Ukuxilongwa kwe-COPD) okungalapheki

COPD yigama lesambulela seqembu lezimo zamaphaphu ezenza ukuthi imigwaqo yomoya inciphe, ngakho-ke labo abanayo bakuthola kunzima ukuphefumula umoya uphume emaphashini abo. Alikho ikhambi le-COPD kepha lingelashwa ukuze izimpawu zilawulwe. Okubalulekile ukuxilongwa kwe-COPD.

Emhlabeni jikelele, cishe abantu abayizigidi ezingama-300 bane-COPD. E-Europe, cishe abantu abayi-5-10% banesimo, kanti e-UK cishe abantu abayizigidi eziyi-1.2 batholakala ukuthi banaso - yize kulinganiselwa ukuthi abantu abayi-1.8 million bangase bangazi ukuthi baphila neCOPD. Lokhu kungenxa yokuthi i-COPD ikhula kancane ngokuhamba kweminyaka, abantu abaningi baqala ukubona izimpawu zabo kuma-50s abo.

Kulinganiselwa ukuthi cishe ama-70% wamacala we-COPD ahlala engatholakali, emhlabeni jikelele. Ngasikhathi sinye, nokho, phakathi kwabantu abathathu nabayisithupha kwabayishumi kucatshangwa ukuthi batholakala ngokungafanele ukuthi bane-COPD.

Izimo ezihambisana ne-COPD

I-bronchitis engapheli ne-emphysema kuvame ukuhlotshaniswa nalesi sifo, futhi kungaholela kwi-COPD. I-bronchitis ibangela ukuthi imigwaqo yomoya icasuke futhi ivuvuke, futhi iholele kubantu abakhiqiza amafinyila amaningi (abizwa nangokuthi isikhwehlela noma i-phlegm) kunalokho abebevame ukwenza. I-Emphysema yenzeka lapho amasaka omoya emaphashini onakalisiwe - kungaba buthakathaka noma aqhekeka. Lokhu kungenza izikhala ezinkulu zomoya futhi kuthinte ukuthi ingakanani i-oksijini efinyelela egazini.

Kufanele ngibone nini udokotela wami?

Izimpawu zokuqala zeCOPD yilezi:

  • Ukwandisa ukuphefumula
  • Isikhwehlela esifubeni esikhiqiza i-phlegm futhi ngeke siphume
  • Ukushisa
  • Ukutheleleka njalo kwesifuba.

Izimpawu zakho zingase zibe zimbi isikhathi esifushane (esibizwa ngokuthi yi-flare-up), ikakhulukazi ebusika.

Uma uhlangabezana nalezi zimpawu ngokuqhubekayo, ikakhulukazi uma uneminyaka engaphezu kwengama-35 ubudala futhi ubhema noma ujwayele ukubhema, bheka udokotela womndeni wakho ukuze uthole iseluleko sezokwelapha. 

I-COPD itholakala kanjani?

I-COPD ivame ukutholakala ngokungafanele njengoba kunezinye izimo nezifo ezinezimpawu ezifanayo, njenge-Bronchiectasis ne-asthma.

Udokotela wakho uzokubuza ngezimpawu zakho nokuthi zithinta kanjani impilo yakho yansuku zonke:

  • Ukuphefumula - ingabe iyaphikelela, ingabe iye yanda ngokuhamba kwesikhathi, ingabe kubi kakhulu uma uzivocavoca, ebusuku noma ngezinye izikhathi?
  • Isikhukhula - ingabe iyafika idlule, ingabe ikhiqiza i-phlegm, ingabe nawe uyashayana?
  • Ukutheleleka kwesifuba - uzithola kangaki lezi?
  • Umlando womndeni / wobuntwana - ngabe kukhona izihlobo zakho eziseduze ezinezinkinga zokuphefumula, ibinjani impilo yakho njengengane nengane?
  • Izici zobungozi noma ukuvezwa - uyabhema noma uyabhema, ingabe umsebenzi wakho noma impilo yasekhaya ikuxhumanisa nokungcola okuvela emoyeni (isb. Uthuli, umusi, intuthu, amagesi, amakhemikhali, intuthu evela ekuphekeni kwasekhaya noma okokubasa?
  • Ezinye izimpawu - uke waba nokuncipha kwesisindo, ukuvuvukala kwamaqakala, ukukhathala, ubuhlungu besifuba noma ukukhwehlela igazi? Lokhu akuvamile kakhulu, ikakhulukazi ku-COPD emnene, futhi kungahle kukhombe ekuxilongweni okuhlukile.

Bazolalela nesifuba sakho nge-stethoscope, bacabangele iminyaka yakho bese ubala inkomba yomzimba wakho (BMI) kusuka kubude bakho nesisindo sakho. Uma udokotela wakho esola ukuthi une-COPD uzodinga ezinye izivivinyo ukuqinisekisa ukuxilongwa futhi unqume ezinye izimbangela ezingaba khona.

Yikuphi ukuhlolwa noma uphenyo engizoludinga?

I-Spirometry

Lokhu ukuhlolwa kokuphefumula okulula okulinganisa ukuthi amaphaphu akho asebenza kanjani kahle. Uzocelwa ukuthi ushaye ngamandla emshinini obizwa nge-spirometer olinganisa inani eliphelele lomoya ongaphefumula kulo kanye, nokuthi ungashesha kangakanani ukuthulula amaphaphu akho omoya. Umthamo ophoqelelwe wokuphefumula ngomzuzwana owodwa (FEV1) uzolinganisa ukuthi ungakanani umoya okhipha emaphashini akho, bese usebenzisa lokhu ukuthola imiphumela yakho.

Uma une-COPD, udokotela wakho uzokwazi ukuyihlola ngokuhlola izimpawu nezimpawu zakho eceleni kwemiphumela yakho ye-spirometry. Abantu abane-COPD bavimbe izindiza ngakho-ke bane-FEV1 encishisiwe. Odokotela bahlukanisa i-COPD ngezigaba ezine - Ezimaphakathi, Ezilinganiselayo, Ezinzima Futhi Ezinzima Kakhulu - kuya ngokuthi sinciphise kanjani isilinganiso sakho se-FEV1 spirometry seminyaka yakho.

Uma ufinyelela ku-80% wenani lakho elibikezelwe le-FEV1, lokhu kuzowela ku-COPD emnene, phakathi kuka-50-79% kungathathwa njengokulingene, phakathi kuka-30-49% kungaba nzima futhi ngaphansi kuka-30% kube nzima kakhulu.

Isifuba X-ray

I-X-ray yesifuba ayihloli i-COPD, kepha ingaveza ezinye izinkinga zamaphaphu ezinezimpawu ezifanayo, njengokutheleleka kwesifuba noma umdlavuza wamaphaphu.

Ukuhlolwa kwegazi

Lokhu kungadingeka ukukhipha ukushoda kwe-iron (i-anemia), ukugxila kwamangqamuzana egazi abomvu aphezulu (i-polycythaemia) kanye nesifo esingajwayelekile sezakhi zofuzo esibizwa ngokuthi yi-alpha-1-antitrypsin.

Ukuhlolwa okungeziwe

Ngezikhathi ezithile ukuhlolwa okuqhubekayo kuyadingeka:

  • Isiko lesikhohlela - ukufuna ukutheleleka
  • Ukuqapha ukuhamba kwezinga eliphakeme - ukukhipha i-asthma
  • I-Electrocardiography ne-serum natriuretic peptides noma i-echocardiography - ukuhlola inhliziyo yakho
  • Isifuba se-CT scan - ukubheka ezinye izimo zamaphaphu njenge-bronchiectasis, i-fibrosis noma umdlavuza wamaphaphu
  • I-Pulse oximetry - ilinganisa izinga le-oxygen egazini lakho
  • Isici sokudlulisa se-carbon monoxide
  • Ukuhlolwa kokubuyiselwa emuva kwe-Spirometric - uma ukuxilongwa kungakaqiniseki.

 

SOURCES

NHS 2019. Sibutsetelo. Isifo esingapheliyo se-pulmonary disease (COPD).  https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/

NHS 2019. I-Bronchitis. https://www.nhs.uk/conditions/bronchitis/

IMayo Clinic 2017. Emphysema. Izimpawu nezimbangela. https://www.mayoclinic.org/diseases-conditions/emphysema/symptoms-causes/syc-20355555 

UDon D. Sin. Ngabe i-COPD kufanele imele "isifo se-pulmonary esihlobene nokuhlangana komzimba"? Ijenali Yokuphefumula yaseYurophu 2015 46: 901-902 https://erj.ersjournals.com/content/46/4/901#:~:text=The%20burden%20of%20chronic%20obstructive,people%20each%20year%20%5B1%5D

IMayo Clinic 2020. Ukuxilongwa nokwelashwa. https://www.mayoclinic.org/diseases-conditions/copd/diagnosis-treatment/drc-20353685#:~:text=During%20the%20most%20common%20test,walk%20test%2C%20and%20pulse%20oximetry

Incwadi emhlophe ye-ERS. Isahluko 13. Izifo zamaphaphu ezingapheli. https://www.erswhitebook.org/files/public/Chapters/13_COPD.pdf

I-BTS. nd. I-COPD. https://www.brit-thoracic.org.uk/quality-improvement/clinical-resources/copd-spirometry/

NICE 2018. Imininingwane yomphakathi. Isifo samaphaphu esingapheliyo: ukunakekelwa okufanele ukulindele. NG115. https://www.nice.org.uk/guidance/ng115/informationforpublic

NHS 2019. Izimpawu. Isifo esingapheliyo se-pulmonary disease (COPD). https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/symptoms/

WebMD 2017. Yiziphi izigaba ezine zesifo esingelapheki sokuvimbela kwamaphaphu (COPD) kanye nezimpawu zaso ngasinye?

https://www.webmd.com/lung/copd/qa/what-are-the-four-stages-of-chronic-obstructive-pulmonary-disease-copd-and-the-symptoms-of-each 

I-Healthline 2020. I-FEV1 ne-COPD: Ungayihumusha Kanjani Imiphumela Yakho. https://www.healthline.com/health/fev1-copd#staging-copd 

NHS. 2019. Ukuxilongwa. Isifo esingapheliyo se-pulmonary disease (COPD). https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/diagnosis/

I-NICE 2018 (ibuyekezwe ngo-2019). Isifo esingapheliyo sokuvimbela kwamaphaphu kuma-16s: ukuxilongwa nokuphathwa. NG115. https://www.nice.org.uk/guidance/ng115/resources/chronic-obstructive-pulmonary-disease-in-over-16s-diagnosis-and-management-pdf-66141600098245

UDiab N, uGershon AS, uSin DD, uTan WC, uBourbeau J, uBoulet LP, u-Aaron SD. I-Underdiagnosis kanye ne-Overdiagnosis Yezifo Ezingapheli Zokuvimbela Amaphaphu. Am J Respir Crit Ukunakekelwa Med. 2018 Novemba 1; 198 (9): 1130-1139. https://pubmed.ncbi.nlm.nih.gov/29979608/