Apnea-Hypopnea Index Zothandiza Kwambiri Kugona kwa Apnea Kuwopsya
Ngati mwakhala ndi phunziro la kugona usiku wonse, dokotala wanu akhoza kukupatsani lipoti lolondola, kuphatikizapo muyezo wotchedwa apnea-hypopnea index (AHI) . Kodi AHI amatanthauza chiyani kwa anthu akuluakulu omwe ali ndi vuto la kugona? Kodi zimagwirizana bwanji ndi kufooka kwa chikhalidwe cha kugonana kwa kugona ? Phunzirani za matanthauzo a AHI omwe amagwiritsidwa ntchito mu kuyesa ndi kugwiritsidwa ntchito pogona komanso zomwe zimatanthauza kwa inu.
Kumvetsetsa momwe AHI Amayesedwera
AHI ndi chiwerengero chofunikira chomwe chimapangidwa malinga ndi zotsatira za phunziro la kugona usiku womwe umatchedwa polysomnogram kapena kuyesa kugonana kwa apabanja. Monga gawo la mayesero awa, pali masensa omwe amaikidwa m'mphuno kapena pafupi ndi kamwa yomwe imayeza kayendetsedwe ka mpweya. Palinso mabotolo omwe ali pamtumbo ndi mimba yomwe imawoneka ngati kupuma kumachitika. Zochitika za Apnea zimachitika pamene mlengalenga imatsekeka kwathunthu ndipo palibe mpweya wa mpweya umene umapezeka ndi mphuno ndi pakamwa ngakhale kuyesayesa kumachitika monga momwe zilili ndi chifuwa ndi mimba yamimba. Ngati mpweya umachepetsedwa pang'onopang'ono, koma osachepera 30 peresenti poyerekeza ndi graph ya chizindikiro, amatchedwa hypopnea .
Zochitika izi zimaganizidwa kuti ndizofunikira pamene zimapezeka pa zochitika zina ziwiri: madontho a mpweya wa oksijeni kapena odzuka kuchokera ku tulo. Mpweya wokhala ndi magazi umayesedwa ndi oximeter, sensa yaing'ono yomwe imawala kuwala kofiira kupyolera pambali.
Pamene mpweya wa okosijeni umagwa, izi zimatchedwa kuti deaturation , ndipo madontho a 3 peresenti ali ovuta. Maphunziro ogona ogona amawerenganso okwera kuchokera ku kuya mpaka kugona komanso ngakhale kuwuka ndi electroencephalogram (EEG) . Kugalamuka kumeneku kungapatule kugona, kumapangitsa kuti kusabweretse, komanso kumabweretsa usana.
Apneas ndi hypopneas amamasuliridwa ngati osokoneza pamene ataphatikizidwa ndi oxygen desaturations kapena okondana.
AHI ndiyeso yowonjezera. Zimayesedwa mwa kutenga chiwerengero cha apnea kapena zochitika za hypopnea zomwe zigawidwa ndi nthawi yonse imene wagona maola ambiri. Mwa kuyankhula kwina, ndi chiwerengero cha nthawi pa ola lagona (kapena kujambula) kuti pandege pang'onopang'ono kapena kugwa kwathunthu, zomwe zimapangitsa kuti madontho akuluakulu a magazi kapena okondwerera amachoke kuchokera ku kuya mpaka kuunika. Ngati AHI yanu ili ndi zaka 15, izi zikutanthauza kuti, kawirikawiri, maulendo 15 pa ola la kupuma mukupunthwa ndipo izi zinachititsa zotsatira zovuta.
Pali malo ogona omwe amagwiritsa ntchito njira zina kuti aone kulemera kwake. Chizindikiro cha kupuma (RDI) chingagwiritsidwe ntchito ngati muyeso wa kukwera kwa ndege ndi kupopera kwapopopayi kumaphatikizidwanso mu phunziroli. Oxygen-desaturation index (ODI) amayesa kuwerengera chiwerengero cha zochitika za apnea kapena hypopnea pa ora lomwe limapangitsa kuti dontho la oksijeni lisachepera 3 peresenti. Izi zimaganizidwa kuti ndizofunika pozindikira kuopsa kwa nthawi yaitali mtima (kuthamanga kwa magazi, kupweteka kwa mtima, ndi mtima wosagwira ntchito) kapena zotsatira za matenda a stroke ndi dementia.
Ngati maphunziro anu ogona sali ndi miyeso yeniyeniyi, izi sizikudetsa nkhawa.
AHI ndi Kupsyinjika kwa Mpweya wa Kugona
Kodi chiwerengerocho chimakhala chotani monga momwe chimafotokozera ndi AHI mogwirizana ndi kufooka kwa kugonana kwa kugona? Ngakhale kuti miyezoyi imavomerezedwa m'madera onse a mankhwala okhudza kugona, anthu omwe amachititsa kuti apeze mankhwalawa, amavomerezedwa mosavuta. Malinga ndi kafukufuku, magulu otsatirawa amagwiritsidwa ntchito akuluakulu:
- Mtundu wamba: 0 mpaka 5
- Kukhala ndi vuto la kugona tulo: 5 mpaka 15
- Kugonana kwapakati pafupipafupi: 15 mpaka 30
- Kugonana kwakukulu kwa kugona: 30 ndi kupitirira
Kawirikawiri, miyeso imeneyi ndi yofunika kwambiri ngati pali umboni wa zotsatira zina zomwe zimayambitsa matenda obisala, kuphatikizapo kukwera kwa msinkhu wa Sleeping Epworth pamwamba pa 10, chizindikiro cha kugona kwambiri kwa usana.
Zambirizi zingagwiritsidwe ntchito pamene mukuganizira njira zamankhwala. Mwachitsanzo, kupuma kofewa pang'ono kumatha kupatsidwa chithandizo chokhazikika chapansi (CPAP) komanso ndi zipangizo zam'kamwa . Thandizo lachithandizo komanso njira zina zingakhale zomveka. Komanso, mankhwala opaleshoni angakhale othandiza kwambiri kuchiritsa anthu omwe ali ndi vuto lopumula kwambiri.
Pali mikangano yokhudza anthu omwe ali ndi matenda obisala kwambiri. Pakati pazirombozi zingakhale amayi omwe asanamwalire (omwe amatetezedwa ndi mahomoni estrogen ndi progesterone) kapena anthu omwe ali ndi thupi lolemera, omwe m'malo mwake amakhala ndi mpweya wambiri wofooka, m'malo mwake amatha kukhala ndi matenda othamanga kwambiri (UARS) .
Tiyeneranso kuzindikiranso kuti ana akhoza kukhala ndi matenda obwera chifukwa cha kugona atapezeka ku AHI. Kawirikawiri, AHI imaganiziridwa kuti si yachilendo pamene iposa 1 (ngakhale kuti izi zinalipo kale 2). Izi ndi zovuta ndi kusintha kwachitukuko komwe kumachitika mu msinkhu. Achinyamata omwe adutsa kale kukula kwawo akhoza kuyesedwa bwino pogwiritsa ntchito mtundu wachikulire. Kuwunika kumeneku ndikulingalira bwino kupangidwa kuchokera kuchigamulo chachipatala cha katswiri wa kugona kwa mwana wanu.
AHI ingathandizenso kuyang'anitsitsa mayankho anu ku chithandizo chopitilira cha mpweya (CPAP). Cholinga chake ndi kukhala pafupipafupi, osachepera 5 zochitika pa ora, koma chiwerengero chochepa chiri bwino. Kawirikawiri ndizotheka kukonzanso zochitika kuti mukhale ndi AHI mpaka 1 kapena 2.
Ngati muli ndi mafunso owonjezera pa zomwe AHI akunena kwa inu, lankhulani ndi dokotala wanu za zotsatira za mayeso ndi njira zabwino zothetsera mavuto anu.
> Chitsime:
> Kryger, MH et al . "Mfundo Zothandiza Pogona Mankhwala." Elsevier , edition lachisanu ndi chimodzi. 2016.