Kodi mapapo anu akuvutika kupuma? Tiyeni tiphunzire za ARDS yoopsa iyi (Acute Respiratory Distress Syndrome)!

Kodi mwadzidzidzi munayamba mwavutika kupuma, mukumva ngati chifuwa chanu chatsekedwa? Kapena mukukumbukira nthawi imene munthu amene mumamudziwa mwadzidzidzi anadwala kwambiri, sankatha kupuma bwino ndipo analowetsedwa mu chipinda chosamalira odwala kwambiri (ICU) cha chipatala? Mwina chifukwa chake chinali matenda otchedwa ARDS (Acute Respiratory Distress Syndrome) . Izi ndi zovuta pang'ono, koma ngati mwadziwitsidwa bwino, zimakhala zosavuta kumvetsetsa zinthu zambiri. Tiyeni tikambirane za izi mwatsatanetsatane, sichoncho?

Kodi ARDS ndi chiyani? Tiyeni timvetse mosavuta.

Mwachidule, ARDS ndi vuto lalikulu lomwe limakhudza mapapo athu. Taganizirani izi motere: Mapapu athu ali ndi timatumba tating'onoting'ono ta mpweya (totchedwa alveoli). Tili ngati mphesa zazing'ono pa mpesa. Tikamapuma, timatumba ta mpweya timeneti timatenga mpweya kuchokera mumlengalenga ndikuutulutsa m'magazi. Koma ARDS ikachitika, timatumba ta mpweya timeneti timadzaza ndi madzi. Zimakhala ngati baluni yamadzi. Kenako mapapo sangadzaze ndi mpweya bwino, ndipo mpweya womwe umalowa m'magazi umatsika kwambiri. Timatcha izi hypoxia. Madokotala nthawi zambiri amaika ARDS m'magulu ofatsa, apakati, kapena ovuta . Izi zimatsimikiziridwa poyerekeza kuchuluka kwa mpweya m'magazi ndi kuchuluka kwa mpweya womwe uyenera kuperekedwa pamlingo umenewo. ARDS ingayambitsenso ziwalo zina zofunika monga ubongo wathu, mtima, impso, ndi matumbo kuti zisalandire mpweya womwe amafunikira. Chifukwa chake, ARDS ndi vuto loopsa lomwe lingakhale loopsa ngakhale moyo. ARDS nthawi zambiri imayamba munthu akalandira chithandizo kuchipatala chifukwa cha matenda ena, matenda, kapena ngozi. Komabe, ngati mutakhala ndi zizindikirozi kunyumba, ndikofunikira kupita kuchipatala nthawi yomweyo.

Kodi pali magawo atatu a ARDS?

Madokotala nthawi zina amagawa ARDS m'magawo atatu: Exudative, Proliferative, ndi Fibrotic. Izi makamaka zimatanthauza kuchuluka kwa kutupa ndi kuchulukana kwa madzi m'mapapo, kenako momwe mapapo amayambira kuchira. Si aliyense amene amapita ku Gawo lachitatu. Gawoli limaphatikizapo zipsera m'mapapo (`(Lung fibrosis)`) ndi kufunikira kopuma mpweya nthawi zonse.

Kodi ARDS ndi yofala bwanji?

Vutoli ndi lalikulu kwambiri. Limakhudza anthu pafupifupi 200,000 pachaka ku United States kokha. Padziko lonse lapansi, limakhudza anthu pafupifupi 3 miliyoni pachaka. ARDS imayang'anira pafupifupi 10% ya onse omwe amalowa m'chipinda chosamalira odwala kwambiri (ICU). Imayang'aniranso pafupifupi 25% ya onse omwe amalowa m'chipatala chifukwa cha makina opumira.

Kodi zizindikiro za ARDS ndi ziti? Kodi mumazindikira bwanji?

Zizindikiro za ARDS zimatha kusiyana malinga ndi chomwe chimayambitsa, kuopsa kwa vutoli, ndi matenda aliwonse a m'mapapo kapena a mtima omwe muli nawo kale. Zizindikiro zazikulu ndi izi:

• Kuvuta kwambiri kupuma :Zikumveka ngati simungathe kupuma, ngati kuti mukupuma pang'ono.
• Kupuma mwachangu komanso movutikira: Kupuma molimbika kwambiri, ngati kuti ukupuma movutikira.
• Kugunda kwa mtima kumawonjezeka.
• Kusintha kwa misomali ndi milomo kukhala yabuluu: Izi zimachitika chifukwa cha mpweya wochepa m'magazi.

Tangoganizani, a Nalin anali ndi malungo ndi chifuwa chachikulu kwa masiku awiri. Mwadzidzidzi, anavutika kupuma, chifuwa chake chinakhala cholimba. Mkazi wake anazindikira kuti misomali yake inali kuoneka yabuluu. Atathamangira kuchipatala, madokotala anati mwina ndi ARDS .

ARDS imatha kukula mkati mwa maola ochepa mpaka masiku angapo kuchokera pamene chochitikacho chachitika, ndipo imathanso kuipiraipira mofulumira kwambiri.

Kodi zifukwa za ARDS ndi ziti?

Pali zifukwa zambiri zomwe zingayambitse ARDS. Tiyeni tiwone zazikuluzikulu:

• Sepsis : Chifukwa chachikulu cha ARDS ndi matenda otchedwa sepsis. Matendawa amatha kuchitika pamene matenda oopsa m'mapapo mwanu (monga chibayo ) kapena matenda m'chiwalo china afalikira m'thupi lanu lonse, zomwe zimapangitsa kutupa kwambiri.
• Chibayo cha mpweya : Ngati zomwe zili m'mimba (chakudya, madzi) zilowa m'mapapo, zimatha kuwononga kwambiri mapapo ndi ARDS. Izi zimachitika pamene chinthu chomwe timadya kapena kumwa chilowa m'njira yopumira. Izi zitha kuchitika makamaka kwa munthu amene sakudziwa kapena wokalamba.
• Kuikidwa magazi: Pali chiopsezo cha ARDS ngati mupatsidwa magazi opitilira 15 munthawi yochepa.
• Covid-19 `( COVID-19 )`: Kachilombo ka Covid-19 kangayambitse matenda oopsa a ARDS.
• Pancreatitis : Kutupa kwakukulu kwa kapamba.
• Ngozi zazikulu kapena kupsa: Ngozi ndi kugwa zimatha kuwononga mapapo mwachindunji, kapena zimatha kuwononga ziwalo zina m'thupi ndikupangitsa kutupa kwambiri m'mapapo.
• Kuvulala kopumira: Kupuma utsi kapena utsi wambiri wa mankhwala.
• Kumwa mankhwala osokoneza bongo mopitirira muyeso : Kumwa mankhwala osokoneza bongo ambiri, monga cocaine kapena opioids.
• Kumira kapena kutsala pang'ono kumira: Mukamira, madzi amalowa m'mapapo mwanu ndikuwawononga.

Ndani ali pachiwopsezo chachikulu cha matenda a ARDS?

Matenda a ARDS nthawi zambiri amakula mwa anthu omwe ali kale m'chipatala chifukwa cha ngozi kapena matenda. Komabe, sizitanthauza kuti mudzakhala ndi matendawa chifukwa choti muli m'chipatala. Pali zinthu zingapo zomwe zimawonjezera chiopsezo chanu:

• Kukhala ndi zaka zoposa 65.
• Kusuta fodya (kusuta ndudu).
• Kugwiritsa ntchito mankhwala osokoneza bongo.
• Kukhala ndi matenda a m'mapapo omwe analipo kale.

Kodi mavuto omwe angakhalepo chifukwa cha ARDS ndi ati?

ARDS ingayambitse mavuto osiyanasiyana, onse ali kuchipatala komanso mukapita kunyumba. Ena mwa mavutowa ndi awa:

• Kuundana kwa magazi kapena kutsekeka kwa mitsempha yamagazi (DVT).
• Pneumothorax: Izi zitha kuchitika chifukwa cha kupanikizika komwe kumachitika ndi chopumira mpweya pa mapapo owonongeka komanso olimba.
• Kusokonezeka maganizo: Kusokonezeka kwa chidziwitso.
• Kulephera kwa ziwalo zingapo .
• Kufooka kwa minofu.
• Kutupa kwa mapapo kapena fibrosis.
• Matenda Ovutika Maganizo Pambuyo pa Zoopsa (PTSD)
• Mavuto amisala monga nkhawa ndi kuvutika maganizo .

Kodi mumazindikira bwanji matenda a ARDS? (Kuzindikira)

Madokotala amazindikira matenda a ARDS potengera mayeso akuthupi komanso zotsatira za mayeso angapo. Popeza zizindikiro za ARDS zimafanana ndi za matenda osatha a m'mapapo kapena a mtima, dokotalayo ayeneranso kuchotsa zifukwa zina. Dokotala atha kuyitanitsa mayeso osiyanasiyana, monga:

• X-ray ya pachifuwa: Kuona kuchuluka kwa madzi m'mapapo.
• Kuyezetsa magazi: Kuyeza kuchuluka kwa mpweya m'magazi ndi kudziwa kuopsa kwa ARDS.
• Echocardiogram (kuyesa mtima kwa ultrasound): Onani momwe mtima ukugwirira ntchito.
• Electrocardiogram (EKG): Imayesa ntchito yamagetsi ya mtima.
• Sensa ya chala `(Pulse oximetry)`: Yang'anirani kuchuluka kwa mpweya nthawi zonse.
• Kujambula kwa CT (Computed Tomography - CT scan): Pezani zambiri zokhudza mapapo.
• Kutenga chitsanzo cha zinthu zotuluka m'thupi kuchokera m'njira yopumira: Pezani chomwe chayambitsa matendawa.

Kodi mankhwala a ARDS ndi otani?

Cholinga chachikulu chochiza ARDS ndikuwonjezera kuchuluka kwa mpweya m'magazi ndikuletsa kulephera kwa ziwalo. Anthu omwe ali ndi ARDS angafunike makina opumira mpweya ndi/kapena chithandizo cha mpweya kuti awonjezere kuchuluka kwa mpweya m'magazi. Angafunikenso thandizo potsegula njira zopumira zomwe zatsekedwa ndi kuwonongeka. Dokotala wanu angatenge njira zochepetsera mavuto a ARDS, monga:

• Kupereka mapiritsi ogonetsa (kuchepetsa ululu) kuti athandize kuchepetsa ululu komanso kukhala chete.
• M'malo mokutembenuzani mozondoka, dziikeni pamalo okhazikika. Izi zimathandiza kuti mpweya uziyenda bwino.
• Chitani mayeso opumira ndi kudziwa nthawi yoyenera yochotsera chubu ndi chopumira.
• Kupereka mankhwala ochepetsa magazi kuti magazi asaundane.
• Kupereka mankhwala ochotsa madzi ochulukirapo m'thupi.
• Kupereka mankhwala ochepetsa kuchulukana kwa madzi m'mapapo.
• Mankhwala opha tizilombo amaperekedwa kuti ateteze matenda kapena kuchiza matenda omwe alipo kale.
• Perekani chithandizo champhamvu komanso cholimbitsa thupi kuti mupewe kufooka kwa minofu.
• Kutumiza ku mapulogalamu obwezeretsa mapapo kuti alimbikitse mapapo ndikuwonjezera mphamvu ya mapapo.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire ku ARDS? Kodi kuchuluka kwa kuchira ndi kotani?

Zimatengera kuopsa kwa vutoli komanso nthawi yomwe mapapo a munthu amatenga kuti achire. Kafukufuku wambiri akusonyeza kuti nthawi zambiri zimatenga miyezi isanu ndi umodzi mpaka chaka kuti mapapo ayambe kugwira ntchito bwino pambuyo pa ARDS. Komabe, anthu ena sachira mokwanira. Chiŵerengero cha kupulumuka kwa ARDS ndi pafupifupi 55% mpaka 70% , ngati atalandira chithandizo mwachangu. Chiŵerengero cha kupulumuka chimachepa ngati chithandizo chachedwa kapena ngati ziwalo zina zayamba kulephera. Kuyezetsa kwanu kumatsimikiziridwa ndi zinthu monga matenda anu, mbiri yachipatala, komanso kuopsa kwa vuto lanu la kupuma. Dokotala wanu adzakambirana nanu izi.

Kodi ARDS ingapewedwe?

Palibe njira yeniyeni yopewera matenda a ARDS. Komabe, ngati muli ndi zizindikiro za kupuma movutikira, kapena ngati muli ndi vuto la mapapo kapena vuto lina, kufunafuna chithandizo chamankhwala nthawi yomweyo kungathandize kupewa matendawo kuti asakule kwambiri. Kupewa kusuta fodya ndi kuchepetsa kumwa mowa kungachepetse chiopsezo chokhala ndi matenda a ARDS oopsa.

Kodi moyo umakhala bwanji pambuyo pa ARDS? Kodi tiyenera kudziwa chiyani?

ARDS ikhoza kukhala yoopsa komanso yoopsa. Koma ndi chithandizo chabwino komanso chithandizo cha mpweya wabwino (makamaka kupangitsa odwala kukhala ndi nkhawa kuti apititse patsogolo mpweya wabwino), anthu ambiri tsopano akupulumuka, ndipo mavuto a ARDS akuchepa. Anthu osakwana zaka 65 ndi omwe ali ndi ARDS pambuyo pa ngozi kapena kuikidwa magazi nthawi zambiri amakhala ndi chiyembekezo chabwino. Kuchira ku ARDS kungatenge nthawi yayitali. Anthu ambiri omwe achotsedwa mu ventilator amatha kupuma momasuka. Ena amachira kwathunthu, koma ena akhoza kukhala ndi mavuto aakulu a m'mapapo. Amafunika chisamaliro cha katswiri wa m'mapapo (pulmonologist).

"Amayi anga adadwala matenda a ARDS ndipo adakhala m'chipatala kwa miyezi ingapo. Ngakhale atabwera kunyumba, anali atatopa kwambiri. Sanathe kuchita ngakhale ntchito zazing'ono kwambiri. Koma atatsatira malangizo a madokotala ndikuchita masewera olimbitsa thupi, pang'onopang'ono akuchira. Pakadali pano, chithandizo ndi chikondi cha banja lawo n'zofunika kwambiri."

Moyo pambuyo pa ARDS ukhoza kukhala wovuta. Khalani oleza mtima ndipo funani thandizo kwa abale ndi abwenzi pamene mukuchira. Mungafunikenso thandizo pa zochita za tsiku ndi tsiku mpaka mapapu anu atachira. Lankhulani ndi dokotala wanu za magulu othandizira kapena zinthu zina zomwe zingakuthandizeni kupezanso mphamvu zanu.

Kodi pali kugwirizana kotani pakati pa COVID-19 ndi ARDS?

Izi sizili zofanana. Munthu amene ali ndi COVID-19 akhoza kudwala ARDS kachilomboka kakafika m'mapapo. Ofufuza amati kuchuluka kwa munthu amene ali ndi COVID-19 ndi ARDS kupulumuka ndi pafupifupi 50% mpaka 60%. Koma izi zimadaliranso zinthu zambiri, monga mbiri ya thanzi lake ndi matenda ena. Kukhala nthawi mu chipinda chosamalira odwala kwambiri (ICU) kungakhale kovuta komanso kovutitsa. Anthu omwe akuchira ku ARDS sangabwererenso ku moyo wawo watsiku ndi tsiku mwachangu, kotero muyeneradi kuthandizidwa. Ndikofunikira kupeza thandizo la akatswiri ndi upangiri mukachira ku ARDS. Funsani gulu lanu lachipatala za mapulogalamu ochira odwala pambuyo pa odwala kwambiri komanso magulu othandizira pa intaneti mdera lanu.

Chofunika Kwambiri: Zinthu Zoyenera Kukumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, nazi zinthu zingapo zomwe muyenera kukumbukira kuchokera pa zomwe takambirana:

• ARDS ndi matenda oopsa omwe amachititsa kuti mapapo awonongeke. Matumba a mpweya m'mapapo amadzaza ndi madzi, zomwe zimachepetsa kuchuluka kwa mpweya womwe ungafike m'magazi.
• Ngati mukumva zizindikiro monga kupuma movutikira kwambiri, kupuma mofulumira, kapena misomali/milomo yabuluu, funsani upangiri wa dokotala nthawi yomweyo.
• ARDS ikhoza kukhala ndi zifukwa zambiri. Sepsis, chibayo, COVID-19, ndi ngozi zoopsa ndi zina mwa izo.
• Chithandizochi chimaphatikizapo mpweya, chithandizo cha mpweya, komanso kuthana ndi mavuto .
• Zimatenga nthawi kuti munthu achire, ndipo anthu ena akhoza kukhala ndi mavuto a m'mapapo kwa nthawi yayitali.
• Kulandira chithandizo mwachangu komanso chithandizo chabwino chamankhwala ndizofunikira kwambiri kuti tipulumutse miyoyo ndikuchepetsa mavuto.
• Chithandizo chochokera ku banja ndi anthu onse n'chofunikira kwa munthu amene akuchira ku ARDS.

Kumbukirani, ndikofunikira kudziwa za vutoli. Ngati inu kapena munthu amene mumamudziwa akukumana ndi zizindikiro izi, musachite mantha kapena kuchita mantha, koma pitani kwa dokotala nthawi yomweyo. Mwanjira imeneyi, mutha kuyamba kulandira chithandizo chofunikira mwachangu momwe mungathere.