Kodi Ndiwe Wosankhira Bronchial Thermoplasty?
Kodi mukudziwa kuti pakalipano muli njira yosagwiritsira ntchito mankhwala omwe alipo ngati muli ndi mphumu yambiri yomwe simukuyendetsedwa bwino ndi corticosteroids yozembetsa komanso agonists omwe akutha nthawi yaitali ? Ndipotu, Alair Bronchial Thermoplasty System inapambana pa 2010 Science Popular "Best of What's New" mu Thanzi labwino pa chitukuko cha teknoloji iyi.
Mphuno yamtundu wotchedwa thermoplasty ndi wodwalayo (kutanthauza kuti odwala ambiri amabwera kunyumba ndikugona pabedi pawo) njira zowonongeka zomwe zimachepetsa kuthekera kwa njira zanu zowonjezera ndi zochepa pamene mukuwoneka kuti mukuyambitsa matenda a mphumu . Bronchial thermoplasty ndi njira yomwe imapereka mphamvu yotentha kumapapo a odwala omwe ali ndi mphumu kuti athe kuchepetsa kuchuluka kwa minofu m'mapapu, minofu yomwe imayambitsa matenda a chifuwa chachikulu ndi matenda a mphumu . Odwala amapindula bwino mphumu yawo chifukwa mapapu sangathe kukhala ochulukirapo ndipo amachitapo kanthu mwamphamvu kuti ayambe kuwomba mphumu.
Bungwe la Alair Bronchial Thermoplasty limachepetsanso mitsempha yowonongeka mofulumira kwambiri poyendetsa mphamvu ya kutentha kumapapo mwachindunji. Mafuta otentha otchedwa thermoplasty amachitidwa mozungulira sedation mopitirira malire ndi wodwalayo akupita kunyumba tsiku lomwelo. Chithandizo chokwanira ndi magawo atatu osiyana omwe aliyense amachitira mbali ina ya mapapo.
Panthawiyi, chitetezo ndi kupindulitsa kwa kubwereza mankhwala sikudziwika.
Zizindikiro za Bronchial Thermoplasty
Malingana ndi webusaiti ya System ya Alair Bronchial Thermoplasty, imasonyezedwa "pofuna kuchiza matenda a mphumu yopitirirabe kwa odwala zaka 18 kapena kupitilira omwe mphumu siyang'aniridwa bwino ndi corticosteroids yomwe imatulutsidwa ndi agonists omwe amatenga nthawi yaitali."
Dokotala wanu amafunika kukhala ndi zochitika mu bronchoscopy ndondomeko, komanso ayenera kuphunzitsidwa wapadera pogwiritsa ntchito bronchial thermoplasty musanathe kugwiritsa ntchito Alair Bronchial Thermoplasty System.
Mankhwala a Bronchial Thermoplasty
Odwala ena sayenera kulandira chithandizo ndi bronchial thermoplasty:
- Odwala ali ndi zipangizo zamakina monga pacemaker , inside defibrillator, kapena zipangizo zina zamagetsi.
- Odwala omwe amadziwika bwino ndi mankhwala omwe amapezeka pa bronchoscopy monga lidocaine, atropine, ndi benzodiazepines.
- Odwala kale akuchitidwa ndi Alair Bronchial Thermoplasty System. Kupepesa sikukudziwitsidwa kuti chitetezo ndi kupindulitsa kwa mankhwala obwereza sikudziwika.
Kuonjezerapo, zikhalidwe zina zingakhale zotsutsana ndi kanthawi kozizira kwambiri. Odwala omwe ali ndi zotsatirazi sayenera kuwonongedwa ndi thermoplasty:
- Matenda opatsirana kwambiri.
- Kuchulukitsa mphumu m'masabata awiri apitawo.
- Kusintha mlingo wa systemic corticosteroids wa mphumu (mmwamba kapena pansi) m'masiku 14 apitawo
- Chodziwika bwino chogwiritsidwa ntchito kapena vuto la magazi
- Odwala ayenera kusiya kumwa antiticoagulants, antiplatelet agents, aspirin ndi NSAIDS musanayambe kukambirana ndi dokotala wawo.
Pomalizira, panali mitundu ina ya odwala asthmatic omwe sanaphunzire m'mayesero a Alair Bronchial Thermoplasty System ndipo sichidziwika ngati angasonyeze phindu lomweli monga odwala ena. Ngati zina mwa zotsatirazi ndi zoona, muyenera kukambirana za ubwino ndi ubwino wa bronchial thermoplasty ndi dokotala wanu monga momwe mungakhalire ndi chiopsezo cha zovuta zomwe zingagwirizane ndi ndondomeko yotentha ya thermoplasty:
- Pambuyo panu-bronchodilator FEV1 ndi zosakwana 65 peresenti yazinenedweratu.
- Muli ndi matenda ena a m'mapapu monga emphysema, kupweteka kwa mawu, kutsekemera kwapansi, cystic fibrosis kapena kugona kosalepheretsa kugona.
- Muyenera kugwiritsa ntchito bronchodilator yaifupi yosavuta 12 patsiku masiku awiri musanayambe njira yowonongeka ya thermoplasty.
- Ndiwe wodalirika wa steroid ndipo mumakhala ndi corticosteroids yamlomo monga prednisone pa mlingo wa mamiligalamu 10 pa tsiku.
- Muli ndi matenda ena omwe angapangitse chiopsezo cha mavuto monga matenda a shuga a shuga, matenda a khunyu, matenda osokonekera a mitsempha yamtundu, matenda osokoneza bongo kapena achimuna osagonjetsedwa.
- Mwapezeka ndi chilolezo cha mphumu chomwe chimafuna chipangizo choyendetsa bwino kapena chidziwitso cha zaka 2 zapitazo.
- Muli ndi matenda 4 kapena kuposerapo kupuma kwapatsiku chaka chatha.
- Muli ndi zilonda zitatu kapena zam'chipatala za zizindikiro za kupuma m'chaka chatha.
- Muli ndi zovuta 4 kapena zambiri za mphumu zomwe zimafuna systemic, oral steroids chaka chatha.
Zotsatira za kutentha kwapachimake
Chiyeso cha AIR2 chinawonetsa kuti odwala omwe amachiritsidwa ndi bronchial thermoplasty anali ndi kusintha kwakukulu kambirimbiri kuphatikizapo zokhudzana ndi mphumu yawo:
- Mkhalidwe wabwino wa moyo
- Kuchepetsa 32% pa matenda a mphumu
- Kuchepetsa 84% muzipinda zam'chipatala
- Kuchepetsa 73% muzipatala
- Kuchepetsa 66% m'masiku otayika kuchokera kusukulu ndikugwira ntchito
Maphunziro ena a Alair Bronchial Thermoplasty System sanasonyeze kuwonongeka kwa FEV1 ndi kachitidwe ka chitetezo cha nthawi yaitali. Umboni wa zachipatala umasonyeza zaka 5 za chitetezo popanda pneumothorax, kutsekemera, mawonekedwe a mpweya, magayimu a mtima, kapena imfa chifukwa cha mankhwala opweteka a mpweya wotentha.
Ngakhale kuti pangakhalenso kuwonjezeka kwa zizindikiro zowonjezera mwamsanga potsatira ndondomekoyi, zinali zofanana ndi zomwe munthu angayembekezere kutsata bronchoscopy mu wodwala mphumu.
Pamsonkhanowu, kampaniyo inati zotsatira za phunziroli zinali zokhudzana ndi chiopsezo chachikulu, zovuta kuti azilamulira asthmatics anali kusintha. Deta yam'tsogolo yatsutsana ndi chithandizo chomwe chilipo kwa zaka zisanu ndikukhala ndi kuchepa kwakukulu kwa nthenda ya mphumu pa nthawiyo.
> Zotsatira:
> ASTHMATX, Inc. Za Bronchial Thermoplasty.
> Wechsler M et al. J Zachilombo Zamtundu wa Immunol. 2013 Dec; 132 (6): 1295-302.