Zotsatira za Mlomo ndi Mphuno Yopuma Pamalo Oxygen Levels
Kodi kupuma pakamwa kumakhudza mpweya wanu wa oxygen ngati muli ndi mankhwala othandizira okosijeni? Ngati ndi choncho, kodi muyenera kudziwa chiyani ndipo mungachite chiyani?
Supplemental Oxygen Therapy Basics
Mankhwala othandizira okosijeni amatchulidwa kawirikawiri kwa anthu omwe mpweya wokhala ndi mpweya wochepa (PaO2) umene umayesedwa ndi magetsi a magazi (ABGs) ndi osachepera kapena ofanana ndi 55 mg Hg ndi mlingo wokhala ndi oxygen wokwanira 88 peresenti kapena ochepa pamene akuwuka (kapena kuti amagwera pamsinkhu uwu pamene wagona kwa mphindi zisanu).
Anthu ambiri amalandira mpweya wokhala m'nyumba-mpweya pogwiritsa ntchito chipangizo cha oxygen chomwe chimatchedwa phokoso lamadzi . Thupi laling'ono la pulasitiki, lili ndi mapira awiri aang'ono pamphepete mwake omwe amakhala m'mphuno. Nkhumba ya nasal ikhoza kutulutsa mpweya wabwino kwa munthu wokhala ndi malita imodzi mpaka asanu pa mphindi imodzi (LPM), m'magawo kuyambira 24 mpaka 40 peresenti, malingana ndi kuchuluka kwa LPM. Poyerekeza, mpweya wa m'chipinda uli ndi pafupifupi 21 peresenti ya oksijeni, yomwe siyikwanira kwa anthu omwe ali ndi matenda a mapapu.
Kodi Mphukira Yam'mphuno Imapindula ndi Oxygen Yowonjezera?
Pali zothandiza zambiri za mankhwala otalika kwa nthawi yayitali , ndipo yaikulu kwambiri ndi yakuti, akagwiritsidwa ntchito osachepera maola 15 pa tsiku, imapulumuka. Koma, kodi anthu omwe amagwiritsa ntchito mpweya ndi kupuma kudzera pakamwa pawo amatha kupeza phindu lonse la mankhwala okosijeni? Kapena, kodi kupuma m'kamwa kumachititsa mpweya wotsika m'magazi, maselo, ndi ziphuphu?
Kafukufuku wokhudza nkhaniyi akutsutsana ndi momwe zitsanzozi zikuwonetsera:
- Mu kafukufuku wokhudza nkhani 323 zopuma pakamwa, ofufuza anapeza kuti zotsatira za kupuma pakamwa pa oxygen. Cholinga cha phunzirolo, kupuma m'kamwa kunayesedwa mwa kuunika kwa thupi ndi mafunso omwe anadzazidwa ndi maphunziro kapena anzawo. Kukhazikika kwa okosijeni kunayesedwa ndi kutentha kwa oxyetry . Zotsatira za phunzirolo zapeza kuti 34.6 peresenti ya anthu anali ndi magulu okwanira okwana oksijeni (95 peresenti kapena kuposa), 22.6 peresenti anali ndi kuchuluka kwa oxygen ya 95 peresenti ndipo 42,8 peresenti ankatengedwa ngati hypoxic , ndi magulu okwanira oksijeni pansi pa gawo lophunzirira la 95 peresenti. Ochita kafukufuku anapeza kuti, pamene kupuma pakamwa sizimapangitsa hypoxia kukhala ndi mphamvu, ikhoza kuthandizira.
- Kafukufuku wina wophatikizapo nkhani 10 zogwiritsira ntchito poyerekeza poyerekeza ndi mpweya wotsekemera wa mpweya wa mpweya wotseguka ndi wotsekedwa pakamwa umatuluka kuchokera kumapeto kwa mphuno ya mphuno m'mphuno. Phunzirolo linatsimikizira kuti sizingowonjezera kuti gawo lochepa la okosijeni louziridwa (FIO2) likuwonjezeka ndi kuchuluka kwa ma oksijeni othamanga koma koma poyerekeza ndi pakamwa pakamwa pakamwa, pakamwa pakamwa pakamwa pakamwa pakamwa pamadzi amadziwa kwambiri FIO2. Komabe, m'nyuzipepala yotsutsana ndi kuwona kwa phunziro lomwe tatchulapo, Dr. Thomas Poulton, Chief Resident of Bowman Gray School of Medicine, Dipatimenti ya Anesthesia, akulongosola kuti zitsanzo za mafuta zomwe zimatengedwa kuchokera kudera lino sizingakhale zolondola chifukwa zili ndi oxygen yokha -madzi odzola-osati mpweya wosakaniza ndi mpweya. Zitsanzo za gasi zomwe zimatengedwa kuchokera ku trachea , zomwe zimapitirira pansi pammero, zimapereka ndondomeko yoyenera ya gasi.
ADO Yambiri Ponena za Kuphulika kwa Mphuno: Kodi Mungachite Bwanji Zomwe Mukuchita?
Njira yothetsera kupuma pakamwa nthawi zambiri imadalira chifukwa chomwe chimayambitsa. Mukapeza bwino, mungathe kuthana ndi chithandizo chamankhwala chomwe chingaphatikizepo zotsatirazi:
- Chotsani mavesi anu - Anthu ena alibe chochita koma kupuma kudzera m'milomo chifukwa malemba awo amatsekedwa. Mphuno yowopsya ingayambidwe chifukwa cha kudwala , matenda, kuvutika kwapadera kapena ngakhale kusintha kwa nyengo. Anti- antihistamines amapezeka kuti asamangidwe ndi kutsegula mazenera amkati. Mchere wa saline ndi njira yachibadwa yochizira mankhwala ndipo imathandizira kuti mafuta azikhala ochepa, nthawi zambiri amachepetsa mpweya. Ngati antihistamines ndi / kapena saline nasal sprays samagwira ntchito kwa inu, lankhulani ndi wothandizira zaumoyo wanu pogwiritsa ntchito mankhwala osokoneza bongo monga Flonase .
- Pangani chiwonetsero ndi dokotala wanu wa mano - Madokotala a mano nthawi zina amadziwa bwino kuposa madokotala pakudziwa pakamwa kupuma. Ngati dokotala wanu wa mano akudziŵa kuti nkhope yosaoneka kapena ya mano ndiyo muzu wa pakamwa panu kupuma, akhoza kukugwirirani ndi chipangizo chothandizira kuti muwothetse vutolo.
- Pitani ku nkhope yosavuta mask - Njira yowonjezera yowonjezera kupuma pakamwa, ngati mukuyenera kuchipatala, ndikutembenukira ku nkhope yosavuta mask. Kawirikawiri, izi sizothandiza kwa anthu ambiri ndipo ayenera kuvomerezedwa ndi wothandizira zaumoyo wanu. Njira ina ndiyo kuganizira ntchito pogwiritsa ntchito mankhwala osokoneza bongo masana komanso kusinthasintha maonekedwe a nkhope usiku, kotero kuti mutha kupeza phindu lenileni la mankhwala a oxygen nthawi yomwe mukugona. Lankhulani ndi wothandizira zaumoyo wanu kuti mudziwe zambiri za njira zina zothandizira mankhwalawa.
- Kuchitidwa opaleshoni - Ngati mavesi anu atsekedwa chifukwa cha mphuno yowonongeka, kuyankhula ndi khutu, Mphuno, ndi Throat (ENT) Wophunzira za opaleshoni yomwe ingathandize kuthetsa vutoli ndikukupatsani mpweya wabwino. Kumbukirani kuti anthu omwe ali ndi COPD ayenera kusamala makamaka pamene akuchitidwa opaleshoni, chifukwa cha zovuta zomwe zimachitika pambuyo pa opaleshoni zomwe zimagwirizanitsidwa ndi anesthesia.
- Tizilombo toyambitsa matenda otchedwa Transtracheal oxygen therapy (TTOT) ndi njira yoperekera mpweya wothandizira mwachindunji mu trachea (windpipe). Mosiyana ndi mchere wamphongo, amapereka ma lita 6 a oxygen pamphindi pang'onopang'ono, pulasitiki yotchedwa catheter. Kawirikawiri TTOT imasungidwira anthu omwe ali ndi mpweya wotsika kwambiri wa magazi omwe samayankha bwino njira zowonetsera mpweya.
Kufunika kwa Oximetry Pulse kwa Amene Ali Supplemental Oxygen
Kaya mumapuma m'kamwa mwako kapena mphuno, pulogalamu ya oximetry yowonongeka ndiyomwe iyenera kukhala nayo kwa aliyense amene amalandira mankhwala a oxygen. Oximeter osokoneza amatha kuona kusintha kofulumira kwa magulu okwanira okosijeni kukupatsani chenjezo kuti muli otsika mpweya. Yerekezerani mitengo pa masewera olimbitsa oximetry ndipo musakhale mumdima za magulu anu odzoza oksijeni kachiwiri.
Pansi pa Mlomo Kupuma ndi Oxygen Therapy
Pali zovuta zina zokhudzana ndi kupuma ndi kowonjezereka kwa okosijeni monga momwe tafotokozera pamwambapa, koma mfundo yofunika ndikuti mukugwiritsa ntchito nthawi yopenda nkhaniyi ndikufunsa mafunso ofunika omwe ambiri omwe ali ndi matenda a mapapo sakumapempha.
Tikuphunzira kuti chimodzi mwa zinthu zofunika kwambiri pa moyo ndi kukhala ndi moyo, osati ndi matenda a m'mapapo koma ndi zokhudzana ndi thanzi labwino, ndikukhala wothandizira payekha. Tapita kuchipatala chomwe palibe dokotala mmodzi yemwe angakhalebe owerengera za kafukufuku watsopano ndi zofufuza, ngakhale m'madera ena monga pulmonology. Pa nthawi yomweyi, pali anthu ochepa amene ali ndi chidwi chofuna kupeza mayankho a mafunso awa kusiyana ndi omwe akulimbana ndi matenda omwe amachititsa kuti mafunsowa ayankhidwe.
Tengani nthawi yoti mufunse dokotala wanu funso limene mukufuna yankho lanu. Pali njira zambiri zosiyana siyana zomwe sizinasindikizidwebe koma zakhala zikuvutitsidwa ndi omwe akukumana ndi mavutowa tsiku ndi tsiku. Musanyalanyaze opaleshoni yopuma ndi othandizira omwe mumagwira nawo ntchito. Awa ndi anthu omwe amagwira ntchito ndi nitty-gritty ya momwe oxygen yowonjezera imathandizira kwa anthu omwe amawafuna pamodzi ndi mafunso ochuluka omwe amadza.
> Zotsatira:
> Pisani, L., Fasano, L., Corcione, N. et al. Sinthani Mapangidwe Opanga Mphamvu ndi Zotsatirapo pa Mmene Mungapangire Kutentha Kwambiri Kutentha kwa Oxygen mu Stable Hypercapnic COPD. Nthano . 2017. 72 (4): 373-375.
> Yamamoto, N., Miyashita, T., Takaki, S., ndi T. Goto. Zotsatira za Mpweya Wofewa pa Oxygen Delivery Kudutsa Pansi kapena Pharyngeal Cannula. Care of Respiratory Care . 2015. 60 (12): 1804-9.