Kodi mukuvutika kupuma? Tiyeni tikambirane za vuto la kupuma movutikira.

Kodi nthawi zina mumamva ngati mukuvutika kupuma? Kapena mumamva ngati simungathe kupuma? Si bwino kungonyalanyaza zinthu izi. Chifukwa, izi zitha kukhala chizindikiro cha matenda oopsa otchedwa Respiratory Failure . Lero, tikambirana izi m'njira yosavuta yomwe mungamvetse. Izi zitha kukhala zadzidzidzi zachipatala, kotero ndikofunikira kudziwa izi.

Kodi timapuma bwanji? Nanga chimachitika ndi chiyani ngati izi sizikugwira ntchito bwino?

Taganizirani izi, mpweya uli m'matupi athu ngati mafuta a galimoto, kapena ngati mafuta omwe timafunikira kuti tiyendetse miyoyo yathu. Tikapuma, mpweya wamtengo wapatali uwu wotchedwa mpweya umalowa m'mapapo mwathu. Kunena zoona, mpweya uwu umalowa m'matumba ang'onoang'ono a mpweya m'mapapo, otchedwa alveoli . Uli ngati basi yomwe ikukwera kupita ku siteshoni ya basi.

Kuchokera pamenepo, magazi "amanyamula" mpweya uwu kupita ku ziwalo zonse za thupi, kuphatikizapo ubongo wathu, mtima, minofu, ndi ziwalo zina. Ngati mpweya uwu sufika pamalo amenewo, maselo a thupi lathu sadzatha kugwira ntchito, ngati galimoto yopanda mafuta.

Tsopano, mpweya ukatha "kutumizidwa" kumalo amenewo, maselo amagazi, akamabwerera, amasonkhanitsa mpweya wa carbon dioxide, mpweya womwe suthandiza thupi komanso zinyalala. Izi zili ngati kutenga zakudya kusitolo ndikubweza mabokosi opanda kanthu. Ngati mpweya wa carbon dioxide uwu usonkhana m'thupi, ndi vutonso. Chifukwa chake palibe malo okwanira kuti magazi azinyamula mpweya watsopano. Chifukwa chake, mpweya wa carbon dioxide uwu umabwerera m'mapapo ndipo umatulutsidwa m'thupi tikamapuma. Pamenepo ndi pomwe timakhala ndi malo oti titenge mpweya watsopano kachiwiri.

Ngati gawo lililonse la ndondomeko yonseyi litalakwika, minofu ya thupi lathu silandira mpweya wokwanira. Ndicho chimene timachitcha kuti Kulephera Kupuma .

Kodi pali mitundu ina ya kulephera kupuma?

Inde, pali mitundu ingapo ya vutoli, kutengera momwe limachitikira komanso zomwe limakhudza kwambiri. Nthawi zina limatha kuchitika mwadzidzidzi (pachimake) , ndipo nthawi zina limatha kukula pang'onopang'ono pakapita nthawi (losatha) . Mitundu iwiri ikuluikulu ndi iyi:

1. Kulephera Kupuma Mopanda Mphamvu - Mtundu 1

Mwachidule, iyi ndi vuto lomwe magazi anu amakhala ndi mpweya wochepa (`hypoxemia`) . Izi zimachitika mukapuma koma magazi anu salandira mpweya wokwanira. Matenda a mtima ndi matenda a m'mapapo ndi zomwe zimayambitsa izi. Anthu ena amatchanso kuti hypoxic respiratory failure.

2. Kulephera kwa Kupuma Kwambiri - Mtundu Wachiwiri

Apa ndi pamene kuchuluka kwa carbon dioxide (CO2) m'magazi anu kumawonjezeka.. Matupi athu akalephera kuchotsa mpweya woipa wa carbon dioxide moyenera, zinyalala zotchedwa CO2 zimasonkhana m'magazi. Kenako, monga tafotokozera kale, palibe malo oti mpweya ulowe m'magazi. Vutoli likhoza kuyambitsidwa ndi matenda a mtima, mapapo, minofu, ndi mitsempha (ubongo ndi msana). Mankhwala ena angayambitsenso izi.

Pali mitundu ina:

• Kulephera Kupuma Pa Opaleshoni (Mtundu Wachitatu): Izi zitha kuchitika panthawi ya opaleshoni. Mankhwala oletsa kupuma omwe amagwiritsidwa ntchito panthawi ya opaleshoni nthawi zina angapangitse kupuma kukhala kovuta. Komanso, matumba a mpweya m'mapapo amatha kugwa (atelectasis), zomwe zimapangitsa kuti mpweya usafike m'magazi.
• Kulephera Kupuma Chifukwa cha Kugwedezeka (Mtundu 4): Kugwedezeka ndi vuto lalikulu lomwe limakhudza kutsika kwadzidzidzi kwa kuthamanga kwa magazi ndi mavuto monga kutupa kwa m'mapapo. Izi zingayambitsenso kulephera kupuma. Kugwedezeka kungayambitsidwe ndi zinthu monga sepsis ( matenda oopsa omwe amafalikira m'thupi lonse), matenda a mtima mwadzidzidzi, komanso kutuluka magazi ambiri.

Kodi zizindikiro za vutoli ndi ziti?

Zizindikiro za kulephera kupuma zimatha kusiyana malinga ndi chomwe chimayambitsa. Komabe, pali zizindikiro zina zodziwika bwino:

• Kuvuta kupuma kapena kumva kupuma movutikira (dyspnea).
• Kupuma mwachangu (tachypnea).
• Kumva kutopa kwambiri (kutopa).
• Kumva ngati mtima wanu ukugunda mofulumira kapena kugunda kwa mtima kwanu sikukuyenda bwino.
• Kutsokomola ntchofu kapena magazi (hemoptysis).
• Kutuluka thukuta kwambiri.
• Kusakhazikika, kusokonezeka.
• Khungu lotumbululuka.
• Kusanduka kwa buluu kwa khungu, milomo, kapena misomali (cyanosis) - Ichi ndi chizindikiro chachikulu cha kusowa kwa mpweya.
• Mutu .
• Maso osawoneka bwino.
• Nkhawa, chisokonezo, kulephera kuganiza bwino.
• Kusintha kwa khalidwe, osati kukhala monga mwachizolowezi.

Chofunika: Ngati muli ndi zizindikiro izi, muyenera kupeza upangiri wa dokotala nthawi yomweyo , chifukwa izi zitha kukhala zadzidzidzi.

Kodi zifukwa za kulephera kupuma ndi ziti?

Mwachidule, vutoli limachitika pamene mphamvu ya thupi lathu yolandira mpweya ndi kutulutsa mpweya wa carbon dioxide yasokonekera pazifukwa zina. Zinthu zomwe zingakhudze izi ndi monga:

• Kusowa mpweya wokwanira kapena kuchepa kwa magazi m'mapapo.
• Kutsekeka, zipsera, kapena madzimadzi m'mapapo.
• Kulephera kupuma bwino kapena mozama.Izi zitha kuchitika chifukwa cha matenda omwe amakhudza mapapo, mavuto a mitsempha kapena minofu yomwe imakuthandizani kupuma, kapena kuvulala pachifuwa.
• Kusayenda bwino kwa magazi mumtima.

Ndani ali pachiwopsezo chachikulu? (Zinthu Zoopsa)

Anthu ena ali pachiwopsezo chachikulu cholephera kupuma bwino.

• Anthu omwe ali ndi matenda a m'mapapo: Mwachitsanzo, matenda monga acute respiratory distress syndrome (ARDS) , chronic obstructive pulmonary disease (COPD) , chibayo , mphumu , cystic fibrosis , pulmonary edema (madzimadzi m'mapapo) , pulmonary embolism (magazi amaundana m'chubu cha mapapo) , ndi pulmonary fibrosis (zipsera m'mapapo) .
• Anthu omwe ali ndi matenda a mtima kapena a mitsempha yamagazi: monga matenda a mtima , matenda a mtima obadwa nawo , kulephera kwa mtima , ndi shock .
• Anthu omwe ali ndi matenda omwe amakhudza mitsempha ndi minofu yomwe imathandiza kupuma: matenda monga muscular dystrophy , amyotrophic lateral sclerosis (ALS) , severe scoliosis (kupindika kwa msana) , ndi Guillain-Barré syndrome .
• Kuvulala pachifuwa, msana, kapena ubongo (kuphatikizapo sitiroko).
• Kusuta kapena kukhudzana ndi zinthu zina zoyambitsa mphuno: utsi wa mankhwala, fumbi, kuipitsidwa kwa mpweya (monga utsi wochuluka wa magalimoto m'misewu yathu, utsi wa fakitale, ndi fumbi lochokera kumalo omanga), ndi asbestos.
• Maopaleshoni omwe amafunika mankhwala oletsa ululu.
• Kugwiritsa ntchito mankhwala osokoneza bongo kapena kumwa mowa mopitirira muyeso.
• Zaka: Ana obadwa kumene (makamaka omwe amabadwa ndi kukula kochepa) ndi akuluakulu opitirira zaka 65 ali pachiwopsezo chachikulu.

Kodi madokotala amazindikira bwanji izi?

Dokotala adzafufuza ngati pali vuto la kupuma mwa kuwona kuchuluka kwa mpweya ndi carbon dioxide m'magazi mwanu . Adzafufuzanso kuthamanga kwa magazi anu ndikugwiritsa ntchito chipangizo chaching'ono cholumikizira mpweya (chotchedwa `pulse oximeter` kapena `pulse ox`) kuti aone kuchuluka kwa mpweya m'magazi mwanu. Adzamvetseranso mtima ndi mapapo anu ndikukufufuzani. Ngati mukukayikira kuti vutoli ndi loopsa, angachite mayeso ena angapo.

Kodi mayeso amenewo ndi ati?

• Kuchuluka kwa mpweya m'thupi:Izi zimaphatikizapo kuyika sensa pa chala chanu kuti muyese kuchuluka kwa mpweya m'magazi anu. Izi nthawi zambiri zimachitika mukapita kukaonana ndi dokotala.
• Kuyesa kwa mpweya wa magazi m'mitsempha (ABG): Chitsanzo chaching'ono cha magazi chimatengedwa ndi singano kuchokera pachikhatho, mkono wapamwamba, kapena khosi ndipo milingo ya mpweya ndi carbon dioxide imayesedwa. Izi zingapereke chidziwitso cholondola kwambiri.
• Mayeso a Ntchito ya M'mapapo (PFT): Mu mayesowa, mukupemphedwa kuti mupume mpweya kudzera pakamwa polumikizidwa ndi makina. Izi zingakuthandizeni kuona momwe mapapu anu akugwirira ntchito.
• Mayeso ojambulira: Ma X-ray ndi ma CT scan amajambula zithunzi za mkati mwa thupi. Ngakhale kuti izi sizingazindikire mwachindunji kulephera kupuma, zingathandize kudziwa chomwe chikuyambitsa vutoli.
• Electrocardiogram (EKG): Izi zimayesa momwe mtima ukugwira ntchito. Ngati dokotala akuganiza kuti vutoli ndi chifukwa cha matenda a mtima, adzaitanitsa EKG.

Kodi izi zimachiritsidwa bwanji?

Chithandizo cha kulephera kupuma chimadalira kuopsa kwake komanso chifukwa chake . Zolinga zazikulu za chithandizo ndi kuchiza chomwe chimayambitsa vutoli, kukupatsani mpweya wochuluka, kapena kugwiritsa ntchito makina opumira (`mechanical ventilation`) mpaka mutayambanso kupuma nokha.

Kulephera kupuma bwino ndi vuto ladzidzidzi ndipo limafunika kuthandizidwa nthawi yomweyo. Komabe, kulephera kupuma pang'ono, kwa nthawi yayitali (kosatha) nthawi zina kumatha kuchiritsidwa kunyumba poyang'anira vuto lomwe limayambitsa vutoli.

Kodi mankhwala enieni ndi ati?

• Mpweya wopumira wa makina: Izi zimaphatikizapo kukulumikizani ku makina opumira ndi chubu cholowetsedwa munjira yanu yopumira, chomwe chimapumira ndikutulutsa mpweya m'mapapu anu.
• Kutulutsa mpweya m'thupi la munthu (ECMO): Ichi ndi chithandizo chovuta pang'ono. Chimaphatikizapo kugwiritsa ntchito makina odulira magazi kuti achotse magazi m'thupi, kuwonjezera mpweya m'thupi, kuchotsa mpweya woipa m'thupi, kenako n'kulowanso m'thupi.
• Chithandizo cha okosijeni: Makina amapereka mpweya wowonjezera kudzera mu chigoba chopumira kapena chubu chaching'ono (cannula) chomwe chimayikidwa m'mphuno. Izi zitha kuchitika kuchipatala kapena kunyumba.
• Madzi: Madzi amaperekedwa kudzera m'mitsempha (IV - mwachindunji mumtsempha). Izi zimathandiza kuti magazi aziyenda bwino m'thupi ndipo zimathandiza kunyamula mpweya wambiri kupita ku minofu.
• Kuchiza matenda omwe amabwera chifukwa cha kupuma movutikira: Kutengera ndi chomwe chimayambitsa kulephera kupuma, dokotala angakulangizeni mankhwala ena kapena mankhwala ena.

Kodi pali njira yopewera izi?

Kulephera kupuma sikungathe kupewedwa nthawi zonse. Komabe, mutha kuchepetsa chiopsezo chanu chokhala ndi vuto la kupuma kosatha mwa kuthana ndi matenda aliwonse a mtima, mapapo, kapena mitsempha omwe mungakhale nawo. Ngati muli ndi chiopsezo cha vutoli, lankhulani ndi dokotala wanu za njira zochepetsera chiopsezo chanu.

Kodi kulephera kupuma kungachiritsidwe?

Uwu ndi matenda oopsa kwambiri. Anthu ambiri amachira. Zimatengera chomwe chayambitsa matendawa, kuopsa kwake, komanso momwe amachizira mwachangu.

Ngakhale zifukwa zambiri zomwe zimayambitsa kulephera kupuma mokwanira zimatha kuchiritsidwa, zimatha kupha ngati sizikuthandizidwa mwachangu. Pafupifupi gawo limodzi mwa magawo atatu a anthu omwe ali m'chipatala omwe ali ndi kulephera kupuma mokwanira amafa. Kulephera kupuma nthawi zambiri kumachitika chifukwa cha matenda omwe amakula pakapita nthawi.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati muli ndi vuto lalikulu lomwe limakuikani pachiwopsezo cha kulephera kupuma, lankhulani ndi dokotala wanu. Iye angakuuzeni zizindikiro za kulephera kupuma zomwe muyenera kuzisamala komanso momwe mungathanirane ndi vutoli.

Kodi ndiyenera kupita ku Dipatimenti Yothandiza Anthu Odwala Pangozi (ETU) liti?

Ngati muli ndi zizindikiro za kulephera kupuma, pitani ku chipinda chapafupi chadzidzidzi nthawi yomweyo, kapena imbani 911. Izi zitha kupha ngati simulandira chithandizo mwachangu.

Kodi ndiyenera kufunsa dokotala wanga chiyani?

Zingakhale zothandiza kufunsa dokotala wanu mafunso monga awa:

• Kodi ndi njira ziti zochiritsira zomwe ndili nazo?
• Kodi chifukwa chake ndi chiyani?
• Kodi ndiyenera kugwiritsa ntchito bwanji mankhwala anga?
• Kodi ndiyenera kugwiritsa ntchito bwanji chipangizochi (monga makina a okosijeni)? Kodi mungandiwonetse momwe ndingagwiritsire ntchito?
• Kodi ndingayembekezere kuti ndidzachira liti?
• Ndiyenera kubweranso liti kudzakuonaninso?

Uthenga Wopita Nawo Kunyumba

Kulephera kupuma bwino ndi vuto lalikulu, nthawi zina limapha. Ngati mukuganiza kuti mukulephera kupuma bwino, chonde imbani 911 nthawi yomweyo kapena funani thandizo lachipatala mwamsanga. Ngati muli ndi vuto la kupuma kosatha, kapena ngati muli ndi matenda omwe amakuika pachiwopsezo chotenga matendawa, lankhulani ndi dokotala wanu za chithandizo choyenera. Iye angakuuzeni njira zomwe mungasankhire chithandizo ndi zomwe mungayembekezere kutengera vuto lanu. Samalani kupuma kwanu, chifukwa ndi moyo wanu!

Kulephera kupuma mokwanira, kupuma movutikira, mpweya, mpweya woipa, mapapo, chisamaliro chadzidzidzi, ARDS, COPD