Zowonongeka, Zowonjezera, ndi Zowonjezera Zokwanira Zowumitsa M'mabuku ndi Akulu
Ngati muli ndi zizindikiro za kupuma, mwina mukudabwa kuti, "Kodi chiwopsezo chachibadwa ndi chiyani?" Tiyeni tiyambe mwa kulankhula za chiwerengero cha kupuma kwa akuluakulu ndi ana, momwe mungayankhire molondola chiwerengero ichi, ndikutanthauza chiyani ngati mlingo ndi wachilendo.
Mwachidule
Mpweya wa kupuma umatanthauzidwa ngati chiwerengero cha kupuma kumene munthuyo amatenga nthawi ya mphindi imodzi pamene akupumula.
Kafukufuku waposachedwapa amasonyeza kuti kulembetsa molondola za kupuma ndikofunika kwambiri pakulosera zochitika zazikulu zachipatala ; Kafukufuku akuwonetsanso kuti miyeso ya kupuma sikuchitika kawirikawiri monga momwe iyenera kukhalira, choncho yakhazikitsidwa "kunyalanyaza chizindikiro chofunika kwambiri."
Kuyeza Mpata Wopuma
Mlingo wa kupuma umayesedwa mwa kuwerengera chiwerengero cha kupuma komwe munthu amatenga mu mphindi imodzi. Popeza zinthu zambiri zingakhudze zotsatira, kumvetsetsa momwe mungatengere molondola ndikofunikira.
Mlingoyo uyenera kuyesedwa pa mpumulo, osati munthu wina atakhala ndikuyenda. Kudziwa kuti kupuma kwanu kukuwerengedwa kungapangitse zotsatirazo kukhala zosavuta, monga momwe anthu nthawi zambiri amasinthira njira yomwe amapuma ngati akudziwa kuti akuyang'anitsitsa. Anesi amadziwa luso lotha kulimbana ndi vutoli powerenga bwinobwino kupuma, ndikuwonekeratu nthawi imene chifuwa chanu chimagwa ndi kugwa-nthawi zambiri mukamayerekezera kuti mukuyendayenda.
Ngakhale kulemba kupuma, pali zizindikiro zingapo za mavuto opuma. Kodi wodwala kapena wokondedwa wanu sasangalala? Kodi minofu ya m'khosi mwake imamveka pamene akupuma? (Odziwa zachipatala amati izi ndi " kugwiritsa ntchito minofu yowonjezereka " kuti apume.) Kodi mumamva kulira kapena kupuma kwapadera?
Kodi kupuma kwa munthu kukuwoneka kuti kumasonyeza kupweteka kapena nkhawa (monga hyperventilation yomwe ikhoza kutsagana ndi ululu waukulu kapena mantha?)
Kodi Zimatanthauza Chiyani?
Chiwerengero cha mpweya umene timatenga pamphindi ndi chizindikiro cha nthawi yomwe ubongo wathu umauza matupi athu kupuma. Ngati mlingo wa oksijeni m'magazi ndi wotsika, kapena ngati mpweya wa carbon dioxide uli m'mwamba, thupi lathu limalangizidwa kupuma mobwerezabwereza. Mwachitsanzo, kukhala ndi matenda oopsa kumapangitsa kuti carbon dioxide ipangidwe m'thupi, choncho ngakhale ngati pali mpweya wokhazikika m'magazi, ubongo umalimbikitsa thupi kuti lizipuma mobwerezabwereza kuti lichotse carbon dioxide.
Koma pali nthawi pamene dongosolo lino siligwira ntchito bwino, monga pamene anthu amachiza mankhwala osokoneza bongo. Mankhwalawa amachititsa kuti ubongo uchite chizindikiro kuchokera m'magazi, choncho munthu akhoza kupuma mobwerezabwereza kuposa momwe akufunira. Izi zingathenso kuchitika ndi kuvulala kumutu kapena kupweteka kwapweteka komwe kumayambitsa malo opuma m'mimba.
Zowonongeka Zowonjezera Zowonjezera Ana
Ana ali ndi chiwopsezo chothamanga kusiyana ndi achikulire, ndipo chiwerengero cha "chizolowezi" chakupuma chimasiyana kwambiri ndi zaka.
Mipiringi yoyenera ya kupuma kwa ana a zaka zosiyana ndi monga:
- Mwana wakhanda: 30-60 kupuma mphindi
- Mtsikana (miyezi 1 mpaka 12): mpweya 30-60 mphindi
- Woyendetsa (1-2 zaka): 24-40 mpweya pa mphindi
- Kusukulu (zaka 3-5): 22-34 kupuma mphindi
- Mwana wa sukulu (zaka 6-12): 18-30 kupuma mphindi
- Wachinyamata (zaka 13-17): 12-16 kupuma mphindi
Kusuta Kwa Ana Nthawi Zonse
Makanda amakhala ndi kupuma mofulumira kwambiri kuposa ana okalamba, ndipo amatha kusonyeza chinthu chomwe chimatchulidwa kuti kupuma nthawi zonse. Ndi kupuma nthawi ndi nthawi chiwerengero cha kupuma kwa mwana chimasiyana; Angakhale ndi nthawi yomwe amapuma mofulumira kuposa momwe amachitira pambuyo pake kupuma mphindi pang'ono mofulumira kuposa momwe zimakhalira.
Kufunika kwa kupuma nthawi ndikuti-ngakhale kungakhale kochititsa mantha monga kholo-kawirikawiri sizingakhale zachilendo kupatula mwana wanu ali ndi zizindikiro zina zosonyeza kuti ali ndi matenda aakulu.
Kawirikawiri Kupuma kwa Odwala Ambiri mwa Okalamba
Mofanana ndi ana, chifuwa chiyenera kuyesedwa pamene munthu akupuma ndipo sanagwire ntchito yamphamvu. Kawirikawiri, miyeso ya kupuma imakhala mofulumira kwambiri kuposa akazi.
Chifuwa cha munthu wamkulu wamkulu chimakhala pakati pa 12 ndi 18 kupuma mphindi.
Kuwotcha Nthawi Zambiri mwa Achikulire
Mosiyana ndi kupuma nthawi kwa ana, mtundu wina wa kupuma nthawi yomwe imatchedwa Cheyne-Stokes kupuma ingapezeke mwa akuluakulu ndipo si zachilendo. Zingatheke chifukwa cha kupweteka mtima kwa mtima, mpweya woipa wa carbon monoxide, mlingo wochepa wa sodium m'magazi (hyponatremia), kutalika kwapamwamba, kapena pamapeto omwalira.
Zosamalidwa Zokwanira Zopuma
Kuwonjezeka ndi kuchepa kwa chifuwa kungakhale chizindikiro chakuti chinachake chiri choipa m'thupi. Chiwombankhanga chosawonongeka n'chosafunikira kwenikweni, kutanthauza kuti pali zinthu zambiri zomwe zimayambitsa msanga komanso mofulumira. N'kofunikanso kuti muzindikire kuti mizere yoyenera ndi yoti anthu azipumula. Mapiritsi odziteteza amawonjezeka pa nthawi yochita masewera olimbitsa thupi.
Kuchuluka kwa Mpweya Wopuma
Kodi chifuwa chokwera ndi chiyani? Kwa akuluakulu, kudulidwa kumatengedwa ngati mpweya wopitirira 20 mphindi iliyonse, ndi mpweya wa mpweya wa mphindi makumi awiri ndi mphambu zisanu ndi ziwiri (24) pamphindi yomwe imasonyeza vuto lalikulu (pamene likukhudzana ndi thupi lakuthupi m'malo mkhalidwe wamaganizo monga mantha kuzunzidwa).
Monga taonera kale, kupuma ndi chizindikiro chofunika kwambiri. Kafukufuku wina anapeza kuti chiŵerengero chapamwamba cha kupuma chinali chodziwika bwino cha anthu omwe anali okhazikika osasunthika kusiyana ndi kutaya kwa mtima kapena kuthamanga kwa magazi.
Pali zifukwa zambiri zomwe zimayambitsa kuchuluka kwa mlingo, zina zomwe zimakhudzana ndi mapapo ndi ena omwe sali. Zina mwazimene zimawoneka bwino ndi izi:
- Chiwopsezo - Kuwonjezeka kwa kupuma ndi malungo ndiyesayesa thupi kutaya kutentha mwa kupuma mofulumira. Izi ndizofunikira chifukwa chakuti kuthamanga kwafupipafupi kungakhale chizindikiro cha matenda opweteka, komanso chifukwa choti malungo amafunika kuwongolera potanthauzira kupuma. Zikuganiza kuti kupuma kumawonjezeka kwa ana pafupipafupi asanu mpaka asanu mpweya mphindi pa digiri ya Celsius kukwera mu kutentha kwa thupi. Kwa ana aang'ono (osakwana miyezi 12) izi sizinatsimikizire kuti ndizochitika, ndipo ana sangakhale ndi chifuwa chowonjezereka chifukwa cha malungo komanso mosiyana. Akakhala ndi kuchuluka kwa kupuma, nthawi zambiri amawonjezeka pafupipafupi asanu ndi awiri mphambu khumi ndi limodzi mpweya pamphindi pa Celsius kukwera kutentha.
- Kutaya madzi m'thupi - Kutaya madzi m'thupi kumokha kungachititse kuti mpweya upume mofulumira.
- Phumu - Pakuukira kwa mphumu, kuchuluka kwa kupuma kumawonjezeka. Ngakhale kuwonjezeka kwakung'ono kwa kupuma kungakhale chizindikiro cha kuwonjezereka, ndipo chifuwa cha kupuma chiyenera kuyang'anitsitsa mosamala ngati ndi choncho.
- COPD - Matenda osokoneza bongo ndi omwe amachititsa kuti munthu azizizira mofulumira, makamaka anthu omwe ali ndi mbiri ya kusuta.
- Hyperventilation - Anthu amatha kupuma mofulumira chifukwa cha kupanikizika, kupweteka, mkwiyo kapena phokoso la mantha.
- Mphungu Mkhalidwe - Matenda monga khansara yamapapo , mapiritsi amadzimadzimadzi (magazi am'mapazi omwe amapita kumapapo), ndi matenda ena ammapapu amatulutsa kupuma.
- Matenda - Matenda omwe amapezeka komanso omwe sakhala achilendo monga chimfine, chibayo, ndi chifuwa chachikulu amatha kupuma mofulumira.
- Ana obadwa kumene , omwe amachititsa kuti munthu azizizira mofulumira, amakhala ndi tachypnea wathanzi (TTN) -chikhalidwe chochepa-komanso zinthu zomwe zimakhala zovuta kwambiri, monga kupuma kwa matenda.
- Acidosis - Kuwonjezeka kwa acidity ya zotsatira za mwazi kuwonjezeka kwa kutulutsa mpweya woipa, ndichifukwa chake kuchuluka kwa kupuma. Izi zikhoza kuchitika ngati munthu ali ndi vuto lomwe limayambitsa matenda a shuga monga matenda a shuga ( matenda a shuga ketoacidosis ).
- Kuchuluka kwa mankhwala - Monga kupitirira mphamvu ya aspirin kapena amphetamines.
- Mavuto a mtima - Chiwerengero cha kupuma kwapamwamba chinapezeka mu phunziro limodzi kuti munthu adziwe kumangidwa kwa mtima m'zipatala zomwe zili ndi mtima.
Kwa ana, zomwe zimayambitsa chifuwa chowonjezereka zimakhala ndi malungo kapena kutaya thupi. Zinthu monga bronchiolitis ndi chibayo zimayambitsa mavuto ambiri. Ana angakhalenso ndi zifukwa za kupuma mofulumira monga ofanana ndi akulu, monga acidosis (ndi shuga) ndi mphumu.
Kuchepetsa Mpweya Wokuzizira
Kuchepetsa kutentha kwa thupi, komwe kumatchulidwa ngati mlingo wosachepera 12 ndi ena, kapena kupuma kwachisanu ndi chitatu pamphindi ndi ena, kungakhalenso chizindikiro chodera nkhawa. (Tawonani, kwa ana kuchepa kwa chifuwa kungakhale kotalikira kwa akuluakulu, ndipo ayenera kutanthauziridwa molingana ndi chiwerengero chomwe chili pamwambapa.) Zina mwa zifukwa za kuchepa kwa chiwerengero ndizo:
- Kugwiritsa ntchito mankhwala osokoneza bongo - Mankhwala ena monga mankhwala osokoneza bongo-kaya amagwiritsidwa ntchito pa zamankhwala kapena mosemphana ndi malamulo-akhoza kupondereza kupuma.
- Mowa - Kugwiritsa ntchito zakumwa zoledzeretsa kumachepetsa kupuma.
- Mankhwalawa amatha kuchepa kuti athetse kuopsa kwa njira zowonongeka zowonongeka m'thupi.
- Kugonana pogona - Ndi kugona tulo , anthu nthawi zambiri amakhala ndi matenda a apnea komanso kuchepa kwa mpweya wothira mpweya wosakanikirana ndi magawo a mpweya wopuma.
- Mavuto a ubongo - Kuwonongeka kwa ubongo, monga kukwapula ndi kuvulala pamutu nthawi zambiri kumachepetsa kuchepetsa kupuma.
Dyspnea: Chisoni cha Kutupa Kwambiri
Ndikofunika kutchula mwamsanga kuti mpweya wopuma ndi wosiyana ndi kumverera kwa kupuma pang'ono. Nthawi zina kupuma kumakhudza ngati wina akumva dyspneic kapena kupuma pang'ono, koma nthawi zina sangathe. Wina amatha kupuma pang'ono ndi mpweya wothamanga kwambiri, ndipo sangathe kupuma pang'ono ndi mlingo wochepa kwambiri wa kupuma.
Nkhani Zamankhwala
Ogwira ntchito zamankhwala amagwiritsa ntchito mawu angapo pofotokoza mitengo yopuma yopuma. Ena mwa awa ndi awa:
- Bradypnea - Bradypnea ndilo mankhwala omwe amagwiritsidwa ntchito kutanthauzira kupuma kumene kuli kosavuta.
- Tachypnea - Tachypnea ndilo mankhwala omwe amagwiritsidwa ntchito kutanthauzira kuchuluka kwa kupuma. Kuthamanga kwapang'onopang'ono kotereku kawirikawiri kumakhala kosavuta, mosiyana ndi hyperpnea yomwe imakhala yofulumira komanso yakuya.
- Dyspnea - Dyspnea imatanthawuza kumverera kwa mpweya wochepa , ndipo ikhoza kuchitika ndi mlingo wokwera, wamtundu, kapena wotsika.
- Hyperpnea - Hyperpnea imatanthawuza kupuma komwe kuli kovuta kwambiri ndipo kumawoneka kuti ikugwira ntchito. Zitha kuchitika kapena popanda kupuma mofulumira.
- Apnea - Apnea amatanthauza "mpweya" ndipo amatanthauza kuti palibe kupuma.
Nthawi yoitanira Dokotala Wanu
Ndithudi, kupuma kwachilendo kosazolowereka ndi chifukwa chothandizira dokotala, makamaka ngati muli ndi matenda monga mphumu kapena matenda a mtima, ngati kuchuluka kwa kupuma kokha kungakhale chizindikiro chochenjeza chomwe chiyenera kuchitidwa. Pa nthawi imodzimodziyo, akatswiri azaumoyo ayenera kuzindikira zomwezi nthawi zambiri samanyalanyaza chizindikiro chofunika. Kafukufuku wina anapeza kuti kuyerekezera kupuma kwa nthawi yoyamba kuchokera kuchipinda chodzidzimutsa kunali kofunika kwambiri kuwonetsetsa kuwonongeka pambuyo poyeretsa.
Mawu Ochokera
Ngakhale kuti anthu ambiri amaganiza moyamba za kuthamanga kwa magazi kapena kuthamanga kwa magazi, tikuphunzira kuti kuyesa kuchuluka kwa kupuma ndikofunika kwambiri ngati si moreso. Ndithudi, kupuma kwabwino kungakhudzidwe ngati mukudziwa kuti kupuma kwanu kumayesedwa, motero ndi kofunikira kuti ogwira ntchito zachipatala akhale odziwa bwino kuyesa izi. Zowonjezera komanso kuchepa kwa chifuwa kungakhale chizindikiro chenichenjezo cha chithandizo chamankhwala ndipo chiyenera kumvera.
Ndikofunika kuwonetsanso kusiyana kwakukulu pakati pa chiwerengero cha kupuma kwa akulu ndi ana. Amene amasamalira ana ayenera kudzidziŵa okha ndi mndandandawu, ndipo dziwani kuti kupuma kuli msanga kapena mofulumira.
> Zotsatira:
> Flenady, T., Dwyer, T., ndi J. Applegarth. Malipiro oyenera Otsitsimula: Choncho Muyenera Kutero! . Australas Emergency Nursing Journal . 2017 Jan 7. (Epub patsogolo pa kusindikiza).
> Kliegman, Robert M., Bonita Stanton, St Geme III Joseph W., Nina Felice. Schor, Richard E. Behrman, ndi Waldo E. Nelson. Nelson Buku Lophunzitsa za Ana. Kusindikiza kwa 20. Philadelphia, PA: Elsevier, 2015. Print.
> Mochizuki, K., Shintani, R., Mori, K. et al. Kufunika kwa Mpweya Wopumphura Ponena za Kuwonongeka kwa Kachilombo Pambuyo pa Dipatimenti Yoopsa ya Dipatimenti Yochokera ku Dipatimenti Yopuma Mwachangu Kuchulukitsa Mankhwala ndi Opaleshoni . 2017. 4 (2): 172-178.
> O'Leary, F., Haven, A., Lockie, F., ndi J. Peat. Kufotokozera Mapiri Okhazikika ndi Makhalidwe a Mtima ndi Otsitsimutsa Mtengo wa Ana ndi Ana: Phunziro Lachigawo cha Odwala Opezeka ku Australia Wachipatala Chakumwamba Dipatimenti Yovuta Yachipatala. Archives of Disease In Childhood . 2015. 100 (8): 733-7.
> Parkes R. Mlingo wa kupuma: chizindikiro chosaiwalika. Namwino Wowopsa . 2011. 19 (2): 12-7.