Ngaba imiphunga yakho inengxaki yokuphefumla? Masifunde ngale ARDS iyingozi (i-Acute Respiratory Distress Syndrome)!

Ngaba wakha wakufumanisa kunzima ukuphefumla ngequbuliso, uvakalelwa kukuba isifuba sakho sixinene? ​​Okanye uyakhumbula ixesha apho umntu omaziyo wagula kakhulu ngequbuliso, akakwazi ukuphefumla kakuhle waza wangeniswa kwigumbi lonyango oluphezulu (ICU) esibhedlele? Mhlawumbi unobangela yayiyimeko ebizwa ngokuba yi-ARDS (Acute Respiratory Distress Syndrome) . Oku kunzulu kancinci, kodwa ukuba unolwazi olufanelekileyo, kulula ukuqonda izinto ezininzi. Makhe sithethe ngale nto ngokweenkcukacha, akunjalo?

Yintoni i-ARDS? Masiyiqonde ngokulula.

Ngamafutshane, i-ARDS yimeko enzima echaphazela imiphunga yethu. Cinga ngale ndlela: Imiphunga yethu ineengxowa zomoya ezincinci (ezibizwa ngokuba yi-alveoli). Zifana neediliya ezincinci kumdiliya. Xa siphefumla, ezi ngxowa zomoya zithatha ioksijini emoyeni ziyikhuphele egazini. Kodwa xa i-ARDS isenzeka, ezi ngxowa zomoya zizala lulwelo. Ifana nebhaluni yamanzi. Emva koko imiphunga ayinakuzaliswa ngumoya ngokufanelekileyo, kwaye ubungakanani beoksijini engena egazini buyehla kakhulu. Oku sikubiza ngokuba yi-hypoxia. Oogqirha badla ngokuhlela i-ARDS njengethambileyo , ephakathi, okanye enzima . Imiselwa ngokuthelekisa inqanaba leoksijini egazini kunye nobungakanani beoksijini ekufuneka ifike kuloo nqanaba. I-ARDS inokubangela ukuba amanye amalungu abalulekileyo anjengengqondo yethu, intliziyo, izintso, kunye namathumbu angafumani ioksijini abayidingayo. Ke ngoko, i-ARDS yimeko eyingozi enokuba yingozi nakubomi. I-ARDS idla ngokuvela xa umntu enyangwa esibhedlele ngenxa yolunye usulelo, ukugula, okanye ingozi. Nangona kunjalo, ukuba uphuhlisa ezi mpawu ekhaya, kubalulekile ukufuna unyango ngokukhawuleza.

Ngaba kukho izigaba ezintathu ze-ARDS?

Oogqirha ngamanye amaxesha bahlulahlula i-ARDS ibe ngamanqanaba amathathu: i-Exudative, i-Proliferative, kunye ne-Fibrotic. Oku kubhekisa kakhulu kwinqanaba lokudumba kunye nokwakheka kolwelo emiphungeni, kwaye emva koko indlela imiphunga eqala ngayo ukuphola. Asinguye wonke umntu oqhubekela kwiSigaba sesi-3. Eli nqanaba libandakanya ukuvaleka kwemiphunga (`(Lung fibrosis)`) kunye nesidingo sokuphefumla rhoqo ngomatshini.

Ixhaphake kangakanani i-ARDS?

Le yimeko embi kakhulu. Ichaphazela abantu abamalunga nama-200,000 ngonyaka eMelika kuphela. Kwihlabathi liphela, ichaphazela abantu abamalunga nezigidi ezi-3 ngonyaka. I-ARDS inoxanduva malunga ne-10% yabo bonke abantu abangeniswa kwigumbi lonyango oluphezulu (ICU). Ikwanoxanduva malunga ne-25% yabo bonke abantu abangeniswa esibhedlele ukuze bafumane umoya ococekileyo.

Zithini iimpawu ze-ARDS? Uzibona njani?

Iimpawu ze-ARDS zinokwahluka ngokuxhomekeke kwisizathu, ubukhali bemeko, kunye nazo naziphi na izifo zemiphunga okanye zentliziyo ezikhoyo onazo. Iimpawu eziphambili zezi:

• Ubunzima obukhulu bokuphefumla :Kuvakala ngathi awukwazi ukuphefumla, ngathi uyafuthanisela.
• Ukuphefumla okukhawulezayo nokunzima: Ukuphefumla ngomzamo omkhulu, ngokungathi uphefumla nzima.
• Isantya sentliziyo siyanda.
• Ukutshintsha kombala oluhlaza okwesibhakabhaka kweenzipho nemilebe: Oku kubangelwa kukuncipha kwamanqanaba eoksijini egazini.

Khawucinge nje, uMnu. Nalin wayenomkhuhlane omkhulu kunye nokukhohlela kangangeentsuku ezimbini. Ngequbuliso, waba nobunzima bokuphefumla, isifuba sakhe saba nzima. Umfazi wakhe waphawula ukuba iinzipho zakhe zazisiba luhlaza okwesibhakabhaka. Bakuba bephuthume esibhedlele, oogqirha bathi kusenokwenzeka ukuba yi-ARDS .

I-ARDS inokuvela kwiiyure ezimbalwa ukuya kwiintsuku emva kwesiganeko esibangela loo nto, kwaye inokuba mandundu ngokukhawuleza.

Zithini izizathu ze-ARDS?

Zininzi izinto ezinokubangela i-ARDS. Makhe sijonge ezona ziphambili:

• I-Sepsis : Eyona nto ibangela i-ARDS yimeko ebizwa ngokuba yi-sepsis. Le meko inokwenzeka xa usulelo olunzima emiphungeni yakho (njenge- pneumonia ) okanye usulelo kwelinye ilungu lomzimba lusasazeka emzimbeni wakho wonke, nto leyo ebangela ukudumba okukhulu.
• I-Aspiration pneumonia: Ukuba okungaphakathi esiswini (ukutya, ulwelo) kungena emiphungeni, kunokubangela umonakalo omkhulu emiphungeni kunye ne-ARDS. Oku kwenzeka xa into esiyityayo okanye esiyiselayo ingena kwimibhobho yomoya. Oku kunokwenzeka ngakumbi kumntu ongazi nto okanye osele ekhulile.
• Utofelo-gazi: Kukho umngcipheko we-ARDS ukuba unikwa iiyunithi zegazi ezingaphezu kwe-15 kwixesha elifutshane.
• I-Covid-19 `( COVID-19 )`: Intsholongwane ye-Covid-19 inokubangela i-ARDS enzima.
• I-Pancreatitis : Ukuvuvukala okukhulu kwe-pancreas.
• Iingozi ezinkulu okanye ukutsha: Iingozi kunye nokuwa kungonakalisa imiphunga ngokuthe ngqo, okanye kungonakalisa amanye amalungu omzimba kwaye kubangele ukudumba okukhulu emiphungeni.
• Ukulimala kokuphefumla: Ukuphefumla umsi okanye umsi oxutyiweyo kakhulu weekhemikhali.
• Ukugqithisa iziyobisi: Ukusela iziyobisi ezininzi, ezifana ne-cocaine okanye ii-opioids.
• Ukuminza okanye ukusondela ekuminzeni: Xa uminza, amanzi angena emiphungeni yakho aze ayonakalise.

Ngubani osengozini enkulu ye-ARDS?

I-ARDS idla ngokukhula kubantu abasele belele esibhedlele ngenxa yengozi okanye ukugula. Nangona kunjalo, akuthethi ukuba uza kuba nayo kuba nje usesibhedlele. Kukho izinto ezininzi ezandisa umngcipheko wakho:

• Ukuba uneminyaka engaphezu kwama-65 ubudala.
• Ukusetyenziswa kwecuba (ukutshaya icuba).
• Ukusetyenziswa kweziyobisi.
• Ukuba nesifo semiphunga esele sikhona.

Ziziphi iingxaki ezinokubakho ze-ARDS?

I-ARDS inokubangela iingxaki ezahlukeneyo, zombini xa usesibhedlele naxa sele ubuyele ekhaya. Ezinye zazo zezi:

• Amahlwili egazi okanye i-deep vein thrombosis (DVT).
• I-Pneumothorax: Oku kunokwenzeka ngenxa yoxinzelelo olukhutshwa yi-ventilator kwimiphunga eyonakeleyo neqinileyo.
• Ukuphambana kwengqondo: Ukuphazamiseka kwengqondo.
• Ukungasebenzi kakuhle kwamalungu amaninzi .
• Ubuthathaka bemisipha.
• Ukuvaleka kwemiphunga okanye i-fibrosis.
• Ingxaki Yoxinzelelo Emva Kwengozi (PTSD)
• Iingxaki zempilo yengqondo ezifana nokuxhalaba kunye nokudakumba .

Uyixilonga njani i-ARDS? (Ukuxilongwa)

Oogqirha baxilonga i-ARDS ngokusekelwe kuvavanyo lomzimba kunye neziphumo zovavanyo oluninzi. Ngenxa yokuba iimpawu ze-ARDS zifana nezo zeengxaki ezingapheliyo zemiphunga okanye zentliziyo, ugqirha kufuneka akhuphe ezinye izizathu. Ugqirha angayalela indibaniselwano yovavanyo, olufana:

• I-X-reyi yesifuba: Ukubona ukuba lungakanani ulwelo olusezimpumlweni.
• Uvavanyo lwegazi: Lulinganisa inqanaba leoksijini egazini kwaye luchonge ubukhali be-ARDS.
• I-Echocardiogram (uvavanyo lwentliziyo lwe-ultrasound): Jonga indlela intliziyo esebenza ngayo.
• I-Electrocardiogram (EKG): Ilinganisa umsebenzi wombane wentliziyo.
• Inzwa yeminwe `(Pulse oximetry)`: Qhubeka ubeka esweni amanqanaba eoksijini.
• I-CT scan (i-Computed Tomography - i-CT scan): Fumana ulwazi oluthe kratya malunga nemiphunga.
• Ukuthatha isampuli yencindi evela kwindlela yokuphefumla: Fumana unobangela wosulelo.

Zithini iindlela zonyango ze-ARDS?

Injongo ephambili yokunyanga i-ARDS kukunyusa amanqanaba eoksijini egazini nokuthintela ukungasebenzi kakuhle kwamalungu omzimba. Abantu abane-ARDS banokufuna i-mechanical ventilator kunye/okanye unyango lweoksijini ukuze kwandiswe amanqanaba eoksijini egazini. Basenokufuna uncedo lokuvula iindlela zomoya ezivalwe ngumonakalo. Ugqirha wakho unokuthatha amanyathelo okunciphisa iingxaki ze-ARDS, ezinje:

• Ukunika iipilisi zokulala (ukuthomalalisa) ukunceda ukulawula iintlungu nokuhlala uzolile.
• Endaweni yokukujika ujonge phantsi, zibeke kwindawo ethe tye. Oku kuphucula ukuhamba kweoksijini.
• Yenza uvavanyo lokuphefumla uze umisele ixesha elifanelekileyo lokususa ityhubhu kunye ne-ventilator.
• Ukunika amayeza okunciphisa igazi ukuthintela ukuqhekeka kwegazi.
• Ukunika amayeza okukhupha ulwelo olugqithisileyo emzimbeni.
• Ukunika amayeza okunciphisa ukwakheka kolwelo emiphungeni.
• Ii-antibiotics zinikwa ukuthintela usulelo okanye ukunyanga usulelo olukhoyo.
• Nika intshukumo esebenzayo kunye nonyango lomzimba ukuthintela ubuthathaka bemisipha.
• Ukudluliselwa kwiinkqubo zokuvuselela imiphunga ukuze kuqiniswe imiphunga kwaye kwandiswe amandla emiphunga.

Kuthatha ixesha elingakanani ukuchacha kwi-ARDS? Lingakanani izinga lokuchacha?

Kuxhomekeke kubunzima bemeko kunye nokuba kuthatha ixesha elingakanani ukuba imiphunga yomntu ibuyele esiqhelweni. Uninzi lwezifundo lubonisa ukuba kudla ngokuthatha iinyanga ezintandathu ukuya kunyaka ukuze umsebenzi oqhelekileyo wemiphunga ubuye emva kwe-ARDS. Nangona kunjalo, abanye abantu abaphindi baphile ngokupheleleyo. Izinga lokusinda kwi-ARDS limalunga ne-55% ukuya kwi-70% , ukuba linyangwa ngokukhawuleza. Izinga lokusinda liyancipha ukuba unyango lulibaziseka okanye ukuba amanye amalungu omzimba aqala ukungasebenzi kakuhle. Ingqikelelo yakho imiselwa zizinto ezifana neemeko zakho zempilo ezisisiseko, imbali yezonyango, kunye nobunzima bokuphefumla kwakho. Ugqirha wakho uza kuxoxa nawe ngale nto.

Ngaba ii-ARDS zinokuthintelwa?

Akukho ndlela ithile yokuthintela i-ARDS. Nangona kunjalo, ukuba uneempawu zokuphefumla okufutshane, okanye ukuba unomonakalo wemiphunga okanye enye imeko, ukufuna uncedo lwezonyango ngokukhawuleza kunokunceda ukuthintela imeko ukuba ingabi mandundu. Ukuphepha ukutshaya nokunciphisa ukusetyenziswa kotywala kunokunciphisa umngcipheko wokuba ne-ARDS enzima.

Bunjani ubomi emva kwe-ARDS? Yintoni esifanele siyiqaphele?

I-ARDS inokuba yingozi kwaye yoyike. Kodwa ngonyango oluphuculweyo kunye nenkxaso yokuphefumla (ingakumbi ukujika izigulana zilale ukuze kuphuculwe ukuhanjiswa kweoksijini), abantu abaninzi ngoku bayasinda, kwaye iingxaki ze-ARDS ziyancipha. Abantu abangaphantsi kweminyaka engama-65 kunye nabo bafumana i-ARDS emva kwengozi okanye utofelo-gazi ngokubanzi banesimo sengqondo esingcono. Ukuchacha kwi-ARDS kungathatha ixesha elide. Abantu abaninzi abasusiweyo kwi-ventilator bayakwazi ukuphefumla ngokukhululekileyo. Abanye bayachacha ngokupheleleyo, kodwa abanye banokuba neengxaki zemiphunga ezingapheliyo. Bafuna ukhathalelo lwengcali yemiphunga (i-pulmonologist).

"Umama waba ne-ARDS waza wahlala esibhedlele iinyanga ezininzi. Kwanasemva kokuba ebuyele ekhaya, wayedinwe kakhulu. Wayengakwazi nokwenza neyona misebenzi incinci. Kodwa emva kokulandela imiyalelo yoogqirha nokwenza unyango lomzimba, kancinci kancinci uya esiba ngcono. Ngeli xesha, inkxaso nothando losapho lwakhe zixabiseke kakhulu."

Ubomi emva kwe-ARDS bunokuba nzima. Yiba nomonde kwaye ufune inkxaso kusapho nakubahlobo njengoko uphila. Ungadinga uncedo ngemisebenzi yemihla ngemihla de imiphunga yakho ibuyele esiqhelweni. Thetha nogqirha wakho malunga namaqela enkxaso okanye ezinye izixhobo ezinokukunceda ufumane amandla akho kwakhona.

Yintoni enxulumene ne-COVID-19 kunye ne-ARDS?

Ezi azifani. Umntu one-COVID-19 unokufumana i-ARDS xa intsholongwane ifika emiphungeni. Abaphandi bathi izinga lokusinda komntu one-COVID-19 kunye ne-ARDS limalunga ne-50% ukuya kwi-60%. Kodwa oku kuxhomekeke kwizinto ezininzi, njengembali yempilo kunye nezinye iimeko zonyango. Ukuchitha ixesha kwigumbi lokhathalelo olunzulu (ICU) kunokuba ngamava anzima nanzima. Abantu abachachayo kwi-ARDS basenokungakwazi ukubuyela kubomi babo besiqhelo ngokukhawuleza, ngoko ke ngokuqinisekileyo uyayidinga inkxaso. Kubalulekile ukufumana uncedo lobuchwephesha kunye neengcebiso ngexesha lokuchacha kwakho kwi-ARDS. Buza iqela lakho lezonyango malunga neenkqubo zokubuyisela unyango emva kokhathalelo olunzulu kunye namaqela enkxaso kwi-intanethi kwindawo okuyo.

Eyona nto ibalulekileyo: Izinto ekufuneka uzikhumbule (Umyalezo oya nawo ekhaya)

Kulungile, nazi izinto ezimbalwa ekufuneka uzikhumbule koko sithethe ngako:

• I-ARDS yimeko embi kakhulu ebangela umonakalo kwimiphunga. Iingxowa zomoya ezikwimiphunga zizaliswa lulwelo, nto leyo enciphisa ubuninzi beoksijini enokufikelela egazini.
• Ukuba ufumana iimpawu ezinje ngobunzima obukhulu bokuphefumla, ukuphefumla ngokukhawuleza, okanye iinzipho/imilebe eluhlaza okwesibhakabhaka, funa ingcebiso kagqirha ngokukhawuleza.
• I-ARDS inokuba nezizathu ezininzi. I-Sepsis, i-pneumonia, i-COVID-19, kunye neengozi ezinkulu zezinye zezizathu ezimbalwa.
• Unyango lubandakanya ikakhulu ioksijini, inkxaso yomoya, kunye nolawulo lweengxaki .
• Kuthatha ixesha ukuba umntu aphile, kwaye abanye abantu banokuba neengxaki zemiphunga ezihlala ixesha elide.
• Unyango olukhawulezileyo kunye nonyango olufanelekileyo kubaluleke kakhulu ekusindiseni ubomi nasekunciphiseni iingxaki.
• Inkxaso evela kusapho nakuluntu ibalulekile kumntu ochacha kwi-ARDS.

Khumbula, kubalulekile ukuqaphela le meko. Ukuba wena okanye umntu omaziyo ufumana naziphi na kwezi mpawu, musa ukoyika okanye ukoyika, kodwa bonana nogqirha ngoko nangoko. Ngale ndlela, ungaqala unyango olufunekayo ngokukhawuleza.