Kufema kwako kwakaderera here? (Kuora Mwoyo/Hypoventilation) - Ngatitaurei nezvazvo!

Wakambonzwa sekunge uri kunetseka kufema here, kana kuti uri kushaya mweya zvakanyanya? Pamwe wakanzwa dzungu kana kuneta. Chimwe chikonzero chingangove chiri shure kwezvinhu izvi kudzikira kwekufema, izvo zvatinodaidza nenyanzvi dzezvehutano kuti (Respiratory Depression) kana kuti (Hypoventilation) .

Chii chinonzi kufema kusuruvara?

Zvichitaurwa zviri nyore, kufema kushoma ( kana kuti hypoventilation) zvinoreva kana kufema kwako kunonoka, kana kuti uchifema zvishoma. Kana izvi zvikaitika, kuchinjana kwemhepo hakuitike zvakanaka mumapapu ako. Funga nezvazvo, patinofema, okisijeni iri mumhepo itsva inopinda muropa kuburikidza nemasagi madiki emhepo (alveoli) ari mumapapu edu. Zvakare, kabhoni dhayiokisaidhi (CO2) , inova tsvina yemuviri wedu, inodzokera mumapapu kubva muropa yoburitswa. Izvi ndizvo zvatinodaidza kuti kuchinjana kwegasi .

Zvino, kana uri paHypoventilation , zvinoitika ndezvekuti nekuti hausi kufema zvakanaka, mweya wecarbon dioxide (CO2) haubvi mumuviri woungana muropa. Tinoudaidza kuti (Hypercapnia) . Kwete izvozvo chete, dzimwe nguva mapapu anogona kusawana okisijeni yakakwana. Ipapo mwero weokisijeni muropa unodzikira, unonzi (Hypoxemia) . Unonzwisisa here?

Zviratidzo zvacho ndezvipi?

Kana wava nekufema kwakaderera (hypoventilation) , unogona kuona zviratidzo zvakaita se:

• Kusvotwa nekurutsa.
• Musoro.
• Kunzwa kuneta, hope , kana kuneta nguva dzese.
• Kuvhiringidzika, kuvhiringidzika , kana kuchinja kwechimiro chepfungwa.
• Kurova kwemoyo kunowedzera.
• Dzungu.
• Kufema kunonzwa kunonoka, kusina kudzika, kana kuti kwakaoma.
• Kuchinja ruvara rwebhuruu rweganda, miromo, kana nzara (cyanosis) . Ichi chiratidzo chakakomba.

Chii chinokonzera izvi?

Zvikonzero zvikuru zvinokonzera kushaya mweya zvinogona kuve kushandisa mishonga zvisirizvo, kushandisa zvinodhaka zvakanyanya , kana kuita zvisingatarisirwi kune zvimwe zvinodhaka kana doro. Funga nezvezvinhu izvi:

• Maopioid: Aya anonziwo mishonga inodhaka . Mienzaniso inosanganisira morphine , tramadol, oxycodone (OxyContin®) , uye fentanyl . Vamwe vanhu vanoshandisa mishonga iyi zvisina kunaka.
• Benzodiazepines:Izvi zvinowanzova mishonga yekunyaradza uye mapiritsi ekurara. Mienzaniso inosanganisira lorazepam (Ativan®) , alprazolam (Xanax®) , uye diazepam (Valium®) .
• Mishonga yeBarbiturates: Dzimwe nguva mishonga iyi inopihwa kune vanhu vane pfari kana migraine .
• Mishonga isiri pamutemo: Zvinhu zvakaita seheroin negamma hydroxybutyrate (GHB) .
• Mapiritsi ekurara: Mishonga inonyorwa nachiremba seyolpidem (Ambien®) .
• Anesthesia: Inogonawo kukonzerwa nemushonga unopihwa kuti unzwe hope usati wavhiyiwa.

Kuwedzera kune mishonga iyi, zvimwe zvirwere zvinogona kukonzera hypoventilation :

• Kufuta: Izvi zvinonzi Obesity Hypoventilation Syndrome (OHS) . Zvinoreva kuti kufema kunova kwakaoma nekuda kwekufuta.
• Matambudziko anokonzera kufema zvakaoma: Semuenzaniso, chirwere chemapapu chinogara kwenguva refu (COPD) uye kufema kusingadzoreki .
• Matambudziko anoderedza kufema: Semuenzaniso , sitiroko uye hypothyroidism .
• Matambudziko anokanganisa musana, tsinga, kana kudzora tsandanyama: Mienzaniso inosanganisira muscular dystrophy, tsinga kana spinal cord disorders, multiple sclerosis (MS) , uye amyotrophic lateral sclerosis (ALS) .
• Kuchinja kwechimiro chechipfuva kana musana: Zvirwere zvakaita se scoliosis ( kukombama kwemusana), ankylosing spondylitis, uye flail chest .
• Chepfu kana chepfu: Zvinhu zvakaita se tetanus , chepfu ye ciguatera, uye botulism .

Ndezvipi zvinhu zvinowedzera njodzi?

Njodzi yekufema zvishoma inogona kuwedzera nekuda kwezvikonzero zvinotevera:

• Kushandisa mishonga isina kunaka yakaita semaopioid kana benzodiazepines .
• Kana wakambovhiyiwa nguva pfupi yadarika (nekuda kwekushandisa mushonga weanesthesia).
• Kana paine zvimwe zvirwere zvemapapu, tsandanyama, uye tsinga (uropi nemusana), sezvatakakurukura pamusoro apa.

Ndezvipi zvinetso zvinogona kukonzera izvi?

Kabhoni dhayiokisi muropa rakoKana huwandu hweCO2 hukakwira zvakanyanya, zvinogona kukonzera matambudziko ane njodzi, kunyange kutyisidzira hupenyu. Tarisa:

• Respiratory Acidosis: Izvi zvinoreva kuti ropa rako rine acid yakawanda kupfuura zvarinofanira kuva.
• Kutadza Kufema: Apa ndipo apo nhengo dzemuviri wako hadzina kuwana okisijeni yakakwana.
• Kumira kwemwoyo: Kumira kwemoyo kamwe kamwe.
• Kushaya simba.
• Pulmonary Hypertension: Kuwedzera kwedzvinyiriro mutsinga dzeropa dzakabatana nemapapu.

Unoona sei izvi?

Kuti vaongorore kushushikana kwekufema , chiremba anotanga nekukubvunza nezvezviratidzo zvako, nhoroondo yako yezvekurapa, uye chero mishonga yauri kutora. Zvadaro, vanogona kuraira kuongororwa kweropa kwakakosha kuti vaone huwandu hwecarbon dioxide (CO2) muropa rako. Vanogonawo kuraira mimwe miedzo kuti vaone kuti chii chiri kukonzera hypoventilation .

Ndedzipi mhando dzebvunzo dzinoitwa?

Miedzo yakaita seiyi inogona kuitwa kuti pave nechikonzero chikuru chekupererwa nemhepo:

• Kuongororwa kweGasi reRopa reArterial: Izvi zvinoongorora huwandu hweokisijeni, kabhoni dhayokisaidhi, uye acidity muropa.
• Miedzo yeMashandiro eMapupa: Iyi miedzo inoongorora kuti mapapu ako ari kushanda zvakanaka sei.
• Pulse Oximetry: Mudziyo unoyera huwandu hweokisijeni muropa rako nekubatanidza kachidhindo kadiki pamunwe wako. Ungave wakamboona izvi.
• Kuongororwa Kweropa: Kune mimwe miedzo yakawanda yeropa inogona kubatsira kuona chirwere ichi kana zvikonzero zvacho. Mienzaniso inosanganisira Complete Blood Count (CBC) , Basic Metabolic Panel (BMP) , Toxicology Screen (yekutarisa zvinhu zvakaita semishonga), Carbon Dioxide (CO2) blood test, uye Thyroid Function Tests.
• Kufungidzira: Chiremba anogona kuraira X-ray yechipfuva chako, CT scans (Computed Tomography scans) yechipfuva chako kana musoro kuti aone zvimwe zvirwere zvirimo.
• Chidzidzo Chekurara / Polysomnography: Bvunzo iyi inobatsira kuona mamiriro akaita sesleep apnea uye obesity hypoventilation syndrome .

Inorapwa sei?

Kurapa kwekushaya mweya kunoenderana nechikonzero uye kuti chirwere chacho chakakomba sei. Vanachiremba vanogona kukupa mishonga yakaita se:

• Kufema Kusingapindi: Izvi zvinosanganisira kushandisa muchina unokubatsira kufema nemasiki inokwana pachiso chako. Semuenzaniso, muchina weContinuous Positive Airway Pressure (CPAP) kana muchina weBilevel Positive Airway Pressure (BiPAP®) . Ungave wakambonzwa nezvazvo.
• Mishonga Inosimudzira Kufema: Dzimwe nguva, kana chirwere ichi chikakonzerwa nekuwedzerwa kweropa kana semhedzisiro yemushonga, mishonga inodzosera simba inogona kupihwa. Semuenzaniso, kana chirwere ichi chikakonzerwa neopioids , mhedzisiro yacho inogona kuderedzwa nekupa mushonga unonzi Naloxone/Narcan® .
• Kurapa Neokisijeni: Okisijeni inogona kupiwa kana zvichidikanwa.
• Kufema Nemichina: Kana chirwere chacho chakakomba, munhu angada kupiwa mushonga wekuzorora, kuiswa muchubhu, uye kufema nemuchina.

Mamiriro ezvinhu akaita sei anogona kutarisirwa mune ramangwana? (Outlook)

Kufanotaura kwemunhu ane dambudziko rekufema kunoenderana nechikonzero chacho. Dambudziko rekukurumidza, rakadai sekunwa opioid yakawanda, rinogona kuuraya kana rikasarapwa nekukurumidza. Zvisinei, kana dambudziko iri rikakonzerwa nesleep apnea, obesity-related obstructive sleep apnea syndrome ( OHS ) , kana zvimwe zvirwere zvenguva refu, zvinoda kurapwa nguva dzose uye zvichavandudzika zvishoma nezvishoma.

Zvingadzivirirwe here?

Nzira yakanakisisa yekudzivirira kushaya mweya ndeyekutora mishonga yako sezvakarairwa uye kugadzirisa chero matambudziko aripo. Iva nechokwadi chekubvunza chiremba wako kana wemishonga usati watora mishonga miviri kana kupfuura, kunyanya opioids nebenzodiazepines, iyo inoderedza kushushikana kwako kana kuti inokuita kuti unzwe hope. Zvakare , ziva nezvemigumisiro yakaipa inogona kuitika kana mishonga iyi ikatorwa nedoro.

"Mushonga ishamwari kana ukashandiswa nemazvo, asi muvengi kana ukashandiswa zvisizvo."

Ndinofanira kuona chiremba rini?

Taura nachiremba wako mune izvi zviitiko:

• Kana muine mibvunzo kana kusava nechokwadi nezvechirwere chamuinacho.
• Kana muine mibvunzo kana kusava nechokwadi nezvemushonga wakanyorerwa nachiremba.
• Kana uine zviratidzo zvekupererwa nemhepo, kunyanya kana uine zvimwe zvirwere zvinowedzera njodzi yako.

Unofanira kuenda kuEmergency Treatment Unit (ETU) riini?

Kana uine chimwe chezviratidzo izvi zvakakomba , enda kuchipatara chiri pedyo nekukasika:

• Kana uine pfari .
• Kana mamiriro epfungwa achinja uye paine kuvhiringidzika .
• Kana uchinzwa hope zvekuti haugone kuramba wakamuka.
• Kana usina chokwadi chekuti uri kupi uye kuti uri riini.
• Kana uchinzwa kutya kana kufungira zvisina kujairika (paranoia) .
• Kana ganda, nzara, kana miromo zvikaita bhuruu.

Mibvunzo ipi yaunofanira kubvunza chiremba?

Zvingabatsira kubvunza chiremba wako mibvunzo yakaita seiyi:

• "Sei izvi zvakaitika kwandiri?"
• "Ndinofanira kuitei kuti ndidzivise kuti chimwe chinhu chakadai chisaitike mune ramangwana?"
• "Ndedzipi nzira dzekurapa dzandinadzo?"

Pakupedzisira, zvinhu zvekurangarira (Mharidzo Yekuenda Kumba)

Kuora mwoyo kwekufema chirwere chakakomba apo carbon dioxide (CO2) inoungana muropa rako. Asi kazhinji inogona kudzivirirwa. Kana uri kutora mishonga inogona kukonzera kuora mwoyo kwekufema, taura nachiremba wako kuti uve nechokwadi chekuti uri kuitora nemazvo uye zvakachengeteka. Kana uine chimwe chirwere chinogona kukonzera chirwere ichi, bvunza chiremba wako nezvematanho aunogona kutora kuderedza njodzi yako. Iye anogona kutaura newe nezvezvinokunetsa uye kugadzira hurongwa hwekutarisira chirwere chako nemishonga yako zvakachengeteka. Kutarisira hutano hwako ndicho chinhu chakakosha.

Kuora mwoyo kwekufema, kushaya mweya wakawanda, kufema kushoma, carbon dioxide, okisijeni, chirwere chemapapu, kushandisa zvinodhaka zvisina kunaka