Yintoni i-Kussmaul Breathing, kwaye ibangelwa yintoni?

Umxholo

• Yintoni ebangela ukuba uKussmaul aphefumle?
• I-ketoacidosis yeswekile
• Ezinye izizathu
• Ziintoni iimpawu?
• Uphathwa njani uKussmaul?
• Ungayikhusela njani iKussmaul yokuphefumla
• Ukuphefumla kukaKussmaul kwahluke njani ekuphefumlweni kweCheyne-Stokes?
• Umgca wezantsi

Ukuphefumla kweKussmaul kubonakaliswa ngokuphefumla okunzulu, okukhawulezayo kunye nokusebenza. Le patheni yokuphefumla ngokungafaniyo inokubangela iimeko ezithile zonyango, ezinje ngesifo seswekile, ketoacidosis, esisifo esibi seswekile.

Ukuphefumla kukaKussmaul kuthiwa nguGqirha Adolf Kussmaul, ophefumla ngo-1874.

Qhubeka ufunda ukuze ufumane okungakumbi malunga nokuphefumla kukaKussmaul, kubandakanya ukuba yintoni ebangela oko kunye nendlela yokuqonda le patheni yokuphefumla.

Yintoni ebangela ukuba uKussmaul aphefumle?

Xa kuziwa ekuphefumlweni kweKussmaul, kuyanceda ukukhumbula ukuba umzimba wakho uhlala uzama ukufumana ibhalansi.

Umzimba wakho ugcina inqanaba le-pH elizinzileyo le-7.35 ukuya kwi-7.45. Xa eli nqanaba le-pH liba phezulu okanye lisezantsi, umzimba wakho kufuneka ufumane iindlela zokuzama ukwenza utshintsho lwe-pH. Kulapho kungena khona ukuphefumla kweKussmaul.

Makhe sijonge ezinye zezinto ezinokubangela utshintsho lwe-pH ezinokukhokelela ekuphefumlweni kweKussmaul.

I-ketoacidosis yeswekile

Esinye sezona zinto zixhaphakileyo zokuphefumla kweKussmaul sisifo seswekile, ketoacidosis, esisifo esibuhlungu esihlala sihambelana noluhlobo lweswekile. Nangona kunjalo, ngohlobo lwe-2 yeswekile.

I-ketoacidosis yeswekile inokubangelwa ukuba umzimba wakho awuyivelisi ngokwaneleyo i-insulin kwaye awunakho ukwenza i-glucose ngokufanelekileyo. Oku kungakhokelela ekuphelelweni ngamanzi emzimbeni, okunokuthi, kunokubangela ukuba umzimba wakho uqale ukophula amanqatha ukuze ufumane amandla ngokukhawuleza.

Iziphumo zezi zinto ziiketoni, ezineasidi eninzi kwaye zinokubangela ukuba i-asidi yakhe emzimbeni wakho.

Nantsi ingcaciso yendlela isifo seswekile ketoacidosis esinokukhokelela ngayo ekuphefumleni kweKussmaul:

• Amaketoni ongezelelweyo emzimbeni wakho abangela i-asidi ukuba yakhe egazini lakho.
• Ngenxa yoku, inkqubo yakho yokuphefumla ichukunyiswa ukuqala ukuphefumla ngokukhawuleza.
• Ukuphefumla ngokukhawuleza kunceda ukukhupha i-carbon dioxide engaphezulu, eyinto ene-asidi egazini lakho.
• Ukuba amanqanaba e-asidi aqhubeka enyuka kwaye awufumani nyango, umzimba wakho uya kubonisa ukuba kufuneka uphefumle nzulu.
• Oku kubangela ukuphefumla kweKussmaul, okubonakaliswa ngokuphefumla okunzulu, okukhawulezayo, ukuzama ukukhupha i-carbon dioxide kangangoko kunokwenzeka.

Ezinye izizathu

Ezinye zezinto ezinokubangela ukuphefumla kukaKussmaul zibandakanya:

• ukusilela komzimba, njengentliziyo, izintso, okanye ukusilela kwesibindi
• ezinye iintlobo zomhlaza
• ukusetyenziswa kotywala ixesha elide
• ukungenisa i-toxins, njenge-salicylates (i-aspirin), i-methanol, i-ethanol, okanye i-antifreeze
• ukuxhuzula
• ispsis
• overexertion, esombulula ngokukhawuleza ngokuphumla

Nganye kwezi meko ibangela ukuba i-asidi inyuse igazi. Ngaphandle kwe-overexertion, uninzi lwezi meko zibangelwa ziimetabolism.

Oku kuthetha ukuba amalungu aqhelekileyo anoxanduva lokucoca iimveliso zenkunkuma awanako ukuqhubeka njengoko kufuneka. Ezi mveliso zenkunkuma, ezihlala zi-asidi, zakha egazini, kwaye umzimba wakho uzama ukuguqula oku kungalingani.

Ziintoni iimpawu?

Ezinye zeempawu zokuphefumla kukaKussmaul zibandakanya:

• ukuphefumla nzulu
• izinga lokuphefumla ngokukhawuleza
• izinga lokuphefumla elilinganayo nelingaguquguqukiyo kwinqanaba kunye nesingqisho

Abanye abantu bachaza ukuphefumla kukaKussmaul “njengendlala yomoya.” Oku kuthetha ukuba ukuba unamava, unokubonakala ngathi uphefumla umoya, okanye ngokungathi ukuphefumla kwakho kubonakala ngathi kuyothuka.

Abantu abaphefumla uKussmaul abanalo ulawulo kwindlela abaphefumla ngayo. Yimpendulo yomzimba kwimeko engaphantsi.

Kuba ukuphefumla kweKussmaul kuhlala kubangelwa sisifo seswekile ketoacidosis, kubalulekile ukuqaphela iimpawu zokulumkisa zale meko, ezinokuza ngokukhawuleza.

Ezinye zeempawu eziqhelekileyo zesifo seswekile ziquka:

• amazinga aphezulu eswekile yegazi
• unxano olugqithisileyo
• isicaphucaphu okanye ukugabha
• ukwanda komchamo
• ukudideka
• umphefumlo onuka kamnandi okanye osisiqhamo
• amanqanaba aphezulu e-ketone kumchamo
• ukudinwa

Ngaphandle kokuba iimpawu zibangelwa kukugqithisa, kubalulekile ukuba nabani na onempawu zokuphefumla kweKussmaul afumane unyango kwangoko.

Uphathwa njani uKussmaul?

Ukunyanga ukuphefumla kweKussmaul kubandakanya ukujongana nemeko ebangeleyo. Rhoqo, unyango lufuna ukuhlala esibhedlele.

Unyango lwe-ketoacidosis yeswekile ludla ngokufuna ukufakwa kwamanzi ngaphakathi kunye nokufakwa endaweni kwe-electrolyte. I-insulini iya kuthi ilawulwe ngendlela efanayo, de amanqanaba eswekile yegazi akho angaphantsi kweemiligram ezingama-240 kwidesilitha nganye.

Kwimeko ye-uremia, unokufuna i-dialysis ukunciphisa ukwakheka kweetyhefu ezingaphezulu ezingenakucocwa zizintso zakho.

Ungayikhusela njani iKussmaul yokuphefumla

Ukuthintela ukuphefumla kweKussmaul kuhlala kubandakanya ukulawulwa ngononophelo kweemeko zonyango ezingapheliyo.

Ukuba unesifo seswekile, oku kubandakanya:

• ukuthatha amayeza eswekile njengoko kuyalelwe
• ukulandela isicwangciso sokutya njengoko kuyalelwe ngumboneleli wezempilo
• ukuhlala kakuhle
• Ukujonga amanqanaba eswekile yegazi rhoqo
• ukuvavanya umchamo kwiietoni

Ukuba unemeko enxulumene nezintso, oku kubandakanya:

• ukwamkela ukutya okuhambelana nezintso
• ukuphepha utywala
• ukuhlala kakuhle
• ukugcina amanqanaba eswekile yegazi ephantsi kolawulo

Ukuphefumla kukaKussmaul kwahluke njani ekuphefumlweni kweCheyne-Stokes?

Olunye uhlobo lwepateni yokuphefumla engaqhelekanga yiCheyne-Stokes ukuphefumla. Nangona oku kunokwenzeka xa uvukile, kuqhelekile ngexesha lokulala.

Ukuphefumla kwe-Cheyne-Stokes kudla ngokubonakaliswa ngu:

• ukonyuka kancinci kokuphefumla, kulandele ukwehla
• i-apneic, okanye ukungaphefumli, isigaba esenzeka emva kokuphefumla komntu sifumana nzulu
• Ithuba lokuphefumla elihlala ngokuthatha imizuzwana eli-15 ukuya kwengama-60

Ukuphefumla kwe-Cheyne-Stokes kuhlala kunxulumene nokusilela kwentliziyo okanye ukubetha. Inokubangelwa yimeko enxulumene nengqondo, enje:

• amathumba engqondo
• ukwenzakala kwengqondo ebuhlungu
• encephalitis
• ukwanda koxinzelelo lwangaphakathi

Nalu uthelekiso phakathi kweCheyne-Stokes kunye nokuphefumla kukaKussmaul:

• Oonobangela: Ukuphefumla kweKussmaul kuhlala kubangelwa ngamanqanaba aphezulu easidi egazini. Ukuphefumla kwe-Cheyne-Stokes kuhlala kunxulumene nokusilela kwentliziyo, ukubetha, ukonzakala kwentloko, okanye iimeko zobuchopho.
• Umzekelo: Ukuphefumla kwe-Kussmaul akuphenduli phakathi kwamaxesha okuphefumla okukhawulezayo kunye nokucothayo. Ayibangeli ukuba ukuphefumla kuyeke okwexeshana njengokuphefumla kweCheyne-Stokes.
• Ireyithi: Ukuphefumla kweKussmaul kuhlala kunjalo kwaye kuyakhawuleza. Nangona ukuphefumla kwe-Cheyne-Stokes kunokukhawuleza ngamanye amaxesha, iphethini ayihambelani. Inganciphisa kwaye iyeke ngaphambi kokuba umntu aqale ukuphefumla kwakhona.

Umgca wezantsi

Ukuphefumla kweKussmaul kubonakaliswa yipateni enzulu, ekhawulezayo yokuphefumla. Ngokwesiqhelo ibonisa ukuba umzimba okanye amalungu sele ene asidi kakhulu. Kwilinge lokugxotha ikhabhon dayoksayidi, eyindawo ene-asidi egazini, umzimba uqala ukuphefumla ngokukhawuleza nangakumbi.

Le ndlela yokuphefumla ingaqhelekanga ihlala ibangelwa sisifo seswekile ketoacidosis, esisicombululo esinzulu kuhlobo 1 kwaye, kunqabile, uhlobo lweswekile sesi-2. Inokubangelwa kukusilela kwezintso okanye isibindi, eminye imihlaza, okanye ukungenisa ityhefu.

Ukuba ukrokrela ukuba wena okanye umntu omthandayo uneempawu zokuphefumla kweKussmaul okanye isifo seswekile ketoacidosis, kubalulekile ukuba uye kwagqirha kwangoko.