Kodi mukuyang'ana kuti mumvetsetse momwe ma nasal cannula oxygen therapy amathandizira kwambiri kupuma? Nkhaniyi ikutsikira mozama pazabwino, kagwiritsidwe ntchito, ndi maubwino a njira yoperekera okosijeni yapamwambayi. Tidzafufuza chifukwa chake ikukhala kusintha kwamasewera pazaumoyo, kupereka njira yabwino komanso yothandiza yoperekera mpweya wowonjezera. Pitirizani kuwerenga kuti muwone momwe chithandizo chamankhwala cha nasal cannula chimatha kusintha zotsatira za odwala ndikuwongolera chisamaliro cha kupuma.
1. Kodi High-Flow Nasal Cannula Oxygen Therapy ndi Chifukwa Chiyani Ndi Njira Yapamwamba Yoperekera Oxygen?
High-flow nasal cannula (HFNC) oxygen therapy ndi njira yapamwamba yoperekera chithandizo cha kupuma kwa odwala omwe amafunikira mpweya wowonjezera. Mosiyana ndi machitidwe achikhalidwe operekera okosijeni, HFNC imatha kupereka okosijeni pamayendedwe okwera kwambiri, nthawi zambiri kuyambira 3 mpaka 50 kuchulukitsa kwa cannula wamba. Kuthekera kumeneku kopereka okosijeni wothamanga kwambiri ndi komwe kumasiyanitsa ndikupangitsa kuti ikhale njira yabwino kwambiri yoperekera okosijeni m'machipatala ambiri.
Njira zachikhalidwe, monga ma cannulas osavuta amphuno kapena masks amaso, zimatengedwa ngati chithandizo chochepa cha okosijeni. Makinawa nthawi zambiri amapereka okosijeni pamlingo wothamanga mpaka malita 6 pamphindi (LPM). Mosiyana ndi izi, chithandizo chamankhwala cha nasal cannula chothamanga kwambiri chimatha kutulutsa kuchuluka kwa malita 60 pamphindi, ndipo nthawi zina kupitilira apo. Kuthamanga kwapamwamba kumeneku kumapereka ubwino wambiri. Choyamba, imatha kukwaniritsa zofunikira zolimbikitsa za wodwala, makamaka pakuwonjezeka kwa kupuma kapena kupsinjika. Kachiwiri, mpweya wotenthedwa komanso wonyowa womwe umaperekedwa kudzera m'mphuno umayenda bwino kwambiri umathandizira kutonthoza mtima kwa odwala ndikuchepetsa kuyanika kwa mucosa wamphuno, nkhani yodziwika ndi chithandizo chachikhalidwe cha okosijeni. Chifukwa chakutha kwake kupereka njira yolondola komanso yabwino yoperekera chithandizo cha okosijeni, HFNC ikukondedwa kwambiri m'malo osiyanasiyana azachipatala.
2. Kodi Kuchiza kwa Cannula Kumathamanga Kwambiri Kumasiyana Bwanji ndi Chizoloŵezi Chachikale Chopanda Oxygen?
Kusiyana kwakukulu pakati pa chithandizo chamankhwala cha nasal cannula chothamanga kwambiri ndi kutsika kwa mpweya wa okosijeni kumakhala pakuyenda kwa mpweya woperekedwa kwa wodwalayo. Makina oyenda pang'onopang'ono, monga ma cannula a m'mphuno, amapangidwa kuti azipereka mpweya pamayendedwe oyenda mpaka 6 LPM. Izi ndizoyenera kwa odwala omwe amafunikira mpweya wocheperako wowonjezera. Komabe, kuchuluka kwa okosijeni komwe kumaperekedwa ndi machitidwe otsika kumatha kukhala kosiyanasiyana ndipo zimatengera kupuma kwa wodwalayo komanso kuchuluka kwa mafunde. Cannula yosavuta ya m'mphuno imatha kupereka kachigawo kakang'ono ka mpweya wouziridwa (FiO2), ndipo nthawi zambiri izi sizimayendetsedwa bwino.
Komano, chithandizo cha nasal cannula chothamanga kwambiri, chimagwiritsa ntchito chipangizo chapadera kuti chipereke mpweya wotentha ndi wonyowa pamayendedwe othamanga kuyambira 15 mpaka 60 LPM, ndipo nthawi zina apamwamba. Kuthamanga kwakukulu kumeneku kumapereka mpweya wokhazikika komanso wodziwikiratu kwa wodwalayo. Kuphatikiza apo, kutenthedwa ndi kunyowa kwamankhwala othamanga kwambiri a nasal cannula oxygen ndikofunikira. Mpweya wa okosijeni wachikhalidwe, makamaka ukaperekedwa pamalo okwera kwambiri, ukhoza kukhala wouma komanso wokwiyitsa m'njira za m'mphuno ndi mpweya. Mpweya wotentha ndi wonyezimira umathandiza kupewa kuyanika kwa mphuno ya m'mphuno, kumachepetsa kukana kwa mpweya, komanso kumapangitsa kuti mucociliary chilolezo chikhale bwino - njira yachilengedwe yochotsera ntchofu kuchokera ku airways. Izi zimapangitsa kuti chithandizo cha nasal cannula chikhale chofewa komanso chothandiza kwambiri kwa odwala omwe amafunikira chithandizo chanthawi yayitali kapena chokwera kwambiri.
3. Kodi Ubwino Waukulu Wotani Wothandizira Kuchiritsa kwa Cannula kwa Odwala Ofunikira Oxygen Therapy?
Thandizo lapamwamba la nasal cannula limapereka ubwino wambiri kwa odwala omwe amafunikira chithandizo cha okosijeni. Chimodzi mwazinthu zabwino kwambiri ndikusintha kwa oxygenation. Popereka okosijeni pamtunda wothamanga kwambiri, HFNC ikhoza kukwaniritsa kapena kupitirira zofuna zolimbikitsa za wodwalayo, kuonetsetsa kuti pali gawo lokhazikika komanso lapamwamba la okosijeni wouziridwa. Izi ndizopindulitsa makamaka kwa odwala omwe ali ndi vuto la kupuma kapena omwe akugwira ntchito mwakhama kuti apume. Mwachitsanzo, wodwala chibayo kapena matenda opumira kwambiri (ARDS) amatha kupuma kwambiri ndipo amafunikira mpweya wochulukirapo. Thandizo la nasal cannula lothamanga kwambiri limatha kupereka mpweya wofunikira pazochitika izi.
Phindu lina lalikulu ndi kutonthoza mtima kwa odwala. Mpweya wotentha komanso wonyezimira umakhala wofewa kwambiri m'mitsempha ya m'mphuno poyerekeza ndi mpweya wouma, wozizira wochokera ku machitidwe achikhalidwe. Izi zimachepetsa kuuma kwa mphuno, kupsa mtima, ndi kusamva bwino, kuwongolera kulolerana kwa odwala komanso kutsatira chithandizo cha okosijeni. Odwala amathanso kudya, kulankhula, ndi kutsokomola mosavuta ndi cannula ya m'mphuno poyerekeza ndi chigoba chakumaso chowagwira, zomwe zimawalimbikitsa kwambiri.
Kuphatikiza apo, chithandizo chamankhwala cha nasal cannula chothamanga kwambiri chikhoza kuchepetsa ntchito yopuma. Kuthamanga kwambiri kwa mpweya kungapangitse pang'ono mpweya wabwino wa mpweya, zomwe zimathandiza kuti mpweya waung'ono m'mapapo ukhale wotseguka komanso kuchepetsa kuyesetsa komwe kumafunika kupuma. Izi ndizothandiza makamaka kwa odwala omwe ali ndi matenda monga chronic obstructive pulmonary disease (COPD) kapena kulephera kwa mtima, komwe kupuma kumatha kugwira ntchito. Kafukufuku wachipatala awonetsanso kuti chithandizo chamankhwala chothamanga kwambiri cha nasal cannula chingachepetse kufunikira kwa intubation ndi makina mpweya wabwino m'magulu ena odwala, zomwe zimapangitsa kuti pakhale zotsatira zabwino komanso nthawi yayitali m'chipatala. Ponseponse, kuphatikiza kupititsa patsogolo katulutsidwe wa okosijeni, chitonthozo chowonjezereka, komanso kupuma pang'ono kumapangitsa kuti chithandizo cha nasal cannula chikhale chida champhamvu pakusamalira kupuma.
4. Ndi Muzochitika Zotani Zachipatala ndi Njira Yoperekera Oxygen Yothamanga Kwambiri?
Kuthamanga kwambiri kwa nasal cannula therapy kwasanduka njira yoperekera mpweya wabwino m'zochitika zosiyanasiyana zachipatala, makamaka pamene odwala amafunikira thandizo lalikulu la kupuma koma sakusowa kapena okonzekera mpweya wabwino wa makina. Mmodzi wamba ntchito ndi pa matenda pachimake kupuma kulephera. Odwala omwe ali ndi matenda monga chibayo, bronchiolitis (makamaka ana), komanso kuwonjezereka kwa COPD nthawi zambiri amapindula ndi mankhwala othamanga kwambiri a nasal cannula. Pazifukwa izi, zitha kuthandizira kupititsa patsogolo mpweya wabwino, kuchepetsa kupsinjika kwa kupuma, komanso kupewa kufunikira kwa njira zophatikizira ngati intubation.
Thandizo la post-extubation ndi malo ena ofunikira kumene cannula yamphuno yothamanga kwambiri ikugwiritsidwa ntchito kwambiri. Wodwala akakhala pa makina opumira mpweya ndipo amatuluka (chubu chopumira chachotsedwa), amakhala pachiwopsezo cha kupuma kapena kulephera. Kafukufuku wambiri, kuphatikizapo kafukufuku wokhudzana ndi zotsatira za postextubation high-flow nasal cannula, asonyeza kuti kugwiritsa ntchito phokoso lamphuno lamphuno pambuyo potuluka kungathe kuchepetsa chiopsezo cha kubwezeretsanso poyerekeza ndi chikhalidwe chochepa cha okosijeni kapena mpweya wosavuta wa m'mphuno. Izi ndizofunikira makamaka kwa odwala omwe amawonedwa kuti ali pachiwopsezo chachikulu chazovuta za kupuma pambuyo potulutsa.
Mu dipatimenti yodzidzimutsa, cannula ya m'mphuno yothamanga kwambiri ikhoza kukhala yofunikira kuti mpweya ukhale wofulumira kwa odwala omwe ali ndi vuto lalikulu la kupuma. Zimalola kulowererapo kwa okosijeni mwachangu komanso kothandiza popanda kufunikira kwa masks olimba, omwe amatha kulekerera bwino. Kuphatikiza apo, m'malo osamalira odwala, cannula yamphuno yothamanga kwambiri imatha kupereka chithandizo chabwino komanso chothandiza cha okosijeni kwa odwala omwe ali ndi matenda omaliza kupuma, kuwongolera moyo wawo pochepetsa kupuma. Kusinthasintha komanso kugwira ntchito kwa cannula yamphuno yothamanga kwambiri kumapangitsa kuti ikhale chida chofunikira pazachipatala zosiyanasiyana komanso odwala omwe akufunika thandizo lalikulu la kupuma.
5. Kodi Cannula Yothamanga Kwambiri ya Nasal Imakulitsa Bwanji Chitonthozo ndi Kulekerera Odwala Poyerekeza ndi Zida Zina Zoperekera Oxygen?
Chitonthozo ndi kulolerana kwa odwala zimakula kwambiri ndi chithandizo chamankhwala chothamanga kwambiri cha nasal cannula poyerekeza ndi zida zina zambiri zoperekera okosijeni, makamaka masks amaso achikhalidwe. Chimodzi mwa zifukwa zazikulu za chitonthozo ichi ndi kusungunuka ndi kutentha kwa mpweya. Thandizo lachizoloŵezi la okosijeni, makamaka pamlingo wothamanga kwambiri, limapereka mpweya wouma, wosasunthika m'mitsempha yamphuno. Izi zingayambitse kuyanika kwakukulu kwa mucosa ya m'mphuno, kuchititsa kusapeza bwino, kutulutsa magazi m'mphuno, ndi kuwonjezeka kwa ntchofu. Mpweya wotentha wa okosijeni wothamanga kwambiri wa nasal cannula umatsutsana ndi kuyanika uku, kusunga mucosal hydration ndi chitonthozo.
Masks amaso, ngakhale amatha kutulutsa mpweya wambiri, nthawi zambiri amakhala ndi claustrophobic komanso amaletsa odwala. Angathenso kuchititsa kuti zikhale zovuta kudya, kumwa, kapena kulankhulana bwino. Mosiyana ndi izi, cannula ya m'mphuno, ngakhale mphuno yotambasula yomwe imagwiritsidwa ntchito pothamanga kwambiri, imakhala yochepa kwambiri. Odwala amatha kudya, kulankhula, ndi kutsokomola mosavuta popanda kusokoneza chithandizo chawo cha okosijeni pogwiritsa ntchito kansalu kothamanga kwambiri. Izi ndizopindulitsa makamaka kwa odwala omwe amafunikira thandizo la oxygen kwa nthawi yayitali kapena omwe ali tcheru komanso olankhulana.
Kuphatikiza apo, cannula ya m'mphuno imalola kutulutsa bwino kwa zotulutsa. Ndi masks amaso, zotsekemera zimatha kubisala pansi pa chigoba, zomwe zitha kukulitsa chiwopsezo cholakalaka kapena kusapeza bwino. Kutseguka kwa cannula ya m'mphuno kumapangitsa kuti kukhale kosavuta kutulutsa katulutsidwe, kulimbikitsa ukhondo wapanjira. Kuphatikiza kwa okosijeni wonyezimira komanso wotenthetsera, mawonekedwe ocheperako, komanso kuthekera kodya ndi kulankhulana bwino kumapangitsa kuti cannula yamphuno yothamanga kwambiri ikhale yothandiza odwala kwambiri poyerekeza ndi zida zambiri zachikhalidwe zoperekera mpweya. Kutonthozedwa kotereku kungayambitse kutsata bwino kwa odwala, kulandira chithandizo kwanthawi yayitali ngati pakufunika, komanso kukhala ndi chidziwitso chabwino ndi chithandizo cha okosijeni.
6. Ndi Mulingo Wanji Woyenda Umene Umagwiritsidwa Ntchito Pochiza Oxygen Oxygen Othamanga Kwambiri M'mphuno Ndipo Amasinthidwa Motani?
Mlingo wothamanga womwe umagwiritsidwa ntchito pamankhwala othamanga kwambiri a nasal cannula oxygen umasinthasintha kwambiri ndipo zimatengera zosowa za wodwala payekha komanso momwe wodwalayo alili. Mosiyana ndi cannula ya m'mphuno yotsika kwambiri, komwe mitengo yothamanga imayikidwa pa 6 LPM, makina othamanga kwambiri amatha kutulutsa mitengo mpaka 60 LPM, ndipo nthawi zina ngakhale apamwamba. Kuthamanga koyambirira kumayikidwa potengera kupuma kwa wodwalayo komanso kuchuluka kwa oxygen. Malo oyambira omwe amapezeka pafupifupi 20-30 LPM, koma ichi ndi chitsogozo chabe ndipo chiyenera kukhala payekha.
Kuthamanga kumayendetsedwa mosamala, kapena kusinthidwa, kutengera kuyang'anira kosalekeza kwa kuyankha kwachipatala kwa wodwalayo. Zofunikira zomwe zimayang'aniridwa ndi monga kuchuluka kwa okosijeni (SpO2), kugunda kwamtima, kugunda kwa mtima, ndi kupuma kwa mpweya. Cholinga ndi kukwaniritsa ndi kusunga mpweya wokwanira wa okosijeni (kawirikawiri pamwamba pa 92-94%, koma zolinga zimatha kusiyana malinga ndi momwe wodwalayo alili) pamene kuchepetsa zizindikiro za kupuma. Ngati mpweya wa okosijeni wa wodwalayo uli wochepa kapena akuwonetsabe zizindikiro za kuwonjezereka kwa kupuma, kuthamanga kwa magazi kumatha kuwonjezeka pang'onopang'ono. Mosiyana ndi zimenezi, ngati mpweya wa okosijeni umakhala wokwera kwambiri ndipo wodwalayo ali womasuka, kuthamanga kwake kungathe kuchepetsedwa mpaka kutsika kwambiri.
Kusintha kwa kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe kake. Sizongokhudza kukwaniritsa chiwerengero cha mpweya wa okosijeni, komanso kuyesa chithunzi chonse cha wodwalayo. Zinthu monga chomwe chimayambitsa kuvutika kupuma, msinkhu wa wodwalayo, ndi zovuta zilizonse zimakhudzanso kusintha kwa kayendedwe kake. Kuwunika pafupipafupi komanso kutchulidwa kwa akatswiri azachipatala ndikofunikira kuti kuwongolera chithandizo cham'mphuno cham'mphuno ndikuwonetsetse kuti chikukwaniritsa zosowa za kupuma kwa wodwalayo.
7. Kodi Cannula Ya M'mphuno Yothamanga Kwambiri Imagwira Ntchito Mwachangu pa Ulamuliro wa Oxygen wa Emergency and Respiratory Distress?
Inde, cannula yamphuno yothamanga kwambiri imakhala yothandiza kwambiri pakuwongolera mpweya wadzidzidzi komanso kuyang'anira odwala omwe ali ndi vuto la kupuma. Kuchita kwake mwachangu komanso kuthekera kopereka mpweya wambiri wa okosijeni kumapangitsa kuti ikhale chida chofunikira pakagwa mwadzidzidzi. Pakakhala pachimake hypoxemia (kuchepa kwa okosijeni m'magazi) kapena kupuma movutikira, kuperekera kwa okosijeni munthawi yake ndikofunikira. Mphuno yam'mphuno yothamanga kwambiri imatha kupereka chithandizo chachangu chotere, nthawi zambiri mogwira mtima kuposa machitidwe otsika otsika kapenanso masks amaso wamba.
Muzochitika zadzidzidzi monga dipatimenti yazadzidzidzi kapena chipatala chachikulu, odwala amatha kukhala ndi zovuta zosiyanasiyana zomwe zimayambitsa kupuma, monga kuchulukirachulukira kwa mphumu, chibayo chachikulu, kapena kulephera kwamtima. Muzochitika izi, kugwiritsa ntchito cannula yamphuno yothamanga kwambiri kumapangitsa kuti pakhale chithandizo chowonjezera cha okosijeni. Kuthamanga kwapamwamba kumatha kupititsa patsogolo kuchuluka kwa mpweya wa okosijeni ndikuchepetsa ntchito zina za kupuma, kupereka chithandizo chofunikira pamene njira zina zowunikira ndi chithandizo zikugwiritsidwa ntchito.
Poyerekeza ndi zida zina zadzidzidzi za okosijeni monga masks osapumiranso, cannula yamphuno yothamanga kwambiri imapereka maubwino angapo pamikhalidwe yovuta. Nthawi zambiri amalekerera bwino, kulola nthawi yayitali yogwiritsidwa ntchito popanda kukhumudwa kwakukulu. Zimathandizanso kuti pakhale kulankhulana kosavuta komanso mwayi wopezeka pakamwa, zomwe ndizofunikira kwambiri pakagwa mwadzidzidzi. Kuphatikiza apo, mpweya wotenthedwa ndi wonyowa ungakhale wopindulitsa kuyambira pachiyambi, kuchepetsa kukwiya kwapanjira komanso kukonza makina onse opumira. Ngakhale kuti cannula yamphuno yothamanga kwambiri singakhale yoyenera pazochitika zilizonse zadzidzidzi kupuma (mwachitsanzo, pakufunika FiO2 yachangu kapena yotetezeka kwambiri) ndi njira yabwino kwambiri komanso yowonjezereka kwa odwala ambiri omwe ali ndi vuto la kupuma lofuna mpweya wowonjezera.
8. Kodi Zowopsa Zomwe Zingatheke ndi Zolingaliridwa Ndi Chiyani Mukamagwiritsa Ntchito Kuchiza Kwa Cannula Kothamanga Kwambiri?
Ngakhale kuti mankhwala a cannula othamanga kwambiri nthawi zambiri amakhala otetezeka komanso olekerera, pali zoopsa zomwe zingachitike komanso malingaliro omwe othandizira azaumoyo ayenera kudziwa. Chofunikira chimodzi chofunikira ndikuthekera kwa barotrauma, kapena kuvulala kwamapapo chifukwa chopanikizika kwambiri. Ngakhale cannula yam'mphuno yothamanga kwambiri imatulutsa mpweya wochepa kwambiri poyerekeza ndi mpweya wabwino wamakina, kuthamanga kwambiri, makamaka kwa odwala omwe ali ndi vuto linalake la m'mapapo, mwachidziwitso kungayambitse kuchulukitsitsa kwamapapo kapena kuvulala. Chifukwa chake, kuyang'anira mosamalitsa makina opumira komanso kutsika koyenera koyenda ndikofunikira.
Kuganiziranso kwina ndiko kuwopsa kwa kawopsedwe wa okosijeni. Ngakhale kuti sizodziwika kwambiri ndi mpweya wa cannula wa m'mphuno ndi njira zapamwamba zoperekera za FiO2 monga masks, kuwonetseredwa kwa nthawi yayitali ndi mpweya wochuluka kungayambitse poizoni wa okosijeni m'mapapo. Izi ndizodetsa nkhawa mukamagwiritsa ntchito cannula yamphuno yothamanga kwambiri kwa nthawi yayitali pamakonzedwe apamwamba kwambiri a FiO2. Kagawo kakang'ono ka okosijeni wouziridwa kamayenera kuchepetsedwa mwachangu momwe zingathere kuti achepetse ngoziyi.
Kupsa mtima ndi kuuma kwa mphuno, ngakhale kuti sikumveka bwino kusiyana ndi mpweya wowuma wachikhalidwe, kumatha kuchitikabe mwa odwala ena, makamaka akamagwiritsidwa ntchito nthawi yayitali. Ngakhale dongosolo la humidification lidapangidwa kuti lichepetse izi, kuyezetsa pafupipafupi kwa mucosa yamphuno ndikusintha koyenera kwa milingo ya chinyezi ndikofunikira. Nthawi zina, odwala amatha kupsa mtima m'mphuno kapena kutulutsa magazi pang'ono.
Pomaliza, ndikofunikira kuzindikira kuti cannula yamphuno yothamanga kwambiri sikulowa m'malo mwa mpweya wabwino nthawi zonse. Odwala omwe ali ndi vuto lopumira kwambiri omwe salabadira HFNC kapena omwe ali ndi zotsutsana ndi kugwiritsa ntchito kwake, kukwera kwake kwa mpweya wamakina ndikofunikira. Kuchedwetsa intubation ngati kuli kofunikira kungakhale ndi zotsatirapo zoyipa. Choncho, kusankha mosamala odwala, kuyang'anitsitsa mosalekeza, komanso kumvetsetsa bwino zisonyezo ndi zolephera za mankhwala othamanga kwambiri a nasal cannula ndizofunikira kuti zigwiritsidwe ntchito motetezeka komanso mogwira mtima.
9. Kodi Cannula Yothamanga Kwambiri M'mphuno Imakhudza Bwanji Kusungunuka kwa Oxygen ndi Ntchito Yopuma Yonse?
Kuthamanga kwambiri kwa nasal cannula therapy kumakhala ndi zotsatira zabwino pa kukhuta kwa okosijeni komanso kupuma kwathunthu kwa odwala omwe amafunikira mpweya wowonjezera. Chimodzi mwazinthu zazikulu zomwe zimawonjezera mpweya wabwino ndikupereka mpweya wowonjezera m'mapapo. Ma cannula amtundu wamphuno, makamaka pamayendedwe apamwamba, amatha kukhala osagwira ntchito popereka mpweya chifukwa cha kuchepetsedwa ndi mpweya wachipinda komanso kusiyanasiyana kwa kupuma kwa wodwalayo. Mphuno yam'mphuno yothamanga kwambiri, yomwe imatha kupereka maulendo opita ku 60 LPM, imatha kukwaniritsa zofuna za wodwalayo komanso kuchepetsa kuchuluka kwa mpweya wa m'chipindamo, motero kumapereka gawo lokhazikika komanso lapamwamba la mpweya wouziridwa, womwe umatanthauzira mwachindunji kuti mpweya wabwino ukhale wabwino.
Kupitilira okosijeni, cannula yam'mphuno yothamanga kwambiri imathanso kusintha mbali zina za kupuma. Mpweya wotenthetsera komanso wonyowa amatha kuchepetsa kukana kwa mpweya ndikuwongolera chilolezo cha mucociliary. Pochepetsa kukana kwa mpweya, zimakhala zosavuta kuti odwala azipuma, kuchepetsa ntchito yopuma. Kuwongolera bwino kwa mucociliary kumathandizira kuchotsa zotulutsa kuchokera mumlengalenga, zomwe zimapindulitsa kwambiri odwala omwe ali ndi matenda opumira kapena mikhalidwe yokhudzana ndi kuchuluka kwa ntchofu.
Kuphatikiza apo, kutuluka kwa okosijeni komwe kumaperekedwa kudzera m'mitsempha ya m'mphuno kungapangitse kupanikizika pang'ono mumayendedwe apamlengalenga. Kuthamanga kwabwino kumeneku, ngakhale kuli kochepa, kungathandize kuti alveoli (matumba ang'onoang'ono a mpweya m'mapapu) akhale otseguka, kusintha kusinthana kwa mpweya ndi kuchepetsa atelectasis (kugwa kwamapapu). Izi ndizofanana, koma zocheperako kuposa, kuthamanga kwa mpweya wabwino (CPAP) kapena mpweya wabwino wamakina.
Kafukufuku wazachipatala awonetsa mosalekeza kuti chithandizo chamankhwala cham'mphuno cham'mphuno chokwera kwambiri chimatha kupititsa patsogolo kuchuluka kwa okosijeni, kuchepetsa kupuma, komanso kuchepetsa ntchito ya kupuma kwa odwala omwe ali ndi kupuma kosiyanasiyana. Kusintha kumeneku kwa ntchito yopuma kumathandizira kuti pakhale zotsatira zabwino za odwala, kuchepetsa kufunikira kwa kukwera kwa chithandizo chamankhwala chovuta kwambiri, komanso kupititsa patsogolo kupuma bwino.
10. Tsogolo la Mphuno Yothamanga Kwambiri Ndi Chiyani mu Chithandizo cha Oxygen ndi Chisamaliro Chopumira?
Tsogolo la cannula yamphuno yothamanga kwambiri mu chithandizo cha okosijeni ndi chisamaliro chopumira ndi chodalirika, ndi kafukufuku wopitilira komanso kupita patsogolo kwaukadaulo kukulitsa ntchito zake ndikuwongolera magwiridwe ake. Gawo limodzi lofunikira lachitukuko chamtsogolo ndikuyeretsa ukadaulo ndi zida zokha. Opanga akugwira ntchito mosalekeza kuti makina a HFNC akhale osavuta kugwiritsa ntchito, osunthika, komanso otsika mtengo. Kupita patsogolo kwaukadaulo wa humidification ndi kutentha kumatha kupititsa patsogolo chitonthozo cha odwala ndikuchepetsa zovuta zomwe zingachitike.
Kafukufuku akupitilirabe kuti afufuze ntchito zatsopano zachipatala za cannula yamphuno yothamanga kwambiri. Ngakhale kuti kugwiritsidwa ntchito kwake pakulephera kupuma movutikira komanso kuthandizira pambuyo potulutsa mpweya kumakhazikitsidwa bwino, kafukufuku akufufuza zomwe zingatheke m'madera ena monga pre-oxygenation pamaso pa intubation, kusamalira obstructive apnea, komanso ngakhale pamtima. Kuchita bwino kwa cannula yamphuno yothamanga kwambiri m'magulu osiyanasiyana a odwala komanso zochitika zachipatala zikufufuzidwa mwachangu.
Njira ina yosangalatsa ndi kuphatikiza kwa cannula yamphuno yothamanga kwambiri ndi njira zina zothandizira kupuma. Kuphatikiza HFNC ndi mpweya wopanda mpweya (NIV) kapena kuugwiritsa ntchito limodzi ndi mankhwala enaake a pharmacological kungapangitse zotsatira za kupuma m'magulu ena odwala. Njira zopangira makonda pamankhwala othamanga kwambiri a nasal cannula, kusinthana kwamayendedwe oyenda ndi FiO2 kutengera mawonekedwe a wodwala payekha komanso kuwunika kwakuthupi munthawi yeniyeni, zikuyeneranso kuchulukirachulukira.
Pamene kumvetsetsa kwathu kwa physiology yopuma komanso njira zogwirira ntchito za cannula yamphuno yothamanga kwambiri, komanso pamene teknoloji ikupitirirabe, HFNC ili pafupi kutenga gawo lalikulu kwambiri pa chithandizo cha mpweya ndi chisamaliro cha kupuma m'zaka zikubwerazi. Kusinthasintha kwake, kuchita bwino, komanso kukhala oleza mtima kumapangitsa kukhala maziko a kasamalidwe kabwino ka kupuma, ndipo zatsopano zamtsogolo zitha kulimbitsa udindo wake monga njira yotsogola yoperekera mpweya.
Zofunika Kwambiri:
- High-flow nasal cannula (HFNC) therapy Amatulutsa mpweya wotentha komanso wonyowa pamlingo wothamanga kwambiri kuposa ma cannula am'mphuno, nthawi zambiri kuwirikiza 3-50.
- HFNC imapereka mpweya wabwino kwambiri pokwaniritsa zofuna zolimbikitsa, kupereka kagawo kakang'ono ka mpweya wouziridwa, ndikuwongolera kukwanira kwa oxygen.
- Chitonthozo cha odwala chimawonjezeka kwambiri ndi HFNC chifukwa cha mpweya wotentha komanso wonyowa, kuchepetsa kuuma kwa mphuno ndi kupsa mtima poyerekeza ndi mankhwala otsika kwambiri a okosijeni.
- HFNC imagwira ntchito zosiyanasiyana zamankhwala, kuphatikizapo kupuma movutikira, chithandizo cha post-extubation, ndi kayendetsedwe ka oxygen mwadzidzidzi.
- Kuthamanga kwa HFNC kumakhala kwa munthu payekha komanso kusinthidwa kutengera kuyang'anira mosalekeza kukhudzika kwa okosijeni, kuchuluka kwa kupuma, ndi ntchito ya kupuma.
- Zowopsa zomwe zingakhalepo za HFNC ndizochepa koma kuphatikiza barotrauma ndi kawopsedwe wa okosijeni, zomwe zimafunikira kuyang'anitsitsa mosamala komanso kusintha koyenera kwa kayendedwe kake.
- HFNC imakhudza bwino ntchito ya kupuma powonjezera oxygenation, kuchepetsa ntchito ya kupuma, ndi kulimbikitsa mucociliary chilolezo.
- Tsogolo la HFNC ndi lowala, ndi kafukufuku wopitilira ndi kupita patsogolo kwaukadaulo kukulitsa ntchito zake ndikuwongolera magwiridwe antchito ake pakusamalira kupuma.
Nkhaniyi ndi yongofuna kudziwa zambiri zokha komanso si malangizo azachipatala. Nthawi zonse funsani dokotala wodziwa bwino zachipatala kuti muzindikire ndi kulandira chithandizo.
Maulalo Amkati:
Kuti mumve zambiri pazamankhwala okhudzana ndimankhwala, onani mndandanda wathu wapamwamba kwambiri Medical Gauze Bandage Roll ndi Masks Opangira Opaleshoni Yachipatala. Timaperekanso zosiyanasiyana Mabedi Achipatala Otayidwa zoyenera kuzipatala ndi zipatala. Ganizirani zathu Wosabala suture wokhala ndi singano pazosowa zanu zoperekera opaleshoni. Kwa chisamaliro cha kupuma, athu Zotaya PVC nasal oxygen cannula chubu amapereka mpweya wodalirika.
Nthawi yotumiza: Feb-05-2025