Ukuqonda Imigomo kanye Nezinhloso Zokukhethwa
Ukudluliswa kwamangwenya kuvame ukusetshenziswa kubantu abane-end-stage- chronic obstructive pulmonary disease (COPD) abahlangabezana nezinqubo ezithile. Lesi sifo sibhekwa njengesiphetho-sigaba lapho izinkinga zokuphefumula kanye nezinkinga zokuphefumula sezilokhu zisongela ukuphila, futhi zonke ezinye izindlela zokwelashwa, kokubili kwezokwelapha nokuhlinzeka, seziphelile.
Konke okukhulunywe ngakho, ukuguquka kwamaphaphu angu-2 000 kwenziwa minyaka yonke e-United States, ngokusho kwezibalo ezivela eScientific Registry of Transplant Acceptors eMinneapolis.
Izinzuzo Zokuhlinzwa
Ukuguquka kwamangqamuzana kungathuthukisa kakhulu izinga lokuphila futhi kubuyisele imisebenzi eminingi isikhathi eside esenqatshelwe abantu abahlala nesigaba 4 COPD . Ngokuphathelene nezinketho, ucwaningi lwamanje lubonisa ukuthi ukufakelwa kwamaphaphu amabili (ukushintshwa kokubili kwamapayipi) ngokuvamile kunenzuzo esikhathini eside uma kuqhathaniswa nokufakelwa kwamaphaphu.
Ngenkathi ukuguqulwa kwamaphaphu akukona, okwamanje, ukwandisa izinga lokuphila lokuhlala isikhathi eside kubantu abaneCOPD, ikhwalithi kanye nobude bokusinda isikhathi esifushane kuyaqhubeka nokuthuthukisa. Ngokusho kocwaningo:
- Phakathi kwamaphesenti angu-80 namaphesenti angu-90 abantu abafakelwa ukufakelwa kusinda ngonyaka wokuqala.
- Phakathi kuka-41% namaphesenti angu-52 baphila iminyaka emihlanu noma ngaphezulu.
Ngaphezu kwalokho, amaphesenti angama-66.7 abantu abanokufakelwa kwamanye amazwe bayakwazi ukuhlala iminyaka emihlanu noma ngaphezulu uma kuqhathaniswa namaphesenti angu-44.9 kuphela alabo abane-single-lung transplant.
Ukukhethwa kwabaFundi
Ngokuvamile, umuntu uthathwa njengomuntu ozokhethwa ukufakelwa kwamaphaphu uma enesikhathi sokuphila seminyaka emibili noma ngaphansi.
Ngaphezu kwalokho, umkhawulo weminyaka engama-65 uvunyelwe ukufakelwa kwe-single-lung kanye neminyaka engama-60 ngokufakelwa kwamanye amazwe. Izibalo zibonise inzuzo encane esikhathini sokuphila noma izinga lokuphila kubantu abadala kunalokhu.
Ezinye izindlela zifaka:
- Ukuba ne- FEV1 engaphansi kwamaphesenti angu-20
- Ukubhekana nokuphelelwa isikhathi eside (carbon dioxide ngokweqile) nokunciphisa amazinga e- oksijeni egazi
- Ubhekana nesifo somfutho wegazi wamaphilisi wesibili
- Ukuba nesilinganiso se- BODE Index ngaphansi kwesishiyagalombili (esibonisa isikhathi esifushane sokuphila)
Kungase kube khona okunye kulezi zinombolo, ngokusekelwe ekubuyekezweni kwecala ngalinye. Ukukhethwa kuzoba nokubandakanya ukuhlola ukuthi ngabe lowo muntu uhamba ngezimoto, unesimiso esiqinile sokusekela, futhi ushukumiseleka ukuba ahlinzekwe ukwelashwa ngokomzimba, ukuvivinya umzimba, ukuyeka ukubhema, nezinye izinguquko zokuphila eziholela ekuhlinzekeni nasekulandeleni okulandelayo.
Abantu abanokuhlinzekwa kwamaphaphu wangaphambilini , okuhlinzekwa ukunciphisa umthamo wamapayipi (LVRS) noma i- bullectomy , bangase bafanelekele uma bekwazi ukuhlangabezana nemigomo.
Izinkinga Zokuthunyelwe Okuthunyelwe
Akekho obala ukuthi ukufakelwa kwamaphaphu kuyindlela enkulu ephethe ingozi enkulu yezinkinga, kufaka phakathi nokufa. Kungenzeka ukuthi ihlobene nokuphefumula noma okungahlobene nokuphefumula.
Izinkinga ezihlobene nokuphefumula yizo ezithinta ngqo amaphaphu futhi zingabandakanya:
- Ukulimala kwe-Ischemia-ukuphindaphindiwe (umonakalo obangelwa lapho igazi libuyela emathiswini emva kwesikhathi sokuncishwa kwe-oksijeni)
- I-Bronchiolitis obliterans (ukuvimbela ukuphefumula ngenxa yokuvuvukala okukhulu)
- I-malacia ye-tracheal (i-windpipe ewile)
- I-Atelectasis (amaphaphu aphelile)
- I-pneumonia
Ngokuphambene, izinkinga ezingezona ukuphefumula yizo ezithinta ezinye izitho noma ezihlobene nezidakamizwa zokudambisa omzimba ezisetshenziselwa ukuvimbela inqatshwa yomzimba . Ngenkathi ukulahlwa komzimba kungukukhathazeka okusheshayo emva kokuhlinzwa kokufakelwa, ezinye zingabandakanya:
- Ukutheleleka
- Isifo se-Lymphoproliferative (esibangelwa ukuthi amangqamuzana amaningi amhlophe egazi, okuthiwa i-lymphocytes, akhiqizwa kubantu abane-immune system)
- I-Lymphoma (umdlavuza wesimiso somzimba omzimba)
- I-hypertension yesistimu
- Ukuhluleka kwezinso
- I-post-transplant isifo sikashukela
Izwi elivela
Nakuba ukuguqulwa kwamaphaphu kuhlale kubhekwa njengendlela yokugcina, ukuthuthuka kwezobuchwepheshe nokunakekelwa emva kokuhlinzwa kuye kwaholela emazingeni amaningi okuphumelela kunanini ngaphambili.
Uma kuthiwa, ukukhathalela okudinga ukwedlula kuzodingeka kuthathwe ukuqinisekisa ukuthi awuqondi nje kuphela izinzuzo zokwelashwa kodwa uqonde izinselelo ongabhekana nazo amasonto, izinyanga, neminyaka elandela ukuhlinzwa.
Izingozi zingaba phezulu. Konke okukhulunywe ngakho, cishe amaphesenti angu-50 abantu abathola ukufakelwa kwamaphaphu avela kumuntu ongeke ahlangane nabo bazobhekana nokulahlwa okungapheli (okuvezwe ukulahlekelwa umsebenzi wendikimba phakathi nenkathi yeminyaka).
Ukuthuthukiswa kwala mazinga kuncike kakhulu ekulawuleni izinkinga. Lokhu kusho ukuthi wena, njengesiguli, kudingeka uzimisele ngokugcwele ukuthatha zonke izinyathelo ezidingekayo ukuze uthuthukise impilo yakho yonke. Ekugcineni, ungenye yezinto ezibaluleke kakhulu ekunqumeni impumelelo yakho yesikhathi eside.
> Imithombo:
> Aziz, F .; I-Penupolu, i-S.; Xu, X. et al. "Ukufakelwa kwamangqamuzana ezigulini ze-chronic obstructive pulmonary (COPD) ekupheleni kwesiteji: ukubuyekezwa okufushane." J Thorac Dis . 2010; 2 (2): 111-6. I-PMCID: PMC3256444.
> I-Valapour, M .; Ama-Skeans, M .; Smith, J. et al. "I-OPTN / SRTR 2015 Yonyaka Wokubika Imininingwane Yedatha: Lung." Am J Ukutshala. 2017; 17 (Suppl 1): 357-424. I-DOI: 10.1111 / ajt.14129.