Ngokwe-Global Initiative for Chronic Disease Lung Disease (GOLD), ukuxilongwa kwesifo esingapheliyo se-pulmonary disease (COPD) kufuneka kuqwalaselwe kuyo nawuphi na isigulane onokuphefumula, ukukhwehlela kwexesha elide okanye ukuvelisa i-sputum, kunye / okanye imbali ukuchayeka kwiimeko zeengozi zeCOPD , ezifana nokubhema, ukuchasana nokukhupha imiphunga njengeekhemikhali, ukungcola, okanye ukutshaya umsi, okanye imfuyo / intuthuko.
Nangona kunjalo, ukufumanisa i-COPD ingaba nzima kuba inempawu ezifanayo kwezinye izifo kwaye ingazibonakalisa ngokwahlukileyo kumntu ngamnye.
IiLabs kunye novavanyo
Ukuba ugqirha wakho ugxeka ukuba unayo i-COPD, mhlawumbi uya kufumana imbali yakho yempilo epheleleyo, enze umzimba, kwaye enze iimvavanyo ukuqinisekisa okanye ukulawula ngaphandle kweCOPD.
Imbali kunye neMzimba
Uvavanyo lwakho luya kuqala ngokujonga ngokubanzi kwimbali yakho. Oku kufanele kubandakanye ukuhlaziya oku kulandelayo:
- Ukubonakaliswa kwakho kwangoku kunye nokudlulileyo kwiimeko ezinobungozi ezifana nokutshaya, ukutshaya komsi , ukungcola komoya , kunye / okanye ukunyanzeliswa komsebenzi othulini, iigesi kunye neekhemikhali.
- Imbali yakho yezokwelapha, ingakumbi njengoko ibhekisela kwiingxaki zokuphefumula ezikhoyo njenge-asthma, i-allergies, i-sinusitis, kunye / okanye izifo zokuphefumula ebuntwaneni bakho.
- Izibhedlele zokuqala, ngakumbi ukuba zidibene nezifo zokuphefumula.
- Ukuba nabani na ohlala kwintsapho yakho baye bafumana i-COPD okanye nayiphina isifo esingapheliyo.
- Ukuba unezinye iimeko zonyango ezikhoyo, ezifana nesifo senhliziyo okanye i-osteoporosis, enokuthi ibe negalelo lokuxilongwa kweCOPD.
- Umzekelo wokuphuhliswa kweempawu zakho, kubandakanywa xa iimpawu zakho zaqala kwaye ubude ixesha elingakanani ngaphambi kokufuna unyango.
- Impembelelo yeempawu zakho kwimpilo yakho yansuku zonke. Umzekelo, ukuba iimpawu zakho zenze ukuba uphoswe emsebenzini, unciphise imisebenzi yakho rhoqo, okanye uzive uxinezelekile okanye uxhalabile.
Ugqirha wakho kufuneka enze kwakhona uvavanyo olusisigxina lokuzibandakanya:
- Ukuthatha ubushushu bakho, ukupompa, ukuphefumula ngomzuzu, ukupompa, kunye negazi.
- Ukuphulaphula intliziyo yakho nemiphunga nge stethoscope.
- Ukuhlolisisa iindlebe, impumlo, amehlo kunye nomqala ngenxa yempawu zentsholongwane.
- Ukuhlola iminwe yakho ngemiqondiso ye-cyanosis kunye ne- clubbing (xa iziphelo zeminwe yakho zandisiwe).
- Ukuvavanya imiqondiso yokuvuvukala emilenzeni, ezinqeni, ezinyaweni okanye kwezinye iindawo zomzimba wakho.
- Ukuvavanya iimvumba entanyeni yakho ukuvavanya iingxaki zeCOPD ezifana ne- cor pulmonale (ukungaphumeleli kwinqanaba elilungileyo lentliziyo yakho).
I-Spirometry
Uvavanyo lwe- spirometry lufunekayo ukwenza ukuxilongwa kwekliniki yeCOPD kwaye kuyisisiseko esiyinhloko sokuvavanya ubunzima beCOPD. Uvavanyo lwe-spirometry lubheka ngokukodwa kwiimpawu ezine eziphambili zomsebenzi wamaphaphu, kuquka:
- Ingakanani umoya ongakwazi ukuwukhupha ngokukhawuleza emva kokuba uthathe umoya ophefumlelweyo (owaziwa njengamandla okunyanzelisa, okanye i-FVC).
- Ingakanani umoya onokuyikhupha ngokukodwa kwisibini enye (eyaziwa ngokuba ngumqulu ophefumlelweyo wokuphefumula kwesibini, okanye i-FEV1 ).
- Ipesenteji yomoya ishiywe kwimiphunga yakho emva kokukhutshwa ngokupheleleyo (eyaziwa ngokuba ngumlinganiselo we-FEV1 ukuya kwi-FVC ).
- Umthamo opheleleyo womoya emiphakeni yakho (eyaziwa ngokuba ngumthamo wamandla onke, okanye i-TLC ).
Ngokubambisana, le miqathango emine ayithethi nje ukuba umonakalo omkhulu wenziwe kumaphaphu akho kodwa iindlela onokuphucula iziphumo zakho zexesha elide ukuba unayo iCOPD. Ukunciphisa ukukhutshwa komoya, okanye i-COPD, kuqinisekiswa xa iziphumo zovavanyo zibonisa i- FEV1 / FVC engaphantsi kwe-0.70 emva kokusebenzisa i- bronchodilator .
Uvavanyo olongezelelweyo lweePlmonary Functions (PFTs)
Ukongeza kwi-spirometry, kukho ezinye iimvavanyo zomsebenzi zepmonta ezibalulekileyo xa zihlola umsebenzi wamaphaphu ku-COPD: iimvavanyo zokusasazeka kwemiphunga kunye nomzimba we-plethysmography. Ezi mvavanyo zilinganisa ukuba i-carbon monoxide yakho imiphunga iyakwazi ukuyisebenzisa kunye nomthamo womoya emiphakeni yakho kwizigaba ezahlukeneyo zokuphefumula, ngokulandelanayo, ngokucacisa indlela i-COPD yakho enzima ngayo.
Gcwalisa iAgazi yeGazi (iCBC)
Nangona uvavanyo lwegazi alukwazi ukuxilonga i-COPD, inani elipheleleyo legazi (CBC) liya kuphawula ugqirha wakho ukuba unesifo, kunye nokubonisa, phakathi kwezinye izinto, ubuninzi be-hemoglobin ekhoyo kwigazi lakho. I-Hemoglobin yi-pigment ene-iron equlethwe ngegazi lakho elithwala i-oksijini emiphakeni yakho ukuya emzimbeni wakho wonke.
Oxetry Pulse
I-oximetry ye-Pulse yindlela engeyiyo ingavumelekanga yokulinganisa indlela iifomthi zakho ezinikwa ngayo i-oksijini. Inkqubo okanye inzwa ngokuqhelekileyo ifakwe kumnwe wakho, ebunzini, i-earlobe, okanye ibhuloho yakho ekhaleni. I-oximetry ye-pulse ingaqhubeka okanye iphakathi kwaye imilinganiselo yama-95 ekhulwini ukuya kuma-100 ekhulwini ithathwa njengesiqhelo. Ukuba ungaphantsi kwama-92 ekhulwini, ugqirha wakho angathanda ukwenza ukuhlolwa kwegesi yegazi (ABG). Ngokumalunga ne-ABG, ukulinganisa izinga lakho lokuzalisa i-oxygen ngendlela ye-pulse oximetry kunceda ugqirha wakho ukuba ahlolisise imfuno yakho yonyango lwe-oxygen.
Iigesi zeGesi zeGesi
Kwi-COPD, isixa somoya ophefumulayo nangaphandle kwemiphunga yakho ayiphumelelanga. Iigesi zegazi ezijikelezayo zilinganisa i-oxygen kunye nezinga le-carbon dioxide egazini lakho kwaye lichonge umzimba wakho we-pH kunye ne-sodium bicarbonate level. I-ABG zibalulekile ekwenzeni ukuxilongwa kweCOPD kwakunye nokuzimisela isidingo kunye nokulungelelanisa izinga lokuhamba kweyiphi imfuneko yonyango lwe- oxygen.
Uhlu lwe-Alpha-1-Antitrypsin
Ukuba uhlala kwindawo apho kukho ukusabalalisa okuphezulu kwe-alpha-1-antitrypsin (AAT), i-World Health Organization (WHO) icebisa ukuba uvavanywe le ngxaki ngokuhlolwa kwegazi. Enyanisweni, i-WHO icebisa ukuba nabani na ofunyaniswe ukuba neCOPD kufuneka ahlolwe ukusilela kwe-AAT kanye.
Ukuntuleka kwe-AAT yimizimba yezofuzo ezingakhokelela kwiCOPD. Ukufunyaniswa kwisifo esincinane (ungaphantsi kweminyaka engama-45 ubudala) kufuneka uqaphele oogqirha ukuba kungenzeka ukuba i-AAT engenakho yimbangela yeCOPD yakho. Ukunyangwa kwe-COPD ebangelwa ukusilela kwe-AAT kuhlukile kunonyango oluqhelekileyo kwaye kubandakanya unyango olongezelelweyo .
Ukucinga
Ugqirha wakho angenza iimvavanyo zokucinga kunye nokunceda ukulawula okanye ukuxilonga iCOPD.
I-X-ray yesifuba
I-x-ray yesikhwama yedwa ayifaki ukuxilongwa kweCOPD. Kodwa ugqirha wakho unokuyalela okokuqala, nangona kunjalo, ukulawula ezinye izizathu zeempawu zakho okanye ukuqinisekisa ukuba kukho imeko ekhoyo ye- comorbid . I-x-ray yesifuba isenokusetyenziswa rhoqo ngamaxesha kunyango lwakho ukujonga inkqubela yakho.
I-Tomography ye-Computing (CT)
Nangona i-CT ayicetyiswa rhoqo xa yenza i-COPD, ugqirha wakho unokuyalela omnye xa kubonisiwe. Ngokomzekelo, unokuba ne-CT scan xa unesifo esingasombululiyo, iimpawu zakho zitshintshile, ugqirha wakho uxolisa ukuba unomdlavuza wamaphaphu, okanye ukuba ucingelwa ukuhlinzwa. Nangona i-X-ray isifuba ibonisa indawo ezininzi zobuninzi emiphakeni, i-CT scan iyicacisa ngakumbi, ibonisa iinkcukacha ezifanelekileyo ukuba i-X-ray ayikho. Ngamanye amaxesha, ngaphambi kokuskena kwe-CT, into ebizwa ngokuba yinto eyahlukileyo ifakwe kwisitya sakho. Oku kuvumela ugqirha wakho ukuba abone ukungaqhelekanga emiphakeni yakho ngokucacileyo.
Ukuxilongwa okuhlukeneyo
Kukho imeko ezininzi zonyango ezinokuthi zifumaneke lula ngokuhlolwa kwegazi okanye ukuhlolwa ngokomzimba. Ezinye azilula. Kwezinye iimeko, akuyi kuba novavanyo olulodwa okanye inkqubo enokuqinisekisa okanye ukungabandakanyi ubukho besifo. I-COPD yenye yezi zifo. Nangona iindidi zokuphefumla, ezifana ne- spirometry , ziyakwazi ukubonisa iimpawu zesifo, zodwa azikwazi ukuqinisekisa ukuxilongwa.
Ngenxa yoko, ugqirha uya kufuneka enze into ebizwa ngokuba yi- diagnosis . Le yinkqubo apho zonke ezinye izizathu zokugula ziye zafakwa ngaphandle. Kuphela xa iprogram iphelile i-diagnostic yeCOPD ibonwa njengento ecacileyo.
Ukuxilonga ngokuhlukileyo kubalulekile ekuqinisekiseni i-COPD kuba ihlala isifo esibi. Nangona i-COPD inxulumene kakhulu nokubhema i-cigarette, akubona bonke ababhemayo abaneCOPD kwaye kungekhona wonke umntu ophethe i-COPD.
Ngaphezu koko, iimpawu kunye nesibonakaliso sesi sifo ziyahlukahluka. Ngokomzekelo, umntu ongeyiphi imvavanyo ye-spirometry engaqhelekanga unokuhlala eneempawu ezinzulu zeCOPD . Ngenye indlela, umntu onokuphazamiseka okuphawulweyo unokukwazi ukulawula ngokumbalwa, ukuba kukho na, iimpawu.
Olu hlobo ludinga ukuba ogqirha bajonge esi sifo ngokwahlukileyo. Kwaye, ngenxa yokuba singayiqondi ngokupheleleyo into eyenza iCOPD, oogqirha badinga ukhuseleko lokuxilonga ngokungafaniyo ukuqinisekisa ukuba ukuxilongwa okufanelekileyo kuyenziwe.
Oku kunjalo ngokukodwa kubantu abadala asebephethwe yintliziyo kunye nesifo somphunga kungabangela ukukhawulwa kwemimoya. Ngokuguqula yonke ilitye, oogqirha banokufumana iyona nto (kunokuba bacinge) isizathu sokuphefumula, ezinye zazo ezinokunyangwa.
Kwindlela yokuxilongwa kwemeko eyahlukileyo, ezinye zophando eziqhelekileyo ziza kubandakanya i-asthma, ukungaphumeleli kwintliziyo yesifo, i-bronchiectasis, isifo sofuba kunye ne-bronchiolitis. Ngokuxhomekeke kwimpilo nakwiimbali zomntu, ezinye izizathu zingabuye zihlolwe.
Isifuba
Esinye seziganeko eziqhelekileyo zokuxilongwa kweCOPD isifo se- asthma . Kwiimeko ezininzi, le mibandela mibili ayinakwenzeka ukuchazela, oko kungenza ulawulo lube lukhuni kuba izifundo zonyango zihluke kakhulu. Iimpawu zesimo se-asthma ziquka:
- Ngokuqhelekileyo uqala kwasekuqaleni ebomini (xa kuthelekiswa neCOPD, eyenzeka kamva ebomini)
- Iimpawu ziyakwazi ukutshintsha phantse imihla ngemihla, zihlala zinyamalalala phakathi kokuhlaselwa
- Iimbali eziqhelekileyo ze-asthma ziqhelekile
- Ubomi, i-rhinitis, okanye i-eczema zihlala zikhona
- Ukunciphisa ukukhutshwa kwe-Air kubaluleke kakhulu ukuguqulwa, ngokungafani neCOPD
Ukunqongophala kweNtliziyo yeCrows
Ukungaphumeleli kwentliziyo yesifo (CHF) kwenzeka xa intliziyo yakho ingakwazi ukupompa igazi elaneleyo ngomzimba ukugcina yonke into isebenza ngokuqhelekileyo. Oku kubangela ukugcinwa kwamanzi kumaphaphu akho nakwezinye iindawo zomzimba wakho. Iimpawu ze-CHF ziquka ukukhwehlela, ubuthathaka, ukukhathala, nokuphefumula okufutshane kunye nomsebenzi. Ezinye iimpawu ze-CHF ziquka:
- Amaqhekeza amahle aviwa nge stethoscope.
- I-xst ray yebhokisi ibonisa ukwanda kwamanzi kunye nokuhluthwa kwenhliziyo.
- Iimvavanyo zomsebenzi wepulmonary zibonisa ukuvinjelwa kwevolumu (ngokuchasene nesithintelo sokukhupha umoya esiboniswe kwiCOPD).
Bronchiectasis
I-Bronchiectasis yintlupheko yokuphazamiseka kwemiphunga enokuthi ibe yintsholongwane (ikhona ngokuzalwa) okanye ibangelwa zizifo ezisemntwaneni ezinjengomfo we-pneumonia, umasisi, umkhuhlane, okanye isifo sofuba. I-Bronchiectasis inokuphela yedwa okanye isebenze kunye kunye neCOPD. Iimpawu ze-bronchiectasis ziquka:
- Ukuvelisa inani elikhulu le-sputum
- Izifo eziqhelekileyo zentsholongwane ye-bacterial lung
- Amaqhekeza ama-coarse azwiwe nge-stethoscope
- I-xst ray ibonisa iipilisi ezixutywe nge-bronchial and walls walls
- I-Clubbing yeminwe
Isifo sofuba
Isifo sesifo sofuba (TB) sisifo esithintekayo kakhulu esibangelwa i-microorganism Mycobacterium isifo sofuba . Nangona i-TB ihlala ichaphazela imiphunga, inokusasazeka kwezinye iindawo zomzimba ngokunjalo, kubandakanya ubuchopho, izintso, amathambo kunye ne-lymph nodes.
Iimpawu ze-TB ziquka ukulahleka kwesisindo, ukukhathala, ukukhwehlela okuqhubekayo, ubunzima bokuphefumla, intlungu yesifuba, kunye ne-sputum enamandla okanye enegazi. Ezinye iimpawu ze-TB ziquka:
- Izifo ziza kwenzeka nanini na ubudala
- I-x-rays i-Chest ibonisa izithuba zomoya ezizaliswe ngamanzi
- Iimvavanyo zegazi okanye i-sputum ziqinisekisa ubungqina be- TB
- Ngokuqhelekileyo kubonwa ngaphakathi kuluntu okanye kubonakale njengenxalenye yokuqhambuka
Bronchiolitis engabonakaliyo
I-bronchiolitis engabonakaliyo yinto eqhelekileyo ye- bronchiolitis engasongela ubomi. Kuyenzeka xa iincinci zomoya ezincinci zemiphunga, ezaziwa ngokuba yi-bronchioles, zivutha kwaye zinqabile, zibangela ukuba zincinci okanye zivale. Ezinye iimpawu ze-bronchiolitis ezidityanisiweyo ziquka:
- Ngokuqhelekileyo kwenzeka ngexesha elincinci kubantu abangabhemi
- Imbali enokwenzeka ye-rheumatoid arthritis okanye i-exposed toxic fumes
- I-scan scan ibonisa indawo ye-hypodence apho izicubu zomphunga zincinci
- Ukuvinjelwa kwe-Airway, njengoko kulinganiswe yi- FEV1 , inokuthi ibe ngaphantsi kwama-16 ekhulwini
Amabanga kunye namaqela eCOPD
Njengengxaki eqhubekayo, iCOPD ibonakaliswe zizigaba zesifo esinokukunceda ukwazi ukuba ungalindela ntoni ngeli xesha, nangona isigaba sakho singagqibekanga ukuba uza kwenza njani ngokunyanga. Ukufumana isigxina sakho, oogqirha baya kubhekisela kwi-Global Initiative ye-Lung Disease (GOLD) yeenkqubo zokubamba izifo ezingapheliyo, ezahlula ukuqhubela isifo kwizigaba ezine ezihlukeneyo ezinqunywe yi-spirometry test.
Bakala 1: I-COPD encinci
Ngebanga le-COPD, unomlinganiselo wokungcola komoya kodwa mhlawumbi uya kuba ungazi. Kwiimeko ezininzi, akuyi kuba nempawu zesifo okanye iimpawu ziya kuba zincinci ukuba zibhekiswe kwezinye izizathu. Ukuba kukho, iimpawu zingabandakanya ukukhwehlela okuqhubekayo kunye nemveliso ebonakalayo ye-sputum (umxube we-sali kunye ne-mucus). Ngenxa yeempawu eziphantsi kwebakala, abantu abakweli nqanaba abanakuze bafune unyango.
IBakala 2: I-COPD ephakathi
Ngebanga lesi-2 le-COPD, ukunciphisa ukukhutshwa kwe-air kuqala kuqhuma, kwaye iimpawu zeCOPD zibonakala zibonakala. Ezi zimpawu zingabandakanya ukukhwehlela okuqhubekayo, ukuveliswa kwe-sputum, kunye nokuphefumula okufutshane kwimigudu emncinci. Le nto isigaba xa abantu abaninzi befuna unyango.
IBakala 3: I-COPD eninzi
Ngebanga le-COPD yebanga lesi-3, umqobo kunye / okanye ukuvinjelwa kweendinyana zakho zomoya zibonakala. Uya kuba nobunzima beempawu ezinzima, ezaziwa ngokuba yi- COPD ukukhushulwa , kunye nokuvama kwenyameko kunye nobukhulu bokukhwehlela. Akunakukuphela nje ukunyamezela ngokunyamekela umsebenzi wokusebenza, kuya kuba nokukhululeka okukhulu kunye nesifuba.
IBanga 4: I-COPD kakhulu
Ngebanga le-COPD, umgangatho wakho wobomi uya kuphazamiseka kakhulu kunye neempawu ezivela kwizinto ezinzulu ezisongela ubomi. Umngcipheko wokusilela ukuphefumula uphakamileyo kwi-grade 4 izifo kwaye kunokukhokelela kwiinkathazo entliziyweni yakho, kubandakanywa neengxaki ezibulalayo ezibizwa ngokuba yi- cor pulmonale .
Amaqela eCOPD
I-GOLD iphinde iphume nezikhokelo zokuqhubela phambili izigulane ngeCOPD kumaqela abhalwe A, B, C, okanye D. Ezi ziqela zichazwe ngolu hlobo lweengxaki ezinxulumene neCOPD ezifana nokukhathala, ukuphefumula okufutshane, ziphi iimpawu eziphazamisa yakho ubomi bemihla ngemihla, kwaye zingaphi ubunzima obuye waba nalo kunyaka odlulileyo. Ukusebenzisa amabini kunye namaqela kunokuncedisa ugqirha wakho ukuba afikelele kwisicwangciso sonyango esingcono kakhulu kwiimfuno zakho.
Iqela A
Awunakho ukukhushulwa okanye ubunzima obuncinane obungafunanga ukulaliswa esibhedlele, kunyaka owedlule. Unomphefumlo omncinci wokumphefumula, ukukhathala kunye nezinye iimpawu.
Iqela B
Awunayo okanye yinto enye yokunciphisa into encinci engazange ifune ukulaliswa esibhedlele kunyaka owedlule. Unokuphefumula kancinci, ukukhathala kunye nezinye iimpawu.
Iqela C
Uye waba noxinzelelo olulodwa olufuna ukulaliswa esibhedlele okanye ezimbini okanye izinto ezinzima ezingenakho ukufunwa esibhedlele kunyaka owedlule. Iimpawu zakho zeCOPD zincinci ukuya kuyingqinisiso.
Iqela D
Unokwenyuka kokubhedlele kwelinye izibhedlele okanye ezimbini okanye ubunzima obukhulu okanye ngaphandle kokulaliswa esibhedlele kunyaka owedlule. Iimpawu zakho zeCOPD zinzima kakhulu.
> Imithombo:
> I-Global Initiative ye-Lung Disease. Isicwangciso sehlabathi soLwazi, uLawulo, kunye noKhuselo lweZifo eziPhezulu eziPhephekayo eziPhezulu: 2018 Ingxelo . Ishicilelwe ngoNovemba 20, 2017.
> Abasebenzi beKliniki yabasebenzi. I-COPD: Ukuxilongwa kunye noTyango. Clinical Mayo. Ukuhlaziywa kwe-Agasti 11, 2017.
> Intliziyo yeSizwe, iLung, neSigqeba seGazi. COPD. Isizwe seZiko lezeMpilo. ISebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu.