Ngaba wakha wambona umntu ephefumla ngokukhawuleza nangokunzulu, ngokungathi usandul’ ukugqiba ukubaleka ixesha elide, engenalo ulawulo? Kodwa wayengabaleki. Oku ngamanye amaxesha sikubiza ngokuba yi-'Kussmaul breathing', esikubona njengophawu lwemeko eyingozi. Oku akusiyo nje into engaqhelekanga, kodwa sisilumkiso esinzulu esivela ngaphakathi emzimbeni. Ngoko ke, masiqonde oku ngqo namhlanje.
Yintoni iKussmaul Breathing?
Ngamafutshane, ukuphefumla kukaKussmohl kukuphefumla okukhawulezayo, okunzulu, nokunesingqisho esingaqhelekanga. Luhlobo lwemeko ebizwa ngokuba yi-hyperventilation.
Khawucinge nje, kukho ingxaki enkulu emzimbeni wethu. Oko kukuthi, umxholo we-asidi egazini uyanda uye kwinqanaba eliyingozi. Ngokwezonyango, siwubiza ngokuba yi- metabolic acidosis . Xa oku kusenzeka, umzimba uzama ukususa le asidi igqithisileyo. Enye yeendlela ezilungileyo zokwenza oku kukukhupha i-carbon dioxide. Kuba i-carbon dioxide nayo yi-asidi enkulu egazini. Ngoko ke, umzimba uphefumla ngokukhawuleza nangokunzulu ukuze ukhuphe le asidi ngokukhawuleza.
Oku kufana nomzamo womzimba wokuzisindisa. Yiyo loo nto umntu obona oku ebonakala ehlushwa "yindlala yomoya."
Into ebalulekileyo kukuba umntu ophefumla ngale ndlela akanakuyilawula. Yindlela umzimba ophendula ngayo kwimeko ethile yezonyango. Ke ngoko, ukuphefumla kukaKussmohl yingxaki yezonyango. Ukuba wena okanye umntu omaziyo uphefumla ngale ndlela, kufuneka umse kwangoko kwisebe likaxakeka lesibhedlele (ETU) .
Oku kwahluke njani kwindlela eqhelekileyo yokuphefumla kunye nezinye iindlela zokuphefumla?
Ngamanye amaxesha ezi ndlela zokuphefumla zinokubhidaniswa. Kodwa kukho umahluko omkhulu. Makhe sijonge umahluko ophambili.
| Ipatheni yokuphefumla | Umahluko ophambili | Esona sizathu siqhelekileyo |
|---|---|---|
| Ukuphefumla kukaKussmaul | Ukuphefumla ngokukhawuleza, nzulu, nangokunesantya. Umzamo wokunciphisa i-asidi yomzimba. | I-ketoacidosis yeswekile (i-DKA). |
| Ukuphefumla kweCheyne-Stokes | Ukuphefumla kuyakhawuleza, kunzulu, kucothe kwakhona, kuze kuyeke okomzuzwana. Isingqi siyaqhubeka nokutshintsha. | Ukungaphumeleli kwentliziyo, isifo sohlangothi. |
| Ukuphefumla ngamandla ngokubanzi | Ukuphefumla ngokukhawuleza okanye nzulu, okubangelwa luxinzelelo, ixhala, okanye uloyiko. | Ixhala, ukuphazamiseka koloyiko. |
Zithini izizathu eziphambili zokuphefumla kukaKussmohl?
Njengoko besitshilo ngaphambili, unobangela oyintloko yimeko ebizwa ngokuba yi-metabolic acidosis. Oku kuthetha ukuba i-asidi egazini iyanda. Unobangela oyintloko noqhelekileyo woku ziimeko ezinxulumene nesifo seswekile.
Unobangela oyintloko: I-Diabetic Ketoacidosis (DKA)
Le yeyona nto ixhaphakileyo ekuphefumleni kukaKussmohl. I-DKA yingxaki esongela ubomi, kodwa inokunyangeka, enokwenzeka kumntu onesifo seswekile.
- Kwenzeka ntoni kwi-DKA?: Xa umzimba ungenalo i-insulin eyaneleyo, i-hormone ebalulekileyo emzimbeni ukuze usebenzise i-glucose ukuze ufumane amandla, umzimba uqala ukutshisa amafutha ukuze ufumane amandla.
- Ingxaki iqala apha: Xa utshisa amafutha, iikhemikhali ezibizwa ngokuba zii-ketones ziyaqokelelana egazini njengemveliso ephumayo. Ezi ketones luhlobo lwe-asidi.
- Isiphumo: Xa ezi ketones ziqokelelana egazini lomntu onesifo seswekile, iasidi (pH) yegazi yehla ngendlela eyingozi.
- Isigaba sokugqibela: Ukuphefumla kukaKussmohl luphawu lwesigaba sokugqibela se-DKA esinzima. Kunokukhokelela nasekufeni ukuba akunyangelwanga ngoko nangoko.
Ziziphi ezinye izizathu?
Ukongeza kwi-DKA, kukho ezinye izizathu ezinokuchaphazela ukuphefumla kweKussmohl.
- Ukungasebenzi Kwezintso: Xa izintso zingakwazi ukususa ii-asidi ngomchamo, ii-asidi ziyaqokelelana egazini. Oku kunokukhokelela kwiimeko ezifana ne-"Renal tubular acidosis".
- I-Sepsis:Usulelo olungene emzimbeni luba nzima kakhulu.
- Ukuginywa kweetyhefu ezithile: Umzekelo, ukuba ityhefu efana ne-methanol ityiwe, kwimeko enjalo, ungatsalela umnxeba iZiko loLwazi ngeTyhefu leSizwe kwiSibhedlele sikaZwelonke saseColombo ukuze ufumane ingcebiso.
- Ingxaki yokusebenzisa utywala.
- Ukungasebenzi kakuhle kwamalungu omzimba abalulekileyo njengentliziyo nesibindi.
- Izifo ezithile ezifana nomhlaza .
Indlela yokunyanga nokuthintela le meko?
Ngenxa yokuba ukuphefumla kukaKussmohl luphawu, unyango lujoliswe kwimeko ebangela oko. Unyango ludla ngokwenziwa esibhedlele.
Oogqirha badla ngokunika ulwelo olufakwa kwimithambo yegazi (IV) kunye nee-electrolytes ukubuyisela ibhalansi ye-acid-base egazini. Kwi-DKA, i-insulin efakwa kwimithambo yegazi (IV) ibalulekile.
Eyona nto ibalulekileyo kukuthintela le meko, ingakumbi i-DKA.
- Ukuba unesifo seswekile: Jonga amanqanaba eswekile yakho yegazi rhoqo. Thatha i-insulin yakho kunye neminye imithi njengoko ugqirha wakho ekuyalele kwangethuba. Ukuba uyagula (njengomkhuhlane okanye umkhuhlane), usemngciphekweni omkhulu we-DKA, ngoko thetha nogqirha wakho malunga nendlela yokulawula isifo sakho seswekile ngeli xesha.
- Isifo seswekile esingafunyaniswanga: Kunzima ukuthintela i-DKA. Ke ngoko, ukwazi iimpawu zayo ezilumkisayo kunokusindisa ubomi.
| Iimpawu ezilumkisayo ze-diabetesic ketoacidosis (DKA) | |
|---|---|
| Iimpawu Zokuqala | |
| |
| Iimpawu Ezinzima | |
|
Ukuba wena okanye umntwana wakho unezi mpawu, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngoko nangoko, ngaphandle kokulibazisa.
Umyalezo Wokuya Ekhaya
- Ukuphefumla kukaKussmohl akuqhelekanga. Luphawu lwengxaki enkulu yezonyango, efana ne-metabolic acidosis.
- Eyona nto ixhaphakileyo yile ketoacidosis yesifo seswekile (i-DKA), ingxaki enkulu yesifo seswekile.
- Le yimeko engxamisekileyo yezonyango. Ukuba ubona umntu ephefumla ngolu hlobo, mse kwiSebe lezeMpilo eziNgxamisekileyo lesibhedlele (ETU) ngokukhawuleza.
- Ukuba unesifo seswekile, ukusilawula ngokufanelekileyo yeyona ndlela ilungileyo yokuthintela i-DKA. Landela imiyalelo kagqirha wakho.
- Qaphela iimpawu zokuqala ze-DKA, ezinje ngokunxanwa kakhulu, ukuchama rhoqo, kunye nevumba leziqhamo emlonyeni. Yenza ngokukhawuleza, endaweni yokulinda utshintsho kwindlela yokuphefumla.
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