Ukwelashwa kwe-COPD

Alikho ikhambi isifo esingapheliyo sokuvimbela kwamaphaphu (COPD). Kodwa-ke, kunezinhlobo zokwelashwa ongazenza kanye nokuziphatha ongakusebenzisa ukusiza ukukumisa ekuqhubekeni - kukusiza ukuba uphile kahle nalesi simo. Udokotela wakho uzosebenza eduze nawe ukuthuthukisa okwenziwe ngezifiso uhlelo lokuzilawula ukumboza impilo yansuku zonke nokuthi yini okufanele uyenze uma uqala ukuzizwa kabi kakhulu.

Siza ukuyeka ukubhema

Uma unayo I-COPD nentuthu, ukuyeka kungaba yinto eyodwa enkulu kunazo zonke ongayenza ukunciphisa izimpawu zakho futhi usize ukumisa isimo sakho siba sibi. Cela udokotela womndeni wakho akusekele ngalokhu. Bangakwazi ukunikela:

  • Imikhiqizo yokufaka esikhundleni seNicotine, etholakala ngezinhlobo ezahlukahlukene njenge-gum, inhaler, spray nasal, isikhumba sesikhumba, i-lozenge noma i-tablet engaphansi kolimi
  • Imithi yokwehlisa izifiso zakho ze-nicotine nezimpawu zokuhoxa
  • Ukusekelwa kokuziphatha njengokululekwa komuntu ngamunye, iqembu, noma uku-inthanethi.

Labo abathola inhlanganisela yokwesekwa nemithi cishe bangamathuba aphindwe kathathu okuyeka ngempumelelo.

Gonywa

Yiba nomkhuhlane waminyaka yonke ukuze uvikeleke kumagciwane emikhuhlane akamuva ebusika njalo. Awunamathuba amancane okuba nama-COPD flare-ups noma ugule kakhulu futhi udinga ukuya esibhedlela.

Ungacela nodokotela wakho umuthi wokugomela i-pneumococcal. Lokhu kuzovikela ekuthelelekeni kwe-pneumococcal, okubangela inyumoniya nezinye izifo. Uzodinga lokhu kanye kuphela, hhayi minyaka yonke.

Uma ungenayo i-kooping ehlangene / i-diphtheria / i-tetanus jab ehlangene lapho usemusha, kunconywa ukuba nayo.
Kufanele futhi ube ne- COVID-19 ukugoma ngokushesha lapho lokhu sekutholakala endaweni yangakini. Ucwaningo lukhombisa ukuthi ubungozi bokuhlushwa yizimpawu ezinzima nge COVID-19 iphezulu kulabo abane-COPD.

Ukuvuselelwa kwamaphaphu

Ukuvuselelwa kwamaphaphu (PR) wuhlelo lomuntu ngamunye lokuzivocavoca, ulwazi, nezeluleko ezikusiza ukuthi uhlale usebenza uma unesimo samaphaphu esifana neCOPD esenza ungaphefumuli. Iningi lezinhlelo ze-PR zihlala cishe amasonto ayisithupha, lapho uzomenyelwa khona ukuba ube khona emihlanganweni yeqembu izikhathi ezimbalwa ngesonto.
I-PR ivame ukulethwa yiqembu labasebenzi bezempilo - kufaka phakathi i-physiotherapists, abahlengikazi abangochwepheshe, kanye nezazi zokudla - kuzilungiselelo zomphakathi. Cishe ingxenye yeseshini yeqembu ngayinye isetshenziselwa ukugadwa Ukuvivinya. Umqondo ukuthi uphelelwe umoya nje kancane - uzobhekwa ukuze ukwazi ukuzivocavoca ngokuphepha.
Yize i-PR kungelona ikhambi le-COPD, inezinzuzo eziqinisekisiwe ku:

  • Thuthukisa amandla emisipha, ngakho-ke uphefumula kahle futhi wehlise umoya
  • Kukusiza ukuthi ufunde izindlela zokubhekana kangcono nokuzizwa uphelelwe umoya
  • Khulisa izinga lakho lokuqina
  • Thuthukisa impilo yakho engqondweni
  • Kukusiza ufunde ukuthi isimo sakho sikuthinta kanjani nokuthi ungasilawula kanjani kangcono. Izibonelo zezihloko zifaka inqubo ye-inhaler, ukudla okunempilo, ukulawula ukukhathazeka nomoya ophansi, nokuthi yini okufanele uyenze uma uzizwa ungalungile.

Kunobufakazi bokuthi abantu abahlanganyela ne-PR bangahamba phambili, bazizwe bengcono emisebenzini yabo yansuku zonke, mancane amathuba okuthi badinge ukuya esibhedlela, bathuthukise impilo yabo yezenhlalo futhi bavame ukubuyela emsebenzini.

Phatha noma yiziphi ezinye izinkinga zempilo

Izimo ezivamile zokuba ne-COPD zibandakanya izifo zenhliziyo, umdlavuza wamaphaphu, ukukhumuzeka kwamathambo, ukucindezeleka, ukukhathazeka kanye ne-reflux yesisu. Zingathinta ukuthi i-COPD yakho iqhubeka kanjani, ikakhulukazi uma ingatholakali futhi ihlala ingalashwa.
Udokotela wakho uzokubuza ngalokhu ukuze ukwandise ukwelashwa kwakho konke nempilo ejwayelekile.

Imithi

Kunemithi ehlukahlukene esetshenziselwa ukwelapha i-COPD. Bangasiza ukunciphisa izimpawu ze-COPD, nciphisa ukuthi unama-flare-ups amangaki nokuthi anzima kangakanani, thuthukisa ikhono lakho lokuzivocavoca umzimba, futhi kukugcine uphilile ngangokunokwenzeka. I-COPD ithinta wonke umuntu ngokuhlukile ngakho udokotela wakho uzosebenzisana nawe ukwenza iphakethe lokwelashwa elingcono kakhulu ukuze lihambisane nezidingo zakho. Inhloso yokwandisa ukuthi uphendula kahle kangakanani ekwelashweni nasekulinganisweni okuphikisana nemiphumela emibi, ukulawula izimpawu, ukuqhuma, kanye nezindleko.

Abahogelwayo

I-inhaler iletha umuthi ngqo emikhakheni yakho yomoya nasemaphashini njengoba uphefumula. Akuwona wonke ama-inhaler ayafana, ngakho-ke udokotela noma umhlengikazi uzokukhombisa ukuthi uyisebenzisa kanjani kahle idivayisi yakho. Imithi yokwelashwa ehogelwe ngeCOPD ifaka phakathi

Ama-beta-2-agonists (SABA) noma ama-anti-muscarinics (SAMA)

I-SABA ne-SAMA imvamisa kuyisinqumo sokuqala. Lawa angama-bronchodilators - enza ukuphefumula kube lula ngokuphumula nokukhulisa imigwaqo yomoya emincane. Lokho kungakhulula umuzwa ongakhululekile lapho amaphaphu akho egcwele ngokweqile. Usebenzisa lolu hlobo lwe-inhaler noma nini lapho uzizwa uphefumula kuze kube kane ngosuku.

Ama-beta-2-agonists asebenza isikhathi eside (i-LABA) nama-anti-muscarinics asebenza isikhathi eside (i-LAMA)

I-LABA ne-LAMA zisetshenziswa uma usenezimpawu zansuku zonke yize usebenzisa i-inhaler yakho ye-SABA noma ye-SAMA kahle. Imiphumela yabo ye-bronchodilation ihlala isikhathi eside ngakho-ke uzodinga ukuyisebenzisa kanye noma kabili ngosuku.

I-corticosteroid engatholakali (ICS)

Uma kunesidingo, i-ICS ingangezwa kwi-bronchodilator inhaler yakho esebenza isikhathi eside ukusiza ukunciphisa ukuvuvukala ezindleleni zakho zomoya. I-ICS ingavimbela cishe ikota yama-flare-ups.

Amaphilisi omlomo

Uma izimpawu zakho ze-COPD zingalawulwa kahle nge-inhaled therapy, udokotela wakho angancoma ukungeza ithebhulethi yomlomo, iphilisi noma i-capsule. Ngokuya ngokuthi yimuphi umuthi abancoma wona, kungadingeka ukuthi uwathathe nsuku zonke, noma lapho nje uhlangabezana nokuqubuka noma ukungenwa yisifo sokuphefumula.

Theophylline

Le bronchodilator yomlomo, evame ukuthathwa kabili ngosuku. Imiphumela emibi ingafaka ikhanda, ukugula (isicanucanu), izinkinga zokulala (ukuqwasha), isilungulela, noma ukushaya kwenhliziyo okungajwayelekile (ukushaya kwenhliziyo). Udokotela wakho uzokuqapha futhi alungise umthamo wakho ukulinganisela ukulawula izimpawu ngokumelene nokunciphisa noma yimiphi imiphumela emibi.

Isidakamizwa se-Mucolytic

Ukuthatha umuthi we-mucolytic nsuku zonke kwesinye isikhathi kungasiza uma unesikhwehlela esiqhubekayo se-phlegmy. Kwenza i-phlegm ibe lula ukukhwehlela. ICarbocisteine ​​iyi-mucolytic ejwayelekile ebekiwe - ithathwa njengethebhulethi noma i-capsule imvamisa kathathu noma kane ngosuku. Enye i-mucolytic - ebizwa nge-acetylcysteine ​​- iza njengempuphu oyixuba namanzi ngaphambi kokuyithatha.

I-steroid yomlomo

Lokhu kunciphisa ukuvuvukala komoya. Zisetshenziswa kakhulu ezifundweni ezimfushane - ngaphezulu kwezinsuku ezinhlanu - ukwelapha ukuqhuma okukhulu. Imiphumela emibi ingafaka ukuzuza kwesisindo, ukuguquguquka kwemizwelo, nokwehla kwethambo (i-osteoporosis). Ngakho-ke, uma udinga ukuthatha ama-steroids isikhathi eside udokotela wakho uzogcina umthamo uphansi ngangokunokwenzeka futhi aqaphe noma yimiphi imiphumela emibi ngokucophelela.

Njengengxenye yohlelo lwakho lokuzilawula, udokotela wakho angakunika inkambo emfushane yamathebulethi ama-steroid ukuze uwagcine ekhaya uma kwenzeka kuvela i-flare-up.

Nemithi Elwa Namagciwane

Ungadinga inkambo emfushane yama-antibiotic ukwelapha ukutheleleka kwesifuba kanye / noma ukuqhuma kweCOPD. Udokotela wakho angakunika inkambo eyodwa yama-antibiotic ukuze uhlale ekhaya futhi uyiphuze uma uba nezimpawu zokutheleleka esifubeni.

I-Roflumilast

Lolu wuhlobo olusha sha lomuthi we-COPD obizwa nge-phosphodiesterase-4 enzyme inhibitor. Ithathwe njengethebhulethi yansuku zonke futhi isebenza ukunciphisa ukuvuvukala. Udokotela onguchwepheshe angahle anikeze i-roflumilast uma une-COPD enamandla futhi usabhekana nokuqubuka okuningana yize usebenzise i-LAMA / LABA / ICS therapy inhaler. I-Roflumilast inemiphumela emibi kakhulu kunokwelashwa kwe-COPD okuhogelwayo, kufaka phakathi isifo sohudo, ukugula, ukunciphisa ukudla, ukunciphisa isisindo, ubuhlungu besisu, izinkinga zokulala nezinhlungu zekhanda.

Izidakamizwa zomchamo

Lokhu kususa amanzi amaningi emzimbeni. Bangakwazi ukukhulula ama-ankle avuvukile ezimweni ezinzima ze-COPD.

Ezinye izindlela zokwelapha

Ukwelashwa kwe-Nebulizer

Uma i-COPD yakho inzima noma une-flare-up embi, umshini obizwa nge-nebulizer ungakusiza uphefumule umuthi wakho ngokusebenzisa i-facemask noma okokukhulumela ukusiza ukukhulula izimpawu. Uma wena noma umnakekeli wakho uqeqeshelwe ukwenza kanjalo, ungasebenzisa i-nebulizer ekhaya.

Ukwelashwa kwe-oxygen

Uma amazinga e-oxygen egazini lakho ephansi ngokungapheli lokhu kungabeka ubunzima obengeziwe enhliziyweni yakho. Ungahlinzekwa ngemishini ukuze uthole ukwelashwa kwe-oxygen ekhaya. Lokhu ngeke kumise noma kunciphise ukuphefumula kwakho, kepha kunganciphisa izinkinga zenhliziyo ezinjenge-pulmonary hypertension. Uzokwazi ukuphefumula umoya-mpilo ovela kumbhobho wesikhumba noma ithumbu lempumulo. Kunezindlela ezahlukahlukene ongasebenzisa ngazo i-oxygen yasekhaya:

  • Ukwelashwa kwe-oxygen yesikhathi eside kuzinzisa amazinga akho oksijini amahora angu-15 noma ngaphezulu
  • Ukwelashwa komoya-mpilo okubizwa ngokuthi i-oxygen ephathekayo - kukuvumela ukuthi usebenze kakhulu ekhaya noma lapho uphumela ngaphandle
  • Ukwelashwa kwe-oksijeni okunciphisayo kungasiza ekunciphiseni ukuphefumula njengengxenye yokuthokomala noma ukuphela kokunakekelwa kwempilo.

I-oksijeni iyasha kakhulu futhi akumele ubheme uma unale ndlela yokwelashwa ngenxa yobungozi bomlilo noma ukuqhuma.

Ukuphefumula okungangenisi umoya

Ukuphefumula okungangenisi umoya (i-NIV) ngumshini ophathekayo osiza ukuphefumula. Uphefumula ngesifihla-buso sobuso noma sekhala - odokotela ngeke badinge ukufaka ishubhu kudoti wakho (i-windpipe). Imishini ye-NIV ithatha omunye umsebenzi onzima ekuphefumuleni lapho une-COPD flare-up futhi udinga ukunakekelwa esibhedlela.

Ukwelashwa okuphumelelayo kwe-NIV kungasebenza kungakapheli ihora elilodwa noma amabili. Awunamathuba amancane okuba nezinkinga ngenkathi usesibhedlela futhi kwandisa amathuba akho okukwazi ukubuyela ekhaya ngokushesha.

Ukuhlinzwa

Cishe umuntu oyedwa kwabangu-50 abane-COPD bane-emphysema engase izuze ekusebenzeni kokunciphisa ivolumu yamaphaphu. Lo msebenzi uhlose ukususa:

  • Izicubu zamaphaphu ezilimele
  • Izikhala ezinkulu zomoya (ezibizwa ngama-bullae) ezibamba umoya.

Ukunciphisa izindawo ezithinteke kakhulu emaphashini akho kuvumela izingxenye ezinempilo ezisele ukuthi ziphumule futhi zisebenze kangcono.

Inani elincane labantu abane-COPD elibi kakhulu lingacatshangelwa ukufakelwa kwamaphaphu. Buza udokotela wakho uma ucabanga ukuthi ungafaneleka.

Funda kabanzi ngokunciphisa izimpawu zakho ze-COPD nokuthuthukisa ikhwalithi yakho yokuphila kumhlahlandlela wethu Ukuphathwa kwe-COPD.

Imithombo:
I-BLF 2018. Izinqubo zokunciphisa ivolumu ye-emphysema.

I-BLF 2019. Yiziphi izindlela zokwelapha ze-COPD?.

I-BLF 2020. Ukuvuselelwa kwamaphaphu (PR).

I-BLF 2021. Ukwelashwa kwe-oxygen ekhaya.

I-ELF 2021. Ukuphila kahle neCOPD.

I-ELF 2021. Ukuvuselelwa kwamaphaphu kubantu abadala.

IGOLIDE 2021.

I-US NLM. 2021. COPD.

I-NHS 2019. Ukwelashwa. Isifo esingapheliyo se-pulmonary disease (COPD).

I-NHS 2020. I-Champix (varenicline).

UMUHLE 2017. I-Roflumilast yokwelapha isifo esingamahlalakhona sokuphazamiseka kwamaphaphu.

I-NICE 2018 (ibuyekezwe ngo-2019). Isifo esingapheliyo sokuphazamiseka kwamaphaphu kuma-16s: ukuxilongwa nokuphathwa. NG115.

I-Soo Hoo GW. 2020. Ukungenisa umoya okungavumelekile.