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透析

ID: ANH11046chis
医学动画文字记录:如果你的肾脏功能不全,医生可能会建议进行透析,这是一个从血液中清除废物的过程。健康的肾脏从血液中过滤出废物、多余的液体和电解质,如钾和钠。这些废物以尿液的形式通过尿道排出体外。如果你患有肾脏疾病,肾脏逐渐失去功能,导致有害废物和多余的液体在体内聚积,血压升高,发生骨骼或血液问题。透析也可以用来治疗急性肾衰竭(肾脏突然停止工作),或者用来清除体内的药物或毒素。透析的一种类型称为血液透析,医生会使用一种称为透析器的仪器在体外清洗血液。在开始血液透析前几周或几个月,医生会在你的身体上建立一个血管通路。医生会创建动静脉移植物或者动静脉瘘管来进入你的血液循环。首先,进行该区域的局部麻醉。为了植入动静脉移植物,医生会在前臂上做一个小切口,然后插入一根称为移植物的软塑料管来连接动脉和静脉。为了创建动静脉瘘管,医生会在皮肤上开一个小切口,把动脉和静脉连接起来,形成一个更大的血管,称为瘘管。一旦血管通路口愈合,就可以开始血液透析。首先,透析护士会在动静脉瘘管或移植物上插入两根针。一旦回路建立,血液就会慢慢流出身体,通过透析器。在透析器内,血液会通过滤过纤维和一种称为透析液的吸收性清洁溶液。纤维会清除血液中的废物和多余的液体和电解质。清洗干净的血液从透析器中流出,并继续通过管道经由位于通路口的第二根针回输入体内。当血液透析疗程结束后,拔除针和管路,你就可以回家了。在另一种类型的透析中,医生会通过腹膜(腹壁内侧的膜)来清洗血液,而不是让血液离开身体。在开始腹膜透析之前,需要进行手术植入一根软管,称为导管。医生会将导管插入肚脐附近,造一个孔,透析液通过这个孔进出腹部。每次腹膜透析称为一次交换。首先,要用导管将透析液充满腹部,时间由医生决定。通过腹膜,废物和多余的液体不断地从血液中抽出,进入透析液。在交换的过程中,随着废物的吸收,透析液从腹部流出到一个一次性收集袋中。

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