Ukukhuluphala ngokweqile kwe-hypoventilation syndrome (OHS)

I-Obesity hypoventilation syndrome (OHS) yisimo kwabanye abantu abakhuluphele lapho ukuphefumula okungahambi kahle kuholela ekwehliseni umoya-mpilo namazinga aphezulu e-carbon dioxide egazini.

Imbangela ngqo ye-OHS ayaziwa. Abaphenyi bakholelwa ukuthi imiphumela ye-OHS ivela ekukhubazekeni kokulawula kobuchopho ekuphefumuleni. Isisindo eseqile odongeni lwesifuba nakho kwenza kube nzima ukuthi imisipha idonse umoya ojulile futhi iphefumule ngokushesha ngokwanele. Lokhu kwenza kube nzima ukulawula ukuphefumula kobuchopho. Ngenxa yalokhu, igazi liqukethe isikhutha esiningi kakhulu ne-oxygen eyanele.

Izimpawu eziyinhloko ze-OHS kungenxa yokuntuleka kokulala futhi zifaka:

• Izinga lokulala elibi
• I-apnea yokulala
• Ukulala kwasemini
• Ukucindezeleka
• Ukuphathwa ikhanda
• Ukukhathala

Izimpawu zezinga le-oxygen ephansi yegazi (i-hypoxia engapheli) nazo zingavela. Izimpawu zifaka ukuphefumula okuncane noma ukuzizwa ukhathele ngemuva komzamo omncane kakhulu.

Abantu abane-OHS imvamisa bakhuluphele ngokweqile. Ukuhlolwa komzimba kungaveza:

• Umbala we-Bluish ezindebeni, eminwe, ezinzwaneni, noma esikhunjeni (i-cyanosis)
• Isikhumba esibomvu
• Izimpawu zokwehluleka kwenhliziyo emaceleni (cor pulmonale), njengokuvuvukala kwemilenze noma izinyawo, ukuphefumula okuncane, noma ukuzizwa ukhathele ngemuva komzamo omncane
• Izimpawu zokulala ngokweqile

Ukuhlolwa okusetshenziselwa ukuxilonga nokuqinisekisa i-OHS kufaka:

• Igazi legazi lomzimba
• I-x-ray yesifuba noma i-CT scan ukukhipha ezinye izimbangela ezingaba khona
• Ukuhlolwa kwemisebenzi yamaphaphu (izivivinyo zomsebenzi wamaphaphu)
• Isifundo sokulala (i-polysomnography)
• I-Echocardiogram (i-ultrasound yenhliziyo)

Abahlinzeki bezempilo bangatshela i-OHS ekuvimbeleni ukuphefumula kokulala okuvimbelayo ngoba umuntu one-OHS unezinga eliphakeme lekhabhoni dioxide egazini lakhe lapho ephapheme.

Ukwelashwa kuhilela usizo lokuphefumula usebenzisa imishini ekhethekile (mechanical ventilation). Izinketho zifaka:

• Ukungenisa umoya okungajwayelekile njengokucindezela okuqhubekayo kwe-airway (CPAP) noma ingcindezi ye-bilevel positive airway (BiPAP) ngokusebenzisa imaski elingana kahle phezu kwekhala noma ikhala nomlomo (ikakhulukazi ukulala)
• Ukwelashwa kwe-oxygen
• Ukuphefumula kusiza ngokuvula entanyeni (tracheostomy) yamacala abucayi

Ukwelashwa kuqala esibhedlela noma njengesiguli esingaphandle.

Ezinye izindlela zokwelapha zihlose ukunciphisa isisindo, okungaguqula i-OHS.

Ukungalashwa, i-OHS ingaholela ezinkingeni ezinkulu zenhliziyo nemithambo yegazi, ukukhubazeka okukhulu, noma ukufa.

Izinkinga ze-OHS ezihlobene nokuntuleka kokulala zingabandakanya:

• Ukudana, ukucasuka, ukucasuka
• Ingozi eyengeziwe yezingozi noma amaphutha emsebenzini
• Izinkinga ngokusondelana nocansi

I-OHS nayo ingadala izinkinga zenhliziyo, njenge:

• Umfutho wegazi ophezulu (umfutho wegazi ophakeme)
• Ukwehluleka kwenhliziyo emaceleni angakwesokudla (cor pulmonale)
• Umfutho wegazi ophezulu emaphashini (umfutho wegazi ophakeme wamaphaphu)

Shayela umhlinzeki wakho uma ukhathele kakhulu emini noma unezinye izimpawu eziphakamisa i-OHS.

Gcina isisindo esinempilo futhi ugweme ukukhuluphala. Sebenzisa ukwelashwa kwakho kwe-CPAP noma kwe-BiPAP njengoba umhlinzeki wakho ekuyalele.

Isifo se-Pickwickian

• Uhlelo lokuphefumula

UMalhotra A, uPowell F. Ukuphazamiseka kokulawulwa komoya. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 80.

UMokhlesi B. Isifo sokukhuluphala ngokweqile. Ku: Kryger M, Roth T, Dement WC, ama-eds. Izimiso Nokwenza Kwendlela Yokulala. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2017: isahluko 120.

UMokhlesi B, uMasa JF, uBrozek JL, et al. Ukuhlolwa nokuphathwa kwesifo sokukhuluphala ngokweqile i-hypoventilation syndrome. Isiqondisi esisemthethweni somkhuba wokwelashwa waseMelika Thoracic Society. Am J Respir Crit Ukunakekelwa Med. 2019; 200 (3): e6-e24. I-PMID: 31368798 www.ncbi.nlm.nih.gov/pubmed/31368798.