Kunenepa kwambiri hypoventilation syndrome (OHS)

Kunenepa kwambiri kwa hypoventilation syndrome (OHS) ndimkhalidwe wa anthu onenepa kwambiri momwe kupuma bwino kumawongolera kutsika kwa mpweya komanso kuchuluka kwa kaboni dayokisaidi m'magazi.

Zomwe zimayambitsa OHS sizikudziwika. Ochita kafukufuku amakhulupirira kuti zotsatira za OHS zimachokera ku vuto lomwe ubongo umalamulira popuma. Kulemera kwakukulu motsutsana ndi khoma la chifuwa kumapangitsanso kuti zikhale zovuta kuti minofu itenge mpweya wabwino ndikupuma mwachangu mokwanira. Izi zimawonjezera kupuma kwa ubongo. Zotsatira zake, magazi amakhala ndi mpweya woipa wochuluka komanso mpweya wokwanira.

Zizindikiro zazikulu za OHS zimachitika chifukwa chakusowa tulo ndipo zimaphatikizapo:

• Kusagona bwino
• Mpweya wogona
• Kugona masana
• Matenda okhumudwa
• Kupweteka mutu
• Kutopa

Zizindikiro za kuchepa kwa mpweya wa oxygen (matenda a hypoxia) amathanso kuchitika. Zizindikiro zimaphatikizira kupuma movutikira kapena kumva kutopa pambuyo poyesetsa pang'ono.

Anthu omwe ali ndi OHS nthawi zambiri amakhala onenepa kwambiri. Kuyezetsa thupi kumatha kuwulula:

• Mtundu wabuluu pamilomo, zala, zala zakumapazi, kapena khungu (cyanosis)
• Khungu lofiira
• Zizindikiro za mtima wosakhazikika (cor pulmonale), monga kutupa miyendo kapena mapazi, kupuma movutikira, kapena kumva kutopa pambuyo poyesetsa pang'ono
• Zizindikiro za kugona kwambiri

Mayeso omwe amagwiritsidwa ntchito kuthandizira kuzindikira ndikutsimikizira OHS ndi awa:

• Magazi amitsempha yamagazi
• X-ray pachifuwa kapena CT scan kuti athetse zina zomwe zingayambitse
• Kuyesa kwa mapapo (kuyesa kwa pulmonary function)
• Kuphunzira kugona (polysomnography)
• Echocardiogram (ultrasound ya mtima)

Opereka chithandizo chamankhwala amatha kuuza OHS kuchokera ku matenda obanika kutulo chifukwa munthu amene ali ndi OHS ali ndi mpweya wambiri wa carbon dioxide m'magazi ake akadzuka.

Kuchiza kumaphatikizapo kuthandizira kupuma pogwiritsa ntchito makina apadera (makina othandizira mpweya). Zosankha ndizo:

• Kutulutsa mpweya wosasunthika monga kupitiliza kwa mpweya wabwino (CPAP) kapena kuthamanga kwa bilevel (BiPAP) kudzera pachisoti chomwe chimakwanira kwambiri pamphuno kapena m'mphuno ndi pakamwa (makamaka tulo)
• Thandizo la oxygen
• Kupuma kumathandizira kupyola pakhosi (tracheostomy) pamavuto akulu

Chithandizo chimayambitsidwa mchipatala kapena ngati wodwala wakunja.

Mankhwala ena amathandizira kuchepetsa thupi, komwe kumatha kusintha OHS.

Osalandira chithandizo, OHS imatha kubweretsa mavuto amtima ndi mitsempha yamagazi, kulumala kwambiri, kapena kufa.

Zovuta za OHS zokhudzana ndi kusowa tulo zingaphatikizepo:

• Kukhumudwa, kukwiya, kukwiya
• Zowonjezera ngozi za ngozi kapena zolakwika pantchito
• Mavuto okondana komanso kugonana

OHS ikhozanso kuyambitsa mavuto amtima, monga:

• Kuthamanga kwa magazi (matenda oopsa)
• Kulephera kwa mtima kumanja (cor pulmonale)
• Kuthamanga kwa magazi m'mapapu (kuthamanga kwa magazi)

Itanani omwe akukuthandizani ngati mwatopa kwambiri masana kapena muli ndi zizindikiro zina zomwe zikusonyeza OHS.

Pitirizani kulemera bwino komanso kupewa kunenepa kwambiri. Gwiritsani ntchito mankhwala anu a CPAP kapena BiPAP monga omwe amakupatsani.

Matenda a Pickwickian

• Dongosolo kupuma

Malhotra A, Powell F. Zovuta zamagetsi zowongolera mpweya. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 80.

Mokhlesi B. Kunenepa-hypoventilation matenda. Mu: Kryger M, Roth T, Dement WC, olemba. Mfundo ndi Zochita za Mankhwala Ogona. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2017: mutu 120.

Mokhlesi B, Masa JF, Brozek JL, et al. Kuwunika ndikuwongolera kunenepa kwambiri kwa hypoventilation syndrome. Chitsogozo chazachipatala cha American Thoracic Society. Ndine J Respir Crit Care Med. 2019; 200 (3): e6-e24. PMID: 31368798 www.ncbi.nlm.nih.gov/pubmed/31368798. (Adasankhidwa)