Ukukhwehlela yisizathu esivame kakhulu ukuthi kungani abantu beya kudokotela wabo oyinhloko. Kwezinye izimo, ukukhwehlela sekuphele amasonto angaphansi kwamathathu futhi kuthiwa "ukukhwehlela okukhulu." Ukukhwehlela okuye kwaphela phakathi kwamasonto amathathu nesikhombisa kuthiwa "ukukhwehlela okuncane." Nokukhwehlela okuye kwaqhubeka Amasonto angaphezu kwangu-8 abizwa ngokuthi "ukukhwehlela okungapheli."
Ngenkathi abanye abantu bebekhwehlela iminyaka, imbangela yokukhwehlela inganqunywa okungenani angu-90% kulawa macala.
Imithi yokukhwehlela inezinga lokuphumelela okungenani u-85%, ngakho-ke, imithi kufanele ihloselwe imbangela eyinhloko, kunokuba nje imishanguzo efaka isikhukhula okwesikhashana.
Yini Ebangelwa Isikhukhula?
Isizathu sokukhwehlela sincike ekutheni uphawu lube lude kangakanani. Isibonelo, izimbangela zokukhwehlela okukhulu zingase zihluke kakhulu nezimbangela zokukhwehlela okungapheli. Ezimweni ezingamaphesenti ama-25% omkhuhlane ongapheliyo, okungenani kunezimo ezimbili zokwelapha ezibangela ukukhwehlela kumuntu.
Yini Ebangelwa Isikhukhula Esiqine?
Izimbangela ezivame kakhulu zokukhwehlela okukhulu zihlanganisa:
- Umkhuhlane ovamile
- Sinusitis enamandla
- I-Pertussis (okhwehlela ukukhwehlela)
- Izifo eziphuthumayo ze-pulmary disease ( COPD )
- I-allergenic rhinitis
- I-rhinitis engelahleki
Isizathu sokukhwehlela okuvame ukuvunywa ngomlando womuntu nokuhlolwa komzimba. Abanye ochwepheshe bazosebenzisa inhlanganisela yokulwa ne-antihistamine / ye-decongestant (njenge-Dimetapp noma i-generic efanayo) ekwelapheni ukukhwehlela okukhulu ngenxa yomkhuhlane ovamile.
Ama-antihistamine amasha / ama-decongestant, afana no-Claritin-D (i-loratadine / pseudoephedrine), abonakala engakusizi.
Abantu abaqhubeka bekhwehlela naphezu kokwelapha okubandayo, noma abanezinye izibonakaliso zesifo esiyingozi, banikwa inkambo yama-antibiotic ahloswe ngesinusitis njengesizathu sokukhwehlela okukhulu.
Izingane zivela ikakhulukazi zijwayele ukukhwehlela njengezibonakaliso kuphela zesifo se-sinus.
Labo abane-COPD eyinhloko (i-emphysema noma i-bronchitis engapheliyo) ingase ibe nokukhuphuka ngokwanda kokukhwehlela, ukuphefumula, ukuguqula nokuguqula ukukhiqizwa kwe-mucus nombala. Ama-antibiotic ngokuvamile anikezwa kulaba bantu abanomkhuhlane omuncu.
Ukukhwehlela okukhwehlela , noma i-Pertussis, kuyaba neminye emiphakathini ethile, futhi ukugoma akuhlinzeki ngaso sonke isikhathi ukuvikelwa okuphelele. Abantu abanePertussis bazoba neziqephu ezinzima zokukhwehlela, ngokuvamile ngokuhlanza ngemva kokukhwehlela. Ukwelashwa ngama-antibiotics kusiza uma kunikezwa ekuqaleni kokutheleleka; uma kungenjalo, ukukhwehlela kungase kungapheli futhi kuphele amasonto amaningi.
I-rhinitis (i-allergic ne- non-allergen ) ingabangela nokukhwehlela okuhlobene nokudonsa okusesiswini (i-phlegm ephuma ngemuva kwempumu ibe emphinjeni). Noma kunjalo, lokhu kungase kube ukukhwehlela okuhluke kakhulu kusuka ngenhla futhi ngaphezulu komjovo wokuhlanza uhlobo lokukhwehlela. I-allergenic rhinitis izophendula ezinhlobonhlobo ezihlukahlukene zokwelapha izifo lapho izinkinga ezingezona okwelashwa zingaphendula kuphela kuma-decongestants noma iziphambano ezihlukahlukene ze-nasal sprays.
Izinto ezingavamile, kodwa ezingathí sina, izimbangela zokukhwehlela okukhulu zihlanganisa ukuhluleka kwenhliziyo , ukuvuthwa kwe-pulmonary , i-pneumonia nokuthola into yangaphandle efakwe emaphashini ( aspiration ).
Yiziphi Izimbangela Zesikhuhlane Esincane?
Ukuze ukhwehlela oye wahlala phakathi kwamasonto amathathu no-8, izimbangela ezivame kakhulu ziyi:
- Ukukhwehlela kokuthunyelwa kwesifo
- Sinusitis enamandla
- I-asthma
Ukukhwehlela okuthunyelwa kokuthunyelwe kuyisikhwehlela esiye saqhubeka ngemva kokutheleleka okubandayo noma okunye okutheleleka kokuphefumula, lapho kungekho pneumonia. Kungaba umphumela we-post-nasal drip noma i-bronchitis. Lezi zimpawu zingase zixazulule ngaphandle kokwelashwa noma zingaba sinusitis enzima efuna ama-antibiotics. Abanye ochwepheshe bayonikeza isilingo senhlanganisela ye-decongestant / antihistamine (njenge-Dimetapp noma i-generic equivalent) ngesonto elilodwa, futhi uma lokhu kuhluleka, isilingo sama-antibiotic.
Uma umuntu futhi ekhononda ngokuphefumula, ukushaya ngesondo noma isifuba, isifo se-asthma singase sibe imbangela yokukhwehlela. Izindlela zokwelashwa ezijwayelekile zokwelapha zizobe zinikezwa.
Yiziphi Izimbangela Zesikhuhlane Esingapheli?
Ukukhwehlela okuhlala isikhathi esingaphezu kwamaviki ayisishiyagalombili kuthiwa ukukhwehlela okungapheli. Abanye abantu bangabhekana nokukhwehlela okungapheli iminyaka, kanti ukwelashwa kungase kungaphumeleli. Kulaba bantu, ukudluliselwa ku- allergenist noma i-pulmonologist (udokotela ogxile emaphashini) kufanele kwenziwe, njengoba kunakekelwa udokotela wezokwelapha.
Izimbangela ezivame kakhulu zokukhwehlela okungapheli zihlanganisa:
- I-Post-nasal drip (i-phlegm ephuma ngemuva kwempumu ibe emphinjeni)
- I-asthma (no-asthma)
- Isifo se-reflux se-gastroesophageal (GERD)
- I-bronchitis ye-Eosinophilic
- Imithi eyenziwe ngemithi ( ACE inhibitors )
- Ukubhema
Ochwepheshe abaningi batusa ukuba benze i-X-ray esifubeni kanye nokukhenwa kwekati kwezoni njengengxenye yokuhlolwa kokukhwehlela okungapheli. Ochwepheshe (allergists kanye ne-pulmonologists) nabo bazokwenza izivivinyo ezikhethekile ze-asthma. Uma i-X-ray yesifuba ingavamile, lokho okubangela ukuthi ngenhla kubangele ukuthi kuningi kakhulu lwamacala okukhwehlela okungapheli.
Udokotela uzokwenza umlando nokuhlolwa kwangokwenyama, okungahle kuhlinzekwe izizathu zokubangela ukukhwehlela okungapheli. Kwezinye izimo, kungase kudingekile ukunikeza ukuhlolwa kokwelashwa okungenhla, njengoba ukuhlola ngokomzimba kungase kungaboni izizathu zokukhwehlela.
Irritants kanye nemithi. Abantu ababhemayo noma abavelele ekucaseni emsebenzini noma ukuzilibazisa kufanele bagweme lezi zimbangela. Imithi efana ne-ACE inhibitors (imithi yengcindezi yegazi njenge-lisinopril nezinye eziningi, ngamagama ajwayelekile okuphela kokuphela kokuthi "pril") izimbangela ezidumile zokukhwehlela futhi kufanele zishintshwe udokotela emshini ohlukile wohlobo lwemithi. Ukukhwehlela kungadlulela kuze kube amasonto amane ngemuva kokuthi i-ACE inhibitor ivaliwe.
Ukudonsa kwe-Post-nasal. Lesi yisizathu esivame kakhulu sokukhwehlela okungapheliyo. Ukudonsa ngemuva, uma kutholakala emlandweni (umhombo-ukuhlanza) noma ekuhlolweni kwangokwenyama, kungase kuphathwe ngenhlanganisela ye-decongestant / antihistamine (njengoba ngenhla kokukhwehlela okunamandla) kanye ne-prescription nasal spray (njenge-steroid yama-nasal). Uma le mithi ingasizi, kungase kudingeke ukuqinisekisa ukuthi ukugaya ngemuva kokuphumula akukona ngenxa yesifo se-sinus ngokwenza iskena lesikrini.
I-asthma. I-asthma iyimbangela yesibili evame kakhulu yokukhwehlela okungapheli. Ukukhwehlela kungaba uphawu olulodwa lwe-asthma, nakuba abantu abaningi bayakhononda nangokuphefumula nokuphefumula. Ukuhlolwa okukhethekile, kufaka phakathi i-spirometry kanye nokuhlola kwe-bronchoprovocation, kungasiza ekunqumeni ukuthi ukukhwehlela kungenxa yokuphefumula. Kodwa-ke, lezi zivivinyo zingase zijwayelekile, ngakho-ke ukuhlolwa kwe-asthma therapy (njenge-steroid engatholakali) kungadingeka cishe izinyanga ezingu-1-2.
I-GERD. I-GERD iyimbangela yesithathu evame kakhulu yokukhwehlela okungapheli, futhi iningi labantu abanalo hlobo lokukhwehlela abakuboni ukuthi bane-GERD. Enye ifomu yeGERD, ebizwa ngokuthi i-laryngopharyngeal reflux (LPR), ibangela ukukhwehlela ngezwi elihlabayo kanye nomsamo wokuhlanza. Ukuhlolwa okukhethekile kungenziwa nge-GERD ne-LPR, kodwa ngezinhlobo ezibangelwa ukukhwehlela, lezi zingabiza futhi zingakhululekile. Isivivinyo sokwelapha i-GERD ne-LPR (ukwelashwa ngokuvamile kuyafana), ngokuvamile kuya emavikini amaningi kuya ezinyangeni, kungadingeka ukuba ukhwehlela ukuxazulula.
I-bronchitis ye-Eosinophilic. Leli fomu lokukhwehlela okungapheli livela kubantu abangamaphesenti angu-13 futhi kungatholakala ukuthi ubheka isikhala somuntu (phlegm) ngaphansi kwe-microscope. Ngenxa yokuthi ayikho enye yokuhlolwa etholakalayo ukuxilonga lolu hlobo lokukhwehlela, isilingo se-steroids engatholakali (izinyanga ezingu-1-2) sivame ukuyingxenye yemithi yokwelapha enikezwa umuntu onomkhuhlane ongapheli lapho imbangela ingabonakali kalula.
Uma ukukhwehlela kuqhubeka naphezu kwalokhu okushiwo ngenhla, ukudluliselwa kumchwepheshe (i-allergenist noma i-pulmonologist) kungadingeka ukuze kuhlolwe okuqhubekayo. Izimbangela ezingavamile zokukhwehlela okungapheli zibandakanya ukukhwehlela komkhuba (u-tic wezinzwa), indlebe ye-ear (noma enye imvelaphi yangaphandle) ukuzwa endlebeni, i- Tourette's syndrome , izinhlobo ezihlukahlukene ze- cancer yamaphaphu , ukuhluleka kwenhliziyo, izifo zamaphaphu ezingaphakathi, njll.
> Imithombo:
> Irwin RS, Madison JM. I-diagnosis kanye nokwelashwa kwe-Cough. N Engl J Med. 2000; 343: 1715-21.
> Weldon DR. Ukuqhathaniswa okungafaniyo kweCough Chronic. Isifo sofuzo kanye nesifo sofuba. 2005; 26: 345-51.