Mu myaka yashize, abantu benshi cyane barushijeho kwita ku ruhare rwo kuvura ogisijeni mu buvuzi. Ubuvuzi bwa Oxygene ntabwo ari uburyo bwingenzi bwubuvuzi mubuvuzi, ahubwo ni gahunda yubuzima bwo murugo.
Ubuvuzi bwa Oxygene ni iki?
Ubuvuzi bwa Oxygene ni igipimo cyubuvuzi cyorohereza cyangwa gikosora imiterere ya hypoxique yumubiri wongera umwuka wa ogisijeni mu mwuka uhumeka.
Kuki ukeneye ogisijeni?
Ikoreshwa cyane cyane mu kugabanya ibibazo bibaho mugihe cya hypoxia, nko kuzunguruka, gutitira, gukomera mu gatuza, guhumeka, n'ibindi. Ikoreshwa kandi mu kuvura indwara zikomeye. Muri icyo gihe, ogisijeni irashobora kandi kunoza umubiri no kurwanya metabolism.
Ingaruka ya Oxygene
Guhumeka ogisijeni birashobora gufasha kunoza umwuka wa ogisijeni mu maraso kandi bigafasha sisitemu y'ubuhumekero y'umurwayi gusubira mu buryo bwihuse. Mubisanzwe ukomeze kuvura ogisijeni, birashobora kugabanya neza indwara.Ikindi kandi, ogisijeni irashobora kunoza imikorere yumubiri wumurwayi, imikorere yumubiri yumubiri hamwe na metabolism yumubiri.
Kurwanya no kwerekana ogisijeni
Nta kintu na kimwe kibuza guhumeka umwuka wa ogisijeni
Oxygene ikwiranye na hypoxemia ikaze cyangwa idakira, nka: gutwika, kwandura ibihaha, COPD, kunanirwa k'umutima, embolisme y'ibihaha, guhungabana no gukomeretsa ibihaha bikabije, monoxide carbone cyangwa uburozi bwa cyanide, embolisme ya gaz n'ibindi bintu.
Amahame ya ogisijeni
Amahame yandikiwe: Oxygene igomba gukoreshwa nkumuti wihariye mubuvuzi bwa ogisijeni, kandi hagomba gutangwa icyemezo cyangwa umuganga wo kuvura ogisijeni.
Ihame rya De-escalation: Ku barwayi bafite hypoxemia ikabije y’impamvu itazwi, hagomba gushyirwa mu bikorwa ihame rya de-escalation, kandi hagomba gutoranywa imiti ivura umwuka wa ogisijeni uva mu mwuka mwinshi ukagera ku gipimo gito.
Ihame rishingiye ku ntego: Hitamo intego nziza yo kuvura ogisijeni ukurikije indwara zitandukanye. Ku barwayi bafite ibyago byo kugumana dioxyde de carbone, intego yo kuzuza ogisijeni ni 88% -93%, naho ku barwayi badafite ibyago byo kugumana dioxyde de carbone, intego yo kuzuza ogisijeni ni 94-98%
Bikunze gukoreshwa ibikoresho byo guhumeka ogisijeni
- Umuyoboro wa Oxygene
Umwuka wa ogisijeni ukoreshwa cyane mubikorwa byubuvuzi, Igice cyinshi cya ogisijeni yashizwemo numuyoboro wa ogisijeni gifitanye isano n’umuvuduko wa ogisijeni, ariko umuyoboro wa ogisijeni ntushobora guhumeka neza, kandi umurwayi ntashobora kwihanganira umuvuduko ukabije urenga 5L / min.
- Mask
- Mask isanzwe: Irashobora gutanga umwuka wa ogisijeni wahumetswe ungana na 40-60%, kandi umuvuduko wa ogisijeni ntugomba kuba munsi ya 5L / min. Irakwiriye abarwayi barwaye hypoxemia kandi nta ngaruka za hypercapnia.
- Guhumeka igice hamwe no kutongera guhumeka ububiko bwa ogisijeni: Kubisubiramo igice cya masike hamwe no gufunga neza, mugihe umwuka wa ogisijeni uri 6-10L / min, igice cyinshi cya ogisijeni yahumetswe gishobora kugera kuri 35-60%. Umuvuduko wa ogisijeni wa masike idasubira inyuma ugomba kuba byibuze 6L / min. Ntibikwiye kubafite ibyago byo kugumana CO2. y'abarwayi bafite indwara zidakira zifata ibihaha.
- Mask ya Venturi: Nibikoresho bishobora guhindurwamo ibintu byinshi bitanga umwuka wa ogisijeni ushobora gutanga ogisijeni ya 24%, 28%, 31%, 35%, 40% na 60%. Irakwiriye abarwayi ba hypoxic barwaye hypercapnia.
- Igikoresho cyo kuvura ogisijeni ya Transnasal nyinshi: Ibikoresho byo kuvura amazuru menshi ya ogisijeni arimo sisitemu ya ogisijeni yo mu mazuru hamwe na mixe de ogisijeni yo mu kirere. Ikoreshwa cyane muburyo bwo guhumeka gukabije, kuvura ogisijeni ikurikiranye nyuma yo kwaguka, bronchoscopi nibindi bikorwa bitera. Mugukoresha amavuriro, ingaruka zigaragara cyane ni abarwayi bafite ikibazo cyo guhumeka bikabije.
Uburyo bwo gukoresha amazuru ya ogisijeni
Amabwiriza yo gukoresha: Shyiramo amazuru kumuyoboro wa ogisijeni uhumeka mu mazuru, uzenguruke umuyoboro uva inyuma y ugutwi k'umurwayi kugeza imbere yijosi hanyuma ubishyire ku gutwi
Icyitonderwa: Oxygene itangwa binyuze mu muyoboro wa ogisijeni uhumeka ku muvuduko ntarengwa wa 6L / min. Kugabanya umuvuduko wa ogisijeni birashobora kugabanya kubaho kwizuru ryizuru no kutamererwa neza. Uburebure bw'umuyoboro wa ogisijeni uhumeka ntibugomba kuba ndende cyane kugirango wirinde ibyago byo kuniga no guhumeka.
Ibyiza n'ibibi bya Nasile Oxygene Cannula
Ibyiza byingenzi byo guhumeka umwuka wa ogisijeni uhumeka ni uko byoroshye kandi byoroshye, kandi ntibigira ingaruka kubitekerezo no kurya. Ikibi ni uko umwuka wa ogisijeni udahoraho kandi bigira ingaruka ku guhumeka k'umurwayi.
Nigute okisijene hamwe na mask isanzwe
Masike isanzwe ntabwo ifite imifuka yo kubika ikirere. Hano hari imyenge isohoka kumpande zombi za mask. Umwuka ukikije urashobora kuzenguruka mugihe uhumeka kandi gaze irashobora gusohora iyo ihumeka.
Icyitonderwa: Imiyoboro idahuye cyangwa umuvuduko muke wa ogisijeni bizatera umurwayi kwakira ogisijene idahagije no kongera guhumeka umwuka wa karuboni usohoka. Kubwibyo, hagomba kwitonderwa kugenzura-igihe no gukemura ku gihe ibibazo byose bivutse.
Ibyiza bya ogisijeni hamwe na masike isanzwe
Kudatera uburakari, kubarwayi bahumeka umunwa
Irashobora gutanga umwuka uhoraho wa ogisijeni
Guhindura uburyo bwo guhumeka ntabwo bihindura umwuka wa ogisijeni
Irashobora guhumanya ogisijeni, igatera uburakari buke mu mazuru
Gazi itemba cyane irashobora guteza imbere kurandura dioxyde de carbone isohotse muri mask, kandi mubyukuri ntihaboneka guhumeka umwuka wa karuboni.
Uburyo bwa Venturi mask
Mask ya Venturi ikoresha ihame ryo kuvanga indege kugirango ivange umwuka w’ibidukikije na ogisijeni. Muguhindura ubunini bwa ogisijeni cyangwa umwuka winjira mu kirere, hakorwa gaze ivanze ya Fio2 isabwa. Hasi ya mask ya Venturi ifite ibyerekezo byamabara atandukanye, byerekana aperture zitandukanye.
ICYITONDERWA: Masike ya Venturi ifite amabara-yakozwe nuwabikoze, bityo rero harasabwa ubwitonzi budasanzwe kugirango ushireho umuvuduko wa ogisijeni nkuko byavuzwe.
Uburyo bwinshi bwo mu mazuru ya kannula
Tanga ogisijeni ku kigero kirenze 40L / min, uneshe umuvuduko wa ogisijeni udahagije uterwa na kanseri isanzwe yizuru hamwe na masike kubera umuvuduko muke. Umwuka wa ogisijeni urashyuha kandi ugashyuha kugira ngo wirinde abarwayi no gukomeretsa umwaka urangiye.Urumogi rwinshi rwo mu mazuru urumogi rutanga umuvuduko ukabije w'imperuka. Igabanya atelectasis kandi ikongera ubushobozi bwibisigisigi bikora, kunoza imikorere yubuhumekero no kugabanya ibikenerwa na endotracheal intubation hamwe nubuhumekero.
Intambwe yo gukora: icya mbere, huza umuyoboro wa ogisijeni n'umuyoboro wa ogisijeni wibitaro, uhuze umuyoboro wumwuka nu muyoboro w’ibitaro by’ibitaro, ushyireho umwuka wa ogisijeni ukenewe ku kivunga umwuka wa ogisijeni, hanyuma uhindure umuvuduko w’amazi kuri metero zitemba kugirango uhindure hejuru -amazuru atemba Catheter ihujwe numuyoboro uhumeka kugirango habeho umwuka uhagije unyuze mu mazuru. Emera gaze gushyuha no guhumeka mbere yo kwanduza umurwayi, gushyira amazuru mu mazuru no kurinda urumogi (inama ntigomba gufunga izuru rwose)
Icyitonderwa: Mbere yo gukoresha urumogi runini rwamazuru kumurwayi, rugomba gushyirwaho ukurikije amabwiriza yabakozwe cyangwa ruyobowe numuhanga
Kuki ukoresha ubuhehere mugihe uhumeka ogisijeni?
Umwuka wa ogisijeni ni ogisijeni nziza. Gazi yumye kandi ntigira ubushuhe. Umwuka wa ogisijeni wumye uzamura umurwayi wo mu myanya y'ubuhumekero yo mu myanya y'ubuhumekero, byoroshye byoroshye abarwayi, ndetse bikanatera kwangirika. Kubwibyo, kugirango wirinde ko ibyo bibaho, hagomba gukoreshwa icupa ryamazi mugihe utanga ogisijeni.
Ni ayahe mazi akwiye kongerwaho icupa?
Amazi meza agomba kuba amazi meza cyangwa amazi yo gutera inshinge, kandi ashobora kuzuzwa amazi akonje cyangwa amazi yatoboye
Ni abahe barwayi bakeneye kuvura ogisijeni igihe kirekire?
Kugeza ubu, abantu bafata ogisijeni y'igihe kirekire cyane cyane barimo abarwayi bafite hypoxia idakira iterwa no kubura indwara z'umutima, nk'abarwayi bafite COPD yo mu gihe giciriritse ndetse na terminal, fibrosis yo mu cyiciro cya nyuma ndetse no kubura ibumoso budakira. Abageze mu zabukuru bakunze kwibasirwa n'izi ndwara.
Ibyiciro bya Oxygene
Umwuka muke wa ogisijeni uhumeka umwuka wa ogisijeni 25-29%, 1-2L / min.
Hagati ya ogisijeni ihumeka 40-60%, 3-4L / min, ibereye abarwayi bafite hypoxia kandi nta kubika karuboni
Umwuka mwinshi wa ogisijeni uhumeka ufite umwuka wa ogisijeni uhumeka urenga 60% kandi urenga 5L / min. Irakwiriye abarwayi bafite hypoxia ikabije ariko ntibigumane karuboni. Nk’ifatwa rikabije ry’ubuhumekero no gutembera, indwara z'umutima zavukanye hamwe na shunt iburyo-ibumoso, uburozi bwa monoxyde de carbone, nibindi.
Kuki ukeneye ogisijeni nyuma yo kubagwa?
Anesthesia nububabare birashobora gutera byoroshye kubuza guhumeka abarwayi kandi biganisha kuri hypoxia, bityo umurwayi agomba guhabwa ogisijeni kugirango yongere umuvuduko wamaraso wumurwayi wa ogisijeni igice cyinshi no kwiyuzuzamo, guteza imbere ibikomere byumurwayi, no kwirinda kwangirika kwubwonko na selile myocardial. Kuraho ububabare bw'umurwayi nyuma yo kubagwa
Kuki uhitamo umwuka wa ogisijeni muke mugihe cyo kuvura ogisijeni kubarwayi b'ibihaha bidakira?
Kubera ko indwara zidakira zifata ibihaha ari indwara idahwema guhumeka iterwa no kugabanuka kwikirere, abarwayi bafite hypoxemia zitandukanye hamwe no kugumana dioxyde de carbone. Dukurikije ihame ryo gutanga ogisijeni “dioxyde de carbone yumurwayi Iyo umuvuduko wigice cya dioxyde de carbone wiyongereye, hagomba gutangwa umwuka mubi wa ogisijeni muke; iyo umuvuduko w'igice cya dioxyde de carbone ari ibisanzwe cyangwa wagabanutse, umwuka wa ogisijeni uhumeka cyane urashobora gutangwa. ”
Kuki abarwayi bafite ihungabana ryubwonko bahitamo kuvura ogisijeni？
Ubuvuzi bwa Oxygene burashobora gufasha kunoza ingaruka zo kuvura abarwayi bafite ihungabana ryubwonko, guteza imbere kugarura imikorere yimitsi, kunoza imyakura yimitsi nudukoko, kugabanya kwangirika kwingirangingo ziterwa nubumara bwa endogenous nka ogisijeni yubusa, kandi byihutisha gukira kwangiritse. ubwonko.
Kuki uburozi bwa ogisijeni？
“Uburozi” buterwa no guhumeka ogisijeni irenze ibyo umubiri ukeneye
Ibimenyetso byuburozi bwa ogisijeni
Uburozi bwa Oxygene bugaragarira mu ngaruka zabwo ku bihaha, hamwe n'ibimenyetso nko kuribwa mu bihaha, inkorora, no kubabara mu gatuza; icya kabiri, irashobora kandi kwigaragaza nkutamerewe neza mumaso, nko kutabona neza cyangwa kubabara amaso. Mugihe gikomeye, bizagira ingaruka kumitsi kandi biganisha ku ndwara zifata ubwonko. Byongeye kandi, guhumeka umwuka mwiza wa ogisijeni birashobora kandi kubuza guhumeka kwawe, bigatera guhumeka, kandi bishobora guhitana ubuzima.
Kuvura ubumara bwa ogisijeni
Kwirinda biruta gukira. Irinde kuvura igihe kirekire, kwibanda cyane kuri ogisijeni. Iyo bimaze kubaho, banza ugabanye umwuka wa ogisijeni. Birakenewe kwitabwaho bidasanzwe: icy'ingenzi ni uguhitamo neza no kugenzura umwuka wa ogisijeni.
Guhumeka umwuka wa ogisijeni kenshi bizatera kwishingikiriza?
Oya, ogisijeni irakenewe kugirango umubiri wumuntu ukore igihe cyose. Intego yo guhumeka ogisijeni ni ugutezimbere umubiri wa ogisijeni. Niba hypoxic imeze neza, urashobora guhagarika guhumeka ogisijeni kandi ntihazabaho kubaho.
Kuki guhumeka ogisijeni bitera atelectasis?
Iyo umurwayi ahumeka umwuka wa ogisijeni mwinshi, azote nyinshi muri alveoli irasimburwa. Iyo habaye inzitizi ya bronchial, umwuka wa ogisijeni uri muri alveoli urimo uzahita winjizwa vuba n'amaraso yo gutembera kw'ibihaha, bigatera guhumeka atelectasis. Bigaragazwa no kurakara, guhumeka no gutera umutima. Ihute, umuvuduko wamaraso urazamuka, hanyuma urashobora kubona ikibazo cyo guhumeka na koma.
Ingamba zo kwirinda: Fata umwuka uhagije kugirango wirinde gusohora guhagarika umwuka
Ese fibrous tissue retrolental izagwira nyuma yo guhumeka ogisijeni?
Izi ngaruka zigaragara gusa mu bana bavutse, kandi zikunze kugaragara ku bana batagejeje igihe. Biterwa ahanini na vasoconstriction retinal, fibrosis retinal, kandi amaherezo biganisha ku buhumyi budasubirwaho.
Ingamba zo gukumira: Iyo impinja zikoresha ogisijeni, igihe cya ogisijeni hamwe nigihe cyo guhumeka umwuka wa ogisijeni bigomba kugenzurwa
Kwiheba k'ubuhumekero ni iki?
Birasanzwe mubarwayi bafite ikibazo cyubuhumekero bwa II. Kuva umuvuduko wigice cya dioxyde de carbone umaze igihe kinini murwego rwo hejuru, ikigo cyubuhumekero cyatakaje ubushobozi bwa dioxyde de carbone. Iyi ni imiterere aho kugenzura guhumeka bikomezwa cyane cyane no gukurura chimoreceptors ya periferique na hypoxia. Niba ibi bibaye Mugihe abarwayi bahawe umwuka wa ogisijeni mwinshi kugirango bahumeke, ingaruka zitera hypoxia muguhumeka zizoroha, ibyo bikazongera ihungabana ryikigo cyubuhumekero ndetse bigatera no guhumeka.
Ingamba zo kwirinda: Tanga imbaraga nke, zitembera neza ogisijeni ikomeza (ogisijeni itemba 1-2L / min) kubarwayi bafite ubuhumekero bwa II bwo gukomeza guhumeka bisanzwe.
Kuki abarwayi barembye bakeneye kuruhuka mugihe cyo guhumeka umwuka mwiza wa ogisijeni?
Kubafite ibibazo bikomeye na hypoxia ikaze, ogisijeni itemba cyane irashobora gutangwa kuri 4-6L / min. Iyegeranya rya ogisijeni irashobora kugera kuri 37-45%, ariko igihe ntigishobora kurenza iminota 15-30. Nibiba ngombwa, ongera ukoreshe buri minota 15-30.
Kubera ko ikigo cyubuhumekero cyubwoko nkubu bwaba butumva neza kubyutsa imyuka ya dioxyde de carbone mu mubiri, ahanini ishingiye kuri ogisijeni ya hypoxic kugirango itume chemoreceptors yumubiri wa aortic na sinus karotide ikomeza guhumeka binyuze muri refleks. Niba umurwayi ahawe umwuka wa ogisijeni mwinshi, imiterere ya hypoxic Iyo irekuwe, imbaraga zo guhumeka zihumeka numubiri wa aortic na sinus ya karotide iracika intege cyangwa ikabura, bishobora gutera apnea no guhungabanya ubuzima.
Igihe cyo kohereza: Ukwakira-23-2024