Ukugula kobude

Ukugula kobude

By Uhlaziyo lweMedia; Ukuhlaziywa ngu-Varixcare.cz. Igqityelwe ukuhlaziywa ngoMeyi 31, 2021.

Yintoni ukugula kokuphakama?

Ukupapashwa kwezeMpilo eHarvard

Kwiindawo eziphakamileyo, uxinzelelo lomoya okujikelezileyo (uxinzelelo lwe-barometric) luyancipha ngenxa yoko kukho ioksijini encinci kumoya ojikelezileyo. Abantu banokuhlala kamnandi kwiindawo eziphakamileyo eziphakathi, kodwa umzimba kufuneka wenze uhlengahlengiso, kwaye oku kuthatha ixesha. Ukuba unyukela phezulu ngaphezu kweenyawo ezingama-8,000, uya kuba semngciphekweni wokukhulisa iimpawu ezingathandekiyo okanye eziyingozi ukusuka kutshintsho oluphezulu.



Iimpawu zokugula okuphezulu ezingabeki ubomi emngciphekweni zibizwa ngokuba kukugula okunamandla kwentaba. Ukunyuka kweentaba kuyo nayiphi na intaba ephakamileyo kunye ne-skiers kwiindawo eziphakamileyo ezifana neColorado zisengozini yokuphathwa sisifo sentaba. Iimpawu zokugula ngokuqaqamba kwentaba ziyaphucuka ukuba wehlela kwindawo ephantsi ngokukhawuleza. Kwiimpawu ezinobumnene kakhulu, ukulibaziseka ngaphambi kokunyuka kunokukwanele ukuvumela iimpawu ukuba zihambe.



iziphumo ebezingalindelekanga ze-oxcarbazepine

Ukugula okuqatha kwintaba yeyona nto inobungozi kwiintlobo ezininzi zezifo eziphakamileyo ezinokuthi zenzeke. Esi sifo sichaphazela phantse isiqingatha sabo bonke abantu abaqala ukusondela kwinqanaba lolwandle kwaye banyuke baye kwi-14,000 yeenyawo zokuphakama ngaphandle kokucwangcisa ixesha elaneleyo lokuphumla.

Iimpawu ezikhula kwindawo ephezulu kufuneka zithathelwe ingqalelo kakhulu, kuba ezinye iingxaki zokuphakama zinokukhula zibe zizifo ezibulalayo. Impendulo eyingozi ekuphakameni okuphezulu yimeko ebizwa ngokuba yi-high-altitude cerebral edema (HACE), apho ingqondo iqokelela ulwelo olongezelelekileyo, idumbe kwaye iyeke ukusebenza ngokufanelekileyo. Ukugula okunxulumene noko, i-edema ephezulu ye-pulmonary edema (HAPE), inokwenzeka kunye okanye ngaphandle kweempawu zesilumkiso ezibonisa ukugula okuphezulu. IHAPE ibangela ukuba ulwelo lungene emiphungeni. Uhlobo lokugula kwendawo ebizwa ngokuba yi-high-altitude retinal hemorrhage (HARH) inokubangela ukonakala kwamehlo. I-Coma kunye nokufa ziziphumo ezibi kakhulu zokugula okuphezulu.



Ukugula kubude kunokwenzeka ukuba kwenzeke kubantu abanembali yangaphambili yokugula kwendawo. Kuyenzeka ukuba unyuke ngokukhawuleza, ukuba uzilolonga ngamandla ngeentsuku zakho zokuqala zokuvezwa komphakamo, kwaye ukuba ubuphila kwindawo ephantsi ngaphambi kokunyuka kwakho. Ukutyeba kakhulu kubonakala kukonyusa umngcipheko wokugula okuphezulu. Imfuza inokubeka abanye abantu emngciphekweni owandayo, ngakumbi kwi-edema ephezulu ye-pulmonary edema (HAPE).

Iimpawu

Njengoko umzimba wakho usenza uhlengahlengiso oluqhelekileyo ukuziqhelanisa nokuphakama okuphezulu, unokufumana iimpawu ezimbalwa eziphazamisayo kodwa ezingabangeli nkxalabo. Babandakanya ukukhawulezisa (kodwa ukhululekile) ukuphefumla, ukuphefumla kancinci ngokuzilolonga, ngamanye amaxesha ukuphefumla kancinci xa ulele, kunye nokuchama rhoqo. Iimpawu ezimbini zokugqibela zibangelwa linqanaba eliphantsi lekhabhon diokside, elibangela uhlengahlengiso kwingqondo nakwintso.

Iimpawu ezinzulu ngakumbi zibangelwa ngamanqanaba asezantsi eoksijini egazini kunye nohlengahlengiso olwenziwa yinkqubo yakho yokujikeleza.



Ukugula kwentaba ihlala ibangela iimpawu ubuncinci kwiiyure ezingama-8 ukuya kwezi-36 emva kokunyuka.

Iimpawu zesifo sentaba ebukhali sinokubandakanya:

  • Intloko engakhululwanga ngamayeza eentlungu ezingaphezulu kwekhawunta
  • Isihlunu okanye ukugabha
  • Utywala okanye intloko
  • Ubuthathaka okanye ukudinwa
  • Kunzima ukulala
  • Ukuphelelwa ngumdla wokutya

Ukuphakama okuphezulu kwengqondo edema yobuchopho iingcali ezininzi ziwujonga njengobulwelwe obugqithisileyo beentaba. Ihlala ikhula emva kweempawu zokugula kakhulu ezintabeni. Iimpawu zesi sifo siphezulu kakhulu asinakuqatshelwa kwangoko kuba isigulo singaqala ebusuku. Ngenxa yokuba le nzakalo ye-oksijini ephantsi ichaphazela ingqondo kunye nenkqubo yokucinga, umntu one-edema ye-cerebral edema ephezulu unokungaqondi ukuba iimpawu ziye zaba qatha de umntu ohamba naye abone indlela yokuziphatha engaqhelekanga.

Iimpawu zingabandakanya:

  • Ukuqaqanjelwa yintloko kunye nokugabha
  • Ukuhamba ngendlela egxadazelayo
  • Ukudideka
  • Ukudinwa
  • Ukubona izinto ezibonakalayo (ukubona izinto ezingezizo)
  • Utshintsho kwisakhono sokucinga
  • Utshintsho kwindlela yokuziphatha eqhelekileyo
  • Coma (kwiimeko eziphambili)

I-edema ephezulu yemiphunga , eyimpendulo yemiphunga ekunyukeni kokuphakama, inokwenzeka kunye okanye ngaphandle kwezinye iimpawu zokugula okuphezulu. Uxinzelelo lweoksijini olusezantsi lunokubangela ukuba imithambo yegazi emiphungeni inyanzelise (ukuqina), ibangele uxinzelelo oluphezulu kwimithambo yemiphunga. Oku kubangela ukuba ulwelo luvuze kwimithambo yegazi luye kwimiphunga. Iimpawu ze-edema ephezulu ye-pulmonary edema ibonakala rhoqo ebusuku kwaye inokuba mandundu ngexesha lomthambo.

Iimpawu ze-edema ephezulu ye-pulmonary edema ibandakanya:

  • Ukuqina kwesifuba okanye ukugcwala
  • Ukudinwa kakhulu
  • Ukungakwazi ukubamba umphefumlo wakho, naxa uphumla
  • Imilebe eluhlaza okwesibhakabhaka okanye engwevu kunye neenzipho
  • Ukukhohlela, okunokuvelisa ukubola okupinki
  • Umkhuhlane (ubushushu bungaphezulu kwesiqhelo kodwa bungaphantsi kwe-101 ° Fahrenheit)
  • Ingxolo xa uphefumla, njengokugquma okanye ukugquma

Ukopha okuphezulu kwi-retinal hemorrhage kunokwenzeka kunye okanye ngaphandle kweempawu. Ihlala ingabonakali ngaphandle kokuba indawo yamehlo ebonelela ngombono oneenkcukacha (macula) iyabandakanyeka.

Umbono ophukileyo luphawu oluphambili lokuphuma kwegazi kukuphakama okuphezulu.

Uxilongo

Kuya kufuneka ukwazi ukuzibona iimpawu zangaphambi kokugula, kwaye kufuneka ujonge ngononophelo xa usengozini ngenxa yokuba ukuphakama kwezifo kunokuba semngciphekweni wobomi.

iindidi zeziyobisi ngexesha lokukhulelwa

Ukuba intloko kuphela kwempawu, kuya kufuneka uyeke ukunyuka kwaye uthomalalise iintlungu. Ukuba unentloko engapheliyo okanye ukuba unezinye iimpawu ezibonisa ukugula okukhulu kwentaba, esi sifo sinokufunyanwa ngaphandle kovavanyo.

I-edema ye-cerebral edema ephezulu inokukwenza kube nzima ukuhamba umgca othe tye, kwaye kungakhokelela kutshintsho kwindlela yokucinga, ukubona izinto ezingekhoyo okanye utshintsho olungaqondakaliyo kubuntu. Ukuba umntu unale mpawu kwindawo ephezulu, kuya kufuneka ucinge ukuba umntu une-edema yecerebral ephezulu. Umntu onezi mpawu kufuneka ehle kwangoko afune unyango. Nje ukuba umntu one-edema ephezulu ye-cerebral edema ahanjiswe kwiziko lonyango, ukuskena ngemagneti yokujonga (iMRI) kunokwenziwa ukuqinisekisa unobangela weempawu. I-MRI inokubonisa ukudumba kwengqondo.

Ukuqaphela i-edema ephezulu ye-pulmona edema kunokuba nzima kumanqanaba ayo okuqala kuba ukudinwa inokuba kuphela komqondiso. Iimpawu ekufanele ukuba zixhalabisa zibandakanya ubunzima bokuzilolonga, ukukhohlela owomileyo, ukubetha kwentliziyo ngokukhawuleza (ngaphezulu kwe-100 beats ngomzuzu), kunye nokuphefumla kancinci ngelixa uphumle. Ukumamela imiphunga nge-stethoscope kunokubonisa ingxolo eqhekezayo ngokuphefumla ngakunye. Ukuba amanqanaba eoksijini egazi alinganisiwe, aya kuba sezantsi kunokuba bekulindelwe ekuphakameni kwakho. IX-reyi inokubonisa iimpawu zokugcwalisa ulwelo enye okanye nangaphezulu imiphunga, inike inkangeleko efanayo nenyumoniya.

Ukopha okuphezulu kwi-retinal hemorrhage kunokuchongwa ngugqirha ovavanya iliso ngesixhobo esiphethwe ngesandla esibizwa ngokuba yi-ophthalmoscope.

Ixesha elilindelekileyo

Ukuba uyanyuka kwaye ungabuyeli umva uye ekuphakameni apho ugcine uzive kamnandi, iimpawu zakho zinokuba mbi kwaye zingabulala. Iimpawu zesifo sentaba ebukhali ziya kuhamba emva kweentsuku ezimbini okanye ezintathu zokuphumla kwindawo ephantsi. Ii-syndromes ezinzima ezifana ne-HAPE zinokuthatha iiveki ukuba zinyamalale, kwaye ziya kufuna unyango kunye nokulaliswa esibhedlele okunokwenzeka.

Uthintelo

Utshintsho olwenzeka ngokuthe ngcembe kubude obuphezulu luya kunceda umzimba wakho ukuba uqhelane nemeko yeoksijini ephantsi kwaye unokunciphisa amathuba akho okuphuhlisa zonke iintlobo zokugula kwindawo. Abantu bazivumelanisa namazinga ahlukeneyo, kodwa kukho izikhokelo ezine eziqhelekileyo zokunyuka ngaphezu kweenyawo ezili-10 000 ezisebenzayo ukuba abagibeli balandele:

  • Sukunyusa ukuphakama kwakho ngaphezulu kweenyawo eziliwaka ngobusuku.
  • Ngalo lonke ixesha usonyusa ukuphakama kwakho ngeenyawo ezingama-3,000, chitha ubusuku besibini kule ndawo iphakamileyo ngaphambi kokuya phambili.
  • Nciphisa umthambo wakho kumanqanaba afanelekileyo ngexesha leentsuku zakho zokuqala zokunyuka uye phezulu.
  • Sela amanzi amaninzi ngexesha lokuvezwa komphakamo wakho.

Ukuba uvelisa iimpawu zokuqala zokugula kwindawo ephezulu, ungagcina usiba mandundu ukuba uyeka ngokukhawuleza ukunyuka okanye ukuba uyehla.

Iimpawu ezinobumnene zokuhlengahlengisa ukuphakama, ezinjengeentloko, zinokuthintelwa okanye ubuncinci zithintelwe ngokuthatha ibuprofen .

Ukuba ukhe wagula ngenxa yokuphakama okuphezulu ngaphambili kwaye uceba ukuphinda uye phezulu, unokufuna ukuxoxa nogqirha wakho malunga nokuthatha iyeza likagqirha. Ezi zisetyenzisiweyo yi-acetazolamide (iDiamox, iinguqulelo eziqhelekileyo) kunye neyeza le-corticosteroid dexamethasone (I-Decadron, iinguqulelo eziqhelekileyo). I-Acetazolamide inokubangela ukuchama rhoqo kunye nokunambitheka kwesinyithi emlonyeni.

Ukuba ngaba ngaphambili wawukhe wavelisa i-HAPE, unokufumana iyeza lomlomo nifedipine (Procardia), isalmeterol yeziyobisi ephefumlelweyo ( ISerevent ), okanye omabini la mayeza okunyuka kwixesha elizayo. La mayeza anokuzinzisa indlela yokuhamba kwegazi kwimiphunga yakho.

Unyango

Umgaqo wokuqala wonyango lweempawu ezinobuzaza bokugula kwentaba ebukhali kukuyeka ukunyuka de iimpawu zakho ziphele. Ukuba unempawu ezinzima okanye nayiphi na impawu ye-edema ephezulu ye-cerebral edema, i-edema ephezulu ye-pulmary edema, okanye umbono ophazamisayo, kufuneka uhambe kwindawo ephantsi ngokukhawuleza, nangona kuphakathi kobusuku. Ukuba uhlala kwindawo okhoyo ngoku okanye uqhubeka usiya phezulu, iimpawu ziya kusiba mandundu kwaye ukugula kungabulala.

Ngaphandle kokufudukela kwindawo ephantsi, unokunyanga ukugula okuphantsi kancinci ngokuphumla kunye nokuphelisa iintlungu. Iyeza i-acetazolamide linokukhawulezisa ukuchacha. Eli chiza lilinganisa umzimba wakho wemichiza kwaye likhuthaza ukuphefumla.

Ukuba uneempawu zokugula okuphezulu, thintela utywala, iipilisi zokulala kunye neyeza zentlungu. Zonke ezi zinokucothisa ukuphefumla kwakho, okuyingozi kakhulu kwimeko yeoksijini ephantsi.

Ukuba ukwehla kufuneka kulibaziseke - unganyanga i-edema ye-cerebral edema ephezulu kunye ne-oksijini eyongezelelweyo kunye ne-dexamethasone yeziyobisi, enciphisa ukudumba kwengqondo. Ukuba umntu uyafumaneka, le meko ikwancedwa lixesha elichithwe kwigumbi eliphathwayo le-hyperbaric (uxinzelelo), efanisa ukwehla ukuya kwindawo ephantsi, ngexesha lolwalathiso kunye namalungiselelo ezothutho enzelwa ukwehla ukuya ezantsi. Unyango olongezelelekileyo lwe-edema ephezulu ye-pulmonary edema inokubandakanya ioksijini kunye ne-nifedipine, kunye nokusetyenziswa kwonyango lwehyperbaric.

Xa ufuna ukubiza uNgcali

Abantu abanokugula okuphezulu abanakuqonda ukuba bayagula okanye ukuba iimpawu zabo ziya zisiba mandundu. Ukuba uhamba nomntu oneempawu zokugula kakhulu, nceda umntu lowo aye kwindawo ephantsi kwaye adibane nogqirha ngokukhawuleza xa sele ekho.

Imiyalelo ye-gavilyte-n

Ukuxela kwangaphambili

Imbonakalo yesifo sokuphakama kwendawo ixhomekeke ekubeni umntu angasiwa njani ngokukhawuleza kwindawo ephantsi, kwaye zibaluleke kangakanani iimpawu zabo. Iimpawu zokugula okuphezulu kunokunyamalala kwiintsuku nje ezimbalwa kwiindawo eziphantsi. Kwiimeko ezininzi, imisebenzi kwindawo ephezulu inokuphinda iqale. Nangona kunjalo, imeko inokubulala ukuba iimpawu zinzima kwaye umntu uhlala kwindawo ephezulu.

Izixhobo zangaphandle

ILayibrari yeSizwe yezoNyango (NLM)
http://www.nlm.nih.gov/

Umbutho wentliziyo yaseMelika (AHA)
http://www.americanheart.org/

Inkcukacha ezithe vetshe

Njalo qhagamshelana nomboneleli wakho wezempilo ukuqinisekisa ukuba ulwazi oluboniswe kweli phepha lisebenza kwiimeko zakho zobuqu.

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