Chikhalidwe asthmaticus, kapena SA kwaifupi, ndi vuto lalikulu la masewera a mphumu kawirikawiri kawirikawiri kapena mwamsanga mwadzidzidzi. Ku SA, zizindikiro za mphumu zimapitirirabe ndipo kupuma kwa thupi kumachepa, ngakhale kuti mankhwala amatha.
Pa anthu onse, mphumu imakhudza pafupifupi asanu ndi atatu mwa anthu akuluakulu komanso 10 peresenti ya ana. Mwa awa, asanu ndi asanu aliwonse ali ndi mphuno yoopsa ya mphumu ndipo ali pangozi yaikulu ya chikhalidwe cha asthmaticus.
SA ikhoza kutsogolera kupuma , kupuma kwa nthawi yaitali, ngakhale imfa. Zimatanthauza chithandizo chachipatala chomwe chimafuna chithandizo chamankhwala mwamsanga. Pafupifupi 10 peresenti ya anthu omwe akumana ndi SA adzafa.
Komanso, chikhalidwe cha asthmaticus chimakhala chofala kwambiri, ndipo chimachititsa kuti anthu oposa 5,000 afa chaka chilichonse ku US. Aliyense amene ali ndi kapena alibe mphumu ayenera kudziwa bwino zizindikilo zomwe zimawonekera.
Mmalo mokhala ndi izi zochititsa mantha kumva, pitirizani kuwerenga. Phunzirani zomwe mungachite kuti musakhale mmodzi wa ziwerengerozi.
Zizindikiro
Panthawi yovutitsa mphumu , momwe thupi limagwiritsira ntchito mpweya wopuma mu alveoli ndizovuta. Izi zimapangitsa kuti mpweya wa okosijeni uchepetse komanso kuti mpweya wa carbon dioxide ukhale wochuluka m'magazi, omwe, nthawi zambiri, amachititsa kuti munthu asamafe komanso afe.
Nthenda ya mphumu imapangitsanso mpweya m'mapapo, zomwe zimayambitsa kupanikizika mu chifuwa. Izi zingayambitse mapaipi komanso ngakhale kumangidwa kwa mtima.
Mitundu
Pali mitundu iwiri ya SA:
- Kuukira kolowera pang'ono . Mtundu uwu wowonjezereka ukhoza kutenga nthawi yaitali kuti uwuluke ndipo kawirikawiri zotsatira chifukwa cha mankhwala osayenera. Munthu yemwe ali ndi mtundu uwu wa SA adzalandira zizindikiro zowonjezereka masiku kapena masabata, atapatsidwa nthawi yotsitsimula ndi kutha kwa zizindikiro zomwe sizingasinthidwe ndi mankhwala kunyumba.
- Kuukira mwadzidzidzi . Munthu amene ali ndi mtundu uwu wa SA sanaonepo zizindikiro zowonjezereka m'masabata apitawo, koma akukankhidwa ndi bronchospasm mwadzidzidzi komanso woopsa, kupuma, kupuma, ndi chifuwa. Kuthamanga kwa mphumu kawirikawiri kumabweretsedwanso ndi zinthu zambiri zomwe zimayambitsa matenda monga mungu, fumbi kapena chakudya chokwanira.
Kudziwa
Zotsatirazi ndi zizindikiro zomwe madokotala amagwiritsa ntchito kuti azindikire SA:
- Kupuma kwa mpumulo (Kupuma pang'ono, kuthamanga pang'ono kungayambe ndi ntchito yokha ndikupitirira kumene kumapezeka panthawi yopuma.)
- Kulephera kulankhula mu ziganizo kapena osakhoza kulankhula konse
- Kuthamanga kwapuma pamapuma (Kuposa 30 mpweya pamphindi kuli kovuta, koma ngakhale ndalama zoposa 18 mwana wa sukulu kapena wamkulu ayenera kuyika nkhawa ndi kuyang'anitsitsa mosamala. Ma tarimu ndi apamwamba kwambiri kwa ana aang'ono ndipo n'kofunika kufunsa katswiri wanu wamagulu kapena wamapapo pafupi ndi mlingo umene muyenera kuwamvera ana aang'ono.)
- Kuthamanga kwamtundu wambiri kumapuma (kupitirira 120 kugunda pa mphindi)
- Kusokonezeka ndi kukwiya (Ngakhale, pamene chiwonongeko chikukula, kugona ndi kusasamala kumapweteka kwambiri.)
- Mavuto ochepa a mpweya m'magazi (hypoxemia kenako hypoxia )
- Kuchepetsa mphamvu ya kupuma, monga kuyerekezera ndi kuthamanga kwazomwekupuma (PEF)
Chithandizo
Kutengera kwachikhalidwe cha chikhalidwe cha asthmaticus mu chipinda chodzidzimutsa chimaphatikizapo:
- Oxygen ndi mask
- Kuyeza kwa PEF ndi spirometry (mu mphumu yoopsa kwambiri, izi zikhoza kukhala zovuta)
- Agent antia beta (monga albuterol) kudzera mu inhaler kapena mwa nebulizer
- Mankhwala a corticosteroid (monga prednisone) operekedwa kudzera pakamwa kapena mkati
- Mankhwala oletsa anticholinergic (monga atrovent)
Mankhwala ena omwe angagwiritsidwe ntchito panthawi yapadera ndi awa:
- Beta-agonists akujambulidwa pansi pa khungu (monga Terbutaline)
- Magnesium sulfate mwachangu
- Mankhwala a leukotriene (monga Zafirlukast kapena Zileuton) pakamwa
Mpweya wotsegula mpweya ndi mankhwala (pafupifupi) otsiriza chifukwa cha chiopsezo cha m'mapapo ndi zovuta zina zomwe zingachitike. Pafupifupi anayi peresenti ya maulendo opita kuchipatala mwadzidzidzi amachititsa wodwalayo kufuna mpweya wabwino. Monga njira yomaliza, ma membrane oxygenation (ECMO) akhala akugwira ntchito kwa odwala ochepa omwe mphumu idafa ngakhale ndi mpweya wokwanira.
ECMO (membrane wodwala oxygenation) imaperekanso njira ina yomaliza komanso njira yomaliza yopangira chithandizo kwa anthu omwe mankhwala onse kuphatikizapo mpweya wotsegula mpweya alephera. Panopa amaganiza kuti ECMO iyenera kuonedwa kuti ndi mankhwala oyambirira kwa anthu omwe ali ndi chikhalidwe cha asthmaticus omwe sagwiritsa ntchito mpweya wabwino (kutaya kwa oxygen ndi kutuluka kwa carbon dioxide) zomwe sizikugwirizana ndi mankhwala omwe alipo. ECMO imapereka njira yobwezeretsa mpweya mu thupi pamene kuteteza kupweteka kwa mapapo kumaphatikizapo mpweya wabwino.
Pef Measurement
Kawirikawiri kuopsa kwa zizindikiro za munthu amene ali ndi mphumu sikugwirizana kwambiri ndi kufooka kwake kwa mapapu ake. Choncho, nkofunika kuti asthmatics yonse iwonetse PEF yawo nthawi zonse. Izi zimagwiritsidwa ntchito pogwiritsa ntchito chiwongoladzanja cha mita , chomwe ndi chipangizo chochepa cha pulasitiki chomwe chimatulutsidwa mwamphamvu, chomwe chimayendera PEF.
Chiwerengero cha PEF chimapereka chidziwitso chokhudza kutentha kwa thupi, kuchepa kulikonse kuchoka kwa munthu wokhazikika (chikhalidwe), ndi kufunika koonjezera mankhwala kapena kuchipatala. Munthu aliyense yemwe ali ndi mphumu yemwe ali ndi kuchepa kwa 30 peresenti kapena kuposerapo mu PEF, makamaka ngati kupulumutsidwa kwa ofhalers sikugwira ntchito, ayenera kupita kuchipatala popanda kukayikira.
Zowopsa
Kodi mungadziwe bwanji ngati muli pachiopsezo chotenga matenda a mphumu ? Ndi chidziwitso cha asthmaticus, pali, mwa tanthauzo, zizindikiro zochepa zochenjeza. Ngati muli ndi mtundu wa chifuwa chimene chingachitike, wodwalayo angakambirane momwe ziwopsezozi zingakhalire komanso momwe zimakhalira mofulumira.
Pang'onopang'ono pang'onopang'ono, asthmaticus, pali zizindikiro zambiri zochenjeza zomwe ziyenera kukuchenjezani kuti muitane dokotala kapena mupeze chithandizo cham'tsogolo. Izi zikuphatikizapo:
- Kuchuluka kwa PEF kwa 30 peresenti kapena kuposerapo, monga tafotokozera pamwambapa, ngakhale kuti wovomerezeka wanu angakupatseni magawo osiyana malinga ndi mphumu yanu
- Kuwonjezeka kwa chidziwitso chakupulumutsidwa kwanu
- Kuwuka kwausiku chifukwa cha mphumu yako
- Kuwonjezereka kwafupipafupi ngakhale mukugwiritsa ntchito mankhwala anu mosalekeza
- Ngati mwagwiritsira ntchito kansalu kawiri kapena kuposerapo ka inhaler yanu yochepa pamwezi watha
Ngati muli ndi mbiri ya vuto lalikulu la chifuwa cha mphumu, muyenera kupeza chisamaliro chankhanza ngati muwona zozizwitsa zomwe munali nazo panthawi yomwe munagonjetsedwa kale.
Mawu Ochokera
Ndikofunika kuti aliyense amene ali ndi mphumu, komanso okondedwa awo omwe amasamalira anthu omwe ali ndi mphumu, adziwe machenjezo a mphumu yambiri komanso kuopsa kwa matendawa. Ngakhale kupita patsogolo kwa chithandizo, palinso anthu ambiri omwe amafa ndi matendawa chaka chilichonse.
Chimodzi mwa vuto ndi chakuti anthu ambiri sazindikira momwe mankhwala omwe amachitira kunyumba amakhala amphamvu, ndipo izi zingapereke chinyengo chachinsinsi. Ngati munthu akuwonjezereka ntchito zawo zapakhomo pakhomo, nthawi zina zimakhala zovuta kuti matendawa athetsere akafika ku chipatala.
Izi zikuti, kukhala ndi mphumu si chifukwa chowopsya. Monga tanenera poyamba, anthu ambiri okhala ndi chikhalidwe cha asthmaticus amayamba kuchepetsa matenda. Kodi kuphunzira za vutoli kuyenera kuchita chiyani kuti anthu omwe ali ndi mphumu, ngakhale omwe ali ndi mphumu yochepa, azifufuza mwatsatanetsatane kuti chiwerengero chawo chikuyendera komanso kuti apeze madokotala omwe ali ndi zizindikiro kuti vuto lawo likukulirakulira. Ngati simukudziwa bwino njirayi, yimbirani ovomerezeka lero ndipo mudziwe momwe mungagwiritsire ntchito ndi mphumu yanu.
Zotsatira:
Di Lascio, G., Prifti, E., Messai, E. et al. Membrane Yachilengedwe Oxygenation Support for Life-Threatening Acute Status Status Asthmaticus. Perfusion . 2017. 32 (2): 157-163.
Miller, A., Breslin, M., Pineda, L., ndi J. Fox. Pulojekiti ya Asthma Yapititsa patsogolo Kugwirizana ndi Malangizo Othandizira Othandiza Odwala Padziko Lomwe Ali ndi Vuto la Asthmaticus mu Dipatimenti ya Emergency. Care of Respiratory Care . 2015. 60 (12): 1759-64.
Tramm, R., Ilic, D., Davies, A., Pellegrino, V., Romero, L., ndi C. Hodgson. Membrane Yachilendo Oxygenation kwa Odwala Odwala. Dongosolo la Cochrane la Zosintha Zogwirizana . 2015. 1: CD010381.