Wake wambona umuntu egunjini lokunakekelwa okujulile (ICU) noma umuntu olethwe egumbini lezimo eziphuthumayo (ETU) enobunzima obukhulu bokuphefumula, bese odokotela beshesha ukumtshela ukuthi "ayenze i-ABG"? Lokhu ukuhlolwa kwegazi okubaluleke kakhulu futhi okukhethekile ngandlela thile. Namuhla, sizokhuluma ngakho kalula, ngendlela ongayiqonda.
Kalula nje, kuyini lokhu kuhlolwa kwe-ABG?
I-ABG (i-Arterial Blood Gas) ukuhlolwa okuthatha inani elincane legazi elivela emthanjeni emzimbeni wethu. Manje ungase ucabange, "Okunye ukuhlolwa kwegazi kuthatha igazi elivela emthanjeni, umehluko uyini?"
Cabanga ngale ndlela. Umzimba wethu ufana nedolobha.
- Imithambo yegazi injengemigwaqo emikhulu eletha izinto ezibalulekile njengomoya-mpilo kanye nokudla okunomsoco edolobheni.
- Imithambo ifana nemigwaqo emidala edolobheni ethwala imfucuza efana ne-carbon dioxide ibuyele edolobheni.
Ngakho-ke, uma sifuna ukwazi kahle ukuthi ingakanani i-oxygen efika ezithweni zomzimba wethu, ikakhulukazi ebuchosheni nasenhliziyweni, sidinga ukuhlola igazi elikulowo "mgwaqo omkhulu," akunjalo? Yingakho igazi lithathwa emthanjeni ukuze kuhlolwe i-ABG.
Lokhu kuhlolwa kulinganisa kakhulu amazinga omoya-mpilo kanye ne-carbon dioxide egazini lakho. Kulinganisa futhi ibhalansi ye-acid-base, noma i-pH, yegazi lakho. Lokhu kulinganisela kubalulekile kuzo zonke izinqubo emizimbeni yethu.
Yini ngempela elinganiswa ukuhlolwa kwe-ABG?
Uma ubheka umbiko we-ABG, uzobona izinhlamvu ezithile okunzima ukuziqonda. Kodwa incazelo ilula kakhulu. Ake sibone ukuthi ngayinye yalezo zindinganiso isho ukuthini.
| Ukulinganisa | Incazelo elula |
|---|---|
| i-pH | Lokhu kukutshela ukuthi igazi lakho line-asidi kangakanani. Leli nani kufanele libe phakathi kuka-7.35 no-7.45. Noma yini engaphansi kwalokho isho ukuthi igazi lakho line-asidi, futhi noma yini ephakeme isho ukuthi line-alkaline. |
| I-PaO2 (Ukucindezela okuyingxenye komoya-mpilo) | Inani lomoya-mpilo oncibilikayo egazini. Lokhu kubonisa ukuthi umoya-mpilo ungena kahle kangakanani egazini elivela emaphashini akho. |
| I-PaCO2 (ingcindezi encane ye-carbon dioxide) | Inani le-carbon dioxide egazini lakho. Lokhu kubonisa ukuthi umzimba wakho uyisusa kahle kangakanani i-carbon dioxide. |
| I-HCO3 (i-Bicarbonate) | Lokhu kuyisisekelo egazini lethu. Kulawulwa yizinso. Kubaluleke kakhulu ekulinganiseni i-pH yegazi. |
| I-O2Sat (Ukugcwala kwe-oksijini) | Kubonisa ukuthi ingakanani iphrotheni i-hemoglobin egazini ethwala umoya-mpilo, njengephesenti. I-pulse oximeter oyibeka emunweni wakho ilinganisa inani elifanayo. |
Kudingeka nini ukuhlolwa kwe-ABG?
Lokhu akulona ukuhlolwa okwenziwa ukuhlolwa okuvamile. Kuvame ukwenziwa ezimweni eziphuthumayo kanye nokuqapha isimo seziguli esezivele zilaliswe esibhedlela . Nazi ezinye zezizathu eziyinhloko ezenza udokotela acele lokhu kuhlolwa:
- Ubunzima obukhulu bokuphefumula: Ezimweni ezifana nokubhebhetheka kwesifuba somoya kanye nokuqongelela koketshezi emaphashini (ukwehluleka okukhulu kokuphefumula).
- Izimo ezithathelwanayo ezinzima: Ezifweni ezisongela ukuphila njenge-sepsis noma i-septic shock.
- Izinkinga ezihlobene nesifo sikashukela: Ezimweni lapho igazi liba ne-asidi, njenge-diabetesic ketoacidosis (DKA).
- Ukuhlaselwa yinhliziyo noma ukwehluleka kwenhliziyo: Lapho inhliziyo iyeka ukusebenza ngokuzumayo (ukwehluleka kwenhliziyo okubukhali) noma lapho inhliziyo iyeka (ukuma kwenhliziyo).
- Ukwehluleka kwezinso: Uma izinso zingakwazi ukususa ama-asidi egazini ngendlela efanele, igazi liba ne-asidi. Funda ngalesi simo.
- Ubuthi: Uma ubuthi obuthile budliwa, i-pH yegazi iyashintsha.
- Ngaphambi nangemva kokuhlinzwa okukhulu: Qapha isimo sokuphefumula sesiguli ngesikhathi sokuhlinzwa kanye nangemva kokuhlinzwa.
- Izifo zamaphaphu ezingamahlalakhona: Bheka ukuthi ukwelashwa kuyaphumelela yini kubantu abanezifo ezifana ne-COPD (isifo samaphaphu esingamahlalakhona).
Lokhu kuhlolwa kwenziwa kanjani? Ingabe kubuhlungu?
Ukuhlolwa kwe-ABG kuhlukile kancane kunokuhlolwa kwegazi okuvamile.
Ngaphambi kokuhlolwa
Ngezinye izikhathi, uma unikezwa umoya-mpilo owengeziwe, ungase uyekwe cishe imizuzu engama-20 ngaphambi kokuhlolwa. Lokhu kwenzelwa ukubona ukuthi umzimba wakho usebenza kanjani ngaphandle komoya-mpilo. Kodwa uma ungakwazi nhlobo ukuphila ngaphandle komoya-mpilo, ungase ungenzi kanjalo. Uma igazi lithathwa esihlakaleni sakho, udokotela noma isikhulu esiqeqeshiwe singenza ukuhlolwa okulula okubizwa ngokuthi 'ukuhlolwa kwe-Allen' ukuze kubonakale ukuthi kukhona yini ukujikeleza kwegazi okuhle engalweni yakho.
Ngesikhathi ngibhala isivivinyo
1. Udokotela noma uchwepheshe oqeqeshiwe uzothola umthambo ngaphakathi kwesandla sakho (i-radial artery), eduze kwendololwane yakho (i-brachial artery), noma embotsheni yakho (i-femoral artery).
2. Hlanza indawo kahle bese ufaka isibulala-magciwane.
3. Ngemuva kwalokho, kufakwa inaliti encane kakhulu emthanjeni bese kukhishwa igazi elincane lifakwe esirinji.
4. Uma ngikhuluma iqiniso , lokhu kungaba buhlungu kakhulu kunokukhipha igazi emthanjeni. Lokhu kungenxa yokuthi umthambo utholakala ujule kancane ngaphansi kwesikhumba sethu futhi unezinzwa eziningi eziwuzungezile. Kodwa ubuhlungu buvela kuphela ngesikhathi inaliti ifakwa.
5. Ngemva kokuba inani elidingekayo legazi seliqoqiwe, susa inaliti bese ucindezela indawo ngendwangu yekotini noma i-gauze ukuze umise ukopha cishe imizuzu emi-5 kuya kweyi-10 . Uma uthatha umuthi wokunciphisa igazi, kungadingeka ukuthi usebenzise ingcindezi isikhathi eside.
Ngemva kokuhlolwa
Indawo lapho inaliti ifakwe khona ingase ibe nemihuzuko noma ibe luhlaza okwesibhakabhaka. Lokhu kuvamile. Udokotela wakho uzokutshela ukuthi ugweme ukuphakamisa izinto ezisindayo ngaleyo ngalo amahora angama-24 ngemva kokukhipha igazi.
Imiphumela yokuhlolwa kwe-ABG itholakala ngokushesha kakhulu, ngokuvamile kungakapheli imizuzu eyi-10-15. Le miphumela ibaluleke kakhulu ekwenzeni izinqumo ezisheshayo ezimweni eziphuthumayo.
Zinjani izilinganiso ezimaphakathi embikweni?
Lezi zindinganiso zingase zihluke kancane kusukela elabhorethri kuya kwelebhu, kodwa lezi yizilinganiso ezijwayelekile zomuntu omdala ophilile olwandle. Kungcono ukucela udokotela wakho incazelo ephelele yamanani embikweni wakho.
| Ukulinganisa | Ibanga Elijwayelekile |
|---|---|
| i-pH | 7.35 - 7.45 |
| PaO2 | 75 - 100 mmHg |
| I-PaCO2 | 35 - 45 mmHg |
| I-HCO3 | 22 - 26 mEq/L |
| O2Mgqibelo | 95% - 100% |
Uma la manani engaphandle kwesilinganiso esijwayelekile, kungasho ukuthi umzimba wakho awutholi umoya-mpilo owanele , noma ukuthi i-carbon dioxide ayiphumi kahle ohlelweni lwakho , noma ukuthi ibhalansi ye-asidi/isisekelo segazi lakho ayilingani . Udokotela wakho uzosebenzisa lo mbiko, izimpawu zakho, kanye nezinye izivivinyo ukuze anqume ukuthi yini ngempela engalungile ngawe.
Umlayezo Wokuya Nawe Ekhaya
- I-ABG akuyona ukuhlolwa kwegazi okuvamile okuthathwa emthanjeni, kodwa ukuhlolwa okukhethekile okuthathwa emthanjeni, umthambo wegazi omkhulu ohlinzeka nge-oxygen emzimbeni.
- Lokhu kukala kakhulu umoya-mpilo, i-carbon dioxide, kanye ne-asidi (pH) egazini.
- Lokhu kubalulekile ekutholakaleni kusenesikhathi kwezimo zezokwelapha ezimweni eziphuthumayo kanye nezimo ezibucayi njengobunzima bokuphefumula, izifo ezinzima, kanye nesifo senhliziyo.
- Nakuba kungase kube buhlungu kakhulu kunokuhlolwa kwegazi okuvamile, ulwazi olunikezayo lungasiza ekusindiseni impilo.
- Khuluma njalo nodokotela wakho okwelaphayo ngemiphumela yokuhlolwa kwakho kwe-ABG nokuthi isho ukuthini.
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