Ese guhumeka kwawe ni guke cyane? (Respiratory Depression/Hypoventilation) - Reka tuvuge kuri ibi!

Ese wigeze wumva urimo kugorwa no guhumeka, cyangwa se ukumva unaniwe cyane? Wenda wumvaga umeze nk'ufite isereri cyangwa unaniwe. Impamvu imwe ishobora kuba iri inyuma y'ibi bintu ni ukugabanuka k'ubuhumekero, ari nabyo twita mu buvuzi (Respiratory Depression) cyangwa (Hypoventilation) .

Ihungabana ry'ubuhumekero ni iki?

Mu magambo make, gucika intege mu myanya y'ubuhumekero ( cyangwa guhumeka buhoro buhoro) ni igihe umuvuduko wawe wo guhumeka ugenda buhoro cyane, cyangwa uhumeka buhoro cyane. Iyo ibi bibaye, guhumeka kw'umwuka ntikubaho neza mu bihaha byawe. Tekereza nawe, iyo duhumeka, ogisijeni iri mu mwuka mwiza yinjira mu maraso binyuze mu dusaho duto tw'umwuka (alveoli) mu bihaha byacu. Nanone, dioxyde de carbone (CO2) , ari yo myanda y'umubiri wacu, isubira mu bihaha ivuye mu maraso igasohoka. Ibi ni byo twita gukwirakwiza gaze .

Noneho, mu gihe cyo kurwara indwara ya (Hypoventilation) , ikibaho ni uko kubera ko udahumeka neza, iyo gaze ya dioxyde de carbone (CO2) ntiva mu mubiri ngo igere mu maraso. Ibi tubyita (Hypercapnia) . Si ibyo gusa, rimwe na rimwe ibihaha bishobora kubura ogisijeni ihagije. Hanyuma urugero rwa ogisijeni mu maraso ruragabanuka, ari byo byitwa (Hypoxemia) . Urabyumva?

Ibimenyetso ni ibihe?

Iyo wagize ikibazo cyo guhumeka nabi (hypoventilation) , ushobora kugira ibimenyetso nk'ibi bikurikira:

• Isesemi no kuruka.
• Umutwe.
• Kumva unaniwe, usinziriye , cyangwa unaniwe igihe cyose.
• Kubura icyerekezo, urujijo , cyangwa impinduka mu mitekerereze.
• Igipimo cy'umutima kiriyongera.
• Kuzungera.
• Guhumeka bisa nkaho bitinze, bito cyane, cyangwa binaniza.
• Ibara ry'ubururu ry'uruhu, iminwa, cyangwa inzara (cyanosis) . Iki ni ikimenyetso gikomeye kurushaho.

Ni iki gitera ibi?

Impamvu nyamukuru zitera kubura umwuka zishobora kuba gukoresha nabi imiti imwe n'imwe, gukoresha ibirenze urugero , cyangwa ingaruka zitunguranye ku nzoga cyangwa ibiyobyabwenge bimwe na bimwe. Tekereza ibi bintu:

• Opioide: Izi nazo zitwa ibiyobyabwenge . Ingero zirimo morphine , tramadol, oxycodone (OxyContin®) , na fentanyl . Hari abantu bakoresha iyi miti nabi.
• Benzodiazepines:Ibi akenshi ni imiti igabanya ububabare n'ibinini bisinziriza. Urugero ni nka lorazepam (Ativan®) , alprazolam (Xanax®) , na diazepam (Valium®) .
• Barbiturates: Iyi miti rimwe na rimwe itangwa ku ndwara zo mu mutwe cyangwa migraine .
• Ibiyobyabwenge bitemewe n'amategeko: Ibintu nka heroine na gamma hydroxybutyrate (GHB) .
• Ibinini byo gusinzira: Imiti yanditswe na muganga nka zolpidem (Ambien®) .
• Anesthesia: Ishobora kandi guterwa n'imiti itangwa kugira ngo ikubuze gusinzira mbere yo kubagwa.

Uretse iyi miti n'imiti, izindi ndwara n'ibindi bibazo bishobora gutera guhumeka nabi :

• Umubyibuho ukabije: Ibi byitwa Obesity Hypoventilation Syndrome (OHS) . Bivuze ko guhumeka bigorana bitewe n'umubyibuho ukabije.
• Indwara zitera ibibazo byo guhumeka: Urugero, indwara idakira yo mu bihaha (COPD) no kubura umwuka wo mu bitotsi .
• Indwara zigabanya imbaraga zo guhumeka: Urugero , indwara yo gucika intege mu bwonko na hypothyroidism .
• Indwara zigira ingaruka ku mugongo, imitsi, cyangwa imitsi: Ingero zirimo indwara z’imitsi , indwara z’imitsi cyangwa uruti rw’umugongo, sclerosis nyinshi (MS) , na sclerosis ya amyotrophic lateral (ALS) .
• Impinduka mu miterere y'igituza cyangwa umugongo: Indwara nka scoliosis ( guhindagurika k'umugongo), ankylosing spondylitis, n'igituza cyo mu gituza .
• Uburozi cyangwa uburozi: Ibintu nka tetanus , uburozi bwa ciguatera, na botulism .

Ni ibihe bintu byongera ibyago?

Ibyago byo guhumeka nabi bishobora kwiyongera bitewe n'impamvu zikurikira:

• Gukoresha nabi imiti nka opioid cyangwa benzodiazepines .
• Niba uherutse kubagwa (kubera ikinya).
• Niba hari indwara zimwe na zimwe zo mu bihaha, imitsi, n'imitsi (ubwonko n'umugongo), nk'uko twabivuze haruguru.

Ni izihe ngorane ibi bishobora gutera?

Diyozede ya karuboni mu maraso yaweIyo urugero rwa CO2 rubaye hejuru cyane, bishobora guteza ingorane zikomeye, ndetse zikanashyira ubuzima mu kaga. Reba:

• Acidosis yo mu myanya y'ubuhumekero: Ibi bivuze ko amaraso yawe afite aside nyinshi kuruta uko bikwiye.
• Kunanirwa guhumeka: Ibi bibaho iyo ingingo z'umubiri wawe zitabona ogisijeni ihagije.
• Guhagarara k'umutima: Guhagarara k'umutima mu buryo butunguranye.
• Koma.
• Umuvuduko ukabije w'amaraso mu bihaha: Ubwiyongere bw'umuvuduko mu mitsi ijyana amaraso mu bihaha.

Ni gute wasuzuma ibi?

Kugira ngo umuganga amenye indwara yo mu myanya y'ubuhumekero , abanza kukubaza ibimenyetso byawe, amateka yawe y'ubuzima, n'imiti iyo ari yo yose ufata. Hanyuma, bashobora gutumiza ibizamini byihariye by'amaraso kugira ngo bapime ingano ya dioxyde de carbone (CO2) mu maraso yawe. Bashobora kandi gutumiza ibindi bipimo kugira ngo bamenye neza icyateye hypoventilation .

Ni ubuhe bwoko bw'ibizamini bikorwa?

Ibizamini nk'ibi bishobora gukorwa kugira ngo hamenyekane impamvu nyamukuru itera kubura umwuka:

• Ikizamini cya gaze mu maraso y'imitsi: Iki kizagenzura ingano ya ogisijeni, dioxyde de carbone, na aside mu maraso.
• Ibizamini by'imikorere y'ibihaha: Ibi ni ibizamini bigenzura uburyo ibihaha byawe bikora neza.
• Pulse Oximetry: Igikoresho gipima ingano ya ogisijeni mu maraso yawe gikoresheje agakoresho gato ku rutoki rwawe. Ushobora kuba warabibonye.
• Gupima Amaraso: Hari ibindi bipimo byinshi by'amaraso bishobora gufasha mu gusuzuma iyi ndwara cyangwa impamvu zayo. Urugero, harimo kubara amaraso yose (CBC) , isuzuma ry'ibanze rya metabolike (BMP) , gusuzuma uburozi (kugira ngo harebwe ibintu nk'imiti), gupima amaraso ya dioxyde de carbone (CO2) , n'ibizamini by'imikorere ya tiroyide .
• Gufata amashusho: Muganga ashobora gutegeka ko ufata X-rays mu gituza cyawe, CT scans (Computed Tomography scans) mu gituza cyawe cyangwa mu mutwe wawe kugira ngo arebe izindi ndwara zihari.
• Inyigo ku gusinzira / Polysomnography: Iki kizamini gifasha kumenya indwara nka apnea yo mu gihe cyo gusinzira n'indwara yo kubyibuha cyane.

Ivurwa ite?

Uburyo bwo kuvura ikibazo cyo kubura umwuka buterwa n'impamvu n'ubukana bw'indwara. Abashinzwe ubuvuzi bashobora kuguha uburyo bwo kuvura nk'ubu:

• Guhumeka bidakoreshejwe: Ibi bikubiyemo gukoresha imashini igufasha guhumeka ukoresheje agapfukamunwa gakwira mu maso. Urugero, imashini ikoresha umuvuduko uhoraho w'umwuka (CPAP) cyangwa imashini ikoresha umuvuduko uhoraho w'umwuka (BiPAP®) . Ushobora kuba warigeze kubyumva.
• Imiti Itera Ubuhumekero: Hari igihe, iyo iyi ndwara itewe no gukabya cyangwa nk'ingaruka mbi z'umuti, imiti ishobora guhindurwa . Urugero, iyo iyi ndwara iterwa na opioid , ingaruka zishobora kugabanuka ukoresheje umuti witwa Naloxone/Narcan® .
• Ubuvuzi bwa Ogisijeni: Ogisijeni ishobora gutangwa iyo bibaye ngombwa.
• Guhumeka hakoreshejwe ikoranabuhanga: Iyo ikibazo gikomeye cyane, umuntu ashobora gukenera ko anyuzwa mu cyuma, agashyirwa mu muyoboro w'amazi, hanyuma agahumeka imashini.

Ni ibihe bintu bishobora kwitezwe mu gihe kiri imbere? (Icyizere)

Igipimo cy’uko umuntu ashobora guhumeka nabi giterwa n’impamvu. Ikibazo cyihutirwa, nko kunywa opioid irenze urugero, gishobora kwica umuntu iyo kidavuwe vuba. Ariko, iyo indwara iterwa n’indwara yo kubura umwuka mu gihe cyo gusinzira, indwara yo kubura umwuka mu gihe cyo gusinzira iterwa n’umubyibuho ukabije ( OHS ) , cyangwa izindi ndwara z’igihe kirekire, bizakenera ubuvuzi buhoraho kandi bizagenda neza buhoro buhoro.

Ese bishobora kwirindwa?

Uburyo bwiza bwo kwirinda kubura umwuka ni ugufata imiti yawe neza uko byategetswe no kwita ku ndwara iyo ari yo yose. Menya neza ko wabajije muganga wawe cyangwa umufarumasiye mbere yo gufata imiti ibiri cyangwa irenga, cyane cyane imiti ya opioid na benzodiazepines, igabanya imbaraga zawe cyangwa ikagutera gusinzira. Nanone , menya ingaruka mbi zishobora kubaho iyo iyi miti ifashwe hamwe n'inzoga.

"Ubuvuzi ni inshuti iyo bukoreshejwe neza, ariko ni umwanzi iyo bukoreshejwe nabi."

Ni ryari ngomba kujya kwa muganga?

Vugana na muganga wawe muri ibi bihe:

• Niba ufite ikibazo cyangwa gushidikanya ku ndwara ufite.
• Niba ufite ibibazo cyangwa gushidikanya ku muti wanditswe na muganga.
• Niba ufite ibimenyetso byo kubura umwuka, cyane cyane niba ufite izindi ndwara zishobora kongera ibyago byo kurwara.

Ni ryari ugomba kujya mu Ishami ry’Ubuvuzi bw’Ingoboka (ETU) ?

Niba ufite kimwe muri ibi bimenyetso bikomeye , jya mu cyumba cy’ubutabazi cy’ibanze kiri hafi yawe vuba:

• Niba ufite indwara yo gucika intege .
• Niba imiterere y'imitekerereze yarahindutse kandi hakabaho urujijo .
• Niba wumva usinziriye cyane ku buryo udashobora gukomeza kuba maso.
• Niba ufite ikibazo cyo kumenya aho uri n'igihe uri.
• Niba ugize ubwoba budasanzwe cyangwa ukekwa (paranoia) .
• Iyo uruhu, inzara, cyangwa iminwa bihindutse ubururu.

Ni ibihe bibazo ugomba kubaza muganga?

Bishobora kuba byiza kubaza muganga wawe ibibazo nk'ibi:

• "Kuki ibi byambayeho?"
• "Nkwiye gukora iki kugira ngo ngire icyo kintu nk'iki kitabaho mu gihe kizaza?"
• "Ni ubuhe buryo bwo kuvura mfite?"

Amaherezo, ibintu byo kwibuka (Ubutumwa bwo kujyana mu rugo)

Ihungabana ry'ubuhumekero ni indwara ikomeye aho gaze karubone (CO2) yiyongera mu maraso yawe. Ariko akenshi ishobora kwirindwa. Niba ufata imiti ishobora gutera ihungabana ry'ubuhumekero, vugana na muganga wawe kugira ngo umenye neza ko uyifata neza kandi mu mutekano. Niba ufite indi ndwara ishobora gutera iyi ndwara, baza muganga wawe intambwe ushobora gutera kugira ngo ugabanye ibyago byawe. Ashobora kukuganiriza ku mpungenge zawe no gushyiraho gahunda yo gucunga neza indwara yawe n'imiti yawe. Kwita ku buzima bwawe ni cyo kintu cy'ingenzi cyane.

Kugabanuka k'ubuhumekero, guhumeka buhoro buhoro, kugabanuka k'ubuhumekero, umwuka mubi wa karuboni, ogisijeni, indwara z'ibihaha, gukoresha ibiyobyabwenge nabi