Ukutyeba kakhulu kwe-hypoventilation syndrome (OHS)

Ukutyeba kakhulu kwe-hypoventilation syndrome (i-OHS) yimeko kwabanye abantu abatyebe kakhulu apho ukuphefumla okungalunganga kukhokelela ekunciphiseni ioksijini kunye namazinga aphezulu ecarbon dioxide egazini.

Isizathu ngqo se-OHS asaziwa. Abaphandi bakholelwa ukuba iziphumo ze-OHS zisuka kwisiphene kulawulo lobuchopho ekuphefumlweni. Ubunzima obugqithisileyo obudongeni lwesifuba bukwenza kube nzima ukuba izihlunu zitsale umoya kunye nokuphefumla ngokwaneleyo ngokwaneleyo. Oku kuyenza mandundu ulawulo lokuphefumla kwengqondo. Ngenxa yoko, igazi line-carbon dioxide eninzi kakhulu kwaye ayonelanga ngeoksijini.

Iimpawu eziphambili ze-OHS zibangelwa kukungabikho kokulala kwaye zibandakanya:

• Ukulala kakubi
• Ukulala ngokuphefumla
• Ukulala emini
• Uxinzelelo
• Intloko ebuhlungu
• Ukudinwa

Iimpawu zenqanaba eliphantsi leoksijini yegazi (i-hypoxia engapheliyo) nayo inokwenzeka. Iimpawu zibandakanya ukuphefumla kancinci okanye ukuziva udiniwe emva komzamo omncinci kakhulu.

Abantu abane-OHS bahlala betyebe kakhulu. Uvavanyo lomzimba lunokubonisa:

• Umbala oluhlaza okwesibhakabhaka kwimilebe, kwiminwe, kwiinzwane, okanye kulusu (i-cyanosis)
• Ulusu olubomvu
• Iimpawu zokusilela kwentliziyo esekunene (i-cor pulmonale), njengokuvuvukala imilenze okanye iinyawo, ukuphefumla kancinci, okanye ukuziva udiniwe emva komzamo omncinci
• Iimpawu zokulala kakhulu

Uvavanyo olusetyenziselwa ukufumanisa isifo kunye nokuqinisekisa i-OHS kubandakanya:

• Irhasi yegazi ejikelezayo
• I-x-ray yesifuba okanye i-CT scan ukukhupha ezinye izizathu ezinokubakho
• Iimvavanyo zomsebenzi wemiphunga (iimvavanyo zomsebenzi wamaphaphu)
• Isifundo sokulala (ipolysomnografi)
• I-Echocardiogram (i-ultrasound yentliziyo)

Ababoneleli ngononophelo lwempilo banokuxelela i-OHS ukusuka ekuthinteleni i-apnea yokulala kuba umntu one-OHS unenqanaba eliphezulu le-carbon dioxide egazini xa evukile.

Unyango lubandakanya ukuphefumla ngoncedo usebenzisa oomatshini abakhethekileyo (umoya ongenisa umoya). Izinketho zibandakanya:

• Ukungenisa umoya okungafunekiyo njengokuqhubeka koxinzelelo lwomoya (CPAP) okanye uxinzelelo lwe-bilevel yomoya (BiPAP) ngesigqumathelo esilingana ngokuqinileyo phezu kwempumlo okanye impumlo nomlomo (ikakhulu ukulala)
• Unyango lweoksijini
• Ukuphefumla kunceda ngokuvula entanyeni (tracheostomy) yamatyala abukhali

Unyango luqaliswa esibhedlele okanye njengesigulana esingaphandle.

Olunye unyango lujolise ekunciphiseni ubunzima, obunokuguqula i-OHS.

Ukunganyangwa, i-OHS inokukhokelela kwiingxaki ezinzulu zentliziyo kunye negazi, ukukhubazeka okukhulu, okanye ukufa.

Iingxaki ze-OHS ezinxulumene nokungabikho kokulala zingabandakanya:

• Uxinzelelo, ukuphazamiseka, ukucaphuka
• Umngcipheko owandileyo weengozi okanye iimpazamo emsebenzini
• Iingxaki ngokusondelana kunye nokwabelana ngesondo

I-OHS inokubangela iingxaki zentliziyo, ezinje:

• Uxinzelelo lwegazi (uxinzelelo lwegazi)
• Ukusilela kwentliziyo esekunene (cor pulmonale)
• Uxinzelelo lwegazi oluphezulu emiphungeni (uxinzelelo lwegazi)

Fowunela umboneleli wakho ukuba ukhathele kakhulu emini okanye unazo naziphi na ezinye iimpawu ezibonisa i-OHS.

Gcina ubunzima obusempilweni kwaye uphephe ukutyeba kakhulu. Sebenzisa unyango lwe-CPAP okanye lwe-BiPAP njengoko kumiselwe ngumboneleli wakho.

Isifo sePickwickian

• Inkqubo yokuphefumla

IMalhotra A, iPowell F. Ukuphazamiseka kolawulo lomoya. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl 80.

UMokhlesi B.I-Obesity-hypoventilation syndrome. Ku: Kryger M, Roth T, Dement WC, ii-eds. Imigaqo kunye nokuziqhelanisa neyeza lokulala. Umhla wesi-6. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 120.

UMokhlesi B, uMasa JF, uBrozek JL, et al. Uvavanyo kunye nolawulo lokukhuluphala kwe-hypoventilation syndrome. Isikhokelo esisemthethweni seAmerican Thoracic Society. NdinguJ J wokuKhathalela uKhathalelo ngeMed. 2019; 200 (3): e6-e24. IINKCUKACHA: 31368798 www.ncbi.nlm.nih.gov/pubmed/31368798.