"Kwiingcali zonyango olubalulekileyo, i-hypoxemia engathethiyo iyaqhubeka njengengxaki yeklinikhi engaqatshelwayo enemiphumo emibi kakhulu. Ibonakaliswa kukususwa kwe-oksijini ngaphandle kokuphelelwa ngamandla (okubizwa ngokuba yi-'silent hypoxia'), le mpawu ingaqhelekanga isebenza njengesibonakaliso esibalulekileyo sokungaphumeleli kokuphefumla okuzayo. Ubungqina obukhulayo buqinisekisa indima yayo njengendlela efihlakeleyo ye-pathophysiological, apho ukuxilongwa okulibazisekileyo kuncedisa ekufeni okunokuthintelwa kuyo yonke i-pneumonia, i-COVID-19, kunye neemeko ezingapheliyo zemiphunga. I-New England Journal of Medicine isandula ukugxininisa le 'ngxaki yogqirha' - apho umgudu oqhelekileyo wokuphefumla ufihla ukunqongophala kwe-oksijini okuyingozi, ufuna uhlaziyo loqwalaselo lweklinikhi kunye nokujonga utshintsho lweprotocol."
Yintoni i-hypoxemia?
“I-Hypoxemia, echazwa njengokunqongophala kwe-oxygen saturation egazini lemithambo yegazi (i-PaO2 < 80 mmHg kwinqanaba lolwandle kubantu abadala), ivela xa uxinzelelo oluncinci luwela ngaphantsi kwemida eqhelekileyo ehlengahlengisiweyo ngokweminyaka (i-AARC Clinical Practice Guideline 2021). Amaqela asemngciphekweni ophezulu abonisa iiprofayili ezahlukeneyo ze-pathophysiological:
- Ukungalingani komoya/ukuvuza kwamanzi: Izigulana ezine-pneumonia enzima ezine-alveolar zingena ziphazamisa amandla okusasazwa kwamanzi
- Iindlela zokosuleleka yintliziyo: Iiqela ezinesifo sentliziyo sasekhohlo/sasekunene ezibonisa ukudumba kwamaphaphu okubangelwa luxinzelelo (PCWP >18 mmHg)
- Ukuphazamiseka kwemisipha: Abantwana abanezihlunu ze-intercostal ezingaphuhliswanga kakuhle kunye nabantu abadala abane-diaphragmatic dysfunction
- Ukuchatshazelwa yintsholongwane ixesha elide: Abantu abasebenzisa icuba ababonakalisa utshintsho kwimiphunga (i-emphysema, inqanaba le-COPD-GOLD ≥2)
- Izinto ezibangela i-Iatrogenic: Izigulana emva kotyando ezifumana uxinzelelo lokuphefumla olubangelwa yi-opioid (RR <12/min) kunye ne-atelectasis
Okuphawulekayo kukuba, ama-38% ezigulana ezityandwa esifubeni ziba ne-hypoxemia kwiiyure ezingama-24 emva kokukhutshwa kwegazi (i-ASA Closed Claims Data 2022), nto leyo egxininisa imfuneko yokujonga rhoqo i-pulse oximetry kwezi qela.
Zithini iingozi ze-hypoxemia?
Ngokwezibalo zeklinikhi, izinga lokufa kwezigulane ezine-hypoxemia enzima linokufikelela kwi-27%, kwaye kwiimeko ezinzulu ngakumbi, izinga lokufa linokufikelela nangaphezu kwe-50%. Ukuba ukungenelela ngexesha akwenziwanga kwizigaba zokuqala zesifo, kusenokwenzeka ukuba kubekho iziphumo ezibi.
- Impembelelo engqondweni: Xa amanqanaba eoksijini egazini ehla (hypoxemia), ingqondo iyaphelelwa yioksijini. Oku kunokubangela iimpawu ezikhawulezileyo ezifana neentloko ezingapheliyo, isiyezi ngequbuliso, kunye nokuphelelwa yinkumbulo. Ukuba ayinyangwa, ukulamba ioksijini ixesha elide kunokonakalisa iiseli zengqondo, okunokubangela isifo sohlangothi esibangelwa kukuvalwa kwegazi (cerebral infarction) okanye ukuqhekeka kwemithambo yegazi (cerebral hemorrhage). Ukuqatshelwa kwangoko kwezi mpawu zesilumkiso kubalulekile ukuthintela umonakalo osisigxina wemithambo-luvo.
- Impembelelo entliziyweni: Xa intliziyo ingafumani ioksijini eyaneleyo, iyasokola ukupompa ngokufanelekileyo. Olu xinzelelo lunokubangela iimpawu ezilumkisayo ezifana nokubetha kwentliziyo okukhawulezayo okanye okungahambelaniyo, ukuqina kwesifuba (i-angina), kunye nokudinwa okungaqhelekanga. Ekuhambeni kwexesha, ukunqongophala kweoksijini okunganyangwanga kunokwenza buthathaka izihlunu zentliziyo, okunokukhokelela kwiingxaki ezisongela ubomi ezifana nokusilela kwentliziyo, apho intliziyo ingakwazi ukuhlangabezana neemfuno zomzimba.
- Impembelelo kwimiphunga: Amanqanaba aphantsi eoksijini anyanzela imiphunga ukuba isebenze nzima ukuze iqhubeke nokusebenza. Ekuhambeni kwexesha, olu hlobo loxinzelelo lungonakalisa iindlela zomoya kunye nezicubu zemiphunga, nto leyo eyonyusa umngcipheko wokuba neengxaki zokuphefumla ezifana neCOPD (isifo semiphunga esingapheliyo). Kwiimeko ezinzima, ukunqongophala kweoksijini ixesha elide kunokunciphisa icala lasekunene lentliziyo njengoko izama ukupompa igazi kwimiphunga eqinileyo, imeko eyaziwa ngokuba yi-cor pulmonale.
- Iziphumo zomzimba wonke: Ukunqongophala kweoksijini okungapheliyo kuhlutha onke amalungu omzimba njengemoto esebenzisa ipetroli encinci. Izintso nesibindi kancinci kancinci azisebenzi kakuhle ekuhluzeni iityhefu, ngelixa inkqubo yomzimba yokuzikhusela iba buthathaka, nto leyo eyenza kube nzima ukulwa nosulelo oluqhelekileyo. Ekuhambeni kwexesha, eli tyala leoksijini engathethiyo landisa umngcipheko wokonakala kwamalungu omzimba kwaye lishiya umzimba usengozini yokwanda kweengxaki zempilo - ukusuka kwizifo ezixhaphakileyo ukuya kumanxeba amalungu omzimba ahlala ixesha elide. Oku kwenza ukuba ukujonga kwangethuba amanqanaba eoksijini kubaluleke kakhulu ekuthinteleni iingxaki zamalungu amaninzi.
Ungafumanisa njani ukuba une-hypoxemia?
Amanqanaba eoksijini egazini yeyona ndlela iphambili yokufumanisa ukungabikho komoya-mpilo. Kubantu abaphilileyo, ukufundwa okuqhelekileyo kususela kwi-95% ukuya kwi-100%. Amanqanaba aphakathi kwe-90-94% abonisa ukungabikho komoya-mpilo okuncinci, okusenokungabonakalisi zimpawu zicacileyo. Ukwehla ukuya kwi-80-89% kubonisa ukungabikho komoya-mpilo okuphakathi, okuhlala kubangela ukuphefumla okunzima okanye ukudideka. Ukufundwa okungaphantsi kwe-80% kubonisa imeko engxamisekileyo, apho amalungu abalulekileyo asengozini yokonakala ngenxa yokungabikho komoya-mpilo kakhulu kwaye afuna unyango olukhawulezileyo.
Ungayigcina njani i-oxygen yegazi igcwele?
- Vula iifestile ukuze kungene umoya
Hlaziya umoya wakho wangaphakathi ngokuvula iifestile yonke imihla ukuze ujikelezise ioksijini entsha. Ukuze ufumane iziphumo ezingcono, tyelela iipaki rhoqo okanye iindawo ezinobutyebi bendalo ngaphandle kwemimandla yasezidolophini ukuze uphefumle nzulu, ucocekile, nto leyo enceda ekuvuseleleni amanqanaba eoksijini emzimbeni wakho.
- Ii-aerobics
Imisebenzi eqhelekileyo ye-aerobic efana nokuhamba ngokukhawuleza, ukudada, okanye ukukhwela ibhayisekile inokunyusa ukuhamba kwegazi kunye nokujikeleza kweoksijini. Khetha iindlela eziphantsi ezifana ne-water aerobics okanye ukubaleka kancinci ukuba usandul' ukuzilolonga - olu qeqesho luthambileyo luphucula ngokukhuselekileyo ukuhanjiswa kweoksijini ngelixa lukwakha amandla ngokuhamba kwexesha.
- Unyango lweoksijini ekhaya
Kubantu abaneengxaki zokuphefumla ezingapheliyo abanengxaki yamanqanaba aphantsi eoksijini, ukusebenzisa isixhobo seoksijini sasekhaya kunokunceda ukugcina ioksijini ifanelekile. Oogqirha badla ngokucebisa ukuba baqale ngee-concentrators zeoksijini eziphathekayo ngexesha lokulala okanye imisebenzi yemihla ngemihla - xa zisetyenziswa njengoko kuyalelwe, olu nyango lunokuphucula amanqanaba amandla, lunciphise ukuphefumla, kwaye luxhase umgangatho wokulala ongcono.
Ixesha leposi: Epreli-25-2025