​UNDERSTANDING HYPERBARIC OXYGEN THERAPY: SECHRIST'S COMPREHENSIVE GUIDE

I-Hyperbaric Oxygen Therapy (HBOT) yonyango yonyango apho isigulane sivalelwe ngokupheleleyo kwigumbi loxinzelelo lokuphefumula i-100% i-oksijeni ecocekileyo (O2) kuxinzelelo olungaphezu kweyodwa emoyeni. Umoya uqulethe phantse i-21% yeoksijini, kunye ne-78% yenitrogen. Kwi-hyperbaric oxygen therapy (HBOT), ipesenteji ye-oksijini ephefumle isigulane iphantse okanye ngokwenene i-100%, phantse ngokuphindwe kahlanu kunomoya. Uxinzelelo lwe-oksijini ephefumulelwe ngumguli kwigumbi le-oksijini ye-hyperbaric ngokuqhelekileyo ngaphezu kwamaxesha e-1.5 (kwaye ingaba ngamaxesha angama-3) ngaphezu koxinzelelo lwe-atmospheric. I-HBOT inokuhambisa phantse i-oksijini eninzi ngokuphindwe ka-15 njengoko kukho emoyeni ngoxinzelelo oluqhelekileyo.

I-Hyperoxygenation: I-HBOT inyibilika ngokwasemzimbeni ioksijini eyongezelelweyo kwiplasma yegazi, ethi ke ihanjiswe kwizicubu. Ukuphefumla ioksijini ecocekileyo kumaxesha amabini ukuya kwamathathu uxinzelelo oluqhelekileyo luhambisa amaxesha angama-10-15 njengeoksijini echithwe ngokwasemzimbeni kwizicubu. Oku kunokunyusa i-oksijini ye-tissue kwii-tissue eziphazamisekile ukuya kumaxabiso amakhulu kunesiqhelo. I-Hyperoxygenation ibonakaliswe ukukhuthaza ukubunjwa kwama-capillaries amatsha kwi-ischemic okanye amanxeba angabonakaliyo. Ngoko ke, luncedo kunyango lwe-ischemic esekelwe kwizilonda ezithintekayo, i-flaps kunye ne-grafts. Ikwaluncedo kwezinye izifo ngokuvumela umsebenzi weseli emhlophe (leukocytic) ukuba uqalise ukusebenza kwakhona. Umphumo weMechanical woxinzelelo olongezelelweyo: Nayiphi na igesi emzimbeni iya kuncipha ngomthamo njengoko uxinzelelo luyanda. Ngokunyuka kathathu koxinzelelo, i-bubble ebanjwe emzimbeni iyancipha ngesibini kwisithathu. Ngaloo ndlela, ukunciphisa umthamo wegesi kusombulula i-air embolism kunye nokugula kwe-decompression xa ukuxilongwa kunyango kwenziwa ngexesha elifanelekileyo. I-Vasoconstriction: I-oksijeni ephezulu yoxinzelelo ibangela ukuxinwa kwemithambo yegazi kwizicubu eziqhelekileyo ngaphandle kokudala i-hypoxia. Ayibangeli ukuxinana kwiithishu zangaphambili ezingenayo i-oxygen. I-vasoconstriction iyancipha i-edema eluncedo kunyango lokutshisa, ukulimala, i-compartment syndromes kunye nezinye i-ischemia ezibuhlungu. Nangona ukuhamba kwegazi okufaka isandla kwi-edema kuncitshisiwe, ukuhanjiswa kwe-oksijini kwiithishu kugcinwa nge-hyperoxygenation effect. Umsebenzi we-Antimicrobial: I-HBOT inqanda ukuveliswa kwe-alpha toxin njengoko kubonwa kwizifo ze-anaerobic ezifana ne-clostridium perfringens (i-gas gangrene). Oyena nobangela uxhaphakileyo werhas gangrene yiclostridium perfringens; nangona kunjalo, kukho izinto eziphilayo ezininzi ezivelisa igesi (i-aerobic kunye ne-anaerobic) ezifuna ukuchithwa kotyando ekuqaleni. Ikwaphucula umsebenzi wokubulala iiseli ezimhlophe obonelela nge-adjuvant egqwesileyo kwi-IV ye-antibiotic kunye nokhathalelo lwenxeba lwendawo. Isenzo sobunzima beegesi: Ukuphuphuma komzimba ngayo nayiphi na igesi enye idla “ekuhlambeni” ezinye. Esi senzo senzeka ngokukhawuleza ngakumbi phantsi koxinzelelo kunaphantsi kweemeko eziqhelekileyo, kwaye senza i-HBOT ibe lunyango olubonakalisiweyo lokugula koxinzelelo. Ukunciphisa Ukulimala Okuphindaphindayo: Ukulandela ixesha le-ischemic, ukulimala ngokungathanga ngqo kwenzeka, okuxutyushwa ngokusebenza okungafanelekanga kwe-leukocytes. I-HBOT ikhusela ukusebenza okunjalo. Ukubambelela kwiiseli ezimhlophe zegazi kwiindonga ze-capillary kuncitshiswe ngokuphawulekayo, ngaloo ndlela kuthomalalisa isenzeko "sokungabuyi kwakhona". Yingakho unyango lwe-HBOT luboniswa kwi-carbon monoxide poisoning kwaye luthathwa njengonyango olukhethiweyo.

I-HBOT ibonakaliswe ukuba iyasebenza kwiimeko ezininzi zonyango, kwaye ngenxa yoko i-Undersea kunye ne-Hyperbaric Medicine Society, enye yamaziko ophando oluphambili, ivume izibonakaliso ezilandelayo: Umoya okanye igesi embolism Ityhefu yeCarbon monoxide Ityhefu yeCarbon monoxide entsonkothileyo yiCyanide Poisoning I-Clostridal Myositis kunye ne-Myonecrosis (iGas Gangrene) I-Crush Injury, i-Compartment Syndrome, kunye nezinye i-Acute Traumatic Ischemias Isigulo soxinzelelo Ukwandiswa kokuPhilisa kwiiNgxaki eziKhethekileyo zeNgxaki; Ukunganeli kweArterial; Ukuvaleka komthambo weRetina I-anemia enzima Ithumba elingaphakathi kwingqondo Necrotizing Soft Tissue Usulelo I-Osteomyelitis ye-Refractory Ukulibaziseka kokwenzakala kweRadi (Izicubu ezithambileyo kunye neBony Necrosis) I-Skin Grafts eNcitshisiweyo kunye neFleps Acute Thermal Burn Injury Ukongeza, ukumiselwa kwe-Medicare kuya kubuyisela e-US kwezi meko zilandelayo: Amanxeba esifo seswekile kwindawo esezantsi kwizigulana ezihlangabezana nezi ndlela zintathu zilandelayo: Isigulana sinohlobo lwe-I okanye uhlobo lwe-II yeswekile kwaye sinesilonda esisezantsi ngenxa yesifo sikashukela; Isigulana sinesilonda esichazwe njenge-Wagner grade III okanye ngaphezulu; kwaye Isigulana asiphumelelanga kwikhosi eyaneleyo yonyango lwenxeba olusemgangathweni.

Ukuba unyango lwenziwa ngaphakathi kwezibonakaliso ezamkelweyo ezipapashwe yi-Undersea & Hyperbaric Medicine Society kwaye njengoko kujongwa yi-Health Care Financing Administration, unyango luvame ukubuyiselwa. Njengazo zonke iinkonzo zonyango ezibonelelweyo, abanye ababoneleli bokhathalelo babucala kunye nabo bonke abalawulwayo bafuna ugunyaziso lwangaphambili.

Ngokufana nazo zonke iindlela zonyango, i-HBOT ayisetyenziselwa izifo apho kungekho bungqina bekliniki obusebenzayo. Kukho amabango okuba i-HBOT inokunceda kwiingxaki ezifana nolusu olugugayo okanye ukwandisa ubomi obuqhelekileyo obusempilweni. Ezo azikhange zibhalwe okanye zamkelwe kuluntu lwezonyango olubanzi.

Ngenkcazo, unyango lwe-oxygen hyperbaric lulawulwa kwisigulane kwigumbi elixinzelelekileyo. Igumbi le-hyperbaric yintsimbi, i-aluminium okanye igumbi leplastiki elicacileyo apho umoya unokunyanzeliswa kuxinzelelo olukhulu kunomgangatho wolwandle. Kukho iindidi ezimbini zamagumbi, i-monoplace kunye ne-multiplace. I-Monoplace Chambers: Igumbi le-monoplace yinkqubo ehlala isigulane esinye ngexesha. Isigulana silala phantsi kwi-stretcher etyibilikayo kwigumbi. Ngokuqhelekileyo igumbi lixinzeleleke nge-100% oksijini. Isigulane sifumana i-100% oksijini ngokuphefumla i-oksijini ngaphakathi kwegumbi. Imaski okanye ihood ayidingeki. Amagumbi e-Monoplace anamandla okunyanzeliswa kwi-3 ATA. Ngaphandle kokugula kwe-decompression kunye ne-gas embolism, i-protocols ye-UHMS yonyango lwe-hyperbaric ayifuni ngaphezu kwe-3 ATA yoxinzelelo lonyango. Izigulana ezigula kakhulu ezifuna izixhobo ezibanzi zokuxhasa ubomi zinokunyangwa kwi-monoplace ye-Sechrist. (Abanye abavelisi be-monoplace ababoneleli ngazo zonke izakhono zokuxhasa ubomi). Uninzi lwezigulane ze-hyperbaric ziphathwa kwigumbi le-monoplace. I-Multiplace Chambers: Igumbi le-multiplace yinkqubo ekwazi ukuhlalisa abantu ababini okanye ngaphezulu. Izigulana zinokuhamba okanye zifakwe ivili (zihleli okanye zilele phantsi) kwigumbi elineendawo ezininzi, kuxhomekeke kubungakanani. Ngokuqhelekileyo, umlindi ungaphakathi kunye nezigulana. Amagumbi axinzezeleka ngomoya oxinzelelweyo ngokusebenzisa inkqubo yonikezelo oluzinikeleyo. I-100% i-oxygen ihanjiswa kwisigulane nge-mask okanye i-hood assembly. Amagumbi amaninzi anamandla okunyanzeliswa kwi-6 ATA. Uxinzelelo oluphezulu lunokufunwa kunyango lwesigulo sokudambisa kunye neemeko ze-air embolism.

Ngaphandle kwesigulo sokudakumba kunye ne-arterial gas embolism, unyango oluqhelekileyo lumalunga neeyure ezimbini ubude. Unyango lwenziwa ngesigulana esileleyo okanye esilaliswe ngaphandle. Kwezinye iimeko ezinzima, unyango lunokwenziwa rhoqo kwiiyure ezisibhozo ukuya kwezilishumi elinesibini.

Impendulo yesigulane kunye nezinye izinto zihlala zichaza inani lonyango olufunekayo. Iimeko ezingxamisekileyo, ezifana netyhefu yecarbon monoxide, i-arterial gas embolism okanye isigulo soxinzelelo, zinokufuna unyango olunye okanye ezimbini kuphela. Amanxeba angapholiyo asenokufuna unyango olumalunga nama-20 ukuya kwangama-30.

Ngokuqhelekileyo, isigulane asiyi kuvakalelwa ngendlela eyahlukileyo. Noko ke, ebudeni beendawo ezithile zonyango, umguli usenokuziva ezele ezindlebeni, ngokufanayo nemvakalelo efunyanwa kwinqwelo-moya. Esi sisiphumo se-eardrum esabela kwiinguqu zoxinzelelo. Ngaphambi kokunyanga, isigulane siya kufundiswa iindlela ezimbalwa ezilula "zokucoca" iindlebe zakhe ukuphepha ukungahambi kakuhle.

Isigulane kufuneka sinxibe i-100% yeengubo zekotoni ngexesha lonyango. Izinto zobuqu azivumelekanga kwigumbi le-hyperbaric. Ngolwazi olongezelelweyo jonga into ongazisiyo kwikhonkco legumbi le-hyperbaric.

The most common side-effects are not serious, those include: Claustrophobia Ear popping Temporary myopia Lung problems in rare cases, the lungs have become irritated by the oxygen, and the patient develops a dry cough that is resolved once the treatment is stopped. In extremely small number of cases, some patients have developed non-life threatening issues. Overall, HBOT is a safe procedure.

Zonke izigulane ze-hyperbaric chamber kufuneka zibe nomyalelo ovela kugqirha othumelayo ukuze ufumane unyango lwe-hyperbaric.

Ukuze i-HBOT igutyungelwe phantsi kwenkqubo ye-Medicare e-United States, ugqirha kufuneka ahlale ekhona ngexesha lonke unyango.

Iiprothokholi zonyango zisekwe ngugqirha ohambayo. Amaxesha onyango olukhuselekileyo, idosi kunye nemida yoxinzelelo iye yasekwa kwi-hyperbaric oxygen exposure kwaye le mida yenza isiseko sazo zonke iiprotocol zonyango. Ngelixa ufumana unyango, isigulane esigula kakhulu sinokubonelelwa nge-ventilation yomatshini, unyango lwe-IV kunye nokuhlolwa kwe-physiological invasive and nonvasive physiological.

Hlamba igumbi ngokohlobo lweemeko ezinyangwayo nanjengoko uyalela abasebenzi bezonyango. Hlamba igumbi kunye nayo yonke i-gurney, i-stretcher kunye nemigangatho ye-matrasi nge-disinfectant evunyiweyo okanye isuphu yokuhlamba izitya. COFA APHA ULUHLU LWENKCAZELO LWEZIKHUSELEKO EZIVUMELEKILEYO