Kulephera Kuthandizira Odwala, Kukwapula, ndi Kukhumudwa Kwambiri Kungathandize
Mu nthano zakale za Chigriki, Kugona kunali mapasa abale a Imfa, ana a Milungu yeniyeni ya Mdima ndi Usiku. Zikuwoneka kuti pakhala pali mgwirizano pakati pa kugona ndi imfa. Pamene anthu amafa mu tulo tawo, zikuwoneka ngati mwamtendere komanso mwa njira yabwino kwambiri yopita. Nchifukwa chiyani anthu amafa mu tulo? Fufuzani zina mwazimene zimayambitsa ndi momwe matenda ogona monga kugona, kugona, ndi kusowa tulo zingapangitse kuti pakhale chiopsezo chachikulu cholephera kudzuka.
Pamene Imfa Idza Usiku
Timagwiritsa ntchito gawo limodzi mwa magawo atatu a moyo wathu ali mtulo, choncho sitiyenera kudabwa kuti anthu ambiri amamwalira. Pali kusiyana kwakukulu pakati pa kufa nthawi yomweyo (makamaka pamene ali wathanzi) ndikufa pamene sakudziwa m'magulu otsiriza a matenda oopsa. Anthu achikulire ndi omwe akudwala omwe amafa samayang'anitsitsa mochepa kuposa achinyamata.
Malinga ndi momwe imfa ikuyendera (nyumba ndi kuchipatala chothandizira chithandizo), imfa imatha kuwonetsedwa ndi dokotala. Kawirikawiri autopsy ikanachitidwa (kapena kuwonetsedwa) pokhapokha ngati palibe. Kuyeza kumeneku kungakhale kovuta kwa achinyamata akuluakulu kapena ana omwe amafa mwadzidzidzi m'mudzi popanda matenda.
Ngakhale autopsy ikhoza kukhala yosadziwika. Chifukwa cha imfa sichingakhale chowonekera. Sitifiketi ya imfa ingaone zifukwa zosagwirizana ndi izi: "Kulephera kwa mtima," "adafa chifukwa cha chilengedwe," ngakhale "ukalamba." Banja ndi abwenzi angakhale akudabwa zomwe zinachitika, ndipo zingakhale zothandiza kumvetsa zifukwa zina za imfa zomwe zimachitika mu tulo.
Kukhazikitsa Zoopsa Zambiri, Chilengedwe, ndi Zida
Nthaŵi zina, imfa imachitika chifukwa cha mtundu wina wa kunja, kaya mwachindunji kuchokera ku chilengedwe kapena kunja kwina. Mwachitsanzo, chivomerezi chimene chimagwa m'nyumba chingabweretse imfa yoopsa mu tulo. Mpweya wa carbon monoxide wochokera ku mpweya wabwino komanso mpweya wabwino wotentha ungathandize. Kupha munthu kungakhalenso pa nthawi ya tulo, ndipo kupha kungabwere nthawi zambiri usiku.
Mankhwala omwe amatengedwa kuti athetse mavuto a zamankhwala, kuphatikizapo ululu ndi kusowa tulo, angapangitse ngozi ya imfa. Izi zikhoza kukhala zovuta ngati mankhwalawa amatengedwa mopitirira muyeso, monga mopitirira muyeso, kapena mowa. Zomwe zimagwiritsidwa ntchito ndi opioids zingasinthe kapena kupondereza kupuma. Mwachitsanzo, zovuta monga khansa zimafuna kuti morphine ikhale yofulumira kufa chifukwa cha kuchepetsa kupuma.
Tiyeni tiganizire zachilengedwe, zifukwa zamkati ndizo zimayambitsa imfa ndikuganizira kwambiri zomwe zimachitika.
Kuganizira Kulephera kwa Mtima ndi Maungulo
Zingakhale zothandiza kulingalira za zifukwa za imfa mwa "Code Blue" zomwe zingatchulidwe mu chipatala. Munthu akafa - kapena pangozi yakufa - pali njira zochepa zomwe zimakhala zolephera. Nthawi zambiri, kulephera kwa ntchito ya mtima ndi mapapo ndilo chifukwa chake.
Kusintha kupuma kwapang'onopang'ono kungapangitse pang'onopang'ono ntchito ya mtima ndi machitidwe ena. Kusinthasintha kwa mtima wa mtima, monga kupweteka kwakukulu kwa mtima, mwamsanga kumakhudza magazi kutulukira mu ubongo ndipo kungachititsenso kuti kupuma kwake kukhale kovuta. Mapapu angakhalenso odzaza ndi madzimadzi monga mbali ya pulema ya edema mu mtima kulephera.
Pofufuza zomwe zimayambitsa kufa mu tulo, zingakhale zothandiza kufufuza zomwe zimayambitsa machitidwe awiriwa:
Kumangidwa kwa mtima
Pali umboni wochuluka wakuti ntchito ya mtima ikhoza kugwedezeka pamene mukugona. Kuthamanga kwa diso mwamsanga (REM) kugona , makamaka, kungayambitsenso dongosolo ndi ngozi yowonjezera m'mawa. Kumeneko kumawoneka ngati njira yozungulira ya mtima wosagwira ntchito, ndipo nthawi zambiri mavuto amabwera usiku ndi pafupi nthawi yakuuka.
Kupweteka kwa mtima kumachitika pamene mitsempha ya magazi (kapena mitsempha yamakono) imapereka minofu ya minofu imatsekeka ndipo minofuyo imapweteka kapena kufa. Izi zimayambitsa zochitika zazing'ono zomwe zimangokhalira kugwirizanitsa ntchito ndi zovuta zomwe zimayambitsa kulephera kwathunthu kwa mtima monga pompu. Ngati magazi sangathe kufalikira, machitidwe ena a thupi amalephera ndipo imfa imatha.
Mtima ukhoza kukumana ndi zolakwika zomwe zimakhudza magetsi ake. Mlandu umene ukufunidwa kuti uzimitse minofu mu mafashoni ogwirizana ungasokonezeke. Zosintha zingakhale zosasintha, mofulumira kapena mopepuka, ndipo kupuma kwa mtima kumatha kusokonezeka.
Arrhythmias akhoza kukhala nthawi zambiri amachititsa imfa pogona. Asystole ndi chikumbumtima chakumangidwa kwa mtima pamene magetsi a mtima sangathe kudziwika. Matenda a atrial kapena flutter angawononge ntchito ya mtima. Zikwangwani zofanana zowonjezereka, kuphatikizapo ventricular tachycardia, zingawonongeke. Mitsempha ya mtima yokhudza magetsi ingayambitsenso kufooka kwa mtima ndi imfa.
Kulephera kwa mtima, kuchepa kwa mtima (CHF) kungapangitse kuti mtima usapere. Kulephera kwa mtima kumbali kumanzere kumakhudza mbali yowongoka ya mtima, zomwe zimapangitsa kuti madzi asungunuke m'mapapu (ali ndi mpweya wochepa, makamaka pamene wagona) ndi kutupa mapazi ndi miyendo yotchedwa edema. Ngati mtima ukugwedezeka, mphamvu yake yofalitsa magazi ingathe.
Chofunika kwambiri, mtima ungakhudze machitidwe ena omwe amadalira mphamvu yake yofalitsira magazi. Chodabwitsa kwambiri, mtima wosasinthasintha wamtima ukhoza kutsogoloka ku ubweya umene umapita ku ubongo ndikupangitsa kuti ukhale ndi matenda. Kuthamanga kwa magazi, kapena kuthamanga kwa magazi, kungapangitse ngozi. Ngati sitiroko imakhudza ubongo, kupuma, kutsegula maso, kuteteza minofu, ndi chidziwitso zingasokonezedwe. Kukwapula kumeneku kungakhale koopsa ndipo kumatha kugona.
Kumangidwa kwa Kupuma
Maungulo amathandizira ntchito ya mtima komanso ngati timagulu, ngati njira imodzi ikulephera, ina imakhala ikutsatira mwachidule. Matenda opatsirana nthawi zambiri amakhala aakulu, ndipo zotsatira zake zingakhale pang'onopang'ono. Pamene malo ovuta afika, komabe imfa ikhoza kuchitika.
Pazikuluzikulu, mapapu ndiwo amachititsa kusintha kwa mpweya ndi carbon dioxide ndi chilengedwe. Ngati sagwira ntchito bwino, mpweya wa okosijeni umagwera, mpweya wa carbon dioxide ukukwera, ndipo kusintha koopsa mu thupi la acid limakhalapo.
Kulepheretsa kwakukulu, monga kukwera pa masanzi, kungachititse kuti asphyxiation. Ngakhale kuti sizingatheke, ndizotheka kuti mwambo wolepheretsa kugona tulo kuti tipeze imfa.
Kulephera kupuma kupuma kungabwere chifukwa cha matenda aakulu, otayika. Izi zikhoza kukhala kulephera kwa mapapo okha, monga:
- Matenda osokoneza bongo (COPD)
- Emphysema
- Cystic fibrosis
- Matenda a khansa
- Pulmonary fibrosis
- Chibayo
- Mkhalidwe asthmaticus
- Kupanga mapulaneti (kumata kumapapu)
N'zotheka kuti mapapo alephereke chifukwa cha kusintha kwa minofu kapena machitidwe amanjenje, monga amyotrophic lateral sclerosis (ALS kapena Lou Gehrig) matenda kapena myasthenia gravis.
Pali mavuto omwe amabwera chifukwa chotha kupuma ngati matenda okhudzana ndi matenda a hypoventilation. Matenda a imfa ya mwadzidzidzi (SIDS) amaimira kulephera kupuma nthawi zonse pamene tigona.
Pamene imfa ikuyandikira pang'onopang'ono, pali kupuma komwe kumachitika. Amatchedwa kupuma kwa Cheyne-Stokes. Kawirikawiri imatchulidwa mu mtima wosalongosoka, kugwiritsa ntchito mankhwala osokoneza bongo, komanso kuvulaza ubongo. Zingasonyeze kutha kwa kupuma ndi imfa. Chisamaliro chikhoza kupsinjika mtima pamene munthu wokhudzidwayo amachokapo.
Kuwona Zifukwa Zina ndi Udindo Wa Matenda a Kugona
N'zotheka kuti imfa imagona chifukwa cha zovuta zina, kuphatikizapo kugona. Makamaka, kugunda kumatha kukhala koopsa. Pali matenda omwe amadziwika kuti imfa mwadzidzidzi mu khunyu (SUDEP) yomwe siimvetsetse bwino.
Kupewa kugona tulo kungapangitse mankhwala ena omwe angawonongeke. Izi zikuphatikizapo zikwapu, matenda a mtima, mtima wosagwedera, ndi arrhythmias zomwe zingathe kupha mwadzidzidzi imfa.
N'zotheka kufa ndi makhalidwe ogona omwe amatchedwa parasomnias . Kugona kungachititse munthu kukhala pangozi, kuphatikizapo kugwa m'mawindo kuchokera kumtunda, kutsika sitimayo, kapena kuyendayenda pamsewu. "Kudzipha mwachinyengo" kumaphatikizapo kuwonongeka pakati pa anthu okhala ndi kuvulala komwe amatha kufa popanda kudzidzidzimuka maganizo kapena kudzipha.
Kusokonezeka kwa kugonana kwa REM kungayambitse kugona ndi kukhumudwa. Izi zikhoza kuyambitsa kutaya magazi mkati; kachilombo ka hematoma kamatha kufa mwamsanga.
Ngakhale vuto la kugona silikupha, pali umboni wakuti kusowa tulo kumawonjezera chiopsezo chodzipha. Kulephera kugona mokwanira kungachititse kuti anthu ambiri asamangogona.
Mawu Ochokera
Pofuna kupewa kufa usiku chifukwa cha matenda ogona, dziwani zizindikiro zina (kuphatikizapo kusowa tulo ndi kuwuka kwa m'mawa kwambiri) kapena zizindikiro za kupuma kwa mpweya (kupuma, kupuma, nocturia , bruxism , kugona kwa usana, nkhawa ndi mavuto , ndi zina zotero). Mwamwayi, vuto la kugona limatha kuchiritsidwa. Limbikitsani thanzi lanu lonse ndipo musaiwale ntchito yofunikira ya kugona bwino.
> Zotsatira:
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> Kryger MH, ndi al . "Mfundo Zothandiza Pogona Mankhwala." Elsevier , 6th edition, 2016.
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