Wake wezwa ngomuntu osegunjini lokunakekelwa okujulile (ICU) onenkinga yokuphefumula futhi oxhunywe kumshini wokuphefumula? Mhlawumbe sekwenzekile komunye wakho. Isizathu esiyinhloko salokhu ngokuvamile yisimo sempilo esibucayi esizokhuluma ngaso esibizwa ngokuthi i-ARDS. Igama lingase lizwakale liyesabisa kancane, kodwa ungakhathazeki. Sizolichaza ngendlela elula ongayiqonda.
Iyini ngempela i-ARDS?
Kalula nje, i-ARDS iwumonakalo omkhulu emaphashini akho. Cabanga ngamaphaphu akho njengezingcezu ezimbili zesiponji. Ngokuvamile, lapho siphefumula, lezi ziponji zigcwala umoya. Kodwa ku-ARDS, amasaka amancane omoya angaphakathi kwala maphaphu (abizwa ngokuthi ama-alveoli) aqala ukugcwala uketshezi.
Manje cabanga, lapho isiponji simunca amanzi, asikho isikhala somoya omningi ongangena kuwo. Kwenzeka into efanayo nasemaphashini. Lapho amanzi egcwala esikhundleni somoya, amaphaphu awakwazi ukugcwala umoya kahle. Ngenxa yalokho, igazi alitholi inani elidingekayo lomoya-mpilo. Kwezokwelapha, lesi simo sibizwa ngokuthi `(hypoxia)` . Lokhu kuyingozi kakhulu.
Ngoba umoya-mpilo ubalulekile ukuze zonke ezinye izitho zomzimba wethu, njengobuchopho, inhliziyo nezinso, zisebenze. Uma umoya-mpilo ungekho, lezo zitho ziqala ukungasebenzi kahle ngasinye ngasinye.
Odokotela bavame ukuhlukanisa i-ARDS ibe amazinga amathathu - aphansi, aphakathi nendawo, kanye nanzima. Lokhu kunqunywa ngokuqhathanisa izinga lomoya-mpilo egazini lakho nenani lomoya-mpilo okudingeka uwunikeze ngaphandle ukuze ubuyisele lelo zinga ezingeni elifanele.
I-ARDS ivame ukwenzeka lapho umuntu elaliswe esibhedlela ngenxa yokutheleleka okunye, ukugula, noma ingozi enkulu. Kodwa-ke, uma uba nalezi zimpawu ngisho noma ungekho esibhedlela, kubalulekile ukufuna usizo lwezokwelapha ngokushesha.
Yiziphi izimpawu eziyinhloko zalesi simo?
Izimpawu ze-ARDS zingahluka kuye ngokuthi imbangela, ubukhulu besimo, kanye nanoma yiziphi izimo zenhliziyo noma zamaphaphu ezikhona kakade onazo. Kodwa-ke, kunezimpawu ezithile ezivamile.
| Isibonakaliso | Incazelo |
|---|---|
| Ubunzima obukhulu bokuphefumula | Kuzwakala kunzima kakhulu ukuphefumula, njengokungathi uyacinana. |
| Ukuphefumula okusheshayo nokukhandlekayo | Inani lokuphefumula liyakhula. Kudinga umzamo omkhulu ukuthatha ukuphefumula ngakunye. |
| Ukushaya kwenhliziyo | Inhliziyo yami izwakala sengathi ishaya ngokushesha. |
| Izindebe eziluhlaza okwesibhakabhaka nezinzipho | Uma izinga lomoya-mpilo egazini lehla ngendlela eyingozi, izindebe nezinzipho ziqala ukuphenduka zibe luhlaza okwesibhakabhaka. Lokhu kuyisimo esiphuthumayo. |
I-ARDS ivame ukuvela zingakapheli amahora noma izinsuku zesigameko esibangela lesi sifo, futhi isimo singaba sibi kakhulu ngokushesha okukhulu.
Yiziphi izimbangela ze-ARDS?
I-ARDS akuyona isifo esizenzekela sodwa. Sivela ngenxa yesinye isimo sezokwelapha noma ingozi. Ake sibheke ezinye zezimbangela eziyinhloko ngezansi.
| Isizathu | Incazelo elula |
|---|---|
| I-Sepsis | Lena imbangela eyinhloko ye-ARDS. Kalula nje, ukutheleleka okukhulu (isib. i-pneumonia ) emzimbeni kuyaba yinto engalawuleki futhi kusakazeke emzimbeni wonke. |
| Ukuphefumulela ukudla/uketshezi emaphashini | Uma ukudla noma isiphuzo noma okuqukethwe esiswini kuhamba ngengozi nge-trachea kuye emaphashini, kungabangela umonakalo omkhulu emaphashini futhi kuholele ku-ARDS. |
| Ukunikela ngegazi ngobuningi obukhulu | Uma umzimba unikezwa amayunithi egazi angaphezu kuka-15 ngesikhathi esifushane, kukhona ingozi ye-ARDS. |
| Igciwane le-covid19 | Iziguli ezinegciwane le-COVID-19 elibi zingase zibe ne-ARDS. |
| I-Pancreatitis | Ngenxa yokuvuvukala okukhulu noma ukutheleleka kwe-pancreas. |
| Izingozi ezinkulu noma ukusha | Ukulimala kwamaphaphu noma ezinye izitho zomzimba ngenxa yengozi enkulu noma ukusha. |
| Ukuphefumula umusi onobuthi | Ukulimala kwamaphaphu ngenxa yokuphefumula umusi wamakhemikhali anobuthi noma intuthu eningi. |
| Ukweqisa izidakamizwa | Ukusetshenziswa ngokweqile kwezidakamizwa ezifana ne-cocaine ne-heroin. |
| Ukuminza emanzini | Uma uminza, amanzi angena emaphashini angabangela umonakalo omkhulu. |
Ubani osengozini enkulu?
Abantu asebevele bebhedlela ngenxa yokugula noma ingozi basengozini enkulu yokuthola i-ARDS. Kodwa-ke, akuwona wonke umuntu obhedlela onayo. Kunezinye izici eziningana ezandisa ingozi:
- Ukuba neminyaka engaphezu kwengu-65 ubudala.
- Ukusetshenziswa kogwayi (ukubhema).
- Ukulutheka kwezidakamizwa noma utshwala.
- Ukuba nesifo samaphaphu esivele sikhona.
Ezinye izinkinga ezingase zenzeke ngenxa ye-ARDS
I-ARDS ayithinti nje amaphaphu kuphela. Ingabangela izinkinga ezahlukahlukene kokubili ngesikhathi usesibhedlela nangemva kokuya ekhaya.
- Amahlule egazi: Amahlule egazi angakheka ngaphakathi kwemithambo yegazi, ikakhulukazi emilenzeni. Lokhu sikubiza ngokuthi "i-deep vein thrombosis - DVT``.
- Ukuwa kwamaphaphu: Iphaphu elonakele lingaqhuma (i-pneumothorax) ngenxa yengcindezi ekhishwa yi-ventilator.
- Ukuhlanya: Ukuhlanya.
- Ukwehluleka kwezitho eziningi: Ukwehluleka kwezitho ngasikhathi sinye njengobuchopho, inhliziyo, nezinso.
- Ubuthakathaka bemisipha: Imisipha iba buthakathaka ngenxa yokuba sembhedeni izinsuku eziningi.
- Izibazi emaphashini: Izicubu zezibazi zingakheka njengoba amaphaphu ephola (i-lung fibrosis).
- Izinkinga zengqondo: Ngemva kokubhekana nokuhlangenwe nakho okubi kangaka, izimo ezifana nokucindezeleka kwangemva kwenhlekelele (PTSD), ukukhathazeka, kanye nokucindezeleka zingavela.
Odokotela bakubona kanjani lokhu?
Ngenxa yokuthi izimpawu ze-ARDS zifana nezinye izifo zenhliziyo noma zamaphaphu, odokotela benza izivivinyo eziningana ukuqinisekisa ukuthi yi-ARDS.
- I-X-ray yesifuba: Ukubona ukuthi kungakanani uketshezi olusemaphashini.
- Ukuhlolwa kwegazi: Kala izinga lomoya-mpilo egazini bese unquma ubukhali be-ARDS.
- I-Echocardiogram: I-ultrasound scan ukuze kuhlolwe ukusebenza kwenhliziyo.
- I-ECG (i-Electrocardiogram): Buka umsebenzi kagesi wenhliziyo.
- I-Pulse Oximetry: Ukuqapha okuqhubekayo amazinga e-oxygen kusetshenziswa idivayisi encane enamathiselwe emunweni.
- I-CT scan: Thola ulwazi oluningiliziwe mayelana namaphaphu.
- Ukuhlolwa koketshezi lokuphefumula: Thola imbangela yokutheleleka.
Iphathwa kanjani?
Umgomo oyinhloko wokwelashwa kwe-ARDS ukwandisa izinga lomoya-mpilo egazini nokuvimbela ezinye izitho zomzimba ukuthi zingaphumeleli. Ukuze benze lokhu, iziguli zidinga ngempela umshini wokuphefumula kanye nokwelashwa komoya-mpilo .
Konke lokhu kwelashwa kwenzeka egunjini lokunakekelwa okujulile (ICU), ngaphansi kokubhekwa njalo kodokotela abangochwepheshe kanye nabasebenzi abahlengikazi.
Ngaphezu kwalokho, odokotela benza ezinye izinto eziningana ukuze banciphise izinkinga.
- Kunikezwa imithi yokudambisa ubuhlungu nokungakhululeki.
- Isiguli siguqulwa sibe yindawo ethambekele esikhundleni sokuma siqonde phezulu. Lokhu kuvumela umoya-mpilo ukuthi ugeleze kalula uye emaphashini.
- Kunikezwa imithi yokunciphisa igazi ukuze kuvinjelwe ukuqhekeka kwegazi.
- Ama-diuretics anikezwa ukususa uketshezi oluningi emzimbeni nasemaphashini.
- Yelapha noma uvimbele izifo uma zikhonaKunikezwa ama-antibiotic.
- Ukwelashwa ngokomzimba kusetshenziselwa ukuvimbela ubuthakathaka bemisipha.
Kuthatha isikhathi esingakanani ukuphulukisa kanye nesimo sengqondo?
Isikhathi esithathwayo sincike ebunzimeni besifo kanye nesivinini sokululama kwamaphaphu. Ngokuvamile, kungathatha izinyanga eziyisithupha kuya onyakeni ukuthi umuntu aphinde asebenze kahle emaphashini ngemva kwe-ARDS. Kodwa-ke, abanye abantu abalulami ngokugcwele.
Amazinga okusinda kwe-ARDS manje akhuphuke kakhulu. Uma belashwa kusenesikhathi, phakathi kuka-55% no-70% bayasinda. Kodwa-ke, leli zinga liyehla uma ukwelashwa kuyephuza noma uma ezinye izitho zomzimba ziqala ukwehluleka.
Ukululama kuwuhambo olude. Iningi labantu liyakwazi ukuphefumula lodwa ngemva kokukhishwa kumshini wokuphefumula. Abanye balulama ngokuphelele. Abanye bangase babe nezinkinga zamaphaphu zesikhathi eside. Kuzodingeka baqhubeke nokubhekwa udokotela wamaphaphu.
Khumbula, ukuchitha isikhathi egunjini lokunakekelwa okujulile kuyisikhathi esinzima kakhulu kokubili isiguli kanye nomndeni. Ukusekelwa ngumndeni wakho nabangani kuzobaluleka kakhulu kuwe ohambweni lwakho lokululama.
Umlayezo Wokuya Nawe Ekhaya
- I-ARDS yisimo esibi kakhulu, esisongela ukuphila esibangelwa uketshezi olugcwalisa izikhwama zomoya zamaphaphu.
- Lesi akusona isifo esizenzekela sodwa; ngokuvamile siwumphumela wesinye isimo sezokwelapha, njenge-sepsis, i-pneumonia, noma izingozi ezinkulu.
- Izimpawu eziyinhloko ukuphelelwa umoya okukhulu, ukuphefumula okusheshayo, kanye nomoya-mpilo ophansi egazini.
- Ukwelashwa kunikezwa eYunithi Yokunakekelwa Okujulile (i-ICU) ngosizo lwemishini yokuphefumula nomoya-mpilo.
- Ukululama kungathatha izinyanga noma ngisho nonyaka, futhi kuwuhambo olude nolunesineke.
- Uma wena noma othile omaziyo ebhekene nobunzima obukhulu bokuphefumula, kubalulekile ukuya e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha.
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