Yadda CPAP da BiPAP zasu iya bi da COPD
Menene ma'anar idan likitanku ya bada shawarar "samun iska mai ban sha'awa?" Ta yaya wannan ya bambanta da iska mai raɗaɗi? Yaya hanyoyi irin su CPAP da BiPAP sun nuna kuma menene amfanin da hadarin magani?
Mene Ne Cigaban Ciki?
Rashin iska mai ban ƙyama ba wata hanya ce ta haɗarin iska (wanda aka sanya shi a cikin ventilalor) don mutanen da ke fama da rashin lafiyar jiki na rashin lafiya ko rashin ƙarfi na numfashi kuma ba za su iya numfasawa a kansu ba.
Har ila yau, ana sani da rashin lafiya na rashin lafiya (NIPPV), iska mai banza ba ta taimaka wa mutum a cikin cikakken numfashi kuma yana taimakawa wajen kula da isasshen iskar gas a jiki.
NIPPV tana bada goyon baya ga ventilatory ga mutum ta hanyar jirgin sama. Yana inganta tsarin numfashi ta hanyar samar da cakuda iska da iskar oxygen daga gwanin wutar lantarki ta hanyar takalmin gyaran fuskar fuska ko hanci. Tun lokacin da huhu yake, a wata hanya, ta hanyar motsa jiki mai kyau, yana da sauƙi don samun oxygen zuwa cikin ƙananan alveoli inda za'a musayar oxygen da carbon dioxide.
A cikin sharuɗɗa marasa magungunan zaku iya ɗaukar hoto kamar alƙalan ƙananan balloons. Amfani da wannan talla ta ventilatory, "balloons" suna cigaba da ƙaranci kadan bayan ka numfasawa don haka suna da sauki don fadada tare da numfashinka na gaba. A wasu kalmomi, yana kama da cika ambaliyar da kuma kula da kada ka bari dukkan iska ta fita tsakanin numfashi don sauƙaƙewa.
Yadda ake amfani da Ingancin Ciki a COPD
Mutanen da ke fama da ciwo na huhu (COPD) a wasu lokuta ana ba da izinin samun iska mai ban sha'awa, kamar CPAP (matsalolin iska mai dorewa) ko BiPAP (yin amfani da matsalolin iska), a lokacin da ake dasu don taimakawa su numfashi.
Yawanci hade da maganin maganin bugun zuciya , duka CPAP da BiPAP sun ba da isasshen oxygen ta hanyar makasudin makirci zuwa tafarkin hankalin mutum.
Jirgin ya hana ƙunƙasar ƙwayar jiki daga rushewa da ƙuntata iska. Ana sanya injin CPAP zuwa matsin lamba guda daya wanda ke ci gaba a cikin dukan dare, yayin da BiPAP yana da matakan matsa lamba biyu, daya don inhaling da daya don ƙusawa.
Amfani da Ingantaccen Ciki a COPD
Wani takardun bincike na 2014 wanda aka buga a Lancet ya sami NIPPV inganta yawan rayuwa a cikin mutane tare da COPD. Shekaru da dama da aka bazu a cikin shekara, binciken bincike na kasa da kasa ya gano cewa mutanen da ke da COPD wadanda suka karbi raunin da ba su da kwaskwarima ba su da kashi 36 cikin dari na mutuwa.
Wasu nazarin da aka nuna sun nuna cewa NIPPV da aka yi amfani da shi a lokacin karamin COPD ya rage yawan buƙata na intubation endotracheal (magungunan injiniya mai inganci), kuma yana haɗuwa da rashin nasarar rashin lafiya da rashin kwanciyar hankali.
Bugu da kari, nazarin shekara ta 2016 ya gano cewa tsawon lokacin NIPPV zai iya haifar da ingantaccen aikin jinin jini (ABGs,) aikin huhu, da halayyar rayuwa. Bugu da ƙari, waɗannan haɓaka sun fi kyau da iska mai zurfi (ta amfani da ƙarfin motsa jiki mafi girma) fiye da ƙananan ƙarfin NIPPV.
A lokacin da Nasarar Abin Nuna ba tare da Amfani ba
A cikin mutanen da ke da COPD da suke fuskantar cututtuka na numfashi na hypercapnic saboda mummunan COPD, ba za a iya amfani da iska mai karfin motsa jiki ba a maimakon rikici na karshe a cikin marasa lafiya.
Kwararku na iya bada shawara ga NIPPV a gare ku idan kuna da matsanancin matsananciyar dyspnea (jijiyar rashin ƙarfi na numfashi,) tachypnea (raunin numfashi,) da kuma hypercarbia (wani nauyin ƙananan carbon dioxide cikin jini,) tare da pH tsakanin 7.25 da kuma 7.35.
Kada a bi da mutane tare da NIPPV maimakon magungunan injiniya idan sun kasance marasa lafiya saboda hypotension ( ƙananan jini ,) sepsis (babbar cuta mai tsanani wanda zai iya haifar da girgiza,) hypoxia (rashi a oxygen a cikin kyallen jikinka ,) ko wasu cututtuka masu guba na rayuwa, suna da matsananciyar halin tunanin mutum, ko kuma suna fuskantar matsalolin wuce gona da iri wanda ya sa su cikin haɗari.
Ba kamar iska mai raɗaɗi ba, wanda ke buƙatar saka idanu a cikin kulawa mai kulawa mai tsanani, rashin iska mai ban sha'awa ba zai iya yin aiki a cikin asibiti na asibiti ba, ya ba ma'aikatan horo cikakke a amfani.
CPAP da BiPAP
Dukkan CPAP da BiPAP sun ba da iskar oxygen ta hanyar mask, ko da yake CPAP an saita shi a ma'auni guda ɗaya yayin da BiPAP yana da saituna biyu, ɗaya don wahayi kuma daya don karewa.
Ana amfani da BiPAP sau da yawa ga mutanen da ke tare da COPD tun lokacin da ya fi sauƙi don fitar da ƙananan matsa lamba. BiPAP kuma yana ba da dama don daidaitawa a lokaci.
Layin Ƙasa
Rashin iska mai ban sha'awa ba dace da kowa ba kuma baya ci gaba da nasara. Abin sani kawai likitanku zai iya ƙayyade idan kun kasance dan takara don samun iska mai ban sha'awa.
Wancan ya ce, binciken da ya nuna cewa rage yawan buƙata na intubation na ƙarshe da kuma inganta yawan rayuwa ga mutanen dake da COPD wadanda masu takara na NIPPV suna ƙarfafawa sosai. Bugu da ƙari, yayin da ake kallon lokaci mai tsawo na yin amfani da iska mai ban sha'awa tare da COPD, canje-canje kamar cigaban cigaban jini da aikin hawan jini, da kuma kyakkyawar rayuwa ta kwanan nan an lura, musamman tare da NIPPV mai girma.
Tabbas, samun iska mai ban sha'awa ba ta zama daidai ba kawai don inganta rayuwarka da rayuwa tare da COPD mai tsanani. Tabbatar da ilmantar da kanka a kan ƙarin matakai don rike da aikin aiki tare da mataki na III COPD .
> Sources
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> Kasper, Dennis, Anthony Fauci, Stephen Hauser, Dan Longo, da J. Jameson. Ka'idodin Magungunan Hoto na Harrison. New York: McGraw-Hill Education, 2015. Print.
> Kohnlein, T., Windisch, W., Kohler, D. et al. Ƙungiyar Harkokin Ƙarfafawa Mai Rashin Kwacewa don Yin Jiyya na Cutar Gwagwarmaya Cikin Gwagwarmayar Kwayar Tsari: Mai yiwuwa, Maɗaukaki, Randomed, Gudanar da gwaji na asibiti. Lancet. Magunguna na numfashi . 2014. 2 (9): 698-705.
> Windisch, W., Storre, J., da T. Kohnlein. Ƙungiyar Neman Harkokin Ƙarfafawa ta Kyau da Kyau don COPD. Kwararrun Kwararru na Magungunan Raunuka . 2015. 9 (3): 295-308.