Ingabe ukuphefumula kwakho akujulile kakhulu? (Ukucindezeleka Kokuphefumula/Ukuphefumula Okuphansi) - Ake sixoxe ngalokhu!

Wake wazizwa sengathi uphefumula kanzima, noma sengathi uphefumula kanzima? Mhlawumbe uzizwe unesizungu noma ukhathele. Esinye isizathu esingaba khona salezi zinto ukwehla kokuphefumula, okuyinto esiyibiza ngokwezokwelapha ngokuthi (Respiratory Depression) noma (Hypoventilation) .

Kuyini ukucindezeleka kokuphefumula?

Kalula nje, ukucindezeleka kokuphefumula ( noma i-hypoventilation) yilapho izinga lakho lokuphefumula liba lincane kakhulu, noma uphefumula kancane kakhulu. Uma lokhu kwenzeka, ukushintshana komoya akwenzeki kahle emaphashini akho. Cabanga ngakho, lapho siphefumula, umoya-mpilo emoyeni omusha ungena egazini ngama-air sacs amancane (alveoli) emaphashini ethu. Futhi, i-carbon dioxide (CO2) , okuwumkhiqizo ongcolile womzimba wethu, ubuyela emaphashini usuka egazini bese ukhishwa umoya. Yilokhu esikubiza ngokuthi ukushintshana kwegesi .

Manje, uma kwenzeka (i-Hypoventilation) , okwenzekayo ukuthi ngoba awuphefumuli kahle, igesi ye-carbon dioxide (CO2) ayiphumi emzimbeni futhi iqoqeke egazini. Lokhu sikubiza ngokuthi (i-Hypercapnia) . Akukhona lokho kuphela, ngezinye izikhathi amaphaphu angase angatholi umoya-mpilo owanele. Bese izinga lomoya-mpilo egazini liyehla, okubizwa ngokuthi (i-Hypoxemia) . Uyaqonda?

Ziyini izimpawu?

Uma uphefumula kanzima (hypoventilation), ungase ube nezimpawu ezifana nalezi:

• Isicanucanu nokuhlanza.
• Ikhanda elibuhlungu.
• Ukuzizwa ukhathele, ulele , noma ukhathele ngaso sonke isikhathi.
• Ukudideka, ukudideka , noma ushintsho esimweni sengqondo.
• Isilinganiso senhliziyo siyanda.
• Isiyezi.
• Ukuphefumula kuzwakala kuhamba kancane, kungajulile, noma kunzima.
• Ukushintsha kombala wesikhumba, izindebe, noma izinzipho (i-cyanosis) . Lesi yisibonakaliso esingathi sína kakhulu.

Yini ebangela lokhu?

Izimbangela eziyinhloko zokuphelelwa umoya kungaba ukusetshenziswa kabi kwemithi ethile, ukudlula ngokweqile , noma ukusabela okungalindelekile kotshwala noma izidakamizwa ezithile. Cabanga ngalezi zinto:

• Ama-opioid: Lawa abizwa nangokuthi ama-narcotic . Izibonelo zifaka phakathi i-morphine , i-tramadol, i-oxycodone (i-OxyContin®) , kanye ne-fentanyl . Abanye abantu basebenzisa kabi le mithi.
• Ama-Benzodiazepine:Lezi ngokuvamile ziyimithi yokudambisa ubuhlungu kanye namaphilisi okulala. Izibonelo zifaka phakathi i-lorazepam (Ativan®) , i-alprazolam (Xanax®) , kanye ne-diazepam (Valium®) .
• Ama-Barbiturates: Le mithi ngezinye izikhathi inikezwa ukuxhuzula noma i-migraines .
• Izidakamizwa ezingekho emthethweni: Izinto ezifana ne -heroin kanye ne-gamma hydroxybutyrate (GHB) .
• Amaphilisi okulala: Imithi kadokotela efana ne-zolpidem (Ambien®) .
• I-Anesthesia: Kungabangelwa futhi umuthi onikezwayo wokukwenza ulale ngaphambi kokuhlinzwa.

Ngaphezu kwale mithi nemithi, ezinye izifo nezimo nazo zingabangela ukuphelelwa umoya :

• Ukukhuluphala ngokweqile: Lokhu kubizwa ngokuthi i-Obesity Hypoventilation Syndrome (OHS) . Kusho ukuthi ukuphefumula kuba nzima ngenxa yokukhuluphala ngokweqile.
• Izimo ezibangela ubunzima bokuphefumula: Isibonelo, isifo samaphaphu esingamahlalakhona (COPD) kanye ne -obstructive sleep apnea .
• Izimo ezinciphisa umfutho wokuphefumula: Isibonelo , isifo sohlangothi kanye ne-hypothyroidism .
• Izimo ezithinta umgogodla, imizwa, noma ukulawula imisipha: Izibonelo zifaka phakathi i-muscular dystrophy, izinkinga zemizwa noma umgogodla, i-multiple sclerosis (MS) , kanye ne-amyotrophic lateral sclerosis (ALS) .
• Izinguquko esimweni sesifuba noma umgogodla: Izimo ezifana ne -scoliosis ( ukugoba komgogodla), i-ankylosing spondylitis, kanye nesifuba esithambile .
• Ubuthi noma ubuthi: Izinto ezifana ne-tetanus , ubuthi be-ciguatera, kanye ne-botulism .

Yiziphi izinto ezandisa ingozi?

Ingozi yokuphelelwa umoya inganda ngenxa yezizathu ezilandelayo:

• Ukusetshenziswa kabi kwemithi efana nama-opioid noma ama-benzodiazepine .
• Uma usanda kuhlinzwa (ngenxa yokuhlinzwa kwe-anesthesia).
• Uma kunezifo ezithile zamaphaphu, imisipha, kanye nesistimu yezinzwa (ubuchopho kanye nomgogodla), njengoba sixoxile ngenhla.

Yiziphi izinkinga ezingabangelwa yilokhu?

I-carbon dioxide egazini lakhoUma amazinga e-CO2 eba phezulu kakhulu, kungabangela izinkinga eziyingozi, ngisho nezisongela ukuphila. Bheka:

• I-Acidosis Yokuphefumula: Lokhu kusho ukuthi igazi lakho line-asidi eningi kunalokho okufanele libe yikho.
• Ukwehluleka Kokuphefumula: Lokhu kwenzeka lapho izicubu zomzimba wakho zingatholi umoya-mpilo owanele.
• Ukuboshwa Kwenhliziyo: Ukumiswa kwenhliziyo ngokuzumayo.
• I-Coma.
• Umfutho wegazi ophezulu wamaphaphu: Ukwanda kwengcindezi emithanjeni yegazi exhunywe emaphashini.

Ukuthola kanjani lokhu?

Ukuze kutholakale ukucindezeleka kokuphefumula , udokotela uzoqala ngokukubuza ngezimpawu zakho, umlando wakho wezokwelapha, kanye nanoma yimiphi imithi oyithathayo. Ngemuva kwalokho, bangase bacele ukuhlolwa kwegazi okukhethekile ukuze balinganise inani le-carbon dioxide (CO2) egazini lakho. Bangase bacele nezinye izivivinyo ukuze bathole ukuthi yini ngempela ebangela i- hypoventilation .

Hlobo luni lokuhlolwa okwenziwayo?

Ukuhlolwa okunjengalokhu kungenziwa ukuthola imbangela eyisisekelo yokuphelelwa umoya:

• Ukuhlolwa Kwegesi Yegazi Emithanjeni: Lokhu kuhlola inani lomoya-mpilo, i-carbon dioxide, kanye ne-asidi egazini.
• Ukuhlolwa Kokusebenza Kwamaphaphu: Lokhu ukuhlolwa okuhlola ukuthi amaphaphu akho asebenza kahle kangakanani.
• I-Pulse Oximetry: Idivayisi elinganisa inani lomoya-mpilo egazini lakho ngokunamathisela i-clip encane emunweni wakho. Kungenzeka ukuthi ukubonile lokhu.
• Ukuhlolwa Kwegazi: Kunezinye izivivinyo eziningi zegazi ezingasiza ekuxilongeni lesi simo noma izimbangela zaso. Izibonelo zifaka phakathi i-Complete Blood Count (CBC) , i-Basic Metabolic Panel (BMP) , i-Toxicology Screen (ukuhlola izinto ezifana nezidakamizwa), ukuhlolwa kwegazi kwe-Carbon Dioxide (CO2) , kanye nokuhlolwa kokusebenza kwe -Thyroid .
• Izithombe: Udokotela angase akucele ukuthi uthathwe ama-X-ray esifubeni sakho, ama-CT scan (ama-Computed Tomography scans) esifubeni sakho noma ekhanda lakho ukuze abheke ezinye izimo eziyisisekelo.
• Ucwaningo Lokulala / I-Polysomnography: Lokhu kuhlolwa kusiza ukuthola izimo ezifana ne -sleep apnea kanye ne-obesity hypoventilation syndrome .

Iphathwa kanjani?

Ukwelashwa kokuphelelwa umoya kuncike embangela kanye nokuthi isimo sibi kangakanani. Abahlinzeki bezempilo bangakunikeza ukwelashwa okufana nalokhu:

• Umoya Ongangenisi Umoya: Lokhu kuhilela ukusebenzisa umshini okusiza ukuphefumula ngemaski efanela ubuso bakho. Isibonelo, umshini we -Continuous Positive Airway Pressure (CPAP) noma umshini we -Bilevel Positive Airway Pressure (BiPAP®) . Kungenzeka ukuthi uke wezwa ngalokhu.
• Imithi Yokuvuselela Ukuphefumula: Ngezinye izikhathi, uma lesi simo sibangelwa ukudlula ngokweqile noma njengomphumela omubi womuthi, imithi yokuguqula inganikezwa. Isibonelo, uma lesi simo sibangelwa ama-opioid , imiphumela ingancishiswa ngokunikeza umuthi obizwa ngokuthi i-Naloxone/Narcan® .
• Ukwelashwa Nge-Oxygen: I-Oxygen inganikezwa uma kudingeka.
• Umoya Ongenisiwe: Uma isimo sibi kakhulu, umuntu angadinga ukuthuliswa, afakwe epayipini, bese ephefumula ngomshini.

Uhlobo luni lwesimo olungalindelwa esikhathini esizayo? (I-Outlook)

Ukubikezela kokuphelelwa umoya kuncike embangela. Isimo esiphuthumayo, njengokusebenzisa ngokweqile i-opioid , singabulala uma singelashwa ngokushesha. Kodwa-ke, uma lesi simo sibangelwa yi-sleep apnea, i-obstructive sleep apnea syndrome ( OHS ) ehlobene nokukhuluphala, noma ezinye izimo zesikhathi eside, sizodinga ukwelashwa okuqhubekayo futhi sizothuthuka kancane kancane.

Ingabe kungavinjelwa?

Indlela engcono kakhulu yokuvimbela ukuphelelwa umoya ukuphuza imithi yakho njengoba uyalelwe futhi uphathe noma yiziphi izimo zezokwelapha eziyisisekelo. Qiniseka ukuthi ubuza udokotela wakho noma usokhemisi ngaphambi kokuthatha imithi emibili noma ngaphezulu, ikakhulukazi ama-opioid nama-benzodiazepine, anciphisa ukugxilisa ingqondo kwakho noma akwenze ulale. Futhi , qaphela imiphumela emibi engaba khona engenzeka uma le mithi ithathwa notshwala.

"Imithi ingumngani uma isetshenziswa kahle, kodwa isitha uma isetshenziswa kabi."

Kufanele ngimbone nini udokotela?

Khuluma nodokotela wakho kulezi zimo:

• Uma unemibuzo noma ukungabaza ngesimo sempilo onayo.
• Uma unemibuzo noma ukungabaza ngemithi enikezwe udokotela.
• Uma unezimpawu zokuphelelwa umoya, ikakhulukazi uma unezinye izimo zezokwelapha ezandisa ingozi yakho.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Uma unezinye zalezi zimpawu ezinkulu , hamba uye ekamelweni lezimo eziphuthumayo eliseduze ngokushesha:

• Uma unesifo sokuwa .
• Uma isimo sengqondo sesishintshile futhi kukhona ukudideka .
• Uma uzizwa ulele kangangokuthi awukwazi ukuhlala uphapheme.
• Uma udidekile ngokuthi ukuphi nokuthi ukuphi.
• Uma ubhekene nokwesaba noma ukusola okungavamile (ukwesaba okukhulu) .
• Uma isikhumba, izinzipho, noma izindebe ziphenduka zibe luhlaza okwesibhakabhaka.

Yimiphi imibuzo okufanele uyibuze udokotela?

Kungaba usizo ukubuza udokotela wakho imibuzo efana nale:

• "Kungani lokhu kwenzeke kimi?"
• "Yini okufanele ngiyenze ukuze ngivimbele into efana nale ukuthi ingenzeki esikhathini esizayo?"
• "Ngiziphi izindlela zokwelapha enginazo?"

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ukucindezeleka kokuphefumula kuyisimo esibi lapho i-carbon dioxide (CO2) inqwabelana khona egazini lakho. Kodwa ngokuvamile kungavinjelwa. Uma uthatha imithi engabangela ukucindezeleka kokuphefumula, khuluma nodokotela wakho ukuqinisekisa ukuthi uyithatha ngendlela efanele nangokuphephile. Uma unesinye isimo sezokwelapha esingadala lesi simo, buza udokotela wakho ngezinyathelo ongazithatha ukuze unciphise ingozi yakho. Angakhuluma nawe ngezinto ezikukhathazayo futhi adale uhlelo lokuphatha isimo sakho kanye nemithi yakho ngokuphephile. Ukunakekela impilo yakho kuyinto ebaluleke kakhulu.

Ukucindezeleka kokuphefumula, ukuphefumula okuncane, ukuphefumula okunciphile, i-carbon dioxide, umoya-mpilo, isifo samaphaphu, ukusetshenziswa kabi kwezidakamizwa