Kuyini Ukukhwehlela Okungapheli?

Ukukhwehlela okungapheli ukukhwehlela okuthatha isikhathi esingaphezu kwamasonto angu-8. Kuvama ukwenzeka ngoba imizwa emphinjeni nasemigudwini yomoya izwela kakhulu. Lokhu kungase kuqale ngemva kokutheleleka okufana nokukhwehlela, COVID-19, noma umkhuhlane.

Abantu abanokukhwehlela okungapheli bavame ukuqaphela ukuthi izinto zansuku zonke zingabangela ukukhwehlela kwabo. Lezi zinto ezicasulayo zingahlanganisa iphunga elinamandla (isb., izihlanzi komoya, iziqeda-phunga, nama-propellants kuma-inhalers), ukushintsha kwezinga lokushisa (kokubili okubandayo kuya kokushisa nokushisa kuya kubanda), kanye nokushintsha kokuma (ukulala phansi ebusuku nangemuva kokuvuka ekuseni). Ezinye izimbangela zokukhwehlela zingase zihlanganisa ukuhleka noma ukukhuluma, ikakhulukazi ocingweni.

I-Navigator Yesiguli Sokukhwehlela Okungapheli

Ukukhwehlela kuyindlela evamile yokuzivikela esiza ekuvikeleni umzimba ngokususa izinto ezicasulayo emigudwini yomoya. Kodwa-ke, uma ukukhwehlela kuhlala isikhathi eside, kungaba uphawu lwenkinga yezempilo eyisisekelo.

Kuchazwa njengokukhwehlela okuhlala isikhathi esingaphezu kwamasonto ayi-8 kubantu abadala noma isikhathi esingaphezu kwamasonto ama-4 ezinganeni. Ukukhwehlela okungapheli kungathinta ukulala, imisebenzi yansuku zonke, kanye nekhwalithi yokuphila.

Izimo eziningi ezahlukene zingabangela ukukhwehlela okungapheli, okuhlanganisa i-asthma, izinkinga ze-sinus, i-acid reflux, kanye nemithi ethile. Kwezinye izimo, ukukhwehlela kungaqhubeka ngisho nangemva kokuba izimbangela ezivamile sezelashiwe.

Ngenxa yokuthi kunezimbangela eziningi ezingaba khona, ukuqonda ukukhwehlela okungapheli ngezinye izikhathi kungaba yinto edidayo. Ulwazi olungezansi lwenzelwe ukukusiza ufunde kabanzi mayelana nalokhu:

  • kuyini ukukhwehlela okungapheli
  • izimpawu ezivamile kanye nezimbangela
  • izimo ezingaba khona eziyisisekelo
  • indlela yokutholakala kokukhwehlela okungapheli
  • izinketho zokwelapha namasu okubhekana nazo

Sebenzisa i-Patient Navigator engezansi ukuhlola isihloko ngasinye futhi ufunde kabanzi ngokukhwehlela okungapheli nokuthi kungaphathwa kanjani. Uma usubuyekeze lonke ulwazi, bhala imibuzo ukuze uhlole lokho okufundile.

Ngokungafani nezinye izinhlobo zokukhwehlela, ukukhwehlela okungamahlalakhona kuvame ukukhiqiza kancane noma kungakhiqizi nhlobo amafinyila. Akuvamile futhi ukuxhunyaniswa nanoma yiziphi izimpawu “zefulegi elibomvu” njengokukhwehlela igazi noma ukulahlekelwa isisindo esiningi. Kungenziwa kube kubi kakhulu izimo ezifana nesifuba somoya, izinkinga ze-sinus noma i-post-nasal drip, kanye ne-acid reflux (GERD).  

Kwesinye isikhathi odokotela basebenzisa amagama ahlukene okukhwehlela okungamahlalakhona anezimbangela noma izimbangela ezahlukene.

  • Ngezinye izikhathi ukukhwehlela akupheli ngisho nangemva kokuba odokotela belaphe izimbangela ezivame kakhulu. Lokhu kubizwa Ukukhwehlela Okungapheli.
  • Uma kungekho sizathu esicacile esitholakalayo, siyabizwa Ukukhwehlela Okungapheli kwe-Idiopathic. 
  • Abantu abaningi banalo I-Cough Hypersensitivity Syndrome, or ukukhwehlela kwe-neurogenic, lapho izinzwa zomoya zizwela ngokweqile. 
  • Ukukhwehlela okuhlala isikhathi eside kungenzeka nangezifo zamaphaphu.
    • Isibonelo esisodwa I-Idiopathic Pulmonary Fibrosis (IPF), isimo lapho amaphaphu eqina futhi abe nezibazi. 
    • Esinye isibonelo yilezi Izifo ze-Interstitial Lung (ILDs), okuyiqembu lezimo ezibanga ukuvuvukala noma izibazi emaphashini. Ukwazi lezi zinhlobo kusiza iziguli nodokotela bakhethe ukunakekelwa okungcono kakhulu.

Ukuphila nokukhwehlela okungamahlalakhona kungaba nomthelela omkhulu eqophelweni lempilo. Ukukhwehlela njalo kungakhandla, ikakhulukazi uma kuphazamisa ukulala futhi kuholele ekukhathaleni okukhulu. 

Ukukhwehlela okungamahlalakhona nakho kungase kubangele amahloni, okungase kubangele abanye abantu ukuba bagweme izimo zomphakathi futhi babe inyumbazane. Ngokuhamba kwesikhathi, lokhu kungase kubangele imizwa yokudabuka noma yokucindezeleka. 

Iziphonso ezinamandla zokukhwehlela kwesinye isikhathi zingadala ezinye izinkinga, njenge:

  • Ukugaya noma ukuhlanza
  • Ingcindezi yokungakwazi ukuzithiba komchamo (ukuvuza komchamo ngesikhathi ukhwehlela), okuvame kakhulu kwabesifazane
  • Ubuhlungu bezimbambo, noma ezimweni ezingavamile, ukuphuka kwezimbambo
  • Ukuquleka noma ukuquleka (i-syncope)

Odokotela bavamise ukubona ukukhwehlela okungapheli ngokusekelwe ezimpawini zakho. Noma kunjalo, kubalulekile ukukhipha izimo ezibucayi, njengomdlavuza wamaphaphu (ikakhulukazi kwababhemayo noma abake babhema) noma izimo zamaphaphu njenge-fibrosis. 

Kwezinye izifo zamaphaphu, njenge-idiopathic pulmonary fibrosis (IPF) noma ezinye izifo zamaphaphu e-interstitial (ILDs), ukukhwehlela okungamahlalakhona kungase kube nokuzwela kwemizwa efanayo okubonwa ekukhwehleleni okungapheli (RCC). Kodwa-ke, ku-IPF, ukukhwehlela njalo kungase kukhuphule izibazi emaphashini. Ngenxa yalesi sizathu, odokotela bavame ukusebenzisa izithombe ezikhethekile, ezifana ne-high-resolution CT scans (HRCT), ukuze bakhiphe lezi zimo ngaphambi kokuqhubekela phambili nokwelashwa kokukhwehlela okungapheli.

Ukuhlola okujwayelekile kufaka phakathi: 

  • Isithombe sephaphu
    • Ama-X-ray noma ama-CT scan asiza ukukhipha isifo esibi futhi angase akhombe ezimweni ezibangela ukukhwehlela okungapheli 
  • Lab umsebenzi
    • Ikhomba izimpawu zokuvuvukala noma ukungezwani komzimba negazi lakho noma isikhwehlela (phlegm) 
  • Ukuhlolwa kokusebenza kwamaphaphu
    • Lezi zihlola ukuthi amaphaphu akho asebenza kahle kangakanani futhi zingasiza ekuxilongeni izimo ezifana ne-asthma ne-COPD. Okuvame kakhulu i-spirometry, kodwa ungase ube nezinye izivivinyo zevolumu yamaphaphu noma ukuthi amaphaphu akho ashintshana kahle kangakanani umoya-mpilo ne-carbon dioxide.
  • Ukuhlola kusetshenziswa isikophu (ikhamera eshubhu)
    Ezimeni lapho udokotela wakho engakwazi khona ukunquma imbangela yokukhwehlela kwakho, angase a-ode ukuhlolwa kobubanzi obukhethekile (ikhamera) okufana nalokhu:
    • I-Rhinoscopy - ebheka ukona kanye nemigudu yamakhala
    • I-bronchoscopy - ibheka ngqo imigudu yomoya namaphaphu. Kwesinye isikhathi bazothatha isampula lethishu elincane (i-biopsy) ukuze lihlolwe elebhu.
  • Ukuqapha ukukhwehlela ukulandelela ukukhwehlela okungapheli

Amadivayisi akhethekile noma izinhlelo zokusebenza zingalandelela ukuthi ukhwehlela kaningi kangakanani. Lokhu kusiza wena, umnakekeli wakho, kanye nodokotela wakho nibone ukuthi imithi yokwelapha iyasebenza yini nokuthi ingabe ukwelashwa kwakho kudingeka kulungiswe.

Ukwelashwa okungcono kakhulu kuya ngembangela yokukhwehlela kwakho. Uma odokotela bengathola futhi belaphe isimo esiwumsuka, njengesifuba somoya, i-reflux, noma i-allergies, ukukhwehlela kuvame ukuba ngcono.

Uma kungekho sizathu esitholakalayo, ngezinye izikhathi esibizwa ngokuthi ukukhwehlela okungapheli kwe-idiopathic, ukwelashwa kungaba inselele kakhulu. Nazi ezinye izinketho udokotela wakho angase axoxe ngazo nawe.

  • Imithi yokukhwehlela

Imithi yokucindezela ukukhwehlela etholakala ngaphandle kwekhawunta kwesinye isikhathi iyaphakanyiswa, kodwa ngokuvamile ayisebenzi kahle ekukhwehleleni okungapheli.

  • Imithi kadokotela
    • Ama-opiate (afana ne-codeine, i-diamorphine, noma i-morphine) angase anqunywe ezimeni ezithile, kodwa kuphela ngaphansi kokuqondisa kwezokwelapha okuseduze.
    • Imithi emisha, ebizwa ngama-P2X3 receptor antagonists, ethulisa imicu yezinzwa esebenza ngokweqile emoyeni, iyatholakala kwamanye amazwe kubantu abadala abanokukhwehlela okungapheli okungaphenduli kwezinye izindlela zokwelapha. Buza udokotela wakho noma usokhemisi uma lezi zitholakala lapho uhlala khona.
  • Ukukhulumisana nokukhuluma kolimi

Amasu akhethekile afundiswa abelaphi angakusiza ukulawula ukukhwehlela nokuthuthukisa izinga lempilo. 

  • I-Airway Clearance Techniques

Ukuzivocavoca okuthile noma amadivaysi angasiza ukususa amafinyila emigwaqweni yomoya, uma lokho kungenye yezimpawu zakho. Kubalulekile ukwazi ukuthi ukukhwehlela okukhiqizayo ngokuvamile akutholakali ekukhwehleleni okungapheli. Uma ukhiqiza isikhwehlela, khuluma nodokotela wakho.

  • Amakhambi asekhaya 

Ukuhlala ungenawo amanzi, usebenzisa i-humidifier, ukumunca ama-lozenji, noma ukuphuza itiye elifudumele elinoju kungase kudambise ukucasuka komphimbo.

  • Izinguquko zokuphila 

Ukugwema intuthu, ukungcola, nentuthu yamakhemikhali kunganciphisa ingozi yakho. Uma ubhema, khuluma nodokotela wakho mayelana nokuyeka noma ukujoyina iqembu lokusekela.

  • Imithi

Ukuhambisana nokugoma okunconyiwe kusiza ukuvikela amaphaphu akho kanye nempilo iyonke.Funda kabanzi lapha mayelana namandla okugoma kubantu abanesifo esingelapheki sokuphefumula.

Abantu abaningi abakhwehlela okungapheli baqale babonane nodokotela womndeni wabo, udokotela wezingane (izingane) noma udokotela ojwayelekile emphakathini wabo. Uma ukukhwehlela kuqhubeka, ungathunyelwa kuchwepheshe ofana nalokhu:

  • I-Pulmonologist - udokotela wamaphaphu
  • I-Allergist - uchwepheshe we-allergies
  • I-Gastroenterologist - udokotela wesistimu yokugaya
  • I-Otolaryngologist - udokotela wezindlebe, ikhala, nomphimbo, owaziwa nangokuthi i-ENT)

Izinto ezithile zingakwenza ube maningi amathuba okuthi uthuthuke noma ugcine ukukhwehlela okungapheli. Ezinye izingozi ezingagwenywa noma zehliswe yilezi:

  • Ukubhema
    • Abantu ababhemayo bavame ukukhwehlela ekuseni okungaba ngcono ngemva kokuyeka ukubhema. Ucwaningo lukhombisa ukuthi ukubhema ngisho nosikilidi abayi-100 empilweni yakho konke kuphinda kabili noma kathathu ingozi yokukhwehlela okungapheli uma kuqhathaniswa nabangabhemi.
  • Imithi yomfutho wegazi noma i-ACE inhibitors (ACE 1)
    • Eminye imithi yomfutho wegazi ophakeme (leyo egcina ngo-pril, njenge-lisinopril) ibangela ukukhwehlela kubantu abangafika koyedwa kwabayi-10. Uma lokhu kwenzeka, udokotela wakho angase akwazi ukukushintshela komunye umuthi ngokuvamile ongabangeli ukukhwehlela.
  • Izinto ezingcolisa imvelo/Umoya 

Ukuhlala eduze kwentuthu, uthuli, noma amakhemikhali kungabangela ukukhwehlela okungapheli.

  • Intuthu kagwayi: ukuhlala noma ukuba nabantu ababhemayo.
  • Ukunukubezeka komoya wangaphakathi nangaphandle: uthuli, amakhemikhali, uphethiloli wokupheka wasendlini, noma ezinye izinhlayiya eziphathwa ngomoya ezicasula amaphaphu.

Kubalulekile ukuqaphela ukuthi nakuba ukukhwehlela okungapheli kuthinta abantu ngabanye ubudala, ubulili, kanye nezizwe, iphrofayili evame ukubikwa ngabesifazane abangaphezu kweminyaka engama-50 bohlanga lwabamhlophe.

Ukukhwehlela okungapheli kuthinta abantu yonke indawo, kodwa ukuthi kuvame kangakanani kungahluka ngokwesifunda. Ucwaningo lubonisa ukuthi kubikwa kaningi ezindaweni ezifana ne-Australia ne-New Zealand (ngaphezu kuka-20% wabantu) futhi kancane kancane e-Asia, Latin America, nase-Afrika. ENyakatho Melika naseYurophu, cishe i-10-15% yabantu ibika ukukhwehlela okungapheli.

Izizathu zalo mehluko aziqondwa ngokugcwele. Kungase kube ngenxa yokungabikwa kahle, umehluko ekuxilongweni okufana nokubizwa ngokuthi isifuba somoya noma ukungezwani komzimba nezinto ezithile, esikhundleni salokho, noma izici zemvelo noma zofuzo.

Abacwaningi bacwaninga ngemithi emisha yokwelapha kangcono ukukhwehlela okungapheli, futhi eminye isesigabeni sokugcina sokuhlolwa.

I-GAAPP isekela lolu cwaningo futhi isiza ukuxhuma iziguli ngolwazi olumayelana nezivivinyo zomtholampiloUkuthola ukuqashwa kokuhlolwa komtholampilo endaweni yangakini, ungasesha incwadi yesilingo. imitholampilo.gov.za usebenzisa amagama afana nokuthi "ukukhwehlela okungapheli," wengeza indawo yakho (izwe) nokukhetha "Ukuqasha futhi ongakabuthi izifundo."

Amaflaya Ezemfundo

Thwebula
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Misa isikhashana imfundo yakho yokuKhohlela kanye nohlelo lwamanxusa esiguli 

Entuthukweni ebalulekile yokulawulwa kwezifo zokuphefumula okungamahlalakhona, ngo-Ephreli 2024 i-GAAPP ihlanganyele ne-Esperity, ehamba phambili ezisombululweni zokunakekelwa kwezempilo okugxiliswe ezigulini, ukwethula ingosi yesimanje enikezelwe ekukhwehleleni okungapheli, egcizelela ngokukhethekile ukukhwehlela okungamahlalakhona. Lokhu kubambisana kuhlelelwe ukuphakamisa ukuqwashisa nokuthuthukisa imiphumela yalo mphakathi wesiguli ongasikiwe ngokunikeza izinsiza zemfundo ezibanzi kanye nohlelo olujulile Lwenxusa Leziguli.

Misa kancane ukukhwehlela kwakho

Okubhekwayo

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Okuqukethwe kubuyekezwe ilungu le-GAAPP Clinical and Scientific Advisory Panel