Yintoni unyango lweoksijini, iintlobo eziphambili kunye nokuba yenzelwe ntoni

Umxholo

• Ezona ntlobo ziphambili zonyango lweoksijini
• 1. Iinkqubo zokuhamba okuphantsi
• 2. Iinkqubo zokuhamba okuphezulu
• 3. Ukungangenisi umoya
• Yenzelwe ntoni
• Khathalela xa usebenzisa ekhaya

Unyango lweoksijini lubandakanya ukulawula ioksijini engaphezulu kunaleyo ifunyanwa kwimeko yesiqhelo kwaye ijolise ekuqinisekiseni ukonyuswa kwezicubu zomzimba. Ezinye iimeko zinokukhokelela ekunciphiseni konikezelo lweoksijini kwimiphunga nakwizicubu, njengoko kusenzeka kwisifo esinganyangekiyo semiphunga, esaziwa ngokuba yiCOPD, ukuhlaselwa sisifo sombefu, ukuphefumla ubuthongo kunye nenyumoniya kwaye ke, kwezi meko, unyango lweoksijini lunokuba yimfuneko.

Olu nyango luboniswa ngugqirha oqhelekileyo okanye ugqirha wamaphaphu emva kokuqinisekisa inqanaba eliphantsi leoksijini egazini, ngokwenza iiarterial gases zegazi, olo luvavanyo lwegazi oluqokelelwe kwimithambo yesihlahla, kunye ne-pulse oximetry, eyenziwa ngokujonga ukugcwala kweoksijini kwaye kufuneka ibe ngaphezulu kwe-90%. Fumana okunye malunga nendlela i-oximetry ye-pulse eyenziwa ngayo.

Uhlobo lonyango lweoksijini luxhomekeke kwinqanaba lobunzima bokuphefumla komntu kunye neempawu zehypoxia, kunye nokusetyenziswa kwecatheter yempumlo, imaski yobuso okanye iVenturi inokucetyiswa. Ngamanye amaxesha, i-CPAP inokuboniswa ukuba iququzelele ukungena kweoksijini kwiindlela zomoya.

Ezona ntlobo ziphambili zonyango lweoksijini

Kukho iintlobo ezininzi zonyango lweoksijini olwahlulahlulwe ngokwemiba yeoksijini ekhutshiweyo, kwaye ugqirha uya kuncoma uhlobo ngokweemfuno zomntu, kunye nenqanaba lokuphefumla kwaye ukuba umntu ubonakalisa iimpawu zehypoxia, njenge fiphaza umlomo neminwe, ukubila okubandayo kunye nokudideka kwengqondo. Ke, ezona ntlobo ziphambili zonyango lweoksijini zinokuba:

1. Iinkqubo zokuhamba okuphantsi

Olu hlobo lonyango lweoksijini luyacetyiswa kubantu abangadingi isixa esikhulu seoksijini kwaye kwezi nkqubo kunokwenzeka ukubonelela ngeoksijini kwindlela yomoya ngokuhamba ukuya kuthi ga kwiilitha ezi-8 ngomzuzu okanye nge-FiO2, ebizwa ngokuba liqhekeza eliphefumlelweyo. ioksijini, ukusuka kwi-60%. Oku kuthetha ukuba kumoya opheleleyo oza kuphefumlelwa ngumntu, i-60% iya kuba yioksijini.

Ezona zixhobo zisetyenzisiweyo kolu hlobo zezi:

• Ipayipi yokufaka impumlo: yityhubhu yeplastiki enemingxuma emibini yomoya ekufuneka ibekwe emathatheni kwaye, ngokomndilili, inika ioksijini kwiilitha ezi-2 ngomzuzu;
• I-canalula okanye i-catheter yeglasi: yenziwe njengetyhubhu encinci ebhityileyo enemingxunya emibini esiphelweni sayo kwaye yaziswa kwisiphelo sempumlo kumgama olingana nobude phakathi kwempumlo nendlebe kwaye iyakwazi ukuhambisa ioksijini ukuya kuthi ga kwiilitha ezi-8 ngomzuzu;
• Imaski yobuso: iqulathe imaski yeplastiki ekufuneka ibekwe ngaphezulu komlomo kunye nempumlo kwaye isebenze ukubonelela ngeoksijini kwimifudlana ephezulu kunaleyo yecatheters kunye neempumlo zempumlo, ukongeza ekusebenzeleni abantu abaphefumla ngakumbi ngomlomo, umzekelo;
• Mask kunye nedama: yimaski enengxowa e-inflatable encanyathiselwe kwaye ekwaziyo ukugcina ukuya kwi-1 litre ye-oxygen. Kukho iimodeli zeemaski ezinamachibi, ekuthiwa ziimaski ezingaphindisiyo ukuphika, ezinevalvu ethintela umntu ekuphefumleni icarbon dioxide;
• Imaski yetracheostomy: ilingana nohlobo lwesigqumathelo seoksijini ngokukodwa kubantu abane-tracheostomy, eyi-cannula efakwe kwi-trachea yokuphefumla.

Ukongeza, ukuze ioksijini ifunxwe yimiphunga ngokufanelekileyo, kubalulekile ukuba umntu angabinazithintelo okanye iimpumlo empumlweni, kwaye ukunqanda ukomisa i-airway mucosa, kufuneka usebenzise i-humidification xa ukuhamba kweoksijini kungaphezulu kweelitha ezi-4 ngomzuzu.

2. Iinkqubo zokuhamba okuphezulu

Iinkqubo zokuhamba okuphezulu ziyakwazi ukubonelela ngoxinzelelo oluphezulu lweoksijini, ngaphezulu kwento umntu akwaziyo ukuyikhupha kwaye iboniswe kwiimeko ezinobuzaza, kwiimeko zehypoxia ebangelwa kukusilela kokuphefumla, i-pulmary emphysema, i-lung lung edema okanye inyumoniya. Bona ngakumbi ukuba yintoni i-hypoxia kunye ne-sequelae enokwenzeka ukuba ayishiywanga inganyangwa.

Imaski yeVenturi yeyona ndlela ixhaphakileyo yolu hlobo lonyango lweoksijini, njengoko ineeadaptha ezahlukeneyo ezisebenza ukubonelela ngamanqanaba eoksijini ngokuthe ngqo nangokwahlukileyo, ngokombala. Umzekelo, iadaptha epinki inika ioksijini engama-40% kwisixa seelitha ezili-15 ngomzuzu. Esi sigqubuthelo sobuso sinemingxunya evumela umoya ophefumlelweyo ukuba uphume, oqukethe ikharbon diokside, kwaye ufuna ukufuma ukuze kungabangeli ukuba i-airways yome.

3. Ukungangenisi umoya

Ukungenisa umoya okungafunekiyo, okwabizwa ngokuba yi-NIV, kubandakanya inkxaso yomoya osebenzisa uxinzelelo olululo ukwenza lula ukungena kweoksijini kwiindlela zomoya. Obu buchule buboniswa ngugulmonologist kwaye bunokwenziwa ngumongikazi okanye ngomzimba kubantu abadala abanengxaki yokuphefumla kwaye banesantya sokuphefumla esingaphezulu kwama-25 okuphefumla ngomzuzu okanye ioksijini engaphantsi kwe-90%.

Ngokungafaniyo nezinye iintlobo, obu buchule abusetyenziswanga ukubonelela ngeoksijini eyongezelelweyo, kodwa isebenza ukulungiselela ukuphefumla ngokuvula kwakhona i-alveoli yemiphunga, ukuphucula ukutshintshiselana ngegesi kunye nokunciphisa iinzame zokuphefumla kwaye kuyacetyiswa kubantu abane-apnea yokulala kwaye banezifo zokuphefumla.

Ukongeza, kukho iintlobo ezininzi zeemaski ze-NIV ezinokusetyenziswa ekhaya kwaye ziyahluka ngokobungakanani bobuso kunye nokulungelelaniswa komntu ngamnye, kwaye i-CPAP lolona hlobo luqhelekileyo. Jonga ngakumbi malunga nokuba yintoni i-CPAP kwaye uyisebenzisa kanjani.

Yenzelwe ntoni

Unyango lweoksijini luyacetyiswa ngugqirha ukuba andise ukubakho kweoksijini kwimiphunga nakwizicubu zomzimba, ukunciphisa iziphumo ezibi zehypoxia, kwaye kufuneka yenziwe xa umntu ene-oxygen saturation engaphantsi kwe-90%, uxinzelelo lweoksijini, okanye iPaO2 , ngaphantsi kwe-60 mmHg, okanye xa iimeko ezinje:

• Ukungaphumeleli kakuhle okanye okungapheliyo ukuphefumula;
• Isifo esinganyangekiyo semiphunga;
• I-emphysema;
• Isifo sombefu;
• Ityhefu yecarbon monoxide;
• Ukuthintela ukuphefumla xa ulala;
• Ityhefu;
• Ukubuyiswa kwasemva kokubulala iintlungu;
• Ukubanjwa kwentliziyo.

Olu hlobo lonyango lubonakalisiwe kwimeko ye-infyoction ye-myocardial kunye ne-angina pectoris engazinzanga, kuba ukubonelelwa kweoksijini kunokunciphisa iimpawu zehypoxia, ebangelwa kukuphazamiseka kwegazi, inyusa amanqanaba eoksijini egazini kwaye, ngenxa yoko alveoli yemiphunga.

Khathalela xa usebenzisa ekhaya

Ngamanye amaxesha, abantu abanesifo sokuphefumla esinganyangekiyo, njengeCOPD, kufuneka basebenzise inkxaso yeoksijini iiyure ezingama-24 ngosuku kwaye ngenxa yesi sizathu, unyango lweoksijini lunokusetyenziswa ekhaya. Olu nyango lwenziwa ekhaya nge-catheter yempumlo, ibekwe emathatheni, kwaye ioksijini inikezelwa kwisilinda, esisikhongozeli sesinyithi apho ioksijini igcinwa khona kwaye kuphela isixa esimiselwe ngugqirha kufuneka silawulwe.

Iisilinda zeoksijini zenziwa zifumaneke ngeenkqubo ezithile ze-SUS okanye zinokuqeshwa kwiinkampani zonyango kunye nezibhedlele kwaye zinokuhanjiswa ngenkxaso enamavili kwaye zingasiwa kwiindawo ezahlukeneyo. Nangona kunjalo, xa usebenzisa iisilinda zeoksijini, ezinye iindlela zokukhusela ziyafuneka, njengokungatshayi xa usebenzisa ioksijini, ukugcina isilinda kude nalo naliphi na idangatye kwaye ikhuselwe elangeni.

Kwakhona, umntu osebenzisa ioksijini ekhaya kufuneka abe nokufikelela kwizixhobo ze-oximetry zokujonga ukugcwala kwaye kwimeko yomntu obonisa iimpawu ezinje ngemilebe emfusa neminwe, isiyezi kunye nokuphelelwa ngamandla, kuya kufuneka uye esibhedlele kwangoko, kuba unokuba nenqanaba eliphantsi leoksijini egazini lakho.