Malingana ndi Global Initiative for Chronic Obstructive Lung Disease (GOLD), matenda omwe amachititsa kuti matendawa asapitirire (COPD) ayenera kuganiziridwa mwa wodwala aliyense yemwe ali ndi mpweya wochepa, chifuwa cha nthawi yaitali kapena kupanga ziphuphu, ndi / kapena mbiri kuwonetsa zoopsa za COPD , monga kusuta fodya, kutsekemera kwa ziphuphu zakumapapu monga mankhwala, kuipitsa mpweya, kapena utsi wothandizira, kapena zinthu zomwe zimayambitsa matenda.
Komabe, kugonana kwa COPD kungakhale kophweka chifukwa kuli ndi zizindikiro zofanana ndi matenda ena ndipo zingadziwonetsere mosiyana ndi munthu aliyense.
Mapulogalamu ndi Mayesero
Ngati dokotala akudandaula kuti muli ndi COPD, iye akhoza kupeza mbiri yanu yathanzi, kuchita zochitika zathupi, ndikuyesera kuti atsimikizire kapena kutulutsa COPD.
Mbiri ndi Thupi
Kuwunika kwanu kudzayamba ndi kuyang'ana mwatsatanetsatane mbiri yanu. Izi zikuphatikizapo kuyang'ana zotsatirazi:
- Zochitika zanu zam'mbuyo ndi zam'mbuyo zomwe zimakhala zoopsa monga kusuta fodya, kusuta fodya , kusokoneza mpweya , ndi / kapena kugwira ntchito ku fumbi, mpweya, ndi mankhwala.
- Mbiri yanu ya zachipatala, makamaka m'mene ikukhudzira matenda a mphumu monga chifuwa cha mphumu, chifuwa, sinusitis, ndi / kapena matenda opuma pamene muli mwana.
- Asanapite kuchipatala, makamaka ngati akugwirizana ndi matenda opuma.
- Ngati wina m'banja lanu adakhalapo ndi COPD kapena matenda ena ammapapu.
- Ngati muli ndi matenda ena omwe alipo, monga matenda a mtima kapena osteoporosis, omwe angapangitse kuti matenda a COPD athane.
- Chitsanzo cha chitukuko chanu cha matenda, kuphatikizapo zizindikiro zanu zoyambira ndi momwe mudadikirira musanayambe kuchipatala.
- Zotsatira za zizindikiro zanu m'moyo wanu wa tsiku ndi tsiku. Mwachitsanzo, ngati zizindikiro zanu zapangitsa kuti muphonye ntchito, musamachepetse ntchito zanu nthawi zonse, kapena muzimva chisoni kapena nkhawa.
Dokotala wanu ayeneranso kufufuza bwinobwino zomwe zingaphatikizepo:
- Kutenga kutentha kwanu, kuthamanga, kupuma kwa mphindi, kuthamanga, ndi kuthamanga kwa magazi.
- Kumvetsera mtima ndi mapapo anu ndi stethoscope.
- Kufufuza makutu anu, mphuno, maso, ndi mmero kwa zizindikiro za matenda.
- Kupenda zala zanu zizindikiro za cyanosis ndi clubbing (pamene mapeto a zala zanu akufutukulidwa).
- Kuyezetsa zizindikiro za kutupa m'milingo, kumapazi, mapazi, kapena ziwalo zina za thupi lanu.
- Kufufuza mitsempha yanu m'khosi kuti muyese zovuta za COPD monga cor pulmonale (kulephera kwa mtima wanu).
Spirometry
Kuyesedwa kwa spirometry kumafunika kuti apange chithandizo chachipatala cha COPD ndipo ndicho chida chachikulu choyesa kuwona kukula kwa COPD. Mayeso a spirometry amawoneka makamaka pazitsulo zinayi zofunika za mapapu, kuphatikizapo:
- Ndi mpweya wochuluka bwanji womwe umatha kupuma mofulumira mutatha kupuma mozama (kudziwika ngati mphamvu yolimbikitsidwa, kapena FVC).
- Ndi mpweya wochuluka bwanji womwe ungathe kutulutsa mwachindunji mumphindi imodzi (yotchedwa voliyumu yofufuzira mu mphindi imodzi, kapena FEV1 ).
- Kuchuluka kwa mpweya kumatsalira m'mapapu anu mutatha kutuluka (kutchedwa chiŵerengero cha FEV1 mpaka FVC ).
- Mtengo wonse wa mpweya m'mapapu anu (omwe amadziwika kuti mphamvu yamapapo, kapena TLC ).
Pamodzi, miyeso iyiyi sikuti imangonena momwe kuwonongeka kwachitidwa m'mapapu anu koma njira zomwe mungakwaniritsire zotsatira za nthawi yaitali ngati muli ndi COPD. Kuperewera kwa mpweya wa mpweya, kapena COPD, kumatsimikiziridwa pamene zotsatira za mayeso zimasonyeza FEV1 / FVC zosakwana 0,70 mutagwiritsa ntchito bronchodilator .
Ntchito Zowonjezera Zowonjezereka (PFTs)
Kuwonjezera pa spirometry, palinso mayesero ena awiri a mapulmasi omwe ali ofunikira pofufuza mapapu akugwira ntchito mu COPD: kuyesa kufalikira kwa mapapo ndi thupi la plethysmography. Kuyezetsa uku kukuyesa kuchuluka kwa mpweya wanu monoxide m'mapapu anu omwe amatha kukonzekera ndi kuchuluka kwa mpweya m'mapapu anu pamapweya osiyanasiyana, motero, kuwonetsera momwe COPD yanu ilili.
Complete Blood Count (CBC)
Ngakhale kuyesa kwa magazi sikuthetsa matenda a COPD, kuchuluka kwa magazi (CBC) kudzazindikira dokotala wanu ngati muli ndi matenda, komanso kusonyeza, mwa zina, kuchuluka kwa hemoglobin m'magazi anu. Hemoglobini ndi pigment yonyezimira m'magazi anu omwe amanyamula oksijeni m'mapapu anu kupita ku thupi lanu lonse.
Pulse Oximetry
Mankhwala osokoneza bongo ndi njira yosagwiritsira ntchito poyeza momwe zimapangidwira ndi mpweya wanu. Pulojekiti kapena sensa nthawi zambiri imamangirizidwa chala chako, pamphumi, earlobe, kapena mlatho wa mphuno zako. Maola ochepa omwe amatha kupitirira amatha kukhala opitilira kapena osakanikirana ndipo chiwerengero cha 95 peresenti pa 100 peresenti chimaonedwa kuti n'choyenera. Ngati muli pansi pa 92 peresenti, dokotala wanu angafunike kuchita kafukufuku wa magazi (ABG). Pamodzi ndi ABGs, kuyerekezera mpweya wanu wa oxygen pogwiritsa ntchito mapulaneti oximetry kumathandiza dokotala wanu kuzindikira momwe mukufunikira thandizo la okosijeni.
Magazi Amagazi Amagazi
Mu COPD, kuchuluka kwa mpweya umene mumapuma ndi kutuluka m'mapapu anu ndi kovuta. Magetsi a m'magazi amayeza oxygen ndi carbon dioxide m'magazi anu ndipo amazindikira kuti thupi lanu ndi pH ndi sodium bicarbonate. ABGs ndi ofunikira popanga matenda a COPD komanso pozindikira kufunika kwa kusintha kwa mlingo wa mankhwala oyenera okosijeni.
Kuloweza kwa Alpha-1-Antitrypsin
Ngati mumakhala m'dera limene anthu ambiri ali ndi vuto la alpha-1-antitrypsin (AAT), World Health Organization (WHO) ikukulimbikitsani kuti muyesedwe matendawa ndi mayeso a magazi. Ndipotu, WHO imalimbikitsa kuti aliyense yemwe anapezeka ndi COPD ayenera kufufuzidwa kuti asaperekere kwa AAT kamodzi.
Kulephera kwa AAT ndi matenda omwe angapangitse COPD. Kudziwa kuti ali ndi zaka zing'onozing'ono (osakwana zaka 45) uyeneranso kuchenjeza madokotala kuti mwina AAT ilibe vuto ndi chifukwa cha COPD yanu. Chithandizo cha COPD chomwe chimayambitsidwa ndi kufooka kwa AAT ndi chosiyana ndi chithandizo choyenera komanso chimaphatikizapo mankhwala opatsirana .
Kujambula
Dokotala wanu akhoza kupanga zojambula zina ndikuthandizira kutulutsa kapena kupeza COPD.
Chifuwa cha X-ray
Chifuwa cha X-ray chokha sichitha kupeza matenda a COPD. Dokotala wanu akhoza kulamula mmodzi poyamba, komabe, kuti awonetse zifukwa zina za zizindikiro zanu kapena kutsimikizira kukhalapo kwa chikhalidwe cha comorbid . Chifuwa cha X-ray chingagwiritsidwenso ntchito nthawi zonse mu mankhwala anu kuti muwone momwe mukuyendera.
Kusinkhasinkha Tomography (CT)
Ngakhale kuti CT siyodalitsika mukadziŵa kuti muli ndi COPD, dokotala wanu akhoza kulamula imodzi pamene ikusonyezedwa. Mwachitsanzo, mungakhale ndi kansa ya kansa ngati muli ndi matenda omwe sali kuthetsa, zizindikiro zanu zasintha, dokotala wanu akudandaula kuti muli ndi khansara yamapapo, kapena ngati mukuganiziridwa kuti mukuchitidwa opaleshoni. Ngakhale chifuwa cha X-ray chimasonyeza mbali zazikulu zamakono m'mapapu, kansalu ya CT imakhala yowonjezereka, yosonyeza bwino kwambiri zomwe X-ray sichifuwa. Nthawi zina, musanayambe kujambulidwa ndi CT, mumatulutsa mankhwala omwe amatchedwa kusiyana. Izi zimapangitsa dokotala wanu kuona zosaoneka bwino m'mapapu anu.
Kusanthula Kusiyanasiyana
Pali zambiri zamankhwala zomwe zingapezeke mosavuta ndi kuyezetsa magazi kapena kuyeza thupi. Zina siziri zophweka. Nthawi zina, sipadzakhalanso mayesero kapena njira zomwe zingathe kutsimikizira kapena kupeleka kukhalapo kwa matenda. COPD ndi imodzi mwa matendawa. Ngakhale mayeso osiyanasiyana opuma, monga spirometry , angathe kutsimikizira zizindikiro za matendawa, iwo okha sangathe kutsimikizira kuti ali ndi matendawa.
Pachifukwa ichi, adokotala ayenera kuchita zomwe zimatchedwa kusiyana ndi matenda . Iyi ndiyo njira yomwe zifukwa zina zonse zimayambitsira matendawa. Pokhapokha ngati ndondomekoyo yatha, chiwerengero cha COPD chiyenera kukhala chotsimikizika.
Kuzindikiritsa kwapadera ndikofunika kuti atsimikizire COPD chifukwa imakhalabe matenda ovuta kwambiri. Ngakhale kuti COPD imakhudzana kwambiri ndi kusuta fodya, sikuti onse osuta ali ndi COPD ndipo si onse omwe ali ndi COPD amasuta fodya.
Komanso, zizindikiro ndi maonekedwe a matendawa ndi osiyana kwambiri. Mwachitsanzo, munthu amene mayesero a spirometry sakuwonekera akhoza kukhala ndi zizindikiro zoopsa za COPD . Mosiyana, munthu amene ali ndi vuto lalikulu akhoza kuthana ndi zizindikiro zochepa ngati zilipo.
Kusiyana kumeneku kumafuna madokotala kuti ayang'ane matendawa mosiyana. Ndipo, popeza sitinamvetsetse chomwe chimayambitsa COPD, madokotala amafunikira chitetezo chodziwikiratu kuti atsimikizidwe kuti ali ndi matenda oyenera.
Izi ndizowona makamaka kwa anthu okalamba omwe matenda a mtima ndi mapapo angayambitse chilolezo. Pogwiritsa ntchito mwala uliwonse, madokotala amatha kupeza zenizeni (osati kuganiza) chifukwa cha matenda opuma, omwe ena amatha kuchiritsidwa.
Pazidziwitso zosiyana, zina mwafukufuku wamba zimaphatikizapo mphumu, congestive mtima kulephera, bronchiectasis, chifuwa chachikulu, komanso bronchiolitis. Malingana ndi thanzi ndi mbiri ya munthu, zifukwa zinanso zingayambidwe.
Phumu
Chimodzi mwa zosiyana kwambiri ndi matenda a COPD ndi mphumu . Kawirikawiri, zinthu ziwirizi sizingatheke kuzigawa, zomwe zingachititse kuti kasamalidwe kavutike chifukwa maphunzirowa ndi osiyana kwambiri. Makhalidwe omwe ali ndi mphumu ndi awa:
- Amayamba kawirikawiri m'moyo (poyerekeza ndi COPD, zomwe zimachitika m'tsogolo)
- Zizindikiro zimasiyana tsiku ndi tsiku, nthawi zambiri zimatuluka pakati pa zigawenga
- Mbiri yodziwika bwino ya mphumu yafala
- Zilonda, rhinitis, kapena eczema nthawi zambiri zimapezeka
- Kuperewera kwa kayendedwe ka ndege kumakhala kotembenuzidwa, mosiyana ndi COPD
Kusweka kwa Mtima Wokondwerera
Kulephera kwa mtima waumtima (CHF) kumachitika pamene mtima wako sungathe kupopera magazi okwanira kupyolera mu thupi kuti zinthu zonse zizigwira ntchito bwinobwino. Izi zimayambitsa kusungira madzi m'mapapu anu ndi ziwalo zina za thupi lanu. Zizindikiro za CHF zimaphatikiza chifuwa, kufooka, kutopa, ndi kupuma pang'ono ndi ntchito. Makhalidwe ena a CHF ndi awa:
- Manyowa abwino amamveka ndi stethoscope.
- Chifuwa cha X-ray chimasonyeza madzi ambiri ndi kuchepetsa minofu ya mtima.
- Kuyeza kwapulogalamu yamakono imasonyeza kuvomerezedwa kwa voliyumu (mosiyana ndi chilolezo cha mpweya chomwe chimapezeka mu COPD).
Bronchiectasis
Matenda a Bronchiectasis ndi matenda osokoneza bongo omwe amatha kubereka (omwe ali ndi kubadwa) kapena chifukwa cha matenda a ubwana monga chibayo, chikuku, chimfine, kapena chifuwa chachikulu. Bronchiectasis ikhoza kukhala yokha kapena kuchitika pamodzi ndi COPD. Makhalidwe a bronchiectasis ndi awa:
- Kupanga kuchuluka kwa sputum
- Matenda osakanikirana a bakiteriya matenda
- Mbalamezi zimamveka kudzera pa stethoscope
- Chida cha x-ray chimaphatikizapo mababu opangidwa ndi chifuwa chachikulu komanso makoma okhwima
- Kupanga zala zala
Chifuwa chachikulu
Chifuwa chachikulu (TB) ndi matenda opatsirana kwambiri owopsa chifukwa cha tizilombo toyambitsa matenda Mycobacterium tuberculosis . Ngakhale kuti TB imakhudza mapapo, imatha kufalikira kumadera ena a thupi, kuphatikizapo ubongo, impso, mafupa, ndi ma lymph nodes.
Zizindikiro za TB zimaphatikizapo kulemera kwa thupi, kutopa, chifuwa chopitirira, kupuma kupweteka, kupweteka pachifuwa, ndi matenda otupa kapena amagazi. Zizindikiro zina za TB zikuphatikizapo:
- Matenda amayamba kuchitika pa msinkhu uliwonse
- Chifuwa x-ray chimasonyeza malo odzaza ndi madzi
- Kuyeza magazi kapena kupopera kumatsimikizira kuti alipo TB
- Kawirikawiri amawonedwa mkati mwawudzi kapena amawonetsa ngati mbali ya chiwopsezo
Bronchiolitis yosavomerezeka
Bronchiolitis yosavomerezeka ndi mtundu wochepa wa bronchiolitis umene ungakhale wowopsya. Zimapezeka pamene ndime zazing'ono za m'mapapo, zomwe zimatchedwa bronchioles, zimawotchedwa komanso zimawopsya, zomwe zimapangitsa kuti pang'onopang'ono kapena kutseka. Zina mwa makhalidwe a bronchiolitis oletsedwa ndi awa:
- Amapezeka nthawi yaying'ono osakhala osuta
- Zikhoza kukhala mbiri ya nyamakazi ya nyamakazi kapena kutsekemera kwa zitsamba zoopsa
- CT ikuwonetsa malo omwe amachititsa kuti thupi likhale lopanda matenda
- Kukaniza kwa ndege, monga kuyerekezedwa ndi FEV1 , kungakhale kotsika kwambiri kwa 16 peresenti
Maphunziro ndi Magulu a COPD
Monga matenda opitirirabe, COPD imadziwika ndi magawo a matenda omwe angakuthandizeni kudziwa zomwe muyenera kuyembekezera panthawiyi, ngakhale kuti siteji yanu sichidziwa momwe mungachitire ndi mankhwala. Kuti mudziwe malo anu, madokotala adzatchula dongosolo loyamba la Global Initiative for Chronic Obstructive Lung Disease (GOLD), lomwe limagawaniza kukula kwa matenda m'zigawo zinayi zosiyana zomwe zimayesedwa ndi testometry.
Kalasi 1: Wofatsa COPD
Ndi kalasi yoyamba ya COPD, muli ndi malire a mpweya koma inu simudziwa. Nthaŵi zambiri, sipangakhale zizindikiro za matenda kapena zizindikiro zidzakhala zochepa kwambiri kuti zikhale ndi zifukwa zina. Ngati alipo, zizindikiro zingaphatikize chifuwa chokhazikika ndi kuwonetsa kasupe (mankhwala osakaniza ndi ntchentche). Chifukwa cha zizindikiro zochepa, anthu panthawiyi safuna kupeza chithandizo.
Kalasi yachiwiri: Yoyera COPD
Ndili ndi grade 2 COPD, kuchepa kwa mpweya wanu kukuyamba kuwonjezereka, ndipo zizindikiro za COPD zimaonekera kwambiri. Zizindikirozi zingaphatikizepo chifuwa chokhazikika, kuchulukitsidwa kwa mankhwala a sputum, ndi kupuma pang'ono pa ntchito yaing'ono. Izi ndizochitika pamene anthu ambiri akufuna chithandizo.
Kalasi 3: Oposa COPD
Pogwiritsa ntchito COPD yachitatu, kuletsedwa ndi / kapena kulepheretsa ndime zanu zapansi zikuonekeratu. Mudzapeza kuwonjezereka kwa zizindikiro zoopsa, kudziwika kuti kuchulukitsidwa kwa COPD , komanso kuwonjezeka kwafupipafupi ndi kuuma kwa chifuwa. Sikuti mudzangokhala olekerera pokhapokha pochita masewera olimbitsa thupi, padzakhalanso kutopa ndi chifuwa chachikulu.
Kalasi 4: COPD Yopambana kwambiri
Pogwiritsa ntchito COPD ya 4, umoyo wanu udzasokonezeka kwambiri ndi zizindikiro kuyambira pakufika poopsya. Kuopsa kwa kupuma kwapachilombo kumafika pa matenda a grade 4 ndipo kungayambitse mavuto m'mtima mwako, kuphatikizapo matenda omwe angapweteke otchedwa cor pulmonale .
Magulu a COPD
GOLD imatuluka ndi malangizo kuti apitirize kugawa odwala omwe ali ndi COPD m'magulu otchedwa A, B, C, kapena D. Magulu awa akufotokozedwa ndi momwe mavuto akuluakulu a COPD aliri monga kutopa, kupuma pang'ono, zizindikiro zochuluka zomwe zimakulepheretsani tsiku ndi tsiku, ndi kuchuluka kwa zovuta zomwe mwakhala nazo chaka chatha. Kugwiritsa ntchito maphunzilo onse ndi magulu kungathandize dokotala kuti adze dongosolo labwino la chithandizo pa zosowa zanu.
Gulu A
Simunakhale ndi zovuta kapena zochepa chabe zomwe sizinkafunikire kuchipatala, chaka chatha. Muli ndi mpweya wochepa, wofooka, ndi zizindikiro zina.
Gulu B
Inu simunakhalepo kapena kuwonjezereka kokha kamodzi kosafuna kuti chipatala chikhale chaka chakale. Muli ndi mpweya wochepa kwambiri, kutopa, ndi zizindikiro zina.
Gulu C
Muli ndi zovuta zambiri zomwe zimafuna kuzipatala kapena zovuta ziwiri kapena zina zomwe zingakhale zosayenera ku chipatala chaka chatha. Zizindikiro zanu za COPD ndi zofatsa mpaka zochepa.
Gulu D
Muli ndi vuto linalake lachipatala kapena zovuta ziwiri kapena zoonjezera zomwe muli nazo kapena popanda chipatala chaka chatha. Zizindikiro zanu za COPD ndizovuta kwambiri.
> Zotsatira:
> Njira Yoyamba Yopeweratu Matenda Opatsirana. Mchitidwe Wadziko Lonse Wofufuza, Kuteteza , ndi Kuteteza Matenda Osawononga Zachilombo: Zizindikiro za 2018 . Lofalitsidwa November 20, 2017.
> Chipatala cha Mayo Clinic. COPD: Kuzindikira ndi Chithandizo. Chipatala cha Mayo. Idasinthidwa pa August 11, 2017.
> National Heart, Lung, ndi Blood Institute. COPD. National Institute of Health. Dipatimenti ya Zaumoyo ya Ukhondo ku United States.