Yini i-COPD?

Isifo se-Chronic obstructive pulmonary disease (COPD) yigama lezokwelapha elisetshenziselwa ukuchaza isimo samaphaphu esibangela ukuba imigudu yokuphefumula ibe mncane futhi ivaleke okwenza kube nzima ukuphefumula.[1]

Lapho igama lihlukaniswa, ungabona ukuthi incazelo iyithola kanjani incazelo yayo:

Okungapheli: isimo sesikhathi eside nesiqhubekayo esingeke siphele

Okuphazamisayo: imigudu yomoya emaphashini akho inciphile futhi iyavaleka noma ivaleke, okwenza kube nzima ukuthi ikhiphe umoya

I-pulmonary: isimo esithinta amaphaphu akho

Izifo: isimo sezempilo esaziwayo 

I-COPD ingachazwa njengesifo semigudu yomoya (i-bronchitis engapheli) kanye/noma isifo samasaka omoya (emphysema).

  • I-bronchitis engapheli kutholakala lapho othile enezimpawu zokukhwehlela isikhathi eside (izinyanga noma iminyaka eminingi) futhi ekhwehlela iphlegm, ebizwa nangokuthi isikhwehlela noma amafinyila. Ngokuvamile kubangelwa ukubhema, kodwa abantu abangakaze babheme nabo abasebenza noma abahlala ezindaweni lapho bephefumula khona uthuli, izinto zokubasa (isb., izinkuni), intuthu yamakhemikhali, noma ukushisisa nokupheka kwasekhaya nabo bangaba ne-bronchitis engapheli. Isifo se-reflux se-gastroesophageal (esivame ukubizwa ngokuthi i-GERD) sihlotshaniswa nalokhu kuxilongwa. 

I-bronchitis engapheli iwumphumela wokucasuka nokuvuvukala kwamashubhu e-bronchial (imigudu yomoya) - amashubhu anomthwalo wokuthwala umoya emaphashini. Amashubhu ayakhukhumala futhi akhiqize ukunqwabelana kwamafinyila eduze kolwelwesi. Izakhiwo ezincane ezinjengezinwele ezikumashubhu okuthiwa i-cilia ngokuvamile zisiza ukukhipha ufinyila emzileni womoya, kodwa ngezinye izikhathi azisebenzi kahle. Lokhu kubangela ukunqwabelana kwamapulaki amafinyila okunzima ukuwakhwehlela futhi ngezinye izikhathi akwenze kube nzima ukukhipha nokungena umoya emaphashini. Abantu abane-bronchitis engapheli bangaba nezimpawu zesifuba noma ubuhlungu besisu.  

  • I-Emphysema kutholakala kuphela ngokuhlolwa kwe-imaging yamaphaphu (njenge-CT scan) ebonisa umonakalo ezindongeni zamasaka amancane omoya emaphashini ekugcineni kwamashubhu e-bronchial - okuthiwa i-alveoli - lo monakalo uwenza akhule. I-alveoli ngokuvamile idlala indima ebalulekile ekudluliseleni umoya-mpilo egazini lakho futhi ihlunge i-carbon dioxide ibuyele ngaphandle. I-Emphysema iqala ngokuhamba kwesikhathi, futhi akuwona wonke umuntu one-emphysema yokuqala onezimpawu, kodwa ukuba ne-emphysema kungenza kube nzima ukuphefumula ngoba amasaka omoya akhulisiwe abamba umoya emaphashini. Ukucupha komoya kutholwa kusetshenziswa ukuhlola ukusebenza kwamaphaphu.

Cishe abantu abayizigidi ezingu-380 emhlabeni wonke bahlaselwe yi-COPD. Kuyimbangela yesithathu ehamba phambili yokufa ngemuva kwesifo senhliziyo nesifo sohlangothi.[2]

Uma unesifo se-chronic obstructive pulmonary, kancane kancane kuba nzima ukuphefumula. I-COPD iyaqhubeka, okusho ukuthi umonakalo emaphashini akho awukwazi ukuhlehliswa futhi ungase uqhubeke. Ukwelashwa, imithi, kanye nokulungiswa kwendlela yokuphila kungakusiza ufunde ukuphatha ngokuphumelelayo, ukulawula izimpawu zakho, futhi kungase kubambezele ukuqhubeka kwe-COPD. 

Izimpawu eziyinhloko zihlanganisa:

  • Ukuphelelwa umoya kalula (igama elivamile elisetshenziselwa ukuphelelwa umoya lithi I-dyspnea) 
  • Ukukhwehlela okungapheli nephlegm
  • Ukutheleleka kwesifuba njalo 
  • Ukushaywa umoya, ikakhulukazi lapho kubanda

Izimpawu zingase zenzeke ngaso sonke isikhathi, noma zingase zibe zimbi kakhulu ngezikhathi ezithile, njengalapho unegciwane noma uphefumula intuthu kagwayi, umoya ongcolile, noma intuthu. Lokhu kubizwa ngokuthi ama-exacerbations, noma ama-flare-ups, e-COPD yakho. Kungenzeka futhi ukuzwa ezinye izimpawu nge-COPD, ikakhulukazi uma lesi sifo siba sibi kakhulu noma unezinye izinkinga zezempilo (i-comorbidities) futhi. 

Ezinye izibonelo zezinye izimpawu zihlanganisa:

  • Ukukhathala nokuntuleka kwamandla 
  • Ukuvuvukala kwamaqakala, imilenze nezinyawo, okubangelwa ukunqwabelana koketshezi (lokhu kwaziwa ngokuthi edema)
  • Ukuncipha kwesisindo ungahlosile 
  • Ukuthola ukucindezela kwesifuba noma ubuhlungu
  • Ukukhwehlela igazi - nakuba lokhu kungaba uphawu lokunye, ngakho-ke kungase kudingeke ukuhlolwa okwengeziwe ukuze kugwenywe ezinye izimo.

Uma une-COPD futhi izimpawu zakho ziba zimbi, noma ungaqiniseki ukuthi uphawu luxhunywe ku-COPD, thintana nodokotela wakho noma umhlinzeki wezempilo.

I-COPD iqala ngenxa yokulimala kwesikhathi eside emaphashini okubangela ukuthi avuvuke noma alimale, avinjwe, futhi anciphe. Ukubhema kuyimbangela eyinhloko ye-COPD. Nokho, akubona bonke ababhemayo, ngisho nababhemayo kakhulu, ababa ne-COPD, futhi okungenani amaphesenti angu-20-30 abantu abaneCOPD ababhemi neze.[3]  

Kubalulekile ukwazi lokho I-COPD ingavinjelwa! Ukuthi umuntu uba ne-COPD noma cha ekuphileni kwakhe kuthonywa ingxube eyinkimbinkimbi yendawo yakhe kanye nokwakheka kofuzo. Isibonelo, ucwaningo lwakamuva luphakamisa ukuthi ukuba nemigudu yomoya emincane ehlobene nobukhulu bamaphaphu kungase kubeke abantu kusengaphambili umthamo wokuphefumula ophansi kanye nengozi eyengeziwe ye-COPD. Izehlakalo zempilo yangaphambi kwesikhathi njengokutheleleka noma umama obhemayo angabeka umuntu engcupheni yokuba ne-COPD.

Risk izici I-COPD ihlanganisa:

  • Ababambe iqhaza kwezemvelo
    • Ukubhema ugwayi noma umlando wokubhema
    • Ukuchayeka emsebenzini (umsebenzi) othulini, umusi, noma amakhemikhali
    • Ukungcoliswa komoya
  • Izici eziyingozi zezakhi zofuzo (okungukuthi, ukushoda kwe-alpha-1 antitrypsin, isimo esingavamile esenza abantu babe sengozini ye-COPD besebancane)
  • Ukuthuthukiswa kwamaphaphu kanye nezici zokuguga
  • Ukutheleleka okungamahlalakhona (isibonelo, i-HIV ihlotshaniswa ne-COPD)
  • Ukucatshangelwa kwezenhlalo nezomnotho
  • Izifo zesifuba zezingane ezivamile noma ukukhula kabi kwamaphaphu

Ukubhema

Njengoba kushiwo ngaphambili, ukubhema kuyimbangela eyinhloko yeCOPD. Nakuba kungebona bonke abantu ababhemayo ababa nalesi simo, ukuyeka ukubhema kutuswa kakhulu njengokwelashwa okunikezwe ukuxhumana phakathi kokubhema nomdlavuza, isifo senhliziyo, nezinye izifo ezingathi sína ezingamahlalakhona. Kunezindlela eziningana ezisekelwe ebufakazini nezindlela zokusiza ekuyekeni ukubhema. Izindlela zokwelapha ezishintsha i-Nicotine kanye nemithi kuboniswe ukuthi ziyasiza.[4] Izinhlangano eziningana zinikeza namaqembu okusekela nabaqeqeshi abaqeqeshelwe ukusekela abantu abayeka ukubhema. 

Kusesekuseni kakhulu ukuqonda ubungozi besikhathi eside bokuphefumula kanye nezifundo zakuqala ziphakamisa ukuthi ukufutha kuhlotshaniswa nesifo samaphaphu.[4] Umphakathi wezokwelapha kanye nezokumela we-COPD ngokuvamile awukukhuthazi ukusetshenziswa kukagwayi we-elekthronikhi kanye ne-vaping, kungakhathaliseki ukuthi endaweni yokubhema ugwayi noma njengethuluzi lokuyeka ukubhema. Khuluma nethimba lakho lezempilo mayelana nokuthi yini engakusebenzela kangcono.

Intuthu nothuli emsebenzini

Cishe u-24% womthelela womhlaba wonke we-COPD ubangelwa ukuchayeka emsebenzini.[5] Ngokwe-National Health Service yase-UK, uthuli namakhemikhali athile asemsebenzini angabangela i-COPD, ikakhulukazi uma uwaphefumula, okuhlanganisa:[6]

  • Uthuli lwe-Cadmium nentuthu.
  • Okusanhlamvu nothuli lukafulawa.
  • I-silica uthuli.
  • Amafutha okushisela.
  • I-Isocyanates.
  • Uthuli lwamalahle.

Ukungcoliswa komoya

Ukunukubezeka komoya wasekhaya kuthinta izigidigidi emhlabeni jikelele. Ukushisa uphethiloli emililo evulekile yokupheka nokushisisa ezindlini ezingenawo umoya ohlanzekile kungaba enye yezimbangela ezinkulu. Lokhu kungase kubeke abantu emazweni amaningi asathuthuka - ikakhulukazi abesifazane, abenza imisebenzi eminingi yokupheka - engozini enkulu ye-COPD. Izindawo zokubasa izinkuni nezifudumezi nazo zandisa ukungcoliswa komoya endlini.

Siyazi ukuthi izinga lomoya eliphansi emadolobheni nasemadolobheni lingaba yingozi emaphashini ethu, ikakhulukazi kubantu asebevele benezimo zenhliziyo noma zokuphefumula. Nokho, akucaci ukuthi lokho kuwathinta kanjani amathuba ethu okuba ne-COPD, njengoba kudingeka ucwaningo olwengeziwe.[7]

Ufuzo

Uma unesifo sofuzo esingavamile esibizwa ngokuthi ukuntula kwe-alpha-1-antitrypsin (AATD), maningi amathuba okuba uhlakulele i-COPD. Cishe abantu abayizigidi ezingu-3.4 emhlabeni wonke bane-AATD, [8] evame kakhulu kubantu bokhokho base-Europe.[9] 

I-Alpha-1-antitrypsin iyikhemikhali evame ukukhiqizwa esibindini evikela amaphaphu ethu ezintweni eziyingozi nasezifweni. Abantu abane-AATD abanayo i-alpha-1 antitrypsin, futhi lokhu kungaholela ekuthuthukiseni i-COPD. Ungase futhi ube ne-COPD usemncane futhi i-COPD yakho ingase ithuthuke ngokushesha,[10] ikakhulukazi uma ubhema.[11] Uma ubhema, ngakho-ke kubaluleke nakakhulu ukuyeka. Buza udokotela wakho noma umhlinzeki wezempilo ukuthi yiziphi ezinye izindlela zempilo nendlela yokuphila ongazithatha futhi ufune imiphakathi yosekelo yabanye nge-Alpha-1.

Abantu abane-COPD bangase babe nezinhlobo ezahlukene zokuvuvukala ezingabonakala ngokulinganisa amangqamuzana omzimba omzimba (isibonelo, ama-neutrophils noma ama-eosinophils) noma amaprotheni esikhwehlela noma izinyathelo ezahlukene emoyeni okhishwa umoya (FeNO). Ukuqonda okuthuthukisiwe kwakamuva kwalezi zinhlobo ezincane zokuvuvukala kusiza abahlinzeki nabathuthukisi bezidakamizwa ukuthi baqondise indlela yokwelapha engcono kakhulu.  

Kubantu abaningi abane-COPD, uhlobo oluvame kakhulu lokuvuvukala ukuvuvukala kwe-neutrophilic, ikakhulukazi abantu ababhemayo noma ababebhema. Kodwa ama-20–40% anokuvuvukala koHlobo lwesi-2 oluhambisana nama-eosinophil aphezulu.[12] Ezivivinyweni zomtholampilo, abantu abanamazinga aphezulu eosinophil basabela kangcono ekwelashweni ngama-steroids ahogeliwe.[13]

Uma uba nezimpawu ezibeleselayo ze-COPD - njengokukhuphuka kokuphefumula, ukukhwehlela okungeke kuphele, ukukhwehlela, noma ukungenwa izifo ezifubeni ezivamile - kungakhathaliseki ubudala bakho noma umlando wokubhema, bonana nodokotela wakho noma umhlinzeki wezempilo. 

Ukuvama

Ivamise kangakanani i-COPD? Emhlabeni jikelele, cishe abantu abayizigidi ezingu-380 bane-COPD. EYurophu, abantu abangaphezu kwezigidi ezingu-36 bane-COPD - lokho kuphindwe kane inani labantu baseLondon.[14] I-COPD kokubili ayixilongwa kahle futhi ayixilongwanga kahle. Lokhu kungenxa yokuthi i-COPD ikhula kancane ngokuhamba kweminyaka, ngakho abantu abaningi baqala ukubona izimpawu eminyakeni yabo-50. [15] Ukuntuleka kokufinyelela ekuhlolweni okufanele kanye nokungahambisani ekusetshenzisweni kweziqondiso ezihlobene nokuxilongwa nakho kunomthelela kulolu daba.[16]

I-COPD ivame ukuba nomthelela kulabo abanamazinga aphansi emfundo, imali engenayo, nomsebenzi futhi ibonakala ngamanani aphezulu emazweni anemali engenayo ephansi kuya emaphakathi. Abacwaningi kanye nomphakathi wokumela i-COPD basebenzela ukubhekana nalokhu kungqubuzana.

Inqubo yokuxilonga

I-COPD itholakala kanjani? Izinyathelo eziningana zihilelekile ekwenzeni ukuxilongwa kwe-COPD. Udokotela wakho uzokubuza ngezimpawu zakho nokuthi ziyithinta kanjani impilo yakho yansuku zonke:

  • Ukuphefumula - ingabe iyaphikelela, ingabe iye yaba nzima ngokuhamba kwesikhathi, ingabe kubi nakakhulu uma uzivocavoca noma wenza umsebenzi womzimba, ingabe kwenzeka ebusuku noma ngezinye izikhathi?
  • Isikhukhula – iyafika ihambe, iveze iphlegm, nawe uyahefuzela?
  • Ukutheleleka kwesifuba – uthola kangaki lezi?
  • Umlando womndeni/wezingane – ngabe kukhona isihlobo sakho esiseduze esinenkinga yokuphefumula, ibinjani impilo yakho usewusana nengane?
  • Izinto ezinobungozi noma ukuchayeka – ingabe ungumuntu obhemayo noma owayekade ebhema, ingabe umsebenzi wakho noma impilo yasekhaya ikwenza uhlangane nokungcoliswa komoya (isb. uthuli, umusi, intuthu, amagesi, amakhemikhali, intuthu yokupheka ekhaya, noma izinto zokubasa zokushisisa)?
  • Ezinye izimpawu – ingabe uke wehla emzimbeni, ukuvuvukala kweqakala, ukukhathala, ubuhlungu besifuba noma ukukhwehlela igazi? Lokhu akuvamile kakhulu, ikakhulukazi ku-COPD encane, futhi kungase kubhekisele ekuxilongweni okuhlukile.

Bazophinde balalele isifuba sakho nge-stethoscope, bacabangele iminyaka yakho, futhi abale inkomba yesisindo somzimba wakho (BMI) ukusuka kubude bakho nesisindo sakho. 

Uma udokotela wakho esola ukuthi une-COPD, uzodinga ukuthi uhlolwe i-spirometry.

I-Spirometry ikala umthamo wamaphaphu akho nokuthi ungawukhipha ngokushesha kangakanani umoya. Umphumela obizwa ngokuthi ivolumu yokuphelelwa umoya ngesekhondi elingu-1 (FEV1) uzokala ukuthi ukhipha umoya ongakanani emaphashini akho. Lokhu kanye neminye imiphumela ingasiza udokotela wakho ukuthi asho ukuthi amaphaphu akho avimbekile yini noma avimbekile. 

I-Spirometry iyindinganiso yamanje yegolide yokuhlola i-COPD; kungasiza futhi ekulawuleni ezinye izimo zamaphaphu, njengesifuba somoya (isifo samaphaphu esingamahlalakhona esivutha futhi sinciphise imigudu yokuphefumula). Ungase futhi ube ne-X-ray yesifuba, i-CT scan, noma ukuhlolwa kwegazi ukuze ukhiphe ezinye izimo futhi uhlole i-COPD. Mayelana ne-CT scans:

  • I-CT scan yedosi ephansi yonyaka (LDCT) iyanconywa ukuthi ihlolwe umdlavuza wamaphaphu kubantu abaneCOPD ngenxa yokubhema, ngokwezincomo zomphakathi jikelele.
  • I-LDCT yaminyaka yonke ayinconyelwe ukuhlolwa komdlavuza wamaphaphu kubantu abane-COPD engahlobene nokubhema, ngenxa yedatha enganele yokuthola inzuzo phezu kokulimala.

Amaphuzu abalulekile:

Yiziphi “izigaba” zeCOPD? Uma uxilongwa, uzozwa ngobunzima bomkhawulo wokugeleza komoya ochazwe kusetshenziswa amamaki okuhlola ukusebenza kwamaphaphu IGOLIDE 1 (elimnene) -4 (libi kakhulu), nokuthi ingabe une-emphysema. Lezi zincazelo zisiza abahlinzeki bakho bokunakekelwa kwezempilo ukuthi bakuncomele izinketho zokwelashwa ezingcono kakhulu.

Akuvamile ukuthi ungazi ukuthi une-COPD. I-COPD ivamise ukukhula kancane eminyakeni eminingi, ngakho-ke akuvamile ukuthi ungazi ukuthi unayo. Abanye abantu bacabanga ukuthi izimpawu zakuqala - njengokuphelelwa umoya - kungenxa yobudala, ukungabi namandla, noma ukuba nesifuba somoya, kanti empeleni imbangela kungaba yi-COPD engelapheka kusenesikhathi.

Ngakho-ke, abantu abaningi bathola ukuthi bane-COPD eminyakeni engama-60, kodwa abantu abadala bangaba ne-COPD kunoma iyiphi iminyaka.

Kubalulekile futhi ukwazi ukuthi ngemva kokuqaphela izimpawu, abantu abaningi bazama ukunciphisa imisebenzi yabo kunokuba bafune iseluleko sezokwelapha. Kodwa njengoba i-COPD ingaba yimbi kakhulu, kubalulekile ukubona umhlinzeki wakho wokunakekelwa kwezempilo ngokushesha kunokuba kamuva. Ngohlelo olulungile lokwelashwa, abantu abane-COPD bangaphila impilo egcwele. 

I-COPD ngezinye izikhathi ayitholakali kahle njengoba kunezinye izimo zamaphaphu ezinezimpawu ezifanayo, njenge-bronchiectasis kanye/noma isifuba somoya noma isifo senhliziyo. Kodwa abanye abantu abane-COPD nabo banalezi zimo ngenkathi beneCOPD njengoba izingozi zokuzithuthukisa zifana. 

Uhlolojikelele Lokwelashwa

Yelashwa kanjani i-COPD? Nakuba lingekho ikhambi le-COPD, ngokwelashwa okufanele, lingaphathwa futhi lilashwe ukuze kunqandwe omunye umonakalo emaphashini akho, kuthuthukise izimpawu zakho, futhi kuvimbele ukuqubuka. Ithimba lakho lomtholampilo lizosebenzisana nawe ukuze lenze uhlelo lomuntu siqu lokuzilawula oluzobhekana nokuphila kwansuku zonke kanye nezinyathelo okufanele uzithathe uma uqala ukuzizwa usiba mubi kakhulu.

Kunezinhlobonhlobo zokwelapha ezitholakalayo ze-COPD. Udokotela wakho angase akunikeze:

  • Ukuvuselelwa kwamaphaphu kuzokunikeza ukwesekwa ohambweni lwakho oluya empilweni engcono futhi kukusize ngesiqondiso sokuzivocavoca okungcono kakhulu, umsoco, namathuluzi okuyeka ukubhema. 
  • Imithi ehogeliwe ebizwa ngokuthi ama-bronchodilator, aphumuza imisipha ezungeze imigudu yokuphefumula, noma eminye imithi ehogelwe ethathwe nge-inhaler noma i-nebulizer.
  • Ama-steroid anikezwa nge-inhaler, ukunciphisa ukuvuvukala emigwaqweni yakho yomoya.
  • Kwezinye izimo, imithi yokwehlisa amafinyila ayanconywa kubantu abadinga usizo lokukhwehlela amafinyila/iphlegm.
  • Kwezinye izimo, uzothola ama-antibiotics noma amaphilisi e-anti-inflammatory ukuze unciphise ingozi yokuqubuka (ukukhuphuka).
  • Kwezinye izimo, ungase udinge ukuhlinzwa okungathuthukisa izimpawu zakho.
  • Kwezinye izimo, ukwelashwa komoyampilo ngeyunithi yasekhaya noma ithangi elincane eliphathwayo. 
  • Kwezinye izimo ezihlobene nokuqubuka (ukushuba), ukusekelwa kokuphefumula ngendlela yokungenisa umoya ongahlaseli (NIV) noma ukwelapha ngamakhala okugeleza okuphezulu (HFNT) kuzonikezwa.

Ngezinye izikhathi kungase kudide ukuqonda amadivaysi akho noma ukhumbule ukuthi ungayiphuza kanjani futhi nini imithi. Awuwedwa; lokhu kuvame kakhulu. Kubaluleke kakhulu ukuthi ungene nodokotela wakho noma ithimba lezempilo, okuhlanganisa nosokhemisi wakho, futhi ubuze noma yimiphi imibuzo onayo. Babonise indlela osebenzisa ngayo i-inhaler noma i-nebulizer futhi ukhulume ngezinyathelo; bacele ukuthi balungise noma yini okungenzeka ukuthi uyenza ngokungalungile ngokungazi. Khumbula futhi ukuthi umoya-mpilo owengeziwe (owengeziwe) uwumuthi onqunyiwe. Nganoma imuphi umuthi, uma ukhohlwa imininingwane yokuthi ungawuphuza kangakanani noma kangaki, cela usizo. Uma uzwa sengathi i-inhaler yakho noma idivayisi yakho ayizifanelekeli izidingo zakho, yazisa umtholampilo wakho. Ithimba lakho lezokunakekelwa kwempilo lifuna ukwelashwa kwakho likunikeze inzuzo enkulu futhi lingakusiza uhlale usendleleni efanele. 

Ukuvuselelwa kwamaphaphu

Ukuvuselelwa kwamaphaphu kuwuhlelo lokuzivocavoca, imfundo, kanye nokweseka. Uzosebenzisana nochwepheshe bokuphefumula ukuze akusize ufunde ukuzivocavoca ngokuphepha, ukuphila kahle ne-COPD, futhi uphefumule kalula. Kuyindlela enomthelela kakhulu yokunciphisa ukulaliswa esibhedlela ukuthuthukisa ukusinda nokunciphisa izimpawu kubantu abane-COPD.[17,18] Ukuvuselelwa kwamaphaphu nakho kuwumthombo wokusekelwa komphakathi futhi kungakusiza ugweme ukuzihlukanisa. Ukuze uthamele uhlelo lokuvuselela i-pulmonary, kungaba mathupha noma cishe, kufanele ube nencwadi kadokotela evela kumhlinzeki wakho wokunakekelwa kwezempilo. 

Cabangela ukufunda okwengeziwe mayelana nezinhlelo ezifana Harmonicas for Health® okungakusiza ukuthi uqinise imisipha esetshenziselwa ukuphefumula, uthuthukise izinga lakho lempilo, futhi uxhume nomphakathi wabantu abaqondayo okuhlangenwe nakho kwakho nesifo samaphaphu.

Ukwelapha ama-COPD exacerbations (ama-flare-ups) 

Kwelashwa kanjani ukukhushulwa kwe-COPD? Ukuqubuka kwe-COPD kungalawulwa ngohlelo lokusebenza - indlela enqunywe nguwe nodokotela wakho. Ngokuya ngezimpawu zakho kanye nezidingo zokwelashwa, uhlelo lwakho lungase luhlanganise ukuphuza ama-antibiotics noma ama-steroid ukuze unciphise izimpawu zakho. Ngokuqubuka okukhulu, ukulaliswa esibhedlela kungase kudingeke. Ukulandela iseluleko sethimba lakho lezempilo mayelana nokwelashwa nokuphathwa kungakusiza ukuba ugweme ukuqubuka futhi ugcine i-COPD yakho izinzile. Ungafunda kabanzi mayelana nezinhlelo zokusebenza kamuva kuleli khasi.

Ubuwazi ukuthi bonke abantu abanesifo sofuba abanolwazi lwe-COPD bangandisa amathuba okuba nesinye isifo? I-GAAPP iyingxenye yoMkhandlu Weziguli we-COPD Womhlaba Wonke owasungula lesi sidakamizwa esisha. Isikhungo Sokukhuphula I-COPDLeli ithuluzi elisebenzisa ividiyo, umbhalo, kanye ne-infographics ukusiza iziguli kanye nemindeni ukuthi baqonde kangcono ukuqubuka kwe-COPD, indlela yokukubona, ukukugwema, kanye nokuphatha, kanye nokubaluleka kokuthatha isinyathelo. Sithemba ukuthi uzothola lo mthombo uwusizo futhi wabelane ngawo nemiphakathi yakho ye-COPD.

Ukwelapha I-COPD Enzima

Yikuphi ukwelashwa okungcono kakhulu kwe-COPD enzima? umbuzo obuzwa njalo. Alukho uhlobo olulodwa lokwelapha olungcono kakhulu lwe-COPD enzima - ukwelashwa okunconywa udokotela wakho kuzoncika ngokuphelele kuzimpawu nezimo zakho, futhi ukwelashwa kwakho kuzofanelana nezidingo zakho. Nge-COPD eqinile, cishe uzodinga inhlanganisela yokwelashwa, kunokwelashwa okukodwa.

Ezimweni ezimbi kakhulu ze-COPD ngenxa ye-emphysema, ukuhlinzwa ngezinye izikhathi kuyadingeka ukuze kukhishwe izingxenye ezilimele zamaphaphu, okuvumela izingxenye ezinempilo ukuthi zisebenze kangcono. Ezimweni ezimbalwa, ukufakelwa kwamaphaphu kungase kube inketho.

Ukuhlinzwa kwe-valve

Ukuhlinzwa kwe-Endobronchial valve kuyinqubo entsha eqondiswe kubantu abane-emphysema enzima. Kubandakanya ukufaka ama-valve amancane emigwaqweni yomoya ukuze avimbe izingxenye zamaphaphu ezilimele. Le nqubo ingasiza ekunciphiseni ukucindezela ku-diaphragm yakho, isize izingxenye ezinempilo zamaphaphu akho ukuthi zisebenze ngokuphumelelayo futhi zinciphise ukuphefumula.

Njenganoma yisiphi isifo esingalapheki, kubalulekile ukuthi unamathele esimisweni esinqunyiwe kanye nohlelo lwemithi enikezwa udokotela wakho. Lokhu kuzokunikeza ithuba elingcono kakhulu lokudambisa izimpawu futhi ugweme ukuqubuka nokulaliswa esibhedlela okungenzeka.

Imithi yesikhathi esizayo

Yiziphi izindlela zokwelapha ezintsha ze-COPD? Ucwaningo ku-COPD luyaqhubeka futhi njengoba kutholakala ukwelashwa okusha, kancane kancane kutholakala ukuze kuzanywe. Kuthatha isikhathi ukuthi ukwelashwa okusha kugunyazwe, nakuba ungase ukwazi ukufinyelela isilingo somtholampilo. Khuluma nodokotela wakho mayelana nokuthi yini etholakala esifundeni sakho nokuthi ingabe ungumuntu ofanelekayo yini. Amaqembu okumela iziguli avame ukuthumela izivivinyo zomtholampilo eziqasha ababambiqhaza. Kunenqwaba yemithi ye-biologics neminye yenoveli esathuthuka.

Ukusebenza nodokotela wakho noma omunye umhlinzeki wezempilo ukuze ulawule i-COPD yakho kungasiza ukubambezela ukuqhubeka kwayo, unciphise ingozi yokuqubuka, futhi ugcine izimpawu zilawulwa. Kunezinyathelo ezisebenzayo ongazithatha ukuze ushintshe imikhuba yakho yokuphila futhi ukwazi ukulawula izimpawu zakho. Lokhu kungase kuhlanganise:

  • Ukuzijwayeza ukuphefumula. 
  • Ukuyeka ukubhema. 
  • Ukuzivivinya njalo.
  • Ukugcina isisindo esinempilo nokudla ukudla okunempilo, okunomsoco.
  • Ukuthatha imithi njengoba kuyalelwe.
  • Ukuhlala unolwazi lwakamuva ngemigomo.
  • Ukunaka inhlalakahle yakho yemizwa.
  • Ukugwema izinto ezingase zibangele ezifana nentuthu yethrafikhi, intuthu kagwayi, nothuli.
  • Ukusebenzisa indwangu emanzi ukumanzisa uthuli ikhaya lakho futhi ukhiphe izinhlayiya zothuli. 

Ake sixoxe ngezinye zalezi ngokuningiliziwe.

Izivivinyo zokulawula ukuphefumula

Amasu okuphefumula kanye nokuzivocavoca kokulawula umoya kungakusiza ulawule ukuphefumula. Ukuzivocavoca okufana nezindebe ezigxiliwe noma amasu e-diaphragmatic kufanelekile ukuzijwayeza njalo. Zingasiza ukuqinisa imisipha oyisebenzisela ukuphefumula futhi kukhulise ukuzethemba kwakho, ukuze wazi ukuthi uziphatha kanjani izinto uma ukuphelelwa umoya kwakho kuba kubi okwesikhashana. Ezinye izifundo zithole ukuthi ukuhlanganisa amasu nokwenza izindlela ezimbalwa kungathuthukisa izimpawu ze-COPD kanye nezinga lempilo.[18]

Ukuphefumula ngezindebe 

Ukuphefumula ngezindebe ezigxiliwe kulula ukukufunda. Kuyasiza ukubambezela ukuphefumula kwakho, kwenze kube lula ukuthi amaphaphu asebenze, futhi kusiza ukugcina imigudu yakho yokuphefumula ivulekile isikhathi eside. Ingenziwa noma nini futhi isetshenziselwe ukusiza ukulawula ukuphefumula kwakho lapho uzivocavoca.

  • Hlala noma ume bese uphefumulela ngaphakathi kancane ngamakhala akho.
  • Gcoba izindebe zakho, sengathi uzoshaya ikhwela.
  • Donsa umoya kancane ngangokunokwenzeka ngezindebe zakho ezicijile futhi uhlose ukuphuma kabili isikhathi eside ophefumule ngaso - kungase kusize ukubala njengoba wenza lokhu.
  • Phinda umsebenzi izikhathi ezinhlanu, uthuthukise ngokuhamba kwesikhathi ukwenza ukuphindaphinda kwe-10.

Ukuphefumula kokwe-diaphragmatic

  • Ukuphefumula kwe-diaphragmatic kuyindlela lapho uhlose ukuphefumula ku-diaphragm yakho, kunesifuba sakho esiphezulu. Ngokuvamile kubizwa nangokuthi 'ukuphefumula okuvela esiswini sakho'. Hlala noma ulale ngokukhululeka futhi uphumuze umzimba wakho ngangokunokwenzeka.
  • Beka isandla esisodwa esifubeni sakho nesinye esiswini sakho.
  • Hofuza ngekhala lakho imizuzwana emihlanu, uzwe umoya uhamba uye esiswini sakho futhi isisu sakho sikhuphuka. Ngokufanelekile, kufanele ukwazi ukuzwa isisu sakho sinyakaza ngaphezu kwesifuba sakho.
  • Yibambe imizuzwana emibili, bese uphefumula futhi imizuzwana emihlanu ngekhala lakho.
  • Phinda umsebenzi izikhathi ezinhlanu.

Ukuphefumula kanzima noma indlela 'yokuvuthela-njengoba-uhamba' 

Indlela yokuphefumula kanzima ingenye ongayisebenzisa uma usebenza. Kungenza kube lula ukwenza imisebenzi edinga umzamo.

  • Ngaphambi kokwenza umzamo (njengokusukuma), phefumula.
  • Ngenkathi wenza umzamo, phefumula kanzima. Ungase ukuthole kulula ukuphefumula kanzima ngenkathi uphuca izindebe zakho.

Ukuzivocavoca nge-COPD

Uma kutholakala ukuthi une-COPD, kungaba lula ukuwela emjikelezweni wokungasebenzi. Ungase ugweme imisebenzi ekwenza uzizwe uphelelwa umoya noma ukhathazeke ngokubhekana nesimo uma uba nobunzima bokuphefumula ngenkathi uzivocavoca. Kodwa-ke, ukuzivocavoca kuboniswe ukusiza ukukhulula izimpawu ze-COPD futhi kuthuthukise izinga lakho lempilo. Ukuzivocavoca kungasiza futhi ukuthuthukisa amandla akho omzimba nokukhuthazela, kanye nokwakha imisipha oyisebenzisayo ukuphefumula. Uma le misipha isinamandla, ngeke udinge ukusebenzisa umoya-mpilo omningi, okuzosiza ukunciphisa ukuphefumula kwakho kwansuku zonke.

Akukho ukuvivinya umzimba okukodwa okungcono kakhulu komuntu one-COPD, kodwa kunezinketho eziningi ezinhle ongazizama. Abantu abane-COPD bangathola ukuhamba, i-tai chi, ukuhamba ngebhayisikili (ngaphandle noma ngebhayisikili elimile), ukusebenzisa izisindo zezandla, noma ukwelula kube usizo. Uma udinga usizo lokuhlala nomsebenzi, thola umngane wokuzivocavoca noma umngane ongahamba naye. Ukuba nenkampani kungasiza ukukuphazamisa ekubeni uzivocavoca futhi kungase kukhulise ukuzethemba kwakho uma ukhathazekile ngokuphelelwa umoya ngenkathi uwedwa.

Ngaphambi kokuqala uhlelo olusha lokuzivocavoca, khuluma nodokotela wakho ukuze uthole iseluleko. Bangase batuse ngisho nohlelo oluhlelekile lokuvuselela amaphaphu ukuze likusize uzivocavoce, ufunde kabanzi ngeCOPD yakho, futhi uxhumane nabanye abanezimo zamaphaphu.

Nakuba ukuzivocavoca kubalulekile, akukuhle ukuziphusha ukuze uzivocavoce lapho ungaphathekile kahle noma ubhekene nengwadla. Khuluma nodokotela wakho mayelana nokusebenzisa i-oximeter (umshini okala umoya-mpilo egazini lakho) lapho uzivocavoca ukuze uhlole izinga le-oxygen egazini lakho. Yiba nengqondo futhi, uma unokukhathazeka mayelana nezimpawu zakho, thintana nodokotela.

Nutrition

Njengezinye izimo eziningi zempilo, ukudla ukudla okunempilo kunenzuzo. Ukuhlanganisa ukudla okunomsoco nokuvivinya umzimba njalo kungakusiza ukuba ugcine isisindo esinempilo—esingekho phansi kakhulu noma esingesikhulu kakhulu kuwe. Kungaba nzima ukunquma ukuthi yini ehlanganisa ukudla okunempilo nokuthi yiluphi uhlobo lwesisindo olulungele wena. Uma ungaqiniseki ukuthi yini engcono kakhulu ukuthi udle, cela udokotela wakho noma ithimba lezempilo ukuze likuqondise. Uma etholakala kuwe, isazi sezokudla singakusiza ukuthi ubone ukudla okunempilo nokudla futhi uzuze ukulinganisela okusebenzela indlela yakho yokuphila.

Ukuphila kahle ngokomzwelo

Ukuphila ne-COPD kungafaka ubunzima enhlalakahleni yakho yengqondo nengokomzwelo kanye neyomndeni wakho nabangane. Ukuphila nesifo esingamahlalakhona kungase kukukhathaze futhi kukushiye ukhathazekile, ucindezelekile noma uphansi. Ngokulandelayo, lokhu kungakwenza ube mancane amathuba okuthi ungasebenzi, okungaba nomthelela ku-COPD yakho.

Kubalulekile ukuzinakekela futhi uzinike isikhathi sokuzijwayeza ukuzinakekela. Zinike isikhathi sokugxila kuwena futhi wenze imisebenzi ebalulekile kuwe. Khuluma nodokotela wakho ngezinto ongathanda ukuzenza. Chazela abanye abantu ukuthi uzizwa kanjani futhi ucabange ukujoyina iqembu lendawo noma le-inthanethi lokusekela noma ukukhuluma nomeluleki. Awudingi ukuphatha i-COPD uwedwa.

imigomo

I-COPD ingakubeka engozini enkulu yokugula kakhulu ngenxa yomkhuhlane (umkhuhlane), i-respiratory syncytial virus (RSV), inyumoniya, kanye COVID-19. Kubalulekile ukuthi ube nemigomo enconywa udokotela wakho futhi etholakala ezweni lakini (isb., ukugonywa komkhuhlane waminyaka yonke, ukugoma ipneumococcal, i-tDap, kanye COVID-19, RSV, kanye nemigomo ye-herpes zoster/shingles, lapho itholakala khona). Buza udokotela wakho ukuthi yiluphi uhlelo lokugoma olukulungele. Kuyokusiza futhi ukugwema izindawo eziminyene, ukumboza ubuso, uqhelelane, futhi ugeze izandla njalo ukuze unciphise ingozi yakho. 

Izinhlelo zokuphatha ze-COPD

Ukuphathwa kwe-COPD noma uhlelo lokusebenza lwe-COPD luyisiqondiso sendlela yokuphatha isimo sakho usuku nosuku. Lolu hlelo kufanele lwenziwe nguwe kanye nodokotela wakho ngqo ezinhlosweni zakho nezimpawu zakho. Uhlelo lwakho kufanele luhlanganise nemithi oyinikeziwe, ukuvivinya umzimba ukuphefumula, ukudla nokuzivocavoca, nokusekelwa ngokomzwelo. Enye ingxenye ebalulekile yohlelo lokuphatha lwe-COPD ukugwema izinto ezingase zibangele lapho kungenzeka khona (isibonelo, ukuchayeka ekungcoleni komoya, intuthu kagwayi, intuthu yomgwaqo, ukubhema ugwayi, nothuli). Uma njengamanje ubhema, yeka ukubhema. Ukuthatha lezi zinyathelo kungasiza ukunciphisa ingozi yezimpawu zibe zimbi kakhulu noma ezibangele ukuqubuka. 

Uzovumelana nodokotela wakho noma ithimba lezempilo mayelana nokuthi yiziphi izinyathelo okufanele uzithathe uma izimpawu zakho ziba zimbi kakhulu. Qiniseka ukuthi uvakashela kabusha uhlelo lwakho njalo - okungenani njalo ezinyangeni eziyisithupha - ukuze lube sesimweni. 

Kubaluleke kakhulu ukwazi ukuthi ngokwelashwa okufanele, ukuphatha, ukudla okunomsoco, ukuvivinya umzimba, ukuvuselelwa kwamaphaphu, nokubonisana njalo nodokotela wakho noma ithimba lezempilo, ungathuthukisa izimpawu zakho futhi uphile kahle neCOPD. 

Ingakanani iminyaka yokuphila kwabantu abane-COPD? Lona ngumbuzo ojwayelekile. Kunezici eziningi ezihilelekile esikhathini sokuphila futhi azikho izinombolo ezibekiwe zabantu abaneCOPD noma yisiphi isimo esingamahlalakhona. Umuntu one-COPD angabona ukuthuthuka kwezimpawu zakhe futhi abe nokuqubuka okuncane (okushubile), ikakhulukazi uma i-COPD itholwa kusenesikhathi, futhi ukulimala okwengeziwe kwamaphaphu kungavinjelwa. Kunokuba ugxile ewashini, THOLA ukulawula isimo sakho futhi usebenzisane nethimba lakho lezempilo ukuze uhlanganise uhlelo lokuphatha lwe-COPD olungabuyekezwa njengoba izidingo zakho zishintsha. Xhumana nezinye iziguli ngokujoyina umphakathi ohlinzeka ngosekelo ku-inthanethi noma endaweni yangakini. Isigaba Sezinsiza ngezansi siqukethe izixhumanisi eziya ezinhlanganweni ezinikeza ukwesekwa komphakathi.  

Amathuluzi Ezemfundo e-COPD

Amathuluzi ethu Ezemfundo aklanyelwe ukwenza ukufunda, ukufundisa, kanye nokwabelana ngolwazi oluthembekile lwe-COPD kube lula.

  • Ulwazi olusebenzayo, olusekelwe ebufakazini
  • Kulula ukuqonda nokusebenzisa
  • Mahhala
Funda kabanzi

Yazi Izimpawu Zokuqhuma Kwe-COPD

Izimpawu ze-COPD zingashintsha usuku nosuku, kodwa ezinye izinguquko zingase zibe izimpawu zokuqubuka kwesifo. Ukwazi ukuthi yini okufanele uyiqaphele nokuthi nini okufanele uyenze kungakusiza ukuthi usabele ngokushesha.

  • Qaphela izinguquko ezimpawu zakho ze-COPD
  • Funda izimpawu ezivamile kanye nezimbangela zokuqubuka kwesifo
  • Yazi ukuthi yiziphi izinyathelo ongazithatha uma izimpawu ziba zimbi kakhulu
Hlola i-COPD Flare-Ups Hub
Amaphaphu amabili anemifanekiso avela ku-COPD Flare-Ups Hub: elinye lithi liphelelwa umoya kancane, elinye lithi ngokuvamile awabi kakhulu futhi kudingeka athathe isinyathelo manje

Inyanga yokuqwashisa nge-copd 2025

NgoSuku Lomhlaba Lwe-COPD lwango-2025, i-GAAPP ihlanganisa amazwi ahlukahlukene - asuka esigulini kanye nomnakekeli ovela e-Brazil ngesibindi ukwabelana ngohambo lwaso lomuntu siqu lokuxilongwa, ukuphathwa kwansuku zonke, nokuhlala nokugula emakhaya abo, kuchwepheshe ohamba phambili wokwelapha ngokomzimba onikeza imininingwane ebalulekile yokwelashwa, ucwaningo, kanye nekusasa lokunakekelwa. Lolu hlelo luhlose ukunika amandla abantu abane-COPD ngokunikeza ulwazi olubanzi, ukugqugquzela umuzwa womphakathi, kanye nokukhuthaza ukutholakala okuthuthukisiwe kusenesikhathi kanye nokufinyelela ekuvuseleleni amaphaphu nokwelashwa emhlabeni wonke.

Isihlalo se-Yoga se-COPD: Ukuphefumula Okumnene & Ukuphumula
Ukusuka Kwesilinganiso Esimaphakathi ukuya Kwesibi kakhulu: Indaba ka-Rita Yokuzivocavoca, COVID, kanye Nokuphatha Isimo Sephaphu Esingamahlalakhona
Izinselele Zokunakekelwa Kwe-COPD e-Brazil: Izazi Zengcweti Zokwelapha Emzimbeni Emaphapheni Ekufinyeleleni Ukuhlunyeleliswa

Izinsiza Eziwusizo

Ukubhaliswa

I-COPD Foundation Patient Powered Research Network
Ukuthuthukisa Isipiliyoni Sesiguli ku-COPD (APEX) (United States)
I-National Chest Registry (Malaysia)

Okubhekwayo

1. IGOLIDE. Isu Lomhlaba Wonke Lokuvimbela, Ukuxilongwa Nokuphathwa Kwe-COPD: Umbiko Wango-2024. Ikhasi lewebhu leGOLIDE. Ishicilelwe Novemba 2023. Ifinyelele Novemba 28, 2023. https://goldcopd.org/2024-gold-report/

2. Aeloye D, Ingoma P, Zhu Y, et al. Ukusabalala komhlaba wonke, kwesifunda, kanye nakuzwelonke, kanye nezici eziyingozi zesifo esingamahlalakhona sokuvimbela i-pulmonary (COPD) ngo-2019: ukubuyekezwa okuhlelekile nokuhlaziywa kokumodela. I-Lancet Respir Med. 2022;10(5):447-458. doi:10.1016/S2213-2600(21)00511-7

3. Stolz D, Mkorombindo T, Schumann DM, et al. Ngokubhekela ekuqedweni kwesifo esingamahlalakhona sokuvimbela amaphaphu: Ikhomishini yeLancet. I-Lancet. 2022;400(10356):921-972. doi:10.1016/S0140-6736(22)01273-9

4. IGOLIDE. Isu Lomhlaba Wonke Lokuvimbela, Ukuxilongwa Nokuphathwa Kwe-COPD: Umbiko Wango-2024. Ikhasi lewebhu leGOLIDE. Ishicilelwe Novemba 2023. Ifinyelele Novemba 28, 2023. https://goldcopd.org/2024-gold-report/

5. Syamlal G, Kurth LM, Dodd KE, Blackley DJ, Hall NB, Mazurek JM. Ukufa Kwezifo Ezingamaphaphu Ezingalapheki Ngomkhakha Nomsebenzi - United States, 2020. I-MMWR Morb Mortal Wkly Rep 2022; 71:1550–1554. I-DOI: http://dx.doi.org/10.15585/mmwr.mm7149a3.

6. I-NHS. Izimbangela Zezifo Ezingamaphaphu Ezingalapheki (COPD). Iwebhusayithi ye-NHS. Ibuyekezwe ngomhla ka-Ephreli 11, 2023. Ifinyelele Novemba 8, 2023. https://www.nhs.uk/conditions/chronic-obstructive-pulmonary-disease-copd/causes/

7. Ramírez-Venegas A, Velázquez-Uncal M, Aranda-Chávez A, Guzmán-Bouilloud NE, Mayar-Maya ME, Pérez Lara-Albisua JL, Hernández-Zenteno RJ, Flores-Trujillo F, Sansores RH. Ama-bronchodilators we-hyperinflation ku-COPD ehlotshaniswa nentuthu ye-biomass: isilingo somtholampilo. I-Int J Chron Obstruct Pulmon Dis. 2019 Aug 6;14:1753-1762. doi: 10.2147/COPD.S201314. 

8. Brantly M, Campos M, Davis AM, et al. Ukutholwa kokushoda kwe-alpha-1 antitrypsin: okwedlule, okwamanje kanye nekusasa. Orphanet J Rare Dis. 2020;15(1):96. Published 2020 Apr 19. doi:10.1186/s13023-020-01352-5

9. Isisekelo se-Alpha-1. Iyini i-Alpha-1? Iwebhusayithi ye-Alpha-1 Foundation. Ifinyelelwe ngomhla ka-8 Novemba 2023. https://alpha1.org/what-is-alpha1/

10. I-Stockley JA, i-Stockley RA, i-Sapey E. Ayikho ithrekhi esheshayo yokuhlonza abenqabayo ngokushesha ekuntuleni kwe-Alpha-1 antitrypsin nge-spirometry: isifundo se-longitudinal sokulinganisa okuphindaphindiwe. I-Int J Chron Obstruct Pulmon Dis. 2021;16:835–840. doi:10.2147/COPD.S298585

11. UFranciosi AN, Alkhunaizi MA, Woodsmith A, Aldaihani L, Alkandari H, Lee SE, Fee LT, McElvaney NG, Carroll TP. Ukushoda kwe-Alpha-1 Antitrypsin kanye Nokubhema Ugwayi: Ukuhlola Izinto Eziyingozi Nokuyeka Ukubhema Kubantu Babhalisiwe. I-COPD. 2021 Feb;18(1):76-82. doi: 10.1080/15412555.2020.1864725. I-Epub 2021 Feb 9. 

12. Rabe KF, Rennard S, Martinez FJ, et al. I-Targeting Type 2 Inflammation kanye ne-Epithelial Alarmins ku-Chronic Obstructive Pulmonary Disease: I-Biologics Outlook. Ngingu-J Respir Crit Care Med. 2023;208(4):395-405. doi:10.1164/rccm.202303-0455CI

13. IGOLIDE. Isu Lomhlaba Wonke Lokuvimbela, Ukuxilongwa Nokuphathwa Kwe-COPD: Umbiko Wango-2024. Ikhasi lewebhu leGOLIDE. Ishicilelwe Novemba 2023. Ifinyelele Novemba 28, 2023. https://goldcopd.org/2024-gold-report/

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