Kuyini i-AFRS?

I-allergic fungal rhinosinusitis (AFRS) yisimo esingapheli (esiqhubekayo) sokuvuvukala kwesinus lapho amasosha omzimba esabela ngokweqile ku-fungi emoyeni njengesikhunta noma imvubelo (impendulo yokucindezeleka). Lokhu kusabela kubangela uketshezi olujiyile, ukuvuvukala, kanye nokuvaleka kwamasinus.

I-AFRS ingathinta impilo yansuku zonke ngokuthi:

• Ukwenza kube nzima ukuphefumula ngekhala lakho.
• Ukwenza kube nzima ukunuka nokunambitha ukudla.
• Okubangela izinkinga zokulala.
• Okuholela ekukhungathekeni nasekucindezelekeni.

Izimpawu Ezivamile Ze-AFRS

Ezinye izimpawu ze-AFRS zifana nokutheleleka okuvamile kwe-sinus.

• Ukuvuvukala (ukuvuvukala) ekhaleni
• Ikhala elivalekile njalo (ukuminyana kwekhala)
• Iphutha le-Runny
• I-post-nasal drip
• Ukucindezeleka kwama-sinus kanye nekhanda elibuhlungu
• Ukulahlekelwa iphunga
• I-mucus ejiyile (i-mucus efana nebhotela lamantongomane)

I-AFRS ingathinta uhlangothi olulodwa lwekhala/ama-sinuses. Ezimweni ezimbi kakhulu, i-AFRS ingabangela ngisho nokuguguleka kwamathambo kanye nokuphazamiseka kokubona okungenzeka.

Cishe 5-15% kubantu abane-rhinosinusitis engapheli bane-AFRS.

Indlela i-AFRS Ehluke Ngayo Kwezinye Izinkinga Ze-Sinus

I-allergic fungal rhinosinusitis (AFRS) ihlukile kwezifo eziningi ze-sinus. Ukutheleleka kwe-sinus okuvamile kwenzeka lapho amagciwane noma amabhaktheriya engena ezimbotsheni zakho ze-sinus futhi ebangela ukutheleleka. Ngakolunye uhlangothi, i-AFRS, akunjalo okubangelwa amagciwane angena kuwo. Kunalokho, kwenzeka lapho umzimba wakho usabela ngokweqile ku-fungi (njengesikhunta) emoyeni.

Ukutheleleka kwe-sinus okuvamile ngokuvamile kungokwesikhashana, kodwa i-AFRS ibangela izimpawu eziqhubekayo nezingapheli.

Ukuhlolwa Nokuxilongwa kwe-AFRS

Okokuqala, udokotela wakho uzokwenza ukuhlolwa ngokomzimba futhi akubuze ngezimpawu zakho kanye nomlando wezokwelapha.

Ukuhlolwa kwe-AFRS kungafaka:

• CT scan: i-X-ray ekhethekile ye-3D ethatha izithombe ezinemininingwane zezindlela zokungena ekhaleni kanye ne-sinus (uma ikhona)
• I-Endoscopy: ukuhlolwa kwamakhala ngekhamera encane ukuze ubheke ngaphakathi kwama-sinus akho
• Ukuhlolwa Kwelabhorethri Yamafinyila Noma Yezicubu (Ukuhlolwa Kwezicubu): Ilebhu ihlola amasampula amancane e-mucus noma izicubu ukuze ibone ukuthi yini ngempela ebangele ukuvuvukala.

Sebenzisa yethu Ikhadi Lami Lokuvakasha le-AFRS lapho uhlangana nodokotela wakho noma umhlinzeki wezempilo. Ingakusiza ukuthi ukhulume kangcono ngezimpawu zakho futhi ukhumbule ukubuza imibuzo ebalulekile.

Izimbangela ze-AFRS

I-AFRS yenzeka lapho umuntu enesimiso somzimba sokuzivikela esibucayi kakhulu (esingezwani nomzimba) esisabela kusikhunta. Iningi labantu abanesimiso somzimba sokuzivikela esinempilo babekezelela isikhunta esifanayo ngaphandle kwenkinga.

Ezinye izici zingaba nomthelela kulokhu kusabela kubantu abane-AFRS.

• Ufuzo: Abanye abantu bazalwa benesimiso somzimba sokuzivikela esibucayi kakhulu esisabela ezinhlamvini ezincane zesikhunta.
• EnvironmentIzimo zezulu ezifudumele nezinomswakama zingabangela ukutheleleka kubantu abane-AFRS.
• Ukugeleza kwamanzi angcolile e-sinus: Imigudu emincane ye-sinus kanye nokuvuvukala kungavimba uketshezi ukuthi lungaphumi kahle. Lokhu kungabamba ama-spores esikhunta ema-sinus. Kwabanye abantu, amasosha omzimba asabela ngokweqile esikhunta esibanjiwe, okuholela ekuvuvukeni okubonakala ku-AFRS.
• Ukubhema insangu noma ukusebenzisa i-hookah: Lokhu kuhlotshaniswa ne-AFRS. Zombili zigcina izinhlayiya zesikhunta futhi zingaveza izindlela zomoya esikhunta. Zingaphinde zenze buthaka izakhiwo ezincane ezifana nezinwele (cilia) ezindleleni zomoya ezisiza ekususeni izinhlayiya eziyingozi. Nakuba ubufakazi obuxhumanisa ukusetshenziswa kwensangu noma i-hookah ngqo ne-AFRS bulinganiselwe futhi abuqiniseki, lokhu kuvezwa kungase kube yizinto ezingaba yingozi.

Izimo Zempilo Ezihambisanayo (Ezibangela Ukucindezeleka)

Izimo ezibangela ukugula ezinye izifo umuntu anazo nge-AFRS. Ngokuvamile, lezi zimo zenzeka ngenxa yezimpendulo ezifanayo zomzimba zokungezwani komzimba.

Izimo ezivamile ze-comorbid zifaka:

• Asthma
• I-Allergic rhinitis (i-hay fever)
• Polyp acinene
• I-sinusitis engapheli

Kuvamile ukuthi abantu abane-AFRS babe nomlando wezifo zokungezwani komzimba, njenge-rhinitis ye-allergy kanye ne-asthma. Lezi zimo zonke zihilela impendulo yomzimba esebenza ngokweqile ezintweni ezisendaweni ezungezile.

I-AFRS ihlotshaniswa nama-polyp asekhaleni, okuyizigaxa ezithambile, ezingenawo umdlavuza ekhaleni ezingabamba amafinyila futhi zenze kube nzima ukuphefumula.

Abanye abantu bangase babe nokuvuvukala okungapheli, njenge-sinusitis engapheli.

Uma lezi zimo zempilo zenzeka ngesikhathi esisodwa, izimpawu zingaba zimbi kakhulu futhi kube nzima ukuzilawula.

Indlela Yokuphatha I-AFRS Yesikhathi Eside

Ukuze uphathe i-AFRS isikhathi eside, kuzodingeka usebenzisane nethimba lezokunakekelwa kwempilo elihlanganisa umhlinzeki wakho oyinhloko, udokotela wezindlebe, impumulo, nomphimbo (ENT), kanye nochwepheshe wezokungezwani komzimba.

Ukuphatha i-AFRS kudinga uhlelo lwesikhathi eside lokuvimbela ukuvuvukala nokuvuvukala nokuvimbela ukwakheka kwamafinyila futhi. Njengoba amasosha omzimba wakho ehlala esabela ngokweqile kuma-fungus emoyeni, kufanele ube nomkhuba wansuku zonke ukuze ugcine ama-sinus akho ehlanzekile.

Ithimba lakho lezokunakekelwa kwempilo lingakusiza ukuthi wakhe uhlelo.

• Ukuhlanza amathumbu: Sebenzisa ukuhlanza amathumbu nsuku zonke ngosawoti (amanzi anosawoti) ukuze ukhiphe “ugibe.” Lokhu kuhlanza kuhlanza isikhunta kanye ne-mucus ejiyile ukuze kungazikhiqizi futhi kubangele ukutheleleka.
• Ama-Steroids: Udokotela wakho angase akunike umuthi we-steroid (ongafakwanga endaweni yomlomo noma wephilisi) ukuze unciphise ukuvuvukala.
• I-Biologics: I-Biologics imithi engavimbela amasosha omzimba wakho ukuba angasabela ngokweqile esikhumbeni/kukhunta. Ayisusi nje kuphela ama-sinuses; ingashintsha nendlela amasosha omzimba wakho asabela ngayo esikhumbeni. Okwamanje kukhona i-biologic eyodwa evunyelwe emhlabeni wonke ye-AFRS (dupilumab).
• Lawula ukungezwani komzimba kwakho: Njengoba i-AFRS iwukusabela kokungezwani komzimba, ukulawula okunye ukungezwani komzimba kwakho kubaluleke kakhulu. Udokotela wakho angase akuncomele imithi noma umjovo wokungezwani komzimba.
• Ukuhlinzwa: Ungadinga ukuhlinzwa kwe-sinus uma ukwelashwa kungasebenzi noma uma uvalekile ngenxa yama-polyp ekhaleni.

Kungani i-AFRS ivame ukubuya

I-AFRS ivame ukubuya ngoba iyisimo esingamahlalakhona, hhayi ukutheleleka kwe-sinus yesikhashana. Ngisho nangemva kokuba izimpawu zakho sezilawulwa ngokuhlinzwa noma ngemithi, umzimba usasabela kuma-spores e-fungus ahlala esemoyeni. Uma uphefumula la ma-spores, angena elangeni lakho le-sinus. Uma ama-sinus akho engawakhiphi amanzi, i-fungus iyabanjwa, futhi ukutheleleka kungabuya.

Izithiyo Zemiphumela Emihle

Ukuthola imiphumela emihle kakhulu nge-AFRS kungaba nzima ngoba kuyisimo esingamahlalakhona esivame ukudinga ukunakekelwa okuqhubekayo. Ezinye izithiyo ezivamile zingenza kube nzima. Esinye isithiyo esivamile ukuthi ingaqhubeka ibuyaNgisho noma ukwelashwa kungaphinde kubuye ngokuhamba kwesikhathi, okwenza kube nzima futhi kube nzima ukukuphatha.

Kungaba nzima ukuxilonga i-AFRS. Njengoba i-AFRS ingabukeka njengezinye izifo ze-sinus, odokotela bangase bangayiboni ngokushesha, okuholela ekubambezelekeni kokuthola ukwelashwa okufanele kanye nokwanda kwezimpawu.

Ukufinyelela okungaguquki ekunakekelweni okusekelwe eziqondisweni futhi kuyisithiyo ekutholeni uhlelo lokwelapha olungcono kakhulu. I-AFRS idinga ithimba elikhethekile elinodokotela abaningi (ukunakekelwa okuyinhloko, odokotela be-ENT, kanye nodokotela bokungezwani komzimba). Abanye odokotela abajwayelene ne-AFRS, okungaholela ekuxilongweni nasekuhlelweni kokwelashwa okulibazisekile. Ngisho noma kutholakale ukuxilongwa, azikho iziqondiso eziqondile ze-AFRS, okusho ukuthi ukwelashwa akuhambisani kahle, futhi ukwelashwa okufanele kuyalibazisa.

Ezinye iziguli zingase zingabi nokufinyelela kodokotela abangochwepheshe noma kungenzeka ukuthi unayo izithiyo zezimali ngenxa yomshuwalense wezempilo noma izindleko zokwelashwa.

Ukungabikho kwama-aphoyintimenti okulandelela esinye isithiyo esivamile. Abantu abane-AFRS badinga ukuhlolwa njalo ukuqinisekisa ukuthi ihlala ilawulwa. Odokotela bangakusiza uqaphele "ukwanda" ngaphambi kokuba uqale ukuzwa izimpawu, ngakho-ke kubaluleke kakhulu ukungaphuthelwa ama-aphoyintimenti.

Izinto ezibangela imvelo, njengesikhunta noma ezinye isikhunta, zingaqhubeka nokubangela ukuvuvukala. Uma zingaphathwa kahle, zingenza kube nzima ukuthi ukwelashwa kusebenze, futhi izimpawu zingaqhubeka zibuya.

Ukwelashwa kungaba nzima. Izinhlelo zokwelapha ngezinye izikhathi zidinga ukuhlinzwa kanye nemithi yesikhathi eside yansuku zonke, njenge-steroids. Njengoba kungekho ikhambi, ukuphatha i-AFRS isikhathi eside kubalulekile, futhi iziguli kudingeka zinamathele ohlelweni lokwelashwa. Ngaphandle kokulandela uhlelo eduze, izimpawu zingabuya noma zibe zimbi kakhulu.

Ukusetshenziswa ngokweqile kwe-steroid kungadala nezinkinga. Nakuba ama-steroid esebenza ukunciphisa ukuvuvukala, ukuwasebenzisa kaningi kungaholela emiphumeleni emibi, njengengozi ephezulu yokutheleleka, umfutho wegazi ophakeme, ukukhuluphala, kanye namathambo abuthakathaka.

Amathiphu Empumelelo Nokuphila Kahle Nge-AFRS

Ukuphila ne-AFRS kudinga ukunakekelwa okuqhubekayo, kodwa abantu abaningi bangakwazi ukulawula izimpawu kahle ngemikhuba efanele kanye nokulandelela.

• Hlala unolwazi ngemihlangano yokulandelela. Ukuvakashela udokotela wakho we-ENT noma udokotela we-allergy njalo kungasiza ekubambeni ukuqubuka kwesikhumba kusenesikhathi.
• Sebenzisa ukwelashwa kwansuku zonke njengoba kuqondiswe. Izifutho zamakhala, ukuhlanza, kanye neminye imithi zisebenza kahle kakhulu uma zisetshenziswa njengoba udokotela wakho ekuyalele.
• Sebenzisa izihlanzisi zikasawoti njalo ukusiza ekususeni amafinyila nezinto ezicasulayo ekhaleni lakho.
• Lawula ukungezwani komzimba. Sebenzisana nodokotela wakho we-allergy ukuze uphathe i-allergy, enganciphisa ukuvuvukala futhi inciphise izinkinga ze-sinus. Ungase ucabangele ukuxoxa nge-immunotherapy (isb., imijovo ye-allergy) ngokumelene nesikhunta, ukuze uthuthukise ukubekezelela i-allergy ukuze umzimba ungasabeli ngokweqile.
• Gwema izinto ezibangela lokhu uma kungenzeka. Gwema izinto ezibangela ukuvuvukala, njengothuli, isikhunta, kanye nensangu ebhemayo ngangokunokwenzeka.
• Landelela izimpawu, futhi uqaphele izimpawu zokuqala. Tshela udokotela wakho uma ubona ukubuya kokuminyana, uketshezi olujiyile, noma ukucindezeleka kwama-sinus, ukuze uthole ukwelashwa kusenesikhathi.
• Thatha ama-steroid kuphela njengoba uyalelwe. Ama-steroid anganciphisa ukuvuvukala, kodwa ukuwaphuza kaningi kungabangela ezinye izinkinga zempilo. Ungalokothi uwaphuze kaningi kunalokho okuyalelwe udokotela wakho.
• Gcina ikhaya liphilile ngokugcina indlu yakho yomile, bese usebenzisa izihlungi zomoya (izihlungi ze-HEPA) ukunciphisa isikhunta emoyeni owuphefumulayo.
• Sebenzisa imikhuba yokuphila enempilo lapho unakekela ngezokwelapha. Nakuba kungewona umuthi we-AFRS, ukudla okunempilo kanye nokuzivocavoca ngohlelo lwakho lokwelashwa kungasiza ekuqiniseni amasosha omzimba wakho futhi kuthuthukise impilo yonke kanye nekhwalithi yokuphila.

Ahileleke

Sakaza izwi nge-AFRS nge ukwabelana ngezinto zomkhankaso kanye nokukhuthaza abangani nomndeni ukuthi bafunde kabanzi nge-AFRS.

Lokhu okuqukethwe kwezemfundo kwenziwe kwaba nokwenzeka ngokusekelwa yiSanofi kanye neRegeneron.