Ina tae ki te dialysis, me whiriwhiri te taputapu tikaNgira fistula AVhe mea nui. He iti nei te āhua neitaputapu hauoraHe mea nui tēnei hei whakarite i te haumaru, te whakamarie, me te whai huatanga o te maimoatanga mō te tūroro. Ahakoa he tākuta koe, he kaiwhakarato hauora, he kaiwhakahaere taputapu hauora rānei, me mārama koe ki te whiriwhiri i te mea tikangira fistula mō te dialysishe mea nui.
I roto i tēnei tuhinga, ka tūhuratia e mātou he aha te ngira AV fistula, he aha te hiranga, me ngā āhuatanga matua e iwa hei whakaaroaro māu i te wā e whiriwhiri ana i tētahi. Ka pā atu hoki mātou ki ngā rahi noa pēnei i te ngira AV fistula 15G, 16G, me te 17G hei ārahi i tāu whiriwhiri.
He aha teNgira Fistula AV?
Ko te ngira fistula arteriovenous (AV) he ngira dialysis motuhake e whakamahia ana hei uru atu ki te toto o te tūroro mā te fistula arteriovenous i te wā ete whakaheke totoKo te AV fistula he hononga i hangaia mā te pokanga i waenganui i te uaua me te uaua toto, i roto i te ringa te nuinga, e āhei ai te rere o te toto e tika ana mō te dialysis whai hua.
Ka werohia te ngira AV fistula ki roto i te fistula hei tango toto hei horoi, kātahi ka whakahokia ki te tinana. He mea nui ēnei ngirangā taputapu hauorai roto i ngā pokapū dialysis me ngā hōhipera, ā, ko te whiriwhiri i te mea tika ehara i te mea ko te hototahi ki ngā taputapu anake—engari ko te arotau i ngā putanga o ngā tūroro.
Te hanganga o te ngira AV fistula
9 Ngā Take Matua hei Kōwhiri i te Mea TikaNgira Fistula AV
1. Ine ngira
Mā te ine ngira ka whakatau te whānui o te ngira, ā, ka pā tika ki te rere o te toto. Ko ngā rahi noa ko:
Ngira AV fistula 15G: He whānui ake te diameter, ka taea ai te tere rere toto teitei ake. He mea whakamahi noa mō ngā tūroro pakeke me ngā fistula kua pakeke.
Ngira AV fistula 16G: He rahi maha hei whakataurite i te tere rere me te whakamarie o te tūroro.
Ngira AV fistula 17G: He iti ake te diameter, he pai mō ngā tamariki me te hunga he uaua pakarukaru.
Ko te whiriwhiri i te ine tika me whai whakaaro ki te āhua o te uaua o te tūroro, ngā hiahia rere toto, me te mahere maimoatanga.
Ripanga 1. Te whakataurite i te ine me te tere rere o te toto
| Te tere rere o te toto (BFR) | Ine ngira e taunakitia ana |
| <300 ml/min | 17 ine |
| 300-350 ml/min | 16 ine |
| >350-450 ml/min | 15 ine |
| >450 ml/min | 14 ine |
2. Te roa o te ngira
Ko te roa tētahi atu mea nui. Ko te roa o ngā ngira e wātea ana i waenga i te 25mm ki te 38mm. Me nui te roa o te ngira kia tae atu ki ngā pakitara o te fistula, engari kaua e roa rawa, ka pā kino pea. Mā te roa tika o te ngira ka pai ake te tika o te whakaurunga, ā, ka whakaitihia te mamae.
Ripanga 2. Te whakataurite i te roa o te ngira e ai ki te tawhiti ki te kiri
| Te tawhiti ki te mata o te kiri | Te roa o te ngira e taunakitia ana |
| <0.4 cm i raro i te mata o te kiri | 3/4″ me te 3/5″ mō ngā fistula |
| 0.4-1 cm mai i te mata o te kiri | 1 inihi mō ngā fistula |
| ≥1 cm mai i te mata o te kiri | 1 1/4″ mō ngā fistula |
3. Hoahoa Here
Ko te piko ko te taha whakarara o te ngira. Mēnā he koi rawa te hoahoa piko, ka kino pea ngā pakitara o te fistula, engari mēnā he pōuri rawa te piko, ka uaua pea te wero i te kiri. Ka rerekē te hoahoa piko pai mō ia tangata, i runga i te rahi me te āhua o tō rātou fistula. Ko ngā momo noa ko:
Poto te piko: He māmā ake te whakahaere, he iti ake te tūponotanga ka haehae te kiko
He roa te piko: He koi ake, ā, he maeneene ake te urunga, engari me nui ake te pūkenga e hiahiatia ana
Mā te whiriwhiri i te anga tika ka taea te whakaiti i te mamae me ngā raruraru o te tūroro i te wā e pokaia ana.
4. Rauemi Ngira
Ka pāngia te mahi me te haumaru o te tūroro e te rauemi ngira. Ko ngā ngira maitai kore waikura kounga teitei te mea e tino kitea ana nā te kaha, te koi, me te hototahi ki te koiora. Me hanga ngā ngira Aseptic Fistula ki ngā rauemi kounga teitei, kounga hauora hei whakaiti i te tūponotanga o te mate. He mea nui kia whiriwhiria ngā ngira mai i tētahi kaihanga ngira av fistula rongonui kia mau ai te haumaru me te roa.
5. Ngā Ngira Pū Hurihuri
Mā ngā ngira porowhita hurihuri ka taea te huri 360-tohu me te kore e nekehia te ngira mai i tōna wāhi. He tino whai hua tēnei āhuatanga mō te whakaiti i ngā piko o ngā ngongo me te urutau ki te nekehanga o te tūroro i ngā wā tātaritanga. Ka whakapai ake hoki i te whakamarie me te whakahaere i ngā whakarerekētanga i te wā e maimoatanga ana.
6. Parirau mō te Pupuri Haumaru
ParirauNgā ngira fistula AVKa nui ake te pumau me te mau. Mā ēnei parirau pūrerehua ngāwari ka taea e ngā kaitiaki te whakau i te ngira me te pupuri pai ake i te wā e werohia ana. He tino whai hua ngā parirau mō ngā tūroro e tango ana i te ngira, ā, ka āwhina ki te whakaiti i te tangohanga tūpono i te wā e tātarihia ana.
7. Ngā Tikanga hei Ārai i te Rerenga o te Toto
He mea nui te aukati i te rere o te toto ki muri mō te haumaru o te tūroro. Ko ētahi ngira AV fistula he mea hanga ki ngā takirere kotahi-ara, ki ngā tikanga ā-roto rānei hei whakaiti i te mōrearea o te rere o te toto ki muri, hei āwhina i:
Ārai i te totohu i roto i te ngongo
Kia mau tonu te koretake
Whakapai ake i te whai huatanga o te dialysis
Ka tino hira tēnei āhuatanga i ngā wā roa o te dialysis, i ngā tūroro rānei e pāngia ana e ngā raruraru toto totoka.
8. Tikanga Whakahoki Ngira
Kua hangaia ngā tikanga hou mō te tango ngira hei whakarei ake i te haumaru mā te whakaiti i te mōrearea o ngā whara o te wero ngira i muri i te whakamahinga. Ka hoki aunoa ēnei tikanga ki roto i te anga tiaki i muri i te werohanga ngira, kia noho haumaru ai te tūroro me te kaitiaki.
Kei te piki haere te whakamahinga o ngā ngira hutihuti i roto i ngā wāhi haumanu nā te mea e tutuki ana i ngā ture haumaru mō ngā mea koi.
9. Whakatairangahia te whakamarie o te tūroro
Hei whakamutunga, ko te ngira pai rawa atu mō te fistula AV ko te mea e tino whakamarie ana i te tūroro. Ko te koi o te ngira, te paninga, te koki whakauru, tae atu ki te ergonomics o te takai ka whai wāhi katoa ki te wheako whānui. Ko te wā dialysis maeneene ake, iti ake te mamae ka hua ake te kaha o te manawanui ki te tango i te ngira me ngā putanga pai ake i te roanga o te wā.
He aha te Hiranga o te Ngira Fistula Matau?
Ehara i te mea he whakatau hangarau noa iho te whiriwhiri i te ngira fistula tika mō te dialysis—engari he pānga tika ki te hauora me te whakamarie o te tūroro. Anei te hiranga o tēnei:
Ka whakapai ake i te whai huatanga o te dialysis:Mā te rahi me te hoahoa tika o te ngira ka pai ake te rere o te toto.
Ka whakaiti i ngā raruraru:Mā ngā ngira i whiriwhiria tika ka whakaitihia te whara, te urunga ki roto, me te toto totoka.
Ka whakapai ake i te haumaru:Ka tiakina ngā tūroro me ngā kaimahi e ngā āhuatanga pēnei i ngā tikanga hoki whakamuri me ngā hoahoa ārai-rerenga whakamuri.
Ka whakanui ake i te whakamarie:Mā te ngira e ngāwari ana te wero, ā, he iti noa te mamae e pā mai ai, ka piki ake te whakawhirinaki me te hiahia o te tūroro ki te whiwhi maimoatanga auau.
I te mea he maimoatanga roa, he whakaora ora hoki te hemodialysis, he mea nui ia taipitopito. Koia te take me whakapau wā ngā whare hauora me ngā tohunga hauora ki te whiriwhiri i te ngira dialysis tika mō ia take.
Whakamutunga
Hei whakarāpopototanga, ko teNgira fistula AVehara i te mea he taputapu noa iho—he wāhanga nui ia mō te whakarato i te tiaki dialysis haumaru me te whai hua. Mai i te rahi me te rauemi o te ine ki ngā āhuatanga tango me te whakamarie o te tūroro, he mahi tā ia āhuatanga.
Ahakoa kei te whiriwhiri koe i waenga i te ngira AV fistula 15G, 16G, 17G rānei, whakaarohia ngā āhuatanga matua e iwa kua kōrerotia i runga ake nei kia pai ai te whiriwhiri. Mā te mahi pera, ehara i te mea ka whakarei ake i ngā putanga haumanu anake, engari ka tino whakapai ake hoki i te wheako dialysis o te tūroro.
Wā tuku: Mei-12-2025