Eminyakeni yamuva nje, abantu abaningi baye banaka kakhulu indima yokwelashwa komoya-mpilo ekunakekelweni kwezempilo. Ukwelashwa nge-oksijini akuyona nje indlela yezokwelapha ebalulekile emithini, kodwa futhi imfashini yezempilo yasekhaya.
Iyini I-Oxygen Therapy?
Ukwelashwa komoyampilo kuyisinyathelo sezokwelapha esikhulula noma esilungisa isimo se-hypoxic somzimba ngokwandisa ukugcwala komoyampilo emoyeni ohogeliwe.
Kungani udinga umoya-mpilo?
Ngokuyinhloko isetshenziselwa ukukhulula izimo ezenzeka ngesikhathi se-hypoxia, njengesiyezi, ukushaya kwenhliziyo, ukucinana kwesifuba, ukuphefumula, njll. Ibuye isetshenziselwe ukwelapha izifo ezinkulu. Ngasikhathi sinye, umoya-mpilo ungathuthukisa ukumelana nomzimba futhi uthuthukise imetabolism.
Umphumela We-oksijeni
Ukuhogela umoya-mpilo kungasiza ekuthuthukiseni umoya-mpilo osegazini futhi kusize isimiso sokuphefumula sesiguli sibuyele esimweni esivamile ngokushesha ngangokunokwenzeka. Imvamisa ukuphikelela ekwelashweni komoyampilo, kungasidambisa ngempumelelo isimo.Ngaphezu kwalokho, umoya-mpilo ungathuthukisa ukusebenza kwezinzwa zesiguli, ukusebenza kwamasosha omzimba kanye nemetabolism yomzimba.
Contraindication kanye nezinkomba ze-oxygen
Azikho izingqinamba eziphelele zokuhogela umoya-mpilo
I-oksijeni ifaneleka ku-hypoxemia eyingozi noma engapheli, Okufana: ukusha, ukutheleleka kwamaphaphu, i-COPD, ukwehluleka kwenhliziyo, i-pulmonary embolism, ukushaqeka ngokulimala okukhulu kwamaphaphu, ubuthi be-carbon monoxide noma i-cyanide, i-gas embolism nezinye izimo.
Izimiso zomoya-mpilo
Imithetho kadokotela:Umoya-mpilo kufanele usetshenziswe njengesidakamizwa esikhethekile ekwelapheni komoyampilo, futhi incwadi kadokotela noma i-oda likadokotela lokwelashwa komoyampilo kufanele kukhishwe.
Umgomo wokwehlisa izinga lokukhuphuka: Ezigulini ezine-hypoxemia enzima yembangela engaziwa, umgomo wokwehlisa izinga kufanele usetshenziswe, futhi ukwelashwa komoyampilo kusuka ekugxilweni okuphezulu kuya ekugxiliseni okuphansi kufanele kukhethwe ngokuya ngesimo.
Umgomo ogxile emigomweni: Khetha okuqondisiwe okuphusile kokwelashwa komoyampilo ngokuya ngezifo ezahlukahlukene. Ezigulini ezisengcupheni yokugcinwa kwe-carbon dioxide, umgomo onconyiwe wokugcwalisa umoya-mpilo ngu-88% -93%, futhi ezigulini ezingenayo ingozi yokugcinwa kwe-carbon dioxide, umgomo onconywayo wokugcwaliswa komoyampilo ngu-94-98%
Amathuluzi okuphefumula komoya-mpilo asetshenziswa kakhulu
- I-oxygen tube
I-oxygen esetshenziswa kakhulu emisebenzini yomtholampilo,Ingxenye yevolumu ye-oksijini edonswe yithubhu le-oxygen ihlobene nesilinganiso sokugeleza komoya-mpilo, kodwa ishubhu le-oxygen alikwazi ukumanziswa ngokugcwele, futhi isiguli asikwazi ukubekezelela izinga lokugeleza elidlula i-5L/min.
- Imaski
- Imaski evamile:Ingahlinzeka ngengxenye yevolumu ye-oksijini ephefumulelwe engu-40-60%, futhi izinga lokugeleza komoyampilo akufanele libe ngaphansi kuka-5L/min. Ilungele iziguli ezine-hypoxemia futhi ayikho ingozi ye-hypercapnia.
- Amamaski okugcina umoya-mpilo aphefumula kancane futhi angawuphefumuli kabusha:Kumaski okuphefumula kancane ngokuvaleka kahle, lapho ukugeleza komoyampilo kungu-6-10L/min, ingxenye yevolumu ye-oxygen ephefumulelwe ingafinyelela ku-35-60%. Izinga lokugeleza komoyampilo lamamaski angaphefumuli kabusha kufanele okungenani libe ngu-6L/min. Azifanele labo abasengozini yokugcinwa kwe-CO2. yeziguli ezinezifo ezingamahlalakhona zokuthikamezeka kwamaphaphu.
- Imaski ye-Venturi:Iwumshini olungisekayo wokuphakelwa komoyampilo wokugeleza okuphezulu onganikeza ukugxila komoyampilo okungama-24%, 28%, 31%, 35%, 40% kanye nama-60%. Ilungele iziguli ezine-hypoxic ezine-hypercapnia.
- Idivaysi yokwelapha i-oxygen egeleza kakhulu e-Transnasal: Imishini yokwelapha i-oksijini egeleza kakhulu emakhaleni ihlanganisa amasistimu oksijini we-cannula yamakhala kanye nezixube komoyampilo womoya. Isetshenziswa kakhulu ekuhlulekeni kokuphefumula okukhulu, ukwelashwa komoya-mpilo okulandelanayo ngemuva kokukhishwa, i-bronchoscopy nokunye ukuhlinzwa okuhlaselayo. Ekusetshenzisweni komtholampilo, umphumela osobala kakhulu ezigulini ezinokuhluleka kokuphefumula kwe-hypoxic acute.
Indlela yokusebenza kwe-nasal oxygen tube
Imiyalo yokusetshenziswa: Faka ipulaki yamakhala eshubhuni lokuhogela umoya-mpilo ekhaleni, ubophe ishubhu ukusuka ngemuva kwendlebe yesiguli uliyise ngaphambi kwentamo bese ulibeka endlebeni.
Qaphela: I-oksijeni inikezwa ngeshubhu lokuhogela umoya-mpilo ngesivinini esiphezulu esingu-6L/min. Ukunciphisa izinga lokugeleza komoyampilo kunganciphisa ukuvela kokuma kwekhala nokungakhululeki. Ubude beshubhu lokuhogela umoya-mpilo akumele bube bude kakhulu ukuvimbela ubungozi bokuklinywa nokuminyanisa.
Izinzuzo kanye Nebubi be-Nasal Oxygen Cannula
Izinzuzo eziyinhloko zokuhogela umoya we-oxygen emakhaleni ukuthi kulula futhi kulula, futhi akuthinti i-expectoration nokudla. Ububi ukuthi ukugcwala komoyampilo akuhlali njalo futhi kuthinteka kalula ukuphefumula kwesiguli.
Ungawufaka kanjani umoya-mpilo ngemaski evamile
Amamaski avamile awanazo izikhwama zokugcina umoya. Kunezimbobo zokukhipha umoya ezinhlangothini zombili zemaski. Umoya ozungezile ungajikeleza lapho uhogela futhi igesi ingakhishwa lapho uphefumula.
Qaphela: Amapayipi anqanyuliwe noma amazinga okugeleza komoyampilo aphansi azobangela isiguli ukuthi sithole umoya-mpilo owanele futhi siphefumule kabusha isikhutha esikhishwe umoya. Ngakho-ke, kufanele kuqashelwe ukuqapha ngesikhathi sangempela kanye nokuxazululwa okufika ngesikhathi kwanoma yiziphi izinkinga eziphakamayo.
Izinzuzo ze-oxygen enamaski ajwayelekile
Okungacasuli, ezigulini eziphefumula ngomlomo
Inganikeza ukugxiliswa komoyampilo okugqugquzelwe njalo njalo
Izinguquko kuphethini yokuphefumula azikushintshi ukugxiliswa komoyampilo ophefumulelwe
Iyakwazi ukunyakazisa umoya-mpilo, ibangele ukucasuka okuncane ku-mucosa yamakhala
Igesi egeleza kakhulu ingakhuthaza ukuqedwa kwe-carbon dioxide ekhishwe kumaski, futhi empeleni akukho ukuhogela okuphindaphindiwe kwe-carbon dioxide.
Indlela ye-oxygen ye-Venturi mask
Imaski ye-Venturi isebenzisa isimiso sokuxuba i-jet ukuze ixube umoya ozungezile nomoya-mpilo. Ngokulungisa usayizi we-oxygen noma i-air inlet hole, igesi exubile ye-Fio2 edingekayo iyakhiqizwa. Iphansi lemaski ye-Venturi inezinhlobonhlobo zemibala ehlukene, emele izimbobo ezihlukene.
QAPHELA: Amamaski e-Venturi anekhodi enemibala ngumkhiqizi, ngakho-ke kudingeka ukunakekelwa okukhethekile ukuze kusethwe kahle izinga lokugeleza komoyampilo njengoba kucacisiwe.
Indlela yokugeleza okuphezulu kwe-nasal cannula
Nikeza umoya-mpilo ngesilinganiso sokugeleza esidlula i-40L/min, sinqoba ukugeleza komoya-mpilo okunganele okubangelwa ama-cannula avamile namamaski ngenxa yemikhawulo yezinga lokugeleza. I-oksijeni iyashiswa futhi ifakwe umswakama ukuze ivimbele ukungakhululeki kwesiguli kanye nokulimala kokuphela konyaka.I-cannula yamakhala egeleza kakhulu ikhiqiza ukucindezela okuhle kokuphela kokuphelelwa umoya. Ikhulula i-atelectasis futhi ikhulise amandla okusala okusebenzayo, ithuthukise ukusebenza kahle kokuphefumula futhi inciphise isidingo se-endotracheal intubation kanye ne-ventilation yemishini.
Izinyathelo zokusebenza: okokuqala, xhuma ishubhu le-oksijini epayipini lomoya-mpilo wesibhedlela, xhuma ishubhu lomoya epayipini lomoya lasesibhedlela, setha ukugcwala komoyampilo odingekayo kusixhumi somoya-mpilo, futhi ulungise izinga lokugeleza kumitha yokugeleza ukuze uguqule izinga eliphezulu. -ukugeleza kwekhala I-catheter ixhunywe kumjikelezo wokuphefumula ukuze kuqinisekiswe ukugeleza komoya okwanele ngokusebenzisa ukuvinjelwa kwamakhala. Vumela igesi ukuthi ifudumale futhi imanzise ngaphambi kokufaka isiguli, ubeke ipulaki yamakhala ekhaleni futhi uvikele i-cannula (ithiphu akufanele livale ngokuphelele ikhala)
Qaphela: Ngaphambi kokusebenzisa i-cannula yamakhala egeleza kakhulu esigulini, kufanele isethwe ngokulandela imiyalelo yomkhiqizi noma ngaphansi kokuqondiswa uchwepheshe.
Kungani kufanele usebenzise i-humidification lapho uhogela umoya-mpilo?
I-oxygen yezokwelapha i-oxygen emsulwa. Igesi yomile futhi ayinawo umswakama. I-oksijeni eyomile izocasula i-mucosa yokuphefumula ephezulu yesiguli, ibangele kalula ukungakhululeki kwesiguli, futhi ibangele nokulimala kwe-mucosal. Ngakho-ke, ukuze ugweme lokhu kungenzeki, ibhodlela lomswakama lidinga ukusetshenziswa lapho unikeza umoya-mpilo.
Yimaphi amanzi okufanele engezwe ebhodleleni lomswakama?
I-humidification liquid kufanele ibe amanzi ahlanzekile noma amanzi okujova, futhi ingagcwaliswa ngamanzi abandayo abilisiwe noma amanzi acwecwe.
Yiziphi iziguli ezidinga ukwelashwa komoya-mpilo isikhathi eside?
Njengamanje, abantu abathatha i-oksijeni yesikhathi eside ikakhulukazi bahlanganisa iziguli ezine-hypoxia engapheli ebangelwa ukungasebenzi kahle kwe-cardiopulmonary, njengeziguli ezine-COPD ephakathi nesikhathi esibulalayo, i-fibrosis ye-interstitial pulmonary fibrosis kanye nokungasebenzi kahle kwe-ventricular kwesokunxele. Izaguga zivame ukuba yizisulu eziyinhloko zalezi zifo.
Ukuhlukaniswa kokugeleza komoyampilo
Ukugeleza okuphansi kwe-oxygen inhalation oxygen concentration 25-29%,1-2L/min, ifanele iziguli ezine-hypoxia ehambisana nokugcinwa kwe-carbon dioxide, njenge-chronic obstructive pulmonary disease, uhlobo lwe-II ukwehluleka ukuphefumula, i-cor pulmonale, i-pulmonary edema, iziguli zangemva kokuhlinzwa, iziguli ezinokushaqeka, i-coma noma isifo sobuchopho, njll.
I-Medium-flow oxygen inhalation concentration 40-60%, 3-4L/min, ifanele iziguli ezine-hypoxia futhi azikho ukugcinwa kwe-carbon dioxide
I-high-flow oxygen inhalation ine-oksijeni ehogeliwe engaphezu kuka-60% nangaphezulu kuka-5L/min.. Ilungele iziguli ezine-hypoxia eqinile kodwa hhayi ukugcinwa kwe-carbon dioxide. Okufana nokuboshwa okunamandla kokuphefumula nokujikeleza kwegazi, isifo senhliziyo sokuzalwa esine-shunt esuka kwesokudla kuye kwesokunxele, ubuthi be-carbon monoxide, njll.
Kungani udinga i-oxygen ngemva kokuhlinzwa?
Ukubulala izinzwa nobuhlungu kungabangela kalula imingcele yokuphefumula ezigulini futhi kuholele ku-hypoxia, ngakho-ke isiguli sidinga ukunikezwa umoya-mpilo ukuze kwandiswe umfutho wegazi wesiguli onomoya-mpilo ngokwengxenye nokugcwala, ukukhuthaza ukuphulukiswa kwesilonda sesiguli, futhi kuvimbele ukulimala kobuchopho namangqamuzana e-myocardial. Yehlisa izinhlungu zesiguli zangemva kokuhlinzwa
Kungani ukhetha ukuhogela komoya-mpilo okugxilwe kancane ngesikhathi sokwelashwa komoya-mpilo ezigulini zamaphaphu ezingapheli?
Ngenxa yokuthi isifo se-pulmonary obstructive isifo esiqhubekayo esibangelwa ukulinganiselwa kokugeleza komoya, iziguli zinamazinga ahlukahlukene e-hypoxemia nokugcinwa kwe-carbon dioxide. Ngokwesimiso sokunikezwa komoya-mpilo “i-carbon dioxide yesiguli Lapho umfutho wengxenye yesikhutha ukhuphuka, ukuhogela umoya-mpilo okugxilile okuncane kufanele kunikezwe; lapho umfutho wengxenye yesikhutha uvamile noma uncishisiwe, ukuhogela umoya-mpilo okugxilile kunganikezwa.”
Kungani iziguli ezinokulimala kobuchopho zikhetha ukwelashwa komoyampilo?
Ukwelashwa nge-oxygen kungasiza ekuthuthukiseni umphumela wokwelapha weziguli ezinokulimala kobuchopho, kukhuthaze ukululama kwemisebenzi yezinzwa, kuthuthukise i-nerve cell edema kanye nokusabela kokuvuvukala, kunciphise ukulimala kwamangqamuzana ezinzwa ngezinto ezinobuthi ezingapheli njengama-radicals mahhala komoya-mpilo, futhi kusheshise ukubuyiswa kokulimala. izicubu zobuchopho.
Kungani ubuthi be-oxygen?
“Ubuthi” obubangelwa ukuhogela umoya-mpilo oweqile ngaphezu kwezidingo ezivamile zomzimba
Izimpawu ze-oxygen poisoning
Ubuthi be-oksijeni ngokuvamile bubonakala ngomthelela wawo emaphashini, nezimpawu ezifana ne-pulmonary edema, ukukhwehlela, nobuhlungu besifuba; okwesibili, kungase futhi kubonakale njengokungakhululeki kwamehlo, njengokukhubazeka okubukwayo noma ubuhlungu bamehlo. Ezimweni ezimbi kakhulu, kuzothinta isimiso sezinzwa futhi kuholele ekuphazamisekeni kwezinzwa. Ngaphezu kwalokho, ukuhogela umoya-mpilo owedlulele kungavimbela ukuphefumula kwakho, kubangele ukuboshwa kokuphefumula, futhi kube ukuphila engozini.
Ukwelashwa kobuthi be-oxygen
Ukuvimbela kungcono kunokwelapha. Gwema ukwelashwa komoya-mpilo okugxilisa ingqondo isikhathi eside. Uma kwenzeka, qala wehlise ukuhlushwa kwe-oxygen. Kudingeka ukunakwa okukhethekile: into ebaluleke kakhulu ukukhetha kahle nokulawula ukuhlushwa komoya-mpilo.
Ingabe ukuhogela umoya komoya njalo kuzodala ukuncika?
Cha, umoya-mpilo uyadingeka ukuze umzimba womuntu usebenze ngaso sonke isikhathi. Inhloso yokuhogela umoya-mpilo iwukuthuthukisa ukutholakala komoyampilo emzimbeni. Uma isimo se-hypoxic sithuthukisiwe, ungayeka ukuphefumula umoya-mpilo futhi ngeke kube nokuncika.
Kungani i-oxygen inhalation ibangela i-atelectasis?
Lapho isiguli sihogela umoya-mpilo ophezulu, inani elikhulu le-nitrogen ku-alveoli liyashintshwa. Uma sekunokuvinjelwa kwe-bronchi, umoya-mpilo ose-alveoli okungowawo uzomuncwa ngokushesha igazi lokujikeleza kwamaphaphu, okubangele i-atelectasis yokuhogela. Kubonakaliswa ukucasuka, ukuphefumula nokushaya kwenhliziyo. Ukusheshisa, umfutho wegazi uyakhuphuka, bese ungase uthole ubunzima bokuphefumula kanye ne-coma.
Izinyathelo zokuvimbela: Thatha umoya ojulile ukuze uvimbele uketshezi ekuvimbeni indlela yokuphefumula
Ingabe izicubu ze-retrolental fibrous zizokwanda ngemva kokuhogela umoya-mpilo?
Lo mphumela ubonakala kuphela ezinganeni ezisanda kuzalwa, futhi uvame kakhulu ezinganeni ezizalwa ngaphambi kwesikhathi. Ngokuyinhloko kungenxa ye-retinal vasoconstriction, i-retinal fibrosis, futhi ekugcineni iholela ebumpumputheni obungenakulungiseka.
Izinyathelo zokuvimbela: Uma izingane ezisanda kuzalwa zisebenzisa umoya-mpilo, ukugcwala komoyampilo kanye nesikhathi sokuhogela komoyampilo kufanele kulawulwe
Kuyini ukucindezeleka kokuphefumula?
Kuvamile ezigulini ezinohlobo lwe-II lokuhluleka kokuphefumula. Njengoba ukucindezela okuyingxenye ye-carbon dioxide sekunezinga eliphakeme isikhathi eside, isikhungo sokuphefumula silahlekelwe ukuzwela kwayo ku-carbon dioxide. Lesi yisimo lapho ukulawulwa kokuphefumula kugcinwa khona ngokuyinhloko ngokukhuthazwa kwama- peripheral chemoreceptors nge-hypoxia. Uma lokhu kwenzeka Lapho iziguli zinikezwa umoya-mpilo ophezulu wokugxilisa umoya ukuze ziwuhogele, umphumela ovuselelayo we-hypoxia ekuphefumuleni uzokhululeka, okuzokwandisa ukucindezeleka kwesikhungo sokuphefumula futhi kubangele ukuboshwa kokuphefumula.
Izinyathelo zokuvimbela: Nikeza ukugxila okuphansi, ukugeleza okuphansi kwe-oksijeni eqhubekayo (ukugeleza kwe-oksijeni 1-2L/min) ezigulini ezinokwehluleka ukuphefumula kwe-II ukugcina ukuphefumula okuvamile.
Kungani iziguli ezigula kakhulu zidinga ukuthatha ikhefu ngesikhathi sokuhogela umoya-mpilo ogeleza kakhulu?
Kulabo abanesimo esibucayi kanye ne-acute hypoxia, umoya-mpilo wokugeleza okuphezulu unganikezwa ku-4-6L/min. Lokhu kuhlushwa kwe-oksijeni kungafinyelela ku-37-45%, kodwa isikhathi akufanele sidlule imizuzu engu-15-30. Uma kunesidingo, sebenzisa futhi njalo ngemva kwemizuzu engu-15-30.
Ngenxa yokuthi isikhungo sokuphefumula salolu hlobo lwesiguli asizweli kangako ekugqugquzelweni kokugcinwa kwe-carbon dioxide emzimbeni, sithembele kakhulu emoyeni we-hypoxic ukuze sivuse ama-chemoreceptors omzimba we-aorta kanye ne-carotid sinus ukugcina ukuphefumula ngokusebenzisa i-reflexes. Uma isiguli sinikezwa i-oksijeni ephezulu, isimo se-hypoxic Lapho sikhululwa, ukukhuthazwa kwe-reflex yokuphefumula ngumzimba we-aortic kanye ne-carotid sinus kuba buthaka noma kunyamalale, okungabangela i-apnea futhi kubeke ukuphila engozini.
Isikhathi sokuthumela: Oct-23-2024