Izinkombandlela ezithuthukisiwe zisekela indlela engcono kakhulu yomuntu
Ngo-2017, i-Global Initiative ye-Chronic Obstructive Lung Disease (GOLD), ikomidi lamazwe omhlaba ochwepheshe bezokwelapha, livuselele izincomo zalo ekuxilongweni nasekulawuleni izifo ezingapheliyo zokuvimbela izifo (COPD) .
Kusukela ekukhululweni kwangaphambilini kwangonyaka ka-2012, ikomidi lenze izinguquko ezinkulu endleleni odokotela abahloswe ngayo ukubhekana nalesi sifo, ukucacisa izincazelo kanye nokushintsha indlela izimpawu ezihlolwa ngayo kanye nemithi yokwelapha echazwe.
Njengoba ososayensi beqhubeka beqonda ukuthi umphumela wesikhathi eside nokusebenza kwe-COPD yokwelapha, ukugxila kugxile kwisiguli, ukulungisa izindlela zokwelashwa komuntu kunokuba isiteji sesifo.
Izinguquko kuNcazelo
Phakathi kwezinguquko ezibalulekile ekubuyekezeni kuka-2017 yincazelo yeCOPD ngokwayo. Esikhathini esedlule, lesi sifo sasichazwe ngokuyinhloko ngezinqubo zayo, kusukela ezindleleni zokuvuvukala endleleni isifo esathuthuka ngayo.
Angiphinde. Endaweni yayo, ikomidi le-GOLD licacisa i-COPD ngokuthi "izifo ezivamile, ezivinjelwayo nezokuphathwayo ezibhekene nezimpawu zokuphefumula eziqhubekayo nokunciphisa ukukhuphuka emoyeni ... ngokuvamile kubangelwa ukuvezwa okuphawulekayo kwezinhlayiya noma ama-gesi."
Asikho isifo esichazwe ngokweqile noma izifo noma izifo ze- comorbid . Esikhundleni salokho, ihlehlisiwe ibe yimbangela-futhi-effect elula: ukuthi ukutholakala kwesimiso esiyingozi (njengama-cigarettes) kungabangela ukugula okuqhubekayo okuphefumula.
Ngenkathi lolu shintsho lungase lubonakale luyinto engafanele, ludlula enye yezinselele ezinkulu ekuhloleni nasekuphatheni i-COPD. Ivuma ukuthi abantu abangenayo ubufakazi bokutholwa kwemithi yokuvimbela umoya bangaba nezibonakaliso zesifo, ngezinye izikhathi zilukhuni.
Ngakho-ke, kunokuba ulinganise ukwelashwa kwemiphumela ye-lab ngokumelene nezimpawu, odokotela manje bagxile embangela, umphumela, nesipiliyoni sokubekezela ukuqondisa inkambo yokwelapha.
Izinguquko ekuthuthukiseni kwethu ukuthuthukiswa kwezifo
Ukuphikisana okufanayo bekulokhu ukuqonda kwethu ukuthuthukiswa kwesifo. Ngenkathi ikakhulukazi sihlobanisa i-COPD nokubhema (echazwe ikomidi le-GOLD ngokuthi "ukuzilimaza"), iqiniso elilula ukuthi akubona bonke ababhemayo abathola i-COPD hhayi bonke abantu abaneCOPD ababhemayo.
Umbiko we-GOLD olusha uvuma ukuthi asisazi ngokugcwele ukuthi iphuzu eliphikisanayo lihlobene nobani othola i-COPD nokuthi ngubani ongenalo. Ngaphandle kokwehliswa kwegwayi, ikomidi le-GOLD liyaqaphela ezinye izici ezikhona ezihlobene nesifo, kufaka phakathi:
- Ukukhula kabi kwamaphaphu ngesikhathi sokubeletha kanye nobuntwana
- Ukuvezwa kwamakhemikhali angcolile ezimweni zokusebenza
- Izinhlobo ezahlukene zokungcola komoya
- Isimo sezomnotho esibi
- Izindawo zokuhlala eziphuthumayo
- Ukuvezwa kokushisa kwamafutha (kubandakanya umlilo wezinkuni nokupheka)
- Ezinye izinkinga zamaphaphu (njenge-bronchitis noma izifo ezingapheli)
- Impendulo engavamile yokuvuvukala, mhlawumbe yokuzala noma umphumela wokulimala okuqhubekayo noma ngaphambi kokulimala
Lokhu okusho nje ukuthi ukusitshela ukuthi, kuze kube yilapho sesinokuqonda kangcono i-pathogenesis yeqiniso (indlela yokugula) ye-COPD, sidinga ukubheka lesi sifo-nezimbangela zesifo-kusuka ekubambeni kabanzi kunokuba ugwayi kanye nogwayi kuphela .
Izinguquko ezenzweni zokwelapha
Esikhathini esedlule, izinhlelo zokwelapha zenziwa yi-test eyaziwa ngokuthi i- post-bronchodilator FEV1 . Ngokusekelwe emiphumeleni, isifo somuntu sasizofakwa njenge-A (obumnene), B (ukulinganisa), C (esinzima), noma uD (kakhulu kakhulu). Ukwelashwa kwakuyobe sekubekiwe ngokusekelwe ekubhalweni.
Ekubuyekezeni kwabo ngo-2012, ikomidi le-GOLD libuyekeze imihlahlandlela ukuze ukubalwa kwe-ABCD kuqokwe kokubili ukubuyekezwa kwemiphumela yebhu, kufaka phakathi i-FEV1 nomlando womuntu ngamunye wezingcingo ze- COPD .
Inkinga yomibili yalezi zindlela ukuthi abahlulekile ukwamukela ukuthi izimpawu zeCOPD azifani ngaso sonke isikhathi ebangeni.
Ngakolunye uhlangothi, umuntu ongenalo ubufakazi bokuvinjelwa kwamanzi angaba nezimpawu ezinkulu zeCOPD. Ngakolunye uhlangothi, umuntu onobungqingili obuncane angase abe nezimpawu ezimbalwa futhi aphathe kahle.
Ngenxa yalokhu, iziqondiso ezintsha zincoma ukuthi ukwelashwa kwemithi ye-COPD kufanele kuqondiswe kuphela yizimpawu zomuntu ngamunye. Ngaphezu kwalokho, ukuzimisela kufanele kusekelwe ekuzihloliseni ngesiguli.
Odokotela abaningi sebeqalile ukwenza lokhu besebenzisa ukuhlolwa kokuhlolwa kwe-COPD (CAT) lapho umuntu ecelwa ukuba alinganise ubunzima bezimpawu noma ukukhubazeka esikalini se-zero kuya ku-5. Ukuhlolwa akuhlosi nje ukuveza ukuqina kwezimpawu kepha ukuthi "okubi" noma "okuhle" umuntu ukubona ukuthi ukugula kwakhe kuyini. Lezi zindlela zingasiza udokotela ukubikezela ukuthi umuntu uzobhekana kanjani nokwelashwa, okungabandakanya imithi, ukuvivinya umzimba, ukudla nokuyeka ukubhema .
Ngokuguqula ukugxila emuva kwesiguli, imihlahlandlela ebuyekeziwe ye-GOLD ibonisa ukubaluleka kokuhlangenwe nakho kwempilo kanye nokwahlulela ekuqondiseni ukwelashwa kunokuba ulandele ibanga lokudlala elilodwa-elilinganayo.
> Umthombo:
> Roversi, S .; Corbetta, L .; kanye no-Clini, E. "izincomo ze-GOLD 2017 zeziguli ze-COPD: ekubhekeni kwendlela eyenziwe ngokwakho," Ucwaningo lwe-COPD nokuzijwayeza. 2017; 3: 5. I-DOI: 10.1186 / s40749-017-0024-y.