Sonke sivile ngoxinzelelo lwegazi oluphezulu. Kodwa ubusazi na ukuba uxinzelelo lwegazi oluphantsi lunokuba yingozi efanayo, kwaye mhlawumbi lube yingozi nangakumbi? Mhlawumbi ukhe weva ngomntu ogula kakhulu ngequbuliso aze angeniswe kwiYunithi yoKhathalelo oluPhezulu (ICU). Ngamaxesha anjalo, uxinzelelo lwegazi lwaloo mntu lusenokuba lwehle kakhulu. Xa oku kusenzeka, amalungu omzimba abalulekileyo, njengengqondo, intliziyo, nezintso, alahlekelwa ligazi elinomoya-mpilo alidingayo. Namhlanje, siza kuthetha ngohlobo olukhethekileyo nolunamandla kakhulu lwamayeza olusetyenziswa ngoogqirha ukusindisa ubomi kwiimeko ezingxamisekileyo ezisongela ubomi. Oku kubizwa ngokuba yiVasopressors kunyango.
Zithini nje ii-vasopressors?
Ngamafutshane, i-vasopressor luhlobo lwamayeza asetyenziswa ngoogqirha ukunceda abantu abanoxinzelelo lwegazi oluphantsi kakhulu ukuba babuyisele kwisimo sabo esiqhelekileyo. La mayeza asebenza ngokucinezela, okanye ukunciphisa, imithambo yegazi emzimbeni wethu.
Cinga ngale ndlela. Igazi elijikeleza emizimbeni yethu lifana nenkqubo yemibhobho yamanzi. Ukuba le mibhobho (imithambo yegazi) iba mikhulu okanye ikhululeke ngequbuliso, uxinzelelo lwamanzi (igazi) oluhamba ngayo luyehla. Oku sikubiza ngokuba yimeko yokothuka. Ngamaxesha anje, igazi liyayeka ukugeleza liye kwizitho ezibalulekileyo zomzimba. Ngaphandle kweoksijini, ezo zitho ziyayeka ukusebenza, kwaye ubomi baloo mntu bunokuba semngciphekweni.
Ngokwesiqhelo, xa uxinzelelo lwehla ngolu hlobo, into yokuqala ekufuneka yenziwe kukunika i-saline (IV fluids). Kodwa ukuba uxinzelelo alubuyeli kwisiqhelo nokuba sele lufakwe i-saline, into elandelayo eyenziwa ngoogqirha kukusebenzisa uhlobo lonyango olubizwa ngokuba yi-vasopressor. La ngamayeza afakwa ngqo emthanjeni. Adla ngokunikezelwa ngetyhubhu ekhethekileyo efakwa kumthambo omkhulu entanyeni okanye esifubeni, ebizwa ngokuba yi-central venous catheter. Emva koko iyeza liya ngokukhawuleza entliziyweni lize lisasazeke emzimbeni wonke.
Eli yeza lisebenza njani emzimbeni?
Amayeza e-vasopressor enza izinto ezimbini eziphambili xa engena emzimbeni.
1. Ukunciphisa imithambo yegazi: Le yeyona nto iphambili. Inciphisa imithambo yegazi emzimbeni wonke. Njengokuba ukucinezela umbhobho wamanzi kwenza amanzi ahambe ngokukhawuleza, xa imithambo yegazi incipha, uxinzelelo lwegazi olungaphakathi kuyo luyanda.
2. Yandisa ukushwabana kwentliziyo: Ezinye ii-vasopressors zisebenza entliziyweni, zinyusa inani legazi elimpompayo ngokubetha ngakunye. Oku kuthetha ukuba ziyandisa okwethutyana amandla okumpompa kwentliziyo.
Zombini ezi ndlela zikhawuleza zibuyisele uxinzelelo lwegazi oluphantsi kwaye zibuyisele ukuhamba kwegazi kwizitho ezibalulekileyo ezifana nengqondo, intliziyo, kunye nezintso .
Ziziphi iintlobo ze-vasopressors ezisetyenziswa kakhulu?
IiVasopressors zisetyenziswa kwiiyunithi zokhathalelo olunzulu (ii-ICU) ukunyanga uxinzelelo lwegazi oluphantsi ngenxa yezizathu ezahlukeneyo. Ugqirha ukhetha amayeza afanelekileyo ngokwemeko yesigulana.
| Igama leziyobisi | Amanye Amagama Eempawu |
|---|---|
| I-Norepinephrine | I-Levophed® |
| I-Epinephrine | I-Adrenalin®, i-EpiPen® |
| I-Vasopressin | IPitressin®, iVasostrict® |
| I-Dopamine | I-Intropin® |
| I-Phenylephrine | I-Biorphen®, iVazculep® |
| I-Angiotensin-II | I-Giapreza® |
Ngaba siyayisebenzisa le ndlela yezonyango kubomi bemihla ngemihla?
Ewe. Sisebenzisa amayeza athile yonke imihla asebenza ngendlela efanayo neli yeza, nangona engenamandla njengaleli.
- Izinto Zokuvula Impumlo: Xa unomkhuhlane, impumlo yakho iyavaleka. Amanye amathontsi empumlo okanye iilozenji esizisebenzisayo ziqulethe izinto ezifana ne-`(Ephedrine)` kunye ne-`(Pseudoephedrine).` Ezi zisebenza ngokucinezela imithambo yegazi ngaphakathi empumlweni, ukunciphisa ukudumba, nokwenza kube lula ukuphefumla.
- I-EpiPen®: I -EpiPen®, esetyenziswa kwiimeko zokunganyamezelani kakhulu, njenge-anaphylaxis ebangelwa kukutyiwa yinyosi okanye yi-wasp, okanye ukutya ukutya okuthile, iqulethe iyeza elifanayo elibizwa ngokuba yi-Epinephrine.
- Amanye amayeza omkhuhlane: Amanye amaphekhi amayeza omkhuhlane anokuba ne-`(Phenylephrine)`. Nayo ikweli candelo loxinzelelo lwegazi.
Ngaba iiVasopressors kunye neeInotropes ziyafana?
Ewe, ezi ziintlobo ezimbini zamayeza. Kodwa oogqirha badla ngokusebenzisa zombini ezi ntlobo kunye. Masiqonde umahluko ngokulula.
Khawuthelekelele ukuba intliziyo yethu yimoto yamanzi, kwaye imithambo yegazi yethu yimibhobho apho amanzi ahamba khona.
- IiVasopressors: La mayeza asebenza ngokunciphisa imithambo yegazi nokunyusa uxinzelelo lwegazi.
- Ii-Inotropes: La mayeza andisa amandla enjini yamanzi (intliziyo) , nto leyo ebangela ukuba ipompe amanzi amaninzi ngaxeshanye.
Ngoko ke, ukuba uxinzelelo lwegazi lomntu luphantsi kwaye intliziyo yakhe ibuthathaka, oogqirha banika la mayeza omabini kunye, bonyusa uxinzelelo ngokucinezela ityhubhu kwelinye icala, kwaye bonyusa amandla enjini kwelinye icala ukupompa igazi emzimbeni ngokufanelekileyo kangangoko.
Ziziphi iimeko apho kufuneka khona ii-vasopressors?
IiVasopressors luhlobo lwamayeza asindisa ubomi anikwa isigulana esiphakathi kokufa nokuphila. La asingomayeza anikwa isifo esiqhelekileyo. Nazi ezinye zeemeko eziphambili apho zifuneka khona.
| Imeko | Ingcaciso elula |
|---|---|
| Umothuko | Uxinzelelo lwegazi lunokwehla ngokuyingozi ngenxa yeemeko ezifana nosulelo olunzima (i-sepsis), ukopha kakhulu, kunye nokuhlaselwa yintliziyo. |
| Ukuhlaselwa yintliziyo | Ngenxa yokuvaleka komthambo wegazi ohambisa igazi entliziyweni, ukusebenza kwentliziyo kuyaphazamiseka kwaye uxinzelelo lwegazi luyehla. |
| Ukumelwa yintliziyo | Intliziyo ayikwazi ukupompa igazi elaneleyo emzimbeni. |
| I-Anesthesia yoMgogodla | Ngexesha lotyando oluthile, amayeza okubulala iintlungu anikwa umqolo anokubangela ukwehla ngequbuliso koxinzelelo lwegazi. |
| Impendulo eqatha yeziyobisi | Iimpendulo eziqatha ze-allergy kumayeza athile zinokubangela uxinzelelo lwegazi oluphantsi. |
| Iingozi kunye notyando | Uxinzelelo lwegazi oluphantsi ngenxa yokopha kakhulu. |
Ngaba kukho naziphi na iziphumo ebezingalindelekanga kweli yeza?
Ewe. IiVasopressors ziziyobisi ezinamandla kakhulu . Ke ngoko, zinokubangela iziphumo ebezingalindelekanga. Ngenxa yesi sizathu, la mayeza anikwa kwigumbi lonyango oluphezulu (ICU), ngelixa ehlala ejonga imeko yesigulana . Oogqirha kunye nabasebenzi babongikazi bahlala bejonga izinga lentliziyo yesigulana, uxinzelelo lwegazi, kunye namanqanaba eoksijini.
Ezinye zeziphumo ebezingalindelekanga zezi:
- Ixhala kunye nokungazoli
- Intloko ebuhlungu
- Iintlungu zesifuba
- Ubunzima bokuphefumla
- Isantya sentliziyo esicothayo ngokungaqhelekanga (iBradycardia)
- Ukunyuka kwesantya sentliziyo okungaqhelekanga (iTachycardia)
- Ukubetha kwentliziyo okungaqhelekanga (i-Arrhythmia)
- Uxinzelelo lwegazi oluphezulu kunokuba kufuneka. (Oku kunokukhokelela kwimeko enzima efana nokopha ebuchotsheni)
- Ukuxinana kakhulu kwemithambo yegazi kubangela ukuncipha kokuhamba kwegazi kwiinwebu zeminwe nakwiinzwane, nto leyo ebangela ukuba ezo ndawo zibe mnyama.
Nangona ezi ziphumo bezingalindelekanga ziyingozi, kubalulekile ukukhumbula ukuba la mayeza anikwa kwiimeko eziyingozi nangakumbi, ezisongela ubomi. Oogqirha basoloko bezama ukuvavanya izinto ezilungileyo nezingalunganga baze benze oko kulungele umguli.
Kuthatha ixesha elingakanani ukuchacha?
Kunzima ukunika impendulo enye kulo mbuzo, kuba ixesha olithathayo ukuze uphile alixhomekeki kumayeza oxinzelelo lwegazi owawanikwayo, kodwa lixhomekeke kwimeko yempilo ebangele ukuba unikwe amayeza .
Umzekelo, umntu ofumana isifo sosulelo esinzima ngenxa yosulelo olunzima unokufuna ukuhlala esibhedlele iiveki, kwaneenyanga, ukuze aphile. Nangona kunjalo, umntu onikwe eli yeza ixesha elifutshane ngexesha lotyando lokunciphisa uxinzelelo olubangelwa yi-anesthesia unokuphila ngokukhawuleza.
Into ebalulekileyo kukuba into yokuba unikwe amayeza anamandla kangaka ithetha ukuba uphilile kwisifo esinzima kakhulu. Ngoko ke, kufuneka unike umzimba wakho ixesha olifunayo lokuphola.
Emva kokuba ufikile ekhaya uvela esibhedlele, ungakhawulezi ubuyele kwindlela yakho yesiqhelo. Sela amayeza ugqirha wakho akunike wona ngexesha. Kwakhona, qiniseka ukuba uyawagcina amaxesha akho okulandela. Ukuba uziva ungaphilanga kwakhona, umzekelo, ukuba unengxaki yokuphefumla, iintlungu esifubeni, okanye uzive ungaphilanga, tsalela umnxeba ugqirha wakho ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane.
Umyalezo Wokuya Ekhaya
- IiVasopressors ludidi olunamandla kakhulu lwamayeza asetyenziselwa ukusindisa ubomi kwiimeko ezingxamisekileyo, ezifana noxinzelelo lwegazi, xa uxinzelelo lwegazi luhla ngendlela eyingozi.
- Umsebenzi wazo ophambili kukunciphisa imithambo yegazi, ukunyusa uxinzelelo lwegazi, nokuqinisekisa ukuhamba kwegazi ukuya kwizitho ezibalulekileyo.
- Ngenxa yamandla azo kunye nemiphumo enokubakho, la mayeza anikwa kuphela kwiiyunithi zokhathalelo oluphezulu (ii-ICU), phantsi kweliso eliqhubekayo loogqirha kunye nabasebenzi babongikazi.
- Ukuba wena okanye umntu osondeleyo kuwe unikwe olu nyango, oko kuthetha ukuba uyaphola kwisifo esinzima kakhulu. Kubalulekile ukulandela iingcebiso zonyango ngononophelo emva kokuphuma esibhedlele.
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