Chii chinonzi oxygen therapy, yakakosha mhando uye ndeyei

Zvemukati

• Mhando huru dzeoksijeni kurapa
• 1. Low kuyerera masisitimu
• 2. Yepamusoro kuyerera masystem
• 3. Mhepo isina-invasive kufefetedza
• Chii ichochi
• Kuchengeta kana uchishandisa pamba

Oxygen therapy inosanganisira kupa yakawanda oksijeni kupfuura inowanikwa munzvimbo yakasikwa uye inotarisira kuvimbisa oxygenation yemaviri materu. Mimwe mamiriro ezvinhu anogona kukonzeresa kudzikisira kupihwa kweoksijeni kumapapu nematukisi, sezvinoitika muchirwere chisingaperi chisingabvumirwe chemapapu, chinozivikanwa seCOPD, asthma attack, apnea yekurara uye pneumonia uye nekudaro, mune idzi kesi, kurapwa kweoksijeni kunogona kudikanwa.

Mushonga uyu unoratidzwa neanowanzo shanda kana pulmonologist mushure mekusimbisa yakaderera mwero weoxygen muropa, nekuita arterial ropa magasi, inova iyo bvunzo yeropa inounganidzwa kubva muchiuno chetsinga, uye pulse oximetry, inoitwa nenzira yekutarisa kwe oxygen saturation uye inofanira kunge iri pamusoro pe90%. Tsvaga zvimwe pamusoro pekuti pulse oximetry inoitwa sei.

Rudzi rwekurapa kweoksijeni kunoenderana nedanho rekufema kwemunhu uye zviratidzo zvehypoxia, uye kushandiswa kwekateti yemhino, kumeso kumeso kana Venturi kunogona kukurudzirwa. Mune zvimwe zviitiko, CPAP inogona kuratidzwa kuti ifambise kupinda kwe oxygen mumhepo.

Mhando huru dzeoksijeni kurapa

Kune akatiwandei marudzi eoksijeni kurapwa ayo akasarudzika zvinoenderana neoksijeni kuwanda kwakaburitswa, uye chiremba achakurudzira iyo mhando zvinoenderana nezvinodiwa nemunhu, pamwe nedhigiri rekufema kutambudzika uye kana munhu achiratidza zviratidzo zvehypoxia, senge purplish muromo neminwe, kutonhora ziya uye kuvhiringidzika kwepfungwa. Nekudaro, iwo makuru marudzi eoksijeni kurapa anogona kuve:

1. Low kuyerera masisitimu

Rudzi urwu rwe oxygen therapy inokurudzirwa kune vanhu vasingade huwandu hwakawanda hwe oxygen uye kuburikidza neaya masisitimu zvinokwanisika kuendesa okisijeni kune yemhepo inoyerera inoyerera inosvika 8 litita paminiti kana iine FiO2, inonzi chidimbu cheakafuridzirwa okisijeni, kubva ku60%. Izvi zvinoreva kuti pamhepo yese iyo munhu anozofema, 60% ichave oxygen.

Zvishandiso zvinoshandiswa zvakanyanya mumhando iyi ndezvi:

• Nasal catheter: ipurasitiki chubhu ine mhepo mbiri dzinofema dzinofanirwa kuiswa mumhino uye, paavhareji, dzinopa kupa okisijeni pa2 litita paminiti;
• Nasal cannula kana eyeglass catheter: inogadzirwa sekapu diki yakatetepa ine maburi maviri kumucheto kwayo uye inounzwa mumhino yemhino nechinhambwe chakaenzana nehurefu pakati pemhino nenzeve uye inokwanisa kuendesa oxygen kusvika kumasere masere paminiti;
• Chiso mask: inoumbwa nemasikisi epurasitiki anofanirwa kuiswa pamusoro pemuromo nemhino uye anoshanda kupa okisijeni mukuyerera kwakakwirira kupfuura macatheta nemakomba emazino, pamusoro pekushandira vanhu vanofema zvakanyanya kuburikidza nemuromo, semuenzaniso;
• Mask ine dura: iri masiki ine inflatable bhegi rakasungirirwa uye rinokwanisa kuchengeta kusvika 1 litre yeoksijeni. Kune mhando dzemasiki dzine matura, anonzi masks asingadzokere shure, ane vharuvhu inotadzisa munhu kufema mu carbon dioxide;
• Tracheostomy mask: iyo yakaenzana nerudzi rwe oxygen mask kunyanya kune vanhu vane tracheostomy, inova cannula yakaiswa mutrachea yekufema.

Uye zvakare, kuitira kuti okisijeni inyurwe nemapapu zvakanaka, zvakakosha kuti munhu wacho asave nezvimisikidzo kana zvinyoro mumhino, uyezve, kuti arege kuomesa mucosa yemumhepo, zvakafanira kushandisa humidification kana inoyerera inoyerera iri pamusoro pemarita mana paminiti.

2. Yepamusoro kuyerera masystem

Yepamusoro kuyerera masystem anokwanisa kupa yakanyanya kuwanda kweoksijeni, pamusoro peizvo munhu anokwanisa kufema uye zvinoratidzwa mune zvakanyanya kukomba zviitiko, mune mamiriro ehypoxia inokonzerwa nekutadza kufema, pulmonary emphysema, acute lung edema kana pneumonia. Ona zvimwe chii chinonzi hypoxia uye inogona kuitika sequelae kana ikasiiwa isina kurapwa.

Venturi mask ndiyo nzira yakajairika yerudzi urwu rwekurapa kweoksijeni, sezvo iine maadapter akasiyana anoshanda kupa chaiwo uye akasiyana mazinga eokisijeni, zvinoenderana neruvara. Semuenzaniso, iyo adapta yepingi inopa 40% okisijeni muhuwandu hwe15 litita paminiti. Ichi chifukidzo chine maburi anotendera mweya wakaburitswa kubuda, uyo une kabhoni dhayokisaidhi, uye inoda humidification kuitira kuti isakonzere kuti nzira dzemhepo dziome.

3. Mhepo isina-invasive kufefetedza

Uninvasive ventilation, inozivikanwawo seNIV, inoumbwa nemhepo inotsigira inoshandisa yakanaka kumanikidza kufambisa kupinda kwe oxygen mumhepo. Iyi nzira inoratidzirwa neyemapapuologist uye inogona kuitwa nemukoti kana physiotherapist mune vanhu vakuru vane mweya wekufema uye vane mweya wekufema pamusoro pe25 kufema paminiti kana kuzadza kweoksijeni pazasi pe90%.

Kusiyana nedzimwe mhando, nzira iyi haina kushandiswa kupa yakawedzera okisijeni, asi inoshanda kuita kuti kufema kuvhurezve pulmonary alveoli, kugadzirisa kuchinjana gasi uye kudzikira kwekufema uye inokurudzirwa kune vanhu vane hope dzekufema uye vane zvirwere zvemwoyo.

Uye zvakare, kune akati wandei mhando dzeNIV masiki dzinogona kushandiswa pamba uye dzinosiyana zvichienderana nehukuru hwechiso uye kuchinjika kwemunhu wega wega, neCPAP iri iri mhando yakajairika. Tarisa uone zvimwe nezve izvo CPAP uye kuti ungashandise sei.

Chii ichochi

Oxygen therapy inokurudzirwa nachiremba kuti awedzere kuwanikwa kweoksijeni mumapapu uye zvinyama zvemuviri, kudzikisira mhedzisiro yakaipa yehypoxia, uye inofanirwa kuitwa kana munhu aine oxygen saturation pazasi pe90%, kukwana kumanikidzwa kweoksijeni, kana PaO2 , isingasviki 60 mmHg, kana kana mamiriro akaita se:

• Kukundikana kwakanyanya kana kusingaperi kwekufema;
• Chisingaperi obstructive pulmonary chirwere;
• Pulmonary emphysema;
• Asthma kurwisa;
• Carbon monoxide chepfu;
• Kudzivisa kufema kufema;
• Cyanide chepfu;
• Post-yokutindivadza kupora;
• Cardiorespiratory kusungwa.

Rudzi urwu rwekurapa runoratidzwawo muzviitiko zveakakomba myocardial infarction uye isina kugadzikana angina pectoris, nekuti okisijeni inopa inogona kudzikisa zviratidzo zvehypoxia, inokonzerwa nekukanganisa kweropa kuyerera, ichiwedzera huwandu hweoksijeni muropa uye, nekudaro, mune alveoli yemapapu.

Kuchengeta kana uchishandisa pamba

Mune zvimwe zviitiko, vanhu vane chirwere chisingaperi chekufema, senge COPD, vanofanirwa kushandisa oxygen rutsigiro kwemaawa makumi maviri nemana pazuva uye nekuda kwechikonzero ichi, oxygen therapy inogona kushandiswa pamba. Mushonga uyu unoitwa pamba kuburikidza nekachetere kemumhuno, akaiswa mumhino, uye oxygen inopihwa kubva musilinda, inova mudziyo wesimbi unochengeterwa oxygen uye chete huwandu hunorayirwa nachiremba hunofanira kupihwa.

Iwo ma oxygen cylinders anoitwa kuti awanikwe nemamwe mapurogiramu eSUS kana anogona kubhadharwa kubva kumakambani ezvekurapa-zvipatara uye anogona kutakurwa kuburikidza nerutsigiro nemavhiri uye anogona kuendeswa kunzvimbo dzakasiyana. Nekudaro, kana uchishandisa macilindiro eoksijeni, dzimwe nzira dzekudzivirira dzinodiwa, sekusasvuta paunenge uchishandisa okisijeni, kuchengetedza humburumbira kure nemurazvo uye kudzivirirwa kubva kuzuva.

Zvakare, munhu anoshandisa oxygen kumba anoda kuwana mukana wekurova oximetry zvishandiso kutarisa kuzadza uye kana ari munhu anoratidza zviratidzo zvakaita semiromo yepepuru nezvigunwe, dzungu nekufenda, unofanira kubva waenda kuchipatara, nekuti unogona kunge uine yakaderera mwero weoxygen muropa rako.