Kodi mudawonapo munthu mu chipinda chosamalira odwala kwambiri (ICU) kapena munthu amene wabweretsedwa ku chipinda chodzidzimutsa (ETU) ali ndi vuto lalikulu lopuma, ndipo madokotala amafulumira kuwauza kuti "achite ABG"? Iyi ndi mayeso a magazi ofunikira kwambiri komanso apadera. Lero, tikambirana mwachidule, m'njira yomwe mungamvetse.
Mwachidule, kodi mayeso a ABG awa ndi otani?
ABG (Arterial Blood Gas) ndi mayeso omwe amatenga magazi ochepa kuchokera mumtsempha wamagazi m'thupi lathu. Tsopano mwina mukuganiza kuti, "Mayeso ena amagazi amatenga magazi kuchokera mumtsempha, kusiyana kwake ndi kotani?"
Taganizirani izi motere. Thupi lathu lili ngati mzinda.
- Mitsempha yamagazi ili ngati misewu ikuluikulu yomwe imabweretsa zinthu zofunika monga mpweya ndi zakudya mumzinda.
- Mitsempha ili ngati misewu yakale mumzinda yomwe imanyamula zinyalala monga carbon dioxide kubwerera mumzinda.
Kotero, ngati tikufuna kudziwa kuchuluka kwa mpweya womwe ukupita ku ziwalo za thupi lathu, makamaka ubongo ndi mtima, tiyenera kuyesa magazi omwe ali pa "msewu waukulu," sichoncho? Ndicho chifukwa chake magazi amatengedwa kuchokera mumtsempha wamagazi kuti akayesedwe ABG.
Kuyesa kumeneku kumayesa makamaka kuchuluka kwa mpweya ndi carbon dioxide m'magazi mwanu. Kumayesanso kuchuluka kwa acid-base, kapena pH, m'magazi mwanu. Kulinganiza kumeneku ndikofunikira kwambiri pazochitika zonse m'thupi lathu.
Kodi mayeso a ABG amayesa chiyani kwenikweni?
Mukayang'ana lipoti la ABG, muwona zolemba zosokoneza. Koma tanthauzo lake ndi losavuta. Tiyeni tiwone tanthauzo lililonse la mfundo zimenezo.
| Muyeso | Tanthauzo losavuta |
|---|---|
| pH | Izi zikusonyeza momwe magazi anu alili ndi asidi. Mtengo uwu uyenera kukhala pakati pa 7.35 ndi 7.45. Chilichonse chochepera pamenepo chimatanthauza kuti magazi anu ali ndi asidi, ndipo chilichonse chokwera chimatanthauza kuti ndi alkaline. |
| PaO2 (Kupanikizika pang'ono kwa mpweya) | Kuchuluka kwa mpweya wosungunuka m'magazi. Izi zikusonyeza momwe mpweya ukulowera m'magazi kuchokera m'mapapo mwanu. |
| PaCO2 (kupanikizika pang'ono kwa kaboni dayokisaidi) | Kuchuluka kwa mpweya wa carbon dioxide m'magazi mwanu. Izi zikusonyeza momwe thupi lanu likuchotsera mpweya wa carbon dioxide. |
| HCO3 (Bicarbonate) | Ichi ndi maziko m'magazi athu. Chimayendetsedwa ndi impso. Ndikofunikira kwambiri pakulinganiza pH ya magazi. |
| O2Sat (Kuchuluka kwa mpweya) | Zimasonyeza kuchuluka kwa mapuloteni a hemoglobin m'magazi omwe amanyamula mpweya, monga peresenti. Choyezera kugunda kwa mtima chomwe mumayika pa chala chanu chimayesa mtengo womwewo. |
Kodi mayeso a ABG amafunika liti?
Iyi si mayeso ochitidwa kuti munthu aone ngati ali ndi matenda nthawi zonse. Nthawi zambiri amachitidwa pa nthawi yadzidzidzi komanso kuti ayang'anire momwe odwala alili m'chipatala . Nazi zina mwa zifukwa zazikulu zomwe dokotala angalamule mayesowa:
- Kuvuta kwambiri kupuma: Pa milandu monga kukulirakulira kwa mphumu ndi madzi m'mapapo (kulephera kupuma mokwanira).
- Matenda opatsirana kwambiri: Pa matenda omwe angawononge moyo monga sepsis kapena septic shock.
- Mavuto okhudzana ndi matenda a shuga: Mu mkhalidwe umene magazi amakhala ndi asidi, monga matenda a shuga otchedwa diabetesic ketoacidosis (DKA).
- Matenda a mtima kapena kulephera kwa mtima: Pamene mtima wasiya kugwira ntchito mwadzidzidzi (Acute heart failure) kapena pamene mtima wasiya (Cardiac arrest).
- Kulephera kwa impso: Impso zikalephera kuchotsa bwino asidi m'magazi, magazi amakhala acid. Dziwani za vutoli.
- Kupha poizoni: Pamene poizoni wina walowetsedwa, pH ya magazi imasintha.
- Musanayambe opaleshoni yayikulu komanso mutatha opaleshoni: Yang'anirani momwe wodwalayo alili panthawi yopuma komanso mukatha opaleshoni.
- Matenda a m'mapapo osatha: Yang'anani ngati chithandizo chapambana kwa anthu omwe ali ndi matenda monga COPD (matenda a m'mapapo osatha).
Kodi mayesowa amachitika bwanji? Kodi akupweteka?
Kuyesedwa magazi kwa ABG n'kosiyana pang'ono ndi kuyezedwa magazi nthawi zonse.
Musanayambe mayeso
Nthawi zina, ngati mukupatsidwa mpweya wowonjezera, ukhoza kuyimitsidwa mphindi 20 musanayesedwe. Izi ndizoona momwe thupi lanu limagwirira ntchito popanda mpweya. Koma ngati simungathe kuchita popanda mpweya, simungachite zimenezo. Ngati magazi akutengedwa m'dzanja lanu, dokotala kapena mkulu wophunzitsidwa bwino angachite mayeso osavuta otchedwa 'Allen test' kuti aone ngati magazi akuyenda bwino m'dzanja lanu.
Pamene ndikuchita mayeso
1. Dokotala kapena katswiri wodziwa bwino ntchito adzapeza mtsempha wamagazi mkati mwa dzanja lanu (radial artery), pafupi ndi chigongono chanu (brachial artery), kapena m'mimba mwanu (femoral artery).
2. Tsukani malowo bwino ndikugwiritsa ntchito mankhwala ophera tizilombo toyambitsa matenda.
3. Kenako, singano yaying'ono kwambiri imalowetsedwa mu mtsempha wamagazi ndipo magazi ochepa amakokedwa mu sirinji.
4. Kunena zoona , izi zingakhale zopweteka pang'ono kuposa kutenga magazi kuchokera mumtsempha. Izi zili choncho chifukwa mtsempha wamagazi uli pansi pa khungu lathu ndipo uli ndi mitsempha yambiri yozungulira. Koma ululu umakhalapo nthawi yomwe singano yalowetsedwa.
5. Mukamaliza kusonkhanitsa magazi okwanira, chotsani singanoyo ndikuyika mphamvu pamalopo ndi thonje kapena gauze kuti magazi asiye kutuluka kwa mphindi 5 mpaka 10. Ngati mukumwa mankhwala ochepetsa magazi, mungafunike kugwiritsa ntchito mphamvuyo kwa nthawi yayitali.
Pambuyo pa mayeso
Malo omwe singano inalowetsedwapo akhoza kukhala ophwanyika pang'ono kapena abuluu. Izi ndi zachilendo. Dokotala wanu adzakuuzani kuti musamanyamule zinthu zolemera ndi mkono umenewo kwa maola 24 mutatha kutenga magazi.
Zotsatira za mayeso a ABG zimapezeka mwachangu kwambiri, nthawi zambiri mkati mwa mphindi 10-15. Zotsatirazi ndizofunikira kwambiri popanga zisankho mwachangu pazochitika zadzidzidzi.
Kodi avareji ya mtengo wa lipotilo ndi yotani?
Miyezo iyi ingasiyane pang'ono malinga ndi labu, koma iyi ndi miyezo yapakati pa munthu wamkulu wathanzi pamadzi. Ndi bwino kufunsa dokotala wanu kuti akufotokozereni mokwanira za miyezo yomwe ili mu lipoti lanu.
| Muyeso | Mitundu Yabwinobwino |
|---|---|
| pH | 7.35 - 7.45 |
| PaO2 | 75 - 100 mmHg |
| PaCO2 | 35 - 45 mmHg |
| HCO3 | 22 - 26 mEq/L |
| O2Sat | 95% - 100% |
Ngati zinthuzi zili kunja kwa mlingo woyenera, zingatanthauze kuti thupi lanu silikupeza mpweya wokwanira , kapena kuti carbon dioxide siikutuluka bwino m'thupi lanu , kapena kuti asidi/base balance m'magazi mwanu siili bwino . Dokotala wanu adzagwiritsa ntchito lipotili, zizindikiro zanu, ndi mayeso ena kuti adziwe chomwe chikukuvutani.
Uthenga Wopita Nawo Kunyumba
- ABG si kuyezetsa magazi nthawi zonse komwe kumatengedwa kuchokera mumtsempha, koma kuyezetsa kwapadera komwe kumatengedwa kuchokera mumtsempha, womwe ndi mtsempha waukulu wamagazi womwe umapatsa thupi mpweya.
- Izi makamaka zimayesa mpweya, carbon dioxide, ndi acidity (pH) m'magazi.
- Izi ndizofunikira kwambiri kuti matenda azindikire msanga pakagwa ngozi komanso pakakhala mavuto aakulu monga kupuma movutikira, matenda oopsa, komanso matenda a mtima.
- Ngakhale kuti zingakhale zopweteka pang'ono kuposa kuyezetsa magazi nthawi zonse, chidziwitso chomwe chimapereka chingathandize kupulumutsa moyo.
- Nthawi zonse lankhulani ndi dokotala wanu za zotsatira za mayeso anu a ABG ndi tanthauzo lake.
💬 Comments (0)
Palibe ndemanga zomwe zatumizidwa pano. Onjezani ndemanga yanu pano koyamba.
Onjezani ndemanga yanu