Kulabo abahlukunyezwa yi- hypoentilation syndrome , kubaluleke kakhulu ukufuna ukwelashwa. Njengoba isimo singase sibe nemiphumela engathà sina futhi ebulalayo, ukungenelela kwangaphambili nokufutheka kungahle kudingeke. Funda ngezinye izindlela ongakhetha ngazo ukwelashwa kwe-fetus hypoventilation syndrome kanye nemigomo yalezi zonyango.
Izinketho zokwelapha
Izinketho zokwelapha ze-fetus hypoventilation syndrome (OHS) zingahlukaniswa ukubhekana nezici ezimbili ezibaluleke kakhulu zesifo: ukulahlekelwa isisindo nokusekela ukuphefumula.
Ukulahlekelwa kwesisindo
Njengoba igama lisho, ukukhuluphala kungumnikelo obalulekile kulesi sifo. Uma ukulahlekelwa isisindo esikhulu kungatholakala, kutholakala usizo. Lokhu kungase kutholakale ngokudla nokuzivocavoca, kepha okungaphezu kwamakhilogremu angu-100 okulahlekelwa isisindo kungadingeka. Njengoba ukulahlekelwa kwesisindo esisheshayo kungaba yingozi, kutuswa ukuthi abantu benze lokhu ngaphansi kokubheka udokotela wabo. Izakondla zinganikeza isiqondiso esiwusizo ekwenzeni izinguquko zokuziphatha. Ngeshwa, akunakwenzeka ukubikezela inani elilinganayo lesisindo okufanele lilahlekelwe umuntu ukuba aphulukise i-OHS.
Njengamanje, imishanguzo yokulahlekelwa isisindo ayinconywa ukuphatha ukukhuluphala ku-OHS.
Njengoba ukudla nokuzivocavoca kungase kungabi nemiphumela emihle ekunciphiseni isisindo, kungadingeka ukuvula izindlela zokuhlinza ezifana nokuhlinzwa kwesisu se-gastric. Lezi zinqubo kubantu abakhuluphele kakhulu futhi bane-apnea yokulala ziye zandisa izingozi. Ikakhulukazi, ukuhamba kwezindiza kungase kuwele ngaphansi kwe-anesthesia esetshenziselwa ukuhlinzekwa nokuphulukiswa kungase kube nzima.
Kunconywa ukuba ukuhlinzeka nge-bariatric kubalwe abantu abanombhalo womzimba womzimba (BMI) omkhulu kunama-35 futhi akukho nezinye izimo zezokwelapha eziyokwandisa ingozi yokuhlinzeka. Kuyasiza ukuba nesifundo sokulala esibizwa ngokuthi i- polysomnogram ngaphambi nangemva kokuhlinzwa ukuhlola izinzuzo zenqubo.
Njengoba ukulahlekelwa kwesisindo kwenzeka esikhathini esingaphezu kwezinyanga, kungadingeka ukusekela ukuphefumula ngalesi sikhathi nezinye izifo.
Ukusekela okuphefumulayo
I-mainstay yokwelashwa ku-OHS ukuhlinzeka ngokusekela umoya, ngokuvamile ngokusebenzisa ukucindezela okuqhubekayo kwe-airway (CPAP) noma i- bilevel . Lawa madivaysi enza ukugeleza komoya okucindezelayo okungagcina umoya ophezulu ungabhubhi ngesikhathi sokulala.
Uma i-OHS ihlobene nenkinga ngokuphefumula, ingabe i- oxygen ingasetshenziswa ukuyiphatha? Ukwelapha okwenziwe nge-oksijeni okungeziwe kungase kwengezwe uma kunesifo samaphaphu esifana ne- COPD , kodwa asanele ngokwalo. Eqinisweni, ukusebenzisa i-oksijini yedwa ku-OHS kungase kugweme ukuphefumula.
Ezimweni ezimbi, kungadingeka ukwenza i- tracheostomy . Le nqubo ihilela ukufaka ithubhu encane epulasitiki ephambi komphimbo. Lokhu kudlula umgwaqo ongenhla, okwazi ukuwa noma ukuvimbela kubantu abane-OHS. Nakuba i-tracheostomy iphumelela, kunezinkinga ezihlobene nokusetshenziswa kwayo. Kungaba nzima ukulungisa ushintsho, ikakhulukazi ukuthi kuthinta kanjani inkulumo. I-brronchitis ingase ibe khona kaningi. Ngokuvamile, enikezwe ezinye izinketho zokwelashwa, manje ayisetshenziswa kaningi.
Kudingeka futhi ukuba ugweme utshwala nezidakamizwa ezithile ezivimbela ikhono lakho lokuphefumula.
Amacala afanelekayo afaka imishanguzo kadokotela, njengama- benzodiazepines , opiates, nama-barbiturates. Kufanele ubuyekeze imithi yakho nodokotela wakho ukuqinisekisa ukuthi akekho kubo obeka engozini eyengeziwe.
Imigomo Yokwelashwa
Ekugcineni, inhloso yanoma yikuphi ukwelashwa ekukhusheni kwe-hypoventilation syndrome ukulungisa izinkinga eziyinhloko ezithinta lesi sifo. Ukuphefumula okungafaneleki okwenza lesi sifo kubangele ukungalingani emazingeni amakhemikhali egazi. Lapho i- carbon dioxide ingakwazi ukususwa kahle, amazinga ayo akhula futhi enze igazi libe lukhuni kakhulu. Lokhu kubangela ushintsho oluningana emzimbeni ongabe nemiphumela emibi.
Ukwelashwa kungavimbela amaconsi ekugcululeni kwe-oksijini egazini lakho, ukuphakama kwesibalo segazi elibomvu elibizwa nge-erythrocytosis, nokuhluleka kwenhliziyo (eyaziwa njenge- cor pulmonale ). Ukulahlekelwa kwesisindo kuvumela amazinga e-oxygen ne-carbon dioxide. Ukusetshenziswa kwe-CPAP noma i-bilevel, kanye nezinye izinyathelo, nokuvimbela le miphumela.
Ekugcineni, ubuthongo buba yingxenye encane futhi lokhu kuthuthukisa ubuthongo obukhulu ngokweqile. Lokhu kubangelwa izinga eliphakeme lokuphila, okuyinjongo yanoma yimaphi ukwelashwa okuphumelelayo.
Imithombo:
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Conway, W et al . "Imiphumela emibi ye-tracheostomy ye-apnea yokulala." I-JAMA 1981; 246: 347.
Perez de Llano, LA et al . "Imiphumela yesikhashana kanye neyesikhathi eside yomsindo ovuthiwe we-nasal intermittent positive ventilation kwiziguli ezinokukhuluphala-i-hypoventilation syndrome." I-Chest 2005; 128: 587.
Scrima, L et al . "Ukwanda kakhudlwana kwe-apnea yokuvimbela ubuthongo ngemuva kokulala ngesikhathi sokulala utshwala: amandla okuhlola kanye nendlela ehlongozwayo yesenzo." Ukulala ngo-1982; 5: 318.
U-Sugerman, H et al . "Imiphumela yesikhathi eside yokuhlinzwa esiswini sokuphatha ukungakwazi ukuphefumula kokukhuluphala." Am J Clin Nutr 1992; 55: 597S.