COPD uphethwe: izimbangela, izimpawu, ukuxilongwa kanye nokwelashwa. Okungalapheki obstructive isifo samaphaphu

COPD (ezingamahlalakhona obstructive isifo samaphaphu) - zokugula ezinjalo okuyinto kuhambisana ukuvuvukala kwezitho zomzimba zokuphefumula. Izizathu kungaba yizici zemvelo kanye nedlanzana labanye, ezihlanganisa ukubhema. Ukuze lesi sifo ejwayelekile intuthuko njalo, okuholela ukwehla ngo ukusebenza umgudu wokuphefumula. Ngokuhamba kwesikhathi, lokhu kuholela ekuhlulekeni zokuphefumula.

Isikhathi esiningi sifo laligujwa eneminyaka engu-iminyaka engu-40 nangaphezulu. Kwezinye izimo, iziguli ezinemishini COPD angeniswe esibhedlela kanti ngesikhathi isencane. Njengomthetho, lokhu kungenxa yofuzo. Futhi ngokuzidela okukhulu kwezifo ngalabo ababhema isikhathi eside.

iqembu ingozi

Sitholakele COPD ezingabantu abadala eRussia waphawula zonke lwesithathu, wangenela embundwini iminyaka engu-70. Izibalo ikuvumela kugcwale umlomo ukuthi lesi kuhlobene ukubhema ugwayi. Futhi, kukhona yini ukuxhumana okuhle kanye indlela yokuphila, okuwukuthi, indawo yomsebenzi: amathuba nesifo lingaphezulu esimweni lapho abantu abasebenza ezimweni eziyingozi qu. Ithinta abahlala emadolobheni zezimboni: lapha iphesenti amacala ephakeme kunaleyo ezindaweni endaweni ehlanzekile.

COPD ngokuvamile eba abantu abadala, kodwa ungakwazi sigule futhi umuntu afe esemncane nge yofuzo. Lokhu kungenxa isizukulwane ezithile umzimba zezinzwa wamaphaphu izicubu. Futhi, kukhona izifundo zokwelapha phikisana sifo ngenxa umntwana ngaphambi kwesikhathi, njengoba kulokhu umzimba akuyona surfactant ngokwanele, yingakho ukuzalwa emizimbeni ayikwazi ukubhekana izicubu.

Lokho ososayensi bathi?

COPD izimbangela zesifo, izindlela zokwelashwa - konke lokhu kwenzakele eside yabakhanga odokotela. Ukuze abe nezinto ezibonakalayo ezanele ucwaningo, iqoqo idatha kwenziwa, phakathi kwesikhathi lapho wafunda amacala lesi sifo phakathi izakhamuzi abahlala emaphandleni nasemadolobheni. Ulwazi oluqoqwe odokotela Russian.

Sakwazi ukukhomba ukuthi uma kuziwa labo abahlala endaweni, emzaneni, kukhona Yiqiniso okunzima COPD is ngokuvamile akusizi lutho wonke zokugula nokushaya indoda Sinemandla. Ngokuvamile abantu bendawo bavele wabukela endobronchitis nge ubovu uketshezi noma izicubu yoma. Izinkinga zenzeka nezinye izifo ukuphathwa kwabathintwayo.

Kuye kwasikiselwa ukuthi isizathu esiyinhloko - ziqu ongaphakeme kwezokulapha ezindaweni zasemakhaya. Ngaphezu kwalokho, ezindaweni zasemakhaya akunakwenzeka ukwenza spirometry, lapho owesilisa ababhemayo kufanele abaneminyaka engu-40 noma ngaphezulu.

Bangaki abantu obaziyo, COPD - kuyini? is it iphathwa kanjani? Kwenzekani kulesi simo? Ikakhulu ngenxa yokunganaki, yokungazi ngaso, ngenxa yokwesaba ukufa, iziguli bayacindezeleka. Ngokulinganayo isici sale izakhamizi ezisemadolobheni, nasemaphandleni. Ukucindezeleka sihlotshaniswa hypoxia ezengeziwe, ezithinta isimiso sezinzwa isiguli.

Inkinga ikuphi-ingabe isifo?

Ukuxilongwa COPD futhi namuhla kunzima, ngoba Akwaziwa kahle, izizathu ekuthuthukiseni egunjini lokuhlolwa kwezifo. Nokho, wakwazi ukusho ukuthi ngobani ezicini eziningana abangela isifo. Amaphuzu amqoka:

• ukubhema;
• izimo ezingezinhle zokusebenza;
• sezulu;
• ukutheleleka;
• elibala ukucinana kwemigudu yokuphefumula,
• izifo yamaphaphu;
• Genet.

Izizathu ngaphezulu

zokuvimbela Ngempumelelo COPD namanje ngaphansi ukuthuthukiswa, kodwa abantu abafuna ukugcina impilo yabo, kufanele imele indlela lezo noma ezinye izizathu nomthelela emzimbeni womuntu, okubangela lokhu egunjini lokuhlolwa kwezifo. Eqaphela ingozi yabo futhi ekuqedeni izingozi, ungakwazi unciphise amathuba asathuthuka lesi sifo.

Into yokuqala Kuhle kokusho ngokuqondene COPD - Yebo, ukubhema. umphumela ngokulinganayo negative kokubili yekwentiwa. Manje imithi iphephile ukusho ukuthi ukubhema - iyona mbangela eyinhloko ukuthuthukiswa zokugula. Izifo kuphakamisa njengoba nicotine kanye nezinye izithako eziqukethwe lentuthu kagwayi.

Ngezindlela eziningi, lo mshini ukuqala ukubhema lihlotshaniswa esifanayo, elibangela normal uma usebenza ezimweni eziyingozi, ngoba lapha, futhi, abantu umoya egcwele izinhlayiya ezincane. Lapho usebenza izimo enothuli, alkalis futhi umusi, njalo ukuphefumula izinhlayiya zamakhemikhali, akunakwenzeka ukuba siqhubeke emaphashini enempilo. Izibalo zibonisa ukuthi COPD komdlavuza ngokuvamile kwenziwa abavukuzi kanye nabantu abasebenza zensimbi: grinders, polishers, metallurgists. Futhi singangena kule welders isifo nabasebenzi uginindela Mills, nabasebenza emapulazini. Zonke lezi zifo ukusebenza ezihlobene nokusebenzelana nolaka uthuli isici.

Ubungozi ezengeziwe ezihlobene nokuntula kwezokulapha: kwezinye akukho odokotela abaqeqeshiwe eseduze, abanye bazame ukugwema ngihlolwa njalo.

symptomatology

COPD iyisifo - kuyini? is it iphathwa kanjani? Njengoba umsolwa lakhe? Lokhu isifinyezo (kanye nencazelo yalo - ezingamahlalakhona obstructive isifo samaphaphu) futhi kuze kube namuhla abantu abaningi abasho lutho. Naphezu nezifo ezithé chithi saka, abantu ngisho nokuwabona yimuphi engozini izimpilo zabo. Yini ukubheka uma usola isifo samaphaphu kanye usola ukuthi kungenzeka babe COPD? Khumbula ukuthi ekuqaleni libhekene zimpawu ezilandelayo:

• ukukhwehlela, phlegm mucosa (ngokuvamile ekuseni);
• iphika, ekuqaleni ezenzeka ngesikhathi umthwalo, ekugcineni ohambisana ukuthula.

Uma COPD exacerbation, ngokuvamile isizathu ukuthi - ngegciwane esithinta:

• dyspnea (inyuka);
• isikhwehlela (iba ubovu, ikhishwe ezingeni eliphakeme).

With ukuthuthukiswa sifo, uma ezingamahlalakhona obstructive isifo samaphaphu uye kwatholakala, lezi zimpawu ezilandelayo:

• ukuhluleka kwenhliziyo;
• ubuhlungu enhliziyweni;
• iminwe nezindebe babe tinge bluish;
• amathambo ubuhlungu;
• imisipha buthaka;
• iminwe ukushwaqa;
• izinzipho ukushintsha ukuma, babe convex.

COPD uphethwe: isigaba

Customary ukuhlukanisa izigaba eziningana.

Qala zokugula - zero. It libhekene ukukhiqizwa isikhwehlela e semali, umuntu njalo ekhwehlela. Lung umsebenzi kulesigaba yentuthuko isifo iqhubeka.

Isinyathelo sokuqala - kwesikhathi lesi sifo, lapho isiguli onesifo ekhwehlela. Khanyisa ukukhiqiza njalo semali phlegm. Esifundweni kohlelo sokuphefumula selulwane asikwazi ukuhlonza isimiso ezincane.

Uma sisheshe amafomu lolingene isifo, it libhekene izimpawu zokwelashwa (esesichaziwe), wabonakaliswa lapho uvivinya umzimba.

Sitholakele COPD, esigabeni sesithathu, kusho ukuthi nokuvaleka kwemigudu yokuphefumula iba okuyisimo esisongela ukuphila. Kuleli fomu zesifo kukhona okuthiwa "inhliziyo yamaphaphu". Obvious isifo ukubonakaliswa: komoya izivimbelo ngesikhathi awumoya okhishwa ngamakhala, dyspnea njalo futhi kanzima. Kwezinye izimo ukuvimbela bronchial, okuyinto ejwayelekile ifomu ogulisa ngokwedlulele yesifo nesenzakalo. Kuyingozi ukuphila komuntu.

Kulula ukubona

Eqinisweni, sitholakele COPD ibekwa ifomu sokuqala lesi sifo incane kakhulu kunalelo elitholakala ngokoqobo. Lokhu kungenxa yokuthi izimpawu hhayi elikhanyayo. Ekuqaleni lo zokugula ngokuvamile ogeleza ngasese. Isithombe emitholampilo kungabonwa uma isimo siqhubeka ungamela kanzima futhi abantu ukuya kudokotela ukukhononda phlegm ukukhwehlela.

Okwakuhlalwa kuzo lapho kusaqalwa abavamisile amacala ngezikhathi ezithile lapho umuntu ukukhwehlela semali phlegm. Njengoba lokhu kwenzeka njalo, abantu akuvamile ukhathazeke futhi musa ukuya kudokotela ngesikhathi. Kudokotela semuva, lapho ngentuthuko isifo kuholela ukukhwehlela ezingamahlalakhona.

Isimo luyindida

Uma lesi sifo kwatholakala futhi izinyathelo ukwelashwa ayabanjwa, ngaso sonke isikhathi, isibonelo, ukuphathwa kazwelonke ka COPD kuye kwabonisa imiphumela emihle. Ngokuvamile inkinga kwenzeka ngenxa izifo.

Lapho igciwane eyengeziwe ngisho uphumule umuntu ehlupheka iphika. Kukhona ushintsho ubunjalo Amahhovisi e isikhwehlela ubovu kuba. Kunezindlela ezimbili ekuthuthukiseni lesi sifo yilabo:

• bronchial;
• blackleg.

Esimweni sokuqala, isikhwehlela ikhishwe obuningi kakhulu futhi njalo bahlushwe ukukhwehlela. Kukhona Ezimweni eziningi zokudakwa, amashubhu bronchial abaphethwe inflammations suppurative, isikhumba cyanosis kungenzeka. Isimiso eba kakhulu. emphysema yamaphaphu kwalolu hlobo isifo elinesimo ababuthakathaka.

Lapho Emphysematous uhlobo dyspnea zokuphefumula fixed, okungukuthi kunzima ukuthatha ikhefu. Wansuku emphysema yamaphaphu. Isikhumba iba grey Pinkish. It kushintsha ukuma esifubeni: kufana emgqonyeni. Uma lesi sifo wehlile lendlela, futhi uma ngabe ukhethe izidakamizwa elungile COPD for iziguli kungenzeka ukuthi uphile uze Esegugile.

intuthuko isifo

In iziguli COPD ukuthuthukisa njengoba zenzeka yezinkinga:

• i-pneumonia,
• nokuvaleka kwemigudu yokuphefumula, ngokuvamile ifomu oyingozi.

Ngaphansi ngokuvamile waphawula:

• pneumothorax;
• ukuhluleka kwenhliziyo;
• pneumosclerosis.

Ngo ezinzima yamaphaphu kungenzeka:

• inhliziyo;
• nomfutho wegazi ophezulu.

Ukuzinza kanye nokungathembani COPD

Lesi sifo kungaba enye yezindlela ezimbili: oyingozi noma ozinzile. Uma noma yiziphi izinguquko emzimbeni ngaphansi kokuqondisa Dynamics ushintsho kungakapheli masonto amangaki, izinyanga, bengayitholi esitebeleni inguqulo yokuthuthukisa. Ungase uphawule isithombe ethile yomtholampilo, uma njalo ukuhlola isiguli okungenani unyaka wonke.

Kodwa ngesikhathi exacerbation nje usuku olulodwa noma ezimbili kakade ukukhombisa ukuwohloka abukhali. Uma exacerbation olunje kabili ngonyaka, noma kaningi, basuke kubhekwe ukuba isifo abalulekile futhi kungaholela esibhedlela nesineke. Exacerbations oluthinta ngqo izinga lokuphila futhi ubude bayo.

Ezimweni ekhethekile walulama iziguli-ababhemayo owayehlushwa somoya ngaphambi. Ngesikhathi esifanayo ukhulume "cross-Sectional syndrome." umzimba Kwangezikhathi ezinjalo nesineke akakwazi kudla kwadingeka kwezinhlelo ukusebenza evamile umoyampilo liyancipha ngokucijile okubangela ekhonweni lomzimba lokukwazi ukuzivumelanisa. Ngo-2011, lolu hlobo sifo behlala ndawonye bengashadile akusashiwo ngokusemthethweni ohlwini esihlukile, kodwa umkhuba, abanye odokotela namuhla zisebenzisa simiso esidala.

Njengoba udokotela kuthola isifo?

Uma uvakashela udokotela isiguli kuzodingeka ibhekane uchungechunge izifundo ukuhlonza COPD noma ukuthola izinkinga imbangela zempilo ezahlukene. izinyathelo Yokucwaninga zihlanganisa:

• ukuhlolwa jikelele;
• spirometry;
• isampula ngokusebenzisa bronchodilator ezifaka COPD ephefumula, ngaphambi nangemva yokuqala isifundo kwenziwe uhlelo olukhethekile zokuphefumula, ababona izinguquko izinkomba;
• X-ray, ngaphezu - tomography, uma kunjalo alucacile (ivumela ukulinganisa izinguquko indlela enkulu kwesakhiwo).

Kuyadingeka isikhwehlela amasampula eqoqwe sokuba ukuhlaziywa KULETHA. Lokhu kwenza kube nokwenzeka ukuze sifinyelele iziphetho ukuvuvukala kangakanani, futhi ngalokho imvelo. Uma kuziwa exacerbation of COPD, isikhwehlela singafinyelela eziphethweni, okuyinto kwabangela ukutheleleka silwanyana futhi lapho imithi elwa namagciwane ingasetshenziswa ngokumelene naye.

plethysmography umzimba kwenziwa, phakathi okuyinto esikalini ukuphefumula zangaphandle. Lokhu kukuvumela ukuba ucacise wamaphaphu umthamo, kanye eziningi nemingcele ezingeke balinganisela spirography.

Qiniseka ukuthi bathathe igazi yokuhlaziya jikelele. Lokhu kwenza kube lula ukubona ukuthi i-hemoglobin, amangqamuzana abomvu egazi, ngemuva ezenza iziphetho mayelana ukuntuleka komoya-mpilo. Uma sikhuluma mayelana okubi kakhulu, ngakho-ke ukuhlaziywa Imininingwane inikeza ulwazi ukuvuvukala. Hlaziya inani leukocyte futhi ESR.

Igazi futhi lwavivinywa okuqukethwe igesi. Lokhu akwembuli nje lokuhlushwa-mpilo kodwa futhi-carbon dioxide. Kungenzeka kahle ukuhlola ngokwezinga ngabe igazi ligcwele umoya-mpilo okwanele.

ucwaningo Esisemqoka iba electrocardiogram, echocardiogram, imisindo ephansi, lapho udokotela uthola ulwazi olufanele mayelana nesimo inhliziyo, futhi uyazi ingcindezi ku Umthambo yamaphaphu.

Ekugcineni, kwenziwe fibrobronchoscopy. Kuyinto lolu hlobo ucwaningo, lapho isimo ecacisiwe we lwamafinyila ku bronchi. Odokotela usebenzisa amalungiselelo ezikhethekile amasampula izicubu, okuvumela ukuthi siphenye ukwakheka kwamangqamuzana we mucosa. Uma uphethwe akucacile, lobu buchwepheshe esisemqoka intuthuko yayo, njengoba evumela ukuba ngakususi ezinye izifo nge nezimpawu ezifanayo.

Kuye imininingwane yalolu icala lingaqoka ukuvakashelwa ozikhethela a Pulmonologist ukucacisa isimo umzimba.

Siphatha yayingenayo imithi

ukuphathwa COPD - nenqubo enzima edinga indlela ephelele. Okokuqala, cabangela izinyathelo ze-non-izidakamizwa angadingeki isifo.

Odokotela batusa:

• ukunikeza ngokuphelele ukubhema;
• ukudla ukudla okunomsoco, kuhlanganise ukudla amaprotheni-ocebile;
• ulungise umsebenzi, ungalilahli ngokweqile;
• ukunciphisa isisindo endinganisweni, uma kukhona isisindo esengeziwe;
• hhayi ukuhamba esheshayo njalo;
• ukubhukuda;
• umkhuba ukuphefumula izivivinyo.

Futhi uma izidakamizwa?

Yiqiniso, e COPD futhi ngeke akwenze ngaphandle yokwelapha wezokwelapha. Okokuqala banake umgomo umkhuhlane futhi Pneumococcal. Kungcono ukuba agome Okthoba noma maphakathi no-November, njengoba eminye incipha kahle, kwandisa amathuba ukuthi kakade ukuxhumana amagciwane, futhi umjovo ayinikeli amasosha omzimba.

Futhi abaqhuba yokwelapha, umgomo wakhe oyinhloko - ukunweba amashubhu bronchial futhi uwagcine zisesimweni esihle. Ukuze wenze lokhu, olwisana amajaqamba futhi zisebenza izindlela ezinciphisa ukukhiqizwa isikhwehlela. Nazi ewusizo imithi ezilandelayo:

• theophylline;
• beta-2 agonists;
• M-cholinolytics.

Le mithi zihlukaniswe subgroups ezimbili:

• isenzo isikhathi eside;
• esifushane nokwenza.

Eyokuqala ukwesekwa bronchi e esimweni esejwayelekile emahoreni angu-24, iqembu lesibili izenzo amahora 4-6.

Esifushane esebenza imithi efanele kuleli esigabeni sokuqala, kanye esikhathini esizayo uma kuphakama isidingo esifushane, okungukuthi, kungazelelwe babe nezimpawu ezidinga kuthathelwe izinyathelo ngokushesha. Kodwa uma lezi imithi unganikezi Imiphumela ezanele, yakhetha imithi eside.

Wena ubuye awanakuziziba izidakamizwa eqeda ukuvuvukala ngoba ukuvimbela ukuphelisa ituthuko engakalungi esihlahleni bronchi. Kodwa futhi ukuzisebenzisa kuyinto isincomo odokotela futhi akunakwenzeka. Kubalulekile ukuthi udokotela abaqondiswa ukwelashwa.

ukwelashwa Ezinkulu - hhayi imbangela funa

Ngo COPD linqume hormone glucocorticosteroid. Ngokuvamile ngesimo inhalations. Futhi lapha ngesimo amaphilisi izidakamizwa ezinjalo zinhle esikhathini exacerbation. Izifundo bedonsa, uma isifo siphela kanzima, iye yathuthuka esigabeni ngasekupheleni. Okuhlangenwe nakho kubonisa ukuthi iziguli besaba ukusebenzisa izindlela ezinjalo lapho udokotela uncoma kubo. Igcwele ukukhathazeka mayelana nemiphumela engemihle.

Landela bakhumbula ukuthi ngokuvamile kubangela ohlangothini ukusabela hormone ezithathwe ngendlela amaphilisi noma umjovo. Kulokhu, akukhona okungavamile ukuba likhithike:

• kwamathambo;
• nomfutho wegazi ophezulu;
• sikashukela.

Uma izidakamizwa babelwa ngesimo inhalations nethonya lazo kuyoba onomoya omnene ngenxa umthamo eliphansi ketshezi asebenzayo emzimbeni. Leli fomu isetshenziswa endaweni, esebenza ngokuyinhloko kwesihlahla bronchial, futhi esisiza ukuba sigweme iningi engemihle.

Futhi khumbula ukuthi lesi sifo lihlotshaniswa ukuvuvukala okungamahlalakhona, okusho imithi ngempumelelo kuzobalwa kuphela nokunwetshiwe izifundo. Ukuze ubone uma yi Isidakamizwa abakhethiwe, kuyodingeka uthathele ke okungenani izinyanga ezintathu, abese uqhathanise imiphumela.

Inhalation ukwakhiwa kungadala lokhu okulandelayo side effects:

• candidiasis;
• izwi hoshozela.

Ukuze ugweme lokhu, kudingeka Hlambulula umlomo wakho ngemva eyamukelayo ngamunye kusho.

Yini enye engasiza?

Lapho COPD ngenkuthalo esetshenziswa ukwakhiwa antioxidant oqukethe eziyinkimbinkimbi amavithamini A, C no E. Kahle kungase kutholakale ejenti mucolytic ngoba mncane lo isikhwehlela ezivezwa lwamafinyila nokusiza ukukhwehlela kwakhe. Ngilusizo yokwelapha oksijini, entuthukweni ezinzima - ukupholisa yokufakelwa kohlelo yamaphaphu. Emhlanganweni exacerbation lesi sifo kungathatha antibiotic, kodwa ngaphansi kokuqondisa kukadokotela.

Ziningi alethwe abakhethayo inhibitor ka phosphodiesterase - 4. Kuyinto izidakamizwa likubeka ngokucacile ukuthi avunyelwe okuhlangana ngayo ezinye izindlela ezisetshenziswa ekwelapheni COPD.

Uma lesi sifo senziwa isici zofuzo, khona-ke wanquma iphendukele replacement therapy. Ngenxa yalesi sebenzisa i-alpha-1-antitrypsin, okuyinto ngenxa azalwa naso yini ezivezwa umzimba ngokwanele.

ukuhlinzwa

Kwezinye izimo, odokotela batusa ukuba baphendukele amathuba ukwelashwa kuhlinzwa. Ngakho udokotela isuswe ezilimele wamaphaphu izakhi, futhi ezimweni ezinzima ikakhulukazi ukufakelwa wamaphaphu.

izinyathelo

Kuyini wayekwenza COPD zokuvimbela? Zikhona izindlela eziphumelelayo ukuvimbela isifo? imithi yesimanje uthi ukuze kuvinjelwe lesi sifo kungenzeka, kodwa lokhu, omunye kumelwe banakekele impilo yabo futhi zithokozise efanele.

Into yokuqala ukuyeka ukubhema, kanye mayelana amathuba okuthola ukuqeda izimo eziyingozi.

Uma lesi sifo itholwa, kulandzelana kwetindzima abakulo kungabonakala behlisa ngokusebenzisa izinyathelo yesibili izifo. Ukuyedlula kwaphumelela:

• Ukugonywa kusiza ekuvimbeleni ukuwohloka Umkhuhlane, pneumococcus;
• engayitholi njalo imithi. Khumbula ukuthi lesi sifo esingelapheki, ngakho yokwelapha okwesikhashana engalethi izinzuzo zangempela;
• ukuqapha lokuzivivinya. Lokhu kusiza ukuba aqeqeshe imisipha umgudu wokuphefumula. Kuyinto ukuhamba isikhathi eside bese uyobhukuda, zisebenzisa izindlela ukuphefumula umzimba;
• isifutho. Badinga ukwazi ukusebenzisa ngendlela efanele, njengoba ukusebenza ayilungile okuholela ngenxa yokungabi bikho kwemiphumela yokwelapha ezinjalo. Ngokuvamile, udokotela akwazi ukuchaza isiguli indlela yokusebenzisa imithi ukuthi yayiphumelela.