"Ngaphakathi kwezokwelapha ezibucayi, i-hypoxemia ethule iyaqhubeka njengento engavamile emtholampilo enemiphumela emibi kakhulu. Njengoba ibonakaliswa yi-oxygen desaturation ngaphandle kwe-dyspnea elinganayo (ebizwa ngokuthi 'i-hypoxia ethule'), lokhu kubonakaliswa okuxakile kusebenza njengesibonakaliso esibucayi sokwehluleka kokuphefumula okuzayo. Ubufakazi obukhulayo buqinisekisa indima yayo njengendlela efihliwe ye-pathophysiological, lapho ukuxilongwa okulibazisekile kunegalelo ekufeni okungavinjelwa kuzo zonke izifo ze-pneumonia, i-COVID-19, kanye nezimo zamaphaphu ezingamahlalakhona. I-New England Journal of Medicine muva nje iqokomise lokhu 'kuxakile kodokotela' - lapho umzamo ojwayelekile wokuphefumula ufihla khona ukushoda komoya-mpilo okubhubhisayo, kudinga ukuqapha okusha kwezokwelapha kanye nokuqapha izinguquko zephrothokholi."
Kuyini i-hypoxemia?
"I-Hypoxemia, echazwa njengokuntuleka kwe-pathological kokugcwala komoya-mpilo egazini lemithambo yegazi (i-PaO2 < 80 mmHg ezingeni lolwandle kubantu abadala), ivela lapho ingcindezi engaphelele iwela ngaphansi kwemingcele evamile elungisiwe ngokweminyaka (i-AARC Clinical Practice Guideline 2021). Amaqoqo asengozini enkulu abonisa amaphrofayili ahlukile e-pathophysiological:
- Ukungafani komoya/ukugeleza kwamanzi: Iziguli ezine-pneumonia enzima ezine-alveolar zingena ziphazamisa amandla okusabalalisa.
- Izindlela zokuhlasela kwenhliziyo: Amaqembu okwehluleka kwenhliziyo kwesobunxele/kwesokudla abonisa ukuvuvukala kwamaphaphu okubangelwa umfutho wegazi (PCWP >18 mmHg)
- Ukuphazamiseka kwemisipha: Izingane ezinemisipha ye-intercostal engakathuthuki kahle kanye nabantu abadala abanezinkinga ze-diaphragmatic
- Ukuchayeka okungapheli: Abasebenzisi bakagwayi ababonisa izinguquko zesakhiwo samaphaphu (i-emphysema, isigaba se-COPD-GOLD ≥2)
- Izimbangela ze-Iatrogenic: Iziguli ezithola ukucindezeleka kokuphefumula okubangelwa yi-opioid (RR <12/min) kanye ne-atelectasis
Okuphawulekayo ukuthi ama-38% eziguli ezihlinzwa esifubeni athola i-hypoxemia zingakapheli amahora angama-24 ngemuva kokuhlinzwa (i-ASA Closed Claims Data 2022), okugcizelela isidingo sokuqapha okuqhubekayo kwe-pulse oximetry kula maqembu abantu.
Ziyini izingozi ze-hypoxemia?
Ngokwezibalo zemitholampilo, izinga lokufa kweziguli ezine-hypoxemia enzima lingafinyelela ku-27%, kanti ezimweni ezimbi kakhulu, izinga lokufa lingafinyelela ngisho nangaphezu kuka-50%. Uma kungenziwa ukungenelela ngesikhathi esifanele ezigabeni zokuqala zesifo, imiphumela emibi ingase ivele.
- Umthelela ebuchosheni: Lapho amazinga omoya-mpilo egazini ehla (i-hypoxemia), ubuchopho bulahlekelwa umoya-mpilo. Lokhu kungabangela izimpawu ezisheshayo njengekhanda elibuhlungu eliqhubekayo, isiyezi esingazelelwe, kanye nokulahlekelwa yinkumbulo. Uma kungelashwa, ukulamba umoya-mpilo isikhathi eside kungalimaza amangqamuzana obuchopho, okungase kuholele ekushayweni yisifo sohlangothi okubangelwa ukuvinjelwa kokugeleza kwegazi (i-cerebral infarction) noma ukuqhekeka kwemithambo yegazi (i-cerebral hemorrhage). Ukuqashelwa kusenesikhathi kwalezi zimpawu eziyisixwayiso kubalulekile ukuvimbela umonakalo wezinzwa ohlala njalo.
- Umthelela enhliziyweni: Uma inhliziyo ingatholi umoya-mpilo owanele, ihluleka ukupompa kahle. Lokhu kucindezeleka kungabangela izimpawu eziyisixwayiso ezifana nokushaya kwenhliziyo okusheshayo noma okungajwayelekile, ukuqina kwesifuba (i-angina), kanye nokukhathala okungavamile. Ngokuhamba kwesikhathi, ukuswela umoya-mpilo okungalashwanga kungenza buthaka imisipha yenhliziyo, okungase kuholele ezinkingeni ezisongela ukuphila njengokwehluleka kwenhliziyo, lapho inhliziyo ingakwazi ukuhlangabezana nezidingo zomzimba.
- Umthelela emaphashini: Amazinga aphansi omoya-mpilo aphoqa amaphaphu ukuba asebenze kanzima ukuze nje ahambisane nawo. Ngokuhamba kwesikhathi, lolu hlobo lomoya-mpilo lungalimaza imigudu yomoya kanye nezicubu zamaphaphu, okwandisa ingozi yokuthola izinkinga zokuphefumula njenge-COPD (isifo samaphaphu esingamahlalakhona). Ezimweni ezimbi kakhulu, ukushoda komoya-mpilo isikhathi eside kungase kwenze inhliziyo ibe buthaka njengoba izama ukupompa igazi emaphashini aqinile, isimo esaziwa ngokuthi i-cor pulmonale.
- Imiphumela yomzimba wonke: Ukuntuleka komoya-mpilo okungapheli kuthinta zonke izitho njengemoto esebenzisa uphethiloli omncane. Izinso nesibindi kancane kancane ziba nzima ukuhlunga ubuthi, kuyilapho isimiso somzimba sokuzivikela siba buthaka, okwenza kube nzima ukulwa nezifo ezivamile. Ngokuhamba kwesikhathi, lesi sikweletu somoya-mpilo esithule sandisa izingozi zokulimala kwezitho futhi sishiya umzimba usengozini yezinkinga zempilo ezinkulu - kusukela ezifweni ezivamile kuya ezibazini ezihlala njalo zezitho. Lokhu kwenza ukuqapha izinga lomoya-mpilo kusenesikhathi kubaluleke kakhulu ekuvimbeleni izinkinga zezitho eziningi.
Unganquma kanjani ukuthi une-hypoxemia?
Amazinga omoya-mpilo egazini ayisilinganiso esibalulekile sokuthola ukuntuleka komoya-mpilo. Kubantu abaphilile, ukufundwa okuvamile kusuka ku-95% kuya ku-100%. Amazinga aphakathi kuka-90-94% abonisa ukuntuleka komoya-mpilo okuncane, okungase kungabonakali izimpawu ezisobala. Ukwehla kuya ku-80-89% kukhombisa ukuntuleka komoya-mpilo okulinganiselwe, okuvame ukubangela ukuphefumula kanzima noma ukudideka. Ukufundwa okungaphansi kuka-80% kumelela isimo esiphuthumayo esinzima, lapho izitho ezibalulekile zisengozini yokulimala ngenxa yokuntuleka komoya-mpilo okukhulu futhi zidinga ukunakekelwa kwezokwelapha okusheshayo.
Ungakugcina kanjani ukugcwala kwe-oxygen egazini okuvamile?
- Vula amafasitela ukuze kungene umoya
Vuselela umoya wakho wangaphakathi ngokuvula amafasitela nsuku zonke ukuze usakaze umoya-mpilo omusha. Ukuze uthole imiphumela engcono, vakashela amapaki ngezikhathi ezithile noma izindawo ezicebile ngokwemvelo ngaphandle kwezindawo zasemadolobheni ukuze uphefumule ngokujulile nangokuhlanzekile okusiza ukuvuselela amazinga omoya-mpilo emzimbeni wakho.
- Ama-aerobics
Imisebenzi ejwayelekile yokuzivocavoca njengokuhamba ngokushesha, ukubhukuda, noma ukugibela ibhayisikili ingathuthukisa ukugeleza kwegazi kanye nokujikeleza komoya-mpilo. Khetha izinketho eziphansi njenge-water aerobics noma ukugijima kancane uma usanda kuqala ukuzivocavoca - lokhu kuzivocavoca okuthambile kuthuthukisa ngokuphephile ukulethwa komoya-mpilo ngenkathi kwakhiwa amandla ngokuhamba kwesikhathi.
- Ukwelashwa komoya-mpilo ekhaya
Kubantu abanezinkinga zokuphefumula ezingamahlalakhona abanenkinga yamazinga aphansi omoya-mpilo, ukusebenzisa idivayisi yomoya-mpilo yasekhaya kungasiza ekugcineni umoya-mpilo ungena kahle. Odokotela bavame ukuncoma ukuqala ngama-concentrator omoya-mpilo aphathwayo ngesikhathi sokulala noma imisebenzi yansuku zonke - uma kusetshenziswa njengoba kuqondisiwe, lokhu kwelashwa kungathuthukisa amazinga amandla, kunciphise ukuphefumula, futhi kusekele ikhwalithi yokulala engcono.
Isikhathi sokuthunyelwe: Ephreli-25-2025