Ukuhamba Ngaphantsi Kweqela Ukuphatha I-Apnea Yokulala Xa i-CPAP ihluleka
Kulabo abangakwazi ukunyamezela ukunyanzeliswa kokuhamba komoya okuqhubekayo (CPAP) ukuphatha i- apnea ye-sleepiness obstructive (OSA) , zeziphi iindlela zokuhlinzwa ezikhoyo? Kukho unyango oluncinci lwezonyango, kodwa lungaba luncedo olukhawulezileyo kwaye lungaba lulowo wonke umntu. Ukuphonononga ezinye zezi zikhethi kunye nokuba ngaba zilungele wena.
Uvulopalatopharyngoplasty (UPPP)
Oku kuye kwimbali yonyango oluqhelekileyo kunyango kubantu abane-OSA abanobucokisekileyo nabangqinelanayo abangakwazi ukunyamezela i-CPAP okanye olunye ulawulo lwezokwelapha.
I-UPPP yinkqubo yokukhutshwa kwezicubu ezingaphezu kweendlela ezihamba phambili, kuquka umva emlonyeni kwi-palate ethambileyo kunye nasemqaleni.
I-UPPP ibandakanya ukukhutshwa kwezicubu ezivela kwiitoni , ukuvula , kunye nenzame epholileyo kunye nobunzima (uphahla lomlomo). Ezi zicubu zinokuthi ziphazamise indlela yokuhamba, kwaye ithemba ukuba ukususa kuzo kuya kucima lo mqobo.
Kukho iingxaki ezahlukeneyo ezinokuthi zenzeke ngenkqubo. Njengoko nayiphi na inkqubo yokucubungela, kukho iingozi zentlungu, ukuphuma kwegazi kunye nosulelo. Ukongezelela, kukho ukutshintshwa kwelizwi, ukunciphisa i- pharynx (ebizwa ngokuba yi-stenosis), inzwa yenyama yangaphandle emqaleni, okanye umngcipheko we-velopharyngeal insufficiency (ukuphindaphinda kokutya, utywala, okanye umatha emmpumlweni xa ukugwinya). Kukho nobunzima bokunyamezela i-CPAP ukuba kuyimfuneko emva kwenkqubo.
Ngelishwa, kuphela ama-50% abantu abadala abaphathwa ngo-UPPP banciphisa inani labo le- apnea neziganeko ze-hypopnea ngesiqingatha okanye ngaphezulu.
Ezi mphuculo zingaphinde zinciphise ngokuhamba kwexesha, ingakumbi ngokuzuza ubunzima nokuguga. Kuqwalaselwa ngonyango lwesibini, emva kwonyango lwe-CPAP, kwaye kuphela kulabo abanokukhutshwa kweethambo zabo. Ngenxa yentlungu kunye nenzuzo encinci, ngokukhawuleza ayikho into yokuba isisombululo sisisombululo.
Olunye uphando olubandakanya i -palate elithambileyo lunokuthi lwenziwa, kuquka ukufakwa kwezinto eziqiniweyo ezibizwa ngokuba yintsika yenqubo.
Ukufakelwa kwe-Pacemaker kwiLwimi elibizwa ngokuba yi-Inspire Nerve Stimulator
Inketho entsha yonyango ebonakala ngathi iyathembisa ukufakwa kwe-pacemaker ngolwimi olubizwa ngokuba ngumgqugquzeli weentliziyo . Isebenza kwi- nerve ye-hypoglossal kwaye iyanciphisa ukuwa kwe-airway ngokubambisana neengxube zolwimi kunye nomoya ophezulu. Kuboniswe kulabo abaye bahluleka ukwelashwa kwe-CPAP kunye nobukho be-apnea obunzima bokulala (kunye ne-AHI yesiseko ye-20 okanye ngaphezulu). I-endoscopy yokulala iqhutyelwa ukuvavanya ukuba ubani onokufumana inzuzo.
I-Tracheostomy njenge-Option Resort yokugqibela
I-Tracheostomy yintambo yokupakisha phambi kombhobho womoya ( trachea ), kunye nokubeka ityhubhu yeplastiki ukuze kugcinwe oku kuvulekileyo, kwaye iyasebenza kakhulu ekuphatheni i-OSA. Iphelisa ukukhutshwa kwe-airway engenhla, eyona nto ibangela imbandezelo. Le yintloko yonyango ekwenzeni i-apnea yobuthongo obukhulu ngaphambi kokuba kuqaliswe unyango lwe-CPAP ngo-1981.
Ngenxa yobuninzi bayo, kunye nokusebenza kwe-CPAP, ayisoloko isetyenziselwa.
Ngokuqhelekileyo igcinelwe abo baneengxaki zokusongela ubomi ezifana ne-cor pulmonale, i-arrhythmias, okanye i-hypoxemia enamandla (amanqanaba e-oxygen ephantsi) awanakulawulwa ngolunye unyango.
Ngaba zikhona ezinye iindlela zokupanda ngeelwimi, umlenze, kunye nephunga?
Ngokuxhomekeka kwimbangela ye-apnea, i-genioglossus (ulwimi) phambili, i-hyoid (chin bone) i-myotomy ngokumiswa, kunye ne- maxillomandibular (umhlathi) ingaqhubeka . Zonke ezi zichanekileyo zichanekile iimpembelelo ze-anatomiki ezinxulumene nezihlunu kunye namathambo axhasa ulwimi kunye nomhlathi osezantsi, kwaye ayenako ukwenza ngaphandle kwezi ziphoso.
Njengoko impumelelo iyahluka, kwaye ubungakanani benkqubo inokuphakanyiswa, oku kuqhutyelwa rhoqo.
Ukuhlinzwa okusemandleni kungenziwa kwakhona ukulungisa i- septum yangasese engaphambukiyo , kodwa oku kuphuculwe kwintlambo yempompo kungabikho ngokwaneleyo ukuxazulula i-apnea yokulala.
Ukuba unomdla malunga nokunyangwa kwonyango onokuba luncedo ekuphuculeni i-apnea yokulala, thetha ne-sleeping specialist uze uqwalasele ukuhanjiswa kwigqirha ukuze uphonononge okongeziweyo lwezo mngcipheko kunye neenzuzo kwimeko yakho.
Imithombo:
Cooper, DH et al. Umqulu waseWashington wezoNyango zeZonyango. 32. ULippincott Williams noWilkins. p. 260.
USher, AE et al. "Ukuphumelela kokuguqulwa kokuhlinzwa kwendlela ephezulu kubantu abadala abane-sleepiness apnea syndrome" Ukulala. 1996; 19: 156-177.
Li, KK et al. "Iziphumo zexesha elide le-maxillomandibular ukuqhutyelwa phambili." Ukulala Nokuphefumula. 2000; 4: 137-139.