Anatomy, Sleep Sleep, ndi Stage Stages Zonse Zovuta Zokhuza Kusokonezeka
Ngati mwauzidwa kuti mupitirize kuchipatala kuti muthetse matenda obisala , mungadzifunse kuti: Kodi kugona kwa mphuno yakugonana kumayesedwa ndi AHI mogwirizana ndi kufunika kwa CPAP kwa mankhwala oyenera? Phunzirani ngati (ndipo ndi motani) zomwe zalembedwa pa CPAP zimagwirizana ndi danga lalikulu la kugonana kwa kugona ndi zinthu zina zomwe zingagwiritsidwe ntchito kuti mupeze chithandizo chabwino, kuphatikizapo anatomy, malo ogona, ndi magawo ogona.
Mmene Kufooka Kwapakati Kumakhudzira Kupsinjika
Ndi zachilendo kuganiza kuti padzakhala mgwirizano pakati pa machitidwe a CPAP omwe ali ndi chiwerengero cha kuperewera kwa kugonana komwe kumaperekedwa. Ngati mukusowa mankhwala okhudza kuthamanga kwa magazi, mlingo wapamwamba mwachibadwa ungakhale ndi zotsatira zowonjezera, chabwino? Eya, mwatsoka, ubalewu suli wolunjika bwino pamene mukudwala matenda obisala.
Kupewa kugona tulo (OSA) kumapezeka kuti tili ndi phunziro la kugona usiku umodzi kapena mayeso ogona a kugona kunyumba omwe amawerengera kangapo pa ola la kugona kumene kumalo akukwera pansi, zomwe zimapangitsa kuti magazi asokonezeke kapena kuti atuluke. Ngati mphepoyo ikugwa kwathunthu, imatchedwa apnea ndipo ngati idawonongeka izi zimatchedwa hypopnea. Chiwerengero cha zochitikazi pa ola lagona ndi ndondomeko ya apnea-hypopnea (AHI) .
AHI imalola mndandanda wa kufooka kwa mphuno yakugona kuti ichitike.
Ngati pali zochitika zosachepera zisanu pa ora, izi zimawoneka ngati zachilendo. Ngati zochitika 5 mpaka 15 pa ora zili zolembedwa, izi ndi zosavuta. Ngati zochitika zoposa 15 koma zosachepera 30 zikuwonetsedwa, izi zimaonedwa kuti ndizochepa. Pomalizira, ngati zochitika zoposa 30 zalembedwa pa ola la kugona, izi zimawoneka ngati OSA yaikulu.
Mungaganize kuti OSA yaikulu imakhala ndi vuto lapamwamba la CPAP kuti lipitirire kuchipatala. Zoonadi, izi sizili choncho nthawi zonse ngati pali zinthu zambiri zomwe zimaphatikizapo pakukhazikitsa zofunikira. Kawirikawiri, mankhwala amayamba pang'onopang'ono ndipo pang'onopang'ono akuwonjezeka kuthetsa zochitika zonse za apnea ndi hypopnea komanso kusewera. Malo otsika kwambiri pa makina a CPAP akhoza kukhala masentimita 4 kapena asanu a mphamvu ya madzi (yofupikitsidwa monga masentimita a H20 kapena CWP). Ambiri mwa anthu amafunika kupanikizika kuposa malo otsika kwambiri. Mawotchi apamwamba amasiyana ndi mtundu wa makina, koma akhoza kukhala okwera 25 kapena 30 CWP.
Kudziwa Chofunika Chokhazikitsa Pulogalamu Yothetsera Kugonana Apnea
Ngati chiwerengero cha CPAP chatsimikiziridwa ngati gawo la phunziro lakutchulidwa usiku mu labata yogona , polysomnography technologist adzawona mpweya ndikukonzekera zakutsogolo pamene mukugona. Izi zimachitidwa kutali ndi chipinda china, kotero kuti kusokonezeka sikuchitika. Cholinga chake ndicho kuthetsa kugona kwa tulo ndikugona ndi kugona tulo tofa nato, kuphatikizapo kugona kwa maso mwamsanga (REM). Zokonzera izi ziyeneranso kukonzedweratu pamene mukugona kumsana (kumbuyo kwanu), pamene kugona tulo kumakhala kovuta.
Anthu ena amatumizidwa kunyumba ndi makina odzigwiritsira ntchito, omwe nthawi zina amatchedwa AutoCPAP kapena APAP.
Pa zochitikazi, dokotala yemwe amalembedwa amalola mavuto osiyanasiyana, ndipo makinawo amayamba kutsika ndikukwera mmwamba momwe amafunira poyesa kutsutsana kwa kayendetsedwe ka ndege (kutanthauza kuwonongeka kosalekeza kwa mapepala ofewa ngati mapepala a mmimba kapena phokoso pamphuno ). Pulogalamuyi imapereka mpweya wambiri wa mpweya kuti ayese kukana ndipo, poonjezera, kaya pamwamba pamtunda ukugwa. Ngati pandege imatsegulidwa pakalipano ya CPAP yaperekedwa, imasungidwa.
Chofunika cha CPAP sichigwirizana kwambiri ndi kufooka kwa kugona kwa kugona.
Anthu ena omwe ali ndi OSA yofatsa amafunika kupsyinjika kwakukulu ndipo anthu ena omwe ali ndi OSA ovuta amafunikira mavuto ochepa. Izi zikunenedwa, anthu omwe ali ndi matenda otupa kwambiri ogona amakhala osowa nthawi zambiri amafunika kupanikizika kwambiri pa CPAP, kapena ngakhale mankhwala a bilevel . Izi ndizochitika makamaka pakakhala kunenepa kwambiri kapena kutsekedwa kwa msana. Ana angafunike zovuta zofanana kwa akuluakulu, ngakhale kukula kwazing'ono zawo.
Kodi ndi zifukwa ziti zomwe zimapangitsa kuti pakhale vuto la CPAP? Zomwe zimachitika m'mphepete mwa msewu ndi chikhalidwe chakutchinga kwapansi ndi gawo lalikulu. Ngati kugona kwa mpweya kumachitika chifukwa cha mphuno yotsekedwa chifukwa cha kupweteka kapena kupumula kwa sevalo , chilakolako chogwa , kapena chilankhulo chomwe chimagwera kumbuyo, mpweya wosiyanasiyana umayenera kukankhira minofuyi.
Kuonjezera apo, kukhala woposa kunenepa kwambiri kapena kunenepa kungapangitse zinthu kuwonjezera. Ndipotu, pamene anthu ataya 10% ya kulemera kwa thupi lawo, zingakhale zofunikira kusintha machitidwe a CPAP mwa kuwatsitsa.
Mowa, mankhwala omwe amamasula minofu ya m'mlengalenga (monga benzodiazepines ), ndipo kugona pamsana panu onse akhoza kuwonjezera pazomwe mumakakamizidwa.
Pomaliza, REM imagona mpaka m'mawa imatha kupumula minofu komanso imapangitsa kuti munthu asagone.
Kukonzekera Moyenera Kungadalire Kubwereza kwa Wokhalamo AHI
Choncho, monga tafotokozera pamwambapa, sikuvuta kuti tidziwe kuti ndi chiani chomwe chiliphamvu cha CPAP chomwe mungafunikire kuchipatala. Zingasinthenso mosiyana pakati pa usiku malingana ndi kugona kwanu ndi kugona. Ngati mavutowa ndi otsika kwambiri, kugona kwanu kosagona sikudzasungidwa bwino. Ngati ili lalikulu kwambiri, mukhoza kukhala ndi zotsatira ngati mask kuphulika kapena mpweya ukumeza .
Ndikofunika kukhala ndi makina abwino omwe ali ndi katswiri wa kugona kuti atsimikizire zabwino zomwe zimapindula nazo komanso phindu lalikulu. Zipangizo zamakono zingapereke chidziwitso chotsalira cha AHI ndipo izi zingathandize kutsogolera zovuta. Zingakhale zabwino kugwiritsa ntchito makina a AutoCPAP omwe amatha kusintha ndi zosiyana zina.
Mawu Ochokera
Ngati mukupitirizabe kukhala ndi zizindikiro, funsani dokotala wanu ogwira ntchito kuti mugwirizane ndi vuto lanu lopanikizika. Musasinthe zoikidwiratu nokha monga momwe simungamvetsetse zinthu zomwe zimayambitsa mavuto omwe mukukumana nawo.
Chitsime:
Kryger, MH et al . "Mfundo Zothandiza Pogona Mankhwala." Elsevier , edition la 6, 2017.