I-Apnea-Hypopnea Index Ewusizo Ukuze Uqaphe Ukushisa Kwama-Apnea Ubuhlungu
Uma ufunde ukulala ubusuku obuthongo obubizwa ngokuthi i- polysomnogram , udokotela wakho kungenzeka ukuthi wakunikeze umbiko oningiliziwe, kuhlanganise nesilinganiso esibizwa ngokuthi i- apnea-hypopnea index (AHI) . Iyini incazelo ye-AHI kubantu abadala abane-apnea yokulala? Ihambisana kanjani nobukhulu be- apnea yokulala ? Funda ngezincazelo ze-AHI ezisetshenziselwa ukuhlolwa nokulala kanye nokuthi kusho ukuthini kuwe.
Ukuqonda ukuthi i-AHI ilinganiselwa kanjani
I-AHI ibalwa ngokubaluleka okwenziwe ngokusekelwe emibhalweni yokuhlola okujwayelekile okulala ngobusuku obubizwa ngokuthi i-polysomnogram noma ukuhlolwa kwe-apnea yokulala ekhaya. Njengengxenye yalezi zivivinyo, kunezinzwa ezibekwa ekhaleni noma eduze komlomo olinganisa ukunyakaza komoya. Kukhona namabhande aphethwe esifubeni nesisu esisondeza njengokuphefumula kwenzeka. Izenzakalo ze-Apnea zenzeka lapho umoya womoya uvinjelwa ngokuphelele futhi akukho ukuthuthwa kwomoya okutholakala ngempumu nomlomo naphezu komzamo owenziwe njengoba kulinganiswa isifuba namabhande omzimba. Uma ukugeleza komoya kuyancipha kuphela, kodwa okungenani ngamaphesenti angu-30 njengokulinganiselwa okusekelwe egrafu yesignali, kubizwa ngokuthi i- hypopnea .
Lezi zenzakalo zicatshangwa ukuthi ziphawuleka uma zenzeka kumongo wezinye izenzakalo ezimbili: izinga le-oksijeni lehla noma livusa kusuka ekulele. I-oxygenation yegazi ilinganiswa ne-oximeter, inzwa encane ekhanyisa ukukhanya okubomvu ngombhalo.
Lapho izinga le-oksijini liwa, lokhu kubizwa ngokuthi i- désaturation , futhi amaconsi okungenani amaphesenti amathathu ayinkinga. Ucwaningo lokulala olujwayelekile luqopha ukuvuka okuvela ekujuleni kokujula kuya ekukhanyeni ngisho nokuvuswa nge- electroencephalogram (EEG) . Lezi zivunguko zingase zihlukanise ubuthongo, zenze zingabuyiselwanga, futhi ziholele ekulele ubusuku.
I-apneas ne-hypopneas zihunyushwa njengokuphazamisa uma zihanjiswa nge-oksijini desaturations noma ukuvusa.
I-AHI isilinganiso esilinganisiwe. Kubalwa ngokuthatha inani eliphelele le-apnea noma imicimbi ye-hypopnea ehlukaniswe inani eliphelele lesikhathi esichithwa ngalo amahora. Ngamanye amazwi, yinombolo yezikhathi ngehora lokulala (noma ukurekhoda) ukuthi ukuhamba kwezindiza kancane kancane noma kuphelile ngokuphelele, okuholela ekuhlaleni okuphawulekayo emazingeni e-oksijeni egazi noma ekuvusweni kusukela ekujuleni kuya esiteji sokulala. Uma i-AHI yakho ineminyaka engu-15, lokhu kusho ukuthi, ngokwesilinganiso, izikhathi ezingu-15 ngehora lokulala ukuphefumula kwakho zancipha futhi lokhu kwaholela emiphumeleni emibi.
Kunezikhungo ezithile zokulala ezisebenzisa ezinye izinyathelo ukuhlola le degree of gravity. Inkomba yokuphefumula (RDI) ingahle isetshenziswe uma isilinganiso sokumelana nomoya womoya ngenani lomthamo ongagxiliyo kufakiwe kuphindwe. Inkomba ye-oxygen-desaturation (ODI) izama ukubala inani le-apnea noma i-hypopnea imicimbi ngehora eliholela ekudoneni okwe-oxygen okungenani amaphesenti amathathu. Lokhu kucatshangwa ukuthi kubalulekile ekuhloleni ingozi ye-long-term cardiovascular (high blood pressure, ukushaya kwenhliziyo, nokuhluleka kwenhliziyo) imiphumela noma imiphumela ye-neurocognitive (stroke and dementia).
Uma isifundo sakho sokulala asiqukethe lezi zinyathelo eziqondile, lokhu akudingeki ukhathazeke ngakho.
I-AHI kanye nobunzima be-Apnea yokulala
Inani lezinombolo libikwa kanjani njengoba libikwe ukuhambisana kwe-AHI nobukhulu bokuphefumula kokuphefumula? Nakuba izindinganiso zamukelwa kabanzi emkhakheni wezokwelapha zokulala, ama-cutoffs ngezigaba ngasinye azivumelananga ngokungaqondile. Ngokusekelwe ocwaningweni, amaqembu alandelayo asetshenziswa kubantu abadala:
- Uhlobo olujwayelekile: 0 kuya ku-5
- I-apnea yokulala okuncane: 5 kuya ku-15
- I-apnea yokulala okulinganiselwe: 15 kuya ku-30
- I-apnea enkulu yokulala: 30 nangaphezulu
Ngokuvamile, lezi zinyathelo zenziwe ngokubaluleka uma kukhona ubufakazi bezinye izimo ezimbi ezivela ku-apnea yokulala, kuhlanganise nokuphakama kwesibalo sokulala sase- Epworth ngaphezu kwe-10, uphawu lokulala ngokweqile kwansuku zonke.
Lolu lwazi lungabuye lusetshenziswe njengoba ucabangisisa ukwelashwa. Isibonelo, i-apnea yokulala ngokunciphisa noma yokulinganisela ingase iphathwe ngokucindezela okuqhubekayo kwe-airway (CPAP) kanye nemishini yomlomo . Ukwelashwa kwesikhashana kanye nokunye ukungenelela kungase kube nokucabangela. Ngaphezu kwalokho, ukwelashwa okusebenzayo kungase kuphumelele kakhulu ekuphulukeleni isimo kubantu abane-apnea yobuthongo obukhulu kakhulu.
Kukhona ukuphikisana okuphathelene nabantu abanesifo esiphezulu sokuphefumula kokulala. Kulezi zinkinga zingase zibe abesifazane besifazane abanesifo sangaphambili (abavikelwe amahomoni e-estrogen ne-progesterone) noma abantu abayisisindo somzimba ovamile, kunokuba babe ne-apnea yokulala ngaphezulu, kungenzeka ukuthi babe ne- airway resistance resistance syndrome (UARS) .
Kumele kuqashelwe ukuthi abantwana bangase babe ne-apnea yokulala ehlongozwayo e-AHI ephansi kakhulu. Ngokuvamile, i-AHI icatshangwa ukuthi ayijwayelekile uma inkulu kune-1 (nakuba lesi sibalo sasiyi-2 ngaphambili). Lokhu kunzima yizinguquko zentuthuko ezenzeka ekukhuleni. Izingane ezisakhulile eziye zabhekana nokukhula kwazo okukhulu zingase zihlolwe kangcono ngokusebenzisa ukuhlukaniswa kwabantu abadala. Lokhu kuhlolwa nokuzimisela kwenziwa kahle ngokusekelwe esahlukweni somtholampilo wengane yokulala kwengane yakho.
I-AHI ingasisiza futhi ukuqapha impendulo yakho ekuthathweni okuqhubekayo kokucindezela umoya we-airway (CPAP). Umgomo kufanele ube ohlangothini olujwayelekile, okungenani ngaphansi kwemicimbi engu-5 ngehora, kodwa inombolo ephansi ingcono. Ngokuvamile kungenzeka ukwandisa izilungiselelo ukuze uthole i-AHI phansi kweyoku-1 noma kwe-2.
Uma unemibuzo eminye mayelana nokuthi i-AHI itho ukuthini kuwe, khuluma nodokotela wakho mayelana nemiphumela yokuhlolwa kanye nezinketho ezinhle zokwelapha ukubhekana nezidingo zakho.
> Umthombo:
> Kryger, MH et al . "Izimiso Nemikhuba Yokulala Imithi." Elsevier , edition 6. 2016.