Kev pham hypoventilation syndrome (OHS)

Kev pham rog hypoventilation syndrome (OHS) yog ib qho kev mob ntawm qee cov neeg rog uas kev ua pa tsis zoo ua rau cov pa oxygen thiab cov pa carbon dioxide ntau nyob hauv cov ntshav.

Vim li cas tiag OHS tsis paub. Cov kws tshawb nrhiav ntseeg OHS yog los ntawm lub hlwb lub hlwb tswj ua pa. Tshaj dhau qhov nyhav tawm tsam lub hauv siab phab ntsa kuj tseem ua rau cov leeg txha nqaj tawv thiab ua pa tau sai. Qhov no ua kom lub hlwb tswj kev ua pa. Raws li qhov tshwm sim, cov ntshav muaj cov roj carbon dioxide ntau dhau thiab tsis muaj oxygen txaus.

Cov tsos mob tseem ceeb ntawm OHS yog vim tsis muaj kev pw tsaug zog thiab suav nrog:

• Pw tsaug zog tsis zoo
• Pw tsaug zog apnea
• Nruab hnub pw tsaug zog
• Kev Nyuaj Siab
• Mob taub Hau
• Nkees nkees

Cov tsos mob ntawm cov ntshav oxygen tsawg (mob hypoxia ntev) kuj tseem tuaj yeem tshwm sim. Cov tsos mob muaj xws li ua pa luv los yog nkees tom qab siv zog heev.

Cov neeg uas muaj OHS feem ntau yog qhov nyhav dhau heev. Kev kuaj mob lub cev yuav qhia:

• Cov xim xiav xiav ntawm daim di ncauj, ntiv tes, ntiv taw, lossis tawv nqaij (cyanosis)
• Daim tawv nqaij liab
• Cov tsos mob ntawm txoj cai nres plawv (tsis zoo li lub ntsws), xws li qog caj pas lossis txhais taw, ua pa luv, lossis nkees tom qab siv zog me ntsis.
• Cov cim ntawm kev tsaug zog ntau dhau

Kev ntsuam xyuas uas siv los pab kuaj mob thiab paub meej OHS suav nrog:

• Arterial ntshav roj
• Kev ntsuas duab xoo hluav taws xob los sis CT scan txhawm rau tshuaj xyuas lwm yam ua rau muaj mob
• Kev kuaj ntsws muaj nuj nqi (kev kuaj ntsuas ntsws muaj nuj nqi)
• Kev kawm pw tsaug zog (polysomnography)
• Echocardiogram (ultrasound ntawm lub plawv)

Cov kws saib xyuas kev noj qab haus huv tuaj yeem qhia OHS los ntawm kev pw tsaug zog tsis tsaug zog vim tias tus neeg nrog OHS muaj qib pa roj carbon dioxide ntau nyob hauv lawv cov ntshav thaum tsaug zog.

Kev kho mob cuam tshuam nrog kev pab ua pa siv tshuab tshwj xeeb (tshuab ua pa). Cov kev xaiv muaj:

• Lub tshuab cua tsis zoo xws li qhov ntsuas pa kom zoo (CPAP) los yog bilevel pa kom zoo rau hauv cov pa (BiPAP) los ntawm daim npog uas haum nruj rau lub qhov ntswg lossis qhov ntswg thiab qhov ncauj (feem ntau yog pw)
• Kev kho mob oxygen
• Ua tsis taus pa pab los ntawm kev qhib hauv caj dab (tracheostomy) rau mob hnyav

Kev kho mob yog pib hauv tsev kho mob lossis kho mob sab nraud.

Lwm txoj kev kho mob yog tsom rau poob phaus, uas tuaj yeem rov qab OHS.

Yog tsis kho, OHS tuaj yeem ua rau mob plawv thiab ntshav txog ntsha hnyav, ua tsis taus, lossis tuag taus.

OHS uas cuam tshuam nrog pw tsis txaus yuav suav nrog:

• Kev nyuaj siab, ntxhov siab, chim siab
• Nce kev pheej hmoo rau kev raug xwm txheej lossis yuam kev ntawm kev ua haujlwm
• Cov teeb meem nrog kev sib daj sib deev thiab kev sib deev

OHS tuaj yeem tsim teeb meem plawv, xws li:

• Ntshav siab (tawg)
• Right-sided heart tsis ua hauj lwm (cor pulmonale)
• Ntshav siab hauv lub ntsws (mob ntsws)

Hu rau koj tus kws kho mob yog tias koj nkees heev thaum nruab hnub lossis muaj lwm cov tsos mob uas qhia txog OHS.

Tswj lub cev noj qab nyob zoo thiab zam kev rog. Siv koj txoj kev kho mob CPAP lossis BiPAP raws li koj tus kws kho mob tau hais.

Tus Mob Pickwickian

• Kev ua pa system

Malhotra A, Powell F. Kev ua tsis taus pa ntawm cov leeg tswj hwm. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 80.

Mokhlesi B. Kev pham-hypoventilation syndrome. Hauv: Kryger M, Roth T, Dement WC, eds. Cov hauv paus ntsiab lus thiab kev coj ntawm Kev Tshuaj Tsaug ZogCov. 6 tus ed. Philadelphia, PA: Elsevier; 2017: cha 120.

Mokhlesi B, Masa JF, Brozek JL, li al. Soj ntsuam thiab tswj cov rog hypoventilation syndrome. Ib qho kev qhia American Thoracic Society kuaj kev qhia. Am J Respir Crit Care MedCov. 2019; 200 (3): e6-e24. PMID: 31368798 www.ncbi.nlm.nih.gov/pubmed/31368798.