Ukwelashwa Kwesitokisi Sokugcina
Naphezu kokusebenza kwezinqubo eziningi zokwelapha, kuhlanganise nokuphika okunamandla okucindezela umoya we-airway (PAP), kunezinye izimo lapho ukwelapha okuningi okungenawo amandla kubonakala kudingekile. Ukusetshenziswa kwe-tracheostomy ekuhlinzekeni kwe-apnea yokulala kubhekene nokukhetha okunokwelapha, uma kunenkinga ngezikhathi ezithile, kulabo abanenkinga yokwelapha noma yokuphefumula okuphazamiseka kokulala-okuphazamiseka kokuphila.
Kungenzeka ukuthi akuyona into yokuqala, kodwa kwabanye kungaba okugcina, okukhethwa kukho okuhle. Funda mayelana nokusetshenziswa kwe-tracheostomy ukuphatha i-apnea yokulala.
Kuyini i-Tracheostomy?
I-tracheostomy ukubeka ukuhlinzekwa kwe-incision ku-trachea, noma i-windpipe, phambi kwentamo. I-tube encane yepulasitiki ingeniswa ukuze kugcinwe ukuvula. Lokhu kuvulwa kuvumela ukunyakaza komoya kwenzeke ngaphandle kokusebenzisa umoya ophezulu, ngokuphumelelayo ngokweqile emaphethweni angaphezulu, emlonyeni, emlonyeni nasezwini. Uma i-apnea yokulala ingathà sina, kungase kube ukungenelela okudingekile.
Kungani usebenzisa i-Tracheostomy e-Sleep Apnea?
Ngaphambi kokufika kwengcindezi eqhubekayo yomoya ohamba phambili (CPAP), i-tracheostomy yayisetshenziswa ukwelashwa okuvame ukusetshenziswa njalo ukuphulukisa i-apnea yokulala. Isebenza ngokuphumelelayo kakhulu uma i-obnetive obne sleep apnea, eyenzeka ngenxa yokuthi umoya ophezulu ungena ngesikhathi sokulala, okuholela ekujuleni okuphindaphindiwe ekuphefumuleni. Ngokususa ukumelana ne-airway engenhla, okufezwa emva kwe-tracheostomy njengoba ukuphefumula kwenzeka ngokuvulwa emphinjeni, ukuphefumula kokuphefumula kuthuthukiswa kakhulu.
Lokhu kungajwayelekile ukwenza ama-oxygen ne-carbon dioxide amazinga nezinye izimpawu.
I-tracheostomy ingasetshenziswa uma ukwehluleka ukuphefumula kwenzeka, futhi ukwelashwa okujwayelekile, okufana ne-CPAP noma ye- bilevel , akubekezelelwanga noma kuphumelele. Lokhu kungase kwenzeke lapho i-apnea yokulala ikhulu kakhulu futhi ingaba yinto evamile kubantu abakhuluphele ngokweqile, njengoba kwenzeka ngokukhuluphala-i-hypoventilation syndrome.
Kungase futhi kudingeke kubantwana abanokukhubazeka okuthuthukisayo okwehlisa ukuphefumula.
Izinkinga Nge-Tracheostomy
Njenganoma iyiphi inqubo yezokwelapha, kunezingozi nezinkinga ezihambisana nokubekwa kwe-tracheostomy, njenge:
- Inkulumo ingase ibe nzima, idinga indawo yokuhlala njenge "inkinobho ye-tracheostomy."
- Kungaba nezinkinga ezinkulu zokulungisa, kufaka phakathi izinkinga zokukhubazeka nezomshado.
- Kukhona ingozi yokutheleleka, ikakhulukazi iziqephu eziphindaphindiwe ze-bronchitis.
- Ukufakelwa kwesikhumba kungahle kudingekile ukuvimbela ukwehluleka ngokweqile kwi-trachea site.
- Eziguli eziningi kakhulu, ukuhlinzwa ngokwabo kunzima kakhulu futhi inkinobho ye-tracheostomy ingase ibe yinkinga enkulu.
Izwi Lokuqapha Iziguli Ezikhulu
Uma ucubungula i-tracheostomy, iziguli ezidinga ukwedlula zonke kudingeka ziqaphele nokuthi zingase zibe yingozi enkulu yokwehluleka ngenqubo. Endabeni yokukhuluphala-hypoventilation syndrome, ukuhlukahluka kwe-apnea yokulala nokuhluleka kokuphefumula kunabantu abakhulu kakhulu, kungase kube nezinkinga ezishisayo ngemva kwe-tracheostomy. Ukwehlisa amandla emisipha yokuphefumula noma ukwehlisa ikhono lokukhulisa amaphaphu kungabangela ukwehluleka kokuphefumula okuqhubekayo naphezu kwenqubo.
Njengemithi yokwelashwa engasebenzi engafanele njengePCAP, i-bilevel, namanye amadivaysi asekelayo manje ayatholakala, i-tracheostomy manje ayisetshenziswa kaningi ukuphatha i-apnea yokulala.
Kodwa-ke, kungaba yindlela yokulondoloza impilo kulabo abayidingayo njengendlela yokugcina.
Imithombo:
Camacho M et al. "I-Mini Tracheostomy Yokuvimbela I-Apnea Yokulala: Isiphakamiso Esisekelwe Ebufakazi." I-Int J Otolaryngol. 2016; 2016: 7195349. Epub 2016 Jan 26.
> Cielo CM, Gungor A. "Izinketho zokwelashwa zokuvimbela izingane ukuthi zilale ubuthongo." I-Curr Probl Pediatr I-Adolesc Health Care. 2016 Jan; 46 (1): 27-33. Epub 2015 Nov 17.
> Conway, W et al . "Imiphumela emibi ye-Tracheostomy ye-Sleep Apnea." I-JAMA 1981; 246: 347.