Shin kun san shakar iskar oxygen?

Hukunci da Rarraba Hypoxia

Me yasa akwai hypoxia?

Oxygen shine babban sinadari da ke raya rayuwa. Lokacin da kyallen takarda ba su sami isasshen iskar oxygen ba ko kuma suna da wahalar yin amfani da iskar oxygen, suna haifar da sauye-sauye marasa kyau a cikin ayyukan rayuwa na jiki, ana kiran wannan yanayin hypoxia.

Tushen don yin hukunci hypoxia

Digiri na hypoxia da bayyanar cututtuka

Rarraba hypoxia

Karancin iskar iskar oxygen a cikin iskar da ake shaka, rashin aiki na fitar numfashi na waje, shunt venous zuwa arteries, da sauransu. Yawanci ana iya gani a cikin cututtuka na huhu na huhu da cututtukan zuciya na haihuwa kamar tetralogy na Fallot.

Rage adadin ko abubuwan da aka canza na haemoglobin, kamar anemia, gubar carbon monoxide, da methemoglobinemia.

hypoxia na jini

hypoxia na kungiya

Sakamakon rashin amfani da iskar oxygen ta ƙwayoyin nama, kamar guba na cyanide.

Oxygen inhalation far da manufarsa

A karkashin yanayi na al'ada, mutane masu lafiya suna shakar iska ta dabi'a kuma suna amfani da iskar oxygen da ke cikinta don kula da bukatun rayuwa. Lokacin da rashin lafiya ko wasu yanayi mara kyau ya haifar da hypoxia a cikin jiki, dole ne a yi amfani da wasu kayan aiki don samar da iskar oxygen ga mai haƙuri, ƙara yawan karfin jini na oxygen (PaO2) da kuma oxygen saturation (SaO2), inganta hypoxia, inganta metabolism, da kuma kula da rayuwa. Ayyuka.

Amfanin iskar oxygen

• Sauƙaƙe angina pectoris kuma hana ciwon zuciya na zuciya
• Hana mutuwa kwatsam daga cututtukan zuciya
• Kyakkyawan maganin asma
• Yadda ya kamata yana magance emphysema, cututtukan zuciya na huhu, da mashako na kullum
• Oxygen inhalation yana da wani taimako warkewa sakamako a kan ciwon sukari: halin yanzu bincike ya nuna cewa ciwon sukari yana da alaka da rashin isashshen jiki. Marasa lafiya masu ciwon sukari suna da raguwar matsa lamba na capillary sosai, kuma ƙwayoyin nama ba za su iya samun cikakkiyar iskar oxygen ba, wanda ke haifar da lahani ga aikin sel da metabolism na glucose. Sabili da haka, aiwatar da maganin iskar oxygen ga masu ciwon sukari ya jawo hankalin al'ummar likitocin.
• Shakar iskar oxygen na iya taka rawa wajen kula da lafiya a cikin mutane masu lafiya: gurbatar iska, amfani da kwandishan na yau da kullun, shakar iskar oxygen na yau da kullun na iya tsaftace tsarin numfashi, inganta aikin gabobin ciki, haɓaka cikakkiyar rigakafi na jiki, da hana cututtuka daban-daban.

Menene rarrabuwa na maganin iskar oxygen?

• Babban wadatar iskar oxygen (5-8L / min): Ana amfani dashi don gazawar numfashi kamar su numfashi da kama zuciya, matsananciyar wahala ta numfashi, guba mai zafi (kamar gubar carbon monoxide ko gubar iskar gas) baƙin ciki na numfashi, da sauransu, inda Dole ne a yi amfani da babban taro ko iskar oxygen mai tsabta kowane daƙiƙa don ceto, amma bai dace da amfani na dogon lokaci ba. don hana gubar iskar oxygen ko wasu matsaloli.
• Matsakaicin iskar oxygen wadata (3-4L / min): Ya dace da marasa lafiya tare da anemia, ƙarancin zuciya, girgiza, da dai sauransu waɗanda ba su da tsauraran hani kan yawan iskar oxygen da aka shaka.
• Ƙarƙashin isar da iskar oxygen (1-2L/min): Kullum ana amfani da shi don cutar mashako, emphysema, cututtukan zuciya na huhu, da dai sauransu, wanda kuma aka sani da cutar cututtukan huhu na yau da kullum. Matsakaicin juzu'i na iskar oxygen na jini yana iya raunana motsin motsa jiki na carotid sinus zuwa cibiyar numfashi, ta haka yana rage samun iska da kuma tsanantar riƙewar carbon dioxide. mai yiwuwa. Sabili da haka, ya kamata a yi amfani da iskar oxygen tare da taka tsantsan, kuma ana amfani da iskar oxygen ci gaba da ƙaranci.

Oxygen maida hankali da kuma kwararar oxygen

Matsakaicin iskar oxygen: Yawan iskar oxygen da ke cikin iska. Matsakaicin iskar oxygen a cikin iska ta al'ada shine 20.93%

• Low maida hankali oxygen <35%
• Matsakaicin maida hankali oxygen 35% -60%
• Babban taro oxygen> 60%

Gudun Oxygen: yana nufin daidaitawar iskar oxygen ga marasa lafiya, naúrar L / min.

Oxygen maida hankali iskar oxygen canza kwarara kwarara

• Cannula na hanci, cunkoso na hanci: Tsarin oxygen (%) = 21 + 4X kwararar oxygen (L / min)
• Mask iskar oxygen (buɗewa da rufe): ƙimar kwararar dole ne ya fi 6 L/min
• Sauƙaƙan numfashi: Yawan kwararar iskar oxygen 6 L/min, iskar oxygen da aka shaka kusan 46% -60%
• Ventilator: Oxygen maida hankali = 80X oxygen kwarara (L/min) / yawan iska + 20

Rarraba maganin oxygen-bisa ga hanyar samar da iskar oxygen

Abubuwan da za a lura yayin amfani da oxygen

• Amintaccen amfani da iskar oxygen: aiwatar da yadda ya kamata "hanyoyi guda hudu": rigakafin girgizar kasa, rigakafin gobara, rigakafin zafi, da rigakafin mai. Aƙalla mita 5 nesa da murhu da mita 1 daga na'urar dumama. Ba za a iya amfani da iskar oxygen ba. Lokacin da mai nuni akan ma'aunin matsa lamba shine 5kg/cm2, ba za a iya sake amfani da shi ba.
• Yi biyayya da hanyoyin aikin oxygen: Lokacin amfani da iskar oxygen, yakamata ku fara amfani da shi. Lokacin tsayawa, cire catheter da farko sannan kashe iskar oxygen. Lokacin canza yawan kwararar ruwa a tsakiyar hanya, yakamata ku ware iskar oxygen da catheter na hanci da farko, daidaita yawan kwarara kafin haɗawa.
• Yi la'akari da tasirin amfani da iskar oxygen: cyanosis yana ragewa, ƙwayar zuciya yana da hankali fiye da baya, an sauke dyspnea, yanayin tunanin mutum yana inganta, da kuma abubuwan da ke faruwa a cikin alamomi daban-daban na nazarin iskar gas, da dai sauransu.
• Canja cannula na hanci da maganin humidification kowace rana (1/3-1/2 cike da ruwa mai narkewa ko haifuwa)
• Tabbatar da yin amfani da gaggawa: Dole ne a rataye silinda na iskar oxygen da ba a yi amfani da su ba tare da alamun "cikakku" ko "marai" bi da bi.

Babban matakan kariya don shakar iskar oxygen

• Kula da tasirin maganin oxygen a hankali: Idan bayyanar cututtuka irin su dyspnea sun ragu ko an rage su, kuma bugun zuciya na al'ada ne ko kusa da al'ada, yana nuna cewa maganin oxygen yana da tasiri. In ba haka ba, ya kamata a gano dalilin kuma a magance shi cikin lokaci.
• Bai kamata a samar da wadataccen iskar oxygen mai girma na dogon lokaci ba. An yi imani da cewa idan yawan iskar oxygen ya kasance> 60% kuma ya ci gaba fiye da sa'o'i 24, gubar oxygen na iya faruwa.
• Ga marasa lafiya da ke fama da matsananciyar cutar cututtukan huhu, sarrafawa (watau ci gaba da ƙaranci) iskar oxygen ya kamata a ba da gabaɗaya.
• Kula da dumama da humidification: Kula da zafin jiki na 37 ° C da zafi na 95% zuwa 100% a cikin fili na numfashi shine yanayin da ya dace don aikin sharewa na yau da kullun na tsarin mucociliary.
• Hana gurɓatawa da toshewar bututu: Ya kamata a canza abubuwa kuma a tsaftace su kuma a shafe su akai-akai don hana kamuwa da cuta. Ya kamata a duba catheters da toshewar hanci a kowane lokaci don ganin ko an toshe su ta hanyar ɓoyewa kuma a maye gurbinsu cikin lokaci don tabbatar da ingantaccen magani na iskar oxygen.

Ka'idoji don rigakafi da magance rikice-rikice na yau da kullun na iskar oxygen

Matsala ta 1: busasshen busasshen busasshen numfashi

Rigakafi da magani: Oxygen da ke fitowa daga na'urar samar da iskar oxygen ya bushe. Bayan an shaka, zai iya bushe magudanar numfashi kuma ya sanya sirrin ya bushe da wahalar fitarwa. Ya kamata a saka ruwan da aka daskare a cikin kwalbar humidification, kuma a saka ruwan da aka haifuwa don humidified oxygen.

Matsala ta 2: Bacin rai na numfashi

Rigakafi da jiyya: A lokacin hypoxemia, raguwa a cikin PaO2 na iya haɓaka chemoreceptors na gefe, da haɓaka cibiyar numfashi, da haɓaka iskar huhu. Idan majiyyaci ya dogara da wannan motsin motsa jiki don kula da numfashi na dogon lokaci (kamar marasa lafiya da cututtukan zuciya na huhu da nau'in gazawar numfashi na II), shakar iskar oxygen mai yawa na iya kawar da wannan tsarin reflex, hana numfashi na kwatsam, har ma da haifar da tsayawar Numfashi. . Sabili da haka, ya zama dole don samar da ƙarancin iskar oxygen, ƙarancin kulawa da kulawa da kula da canje-canje a cikin PaO2 don kula da PaO2 mai haƙuri a 60mmHg.

Rikici 3: Absorptive atelectasis

Rigakafi da magani: Bayan majiyyaci ya shakar iskar oxygen mai yawa, ana maye gurbin babban adadin nitrogen a cikin alveoli. Da zarar an toshe bronchus, iskar oxygen da ke cikin alveoli zai iya shiga cikin sauri ta hanyar jini mai yawo, yana haifar da alveoli ya rushe kuma ya haifar da atelectasis. Don haka, hana toshewar numfashi shine mabuɗin. Matakan sun haɗa da ƙarfafa majiyyata don ɗaukar numfashi mai zurfi da tari, ƙarfafa fitar da sputum, canza matsayi na jiki akai-akai, da rage yawan iskar oxygen (<60%). Za a iya hana marasa lafiya a kan masu ba da iska ta hanyar ƙara matsi na ƙarshe na ƙarshe (PEEP).

Rikici 4: Retrolental fibrous tissue hyperplasia

Rigakafi da jiyya: Bayan yin amfani da iskar oxygen mai girma, matsananciyar ɓangaren iskar oxygen ta wuce kima (PaO2 ya kai fiye da 140mmHg) shine babban abin haɗari don haifar da retrolental fibrous nama hyperplasia a cikin jarirai (musamman jarirai da ba a kai ba). Don haka, yakamata a kula da yawan iskar oxygen na jarirai a ƙasa da kashi 40%, kuma yakamata a sarrafa lokacin iskar oxygen.

Matsala ta 5: Guba Oxygen

Bayyanar cututtuka:

• Alamomin guba na iskar oxygen na huhu: ciwon baya, busassun tari da dyspnea na ci gaba, rage ƙarfin mahimmanci
• Alamomin guba na iskar oxygen na cerebral: nakasar gani da ji, tashin zuciya, jujjuyawa, syncope da sauran alamun jijiya. A lokuta masu tsanani, coma da mutuwa na iya faruwa.
• Bayyanar cututtukan iskar oxygen na ido: atrophy na ido. Idan jariran da ba su kai ba sun ɗauki iskar oxygen na dogon lokaci a cikin incubator, retina za ta sami babban rufewar jijiyar jini, kutsewar fibroblast, da yaduwar fiber na baya, wanda zai iya haifar da makanta.