Zifukwa Zomwe Zimapangidwira Mthupi, Kuzindikira, ndi Udindo mu Khansara Yam'mimba
Kodi ndi mtundu wotani wa spirometry ndipo ndi chifukwa chiyani ntchito yofunika kwambiri ya mapulmasi? Kodi imagwira ntchito yotani pa matenda ndi khansa yamapapo ndi COPD?
Tanthauzo: Spirometry
Spirometry ndi mtundu wa mapiritsi oyendetsera pulmonary omwe amayesa kuchuluka kwa mpweya wotengedwa mu (voliyumu) ndi kutulutsidwa ngati ntchito ya nthawi. Zonsezi, zimakuuzani kuchuluka kwa mpweya womwe mukuyenda m'mapapu anu, komanso momwe zimakhalira mwamsanga.
Ngati mwakhala mukuyenda bwino muofesi, mayeserowa ndi ofanana koma olondola.
Zingakhale zovuta kumvetsa nambala ndi tanthauzo la mayesero anu, koma tengani kamphindi kuti mudziwe za spirometry yanu. Mukamvetsetsa nambala yomwe mudzakhala nayo yabwino kwambiri yothetsera vuto lililonse limene mungakhale nalo.
Tiyeni tiwone chifukwa chake mayeserowa ndi amodzi, ndi zinthu ziti zomwe zingathe kusiyanitsa, ndikupita ku zikhalidwe zomwe si zachilendo.
Zifukwa Zopangira Zochita Zachilengedwe
Spirometry imachita mbali yofunikira pakuzindikira ndikusamalira zambiri zamapapu. Ikhoza kugwiritsidwa ntchito kusiyanitsa zinthu zomwe zingawonekere zofanana ndi zizindikiro zokha. Ndizothandiza kwambiri ngati chiwerengero cha momwe matenda a m'mapapu akupitilira komanso momwe akuyankhira mankhwala. Spirometry ikhoza kulamulidwa kuti:
- Amadziŵa matenda a m'mapapo.
- Kuyeza kuyankha mankhwala - Kuwona ngati mankhwala monga mankhwala akuthandiza matenda a m'mapapo kukhala abwino, kapena kuchepetsa matendawa.
- Pezani chitukuko cha matenda a mapapo - Kuti awone ngati akukulirakulira.
- Ganizirani kuopsa kwa matenda a m'mapapo.
- Kufufuza mapapu kumagwira ntchito opaleshoni yamapapo - Spirometry ndiyeso yofunikira musanachite opaleshoni pa zifukwa zambiri. Amapatsa opaleshoni lingaliro la momwe munthu yemwe ali ndi matenda a mapapu amalekerera opaleshoni kuchokera ku mpweya wopuma, komanso momwe munthu angayankhire kuti atenge gawo kapena mapapo onse.
- Ngakhale kuti sizinagwiritsidwe ntchito nthawi zonse, phunziro la 2017 linapeza kuti spirometry inali chida chothandiza kwambiri kuti liwonetsere kukhalapo kwa khansa ya m'mapapo mwa anthu omwe ali ndi asibesitosi . Zokwanira kotero kuti ofufuza adalimbikitsa kuti spirometry iyenera kuperekedwa kwa ogwira ntchito onse omwe ali ndi chiwonetsero cha asbesito ndipo akubwereza zaka zitatu.
Spirometry mwa Anthu Amene Ali ndi Khansa Yam'mimba
Spirometry ikhoza kuchitidwa kwa anthu omwe ali ndi khansara yamapapu kuti ayese ndikuyang'ana momwe akuyankhira mankhwala ochizira matenda. Zingathenso kuthetseratu ngati opaleshoni yamapapo ikulimbikitsidwa-mwa kuyankhula kwina, kuti awone ngati pali mapapu okwanira kotero kuti opaleshoni ya khansa yamapapo idzalekerera.
Kodi Mliri wa Spirometry Wapangidwa Motani?
Spirometry kawirikawiri imachitidwa ku ofesi ya dokotala. Pa spirometry, mudzakhala pampando ndikupemphani kuti mupume mokhazikika. Mukatero mudzapatsidwa kamvekedwe koika pakamwa panu pazomwe zimagwirizanitsidwa ndi makina otchedwa spirometer. (Zithunzi zikhoza kuikidwa pa mphuno zanu kuti zitsimikizire kuti mpweya wanu wonse umalowa ndi kuchoka pakamwa panu.) Kenako mudzafunsidwa kuti mutenge mpweya wozama kwambiri ndikuwombera mwamphamvu momwe mungathere. Dokotala wanu kapena wodwala kupuma akhoza kukupemphani nthawi zambiri kuti atsimikizire kuwerenga.
Ngati pulogalamu yanu ikuwonetsetsa pansipa) dokotala wanu akhoza kugwiritsa ntchito bronchodilator (monga inhaler) ndikuyerekeza zotsatira zanu zonse ndi popanda bronchodilator. Zonsezi, mayesero amatenga pafupifupi mphindi 15, kuphatikizapo kapena kuchepetsa nthawi yowonjezera.
Kodi Kuyeza Koyeso N'kutani? Inu
Spirometry amapereka akatswiri azaumoyo nambala ziwiri zofunikira zomwe zingasonyeze kuti vuto limakhala ndi mapapo. Izi ndi:
- Mphamvu Yofunika Kwambiri (FVC) - FVC ndiyeso ya momwe mungathere mpweya wanu m'mapapo anu ndi mpweya wonse.
- Volume For Exiratory Volume (FEV1) - FEV1 ndi kuchuluka kwa mpweya womwe mungatuluke m'mapapu anu m'phindi 1.
Chiŵerengero cha FEV1 mpaka FVC chiwerengedwenso.
Sungani Mzere
Zotsatira za spirometry zingakhale zachilendo kapena zachilendo. Ngati ali achilendo amawoneka mwa njira imodzi:
- Njira yolepheretsa - Pamene mpweyawo uli wopepatika (kutsekedwa), kuchuluka kwa mpweya womwe mungathe kuthamanga mwamsanga kwa mphindi imodzi (FEV1) ndipang'ono kuposa momwe mungaganizire malinga ndi msinkhu wanu, msinkhu, ndi kulemera kwake. Popeza kuti FEV1 yanu, panopa, ili yochepetsetsa zomwe zingayembekezereke, chiŵerengero cha FEV1 / FVC ndi chocheperapo.
- Chizoloŵezi choletsa - Kuletsedwa kungaphatikizepo kupweteka m'mapapo kapena zilema zomwe zimapangitsa kuti mapaipi asachepetse kugwira ntchito, m'malo molepheretsa mpweya. Pachifukwa ichi, FVC yatsika koma chiŵerengero cha FEV1 / FVC ndi chachilendo (zonsezi zacheperapo.)
Nambala mu Spirometry
Pamene spirometry yatha, ziwerengero zimapezedwa pazomwe zili pamwambapa. Ziwerengerozi zikhoza kuyesedwa zonse popanda mankhwala komanso kachiwiri pambuyo pogwiritsa ntchito bronchodilator.
- Njira zoletsera - FEV1 zosakwana 80 peresenti yazinenedweratu, ndipo FEV1 / FVC yofanana ndi 0.7 kapena zochepa.
- Chizoloŵezi choletsa
Zinthu Zodziwika ndi Spirometry
Spirometry ndiyeso yothandiza koma amagwiritsidwa ntchito kuphatikizapo zina zomwe zapeza m'mbiri, zochitika, ndi zojambula zowunikira kuti adziwe. M'mawu ena, zotsatira sizimagwiritsidwa ntchito mokha. Spirometry ingagwiritsidwe ntchito kuthandiza kuthandizira:
- Matenda osokoneza bongo (COPD) kuphatikizapo emphysema, bronchitis, ndi bronchiectasis.
- Emphysema (mtundu wa COPD)
- Bronchiectasis (mtundu wa CP {D)
- Bronchitis Yachilendo (mtundu wa COPD)
- Phumu
- Pulmonary fibrosis, kuphatikizapo idiopathic pulmonary fibrosis
- Cystic fibrosis
Zitsanzo ndi Matenda Okhalitsa
Chitsanzo chowonedwa pa spirometry chingagwiritsidwe ntchito posiyanitsa matenda osiyanasiyana a mapapu, mwachitsanzo:
- Zomwe zingadziteteze - Mchitidwe wolepheretsa udzawonedwa m'mapapo akukhudza mpweya monga COPD ndi mphumu.
- Mchitidwe wolepheretsa - Mchitidwe woletsera udzawoneka m'mkhalidwe umene uli ndi vuto la kupweteka kwa mapapo ndi kupweteka monga pulmonary fibrosis.
- Chitsanzo cha Mgwirizano - Ngati anthu ali ndi matenda oposa mapapu - monga cystic fibrosis ndi mphumu-kaphatikizidwe kamodzi kowoneka pa spirometry.
Phunzirani zambiri za kusiyana pakati pa matenda obisala ndi obvuta.
Zowononga Matenda Opatsirana - Zitsanzo ndi:
- Phumu
- COPD (emphysema, bronchitis, ndi bronchiectasis)
Matenda Oletsa Matenda - Zitsanzo ndi:
- Pulmonary fibrosis
- Post-opera (pambuyo pa lumpectomy kapena pneumonectomy)
- Kunenepa kwambiri
- Scoliosis
Kodi Ndi Mayesero Ena Angakhale Ofunika?
Nthawi zina spirometry yokha silingathe kudziwa ngati muli ndi matenda olepheretsa kapena opondereza ammapapo kapena ena awiriwo. Mwachitsanzo, kuphatikizapo pamwambapa munthu akhoza kukhala ndi matenda obisala m'mimba (asthma) komanso matenda opatsirana (monga pulmonary fibrosis)
Chiyeso chimene nthawi zina chimagwiritsidwa ntchito kuthandiza kuwunikiritsa izi ndi kupuma kwa mapapo.
Kutanthauzira Anu Spirometry Zotsatira
Zingamveke zovuta pamene mukuyang'ana mukuwerenga, koma poziphwanya ngati madokotala, mutha kuŵerenga ndi kumvetsa zomwe zili zachibadwa komanso zomwe zotsatira zanu zikutanthauza kwa inu.
Monga sitepe yoyamba, ingoyang'anirani manambala a FVC yanu ndi FEV1 ndi kuwafanizitsa ndi zotsatira zomwe zinaloseredwa malinga ndi kuwerengera pogwiritsa ntchito kutalika ndi kulemera kwako. Ngati nambalayi ndi 80 peresenti kapena yapamwamba yotsimikiziridwa, zotsatira zake zimakhala zachizolowezi (zolemba - nthawi zonse zimakhala zosiyana ndizofunika kuti mulankhule ndi dokotala wanu.
Ngati FVC kapena FEV1 yanu ndi yachilendo (osachepera 80 peresenti yazinenedweratu), masitepe ena amafunika kuti mumvetse zotsatira.
Ngati FVC kapena FEV1 yanu ndi yachilendo, yang'anani zotsatira za chiwerengero chanu cha FEV1 mpaka FVC. Izi zikhoza kusindikizidwa ngati gawo limodzi la FEV1 pa FVC. Ngati nambalayi yoposa 70 peresenti ikhoza kukhala kuti muli ndi matenda ochepetsa mapapo. Ngati chiwerengerochi sichichepera 70%, mukhoza kukhala ndi matenda obwera m'mapapo.
Apanso, nkofunika kuzindikira kuti pali zosiyana, ndipo mayesero ena angafunike. Komabe kuyang'ana pa manambala anu mpaka pano kukuthandizani kumvetsa zomwe zikuchitika pamene dokotala akukambirana njira zotsatirazi.
Kuchuluka kwa Matenda Ochokera ku Spirometry Results
Kuwonjezera pa kulekanitsa zolepheretsa ndi zovuta zowononga matenda a mapapo, spirometry ikhoza kupereka chisonyezero cha momwe matenda aakulu alili. Ndili ndi COPD magulu awa akuwerengera zomwe ziwerengero zilipo munthu atagwiritsa ntchito bronchodilator. Mwa kuyankhula kwina, iwo amasonyeza kuti kutseka kwakukulu sikutembenuzidwa (ndipo kotero, mwinamwake kosatha.)
- An FEV1 oposa 80 peresenti amaonedwa kuti ndi abwino.
- Chiwerengero cha FEV1 cha 60 mpaka 79 peresenti chimapangitsa kuwonongeka pang'ono
- An FEV1 ya 40 mpaka 59 peresenti pambuyo pa bronchodi ngati yochepa.
- An FEV1 ocheperapo 40 peresenti amachititsa Cas kwambiri.
Miyeso ingayang'ane pawiri ndi popanda bronchodilator
Ngati muli ndi COPD, chiyesochi chidzagwiritsidwa ntchito pamodzi ndi mfundo zina kuti mudziwe "GOLD".
Ngozi za Ndondomeko
Spirometry ndi njira yotetezeka kwambiri, koma anthu ena amatha kukhala ndi mpweya wabwino ndi kupuma kwakukulu komwe kumatengedwa panthawi ya mayesero. Sikoyenera kuti anthu ayesedwe ngati atakhala ndi vuto la mtima wam'tsogolo kapena kupwetekedwa, kapena ndi zizindikiro monga mapapo omwe agwa (pneumothorax).
Pansi pa Spirometry
Spirometry ndiwopindulitsa kwambiri komanso wamba omwe amagwiritsidwa ntchito kusiyanitsa pakati pa matenda a m'mapapo ndi kuzindikira kuopsa kwake - kaya matenda akuyankha mankhwala kapena kupita patsogolo. Nthaŵi zina, mayesero ena a mapulmasi adzagwiritsidwa ntchito pamodzi ndi spirometry kuti amvetsetse matenda. Ngati mwakhala ndi spirometry, mutengereni dokotala wanu kuti afotokoze nambala yanu, komanso kusintha kulikonse kwa nthawi yanu. Kukhala wothandizira nokha ndikudziŵa za matenda anu kumakupatsani mwayi wabwino kuti mupeze chithandizo chabwino kwambiri ndikuchita zonse zomwe muyenera kuchita kuti mukhale ndi moyo wabwino ndi matenda anu.
Zomwe zimadziwika kuti: pulmonary function test
> Zotsatira:
> Borlee, F., Yzermans, C., ndi E. Krop. Spirometry, Questionaire ndi Record Medical Medical Based COPD mu Population Survey: Kuyerekezera kuchuluka, mgwirizano wa mgwirizano ndi mgwirizano ndi Zowopsa Zowopsa. PLoS One . 2017. 12 (3): e0171494.
> Gentry, S., ndi B. Gentry. Matenda Ovutitsa Matendawa: Matenda ndi Mavuto. American Family Physician . 2017. 95 (7): 433-441.
Kasper, Dennis L .., Anthony S. Fauci, ndi Stephen L .. Hauser. Mfundo za Harrison za Mankhwala a M'kati. New York: maphunziro a Mc Graw Hill, 2015. Print.