Ingabe Ungumuntu Okhethwe I-Bronchial Thermoplasty?
Ingabe wayazi ukuthi manje inqubo engeyona yezidakamizwa etholakalayo uma une- asthma ephikisanayo engavunyelwe kahle nge- corticosteroids engatholakali nama -agonists asebenza isikhathi eside ? Eqinisweni, uhlelo lwe-Alair Bronchial Thermoplasty lwathola i-2010 Science Science "Best of What's New" esigabeni sezeMpilo sokuthuthukiswa kwalolu buchwepheshe.
I-thermoplasty ye-bronchial isifo sokuphulukisa (okusho ukuthi iziguli eziningi zifika ekhaya futhi zilele embhedeni wazo) inqubo ye-bronchoscopic eyanciphisa ikhono le-airways yakho ukuba iminyene futhi iminyene uma ubhekene nezimbangela eziholela ekuhlaselweni kwe-asthma . I-thermoplasty ye-Bronchial yinqubo eyenza amandla okushisa emaphashini weziguli ezine-asthma ukuze kunciphise inani le-muscle elibushelelezi emaphashini, imisipha eholele ekutheni i-bronchoconstriction nezimpawu ze-asthma . Iziguli zithola ukulawulwa kangcono kwesifuba somoya ngenxa yokuthi amaphaphu akakwazi ukugxila kakhulu futhi asebenze ngamandla ngokubangela izifo ze-asthma.
Uhlelo lwe-Alair Bronchial Thermoplasty luyanciphisa umfutho we-airway obushelelezi ngokweqile ngokuqondisa amandla okushisa emaphashini ngokuqondile. I-thermoplasty ye-bronchial ivame ukuqhutshwa ngaphansi kwesilwane esilinganiselwe nesiguli ngokuvamile esiya ekhaya ngosuku olufanayo. Ukwelashwa okuphelele yizikhathi ezintathu ezihlukene lapho ngamunye aphatha indawo ehlukile yamaphaphu.
Ngalesi sikhathi, ukuphepha nokusebenza kwezidakamizwa eziphindaphindiwe aziwa.
Izinkomba ze-Bronchial Thermoplasty
Ngokusho kwe-website ye-Alair Bronchial Thermoplasty System, kuboniswa "ukwelashwa kwesifo sokuphefumula okuqhubekayo ezigulini ezineminyaka engu-18 nangaphezulu okuphethwe yi-asthma okungenakulawulwa kahle nge-corticosteroids etholakalayo ne-agonists esebenza isikhathi eside."
Udokotela wakho udinga ukuba nesipiliyoni ezinkambisweni ze-bronchoscopy, kodwa futhi udinga ukuqeqeshwa okukhethekile ekusetshenzisweni kwe-thermoplasty ye-bronchial ngaphambi kokuba akwazi ukusebenzisa uhlelo lwe-Alair Bronchial Thermoplasty.
Ukuqhathaniswa kwe-Bronchial Thermoplasty
Iziguli ezithile azifaneleki ukwelashwa nge-bronchial thermoplasty:
- Iziguli ezinanoma yiluphi uhlobo lwamadivaysi angenawo ama- pacemaker , i-defibrillator yangaphakathi, noma amanye amadivaysi kagesi angasetshenziswa.
- Iziguli ezinokuzwela owaziwayo noma ukungahambi kahle kwemithi esetshenziswa ngesikhathi se-bronchoscopy njenge-lidocaine, i-atropine, ne-benzodiazepines.
- Iziguli kakade ziphathwe nge-Alair Bronchial Thermoplasty System. Ukuthunjwa okwamanje akukwaziswa ukuthi ukuphepha nokuphumelela kokwelashwa okuphindayo akukwaziwa.
Ukwengeza, izimo ezithile zingase zibe yizingqinamba zesikhashana kwi-thermoplasty ene-bronchial. Iziguli ezinalokhu okulandelayo akufanele zitholwe nge-bronchial thermoplasty:
- Ukutheleleka okunamandla okuphefumula.
- Ukuqhuma kwesifuba emavikini amabili okugcina.
- Ukushintsha umthamo we- corticosteroids yohlelo lwe-asthma (phezulu noma phansi) ezinsukwini ezingu-14 ezedlule
- I-coagulopathy eyaziwayo noma inkinga yokuphuma
- Iziguli kufanele ziyeke ukuthatha ama-anticoagulants, ama-antiplatelet agents, i-aspirin ne-NSAIDS ngaphambi kwenqubo ngemuva kokukhuluma nodokotela wabo.
Okokugcina, kwakukhona izinhlobo ezithile zeziguli zesifo se-asthmatic ezingazange zifundwe ekuvivinyweni kohlelo lwe-Alair Bronchial Thermoplasty futhi akukwazi ngempela ukuthi bazobonisa izinzuzo ezifanayo nezinye iziguli. Uma kunoma yikuphi okulandelayo okuyiqiniso, udinga ukuxoxa ngezingozi nezinzuzo ze-thermoplasty ene-bronchial nodokotela wakho njengoba kungenzeka ube engozini enkulu yokwenza izenzakalo ezimbi ezingase zihlotshaniswe nenqubo ye-thermoplasty enamandla:
- I-post-bronchodilator ye- FEV1 ingaphansi kwamaphesenti angu-65 okubikezelwe.
- Unezinye izifo zamaphaphu ezinjenge-emphysema, ukungasebenzi komthambo wezwi, ukuvinjelwa kwamandla omgwaqo, i-cystic fibrosis noma i-apnea yokulala engalawuliwe.
- Udinga ukusebenzisa i-bronchodilator yakho encane engaphezu kwezingu-12 ngosuku ngosuku lwezinsuku ezimbili ngaphambi kwenqubo yakho ye-thermoplasty ye-bronchial.
- Ungumuntu othembekile we-steroid futhi udinga i-corticosteroids yomlomo njenge-prednisone kumthamo wama-milligram angu-10 ngosuku.
- Unezinye izimo zezokwelapha ezingakwandisa ingozi yezinkinga ezifana nesifo sikashukela esinesifo sikashukela, isithuthwane, isifo se-coronary umthambo ongalawuleki, ukuhluleka okunamandla noma okungapheli komlomo, kanye nokucindezeleka okungalawulwa kalula.
- Uthole ukungena kwe-asthma okudinga i-unit enkulu yokunakekela noma intubation eminyakeni emibili edlule.
- Ube nezifo ezine noma ngaphezulu ezithinta ukuphefumula ngonyaka odlule.
- Ube nezibhedlela ezingu-3 noma ngaphezulu ezibonakaliso zokuphefumula ngonyaka odlule.
- Usuke wenza ukucindezeleka okungama-4 noma ngaphezulu okudinga ama-systemic, i-oral steroids ngonyaka odlule.
Imiphumela ye-Bronchial Thermoplasty
Isivivinyo se-AIR2 sibonise ukuthi iziguli eziphathwe nge-bronchial thermoplasty zazinokuthuthukiswa okuphawulekayo kwemitholampilo kuhlanganise nokuhlobene nesifuba saso:
- Ikhwalithi engcono yokuphila
- Ukuncipha kuka-32% ekuhlaselweni kwe-asthma
- Ukunciphisa okungu-84% ekuvakasheni kwamagumbi okuphuthumayo
- Ukuncipha kwezingu-73% ezibhedlela
- Ukunciphisa ama-66% ezinsukwini ezilahlekile esikoleni nasemsebenzini
Ezinye izifundo ze-Alair Bronchial Thermoplasty System azibonanga ukulimala ku-FEV1 kanye nephrofayela ephephile, yesikhathi eside yokuphepha. Ubufakazi bokuhlolwa kobuvivinyo bubonisa iminyaka engu-5 yokuphepha ngaphandle kwe-pneumothorax, ukuthungatha, ukuphuma umoya, ama-arrhythmias enhliziyo, noma ukufa ngenxa yokuphathwa kwe-thermoplasty ye-bronchial.
Ngenkathi kubekhona ukunyuka kwezinye izimpawu zokuphefumula ngokushesha emva kwenqubo, kwakufana nalokho umuntu angalindela ukulandela i-bronchoscopy kwisiguli se-asthma.
Ekhulwini lokuqala, le nkampani yathi imiphumela yocwaningo yayithembise njengengozi enkulu, izibalo ezinzima zokulawula i-asthmatics zazingcono. Idatha yamuva yakhulume ngemithi yokwelashwa etholakalayo iminyaka emihlanu futhi inciphisa kakhulu ukukhushulwa kwe-asthma ngalesi sikhathi.
> Imithombo:
> ASTHMATX, Inc. Mayelana ne-Bronchial Thermoplasty.
> Wechsler M et al. J Allergy Clin Immunol. 2013 Dec; 132 (6): 1295-302.