Ngenxa yokuthi i-asthma ivame kakhulu isimo sezokwelapha, akumangazi ukuthi amaphesenti angu-3 kuya kwangu-8 azo zonke ukukhulelwa ahilela ukuxilongwa kwesifo se-asthma.
Ngokungafani neminye imibandela lapho ungayeka khona imithi ngesikhathi ukhulelwe noma ngesikhathi sokuqala kokukhulelwa phakathi nesikhathi esengozini enkulu yokuthola imiphumela ye-teratogenic, i-asthmatics idinga ukuthatha imithi yabo ukuze igcine ukulawula okuhle.
Lokhu kuholela emininingwaneni yemibuzo ehlobene nokuphepha kwemithi ye- asthma ngesikhathi ukhulelwe, umthelela wokukhulelwa ekulawuleni kwakho kwe-asthma, futhi ingabe i-asthma yenza ukukhulelwa okuphezulu noma ukulimaza ingane noma yebo?
Ukulawula I-Asthma Phakathi Nokukhulelwa
Ukulawula i-asthma ekukhutheni kungacatshangwa ngomthetho wezintathu-ingxenye eyodwa kwezintathu zokuzizwa kwe-asthmatics ezithintekayo ezithuthukisiwe, ingxenye yesithathu ayikho ushintsho, kanti okuyisithathu okuhlangenwe nakho kokuya kwezimpawu zabo. Ngokuvamile, ukuqina kwakho kwe- asthma ngaphambi kokukhulelwa kuhlobene nokuqina kwesifuba sakho ngesikhathi ukhulelwe.
Ngenkathi omunye engase acabange ukuthi njengoba ibhande lakho lesisu likhuphuka ukuthi ukulawula isifo sofuba kuyodala, kodwa kubonakala kungukuthi okungafani neze-asthma kunzima kakhulu emavikini okugcina okukhulelwa. Lapho ukulawula isifo se-asthma kuthuthukile kubonakala sengathi kwenze kancane kancane ngaphezu kokukhulelwa. Kwabesifazane abahlukumezeka yi-asthma, ukuwohloka kwakuvame kakhulu phakathi kwamasonto angu-29-36 okukhulelwa.
Izimpawu ezibalulekile ze-asthma zivamile ngesikhathi sokubeletha nokubeletha. Ukuhlaselwa kwe-asthma kubonakala sengathi kwenzeka kaningi ngesikhathi se-second and third trimester. Okokugcina, inkambo ye-asthma ngesikhathi sokukhulelwa ijwayele ukuphinda ngokukhulelwa okulandelayo. Uma i-asthma yakho ithuthukisiwe ngesikhathi sokukhulelwa ithambekele ekuthuthukiseni ukukhulelwa okuzayo futhi ngokuphambene nalokho.
Impact Of Asthma on Ukukhulelwa
I-asthma elawulwa kabi ikwazi ukuholela kuzo zonke izinkinga ezilandelayo:
- Ukufa kwezingane
- Ukulethwa kokuqala
- Isisindo sokuzalwa esincane
- Ukushada
- Ukuzibilisa kokubili ngaphambi nangemva kokubeletha
- Ukucindezeleka
- I-Preeclampsia noma ukucindezeleka okubangelwa ukukhulelwa
- Ama-clots wegazi noma i-embolism ye-pulmonary
- Ukungalungi kwama-Congenital
- I-Hyperemesis, isifo sokuhlanza
- Umsebenzi obanzi
Lezi zinkinga zingase zibangelwe ukwehla kwamazinga e-oxygen. Ukwehlisa amazinga e-oksijeni kumama kungaholela ekunciphiseni amazinga e-oksijeni wengane yakho futhi wehla ukugeleza kwegazi ku-placenta. Kukhona nezinkinga ezikhona ezivela emithini ye-asthma.
Ayikho yalezi zinguquko ezihlobene nokulawulwa kwe-asthma noma umphumela wesifuba ekukhulelwe kufanele kuthathwe ukuthi kusho ukuthi i-asthmatics akufanele ikhulelwe. Ukwelashwa okuhle nokulawula kuzonciphisa futhi kunciphise ingozi yalezi zinkinga.
Uma i-asthma yakho ilukhuni kakhulu, cishe uzoba nezinkinga ze-asthma.
I-Asthma Treatment In Ukukhulelwa
Ukwelashwa kwakho nge-asthma ekukhulelweni akuyona yonke into ehlukile kunokwelashwa kwakho esimweni esingakhulelwe. Udinga uhlelo lwesenzo se- asthma , kudingeka uqaphele njalo izimpawu zakho ze-asthma , futhi uzame ukugwema izimbangela. Enye yezinto ezenza ukubhekwa kanzima kakhudlwana ekukhutheni kungukuzwa ukuphefumula kweziguli eziningi ezikhulelwe zithola, ikakhulukazi kamuva ekukhulelwe.
Nokho, ukugaya nokugubha, akusho neze izimpawu zokukhulelwa futhi kungaba uphawu lokulawulwa kwe-asthma. Ngenxa yalokho, ukuqapha i-asthma nge- peak flows noma i- FEV1 ingase ibe yithembeke kancane kwesiguli esikhulelwe. Ukuncipha kunoma yikuphi kwalokhu kungase kusiphakamise ukukhushulwa kwe-asthma.
Njengaye isiguli esingakhulelwe, ukuyeka ukubhema kubalulekile ku-asthmatic ekhulelwe. Ukubhema akukona nje ukwandisa ingozi yokuqhuma kwesifo se- asthma , kodwa kungenza amazinga aphansi e-oksijeni abe mabi kakhulu futhi angase akhulise ingozi yokubhekana nenye yezinkinga ezikhulunywe ngaphambili. Ngokufanayo, ukugwema ezinye izicasula ezinjengothuli, i- dander , nezidakamizwa zothuli yingxenye ebalulekile yecebo lakho lohlelo.
Imithi ngesikhathi sokukhulelwa
Ngokuhlobene nokuphathwa kwe-asthma ekukhulelwe, imibuzo emibili iphakama ngokuhlobene nemithi.
1. Ingabe imishanguzo ye-asthma inemiphumela emibi kumntwana osathuthuka?
2. Ingabe ukukhulelwa kuthinta ukusebenza komuthi othize uma kuqhathaniswa nokusebenza kwayo esimweni esingakhulelwe?
Imithi ye-asthma ngesikhathi sokukhulelwa iye yahlotshaniswa nemiphumela eminingi emibi kakhulu efana nalokhu:
- Ukushada
- Ukufa
- Ukungalungi kwama-Congenital
- Ukunciphisa ukukhula kwe-utero
- Ukuthuthukiswa okubi
- Ukunciphisa ukugeleza kwegazi ku-placenta
- Ingozi eyengeziwe yokulethwa kwangaphambi kwesikhathi
Kodwa-ke, umuntu kufanele aqaphele yonke le miphumela emibi evamile ekukhulelwe, ngisho nakwabesifazane abakhulelwe abangenayo i-asthma. Isibonelo, ukuhlukumezeka kokuzalwa kubangelwa ku-3% kokuzalwa okuphilayo kanye nokuhlukumeza okungu-10-15% kokukhulelwa. Awekho izidakamizwa ze-asthma zamanje okwamanje ezibhalwe Isigaba A yi-United States Yokudla Nezidakamizwa Zokuphatha. Lezi ziyoba izidakamizwa ezilawula ukucwaninga kwabesifazane abakhulelwe behluleka ukubonisa ingozi kumntwana ekukhulelweni kokuqala futhi akukho bufakazi obungozi ngemuva kokukhulelwa. Izidakamizwa eziningi ze-asthma ziyi-class B noma i-class C. Isidakamizwa sekilasi B kusho ukuthi izilwane zezilwane azizange zibonise noma iyiphi ingozi yengane, kodwa azikho izifundo ezilawulwayo kwabesifazane abakhulelwe. Kungasho futhi ukuthi kwakukhona ingozi ekhonjiswe ezifundweni zesilwane ezingakaqinisekiswa ngokuqhubekayo kwizifundo zabesifazane ku-trimester yokuqala yokukhulelwa futhi abukho ubufakazi obungozi ngemuva kokukhulelwa. Emngciphekweni weC class C angeke kukhishwe futhi ukusetshenziswa kufanele kuthathwe kuphela uma izinzuzo ezinganeni zingaphezu kwezingozi. Esiklasini D kunebufakazi obuhle bengozi, kepha ukusebenzisa izidakamizwa kungamukeleka naphezu kwengozi.
Ngokuvamile, kubonakala sengathi ukwelashwa okusebenzayo ukuze kugcinwe ukulawulwa kwe-asthma okuhle futhi kuvimbele ukukhuphuka okungaphezu kwezingozi zemithi eminingi esetshenziswa njalo ekwelapheni i-asthma. I-Albuterol, i-beclomethasone, ne-budesonide sonke isetshenzisiwe ekufundeni kwe-asthmatics ekhulelwe kanti zonke izifundo zazinemiphumela eqinisekisayo. Ngakolunye uhlangothi, izifundo nge-prednisone yomlomo azizange ziqiniseke. Kukhona futhi izidakamizwa ezinokuhlangenwe nakho okuncane kakhulu kweziguli ezikhulelwe.
SABAs . Ama-agonists abambalwa abamba ama-beta ahlinzeka ngokuphuthuma okusheshayo izimpawu ze-asthma ezifana nalezi:
Ngenkathi ukuphakama okukhulu kwe-SABAs kubonise imiphumela ye-teratogenic ezilwaneni, akukho idatha ebonisa ngokucacile imiphumela ye-teratogenic kubantu. Izifundo zibonise ziboniswe ezimbalwa uma kunezinkinga nge-albuterol. Kodwa-ke, izifundo ezimbalwa ezincane zibonise i-gastroschisis noma isici sokuzalwa lapho ingane izalwa khona noma yonke imathumba yakhe ngaphandle kwesisu ngenxa yokuvula okungavamile emdongeni wamasipha esiswini. Enye inkinga ngezinye zezifundo zemiphumela ekhombisa ukulimala kungukuthi ukusetshenziswa kwe-SABA kuhlotshaniswa ne-asthma engalawulwa kahle engabangela izinkinga eziningi ezichazwe ngaphambili.
Ngezinye izikhathi ama-agonists ase-beta-adrenergic asetshenziselwa ukuvimbela ukusebenza ngaphambi kwesikhathi. Esikhundleni sokungenelela lezi zidakamizwa zinikezwa nge-IV. Imiphumela emibi kakhulu ebonakalayo nale ndlela yokuphatha i-hyperglycemia noma ishukela ephakeme yegazi. Lapho izinsana zizalwe ngezinye izikhathi zinezinga eliphezulu lenhliziyo, ukuthuthumela, kanye noshukela ephansi wegazi ngenxa yomuthi wokwelashwa. Yonke yale miphumela emibi emntwaneni osanda kuzalwa iyaphathwa futhi ngokuvamile, ibuyele ngokusheshisa ngakho-ke ayinqatshelwe.
LABAs . Ukuhlangenwe nakho kwama-LABA nokukhulelwa akubaluleki kangako kunamaSABA. Ngokusekelwe ekuhlangenwe nakho okukhona okwamanje okubandakanya kokubili izifundo zabantu nezilwane, akubonakali ukuthi i-salmeterol noma i-formoterol yandisa ingozi ye-anomalies engavamile. Kunokuhlangenwe nakho okuqondile komuntu nge-salmeterol. Ngenxa yalokho, kunengqondo uma owesifazane ekhulelwa ukuqhubeka ne-LABA eyadingeka ekulawuleni i-asthma esimweni sokukhulelwa. Ingozi yokukhubazeka okuzalwa okungenayo inhlanganisela ephansi ye-LABA / i-steroid engenayo ibonakala ifana ne-dose ephakeme noma ephezulu ye-ICS monotherapy.
Epinephrine. Ngenxa yengozi yokunciphisa ukugeleza kwegazi ku-placenta, iQembu Lokusebenza Ngokukhulelwa kanye ne-Asthma lincoma ukuthi lesi sidakamizwa sisetshenziswe kuphela ekusetshenzisweni kwe-anaphylaxis.
I-steroids yomlomo. Ama-steroids omlomo avame ukusetshenziselwa ukukhulelwa ngezimo ezihlukahlukene ngaphandle kwe-asthma. Ezinye zezimpikiswano mayelana nokusetshenziswa kwazo zihlanganisa ukwandisa ingozi yokuguqulwa komzimba, ukukhubazeka kokubeletha (ikakhulukazi i-palate palate), ukucindezeleka okubangelwa ukukhulelwa, isifo sikashukela sokukhulelwa, isisindo sokubeletha esincane, kanye nokuntuleka kokubeletha kwe-neonatal. Kunezimpendulo ezimbalwa ezicacile. Isibonelo, ezinye izifundo zibonise ingozi ekhuphukile ye-palate ye-cleft kanti abanye abangekho. Ubufakazi obonisa ukubeletha ngaphambi kwesikhathi phakathi kwabesifazane abathola i-steroid ngesikhathi sonke sokukhulelwa kunamandla kakhulu. Okokugcina, i-hypertension kanye namazinga aphezulu e-glucose ayaziwa ngokuzibandakanya ngakho-ke, akumangalisi. Ngakho-ke kuya phansi engozini. Kukhona ingozi enkulu kubomama kanye ne-fetus ehlobene nokulawulwa kwe-asthma okungalungile. Izingozi ze-asthma ezingalawulwayo zizobonakala zingaphezu kwezingozi ezingase zibe khona ze-steroids ezigulini eziningi.
I-steroids engabhalisiwe. Idatha yokuphepha ye-steroid engatholakali ngesikhathi sokukhulelwa, njengaleyo iziguli ezingakhulelwe, iqinisekisa kakhulu. Ucwaningo lokubhalisa lwe-steroid budesonide olufakwe ngaphakathi kwebesifazane baseSweden alukhombisi ubungozi obuningi bokungalungi uma kuqhathaniswa nomphakathi jikelele. Ucwaningo alubonanga neze izinkinga ezihlobene nokukhula komntwana, ukushona noma ukuguqulwa komzimba. Ngokusekelwe kulokho okutholwe yiyona kuphela i-steroids engatholakali okwamanje enezinga lesigaba B. Kwesinye database njengokwesifundo, i-fluticasone ayibonanga ukwanda kwezinkinga ezingenasifo sokuqhathaniswa uma kuqhathaniswa namanye ama-steroids akhulelwe. Izilinganiso ezimbili ezilawulwe ngokungahleliwe zenze umsebenzi wokuphumula wamaphesenti futhi zinciphisa amanani okufundwa.
Ama-modifiers e-leukotriene. Njenge-LABAs, leli klasi lezidakamizwa linemininingwane encane yokwelashwa okwamanje, kodwa idatha ne-montelukast ikhula. Idatha engashicilelwe kusukela ku-Registry Merck Pregnancy kanye nesilingo esilawulwayo, esilingwayo, sibonisa ukuthi amanani okukhubazeka okuzalwa angabonakali ahluke kubantu abaningi. Ngenxa yalokho, iziguli ezidinga i-leukotriene modifier zingasetshenziswa kangcono yi-montelukast kuze kube yilapho idatha eyengeziwe itholakala kwamanye ama-agent.
I-Anti-immunoglobulin E. I- anti-immunoglobulin E-anti-immunoglobulin E noma i-omalizumab ivunyelwe iziguli ezine-asthma ezilawulwa kahle ezingeni eliphezulu ze-IgE naphezu kokusetshenziswa kwe-steroids engatholakali. Ngenkathi ingahlolwa ngendlela efanele emfundweni yomtholampilo, amazinga ezinkinga ezifana nokukhulelwa kwesisu, ukuzalwa ngaphambi kokubeletha, izinsana ezincane zokubeletha, kanye nezinkinga ezingenayo yokubeletha kubonakala sengathi zifana nezinye izifundo ze-asthmatics ekhulelwe. Akukho okwamanje idatha eyanele yokwenza isincomo sokusetshenziswa kwayo ekukhulelwe.
Ama-Methylxanthini. Kunokuhlangenwe nakho okubanzi komtholampilo we-theophylline ne-aminophylline ekukhulelweni. Yize lezi zidakamizwa ziphephile emtholampilo, ukuguqula umzimba kwazo kuguqulwa kakhulu ekukhupheni kanye namazinga kufanele ahlolwe. Uhla oluncane lwezokwelapha lincane kakhulu okwenza ukwelashwa kweziguli ezingakhulelwe kube nzima. Ngaphezu kwalokho, njengalokhu kuziguli ezingezona ezikhulelwe, i-steroids e-inhaled iyasebenza kakhulu ekulawuleni i-asthma. Ngenxa yalokho, lezi zidakamizwa zicatshangelwa kangcono njengama-add-on agents uma ukulawula kungakwazi ukufezwa nge-steroids engatholakali.
Immunotherapy. Yize kungavunyelwe ukuqala imithi yokwelapha ngesikhathi sokukhulelwa, akubonakali lezi zindlela zokwelapha zenza ingozi eyengeziwe kumama noma kumntwana okumele uqhubeke ngesikhathi sokukhulelwa.
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