Wake waya esibhedlela? Noma wake waya ukuyobona umuntu? Kumelwe ukuba uke wabona ibhodlela likasawoti linamathele engalweni yakho ngaleso sikhathi, akunjalo? Iningi lethu licabanga ukuthi wonke amabhodlela kasawoti anikezwa umzimba ngale ndlela aqukethe into efanayo. Kodwa empeleni, akunjalo. Kunezinhlobo ezahlukene zoketshezi lwe-IV ezisetshenziselwa izimo zezokwelapha ezahlukene kanye nasezimweni ezahlukene. Ngakho-ke namuhla, ake sixoxe ngezibili zoketshezi lwe-IV ezisetshenziswa kakhulu ezweni lakithi, okuyi-Lactated Ringers kanye ne-Normal
saline .
Kungani uketshezi lubaluleke kangaka emizimbeni yethu?
Okokuqala, ake sibheke ukuthi kungani imizimba yethu ibaluleke kangaka ukuze ithole uketshezi. Cabanga nje,
ama-60% emizimba yethu yakhiwe ngamanzi. Lawa manzi abalulekile ekusebenzeni kahle kwazo zonke izitho zomzimba wethu, okuhlanganisa ubuchopho bethu,
inhliziyo , amaphaphu kanye nezinso. Kalula nje, amanzi enza izinto eziningi ezibalulekile emizimbeni yethu, okuhlanganisa:
- Kusiza amaseli ukuthi enze umsebenzi wawo ngendlela efanele.
- Igcoba amalunga ethu.
- Ilawula izinga lokushisa lomzimba.
- Izakhamzimba zithwalwa emzimbeni wonke.
- Imfucuza ikhishwa ngomchamo kanye nendle.
- Kuvikela ubuchopho kanye nomgogodla ekulimaleni.
Manje usuyaqonda ukuthi amanzi abaluleke kangakanani? Ngesizathu esithile, isibonelo, lapho
sihlanza kakhulu, lapho
silahlekelwa igazi eliningi engozini enkulu, noma lapho sihlushwa ukusha, inani elikhulu loketshezi liyasuswa emzimbeni wethu. Lokhu sikubiza ngokuthi
ukuphelelwa amanzi emzimbeni. Uma lokhu kwenzeka, inani lama-electrolyte emzimbeni liyaba lingalingani, igazi liyaqina, futhi inhliziyo kufanele isebenze kanzima. Lokhu yilapho uketshezi lunikezwa ngemithambo yegazi (IV) ukuze kubuyiselwe imisebenzi yomzimba.
Ziyini i-Lactated Ringers kanye ne-Normal Saline?
Lezi yizinhlayiya ezimbili ze-IV ezisetshenziswa kakhulu ezibhedlela. Zombili sizibiza ngokuthi
izixazululo ze-crystalloid . Lokhu kusho ukuthi izinhlayiya ezikulezi zinhlayiya zincane kakhulu. Ngakho-ke zingadlula kalula ezingxeni zethu zamaseli bese zimuncwa emzimbeni. Futhi, zombili lezi zinhlayiya
ziyi-isotonic . Lokhu kusho ukuthi ukuhlushwa kwalezi zinhlayiya kufana kakhulu nokuhlushwa kwe-plasma yegazi lethu. Ngakho-ke uma zinikezwa emzimbeni, azilimazi amaseli. Kodwa kukhona umehluko omkhulu phakathi kwalezi zinhlayiya ezimbili. Ngenxa yalezo zinhlayiya, odokotela bakhetha uhlobo loketshezi olufanele isiguli ngasinye.
| Uhlobo Loketshezi | Izithako | Okukhethekile |
|---|
| Usawoti Ojwayelekile (0.9% i-sodium chloride) | I-sodium chloride (usawoti) kanye namanzi kuphela. | Uketshezi oluyisisekelo lwe-IV olusetshenziswa kakhulu. |
| Ama-Lactated Ringers (LR) | I-sodium chloride, i-sodium lactate, i-potassium chloride, i-calcium chloride kanye namanzi. | Isixazululo esilinganiselayo, esifana kakhulu ne-plasma egazini lethu. |
Njengoba ubona, i-Normal Saline imane nje iyimanzi anosawoti. Kodwa i-Lactated Ringers iqukethe amanye amasawoti amaningana (ama-electrolyte) adingwa yimizimba yethu. Ngakho-ke, isixazululo se-Lactated Ringers siseduze nokwakheka kwegazi lethu.
Odokotela bazikhetha kanjani lezi?
Kulungile, manje into ebaluleke kakhulu. Kufanele nini unikezwe i-Normal Saline? Kufanele nini unikezwe i-Lactated Ringers? Lesi sinqumo senziwa udokotela kuphela okwelaphayo. Kunezici eziningi ezisithonyayo.
Into ebaluleke kakhulu ukuthi akukaze kube sesigulini ukunquma ukuthi hlobo luni loketshezi lwe-IV esiludingayo. Lesi yisinqumo udokotela azosenza ngokusekelwe esimweni sesiguli, imiphumela yokuhlolwa kwegazi , kanye nezinye izimo zezokwelapha.
Ake sichaze lokhu kabanzi kuthebula elingezansi.
| Uhlobo loketshezi lwe-IV | Izikhathi ezinhle kakhulu zokusebenzisa | Izimo okufanele uzigweme/uqaphele ngokusebenzisa |
|---|
| Usawoti Ojwayelekile | - Ezimweni eziningi zokuphelelwa amanzi emzimbeni (ukuhlanza/uhudo).
- Uma kwenzeka ukopha.
- Esesimweni sokushaqeka .
- Ezimweni lapho i-sodium iphansi egazini.
- Lolu uketshezi kuphela olunganikezwa ngokumpontshelwa igazi.
| - Iziguli ezinesifo senhliziyo .
- Iziguli ezinesifo sezinso.
- Abantu abasengozini yokugcwala ngokweqile koketshezi.
- Ingozi yokwanda kwamazinga e-chloride egazini (i-Hyperchloremia).
|
| Ama-Ringer ancelisiwe | - Uma kwenzeka ukusha kanye nezingozi ezinkulu (Ukuhlukumezeka).
- Uma kwenzeka ukopha ngokuzumayo.
- Ngesikhathi sokuhlinzwa nangemva kokuhlinzwa.
- Uma umzimba ulahlekelwa ama-electrolyte .
- Ezimweni ezifana ne-metabolic acidosis.
| - Iziguli ezinesifo sesibindi.
- Ukwehluleka okukhulu kwezinso.
- Uma kwenzeka i-lactic acidosis (ukwanda kwe-lactic acid egazini).
- Uma i-pH yegazi ingaphezu kuka-7.5.
|
Ingabe zikhona izingozi ngoketshezi lwe-IV?
Uketshezi lwe-IV ngokuvamile luphephile kakhulu ukulusebenzisa ngaphansi kokuqondisa kukadokotela. Kodwa-ke, njenganoma yikuphi ukwelashwa, kunezingozi. Izingozi ezinkulu ukunikeza
uhlobo olungalungile loketshezi, ukunikeza oluningi kakhulu noma oluncane kakhulu, noma ukunikeza oluncane kakhulu .
Uma uthola uketshezi oluningi kunalokho okudingayo:
- Ukuvuvukala kwemilenze nezingalo.
- Umfutho wegazi ophezulu.
- Ubunzima bokuphefumula.
- Ukupholisa amanxeba okulibaziseka.
Uma ungatholi uketshezi olwanele (uma ukuphelelwa amanzi emzimbeni kuqhubeka):
- Ukwanda kwesilinganiso senhliziyo.
- Umfutho wegazi ophansi.
- Ukwehluleka kwezinso.
- Ukushaqeka kanye nokwehluleka kwezitho zomzimba.
Yingakho uma unikezwa uketshezi lwe-IV esibhedlela, abahlengikazi bahlala beza bezohlola izinga lokugeleza kwegazi kanye nesimo sakho.
Umlayezo Wokuya Nawe Ekhaya
- Nakuba sithi "usawoti," kunezinhlobo eziningana zoketshezi lwe-IV ezisetshenziswa ezibhedlela. I-Normal Saline kanye ne-Lactated Ringers ziyizinhlobo ezimbili eziyinhloko.
- Ngayinye yalezi zinhlayiya inokwakheka okuhlukile, ngakho-ke zisebenza ngendlela ehlukile emzimbeni.
- Udokotela wakho uzokhetha uhlobo olufanele kakhulu loketshezi lwe-IV ukuze akunike lona, ecabangela isimo sakho sezokwelapha, ubudala, ezinye izimo zezokwelapha, kanye nemiphumela yokuhlolwa kwegazi.
- Uketshezi oluphuma nge-IV luphephile kakhulu uma lunikezwa ngendlela efanele ngaphansi kweseluleko sikadokotela, ngakho-ke ungesabi ngokungadingekile.
- Uma unemibuzo noma ukukhathazeka ngalokhu, ungalokothi unqikaze ukubuza udokotela noma abasebenzi abakulaphayo.
Uketshezi lwe-IV, usawoti, Usawoti Ojwayelekile, Ama-Lactated Ringers, ukuphelelwa amanzi emzimbeni, Ukuphelelwa amanzi emzimbeni, uketshezi lwe-IV IsiSinhala, izinhlobo zosawoti
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