Ngati wina angakufunseni zomwe zimakulepheretsani kuchita masewera olimbitsa thupi mukakhala ndi COPD , mungathe kunena dyspnea (omwe amatchulidwa kuti kupuma). Mu COPD, dyspnea ndi minofu yotopa ndizo zowononga kuti ayambe kuchita masewera olimbitsa thupi . Izi ndizosautsa chifukwa njira yabwino yowonjezeretsa zolimbitsa thupi ndikuchepetsa kuchepa kwa COPD ndiko kuchita nthawi zonse.
Kotero, mumatha bwanji kuchita masewera ngati minofu yanu ikutha ndipo simungathe kupuma?
Ngakhale kuti nthawi zonse muyenera kuyendera dokotala musanayambe kugwiritsa ntchito njira zomwe zili pansipa, njira zotsatirazi zingakuthandizeni kuchita masewera olimbitsa thupi komanso kuchepetsa kupuma pa nthawi yochita masewera olimbitsa thupi:
Zosakhudzidwa Zopinga Mpweya Wopuma
Ngakhale kuti sizingatheke, kafukufuku wasonyeza kuti anthu omwe amagwiritsa ntchito nthawi zonse pogwiritsa ntchito mpweya wabwino (NIPPV) akhoza kukhala ndi mwayi wophunzira kuposa iwo omwe sachita. Sikuti NIPPV imalola odwala COPD kuti azichita nthawi yaitali, koma amatha kugwira ntchito yowonjezera pa nthawi yochita masewero olimbitsa thupi kusiyana ndi pamene akuchita zosavomerezeka. Tikukhulupirira kuti kupita patsogolo kwa zamakono azachipatala kumapangitsa kuti oxygen iperekedwe bwino pa nthawi ya NIPPV, osati ndi masikiti omveka bwino.
Kugwiritsa ntchito NIPPV usiku kungakhale yankho lothandiza kwambiri.
Kafukufuku akuwonetsa kuti odwala omwe amagwiritsira ntchito mausiku a NIPPV ali ndi mayendedwe a maola asanu ndi limodzi , FEV1 , mphamvu ya hyperinflation komanso magetsi a m'magazi . Odwala akhozanso kuwona kusintha kwa thupi lawo, machitidwe awo, thanzi lawo, ndi mphamvu.
Kusokoneza Magetsi
Odwala a COPD omwe asunga mphamvu ya minofu ndi minofu akhoza kupindula ndi kuthamanga kwa magetsi (hf-NMES). Kafukufuku amasonyeza kuti zimapangitsa kuti thupi likhale luso lochita masewera olimbitsa thupi mwa kulola odwala kuti alekerere msinkhu wa masewera olimbitsa thupi. Zingapangitsenso kuti ukhale wopuma.
Njira yabwino yothetsera HF-NMES ndi kuigwiritsa ntchito musanayambe kugwiritsidwa ntchito minofu (yodziwika bwino ku COPD), ngakhale kuti ikhoza kukhala yopindulitsa kwa odwala omwe ali olumala kwambiri osasokoneza dyspnea, komanso.
Kukonzekera kwa magetsi kungagwiritsidwe ntchito pakhomo, kapena monga gawo la pulogalamu yowonetsera kukonzanso mapulaneti.
Oxygen Supplementation
Kafukufuku wofalitsidwa ku Thorax amasonyeza kuti mpweya wochulukitsa panthawi yochita masewera olimbitsa thupi umapereka mpumulo wokhazikika kuchokera ku dyspnea ndipo sichithandiza pang'ono kuchita zolimbitsa thupi ku COPD. Komabe, kufufuza kumeneku kumasonyeza kuti kungapangitse kupirira kolimbika, kuchepetsa malingaliro a dyspnea ndi kuchepetsa mapapu a hyperinflation kwa odwala omwe ali ndi mpweya wabwino wa magazi.
Pali zongoganizira za m'mene njira yobweretsera - nasal cannula kapena transtracheal - ndi yabwino pazochita zolimbitsa thupi. Kafukufuku wogwiritsira ntchito njira ya transtracheal ndi yosakhalitsa nthawi; Komabe, otsutsa za kuperekedwa kwa oxygen transtocal amakhulupirira kuti zimayenda bwino.
Kukonzekera Kwazitsulo
Kukonzekera kwa kayendetsedwe ka mankhwala ndi gawo lofunika la mankhwala a COPD ndipo limalimbikitsidwa kwa odwala onse omwe ali m'zigawo zovuta kwambiri za COPD. Kukonzekera kwa kayendetsedwe ka mankhwala kumathandiza odwala COPD :
- Pitirizani kuchita zinthu zolimbitsa thupi
- Kuchepetsa kupuma
- Kukulitsa umoyo wa moyo
- Kuchepetsa nthawi ya chipatala komanso kuchipatala
- Kuchepetsa nkhawa ndi kupanikizika
- Tsambitsani ntchito yomanga
- Kupititsa patsogolo mphamvu ya kupuma kwa minofu (pokhudzana ndi zochitika zonse)
Mankhwala
Pali mankhwala angapo omwe asonyezedwa kuti apangitse ntchito zolekerera ndi kuchepetsa kuchita masewero olimbitsa thupi ku COPD.
Kawirikawiri kuphunzira ndi:
- Albuterol - Imodzi mwa makhalidwe a COPD ndi kuchepa kwa mpweya. Kuchepetsa mphamvu ya kutentha kwa mpweya ndi zotsatira zazikulu za kuchepetsa kutuluka kwa mpweya panthawi ya masewera olimbitsa thupi ku COPD komanso chothandizira kuti ukhale wopuma. Kafukufuku amasonyeza kuti inhaled albuterol, agonist yogwira ntchito yochepa yochepa, imachepetsanso mphamvu zowonongetsa zolimbitsa thupi komanso zimapangitsa ntchito zina zofunikira kuzizira.
- Spiriva - Yophatikizidwa ndi mapulitsikidwe a pulmonary, anticholinergic bronchodilator Spiriva (tiotropium) amathandiza kupitiriza kupirira, kupuma, ndi umoyo poyerekezera ndi kugwiritsa ntchito mankhwala odziteteza okha.
- Salmeterol - Salmeterol, agonist wachitali wachitali, amalimbikitsa kupuma pa nthawi ya masewera olimbitsa thupi koma sikuti amachulukitsa nthawi yopuma.
- Kuwonjezera pa malo a placebo, nebulized ipratropium bromide (anticholinergic) imapangitsa kupirira nthawi yowonjezera, imachepetsa dyspnea ndipo imachepetsa mphamvu ya hyperinflation. Kuonjezerapo, atagwiritsa ntchito ipratropium bromidi, odwala m'maphunziro a zachipatala anawonetsa kuwonjezeka kwa FEV1, FVC ndi mphamvu yowonjezera (mphamvu ya mpweya yomwe ikhoza kutsekedwa pambuyo kutuluka mpweya wabwino).
Maphunziro a Pakati
Pa nthawi yophunzitsa, wodwalayo akubwereza zomwe zimaphatikizapo masewera olimbitsa thupi omwe amayendetsedwa ndi zozizwitsa zozizwitsa (zomwe zimawerengedwa kwambiri ku COPD) kapena kupumula. Kupititsa patsogolo maphunziro ku COPD zotsatira zothandiza kuphunzitsa kwa odwala ena ndipo nthawi zambiri amagwiritsidwa ntchito monga gawo la pulogalamu ya kukonzanso mapulitsi.
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