I-Orthopnea yigama odokotela abasebenzisa isifo se- dyspnea (ukuphefumula) okwenzeka lapho umuntu elele phansi. I-Orthopnea ibhekwa njengesibonakaliso esibalulekile ngokuyinhloko ngoba ngokuvamile kuvame ukubonisa ukuhluleka kwenhliziyo , kodwa kungabangela nezinye izimo zezokwelapha. Ngenxa yalesi sizathu, noma ubani othola i-orthopnea kufanele ahlolwe njalo ngudokotela.
Yini Ebangela I-Orthopnea?
Uma umuntu elele phansi, amandla adonsela phansi adala ukubuyiswa komzimba emzimbeni. Ngokuvamile, ezinye ze-fluid engxenyeni engezansi yomzimba, ikakhulukazi imilenze nezitho zesisu, zifaka endaweni yesifuba. Lokhu kwabiwa kabusha kwe-fluid ngokuvamile kuyinto encane kakhulu, futhi kubantu abaningi akanayo umphumela wokuphefumula.
Kodwa-ke, kubantu abanesifo senhliziyo esiphumelelayo , inhliziyo ingase ingakwazi ukwamukela lo mthombo owengeziwe, futhi ayikwazi ukwenza umsebenzi owengeziwe okudingekayo ukuze kugcinwe lokhu ketshezi oluthe xaxa ekuqoqeni emaphashini. Ngenxa yalokho, ukungqubuzana kwe-pulmonary - kanye ne -edema yamapayipi yokuqala - kungenzeka, kanye nokuphefumula komphumela. Ngaphandle kwe-dyspnea, abanye abantu bayothola ukukhwehlela noma ukushaya lapho belele phansi. Lezi zinkinga zokuphefumula ezibangelwa ukucabanga ukuthi isikhundla esiphezulu sibizwa ngokuthi i-orthopnea.
Uma umuntu ehlangabezana ne-orthopnea, ukuhlala phezulu noma ukuphakamisa ikhanda kuhoxisa ukubuyisana okuketshezi okwenzekile, futhi kunciphisa ukucindezeleka kwamapulmonari.
Izimpawu ngokuvamile zithuthukiswa ngokushesha nje ngokushintsha isimo.
Ukuhluleka kwenhliziyo akusona kuphela imbangela ye-orthopnea, kodwa yiyona imbangela evame kakhulu. Ngezinye izikhathi abantu abane- asthma noma i-bronchitis engapheli bayoba nezinkinga zokuphefumula eziningi ngenkathi belele phansi. Izimpawu zokuphefumula nokuphefumula okwenzeka nalezi zimo, noma kunjalo, ngokuvamile akudabuki ngokushesha ngemuva kokuhlezi phezulu, kodwa kuthatha isikhathi esengeziwe sokuxazulula.
I-apnea yokulala ingaveza futhi izimpawu ezifana ne-orthopnea, noma kaningi, ku-paroxysmal nocturnal dyspnea (okushiwo esigabeni esilandelayo).
Izimpawu ezihlobene
Esinye isifo esihlotshaniswa nokuhluleka kwenhliziyo yi- paroxysmal nocturnal dyspnea, noma i-PND . I-PND iphinde ihlobene nokubuyiswa komthamo okwenzekayo ngesikhathi sokulala, kodwa isimo esiyinkimbinkimbi kune-orthopnea "elula". Ngokuvamile, abantu abane-PND abaqapheli i-dyspnea ngemva kokulala phansi. Kunalokho, bavuswa ebuthongweni ngesiphithiphithi sokuphefumula okukhulu okubangela ukuba bahlale ngokushesha ukuze bathole usizo. Ngaphandle kwe-dyspnea, iziguli ezine-PND nazo zivame ukuzwa amapulpitations , ukuvuthwa okukhulu, nokwesaba.
Ngokusobala, i-PND yinto ephawulekayo kakhulu kune-orthopnea. Kucatshangwa ukuthi enye indlela eyengeziwe (ngaphandle kokuhlelwa kabusha okulula kwamanzi) ikhona kubantu abane-PND, mhlawumbe ehlobene nezinguquko esikhungweni sokuphefumula esibuchopho esingase sihlotshaniswe nokuhluleka kwenhliziyo.
Muva nje, odokotela baye babona olunye uhlobo lwezimpawu kubantu abanenhliziyo ehlulekayo futhi ehlobene nokubuyiswa kwamanzi abizayo - "i- bendopnea ," noma i-dyspnea ebangelwa ukugoqa ngaphezulu.
Ukuhlola i-Orthopnea
Odokotela kumele bahlale bebuza noma yisiphi isiguli ngokuhluleka kwenhliziyo noma ukusoleka kwenhliziyo noma ngabe bahlangabezana nanoma iyiphi i-dyspnea uma belele phansi.
Lo mbuzo obalulekile ngoba ukuqhuma kwe-orthopnea ngokuvame ukukhombisa ukuwohloka okuyisisekelo emsebenzini wenhliziyo.
Abantu abaningi abane-orthopnea babhekana nesifo ngokungazi kahle ngokufaka umcamelo noma ababili. Bangase bangaqapheli ukuthi bayaphumelela uma belele phansi - bangase bazizwe bekhululekile kakhulu ngamakhanda abo ephakanyisiwe. Yingakho odokotela bavame ukubuza ukuthi bangaki imithwalo isiguli esinokuhluleka kwenhliziyo esisebenzisayo, futhi sizorekhoda izimpendulo eshadini ngokuthi "i-orthopnea emibili" noma "i-orthopnea emithathu-umcamelo."
Ngenxa yokuthi i-orthopnea ephuthumayo ivame ukubonisa ukuhluleka kwenhliziyo ekweqile, noma ubani onokwehluleka kwenhliziyo (nabanye abaqakathekileko) kufanele baqaphele izimpawu ezimbi kakhulu, ngisho nenani lemithwalo ayisebenzisayo.
Ukwelashwa kwasekuseni lapho izimpawu ziba mnene kungagwema ukuhlukunyezwa kwenhliziyo, futhi kuvimbele isidingo sokunakekelwa esibhedlela.
Izwi elivela
I-Orthopnea ingenye yezibonakaliso eziningi zokungqubuzana kwe-pulmonary okungenzeka kubantu abanesifo senhliziyo. Ukuqala kwe-orthopnea, noma ukuguqulwa kobunzima be-orthopnea, kungabonisa ushintsho olubalulekile ekukhulekeni kwenhliziyo. Ngakho-ke, noma ubani onokwehluleka kwenhliziyo kufanele anake lesi siginci.
> Imithombo:
> Ganong WF. Ukuguqula Ukuphefumula Kwezempilo Nezifo. Ku: Ukubuyekezwa kwe-Physiology yezokwelapha, ngo-12th. I-Los Altos: I-Lange Medical Publications, 1985; 558-71.
> Thibodeau JT, Turer AT, Gualano SK, et al. Ukufaniswa kweSikhumbuzo Sobuningi Sokwehluleka Kwenhliziyo Ephakeme: I-Bendopnea. I-JACC Heart Fail 2014; 2: 24-31.
> Yancy CW, Jessup M, Bozkurt B, et al. Umhlahlandlela we-ACCF / AHA ka-2013 we-Management of Heart Failure: Summary Executive: Umbiko we-American College Association of Cardiology Foundation / American Heart Association Task Force emithethweni yokuziphatha. Ukujikeleza 2013; 128: 1810.