Ukuphefumula kuyinselele njengoba umsebenzi wakho wamaphaphu ungaphansi
Isifo se-End-stage chronic obstructive pulmonary (COPD) sibhekisela ekugcineni kwezifo zesifo. Lokhu kusho ukuthi umuntu unokuphefumula okuphawulekayo ngisho nalapho ephumula futhi esengozini enkulu yezifo zamaphaphu nokuhluleka kokuphefumula. Abantu abaningi bahlobanisa igama elithi "ukuphela kwesiteji" ngokufa okukude noma ukukhubazeka okukhulu okuholela ekufeni.
Kodwa lokhu akunjalo ngaso sonke isikhathi.
Incazelo
Ngencazelo, "ukuphela kwesigaba" kubhekisela "esigabeni sokugcina phakathi nesifo esiqhubekayo." Abanye abantu bacabanga ukuthi leli gama lisetshenziselwa isiguli lapho abahlinzeki bezempilo bezwa ukuthi benze konke abangakwenza ngokwelashwa ngesiguli. Kodwa ngokuvamile kuvame ukuthi abanye abahlinzeki bezempilo bangayenza iziguli zabo ezinezifo ezingavamile zokuphefumula ( COPD ). Kungase kusho ukuthi izinhloso zokunakekelwa ziye zashintsha, kusukela ekuphatheni isifo ukunikeza induduzo.
Ngokwe-Global Initiative for Obstructive Lung Disease (GOLD), kunezinyathelo ezine ze-COPD :
- Isigaba I: I- COPD encane. Umsebenzi we-Lung uqala ukwehla kodwa awukwazi ukuwuqaphela.
- Isigaba II: I- COPD ejwayelekile. Izimpawu ziyaqhubeka, ngokuphefumula kufinyelele ekusebenziseni.
- Isigaba III: I-COPD ekhulu. Ukuphefumula kuyaba kubi nakakhulu futhi ukuqhuma kwe-COPD kuvamile.
- Isigaba IV: COPD Ekhulu kakhulu. Ikhwalithi yokuphila ikhubazekile kakhulu. Ukukhushulwa kwe-COPD kungasongela ukuphila.
Isigaba ngasinye sichazwa ngokusho kwe- spirometry isilinganiso se- FEV1 (ivolumu yomoya iphefumula okwesibili sokuqala emva kokuphuma kwephoyisa). Ukuphela kwesigaba se-COPD yisigaba se-IV noma i-COPD kakhulu.
Ngenkathi abanye kulesi sigaba begula kakhulu, kukhona abanye abangenalo. Iliphi iqembu owela kulo lihlobene nezinombolo ezimbalwa ezithinta isikhathi sokuphila se-COPD kufaka phakathi umlando wakho wokubhema, izinga lakho le-dyspnea (ukuphefumula), izinga lomzimba kanye nesimo somsoco.
Abanye abantu esiteji IV basakwazi ukusebenza kahle ngokulinganiselwa okumbalwa. Ngakolunye uhlangothi, kunabantu abaningi kuleli sigaba abagula kakhulu.
Ukwelapha
Nakuba ukungenelela okuhlinzekwayo kungase kube yindlela yokukhetha (isibonelo, i-bullectomy, ukuhlinzwa kwe-volume volume lungamaphesenti, noma ukufakelwa kwamaphaphu), kungenzeka ukuthi kuzuze inombolo encane yeziguli ze-COPD.
Kwabanye, njengoba ubukhulu besifo sabo banda, ukugxila kokwelashwa kuqala ukususa ekukhuliseni impilo ekuhlinzekeni ukunakekelwa kokunakekelwa kokunciphisa ukukhulula izimpawu zeCOPD .
Ngalokho, uma ubhekene nokuxilongwa kokuphela kwesigaba se-COPD, udokotela wakho angase anikeze lezi zindlela zokwelapha ezilandelayo:
- Ama-bronchodilators: Kunconywa ukuthi ama- bronchodilator amancane asebenza isikhathi esifushane futhi asebenza isikhathi eside uma ukuphefumula ngesikhathi sokusebenza okuvamile kungakhululwa yi-bronchodilators emifushane yedwa.
- Ama-ophiates: I- Morphine, ikakhulukazi, ingase ithuthukise kakhulu ukuphefumula. Kodwa-ke, ezinye izifundo zibonisa ukuthi zingase zibe nemiphumela emibi kakhulu futhi ukuthi inzuzo kuphela inombolo ekhethiwe yeziguli.
- I-glucocorticoids engabhalisiwe: Lezi zingase zibekwe ezigulini ezine-FEV1 ngaphansi kwamaphesenti angu-50 okubaluleka okubikezelwe kanye nomlando wokukhushulwa okuphindaphindiwe kwe- COPD .
- I-oxygen eyengeziwe: I- oksijeni inciphisa ukuphefumula okubangelwa umsebenzi futhi ithuthukise ukubekezelelana kokuzivocavoca kweziguli ezinezinga eliphansi le-oksijeni yegazi.
- I-NIPPV engeyona ingavamile yomoya (i-NIPPV): Ukungena umoya okungavumelekile kunganciphisa ukugcinwa kwe-carbon dioxide futhi kuthuthukise ukuphefumula kwezinye iziguli, kodwa akukhuthazwa njalo.
- Ukuvuselelwa kwepulmonary: Lokhu kuye kwafakazelwa ukusiza iziguli ze-COPD kuzo zonke izigaba zesifo.
- Ukweluleka kokudla okunempilo: Lokhu kungase kuphakanyiswe ngoba ukungondleki kuyinkinga evamile ekupheleni kwesigaba se-COPD futhi kwandisa ingozi yokufa.
- Ukusekelwa kwengqondo nezenhlalakahle: Lezi zici ezibalulekile zokwelashwa ngoba iziguli eziningi azixoxisisani nezindaba zokuphela kokuphila nodokotela bazo.
- Izindlela zokwelapha ezihambisanayo: Ukuphumula nokubukwa kwesisindo, ukusikhipha imithi yokwelashwa, kanye nokwelashwa komculo ngezinsimbi eziphilayo, i-CD, noma umsakazo kungasiza ukuqeda izimpawu ezifana nokuphefumula.
Izinkinga Zokuphela Kwezinto Zokuphila
Uma ukholwa ukuthi ukufa komuntu othandekayo kusondela ngenxa yeCOPD, sekuyisikhathi sokubhekana nokuphatha izindaba zabo zokuphela kokuphila. Noma kunjalo, lokhu kungaba nzima kakhulu ngenxa yokukhubazeka kwesifo se-chronic obstructive pulmonary.
Ukuze ucindezele izindaba, ucwaningo luye lwabonisa ukuthi naphezu kokuhlangana kukaCOPD nokukhubazeka okukhulu nokufa ngaphambi kwesikhathi, iziguli ze-COPD zisathola ukunakekelwa kokuphela kokuphila okunganele. Ngenxa yalezi zizathu, wena nomndeni wakho ningafuna ukucabangela ukubhalisa usizo lwe- hospice ukukuqondisa ngalesi sikhathi.
Ukuphathwa kwesimiso kungenye yezici ezibaluleke kakhulu ekupheleni kokunakekelwa kokuphila ngoba izimpawu ze-COPD zivame ukonakala ezinsukwini zokugcina-ikakhulukazi, i-dyspnea kanye nokukhwehlela , ubuhlungu, ukukhathazeka nokucindezeleka, ukudideka, i-anorexia, ne- cachexia .
Ngokuphelele, ukuphela komuntu komuntu kungaba yisikhathi sokuzindla ngokujulile kokubili isiguli nomndeni. Kungaba yisikhathi sokudabuka okukhulu. Khumbula ukuthi ukuthinta okulula njengokubamba isandla somthandi wakho nokuba khona kunganikeza induduzo enkulu.
I-COPD yokuphela kwe-End-Stop
Uma lesi sifo singakafiki, kunezinguquko eziningana zokuphila umuntu angakwazi ukuzifaka ngendlela yokuphila ukuze alondoloze impilo enhle .
- Yeka ukubhema: Ukuyeka ukubhema kuyindlela ebaluleke kakhulu, engabizi kakhulu yokuvimbela nokuphatha i-COPD. Uma umgomo wakho ukuzizwa ungcono, unciphisa ukuqhubeka kwesifo, futhi uphile isikhathi eside, khona-ke kufanele usho ukuthi ugwayi ugwayi kanye nhlobo.
- Ukuzivocavoca: Ngaphandle kokuyeka ukubhema, uma wenza ushintsho olulodwa lokuphila emva kokuxilongwa kwe-COPD ezoba nomthelela omkhulu empilweni yakho, cabangela uhlelo lokuzivocavoca nsuku zonke.
- Yidla Impilo: Ukudla okunempilo okufanele kube yisisekelo lapho uqala khona uhambo lwakho emva kokuxilongwa kwe-COPD, noma ngabe uthola ukuthi uneminyaka eminingi futhi ufuna ukushintsha izinguquko zokuphila ukuze kukuzwe uzizwe kangcono. Ingxenye ebalulekile yimuphi uhlelo lokuphathwa kwezifo futhi unikeza labo abane-COPD amandla abalulekile adinga ukuphefumula nokulwa nokutheleleka.
- Hlala Uhlelekile: Omunye usho ukuthi impilo ingamaphesenti angu-10 okwenzeka kuwe namaphesenti angu-90 okwenzayo ngakho. Ukuhlala unempilo phakathi kwesifo sokugula okungapheli kunzima, kodwa akunakwenzeka. Konke mayelana nokuthuthukisa izindlela ezintsha zokubhekana nazo ezizohambisana nendlela yakho yokuphila.
Izwi elivela
Ukuqonda ukuphela kwesigaba se-COPD nokuthi yini ongayenza ukuze uzivimbele ekufikeni lapho uqala ngokuthatha isikhathi eside, ubheke kanzima esibukweni bese uzibuza umbuzo owodwa othize: "Ngingakufanele?" Umuntu obuka emuva uzethemba ukumomotheka futhi uphendule, "yebo."
Imithombo:
> Ambrosino N, Gherardi M, Carpenè N. End-Stage Chronic Obstructive Izifo Eziphuthumayo. I-Pneumonol Alergol Pol. 2009; 77 (2): 173-9.
> Vestbo J, Hurd SS, Agustà AG, et al. Isu Lomhlaba Wonke Lokuthola Ukuxilongwa, Ukuphathwa Nokuvimbela Izifo Eziphuthumayo Zokuvimbela Izifo. I-American Journal of Respiratory and Critical Care Medicine . 2013; 187 (4): 347-365. i-doi: 10.1164 / rccm.201204-0596pp.