Mumakore achangopfuura, vanhu vakawanda vakabhadhara zvakanyanya basa reokisijeni kurapwa muhutano hwehutano. Oxygen therapy haisi nzira yakakosha yekurapa mumishonga, asiwo fashoni yehutano hwemusha.
Chii chinonzi Oxygen Therapy?
Oxygen therapy chiyero chekurapa chinobvisa kana kugadzirisa hypoxic mamiriro emuviri kuburikidza nekuwedzera huwandu hweokisijeni mumhepo inofema.
Sei uchida oxygen?
Inonyanya kushandiswa kusunungura mamiriro ezvinhu anoitika panguva ye hypoxia, zvakadai sedzungu, palpitation, kuoma kwechipfuva, kuvharwa, nezvimwewo. Inoshandiswawo kurapa zvirwere zvikuru. Panguva imwecheteyo, okisijeni inogonawo kuvandudza kuramba kwemuviri uye kukurudzira metabolism.
Mhedzisiro yeOxygen
Kufema mweya weokisijeni kunogona kubatsira kuvandudza okisijeni yeropa uye kubatsira kufema kwemurwere kuti adzokere kune zvakajairika nekukurumidza. Kazhinji inorambira mukurapwa kweokisijeni, inogona kunyatso kudzikamisa mamiriro acho. Uyezve, okisijeni inogona kuvandudza kushanda kwetsinga dzemurwere, immune system yemuviri uye metabolism yemuviri.
Contraindications uye zviratidzo zveokisijeni
Iko hakuna zvachose contraindications kune oxygen inhalation
Okisijeni inokodzera acute kana isingaperi hypoxemia, Senge: kupisa, hutachiona hwemapapu, COPD, congestive heart failure, pulmonary embolism, kuvhunduka nekukuvara kwakanyanya kwemapapu, carbon monoxide kana cyanide poisoning, gas embolism nemamwe mamiriro.
Nheyo dzeokisijeni
Mitemo yemishonga:Okisijeni inofanira kushandiswa semushonga unokosha mukurapwa kweokisijeni, uye tsamba yekurapa kana kuti chiremba wekurapwa kweokisijeni inofanira kupihwa.
De-scalation musimboti: Kune varwere vane yakanyanya hypoxemia yechikonzero chisingazivikanwe, musimboti wekudzikisa-kukwira unofanirwa kuitwa, uye kurapwa kweokisijeni kubva pakakwirira kusvika kune yakaderera kunofanirwa kusarudzwa zvinoenderana nemamiriro.
Chinangwa-chinotungamirwa musimboti:Sarudza zvine musoro kurapa okisijeni zvinangwa zvinoenderana nezvirwere zvakasiyana. Kune varwere vari panjodzi yekuchengetwa kwekabhoni dioxide, iyo yakakurudzirwa oxygen saturation tarisiro ndeye 88% -93%, uye kune varwere vasina njodzi yekuchengetwa kwekabhoni dioxide, iyo inokurudzirwa oksijeni saturation chinangwa ndeye 94-98%
Inowanzo shandiswa okisijeni kufema maturusi
- Oxygen chubhu
Iyo okisijeni inonyanya kushandiswa mumakiriniki maitiro, Chikamu chevhoriyamu chinofemerwa neokisijeni chubhu chakabatana neiyo okisijeni inoyerera, asi iyo okisijeni chubhu haigone kunyoroveswa zvakakwana, uye murwere haagone kushivirira kuyerera kunopfuura 5L/min.
- Mask
- Yakajairika mask:Inogona kupa yakafuridzirwa okisijeni vhoriyamu chikamu che40-60%, uye mwero wekuyerera kweokisijeni haufanirwe kunge uri pasi pe5L/min. Inokodzera varwere vane hypoxemia uye hapana njodzi ye hypercapnia.
- Kufema patsva uye kusiri kufema masiki ekuchengetedza okisijeni: Kune masiki ekufema zvishoma ane chisimbiso chakanaka, kana kuyerera kweokisijeni kuri 6-10L/min, chikamu chevhoriyamu yeokisijeni yakafuridzirwa inogona kusvika 35-60%. Iko kuyerera kweokisijeni yemasikisi asina kufema zvakare inofanira kunge iri 6L / min. Izvo hazvina kukodzera kune avo vane njodzi yekuchengetedza CO2. yevarwere vane chronic obstructive pulmonary disease.
- Venturi mask:Iyo inochinjika yakakwirira-kuyerera kwakanyatso kuyerera kweokisijeni mudziyo unogona kupa huwandu hweokisijeni ye24%, 28%, 31%, 35%, 40% uye 60%. Inokodzera varwere vane hypoxic vane hypercapnia.
- Transnasal high flow oxygen therapy device: Nasal high-flow oxygen therapy zvishandiso zvinosanganisira nasal cannula oxygen systems uye air oxygen mixers. Inonyanya kushandiswa mukutadza kufema kwakanyanya, sequential oxygen therapy mushure me extubation, bronchoscopy uye mamwe mavhiya anoparadza. Mukushandiswa kwekiriniki, iyo inonyanya kuoneka mhedzisiro iri muvarwere vane acute hypoxic kufema kutadza.
Nasal oxygen tube operation nzira
Mirayiridzo yekushandisa: Isa chivharo chemhino pachubhu yekufemera mweya weokisijeni mumhino, sunga chubhu kubva kuseri kwenzeve yemurwere kumberi kwehuro woiisa panzeve.
Cherechedza: Okisijeni inopiwa kuburikidza neokisijeni inhalation tube pahupamhi hwepamusoro hwe6L / min. Kuderedza kuyerera kweokisijeni kunogona kuderedza kuitika kwekuoma kwemhino uye kusagadzikana. Hurefu hwehubhu yeokisijeni haifanire kunge yakareba kudzivirira njodzi yekudzipwa nekudzipwa.
Zvakanakira uye Zvakaipa zveNasal Oxygen Cannula
Mabhenefiti makuru emhino okisijeni chubhu inhalation okisijeni ndeyekuti iri nyore uye yakanakira, uye haina kukanganisa expectoration uye kudya. Izvo zvisingabatsiri ndezvekuti iyo oxygen concentration haisi nguva dzose uye inokanganiswa nyore nekufema kwemurwere.
Maitiro ekuita oxygen neyakajairwa mask
Masikisi akajairika haana mabhegi ekuchengetedza mweya. Kune maburi ekupedza mativi ese emasikisi. Mhepo yakatenderedza inogona kutenderera paunenge uchifema uye gasi rinogona kubuditswa kana uchifemesa.
Cherechedza: Mapaipi akabviswa kana kuyerera kweokisijeni kuderera kuchaita kuti murwere agamuchire okisijeni yakakwana uye kufemazve kabhoni dhayokisaidhi. Naizvozvo, kutarisisa kunofanirwa kubhadharwa kune chaiyo-nguva yekutarisa uye kugadzirisa panguva kwayo chero matambudziko anomuka.
Zvakanakira zveokisijeni nemasiki akajairwa
Kusatsamwisa, kune vanofema muromo
Inogona kupa iyo inogara yakafemerwa oksijeni concentration
Kuchinja kwemaitiro ekufema hakushandure yakafuridzirwa oksijeni
Inogona kunyorovesa okisijeni, zvichikonzera kushatirwa kudiki kumhino mucosa
Gasi repamusoro-soro rinogona kukurudzira kubviswa kwekabhoni dhayokisaidhi mumasiki, uye hapana kudzokororwa kudzokororwa kwekabhoni dioxide.
Venturi mask okisijeni nzira
Iyo Venturi mask inoshandisa iyo jet kusanganisa musimboti kusanganisa ambient mhepo neokisijeni. Nekugadzirisa saizi yeokisijeni kana mhepo inopinza gomba, gasi rakasanganiswa reFio2 inodiwa inogadzirwa. Pazasi peVenturi mask ine intrainments yemavara akasiyana, anomiririra akasiyana apertures.
CHERECHEDZA: Venturi masks ane mavara-coded nemugadziri, saka kutarisisa kwakakosha kunodiwa kuti uise nemazvo mwero wekuyerera kweokisijeni sezvakatsanangurwa.
High kuyerera nasal cannula nzira
Ipa okisijeni pamwero wekuyerera unopfuura 40L/min, kukunda kusakwana kweokisijeni kuyerera kunokonzerwa neakajairwa nasal cannulas uye masks nekuda kwekuyerera kwekuyerera. Iyo okisijeni inopisa uye inonyoroveswa kudzivirira kusagadzikana kwemurwere uye kukuvara kwekupera kwegore.Kuyerera-kuyerera kwenasal cannula kunogadzira ine mwero yakanaka yekupedzisira-expiratory pressure. Inobvisa atelectasis uye inowedzera kushanda kwakasara simba, kuvandudza kushanda kwekufema uye kuderedza kudiwa kwe endotracheal intubation uye mechanical ventilation.
Matanho ekushanda: chekutanga, batanidza chubhu yeokisijeni kune pombi yeokisijeni yechipatara, batanidza chubhu yemhepo kune pombi yemhepo yechipatara, isa iyo inodiwa yeokisijeni pamhepo-okisijeni musanganisi, uye gadzirisa kuyerera pamita yekuyerera kushandura yakakwirira. -kuyerera mhino Iyo catheter yakabatana nemhepo yekufema kuti ive nechokwadi chekuyerera kwemhepo yakakwana kuburikidza nekuvharwa kwemhino. Bvumira gasi kupisa uye kunyorovesa murwere asati aita cannulating, achiisa plug yemhino mumhino nekuchengetedza cannula (tipi haifanire kunyatsosunga mhino)
Cherechedza: Usati washandisa high-flow nasal cannula pamurwere, inofanira kuiswa maererano nemirairo yemugadziri kana pasi pekutungamirirwa kwenyanzvi.
Sei uchishandisa humidification paunenge uchifema oxygen?
Okisijeni yezvokurapa iokisijeni yakachena. Iyo gasi yakaoma uye haina unyoro. Dry oxygen ichatsamwisa murwere wepamusoro kufema turakiti mucosa, nyore kukonzera murwere kusagadzikana, uye kunyange kukonzera mucosal kukuvara. Naizvozvo, kuti izvi zvisaitike, bhodhoro rehumidification rinoda kushandiswa pakupa oxygen.
Ndeipi mvura inofanira kuwedzerwa kubhodhoro rehumidification?
Iyo humidification fluid inofanirwa kunge iri mvura yakachena kana mvura yejekiseni, uye inogona kuzadzwa nemvura inotonhora yakafashaidzwa kana mvura yakabikwa.
Ndevapi varwere vanoda kwenguva refu oksijeni kurapwa?
Parizvino, vanhu vanotora okisijeni kwenguva refu vanonyanya kusanganisira varwere vane chirwere chisingaperi che hypoxia chinokonzerwa ne cardiopulmonary insufficiency, zvakadai sevarwere vane pakati uye kupera kweCOPD, kuguma-danho re interstitial pulmonary fibrosis uye kusingaperi kuruboshwe ventricular insufficiency. Vakwegura ndivo vanowanzobatwa nezvirwere izvi.
Oxygen flow classification
Low flow okisijeni inhalation oxygen concentration 25-29%,1-2L/min, inokodzera varwere vane hypoxia inoperekedzwa nekabhoni dioxide kuchengetedza, zvakadai sechirwere chisingaperi chemapapu, chirwere chechipiri chekufema, cor pulmonale, pulmonary edema, postoperative varwere, varwere vane kuvhunduka, coma kana chirwere chepfungwa, nezvimwewo.
Pakati-inoyerera okisijeni inhalation concentration 40-60%, 3-4L/min, yakakodzera varwere vane hypoxia uye pasina carbon dioxide kuchengetedza
High-flow oxygen inhalation ine inhaled oxygen concentration inopfuura 60% uye inopfuura 5L/min.. Inokodzera varwere vane hypoxia yakaoma asi kwete carbon dioxide kuchengetedza. Zvakadai senge acute kufema uye kutenderera kusungwa, congenital moyo chirwere chine kurudyi-kuruboshwe shunt, carbon monoxide poisoning, nezvimwe.
Sei uchida okisijeni mushure mekuvhiyiwa?
Anesthesia uye marwadzo zvinogona kukonzera kufema zvirambidzo muvarwere uye kutungamirira ku hypoxia, saka murwere anoda kupiwa oxygen kuti awedzere ropa remurwere oksijeni chikamu chekumanikidzwa uye saturation, kukurudzira kuporesa kweronda remurwere, uye kudzivirira kukanganisa kuuropi uye myocardial masero. Bvisa kurwadziwa kwemurwere mushure mekuvhiyiwa
Sei uchisarudza yakaderera-yakadzika oksijeni inhalation panguva yeokisijeni kurapwa kune vasingaperi mapapu varwere?
Nekuti chisingaperi chinovharidzira pulmonary chirwere chinoramba chiripo chepulmonary ventilation kusagadzikana kunokonzerwa nekudzika kwemhepo, varwere vane madhigirii akasiyana e hypoxemia uye carbon dioxide retention. Maererano nenheyo yekugovera okisijeni "murwere kabhoni dhaikisaidhi Kana kudzvinyirirwa kwekabhoni dhaikisaidhi kwakwira, kufemerwa kweokisijeni kwakaderera kunofanira kupihwa; apo dzvinyiriro yakati yekabhoni dhaikisaidhi inenge iri yenguva dzose kana kuti yakaderedzwa, kufema kweokisijeni yakakwira-concentration kunogona kupiwa.”
Sei varwere vane kukuvara kwehuropi vachisarudza okisijeni kurapwa?
Oxygen therapy inogona kubatsira kuvandudza kurapa kwevarwere vane kukuvara kwehuropi, kukurudzira kudzoreredza kwemabasa etsinga, kunatsiridza nerve cell edema uye kuzvimba maitiro, kuderedza kukuvadzwa kwemaseru etsinga ne endogenous chepfu zvinhu zvakaita seokisijeni isina radicals, uye kukurumidza kudzoreredza kwakakuvadzwa. Muropi tishu.
Sei oxygen ichityisa?
“Chepfu” inokonzerwa nokufema oxygen yakawandisa kupfuura zvinodiwa nomuviri
Zviratidzo zve oxygen poisoning
Muchetura weokisijeni unowanzo kuratidzwa mukukanganisa kwayo pamapapu, nezviratidzo zvakaita sepulmonary edema, kukosora, uye kurwadziwa kwechipfuva; chechipiri, inogonawo kuratidza sekusagadzikana kweziso, zvakadai sekutadza kuona kana kurwadziwa kweziso. Muzviitiko zvakakomba, zvinokanganisa hurongwa hwemitsipa uye zvinotungamirira kuhutano hwehutano. Pamusoro pezvo, kufema mweya weokisijeni yakawandisa kunogonawo kumisa kufema kwako, kukonzeresa kubatwa nekufema, uye kuve nenjodzi yehupenyu.
Kurapa kwe oxygen toxicity
Kudzivirira kuri nani pane kurapa. Dzivisa kwenguva refu, yakakwirira-concentration oxygen therapy. Kana zvangoitika, tanga wadzikisa huwandu hweokisijeni. Kunyanya kutarisisa kunodiwa: chinhu chinonyanya kukosha ndechokusarudza nemazvo uye kudzora iyo oksijeni yemukati.
Ko kugara uchifemerwa neokisijeni kunokonzeresa kutsamira here?
Kwete, okisijeni inodiwa kuti muviri wemunhu ushande nguva dzese. Chinangwa chekufema mweya weokisijeni ndechekuvandudza kufambiswa kweokisijeni mumuviri. Kana iyo hypoxic mamiriro akagadziridzwa, unogona kumisa inhale okisijeni uye hapazovi nekuvimba.
Sei okisijeni inhalation ichikonzera atelectasis?
Kana murwere achifema yakakwira-concentration oxygen, yakawanda yenitrogen mualveoli inotsiviwa. Kana paine kuvharika kwebronchi, iyo okisijeni iri mualveoli iyo yairi ichakurumidza kutorwa nemapapu ekutenderera kweropa, zvichikonzera inhalation atelectasis. Inoratidzwa nekushatirwa, kufema uye kurova kwemoyo. Kurumidza, BP inokwira, uye ipapo unogona kuwana kunetseka kufema uye coma.
Matanho ekudzivirira: Tora kufema kwakadzika kudzivirira kuvharika kubva pakuvhara nzira yemhepo
Ko retrolental fibrous tissue ichawanda mushure mekufema oxygen?
Iyi side effect inoonekwa chete muvana vachangoberekwa, uye inowanzoonekwa muvana vasati vasvika. Zvinonyanya kukonzerwa neretinal vasoconstriction, retinal fibrosis, uye pakupedzisira inotungamira kuhupofu husingadzokerike.
Matanho ekudzivirira: Kana vana vachangozvarwa vachishandisa okisijeni, kugadzika kweokisijeni uye nguva yekufema kweokisijeni inofanira kudzorwa
Chii chinonzi kufema depression?
Zvinowanzoitika kune varwere vane rudzi rwechipiri rwekufema kukundikana. Sezvo kudzvinyirirwa kwekabhoni dhaokisaidi kwave kuri padanho repamusoro kwenguva yakareba, nzvimbo yekufema yakarasikirwa nekunzwa kwayo kucarbon dioxide. Iyi ndiyo mamiriro apo mutemo wekufema unonyanya kuchengetedzwa nekukurudzira kweperipheral chemoreceptors ne hypoxia. Kana izvi zvikaitika Kana varwere vachipihwa yakakwira-concentration oxygen kuti inhale, iyo inosimudzira mhedzisiro ye hypoxia pakufema inozorerutswa, izvo zvichawedzera kuderera kwenzvimbo yekufema uye kunyange kukonzera kusungwa kwekufema.
Matanho ekudzivirira: Ipa yakaderera-concentration, yakaderera-inoyerera inoramba iine okisijeni (oxygen inoyerera 1-2L / min) kune varwere vane II kutadza kufema kuchengetedza kufema kwakajairika.
Sei varwere vanorwara zvakanyanya vachida kutora zororo panguva yekukwira-kuyerera kweokisijeni?
Kune avo vane mamiriro akaoma uye acute hypoxia, high-flow oxygen inogona kupiwa pa 4-6L / min. Iyi okisijeni yehuwandu inogona kusvika 37-45%, asi nguva haifaniri kudarika maminitsi 15-30. Kana zvichidiwa, shandisa zvakare 15-30 maminetsi ose.
Nekuti nzvimbo yekufema yerudzi urwu rwemurwere haina hanya nekukurudzira kuchengetwa kwekabhoni dioxide mumuviri, inonyanya kuvimba nehypoxic oxygen kukurudzira chemoreceptors yemuviri weaortic uye carotid sinus kuchengetedza kufema kuburikidza nemafungiro. Kana murwere akapiwa high-flow oxygen, iyo hypoxic state Painosunungurwa, reflex stimulation yekufema neaortic body uye carotid sinus inopera simba kana kupera, iyo inogona kukonzera apnea uye kuisa upenyu pangozi.
Nguva yekutumira: Oct-23-2024