Zimayambitsa, Zizindikiro, ndi Chithandizo cha Carbon Dioxide Kusungidwa M'magazi
Nthenda ya hypercapnia imapezeka pamene pali carbon dioxide yochuluka - chowonongeka cha kupuma - m'magazi. Ngakhale kuti nthawi zina zimayambitsa zinthu monga hypoventilation kapena mankhwala osokoneza bongo amodzi, vuto lalikulu ndi matenda a mapapo a COPD .
COPD ndi Hypercapnia Link
Nthaŵi zambiri, tikapuma, timapuma mpweya wabwino ndi kutulutsa carbon dioxide.
Mipweya iwiri yotentha imasinthana mkati m'mapapu m'magulu ang'onoang'ono, monga mphesa, kapena masamba a mpweya, wotchedwa alveoli .
Kwa anthu omwe ali ndi COPD, njirayi ndi yovuta chifukwa ma alveoli amawonongeka, osasiya mpweya kuti apite kuchokera m'mapapu kupita m'magazi ndi carbon dioxide kuti achoke m'magazi kupita m'mapapo kuti atuluke. Izi zimapangitsa kuti mpweya wabwino ukhale wotsika m'magazi, matenda otchedwa hypoxemia , ndi mpweya wabwino wa carbon dioxide m'magazi, omwe amatchedwa hypercapnia.
Kusungidwa kwa carbon dioxide mwa anthu omwe ali ndi COPD ndi chifukwa cha njira yotchedwa kupuma kwa mpweya wabwino (V / Q mismatch) m'mapapu. Izi zimachitika pamene ma capillaries ndi alveoli m'mapapu sakuyendayenda komanso mwachizoloŵezi chosinthanitsa bwino mpweya.
Zifukwa za Hypercapnia
Kuwonjezera pa COPD, palinso zinthu zina zomwe zingayambitse mpweya woipa m'magazi.
Zitsanzo zina ndi izi:
- Kugwiritsa ntchito mankhwala osokoneza bongo, monga opioid kapena benzodiazepine
- Brainstem kupweteka
- Hypothermia
- Matenda ena amadzimadzi (mwachitsanzo, otsika phosphate ndi ma magnesium m'magazi)
- Matenda ena a mitsempha kapena amanjenje monga encephalitis, muscular dystrophy, ALS, kapena myasthenia gravis
- Mapeto a Matenda a M'magazi (ILD)
- Kuletsa kugona tulo
- Matenda olemera kwambiri a hypoventilation
Zizindikiro za Hypercapnia
Anthu ambiri samadziwa kuti ali ndi hypercapnia. Nthawi zina zimakhala zochepa pang'onopang'ono komanso zimakhala zochepa kwambiri, simungathe kuwona zizindikiro zilizonse. Ngati zizindikiro zimapezeka, zimaphatikizapo kupuma pang'ono, kupweteka mutu, kusakhoza kuganiza bwino, kapena kugona kapena kugona. Chifukwa ndi zosavuta kuti muphonye zizindikiro za maulendo a mile, kuzindikira ndikofunika.
Kumbali ina, zizindikiro za kupweteka kwakukulu zimatchulidwa kwambiri. Kutaya mtima kwakukulu kumapeto kumapeto kumapangitsa kuti munthu asapume mpweya komanso mwina kufa. Zizindikiro ndi zizindikiro zingaphatikizepo:
- Paranoia, kudandaula, ndi chisokonezo, zomwe zingapite patsogolo
- Zosokoneza minofu
- Kugonjetsa
- Kusinthana kapena kufalikira kwa mitsempha yeniyeni pakhungu
- Papilledema - chizindikiro cha kuwonjezeka kwa ubongo mu ubongo
Kuchiza kwa Hypercapnia
Chithandizo cha matenda oopsa chimadalira kwambiri ndipo chimayamba ndi kuthetsa vuto.
- Kupanda mpweya wabwino : Kupanda mpweya wabwino kumapereka mpweya wothandizira wodwala kudzera m'mwamba. Zimathandiza kupuma kupatsa wodwalayo chisakanizo cha mpweya ndi mpweya kuchokera ku jenereta yothamanga kupyolera mu chigoba chowoneka bwino kapena chamkati.
- Kutulutsa mpweya ndi mpweya wabwino : Kutsegula ndi njira yowonjezeramo chubu yapadera kudzera pakamwa ndikupita panjira. Pambuyo pake chubu imathamangitsidwa kupita ku chimbudzi chomwe chimapuma kupuma kwa wodwalayo.
Nthawi yoyenera Dokotala
Chifuwachi chingayambitse kupuma ndi imfa ngati sichikuchitidwa. Ngati muli ndi COPD, kudziwa zizindikiro za hypercapnia ndizofunikira kuti muzindikire msanga. Dandauzani dokotala mwamsanga ngati mutasintha kusintha zizindikiro zanu kapena thanzi lanu lonse. Ngati dokotala akuda nkhaŵa za hypercapnia, akhoza kuchita mayeso otchedwa magazi ophera magazi - njira yosavuta, yogona pambali yomwe magazi amachokera ku mitsempha ya m'manja.
Mawu Ochokera
Mukamaphunzira za matenda osokoneza bongo, yesetsani kuti musagwedezeke ndi zovuta zogwirizana ndi mankhwalawa. Mmalo mwake, kumvetsetsa chithunzi chachikulu - chidziwitso chimatumikira monga chizindikiro kuti kusamvetsetsana kukuchitika mthupi.
Komanso, uthenga wodalirika wokutira mutu wako ndikuti monga hypercapnia ali ndi zifukwa zambiri ndipo sizichokera ku COPD, sikuti onse omwe ali ndi COPD ali ndi hypercapnia.
> Zotsatira:
> Feller-Kopman DJ, Schwartzstein RM. (2017). Kupenda, kuyezetsa, ndi chithandizo cha wodwala wamkulu yemwe ali ndi vuto lopumphuka kwambiri la kupuma. Mu: UpToDate, Stoller JK (Ed), UpToDate, Waltham, MA.
> Poon CS, Tin C, Song G. Kugonjera kwabwino: Chifukwa chiyani odwala COPD amatha kusunga CO2 kuposa odwala mtima. Respir Physiol Neurobiol. 2015. Sep 15; 216: 86-93.
> West JB. Zimayambitsa ndi zowonjezera za mankhwala a hypoxemia ndi hypercapnia. Compr Physiol . 2011 Jul; 1 (3): 1541-53.