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Mankhwala Oxygen Hyperbaric (HBOT)
The Science Behind Hyperbaric Medicine
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Mankhwala Oxygen a Hyperbaric, wotchedwanso HBOT, ndi mankhwala omwe amapereka 100% mpweya dongosolo lam'mapapo la wodwala pomwe ali mchipinda chopanikizika. Wodwalayo akupuma mpweya wambiri pamiyeso yayikulu kwambiri kuposa 21% yomwe imapezeka munyanja yabwinobwino.
Therapy Hyperbaric imachokera pa malamulo awiri ofunika a sayansi.
"Chilamulo cha Henry"Imanena kuti kuchuluka kwa mpweya umene umasungunuka m'madzi kumakhala kofanana ndi kukakamizidwa kwa mpweya pamwamba pa madzi, ngati palibe mankhwala omwe amapezeka.
"Chilamulo cha Boyle"Imanena kuti pa kutentha nthawi zonse, mphamvu ndi kuthamanga kwa mpweya zimakhala zosiyana kwambiri.
Izi zikutanthauza kuti mpweya umapanikizika molingana ndi kuchuluka kwa kupanikizika komwe kumachitika. Kugwiritsa ntchito malamulowa Oxygen Therapy imalola kuti mpweya wambiri uperekedwe kumatumba ndi ziwalo.
Kuwonjezeka kwa kupanikizika pang'ono kwa mpweya pamasamba am'manja kumatha kupititsa patsogolo njira zochiritsira ndikuthandizira kuchira pazizindikiro zambiri.
Zotsatira zoyipa zimakhala zochepa ndipo sizikhala zazitali kwambiri. Hyperbaric Medicine siyichiritso pazizindikiro zambiri koma yawonetsa kukulitsa kuthekera kwa chitetezo cha mthupi, kuthandiza odwala omwe ali ndi mavuto kuyambira zilonda zamatenda mpaka zolemala zovuta komanso kuwonongeka kwamitsempha.
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Mbiri ya Oxygen Hyperbaric History
Chithandizo chamankhwalachi chomwe chingachokere kumbuyo kwa 1600.
Mu 1662, Chamber yoyamba ya Hyperbaric inamangidwa ndikugwiritsidwa ntchito ndi mtsogoleri wachipembedzo wa ku Britain dzina lake Henshaw. Anamanga nyumba yotchedwa Domicilium, yomwe inkagwiritsidwa ntchito pochiza matenda osiyanasiyana.
Mu 1878, Paul Bert, katswiri wa sayansi ya zakuthambo ku France, adapeza kugwirizana pakati pa matenda osokoneza bongo ndi mitsempha ya nayitrogeni m'thupi. Kenaka Bert anazindikira kuti ululuwo ukhoza kukonzedwanso ndi kubwezeretsedwa.
Lingaliro lochiza odwala pansi pa chitsimikizo linapitilizidwa ndi dokotala wa opaleshoni wa ku France Fontaine, yemwe kenaka anamanga chipinda chogwiritsira ntchito chosungiramo mafoni ku 1879. Fontaine anapeza kuti kutulutsa nitrous oxide kumakhala kovuta kwambiri, kuphatikizapo odwala omwe ali ndi mpweya wabwino.
Kumayambiriro kwa 1900 a Dr. Orville Cunningham, pulofesitanti wa anesthesia, adawona kuti anthu omwe ali ndi matenda a mtima amakula bwino akamakhala pafupi ndi nyanja kusiyana ndi omwe amakhala kumtunda wapamwamba.
Anagwira naye ntchito yemwe anali ndi matenda a chimfine ndipo anali pafupi kufa chifukwa choletsedwa m'mapapo. Kupambana kwake kwakukulu kunam'pangitsa kukhala ndi chipatala chotchedwa "Steel Ball Hospital" chomwe chili pamphepete mwa nyanja ya Erie. Zithunzi zisanu ndi chimodzizi zinamangidwa mu 1928 ndipo zinali ndi 64 mapazi mwake. Chipatalachi chikhoza kufika 3 atmospheres absolute (44.1 PSI). Mwamwayi, chifukwa cha mavuto a zachuma a zachuma, idakhazikitsidwa panthawi ya 1942 kwa zidutswa.
Patapita nthawi, Hyperbaric Chambers anapangidwa ndi ankhondo a 1940 kuti athetse anthu ovutika panyanja omwe amadwala matenda opatsirana.
Mu 1950, madokotala anagwiritsira ntchito Hyperbaric Medicine pa opaleshoni ya mtima ndi yamapapo, yomwe inachititsa kuti azigwiritsa ntchito poizoni wa carbon monoxide mu 1960. Kuchokera nthawi imeneyo, mayesero akuluakulu a 10,000 ndi kafukufuku wamakono adatsirizidwa ndi ntchito zina zambiri zokhudzana ndi thanzi labwino ndipo zotsatira zake zambiri zimapindulitsa kwambiri.
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The UHMS ikufotokoza Mankhwala Oxygen a Hyperbaric (HBOT) monga njira yomwe munthu amapuma pafupi ndi 100% mpweya intermittently mkatikati mwa chipinda cha hyperbaric chimene chimakakamizidwa kuti chikhale chachikulu kuposa mphamvu ya m'nyanja (1 atmosphere absolute, kapena ATA).
Kuti mutha kuchipatala, vutoli liyenera kulingana kapena kupitirira 1.4 ATA pamene akupuma pafupi ndi 100% mpweya.
United States Pharmacopoeia (USP) ndi Compressed Gas Association (CGA) Gawo A imatchula mpweya wa okosijeni kuti asakhale ochepa kuposa 99.0% ndi volume, ndipo bungwe la National Fire Protection Association limalongosola za USP degree of oxygen.
Nthaŵi zina zimayimira njira yoyamba yothandizira ena, koma inanso ndiyo njira yothandizira opaleshoni kapena mankhwala.
Chithandizochi chikhoza kuchitika kaya ndi Monoplace Hyperbaric Oxygen Therapy Chamber kapena Multiplace Hyperbaric Oxygen Therapy Chamber.
Monoplace Hyperbaric Oxygen Therapy Chambers kumakhala wodwala mmodzi; chipinda chonsecho chimapanikizika ndi pafupi 100% mpweya, ndipo wodwala amapuma mpweya wozungulira mwachindunji.
Phatikizani Hyperbaric Oxygen Therapy Chambers gwirani anthu awiri kapena kuposa (odwala, owonerera, ndi / kapena ogwira ntchito othandizira).
Mafakitala ambiri amatsitsimutsidwa ndi mpweya wothandizira pamene odwala amapuma pafupi ndi 100% mpweya kudzera masikiti, mitu yamutu, kapena mazira opota.
Malingana ndi kutanthauzira kwa UHMS ndi chidziwitso cha Centers for Medicare ndi Medicaid Services (CMS) ndi othandizira ena a chipani, kupumira kuchipatala 100% mpweya pa 1 mpweya wozizira kapena kuwonetsera mbali zina za thupi kuti 100% mpweya sungapange Hyperbaric oxygen therapy.
Wodwala wa Hyperbaric ayenera kulandira mpweya wokhala ndi mkati mwa chipinda chopanikizika. Zomwe zikuchitika panopa zikusonyeza kuti kuponderezedwa kuyenera kukhala kwa 1.4 ATA kapena kuposa.
Pakali pano pali zizindikiro zovomerezeka za 14 ku USA.
- Ubweya wamagetsi kapena gasi
- Mpweya wa Monixide Poizoni
- Clostridial Myositis ndi Myonecrosis (Gas Gangrene)
- Kuphwanya Zowononga, Syndrome Yachigawo ndi Zina Zovuta Zoopsa za Ischemias
- Kugonjetsedwa kwa Matenda
- Kusakwanira kwabongo
- Anemia Wamphamvu
- Amadzimadzi Achilendo
- Matenda Opatsa Mavitamini Okhaokha
- Osteomyelitis (Refractory)
- Kuchedwa Kwambiri kwa Mvula (Zojambula Zofewa ndi Bony Necrosis)
- Zojambulajambula Zovomerezeka ndi Flaps
- Kutentha Kwambiri Kwambiri Kuwotchera
- Idiopathic Sudden Sensorineural Kumva Kutayika
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Kodi si Nyumba ya Hyperbaric?
Okosijeni, kapena Topox, amaperekedwa kudzera m'kachipinda kakang'ono kamene kamayikidwa pamapeto ndi kupanikizidwa ndi mpweya. Wodwala sakupuma mpweya, komanso thupi silinatsitsike. Choncho, wodwala sangapindule ndi zotsatira zabwino za Hyperbaric Medicine, zomwe zimakhala zochitika kapena zimakhala pamtunda kuposa momwe mpweya wabwino umalowerera (onani Hyperbaric Physics ndi Physiology gawo ili pansipa). Topox imachokera ku lingaliro lakuti mpweya umasokoneza kudzera minofu pa kuya kwa 30-50 microns. [4] Njira iyi siimagwira DCS, mpweya woipa womwe umakhalapo (AGE), kapena carbon dioxide (CO) poizoni.
Pokhala ndi Topox amapanga kusiyana pakati pa makina ndi mawonekedwe otseguka kuti akakamize makinawo. Pofuna kuti mapeto ake asasunthike kunja kwa makina oponderezedwa, chikho cha bokosi chiyenera kukhala chokwanira mozungulira, potero kupanga chowoneka ngati zotsatira. Topox sichikuphimbidwa ndi inshuwalansi, komanso sichivomerezedwa ndi magazini ya Diabetes Care pofuna kuchiza zilonda zamapazi.
Chipinda china ndi chipinda Chosavuta cha Hyperbaric Chamber. Zombo zofewazi zitha kupanikizika mpaka 1.2-1.5 atmospheres absolute (ATA). Amangovomerezedwa ndi FDA pochiza matenda okwera. Ambiri mwa matumba a High Altitude Illness akugulitsidwa molakwika ngati "Mild Hyperbaric Chambers" pazizindikiro zosavomerezeka pamakalata.
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Physics ndi Physiology ya mankhwala osokoneza bongo
Fizikiya motsatira Hyperbaric Oxygen Therapy (HBOT) ili mkati mwa malamulo abwino a gesi.
Kugwiritsa ntchito lamulo la Boyle (p1 v1 = p2 v2) likuwonekera pazinthu zambiri za Hyperbaric Medicine. Izi zingakhale zothandiza ndi zochitika zochititsa chidwi monga matenda osokoneza bongo (DCS) kapena magetsi omwe amapezeka (AGE). Pamene chiwerengero chikuwonjezeka, mau okhudzana ndi thovu amachepa. Izi zimakhalanso zofunika ndi chisokonezo cha chipinda; ngati wodwalayo amugwira mpweya wake, mpweya wa mpweya womwe umalowa m'mapapu umawonjezeka ndipo ukhoza kuyambitsa pneumothorax.
Lamulo la Charles ([p1 v1] / T1 = [p2 v2] / T2) limafotokoza kukula kwa kutentha pamene chotengera chikukakamizidwa ndi kuchepa kwa kutentha. Izi ndi zofunika kukumbukira pamene mukuchiza ana kapena odwala omwe akudwala kwambiri kapena osokonezeka.
Lamulo la a Henry limanena kuti kuchuluka kwa mpweya wosungunuka m'madzi ndikofanana ndi mpweya womwe umakhudzidwa ndi madziwo. Powonjezera kupsinjika kwamlengalenga mchipindacho, mpweya wochulukirapo umatha kusungunuka m'madzi am'magazi kuposa momwe zimawonekera pompopompo.
Wodwala ayenera kuyembekezera kuchuluka kwa mpweya wodwala akulandira. Pofuna kuyeza ndalamazi, atmospheres absolute (ATA) imagwiritsidwa ntchito. Izi zikhoza kuwerengedwa kuchokera ku chiwerengero cha oksijeni mu mpweya wosakaniza (kawirikawiri 100% mu Oxygen Therapy; 21% ngati akugwiritsa ntchito mpweya) ndi kuchulukitsidwa ndi kukakamizidwa. Kuponderezedwa kumayesedwa m'mapazi a madzi amchere, omwe ali ndi vuto ngati wina akutsikira kuzama pomwe ali m'madzi a m'nyanja. Kuzama ndi kuthamanga kungakhoze kuwerengedwa m'njira zambiri. Ena otembenuka mtima ndi 1 mpweya = 33 mamita a madzi amchere = 10 mamita a madzi a m'nyanja = 14.7 mapaundi pa lalikulu mainchesi (psi) = 1.01 bar.
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Mankhwala Oxygen Therapy (HBOT) a Hyperbaric
Hyperbaric oxygen therapy limafotokoza munthu kupuma kwa 100 peresenti ya oksijeni pamtunda waukulu kuposa nyanja yamtundu wa nthawi yoikika-nthawi zambiri 60 kwa 90 maminiti.
Kupanikizika Kwa Atmospheric - Mpweya womwe timapuma umapangidwa ndi 20.9% ya oxygen, 79% ya nayitrogeni, ndi 0.1% ya mpweya wopanda mphamvu. Mpweya wabwinobwino umapanikizika chifukwa umakhala wonenepa ndipo kulemera kumeneku amakokera kulikulu la mphamvu yokoka ya dziko lapansi. Kupsyinjika komwe kumachitika kumawonetsedwa ngati kuthamanga kwamlengalenga. Kuthamanga kwamlengalenga kunyanja ndi mapaundi a 14.7 pa mainchesi (psi).
Kupanikizika kwa Hydrostatic - Mukakwera pamwamba pamadzi, kuthamanga kwamlengalenga kumachepa chifukwa mpweya womwe uli pamwamba panu umalemera pang'ono. Mukayenda pansi pamadzi, zotsutsana zimachitika (kuthamanga kumawonjezeka) chifukwa madzi amalemera kuposa mpweya. Chifukwa chake, chozama chimatsikira m'madzi kwambiri. Izi zimatchedwa kuthamanga kwa hydrostatic.
Atmospheres Absolute (ATA) - ATA imatanthawuza kuyeza kuthamanga komwe kuli koona mosasamala komwe kuli. Mwanjira iyi, kuya kwakanthawi kumatha kufikira ngati kuli pamwamba kapena pansi pamadzi.
Pali mawu osiyanasiyana oyezera kuyeza. Mankhwala a HBO amagwiritsa ntchito mphamvu yaikulu kuposa imene imapezeka padziko lapansi panyanja, yomwe imatchedwa kuti hyperbaric pressure. Mawu kapena mayunitsi omwe amagwiritsidwa ntchito pofotokozera kutentha kwa hyperbaric ndi ma millimeters kapena masentimita a mercury (mmHg, inHg), mapaundi pa mainchesi (psi), mamita kapena mamita a madzi a m'nyanja (fsw, msw), ndi atmospheres absolute (ATA).
Mlengalenga wamtundu umodzi, kapena 1 ATA, ndilopakatikatikatikatikatikatikatikati mwa nyanja yomwe imagwiritsidwa ntchito panyanja, kapena 14.7 psi. Mlengalenga mlengalenga, kapena 2 ATA, imakhala kawiri kawiri kawiri kawiri kawiri kawiri pamlengalenga. Ngati dokotala akulamula ola limodzi la mankhwala a HBOT pa 2 ATA, wodwala amapuma oxygen okwana 100 kwa ora limodzi pomwe nthawi ziwiri zimakhala zovuta pamlengalenga.
Mafunso a Hyperbaric: Kusaka kwa hyperbaric : Chidziwitso cha Hyperbaric
Tili ndi katswiri wodikira kukuthandizani!
Onetsetsani kuti mulowetse dzina lanu mosamala, Nambala ya foni, ndi Adilesi ya Imelo ndipo tidzakayankha mwamsanga. Zikomo!
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