Zvakajairika kunzwa kutya kukuru uye kuzvidya mwoyo paunonzwa kuti mumwe munhu waunoziva ari muIntensive Care Unit (ICU) akaiswa pamuchina wekufema. Kutya uku kunowedzera nekusaziva zvakawanda nezvemuchina uyu. Chaizvoizvo mudziyo unokosha zvikuru unogona kubatsira muhondo pakati pehupenyu nerufu. Saka nhasi, ngatitaurei nezvechinhu chinonzi muchina wekufema, kana kuti sezvachinonzi musainzi yekurapa, uye zvachinoita, mumutauro uri nyore uye unonzwisisika.
Zvichitaurwa zviri nyore, chii chinonzi mudziyo wekufema?
Muchina wekufema unobatsira munhu kufema kana achinetseka kufema ari ega. Funga nezvazvo sekushandisa madondoro kana uine gumbo rakatyoka. Kungofanana nemadondoro anokubatsira kufamba nehuremu hwako, muchina wekufema unobata basa rekufema remapapu ako, kungave zvizere kana kusvika pamwero wakati.
Chinhu chinonyanya kukosha ndechekuti mudziyo wekufema hausi mushonga. Inzira inotsigira hupenyu. Kureva kuti, inobatsira kuchengetedza kufema kusvika muviri wapora kuburikidza nemimwe mishonga nemishonga.
Zvinhu izvi zvinonyanya kuitika nekushandisa mudziyo wekufema:
- Inopa mapapu ako okisijeni yaanoda.
- Inobatsira kubvisa gasi rine carbon dioxide rinokuvadza rinoungana mumapapu.
- Matumba madiki emhepo ari mumapapu, anonzi alveoli, anopa simba rinodiwa kuti arambe akavhurika asingaputsike.
Vanachiremba vanogona kuchinja marongero emuchina uyu zvichienderana nezvinodiwa nemurwere.
Kupinza nhubhu nekufema zvinhu zvakasiyana here?
Ehe. Apa ndipo panovhiringika vanhu vazhinji. Kunyangwe izvi zviviri zvichiitika pamwe chete, aya maitiro maviri akasiyana.
- Kupinza dumbu muchubhu: Maitiro anoitwa nachiremba kuisa chubhu muchubhu yemhepo yemurwere (trachea) kuburikidza nemuromo wemurwere.
- Kufema Kwemuchina: Izvi zvinoreva kubatanidza chubhu inopinzwa nenzira iyi nemuchina wekufema unobatsira kufema.
Mune zvimwe zviitiko, zvinokwanisika kubatanidza mudziyo wekufema nemasiki ekumeso anokwana zvakanaka pachiso, pasina kuisa chubhu yakaita seiyi.
Ndedzipi nzira dzekufema dziripo?
Mafentilator anosundira mweya mumapapu achishandisa kumanikidzwa kwakanaka. Izvi zvinogona kuitwa nenzira mbiri huru. Kuti ruzivo urwu ruve nyore kunzwisisa, ngatigadzirei tafura yakaita seiyi.
| Rudzi rweKufefetera | Tsananguro iri nyore |
|---|---|
| Kufefetera Kwemuchina Kunopinda Munzvimbo Dzemhepo (chubhu yakaiswa) | Muizvi, chubhu inopinzwa mumhepo. Chubhu iyi inopinzwa nemuromo (intubation) kana kuburikidza nekuvhiyiwa kudiki mumutsipa (tracheostomy) uye yakabatana nemuchina wekufema. |
| Kufema kusingapindi mhepo | Izvi zvinosanganisira kushandisa chifukidziro chinokwana zvakanaka pachiso. Chifukidziro ichi chakabatana nemuchina wekufema unopinza mweya mumapapu. Midziyo yakaita seCPAP kana BiPAP®, inoshandiswa kunyangwe kumba, inowira muchikamu ichi. |
Ndiani anoda rubatsiro rwemuchina wekufema?
Rubatsiro rwemuchina wekufema unogona kudiwa chero nguva munhu asingakwanise kufema ega, kunyanya mumamiriro ezvinhu akadai seaya:
- Panguva yekuvhiyiwa: Kunzwa kusingafadzi kunoderedza kugona kwedu kufema. Saka, muchina wekufema unobatsira kuchengetedza kufema nguva dzose panguva yekuvhiyiwa.
- Utachiona kana mamiriro emapapu akanyanya: Mumamiriro ezvinhu akadai sepneumonia, COVID-19, acute respiratory distress syndrome (ARDS), uye chronic obstructive pulmonary disease (COPD).
- Njodzi kana njodzi dzehutano: Kana tsaona ikaita kuti pave nekuvharika kwenzira yekufema kana kutadza kufema. Semuenzaniso, chirwere chakakomba chinonzi anaphylaxis.
- Kukuvadzwa kwehuropi: Kukuvadzwa kwehuropi, senge sitiroko kana koma, kunogona kudzivirira kuti shoko rinobva kuuropi riende kumapapu risafambe zvakanaka.
- Kusaenzana kwehuwandu hwemagasi muropa: Mumamiriro ezvinhu akadai sekuwedzera kwecarbon dioxide muropa (hypercapnia) kana kudzikira kweokisijeni (hypoxemia).
- Kudzivirira chikafu kana mate kuti asapinde mumapapu: Kudzivirira kusvuta kwezvinhu (mate, chikafu) mumuromo memunhu asina chaanoziva zvichikonzera hutachiona.
Chii chinoitika kana wakabatana nemuchina wekufema?
Nekuti munhu akabatana nemuchina wekufema anofanira kutariswa zvakanyanya, anowanzo chengetwa muchikamu chevarwere vane chirwere chakanyanya (ICU).Ikoko, chikwata chevanachiremba vakadzidziswa zvine hunyanzvi, vanamukoti, uye varapi vezvekufema vanochengeta murwere.
Kutarisa murwere
Uchaona kuti mudiwa wako ane mimwe michina yakabatana nemuviri wake. Vanogara vachiyera zvinhu zvakaita seBP, kurova kwemoyo, kufema, uye mwero weoxygen muropa. Vanoitawo maX-ray epachipfuva uye bvunzo dzeropa.
Kubvisa
Madzihwa anogona kuungana mumhepo inofambisa mweya. Nokudaro, vashandi vekuchengeta varwere vanowanzoisa chubhu yakatetepa (catheter) kubvisa madzihwa. Panguva ino, murwere anogona kukosora. Izvi zvingasakunakira kutarisa, asi izvi zvakakosha kuti mhepo irambe yakachena.
Mishonga, kudya kunovaka muviri uye hutsanana
Mimwe mishonga inopinzwa mumapapu kuburikidza nechubhu yekufema. Sezvo vasingakwanise kudya kana kunwa, zvinovaka muviri zvinopihwa kuburikidza nechubhu inopfuudzwa nemumhino ichipinda mudumbu. Mvura inodiwa inopinzwa netsinga kuburikidza nesaline.
Murwere akamuka here?
Vanachiremba vanoedza kuchengetedza murwere akasununguka, akadzikama, uye akangwarira sezvinobvira. Zvisinei, zvichienderana nemamiriro emurwere, zvingava zvakakosha kupa murwere zororo uye kubvumira muviri kuti upore, kana kumuisa muhope dzakadzika (deep sedation). Dzimwe nguva, murwere angada kudzorwa kuti asazvikuvadze, semuenzaniso, kumudzivisa kuedza kubvisa chubhu. Izvi zvinoitirwa kuchengetedzeka kwemurwere.
Ndezvipi zvakanakira uye njodzi dzacho?
Kufanana nekurapa kupi zvako, kushandisa muchina wekufema kune zvakanakira uye njodzi.
| Zvakanakira | Njodzi |
|---|---|
| Hamufanirwe kushanda nesimba kuti mufeme. Isa pfungwa dzenyu pakupora uye kurwisa hutachiona hunogona kubatwa nemuviri wenyu. | Mabhakitiriya anogona kufamba nemu trachea kuenda kumapapu okonzera hutachiona (semuenzaniso pneumonia). |
| Muviri unowana okisijeni yakakwana yaunoda. Kabhoni dhayokisaidhi inobviswa. | Kumanikidzwa kunobva kumuchina dzimwe nguva kunogona kukuvadza mapapu. |
| Inodzivirira mabhegi emhepo ari mumapapu kuti asaputsike. | Nzvimbo isina kusimba mumapapu inogona kukonzera kuti mapapu apere (pneumothorax). |
| Zvinobatsira kuti nzira yekufema irambe yakavhurika. | Kushanda kwemoyo neBP zvinogona kukanganiswa. |
Mune zvimwe zviitiko zvakakomba, murwere anogona kusazokwanisa kufema ega zvakare. Uyewo, kuisa murwere pamuchina wekufema usina mukana wekupora kunogona kurebesa nguva yekufa. Mumamiriro ezvinhu akaomarara akadaro, zvakakosha kutaura pachena nachiremba wako uye kuita sarudzo yakanakira murwere.
Unozvibvisa sei kubva muchina wekufema?
Kana mamiriro emurwere ava nani uye vanachiremba vava nechokwadi chekuti vanogona kufema vega, vanotanga nzira yeku "bvisa" murwere kubva muchina wekufema. Kutanga, vanodzikisa zvishoma nezvishoma rutsigiro rwemuchina uye voona kana murwere achigona kufema ega. Kana zvese zvakanaka, chubhu ye endotracheal (ET tube) inobviswa.
Kana chubhu yabviswa, unogona kuva nekurwadziwa pahuro uye kuchema kwemazuva mashoma. Izvi zvakajairika.
Mharidzo Yekuenda Nayo Kumba
- Kufefetera kwemuchina hakusi mushonga wechirwere, inzira yekutsigira hupenyu inobatsira muviri kufema kusvika wapora.
- Izvi hazvina chekunetsa nazvo. Chikwata chevanachiremba chakadzidziswa muchikamu chevarwere vakanyanya kurwara chiri kutarisira murwere zvakanyanya.
- Sezvinoitwa pakurapa kwese, kune njodzi, asi timu yezvekurapa iri kuramba ichiedza kuderedza njodzi idzodzo.
- Taura pachena nachiremba wako nezvemibvunzo kana zvinokunetsa. Vachakutsanangurira mamiriro acho ezvinhu.
- Chekupedzisira, zvakakosha kuti chero ani zvake ataure zvaanoda nemhuri yake nezvekurapa kwaanofanira kuwana kana akabatwa nechirwere chakakomba, kunyangwe achiri mutano.
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