Zozoloŵera, Zowonjezera, ndi Zowonjezera V / Q Results
V / Q mismatch ndi vuto limene limapezeka m'mapapu momwe mpweya wabwino umasinthira (kusinthana kwa mpweya pakati pa mapapo ndi chilengedwe) ndi kusakaniza (gawo la magazi m'mapapu) silofanana, chizindikiro cha matenda osokoneza bongo ( COPD ).
Kodi V / Q Imatanthauza Chiyani?
Musanafotokoze zomwe zimachitika mu V / Q zolakwika, nkofunika kufotokoza zomwe V / Q zikutanthauza:
- V imaimira mpweya wabwino , mpweya umene umapuma kudzera m'mphuno ndi pakamwa, kudutsa mumtambo, kupita ku bronchi, kenako kumadutsa mumphepete mwa mpweya wang'ono kupita kumalo ang'onoang'ono omwe amadziwika kuti Alveoli komwe mpweya wabwino umatulutsa mpweya woipa ndi carbon dioxide. .
- Q amaimira perfusion kapena magazi. Kuchokera pamtima, deoxygenated ("magazi a buluu") amadutsa m'mitsempha ya pulmonary (yomwe imakhala ngati mitsempha chifukwa imakhala ndi magazi osowa) pogwiritsa ntchito zida zazing'ono ndi zing'onozing'ono komanso mitsempha yaing'ono yomwe imapezeka mpweya wabwino. zimachitika.
Magulu a alveoli ndiwo ang'onoang'ono m'mlengalenga, khungu limodzi lokha. Pafupi ndi alveoli ili ndi capillary, mitsempha yaing'ono kwambiri ya magazi komanso selo imodzi yokha. Apa ndi malo omwe mpweya wa okosijeni ndi mpweya umapezeka m'mapapu, pamene mpweya umachokera ku alveoli kupita kwa capillaries, ndipo carbon dioxide imachokera ku capillaries kupita ku alveoli.
V / Q kapena mpweya wabwino / phulusa limatanthauza kuchuluka kwa mpweya umene ukufika ku alveoli yomwe imagawanika ndi kuchuluka kwa magazi omwe amapitirira kupyolera mu capillaries m'mapapu.
Kumvetsetsa Dead Space
Ndikofunika kuti kenaka tifotokoze "malo okufa." Izi zikutanthauza malo alionse omwe alveoli ndi capillaries sagwirizana.
Danga lakufa ili:
- Malo osokoneza bongo, omwe amachititsa kuti pakhale njira zowonongeka kapena zowonjezera magazi, monga kupopera magazi (kutseka magazi) kapena thupi lachilendo lilowetsa panjira.
- Malo osokonekera a thupi, omwe amapezeka pamene miyendo ya mpweya kapena mitsempha ya magazi ndi yachilendo, koma palinso zifukwa zina zomwe alveoli ndi capillaries sizikufanana ndi kuthamanga kwa magazi kuchoka kumadera ammapapu (kutseka thupi) .
Pokhala ndi malo othawa, kwenikweni mumabweretsa magazi kumalo omwe sungathe kutenga oksijeni, kapena kubweretsa mpweya ku dera lomwe silingathe kutulutsa oksijeni.
Kuyeza V / Q Kugwirizana
Kuyeza chiwerengero cha V / Q chachitika pamayesero awiri. Kuti muyese mpweya wabwino, munthu ali ndi mask anaika nkhope yake pansi ndikupuma mu mpweya wa radioactive. Kuti muyese perfusion, puloteni ya radioactive imayikidwa mu mitsempha. Ndiye zotsatira za mayeso awiriwa zikufanizidwa.
Kodi V / Q Zimatanthauzanji?
V / Q misampha imatanthawuza kuti m'madera ena m'mapapu, alveoli ndi capillaries sagwedezeka kapena pali malo okufa. Izi zikhoza kutanthauza kuti m'madera ena a mapapo, pali capillaries zambiri kuposa alveoli, mwazinthu zina, m'mapapu omwe amatsitsimutsidwa bwino ndi magazi kuposa mpweya wokwanira.
M'madera ena, pakhoza kukhala alveoli zambiri ndi oksijeni kuposa ma capillaries kuti atenge mpweya umenewo. M'mawu ena, madera ena m'mapapu akhoza kukhala mpweya wambiri kusiyana ndi kusokonezedwa.
Zina mwazidzidzidzi zimachitika kawirikawiri, koma zikawonjezereka pamtundu wina, zimayambitsa mavuto. Nchifukwa chiyani V / Q Imayambitsa Vuto? Cholakwika cha V / Q ndicho chofala kwambiri cha hypoxemia ndipo chimayambitsa zifukwa zambiri za kupuma kupuma.
Hypoxemia ndi mawu omwe amatanthauza mpweya wotsika m'magazi. Pamene maselo a thupi amachotsedwa mpweya (ndipo amaonongeka ndikufa) chifukwa cha hypoxemia, amatchedwa hypoxia.
Zizindikiro za hypoxia zikhoza kukhala kutaya mtima, kupuma pang'ono, chisokonezo, ndipo ngati sichidzasamalidwa, imfa.
Zifukwa za V / Q Sungani
Kusokonekera kwa V / Q kungayambitsidwe ndi chirichonse chomwe chimapangitsa kapena kuchepetsa mpweya wabwino wamapapo kapena kuwonjezeka kapena kuchepetsa kuperewera kwa mapapo. Mwa kuyankhula kwina, chirichonse chimene chimasokoneza luso la mpweya watsopano kuti ufike ku alveoli, kapena chirichonse chimene chimaletsa magazi kuthamangira kwa capillaries. Zonsezi zingasokoneze kayendedwe ka mpweya wabwino.
Zachizolowezi, Zochepa, Zowonjezera V / Q Zotsatira
Gawo labwino la V / Q liri pafupi 0.80. Izi zikutanthauza kuti pafupifupi 4 malita a oksijeni amapita m'mapapu mphindi iliyonse pamene 5 malita a magazi amadutsa m'mapapu.
Kuchuluka kwa chiwerengero cha V / Q chimachitika pokhapokha pali kuchepa kwa mpweya m'mapapo kapena kuchulukitsa mafuta (magazi ambiri amayenda m'mapapo). Zinthu zomwe zingayambitse chiwerengero cha V / Q chocheperachepera chikuphatikizapo:
- Bronchitis yachilendo : Kuphatikizidwa kwa bronchospasm , mucus plugs, kutupa, ndi kutsekeka kwa ponseponse kumaphatikizapo mpweya woipa kwambiri ndipo motero kuchepetsa chiŵerengero cha mpweya wokwanira kupuma mafuta.
- Phumu
- Edema yamaphunziro
- Kupewera kwa kayendetsedwe ka ndege (chilakolako cha thupi kunja)
Kuwonjezeka kwa V / Q kumachitika pokhapokha kulikuwonjezeka kwa mpweya wabwino kapena kuchepa kwa phulusa (kuthamanga kwa magazi kupita kumapapo.) Kuwonjezeka kwa V / Q kuwonetsekera kungawonedwe ndi:
- Kumangirira pamapangidwe: Kupuma kwapopysi ndi magazi m'mapapu omwe nthawi zambiri amayamba ngati magazi mu miyendo yomwe imachoka ndikupita kumapapo. Ngati yayikulu mokwanira, clot ikhoza kuyamwa mitsuko yambiri ya magazi yomwe imakhala yopanda mafuta m'madera ena a mapapo omwe akupeza mpweya wabwino. Choncho V / Q ikuwonjezeka chifukwa mpweya wabwino (V) umakhala wofanana ndipo kufalikira (Q) kumapita. Pa kuyeza kwa V / Q, padzakhala umboni wakuti zigawo za m'mapapo mugawidwe wa magazi okhudzidwa sizikugwedezeka.
- Emphysema : Emphysema ikhozanso kuyambitsa chiŵerengero cha V / Q chokwera. Chifukwa cha kuwonongeka kwa alveoli m'mapapu, malo omwe amapezeka kuti azitengera mpweya ndi carbon dioxide amatha. Choncho mpweya wabwino umakwera mmwamba, zomwe zimayambitsa chiwerengero cha V / Q.
Zotsatira:
Jobse, B., McCurry, C., Morissette, M. et al. Zotsatira za Kutupa, Emphysema, ndi Kusuta Kuchokera pa V / Q mu Zithunzi Zamakono Zomangirira Makombo. Kafukufuku Wopuma . 2014. 15:42.
Laibulale ya National National Medicine. MedlinePlus. Kupanga Mpweya Wopuma / Kusintha kwa Perfusion. https://www.nlm.nih.gov/medlineplus/ency/article/003828.htm.