Kwiminyaka elishumi edlulileyo, iingcali ezininzi zezempilo ziye zavakalisa intlungu ngenxa yokunyuka kwenani lamachiza anikwe izigulana ukunyanga iimeko ezihlukeneyo. Amachiza anemiphumo emibi, kwaye ukuba umntu ufanele athathe imishinga engayifuniyo, bazibeka esichengeni semiphumo emibi. Ngaphezu koko, imishishini ixabisa imali kwaye ithatha imithi engaphezulu kunokonakalisa kwaye iyancipha.
Uphando olusakhulayo lubonisa ukuba umntu wesithathu wabantu abane- asthma abafumana unyango ayenayo. Okokuqala, abaninzi bala bantu babecatshungulwa okokuqala ngaphandle kwenzuzo yokuhlolwa kwezinto eziphambili (ie, i-spirometry okanye i-test function). Okwesibini, aba bantu bafumana ukuxolelwa kwi-asthma yabo.
I-Asthma Basics
Isifo se-asthma sisifo esingapheliyo esibangelwa ngumzimba esibangela ukuguquka komoya kunye neempembelelo zokuxhamla komoya ezinokuthi zitshintshwe ngokukhawuleza okanye ngamachiza . Ingqalelo, i- bronchi yindlela yokuhamba emiphakeni esekelwe kwi-trachea, okanye i-windpipe.
Ngethuba lokuphefumula kwesifo se-asthma, okanye ukugqithisa, i-bronchi iyaba ne-responsive response and start spasm (oko kukuthi, i-bronchospasm). Amachiza asetyenziswa ukuphefumula i-asthma afaka i-corticosteroids kunye ne-beta-agonist bronchodilators.
Izimpawu eziqhelekileyo zesifo se-asthma ziquka iziqulatho zokuphefumla, ukugubha, ukuqina kwesifuba (kunye nexesha lokuhlwa) ukukhwehlela. I-asthma inokubangela ukunyuka, ukutshaya, ukuzivocavoca, uxinzelelo kunye nokunye.
Ukuxilongwa kwe-asthma kusekelwe kwimbali yonyango, uvavanyo lwekliniki, ukuhlolwa komsebenzi we-pulmonary (oko kukuthi, i-spirometry) kunye nokuhlolwa kobunzima be-bronchial usebenzisa i-methylcholine okanye i-histamine.
I- spirometer isixhobo esisetyenziselwa ukulinganisa umsebenzi womphunga kunye nemiphepha yemiphunga ukuze ubone indlela umntu ephefumula ngayo. I-bronchodilator spirometry yimihlobo ye-spirometry apho ugqirha kuqala ulawula i-bronchodilator ukuvula i-airways (njenge-beta-agonist) kwaye emva koko ukhangele ukuphucula kwimilinganiselo yemiphunga ebonakalisa i-asthma.
Ngamanye amaxesha i-spirometry ayixhasi ukuxilongwa kwesifo se-asthma kodwa umntu ukhangeleka ukuba une-asthma. Kule meko, uvavanyo lovavanyo lomngeni olunzima luya kwenziwa. Ngokuhlolwa kobunzima beengxaki, inzululwazi ilawula i-bronchoconstrictor, efana ne-methylcholine okanye i-histamine, eqinisa imimoya yomoya, kwaye ikhangele ubungqina bokuncipha komsebenzi wamaphaphu obonisa isifo se-asthma.
Uphando olutsha
Iziphumo ezivela kuJanuwari ka-2017 i-longitudinal study eyapapashwa kwi-JAMA ibonisa ukuba omnye umntu wesithathu wabantu base-Canada abasanda kufumanisa ukuba bane-asthma ayenayo, eneneni.
Kule ngxelo, 613 abathathi-nxaxheba abafake izicelo ngokukhawuleza bevela kwiidolophu ezili-10 ezinkulu kwiCanada bavavanywa phakathi kukaJanuwari 2012 noFebruwari 2016. Abathathi-nxaxheba babeneminyaka engama-18 ubudala kwaye bafumanisa ukuba bane-asthma kwiminyaka emihlanu edlulileyo. Abathathi-nxaxheba kwiphononongo badibana nale migaqo elandelayo:
- Akukho mlando wokutshaya okanye umlando wokutshaya ongaphantsi kweminyaka eyi-10 yepakethi (ukuba ungabandakanyi abathathi-nxaxheba abane- epidemic obstructive disease pulmonary )
- Akukho tyenziswa kwexesha elide le-prednisone (glucocorticoid) unyango
- Ungakhulelwa okanye uncelise
- Unako ukwenza i-spirometry
- Akukho hlaselwa yintliziyo, ukuphazamiseka, okanye i-aneurysm kwiinyanga ezintathu ezedlule (ukuchasene nokuhlolwa kovavanyo lomngeni)
Xa kunokwenzeka, abaphandi bafumene iirekhodi zokuxilonga kumagqirha abathathi-nxaxheba malunga nendlela aba bantu babesifumene ngayo ukuba bane-asthma. Kulo cwaningo, ama-24 eepesenti zamagqirha asekuhlaleni awaphendulanga kwizicelo zophando malunga nolwazi olunjalo.
Ngexesha loluhlu lweetyelelo ezininzi kwiiveki ezimbalwa, abaphandi basebenzisa iimitha ezihamba phambili zekhaya kunye nokuqapha kweempawu, i-bronchodilator i-spirometry, kunye neemvavanyo zoxinzelelo ze-bronchial ukufumana ukuba ngubani ongenayo i-asthma. Abo bathathi-nxaxheba abangenawo isifo se-asthma baxiliswa kwiyeza zabo ze-asthma kwaye baphinde bavavanywa ngexesha lokuqhutywa konyaka. Abaphandi nabo bafuna ukufumana ezinye iindlela zokufumana iingxaki kwiimeko apho abathathi-nxaxheba bengenaso isifo se-asthma.
Ekugqibeleni, isifo se-asthma sasilawulwa ngaphandle kwabathathi-nxaxheba abangama-203 (i-33.1%). Ngaphezu koko, abathathi-nxaxheba abangu-181 (i-29.5 ekhulwini) baqhubeka bengenalo ubungqina bomoya wesifuba emva kweenyanga ezili-12 zokulandelelana. Ababathathi-nxaxheba abalishumi elinesibini (iipesenti ezimbini) abazange babe ne-asthma, kodwa kunoko babe neemeko eziphambili ze-cardiorespiratory ezazingenakucatshulwa kakubi ngamagqirha asekuhlaleni. Ekugqibeleni, abathathi-nxaxheba abaye baxilongwa ngesifo se-asthma baphankanywe ukuba babengenakukwazi ukuqala ukuvavanywa ukuba basebenzise ukuhlolwa kovavanyo lwe-pulmonary kunye neemvavanyo zokunciphisa ukukhutshwa komoya kunokuba abo baqinisekiswa yi-asthma.
Iimbono ezimbini ezibalulekileyo ziyakuthotholwa kulolu cwaningo:
- Abantu abadala abanokuxilongwa abanomntu omdala-ukuvuka kwe-asthma abanakuqhubeka nokuba nesifo se-asthma okanye badinga imishanguzo ye-asthma ngonaphakade.
- Ngokwezikhokelo zeklinikhi, oogqirha abaninzi kufuneka basebenzise uvavanyo lwe-physiologicalic diagnostic, ezifana ne-bronchodilator spirometry, ukufumanisa kakuhle i-asthma kwindawo yokuqala. Ukuthembela nje kwimbali yesigulane, ukuhlolwa ngokomzimba, kunye ne-acumen yekliniki ayaneleyo xa ufumanisa le meko.
Qaphela ukuba lo mboniso unemiqathango eyenza kube nzima ukuvelisa iziphumo kubo bonke abane-asthma. Ngokukodwa, abaphandi babandakanyela abantu abaninzi abanomlinganiselo othe ngqo kwi-asthma (okt, abo bafuna unyango lwe-prednisone elide) kwaye kuphela i-45 ekhulwini yabathathi-nxaxheba bafuna imithi yemihla ngemihla yokulawula i-asthma yabo. Ngaloo ndlela, ukuxolelwa phakathi kwabathathi-nxaxheba abane-asthma enzima ayinakuqikelelwa. Esikhundleni saloo ndlela, izinga eliphezulu lokuxolelwa liboniswe (iipesenti ezingama-33.1) kuphela kuphela kulabo bafunyaniswa ukuba bane-asthma ezinamandla. Enyanisweni, olunye uphando olunexesha elide lokuhlola i-infmma yokukhululwa kwe-asthma rate rates phakathi kwalabo abanomdla wesifo esiqinileyo kubonisa ukuba izinga lokuxolelwa liphantsi.
Ukongezelela koko, kuba abanye abathathi-nxaxheba babengenamaphepha ukususela xa befunyanwe ukuba bafumana isifo se-asthma, okanye baqale baxilongwa ngaphandle kokufumana uvavanyo lokuhlola, kuyacaca ukuba bangaphi abathathi-nxaxheba abafumananga ngokungafanelekanga abane-asthma kwindawo yokuqala. Ngamanye amazwi, abanye abathathi-nxaxheba abaye bafumana "ukuxolelwa" abanakuze babe ne-asthma kwindawo yokuqala.
Ziyintoni oku kuthetha konke
Phantse i-75 ekhulwini yabantwana abane-asthma ekugqibeleni bayeke umqathango ngokudala. Nangona kunjalo, uphando luye lwabonisa ukuba ukuxolelwa phakathi kwabantu abane-astmma isuka ngaphantsi. Uphononongo lwangoku, kodwa ke, lubonisa ukuba abantu abadala kunokuba bacinga ukuba bafumane ukuxolelwa kwe-asthma. Aba bantu abadala abasayi kuphinda bafune imithi ye-asthma.
Ukuba wena okanye othandekayo uye wafumanisa ukuba unomntu omdala-uphumela isifuba somoya, nceda ugcine okulandelayo engqondweni:
- Icandelo lolawulo lo mqathango libeka iliso. Ukuba iimpawu zakho zinciphisa okanye ziyakudlulisa, ungadinga ukuba ungaphantsi okanye ungabi namachiza e-asthma, ngokulandelanayo. Kufuneka uqaphele iimpawu zakho kunye nokuphuphuma kwesifo se-asthma (oko kukuthi, "ukuhlaselwa kwesifo se-asthma") kwaye wabelane ngale ngcaciso kunye nodokotela wakho.
- Kufuneka usebenzise umlinganiselo weemitha ukujonga ukuba i-asthma yakho ilawulwa njani ekhaya. Ukuba ufumanisa ukuba i-asthma yakho iyayisindisa, buyela kudokotela wakho ukuze uphonononge kwakhona. Awuyi kuphinda ufumane imishanguzo ye-asthma.
Ekugqibeleni, ukuba ufumene ukuba ufumene umntu okhulile, sukuba ugqirha wakho akaze asebenzise i-spirometry okanye ezinye iimvavanyo zokuxilonga ukuqinisekisa ukuxilongwa, unokufuna ukumisela ukutyelelwa ngutitshala oza kwenza le mvavanyo. Omnye omkhulu uthathe kulolu cwaningo kukuba ukuhlolwa kwe-physiologic kuyimfuneko ukufumanisa i-asthma-kunye nezikhokelo zamanje zincoma olo vavanyo.
> Imithombo
> Aaron, SD, et al. Ukuhlaziywa kwakhona kweNgcaciso kwiBantu abadala kunye ne-Asthma efunyenwe ngogqirha. JAMA. 2017; 317: 269-279.
> Iziphumo zoBuchule kunye noLawulo. I-American Academy ye-Asthma, i-Allergy & Immunology. https://www.aaaai.org/
> Hollingsworth, HM no-O'Connor GT. I-Asthma-Nantso Namhlanje, Sihambe Ngomso? JAMA. 2017; 317: 262-263.
> Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. Isahluko 55. Isifuba. Ku: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr .. eds. Umbala we-Atlas we-Medicine Family, 2e . New York, NY: McGraw-Hill; 2013.