Uvavanyo lwemiqathango ye-Pulmonary (PFT) ludideka kwizigulane ezininzi zeCOPD . Kwaye ukuqonda indlela ugqirha wakho aguqulela ngayo iziphumo zinokuba nzima kakhulu.
Nangona kunjalo, ukwazi iinombolo zakho njengoko kusebenza kwiimvavanyo zepmonta kubaluleke kakhulu njengoko ukwazi ukunyanga kwegazi xa unesifo senhliziyo. Iziphumo zakho zokuvavanya akunikezi nje indlela yokuthelekisa xa uqikelela ukuba uphendule kakuhle kangakanani unyango, kodwa zikwaxelela ukuba isifo sakho siphucula, sihlala sisinye, okanye siyaqhubeka.
Sibanzi
Ekuxilongweni kweCOPD , iimvavanyo zomsebenzi wamapulmoni zenziwa ukuhlola umsebenzi wamaphaphu kwaye zinqume umlinganiselo womonakalo kwimiphunga. Ukongeza kwimbali yesigulane kunye nezifundo zomzimba, izikhumbuzo zeemiphunga (i- X-ray kunye ne- CT scan ), kunye ne-PFTs zibaluleke kakhulu ekuhloliseni impilo yokuphefumula.
Iimvavanyo zomsebenzi wePulmonary zisetyenziswa xa:
- Ukucoca ngokubakho kwezifo eziphazamisayo kunye / okanye ezithintekayo zemiphunga
- Ukumisela imeko yesigulane ngaphambi kokuhlinzwa ukuze kuhlolwe ingozi yokuphefumula emva kokuhlinzwa
- Ukuvavanya ukuqhubela phambili kwesifo semiphunga kunye nokusebenza kwonyango
Iintlobo ezintathu zeemvavanyo zepmonta zisetyenziselwa ukuxilongwa kweCOPD:
- I-Spirometry
- Izifundo zokusabalalisa
- I-plethysmography
Uvavanyo lwe-Spirometry
I-COPD ibangela umoya kwimipompo ukuba ikhutshwe ngezinga eliphantsi kunye nexabiso elincinane lifaniswa nomntu onemiphunga enempilo. Isixa semimoya emiphakeni asikhupheli ngokukhawuleza ngenxa yokhuseleko lomzimba (njengokwenziwa kwemveliso ye-mucus ) okanye ukungqinqwa kwamanzi okubangelwa ukuvuvukala okungapheliyo.
Yilapho i-spirometry ingena khona.
I-Spirometry yinto eqhelekileyo kuzo zonke iimvavanyo zomsebenzi wepmonta. Yenziwa ngecebo eligcinwe ngesandla elibizwa ngokuba yi-spirometer kwaye linokusetyenziswa lula ngabagulane abancediswa nguchwepheshe onamava.
Ngokuqhelekileyo ukhetho lokuqala lokuqala lwezonyango xa uzama ukufumanisa ingxaki yokuphefumula.
Kuqhelekileyo kusetyenziswa ukuchaza amabakala (amanyathelo) e-COPD.
Inkqubo efanelekileyo, engeyiyo ingenasvasive, i-spirometry ingaqhutyelwa ngasese kwi-ofisi yakho ugqirha okanye kwiindawo ezininzi zokugula okanye izibonelelo zonyango. Uvavanyo ludinga isigulane, emva kokuba yonke umoya ikhutshwe, ukunyanzelisa.
Lo mkhangeli ulandelwa ngumoya wokukhawuleza ukuze yonke umoya iphelelwe yimiphunga. Iziphumo zovavanyo ze-Spirometry ziyahluka kodwa zisekelwe kwiimilinganiselo eziqikelelweyo zolu hlobo, oluntu olunempilo (jonga ngezantsi).
Isigama sokwazi
Iimvavanyo ze-Spirometry zilinganisa umlinganiselo wenguqu kwimiphepha yemiphunga ngexesha lokunyusa ukuphefumula. Lezo zilinganiso ziboniswa ngokusetyenziswa kwesi sigama:
- Ubungakanani bemandla (VC) -Ingakanani yomoya enokukhutshwa ngamandla kumaphaphu akho emva kokuphazamiseka okupheleleyo.
- Ukuxhotyiswa kweVital (Capacity Capacity Capacity) (i-FVC) -Ingakanani yomoya enokukhutshwa ngamandla kwimiphunga emva kokuthatha umoya ophezulu.
- Umqulu oPhezulu oPhezulu kwiSibini sibini (FEV1) -Ingqikithi yomoya enokukhutshwa ngamandla emiphakeni kwisibini sokuqala yomsindo wokunyanzeliswa.
- I-FEV1 / FVC Ratio-Ivakaliswe njenge-FEV1% okanye i-% FEV1, inika umlinganiselo we-FEV1 ukuya kwi-FVC. Oku kuxelela ugqirha ukuba yiyiphi ipesenteji yesibalo somoya esivela kumaphaphu ngexesha lesibini lokuqala lokunyuka kwamanzi.
- I-Peak Exiratory Flow Rate (PEFR) -Izinyathelo ukuba unyango lunempumelelo ekuphuculeni izifo zomoya, njengeCOPD.
- I-FlowF Expacatory Flow (I-FEF) -Ilinganiso zendlela umoya onokukhutshwa ngayo kwimiphaphu. Yisalathisi sokukhutshwa kwamanzi.
- I-FEF25% -Lolu xabiso lubonisa inani lomoya elinokukhutshwa ngamandla kumaphaphu kwiipesenti zokuqala ezingama-25 zovavanyo olupheleleyo oluqhutywe ngamandla.
- I-FEF50% -Lolu hlobo lubonisa inani elipheleleyo lokukhutshwa emoyeni kwimiphunga ngexesha lesibini kwisiqingatha (50 ekhulwini) yokuhlolwa kobunzima obunyanzelekileyo. Kuyiluncedo xa ugqirha egxeka izifo eziphazamisayo. Kwisigulane esinomqobo, umlinganiselo womoya oya kukhishwa ngawo uya kuba ngaphantsi komntu onemiphunga enempilo.
- I-FEF25% -75% -Lolu hlobo lubonakalisa inani elipheleleyo lomoya ophuma emaphafini ngexesha lesigidi esiphakathi kovavanyo oluvakalayo olunamandla. Amakliniki amaninzi abhekisela kule xabiso ngenxa yoluphawu lwesifo esiphephayo somphunga.
- I-Maximal Voluntary Ventilation (MVV) -Ixabiso elinqunywe isigulane sokungena kunye nokutshatyalaliswa ngokukhawuleza kwaye ngokugcwele ngokusemandleni kwimizuzwana engama-12. Iziphumo zibonisa isimo semisipha esetyenziselwa ukuphefumla, indlela enzima ngayo imiphunga, kwaye ukuba kukho naluphi na ukuchasana kwi-airways xa iphefumula. Olu vavanyo luchazela oogqirha ukuba unamandla kangakanani imiphunga yesigulane ngaphambi kokuhlinzwa. Ukuba izigulane zibonisa ukusebenza kakubi kulo mvavanyo, luchaza ugqirha ukuba iingxaki zokuphefumula zingenzeka emva kokuhlinzwa.
Ukutolika iziphumo
I-Spirometry inceda oogqirha bakhankanya ubukho bezifo eziphazamisayo nezikhuselweyo zezifo zemiphunga. Njengawuphi na uvavanyo lovavanyo, ugqirha wakho ngumntu ongcono kakhulu onokufanele uxoxe ngawo ngemiphumo yakho yokuvavanya i-spirometry kwaye yedwa onokukunika ukuxilongwa ngokuchanekileyo.
Kukho iindlela ezininzi ezisetyenziselwa ukutolika-lowo ugqirha wakho usebenzisa umcimbi wokukhetha. Okubaluleke ngokwenene nakuphi na uvavanyo lwe-spirometry kukuba lwenziwe ngokuchanekileyo kwaye ukuba uvavanyo luchazwe ngokuchanekileyo kwaye luchanekileyo ngunyango oqeqeshiwe.
Oku kulandelayo yindlela enye yokuchazwa kovavanyo ogqirha wakho. (Kuthelelwe iinjongo zokwazisa kuphela kwaye akufanele kuthathe indawo yeengcebiso zonyango ephilileyo evela kumboneleli wakho wezempilo.)
- Inyathelo 1: Khangela i-FVC yakho ukubona ukuba iyinto evamile.
- Inyathelo 2: Khangela i-FEV1 yakho ukubona ukuba iyinto evamile.
- Inyathelo 3: Ukuba zombini i-FVC kunye ne-FEV1 ziqhelekileyo, unesivivinyo esiqhelekileyo kwaye unokumisa kweli nqanaba.
- Isinyathelo 4: Ukuba i-FVC yakho kunye / okanye ii-FEV1 zakho ziphantsi, ngoko unakho unokufumana isifo seemiphunga kunye neemvavanyo ezongezelelweyo zifunekayo ukuvavanya oku.
- Inyathelo lesi-5: Ukuba isinyathelo 4 sikhombisa isifo sesifo somphunga, jonga kwi-% echazwe kwi-FEV1 / FVC yakho. Ukuba ngaba ngamaphesenti angama-69 okanye ngaphantsi, izifo eziphazamisayo kufuneka zikhankanywe. Ukuba ngaba ngama-85 ekhulwini okanye ngaphezulu, ngoko-ke imfuyo yesifo somngcipheko kufuneka ikhunjulwe.
Ngokuqhelekileyo, abantu baya kwi-spirometry baze babuze ukuba ngaba iziphumo zichanile ngokwenene. Enyanisweni, kukho izinto ezithile ezinokuchaphazela iziphumo zakho ze- spirometry ngendlela engaphantsi.
Ukuqulunqa ubunzima beCOPD
Oogqirha basebenzisa i-spirometry ukujonga ubunzima beCOPD. Nangona kukho iinkqubo ezininzi ozikhethayo, itafile engezantsi yindlela ephakanyiswe yiNkqubo yoLuntu lweMihlaba yokuLungisa izifo (GOLD).
Iziphumo zakho zokuvavanya zifaniswa neetrafti eziqhelekileyo, izithethe ezichongiweyo ezisebenzisa ukuguquguquka kwemimandla efana nobudala, ubulili, ubungakanani bomzimba kunye nobuhlanga njengendlela yokubeka imilinganiselo. Ipesenti eqikelelweyo, njengoko ixesha libhekiswe kulo, linika oogqirha ithuluzi lokuthelekisa iziphumo zakho zokuvavanya kunye neziphumo ezifunyanwa kubantu abaneemiphunga enempilo.
| IGOLD I-Spiromric Criteria ye-COPD yobunzima | ||
| I. Mild COPD | * FEV1 / FVC <0.7 * FEV1> / = = 80% iqikelelwe | Kule nqanaba, isiguli mhlawumbi asiyazi ukuba umsebenzi wamaphaphu uqala ukuhla |
| II. COPD efanelekileyo | * FEV1 / FVC <0.7 * 50% | Izibonakaliso ngeli nqanaba kwinkqubela phambili, ngokuphefumula okufutshane okuphuhliswayo ekusebenziseni. |
| III. COPD | * FEV1 / FVC <0.7 * 30% | Ukuphefumula kufutshane ngakumbi kule nqanaba kwaye iimeko zee- COPD eziqhelekileyo ziqhelekile. |
| IV. COPD kakhulu | * FEV1 / FVC <0.7 * I-FEV1 <30% iqikelelwe okanye i-FEV1 <50% iqikelelwe ukuhluleka kokuphefumula | Umgangatho wobomi kweli nqanaba unzima kakhulu. Ukukhushulwa kweCOPD kungasongela ubomi. |
Iziphumo zovavanyo lwe-Spirometry ziya kulandelwa kabini, zombini ngaphambi nangemva kokulawula i-bronchodilator. Ngokutsho kwe- American Thoracic Society , ukuba kukho ubuncinane i-12 ekhulwini kunye no-200-milliliter uphuculo ukusuka kwisiseko esilandelayo kwi-post-bronchodilator i-FEV1 kwimizi emibini kwimizuzu emithathu ye-spirometry, kuthiwa uphendule ngokuphawulekayo kwi-bronchodilator. Oku kufuneka kulungelelanise nendlela ophendula ngayo kunyango-into ebalulekileyo yokuxela.
Ezinye iimvavanyo
Ngokubambisana ne-spirometry, ezinye iimvavanyo zomsebenzi wamapulmoni zibalulekile ekuxilongweni kwesifo somphunga:
- Izifundo zokusabalalisa -Le PFT ikuxelela ukuba i-oksijini ophefumulayo ishukumisela njani kwigazi lakho.
- I-plethysmography ye-Body -Uvavanyo olubonisa ukuba umoya ukhona kangakanani emiphakeni yakho xa uthatha umoya ophefumlelweyo kwaye ungakanani umoya oshiyayo kwimiphunga yakho emva kokuba uphumelele kangangoko unakho.
> Imithombo:
KwiNyuvesi yaseNorthern Arizona. Uvavanyo lokuSebenza kwePulmonary.
Isicwangciso sehlabathi soLwazi, ukuLawula kunye nokuKhuselwa kweCOPD, iNkqubo yoHlabathi kwiZifo eziLungelayo eziLungile (GOLD). 2010.