Ukuhlolwa kwemisebenzi yamapulmonary (PFT) kudideka kwabathengi abaningi beCOPD . Futhi ukuqonda ukuthi udokotela wakho uhumusha kanjani imiphumela kungase kube nzima nakakhulu.
Kodwa-ke, ukwazi izinombolo zakho njengoba kusebenza ezivivinyweni zomsebenzi we-pulmonary kubaluleke kakhulu njengoba ukwazi ukucindezeleka kwegazi uma unesifo senhliziyo. Imiphumela yakho yokuhlola ayikona nje ukunikeza indlela yokuqhathanisa lapho uthola ukuthi uphendula kahle kangakanani ukwelashwa, kodwa futhi ikutshele ukuthi isifo sakho siyathuthuka, sihlala esifanayo, noma siyaqhubeka.
Sibutsetelo
Lapho kutholakala ukuthi i-COPD , ukuhlolwa komsebenzi wamaphalenda kwenziwa ukuze kuhlolwe umsebenzi wamaphaphu futhi kunqume izinga lokulimala emaphashini. Ukwengeza emlandweni wesiguli kanye nezifundo zomzimba zamapayipi ( lungxube X-ray kanye ne- CT scan ), kanye ne-PFTs kubaluleke kakhulu ekuhloleni impilo yokuphefumula.
Ukuhlolwa kokusebenza kwamapulmonary kusetshenziswa lapho:
- Ukuhlola ukutholakala kwezifo ezithintekayo nokuvimbela amaphaphu
- Ukunquma isimo sesiguli ngaphambi kokuhlinzwa ukuze kuhlolwe ingozi yokucindezeleka kokuphefumula ngemva kokuhlinzwa
- Ukuhlola ukuqhubeka kwezifo zamaphaphu nokusebenza kokwelashwa
Izinhlobo ezintathu zezinyathelo zokusebenza kwamaphalona zisetshenziswa ekuxilongweni kweCOPD:
- I-Spirometry
- Ucwaningo lokusakaza
- I-plethysmography yomzimba
Ukuhlolwa kwe-Spirometry
I-COPD ibangela umoya emaphashini ukuthi uphuthumiswe ngesilinganiso esisheshayo nangamanani amancane kuqhathaniswa nomuntu onamapayipi enempilo. Inani lemimoya emaphashini alikhiphi kalula ngenxa yokuvinjelwa ngokomzimba (njengokukhiqiza kwe- mucus ) noma ukuhamba kancane kwamanzi okubangelwa ukuvuvukala okungapheli.
Yilapho i-spirometry ingena khona.
I-spirometry iyona evame kakhulu kuzo zonke izivivinyo zomsebenzi we-pulmonary. Iyenziwa ngedivayisi egcinwe ngesandla ebizwa ngokuthi i-spirometer futhi ingasetshenziswa kalula yiziguli ezisiza ngomchwepheshe onolwazi.
Ngokujwayelekile kuyisinqumo sokuqala somtholampilo lapho ezama ukuhlola inkinga yokuphefumula.
Kubuye kuvame ukusetshenziswa ukuchaza amamaki (izigaba) ze-COPD.
Inqubo elula, engavumelekile, i-spirometry ingenziwa ngasese ehhovisi likadokotela wakho noma ezindaweni eziningi ezingelapheki. Isivivinyo sidinga isiguli, ngemuva kokuba umoya wonke uxoshwe, ukugxilisa ngokujulile.
Lo mkhuba ulandelwa ukuphuma okusheshayo ukuze umoya wonke uphele amandla emaphashini. Imiphumela yokuhlolwa kwe-Spirometry ihlukahluka kodwa isekelwe kumanani okubikezelwa wezinga elilinganiselwe, elinempilo (bheka ngezansi).
Isiqephu sokwazi
Ukuhlolwa kwe-Spirometry kulinganisa izinga lokuguquka emapulazini emaphaphu lapho kuqhutshwa ukuphefumula okuphoqelelwe. Lezo zilinganiso zivezwa ngokusebenzisa igama elilandelayo:
- Ikhono le-Vital (VC) -Ingqikithi yomoya engabhalwa ngamandla emapapheni akho emva kokuphumula okugcwele.
- Ubunamandla obunamandla obunamandla (i-FVC) -Ingqikithi yomoya engabhalwa ngamandla emaphashini ngemuva kokuthatha umoya ojulile.
- Umqulu Wokuphefumula Okuphoqelelwe Ngomunye Wesibili (I-FEV1) -Ingqikithi yomoya engabhalwa ngamandla emaphashini ngomzuzwana wokuqala wokuphefumula okuphoqelelwe.
- Ukulinganiswa kwe-FEV1 / FVC-Iphinde ivezwe njengo-FEV1% noma i-% FEV1, inika isilinganiso se-FEV1 kuya ku-FVC. Lokhu utshela umtholampilo ukuthi yiyiphi iphesenti yenani eliphelele lomoya eliphuma emaphashini ngesikhathi sesibili sokuqala sokukhishwa umoya.
- I-Peak Expiratory Flow Rate (PEFR) -Izinyathelo uma ukwelashwa kuphumelela ekuthuthukiseni izifo zomoya, njengeCOPD.
- Ukugeleza Okuphefumulelwe Okuphoqelelwe (FEF) -Ilinganiso zokuthi umoya ungaphuma kanjani emaphashini. Iwuphawu lokuvimbela okukhulu kwezindiza.
- I-FEF25% -Leli nani limelela inani lomoya elingaxoshwa ngokuphumelelayo emaphashini kuma-25 okuqala we-total test test force.
- I-FEF50% -Ukulinganisa lokhu kubonisa inani lemvelo elixoshwa emaphashini phakathi nengxenye yokuqala (amaphesenti angu-50) wokuhlolwa okunamandla okuphoqelelwe. Kuwusizo lapho umtholampilo esolwa ngesifo esivimbelayo. Esigulini esinokuvinjelwa, inani lomoya elizobe seliphelile lizobe liphansi kunalowo ophethe amaphaphu enempilo.
- I-FEF25% -75% -Ukulinganisa lokhu kubonisa inani eliphelele lomoya ophuma emaphashini phakathi nengxenye ephakathi yokuhlolwa okunamandla okuphoqelelwe. Abahlengikazi abaningi babhekisela kule nzuzo ngoba kubonisa ukuthi kukhona isifo se-lungs obstructive.
- I-Maximal Ventilation Voluntary (MVV) -Ixabiso elinqunywe yisiguli sokukhipha nokukhipha ngokushesha ngokugcwele ngangokunokwenzeka emasekhondini angu-12. Imiphumela ibonisa isimo semisipha esetshenziselwa ukuphefumula, indlela enzima ngayo amaphaphu, futhi uma kukhona ukuphikiswa emoyeni lapho kuphefumula. Lokhu kuhlolwa kutshela odokotela abahlinzayo ukuthi imaphaphu omguli aqinile kangakanani ngaphambi kokuhlinzwa. Uma iziguli zibonisa ukusebenza okungalungile kulolu vavanyo, kuphakamisa udokotela ukuthi izinkinga zokuphefumula zingenzeka ngemuva kokuhlinzwa.
Ukuhumusha Imiphumela
I-Spirometry isiza odokotela ukubona ukuthi kukhona izifo eziphazamisayo nezivimbela ukuphazamiseka kwamaphaphu. Njengazo zonke izivivinyo zokuhlola, udokotela wakho ngumuntu ongcono kakhulu okufanele uxoxe ngawo ngemiphumela yokuhlolwa kwe-spirometry futhi yedwa ongakunikeza ukuxilongwa okunembile.
Kunezinhlobo eziningi zezindlela ezisetshenziselwa ukuhumusha-lowo udokotela wakho esebenzisa kuyindaba yokukhetha. Okubaluleke ngempela kunoma yiliphi uhlolo lwe-spirometry ukuthi lwenziwa ngendlela efanele nokuthi ukuhlolwa kuhunyushwa ngokunembile nangokuhlelekile ngumtholampilo oqeqeshiwe.
Okulandelayo kuyindlela eyodwa yokuhumusha okuhlolwa ukuthi udokotela wakho angasebenzisa. (Kuhloswe ngenhloso yokwaziswa kuphela futhi akufanele ithathe iseluleko sezokwelashwa ezivela kumhlinzeki wakho wezempilo.)
- Isinyathelo 1: Bheka i-FVC yakho ukubona ukuthi kuvamile yini.
- Isinyathelo 2: Bheka i-FEV1 yakho ukubona ukuthi kuvamile yini.
- Isinyathelo sesi-3: Uma kokubili i-FVC yakho ne-FEV1 zijwayelekile, unesivivinyo esivamile futhi ungayeka kulesi sinyathelo.
- Isinyathelo sesi-4: Uma i-FVC yakho kanye / noma i-FEV1 yakho iphansi, khona-ke kungenzeka ukuthi isifo sakho se-lungs kanye nokuhlolwa okuqhubekayo kuyadingeka ukuze kuhlolwe lokhu.
- Isinyathelo sesi-5: Uma Isinyathelo 4 sikhombisa ukuthi kungenzeka yini isifo samaphaphu, bheka% okubikezelwe ku-FEV1 / FVC yakho. Uma kunamaphesenti angu-69 noma ngaphansi, isifo sokuvimbela kufanele sisolakala. Uma kunamaphesenti angama-85 noma ngaphezulu, khona-ke isifo sengculazi esisemthethweni kufanele sikhohlwe.
Ngokuvamile, abantu bahamba nge-spirometry bese bebuza ukuthi imiphumela iyenembile ngempela. Ngempela, kunezici ezithile ezingathonya imiphumela yakho ye- spirometry ngendlela engaphansi kokuhle.
Ukunquma ubukhulu be-COPD
Odokotela basebenzisa i-spirometry ukucacisa ubukhulu beCOPD. Nakuba kunezinhlelo eziningi ongakhetha kuzo, ithebula elingezansi yindlela ephakanyiswa yi-Global Initiative ye-Lung Dung (GOLD).
Imiphumela yakho yokuhlolwa iqhathaniswa namatafula ejwayelekile, amanani alinganiselwe asebenzisa ukuguqulwa kwezenzo ezinjengebudala, ubulili, ubukhulu bomzimba, nobuzwe njengendlela yokwenza umsebenzi. Iphesenti libikezele, njengoba leli gama libhekiswe kuwo, linika odokotela ithuluzi lokuqhathanisa imiphumela yakho yokuhlolwa kanye nemiphumela etholakala kubantu abanezimaphaphu ezinempilo.
| GOLD Imingcele ye-Spirometric ye-COPD Inzima | ||
| I. I-COPD enhle | * FEV1 / FVC <0.7 * FEV1> / = 80% yabikezelwa | Kule nkathi, isiguli cishe asiyazi ukuthi umsebenzi wamaphaphu uqala ukwehla |
| II. I-COPD ephakathi | * FEV1 / FVC <0.7 * 50% | Izimpawu phakathi nalesi sigaba inqubekela phambili, ngokuphefumula okuqhubekayo ekusebenziseni. |
| III. I-COPD enamandla | * FEV1 / FVC <0.7 * 30% | Ukuphefumula kuyaba kubi nakakhulu kulezi zigaba kanti ukukhushulwa kwe-COPD kuvamile. |
| IV. I-COPD Enamandla kakhulu | * FEV1 / FVC <0.7 * I-FEV1 <30% ibikezelwe noma u-FEV1 <50% wabikezela ukuhluleka okungapheli kokuphefumula | Ikhwalithi yokuphila kulesi sigaba sinzima kakhulu. Ukukhushulwa kwe-COPD kungaba yingozi yokuphila. |
Imiphumela yokuhlolwa kwe-Spirometry izovame ukulinganiswa kabili, kokubili nangaphambi kokuphatha i-bronchodilator. Ngokusho kwe- American Thoracic Society , uma kukhona okungenani amaphesenti angu-12 kanye no-200-milliliter ngcono kusuka kwesisekelo ku-post-bronchodilator i-FEV1 kokubili kwezingu-3 ze-spirometry, kuthiwa uphendule ngokuphawulekayo ku-bronchodilator. Lokhu kufanele kuhambisane nendlela ophendula kahle ngayo ukwelashwa-isici esibalulekile sokubikezela.
Ezinye izivivinyo
Kanye ne-spirometry, ezinye izivivinyo zomsebenzi we-pulmonary ezimbili zibalulekile ekuxilongweni kwesifo samaphaphu:
- Ucwaningo lokusabalalisa -Le PFT ikutshela indlela umoya ophefumulayo ohamba ngayo egazini lakho.
- I-plethysmography yomzimba -Uhlolo oluhlosisa ukuthi umoya ukhona kangakanani emaphashini akho lapho uthatha umoya ojulile nokuthi umoya ushiywe kanjani emapapheni akho emva kokuba uphumelele ngangokunokwenzeka.
> Imithombo:
I-Northern Arizona University. Ukuhlolwa kokusebenza kwePulmonary.
Isu Lomhlaba Wonke Lokuthola Ukuxilongwa, Ukuphathwa Nokuvimbela I-COPD, Global Initiative for Chronic Acstructive Lung Disease (GOLD). 2010.