Unyango lweNqatyana yokugqibela
Nangona uphumelelo lwezonyango ezininzi, oluquka ukunyanga kwe-airway pressure (PAP), kukho ezinye iimeko xa unyango olungakumbi olungabonakaliyo lubonakala luyimfuneko. Ukusetyenziswa kwe-tracheostomy ukuhlinzwa kwe- apnea yokulala kuhlala kunokhepheka kakhulu, ukuba ngaba kunokwenzeka ukuba kunzima ukukhetha ukuphefumula okanye ukuphefumula okuphazamisekileyo kokulala.
Akunakuba yinto yokuqala yokukhetha, kodwa kwezinye iindawo zokugqibela ezifanelekileyo. Funda malunga nokusetyenziswa kwe-tracheostomy ukuphatha i-apnea yokulala.
Yintoni i-Tracheostomy?
I-Tracheostomy yindlela yokugqitywa kwe-incision kwi-trachea, okanye i-windpipe, phambi kwentamo. I-tube eplastiki encinci ingeniswa ukuze kugcinwe ukuvula. Lo mnyango uvumela ukuhamba komoya ukuba kwenzeke ngaphandle kokusebenzisa umoya ophezulu, ngokugqithiseleyo ngokugqithisela umhlathi ophezulu, ulwimi, umlomo kunye namanqa. Xa i-apnea yokulala ibuhlungu, kunokungenelela okuyimfuneko.
Kutheni usebenzisa i-Tracheostomy kwi-Apnea yokulala?
Ngaphambi kokufika koxinzelelo oluqhubekileyo lwe-airway (CPAP), i-tracheostomy yonyango olusetyenziswa ngokuphindaphindiweyo lokunyanga i-apnea yokulala. Isebenza kakuhle kakhulu kwimeko yokuphazamiseka kokuphazamiseka kokulala, okwenzekayo ngenxa yokuba umgwaqo ophezulu ugoba ngexesha lokulala, okukhokelela ekuphumeni kokuphefumula. Ngokususa ukuxhatshazwa kwe-airway engenhla, eyenziwa emva kwe-tracheostomy njengoko ukuphefumla kwenzeka ngokuvulwa emqaleni, ukuphulukiswa kwe-apnea kuphuculwe kakhulu.
Oku kungenza ukuba i-oxygen kunye ne-carbon dioxide kunye nezinye iimpawu zenzeke.
I-Tracheostomy ingasetyenziswa xa ukungaphumeleli kokuphefumula kwenzeka, kwaye unyango oluqhelekileyo, olufana ne-CPAP okanye ye- bilevel , alunyanzelwanga okanye lusebenza. Oku kuya kwenzeka xa i-apnea yokulala ibuhlungu kakhulu kwaye ingaba yinto eqhelekileyo kubantu abanokugqithisa ngokugqithiseleyo, njengoko kwenzeka kwi-fetes-hypoventilation syndrome.
Kwakhona kungadingeka kubantwana abanokuphuhliswa kokuphucula ukuphefumula.
Iingxaki ngeTracheostomy
Njengoko nayiphi na inkqubo yonyango, kukho iingozi kunye neengxaki ezinxulumene nokubekwa kwe-tracheostomy, njenge:
- Intetho ingaba nzima, ifuna indawo yokuhlala njenge "inkinobho ye-tracheostomy."
- Kukho ubunzima obunzima bokuguqula, kubandakanywa iingxaki zokukhubazeka kunye nomtshato.
- Kukho umngcipheko wokusuleleka, ikakhulukazi iziqulatho eziphindaphindiweyo ze-bronchitis.
- Uluhlu lwesikhumba lunokuba luyimfuneko ukukhusela ukukhawulwa ngokweqile kwisayithi ye-trachea.
- Kwizigulane ezigqithiseleyo, ukuhlinzwa ngokwabo kunzima kwaye inkinobho ye-tracheostomy ingaba nzima nakakhulu.
ILizwi Lokulumkisa Kwabaguli Abangenayo
Ukuba ucinga nge-tracheostomy, izigulane ezigqithisileyo kufuneka ziqonde ukuba zinokuba zengozini yokwehluleka kwenkqubo. Kwimeko yokukhuluphala-i-hypoventilation syndrome, ukuhluka kwe-apnea yokulala kunye nokungaphumeleli kokuphefumula kunabantu abagqithiseleyo, kunokubakho iingxaki ezithintekayo emva kwe-tracheostomy. Amandla amancinci kwimisipha yokuphefumula okanye ukunciphisa amandla okwandisa imiphunga ingabangela ukuphumelela ukuphefumula ngokuqhubekayo nangona inkqubo.
Njengemisebenzi engabonakaliyo engaphelelwanga njenge-CPAP, i-bilevel, kunye nezinye izixhobo ezixhasayo ngoku ziyafumaneka, i-tracheostomy ngoku ayifumaneki isetyenziswa ukuphatha i-apnea yokulala.
Noko ke, unako ukhetho lokugcina ubomi kubantu abayidingayo njengento yokugqibela.
Imithombo:
Camacho M et al. "I-Mini Tracheostomy yokukhusela i-Apnea yoButhongo: IsiPhulo esisekelwe kuMboniso." Int J Otolaryngol. 2016; 2016: 7195349. Epub 2016 Jan 26.
> Cielo CM, Gungor A. "Izinketho zokwelapha kwi-Pediatric Obstructive Sleep Apnea." I-Curr Probl I-Pediatr I-Adolesc Health Care. 2016 Jan; 46 (1): 27-33. Epub 2015 Nov 17.
> Conway, W et al . "Imiphumo emibi yeTracheostomy ye-Apnea yokulala." JAMA 1981; 246: 347.