Kodi kupuma kwanu kuli kocheperako? (Kuvutika maganizo/Kuchepa kwa mpweya m'thupi) - Tiyeni tikambirane za izi!

Kodi munayamba mwamvapo ngati mukuvutika kupuma, kapena ngati mukulephera kupuma mokwanira? Mwina munamva chizungulire kapena kutopa. Chimodzi mwa zifukwa zomwe zimayambitsa izi ndi kuchepa kwa kupuma, komwe timatcha azachipatala kuti (Respiratory Depression) kapena (Hypoventilation) .

Kodi kuvutika maganizo chifukwa cha kupuma n’chiyani?

Mwachidule, kupuma movutikira ( kapena kupuma pang'onopang'ono) ndi pamene mpweya wanu umayenda pang'onopang'ono kwambiri, kapena mumapuma pang'ono kwambiri. Izi zikachitika, kusinthana kwa mpweya sikumachitika bwino m'mapapu anu. Taganizirani izi, tikamapuma, mpweya wabwino umalowa m'magazi kudzera m'matumba ang'onoang'ono a mpweya (alveoli) m'mapapu athu. Komanso, carbon dioxide (CO2) , yomwe ndi chinyalala cha thupi lathu, imabwerera m'mapapo kuchokera m'magazi ndipo imatuluka. Ichi ndi chomwe timachitcha kusinthana kwa mpweya .

Tsopano, pankhani ya (Hypoventilation) , chomwe chimachitika ndi chakuti chifukwa simukupuma bwino, mpweya wa carbon dioxide (CO2) sutuluka m'thupi ndipo umasonkhana m'magazi. Timatcha izi (Hypercapnia) . Sikuti nthawi zina mapapo sangalandire mpweya wokwanira. Kenako mpweya wa okosijeni m'magazi umachepa, womwe umatchedwa (Hypoxemia) . Kodi mukumvetsa?

Kodi zizindikiro zake ndi ziti?

Mukapuma pang'ono (hypoventilation) , mutha kuwona zizindikiro monga:

• Kusanza ndi kusanza.
• Mutu.
• Kumva kutopa, kugona , kapena kutopa nthawi zonse.
• Kusokonezeka maganizo, chisokonezo , kapena kusintha kwa maganizo.
• Kugunda kwa mtima kumawonjezeka.
• Chizungulire.
• Kupuma kumakhala kochedwa, kopanda mphamvu, kapena kotopetsa.
• Kusanduka kwa buluu kwa khungu, milomo, kapena misomali (cyanosis) . Ichi ndi chizindikiro choopsa kwambiri.

Kodi n’chiyani chimayambitsa izi?

Zomwe zimayambitsa kupuma movutikira zingakhale kugwiritsa ntchito mankhwala ena molakwika, kumwa mankhwala mopitirira muyeso , kapena kuchita zinthu mosayembekezereka chifukwa cha mowa kapena mankhwala enaake. Ganizirani izi:

• Opioids: Izi zimatchedwanso mankhwala osokoneza bongo . Zitsanzo zake ndi monga morphine , tramadol, oxycodone (OxyContin®) , ndi fentanyl . Anthu ena amagwiritsa ntchito mankhwala osokoneza bongowa molakwika.
• Benzodiazepines:Izi nthawi zambiri zimakhala mankhwala ogonetsa komanso mapiritsi ogonetsa. Zitsanzo zake ndi monga lorazepam (Ativan®) , alprazolam (Xanax®) , ndi diazepam (Valium®) .
• Mankhwala a Barbiturates: Nthawi zina mankhwalawa amaperekedwa kwa khunyu kapena mutu waching'alang'ala .
• Mankhwala osaloledwa: Zinthu monga heroin ndi gamma hydroxybutyrate (GHB) .
• Mapiritsi ogonetsa: Mankhwala olembedwa ndi dokotala monga zolpidem (Ambien®) .
• Mankhwala oletsa ululu: Angayambitsidwenso ndi mankhwala omwe amaperekedwa kuti akupangitseni kugona musanachite opaleshoni.

Kuwonjezera pa mankhwala ndi mankhwala awa, matenda ena ndi zina zomwe zimayambitsa hypoventilation :

• Kunenepa Kwambiri: Izi zimatchedwa Obesity Hypoventilation Syndrome (OHS) . Zimatanthauza kuti kupuma kumakhala kovuta chifukwa cha kunenepa kwambiri.
• Zinthu zomwe zimayambitsa mavuto opuma: Mwachitsanzo, matenda osatha oletsa kupuma (COPD) ndi obstructive sleep apnea .
• Zinthu zomwe zimachepetsa mphamvu ya kupuma: Mwachitsanzo , sitiroko ndi hypothyroidism .
• Matenda omwe amakhudza msana, mitsempha, kapena kulamulira minofu: Zitsanzo ndi monga muscular dystrophy, mitsempha kapena spinal cord disorders, multiple sclerosis (MS) , ndi amyotrophic lateral sclerosis (ALS) .
• Kusintha kwa mawonekedwe a chifuwa kapena msana: Matenda monga scoliosis ( kupindika kwa msana), ankylosing spondylitis, ndi chifuwa chofooka .
• Poizoni kapena poizoni: Zinthu monga tetanus , ciguatera poizoni, ndi botulism .

Ndi zinthu ziti zomwe zimawonjezera chiopsezo?

Chiwopsezo cha kupuma movutikira chingachuluke chifukwa cha zifukwa zotsatirazi:

• Kugwiritsa ntchito molakwika mankhwala monga ma opioid kapena benzodiazepines .
• Ngati mwangochitidwa opaleshoni posachedwapa (chifukwa cha mankhwala oletsa ululu).
• Ngati pali matenda enaake a m'mapapo, minofu, ndi mitsempha (ubongo ndi msana), monga tafotokozera pamwambapa.

Kodi izi zingayambitse mavuto otani?

Kaboni dayokisaidi m'magazi anuNgati kuchuluka kwa CO2 kukwera kwambiri, kungayambitse mavuto oopsa, ngakhale oopsa. Yang'anani:

• Acidosis Yopuma: Izi zikutanthauza kuti magazi anu ali ndi asidi wambiri kuposa momwe ayenera kukhalira.
• Kulephera Kupuma: Izi zimachitika pamene minofu ya thupi lanu silandira mpweya wokwanira.
• Kuyima kwa Mtima: Kuima kwadzidzidzi kwa mtima.
• Chikomokere.
• Kuthamanga kwa magazi m'mapapo: Kupanikizika kowonjezereka m'mitsempha yamagazi yolumikizidwa ndi mapapo.

Kodi mumazindikira bwanji izi?

Kuti adziwe ngati muli ndi vuto la kupuma movutikira , dokotala adzakufunsani kaye za zizindikiro zanu, mbiri yanu yachipatala, ndi mankhwala aliwonse omwe mukumwa. Kenako, angakufunseni mayeso apadera a magazi kuti ayesere kuchuluka kwa carbon dioxide (CO2) m'magazi anu. Angakuuzeninso mayeso ena kuti adziwe chomwe chimayambitsa hypoventilation .

Ndi mayeso amtundu wanji omwe amachitidwa?

Mayeso otsatirawa angachitike kuti apeze chomwe chimayambitsa kupuma movutikira:

• Kuyesa kwa Gasi la M'magazi a Mitsempha: Izi zimayang'ana kuchuluka kwa mpweya, carbon dioxide, ndi asidi m'magazi.
• Mayeso a Ntchito ya M'mapapo: Awa ndi mayeso omwe amafufuza momwe mapapu anu akugwirira ntchito.
• Pulse Oximetry: Chipangizo chomwe chimayesa kuchuluka kwa mpweya m'magazi mwa kuyika kachidutswa kakang'ono pa chala chanu. Mwina mwawonapo izi.
• Kuyesa Magazi: Pali mayeso ena ambiri a magazi omwe angathandize kuzindikira vutoli kapena zomwe zimayambitsa. Zitsanzo zikuphatikizapo Kuwerengera Magazi Konse (CBC) , Basic Metabolic Panel (BMP) , Kuyeza Toxicology (kuti muwone ngati pali zinthu monga mankhwala), Kuyesa magazi kwa Carbon Dioxide (CO2) , ndi Kuyesa kwa Ntchito ya Chithokomiro .
• Kujambula Zithunzi: Dokotala angakupatseni X-ray pachifuwa chanu, CT scans (Computed Tomography scans) pachifuwa chanu kapena pamutu kuti aone matenda ena omwe amayambitsa matendawa.
• Kafukufuku wa Kugona / Polysomnography: Mayesowa amathandiza kuzindikira matenda monga sleep apnea ndi kunenepa kwambiri.

Kodi chimachiritsidwa bwanji?

Chithandizo cha kupuma movutikira chimadalira chomwe chimayambitsa komanso momwe vutoli lilili lalikulu. Ogwira ntchito zachipatala angakupatseni chithandizo monga:

• Kupuma Mopanda Kulowa: Izi zimaphatikizapo kugwiritsa ntchito makina omwe amakuthandizani kupuma kudzera mu chigoba chomwe chimakwanira pankhope panu. Mwachitsanzo, makina opitilira kukhala ndi mpweya wabwino (CPAP) kapena makina opitilira kukhala ndi mpweya wabwino (BiPAP®) . Mwina munamvapo za izi.
• Mankhwala Olimbikitsa Kupuma: Nthawi zina, ngati vutoli layamba chifukwa cha kumwa mopitirira muyeso kapena ngati zotsatira zoyipa za mankhwala, mankhwala obwezeretsa mphamvu amatha kuperekedwa. Mwachitsanzo, ngati vutoli layamba chifukwa cha opioids , zotsatira zake zitha kuchepetsedwa popereka mankhwala otchedwa Naloxone/Narcan® .
• Chithandizo cha Oxygen: Mpweya wa oxygen ungaperekedwe ngati pakufunika kutero.
• Kupuma Moyenera: Ngati vutoli ndi lalikulu kwambiri, munthu angafunike kupatsidwa mankhwala oletsa ululu, kuikidwa m'chubu, ndi kupumira mpweya pogwiritsa ntchito makina.

Kodi ndi mkhalidwe wanji womwe ungayembekezeredwe mtsogolo? (Outlook)

Kuyembekezeka kwa kupuma movutikira kumadalira chomwe chimayambitsa. Zadzidzidzi, monga kumwa mankhwala osokoneza bongo a opioid , zitha kupha ngati sizikuthandizidwa mwachangu. Komabe, ngati vutoli layamba chifukwa cha sleep apnea, kunenepa kwambiri komwe kumabweretsa vuto la sleep apnea syndrome ( OHS ) , kapena matenda ena a nthawi yayitali, lifunika chithandizo chopitilira ndipo lidzasintha pang'onopang'ono.

Kodi zingatheke kupewedwa?

Njira yabwino yopewera kupuma movutikira ndikumwa mankhwala anu monga momwe mwalangizidwira komanso kuthana ndi matenda aliwonse omwe amabwera chifukwa cha matendawa. Onetsetsani kuti mwafunsa dokotala wanu kapena wamankhwala musanamwe mankhwala awiri kapena angapo, makamaka opioids ndi benzodiazepines, omwe amakuchepetsani chidwi chanu kapena kukupangitsani kugona. Komanso , dziwani za zotsatirapo zoyipa zomwe zingachitike ngati mankhwalawa atengedwa ndi mowa.

"Mankhwala ndi bwenzi ngati agwiritsidwa ntchito moyenera, koma mdani ngati agwiritsidwa ntchito molakwika."

Kodi ndiyenera kupita kwa dokotala liti?

Lankhulani ndi dokotala wanu pazochitika izi:

• Ngati muli ndi mafunso kapena kukayikira kulikonse pankhani ya matenda omwe muli nawo.
• Ngati muli ndi mafunso kapena kukayikira za mankhwala omwe dokotala wakupatsani.
• Ngati muli ndi zizindikiro za kupuma movutikira, makamaka ngati muli ndi matenda ena omwe amawonjezera chiopsezo chanu.

Kodi muyenera kupita ku Chipinda Chothandizira Anthu Odwala Mwadzidzidzi (ETU) liti?

Ngati muli ndi zizindikiro zazikulu izi , pitani ku chipinda chapafupi chadzidzidzi nthawi yomweyo:

• Ngati muli ndi khunyu .
• Ngati maganizo asintha ndipo pali chisokonezo .
• Ngati mukumva tulo tofa nato moti simungathe kukhala maso.
• Ngati muli ndi vuto la kusokonezeka maganizo chifukwa cha komwe muli komanso nthawi yomwe muli.
• Ngati mukukumana ndi mantha kapena kukayikira kwachilendo (kuopa zinthu) .
• Ngati khungu, misomali, kapena milomo yasanduka buluu.

Ndi mafunso ati omwe muyenera kufunsa dokotala?

Zingakhale zothandiza kufunsa dokotala wanu mafunso monga awa:

• "N’chifukwa chiyani izi zandichitikira ine?"
• "Ndiyenera kuchita chiyani kuti chinthu chonga ichi chisachitike mtsogolo?"
• "Ndi njira ziti zochiritsira zomwe ndili nazo?"

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Kuvutika maganizo chifukwa cha kupuma ndi vuto lalikulu lomwe mpweya woipa (CO2) umasonkhana m'magazi mwanu. Koma nthawi zambiri limapewedwa. Ngati mukumwa mankhwala omwe angayambitse kuvutika maganizo chifukwa cha kupuma, lankhulani ndi dokotala wanu kuti muwonetsetse kuti mukumwa mankhwalawo moyenera komanso mosamala. Ngati muli ndi vuto lina lachipatala lomwe lingayambitse vutoli, funsani dokotala wanu za njira zomwe mungachite kuti muchepetse chiopsezo chanu. Iye akhoza kukuuzani za nkhawa zanu ndikupanga dongosolo losamalira bwino vuto lanu ndi mankhwala anu. Kusamalira thanzi lanu ndiye chinthu chofunikira kwambiri.

Kupuma movutikira, kupuma movutikira pang'ono, kupuma movutikira, mpweya woipa, matenda a m'mapapo, kugwiritsa ntchito mankhwala osokoneza bongo