Masifunde nge-hypoxemia - ukwehla kweoksijini egazini!

Ngaba ngamanye amaxesha uziva ngathi uphelelwa ngumoya? Okanye ngathi isifuba sakho siqinile? Esinye sezizathu zoku kusenokuba kukwehla kwenqanaba leoksijini egazini lakho. Oku sikubiza ngokwezonyango ngokuba yi-hypoxemia. Nangona le inokuba yimeko enzima, ingalawulwa kakuhle ukuba uyayiqonda kakuhle kwaye wenze izinto ezifunekayo. Ngoko ke, masithethe ngale nto ngeenkcukacha ezithe vetshe namhlanje, akunjalo?

Yintoni iHypoxemia?

Ngamafutshane, i-hypoxemia kuxa igazi lethu lineoksijini encinci kunokuba kufanele. Cinga ngale ndlela: imizimba yethu ifana nemoto. Njengokuba imoto ifuna ipetroli ukuze isebenze, onke amalungu kunye neseli emzimbeni wethu zifuna ioksijini ukuze zisebenze kakuhle.

Le oksijini ingena egazini lethu ngemiphunga xa siphefumla. Xa siphefumla, ioksijini esemoyeni ingena emiphungeni yethu. Ngaphakathi emiphungeni kukho iingxowa zomoya ezincinci, njengeediliya ezincinci kumdiliya. Ezi sizibiza ngokuba yi -'(Alveoli)' . Zijikeleze ezi '(Alveoli)' kukho imijelo emininzi emihle yegazi '(Capillaries) . Xa siphefumla, ioksijini esemoyeni engena ifunxwa kwezi '(Alveoli)' ngezo mijelo emihle yegazi. Emva koko le oksijini ihamba negazi emzimbeni wonke ize ifikelele kwizicubu zethu.

Ngoko ke, ukuba kukho ingxaki kwenye indawo kule nkqubo, oko kukuthi, ukuba akukho oxygen yaneleyo ekuphefumleni kwethu, okanye ukuba imiphunga ayikwazi ukufunxa ioksijini egazini ngokufanelekileyo, ngoko ke inqanaba leoksijini egazini liyehla, nto leyo ethetha ukuba kukho i-hypoxemia.

I-Hypoxemia inokuba nemiphumo eyahlukeneyo, kuxhomekeke kubukhali bayo kunye nobude bayo . Ngamanye amaxesha inokubangela iimpawu ezincinci ezifana nentloko ebuhlungu kunye nokuphefumla kancinci. Kodwa kwiimeko ezinzima, inokuphazamisana nokusebenza kwentliziyo nengqondo, ibangele imeko ebizwa ngokuba yi-"Hypoxia", apho amalungu omzimba kunye nezicubu ziphelelwa yioksijini, kwaye inokukhokelela ekufeni.

Xa oku kusenzeka kwixesha elifutshane, sikubiza ngokuba "kukusilela kokuphefumla okukhawulezileyo," kwaye xa kuyingxaki eqhubeka iinyanga okanye iminyaka, sikubiza ngokuba "kukusilela kokuphefumla okungapheliyo."

Yintoni umahluko phakathi kwe-Hypoxemia kunye ne-Hypoxia?

Usenokuba ukhe weva amagama athi hypoxemia kunye ne-hypoxia. Nangona zivakala zifana, kukho umahluko omncinci.

• I-Hypoxemia kukuncipha kweoksijini egazini.
• I-Hypoxia kukuncipha komthamo weoksijini ofikelela kwizicwili zomzimba wethu.

I-Hypoxia idla ngokubangelwa yimeko ebizwa ngokuba yi-hypoxemia. Oku kuthetha ukuba xa igazi line-oxygen ephantsi, izicubu nazo zine-oxygen ephantsi. Kodwa oko akusoloko kunjalo. Ngamanye amaxesha, izicubu zinokuba ne-oxygen ephantsi nangona igazi line-oxygen eqhelekileyo, okanye izicubu zinokuba ne-oxygen ephantsi nangona igazi line-oxygen ephantsi. Kunzima kancinci, kodwa into ephambili kukuba zombini zinxulumene ne-oxygen ephantsi.

Ngubani onokuthi abe nethuba lokufumana i-hypoxemia?

Nangona nabani na enokuba nale meko ibizwa ngokuba yi-hypoxemia, abanye abantu basengozini enkulu yokuba nayo.

• Lo mngcipheko uphezulu kakhulu kubantu abanezifo zemiphunga, umzekelo, i-asthma, i-COPD (iSifo esingapheliyo seMiphunga), kunye ne-pneumonia.
• Oku kunokuchaphazela nabantu abanesifo sentliziyo . Kuba intliziyo yiyo epompa igazi elinomoya-mpilo emzimbeni wonke. Ngoko ke ukuba kukho ingxaki ekusebenzeni kwentliziyo, iya kuchaphazela namanqanaba eoksijini egazini.
• Ukongeza, ezinye izifo ezisulelayo ezifana nomkhuhlane, i-pneumonia, kunye ne-COVID-19 nazo zinokunyusa umngcipheko wokungabikho koxinzelelo lwegazi emzimbeni.

Zithini iimpawu zoku?

Kulungile, ngoku masibone ukuba zeziphi iimpawu esizibonayo kule meko yokungabikho koxinzelelo lwegazi. Ezi mpawu zinokwahluka ngokuxhomekeke kubukhali besifo, oko kukuthi, i-oxygen iphantsi kangakanani, kwaye yintoni unobangela.

• Intloko ebuhlungu: Intloko ebuhlungu rhoqo.
• Ukuphelelwa ngamandla: Ukuziva kunzima ukuphefumla, ukuqina esifubeni, kunye nokuphefumla kancinci.
• I-Tachycardia: Ukunyuka kwesantya sokubetha kwentliziyo.
• Ukukhwehlela: Ukukhwehlela okungapheliyo.
• Ukuphefumla: Isandi somlozi esiphuma esifubeni xa uphefumla.
• Ukudideka: Ukuziva unesizungu kwaye ungazi ukuba wenze ntoni.
• Ulusu oluluhlaza, iinzipho, kunye nemilebe (iCyanosis): Olu luphawu olubi kakhulu. Xa umzimba ungafumani ioksijini eyaneleyo, ngamanye amaxesha ulusu, iinzipho, kunye nemilebe zinokujika zibe luhlaza okwesibhakabhaka.

Ziziphi izizathu eziphambili ze-hypoxemia?

Ukungabikho koxinzelelo lomoya (Hypoxemia) kunokuba nezizathu ezininzi. Kodwa uninzi lwezizathu, eyona nto iphambili yimeko yezonyango efihlakeleyo. Oku kuthetha ukuba isifo sentliziyo okanye semiphunga esichaphazela ukuphefumla okanye ukujikeleza kwegazi sihlala singunobangela. Amanye amayeza anokubangela ukungabikho koxinzelelo lomoya (hypoxemia) ngokucothisa ukuphefumla.

Usenokuba ukhe weva ngemeko ebizwa ngokuba yi-`(Sleep Apnea)`. Yimeko apho ukuphefumla kuyeka khona ngamaxesha athile xa ulele. Kwiimeko ezinjalo, okanye kubantu abanezifo zemiphunga ezingephi, inqanaba leoksijini egazini linokwehla ebusuku. Oku kubizwa ngokuba yi-`(Nocturnal Hypoxemia)`.

Enye into kukuba i-hypoxemia inokwenzeka naxa uhamba uye kwiindawo eziphakamileyo . Khawuthelekelele ukuba xa usiya kwindawo ephakamileyo yeentaba efana neNuwara Eliya, yiyo loo nto abanye abantu beziva ngathi banengxaki yokuphefumla. Oku kungenxa yokuba ubungakanani beoksijini emoyeni buyancipha njengoko ukuphakama kusanda.

Ezinye izizathu ezimbalwa...

Ezinye iimeko ezinokubangela i-hypoxemia ziquka:

• I-Acute Respiratory Distress Syndrome (ARDS)
• I-anemia - oko kuthetha ukunqongophala kwegazi
• Isifuba
• I-Bronchitis
• Isifo Esingapheliyo Sokuqanda Amaphaphu (i-COPD)
• Iziphene zentliziyo ezizalwa nazo - izifo zentliziyo ezikhoyo ekuzalweni
• Ukungaphumeleli kwentliziyo okubangelwa kukunganyamezelani
• I-Emphysema - umonakalo kwiingxowa zomoya emiphungeni
• Ukukrala kwemiphunga
• Umoya ojikeleze imiphunga okanye ukuwa kwemiphunga (i-Pneumothorax)
• Ukudumba kwepulmonary
• Ukuxhuzula kwemithambo yegazi (pulmonary embolism)
• Ukuvaleka kwemiphunga (i-Pulmonary fibrosis)
• Uxinzelelo lwegazi oluphezulu lwemiphunga

Iindidi ezi-5 eziphambili zezinto ezibangela i-hypoxemia

Ngoku makhe sijonge iindlela ezi-5 eziphambili ezibangela ukuba kubekho i-hypoxemia. Ezi zizinto zonyango, kodwa masizame ukuziqonda ngokulula.

1. Ukungalingani komoya-mpilo (V/Q): Cinga ngako oku, ukuze igazi lifumane ioksijini, imiphunga kufuneka ifumane umoya owaneleyo (oku kubizwa ngokuba kukungena komoya), kwaye ukuze ithwale loo oksijini, imiphunga kufuneka ifumane igazi elaneleyo (oku kubizwa ngokuba kukungena komoya). Ukuba kukho ingxaki kwenye yezi zimbini, umzekelo, ukuba imiphunga ifumana umoya owaneleyo kodwa igazi lingabikho, okanye ukuba igazi lifumana umoya owaneleyo kodwa umoya ungabikho, ioksijini ayingeni egazini ngokufanelekileyo. Oku kubizwa ngokuba kukungahambelani `(V/Q). Oku kudla ngokubangelwa sisifo sentliziyo okanye isifo semiphunga.

2. Ukuphazamiseka kokusasazwa: Ngamanye amaxesha imiphunga ifumana umoya owaneleyo kunye negazi, kodwa kuba nzima ukuba ioksijini emiphungeni ifunxwe (isasazwe) kwimithambo yegazi. Njengaxa iimbobo zesihluzo zivalekile, amanzi awakwazi ukudlula. Oku kunokwenzeka ngenxa yeemeko ezifana ne-emphysema okanye amanxeba emiphungeni.

3. Umoya ophumayo: Oku kwenzeka xa siphefumla nzulu kakhulu okanye kancinci kakhulu. Oku kuthetha ukuba ioksijini enganeleyo ayifiki emiphungeni. Oku kunokubangelwa zizifo ezininzi zemiphunga kunye nezinye izifo zobuchopho.

4.Ioksijini ephantsi kokusingqongileyo: Ukuba umoya okwindawo esikuyo uneoksijini ephantsi, nokuba siphefumla kangakanani na, imizimba yethu ayizukufumana oksijini eyidingayo. Njengoko benditshilo ngaphambili, umoya okwiindawo eziphakamileyo zeentaba uneoksijini ephantsi.

5. Ukushukuma ukusuka ekunene ukuya ekhohlo: Ngokwesiqhelo, igazi elingenaoksijini (elingenawo umoya) emzimbeni wethu liya kwicala lasekunene lentliziyo, ukusuka apho liya emiphungeni ukuze lithathe ioksijini (ukucoca), lize libuyele kwicala lasekhohlo lentliziyo lize limpompe emzimbeni wonke. Nangona kunjalo, kwabanye abantu, eli gazi lingenaoksijini lingahamba ngqo ukusuka kwicala lasekunene lentliziyo ukuya kwicala lasekhohlo lomzimba endaweni yokuya emiphungeni. Emva koko, igazi elingenaoksijini lihamba emzimbeni wonke. Oku kubizwa ngokuba kukushukuma ukusuka ekunene ukuya ekhohlo. Uninzi lwexesha, oku kwenzeka ngenxa yokungaqheleki okuthile entliziyweni.

Uyixilonga njani le nto?

Kulungile, ngoku makhe sibone ukuba ugqirha uyifumanisa njani le meko ye-hypoxemia. Xa usiya kugqirha, uya kuqala akuphulaphule intliziyo yakho nemiphunga. Kuba naziphi na iingxaki kwezi zitho zinokuba luphawu lwe-oxygen ephantsi egazini. Uya kujonga nokuba ulusu lwakho, imilebe, kunye neenzipho zakho ziluhlaza okwesibhakabhaka na.

Ukongeza, ungenza ezi mvavanyo zilandelayo ukujonga amanqanaba akho eoksijini:

• I-pulse oximetry: Mhlawumbi sele uyibonile le nto. Sisixhobo esincinci esiqhoboshela emnweni wakho size silinganise inqanaba leoksijini egazini lakho. Asinabuhlungu kwaye asifuni gazi. Oogqirha abaninzi bayasisebenzisa xa behlolwa rhoqo.
• Uvavanyo lwegesi yegazi elisemithanjeni: Olu luvavanyo olulinganisa ngokuchanekileyo inqanaba leoksijini egazini ngokuthatha isampuli yegazi elincinci kwindawo efana nesandla, igophe lengalo, okanye i-groin.
• Uvavanyo lokuhamba ngeenyawo lwemizuzu emithandathu (6MWT): Oku kuquka ukuhamba kwindawo ethe tyaba imizuzu emithandathu, ulinganisa indlela amanqanaba akho eoksijini atshintsha ngayo kunye nokuba ungahamba umgama ongakanani. Oku kunokukunika umbono wokuba imiphunga nentliziyo yakho zisebenza kakuhle kangakanani.

Zithini iindlela zonyango?

Xa unyanga i-hypoxemia, unyango luxhomekeke kwisizathu. Ugqirha wakho unokukunika i-oxygen eyongezelelweyo ukuze wonyuse amanqanaba e-oxygen egazini lakho. Oku kunokunikezelwa ngeetanki ze-oxygen okanye oomatshini ababizwa ngokuba zii-oxygen concentrators. Abanye abantu banokuyifuna rhoqo, ngelixa abanye banokuyifuna kuphela xa bediniwe. Kuxhomekeke kubukhali bemeko.

Kwiimeko ezinzima zokungabikho koxinzelelo lwegazi, ezifana ne-acute respiratory distress syndrome (ARDS), umatshini obizwa ngokuba yi-ventilator unokusetyenziswa ukukunceda uphefumle.

Eyona nto ibalulekileyo kukulungisa unobangela oyintloko. Umzekelo:

• Ii-inhalers zabantu abanezifo zemiphunga ezifana ne-COPDoko kukuthi, ii-inhalers eziqulethe `(Bronchodilators)` (bronchodilators) okanye `(Steroids)` zinokunikwa.
• I-diuretics inganikwa ukususa ulwelo olugqithisileyo emiphungeni.
• Usenokucelwa ukuba usebenzise imaski yeCPAP (Continuous Positive Airways Pressure) ukunyanga i-sleep apnea.
• Ukuba kukho umngcipheko wokuqhubeka nokungabikho koxinzelelo lwegazi emzimbeni, unokunikwa ioksijini eyongezelelweyo. Kukho iintlobo ngeentlobo zezixhobo zokuhambisa ioksijini. Ioksijini inokunikwa ngemaski yokuphefumla, ityhubhu encinci efakwe empumlweni (i-cannula). Le inganikwa ekhaya, kumatshini omncinci onokuhamba nawo xa uhamba, okanye esibhedlele.

Ungazilawula njani iimpawu?

Ukuba ngequbuliso uziva udidekile, unengxaki yokuphefumla, ubetha ngesantya esiphezulu, okanye uqaphela ukuba iinzipho zakho, imilebe, okanye ulusu lwakho lujika lube luhlaza okwesibhakabhaka, kufuneka ufune uncedo lwezonyango ngokukhawuleza. Ukuba une-pulse oximeter ekhaya, ungayisebenzisa ukujonga amanqanaba akho eoksijini. I-Hypoxemia kufuneka inyangwe ngokukhawuleza ukuthintela umonakalo kwizitho zomzimba kwiimeko ezinzima.

Abantu abaneemeko ezithile, ezifana ne-COPD kunye ne-Sleep Apnea, banokufumana i-hypoxemia rhoqo okanye rhoqo, kodwa basenokungabi nazo naziphi na iimpawu ezinkulu. Ngoko ke, thetha nogqirha wakho malunga nendlela yokulawula imeko yakho, ukunciphisa iimpawu, kunye nokunciphisa umngcipheko wamanqanaba aphantsi eoksijini.

Zeziphi iingxaki ezinokubangela oku?

Xa inqanaba leoksijini egazini lehla, amalungu ethu kunye nezicubu zethu azifumani umlinganiselo weoksijini eziwudingayo ukuze zisebenze. Njengoko sele sixoxile, oku kubizwa ngokuba yi-`(Hypoxia).` Ukuba le meko iyaqhubeka, umzekelo, `(Sleep Apnea)` ebangela ukwehla kweoksijini ebusuku (`Nocturnal hypoxemia`), intliziyo yethu kunye nengqondo zinokonakala. I-hypoxemia enzima ngequbuliso inokuba yingozi ebomini.

Ungayinciphisa njani ingozi?

Eyona ndlela ilungileyo yokunciphisa umngcipheko wakho we-hypoxemia kukulawula ngokufanelekileyo iimeko zakho zempilo ezisisiseko. Ukuba unesifo semiphunga okanye sentliziyo, thetha nogqirha wakho ngeendlela ezithile zokunciphisa umngcipheko wakho.

Kwanakwabo bangenazo izifo zentliziyo okanye zemiphunga, umngcipheko wokuphelelwa yioksijini emzimbeni unokwanda ngenxa yamayeza athile okanye xa uhamba kwiindawo eziphakamileyo. Ngoko ke, buza ugqirha wakho malunga namayeza owasebenzisayo kunye namanyathelo akhethekileyo omele uwathathe xa uhamba. Xa uhamba kwiindawo eziphakamileyo, nika umzimba wakho ixesha elaneleyo lokuziqhelanisa.

Yintoni onokuyenza ukuze wonyuse amanqanaba eoksijini?

Eyona ndlela ilungileyo yokugcina amanqanaba akho e-oksijini egazini ekhuselekile kwaye unciphise umngcipheko we-hypoxemia kukulawula ngokufanelekileyo iimeko zakho zempilo.

• Ungalibali ngeempawu ezintsha.Ukuba uziva into engaqhelekanga, yiqwalasele. Bona ugqirha okanye uye kwigumbi likaxakeka.
• Ukuba ugqirha wakho ukunike ioksijini, yisebenzise ngokufanelekileyo.
• Lumka impilo yakho yemiphunga (`ucoceko lwemiphunga`). Ukuba une-`COPD` okanye i-asthma, yazi ukuba zeziphi izinto ezikubangelayo. Soloko ugcina i-``rescue inhaler`` yakho kuwe. Sebenzisa i-``incentive spirometer``, yenza umthambo wokuphefumla, kwaye ulandele amanye amacebiso empilo yemiphunga akunika wona ugqirha wakho.
• Ukuba uyatshaya, yeka. Ukuyeka ukutshaya kuphucula ukusebenza kwemiphunga, kuvumela imiphunga yakho ukuba ifumane ioksijini engaphezulu. Kukwathintela nomonakalo ongakumbi kwimiphunga yakho.
• Sela amayeza kanye njengoko ugqirha ekuyalele.
• Yenza isicwangciso xa uhamba uye kwiindawo eziphakamileyo. Kwanabo bangenazo iingxaki zentliziyo okanye zemiphunga, kunokuba nzima ukuphefumla kwiindawo eziphakamileyo. Cinga kwangaphambili ngendlela okuya kukuchaphazela ngayo nendlela oza kuqhelana ngayo notshintsho. Kwakhona cwangcisa kwangaphambili into oza kuyenza ukuba ufuna uncedo lwezonyango olungxamisekileyo. Zinike ixesha elaneleyo lokuqhelana nezinto ukuba kuyimfuneko, kwaye uzise naziphi na izixhobo okanye amayeza ongezelelweyo onokuwadinga.

Kufuneka uye nini esibhedlele ngokukhawuleza?

Ukungabi naso isifo soxinzelelo lwegazi (Hypoxemia) yimeko esongela ubomi. Kwiimeko ezinjalo , kufuneka uye kwiSebe leNgxamiseko (ETU) ngoko nangoko:

• Ukuba uneempawu zokungabikho koxinzelelo lwegazi emzimbeni, okanye ukuba abanye baphawula utshintsho olukhawulezileyo kwindlela oziphatha ngayo okanye engqondweni yakho (ukungazinzi, ukudideka, ingqondo etshintshileyo).
• Ukuba unesifo esiqhubekayo, kwaye iimpawu zakho eziqhelekileyo ziba mandundu ngequbuliso, okanye ukuba ubonakalisa iimpawu ezintsha ocinga ukuba zibangelwa kukungabikho koxinzelelo lwegazi emzimbeni.

Yeyiphi imibuzo omele uyibuze ugqirha?

Ukuba ugqirha wakho ukuxelela okanye umntu omthandayo ukuba une-hypoxemia, ungambuza imibuzo efana nale:

• Ingaba olu xinzelelo lwegazi lubangelwa yenye imeko yezonyango esisiseko?
• Ndingayilawula njani imeko yam ukuze ndinciphise umngcipheko we-hypoxemia?
• Ingaba oku kubangele umonakalo kwizitho zomzimba okanye ezinye iingxaki?
• Zeziphi iinguqulelo zendlela yokuphila ezinokunciphisa umngcipheko we-hypoxemia?
• Ngaba ukutshintsha izicwangciso zam zokuhamba okanye ukutshintsha amayeza am kuya kwandisa umngcipheko wokuba ndingabi naso isifo soxinzelelo lwegazi?

Ngamafutshane (Umyalezo Wokuya Ekhaya)

Ngoko ke, ngamafutshane, i-hypoxemia yimeko apho kukho ukwehla kwenqanaba leoksijini egazini. Oku ngamanye amaxesha kunokuba yingozi ebomini. Nangona kunjalo, kunokunyangeka ngokufanelekileyo ukuba ufuna uncedo lwezonyango ngokukhawuleza.Ngamanye amaxesha, umzekelo, ukuba une-"Sleep Apnea", amanqanaba akho eoksijini anokwehla ebusuku nangona kungekho zimpawu zibalulekileyo. Ukuba oku kuyaqhubeka, kungonakalisa intliziyo yakho.

Kungoko ke, kubaluleke kakhulu ukuba uqaphele umngcipheko wakho kunye nento onokuyenza ukuze uwuthintele. Ukuba unamathandabuzo, ungoyiki ukuthetha nogqirha. Hlala uphilile!

Ukungabikho komoya-mpilo omninzi, ukunqongophala komoya-mpilo, ubunzima bokuphefumla, isifo semiphunga, isifo sentliziyo, inqanaba lomoya-mpilo, i-cyanosis