Momwe CPAP ndi BiPAP zingathandizire COPD
Kodi zikutanthauzanji ngati dokotala wanu atsimikiza kuti "mpweya wotsekulawu ulibe mphamvu?" Kodi izi zimasiyana bwanji ndi mpweya wabwino? Kodi ndi njira ziti monga CPAP ndi BiPAP zomwe zasonyezedwa ndipo ndi phindu lanji?
Kodi Mpweya Wosakhala Wosatha?
Kupanda mpweya wabwino kulibe njira yowonjezera mpweya wabwino (kuikidwa pa ventilalor) kwa anthu omwe ali ndi vuto lopuma kupuma kapena kupuma kopuma ndipo sangathe kupuma mokwanira paokha.
Kuzindikiranso kuti Noninvasive Positive Pressure Ventilation (NIPPV), mpweya wosagwira ntchito umathandiza munthu kupuma mokwanira ndikuthandizira kukhala ndi mpweya wochuluka wa mpweya.
NIPPV imapereka chithandizo cha mpweya kwa munthu kudzera kumtunda wapamwamba. Amapangitsa mpweya kupuma pogwiritsa ntchito mpweya wabwino ndi mpweya kuchokera ku jenereta yothamanga kupyolera mu maski oyenda bwino. Popeza mapapo ali, mwa njira inayake, yotseguka chifukwa cholimbikitsidwa, zimakhala zosavuta kupeza oxygen kulowa mu alveoli yaing'onoting'ono kumene mpweya wa oksijeni ndi carbon dioxide umachitika.
M'maganizo osagwira ntchito mukhoza kuganizira alveoli yanu ngati mabuloni ang'onoang'ono. Pogwiritsira ntchito pulogalamu yoteteza mpweya, "balloons" amatsitsimutsa pang'ono mutapuma kunja kotero kuti ndizowonjezera mosavuta ndi kupuma kwanu. Mwa kuyankhula kwina, kuli ngati kudzaza buluni ndi kusamala kuti musalole mpweya uliwonse pakati pa kupuma kuti zikhale zosavuta kudzaza.
Momwe Mpweya Wopanda Kuperewera Umagwiritsidwira ntchito ku COPD
Anthu omwe ali ndi matenda osokoneza bongo (COPD) nthawi zina amalephera kutulutsa mpweya wabwino, monga CPAP (kupitilirabe mpweya wabwino) kapena BiPAP (bilevel positive airway pressure), pakuwopsa kuti awathandize kupuma.
Kawirikawiri amagwirizanitsa ndi matenda opatsirana pogona , CPAP ndi BiPAP zimapereka mpweya wopanikizika pogwiritsa ntchito chigoba cha munthu.
Kupsyinjika kumathandiza kuti minofu ya mmero iwonongeke ndikuletsa mpweya wa mpweya. Makina a CPAP amaikidwa pa msinkhu umodzi wokha umene umakhalapo nthawi zonse usiku wonse, pamene BiPAP ili ndi mavuto awiri, imodzi yokhazikika komanso imodzi yokha.
Kugwira ntchito kwa Mpweya Wopanda Phindu ku COPD
Pepala lafukufuku wa 2014 lomwe linafalitsidwa ku Lancet linapeza kuti NIPPV yowonjezera chiwerengero cha anthu omwe ali ndi COPD. Kuyambira kafukufuku wamakono, maphunziro a mayiko ambiri adapeza kuti anthu omwe ali ndi COPD omwe adalandira mpweya wozizira wosagwira ntchito amakhala ndi chiopsezo chachikulu cha imfa cha 36 peresenti.
Kafukufuku wina amasonyeza kuti NIPPV imagwiritsidwa ntchito panthawi yovuta ya COPD imachepetsa kufunika kokhala ndi mpweya wabwino, ndipo umagwirizanitsidwa ndi mlingo wotsika wa mankhwala osagwira ntchito komanso kuchepa kwa chipatala.
Kuonjezera apo, kafukufuku wa 2016 anapeza kuti nthawi yayitali ya NIPPV ikhoza kubweretsa kusintha kwa magazi (ABGs,) mapaipi, ndi umoyo wokhudzana ndi thanzi. Kawirikawiri, kusintha kumeneku kunali bwino kwambiri ndi kutulutsa mpweya wotsika kwambiri (osagwiritsidwa ntchito molimbika kwambiri) kusiyana ndi mphamvu yochepa ya NIPPV.
Pamene Kupuma Mpweya Wopanda Phindu Kumaperekedwa
Kwa anthu omwe ali ndi COPD omwe ali ndi vuto lopuma kupuma chifukwa cha kuwonjezeka kwa COPD, kupuma kwapadera kosagonjetseka kungagwiritsidwe ntchito mmalo mwa chidziwitso chotsalira cha odwala.
Dokotala wanu angakulimbikitseni NIPPV kwa inu ngati muli ndi dyspnea (yochepa mpweya), tachypnea (mpweya wothamanga,) ndi hypercarbia (mkulu wa carbon dioxide m'magazi), okhala ndi pH pakati pa 7.25 ndi 7.35.
Anthu sayenera kuchiritsidwa ndi NIPPV mmalo mwa mpweya wabwino ngati alibe mankhwala chifukwa cha hypotension ( kutsika kwa magazi ), sepsis (matenda aakulu omwe angayambitse mantha,) hypoxia (kusowa kwa oxygen m'matumbo a thupi lanu ,) kapena matenda ena owopsya, amavutika maganizo, kapena akukumana ndi zipsinjo zambiri zomwe zimawapangitsa kukhala ndi chiopsezo chachikulu.
Mosiyana ndi mpweya wabwino, womwe umafuna kuyang'anitsitsa mu chipatala chachikulu, mpweya wabwino umene sungathe kuchitidwa kawirikawiri ukhoza kuchitidwa mu chipatala cha chipatala chachikulu, kupereka antchito omwe akuphunzitsidwa bwino.
CPAP vs. BiPAP
Zomwe PCAP ndi BiPAP zimapereka okosijeni opanikiza pogwiritsa ntchito chigoba, ngakhale CPAP imayikidwa nthawi imodzi pomwe BiPAP ili ndi zochitika ziwiri, zozizwitsa komanso zina zatha.
BiPAP imagwiritsidwa ntchito mobwerezabwereza kwa anthu omwe ali ndi COPD chifukwa zimakhala zosavuta kuzimitsa kupanikizika. BiPAP imathandizanso kusintha kwa nthawi.
Mfundo Yofunika Kwambiri
Kupanda mpweya wokhazikika sikoyenera kwa munthu aliyense ndipo sikuli bwino nthawi zonse. Dokotala wanu ndi amene angadziwe ngati ndinu woyenera kuti mpweya wabwino usakhale wovuta.
Izi zinati, maphunziro akuwonetsa zosowa zochepa zowonjezereka zowonjezereka ndikupulumuka kwa anthu omwe ali ndi COPD omwe akufuna ku NIPPV ali olimbikitsa kwambiri. Kuonjezera apo, poyang'ana kugwiritsiridwa ntchito kwa mpweya wosagwirizana ndi COPD, kusintha ngati kusintha kwa magazi ndi mapapu kumagwirira ntchito, komanso moyo wabwino kwambiri posachedwapa, makamaka ndi kutuluka kwapamwamba kwa NIPPV.
N'zoona kuti mpweya wabwino wokhala ndi mpweya umodzi ndi umodzi wokha pa moyo wanu komanso kukhala ndi COPD. Onetsetsani kuti mwadziphunzitsa nokha pazowonjezereka zowonjezera mapangidwe a mapapu ndi gawo la COPD lachitatu .
> Zosowa
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> Kasper, Dennis, Anthony Fauci, Stephen Hauser, Dan Longo, ndi J. Jameson. Mfundo za Harrison za Mankhwala a M'kati. New York: Maphunziro a McGraw-Hill, 2015. Print.
> Kohnlein, T., Windisch, W., Kohler, D. et al. Matenda Osagonjetsa Mpweya Woteteza Mpweya Wochizira Odwala Matenda Opatsirana Amadzimadzi: Matenda Odziwika, Multicentre, Randomzed, Controlled Clinical Trial. Lancet. Mankhwala Opuma . 2014. 2 (9): 698-705.
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