Wakamboona mumwe munhu ari muchikamu chevarwere vanorwara zvakanyanya (ICU) here kana mumwe munhu akaunzwa kuchipatara chekukurumidzira (ETU) aine dambudziko guru rekufema, uye vanachiremba vanomhanyira kuvaudza kuti "vaite ABG"? Uku kuongororwa kweropa kwakakosha uye kwakanyatsogadzirwa. Nhasi, tichataura nezvazvo zviri nyore, nenzira yaunogona kunzwisisa.
Zvichitaurwa zviri nyore, chii chinonzi bvunzo iyi yeABG?
ABG (Arterial Blood Gas) bvunzo inotora ropa shoma kubva mutsinga yeropa iri mumuviri wedu. Zvino ungave uchifunga kuti, "Kumwe kuongororwa kweropa kunotora ropa kubva mutsinga, musiyano chii?"
Funga nezvazvo nenzira iyi. Muviri wedu wakaita seguta.
- Mitsipa yeropa yakafanana nemigwagwa mikuru inounza zvinhu zvakakosha zvakaita seokisijeni nekudya kunovaka muviri muguta.
- Mitsetse yakaita semigwagwa yekare muguta inotakura marara akaita secarbon dioxide kudzokera nawo kuguta.
Saka, kana tichida kuziva kuti mweya uri kusvika mumiviri yedu zvakadii , kunyanya uropi nemoyo, tinofanira kuyedza ropa riri pa "mugwagwa mukuru," handiti? Ndosaka ropa richitorwa kubva mutsinga kuti riongororwe ABG.
Kuongororwa uku kunonyanya kuyera huwandu hweokisijeni nekabhoni dhayokisaidhi muropa rako. Kunoyerawo chiyero cheacid-base, kana kuti pH, muropa rako. Kuyera uku kwakakosha kune zvese zvinoitika mumuviri wedu.
Chii chaizvo chinoyerwa neABG test?
Kana ukatarisa mushumo weABG, uchaona mamwe mavara akaoma kunzwisisa. Asi zvarinoreva zviri nyore kwazvo. Ngationei kuti chimwe nechimwe chezviyero izvozvo chinorevei.
| Kuyera | Zvinoreva zviri nyore |
|---|---|
| pH | Izvi zvinokuudza kuti ropa rako rine acid yakawanda zvakadii. Kukosha uku kunofanira kuva pakati pe7.35 ne7.45. Chero chipi zvacho chiri pasi paizvozvo zvinoreva kuti ropa rako rine acid yakawanda, uye chero chipi zvacho chiri pamusoro zvinoreva kuti rine alkaline. |
| PaO2 (Kumanikidzwa kweokisijeni zvishoma) | Huwandu hweokisijeni inonyungudika muropa. Izvi zvinoratidza kuti okisijeni iri kupinda zvakanaka sei muropa kubva mumapapu ako. |
| PaCO2 (Kumanikidzwa kwekabhoni dhayokisaidhi) | Huwandu hwekabhoni dhayiokisijeni muropa rako. Izvi zvinoratidza kuti muviri wako uri kubvisa kabhoni dhayiokisijeni zvakanaka sei. |
| HCO3 (Bicarbonate) | Ichi chinhu chiri muropa redu. Chinodzorwa neitsvo. Zvakakosha zvikuru pakuenzanisa pH yeropa. |
| O2Sat (Kuzara kweokisijeni) | Inoratidza kuti hemoglobin iri muropa inotakura okisijeni yakawanda sei, sechikamu. Chiyero che pulse oximeter chaunoisa pamunwe wako chinoyera kukosha kwakafanana. |
Kuongororwa kweABG kunodiwa rini?
Iyi haisi bvunzo inoitirwa kuongororwa nguva dzose. Inowanzoitwa panguva dzenjodzi uye kutarisa mamiriro evarwere vakatove muchipatara . Heano mamwe ezvikonzero zvikuru nei chiremba angaraira bvunzo iyi:
- Kuoma kwekufema kwakanyanya: Muzviitiko zvakaita sekuwedzera kweasthma uye kuungana kwemvura mumapapu (kutadza kufema zvakanyanya).
- Matambudziko akanyanya ekutapurirana: Muzvirwere zvinouraya zvakadai se sepsis kana septic shock.
- Matambudziko ane chekuita nechirwere cheshuga: Mumamiriro ezvinhu apo ropa rinova neacidic, senge diabetic ketoacidosis (DKA).
- Kurwara nemoyo kana kutadza kushanda zvakanaka: Kana moyo ukangoerekana wamira kushanda (Acute heart failure) kana kana moyo wamira (Cardiac arrest).
- Kutadza kushanda kweitsvo: Kana itsvo dzikatadza kubvisa acid kubva muropa nemazvo, ropa rinova acid. Dzidza nezvechirwere ichi.
- Kuchetura: Kana zvimwe zvinhu zvine chepfu zvikadyiwa, pH yeropa inochinja.
- Usati wavhiyiwa uye mushure mekuvhiyiwa kukuru: Tarisa mamiriro ekufema kwemurwere panguva yekunzwa kuneta uye mushure mekuvhiyiwa.
- Zvirwere zvemapapu zvisingaperi: Ona kana kurapwa kwacho kuchibudirira kune vanhu vane zvirwere zvakaita seCOPD (Chronic obstructive pulmonary disease).
Kuongororwa uku kunoitwa sei? Kunorwadza here?
Kuongororwa ropa kweABG kwakasiyana zvishoma nekuongororwa ropa nguva dzose.
Pamberi pebvunzo
Dzimwe nguva, kana uchipiwa okisijeni yekuwedzera, inogona kumira kwemaminitsi makumi maviri bvunzo isati yaitwa. Izvi zvinoitirwa kuona mashandiro anoita muviri wako usina okisijeni. Asi kana usingakwanise kurarama usina okisijeni, ungasadaro. Kana ropa richitorwa kubva muruoko rwako, chiremba kana mukuru akadzidziswa anogona kuita bvunzo iri nyore inonzi 'Allen test' kuti aone kana ropa riri kufamba zvakanaka muruoko rwako.
Paunenge uchinyora bvunzo
1. Chiremba kana nyanzvi yakadzidziswa ichawana tsinga mukati meruoko rwako (radial artery), pedyo negokora rako (brachial artery), kana muhudyu mako (femoral artery).
2. Chenesa nzvimbo yacho zvakanaka woisa mushonga wekuuraya utachiona.
3. Zvadaro, tsono diki kwazvo inopinzwa mutsinga uye ropa shoma rinodhonzwa musirinji.
4. Kutaura chokwadi , izvi zvinogona kurwadza zvishoma kupfuura kutorwa ropa kubva mutsinga. Izvi zvinokonzerwa nekuti tsinga iri pasi peganda redu uye ine tsinga dzakawanda dzakaipoteredza. Asi kurwadziwa kunoitika panguva inoiswa tsono.
5. Kana ropa rakawanda ratorwa, bvisai tsono moisa kumanikidza panzvimbo yacho nedonje kana gauze kuti ropa rimire kubuda kwemaminitsi mashanu kusvika gumi . Kana muri kutora mushonga wekuderedza ropa, mungangoda kuisa kumanikidza kwenguva yakareba.
Mushure mebvunzo
Nzvimbo yakapinzwa tsono inogona kunge yakakuvara zvishoma kana kuti yebhuruu. Izvi zvakajairika. Chiremba wako achakuudza kuti usasimudze zvinhu zvinorema neruoko irworwo kwemaawa makumi maviri nemana mushure mekutorwa ropa.
Mhedzisiro yebvunzo yeABG inowanikwa nekukurumidza, kazhinji mukati memaminitsi gumi kusvika gumi nemashanu. Mhedzisiro iyi yakakosha zvikuru pakuita sarudzo nekukurumidza munguva dzenjodzi.
Avhareji yemitengo iri mumushumo wacho yakaita sei?
Zviyero izvi zvinogona kusiyana zvishoma kubva murabhoritari kuenda kune imwe, asi izvi ndizvo zvinoyera munhu mukuru ane hutano ari padanho regungwa. Zvakanaka kubvunza chiremba wako kuti akutsanangurire zvizere nezvezviyero zviri mumushumo wako.
| Kuyera | Range Yakajairika |
|---|---|
| pH | 7.35 - 7.45 |
| PaO2 | 75 - 100 mmHg |
| PaCO2 | 35 - 45 mmHg |
| HCO3 | 22 - 26 mEq/L |
| O2Mugovera | 95% - 100% |
Kana zvinhu izvi zviri kunze kwehuwandu hwakajairika, zvinogona kureva kuti muviri wako hausi kuwana oxygen yakakwana , kana kuti carbon dioxide haisi kubuda mumuviri wako nemazvo , kana kuti acid/base balance yeropa rako haina kuenzana . Chiremba wako achashandisa mushumo uyu, zviratidzo zvako, nedzimwe bvunzo kuti aone kuti chii chiri kukunetsa.
Mharidzo Yekuenda Nayo Kumba
- ABG haisi bvunzo yeropa inotorwa kubva mutsinga, asi bvunzo yakakosha inotorwa kubva mutsinga, tsinga huru yeropa inopa okisijeni kumuviri.
- Izvi zvinonyanya kuyera okisijeni, kabhoni dhayokisaidhi, uye acidity (pH) muropa.
- Izvi zvakakosha kuti pave nekuonekwa kwezvirwere nekukurumidza munguva dzekukurumidzira uye mumamiriro ezvinhu akakomba akadai sekutadza kufema, hutachiona hwakakomba, uye chirwere chemwoyo.
- Kunyangwe zvingava zvinorwadza zvishoma pane kuongororwa ropa nguva dzose, ruzivo rwazvinopa runogona kubatsira kuponesa hupenyu.
- Gara uchitaura nachiremba wako anokurapa nezvemhedzisiro yekuongororwa kwako kweABG uye zvazvinoreva.
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