Ba zabar dialysis wani zaɓi ne mai inganci ba, amma menene halayen
Magunguna da ciwon ƙwayar ciwon daji wanda ke fuskantar mataki 5 yana da zabi biyu idan ya dace da maganin cutar, ko dai farawa a kan wasu nau'o'in dialysis (a cikin cibiyar hemodialysis zama mafi yawanci a Amurka, ko kuma a cikin gida wanda zai iya zama ko hemodialysis ko peritoneal dialysis ), ko kuma samun dashi na koda. Amma idan idan mai haƙuri ba zai iya samun ba, ko kuma ba ya son kowane daga cikin wadannan zaɓuɓɓuka don kowane dalili.
Menene ya faru a yayin da mai ciwo da rashin cin nasara koda ba ya karbi dialysis ko dashi? Har yaushe zasu iya tsammanin rayuwa? Wannan labarin zai ƙoƙari ya amsa wasu daga cikin waɗannan tambayoyi.
BABI BAKE DIALYSIS YAKE KYAU KUMA KUMA, BA WANNAN DUNIYA DUNIYA
Yin hukunci game da wanene wannan "hakuri mai haƙuri" shine yanke shawara wanda ya fi dacewa a tattauna tsakanin masu haƙuri da masu nefrologist . A al'ada, lokacin da marasa lafiya sun kasance 'yan takara don maganin ƙwararru, masu ilimin lissafi za su ce, "za mu rike maganganu a kan Ms. X". Duk da haka, yana cewa "riƙe" yana da ƙananan ra'ayi (zaton "za mu riƙe goyon bayan rayuwa, da dai sauransu."). Ga wani mai haƙuri da iyalin su, yana ba da ra'ayi cewa likita ba zai bayar da wani abu ba kuma muna jira har sai mai lafiya ya mutu. Duk da haka, wannan baza'a iya karawa daga gaskiyar tun da yawancin rikitarwa na cutar koda zai iya kuma ya kamata a gudanar da shi tare da magunguna.
A wasu kalmomi, masu ba da ilimin lissafi zasu iya bayar da yawa; kyawawan abubuwa da yawa daga ƙuƙurin mai haƙuri zuwa na'urar inganci. Sabili da haka, don sadarwa mafi kyau ga masu haƙuri, lokaci mai dacewa don maganin rashin kwarewar koda wanda aka yi amfani da shi yanzu shi ne Mashawarcin Conservative Management (MCM) .
An rufe wannan dalla-dalla a nan.
WANNAN MUTANE MUTANE GA GASKIYA GASKIYA DA KUMA DA KUMA YA YI BA WANE KUMA
Ba kowane mai haƙuri zai zama dan takara mai kyau na MCM ba, kuma wasu zaɓuɓɓuka na iya zama mafi dacewa. Gudanar da ra'ayin nagari yana da kyau a wasu saituna. Wadannan zasu iya hada da tsofaffi da tsofaffi, ciwo mai tsanani, kasancewa da wasu cututtuka irin na cututtukan zuciya ko ciwon daji, da dai sauransu. A irin waɗannan lokuta, yana da wuyar ganewa ko da yaushe dialysis zai kara wani abu ga ƙimar / yawan rayuwa. Kuma sau da yawa, marasa lafiya suna kallon "babban hoton", musamman idan an yi iyakacin rai.
Duk da haka, MCM ba ga kowa ba ne. Dole ne a sanar da marasa lafiya cewa akwai matsaloli masu yawa na rashin cin nasara koda wanda za'a iya amfani da shi tare da kwayoyi, kuma wasu alamu / alamu zasu amsa maganganu kawai. Wannan shi ne saboda abin da ake kira ciwon daji wanda ke tattare da gazawar koda kuma dalilin da ya sa mafi yawan rikitarwa ba za a cire ta ba tare da yin gyare-gyare na kodayaushe (ko da yake bidiyon ba dole ba ne cire dukkan su). Mai haƙuri da likita zasu iya buƙatar zama tare don biyan bukatun da kuma tsara wani shirin kulawa.
Kuma idan magana ta kasance game da tsammanin, wasu tambayoyin biyu zasu sauke daga marasa lafiya wanda ke ƙi dialysis:
- Yaya zan ji idan na ki amincewa?
- Shin rayuwata za ta zama taqaitaccen idan na ƙi inganci?
Bada yawan adadin bayanai, waɗannan ba tambayoyi masu sauki ba ne don amsawa. Amma muna da ƙarin bayanai game da yanayin rai a cikin marasa lafiya waɗanda suka yi ƙoƙari don suzari. Kamar yadda rahotanni na Renal Data System na Amurka, lafiyar da ake tsammani ga marasa lafiya a kan dialysis zai iya bambanta daga shekaru 8 (ga marasa lafiya shekaru 40 zuwa 44) zuwa shekaru 4.5 (marasa lafiya tsakanin 60 zuwa 64). Wannan dai shi ne matsakaici, tare da hanyoyi masu yawa da aka gani dangane da shekarun mai haƙuri, halin jin dadi, da kuma kasancewa da wasu cututtukan cututtuka kamar yadda cutar cututtukan zuciya, ciwon daji, da dai sauransu.
Har ila yau ina son in ba da hankalin ku ga wani jadawali wanda ya kwatanta fatawar wani namiji mai shekaru 55 da haihuwa zuwa irin wannan mai haƙuri a kan dialysis, ko wanda ya karbi kaya.
BABI DA RUHAN SPAN DA DA BA TARE DA DIALYSIS
Bari mu dubi wasu binciken da suka yi kokarin kwatanta rayuwa tsakanin waɗannan nau'i biyu. Binciken kan marasa lafiya wadanda suka kamu da cutar koda 5 wadanda suka kai kimanin shekaru 80 sun ruwaito tsawon rayuwarsu ta tsawon shekaru 20 (watannin 29 da 9) a cikin marasa lafiya da suka zaɓa dialysis. Wani binciken da aka kwatanta da zaman lafiya tsakanin marasa lafiya da suka yi ƙoƙari don haɓaka tare da waɗanda suka zaɓi shawara mai ra'ayin mazan jiya sun kuma bada rahoto mafi alheri ga marasa lafiya waɗanda suka zaɓi dialysis. Dukan marasa lafiya sun kasance akalla shekaru 75. Kwanan kuɗin da ake yi na tsawon shekaru 1 yana da kashi 84 cikin 100 a cikin rukunin da ke zaɓin dialysis kuma 68% a cikin rukunin zaɓin dabarun marasa lafiya. Mutum zai iya cirewa daga wannan bayanan cewa gazawar gajiyar marasa lafiya wanda ke neman inganci zai zama mafi tsawo.
Duk da haka, abin da ke sama za su zama zato mai sauƙi. Magunguna da ciwon ƙwayar cututtuka da yawa za su sami lokuta masu tsanani irin su zuciya rashin ciwo, ciwon sukari, ciwon daji, da sauransu; abin da mu likitoci suke kira "co-morbidities" . Sabili da haka, idan muka sake nazarin bayanan da muka tattauna a sama, mun gane cewa fatawar rai a cikin marasa lafiya wanda ke da wasu cututtukan cututtuka masu tsanani kamar yadda cutar cututtukan zuciya ke yi ba ta bambanta ba; ko sun zaba dialysis ko a'a ! A wasu kalmomi, a cikin mai haƙuri da ke da mummunan cututtuka, za a iya ƙayyade rayuwa ta hanyar waɗannan ka'idojin fiye da ko mai haƙuri ne dialyzed ko a'a. Hanya na saƙo gida shine cewa dialysis zai kara yawan rayuwarka muddin ba ka da sauran cututtuka masu tsanani da aka ambata a sama. Zan kuma kai hankalin ku ga Figure 2 daga wannan labarin wanda ya karfafa abin da muka tattauna kawai.
A ƙarshe, bari in ambaci wani ƙididdiga mai muhimmanci (bayanai a nan, a nan, da kuma a nan). Rayuwa tsawon rayuwar bayan mai haƙuri da aka riga a kan dialysis an cire shi a hankali a cikin kwanaki 6 zuwa 8, amma matsananciyar yanayin zai iya canzawa ko'ina a tsakanin kwanaki 2 zuwa 100.
KARANIN KASHI DA KUMA OF RAYUWA DA KUMA DIALYSIS
Ga marasa lafiya wadanda suka yanke shawarar kada su zabi jinsin zuciya bayan tattaunawa da masu nephrologists, wata hujja ta fito da ita ce, "Yaya zan ji"? Yawancin marasa lafiya suna da damuwa game da hakan fiye da yiwuwar rage yiwuwar rayuwa.
A shekara ta 1949, Dr David Karnofsky yayi bayani game da sikelin (100 yana da lafiyar lafiyar jiki, da kuma 0 yana nuna mutuwa) wanda za'a iya amfani dasu don daidaita yanayin matsayin masu ciwon daji. An yi amfani da sikelin don auna ma'aunin rashin aikin aiki na marasa lafiya na koda wanda aka gudanar da ra'ayin rikitarwa ba tare da dialysis ba. Labarin nan (duba Figure 1) ya bayyana abin da waɗannan marasa lafiya zasu kasance daga aiki / ingancin rayuwar rayuwa a bara na rayuwarsu. Abin da ke sha'awa a lura shi ne cewa irin wadannan marasa lafiya zasu buƙaci taimako na lokaci kawai har zuwa watanni na karshe na rayuwarsu, bayan haka za su ga mummunan raguwa a matsayin matsayi, saboda haka ne ake bukata na bukatar kulawa na musamman / asibiti. Matakan da labarin ke ba mu ƙarin haske game da abin da za mu yi tsammanin lokacin da marasa lafiyar koda za su duba cikin makomar kuma za su yanke shawarar barin rayuwa ba tare da dialysis ba. Abin da zan so in jaddada a nan shi ne, wadannan ƙaddara sun dogara ne akan zaton cewa marasa lafiya suna kulawa da ra'ayin rikice-rikice, a hanya marar tsattsauran ra'ayi. Wannan shi ne abin da muke yanzu a matsayin Mashawarcin Conservative Management (MCM) kuma a nan su ne cikakkun bayanai.