Ngaba wakha wambona umntu okwiyunithi yokhathalelo olunzulu (ICU) okanye umntu oye waziswa kwigumbi longxamiseko (ETU) eneengxaki zokuphefumla ezinzima, baze oogqirha bakhawuleze babaxelele ukuba "benze i-ABG"? Olu luvavanyo lwegazi olubaluleke kakhulu nolukhethekileyo. Namhlanje, siza kuthetha ngalo ngokulula, ngendlela onokuyiqonda.
Kalula nje, yintoni olu vavanyo lwe-ABG?
I-ABG (iArterial Blood Gas) luvavanyo oluthatha igazi elincinci kumthambo osemzimbeni wethu. Ngoku usenokuba ucinga, "Olunye uvavanyo lwegazi luthatha igazi emthanjeni, yintoni umahluko?"
Cinga ngale ndlela. Umzimba wethu ufana nesixeko.
- Imithambo yegazi ifana neendlela ezinkulu ezizisa izinto ezibalulekileyo njengeoksijini kunye nesondlo kwisixeko.
- Imithambo ifana neendlela ezindala esixekweni ezithwala inkunkuma efana nekharbon diokside zibuyela esixekweni.
Ngoko ke, ukuba sifuna ukwazi ukuba ingakanani na ioksijini efikelela kumalungu omzimba wethu, ingakumbi ingqondo nentliziyo, kufuneka sivavanye igazi elikuloo "ndlela iphambili," akunjalo? Yiyo loo nto igazi lithathwa kumthambo ukuze kwenziwe uvavanyo lwe-ABG.
Olu vavanyo lulinganisa ikakhulu amanqanaba eoksijini kunye nekhabhoni dayoksayidi egazini lakho. Lukwalinganisa ibhalansi ye-asidi-base, okanye i-pH, yegazi lakho. Olu lungelelwaniso lubalulekile kuzo zonke iinkqubo emizimbeni yethu.
Yintoni kanye kanye elinganiswa luvavanyo lwe-ABG?
Xa ujonga ingxelo ye-ABG, uza kubona oonobumba abathile abanzima ukuyiqonda. Kodwa intsingiselo ilula kakhulu. Makhe sibone ukuba ithetha ukuthini nganye kwezo xabiso.
| Umlinganiselo | Intsingiselo elula |
|---|---|
| i-pH | Oku kukuxelela ukuba igazi lakho line-asidi kangakanani. Eli xabiso kufuneka libe phakathi kwe-7.35 kunye ne-7.45. Nantoni na engaphantsi koko ithetha ukuba igazi lakho line-asidi, kwaye nantoni na ephezulu ithetha ukuba line-alkaline. |
| I-PaO2 (Uxinzelelo oluncinci lweoksijini) | Ubungakanani beoksijini enyibilikisiweyo egazini. Oku kubonisa indlela ioksijini engena ngayo egazini esuka kwimiphunga yakho. |
| I-PaCO2 (Uxinzelelo oluncinci lwekhabhoni dayokhsayidi) | Ubungakanani bekhabhoni dayokhsayidi egazini lakho. Oku kubonisa indlela umzimba wakho owususa ngayo ikhabhoni dayokhsayidi. |
| I-HCO3 (iBicarbonate) | Le yisiseko egazini lethu. Ilawulwa zizintso. Ibaluleke kakhulu ekulinganiseni i-pH yegazi. |
| I-O2Sat (Ukwanda kweoksijini) | Ibonisa ukuba ingakanani iproteni ye-hemoglobin egazini ethwala ioksijini, njengepesenti. I-pulse oximeter oyibeka emnweni wakho ilinganisa ixabiso elifanayo. |
Lufuneka nini uvavanyo lwe-ABG?
Olu asilovavanyo olwenziwa rhoqo xa kufuneka uhlolwe. Ludla ngokwenziwa kwiimeko ezingxamisekileyo nokujonga imeko yezigulana esele zilaliswe esibhedlele . Nazi ezinye zezizathu eziphambili zokuba ugqirha angayiyalela le vavanyo:
- Ubunzima obukhulu bokuphefumla: Kwiimeko ezinje ngokubakho kwesifo sombefu kunye nokuqokelelwa kolwelo emiphungeni (ukungasebenzi kakuhle kokuphefumla).
- Iimeko ezinzulu zosulelo: Kwiintsholongwane ezisongela ubomi ezifana ne-sepsis okanye i-septic shock.
- Iingxaki ezinxulumene nesifo seswekile: Kwiimeko apho igazi liba ne-asidi, njenge-diabetesic ketoacidosis (DKA).
- Ukuhlaselwa yintliziyo okanye ukungasebenzi kakuhle kwentliziyo: Xa intliziyo iyeka ukusebenza ngequbuliso (ukungasebenzi kakuhle kwentliziyo) okanye xa intliziyo iyeka (ukubanjwa yintliziyo).
- Ukungasebenzi kakuhle kwezintso: Xa izintso zingakwazi ukususa ii-asidi egazini ngokufanelekileyo, igazi liba ne-asidi. Funda ngale meko.
- Ityhefu: Xa kutyiwa iityhefu ezithile, i-pH yegazi iyatshintsha.
- Ngaphambi nasemva kotyando olukhulu: Jonga imeko yokuphefumla kwesigulana ngexesha lotyando lokubulala iintlungu nasemva kotyando.
- Izifo zemiphunga ezingapheliyo: Jonga ukuba unyango luphumelele na kubantu abanezifo ezifana neCOPD (isifo semiphunga esingapheliyo).
Lwenziwa njani olu vavanyo? Ingaba lubuhlungu?
Ukufumana uvavanyo lwe-ABG kwahlukile kancinci kunovavanyo lwegazi oluqhelekileyo.
Ngaphambi kovavanyo
Ngamanye amaxesha, ukuba unikwa ioksijini eyongezelelweyo, inokumiswa malunga nemizuzu engama-20 ngaphambi kovavanyo. Oku kwenzelwa ukubona indlela umzimba wakho osebenza ngayo ngaphandle kweoksijini. Kodwa ukuba awukwazi ukuphila ngaphandle kweoksijini, awunakwenza njalo. Ukuba igazi lithathwa esihlahleni sakho, ugqirha okanye igosa eliqeqeshiweyo lingenza uvavanyo olulula olubizwa ngokuba yi-'Allen test' ukuze kubonwe ukuba kukho ukujikeleza kwegazi okuhle engalweni yakho.
Ngelixa ndibhala uvavanyo
1. Ugqirha okanye ingcali eqeqeshiweyo iya kufumana umthambo ngaphakathi esihlahleni sakho (i-radial artery), kufutshane nengqiniba yakho (i-brachial artery), okanye kwi-groin yakho (i-femoral artery).
2. Coca indawo kakuhle uze ufake isibulali-ntsholongwane.
3. Emva koko, kufakwa inaliti encinci kakhulu kumthambo wegazi kwaye kutsalwa igazi elincinci kwisirinji.
4. Inyaniso kukuba , oku kunokuba buhlungu ngakumbi kunokutsalwa kwegazi emthanjeni. Oku kungenxa yokuba umthambo ungaphakathi kancinci ngaphantsi kolusu lwethu kwaye unemithambo-luvo emininzi ewujikelezileyo. Kodwa intlungu ibakho kuphela xa inaliti ifakwa.
5. Emva kokuba kuqokelelwe igazi elifunekayo, susa inaliti uze ufake uxinzelelo kuloo ndawo ngekotoni okanye i-gauze ukuze umise ukopha malunga nemizuzu emi-5 ukuya kweli-10 . Ukuba uthatha amayeza okunciphisa igazi, kunokufuneka usebenzise uxinzelelo ixesha elide.
Emva kovavanyo
Indawo apho inaliti ifakwe khona isenokuba nenxeba elincinci okanye iluhlaza okwesibhakabhaka. Oku kuqhelekile. Ugqirha wakho uza kukuxelela ukuba ungaphakamisi izinto ezinzima ngaloo ngalo kangangeeyure ezingama-24 emva kokutsalwa kwegazi.
Iziphumo zovavanyo lwe-ABG zifumaneka ngokukhawuleza kakhulu, ngesiqhelo kwimizuzu eli-10-15. Ezi ziphumo zibaluleke kakhulu ekwenzeni izigqibo ngokukhawuleza kwiimeko ezingxamisekileyo.
Zinjani ixabiso eliphakathi kwingxelo?
La maxabiso anokwahluka kancinci kwilabhoratri nganye, kodwa la ngamaxabiso aqhelekileyo kumntu omdala osempilweni kwinqanaba lolwandle. Kungcono ucele ugqirha wakho ingcaciso epheleleyo ngamaxabiso akwingxelo yakho.
| Umlinganiselo | Uluhlu oluQhelekileyo |
|---|---|
| i-pH | 7.35 - 7.45 |
| PaO2 | 75 - 100 mmHg |
| I-PaCO2 | 35 - 45 mmHg |
| I-HCO3 | 22 - 26 mEq/L |
| O2Mgqibelo | 95% - 100% |
Ukuba la maxabiso angaphandle komlinganiselo oqhelekileyo, oko kuthetha ukuba umzimba wakho awufumani ioksijini eyaneleyo , okanye ukuba i-carbon dioxide ayiphumi kakuhle kwinkqubo yakho , okanye ukuba ibhalansi ye-asidi/isiseko segazi lakho ayilingani . Ugqirha wakho uza kusebenzisa le ngxelo, iimpawu zakho, kunye nezinye iimvavanyo ukufumanisa ukuba yintoni kanye kanye ingxaki ngawe.
Umyalezo Wokuya Ekhaya
- I-ABG ayilovavanyo lwegazi oluqhelekileyo oluthathwa kumthambo, kodwa luvavanyo olukhethekileyo oluthathwa kumthambo wegazi, umthambo wegazi omkhulu onika umzimba ioksijini.
- Oku ikakhulu kulinganisa ioksijini, ikharbon diokside, kunye neasidi (pH) egazini.
- Oku kubalulekile ekufumanekeni kwangoko kweemeko zonyango kwiimeko ezingxamisekileyo kunye neemeko ezinzima ezifana nobunzima bokuphefumla, usulelo oluqatha, kunye nesifo sentliziyo.
- Nangona inokuba buhlungu ngakumbi kunovavanyo lwegazi oluqhelekileyo, ulwazi olulunikayo lunokunceda ekusindiseni ubomi.
- Soloko uthetha nogqirha wakho onyangayo malunga neziphumo zovavanyo lwakho lwe-ABG kunye nentsingiselo yazo.
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