Kwa omwe akudwala matenda obisala kwambiri a hypoventilation , ndikofunikira kwambiri kupeza chithandizo. Monga momwe chikhalidwe chingakhale ndi zotsatira zazikulu komanso zowonongeka, kuthandizira mofulumira ndi koopsa kungakhale kofunikira. Phunzirani za zina mwa njira zotheka kuchiza matenda obwera kwambiri a hypoventilation ndi zolinga za mankhwalawa.
Njira Zothandizira
Njira zothandizira odwala hypoventilation syndrome (OHS) zikhoza kugawidwa kuti zikhale zofunikira kwambiri pa matendawa: kulemera ndi kupuma.
Kuchepetsa Kulemera
Monga dzina limatanthawuza, kunenepa kwambiri ndiwothandizira kwambiri ku matendawa. Ngati kulemera kwakukulu kungatheke, chithandizo chimapezeka. Izi zikhoza kuperekedwa kudzera mu zakudya ndi masewero olimbitsa thupi, koma oposa 100 peresenti ya kulemera kwake kungafunike. Ngati kulemera kwa msanga mofulumira kungakhale koopsa, ndibwino kuti anthu achite izi motsogoleredwa ndi dokotala wawo. Nutritionists angapereke malangizo othandiza pakupanga kusintha kwa khalidwe. Mwatsoka, sikutheka kufotokozera kuchuluka kwa kuchuluka kwa kulemera komwe kumayenera kutayika kuti munthu athe kuchiritsa OHS.
Pakalipano, mankhwala ochepetsa kulemera kwa thupi sakulangizidwa kuti athetse kulemera kwa OHS.
Pamene zakudya ndi masewero olimbitsa thupi sizingakhale ndi zotsatirapo zochepetsetsa kulemera, pangakhale koyenera kuti mutembenukire kuzipatala monga opaleshoni yowonjezera opaleshoni. Njirazi mwa anthu omwe ali onenepa kwambiri komanso omwe ali ndi matenda obwera chifukwa cha kugona awonjezera ngozi. Makamaka, mlengalenga akhoza kugwa pansi pa anesthesia yomwe imagwiritsidwa ntchito opaleshoni ndi kupulumutsidwa ingakhale yovuta.
Ndikoyenera kuti opaleshoni ya bariatric ikhale yosungidwa kwa anthu omwe ali ndi chiwerengero cha mthupi (BMI) chachikulu kuposa 35 ndipo palibe matenda ena omwe angawonjezere chiopsezo cha opaleshoni. Ndikofunika kukhala ndi phunziro la kugona lomwe limatchedwa polysomnogram musanafike ndi pambuyo pa opaleshoniyo kuti muwone zotsatira za njirayi.
Pamene kulemera kwake kumachitika kwa miyezi ingapo, zingakhale zofunikira kuti pitirizani kupuma panthawiyi ndi mankhwala ena.
Thandizo Lopuma
Chithandizo chachikulu cha OHS ndicho kupereka chithandizo cha kupuma, nthawi zambiri kupyolera mu kugwiritsa ntchito njira yowonjezera ya mpweya (CPAP) kapena bilevel . Zipangizo zimenezi zimapangitsa kuti mphepo yambiri isagwedezeke.
Ngati OHS ikukhudzana ndi vuto ndi kupuma, kodi mpweya ungagwiritsidwe ntchito kuti uchitire? Mankhwala othandizira okosijeni angaphatikizidwe ngati pali matenda omwe amapezeka m'mapapu monga COPD , koma sali okwanira paokha. Kwenikweni, kugwiritsa ntchito mpweya wokha mu OHS kungathetsere kupuma.
Pazifukwa zovuta, zingakhale zofunikira kuchita tracheostomy . Njirayi imaphatikizapo kuika kachidutswa kakang'ono ka pulasitiki kamene kali kutsogolo kwa mmero. Izi zimadutsa pamtunda wamtunda, womwe umangowonongeka kapena kutchinga kwa anthu omwe ali ndi OHS. Ngakhale tracheostomy ndi yothandiza, pali mavuto ogwirizana ndi ntchito yake. Zingakhale zovuta kusintha kusintha, makamaka momwe zimakhudzira kulankhula. Bronchitis ikhozanso kupezeka mobwerezabwereza. Kawirikawiri, opatsidwa mankhwala ena, tsopano sagwiritsidwa ntchito.
Muyeneranso kupewa kumwa mowa ndi mankhwala ena omwe amalepheretsa kupuma.
Zowonongeka zingakhalepo monga mankhwala oyenera, monga benzodiazepines , opiates, ndi barbiturates. Muyenera kupenda mankhwala anu ndi dokotala kuti muwone kuti palibe aliyense amene amakuchititsani ngozi.
Zolinga za Chithandizo
Pamapeto pake, cholinga cha mankhwala alionse mu vuto la kunenepa kwambiri kwa hypoventilation ndi kukonza mavuto omwe amachititsa kuti matendawa apitirire. Kupuma kosafunikira kumene kumayambitsa matendawa kumayambitsa kusamvana muzigawo zamagazi. Pamene carbon dioxide sichikhoza kuchotsedwa bwino, miyeso yake imakula ndikupangitsa magazi kukhala ovuta kwambiri. Izi zimayambitsa kusintha kwambiri mu thupi lomwe lingakhale ndi zotsatira zoipa.
Kuchiza kungalepheretse madontho m'magazi a magazi anu, kukwera mu maselo ofiira a m'magazi otchedwa erythrocytosis, ndi mtima wolephera (wotchedwa cor pulmonale ). Kulemera kwa thupi kumayimitsa mpweya wa okosijeni ndi carbon dioxide. Kugwiritsira ntchito CPAP kapena bilevel, komanso njira zina, zimathandizanso zotsatirazi.
Pamapeto pake, kugona kumakhala kochepa ndipo izi zimapangitsa kuti munthu asagone usana. Izi zimabweretsa moyo wabwino, womwe ndi cholinga cha chithandizo chamankhwala.
Zotsatira:
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Conway, W et al . "Zovuta za tracheostomy kwa kugonana kwa kugona." JAMA 1981; 246: 347.
Perez de Llano, LA ndi al . "Kanthawi kochepa komanso nthawi yaitali zotsatira za mpweya wothamanga wa mpweya wabwino kwa odwala omwe ali ndi kunenepa kwambiri-matenda a hypoventilation." Chifuwa cha 2005; 128: 587.
Scrima, L et al . "Kuchuluka kwa matenda obisala ogona tulo tomwe timakhala tomwe timakhala titatha kugona nthawi yogona panthawi yoledzera: njira yothetsera matenda ndi njira zomwe tingachite." Kugona 1982; 5: 318.
Sugerman, H et al . "Zotsatira za nthawi yaitali za opaleshoni ya m'mimba zimathandiza kuti munthu asapitirire kupuma chifukwa cha kunenepa kwambiri." Am J Clinic 1992; 55: 597S.