Isimo se-asthmaticus, okanye i-SA emfutshane, sisifo esibuhlungu besifo se-asthma ngokuqhelekileyo ixesha elide okanye ngokukhawuleza ngokukhawuleza. E-SA, iimpawu ze-asthma ziyaqhubeka kwaye umsebenzi wokuphefumula uncipha, nangona unyango oluqhelekileyo.
Kubantu bonke, i-asthma ichaphazela malunga neepesenti ezisibhozo zabantu abadala kunye neepesenti ezili-10 zabantwana. Kule mivuzo, amahlanu ukuya kwi-10 ekhulwini anesimo esibi se-asthma kwaye ayingozi kakhulu kwimeko ye-asthmaticus.
I-SA ingakhokelela ekuphumeleleni ukuphefumula , ukulaliswa esibhedlele, kunye nokufa. Ibonisa ixakeka-zonyango lwezonyango olufuna unyango olusondeleyo nolushushu. Inani elinama-10 ekhulwini labantu abafumana ama-SA baya kufa.
Kwakhona, isimo se-asthmaticus sixhaphake kakhulu, esibangele ukufa kwabangaphezu kwama-5,000 ngonyaka ngamnye e-US Wonke umntu ongenakho ngaphandle kwesifuba kufuneka azi kakuhle iimpawu kunye nezibonakaliso eziqhelekileyo.
Endaweni yokwenza oku kukoyike ukuva, qhubeka ufunda. Funda into onokuyenza ukuze ugweme ukuba yile ya manani.
Iimpawu
Ngexesha lokuhlaselwa kwesifo se-asthma esibi, indlela umzimba ngokuqhelekileyo iqhuba ngayo amagesi okuphefumula kwi- alveoli ayinakukhubazeka. Oku kukhokelela ekunciphiseni amazinga oksijini kunye namazinga aphezulu e-carbon dioxide egazini, apho, kwiimeko ezimbi kakhulu, kunokubangela i-coma nokufa.
I-asthma idala ukunyuka kwomoya kwimiphunga, imeko ebangela uxinzelelo olongezelelweyo kwisifuba. Oku kungabangela ukubola kwempompo kunye nokuboshwa kwenyama.
Iintlobo
Kukho ezimbini iintlobo ze-SA:
- Ukuhlaselwa ngokukhawuleza . Olu hlobo oluqhelekileyo lunokuthatha ixesha elide ukuba liveze kwaye ngokuqhelekileyo liphumo ngenxa yokunyanga okungonelanga. Umntu onalolu hlobo lwe-SA uya kuba neentsuku okanye iiveki ezonakalisa iimpawu, eziphuculwe ngamaxesha okuphucula kunye nokuphela kweempawu ezingenakuguqulwa ngamachiza ekhaya.
- Ukuhlaselwa ngokukhawuleza . Umntu onololu hlobo lwe-SA akazange ahlangabezane neempawu ezibuhlungu kwiiveki ezidlulileyo, kodwa uhlaselwa nge-bronchospasm ngokukhawuleza nangobunzima, ukuphefumla, ukuvutha, nokukhwehlela. Olu hlobo lokuhlaselwa sisifo se-asthma luvame ukuziswa ngokubakho okukhulu kokubangela izinto, ezifana ne-pollen, uthuli okanye izifo zokutya.
Ukuxilongwa
Ezi zilandelayo ziimpawu kunye neempawu ukuba oogqirha basebenzise ukuxilonga i-SA:
- Ukuphefumula ukuphumla (Ngokuhlaselwa ngokukhawuleza, ukuphefumula okufutshane kunokuqala ngokusebenza kuphela kunye nokuqhubela phambili apho kwenzeka khona ngokuphumla.)
- Ukungakwazi ukuthetha ngezivakalisi okanye ukungakwazi ukuthetha nonke
- Umgangatho ophezulu wokuphefumula ekuphumleni ( Ukuphefumula okungaphezu kwe-30 ngomphefumlo ngomzuzu kukukhathazeka, kodwa kwanamazinga angaphezu kwe-18 kumntwana oneminyaka elidala okanye esikhulileyo kufuneka akhulise ingqalelo kwaye abukele ngokugqithiseleyo. Iifundo zivame ukuphakama kwabantwana abancinci kwaye kubalulekile ukubuza ingcali yakho ye-allergen okanye yomphunga malunga nesantya apho kufuneka uxhalabele kubantwana abancinci.)
- Ukuphakama kwezinga lokupasa ekuphumleni (ngaphezulu kwe-120 beats ngomzuzu)
- Ukutshatyalaliswa nokugwenxa (nangona, njengoko ukuhlaselwa kuqhubeka, ubuthongo nobumnyama bubuhlungu kakhulu.)
- Amanqanaba aphantsi oksijini egazini (i-hypoxemia kunye ne- hypoxia )
- Ukunciphisa amandla okuphefumula, njengoko kulinganiswe ngophulo lokuphalaza (PEF)
Unyango
Ukunyanga okusemgangathweni kwimeko ye-asthmaticus kwigumbi loxinzelelo kubandakanya:
- I-oksijeni ngeemaski
- Ukulinganiswa kwe-PEF nge-spirometry (kwi-asthma enzima kakhulu, le milinganiselo ingaba nzima)
- I-short acting aca agonists (njenge-albuterol) nge-inhaler okanye mhlawumbi ngokusebenzisa i-nebulizer
- Imithi yeCorticosteroid (njenge-prednisone) enikezwe ngomlomo okanye nge-intravenously
- Ukunyangwa kwamayeza okulwa ne-anticholinergic (njenge-atrovent)
Amanye amayeza angasetyenziswe ngexesha lesiganeko esiqulathekileyo aquka:
- I-Beta-agonists injected phantsi kwesikhumba (njenge-Terbutaline)
- I-Magnesium sulfate ngaphakathi
- I-leukotriene modifiers (njengeZafirlukast okanye iZileuton) ngomlomo
I-ventilation yamashishini yonyango (phantse) isenzo sokugqibela ngenxa yomngcipheko wexinzelelo kwimiphunga kunye nezinye iingxaki ezinokuthi zenzeke. Phantse iine pesenti yokuvakatyezwa kwegumbi lokuphucula i-asthma kuya kubangela isigulane esidinga ukungena kwamanzi. Njengomgangatho wokugqibela, i-membrane i-oxygenation ye-oxygenation (ECMO) iphumelele kwizigulana ezimbalwa apho i-asthma yayiya kuba yingozi ngisho nangomoya wokungenisa umoya.
I-ECMO (i-membrane e-extracoral membrane oxygenation) inika esinye isithuba sokugqibela kunye nesimo sokugqibela sonyango kulabo abazonyango zonke ezibandakanya ukuphuphuma umoya. Ngoku kucinga ukuba i-ECMO imele ithathelwe ingqalelo njengonyango lokuqala kubantu abanesimo se-asthmaticus abanokutshintshiselana kwe-gas (ukungadli kakuhle kwe-oxygen kunye nokuphela kwe-carbon dioxide) engayiphenduli kakuhle kunyango ekhoyo. I-ECMO inikezela indlela yokubuyisela ukutshintshwa kwegesi emzimbeni ngelixa ukukhusela ukulimala kwemiphunga ehambelana nokuphuza umoya.
Imilinganiselo ye-PEF
Ngokuqhelekileyo ubunzima beempawu zomntu one-asthma alunxulumene ngokusondeleyo nokukhathazeka kwakhe kwemiphunga. Ngoko ke, kubalulekile ukuba bonke abafundi be-asthmatics balinganise i-PEF yabo rhoqo. Oku kwenziwa ngokusebenzisa umlinganiselo weemitha ezihamba phambili , okuyiyona ifowuni encinci yeplastiki ekhutshwa ngamandla, eyenza i-PEF.
Isilinganiselo se-PEF sinikeza ulwazi malunga nesimo sokuphefumula, nayiphi na ukuhla kweyomntu oqhelekileyo (imeko yesiseko), kunye nesidingo sokwandisa amayeza okanye ukufumana unyango. Nabani na umntu onesifo se-asthma oyehla kweepesenti ezingama-30 okanye ngaphezulu kwi-PEF, ingakumbi ukuba u-rescue inhalers asebenzanga, kufuneka afune unyango ngaphandle kokungabaza.
Izinto zobungozi
Ungazi njani ukuba usengozini yokuhlaselwa kwe-asthma ebulalayo ? Ngesimo esiphuthumayo se-asthmaticus, kukho, ngentca, impawu ezimbalwa zezilumkiso. Ukuba unoluhlobo lwesifo esingaba khona, u-allergist uza kuxubusha indlela ezibuhlungu ngayo ezi hlaselo kunye nokuba zikhawuleza kangakanani.
Ngomgangatho ophuzileyo we-asthmaticus, kukho imiqondiso emininzi yokulumkisa okumele ikuqaphele ukuba ubize ugqirha okanye ufune unyango lwengxamiseko. Ezi ziquka:
- Ukuhla kwe-PEF yeepesenti ezingama-30 okanye ngaphezulu, njengoko kuphawuliwe ngasentla, nangona i-allergenist yakho ingakunika iiparitha ezahlukeneyo ngokuxhomekeka kwisifo sakho se-asthma
- Ukwanda kweemfuno zakho zokunceda
- Uvuko lwamabusuku ngenxa yesifuba sakho se-asthma
- Ukwandisa ukuphefumlelwa kokuphefumula naphezu kokusetyenziswa ngokufanelekileyo kwamayeza akho
- Ukuba usetyenzisile ezimbini okanye ngaphezulu zokuhambisa i-inhaler yakho encinane kwinyanga edlulileyo
Ukuba unembali yokuhlaselwa kwe-asthma enkulu, kufuneka ufune unyango olungxamisekileyo ukuba uyaphawula nayiphina impawu owaye nayo ngexesha lokuhlasela kwakho kwangaphambili.
ILizwi
Kubalulekile ukuba wonke umntu one-asthma, kunye nalabo abathandayo abanobakhathalele abantu abane-asthma, qaphela zonke izilumkiso iimpawu zesifo se-asthma esinzulu kunye nobubi besifo. Nangona uphumelelo kunyango, kusekho abantu abaninzi kakhulu abafa kwesi sifo unyaka ngamnye.
Ingxenye yengxaki kukuba abantu abaninzi abaqapheli ukuba amandla abo ayenayo ekhaya ayenzeka njani, kwaye oku kunokunika ingqiqo yokhuseleko. Ukuba umntu ukwandisa ukusebenzisa i-inhaler ekhaya, ngamanye amaxesha kunzima kakhulu ukufumana eso sifo phantsi kolawulo xa befika kwigumbi elingxamisekileyo.
Oko kwathiwa, ukuba nesifo se-asthma akusona isizathu sokwesaba. Njengoko kuphawuliwe ngaphambili, abantu abaninzi abanesimo se-asthmaticus banesifo esicothayo. Yiyiphi imfundo ekufuneka iyenze yinto ekhuthaza abantu abane-asthma, nokuba nabo baqubuzana nesifo se-asthma, ukuba baqaphele inkolo yabo ingqungquthela yokuhamba kunye nokudibanisa noogqirha babo nangayiphi na impawu yokuba imeko yabo iyanda. Ukuba awuqhelani nale nkqubo, fowuna i-allergen yakho namhlanje kwaye ufunde indlela yokusebenza ngayo nesifuba sakho se-asthma.
Imithombo:
Di Lascio, G., Prifti, E., Messai, E. et al. I-membrane I-Oxgenation Support Support-Life-Threating Acute Status Statute Asthmaticus. Perfusion . 2017. 32 (2): 157-163.
Miller, A., Breslin, M., Pineda, L., kunye noJ. Fox. Iprogram ye-Asthma Iphuculwe ngokubhekiselele kwiZikhokelo ezisekelwe kwiziBakala zeZifundo zezilwanyana kunye neSimo se-Asthmaticus kwiSebe eliPhezulu. Ukunyamekela . 2015. 60 (12): 1759-64.
I-Tram, R., Ilic, D., Davies, A., Pellegrino, V., Romero, L., noC. Hodgson. Ummangalo ongaphezulu kwe-Oxygenation kubantu abadala abagulayo. I-Cochrane Database yeeNkqubo eziPhezulu . 2015. 1: CD010381.