Ngaba ukuphefumla kwakho akunzulu kakhulu? (Ukuxinezeleka kokuphefumla/Uxinzelelo oluphezulu lwegazi) - Masithethe ngale nto!

Ngaba wakha waziva ngathi unengxaki yokuphefumla, okanye ngathi uphelelwa ngumphefumlo? Mhlawumbi uzive unesizungu okanye udiniwe. Esinye isizathu esinokubangela ezi zinto kukuncipha kokuphefumla, nto leyo esiyibiza ngokwezonyango ngokuba yi-Respiratory Depression (Uxinzelelo Lokuphefumla) okanye i-Hypoventilation (Uxinzelelo Lokuphefumla) .

Yintoni ukudakumba kokuphefumla?

Ngamafutshane, ukudakumba kokuphefumla ( okanye i-hypoventilation) kuxa izinga lakho lokuphefumla licotha kakhulu, okanye uphefumla kancinci kakhulu. Xa oku kusenzeka, utshintshiselwano lomoya alwenzeki kakuhle emiphungeni yakho. Cinga ngako, xa siphefumla, ioksijini emoyeni omtsha ingena egazini ngeengxowa zomoya ezincinci (i-alveoli) emiphungeni yethu. Kwakhona, i-carbon dioxide (CO2) , eyinkunkuma yomzimba wethu, ibuyela emiphungeni isuka egazini ize ikhutshwe. Oku sikubiza ngokuba yi-gas exchange .

Ngoku, kwimeko ye- (Hypoventilation) , okwenzekayo kukuba ngenxa yokuba ungaphefumli kakuhle, loo gesi ye-carbon dioxide (CO2) ayiphumi emzimbeni ize iqokelele egazini. Oku sikubiza ngokuba yi- (Hypercapnia) . Ayipheleli apho, ngamanye amaxesha imiphunga isenokungafumani ioksijini eyaneleyo. Emva koko inqanaba leoksijini egazini liyehla, elibizwa ngokuba yi- (Hypoxemia) . Uyaqonda?

Zithini iimpawu?

Xa uphefumla kancinci (hypoventilation) , unokufumana iimpawu ezifana nezi:

• Isicaphucaphu nokuhlanza.
• Intloko ebuhlungu.
• Ukuziva udiniwe, ulele , okanye udiniwe ngalo lonke ixesha.
• Ukudideka, ukudideka , okanye utshintsho kwimeko yengqondo.
• Isantya sentliziyo siyanda.
• Isiyezi.
• Ukuphefumla kuvakala ngathi kucotha, kunzulu, okanye kunzima.
• Ukutshintsha kombala oluhlaza okwesibhakabhaka kolusu, imilebe, okanye iinzipho (i-cyanosis) . Olu luphawu olubi kakhulu.

Yintoni ebangela oku?

Eyona nto ibangela ukuphefumla kancinci inokuba kukusetyenziswa gwenxa kwamayeza athile, ukugqithisa kakhulu , okanye impendulo engalindelekanga kutywala okanye iziyobisi ezithile. Cinga ngezi zinto:

• Ii-opioids: Ezi zikwabizwa ngokuba zii-narcotics . Imizekelo ibandakanya i-morphine , i-tramadol, i-oxycodone (i-OxyContin®) , kunye ne-fentanyl . Abanye abantu basebenzisa kakubi la mayeza.
• IiBenzodiazepines:Ezi zihlala ziyimithi yokuthomalalisa kunye neepilisi zokulala. Imizekelo ibandakanya i-lorazepam (Ativan®) , i-alprazolam (Xanax®) , kunye ne-diazepam (Valium®) .
• IiBarbiturates: La mayeza ngamanye amaxesha anikwa abantu abanesifo sokuxhuzula okanye abanentloko ebuhlungu .
• Iziyobisi ezingekho mthethweni: Izinto ezifana ne -heroin kunye ne-gamma hydroxybutyrate (GHB) .
• Iipilisi zokulala: Amayeza asetyenziswa ngugqirha afana ne-zolpidem (Ambien®) .
• I-Anesthesia: Ingabangelwa namayeza anikiweyo okukwenza ulale ngaphambi kotyando.

Ukongeza kula mayeza namayeza, ezinye izifo kunye neemeko zinokubangela ukuphelelwa ngamandla komoya :

• Ukutyeba kakhulu: Oku kubizwa ngokuba yi-Obesity Hypoventilation Syndrome (OHS) . Oku kuthetha ukuba ukuphefumla kuba nzima ngenxa yokutyeba kakhulu.
• Iimeko ezibangela ubunzima bokuphefumla: Umzekelo, isifo esingapheliyo sokuvaleka kwemiphunga (COPD) kunye ne-obstructive sleep apnea .
• Iimeko ezinciphisa amandla okuphefumla: Umzekelo , istroke kunye ne-hypothyroidism .
• Iimeko ezichaphazela umqolo, imithambo-luvo, okanye ulawulo lwemisipha: Imizekelo ibandakanya i-muscular dystrophy, i-nerve okanye i-spinal cord disorders, i-multiple sclerosis (MS) , kunye ne-amyotrophic lateral sclerosis (ALS) .
• Utshintsho kwimilo yesifuba okanye umqolo: Iimeko ezinje nge -scoliosis ( ukugoba komqolo), i-ankylosing spondylitis, kunye nesifuba esithambileyo .
• Iityhefu okanye ubuthi: Izinto ezifana ne -tetanus , ubuthi be-ciguatera, kunye ne-botulism .

Ziziphi izinto ezandisa umngcipheko?

Umngcipheko wokuphefumla kancinci unokwanda ngenxa yezi zizathu zilandelayo:

• Ukusetyenziswa gwenxa kwamayeza anjengee -opioids okanye ii-benzodiazepines .
• Ukuba usandul’ ukwenziwa utyando (ngenxa ye-anesthesia).
• Ukuba kukho izifo ezithile zemiphunga, izihlunu, kunye nenkqubo yemithambo-luvo (ubuchopho kunye nomgogodla), njengoko sixoxe ngasentla.

Zeziphi iingxaki ezinokubangela oku?

I-carbon dioxide egazini lakhoUkuba amanqanaba e-CO2 aphezulu kakhulu, anokubangela iingxaki eziyingozi, nezisongela ubomi. Jonga:

• I-Acidosis yokuphefumla: Oku kuthetha ukuba igazi lakho line-asidi engaphezulu kunokuba kufanele libe njalo.
• Ukungasebenzi kakuhle kokuphefumla: Oku kwenzeka xa izicubu zomzimba wakho zingafumani ioksijini eyaneleyo.
• Ukubanjwa yintliziyo: Ukumiswa kwentliziyo ngequbuliso.
• I-Coma.
• Uxinzelelo lwegazi oluphezulu kwimiphunga: Uxinzelelo oluphezulu kwimithambo yegazi edibene nemiphunga.

Uyixilonga njani le nto?

Ukuze kuchongwe ukudakumba kokuphefumla , ugqirha uza kuqala akubuze ngeempawu zakho, imbali yakho yezonyango, kunye nayo nayiphi na imithi oyithathayo. Emva koko, banokuyalela uvavanyo lwegazi olukhethekileyo ukulinganisa ubungakanani bekhabhoni diokside (CO2) egazini lakho. Banokuyalela nezinye iimvavanyo ukuze bafumane kanye kanye ukuba yintoni ebangela ukuphefumla kancinci .

Luhlobo luni lovavanyo oluqhutywayo?

Uvavanyo olufana nolu lunokwenziwa ukuze kufunyanwe unobangela oyintloko wokuphefumla kancinci:

• Uvavanyo lweGesi yeGazi yeArterial: Olu vavanyo lujonga ubungakanani beoksijini, ikharbon diokside, kunye neasidi egazini.
• Uvavanyo Lokusebenza Kwemiphunga: Olu luvavanyo olujonga ukuba imiphunga yakho isebenza kakuhle kangakanani na.
• I-Pulse Oximetry: Sisixhobo esilinganisa ubungakanani beoksijini egazini lakho ngokuncamathisela ikliphu encinci emnweni wakho. Usenokuba ukubonile oku.
• Uvavanyo lweGazi: Kukho ezinye iimvavanyo ezininzi zegazi ezinokunceda ekuxilongeni le meko okanye izizathu zayo. Imizekelo ibandakanya i-Complete Blood Count (CBC) , i-Basic Metabolic Panel (BMP) , i-Toxicology Screen (ukujonga izinto ezifana namayeza), uvavanyo lwegazi lwe-Carbon Dioxide (CO2) , kunye novavanyo lwe-Thyroid Function.
• Imifanekiso: Ugqirha unokuyalela ii-X-ray zesifuba sakho, ii-CT scans (ii-Computed Tomography scans) zesifuba sakho okanye intloko yakho ukujonga ezinye iimeko ezifihlakeleyo.
• Isifundo Sokulala / I-Polysomnography: Olu vavanyo lunceda ekufumaneni iimeko ezifana ne -sleep apnea kunye ne-obesity hypoventilation syndrome .

Iphathwa njani?

Unyango lokuphefumla kancinci luxhomekeke kwisizathu kunye nokuba imeko imbi kangakanani. Ababoneleli ngeenkonzo zonyango banokukunika unyango olufana nolu:

• Umoya Ongangenisi Umoya: Oku kuquka ukusebenzisa umatshini okuncedayo ukuphefumla ngemaski ehambelana nobuso bakho. Umzekelo, umatshini we -Continuous Positive Airway Pressure (CPAP) okanye umatshini we -Bilevel Positive Airway Pressure (BiPAP®) . Usenokuba ukhe weva ngezi zinto.
• Amayeza Okuvuselela Ukuphefumla: Ngamanye amaxesha, ukuba le meko ibangelwa kukusebenzisa i-overdose okanye njengesiphumo esibi seyeza, amayeza okuguqula imeko anganikwa. Umzekelo, ukuba le meko ibangelwa zii -opioids , iziphumo zingancitshiswa ngokunika iyeza elibizwa ngokuba yiNaloxone/Narcan® .
• Unyango lwe-oksijini: I-oksijini inganikwa ukuba kuyimfuneko.
• Umoya Ongeniswa Ngoomatshini: Ukuba imeko imbi kakhulu, umntu unokufuna ukuthomalaliswa, afakwe kwityhubhu, aze aphefumle ngomatshini.

Luhlobo luni lwemeko olunokulindeleka kwixesha elizayo? (Imbono)

Uqikelelo lokuba umntu uza kuphefumla kancinci luxhomekeke kwisizathu. Ingxaki engxamisekileyo, efana nokusela i-opioid ngokugqithisileyo, inokubulala ukuba ayinyangwa ngokukhawuleza. Nangona kunjalo, ukuba imeko ibangelwa yi-sleep apnea, i-obstructive sleep apnea syndrome ( OHS ) , okanye ezinye iimeko ezihlala ixesha elide, iya kufuna unyango oluqhubekayo kwaye iya kuphucuka kancinci kancinci.

Ngaba ingathintelwa?

Eyona ndlela ilungileyo yokuthintela ukuphefumla kancinci kukuthatha amayeza akho njengoko kuyalelwe kwaye ulawule naziphi na iimeko zempilo ezifihlakeleyo. Qiniseka ukuba ubuza ugqirha wakho okanye ikhemisti ngaphambi kokuba uthathe amayeza amabini okanye ngaphezulu, ngakumbi ii-opioids kunye nee-benzodiazepines, ezinciphisa ukuxinana kwakho okanye ezikwenza ulale. Kwakhona , qaphela iziphumo ezingalunganga ezinokubakho xa la mayeza ethathwa notywala.

"Unyango luba ngumhlobo ukuba lusetyenziswa ngokuchanekileyo, kodwa lutshaba ukuba lusetyenziswa gwenxa."

Ndifanele ndimbone nini ugqirha?

Thetha nogqirha wakho kwezi meko zilandelayo:

• Ukuba unemibuzo okanye amathandabuzo malunga nesifo onaso.
• Ukuba unemibuzo okanye amathandabuzo malunga namayeza anikwe ngugqirha.
• Ukuba uneempawu zokuphefumla kancinci, ingakumbi ukuba unezinye izifo ezibangela ukuba ube sengozini.

Ufanele uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba unenye yezi mpawu zibalulekileyo , yiya kwigumbi likaxakeka elikufutshane ngoko nangoko:

• Ukuba unesifo sokuxhuzula .
• Ukuba imeko yengqondo itshintshile kwaye kukho ukudideka .
• Ukuba uziva ulele kangangokuba awukwazi ukuhlala uphaphile.
• Ukuba udidekile malunga nokuba ukuphi kwaye nini.
• Ukuba ufumana uloyiko okanye ukurhanelwa okungaqhelekanga (i-paranoia) .
• Ukuba ulusu, iinzipho, okanye imilebe ijika ibe luhlaza okwesibhakabhaka.

Yeyiphi imibuzo omele uyibuze ugqirha?

Kunganceda ukubuza ugqirha wakho imibuzo efana nale:

• "Kutheni oku kwenzeke kum?"
• "Ndingenza ntoni ukuthintela into efana nale ukuba ingenzeki kwixesha elizayo?"
• "Zeziphi iindlela zonyango endinazo?"

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ukudakumba kokuphefumla yimeko enzima apho i-carbon dioxide (CO2) iqokelelana egazini lakho. Kodwa idla ngokuthintelwa. Ukuba usela amayeza anokubangela ukudakumba kokuphefumla, thetha nogqirha wakho ukuqinisekisa ukuba uwasela ngokuchanekileyo nangokukhuselekileyo. Ukuba unesinye isifo esinokubangela le meko, buza ugqirha wakho ngamanyathelo onokuwathatha ukunciphisa umngcipheko wakho. Angathetha nawe malunga neenkxalabo zakho aze enze isicwangciso sokulawula imeko yakho ngokukhuselekileyo kunye namayeza. Ukunyamekela impilo yakho yeyona nto ibalulekileyo.

Ukudakumba kokuphefumla , ukuphelelwa ngamandla komoya, ukuncipha kokuphefumla, i-carbon dioxide, ioksijini, isifo semiphunga, ukusetyenziswa gwenxa kweziyobisi