Sibutsetelo
Kunezinhlobo ezintathu eziyinhloko zokukhwehlela : ukukhwehlela okunzima, kwe-subacute nokuhlala njalo. Uma ukukhwehlela kwakho kuqhubeka isikhathi esingangaphansi kwamasonto amathathu, ube nokukhwehlela okunzima okuxazululwe. Izinhlayiya ezihlala isikhathi esingaphezu kwamasonto amathathu kodwa amasonto angaphansi kuka-8 abhekwa njengesiqu. Ukukhwehlela kwe-post-viral kubhekwe njengesiqu. Kodwa-ke, uma unomkhuhlane owedlule amasonto angaphezu kwangu-8, ukukhwehlela kwakho kuzobhekwa njengokungapheli.
Uma ukukhwehlela kwakho sekuqhubekile izinsuku ezingaphezu kwezingu-21 ngemuva kokushisa, kungenzeka ukuthi manje ubhekene nokukhwehlela kokuthunyelwa. Ngenkathi iningi lokukhwehlela okusuleleka ngokutheleleka yizifo ezibangelwa igciwane eliphezulu izifo zokuphefumula , kungenzeka ukuthi zivela ezifweni ezibangelwa amagciwane noma fungal.
Isizathu Sokuba Nesikhumba
Uke waqala ukukhwehlela lapho uzizwa othile egqoke i-cologne kakhulu noma iphunga . Noma mhlawumbe une- post-nasal drip futhi ubelokhu ukhwehlela kusukela ngaleso sikhathi. Ukugaya kungumcabango ongabangela kokubili ukuvuselela kwamakhemikhali namakhemikhali . Nakuba ngokuvamile kuthiwa yi-airways engenhla, i-reflex yokukhwehlela ingabangela: i-high and low respiratory tract, i-pericardium (izinhliziyo zenhliziyo), isifo se-diaphragm nesisu.
Ama-receptors ama-mechanical abangela ukukhwehlela uma ethintwa noma ehanjiswa. Ama-receptor ama-Chemical aphendula uma evezwe: izinguquko ekushiseni, ezivezwe ku-asidi, noma izinto ezifana ne-capsaicin.
Amamukeli azungeze i-larynx, i-trachea, ne-bronchi, ingabangelwa yizo zombili izindlela zomshini noma zamakhemikhali. Uma ama-receptor noma ama-chemical receptors esebenza, uqala ukukhwehlela.
Ukuvama
Kungenzeka kangakanani ukuthi ube nokukhwehlela kokungena komzimba? Ngemuva kokuthola ukutheleleka okuphezulu kokuphefumula kwesandulela ngculaza, abantu abangu-11 kuya kwangu-25 abantu abayi-100 bazoba nokukhwehlela okuqhubekayo kohlobo lwe-viral.
Ngalesi sikhathi, ngeke usakazelele, kodwa uzoba nokukhwehlela okuphazamisayo okungenzeka noma kungathinti imisebenzi yakho yansuku zonke. Uma ngabe uthola ukutheleleka kokuphefumula okufayilini noma ukwelapha okufana ne- Mycoplasma pneumoniae noma i-Bordetella pertussis (ukutheleleka kwamagciwane), ingozi yakho ikhuphuka ibe yingozi engaba ngu-25 kuya kwezingu-50 wamaphesenti okuba nokukhwehlela kokuthunyelwa kwesifo.
Ukukhwehlela kwe-post-virus kubuye kube nokuhlangenwe nakho njalo ezinyangeni zasebusika ngenxa yokwanda kwezifo ezingaphezulu zokuphefumula. Ukugwinya ngokuvamile kubhekana nokuningi kwezingane ezifunda esikoleni; uhlangabezana neziqephu ezingu-7 kuya ku-10 ngonyaka. Ngenkathi abantu abadala bezwa kuphela iziqephu ezimbili kuya ku-5 ngonyaka, ingozi ayikho kakhulu kakhulu kubantwana noma kubantu abadala.
Izimbangela
Isizathu sokuthi ugcina ukukhwehlela ngemuva kokutheleleka kokuphefumula okuphezulu akuhlali kahle. Kodwa bakholelwa ukuthi ukuhlala ukuvuvukala nokwehlisa izicubu eziphezulu noma eziphansi ezingaphansi kwe-airway (epithelial) kusukela emakhazeni kunomthwalo wemfanelo. Njengoba izimfihlo ziphuma emoyeni ongenhla (njengokungena kokuphuma kwe-nasal), i-reflex yokukhwehlela ingabangela. Izimbangela ezivamile zokukhwehlela kokuhamba komzimba zihlanganisa:
- Igciwane lesifo se-syncytial (RSV)
- umkhuhlane (umkhuhlane)
- i-parainfluenza (evame ukuhambisana ne- croup )
Nini Ukubona Udokotela
Ezimweni eziningi, ngeke udinga ukubona udokotela ukukhwehlela kokugoma. Kodwa-ke, uma ukukhwehlela kwakho okuqhubekayo kukhula kakhulu noma kuyinkinga kuwe, futhi ungaqhubeka isikhathi eside kunamaviki ayisishiyagalombili, uzofuna ukubona udokotela ngokukhululeka okuyisifo noma ukuqhubeka nokusebenza.
Ukuxilongwa
Ngaphansi kwezimo ezivamile ngeke kudingeke uthole ukuxilongwa kokukhwehlela kokungena komzimba uma usanda kuba nokutheleleka okuphezulu kokuphefumula futhi ube nomkhuhlane ongazange uqhubeke isikhathi eside kunamaviki angu-8. Kodwa uma unesifo esibucayi esibonisa izinga lakho lokuphila, uzofuna ukubona udokotela.
Udokotela wakho uzothatha umlando ogcwele kuhlanganise nokuqala komkhuhlane wakho, kanye nezici zokukhwehlela kwakho kwamanje. Ukukhwehlela kwamagciwane kuyatholakala ukuthi akukhipha ezinye izimbangela (etiologies) zokukhwehlela okungapheli. Ngokuya ngomlando wakho, udokotela wakho angadinga ukulawula lezi ezinye izimbangela zokukhwehlela okungapheli:
- isifo se-reflux ye-gastroesophageal (GERD)
- reflux laryngopharyngeal (LPR)
- ukuphefumula kwe-airway okuphezulu (UACS)
- i-asthma
- ezinye izifo ezingapheli zomoya
- imithi-yenziwe
Udokotela wakho cishe angeke akudinge ukuba akuhlole ngayinye yalezi ezinye izimbangela. Bazonquma ukuthi noma yikuphi kwalokhu kufanele kuhlolwe ngokusekelwe ekuhlolweni kwabo kwezokwelapha kanye nomlando wakho wezokwelapha.
Ukwelapha
Ngaphandle kokunakekelwa, ukukhwehlela okuvela kwamagciwane kuzokuxazulula ngokwakho. Kodwa uma ukukhwehlela kwakho kuthinta kakhulu izinga lakho lokuphila, ungathola ukuthi isikhathi sokuxazulula phakathi kwamasonto amathathu no-8 sibe eside kakhulu. Uma kunjalo, uzodinga ukubona udokotela wezokwelapha ezenzakalelayo. Kunezinhlobo ezimbili zokwelashwa eziyinhloko udokotela wakho azokuhlaziya ukuze unikeze ukukhululeka okungcono kakhulu.
Ukuze kukuphathe ngendlela efanele, udokotela wakho kuzodinga ukuthi anqume ukuthi ukukhwehlela kwakho kokuthunyelwa komzimba kungenxa ye-post-nasal drip (manje ebizwa ngokuthi yi-upper airway cough syndrome) noma uma ihlobene ngokuqondile nokuguquka kwesibindi noma ukukhwehlela ukutheleleka ngegciwane.
Isikhukhula esihlobene nomoya ophezulu we-airway ukhwehlela (UACS) unokwelashwa okufanayo njengokuthi uthola ukuthi unama-UACS angenalutho. Njengokwelapha kokuqala, udokotela wakho uzokunika i-antihistamine yesizukulwane sokuqala. Ngenkathi leli klasi lemithi lidlula kakhulu kunezinhlobo eziningi ze-antihistimines ezintsha, ziphumelela kakhulu ekunciphiseni ukukhwehlela kwakho kokulandela. Ama-antihistamine angase abekwe ngokujwayelekile ahlanganisa:
- i-brompheniramine
- i-chlorpheniramine
- isicacastine
Kodwa-ke uma kudingeka usebenze noma usebenze ngokwengeziwe kanye nemiphumela emibi ye-antihistamine echazwe ngenhla ayifuni, ungasebenzisa le mithi yesizukulwane sesibili:
- I-Zyrtec (cetirizine hydrochloride)
- I-Claratin (i-loratadine)
- I-Allegra (i-fexofenadine hydrochloride)
Ukukhwehlela kwamagciwane ngaphandle kwe-UACS kuhlobene ngokuqondile nezinguquko emathanjeni asuka emoyeni nasezinkonyeni zokukhwehlela ezivela ekutheleleni kwakho ngegciwane. Ukunakekelwa kokukhwehlela okuphazamisa ukugoma okwamanje kulesi sifo kufana nokukhwehlela okwehlukile kwesifo se-asthma . Udokotela wakho kuleli cala kungenzeka ukuthi uthathe isilingo se-methacholine noma se-antihistamine ukuhlola ukuthi une-hyperreactivity ye-bronchial. Ngokuya ngobukhulu bezimpawu zakho uzobe unqunywe uhlobo olulodwa noma ngaphezulu kwalolu hlobo lwemithi:
- i-glucocorticoids engenele
- i-bronchodilators engenele
- i-leukotriene receptor antagonists
- i-prednisone yomlomo
Uma ukuhlolwa kwakho kungabonisi ukuxilonga okuxilisayo, kungase kube usizo ekuvivinyeni inkambo ye-ipratropium bromide (i-Atrovent). I-Atrovent iboniswe ukuthi iphumelele ekuqalisweni kwe-post-viral lapho ukukhwehlela i-asthma ehlukile akusola.
Imithombo:
U-Braman, i-SS. (2006). Isikhukhula esithathelwanayo: I-ACCP Imihlahlandlela Yokusebenza Yomtholampilo Ebukelwe Ebufakazi. Isifuba. 129 (I-Suppl 1): 138S-146S.
UHughes, J & Shield, MD. (2009). Ukukhwehlela okuqhubekayo okungavamile. I-Paediatrics ne-Health Child, 19 (6): 291-293.
Rutter, P. (2013). System Respiratory. I-Pharmacy yomphakathi: Izimpawu, Ukuxilongwa Nokunakekelwa. Kufinyelelwe ngo-Okthoba 29, 2016 kusuka ku-http: //www.clinicalkey.com. (Okubhaliselwe Kudingekile)
U-Sylvestri, uRC & Weinberger, SE. (2014). Ukuhlolisisa ukukhwehlela nokuhlukunyezwa okungapheli kubantu abadala. Kufinyelelwe ngo-Okthoba 29, 2016 kusuka ku-http: //www.uptodate.com. (Okubhaliselwe Kudingekile)
U-Sylvestri, uRC & Weinberger, SE. (2016). Ukwelashwa kwesifo somzimba nesifo sokugoma okungapheli kubantu abadala. Kufinyelelwe ngo-Okthoba 30, 2016 kusuka ku-http: //www.uptodate.com. (Okubhaliselwe Kudingekile)