Kuyeza kwapulmonary function (PFT) kumasokoneza odwala ambiri a COPD . Ndipo kumvetsetsa momwe dokotala akumasulira zotsatira kungakhale kovuta kwambiri.
Komabe, kudziŵa nambala yanu pamene ikugwiritsidwa ntchito ku zovuta zapoponomu n'kofunika kwambiri monga kudziŵa kuponderezedwa kwa magazi ngati muli ndi matenda a mtima. Zotsatira zanu zowonetsera zimakupatsani njira yowonetsera pozindikira momwe mukuchitira mankhwala, komanso akukuuzani ngati matenda anu akukula, kukhalabe chimodzimodzi, kapena kupita patsogolo.
Mwachidule
Pozindikira kuti COPD , mapulogalamu a pulmonary amayesedwa kuti ayang'ane ntchito yamapapo ndikuzindikira kukula kwa mapapo. Kuwonjezera pa mbiri ya wodwala komanso masewero olimbitsa thupi, mapuloteni a mapapu ( chifuwa cha X-ray ndi CT scan ), ndi PFTs ndizofunikira kwambiri pofufuza thanzi la kupuma.
Mayendedwe a ntchito yamapulaneti amagwiritsidwa ntchito pamene:
- Kuwonetsetsa kwa kukhalapo kwa matenda obisala ndi / kapena oletsa kupweteka
- Kuzindikira mkhalidwe wa wodwala musanachite opaleshoni kuti muone ngati chiopsezo chakumapeto kwa opaleshoni chimachitika
- Kuwunika kukula kwa matenda a mapapo ndi mphamvu ya chithandizo
Mitundu itatu ya ma pulmonary function test is used in diagnosis of COPD:
- Spirometry
- Kusokoneza maphunziro
- Thupi lothandizira
Kuyesedwa kwa Spirometry
COPD imayambitsa mpweya m'mapapu pang'onopang'ono komanso pang'onopang'ono poyerekeza ndi munthu yemwe ali ndi mapapu abwino. Kuchuluka kwa mpweya m'mapapu sikuchotsedwa mwadzidzidzi chifukwa cha kutsekeka kwa thupi (monga kupanga mafasho ) kapena kuchepa kwa pang'onopang'ono chifukwa cha kutupa kosatha.
Ndiko kumene spirometry imabwera mkati.
Spirometry ndizovuta kwambiri pazitsulo zonse zapoponomu. Zimagwiritsidwa ntchito ndi chipangizo chopangidwa ndi dzanja chotchedwa spirometer ndipo chingagwiritsidwe ntchito mosavuta ndi odwala omwe amathandizidwa ndi katswiri wodziwa bwino ntchito.
Kawirikawiri chisamaliro cha wodwala ndikuyesa kupeza vuto la kupuma.
Amagwiritsidwanso ntchito kwambiri kuti afotokoze sukulu (magawo) a COPD.
Njira yabwino, yosagwira ntchito, spirometry ikhoza kuchitidwa payekha ku ofesi ya dokotala kapena kuchipatala chachikulu kapena kuchipatala. Chiyesochi chimafuna kuti wodwalayo atulukidwe, atenge mwamphamvu kwambiri.
Njirayi imatsatiridwa ndi kutuluka mwamsanga kuti mpweya wonse utope kuchokera m'mapapu. Zotsatira za testamento za Spirometry zimasiyanasiyana koma zimachokera ku zikhalidwe zanenedwa zowonongeka, wathanzi (onani m'munsimu).
Mawu omveka kuti adziwe
Mayeso a Spirometry amayeza kuchuluka kwa kusintha m'mapapu panthawi yopuma kupuma. Miyesoyi ikuwonetsedwa pogwiritsa ntchito mawu awa:
- Mphamvu Yofunika (VC) - Kuchuluka kwa mpweya umene umatha kutuluka m'mapapu mwamphamvu pambuyo pake.
- Mphamvu Yofunika Kwambiri (FVC) -Ung'onoting'ono wa mpweya umene umatha kutuluka kuchokera m'mapapu mwamsanga mutatenga mpweya wozama kwambiri.
- Volume For Exiratory Volume mu Second Second (FEV1) - Kuchuluka kwa mphepo yomwe imatha kutulutsa mpweya kuchokera m'mapapu muyeso yachiwiri ya mpweya wokakamizidwa.
- Pakati pa FEV1 / FVC-Zowonjezeredwa monga FEV1% kapena% FEV1, zimapereka chiŵerengero cha FEV1 mpaka FVC. Izi zimauza wogwira ntchito kuti ndi chiani chiwerengero cha mpweya womwe umatulutsa kuchokera m'mapapu pa nthawi yachiwiri ya mpweya wokakamizidwa.
- Zowonongeka Zowonjezera Mtengo (PEFR) - Njira ngati mankhwala akuthandizira kuthetsa matenda oyenda mumlengalenga, monga COPD.
- Kuthamanga Kwambiri Kulimbidwa (FEF) -Myeso wa momwe mpweya ungathere kuchokera m'mapapo. Ichi ndi chisonyezero cha kukanika kwakukulu kwa ndege.
- FEF25% - Mtengo umenewu umayimira kuchuluka kwa mpweya umene umatha kutuluka m'mapapu mwamsanga pa 25 peresenti ya kuyesedwa kokwanira kofunikira.
- FEF50% -Zomwezo zimayimira kuchuluka kwa mpweya kuthamangitsidwa m'mapapu pakati pa theka lachiwiri (50 peresenti) ya kuyesedwa koyenera. Ndiwothandiza pamene wodwala akudandaula matenda olepheretsa. Kwa wodwala amene akulepheretsa, kuchuluka kwa mpweya umene ukhala utatha kale kudzakhala wochepa kuposa wa munthu amene ali ndi mapapu abwino.
- FEF25% -75% -Zomwezi zimayimira kuchuluka kwa mpweya wotuluka m'mapapo pakati pa theka la kuyesedwa koyenera. Madokotala ambiri amatchula kufunika kwake chifukwa cha matenda obwera m'mapapo.
- Maximum Voluntary Ventilation (MVV) -Mtengo wotsimikiziridwa ndi wodwala wodwalayo ndikuwotha mofulumira mwamsanga pamasekondi khumi ndi awiri. Zotsatira zimasonyeza momwe minofu imagwiritsire ntchito kupuma, momwe zimakhalira mapapu, komanso ngati kulimbana kulikonse mu mpweya pamene mukupuma. Mayesowa amauza ochita opaleshoni momwe mapapu amphamvu aliri amphamvu asanayambe opaleshoni. Ngati odwala amasonyeza kuti sakugwira bwino ntchitoyi, zimapereka kwa dokotala kuti vuto la kupuma likhoza kuchitika pambuyo pa opaleshoni.
Kutanthauzira Zotsatira
Spirometry imathandiza madokotala kudziwa kuti pali matenda omwe amachititsa kuti anthu asamapezeke. Monga chiyeso chilichonse choyesa matenda, dokotala wanu ndi munthu wabwino kwambiri amene muyenera kukambirana naye zotsatira za kuyesa kwa spirometry ndipo yekhayo amene angakupatseni chidziwitso cholondola.
Pali njira zingapo zomwe zimagwiritsidwa ntchito kutanthauzira-zomwe dokotala wanu amagwiritsa ntchito ndi nkhani yokonda. Chofunika kwambiri pamayeso onse a spirometry ndi kuti amachitika molondola ndipo kuti mayeserowa amatanthauziridwa molondola komanso mwachindunji ndi wodwala wophunzitsidwa.
Njira zotsatirazi ndi njira imodzi yokha yomasulira zomwe dokotala angagwiritse ntchito. (Icho chiyenera kuti chidziwitso chokha komanso musamalowetsedwe uphungu wamankhwala wochokera kwa wothandizira zaumoyo wanu.)
- Khwerero 1: Yang'anani FVC yanu kuti muone ngati ndi zachilendo.
- Khwerero 2: Yang'anani FEV1 anu kuti awone ngati ndi zachilendo.
- Khwerero 3: Ngati FVC yanu yonse ndi FEV1 zili zachilendo, muli ndi mayeso abwino ndipo mukhoza kuyima pa sitepe iyi.
- Khwerero 4: Ngati FVC yanu ndi / kapena FEV1 yanu ili yochepa, ndiye kuti mukhoza kukhala ndi matenda a mapapu ndi mayeso ena kuti muyese izi.
- Khwerero 5: Ngati Gawo 4 likuwonetsa matenda omwe angatheke m'mapapu, yang'anirani% zanenedweratu za FEV1 / FVC yanu. Ngati ndi 69 peresenti kapena zochepetsetsa, ayenera kudandaula kuti matendawa ndi oletsedwa. Ngati ndi 85 peresenti kapena apamwamba, ndiye kuti matenda opatsirana ammimba ayenera kuganiziridwa.
Nthaŵi zambiri, anthu amapita ku spirometry ndikukayikira ngati zotsatirazo ziri zolondola. Inde, pali zinthu zina zomwe zingakhudze mtima wanu wa spirometry mwa njira zochepa.
Kuzindikira kulemera kwa COPD
Madokotala amagwiritsanso ntchito spirometry kuti adziwe kuopsa kwa COPD. Ngakhale pali njira zambiri zomwe mungasankhe, tebulo ili m'munsiyi ndi njira yovomerezeka ndi Global Initiative for Obstructive Lung Disease (GOLD).
Zotsatira zanu zowunikira zikufaniziridwa ndi matebulo oyenera, zikhalidwe zomwe zanenedweratu zomwe zimagwiritsa ntchito ziwerengero za anthu monga zaka, chilili, kukula kwa thupi, ndi mtundu monga njira yowunikira. Chiwerengerochi chinanenedwa, monga momwe amatchulidwiramo, amapereka madokotala chida choyerekeza zotsatira za zotsatira zanu ndi zotsatira zomwe zimapezeka kwa anthu omwe ali ndi mapapu abwino.
| GOLD Zowonjezera Zowonjezera Zokwanira za COPD | ||
| I. Wofatsa COPD | * FEV1 / FVC <0.7 * FEV1> / = 80% adaneneratu | Panthawiyi, wodwalayo mwina sakudziwa kuti mapapu akuyamba kuchepa |
| II. COPD yapakati | * FEV1 / FVC <0.7 * 50% | Zizindikiro panthawiyi zikupita patsogolo, ndi mpweya wochepa ukayamba kuchita khama. |
| III. COPD yolimba | * FEV1 / FVC <0.7 * 30% | Mpweya wochepa umakhala woipitsitsa panthawiyi ndipo kuwonjezeka kwa COPD kuli kofala. |
| IV. COPD Yopambana kwambiri | * FEV1 / FVC <0.7 * FEV1 <30% ananeneratu kapena FEV1 <50% akudziwika kuti akulephera kupuma | Makhalidwe abwino pa gawo ili ndi ovuta kwambiri. Kuchulukitsa kwa COPD kungakhale koopsa. |
Zotsatira zoyesera za Spirometry zikhoza kuwerengedwa kawiri, zonse zisanayambe ndi pambuyo poyambitsa bronchodilator. Malingana ndi American Thoracic Society , ngati pali osachepera 12 peresenti ndi 200-milliliter kusintha kuchokera mzere woyamba pambuyo bronchodilator FEV1 mu awiri mwa atatu pa spirometry miyeso, inu amati amayankha kwambiri kwa bronchodilator. Izi ziyenera kugwirizana ndi momwe mumayankhira bwino kuchipatala-chinthu chofunika kwambiri cholosera.
Mayesero Ena
Kuphatikizana ndi spirometry, mayeso ena awiri a mapiritsi ndi ofunika kwambiri pa matenda a mapapo:
- Maphunziro osiyana -This PFT imakuuzani momwe mpweya umene mumapuma umalowerera m'magazi anu.
- Thupi lopemphana-Thupi lomwe limatsimikizira kuti mpweya ulipo bwanji m'mapapu anu pamene mutenga mpweya wakuya komanso momwe mpweya umasiyamo m'mapapu anu mutatha kutulutsa zonse zomwe mungathe.
> Zotsatira:
Northern Arizona University. Ntchito Yowonongeka.
Mchitidwe Wadziko Lonse Wofufuza, Kuteteza, ndi Kuteteza COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2010.