I-asthma eyenziwa ngokuzivocavoca, noma i-bronchoconstriction eyenziwe ngokuzivocavoca, ibangela izimpawu ze-bronchoconstriction nezimo ze-asthma ezifana nokushaya, ukuphefumula , ukukhwehlela nokuqina kwesifuba okukhula ngesikhathi sokuvivinya umzimba. Ithinta amaphesenti angu-7 ukuya kwangu-20 ebantwini jikelele.
Nakuba ngabe uke wezwa mayelana nesifo sokuphefumula esibangelwa ukuvivinya umzimba, ngaphambili umhlinzeki wakho wokunakekela i-asthma uyibhekisela kuso njenge-EIB.
Odokotela be-Asthma bakhetha i-EIB ngokuthi i-asthma etholakala ekuzivocavoca umzimba ngoba ukuzivocavoca akuyona into engozini yokuphefumula ngesifo se- asthma , kodwa kunalokho kuyisisusa .
Izimpawu
Izimpawu zokuphefumula okubangelwa ukuzivocavoca zingase zenzeke ngemva kwesikhashana sokuzivocavoca noma imizuzu engu-10 kuya kwemihlanu isikhathi eside sokuzivocavoca. Izimpawu ezivame kakhulu zokuzivocavoca umzimba ezibandakanya ukuvivinya umzimba zihlanganisa:
- Ukuphelelwa umoya
- Ukuqina kwesifuba
- Ukushaya
Izimpawu zixazulula ngokuphumula emaminithini angaphezu kuka-30 kuya kwangu-60. Isimo sezulu esibandayo sandisa ukuvama nokuqina kwempawu.
Ukuxilongwa
Kuziguli eziyaziwa nge-asthma ezithola izibonakaliso ezijwayelekile ngesikhathi noma ngemva kokuzivocavoca, udokotela uzovamise ukuxilongwa ngokucophelela kokuzivocavoca umzimba ngokuxoxa ngezimpawu nesiguli. Izikhathi eziningi udokotela ngeke afune ukuhlolwa okuqhubekayo kokuhlola ngaphandle kokuthi izimpawu zesifo se-asthma ezenza umsebenzi-mgomo ziqhubeka noma izimpawu ze-asthma ezenzelwe ukuvivinya umzimba azivimbeli ezinye zezinyathelo ezibalulwe ngenzansi.
Uma ungenayo i-asthma diagnostic, kodwa uthola ukuphefumula, ukuqina kwesifuba, nokukhwehlela ngesikhathi noma emva kokuzivocavoca, uphenyo olwengeziwe luyadingeka ukuze kuqinisekiswe ukuthi izimpawu azikho ngenxa yesinye isimo, njengesifo senhliziyo.
Ezimweni eziningi, uhlobo lokuvivinya umzimba nge-pre-post-exercise i- spirometry lisetshenziselwa ukuqinisekisa ukuxilongwa kwe-asthma.
Ngokuvamile, uzozivocavoca ngesithuthuthu noma ibhayisikili kuze kube yilapho ufinyelela kuma-85% wezinga lakho lenhliziyo elilindelekile. Ucatshangwa ukuthi u-asthma owenziwe ngokuzivocavoca uma i- FEV1 yakho (ivolumu ephoqelekile yokuphefumula) iwa ngaphezu kwamaphesenti ayishumi ngokuzivocavoca.
Abanye abahlinzeki bokunakekelwa kwe-asthma bangase batuse ukuhlolwa kwenselelo ye-bronchoprovocation , kodwa lokhu akuyona into ecacile yokuzivocavoca umzimba. Ngokufanayo, ukulinganisa ukuphakama kokuhamba ngaphambi kokuqala nokuzivocavoca akunconywa ukuhlola isifo sofuba esibangelwa ukuzivocavoca ngoba imiphumela kaningi ayilungile.
Ezinye izimbangela zokuphefumula, ukuqina kwesifuba, nokukhwehlela okulingisa ukuphefumula kwesibindi kuyadingeka kucatshangelwe. Lokhu kubaluleke kakhulu uma ungabonisi izimpawu ezithile ze-asthma futhi awuzuzi kwezinye zezinyathelo zokuvimbela ezichazwe ngezansi. Okunye okuthola ukuthi udokotela wakho angayicabangela kufaka:
- Ukusebenza komthamo wokugcoba
- Ukuhluleka kwenhliziyo
- Isifo senhliziyo seCoronary
- Isifo se-reflux se-gastroesophageal
Ukuvimbela
Uma ulawulwe kabi nge-asthma futhi uzwa izimpawu ngokuzivocavoca, ukwelapha i-asthma engalawulwa kahle kungase kube isu elizuzisa kakhulu kuwe. I-asthma eyenziwa ngokuzivocavoca ingavinjelwa ngokujwayelekile usebenzisa imithi elandelayo ehoxisiwe:
- I- bronchodilator esebenza ngokusheshayo: Ukusebenzisa ukuthukuthela okubili kwemishanguzo yokuphuthuma ngokushesha efana ne-Albuterol noma i-Formoterol imizuzu engu-10 ngaphambi kokuvivinya umzimba kungavimbela izimpawu zesifo sokuphefumula.
- I-Cromolyn sodium (i-intal): I- Cromolyn sodium ingasetshenziswa ukuvimbela i-asthma esetshenziselwa ukuzivocavoca futhi ingahle isetshenziswe ngokuhambisana nemithi yokutakula ngokushesha.
Kubantwana kanye nabantu abadala abasebenzisa umzimba ngesikhathi sosuku futhi bengakwazi ukuthatha imithi ngaphambi komsebenzi ngamunye, i-bronchodilator ende (LABA) noma i-leukotriene inhibitor ingasetshenziswa:
- Ama-bronchodilator asebenza isikhathi eside: Ama- LABA afana ne-Salmeterol ne-Formoterol, ngenkathi engavunyelwe njengokwelashwa kuphela kwe-asthma, angasetshenziselwa i-asthma esetshenziselwa ukuvivinya umzimba. I-Salmeterol ne-Formoterol kufanele kuthathwe imizuzu engu-30 no-5 ngaphambi kokuzivocavoca, ngokulandelana. Akufanele futhi isetshenziswe kaningi ngaphezu kwamahora angu-12.
- I-Leukotriene inhibitors: I- Leukotriene inhibitors njenge-Montelukast (Singulair) ne-Zafirlukast (i-Accolate) ingasetshenziselwa ukuvimbela izimpawu zesifo sofuba ezibangelwa ukuzivocavoca ezigulini ezidinga isikhathi eside sokuvikelwa noma ezinenkinga ngokusebenzisa i-inhalers. Uma uthuthukisa izimpawu zesondo noma i-bronchoconstriction ngemuva kokuzivocavoca, noma ukhohlwa ukuthatha imithi ngaphambi kokuvivinya umzimba, uzofuna ukusebenzisa i-inhaler yakho yokuphepha bese ulandela uhlelo lwakho lwesenzo se-asthma .
> Imithombo:
> O'Byrne PM. Imfundo yesineke: I-asthma eyenziwa ngokuzivocavoca (Ngaphandle Kwezinto Eziyisisekelo). Ku: UpToDate. 2017.
> Iziphepho WW. I-Asthma Ehlanganiswe Nokuzivocavoca. I-Immunol Yokuphefumula Kwemithi Clin North Am. 25 (1): 31-43.