokubambelela kukhathalelo lwasemva kokutshintshwa. Kwizibhedlele ze-Apollo, kunye namaqela eengcali zonyango kunye nokhathalelo oluphezulu, siqinisekisa ezona ziphumo zibalaseleyo kwizigulana zethu.
15. Ndinganikela ngezintso emva koTshintsho Lwezintso lwam?
Ngokubanzi, abantu abafumene i-Kidney Transplant abafanelekanga ukuba banikele ngezintso. Nangona kunjalo, dibana nomboneleli wakho wezempilo ngengcebiso ezenzelwe wena.
16. Ndingenza ntoni ukuba ndiphose idosi yeyeza lam le-immunosuppressive?
Ukuba uyaliphosa ithamo leyeza lakho le-immunosuppressive, lithathe ngokukhawuleza xa ukhumbula ngaphandle kokuba lisondele kwixesha ledosi yakho elandelayo. Ungaze uphindaphinde iidosi. Qhagamshelana nogqirha wakho ngesikhokelo esithile.
17. UTshintsho Lwezintso luyichaphazela njani impilo yam yengqondo?
Izigulana ezininzi zifumana utshintsho lweemvakalelo emva koTshintsho lwezintso. Kubalulekile ukufuna inkxaso kwiingcali zempilo yengqondo okanye amaqela enkxaso ukujongana nayo nayiphi na inkxalabo.
18. Zeziphi iingozi zoTshintsho lweZintso?
Imingcipheko ibandakanya usulelo, ukwaliwa kwezintso ezintsha, kunye neengxaki ezivela kuqhaqho. Nangona kunjalo, ngononophelo olufanelekileyo kunye nokubeka iliso, izigulane ezininzi ziphila ubomi obunempilo emva kokutshintshwa.
19. Ndingabuyela emsebenzini emva koTshintsho Lwezintso?
Uninzi lwezigulana zinokubuyela emsebenzini kwiinyanga ezimbalwa emva koTshintsho Lwezintso, kuxhomekeke ekuchacheni kwazo kunye nohlobo lomsebenzi wazo. Xoxa ngesicwangciso sakho sokubuyela emsebenzini kunye neqela lakho lezempilo.
20. I-Kidney Transplant ifaniswa njani namanye amazwe eIndiya?
UTyalo lweZintso eIndiya luhlala lufikeleleka ngakumbi kunamazwe aseNtshona, kunye nomgangatho ofanayo wokhathalelo. Izigulana ezininzi zikhetha iIndiya kumaqela ayo onyango anamava kunye nezixhobo eziphambili.
21. Bubuphi obona bomi buphezulu emva kofakelo lwezintso, kwaye ndingalindela ntoni ngobomi emva koqhaqho-fakelo lwezintso?
Ubomi obuninzi emva kokufakelwa kwezintso bunokuqala ukusuka kwi-10 ukuya kwi-20 iminyaka okanye ngaphezulu, kuxhomekeke kwimpilo yomntu kunye nokhathalelo. Ubomi emva kofakelo lwezintso ngokubanzi buphucuka kakhulu, bunika amandla angcono kunye nomgangatho wobomi, kodwa kufuna amayeza obomi bonke kunye nolandelelo lwezonyango rhoqo ukuqinisekisa impumelelo yofakelo.
22. Zeziphi iziphumo ebezingalindelekanga eziqhelekileyo zofakelo lwezintso?
Ngelixa ukufakelwa kwezintso kunokuphucula kakhulu umgangatho wobomi, ezinye iziphumo ebezingalindelekanga zinokwenzeka. Iziphumo eziqhelekileyo zokufakelwa kwezintso zibandakanya ukusabela kumayeza e-immunosuppressant (njengokuzuza ubunzima, igazi elonyukayo, okanye ukwanda komngcipheko wosulelo), umngcipheko wokulahlwa kwelungu, kunye neengxaki zotyando ngokubanzi njengokuphuma kwegazi okanye ukusuleleka. Ukulandelwa rhoqo kunceda ukulawula nokunciphisa le mingcipheko ngokufanelekileyo.
23. Ingaba kukho umda weminyaka wofakelo lwezintso?
Akukho mda ungqongqo wobudala bokufakelwa kwezintso. Ukufaneleka kusekelwe ngakumbi kwimpilo yonke kunokuba ubudala bodwa. Abaguli abancinci njengeentsana kunye nabantu abadala abangaphezu kweminyaka engama-70 baye baphumelela uqhaqho lwezintso. Oogqirha bavavanya imeko nganye ngabanye ukuze banqume ukuba isigulane sinokutyandwa ngokukhuselekileyo kwaye silawule ukhathalelo emva kokutshintshwa.
isiphelo
Ukutshintshwa kwezintso yinkqubo yokuguqula ubomi enokuthi iphucule kakhulu impilo kunye nomgangatho wobomi kwizigulane ezinesifo sokugqibela sesifo. Ukuqonda inkqubo yokubuyisela, izibonelelo, kunye neendleko ezinxulumene nokufakelwa kwezintso kubalulekile ukwenza izigqibo ezinolwazi. Ukuba wena okanye umntu omthandayo ucinga ngofakelo lwezintso, kubalulekile ukuthetha nochwepheshe bezonyango ukuxoxa ngokhetho lwakho kwaye uphuhlise isicwangciso sokhathalelo lomntu.
Isibhedlele esiBalaseleyo esikufutshane nam eChennai
