Ukungaphumeleli kwe-Cardiorespiratory, Strokes, kanye Nokukhathazeka Kwokulala Kungase Kwenezele
Emlandweni wasendulo weGrithani, Ukulala kwakuyizimpumputhe zoKufa, abantwana bezithombe zikaNkulunkulu zobumnyama nobusuku obomuntu. Kubonakala sengathi bekukhona ubudlelwane phakathi kokulala nokufa. Lapho abantu befa ebuthongweni babo, kubonakala sengathi kuyindlela enokuthula futhi ehlelekile yokudlula. Kungani abantu befa ebuthongweni babo? Hlola ezinye zezimbangela ezivame kakhulu nokuthi ukuphazamiseka kokulala okufana ne-apnea yokulala, ukugwedla nokulala okungabangela ukuleleka kungabangela ingozi ephakeme yokungavuka.
Lapho Ukufa Kufika Ebusuku
Sichitha ingxenye eyodwa kwezintathu zempilo yethu elele, ngakho akufanele kusimangaze ukuthi abantu abaningi bafa belele. Kukhona umehluko obalulekile phakathi kokufa ngaphezu kwamabili (ikakhulu uma unempilo) futhi ufa uma ungazi lutho ezinyangeni zokugcina zesifo esibulalayo. Abantu asebekhulile nalabo abagulayo abafayo bahlolisisa kakhulu kunabasha.
Kuncike ekubekeni kokufa (ekhaya ngokumelene nesikhungo sokunakekelwa esibhedlela esibhedlela), ukufa kungase kuphawulwe udokotela. Ngokuvamile ngabe i-autopsy ingenziwa (noma iboniswe) ngaphandle kokuthi izimo ezingavamile zikhona. Lokhu kuhlola kungase kwenzeke kakhulu kubantu abadala noma izingane ezifa ngokuzumayo emphakathini ngaphandle kokugula okuwaziwayo.
Ngisho noma i-autopsy ingase ingabonakali. Isizathu sokufa angeke sibe sobala. Isitifikedi sokufa singase sibone izizathu ezingezona ezicacile: "ukwehluleka kwe-cardiorespiratory," "kwafa ngezimbangela zemvelo," noma ngisho "ukuguga." Umndeni nabangane bangase bashiye ukuthi kwenzekani, futhi kungasiza ukuqonda ezinye zezimbangela kokufa okuvela ebuthongweni.
Ukubeka Ukuhlukumezeka Okuncane, Imvelo, Nezimo
Kwezinye izimo, ukufa kubangelwa ngenxa yento ethile yangaphandle, ngokuqondile kwimvelo noma kwenye i-agent engaphandle. Isibonelo, ukuzamazama komhlaba okudiliza isakhiwo kungaholela ekufeni okuphazamisayo ekulele. Umuthi we-Carbon monoxide ovela emoyeni ophuthumayo futhi umthombo oshisayo wokushisa ungabamba iqhaza. Ukuzibulala kungase kwenzeke ngesikhathi sokulala, futhi ukubulawa kungase kwenzeke kaningi ebusuku.
Imithi ethathwa ukuphatha izifo zezokwelapha, kuhlanganise nobuhlungu nokuqwashisa, ingandisa ingozi yokufa. Lokhu kungaba amathuba uma lezi zidakamizwa zithathwa ngokweqile, njengokudlula ngokweqile, noma ngokuphuza utshwala. Izidakamizwa kanye nama-opioids angashintsha noma ukucindezela ukuphefumula. Izimo ezibuhlungu ezifana nomdlavuza, isibonelo, zingadinga amazinga e-morphine okusheshisa inqubo yokufa ngokunciphisa ukuphefumula.
Ake sicabange ukuthi imvelo, imbangela yangaphakathi iyimbangela yokufa futhi igxile emacala okuba khona.
Ukugxila ekuhlulekeni kwenhliziyo kanye nemifula
Kungaba usizo ukucabanga ngezimbangela zokufa ngokwe "Code Blue" okungase kuthiwe esibhedlela. Lapho umuntu efa-noma engozini yokufa-kunezinhlelo ezimbalwa ezikhona ezivame ukuhluleka. Ngokuvamile, ukwehluleka komsebenzi wezinhliziyo namaphaphu kuyisola.
Ukuhluleka ukuphefumula ukuphefumula kungase kuthinte kancane kancane umsebenzi wenhliziyo nezinye izinhlelo. Ukuncipha okunamandla komsebenzi wezinhliziyo, njengokuhlasela okukhulu kwenhliziyo, ngokushesha kuthinta ukugeleza kwegazi emqondweni futhi kungase kuholele ekuhlulekeni okuphefumula okusheshayo. Amapayipi angaphinda agcwalise ngokushelela njengengxenye ye-edema ye-pulmona ngokuhluleka kwenhliziyo.
Uma uhlola izimbangela zokufa ebuthongweni bakho, kungasiza ukuhlola izimbangela ezithinta lezi zindlela ezimbili ezixhunyanisiwe:
Ukuboshwa kwe-Cardiac
Kunobufakazi obuningi bokusebenza komzimba okungase kugxilwe ngesikhathi sokulala. Ukunyakaza kwamehlo okuphuthumayo (REM) ukulala , ikakhulukazi, kungase kulungiswe kabusha uhlelo ngokufaka ingozi ekukhuleni. Kubuye kubonakale sengathi kuyinkimbinkimbi yokukhubazeka komzimba, nezinkinga ngokuvamile ezivela ngasekupheleni kwebusuku nasekuseni isikhathi sokuvuka.
Ukuhlaselwa kwenhliziyo kwenzeka uma isitsha segazi (noma i-coronary artery) esinikeza izicubu zomzimba zivinjelwa futhi izicubu ezinikezwayo zilimala noma zifa. Lezi zihlukumezi ze-myocardial zingase zivele emidlalweni encane eyenza ukuyekethisa umsebenzi ekuvimbeleni okulimazayo okuholela ekuhlulekeni kwenhliziyo ngokuphelele njengepompo. Uma igazi lingakwazi ukusakazwa, ezinye izinhlelo zomzimba ngokushesha zihluleka futhi ukufa kuqhubeka.
Inhliziyo ingabhekana nokungahambi kahle okuthinta uhlelo lwayo kagesi. Ukukhokhwa okudingekayo ukucima imisipha ngendlela evumelanisiwe kungaphazamiseka. Ukuphambana kungase kube okungajwayelekile, okusheshayo noma okunciphisa kakhulu, futhi ukuphumelela kwenhliziyo kuyaphathiswa.
I-Arrhythmias ingaba yisisusa esiningi sokufa ngesikhathi sokulala. I-Asystole yisigqi sokubopha inhliziyo lapho umsebenzi kagesi wenhliziyo ungatholakali. I-fibrillation ye-atrial noma i-flutter ingadambisa ukusebenza kwenhliziyo. Izinga elifanayo le-ventricular, kuhlanganise ne-tachycardia ye-ventricular, lingase libulale. Izivimbela ze-cardiac ezithinta iphethini kagesi zingase ziholele ekusebenzeni kwenhliziyo nokufa.
Ukuhluleka kwenhliziyo okungapheliyo, ukuphelelwa yisikhathi kwenhliziyo (CHF) kungase kuholele kancane ekuhlulekeni kwenhliziyo. Ukuhluleka kwenhliziyo kwangakwesokunxele kuthinta ngokushesha uhlangothi lwesokudla senhliziyo, okuholela ekubutheni kwamanzi emaphashini (ngokuphefumula, ikakhulukazi uma ulele phansi) nokuvuvukala ezinyaweni nasemilenzeni ebizwa ngokuthi i-edema yedolobha. Uma inhliziyo ibhekana nokuvuthwa kwevolumu, ikhono layo lokujikeleza igazi lingase liphele.
Okubalulekile, inhliziyo ingathinta ezinye izinhlelo ezithembele ekutheni zikwazi ukujikeleza igazi. Okubaluleke kakhulu, isigqi senhliziyo esingavamile singaholela ekhwameni eliya ebuchosheni futhi lidale isifo. Umfutho wegazi ophezulu, noma umfutho wegazi ophakeme, ungandisa ingozi. Uma ukushaywa komzimba kuthinta i-brainstem, ukuphefumula, ukuvula amehlo, ukulawula imisipha, nokuqonda kungase kukhishwe. Lezi ziphazamiso zingase zibulale futhi zingase zilale.
Ukuboshwa kokuphefumula
Amalunga agcwalisa umsebenzi wenhliziyo futhi afana neqembu, uma uhlelo olulodwa lungaphumeleli, olunye luzokwazi ukulandela ngokulandelana okufutshane. Isifo se-pulmonary ngokuvamile sihlala singapheli, futhi imiphumela ingase ithuthuke kancane kancane. Uma isivinini esibucayi sifinyelelwa, noma kunjalo, ukufa kungenzeka.
Ezingeni eliyisisekelo, amaphaphu anesibopho sokushintshaniswa kwe-oxygen ne- carbon dioxide nemvelo. Uma zingasebenzi kahle, amazinga e-oksijeni awela, amazinga e-carbon dioxide aphakama, futhi ushintsho oluyingozi emkhatsini we-asidi-base womzimba kungenzeka.
Ukuvinjelwa okunamandla, okufana nokwehla ngokuhlanza, kungabangela ukuphefumula. Nakuba kungenakwenzeka, kungenzeka ukuthi umcimbi wokuvimbela ubuthongo wokuvimbela ubuthongo uzofakazela ukuthi uyafa.
Ukuhluleka kokuphefumula kungase kwenzeke ngenxa yesifo esingapheli, isifo esibizayo. Lokhu kungaba ukwehluleka kwamaphaphu ngokwawo, njengokuthi:
- Isifo se-Chronic obstructive pulmonary (COPD)
- Emphysema
- I-cystic fibrosis
- Umdlavuza we-Lung
- I-pulmonary fibrosis
- I-pneumonia
- Isimo se-asthmaticus
- I-pulmonary embolus (i-clot emaphashini)
Kungenzeka nokuthi amaphaphu ahluleke ngenxa yezinguquko kumisipha noma izinhlelo zezinzwa, njenge-amyotrophic lateral sclerosis (i-ALS noma isifo sikaLou Gehrig) noma i-myasthenia gravis.
Kukhona ngisho nezifo ezibangelwa ukubeletha ezithinta ikhono lokuphefumula njenge-congenital central hypoventilation syndrome. I-infantly death syndrome (SIDS) engakazelelwe isho ukuhluleka ukuphefumula ngokujwayelekile ngesikhathi sokulala.
Lapho ukufa kuhamba kancane, kunesimo sokuphefumulela esijwayelekile. Ubizwa ngokuthi ukuphefumula kwe-Cheyne-Stokes. Ngokuvamile kubonakala ekuhlulekeni kwenhliziyo, ukusebenzisa imithi yezokwelapha, nokulimala ebuchosheni. Kungase kubonise ukuthi ukuphefumula nokuphefumula kuseduze. Ukuqaphela kungase kucindezeleke njengoba umuntu othintekile ehlukana.
Ukucabangela Ezinye Izimbangela Nendima Yezinkinga Zokulala
Kungenzeka ukuthi ukulala ebuthongweni kungenzeka ngenxa yezifo ezithile ezimbalwa, kuhlanganise nezimo zokulala. Ngokuyinhloko, ukugabuka kungase kubulawe. Kukhona isimo esaziwa ngokuthi ukufa okungazelelwe ku-epilepsie (i-SUDEP) engaziqondi ngokugcwele.
I-apnea yokulala engavimbisani ingase ikhulise ezinye izimo zezokwelapha ezingase zibulale. Lokhu kufaka phakathi imivimbo, ukuhlaselwa yinhliziyo, ukwehluleka kwenhliziyo, kanye nokuhlelwa kwemithi okungaholela ekufeni okungazelelwe.
Kungenzeka ukuthi ufe ngokuziphatha okulalayo okuthiwa i- parasomnias . Ukulala kungenza umuntu abe ngaphansi kwezimo eziyingozi, kuhlanganise nokuwa ngamafasitela avela phezulu, ukuhamba ngomkhumbi, noma ukugibela emgwaqweni ukuya emgwaqweni. "Ukuzibulala ngokuzibulala" kuchaza ukushona phakathi kwabantu abanokulimala abalala ngaphandle kokucindezeleka okuyaziwayo noma ukuzibulala.
Ukukhubazeka kokuziphatha kwe-REM kungabangela ukuwa kwembhedeni nokuhlukunyezwa kwekhanda ekulele. Lokhu kungabangela ukubola kwegazi kwangaphakathi; i-hematoma ye-epidural ingasheshe ibonakale ibulale.
Ngisho noma ukuphazamiseka kokulala kungekudala kubulawe, kunobunye ubufakazi bokuthi ukungabulala kwandisa ingozi yokuzibulala. Ukwehla okungapheli kokulala kungase kwande inani lokufa kwabantu emva kweminyaka yokulala okuncane.
Izwi elivela
Ukuze ugweme ukushona ebusuku ngenxa yokugula kwesifo, qaphela ezinye izimpawu (kufaka phakathi ukuleleka nokuvuswa kokusa ekuseni) noma izibonakaliso zokuphefumula ukulala (ukuyeka ukuphefumula, ukugubha, i- nocturia , i- bruxism , ukulala ngokweqile kwamalanga, imizwa kanye nezinkinga zokuzicabangela , njll). Ngenhlanhla, ukuphazamiseka kokulala kuyaphathwa. Lungiselela impilo yakho yonke futhi ungakhohlwa indima ebalulekile yokulala kahle.
> Imithombo:
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> Jeyaraj D, et al . "Izinga le-circadian lilawula ukuguqulwa kwenhliziyo nokuhlelwa kwe-arrhythmogenesis." Imvelo , ka-2012; I-DOI: 10.1038 / imvelo10852.
> Kryger MH, et al . "Izimiso Nemisebenzi Yokulala Imithi." Elsevier , edition 6, 2016.
> Shepard JJ. "I-hypertension, i-arrhythmias ye-cardiac, i-infarction ye-myocardial, nesifo sokushaywa ngokumelene nokuphefumula okuphazamisayo kokulala." I-Clin Chest Med 1992; 13: 437-458.