Gemodializ paytida trubkalarning egilishi natijasida yuzaga keladigan o'tkir gemoliz bemorning hayotiga tahdid soladigan asoratlardan biridir. Gemodializ paytida quvurlarning egilishi natijasida yuzaga keladigan gemoliz holatlari juda kam bo'lsa-da, uning zarari juda jiddiy. Agar u o'z vaqtida aniqlanmasa va samarali choralar ko'rilmasa, giperkalemiya, o'tkir pankreatit va hatto o'lim kabi asoratlarni keltirib chiqarishi mumkin.
Mexanik gemoliz odatda qon aylanishining turli darajadagi tiqilib qolishi natijasida yuzaga keladi, jumladan: ignaning ochilishi qon tomir devoriga yaqin joylashgan yoki teri osti gematomasi bilan siqilib, qon oqimiga jiddiy to'sqinlik qiladi; bitta igna dializ; qon pompasi tamburiga haddan tashqari bosim, trubaning egilishi va qon kesish kuchiga duchor bo'ladi. Nasosning orqa qismidan dializatorning kirish qismigacha bo'lgan qismda, ayniqsa, mahkamlangan yoki qo'llab-quvvatlovchi trubka qisqichlari va dializatorning kirish qismiga yaqin bo'lgan trubaning kesimida ko'pincha quvurlarning burmalari paydo bo'ladi.
Gemolizning zarari
Gemoliz nafaqat bemorlarga noqulaylik tug'diradi, balki anemiyani keltirib chiqaradi, gemodinamik beqarorlikni kuchaytiradi, gemolitik tomirlarning torayishi va gipertoniyani keltirib chiqaradi, koronar arteriyalar va miya to'qimalarining qon bilan ta'minlanishiga to'sqinlik qiladi yoki gipotenziya va dializ paytida qonning kislorod bilan to'yinganligini kamaytiradi. Agar gemolizning sababi o'z vaqtida aniqlanmasa va to'g'ri davolanmasa, gemodializ simptomlarni bartaraf etmasligi sababli to'xtashga majbur bo'ladi, bu muqarrar ravishda dializ ta'sirini kamaytiradi. Og'ir gemoliz o'tkir pankreatit, giperkalemiya, aritmiya va hatto o'limga olib kelishi mumkin. Bemorlarga gemoliz oqibatlarining og'irligi bemorning o'z omillari bilan bog'liq. Uremiya bilan og'rigan bemorlarda qizil qon hujayralarining omon qolish muddati sezilarli darajada qisqaradi, oksidlovchi stress kuchayadi va antioksidant salohiyat kamayadi, bularning barchasi bemorlarda turli darajadagi gemolizga olib keladi.
Gemodializ gemolizining diagnostikasi
Nausea, shortness of breath, abdominal/back pain, chills, and acute hypertension occur during dialysis. Severe hemolysis patients may even have their skin color turn brown. The blood color at the back of the blood line pump, especially at the venous pot, is wine-colored; after centrifuging the blood sample, the supernatant shows pink; blood tests show that serum haptoglobin is significantly reduced to disappearance, lactate dehydrogenase (LDH) is significantly increased, and hematocrit is reduced. Since the pressure alarm device cannot effectively alarm for less severe hemolysis, medical staff and technicians are mainly required to check the installation status of the pipeline, including whether the pipeline is bent, whether there is abnormal and obvious pulsation, whether the blood in the pipeline is discolored, etc., and monitor the pressure changes and trends of the pipeline. If the arterial and venous pressures are significantly reduced at the same time (>25 mmHg), quvur liniyasi egilgan bo'lishi mumkin.