Ziyini izigaba ezine ze-COPD (chronic obstructive pulmonary disease)?

Yini i-COPD?

COPD yigama leqembu lezimo zamaphaphu - kufaka phakathi i-bronchitis engapheli kanye ne-emphysema - okwenza ukuthi imigwaqo yomoya inciphe, okwenza kube nzima ukuphefumula umoya uphume emaphashini. Kulinganiselwa ukuthi cishe abantu abayizigidi ezingama-300 banesimo emhlabeni jikelele.

Luyini uhlelo lokuhlola lwe-GOLD lwe-COPD? 

IGOLD imele iGlobal Initiative for Chronic Obstructive Lung Disease, okuyinhlangano ekhipha imihlahlandlela yamazwe omhlaba yokunakekelwa kweCOPD. Odokotela emhlabeni wonke basebenzisa imihlahlandlela ye-GOLD lapho bethatha isinqumo sendlela engcono yokwelapha nokuphatha iziguli zabo ezine-COPD.

The GOLD uhlelo ihlola i-COPD isebenzisa i-Refined ABCD Assessment Tool, ebheka:

  • Umphumela we-Spirometry - ukuqinisekisa ukutholakala kokuqala kwe-COPD nokukala ukuvinjelwa komoya
  • Izimpawu zakho nokuthi zithinta kanjani impilo yakho
  • Ingozi yakho yokukhula (i-flare-up), lapho izimpawu zakho ziba nzima ngokungazelelwe.

Ukusuka kulokhu i-COPD yakho ihlukaniswa ngenombolo kusuka ku-Grade 1 kuya ku-Grade 4, kanye nencwadi evela ku-Group A kuya ku-Group D. Lokhu kunikeza udokotela wakho imininingwane ebalulekile yokuthi ungayiqapha futhi uyiphathe kanjani i-COPD yakho. Bazokhumbula futhi ukukhomba futhi belaphe ngokushesha noma yiziphi ezinye izifo onazo ezingaba nomthelela ku-COPD yakho.

 

Izigaba ezine zeCOPD: GOLD COPD amamaki 1 kuye ku-4

Amabanga 1 kuya ku-4 atshela udokotela wakho ngezinga lakho lokuvinjelwa komoya, njengoba kulinganiswa yi-spirometry. Kulesi sivivinyo sokuphefumula esilula umshini obizwa nge-spirometer usetshenziselwa ukukala:

  • Umthamo ophelele womoya ongawukhiphela ngaphandle ngasikhathi sinye - obizwa ngomthamo obalulekile ophoqiwe (FVC)
  • Ungakanani umoya ongaphefumula ngawo owesibili wokuqala we-exhale enzima - obizwa ngokuthi ivolumu yokuphoqelela yokuphefumula ngomzuzwana owodwa (FEV1).

Abantu abanemigwaqo yomoya evinjiwe bane-FEV1 encishisiwe yeminyaka yabo. A Ukuxilongwa kwe-COPD iqinisekisiwe uma i-FEV1 / FVC yakho ingaphansi kwama-70%. Udokotela wakho uzokala i-COPD yakho kusuka ezigabeni ezine ze-COPD, 1 kuye ku-4 - Mild, Moderate, Severe and Very Severe - kuya ngokuthi sinciphise kanjani isilinganiso sakho se-FEV1 spirometry seminyaka yakho ngokulandelayo:

I-GOLD COPD Ibanga 1 Emnene i-FEV1 ingu-80% noma ngaphezulu
IGOLIDE COPD Ibanga lesi-2   
I-FEV1 emaphakathi iphakathi kuka-50% no-79%
IGOLIDE COPD Ibanga lesi-3    I-FEV1 enamandla iphakathi kuka-30% no-49%
IGOLIDE COPD Ibanga lesi-4    I-FEV1 ebucayi kakhulu ingaphansi kwama-30%

Yize lawa mabanga ekala ukuthi imigoqo yakho yezindiza ivinjelwe kangakanani, ayisizi kangako uma kukhulunywa ngokukhetha ukwelashwa okungcono kakhulu kuwe. Ekuqaleni odokotela babecabanga kuphela imiphumela yakho ye-FEV. Kodwa-ke, ukuthola ukuqonda okubanzi ngesimo sakho, manje bazohlola nezimpawu zakho zamanje, amathuba okuthi i-COPD yakho yande, kanye nezinye izimo zempilo onazo.

GOLD COPD amaqembu A kuya ku-D

Udokotela wakho uzobeka i-COPD yakho kwelinye lamaqembu amane ngokusho ukuthi unaziphi izimpawu, ukuthi mncane kangakanani noma unzima kangakanani, kanye nengozi yokuba ne-exacerbation (flare-up).

Ngabe ingozi yokuqhuma ilinganiswa kanjani?

Kalula nje, usengozini yokuba ne-flare-up uma usanda kuba nayo kamuva nje. Ngakho-ke uma ungazange ube ne-flare-ups ye-COPD yakho ngonyaka odlule, ubungozi bakho besikhathi esizayo buhlukaniswa njengobuphansi. Uma ngabe ube ne-flare-up eyodwa kuphela ngonyaka odlule futhi awudingi ukuya esibhedlela, lokho futhi kukubeka engcupheni ephansi.

Uma uke wangena esibhedlela ngenxa ye-COPD yakho ngonyaka odlule, usengozini enkulu yokuthola enye i-flare-up. Ukuqhuma kabili noma ngaphezulu ngonyaka odlule nakho kukufake esigabeni esinobungozi obukhulu, noma ngabe ubungaphilile ngokwanele ukuya esibhedlela nganoma yisiphi salezi zikhathi.

Zihlolwa kanjani izimpawu zami?

Imvamisa udokotela wakho uzokucela ukuthi ugcwalise uhlu lwemibuzo olufushane mayelana nokuthi unaziphi izimpawu nokuthi ziyithinta kanjani impilo yakho. Imibuzo emibili esetshenziswa kakhulu yile:

  • I-COPD Assessment Test (CAT) - lokhu kukucela ukuthi ulinganise ukuthi iCOPD iyithinta kanjani impilo yakho ngokukhwehlela, ukukhwehlela, imizwa, ukulala, ukuqina kwesifuba, ukuphefumula, imisebenzi yansuku zonke, amandla nalapho uphuma khona futhi. Kumaphuzu aphelele angama-40, amaphuzu ayi-5 noma ngaphansi angalindelwa kumuntu ongabhemi onempilo. Kuhlelo lwe-GOLD amaphuzu we-CAT angaphansi kuka-10 akhombisa 'amasistimu amancane' futhi amaphuzu e-CAT ayi-10 noma ngaphezulu akhombisa 'izimpawu eziningi'. 
  • Kushintshwe i-MRC Dyspnea Scale (mMRC) - lokhu kuyindlela elula yokuphefumula esikalini samaphoyinti amane. Kuhlelo lwe-GOLD isilinganiso se-mMRC se-0 kuye ku-1 sikhombisa 'izimpawu ezingaphansi' futhi isilinganiso se-mMRC esingu-2 noma ngaphezulu sikhombisa 'izimpawu eziningi'.

Udokotela wakho uzohlanganisa ubungozi be-flare-up kanye nesibonakaliso sezimpawu ukunquma iqembu lakho le-COPD, ngokulandelayo:

IGOLIDE COPD Iqembu A Ingozi ephansi yokuqhuma, izimpawu ezimbalwa
IGOLIDE COPD Iqembu B Ingozi ephansi yokuqhuma, izimpawu eziningi
IGOLIDE COPD Iqembu C Ingozi ephezulu yokuqhuma, izimpawu ezimbalwa
IGOLIDE COPD Iqembu D Ingozi ephezulu yokuqhuma, izimpawu eziningi

 

Ngabe i-COPD Ibanga neqembu lami lizosho ukuthini kimi?

Ibanga lakho likutshela ukuthi i-COPD yakho ifinyelele kusiphi isigaba. Iqembu lakho, kanye nanoma yiziphi ezinye izinkinga zezokwelapha, kunquma ukuthi yiluphi ukwelashwa futhi uhlelo lokuphatha ikulungele kakhulu. Udokotela wakho angalungisa ukwelashwa kwakho kuye ngokuthi isimo sakho siphendula kahle kangakanani noma uma sibi kakhulu.

Wonke umuntu wehlukile futhi iBanga neQembu akuhambelani kahle. Isibonelo, umuntu one-COPD ebucayi kakhulu kepha ezinzile futhi engenakho ukuvuthwa ngonyaka owedlule uzoba no-Grade 4, Group B COPD, kanti omunye umuntu one-COPD enzima kakhulu odinge ukwelashwa esibhedlela kabili ngonyaka odlule ngenxa yesimo sakhe IBanga 4, Iqembu D COPD. Uma kukhona umehluko omkhulu phakathi kweBanga neBanga udokotela wakho angenza ezinye izivivinyo ezengeziwe, njengokuhlolwa kokusebenza kwamaphaphu noma ukuskena kwe-CT, noma abukeze ezinye izinkinga zezokwelapha okufanele uqonde ukuthi kwenzekani nge-COPD yakho.

 

Ziyini izimpawu esigabeni ngasinye seCOPD?

Wonke umuntu wehlukile futhi izimpawu nezimpawu ze-COPD ziyahlukahluka kakhulu kuye ngomuntu. Kodwa-ke izigaba zeCOPD zithuthuka kabanzi ngokulandelayo:

  • Isigaba 1 (imnene) i-COPD: Kuvamile ukuthi ungaboni zimpawu uze ube seminyakeni yama-50s, ngakho-ke i-COPD yokuqala ingakhombisa izimpawu nhlobo. Noma ungahle ube nesikhwehlela esikhanyayo esomile noma esikhiqiza i-phlegm encane. Ukuphefumula okuncane ngemuva kokuvivinya umzimba kuyisifo esivamile sakuqala, noma kulula ukwenza iphutha ngalokho ngokuba sesimeni esincane.
  • Isigaba 2 (ngokulinganisela) i-COPD: Ungathola ukukhwehlela okungapheli kanye ne-phlegm (okuvame ukuba kubi kakhulu ekuseni), ukwanda komoya, ukukhathala, izinkinga zokulala, noma ukuphefumula. Cishe umuntu oyedwa kwabahlanu unezikhukhula ezenza izimpawu zabo zibe zimbi kakhulu futhi zenze umbala wephlegm yabo ushintshe. Ingaqala ukuthinta impilo yakho yengqondo, ikwenze ube nemizwelo ephansi kanye / noma nokudideka.
  • Isigaba 3 (i-COPD enamandla): Izimpawu zakuqala ziba zimbi kakhulu futhi ungahle uqaphele ukuthi unama-flare-ups amaningi kunakuqala. Ungakuthola ukuthi unezifo eziningi zesifuba kunakuqala, unomuzwa wokuqina kwesifuba futhi ushaywa yimisebenzi yansuku zonke. Abanye abantu bangabona ukuvuvukala emaqakaleni, ezinyaweni nasemilenzeni.
  • Isigaba 4 (i-COPD enzima kakhulu noma esekupheleni): Izimpawu ezivela esiteji sesi-3 ziya ngokuba zimbi futhi ziphikelela kakhulu. Ukuphefumula nje kuba ngumzamo. Ama-flare-ups angaba kaningi futhi abe nzima kakhulu. Ezinye izimpawu zingabandakanya 'ukuqhekeka' lapho uphefumula, isifuba somgqomo, i-delirium, ukushaya kwenhliziyo okungajwayelekile noma okusheshayo, ukwehla kwesisindo, noma umfutho wegazi ophakeme wamaphaphu.

 

Ngingayeka noma nginciphise i-COPD yami ekubeni yimbi?

Alikho ikhambi le-COPD futhi lingasongela impilo. Ucwaningo olulodwa lubalwe ukuthi i-COPD ebucayi futhi ebucayi kakhulu ingahlotshaniswa nesikhathi esinciphile sokuphila seminyaka ecishe ibe yisishiyagalombili.

Kodwa-ke izindaba ezimnandi ukuthi, i-COPD yaphambilini iyatholakala, usheshe uqale ukwelashwa futhi uthathe isinyathelo sokubambezela ukuqhubeka kwayo. Noma kusigaba 4, ngokwelashwa okufanele i-COPD akudingeki ibeke umkhawulo wokuthi uhlala isikhathi esingakanani. Kunezinto eziningi ongazenza:

  • Yeka ukubhema futhi ugweme ezinye izinto ezingcolisa umoya
  • Vivinya umzimba ngokuphepha
  • Qaphela izimpawu zokuqala zesexwayiso bese uthatha isinyathelo
  • Thatha indima esebenzayo nodokotela wakho ekwelashweni nasekubuyekezweni okuvamile
  • Yidla ngendlela enempilo.

Udokotela wakho angakusiza ukuthi wakhe uhlelo lokukusiza ubhekane nanoma yiziphi ezinye izimo zezokwelapha, kufaka phakathi ukudangala nokukhathazeka okuthinta kakhulu abantu abane-COPD.

 

UDon D. Sin. 2015. Ingabe i-COPD kufanele imele "isifo se-pulmonary se-comorbidity-related obstructive"? https://erj.ersjournals.com/content/46/4/901 

Izigaba ze-COPD kanye nemigomo yegolide. 2019. https://www.webmd.com/lung/copd/gold-criteria-for-copd 

I-Healthline 2018. I-FEV1 ne-COPD: Ungayihumusha Kanjani Imiphumela Yakho. https://www.healthline.com/health/fev1-copd#diagnosing-copd