Khawuthelekelele umntu osondeleyo kuwe egula kakhulu ngequbuliso aze angeniswe kwiYunithi yoKhathalelo oluPhezulu (ICU). Oogqirha bathi, 'Uxinzelelo lwegazi (BP) luphantsi kakhulu, kwaye kufuneka kuqalwe amayeza akhethekileyo ukuze lunyuswe.' Usenokuba ukhe weva amagama anje 'ngee-pressors' eqaliswa. Ii-Vasopressors ludidi olubaluleke kakhulu lwamayeza asetyenziswa kwidabi elisindisa ubomi. Kubaluleke kakhulu ukwazi ukuba zeziphi kanye kanye ezi. Ngoko masithethe ngale nto namhlanje.
Ngamafutshane, ziintoni ezi Vasopressors?
IiVasopressors ngamayeza anamandla asetyenziswa ngoogqirha ukunyusa uxinzelelo lwegazi oluye lwehla kakhulu. Adla ngokunikwa izigulane ezikwimeko yokothuka . Kule meko yokothuka, uxinzelelo lwegazi luyehla kakhulu kangangokuba amalungu abalulekileyo omzimba, anje ngengqondo, intliziyo, nezintso, aphelelwa ligazi elinomoya-mpilo omninzi alifunayo. Oku kungonakalisa loo malungu kwaye kube yingozi kubomi.
Ngokwesiqhelo, xa uxinzelelo lwegazi lomntu luhla, into yokuqala abayenzayo kukunika i-saline (IV fluids). Nangona kunjalo, ukuba uxinzelelo lwegazi alunyuki luye kwinqanaba elifunekayo nasemva kokunika i-saline, oogqirha basebenzisa ezi vasopressors njengenyathelo elilandelayo.
La mayeza angeniswa njani emzimbeni?
Ngenxa yokuba la mayeza anamandla kakhulu, awasoloko enikwa nge-cannula ebekwe emthanjeni engalweni. Anikwa nge -'central venous catheter' . Le yityhubhu ekhethekileyo efakwa kumthambo wegazi omkhulu entanyeni, esifubeni okanye emathunjini. Ngale ndlela, iyeza lingena ngqo kumthambo omkhulu okufutshane nentliziyo, okwenza kube lula kwaye kukhawuleze ukusebenza.
Kwenzeka ntoni emzimbeni xa kukho i-vasopressors?
La mayeza anemisebenzi emibini ephambili:
1. Ukuxinana: Cinga ngombhobho wamanzi. Ukuba sicinezela umbhobho kancinci, isantya kunye noxinzelelo lwamanzi ziya kwanda, akunjalo? Ii-Vasopressors zenza into efanayo. La mayeza abangela ukuba imithambo yegazi emincinci emzimbeni wethu ixinane okwethutyana (inciphe). Oku kubangela ukuba uxinzelelo lwegazi lunyuke.
2. Ukwandisa ukusebenza kwentliziyo: Ezinye iintlobo ze-vasopressors zichaphazela izihlunu zentliziyo, zinceda intliziyo ukuba ipompe igazi ngamandla.
Ngazo zombini ezi ndlela, uxinzelelo lwegazi oluphantsi luyanda kwaye igazi liqala ukuhamba kakuhle liye kwizitho ezibalulekileyo kwakhona.
Into ebalulekileyo kukuba la mayeza awasetyenziselwa ukunyanga isifo. Asetyenziselwa ukulawula uxinzelelo lwegazi nokukhusela amalungu omzimba ngelixa imeko engaphantsi (umz., usulelo olunzima, ukuhlaselwa yintliziyo) inyangwa.
Iintlobo zeVasopressor ezisetyenziswa ngokuqhelekileyo kunye nemizekelo
Iindidi ezahlukeneyo ze-vasopressors zisetyenziswa kwiindawo zokhathalelo oluphezulu. Ugqirha ukhetha iyeza elifanelekileyo ngokusekelwe kwimeko yesigulana.
| Igama eliqhelekileyo | Phawula |
|---|---|
| I-Norepinephrine | Liyeza elisetyenziswa kakhulu kwiimeko ezininzi zokukhwankqiswa. |
| I-Epinephrine (iAdrenaline) | Isetyenziswa kwi-allergies ezinzima (i-anaphylaxis) kunye nokuhlaselwa yintliziyo. |
| I-Vasopressin | Ihlala isetyenziswa kunye neNorepinephrine. |
| I-Dopamine | Iidosi eziphantsi zichaphazela izinga lentliziyo kunye noxinzelelo lwegazi. |
| I-Phenylephrine | Isetyenziswa rhoqo kuxinzelelo lwegazi oluphantsi olubangelwa yi-anesthesia. |
Ngaba nathi singazi sisebenzisa ii-vasopressors?
Ewe, ngandlela ithile. Izinto zokuvala iimpumlo, ezisetyenziselwa ukunciphisa ukuxinana kweempumlo xa unesifo somkhuhlane, zikwanayo neyeza elinciphisa imithambo yegazi. Oku kunciphisa imithambo yegazi ngaphakathi kwempumlo, kunciphisa ukudumba nokwenza kube lula ukuphefumla. Kwakhona, i-EpiPen® , eyi-vasopressor enamandla abantu abane-allergies ezinzima abafanele bayigcine, ine-epinephrine.
La mayeza afuneka phantsi kweziphi iimeko zonyango?
IiVasopressors ziyindlela yokuxhasa ubomi. Zifuneka kwiimeko ezinzima kakhulu nezisongela ubomi.
- Ukothuka: Ukothuka okubangelwa lusulelo olunzima (ukothuka okubangelwa yi-septic), ukusilela kwentliziyo (ukothuka okubangelwa yintliziyo), okanye ukopha kakhulu.
- I-Sepsis:Ngenxa yokungakwazi ukulawula usulelo olungene emzimbeni, umzimba wonke usabela ngendlela engaqhelekanga, nto leyo ebangela ukwehla koxinzelelo lwegazi.
- Ukuhlaselwa yintliziyo kunye nokusilela kwentliziyo: Xa intliziyo ingakwazi ukupompa igazi ngokufanelekileyo.
- Ngexesha lotyando: Ingakumbi xa uxinzelelo lwegazi luhla ngenxa ye-anesthesia yomqolo.
- Ukusabela okuqatha kwiziyobisi okanye ukulunywa yinyoka.
- Ngexesha lokuvuselelwa kwentliziyo engxamisekileyo (CPR).
Ngaba ii-vasopressors zineziphumo ebezingalindelekanga?
Ewe. La mayeza anamandla kakhulu kwaye kukho umngcipheko weziphumo ebezingalindelekanga. Yiyo loo nto enikwa kuphela kwigumbi lonyango oluphezulu (ICU), phantsi kweliso elihlala lihleli loogqirha nabahlengikazi. Yonke into ukususela kwisantya sentliziyo yesigulana, uxinzelelo lwegazi, kunye namanqanaba eoksijini ijongwa rhoqo ngabahloli.
Ezinye zeziphumo ebezingalindelekanga ezinokubakho:
- Ixhala kunye nentloko ebuhlungu.
- Iintlungu zesifuba.
- Ukuphazamiseka kwesantya sentliziyo - ukunyuka kwesantya (iTachycardia) okanye ukwehla kwesantya (iBradycardia).
- Ukunyuka okugqithisileyo koxinzelelo lwegazi.
- Ukuncipha kokunikezelwa kwegazi kwiiminwe ngenxa yokuxinana okukhulu kwemithambo yegazi.
- Umngcipheko wokuqhekeka kwegazi (i-thromboembolism).
Iqela lezonyango lihlala lijonga isigulana ukuze linciphise ezi ziphumo bezingalindelekanga. Bahlala belungisa umthamo wamayeza njengoko kufuneka.
Ixesha lokuchacha
IiVasopressors zizifo ezinzulu kakhulu ezifuna ukuba uzisebenzise. Ixesha lokuchacha lixhomekeke kwimeko ebangela ukuba unikwe la mayeza. Kusenokufuneka uhlale esibhedlele iiveki okanye iinyanga. Kwanasemva kokuba ufikile ekhaya, kufuneka uzinike ixesha lokubuyela kwindlela yakho yesiqhelo.
Wakuba ubuyele ekhaya, kubaluleke kakhulu ukuthatha onke amayeza owanikwe ngugqirha wakho ngexesha, ngedosi echanekileyo, kwaye uye kwintlanganiso yakho yeklinikhi ngexesha. Ukuba ufumana naziphi na iimpawu ezifana nokungaziva kakuhle, iintlungu zesifuba, okanye ubunzima bokuphefumla, qhagamshelana nogqirha wakho ngoko nangoko okanye uye kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane.
Umyalezo Wokuya Ekhaya
- IiVasopressors ludidi olunamandla lwamayeza anokunceda ukusindisa ubomi ngokunyusa uxinzelelo lwegazi oluphantsi kakhulu.
- Ezi zisebenza ngokunciphisa imithambo yegazi nokwandisa ukusebenza kwentliziyo.
- La mayeza anikwa kuphela kwiiyunithi zokhathalelo oluphezulu (ii-ICU), phantsi kweliso eliqhubekayo loogqirha.
- Nangona ezi zineziphumo ebezingalindelekanga, amaqela ezonyango asebenza rhoqo ukuzilawula.
- Kuthatha ixesha ukuchacha ngokupheleleyo emva kokufumana olu hlobo lonyango, kwaye kubaluleke kakhulu ukulandela imiyalelo yezonyango.
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