Ngaba Iimpawu Zam zivela kwiCOPD, Ukungaphumeleli Kwintliziyo, okanye zombini?

Izigulane ezininzi ezine-COPD nazo zinokuphelelwa yintliziyo yokuphelelwa yintliziyo

Ukuphefumula kukubonakalisa uphawu oluphambili lwesifo esingapheliyo se-pulmonary disease (COPD) . Ngokuqhelekileyo isizathu sokuba izigulane zeCOPD zenze kwigumbi lexakeka okanye zi tyelele ugqirha. Uninzi olunzima lweCOPD lubonakalisa ukuphefumula okufutshane, ukuqhuma, nokukhwehlela Ukuba unesigulane neCOPD, mhlawumbi uyazi le mpawu kakuhle, kwaye mhlawumbi wena okanye oogqirha bakho unokucinga ukuba iimpawu zakho zonke zihlobene neCOPD.

Nangona kunjalo, kubalulekile ukukhumbula ukuba iipesenti ezingama-30 zezigulane ezinezifo ezingapheliyo zokuphefumula (COPD) zinezinga elithile lokuhluleka kwentliziyo (CHF) . Ngamanye amazwi, izigulane ezineCOPD ezinempawu ezilawulwa kakubi ezifana nokuphefumula okufutshane okanye ukuvuthwa kufuneka zihlolwe kwakhona ukuhluleka kwentliziyo ye-congestive (CHF).

Ukufana phakathi kweCOPD ne-CHF

1. Iimpawu: I- COPD kunye ne-CHF isifo esinezibonakaliso ezifanayo: ukuphefumula, ukukhwehlela , kunye / okanye ukuhamba. Ukongeza, i-CHF ingabangela ukuvuvukala komlenze, okungekho uphawu lwe-COPD, kodwa akubona zonke izigulane ezine-CHF ezinokukhukhumeza komlenze.
2. Ukukhushulwa: Iikhowudi zeCOPD kunye ne-CHF zizifo ezihlala ziba zibi kakhulu, ke zingcono, zibe zibi ngakumbi. Iimeko ezimbi zibizwa ngokuthi 'ukuxhatshazwa' kwaye ziyimpawu ezibalaseleyo kwezi zifo zimbini zezifo. Iingozi ze-COPD zinokubangelwa zizifo, izibanda (ii-virus), umsi kunye nomsi. I-CHF exacerbations idla ngokubangelwa utshintsho ekudleni (ukutya ukutya okuninzi okotyuwa okanye amanzi), ukulibale ukuthatha amayeza, kunye nokutshintsha kwimeko yempilo (umzekelo, ukuhlasela kwentliziyo okanye iingxaki zeengtso). Kuzo zombini iimeko, ukuba uxhomekeke kwiCOPD okanye ukukhushulwa kwe-CHF, unokwazi ukuba iimpawu zakho ziya kuqhubeka. Imisebenzi elula iyakwenza ube nokuphefumula, unakho ukukhwehlela ngakumbi okanye uzive ujikeleza. Ngamanye amaxesha kunzima ukuchazela umahluko phakathi kokukhushulwa kweCOPD kunye nokunyanzeliswa kwe-CHF, ingakumbi kwizigulane ezithwaxwa zizifo zombini.

1. Ukunciphisa ukusebenza kwipmonta: Ukuba unayo i-COPD, awuziwayo kwimvavanyo yokuphefumula, okanye iimvavanyo zomsebenzi wamapulmoni. Olu vavanyo lubandakanya ukuvuthela kumatshini olinganisa umsebenzi wakho wokuphefumula, nenani eliphambili lomdla yi-FEV-1 (umqulu ophefumlelweyo wokuphefumula). Xa izigulane ezineCOPD okanye i-CHF zineziphumo ezinzima, le nombolo iyancipha, nto leyo ibonisa ukwehla komsebenzi wamaphaphu. Emva kokuphuculwa kokuphuculwa, le nombolo iya kuphucula kwakhona. Ukugqithisa kakhulu ukunyuka komsebenzi wamaphaphu, kunzima kakhulu ukukhushulwa-kwaye oku kuyinyaniso kwii-COPD kunye ne-CHF.

Ngaba oogqirha baxelela njani iCOPD kunye neCFF ngaphandle?

1. Uvavanyo lweMzimba: Naliphi na ixesha xa unobungozi obunzima, kubalulekile ukutyelela ugqirha ukuze bakwazi ukuhlola ngokusemgangathweni. Ngokukodwa, oogqirha baya kukhangela iimpawu ezixelela iCOPD kunye ne-CHF ngaphandle. Ukuhlolwa kwemiphunga, oogqirha banokubona ukuvuthwa (okwenzeka ngexesha le-COPD kunye ne-CHF exacerbations). Nangona kunjalo, ukuba ingxaki i-CHF ngokuyinhloko, ingxolo ebizwa ngokuthi "i-crackle" (ebonisa ukuba i-buildup) iyakuba yinto ephezulu. Oogqirha baya kuphinda bahlolwe imilenze yakho ukuvavanya ukuvuvukala, eyona ngxaki eqhelekileyo kwi-CHF kodwa ngaphantsi kwee-COPD ukukhushulwa. Ukuhlolwa komzimba kungabonakalisa ukukrokra okutsha, okuye kwenzeka rhoqo xa i-CHF ingxaki kunye nemithanjeni yentamo ingaxhatshazwayo leyo ingayibonisa ukugcinwa kwendalo. Zonke ezi ziphumo zikhokelo, nangona kunjalo, kwaye akukho namnye kubo oqinisekisa ukuba isifo esinye sinomthwalo wempawu zakho.
2. I-chest-xrays: I-x-ray yesifuba yindlela enye oogqirha abanokujonga ngayo ukucacisa umahluko phakathi kwe-COPD yokukhushulwa kunye nokukhushulwa kwe-CHF kwizigulane ezinokubakho izifo zombini. Xa isigulane sinokukhushulwa kwe-CHF, i-fluid yakha okanye ijikeleze imiphunga, kwaye oku kuya kubonakala kwi-x-ray yesifuba. Nangona kunjalo, ukuba iimpawu ziphela nje ngenxa yeCOPD, ke lo mkhuhlane awuyi kubonwa.

1. I-Echocardiograms: I-echocardiogram yintsholongwane yentliziyo. Ivumela oogqirha ukuba bajonge isakhiwo senhliziyo, ukuhamba kwegazi, kunye nomsebenzi wokupompa we-muscle yenhliziyo ngokwawo. Ukuba umsebenzi wentliziyo uncitshiswe (ngezinye izihlandlo ebizwa ngokuba yiqhezu elincinci ye-ejection), oku kunokubangela ukusola ugqirha ukuba i-CHF yinkxalabo enkulu. Ukuba intliziyo isebenza ngokuqhelekileyo, oku kunokukwenza ukuba ugqirha agxeke ukuba i-COPD yinkxalabo enkulu, endaweni yoko. Khumbula, nangona kunjalo, izigulane zinokuba neengxaki EZINYE, kwaye ke zonke ezi ziphumo kufuneka zithathwe kumxholo.
2. Ukuhlolwa kwegazi . Ekugqibeleni, ukuhlolwa kwegazi okubizwa ngokuba yi-BNP, okanye i-peptide ye-natriuretic eyinqobo inokuphakanyiswa kakhulu ngexesha lokukhushulwa kwe-CHF. Olu vavanyo lunokukunceda kakhulu xa luphantsi, kuba oko kuphakamisa ukuba intliziyo ayiqeshwanga.

Ziziphi iindawo ezahlukileyo kunyango?

Ukunyanzeliswa kwe-COPD , unyango lubandakanya i-bronchodilators okanye i-steroids enganyangekiyo kunye ne-steroids yomlomo (njenge-prednisone) okanye ngamanye ama-IV steroids. Izigulane ezinobungakanani beCOPD kufuneka zifumane nebulizers okanye i-albuterol inhalers . Ngokuqhelekileyo, i- antibiotics imiselwe kwakhona.

Ngenxa yokunyuka kwe-CHF , unyango oluphambili lubandakanya i-diuretics (njengeLasix okanye iBumex). Ukwenyuka kokutsha kwe-CHF kufuneka kuhanjiswe kwi-cardiologist yakho ukwenzela ukuba uqinisekise ukuba akukho zintliziyo zengxaki eziye zadala iimpawu zakho ezibuhlungu. Olunye unyango lunokulungiswa okanye lubekwe ngexesha lokunciphisa i-CHF ngokunjalo, kwaye oko kusoloko kuluvo olufanelekileyo ukuthetha nodokotela wakho ukuba unempawu ezintsha.

Xa izigulane zine-COPD kunye ne-CHF kubakho nzima ukubalula-kunye namaxesha amaninzi, izigulane zinokuba nezizifo zombini zihlala zijikeleza ngexesha elifanayo. Oogqirha baya kuhlala bephethe iimpawu zeCOPD kunye neempawu ze-CHF ngexesha elifanayo ukuba ingacacanga ngokupheleleyo ukuba sisiphi isifo esibangela ukuba izibonakaliso zininzi kunye nezikhokelo zincome izigulane ezinokukhubazeka kwentliziyo kwiimpawu zonyango zamanje (kubandakanywa ne-beta blockers) kwaye zikhuthaze ukuba unyango oluqhubekayo lwe-COPD ukuba zombini izifo zinegalelo kwiimpawu.

Ngaphantsi

I-COPD ne-CHF zifana kakhulu ngokwempawu kunye nezinye iziphumo, kwaye izigulane ezininzi zivalelwa kwezi zifo zombini. Ngako oko, akuqhelekanga ukuba oogqirha bakuphathe ngokubambisana neCOPD kunye ne-CHF ngexesha elifanayo ukuba akucaci ukuba yisiphi isifo esiyiyo.

> Umthombo
I-Initiative Yomhlaba Wonke Yengxaki Ezingapheliyo Zokukhusela Izifo (i-GOLD Guidelines) 2016