Kodi mwayesa mankhwala osiyanasiyana pofuna kuchepetsa zizindikiro za COPD ndipo palibe chikuwoneka kuti chikugwira ntchito? Ngati mchitidwe wathanzi wa COPD wakulepheretsani inu ndipo mukupitirizabe kulimbana ndi kupuma, ndiye kuti chithandizo chachipatala cha COPD chikhoza kukhala chinthu chomwe muyenera kukambirana ndi wothandizira.
Mitundu Yopewera Opaleshoni
Pali mitundu itatu ya opaleshoni yomwe ingakhale yotheka kwa wodwala ndi COPD, omwe akudwala zizindikiro zoopsa.
Bullectomy
Bullae amakula (malo oposa 1 masentimita) m'kati mwa mapapo omwe nthawi zina amakhala apamwamba kwa COPD. Zotsatira zake ndizitsulo zomwe zimapangitsa kuti bronchiole tubes kapena bronchus zisokonezeke. Mphungu yamphongo imayambitsa kupanikizika kwakukulu pazomwe zimayambira, mapepala a mapapu abwino omwe amachititsa kuchepetsa magazi ndi mpweya m'mapapo. Izi zimayambitsa kupuma kochepa.
Pamene bullae imachotsedwa kudzera mwa opaleshoni yotchedwa bullectomy , mapepala abwino a m'mapapo angapitirize kupuma ndi kupuma zidzakhala zosavuta.
Omwe akufuna kukhala bullectomy amaphatikizapo odwala omwe amadwala kwambiri dyspnea, hemoptysis kapena matenda opitirira bullae. Dokotala wanu angapereke mayesero otsatirawa monga njira yowunika mapapu anu musanachite opaleshoni:
- Chifuwa cha X-ray
- Chifuwa CT
- Kuyesera kochita ntchito
- Kupuma mpweya / phulusa (VQ)
- Angiography ya mapapo (kwa odwala ena)
Zinthu zomwe zimatsutsana ndi bullectomy ndizo:
- Kupezeka kwa bullae angapo, ang'onoang'ono
- Zojambula zapamwamba zam'mimba mu mapafupi omwe sali pafupi
- Hypercapnia
- Cor pulmonale
- Pamene FEV1 ili ndi zaka zosachepera 40% kapena 500 ml
Ngakhale kuti njirayi ndi yotheka, bullectomy sichimachitika kawirikawiri, monga gawo lochepa kwambiri la odwala omwe ali ndi emphysema ali ndi chimphona chachikulu.
Malingana ndi Chifuwa , chiopsezo cha imfa nthawi kapena chitachitika opaleshoni ndi 0-22% m'mabuku ofalitsidwa. Zovuta zina zikuphatikizapo kutuluka kwa mpweya wautali, matenda a m'mapapo ndi kulephera kupuma .
Opaleshoni Yopewera Mphamvu (LVRS)
LVRS imaphatikizapo kuchotsa pafupifupi 30 peresenti ya matenda a mapaipi odwala kuti matenda abwino a mapapu athe kugwira bwino ntchito. Ndi njira yomwe imathandiza anthu omwe ali ndi emphysema kwambiri kupuma bwino kuti athe kukhala ndi moyo wopindulitsa kwambiri.
Odwala omwe amapindula kwambiri ndi njirayi ndi omwe ali ndi emphysema amphamvu m'mapapu apamwamba, omwe ali pangozi yaikulu ya opaleshoni ndipo omwe sanayankhe bwino kuchipatala asanayambe opaleshoni. Kupambana kwa LVRS kumagwirizana kwambiri ndi kusankha kosamalitsa kwa odwala omwe amakwaniritsa izi.
Phunziro lalikulu linatsimikizira kuti anthu omwe ali ndi emphysema kwambiri m'mapapo apamwamba a m'mapapo komanso omwe ali ndi chiopsezo chochepa cha opaleshoni, koma omwe samayankha kuchitidwa opaleshoni asanayambe opaleshoni, adzapindula kwambiri kuchokera ku LVRS. Phunzirolo linasonyezanso kuti odwala omwe ali pangozi yaikulu ya opaleshoni ndi omwe ali ndi emphysema m'madera ena a mapapo angakhale ndi phindu lapang'ono ndipo akhoza kuvulazidwa (maphunziro a NETT).
Kuti aganizidwe kuti ali ndi LVRS, odwala ayenera kuchita izi:
- Kukhala ndi mbiri ya emphysema
- Osasuta fodya kwa miyezi inayi asanayambe ndikuyesa njira yonse yowunika
- Osakhala ndi LVRS yapitayi
- Osakhala ndi mitsempha yam'mbuyomu yam'mbuyomu kapena yamtundu wina wa mtima
Kuonjezera apo, wodwalayo ayenera kupatsidwa mankhwala a pulmonary pamaso ndi pambuyo pa opaleshoniyo.
Izi ziyenera kufotokozedwa kuti ngakhale opaleshoni ya LVRS yasonyezedwa kuti ikuthandizire kupititsa patsogolo mphamvu ya kupuma, mphamvu yamapapo, ndi umoyo wathanzi. Sichikuwonjezera kupulumuka.
Kupaka Mapira
Kuwongolera pamapangidwe kumachitidwa ngati njira yothandizira opaleshoni zosiyanasiyana za m'mapapo kuphatikizapo pulmonary fibrosis ndi pulmonary hypertension.
COPD, komabe, ndiyo njira yowonjezera yowonjezera mapapu.
Odwala omwe ali ndi zaka zopitirira 65 omwe ali ndi mapeto a COPD popanda matenda ena akuluakulu ayenera kuganiziridwa kuti akonze mapepala oyeza ndikuwunika. Mapulogalamu ena adzalingalira odwala omwe ali achikulire kuposa zaka 65, koma ndondomeko zoyenera ziyenera kukumana kuti ziganizidwe.
Omwe angatenge mphotho yopambana kuchokera ku mapeto a mapapowa ndi odwala omwe amasonyeza zotsatirazi:
- An FEV1 a 20% kapena osachepera azinenedweratu
- Hypercapnia
- Amene ali ndi matenda oopsa kwambiri
- Amene ali ndi mwayi wopulumuka adzakhala wamkulu ngati atapatsidwa mapapo kusiyana ndi ngati sanatero
Kuonjezera apo, ofuna kukonzekera ayenera kukhala ambulatory, kulemera koyenera, komanso okhudzidwa ndi dongosolo lothandizira.
Ndizosangalatsa kuzindikira kuti bullectomy yapitayi kapena LVRS sizotsutsana ndi kupatsa mapapo. Ndondomekozi zingathandize kukhala ngati mlatho wopatsa mapiritsi kwa odwala ena.
Ngakhale kupuma kwa mapapo sikupangitsa kukhalabe ndi moyo kwa odwala COPD, kupindula kwa kuikidwa m'mapapo kumafunika kuyang'anitsitsa pothandiza phindu labwino.
Mfundo Yofunika Kwambiri
Mtolo umene COPD umakhalapo pa wodwala ukhoza kuwononga kwambiri umoyo wawo. Kwa iwo omwe ali ndi COPD yotsirizira yomwe samayankha bwino mankhwala, opaleshoni yotenga opaleshoni ikhoza kusankha. Wopereka chithandizo choyambirira yekha ndi amene angadziwe ngati mungapange opaleshoni yabwino ya opaleshoni imeneyi.
Zotsatira
Association of Lung America. LVRS Fact Sheet. August 2005.
American Thoracic Society, European Thoracic Society. 2004. Miyezo yowunikira ndi kuyang'anira odwala omwe ali ndi COPD. Version 1.2. 2005. Ipezeka pa http://www.thoracic.org.
Huang FRCPC, Max MD, Singer, FRCPC, Lianne G. MD. "Kupititsa Opaleshoni kwa COPD". Okalamba okalamba. 2005; 8 (3): 40-46.
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Gulu lofufuza kafukufuku wa National Emphysema. Odwala ali pangozi yaikulu ya imfa pambuyo pa opaleshoni yochepetsetsa. N Engl J Med 2001; 345 (15): 1075-1083.
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