Mwero weokisijeni muropa rako wakarurama here? Ngatidzidzei nezvebvunzo yeABG (Arterial Blood Gas) nenzira iri nyore!

Tose tinoziva kukosha kweokisijeni kumiviri yedu. Kufema zvakanaka uye kuva neokisijeni yakakwana muropa kwakakosha kuti ugare uine hutano. Saka, dzimwe nguva vanachiremba vanofanira kuziva kuti okisijeni necarbon dioxide zvakadii zviri muropa rako. Ndipo panoitwa bvunzo iyi inonzi ABG (Arterial Blood Gas).

Chii chinonzi bvunzo iyi yeABG (Arterial Blood Gas)?

Zvichitaurwa zviri nyore, bvunzo yeABG (Arterial Blood Gas) bvunzo inoshandisa sampuro yeropa inotorwa kubva mutsinga yako kuyera huwandu hweokisijeni nekabhoni dhayokisaidhi muropa rako. Funga nezvazvo, kune mhando mbiri dzetsinga dzeropa mumuviri wedu, imwe itsinga, uye imwe itsinga. Mitsinga inotakura ropa rakachena, rine oxygen yakawanda kubva pamoyo kuenda kumuviri wese. Saka, pakuongororwa uku kweABG, sampuro yeropa inotorwa kubva mutsinga idzodzo.

Kuongororwa uku hakungoyeresi chete okisijeni nekabhoni dhayokisaidhi, asiwo acid-base balance , kana pH, yeropa rako. Miviri yedu inowanzo dzora huwandu hweokisijeni nekabhoni dhayokisaidhi muropa redu zvakanyanya. Kana huwandu hweokisijeni muropa redu hukadzikira (hwatinoti `hypoxemia` mukurapa), zvinogona kukonzera matambudziko akakomba . Zvinogona kukuvadza uropi hwako nemoyo wako kunyanya.

Kuongororwa kweABG kunobatsira vanachiremba kunzwisisa zvirwere zvine chekuita nekufema kwako, kufamba kweropa , uye mashandiro ekugaya chikafu (nzira yaunoshandura chikafu chaunodya kuita simba). Izvi zvinonyanya kukosha mumamiriro ezvinhu enjodzi .

Kune imwe bvunzo inonzi "kuongorora gasi reropa." Mubvunzo uyu, sampuro yeropa inogona kutorwa kubva chero kupi mumuviri (tsinga, tsinga, kana capillary). Zvisinei, mubvunzo yeABG, ropa rinofanira kutorwa kubva mutsinga .

Bvunzo iyi yeABG ine mamwe mazita akati wandei:

• Kuedzwa kwegasi reropa
• Magasi eropa e arterial
• ABG
• Kuongororwa kwegasi reropa

Chii chaizvo chinoyerwa neABG test?

Kuongororwa kweABG kunowanzo ratidza zvinotevera:

• Kuwanda kweokisijeni (O2CT) : Izvi zvinoyera huwandu hweokisijeni iri muropa rako.
• Hemoglobin : Hemoglobin ipuroteni inowanikwa mumasero edu matsvuku eropa inotakura okisijeni mumuviri wese. Izvi zvinoyera huwandu hwehemoglobin.
• Kuwanda kweokisijeni mumuviri (O2Sat) : Izvi zvinoyera kuti hemoglobin iri kutakurwa neokisijeni yakawanda sei muropa rako.
• Kumanikidzwa kweokisijeni zvishoma (PaO2) : Izvi zvinoyera kumanikidzwa kweokisijeni yakanyungudutswa muropa rako. Zvinoratidza kuti okisijeni iri kupinda zvakanaka sei muropa rako kubva mumapapu ako.
• Kumanikidzwa kwekabhoni dhayokisaidhi (PaCO2): Izvi zvinoyera huwandu hwekabhoni dhayokisaidhi muropa rako uye kuti kabhoni dhayokisaidhi iri kubviswa sei mumuviri wako.
• pH (`pH`) : Izvi zvinoyera chiyero pakati pemaacids nemabases muropa rako. Kazhinji, pH yeropa inofanira kuva pakati pe7.35 ne7.45. Chero chipi zvacho chiri pasi peizvozvo chinoonekwa sechiine acid yakawanda, uye chero chipi zvacho chiri pamusoro peizvozvo chinoonekwa sechisina acid yakawanda kana kuti alkaline .
• Bicarbonate (`Bicarbonate - HCO3`) : Izvi zvinoverengerwa uchishandisa pH nePaCO2. Izvi zvinoona huwandu hwechinhu chinoumbwa kubva kucarbon dioxide.

Kuongororwa kweABG kunoitwa rini?

Vanachiremba vanowanzo raira bvunzo yeABG muzviitiko zvakaita seizvi:

• Mushonga wekukurumidzira : Izvi zvinoreva zvirwere kana tsaona dzinoda kurapwa nekukurumidza.
• Anesthesiology : Chikamu chekurapa chine chekuita nekutarisira varwere vasati vavhiyiwa, panguva yekuvhiyiwa, uye mushure mekuvhiyiwa.
• Pulmonology : Chikamu chinotarisa zvirwere zvine chekuita nehurongwa hwekufema.

Vanachiremba vanoshandisa bvunzo yeABG kuongorora zvirwere zvakasiyana-siyana, zvinosanganisira:

• Chirwere chekufema chinouraya vanhu vakawanda (ARDS) : Ichi chirwere chinouraya vanhu vakawanda mumapapu chinokonzera oxygen shoma muropa. Chinogona kukonzerwa nemamiriro ezvinhu akadai se sepsis neCOVID-19.
• Sepsis yakanyanya : Sepsis chirwere chinouraya chinokonzerwa nekuita kwemuviri wako kana wabatwa nehutachiona.
• Kuvhunduka kweropa : Ichi chirwere chinotyisidzirawo hupenyu apo BP yako inoderera zvine njodzi mushure mehutachiona.
• Kuvhunduka kweropa: Kuvhunduka kwemoyo (hypovolemic shock ): Kurwara kwemoyo kunotadza kupomba ropa rakakwana mumuviri nekuda kwekurasikirwa neropa rakawanda kana kurasikirwa nezvimwe zvinwiwa.
• Ketoacidosis inokonzerwa nechirwere cheshuga (DKA) : Ichi chirwere chakakomba, chinotyisidzira hupenyu hwevanhu vane chirwere cheshuga (kunyanya chirwere cheshuga cherudzi rwekutanga) uye chirwere cheshuga cherudzi rwekutanga chisati chaonekwa. Chinokonzera kuti ropa rive neacid.
• Renal tubular acidosis (RTA) : Muchirwere ichi, itsvo dzako hadzibvisi acid kubva muropa rako zvakanaka muweti yako, zvichiita kuti ropa rako riwedzere acid.
• Kutadza kufema zvakanaka : Izvi zvinoitika kana mvura yaungana mumapapu, zvichiita kuti zviomere mapapu kuburitsa okisijeni muropa.
• Kukundikana kwemoyo kwakanyanya: Ichi chirwere apo mwoyo unongoerekana washaya simba uye mashandiro awo anogumira.
• Kumira kwemwoyo : Apa ndipo apo mwoyo wako unomira kurova kamwe kamwe.
• Kurwiswa neAsthma : Kuwedzera kamwe kamwe kwezviratidzo zveAsthma kunokonzerwa nekuoma kwetsandanyama dzakatenderedza nzira dzekufema.
• Zvikanganiso zvemuviri pakugadzirwa kwemuviri : Aya mamiriro asingawanzoitika, emumajini (ekugara nhaka) umo muviri wako usingakwanise kushandura chikafu kuita simba nemazvo.

Kana uine chimwe chezvirwere izvi zvemapapu, chiremba wako anogonawo kuita bvunzo yeABG kuti aone kana kurapwa kwako kuri kushanda nemazvo:

• Asima
• Chirwere chemapapu chinovhara mapapu (COPD)
• Cystic fibrosis
• Chirwere chemwoyo

Ndiani anoita bvunzo yeABG?

Nyanzvi yezvekufema inowanzo tora ropa kuti riongororwe ABG. Vanotora ropa kubva mutsinga iri muruoko rwako, paruoko, kana pahudyu. Vanozoedza ropa racho vega, kana kuti vanoritumira nekukurumidza kurabhoritari, uko masayendisiti erabhoritari yezvekurapa vanoedza ropa racho.

Chii chinoitika bvunzo yeABG isati yaitwa?

Murapi wekufema asati atora ropa kubva muruoko rwako, anogona kuita bvunzo yekuyerera kweropa inonzi Allen test . Izvi zvinosanganisira kusimudza ruoko rwako neruoko rwako muchibhakera. Murapi achadzvanya tsinga iri muruoko rwako kwemasekonzi mashoma. Iyi bvunzo iri nyore inoongorora kana tsinga dzese dziri muruoko rwako dziri kushanda nemazvo uye dzakavhurika.

Kana uri pakurapa neoxygen, chiremba wako anogona kudzima oxygen yako maminitsi makumi maviri ropa risati ratorwa. Izvi zvinonzi room air test . Zvisinei, kana usingakwanise kufema usina oxygen yekuwedzera, havazoiti bvunzo iyi.

Rudzii rweruzivo rwaunowana paunenge uchiita bvunzo yeABG?

Kuongororwa kweropa kwakawanda kunotora ropa kubva mutsinga yako. Asi pakuongororwa kweABG, chiremba wekufema anotora ropa kubva mutsinga yako. Izvi zvinokonzerwa nekuti ropa retsinga rine oxygen yakawanda kupfuura ropa retsinga.

Chiremba wekufema anowanzo tora ropa kubva mutsinga iri mukati meruoko rwako. Dzimwe nguva vanogonawo kutora ropa kubva mutsinga iri muruoko rwako (brachial artery) kana muhudyu (femoral artery).

Kana mwana achangoberekwa achida kuongororwa ABG, chiremba anogona kutora ropa kubva pachitsitsinho chemwana kana parukuvhute.

Zvakakosha: Kutora ropa kubva mutsinga yeropa kazhinji kunorwadza zvishoma pane kutora ropa kubva mutsinga. Izvi zvinokonzerwa nekuti mitsinga iri mukati memuviri kupfuura mitsinga, uye ine tsinga dzakaipoteredza. Unganzwa dzungu, musoro wakaneta, kana kuda kurutsa kana ropa rako ratorwa.

Aya ndiwo matanho ekutevera kana uchitora ropa kuti uongororwe ABG:

1. Uchagara pachigaro kana kuti wakarara pamubhedha. Chiremba wekufema achawana tsinga, kazhinji mukati meruoko rwako. Vanogona zvakare kushandisa ultrasound scan ('ultrasound imaging') kuti vawane tsinga.

2. Kana tsinga yeropa yaonekwa, nzvimbo yacho inocheneswa uye inopiswa nemishonga inouraya utachiona.

3. Vachaisa tsono diki mutsinga yako yeropa votora ropa. Unganzwa kurwadziwa kwakanyanya tsono painopinda mutsinga.

4. Mushure mekupinza tsono, ropa diki rinounganidzwa musirinji.

5. Kana vatora ropa rakakwana kuti vaongororwe, vanobvisa tsono yacho voisa simba panzvimbo yacho nedonje kana gauze kuti ropa risabude. Kana uri kutora mushonga unobvisa ropa, ungangoda kumisa simba kwemaminitsi mashanu kusvika gumi kana kupfuura.

6. Vanoisa bhandeji panzvimbo yacho. Basa rinopera.

Chii chaungatarisira mushure mekuongororwa kweABG?

Unganzwa mavanga kana kurwadziwa pakaiswa tsono. Chiremba wako anogona kukuudza kuti usasimudze chinhu chinorema kwemaawa makumi maviri nemana mushure mekutorwa ropa.

Pane njodzi here nebvunzo yeABG?

Kana chiremba wekufema akaita bvunzo iyi nemazvo, bvunzo yeABG haina njodzi yakawanda . Mitsipa yeropa yemunhu wese yakasiyana saizi, uye inosiyana kubva kurutivi rumwe rwemuviri kuenda kune rumwe. Saka zvinogona kuoma zvishoma kutora ropa kubva kune vamwe vanhu kupfuura vamwe.

Njodzi dzinosanganisirwa nekutorwa ropa kuti uongororwe ABG dzakaderera zvikuru, asi zvinhu zvakaita seizvi zvinogona kuitika:

• Kunzwa dzungu kana kusuruvara.
• Kuboorwa netsono kakawanda kuti uwane tsinga.
• Kugwamba kweropa (hematoma - muunganidzwa weropa pasi peganda).
• Kubuda ropa zvakanyanya.
• Kutapukirwa (pane njodzi diki chero nguva ganda rakatyoka).

Zvinotora nguva yakareba sei kuti uwane mhedzisiro yebvunzo yeABG?

Kuongororwa kweABG kunowanzo buritsa mhinduro nekukurumidza . Vanachiremba vekufema nevesainzi verabhoritari vanowanzo shandisa ma "automatic blood gas analyzers", ayo anogona kupa mhinduro mukati memaminitsi gumi kusvika gumi nemashanu.

Mhedzisiro yekuongororwa kweABG inoti chii?

Mishumo yekuongororwa kweropa, kusanganisira mishumo yekuongororwa kweABG, inowanzova neruzivo runotevera:

• Zita rekuongororwa kweropa kana kuti chii chakayerwa muropa rako.
• Nhamba kana chiyero chemhedzisiro yekuongororwa kweropa rako.
• Ndiyo nzira yakajairika yekuyera bvunzo.
• Ruzivo runoratidza kana mhedzisiro yako iri yakajairika, isina kujairika, kana kuti yakakwira kana yakaderera.

Kana mhinduro dzako dzebvunzo dzeABG dzisina kunaka, zvinogona kureva zvinhu zvakaita se:

• Hausi kuwana oxygen yakakwana.
• Hausi kubudisa mweya wakakwana wecarbon dioxide.
• Ropa rako rine pH imbalance (ingave ine acid yakawanda kana kuti ine alkaline yakawanda).

Kuongororwa kweABG kunogona kubatsira kuona zvimwe zvirwere. Kana zvabuda muongororo yako zvisina kujairika, chiremba wako anogona kuraira mimwe miedzo (yakadai sekuongororwa kweropa uye/kana kuskena) kusimbisa kana kubvisa chirwere.

Ndezvipi zviyero zvakajairika zvekuyedzwa kweABG?

Kuyera kwakajairika kunogona kusiyana zvishoma kubva murabhoritari kuenda kune imwe. Paunowana zvabuda mukuongororwa kweropa rako, zvichasanganisira ruzivo runoratidza kuti zviyero zvakajairika zvechiyero chega chega kubva murabhoritari iyoyo ndezvipi. Kana uine mibvunzo nezve zvabuda, iva nechokwadi chekubvunza chiremba wako .

Kazhinji, avhareji yehuwandu hwegungwa ndeiyi inotevera:

• pH : 7.35-7.45
• Kumanikidzwa kweokisijeni zvishoma (`PaO2`) : 75 kusvika 100 millimeters yemercury (mmHg)
• Kumanikidzwa kwekabhoni dhayokisaidhi (`PaCO2`) : 35 kusvika 45 mmHg
• Bicarbonate (`HCO3`) : 22 kusvika 26 milliequivalents pa litre (mEq/L)
• Kuzara kweOkisijeni (`O2Sat` kana `SaO2`) : 95% kusvika 100%

Pakukwirira kwemamita 900 zvichikwira, mwero weokisijeni uri pasi zvakanyanya.

Ndinofanira kuona chiremba wangu rini?

Kana uine chirwere chemapapu chisingaperi seCOPD kana asthma, ungangoda kuona chiremba wako nguva nenguva uye kuongororwa kweABG kuti uve nechokwadi chekuti kurapwa kwako kuri kushanda nemazvo. Kana ukaona zviratidzo zvinonetsa zvine chekuita nechirwere chemapapu ako, taura nachiremba wako nekukurumidza.

Pakupedzisira, zvinhu zvekurangarira

Kuongororwa kweABG chishandiso chinobatsira pakuongorora chirwere , kunyanya mune dzimwe nguva dzenjodzi. Vanachiremba vanoshandisawo bvunzo iyi kutarisa mamwe mamiriro ehutano. Kana uri kuongororwa kweABG, yeuka kuti inzira yakasiyana zvishoma pane kuongororwa ropa nguva dzose, uye inogona kurwadza zvishoma. Kana uine mibvunzo nezve nzira iyi kana kuti zvaunotarisira, usazeza kubvunza chiremba wako . Varipo kuti vakubatsire.

Kuongororwa kwegesi reropa , gasi reropa remutsinga, okisijeni, kabhoni dhayokisaidhi, pH kukosha, masisitimu ekufema, bvunzo dzekurapa