Iimbangela, iiMpawu, kunye nokuPhathwa kweCarbon Dioxide Ukugcinwa kwiGazi
I-hypercapnia yimeko eyenzekayo xa kukho i-carbon dioxide kakhulu-into yokuchitha umfutho-egazini. Nangona ngamanye amaxesha kubangelwa izinto ezinjenge- hypoventilation okanye ukugqithisa izidakamizwa ezidakisayo, into ebangelwayo isifo seMiphunga COPD .
COPD kunye ne-Hypercapnia Link
Ngokuqhelekileyo, xa siphefumula, siphucula umoya we-oxygen size siphume i-carbon dioxide.
Ezi zimbini zomoya zokuphefumula zitshintshaniswa ngaphakathi kwimiphunga emancinci, amaqoqo afana namagilebhisi, okanye iibhasi zomoya, ezibizwa ngokuba yi- alveoli .
Kubantu abano-COPD, le nkqubo ayiphumeleli ngenxa yokuba i-alveoli iyatshatyalaliswa, ishiya indawo engaphantsi kwe-oksijini ukuba iphume kwimiphunga ibe yigazi kunye ne-carbon dioxide ukuba iphume egazini ibe yimiphunga. Oku kubangela umlinganiselo ophantsi we-oksijini egazini, imeko ebizwa ngokuba yi- hypoxemia , kunye namazinga aphezulu e-carbon dioxide egazini, imeko ebizwa ngokuba yi-hypercapnia.
Ukugcinwa kwe-carbon dioxide kubantu abaneCOPD kubangelwa kwinkqubo ebizwa ngokuba yi- ventilation-perfusion mismatch (V / Q mismatch) kwimiphunga. Oku kwenzeka xa i-capillaries kunye ne-alveoli emipompini ayifaki ukudibanisa kunye nokuqhelekileyo ukutshintshiselana ngokufanelekileyo kwegesi.
Iingxaki Zokungabi Nokholo
Ngaphandle kweCOPD, kukho ezinye iimeko ezingakhokelela kumazinga aphezulu e-carbon dioxide egazini.
Ezinye imizekelo ziquka:
- Ukugqithisa izidakamizwa, njenge- opioid okanye benzodiazepine
- I-Brainstro stroke
- Hypothermia
- Izifo ezithile ze-metabolic (umzekelo, i-phosphate ephantsi kunye ne-magnesium egazini)
- Eminye imiqobo yesistim okanye i-nervous disorder njenge-encephalitis, i-muscular dystrophy, i-ALS, okanye i-myasthenia gravis
- Isiphelo sokugqibela Isifo seLung (ILD)
- Ukukhubazeka kokulala kokugula
- Ukunyameka kwe-hypoventilation syndrome
Iimpawu ze-Hypercapnia
Abantu abaninzi abaqapheli ukuba banomdla. Kwiimeko apho zikhula ngokukhawuleza emva kwexesha kwaye zibuhlungu kakhulu, unganakufumana nayiphi na impawu. Ukuba iimpawu zivela, zingabandakanya ukuphefumula okufutshane, iintloko, ukungakwazi ukucinga ngokuchanekileyo, okanye ukuguquka okanye ukulala. Ngenxa yokuba kulula ukuphosakela iimpawu ze-mile hypercapnia, ukuqonda kuyinto eyona nto.
Ngakolunye uhlangothi, iimpawu zoxinzelelo olunzulu zichazwe ngakumbi. Ukuxhamla ngokugqithiseleyo kunokugqibela kukukhokelela ekupheleleni ukuphefumula kwaye mhlawumbi ukufa. Iimpawu kunye neempawu zingabandakanya:
- Iparanoia, ukuxinezeleka, kunye nokudideka, ezinokuthi zenze inkqubela phambili
- Iimpawu zengxube
- Ukuxhamla
- Ukuxilwa okanye ukukhulisa imithanjeni engasesikweni kwesikhumba
- I-Papilledema - uphawu loxinzelelo oluphezulu kwingqondo
Unyango lwe-Hypercapnia
Utyando lwe-hypercapnia luxhomekeke kubuqili balo kwaye luqala ngokujongana nesizathu esiyintloko.
- Ukungena kwemvelo : Ukungena kwamandla okungenwa kwemvelo kunika inkxaso yentsholongwane kwisigulane ngokusebenzisa umoya ophezulu. Iyakwandisa inkqubo yokuphefumula ngokunika isigulane umxube womoya kunye ne-oksijini evela kwi-generator ye-flow generator ngokusebenzisa imaski ebonakalayo eqinile okanye ebusweni.
- Intubation kunye nomoya wokungena umoya : Intubation yinkqubo yokufaka ityhubhu ekhethekileyo emlonyeni ize ihambe ngendlela. I-tube ithoxiswa kwi-ventilator eyenza ukuphefumula ngokunyamezela isigulane.
Ngexesha lokuya kubiza ugqirha
I-Hypercapnia ingakhokelela ekuphumeleleni ukuphefumula nokufa xa kungashiywanga. Ukuba unayo i-COPD, ukuqaphela iimpawu zokuxhaswa kwempilo kubalulekile ekufumaneni kwangaphambili. Shayela ugqirha wakho ngokukhawuleza ukuba unokufumana utshintsho kwiimpawu zakho okanye kwimpilo jikelele. Ukuba ugqirha wakho ukhathazekile nge-hypercapnia, unokukwenza uvavanyo olubizwa ngokuba yi- gas blood pressure - elula, uvavanyo lwebhedlele apho igazi lithathwa kwi-artery kwisikrini sakho.
ILizwi
Xa ufunda malunga nokunyaniseka, zama ukungazitholi ngokugqithisileyo ngeenkomfa ezinzima zeli gama lonyango. Endaweni, qonda umfanekiso omkhulu - u-hypercapnia ukhonza njengomakishi wokungalingani okwenzekayo emzimbeni.
Kwakhona, iindaba ezilungileyo zokugubungela intloko ejikelezayo kukuba njengokuba i-hypercapnia inobangela obuninzi kwaye akunjalo ukususela kwi-COPD, kungekhona wonke umntu ophethe i-COPD ene-hypercapnia.
> Imithombo:
> Feller-Kopman DJ, Schwartzstein RM. (2017). Uvavanyo, ukuxilongwa, kunye nokunyangwa kwesigulane somntu omdala ngesifo sokuphefumula okuphefumulayo. Ku: U-UpToDate, i-Stoller JK (Ed), UpToDate, i-Waltham, MA.
> I-Poon CS, Tin C, Ingoma G. Ukuzithoba kwengqondo: Kutheni izigulane zeCOPD zithandana nokugcinwa kwe-CO2 kunezigulane ze-heart failure. Respir Physiol Neurobiol. 2015. Sep 15; 216: 86-93.
> West JB. Iingxaki kunye nokuhlawulwa kwe-hypoxemia kunye nokunyaniseka. Compr Physiol . 2011 Julayi; 1 (3): 1541-53.