"Phakathi kweyeza lokhathalelo olubalulekileyo, i-hypoxemia ethe cwaka iyaqhubeka njengento engaqondakaliyo yekliniki eneziphumo ezibi kakhulu. Ibonakaliswa kukuchithwa kweoksijini ngaphandle kwe-dyspnea elinganayo (ebizwa ngokuba 'yi-hypoxia ethuleyo'), olu bonakaliso luphazamisayo lusebenza njengesalathisi esibalulekileyo sokungaphumeleli kokuphefumla. Ukubhubha kwabantu kwinyumoniya, i-COVID-19, kunye neemeko ezingapheliyo zemiphunga I-New England Journal of Medicine isandula ukuqaqambisa le 'ngxaki yonyango' - apho iinzame zokuphefumla eziqhelekileyo zifihla intlekele yokunqongophala kweoksijini, ifuna ukuba kuhlaziywe uqwalaselo lweklinikhi kunye nohlaziyo lweprotocol.
Yintoni i-hypoxemia?
"I-Hypoxemia, echazwa njengokungabikho kwe-pathological saturation ye-oxygen saturation kwi-arterial blood (PaO2 <80 mmHg kwinqanaba lolwandle kubantu abadala), ivela xa uxinzelelo oluncinci luwela ngaphantsi kwee-normative normative thresholds (AARC Clinical Practice Guideline 2021).
- Ukungena komoya / ukutyhutyha ngendlela engafaniyo: Izigulana ezibukhali zenyumoniya ezine-alveolar zingena ziphazamisa amandla okusasaza
- Iindlela zeCardiogenic: Amaqela okusilela kwentliziyo asekhohlo/asekunene abonisa i-edema yepulmonary edema (PCWP>18 mmHg)
- I-Neuromuscular compromise: Abemi babantwana abane-intercostal musculature engaphuhliswanga kunye nabantu abadala abane-diaphragmatic dysfunction.
- Ukuvezwa okungapheliyo: Abasebenzisi becuba babonakalisa utshintsho kwisakhiwo semiphunga (emphysema, COPD-GOLD isigaba ≥2)
- I-Iatrogenic triggers: Izigulana zasemva kokuhlinzwa ezifumana i-opioid-induced breathing depression (RR <12 / min) kunye ne-atelectasis
Ngokucacileyo, i-38% yezigulana zotyando lwe-thoracic ziphuhlisa i-hypoxemia ngaphakathi kwe-24h emva kokukhutshwa (iDatha yamaBango evaliweyo ye-ASA ngo-2022), igxininisa imfuneko yokubekwa esweni kwe-pulse oximetry eqhubekayo kwaba bantu.
Ziziphi iingozi ze-hypoxemia?
Ngokwezibalo zeklinikhi, izinga lokufa kwezigulane ezine-hypoxemia enzima linokufikelela kwi-27%, kwaye kwiimeko ezinzima kakhulu, izinga lokufa lingafikelela ngaphezu kwe-50%. Ukuba ukungenelela ngexesha elifanelekileyo akwenziwanga kwizigaba zokuqala zesifo, iziphumo ezibi zinokuthi zenzeke.
- Impembelelo kwingqondo: Xa amanqanaba e-oksijini yegazi ehla (hypoxemia), ingqondo iyancipha ioksijini. Oku kunokubangela iimpawu ezikhawulezayo njengentloko engapheliyo, isiyezi esikhawulezileyo, kunye nokuphelelwa yinkumbulo. Ukuba ayiphathwanga, indlala yeoksijini ixesha elide inokonakalisa iiseli zengqondo, ezinokukhokelela kwizibetho ezibangelwa ukuhamba kwegazi okuvaliweyo (i-cerebral infarction) okanye imithambo yegazi ephukileyo (i-cerebral hemorrhage). Ukuqondwa kwangethuba kwezi mpawu zilumkisayo kubalulekile ukunqanda umonakalo osisigxina wemithambo-luvo.
- Impembelelo entliziyweni: Xa intliziyo ingafumani ioksijini yaneleyo, iyasokola ukumpompa ngokufanelekileyo. Olu xinzelelo lunokubangela iimpawu ezilumkisayo ezifana nokubetha kwentliziyo ngokukhawuleza okanye okungaqhelekanga, ukuqina kwesifuba (i-angina), kunye nokudinwa okungaqhelekanga. Ngokuhamba kwexesha, ukunqongophala kweoksijini engaphathwanga kunokuwenza buthathaka isihlunu sentliziyo, nto leyo enokukhokelela kwiingxaki ezisongela ubomi ezifana nokungaphumeleli kwentliziyo, apho intliziyo ingakwaziyo ukuhambisana neemfuno zomzimba.
- Impembelelo kwimiphunga: Amanqanaba asezantsi eoksijini anyanzela imiphunga ukuba isebenze nzima ukuze nje iqhubeke. Ngokuhamba kwexesha, olu xinzelelo lungonakalisa iindlela zomoya kunye nezicubu zemiphunga, kwandisa umngcipheko wokuphuhlisa ukuphazamiseka kokuphefumla njengeCOPD (isifo esingapheliyo se-pulmonary). Kwiimeko ezimandundu, ukuvinjwa kweoksijini ixesha elide kunokude kwenze buthathaka icala lasekunene lentliziyo njengoko isokola ukumpompa igazi ngemiphunga eqinile, imeko eyaziwa ngokuba yi-cor pulmonale.
- Iziphumo zomzimba wonke: Ukunqongophala kweoksijini okungapheliyo kutsala amalungu onke afana nemoto esebenza kumafutha aphantsi. Izintso kunye nesibindi ngokuthe ngcembe ziye zingasebenzi kakuhle ekuhluzeni ityhefu, ngelixa amajoni omzimba esenza buthathaka, nto leyo eyenza kube nzima ukulwa usulelo oluqhelekileyo. Ngokuhamba kwexesha, eli tyala leoksijini lithuleyo linyusa imingcipheko yokonakaliswa kwamalungu kwaye liwushiya umzimba usesichengeni seengxaki zempilo – ukusuka kwizigulo ezihlala rhoqo ukuya kumanxeba ahlala ekhona. Oku kwenza ukuba ukujongwa kwinqanaba leoksijini kwangoko kubaluleke kakhulu ekuthinteleni iingxaki zamalungu amaninzi.
Ufumanisa njani ukuba une-hypoxemia?
Amanqanaba eoksijini yegazi ngumlinganiselo ophambili wokufumanisa ukusilela kweoksijini. Kubantu abasempilweni, ufundo oluqhelekileyo lusuka kwi-95% ukuya kwi-100%. Amanqanaba phakathi kwe-90-94% abonisa ukunqongophala kwe-oksijini encinci, enokuthi ingabonakali iimpawu ezicacileyo. Ukuhla ukuya kwi-80-89% kubonisa ukunqongophala kweoksijini ephakathi, okuhlala kubangela ukuphefumla okusebenzayo okanye ukudideka. Ukufundwa okungaphantsi kwe-80% kubonisa imeko engxamisekileyo, apho izitho ezibalulekileyo zibeka ingozi ngenxa yendlala ye-oksijini eninzi kwaye ifuna unyango olukhawulezileyo.
Ukugcina njani ukugcwala okuqhelekileyo kwegazi kwe-oxygen?
- Vula iifestile zokungenisa umoya
Hlaziya umoya wakho wangaphakathi ngokuvula iifestile yonke imihla ukuze ujikeleze ioksijini entsha. Ukufumana iziphumo ezingcono, tyelela rhoqo iipaki okanye iindawo ezityebileyo zendalo ngaphandle kweendawo zasedolophini ukuze uthathe impefumlo enzulu, ecocekileyo enceda ukutshaja amanqanaba eoksijini yomzimba wakho.
- Aerobics
Imisebenzi yesiqhelo ye-aerobic efana nokuhamba ngokukhawuleza, ukuqubha, okanye ukukhwela ibhayisekile kunokonyusa ukuhamba kwegazi kunye nokujikeleza kweoksijini. Khetha iindlela ezinobunzima obusezantsi obufana ne-aerobics yamanzi okanye ukubaleka kancinci ukuba umtsha ukuzilolonga - oku kuzilolonga okuthambileyo kuphucula ngokukhuselekileyo ukuhanjiswa kweoksijini ngelixa kusakha amandla ngokuhamba kwexesha.
- Unyango lwe-oxygen ekhaya
Kubantu abaneemeko zokuphefumla ezingapheliyo abasokola kumanqanaba asezantsi eoksijini, ukusebenzisa isixhobo seoksijini yasekhaya kunokunceda ukugcina i-oxygen efanelekileyo. Oogqirha bahlala bencoma ukuqala nge-oxygen concentrators ephathekayo ngexesha lokulala okanye imisebenzi yemihla ngemihla - xa isetyenziswe njengoko iyalelwe, olu unyango lunokuphucula amanqanaba amandla, ukunciphisa ukuphefumula, kunye nokuxhasa umgangatho ongcono wokulala.
Ixesha lokuposa: Apr-25-2025