Kodi chithandizo cha oxygen, mitundu yayikulu ndi chiyani?

Zamkati

• Mitundu yayikulu yamankhwala othandizira mpweya
• 1. Machitidwe otsika otsika
• 2. Machitidwe othamanga kwambiri
• 3. Mpweya wosalowerera
• Ndi chiyani
• Kusamalira mukamagwiritsa ntchito kunyumba

Thandizo la oxygen limakhala ndikupereka mpweya wochulukirapo kuposa momwe umapezekera m'malo abwinobwino ndipo umafuna kuwonetsetsa kuti matupi amthupi apuma. Zinthu zina zimatha kubweretsa kuchepa kwa mpweya m'mapapu ndi minyewa, monga momwe zimakhalira ndi matenda opatsirana am'mapapo, otchedwa COPD, matenda a mphumu, matenda obanika kutulo ndi chibayo motero, pakadali pano, chithandizo cha oxygen chitha kukhala chofunikira.

Mankhwalawa amawonetsedwa ndi dokotala kapena pulmonologist atatsimikizira mpweya wochepa m'magazi, pochita magazi amitsempha yamagazi, omwe amayesedwa magazi kuchokera kumtunda wamaoko, komanso kugunda kwa oximetry, komwe kumachitika poyang'ana machulukitsidwe mpweya ndipo ayenera kukhala pamwamba 90%. Pezani zambiri za momwe oximetry imagwirira ntchito.

Mtundu wa chithandizo cha oxygen umadalira kuchuluka kwa kupuma kwamunthu komanso zizindikilo za hypoxia, komanso kugwiritsa ntchito catheter wammphuno, chigoba cha nkhope kapena Venturi. Nthawi zina, CPAP ikhoza kuwonetsedwa kuti ithandizire kulowa kwa mpweya mumlengalenga.

Mitundu yayikulu yamankhwala othandizira mpweya

Pali mitundu ingapo ya mankhwala a oxygen omwe amagawidwa molingana ndi kuchuluka kwa oxygen komwe kumatulutsidwa, ndipo adotolo amalimbikitsa mtunduwo kutengera zosowa za munthuyo, komanso kuchuluka kwa kupuma kwake komanso ngati munthuyo akuwonetsa zizindikiro za hypoxia, monga purplish pakamwa ndi zala, thukuta lozizira komanso kusokonezeka kwamaganizidwe. Chifukwa chake, mitundu yayikulu yamankhwala a oxygen atha kukhala:

1. Machitidwe otsika otsika

Mtundu wamachiritso amtunduwu umalimbikitsidwa kwa anthu omwe safuna mpweya wambiri ndipo kudzera munjira izi ndizotheka kuperekera mpweya kuma airways pakuyenda mpaka malita 8 pamphindi kapena ndi FiO2, yotchedwa kachigawo kouziridwa mpweya, kuchokera 60%. Izi zikutanthauza kuti pa mpweya wonse womwe munthuyo adzapumako, 60% idzakhala mpweya.

Zida zomwe amagwiritsa ntchito kwambiri ndi izi:

• Catheter yammphuno: ndi chubu cha pulasitiki chokhala ndi ma mpweya awiri omwe amayenera kuyikidwa m'mphuno ndipo, pafupifupi, amapereka oxygen pamalita awiri pamphindi;
• Nasal cannula kapena eyeglass catheter: amapangidwa ngati chubu chochepa kwambiri chokhala ndi mabowo awiri kumapeto kwake ndipo amalowetsedwa m'mimbamo yamphongo patali kofanana ndi kutalika pakati pa mphuno ndi khutu ndipo amatha kuperekera mpweya mpaka malita 8 pamphindi;
• Nkhope chigoba: imakhala ndi chigoba cha pulasitiki chomwe chiyenera kuyikidwa pakamwa ndi m'mphuno ndipo chimagwira ntchito yopereka mpweya woyenda bwino kuposa ma catheters ndi ma cannulas am'mphuno, kuphatikiza potumikira anthu omwe amapuma kwambiri pakamwa, mwachitsanzo;
• Chigoba ndi posungira: ndi chigoba chokhala ndi thumba lofufuma ndipo limatha kusunga mpweya wokwanira 1 litre. Pali mitundu ya masks okhala ndi malo osungira, omwe amatchedwa masks osabwezera, omwe ali ndi valavu yomwe imalepheretsa munthu kupuma mpweya woipa;
• Chigoba cha Tracheostomy: ndi ofanana ndi mtundu wa chigoba cha oxygen makamaka kwa anthu omwe ali ndi tracheostomy, yomwe ndi chingwe cholowetsedwa mu trachea yopumira.

Kuphatikiza apo, kuti mpweya uzilowetsedwa ndi mapapo moyenera, ndikofunikira kuti munthuyo asakhale ndi zotchinga kapena zotsekera m'mphuno, komanso, kuti apewe kuyanika mucosa wapanjira, ndikofunikira kugwiritsa ntchito chinyezi mpweya umayenda pamwamba pa malita 4 pamphindi.

2. Machitidwe othamanga kwambiri

Kuthamanga kwamphamvu kumatha kupereka mpweya wambiri, kuposa zomwe munthu amatha kupumira ndikuwonetsedwa pamavuto akulu, pakagwa hypoxia yoyambitsidwa ndi kupuma, kupuma kwa m'mapapo mwanga, edema yamapapo kapena chibayo. Onani zambiri zomwe hypoxia ndi sequelae zotheka ngati sizichiritsidwa.

Venturi mask ndi njira yodziwika bwino kwambiri yothandizirayi, popeza ili ndi ma adapter osiyanasiyana omwe amagwiritsa ntchito mpweya wabwino mosiyanasiyana, kutengera mtundu. Mwachitsanzo, adaputala ya pinki imapereka 40% ya oxygen pamlingo wa 15 malita pamphindi. Chigoba ichi chimakhala ndi mabowo omwe amalola mpweya wotulutsidwa kutuluka, womwe uli ndi kaboni dayokisaidi, ndipo umafunikira chinyezi kuti chisapangitse kuti ma airways awume.

3. Mpweya wosalowerera

Mpweya wabwino wosadziwika, womwe umadziwikanso kuti NIV, umakhala ndi mpweya wabwino womwe umagwiritsa ntchito mphamvu kuti mpweya ulowe mumlengalenga. Njirayi imawonetsedwa ndi pulmonologist ndipo imatha kuchitidwa ndi namwino kapena physiotherapist mwa achikulire omwe ali ndi vuto la kupuma komanso omwe amapuma mopitilira 25 kupuma pamphindi kapena kutsitsa kwa oxygen pansi pa 90%.

Mosiyana ndi mitundu ina, njirayi siigwiritsidwa ntchito popereka mpweya wowonjezera, koma imagwira ntchito yopumira kupumira poyambiranso pulmonary alveoli, kukonza kusinthana kwa gasi ndikuchepetsa kupumira ndipo ndikulimbikitsidwa kwa anthu omwe ali ndi vuto la kupuma tulo komanso omwe ali ndi matenda amtima.

Kuphatikiza apo, pali mitundu ingapo ya maski a NIV omwe angagwiritsidwe ntchito kunyumba ndipo amasiyanasiyana kutengera kukula kwa nkhope ndikusintha kwa munthu aliyense, CPAP ndiyo mtundu wofala kwambiri. Onani zambiri za CPAP ndi momwe mungagwiritsire ntchito.

Ndi chiyani

Thandizo la oxygen limalimbikitsidwa ndi dokotala kuti achulukitse kupezeka kwa mpweya m'mapapu ndi minyewa ya thupi, kuchepetsa zovuta zoyipa za hypoxia, ndipo ziyenera kuchitika munthuyo akakhala ndi mpweya wokwanira pansi pa 90%, kuthamanga pang'ono kwa oxygen, kapena PaO2 , osakwana 60 mmHg, kapena zinthu ngati:

• Pachimake kapena matenda kupuma kulephera;
• Matenda osokoneza bongo;
• Emphysema wamapapo;
• Chifuwa cha mphumu;
• Mpweya wa carbon monoxide;
• Cholepheretsa kugona tulo;
• Poyizoni;
• Kuchira pambuyo pake;
• Kumangidwa kwamtima.

Mankhwala amtunduwu amawonetsedwanso pakakhala infarction yaminyewa yam'mimba ndi angina pectoris, chifukwa mpweya umatha kuchepetsa zizindikilo za hypoxia, yoyambitsidwa ndi kusokonekera kwa magazi, kukulitsa kuchuluka kwa mpweya m'magazi, motero, mu alveoli wa m'mapapo.

Kusamalira mukamagwiritsa ntchito kunyumba

Nthawi zina, anthu omwe ali ndi matenda opuma opatsirana, monga COPD, amafunika kugwiritsa ntchito mpweya wothandizira kwa maola 24 patsiku ndipo pachifukwa ichi, mankhwala a oxygen atha kugwiritsidwa ntchito kunyumba. Mankhwalawa amachitika kunyumba kudzera pacatheter ya m'mphuno, yoyikidwa m'mphuno, ndipo mpweya umaperekedwa kuchokera ku silinda, chomwe ndi chidebe chachitsulo komwe amasungamo mpweya ndipo ndi ndalama zokha zomwe dokotala ayenera kupereka.

Ma cylinders a oxygen amapangidwa ndi mapulogalamu ena a SUS kapena amatha kubwereka kuchokera kumakampani opanga mankhwala azachipatala ndipo amathanso kunyamulidwa kudzera pakuthandizidwa ndi matayala ndipo atha kupita nawo kumadera osiyanasiyana. Komabe, mukamagwiritsa ntchito masilindala a oxygen, njira zina zodzitetezera ndizofunikira, monga kusasuta fodya mukamagwiritsa ntchito mpweya, kuteteza silindayo kutali ndi lawi lililonse ndikutetezedwa padzuwa.

Komanso, munthu amene amagwiritsa ntchito mpweya kunyumba amafunika kukhala ndi zida zogwiritsira ntchito ma oetetry poyang'ana machulukitsidwe ndipo ngati munthu akuwonetsa zizindikilo monga milomo yofiirira ndi zala, chizungulire komanso kukomoka, muyenera kupita kuchipatala nthawi yomweyo, chifukwa mutha kukhala ndi mpweya wochepa m'magazi anu.