Ngenxa yokuba isifuba sixhaphakile imeko yonyango, akumangalisi ukuba ama-3 ukuya kwangu-8 ekhulwini lokukhulelwa aquka ukuxilongwa kwe-asthma.
Ngokungafani nezinye iimeko apho unokumisa imithi ngexesha lokukhulelwa okanye ngexesha lokuqala lokukhulelwa ngethuba lexesha elibi kakhulu lomngcipheko we-teratogenic effects, i-asthmatics kufuneka ithathe amachiza abo ukuba agcine ukulawula kakuhle.
Oku kukhokelela emininzi yemibuzo enxulumene nokukhuselwa kweemfuyo ze- asthma ngexesha lokukhulelwa, impembelelo yokukhulelwa kwisifo sakho se-asthma, kwaye isifo se-asthma senza ukhuseleko oluphezulu okanye lubangela ingozi kumntwana okanye yewe?
Ulawulo lwe-Asthma ngexesha lokukhulelwa
Ukulawula i-asthma ekukhulelweni kunokucingelwa ngumgaqo wesithathu-yesithathu kwisithathu se-asthmatics ekhulelweyo yokulawula ukuphucula ukuphucula, okwesithathu ayibonisi utshintsho, kunye neyesithathu yokugqibela ibona ukunyuka kweempawu zabo. Ngokuqhelekileyo, ubunzima bakho be- asthma ngaphambi kokukhulelwa kuhlobene nokuqina kwesifuba sakho ngexesha lokukhulelwa.
Ngethuba umntu unokucinga ukuba njengokuba ubhinqa lwakho lwesisu luya kwandula ukuba ukulawula isifo se-asthma kuya kuba nzima, kodwa kuya kuba yinto echaseneyo kunye ne-asthma inzima kakhulu kwiiveki zokugqibela zokukhulelwa. Xa ukuphucula i-asthma kuphuculwe kubonakala kuyenjenjalo ngokuthe ngcembe kwithuba lokukhulelwa. Kubasetyhini ababenzima kakhulu ukuqhuma isifo se-asthma, ukugqithisa kwakuxhaphake kakhulu phakathi kweeveki ezingama-29-36 zokukhulelwa.
Iimpawu ze-asthma ezibalulekileyo aziqhelekanga ngexesha lokubambisana nokuhanjiswa. Ukuhlaselwa kwe-asthma kubonakala sengathi kwenzeka ngokuqhelekileyo ngexesha lesibini neyesithathu. Ekugqibeleni, izifundo ze-asthma ngexesha lokukhulelwa zivame ukuziphindaphinda ngokukhulelwa okulandelayo. Ukuba i-asthma yakho iphuculwe ngexesha lokukhulelwa livame ukuphucula ukukhulelwa kwangaphambili kunye nangoko.
Impact Of Asthma on Pregnancy
I-asthma elawulwa kakubi ingakhokelela kuzo zonke iingxaki ezilandelayo:
- Ukufa kweintsana
- Ukunikezelwa kwangaphambili
- Isisindo sokuzalwa esincinane
- Ukutshatyalaliswa
- Ukuhlamba kokubili ngaphambi nangemva kokunikezelwa
- Ukuxinezeleka
- I-Preeclampsia okanye ukukhulelwa-kubangele ingozi yenyongweni
- Amacwecwe eGazi okanye u-embolism
- Ukungabikho komntwana
- I-Hyperemesis, ingxaki yokuhlanza
- Umsebenzi oqatha
Ezi ngxaki zingabangela ukuhla kwezinga le-oxygen. Ukunciphisa ama-oksijeni amanina kumama kunokukhokelela ekunciphiseni amazinga oksijini wengane yakho kwaye wehla ukuhamba kwegazi kwi-placenta. Kukho iingxaki ezikhoyo ezivela kumachiza e-asthma.
Akukho nanye kwezi ziinguqu ezinxulumene nokulawula i-asthma okanye umphumo wesifuba ekukhulelweni kufuneka kuthathelwe ukuba i-asthmatics ayifanele ikhulelwe. Uphuhliso olufanelekileyo kunye nokulawula kuya kuncitshiswa kwaye kunciphise ingozi yezi ngxaki.
Ingxaki yakho yokuphefumula i-asthma yakho, mhlawumbi unokuba neengxaki ze-asthma.
Uphulo lwe-Asthma Ukwakheka
Ukwelashwa kwakho kwe-asthma ekukhulelweni akuko konke okuhlukileyo kunonyango lwakho kwilizwe elingakhulelanga. Ufuna isicwangciso sesenzo se - asthma , kufuneka uqaphele rhoqo iimpawu zakho ze-asthma , kwaye uzame ukuphepha izibangela. Enye yezinto ezenza ukubeka ingqalelo kunzima kunzima ekukhulelweni kukuva ukuphefumla okufutshane izigulane ezininzi ezikhulelweyo zifumana, ngakumbi emva koko ekukhulelweni.
Nakuba kunjalo, ukugquma kunye nokujikeleza, asikho nto impawu eziqhelekileyo zokukhulelwa kwaye ingaba ngumqondiso wokulawulwa kwe-asthma. Ngenxa yoko, ukubeka esweni i-asthma nge- peak flows okanye i- FEV1 inokuba yinto ethembeke ngakumbi kwisigulana esikhulelwe. Ukunciphisa kuzo zonke zezi zinto kunokubonisa ukuphulukiswa kwe-asthma.
Njengoko isigulane esingakhulelwe , ukuyeka ukutshaya kubalulekile kwi-asthmatic ekhulelwe. Ukubhema kungabinyuli kuphela umngcipheko we- asthma exaceration , kodwa kungenza amanqanaba e-oxygen aphantsi kwaye anokwandisa umngcipheko wokufumana enye yeengxaki ezikhankanywe ngaphambili. Ngokufanayo, ukuphepha ezinye izinto ezivuthayo ezinjengothuli, i- dander , kunye nezidumba zothuli yingxenye ebalulekileyo yesicwangciso sakho sokusebenza.
Imithi ngexesha lokukhulelwa
Ngokumalunga nokunyangwa kwe-asthma ekukhulelweni, imibuzo emibini ibonakala ihambelana namayeza.
1. Ngaba imishanguzo ye-asthma inefuthe elibi kumntwana okhulayo?
2. Ngaba ukukhulelwa kuthintana nokusebenza kweyeza elithile xa kuthelekiswa nokusebenza kwayo kwimeko engakhulelwe?
Iimfuyo ze-asthma ngexesha lokukhulelwa zidibaniswe neenombolo eziphambili iziphumo ezinjenge:
- Ukutshatyalaliswa
- Ukufa
- Ukungabikho komntwana
- Ukukhula okuphantsi kwe-utero
- Uphuhliso olubi
- Ukuhamba kwegazi okwehla kwi-placenta
- Umngcipheko ophezulu wokunikezelwa kwangaphambili
Nangona kunjalo, umntu kufuneka aqonde yonke le miphumo emibi eqhelekileyo ekukhuleleni, nakwabasetyhini abakhulelwe bengenaso isifuba. Ngokomzekelo, ukungabikho komntwana kubangelwa kwi-3% yokuzalwa okuphilayo kunye nokulahlekelwa kwezinto ezilahlekileyo 10-15% yokukhulelwa. Akukho ziyobisi ezikhoyo njengamanje zibhalwa kwiCandelo A yi-United States Yokutya kunye noLawulo lweeDrug. Ezi ziza kuba iziyobisi ezilawula uphando olwenziwa ngabafazi abakhulelwe abazange babonise umngcipheko kumntwana ekukhulelweni kokuqala kwaye akukho bungqina bengozi emva kokukhulelwa. Izidakamizwa ezininzi ze-asthma zikwinqanaba le-B okanye iklasi C. Isicatshulwa B seklasi sithetha ukuba izifundo zezilwanyana azibonanga naluphi na umngcipheko wobusana, kodwa akukho zifundo ezilawulwayo kwabasetyhini abakhulelweyo. Kungathetha ukuba kukho umngcipheko othile ochazwe kwizifundo zezilwanyana ezingazange ziqinisekiswe ngokuqinisekileyo kwizifundo zabasetyhini lokuqala lokukhulelwa kwaye akukho bungqina bengozi emva kokukhulelwa. Kwimeko yengozi C ayikwazi ukulawulwa ngaphandle kwaye ukusebenzisa kufuneka kuthathelwe ingqalelo kuphela ukuba iinzuzo eziya kumntwana zingaphezu kweengozi. Kwiklasi D kukho ubungqina obunobungozi, kodwa ukusetyenziswa kwesi sidakamizwa kuya kwamkeleka nangona kukho umngcipheko.
Ngokuqhelekileyo, kuvakalelwa ukuba unyango olusebenzayo ukugcina ulawulo olufanelekileyo lwe-asthma nokukhusela ukugqithisa okugqithiseleyo ingozi yexesha eliqhelekileyo elisetyenziselwa unyango lwe-asthma. I-Albuterol, beclomethasone, kunye ne-budesonide sele isetyenziselwa kwizifundo ze-asthmatics ezikhulelweyo kunye nezifundo zonke zaziziphumo eziqinisekisayo. Ngakolunye uhlangothi, izifundo nge-prednisone yomlomo azizange zikhuthaze. Kukho nenani leziyobisi ezinamava amancinci abantu kwizigulana ezikhulelweyo.
SABA . Amagonists abambalwa abamba i-beta anikezela ngokukhawuleza iimpawu ze-asthma ezifana:
Nangona iimeko eziphezulu kakhulu ze-SABA zibonise iziphumo ze-tatogenic kwizilwanyana, akukho datha ebonisa ngokucacileyo imiphumo ye-teratogenic kubantu. Izifundo zibonisile zibonise ezimbalwa ukuba kukho iingxaki ze-albuterol. Nangona kunjalo, izifundo ezimbalwa ezincinci zibonise i-gastrostisis okanye isiphako sokuzalwa apho umntwana uswelelwa khona okanye onke amathumbu akhe ngaphandle kwesisu ngenxa yokuvula okungavamile kwodonga lwesisu esiswini. Enye ingxaki ngezinye zeziphumo zophando ezibonisa ukuba kunokulimala kukuba ukusetyenziswa kwe-SABA kudibene ne-asthma engalawulwa kakuhle engakhokelela kwiinkalo ezininzi ezichazwe ngaphambili.
Ngamanye amaxesha ukusetyenziswa kwe-beta-adrenergic agonists kusetshenziselwa ukuthintela abasebenzi abangaphambi kwesikhathi. Esikhundleni sokungenelela ezi zi yobisi zinikezwa nge-IV. Imiphumo echaphazelekayo ebonwayo yile ndlela yokulawula i-hyperglycemia okanye i-sugar suisse ephakamileyo. Xa iintsana zizalwe ngamanye amaxesha ziye zaphakamisa iintliziyo zeentliziyo, ukuthuthumela, kunye noshukela ophantsi wegazi ngenxa yonyango lomama. Zonke iziphumo zempembelelo kwintsana ziza kunyangwa kwaye zivame, ziguquke ngokukhawuleza ngoko zingaphikiswanga.
LABAs . Amava kunye ne-LABAs kunye nokukhulelwa akubalulekanga kangako kunama-SABA. Ngokusekelwe kwimeko yamava ekhoyo okwakubandakanya izifundo zomntu kunye nezilwanyana, akubonakali ukuba i-salmeterol okanye i-formoterol yandisa umngcipheko wokungabikho komntwana. Kukho amava oluthe ngqo kumntu kunye ne-salmeterol. Ngenxa yoko, kunengqiqo ukuba umfazi ukhulelwe ukuba aqhubeke ne-LABA efunekayo ekulawuleni i-asthma kwisimo sokukhulelwa kwangaphambili. Umngcipheko wokungazalwanga komntwana kunye ne-dose ephantsi ye-LABA / i-steroid engabonakaliyo ibonakala ifana ne-dose ephakamileyo okanye ephezulu ye-ICS monotherapy.
Epinephrine. Ngenxa yomngcipheko wokuncipha kwegazi kwi-placenta, iQela lokuSebenza ekukhulelweni kunye ne-Asthma lincoma ukuba le nkunkuma ingasetyenziselwa ukubeka i-anaphylaxis.
Oral steroids. I-oral steroids isetyenziswa ngokuqhelekileyo xa ukhulelwe kwiimeko ezahlukeneyo ngaphandle kwe-asthma. Ezinye iinkxalabo malunga nokusetyenziswa kwazo ziquka ukwanda komngcipheko wokungabikho kokuqhaqhaqhaqha, ukukhubazeka kokuzalwa komntwana (ininzi ye-palate palate), ukukhulelwa kwengcinezelo, isifo sikashukela, isisindo sokuzalwa esincinci, kunye ne-neonatal adrenal insufficiency. Kukho iimpendulo ezicacileyo. Ngokomzekelo, uphando oluthile lubonise umngcipheko ophezulu wecalate kunye nabanye abangekho. Ubungqina obubonisa ukuzalwa kwangaphambi kokuzalwa kwabasetyhini abafumana i-steroids ngexesha lokukhulelwa kuncinci. Ekugqibeleni, uxinzelelo lwegazi kunye namanqanaba ephakamileyo e-glucose ayaziwa ngokuxhalabisa kwaye ngoko, akumangalisi. Ngoko ihla ke ingozi. Kukho umngcipheko omkhulu kumama kunye nomntwana onxulumene nokulawulwa kwe-asthma. Ubungozi be-asthma obungalawulekiyo buya kubonakala bugqithiseleyo ingozi ebalulekileyo ye-steroids kwizigulane ezininzi.
I-steroids ye-inhaled. Idatha yokukhusela i-steroid yokukhulelwa ngexesha lokukhulelwa, njengaleyo kwizigulana ezingakhulelwe, zikhuthaza ngakumbi. Uvavanyo lokubhalisa lwe-steroid budesonide kwabaseSweden abasetyhini abonakalanga mngcipheko weengxaki ezinxulumene noluntu jikelele. Uphononongo lwalubonisekanga neengxaki ezinxulumene nokukhula komntwana, ukufa, okanye ukuguqulwa komzimba. Ngokusekelwe kwezi zinto zifunyenwe yi-steroids kuphela e-inhaled inqanaba le-B. Kwesinye isiseko sedatha njengokufunda, i-fluticasone ayibonanga ukwanda kweentlungu ezizalwe ngumntwana ngokuthelekiswa nezinye i-steroids ezikhuselweyo. Izilingo ezimbini ezilawulwe ngandlela-thile zibonise umsebenzi wokuphucula umphunga kunye nokuhla kwezinga lokumkelwa.
Leucotriene modifiers. Njengama-LABA, eli klasi leziyobisi linamathuba amancinci kuphela okwangoku, kodwa idatha ne-montelukast ikhula. Idatha engashicilelweyo evela kwiRegress Pregnancy Registry kunye novavanyo oluzayo olulawulwayo lubonisa ukuba amaxabiso ezintsholongwane ezingabonakaliyo angabonakali ahluke kubantu bonke. Ngenxa yoko, izigulana ezifuna i-leukotriene modifier ziza kulungiswa kangcono yi-montelukast kude kubekho idatha efumanekayo evela kwamanye amanxusa.
I-Anti-immunoglobulin E. I- antioconal anti-immunoglobulin E okanye i-omalizumab ivunyiwe kwizigulane ezine-asthma ezilawulwa kakubi kunye namazinga aphezulu e-IgE naphezu kokusetyenziswa kwe-steroids engabonakaliyo. Nangona ingakhange ihlolwe ngokusemthethweni kwizifundo zonyango, amazinga ezinkathazo ezifana nokukhulelwa komzimba, ukuzalwa kwangaphambili, iintsana ezincinci, kunye nokukhubazeka komntwana kubonakala ngathi kufana nezinye izifundo ze-asthmatics ezikhulelweyo. Ayikho idatha ngokwaneleyo yokwenza isincomo sokusetyenziswa kwayo ekukhulelweni.
Methylxanthini. Kukho amava ephilileyo ekliniki kunye ne-theophylline kunye ne-aminophylline ekukhulelweni. Nangona la machiza ekhuselekileyo kwikliniki, ukutshatyalaliswa kwawo kwemitha kuguqulwa kakhulu xa ukhulelwa kwaye amanqanaba kufuneka ahlolwe. Uluhlu oluncinci lwezonyango luba luncinci kakhulu olwenza ukhathaze izigulane ezingakhulelweyo. Ukongezelela, njengoko kunjalo kwizigulane ezingezangezikhulelwe, i-steroid inhayile iphumelela ngakumbi ekulawuleni i-asthma. Ngenxa yoko, ezi zi yobisi zicinga ngokugqithiseleyo njengezongezelelo zee-add-on if i-control isingakwazi ukuphunyezwa nge-steroid enganyangekiyo.
Immunotherapy. Nangona kungenakucetyiswa ukuba uqale ukuxilongwa kwe-immunotherapy ngexesha lokukhulelwa, akubonakali ezi zonyango zenza umngcipheko owongezelelweyo kumama okanye kumntwana ukuze uqhubeke nokukhulelwa.
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