Chifuwa ndi chifukwa chachikulu chomwe anthu amapita kwa dokotala wawo wamkulu. Nthawi zina, chifuwa chakhala patatha masabata osachepera atatu ndipo chimatchedwa "chifuwa chachikulu." Chifuwa chomwe chakhala pakati pa masabata atatu ndi asanu ndi atatu chimatchedwa "chifuwa chachikulu." Ndipo kukokera kumene kwachitika Masabata oposa asanu ndi atatu amatchedwa "chifuwa chachikulu."
Ngakhale kuti anthu ena akhala akutsokomola kwa zaka zambiri, chifukwa cha chifuwachi chikhoza kutsimikiziridwa pafupifupi 90% mwa milanduyi.
Mankhwala a chifuwa amatha kupambana 85%, ndipo motero, mankhwala ayenera kugwiritsidwa ntchito pazifukwa zenizeni, osati mankhwala okhaokha ophimba kanthawi.
N'chiyani Chimachititsa Chigumula?
Chifukwa cha chifuwa chimadalira momwe chiwonetsero chakhalapo kwa nthawi yayitali bwanji. Mwachitsanzo, zomwe zimayambitsa chifuwa chachikulu zimakhala zosiyana kwambiri ndi zomwe zimayambitsa chifuwa chachikulu. Pafupifupi 25 peresenti ya matenda a chifuwa chachikulu, pali mankhwala ocheperachepera awiri omwe amachititsa chifuwa mwa munthuyo.
N'chiyani Chimachititsa Chimwala Chokwanira?
Zomwe zimayambitsa chifuwa chachikulu ndizo:
- Chimfine
- Acute sinusitis
- Pertussis (akufuula chifuwa)
- Matenda osokoneza bongo omwe amachititsa kuti matendawa asapitirire ( COPD )
- Allergic rhinitis
- Osagwirizana ndi rhinitis
Choyambitsa chifuwa chachikulu chimakhala chodziwika ndi mbiri ya munthu ndi kuunika kwake. Akatswiri ena amagwiritsa ntchito mankhwala oletsa antihistamine / decongestant (monga Dimetapp kapena otero generic) pochizira chifuwa chachikulu chifukwa cha chimfine.
Mankhwala atsopano antihistamines / decongestants, monga Claritin-D (loratadine / pseudoephedrine), samaoneka ngati othandiza.
Anthu omwe amapitirizabe kusuta ngakhale kuti amachizidwa ndi chimfine, kapena omwe ali ndi zizindikiro zina za sinusitis, amapatsidwa mankhwala omwe amachititsa sinusitis ngati chifukwa cha chifuwa chachikulu.
Ana amawoneka kuti amakhala ndi chifuwa ngati chizindikiro chokha cha matenda a sinus.
Anthu omwe ali ndi vuto la COPD (emphysema kapena bronchitis) akhoza kukhala owonjezereka ndi kuwonjezeka kwa chifuwa, kupuma kwafupipafupi, kupuma ndi kusintha kusintha kwa ntchentche ndi mtundu. Maantibayotiki amaperekedwa kwa anthuwa ndi chifuwa chachikulu.
Chifuwa , kapena Pertussis, chikuwonjezeka kwambiri m'madera ena, ndipo katemera sikuti amapereka chitetezo chathunthu. Anthu omwe ali ndi Pertussis adzakhala ndi zipsyinjo zovuta kutsokomola, nthawi zambiri ndi kusanza pambuyo pa chifuwa. Kuchiza ndi maantibayotiki kumathandiza ngati kuperekedwa mwamsanga ku matenda; Apo ayi, chifuwa chingakhale chachilendo ndipo chimatha milungu ingapo.
Matendawa amachititsanso chifuwa chokhudzana ndi kupweteka kwa msana (kutuluka kwa mphuno kumbuyo kwa mphuno kummero). Komabe, izi zingakhale chifuwa chosiyana kwambiri kuchokera pamwambapa komanso kupweteka kwa khosi. Allergic rhinitis idzayankha njira zochizira zosiyana siyana koma nthawi zina sizingatheke kuti zitha kuchitapo kanthu ndi mankhwala otupa thupi kapena mankhwala opatsirana.
Zovuta zochepa, koma zoopsa, zimayambitsa chifuwa chachikulu zimaphatikizapo mtima wosalimba , kupuma kwa pulmonary , chibayo ndi kupeza chinthu chachilendo chokhala m'mapapo ( aspiration ).
Kodi N'chiyani Chimayambitsa Kuthwa Kwambiri?
Chifukwa cha chifuwa chomwe chakhala pakati pa masabata atatu ndi asanu ndi atatu, zomwe zimayambitsa izi ndi izi:
- Chifuwa chotenga matenda
- Acute sinusitis
- Phumu
Chifuwa choterechi chimakhala chifuwa chimene chakhalapo pambuyo pa chimfine kapena matenda ena amtundu wa kupuma, omwe mulibe chibayo. Zingakhale zotsatira za kumbuyo kwa msana kapena bronchitis. Zizindikirozi zingathetsere popanda mankhwala kapena zikhoza kukhala sinusitis yovuta yomwe imadalira maantibayotiki. Akatswiri ena amapereka mayeso a combongestant / antihistamine kuphatikiza (Dimetapp kapena otero generic) kwa sabata imodzi, ndipo ngati izi zikulephera, kuyesa kwa mankhwala opha tizilombo.
Ngati munthu akudandaula za kupuma pang'ono, kupuma, kapena chifuwa, ndiye kuti mphumu ikhoza kuyambitsa chifuwa. Momwemo mankhwala opatsirana a mphumu amatha kuperekedwa.
Kodi N'chiyani Chimayambitsa Chisamba Chokhalitsa?
Chifuwa chosatha kwa milungu yoposa 8 chimatchedwa chifuwa chachikulu. Anthu ena akhoza kukhala ndi chifuwa chachikulu kwa zaka zambiri, ndipo mankhwala sangapambane. Kwa anthu awa, kutumizira kwa munthu wotsutsa kapena wodwala mankhwala (dokotala yemwe amadziwika bwino m'mapapo) ayenera kupangidwa, monga chithandizo cha zamankhwala chingakhale chofunikira.
Zomwe zimayambitsa chifuwa chachikulu ndi izi:
- Mphuno yamphongo (yomwe imachokera kumbuyo kwa mphuno mpaka kummero)
- Phumu (ndi chifuwa-chosiyana mphumu)
- Matenda a reflux a Gastroesophageal (GERD)
- Eosinophilic bronchitis
- Mankhwala opangidwa ndi mankhwala ( ACE inhibitors )
- Kusuta
Akatswiri ambiri amalimbikitsa kukonza chifuwa cha X-ray ndi katsulo kamene kali ndi kachilombo koyambitsa matenda. Akatswiri (allergists ndi pulmonologists) adzayesanso mayeso apadera a mphumu. Pamene chifuwa cha X-ray chiri chachilendo, ndiye kuti pamwambapa zimapangitsa kuti ambiri azidwala matenda okhwima.
Dokotala adzachita kafukufuku wambiri ndi thupi, zomwe zingapereke zifukwa zowononga chifuwa chachikulu. Nthawi zina, zingakhale zofunikira kupereka mayesero a chithandizo cha pamwambapa, pamene kuyeza kwa thupi sikungapereke chitsimikizo pa chifukwa cha chifuwa.
Malingaliro ndi mankhwala. Anthu omwe amasuta kapena omwe amavutitsidwa kuntchito kapena zokondweretsa ayenera kupewa izi. Mankhwala monga ACE inhibitors (mankhwala ozunguza magazi monga lisinopril ndi ena ambiri, ndi mayina omwe amatha kukhala "pril") amadziwika bwino chifukwa cha kukopa ndipo ayenera kusinthidwa ndi dokotala kwa mankhwala osiyanasiyana. Chifuwa chingakhale kwa milungu isanu ndi umodzi mutatha kuyimitsa ACE inhibitor.
Kuthamanga kwa nsana. Izi ndizimene zimayambitsa chifuwa chachikulu. Kuthamanga kwa nsagwada , ngati kulipo pambiri (kupweteka kwa khosi) kapena pa kuunika kwa thupi, kukhoza kuchitidwa ndi combongestant / antihistamine kuphatikiza (monga pamwamba pa chifuwa chachikulu) ndi mankhwala a nasal spray (monga nasal steroid). Ngati mankhwalawa sakuthandiza, zingakhale zofunikira kuonetsetsa kuti kutaya kwa msana sikuchitika chifukwa cha matenda opatsirana pogwiritsa ntchito katemera wa katemera.
Phumu. Nthendayi ndi yachiwiri chifukwa cha chifuwa chachikulu. Chifuwa chikhoza kukhala chizindikiro chokha cha mphumu, ngakhale kuti anthu ambiri amadandaula za kupuma komanso kupuma pang'ono. Mayesero apadera, kuphatikizapo spirometry ndi maphunziro a bronchoprovocation, angathandize kudziwa ngati chifuwa chimachitika chifukwa cha mphumu. Komabe, mayeserowa akhoza kukhala achilendo, choncho mayesero a asthma therapy (monga steroid yosakanizidwa) angafunikire kwa pafupifupi miyezi 1-2.
GERD. GERD ndilochitatu chifukwa cha chifuwa chachikulu, ndipo ambiri omwe ali ndi chifuwachi samadziwa kuti ali ndi GERD. Mtundu wina wa GERD, wotchedwa laryngopharyngeal reflux (LPR), amachititsa chifuwa ndi mawu otukumula ndi kumbuyo kwa khosi. Kuyeza kwapadera kungachitidwe kwa GERD ndi LPR, koma mwa mitundu yomwe imayambitsa chifuwa, izi zingakhale zodula komanso zosasangalatsa. Chiyeso cha mankhwala kwa GERD ndi LPR (mankhwalawa ndi ofanana), kawirikawiri kwa masabata ambiri mpaka miyezi, angafunikire kuti chifuwa chikhazikitsidwe.
Eosinophilic bronchitis. Mtundu uwu wa chifuwa chachikulu umapezeka pakati pa anthu 13 peresenti ndipo amatha kupezeka ndi kuyang'ana pamutu wa munthuyo (phlegm) pansi pa microscope. Chifukwa palibe mayesero omwe amapezeka kuti apeze chifuwachi, mayesero a steroid (osaphatikizapo miyezi 1-2) nthawi zambiri amakhala mbali ya mankhwala operekedwa kwa munthu amene ali ndi chifuwa chachikulu pamene vutoli silikuwonekera mosavuta.
Ngati chifuwa chikupitirizabe ngakhale mutatchula pamwambapa, kutumiza kwa katswiri (wodwalayo kapena wodwala pulmonologist) angafunike kuti apitirize kuyesa. Zovuta zochepa zomwe zimayambitsa chifuwa chachikulu zimakhala chifuwa cha chizoloŵezi (nthenda yotchedwa tic), khutu la khutu (kapena thupi linalake) kumvetsera, Tourette's syndrome , mitundu yosiyanasiyana ya khansa ya m'mapapo , kulephera kwa mtima, matenda a m'mapapo, ndi zina zotero.
> Zotsatira:
> Irwin RS, Madison JM. Kuzindikira ndi Chithandizo cha Chilakolako. N Engl J Med. 2000; 343: 1715-21.
> Weldon Kusiyanitsa Kusiyanasiyana kwa Chida Chokhalitsa. Zotsatira za kupatsirana ndi mphumu Proc. 2005; 26: 345-51.