Ingabe Izimpawu Zami Ezivela COPD, Ukuhluleka Inhliziyo, Noma Bobabili?

Iziguli eziningi ezine-COPD nazo zinezinkinga ze-heart congestive futhi ngokufanayo

Ukuphefumula kuyisifo esiyinhloko se- chronic obstructive pulmonary disease (COPD) . Kuyinto evamile ukuthi iziguli ezine COPD ziya ekamelweni eliphuthumayo noma uvakashele udokotela. Ukugqama okukhulu kwe-COPD kubonakala ngokuphefumula okuphawulekayo, ukukhwehlela, nokukhwehlela Uma unesiguli ne-COPD, cishe uyazi lezi zimpawu kahle, futhi mhlawumbe wena noma odokotela bakho bangase bacabange ukuthi izimpawu zakho zonke zihlobene ne-COPD.

Noma kunjalo, kubalulekile ukukhumbula ukuthi amaphesenti angu-30 weziguli ezinezifo ezingavamile zokuphazamiseka kwegazi (COPD) zinesilinganiso esithile sokuhluleka kwenhliziyo (CHF) . Ngamanye amazwi, iziguli ezine-COPD ezinezimpawu ezilawulwa kabi ezinjengokuphefumula noma ukuhamba ngegazi kufanele nazo zihlolwe ngokuhluleka kwenhliziyo ye-congestive (CHF).

Ukufana Phakathi kweCOPD ne-CHF

1. Izimpawu: Kokubili i-COPD ne-CHF yisifo esinezibonakaliso ezifanayo: ukuphefumula, ukukhwehlela , kanye / noma ukuvutha. Ngaphezu kwalokho, i-CHF ingabangela ukuvuvukala komlenze, okungesiwo uphawu lwe-COPD, kodwa akuzona zonke iziguli ezine-CHF ezinokugwinya komlenze.
2. Ukuzikhukhumeza: Kokubili i-COPD ne-CHF yizifo ezivame ukuqhubeka ziba zimbi kakhulu, bese ziba ngcono, bese zibi nakakhulu. Izinto ezimbi zibizwa ngokuthi 'ukukhushulwa' futhi ziphawuleka kulezi zifundo ezimbili zezifo. Ukukhushulwa kwe-COPD kungabangela izifo, izikhuhlane (amagciwane), umusi nomsizi. Ukukhwabanisa kwe-CHF kuvame ukubangelwa izinguquko ekudleni (ukudla usawoti okwedlulele noma amanzi), ukhohlwa ukuthatha imithi, kanye nokushintsha esimweni sezempilo (isibonelo, ukuhlasela kwenhliziyo noma izinkinga zezinso). Kuzo zombili izimo, uma unesifo se-COPD noma se-CHF, ungabona ukuthi izimpawu zakho ziyaqhubeka zimbi nakakhulu. Imisebenzi elula ingakwenza wenze ukuphefumula okungaphezulu, ungakhohlela ngaphezulu noma uzizwe ugijima. Ngezinye izikhathi kunzima kakhulu ukutshela umehluko phakathi kokukhushulwa kwe-COPD nokukhwabanisa kwe-CHF, ikakhulukazi ezigulini ezihlupheka kuzo zombili izifo.

1. Ukuncipha komsebenzi wamaphamitha: Uma une-COPD, awukwazi ukuhlolwa kokuphefumula, noma izivivinyo zomsebenzi we-pulmonary. Lokhu kuhlolwa kuhilela ukungena kumshini olinganisa umsebenzi wakho wokuphefumula, nenani eliyinhloko lentshisekelo yi-FEV-1 (ivolumu yokuphoqa okuphoqelelwe). Uma iziguli ezine-COPD noma i-CHF zinezikhwama, le nombolo iyancipha, okusho ukwehla komsebenzi wamaphaphu. Uma ukuthuthukiswa kuthuthukisiwe, le namba kufanele ithuthuke futhi. Okubi kakhulu ukwehla komsebenzi wamaphaphu, kube nzima nakakhulu ukucindezeleka- futhi lokhu kuyiqiniso kokubili ukukhushulwa kwe-COPD kanye ne-CHF.

Odokotela bakutshela kanjani i-COPD ne-CHF ngaphandle?

1. Ukuhlolwa Kwamzimba: Noma kunini lapho unesifo esibucayi, kubalulekile ukuvakashela udokotela ukuze bakwazi ukuhlolwa ngokugcwele. Ngokuyinhloko, odokotela bazobheka izibonakaliso ezitshela i-COPD ne-CHF ngaphandle. Ukuze kuhlolwe ukuphazamisa, odokotela bangase babone ukuthi isondo (okuyinto eyenzeka ngesikhathi zombili COPD kanye CHF ukucima). Kodwa-ke, uma inkinga ngokuyinhloko i-CHF, khona-ke umsindo obizwa ngokuthi "crackle" (okusho ukuthi umakhi owuketshezi) ungaba umsindo omkhulu. Odokotela bazophinde bahlole imilenze yakho ukuze bahlole ukuvuvukala, okuyinto inkinga evamile ku-CHF kodwa kancane kakhulu ukukhushulwa kwe-COPD. Ukuhlolwa komzimba kungabonisa ukububula okusha, okuvame ukwenzeka uma i-CHF yinkinga nemisipha yentamo ingase ihanjiswe okungabonakalisa ukusekela okuketshezi. Konke lokhu okutholakele kuyinkomba, kodwa-ke, futhi akekho kubo oqinisekisa ukuthi isifo esisodwa sinesibopho sezimpawu zakho ngokumelene nomunye.
2. I-chest-xrays: I-x-ray yesifuba enye indlela odokotela abangase babheke ngayo ukuthola ukuthi umehluko phakathi kokukhushulwa kwe-COPD nokukhushulwa kwe-CHF kuziguli ezingahle zibe nezifo zombili. Lapho isiguli sinamandla okwedlulela i-CHF, ukwakhiwa kwamanzi kumapayipi noma okuzungezile, futhi lokhu kungabonakala kwi-x-ray yesifuba. Kodwa-ke, uma izimpawu zivele ngenxa ye-COPD, khona-ke lokhu okuketshezi ngeke kubonakale.

1. Ama-Echocardiograms: I-echocardiogram iyinhlangano ye-ultrasound yenhliziyo. Ivumela odokotela ukuba babheke isakhiwo senhliziyo, ukugeleza kwegazi, kanye nokusebenza kwempumputhe yomzimba wenhliziyo ngokwayo. Uma umsebenzi wenhliziyo unciphisa (ngezinye izikhathi ubizwa ngokuthi i-fraction ejection fraction), lokhu kungase kubangele udokotela ukuthi i-CHF iyinkinga enkulu. Uma inhliziyo isebenza ngendlela evamile, lokhu kungenza udokotela asole ukuthi i-COPD yinkinga enkulu, kunalokho. Khumbula, noma kunjalo, iziguli zingase zibe nezinkinga ezincane, ngakho-ke yonke le miphumela kufanele ithathwe ngomongo.
2. Ukuhlolwa kwegazi . Okokugcina, ukuhlolwa kwegazi okuthiwa yi-BNP, noma i-peptide yesi-natriuretic eyisisekelo ingakhuphuka kakhulu ngesikhathi kukhishwa amandla kwe-CHF. Lokhu kuhlolwa kungasiza kakhulu uma sekuphansi, ngoba lokho kusikisela ukuthi inhliziyo ayiqediwe kakhulu.

Yiziphi Ukuhlukana Ukwelashwa?

Ukuze kube nokucindezeleka kwe-COPD , ukwelashwa kuhilela ama-bronchodilators noma ama-steroid angenayo kanye ne-steroids yomlomo (njenge-prednisone) noma ngezinye izikhathi i-IV steroids. Iziguli ezinokukhushulwa kwe-COPD kufanele zithole nebulizers noma i-albuterol inhalers . Ngokuvamile, ama-antibiotic anqunywe kahle.

Ngenxa yokucindezeleka kwe-CHF , ukwelashwa okuyinhloko kuhilela ama-diuretics (njengeLasix noma i-Bumex). Ukukhwabanisa okusha kwe-CHF kufanele kuhambisane nokuvakashela i-cardiologist yakho ukuze uqiniseke ukuthi akukho zinkinga zenhliziyo ezintsha ezazibangele izimpawu zakho ezimbi kakhulu. Eminye imishanguzo ingashintshwa noma ibekwe ngesikhathi sokukhukhumeza kwe-CHF futhi, ngakho-ke ngaso sonke isikhathi kungumqondo omuhle ukukhuluma nodokotela wakho uma unezimpawu ezintsha.

Uma iziguli zinezocansi ze-COPD kanye ne-CHF ngokuvamile kunzima ukuzichazela-futhi izikhathi eziningi, iziguli zingase zibe nezifo zombili ezivame ukuzungeza ngesikhathi esifanayo. Odokotela bazovame ukuphatha izimpawu ze-COPD kanye nezimpawu ze-CHF ngesikhathi esisodwa uma kungenakucaca ukuthi yisiphi isifo esibangela izimpawu kakhulu kanye nemihlahlandlela batusa iziguli eziqhubekayo ngokuhluleka kwenhliziyo emithini yabo yemithi yamanje (kufaka phakathi izivimbela ze-beta) futhi iphinde ikhuthaze ukuqhubeka kwemithi ye-COPD uma kokubili izifo zenza izimpawu.

Okubalulekile

I-COPD ne-CHF zifana kakhulu ngokwezimpawu nezinye iziphumo, futhi iziguli eziningi zihlupheka kuzo zombili izifo. Ngakho-ke, akuyona into engavamile odokotela ukukuphatha kokubili i-COPD ne-CHF ngesikhathi esifanayo uma kungacacisi ukuthi yisiphi isifo esingumlandu.

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Isiqalo Sezwe Lomhlaba Sokuvimbela Izifo Zengculazi Ezingapheliyo (Izikhombandlela ze-GOLD) 2016