Ngaba wakha weva ngomntu okwiyunithi yokhathalelo oluphezulu (ICU) onengxaki yokuphefumla kwaye eqhagamshelwe kwi-ventilator? Mhlawumbi senzeke komnye wakho. Isizathu esiphambili soku sidla ngokuba yimeko yempilo embi esiza kuthetha ngayo ebizwa ngokuba yi-ARDS. Igama lisenokuvakala liyoyikisa kancinci, kodwa ungakhathazeki. Siza kulichaza ngendlela elula onokuyiqonda.
Yintoni kanye kanye i-ARDS?
Ngamafutshane, i-ARDS yingozi enkulu emiphungeni yakho. Cinga ngemiphunga yakho njengeziqwenga ezibini zesiponji. Ngokwesiqhelo, xa siphefumla, ezi siponji zizaliswa ngumoya. Kodwa kwi-ARDS, iingxowa zomoya ezincinci ngaphakathi kwezi miphunga (ezibizwa ngokuba yi-alveoli) ziqala ukuzaliswa lulwelo.
Khawucinge nje, xa isiponji sifunxa amanzi, akukho ndawo yokungena komoya omninzi kuwo. Kwenzeka into efanayo nasemiphungeni. Xa amanzi egcwala endaweni yomoya, imiphunga ayikwazi ukuzalisa umoya ngokufanelekileyo. Ngenxa yoko, igazi alifumani umlinganiselo ofunekayo weoksijini. Kwizonyango, le meko siyibiza ngokuba yi -`(hypoxia)` . Oku kuyingozi kakhulu.
Kuba ioksijini ibalulekile ukuze zonke ezinye izitho zomzimba wethu, njengengqondo, intliziyo, kunye nezintso, zisebenze. Xa ioksijini ingekho, ezo zitho ziqala ukusebenza kakubi nganye nganye.
Oogqirha badla ngokuhlela i-ARDS ibe ngamanqanaba amathathu - aphantsi, aphakathi, kunye naqatha. Oku kuqinisekiswa ngokuthelekisa inqanaba leoksijini egazini lakho kunye nobungakanani beoksijini ekufuneka uyinike ngaphandle ukuze ubuyisele elo nqanaba kwinqanaba elifanelekileyo.
I-ARDS idla ngokuvela xa umntu elaliswe esibhedlele ngenxa yolunye usulelo, ukugula, okanye ingozi enkulu. Nangona kunjalo, ukuba ufumanisa ezi mpawu nokuba awulaliswanga esibhedlele, kubalulekile ukufuna unyango ngokukhawuleza.
Ziziphi iimpawu eziphambili zale meko?
Iimpawu ze-ARDS zinokwahluka ngokuxhomekeke kwisizathu, ubukhali bemeko, kunye nazo naziphi na izifo zentliziyo okanye zemiphunga ezikhoyo onazo. Nangona kunjalo, kukho iimpawu eziqhelekileyo.
| Uphawu | Inkcazo |
|---|---|
| Ubunzima obukhulu bokuphefumla | Kunzima kakhulu ukuphefumla, ngokungathi uyafuthanisela. |
| Ukuphefumla okukhawulezayo nokunzima | Inani lokuphefumla liyanda. Kuthatha umgudu omkhulu ukuphefumla ngakunye. |
| Ukubetha kwentliziyo | Intliziyo yam ivakala ngathi ibetha ngokukhawuleza. |
| Imilebe eluhlaza okwesibhakabhaka kunye neenzipho | Xa inqanaba leoksijini egazini lehla ngendlela eyingozi, imilebe kunye neenzipho ziqala ukujika zibe luhlaza okwesibhakabhaka. Le yimeko engxamisekileyo. |
I-ARDS idla ngokuvela kwiiyure okanye kwiintsuku emva kwesiganeko esibangela esi sifo, kwaye imeko inokuba mandundu ngokukhawuleza.
Zithini izizathu ze-ARDS?
I-ARDS ayisosifo esizenzekela ngokwaso. Sivela ngenxa yesinye isifo okanye ingozi. Makhe sijonge ezinye zezizathu eziphambili apha ngezantsi.
| Isizathu | Ingcaciso elula |
|---|---|
| I-Sepsis | Le yeyona nto ibangela i-ARDS. Kalula nje, usulelo olunzima (umz. i-pneumonia ) emzimbeni alulawuleki kwaye lusasazeka emzimbeni wonke. |
| Ukufuthwa kokutya/ulwelo emiphungeni | Ukuba ukutya okanye isiselo okanye umxholo wesisu uhamba ngengozi nge-trachea uye emiphungeni, kunokubangela umonakalo omkhulu emaphashini kwaye kukhokelele kwi-ARDS. |
| Ukunikela ngegazi ngobuninzi | Ukuba umzimba unikwa iiyunithi zegazi ezingaphezu kwe-15 ngexesha elifutshane, kukho umngcipheko we-ARDS. |
| Intsholongwane ye-covid19 | Izigulana ezinosulelo olukhulu lwe-COVID-19 zinokuba ne-ARDS. |
| I-Pancreatitis | Ngenxa yokuvuvukala okukhulu okanye usulelo lwepancreas. |
| Iingozi ezinkulu okanye ukutsha | Ukonakala kwemiphunga okanye ezinye izitho zomzimba ngenxa yengozi enkulu okanye ukutsha. |
| Ukuphefumla umsi onetyhefu | Ukonakala kwemiphunga ngenxa yokuphefumla umsi onobungozi weekhemikhali okanye umsi omninzi. |
| Ukugqithisa iziyobisi | Ukusetyenziswa kakhulu kweziyobisi ezifana ne-cocaine kunye ne-heroin. |
| Ukuntywiliselwa emanzini | Xa kutshona, amanzi angena emiphungeni anokubangela umonakalo omkhulu. |
Ngubani osengozini enkulu?
Abantu abasele belele esibhedlele ngenxa yokugula okanye ingozi basengozini enkulu yokufumana i-ARDS. Nangona kunjalo, ayinguye wonke umntu olele esibhedlele ofumana le ngxaki. Kukho ezinye izinto ezininzi ezonyusa umngcipheko:
- Ukuba uneminyaka engaphezu kwama-65 ubudala.
- Ukusetyenziswa kwecuba (ukutshaya).
- Ukuxhomekeka kwiziyobisi okanye utywala.
- Ukuba nesifo semiphunga esele sikhona.
Ezinye iingxaki ezinokwenzeka ngenxa ye-ARDS
I-ARDS ayichaphazeli imiphunga kuphela. Inokubangela iingxaki ezahlukeneyo, zombini xa usesibhedlele naxa sele ubuyele ekhaya.
- Amahlwili egazi: Amahlwili egazi anokwakheka ngaphakathi kwemithambo yegazi, ingakumbi emilenzeni. Oku sikubiza ngokuba yi-"deep vein thrombosis - DVT``.
- Ukuwa kwemiphunga: Umphunga owonakeleyo ungaqhuma (pneumothorax) ngenxa yoxinzelelo olukhutshwa yi-ventilator.
- Ukuphambana: Ukuphambana.
- Ukungasebenzi kakuhle kwamalungu amaninzi: Ukungasebenzi kakuhle kwamalungu afana nengqondo, intliziyo, nezintso ngaxeshanye.
- Ubuthathaka bemisipha: Imisipha iba buthathaka ngenxa yokuba sebhedini kangangeentsuku.
- Ukuvaleka kwemiphunga: Izicubu ezivalekileyo zinokwenzeka njengoko imiphunga iphola (lung fibrosis).
- Iingxaki zengqondo: Emva kokujamelana namava amabi kangaka, iimeko ezifana ne-post-traumatic stress disorder (PTSD), ixhala, kunye nokudakumba zinokwenzeka.
Oogqirha bayibona njani le nto?
Ngenxa yokuba iimpawu ze-ARDS zifana nezinye izifo zentliziyo okanye zemiphunga, oogqirha benza iimvavanyo ezininzi ukuqinisekisa ukuba yi-ARDS.
- I-X-reyi yesifuba: Ukubona ukuba lungakanani ulwelo olusezimpumlweni.
- Uvavanyo lwegazi: Linganisa inqanaba leoksijini egazini uze ubone ubukhali be-ARDS.
- I-Echocardiogram: I-ultrasound scan ukujonga ukusebenza kwentliziyo.
- I-ECG (i-Electrocardiogram): Jonga umsebenzi wombane wentliziyo.
- I-Pulse Oximetry: Ukujonga rhoqo amanqanaba eoksijini kusetyenziswa isixhobo esincinci esincamathiselwe emnweni.
- I-CT scan: Fumana ulwazi oluthe kratya malunga nemiphunga.
- Ukuhlolwa kwencindi yokuphefumla: Fumana unobangela wosulelo.
Iphathwa njani?
Injongo ephambili yonyango lwe-ARDS kukunyusa amanqanaba eoksijini egazini nokuthintela amanye amalungu omzimba ukuba angasebenzi. Ukuze benze oku, ngokuqinisekileyo izigulana zidinga i-mechanical ventilator kunye ne-oxygen therapy .
Lonke olu nyango lwenzeka kwiyunithi yokhathalelo olunzulu (ICU), phantsi kweliso eliqhubekayo loogqirha abaziingcali kunye nabasebenzi bobuhlengikazi.
Ukongeza, oogqirha benza ezinye izinto ezininzi ukunciphisa iingxaki.
- Kunikwa amayeza okuthomalalisa iintlungu nokungonwabi.
- Isigulana siguqulwa sibe kwindawo ethe nkqo endaweni yokuba sime nkqo. Oku kuvumela ioksijini ukuba ihambe lula ukuya emiphungeni.
- Kunikwa izinto zokunciphisa igazi ukuthintela ukuqhekeka kwegazi.
- I-diuretics inikwa ukususa ulwelo olugqithisileyo emzimbeni nasemiphungeni.
- Nyanga okanye uthintele izifo ukuba zikhonaKunikwa amayeza okubulala iintsholongwane.
- Unyango lomzimba lusetyenziselwa ukuthintela ubuthathaka bemisipha.
Kuthatha ixesha elingakanani ukuphola kunye nethemba lokuphila?
Ixesha elithathwayo lixhomekeke kubukhulu besifo kunye nesantya sokuchacha kwemiphunga. Ngokwesiqhelo, kunokuthatha iinyanga ezintandathu ukuya kunyaka ukuba umntu abuyele ekusebenzeni kwemiphunga yakhe eqhelekileyo emva kwe-ARDS. Nangona kunjalo, abanye abantu abaphili ngokupheleleyo.
Amanani okusinda kwi-ARDS ngoku anyuke kakhulu. Ukuba anyangwa kwangethuba, phakathi kwama-55% nama-70% ayasinda. Nangona kunjalo, eli nani liyehla ukuba unyango luye lwalibaziseka okanye ukuba amanye amalungu omzimba aqala ukungasebenzi kakuhle.
Ukuchacha luhambo olude. Uninzi lwabantu luyakwazi ukuphefumla bodwa emva kokukhutshwa kwi-ventilator. Abanye bayakwazi ukuchacha ngokupheleleyo. Abanye banokuba neengxaki zemiphunga ixesha elide. Kuya kufuneka baqhubeke bejongwa yingcali yemiphunga.
Khumbula, ukuchitha ixesha kwigumbi lokhathalelo oluphezulu lixesha elinzima kakhulu kwisigulana nakwintsapho. Inkxaso yosapho lwakho kunye nabahlobo bakho iya kuba yinto ebaluleke kakhulu kuwe kuhambo lwakho lokuchacha.
Umyalezo Wokuya Ekhaya
- I-ARDS yimeko embi kakhulu, esongela ubomi ebangelwa lulwelo oluzalisa iingxowa zomoya zemiphunga.
- Esi asisosifo esizenzekela ngokwaso; sidla ngokuba sisiphumo senye imeko yezonyango, efana ne-sepsis, i-pneumonia, okanye iingozi ezinkulu.
- Iimpawu eziphambili kukuphefumla kancinci, ukuphefumla ngokukhawuleza, kunye neoksijini ephantsi egazini.
- Unyango lunikezelwa kwiYunithi yoKhathalelo oluNzulu (i-ICU) ngoncedo lwee-ventilators kunye ne-oxygen.
- Ukuchacha kungathatha iinyanga okanye unyaka, kwaye luhambo olude nolunomonde.
- Ukuba wena okanye umntu omaziyo unengxaki yokuphefumla, kubalulekile ukuya kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele ngoko nangoko.
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