Ukuba umntu wayenokubuza oko kukugcina ekusebenziseni xa unayo i- COPD , amathuba okuthi ungathi i- dyspnea (ebizwa ngokuqhelekileyo njengokuphefumla). Kwi-COPD, i-dyspnea ne-muscle yokukhathala yizona zixhobo eziphambili zokuqalisa inkqubo yovavanyo. Oku kuyilusizi kuba indlela engcono yokuphucula ukunyamezela komzimba nokunciphisa ukuphefumla kwiCOPD kukusebenzisa rhoqo.
Ngoko, uyakwazi njani ukusebenzisa xa imisipha yakho iphela kwaye awukwazi ukuphefumula?
Nangona ufanele uhlale uhlolisisa nodokotela wakho ngaphambi kokuba usebenzise naliphi na indlela echazwe ngezantsi, izicwangciso ezilandelayo zinokukunceda ukuba usebenzise ixesha elide kwaye unciphise ukuphefumla ngexesha lokuzilolonga:
Ukunyanzeliswa kokuPhepha okuNgekhoyo
Nangona kungenakwenzeka, uphando lubonise ukuba abantu abaqhuba rhoqo basebenzise ukungena kwe-ventilation ( non-invasive positive vententi ventilation) (NIPPV) banokufumana inzuzo yokuqeqeshwa ngaphezu kwabo bangenayo. I-NIPPV ayivumelekanga kuphela izigulane zeCOPD ukuba zisebenzise ixesha elide, kodwa ziyakwazi ukufikelela umthwalo ophezulu kumsebenzi ngexesha lokuzivocavoca kunokuba zisebenzise. Ngethemba, intuthuko kwezobuchwepheshe bezobugcisa iya kubangela ukuba i-oksijeni ithunyelwe ngokukhululekile ngexesha le-NIPPV, kunokuba kube ne-mask-tight fit masal.
Ukusebenzisa i-NIPPV ebusuku kungaba yimpendulo ebonakalayo ngakumbi.
Uphando lubonisa ukuba xa kuhlanganiswe nokuvuselelwa kwamapulmoni, izigulane ezisebenzisa i-NIPPV emini zibonisa ukuphuculwa kwimizuzu yoku-6 yokuvavanya ukuhamba , i- FEV1 , i- hyperinflation enamandla kunye negesi yegazi . Izigulana nazo ziyabona ukuphucula umsebenzi wazo, umsebenzi wezenhlalakahle, impilo yengqondo kunye nobunzima.
U ku khuthazwa kombane
Izigulane zeCOPD ezizilondoloze kakuhle amandla omzimba kunye nomsebenzi wesisundu zinokuzuza kwi-high frequency neuromuscular stimulation (hf-NMES). Uphononongo lubonisa ukuba kuphucula umthamo wokuzivocavoca ngokuvumela izigulane ukuba zinyamezele izinga eliphezulu lokusebenzisa umzimba. Inokuphucula nokuphefumla.
Indlela engcono kakhulu yokusondela kwi-hf-NMES ukuyisebenzisa ngaphambi kokutshatyalaliswa kwezicubu (eziqhelekileyo kwi-COPD ephambili), nangona kungenokuba luncedo kwizigulane ezikhubazekileyo ngokukhubaza i-dyspnea, ngokunjalo.
Ukuvuselelwa kombane kungasetyenziselwa ekhaya, okanye njengenxalenye yesicwangciso esisemthethweni sokuvuselela i-pulmonary.
Ukongezwa kweOxygen
Uphando olupapashwe kwi- Thorax lubonisa ukuba i-oksijeni eyongezelelweyo ngexesha lokuzivocavoca linikeza isihluthulelo esincinane kwi-dyspnea kwaye ayinanto yokuphucula ukunyamezelana komzimba kwiCOPD. Nangona kunjalo, uphando olulandelayo lubonisa ukuba lunokuphucula ukunyamezela kokunyamezela, ukunciphisa umbono we-dyspnea kunye nokunciphisa i-lung hyperinflation kwizigulane ezinezinga eliqhelekileyo le-oksijeni yegazi.
Kukho ukucatshulwa okuqhubekayo malunga nendlela yokuhambisa - i-canal cannula okanye i- transtracheal - iyona nto ibhetele ngexesha lokuzivocavoca. Uphando olwaluxhasa ukusetyenziswa kweendlela ezigqithiseleyo kunokuba luphelelwe yisikhathi; Nangona kunjalo, abaxhasi bee-oxygen zokuhambisa i-oxygen bahlala benokholo lokuba isebenza kakuhle.
Ukubuyiselwa kwePulmonary Rehabilitation
Ukulungiswa kwepulmonary yinto ebalulekileyo yonyango lweCOPD kwaye iyanconywa kuzo zonke izigulane ezisemgangathweni ukuya kwiinqanaba ezinzima zeCOPD. Ukuvuselelwa kwepulmonary kunokunceda izigulane zeCOPD :
- Ukuphucula ukunyamezela
- Ukunciphisa ukuphefumla
- Ukuphucula umgangatho wobomi
- Ukunciphisa ixesha lokubhedlele kunye nokuhlala esibhedlele
- Ukunciphisa ukuxhalabisa nokuxinezeleka
- Ukuphucula umsebenzi wengalo
- Ukuphucula amandla okuphefumula (xa kudibaniswa nokusebenza ngokubanzi)
Amachiza
Kukho inani lamachiza ekhoyo eboniswe ekuphuculeni ukunyamezelana komzimba nokunciphisa ukuphefumula okubangelwa ngumzimba kwiCOPD.
Ukufunda ngokuqhelekileyo kukuba:
- I-Albuterol - Enye yeempawu zeCOPD ukukhawulelwa kwamanzi. I-hyperinflation ye-Dynamic iyona miphumo ebalulekileyo yokunciphisa ukuhamba komoya ngexesha loqeqesho kwiCOPD kunye negalelo elibalulekileyo ekuphefumla. Uphando lubonisa ukuba i-albuterol, i-albuterol, i-agaist i-short-acting aca agonist, inciphisa i-hyperinflation enxulumene nokusebenza kunye nokuphucula neminye imisebenzi ebalulekileyo ye-ventilatory.
- I-Spiriva - Ihlanganiswe nokuvuselelwa kwamapulmoni, i- anticholinergic bronchodilator Spiriva (tiotropium) ithuthukisa ukunyamezela, ukuphefumla, kunye nesimo sempilo xa kuthelekiswa nokusebenzisa ukulungiswa kwempompo yodwa.
- I-Salmeterol - i-Salmeterol, i-agonist ye-beta ende ende ende, iphucula ukuphefumla ngexesha lokuzivocavoca kodwa ayinyuli ixesha lokusebenzisa.
- I-nebulized ipratropium bromide - Ngokuthelekiswa ne-placebo, i- nebulazed ipratropium bromide (i-anticholinergic) yandisa ukunyamezela ixesha, inciphisa i-dyspnea kwaye iyanciphisa i-hyperinflation enamandla. Ukongeza, emva kokusebenzisa ipratropium bromide, izigulane kwizifundo zonyango zibonise ukwanda kwe-FEV1, i-FVC kunye namandla okuphefumula (umthamo womoya onokukhatshwa emva kokuphuma kwimoya evamile).
Uqeqesho loKhuseleko
Ngethuba lokuqeqeshwa kwexesha, isigulane siphinda ukulandelelana kovavanyo oluphezulu oluqhutywe ngomzimba wokukhanya (ininzi efundwa kwiCOPD) okanye ukuphumla. Ixesha lokuqeqeshwa kwiziphumo zeCOPD kwiziphumo ezifanelekileyo zokuqeqesha ezinye izigulane kwaye zisoloko zisetyenziswa njengenxalenye yenkqubo yokuvuselela i-pulmonary.
Imithombo
Belman MJ, et.al. I-bronchodilators engabonakaliyo iyanciphisa i-hyperinflation enamandla ngexesha lokuzilolonga kwizigulane ezinezifo ezingapheliyo. Ngaba i-J Respir Crit Care Med1996; 153: 967-75
Calverley, PMA. Ukuphefumula ngexesha lokuzivocavoca kwiCOPD: izidakamizwa zisebenza njani? I-Thorax 2004; 59: 455-457 inkcazo: 10.1136 / thx.2004.023150.
Casaburi R., etal. Ukuphucula ukunyamezelana komzimba kunye nokuhlanganiswa kwe-tiotropium kunye nokuvuselelwa kwepulmoni kwizigulane ezineCOPD .CHEST 2005; 127 (3): 809-817.
Napolis, uLara Maris et al. Ukuvuselelwa kombane nge-neuromuscular kukuphucula ukunyamezela kokunyamezela kwizifo ezingapheliyo zokuphazamiseka kwezigulane izigulane ezinezilwanyana ezingenamafutha alondoloziweyo. Iikliniki [online]. 2011, vol.66, n.3 [ekhankanywe ngo-2012-07-02] 401-406.
Neder, JA et. al. Ukuvuselelwa kombane nge-neuromuscular njengendlela entsha yokuvuselela izigulane ezikhubazekileyo ezinezifo ezingapheliyo zokuphazamiseka kwezifo (COPD). I-Thorax 2002; 57: 4 333-337 ngongoma: 10.1136 / i-thorax.57.4.333.
O'Donnell DE, et.al. I-spirometric correlates yokuphucula ukusetyenziswa komzimba emva kwonyango ye-anticholinergic kwizifo ezingapheliyo zokuphefumula. U-J U-Respir Crit Care Med 1999; 160: 542-9.
Schönheit, uKöhnlein T. et. al. Ukungena kwemvelo kwindlela yokuvuselela iipulmari zegulane zeCOPD. Respir Med. 2009; 103 (9): 1329.
Somfay, A. etal Impembelelo yomsiza we-oksijeni kwi-hyperinflation kunye nokunyamezela kwizigulane zeCOPD ezingekho komzimba. ERJ Julayi 1, 2001 vol. 18 no. 1 77-84.
Wesmiller SW et.al. Ukunyamezela ngokunyamezela ngexesha le-cannula yamanzi kunye nokuthunyelwa kwe-oksijeni ye-oxygen. Ngaba Ingxelo yokuHlonipha iNkunkuma. Ngo-1990 uMatshi; 141 (3): 789-91.