Ngokusho kwe-Global Initiative ye-Chronic Obstructive Lung Disease (GOLD), ukuxilongwa kwesifo esingenasifo sengculazi (COPD) kufanele kubhekwe kunoma yisiphi isiguli esinesifo sokuphefumula, ukukhwehlela isikhathi eside noma ukukhiqizwa kwe-sputum, kanye / noma umlando ukuchayeka kwizinto ezibeka ingozi ku- COPD , njengokubhema, ukuvezwa kwezimpumputhe ezifana namakhemikhali, ukungcola, noma ukubhema komshini wesibhamu, noma izici zofuzo / zentuthuko.
Noma kunjalo, ukuhlonza i-COPD kungaba nzima ngoba kunezibonakaliso ezifanayo kwezinye izifo futhi kungase kubonakale ngokuhlukile kumuntu ngamunye.
Ama-Labs nezivivinyo
Uma udokotela wakho esolwa ukuthi une-COPD, cishe uzothola umlando wakho wezempilo ophelele, enze umzimba, futhi enze ukuhlolwa ukuqinisekisa noma ukulawula i-COPD.
Umlando kanye noMzimba
Ukuhlola kwakho kuzoqala ngokubuka okuningiliziwe emlandweni wakho. Lokhu kufaka phakathi ukubukeza okulandelayo:
- Ukuvezwa kwakho okwamanje kanye nokudlulela ezinkingeni ezifana nokubhema, ukubhema umsizi , ukungcola komoya , kanye / noma ukuvezwa komsebenzi othulini, amagesi, namakhemikhali.
- Umlando wakho wezokwelapha, ikakhulukazi njengoba ukhuluma ngezinkinga zokuphefumula zamanje ezifana ne-asthma, imithi, isifo se-sinusitis, kanye / noma izifo zokuphefumula phakathi nobuntwana bakho.
- Ngaphambi kokubhedlela, ikakhulu uma behambisana nezifo zokuphefumula.
- Uma noma ubani emndenini wakho eseke abe ne-COPD noma yisiphi esinye isifo samaphaphu esingapheli.
- Uma unezinye izimo zezokwelapha ezikhona, ezifana nesifo senhliziyo noma ukugaya i-osteoporosis, okungase kuqhubekele phambili ekuthatheni ukuxilongwa kwe-COPD.
- Isibonelo sokuthuthukiswa kwesibonakaliso sakho, kufaka phakathi lapho izimpawu zakho ziqala nokuthi ubude isikhathi eside ngaphambi kokufuna usizo lwezokwelapha.
- Umthelela wezimpawu zakho empilweni yakho yansuku zonke. Isibonelo, uma izimpawu zakho zenze ukuthi uphelelwe umsebenzi, yenza umkhawulo wemisebenzi yakho evamile, noma uzizwe ucindezelekile noma ukhathazekile.
Udokotela wakho kufanele futhi ahlole ngokucophelela ngokomzimba okungase kuhlanganise:
- Ukuthatha ukushisa kwakho, ukushaywa umoya, ukuphefumula ngomzuzu, ukushayela, nokucindezelwa kwegazi.
- Ukulalela inhliziyo yakho namaphaphu nge-stethoscope.
- Ukuhlola izindlebe zakho, impumu, amehlo, nomphimbo ukuze uthole izimpawu zokutheleleka.
- Ukuhlola iminwe yakho ngezibonakaliso ze-cyanosis kanye ne- clubbing (lapho ukuphela kweminwe yakho kukhuliswa).
- Ukuhlola izibonakaliso zokuvuvukala emilenzeni, ezinqoleni, ezinyaweni noma kwezinye izingxenye zomzimba wakho.
- Ukuhlolisisa imithanjeni entanyeni yakho ukuhlola izinkinga zeCOPD ezifana ne- cor pulmonale (ukwehluleka kwesokudla senhliziyo yakho).
I-Spirometry
Ukuhlolwa kwe- spirometry kuyadingeka ukwenza ukwelashwa kwemitholampilo ye-COPD futhi kuyithuluzi eliyinhloko lokuhlola ubukhulu beCOPD. Ukuhlolwa kwe-spirometry kubheka ngokuqondile emine izinyathelo eziyinhloko zomsebenzi wamaphaphu, kufaka phakathi:
- Kungakanani emoyeni ongakwazi ukukhipha ngokucindezela ngemva kokuthatha umoya ojulile (owaziwa ngokuthi unamandla okuphoqelela, noma i-FVC).
- Kungakanani emoyeni ongakwazi ukuwukhuphula ngokukodwa ngomzuzwana owodwa (owaziwa njengevolumu yokuphoqa okuphoqelelwe ngomzuzwana owodwa, noma i-FEV1 ).
- Amaphesenti emoyeni asele emaphashini emva kokuphuma okugcwele (eyaziwa ngokuthi isilinganiso se-FEV1 kuya ku-FVC ).
- Ingqikithi yeningi emaphashini akho (eyaziwa ngokuthi umthamo wamaphutha we-lung, noma i-TLC ).
Ngokubambisana, lezi zinyathelo ezine azigcini nje ukuthi utshele umonakalo omkhulu emaphashini akho kodwa izindlela ongayithuthukisa ngazo imiphumela yakho yesikhathi eside uma kufanele ube ne-COPD. Ukunciphisa ukuhamba kwe-air persistent, noma i-COPD, kuqinisekiswa uma imiphumela yokuhlola ibonisa i- FEV1 / FVC engaphansi kuka-0.70 ngemuva kokusebenzisa i- bronchodilator .
Izivivinyo zemiSebenzi yePulmonary Additional (PFTs)
Ngaphandle kwe-spirometry, kunezinye izivivinyo ezimbili zomsebenzi wamapayipi ezibalulekile lapho zihlola umsebenzi wamaphaphu ku-COPD: izivivinyo zokusabalalisa amaphaphu nomzimba we-plethysmography. Lezi zivivinyo zikala ukuthi lungakanani amaphaphu e-carbon monoxide akho akwazi ukucubungula kanye nomthamo womoya emaphashini akho ngezigaba ezahlukene zokuphefumula, ngokulandelana, okucacisa ukuthi i-COPD yakho ilukhuni kanjani.
Qedela i-Blood Count (CBC)
Nakuba ukuhlolwa kwegazi kungenakuthola i-COPD, inani eliphelele legazi (i-CBC) lizoxwayisa udokotela wakho uma unesifo, kanye nokubonisa, phakathi kwezinye izinto, ukuthi i-hemoglobin ingakanani egazini lakho. I-Hemoglobin yi-pigment ene-iron equkethe igazi lakho eliphethe i-oksijini emaphaphini akho kuya emzimbeni wakho wonke.
I-Oxetry ye-Pulse
I-oximetry ye- pulse iyindlela engavumeleki yokulinganisa ukuthi izicubu zakho zihlinzeka kangakanani nge-oxygen. I-probe noma inzwa ngokuvamile ifakwe emunwe wakho, ebunzini, i-earlobe, noma ibhuloho ekhaleni lakho. I-oximetry ye-pulse ingaqhubeka noma iphakathi futhi isilinganiso samaphesenti angu-95 kuya ku-100% kubhekwa njengokujwayelekile. Uma ungaphansi kwamaphesenti angu-92, udokotela wakho angase afune ukwenza ukuhlolwa kwegesi legazi (ABG). Kanye ne-ABGs, ukulinganisa izinga lakho lokugcwalisa oksijini nge-pulse oximetry kusiza udokotela wakho ukuba ahlole isidingo sakho sokwelapha oksijini.
Amagesi Egazi Amandla
Ku-COPD, inani lomoya ophefumulela ngaphakathi nangaphandle kwamapayipi akho alimele. Amagesi egazi egazi ahlola amazinga e-oxygen ne-carbon dioxide egazini lakho futhi anqume ama-pH nomzimba wakho we-sodium bicarbonate. I-ABG ibalulekile ekwenzeni ukuxilongwa kwe-COPD kanye nokunquma isidingo sokulungisa nokugeleza kwenani lokugeleza kwanoma yikuphi ukwelashwa oksijini okwakudingeka.
I-Alpha-1-Antitrypsin Ukukhubazeka Ukuhlolwa
Uma uhlala endaweni lapho kutholakala khona ukukhubazeka okuphezulu kwe-alpha-1-antitrypsin (AAT), i-World Health Organization (WHO) incoma ukuba uhlolwe ngale disorder ngokuhlolwa kwegazi okulula. Eqinisweni, i-WHO incoma ukuthi noma ubani otholwe ukuthi uneCOPD kufanele ahlolwe ukulahlekelwa kwe-AAT kanye.
Ukuntuleka kwe-AAT yisimo sezakhi zofuzo ezingaholela ku-COPD. Kutholakala ukuthi usemncane kakhulu (ungaphansi kweminyaka engama-45 ubudala) kufanele uqaphele odokotela ukuthi kungenzeka ukuthi i-AAT engenakho imbangela yeCOPD yakho. Ukwelashwa kwe-COPD okubangelwa ukulahlekelwa kwe-AAT kuhlukile kunokwelashwa okujwayelekile futhi kuhlanganisa ukwelashwa okunyukayo .
Ukucabanga
Udokotela wakho angenza ezinye izivivinyo ze-imaging futhi asize ukulawula noma ukuxilonga i-COPD.
I-X-ray yesifuba
I-x-ray yesifuba yedwa ayifuni ukuxilongwa kwe-COPD. Udokotela wakho angase ahlele omunye ekuqaleni, kodwa, ukulawula ezinye izizathu zezimpawu zakho noma ukuqinisekisa ukuthi kukhona isimo esidala se-comorbid . I-x-ray yesifuba ingasetshenziswa futhi ngezikhathi ezithile kulo lonke ukwelashwa kwakho ukuqapha intuthuko yakho.
Iskripthi se-Tomography (CT) yekhompuyutha
Yize i-CT ingavunyelwe njalo lapho yenza ukuxilongwa kwe-COPD, udokotela wakho angase alayishe eyodwa uma kubonisiwe. Ngokwesibonelo, ungaba ne-CT scan uma unesifo esingaxazululi, izimpawu zakho zishintshile, udokotela wakho usola ukuthi unomdlavuza wamaphaphu, noma uma ucatshangelwa ukuhlinzwa. Nakuba i-X-ray yesifuba ibonisa izindawo eziningana zobuningi emaphashini, i-CT scan iyicacisa kakhulu, ibonisa imininingwane enhle ukuthi i-X-ray ayikho esifubeni. Ngezinye izikhathi, ngaphambi kokuskena kwe-CT, izinto ezibizwa ngokuthi ukungafani zijova emvuthweni wakho. Lokhu kuvumela udokotela wakho ukuba abone okungajwayelekile emaphashini akho ngokucacile.
Ukuhlonza okuhlukile
Kunezimo eziningi zezokwelapha ezingatholakala kalula ngokuhlolwa kwegazi noma ukuhlolwa ngokomzimba. Ezinye azilula kakhulu. Kwezinye izimo, ngeke kube khona ukuhlolwa okufanayo noma inqubo engase iqinisekise noma ingabandakanyi ubukhona bokugula. I-COPD ingenye yalezi zifo. Nakuba izivivinyo ezihlukahlukene zokuphefumula, ezifana ne- spirometry , zingaqinisekisa izimpawu zalesi sifo, zodwa azikwazi ukuqinisekisa ukutholakala.
Ngenxa yalokhu, udokotela kuzodingeka enze lokho okubizwa ngokuthi ukuxilongwa okuhlukile . Lena yinkqubo lapho zonke ezinye izimbangela zokugula ziye zafakwa ngaphandle. Kuphela uma inqubo isiphelile ingabe ukuhlolwa kwe-COPD kubhekwa njengokucacile.
Ukuxilongwa ngokuhlukana kubalulekile ekuqinisekiseni i-COPD ngoba ihlala isifo esinzima. Nakuba i-COPD ihlotshaniswa kakhulu nokubhema ugwayi, akubona bonke ababhema abane-COPD futhi akuwona wonke umuntu ophethe i-COPD obhemayo.
Ngaphezu kwalokho, izimpawu kanye nesibonakaliso sesifo zihluka kakhulu. Isibonelo, umuntu okuhlolwa okungahambisani nawo nge-spirometry angaba nezimpawu ezinzima ze- COPD . Ngenye indlela, umuntu obhekene nokukhubazeka okuphawulekayo angakwazi ukuphatha ngezimbalwa ezimbalwa, uma zikhona, izimpawu.
Lokhu kuhlukahluka kudinga odokotela ukuba babheke lesi sifo ngokuhlukile. Futhi, ngenxa yokuthi asikaqondi ngokugcwele ukuthi yini eyenza i-COPD, odokotela badinga inetha lokuphepha lokuhlonza ukuhlukana ukuze kuqinisekiswe ukuthi kutholakala yini ukuhlolwa okulungile.
Lokhu kuyiqiniso ngokukhethekile kubantu asebekhulile abanesifo senhliziyo nesiphunga abangabangela ukuvinjelwa komgwaqo. Ngokuguqula wonke amatshe esaga, odokotela bangathola ngokuvamile (okungenokuba bacatshangelwe) imbangela yokuphefumula okuphefumulayo, okunye okungaphathwa.
Ngesikhathi sokuhlolwa okuhlukile, ukuphenywa okuvamile okungajwayelekile kufaka phakathi i-asthma, ukwehluleka kwe-heart congestive, i-bronchiectasis, isifo sofuba, kanye ne-bronchiolitis ebomvu. Ngokuya ngempilo nomlando womuntu ngamunye, ezinye izimbangela zingabuye zihlolwe.
I-asthma
Esinye sezifo ezivame ukuhlukana kweCOPD yi- asthma . Ezimweni eziningi, lezi zimo ezimbili akunakwenzeka ukutshela ukuthi zingaphambene, okungenza kube nzima ukuphatha kusukela izifundo zokwelapha zihluke kakhulu. Isici sici se-asthma sihlanganisa:
- Ngokuvamile kuqala ekuqaleni kokuphila (kuqhathaniswa ne-COPD, okwenzeka kamuva ekuphileni)
- Izimpawu zingashintsha cishe nsuku zonke, ngokuvamile ziphele phakathi kokuhlaselwa
- Umlando womndeni we-asthma uvamile
- Amagciwane, i-rhinitis, noma i-eczema ngokuvamile ikhona
- Ukukhawulelwa kwe-Airflow kubonakala kuguquke, ngokungafani ne-COPD
Ukungaphumeleli Kwezinhliziyo Zenkululeko
Ukuhluleka kwenhliziyo ukushisa (CHF) kwenzeka lapho inhliziyo yakho ingakwazi ukushaya igazi elanele emzimbeni ukugcina konke kusebenza ngokujwayelekile. Lokhu kubangela ukugcinwa kwamanzi emaphaphu akho nakwezinye izingxenye zomzimba wakho. Izimpawu ze-CHF zihlanganisa ukukhwehlela, ubuthakathaka, ukukhathala nokuphefumula komsebenzi. Ezinye izici ze-CHF zifaka:
- Ama-crackles amahle azwakala nge-stethoscope.
- I-x-ray ye-chest ibonisa uketshezi okweqile nokuhlanza isisu senhliziyo.
- Ukuhlolwa komsebenzi we-pulmonary kubonisa ukuvinjelwa kwevolumu (ngokuphambene nomkhawulo wokugeleza komoya obonwe ku-COPD).
Bronchiectasis
I-Bronchiectasis iyisifo sokuphazamiseka kwamaphaphu esingabangela ukuzalwa (okukhona ngesikhathi sokubeletha) noma esibangelwa izifo zakuqala ezincane ezifana ne-pneumonia, isishubhu, umkhuhlane, noma isifo sofuba. I-Bronchiectasis ingaba yedwa noma isebenze eceleni kwe-COPD. Izici ze-bronchiectasis zihlanganisa:
- Ukukhiqiza inani elikhulu le-sputum
- Izibhamu eziphindaphindiwe zokutheleleka kwe-bacterial lung
- Ama-crackles ama-coarse azwiwe nge-stethoscope
- I-x-ray ikhombisa izibhubhu ezinamahloni ezincibilikisiwe kanye nezindonga ezinamathele
- Clubbing of iminwe
Isifo sofuba
Isifo sesifo sofuba (i-TB) isifo esithathelwanayo esibangelwa yi-microorganism I- Mycobacterium isifo sofuba . Ngenkathi i-TB ivame ukuphazamisa amaphaphu, angasakazeka kwezinye izingxenye zomzimba, kuhlanganise nobuchopho, izinso, amathambo, kanye namagciwane.
Izimpawu ze-TB zifaka phakathi ukulahlekelwa isisindo, ukukhathala, ukukhwehlela okuqhubekayo, ubunzima bokuphefumula, ubuhlungu besifuba, kanye nesiputum esinyene noma egazini. Ezinye izici ze-TB zihlanganisa:
- Ukuqala ukugula kungenzeka nganoma yisiphi isikhathi
- I-x-rays i-chest ikhombisa izindawo zomoya ezigcwele uketshezi
- Ukuhlolwa kwegazi noma ukuhlaselwa kwe-sputum kuqinisekisa ukuthi kukhona i- TB yesifo sofuba
- Kubonakala ngokujwayelekile emphakathini noma kubonakale njengengxenye yokugqashuka
I-Bronchiolitis engabonakali
I-bronchiolitis engabonakali iyindlela engavamile ye- bronchiolitis engasongela ukuphila. Kuyenzeka lapho izingxenye ezincane zomoya zamaphaphu, eyaziwa ngokuthi i-bronchioles, zivutha futhi zibhubhisa, zibangele ukuba zinciphise noma zivale. Ezinye izici ze-bronchiolitis obliterative zihlanganisa:
- Ngokuvamile kwenzeka ngesikhathi esincane kunabangabhemi
- Umlando ongenakwenzeka we-arthritis we-rheumatoid noma ukuvezwa kwezinkungu ezinobuthi
- I-CT scan ibonisa izindawo ze-hypodensity lapho izicubu zamaphaphu zincipha khona
- Ukuvinjelwa kwe-Airway, njengoba kulinganiswa yi- FEV1 , kungase kube ngaphansi kwamaphesenti angu-16
Amabanga namaqembu e-COPD
Njengesifo esiqhubekayo, i-COPD ibonakala ngezigaba zesifo esingakusiza ukwazi ukuthi yini ongayilindela ngaleso sikhathi ngesikhathi esifanayo, nakuba isiteji sakho singanqume ukuthi uzokwenza kanjani kahle ngemithi. Ukuze unqume isigaba sakho, odokotela bazobhekisela ohlelweni lwe-Global Initiative lwe-Chronic Obstructive Lung Disease (GOLD), oluhlukanisa ukuqhubekela phambili kwezifo zibe yizinyathelo ezine ezihlukene ezibekwe yi-testometro.
Ibanga 1: I-COPD enhle
Ngebanga le-COPD yebanga 1, unomkhawulo wokungena kwe-airflow kodwa kungenzeka ukuthi awukwazi. Ezimweni eziningi, ngeke kube nezibonakaliso zesifo noma izimpawu zizoba mncane kangangokuba zibhekiswe kwezinye izimbangela. Uma kukhona, izimpawu zingabandakanya ukukhwehlela okuqhubekayo nokukhiqizwa okubonakalayo kwe-sputum (ingxube yamathe kanye ne-mucus). Ngenxa yezibonakaliso eziphansi, abantu abakulesi sigaba ngeke bafune ukwelashwa.
Ibanga lesi-2: I-COPD ejwayelekile
Ngomkhakha we-COPD webanga lesibili, ukukhawulelwa kwakho kwe-airflow kuqala ukuqala ukonakala, futhi izimpawu ze-COPD zibonakala ngokucacile. Lezi zimpawu zingabandakanya ukukhwehlela okuqhubekayo, ukukhiqizwa okwenyuka kwe-sputum, nokuphefumula okuncane kokusebenza kancane. Lokhu ngokuvamile isiteji lapho abantu abaningi befuna ukwelashwa.
Ibanga lesi-3: I-COPD ekhulu
Ngebanga lesi-3 COPD, ukuvinjelwa kanye / noma ukuvinjelwa kwezingxenye zakho zomoya obala kuyabonakala. Uyothola ukuwohloka kwezibonakaliso ezinzima, owaziwa ngokuthi ukukhushulwa kwe-COPD , kanye nemvamisa eyandayo nokuqina kokukhwehlela. Ngeke nje ube nokubekezelelana okuncane kokusebenza komzimba, kuyoba nokukhathala okukhulu nesifuba.
IBanga 4: I-COPD ekhulu kakhulu
Ngebanga le-COPD yebanga lesi-4, izinga lakho lokuphila lizokhungatheka kakhulu ngezimpawu ezivela ekubaluleke kakhulu kokusongela impilo. Ingozi yokuhluleka ukuphefumula iphezulu ebangeni lesi-4 futhi ingabangela izinkinga enhliziyweni yakho, kufaka phakathi isifo esibulalayo esibizwa ngokuthi i- cor pulmonale .
Amaqembu e-COPD
I-GOLD iphinde iphume neziqondiso zokuqhubeka ngezigaba ngeziguli ezibizwa nge-COPD emaqenjini okuthiwa i-A, B, C, noma D. Lezi zigaba zichazwe ukuthi izinkinga ezihlobene ne-COPD ezihlobene nokukhathala, ukuphefumula, ukuthi izimpawu eziningi ziphazamisa kanjani impilo yansuku zonke, nokuthi yikuphi ukukhwabanisa okwenziwe ngonyaka odlule. Ukusebenzisa kokubili amamaki namaqembu kungasiza udokotela wakho ukuba afike ohlelweni oluhle kakhulu lokwelapha izidingo zakho.
Iqembu A
Awunakho ukukhushulwa noma ukucindezela okuncane okuncane okungazange kudinga ukunakekelwa esibhedlela, ngonyaka odlule. Unomoya omfushane wokunciphisa umoya, ukukhathala nezinye izimpawu.
Iqembu B
Awunayo noma ukukhipha okuncane okuncane okungazange kudinga ukunakekelwa esibhedlela ngonyaka odlule. Uphefumula kakhulu, ukukhathala, nezinye izimpawu.
Iqembu C
Uke waba nokucindezela okukodwa okudinga ukunakekelwa esibhedlela noma ukucindezeleka okubili noma okungaphezulu okungenzeka ukuthi akudingeki ukuthi kutholakale esibhedlela ngonyaka odlule. Izimpawu zakho ze-COPD zinomthelela kancane.
Iqembu D
Ube nokukhwabanisa okukodwa kokubhedlela noma ukucindezeleka kokubili noma okungaphezulu kokungena esibhedlela ngonyaka odlule. Izimpawu zakho ze-COPD zinzima kakhulu.
> Imithombo:
> I-Global Initiative ye-Lung Dungase Chronicle Obstructive. Isu Lomhlaba Wonke Lokuthola Ukuxilongwa, Ukuphathwa Nokuvimbela Izifo Eziphuthumayo Zokuvimbela Izifo Eziphuthumayo: Umbiko we-2018 . Ishicilelwe ngoNovemba 20, 2017.
> Abasebenzi beMayo Clinic. I-COPD: Ukuxilongwa Nokuphathwa. I-Mayo Clinic. Kubuyekezwe u-Agasti 11, 2017.
> Inhliziyo kaZwelonke, iLung, ne-Blood Institute. I-COPD. I-National Institute of Health. UMnyango WezeMpilo waseMelika kanye Nezinsizakalo Zabantu.