Kumvetsetsa Zolinga ndi Zofunikira Zosankha
Kuwongolera mazira kumagwiritsidwa ntchito kawirikawiri kwa anthu omwe ali ndi mapeto a matenda osapatsirana (COPD) omwe amakumana ndi zoyenera. Matendawa amatchulidwa ngati mapeto pamene mavuto ndi kupuma akutha kuika moyo pachiswe, ndipo njira zina zonse zothandizira, kuchipatala ndi opaleshoni, zakutha.
Zonsezi zanenedwa, kuzungulira kwa mapiri 2,000 kumachitika chaka chilichonse ku United States, malinga ndi chiwerengero cha Scientific Registry of Transplant Recipients ku Minneapolis.
Ubwino Wopaleshoni
Kuwongolera mapuloteni kumatha kusintha kwambiri moyo ndi kubwezeretsa ntchito zambiri zomwe anthu akhala akukhala ndi gawo la COPD . Malinga ndi zosankha, kafukufuku wamakono akusonyeza kuti kuika mapapo m'mapapo (m'malo mwa mapapo awiri) kumakhala kopindulitsa kwambiri kwa nthawi yaitali poyerekeza ndi kuika khungu limodzi.
Ngakhale kusintha kwa mapapu sikungowonjezereka, kupitirira kwa nthawi yaitali kupulumuka kwa anthu omwe ali ndi COPD, khalidwe ndi nthawi ya kupulumuka kwa nthawi yochepa ikupitirirabe. Malingana ndi kafukufuku:
- Pakati pa 80 peresenti ndi 90 peresenti ya anthu omwe akukula akukhalabe chaka choyamba.
- Pakati pa 41 peresenti ndi 52 peresenti amapulumuka zaka zisanu kapena kuposerapo.
Komanso, 66.7 peresenti ya anthu omwe amagwiritsidwa ntchito limodzi amatha kukhala ndi moyo zaka zisanu kapena kuposerapo poyerekeza ndi 44.9 peresenti ya anthu omwe ali ndi mapulogalamu amodzi okha.
Kusankhidwa kwa Otsatila
Kawirikawiri, munthu amaonedwa kuti ndi woyenera kukweza mapapu ngati ali ndi chiyembekezo cha moyo zaka ziwiri kapena zosachepera.
Komanso, zaka makumi asanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu ndi zisanu (65) zimalangizidwa kuti zikhazikitsidwe m'modzi-mapapu ndipo zaka 60 zowonjezera. Ziwerengero zasonyeza pang'ono zopindulitsa mu nthawi yopulumuka kapena moyo wa anthu okalamba kuposa awa.
Njira zina ndizo:
- Kukhala ndi FEV1 zosakwana 20 peresenti
- Kukumana ndi matenda aakulu (carbon dioxide) komanso kuchepa kwa magazi
- Kupeza yachiwiri mapulaneti oopsa kwambiri
- Kukhala ndi chiwerengero cha BODE cha pansi pa zisanu ndi ziwiri (kusonyeza kuyerekezera kwa nthawi ya moyo)
Pakhoza kukhala paliponse mu ziwerengero izi, zogwirizana ndi kafukufuku wa vutoli. Kusankhidwa kungaphatikizepo kufufuza ngati munthuyo ali ndi ambulatory, ali ndi mphamvu zothandizira, ndipo akulimbikitsidwa kuti azitha kuchipatala, kuchita masewera olimbitsa thupi, kusuta fodya, ndi kusintha kwa moyo wina kutsogolera ndikuchitika opaleshoni.
Anthu omwe ali opaleshoni yamapapo yapitayi, monga opaleshoni yoperekera kuchepetsa mphamvu ya m'mapapo (LVRS) kapena bullectomy , amatha kukhala oyenerera ngati angathe kukwaniritsa.
Mavuto a Post-Surgical
Palibenso kuwonetsa kuti kupatsa mapapo ndi njira yaikulu yomwe imakhala ndi chiopsezo chachikulu cha mavuto, kuphatikizapo imfa. Zikhoza kukhala zokhudzana ndi kupuma kapena zosapuma.
Matenda okhudzana ndi kupuma ndi omwe amakhudza mwachindunji mapapu ndipo angaphatikizepo:
- Kuvulala kwa Ischemia (kuwonongeka kumene kumachitika pamene magazi amabwerera ku minofu pambuyo pa nthawi ya mpweya wokwanira)
- Bronchiolitis obliterans (kulepheretsa kupuma chifukwa cha kutupa koopsa)
- Malachi othamanga (mphepo yothamanga)
- Atelectasis (mapapo otumphuka )
- Chibayo
Mosiyana ndi zimenezi, mavuto osakhudzana ndi kupuma ndi omwe amakhudza ziwalo zina kapena zokhudzana ndi mankhwala osokoneza chitetezo a m'thupi omwe amatetezedwa ndi ziwalo . Ngakhale kukanidwa kwagulu ndi chinthu chofunika kwambiri potsatira opaleshoni yopangira, ena angaphatikizepo:
- Kutenga
- Matenda a Lymphoproliferative (omwe amayamba pamene maselo oyera ambiri amagazi, otchedwa lymphocytes, amapangidwa ndi anthu omwe ali ndi chitetezo cha m'thupi)
- Lymphoma (khansa ya chitetezo cha m'thupi)
- Kuthamanga kwambiri kwa magazi
- Kulephera kwa impso
- Matenda a shuga
Mawu Ochokera
Ngakhale kusintha kwa mapapu nthawizonse kumaganiziridwa kukhala chinthu chomaliza, kupita patsogolo kwa teknoloji ndi kusamalidwa pambuyo pa opaleshoni kwachititsa kuti zikhale zambiri zapambana kuposa kale lonse.
Ndikunena kuti, chisamaliro chachikulu chiyenera kuthandizidwa kuti mutsimikizire kuti simukumvetsetsa ubwino wa chithandizo koma mumvetsetse mavuto omwe mungakumane nawo masabata, miyezi, ndi zaka zotsatira za opaleshoni.
Zoopsa zingakhale zapamwamba. Zonse zanenedwa, pafupi 50 peresenti ya anthu omwe akulandira mapapu kuchokera kwa wothandizira osagwirizana adzakumana ndi kukanidwa kosatha (chodziwika ndi kuperewera kwa thupi kugwiritsidwa ntchito kwa zaka zambiri).
Kupititsa patsogolo mitengoyi kumadalira makamaka kuyang'anira mavuto. Izi zikutanthauza kuti iwe, monga wodwalayo, uyenera kudzipereka kwathunthu kuti mutenge zofunikira zonse kuti mukhale ndi thanzi labwino. Pamapeto pake, ndiwe mwazimene zimapangitsa kuti mukhale ndi moyo wabwino nthawi yaitali.
> Zotsatira:
> Aziz, F .; Penupolu, S .; Xu, X. et al. Kuwongolera mazira kumapeto kwa odwala matenda a mphuno (COPD). J Thorac Dis . 2010; 2 (2): 111-6. PMCID: PMC3256444.
> Valapour, M .; Skeans, M .; Smith, J. et al. "OPTN / SRTR 2015 pachaka Report Report: Lung." Am J Kujambula. 2017; 17 (Suppl 1): 357-424. DOI: 10.1111 / ajt.14129.