Isimo se-asthmaticus, noma i-SA okwesikhashana, ukuhlaselwa kwesifo se-asthma esivame ukuhlala isikhathi eside noma ngokuzumayo ekuqaleni. E-SA, izimpawu ze-asthma ziyaqhubeka futhi umsebenzi wokuphefumula wehla, naphezu kokwelapha okujwayelekile.
Kubantu bonke, i-asthma ithinta cishe amaphesenti ayisishiyagalolunye yabantu abadala namaphesenti angu-10 ezingane. Kulezi, amaphesenti amahlanu kuya kwezingu-10 anesimo esibi se-asthma futhi esengozini enkulu ye-asthmaticus yesimo.
I-SA ingabangela ukwehluleka ukuphefumula , ukuhlala esibhedlela isikhathi eside, ngisho nokufa. Kusho ukuphuthumayo kwezokwelapha okudinga ukwelashwa okusheshayo nokufutheka. Abantu abangamaphesenti angu-10 ababhekana neSA bazofa.
Futhi, isimo se-asthmaticus sivame kakhulu, okuholela ekufeni kwabantu abangaphezu kuka-5 000 minyaka yonke e-US Wonke umuntu ongenakho noma ongenayo i-asthma kufanele ajwayele izimpawu nezimpawu ezivamile zokuxwayisa.
Esikhundleni sokuba lokhu kube okwesabisa ukuzwa, qhubeka ufunda. Funda ukuthi ungenzani ukuze ugweme ukuba omunye walazi zibalo.
Izimpawu
Ngesikhathi sokuhlaselwa kabuhlungu kwesifo se-asthma , indlela umzimba ngokuvamile eqhuba ngayo amagesi okuphefumula e- alveoli ayiphutheli. Lokhu kubangela amazinga e-oksijeni aphansi kanye namazinga aphezulu e-carbon dioxide egazini, okuyizimo ezimbi kakhulu, ezingabangela i-coma nokufa.
I-asthma idala umoya wokubamba emaphashini, isimo esibangela ukucindezela okwandayo esifubeni. Lokhu kungabangela ukuwa kwephunga nokuboshwa komzimba.
Izinhlobo
Kunezinhlobo ezimbili ze-SA:
- Ukuhlasela okuzenzekelayo . Lolu hlobo oluthe xaxa lungathatha isikhathi eside ukuba luveze futhi ngokuvamile luphumela ngenxa yokwelashwa okunganele. Umuntu onalolu hlobo lwe-SA uzothola izinsuku noma amasonto wezimpawu ezibuhlungu, okuphawulwe ngezikhathi zokukhululeka nokuphelisa izimpawu ezingenakuguqulwa nemithi ekhaya.
- Ukuhlaselwa okungazelelwe . Umuntu obhekene nalolu hlobo lwe-SA akakaze abone izimpawu ezibuhlungu emavikini asandulele, kodwa ushaywa nge-bronchospasm engazelelwe futhi enzima, ukuphefumula, ukuvuthwa, nokukhwehlela. Lolu hlobo lokuhlaselwa kwesifuba somoya luvame ukulethwa ukugxila okukhulu ezintweni ezinjenge-pollen, uthuli noma izifo zokudla.
Ukuxilongwa
Okulandelayo yizibonakaliso nezimpawu odokotela abasebenzisa ukuxilonga iSA:
- Ukuphefumula ekuphumuleni (Ngokuhlasela okuncane kancane, ukuphefumula kungase kuqale ngomsebenzi wedwa futhi uthuthuke lapho kwenzeka khona ngokuphumula.)
- Ukungakwazi ukukhuluma emisho noma ukungakwazi ukukhuluma nhlobo
- Izinga lokuphefumula eliphakeme ekuphumuleni (Okukhulu kunezingu-30 ukuphefumula ngomzuzu kuwukukhathazeka, kodwa ngisho namanani angaphezulu kuka-18 esikoleni esikhulile noma esikhulile kufanele aphakamise ukukhathazeka futhi ahlolwe ngokucophelela. Amanani avame ukuphakama ezinganeni ezincane futhi kubalulekile ukubuza isazi sakho se-allergen noma sephaphu ngesilinganiso okufanele usikhathalele izingane ezincane.)
- Ukuphakama kwesilinganiso se-pulse ekuphumuleni (ngaphezulu kuka-120 beats ngomzuzu)
- Ukufutheka nokucasula (Nakuba, njengoba ukuhlaselwa kuqhubeka, ukulala nokungazinzi kuyingozi nakakhulu.)
- Amazinga aphansi oksijini egazini (i-hypoxemia bese i- hypoxia )
- Ukunciphisa amandla okuphefumula, njengoba kulinganiswa ukuphakama okuphefumulayo (PEF)
Ukwelapha
Ukwelashwa okujwayelekile kwesimo se-asthmaticus ekamelweni eliphuthumayo kuhlanganisa:
- I-oksijeni nge-mask
- Ukulinganisa kwe-PEF nge-spirometry (e-asthma enzima kunazo zonke, lezi zilinganiso kungaba nzima)
- Ama-agonists abambalwa abenza ama-beta (njenge-albuterol) nge-inhaler noma mhlawumbe ngokusebenzisa i-nebulizer
- Imithi ye-corticosteroid (njenge-prednisone) enikezwa ngomlomo noma nge-intravenously
- Imithi yokulwa ne-anticholinergic (njenge-atrovent)
Eminye imithi engasetshenziswa ngesikhathi sesiqephu esiyinkimbinkimbi ihlanganisa:
- I-Beta-agonists injected ngaphansi kwesikhumba (njenge-Terbutaline)
- I-Magnesium sulfate ngaphakathi
- Ama-modifiers e-leukotriene (afana ne-Zafirlukast noma i-Zileuton) ngomlomo
I-ventilation ye-mechanical iyindlela yokwelapha (cishe) isenzo sokugcina ngenxa yengozi yokulimala emaphashini nezinye izinkinga ezinkulu ezingase zenzeke. Cishe amaphesenti amane okuvakasha okwakhiwa ngokuphuthumayo kwe-asthma kuzoholela esigulini esidinga ukuphuma umoya. Njengesimiso sokugcina, i- membrane yochungechunge ye-oxygenation (ECMO) ephumelele iye yaphumelela ezigulini ezimbalwa lapho isifo sofuba sasingaba sengozini ngisho nangomoya wokuphuza umoya.
I-ECMO (i-membrane eyakhiwe nge-extracorporeal oxygenation) inikeza esinye isisetshenziswa sokugcina kanye nesimo sokugcina sokwelapha kulabo abazo zonke izifo zokwelapha ezifaka umoya wokuphuza umoya ohlulekile. Manje sekucatshangwa ukuthi i-ECMO kufanele ibhekwe njengendlela yokwelapha okusheshayo kubantu abane-status asthmaticus abane-gas exchange rate (ukungenwa kahle kwe-oxygen nokuphelelwa yisikhathi kwe-carbon dioxide) engaphenduli kahle ekwelapheni etholakalayo. I-ECMO inikeza indlela yokubuyisela ukushintshaniswa kwegesi emzimbeni ngenkathi ivimbela ukulimala kwamaphaphu okuhlobene nokuphuza umoya.
Isilinganiso se-PEF
Ngokuvamile ubukhulu bezimpawu zomuntu one-asthma abuhlobene kakhulu nobukhulu bokuphuza kwamaphaphu akhe. Ngakho-ke, kubalulekile ukuthi zonke izibalo ze-asthmatics zilinganise i-PEF yazo njalo. Lokhu kwenziwa ngokusebenzisa imitha yokuphakama ye- peak , okuyinto i-plastic encane device ekhishwa ngamandla, okulinganisa i-PEF.
Isilinganiso se-PEF sinikeza ulwazi mayelana nesimo sokuphefumula, noma yikuphi ukwehla kwesimo somuntu siqu (esimisiwe), nesidingo sokwandisa imithi noma ukufuna ukwelashwa. Noma yimuphi umuntu one-asthma oyehla kwezingamaphesenti angu-30 noma ngaphezulu ku-PEF, ikakhulukazi uma i-inhalers yokulondoloza ingasebenzi, kufanele ifune usizo lwezokwelapha ngaphandle kokungabaza.
Izingozi Zezingozi
Ungazi kanjani ukuthi usengozini yokuhlaselwa kwesifo se-asthma esibulalayo ? Ngesimo esiphuthumayo i-asthmaticus, kukhona, ngencazelo, izibonakaliso ezimbalwa zokuxwayisa. Uma unolwazi lwemizimba lapho lokhu kungenzeka khona, i-allergenist yakho izoxoxa ukuthi lezi zihlaselo zingaba zimbi kangakanani nokuthi zingashesha kanjani.
Ngesimo sokuqala esisheshayo i-asthmaticus, kunezibonakaliso eziningana ezixwayisayo okufanele zikuxwayise ukuthi ushayele udokotela wakho noma ufune ukwelashwa okuphuthumayo. Lokhu kufaka:
- Ukuncipha kwe-PEF kwamaphesenti angu-30 noma ngaphezulu, njengoba kuphawuliwe ngenhla, nakuba i-allergenist yakho ingakunika imingcele ehlukile kuye ngokuthi i-asthma yakho
- Isidingo esikhulu se-rescue inhaler yakho
- Ukuphaphama kwamasuku ngenxa ye-asthma yakho
- Ukwandisa ukuphefumula naphezu kokusetshenziswa okunamandla kwemithi yakho
- Uma ususebenzise amathrekhi amabili noma ngaphezulu we-inhaler yakho encane ekwenzeni inyanga edlule
Uma unomlando wokuhlaselwa kwesifo se-asthma, kufanele ufune ukunakekelwa okuphuthumayo uma ubhala noma yiziphi izimpawu ozenazo ngesikhathi sokuhlasela kwakho kwangaphambilini.
Izwi elivela
Kubalulekile ukuthi wonke umuntu one-asthma, nalabo abathandekayo abanakekela abantu abane-asthma, qaphela kokubili izixwayiso zesifo sofuba esinamandla nesifo esibi sesifo. Naphezu kwentuthuko ekwelapheni, kusekhona abantu abaningi kakhulu abafa ngalesi sifo unyaka ngamunye.
Ingxenye yenkinga ukuthi abantu abaningi abaqapheli ukuthi imithi abayithatha ekhaya inamandla kangakanani, futhi lokhu kunganikeza umuzwa wokuphepha wamanga. Uma umuntu ekhuphula ukusetshenziswa kwe-inhaler ekhaya, ngezinye izikhathi kungaba nzima kakhulu ukuthola lesi sifo ngaphansi kokulawula uma befika ekamelweni eliphuthumayo.
Lokho kusho ukuthi, ukuphefumula kwesifuba akusona isizathu sokwesaba. Njengoba kuphawuliwe ekuqaleni, abantu abaningi abane-status asthmaticus banezifo eziqala kancane. Yikuphi ukufundwa mayelana nalesi simo okufanele kuyenze kukhuthaza labo abane-asthma, ngisho nalabo abane-asthma enobumnene, ukuhlola ngenkolo ukuphakama kwabo nokuxhumana nodokotela babo nganoma yiziphi izimpawu ukuthi isimo sabo siyanda. Uma ungajwayele le nqubo, shayela i-allergen yakho namuhla futhi ufunde indlela yokusebenza nge-asthma yakho.
Imithombo:
Di Lascio, G., Prifti, E., Messai, E. et al. I-Membrane yangaphandle Kwesekelo Lokususwa Kwama-oxygen for Life-Threatening Status Acute Status Asthmaticus. I-Perfusion . 2017. 32 (2): 157-163.
UMiller, A., uBreslin, M., Pineda, L., noJo Fox. I-Asthma Protocol Yathuthukisa Ukunamathela Emibhalweni Esekelwe Ebufakazi Yezihloko Zengane Ngesimiso Sesi-Asthmaticus eMnyangweni Wezimo Eziphuthumayo. Ukunakekelwa kokuphefumula . 2015. 60 (12): 1759-64.
Tramm, R., Ilic, D., Davies, A., Pellegrino, V., Romero, L., noC. Hodgson. I-membrane yangaphandle ye-Oxygenation yabadala abagulayo. I-Cochrane Database yezibuyekezo ezihleliwe . 2015. 1: CD010381.