Ukwelashwa Kwe-COPD

Alikho ikhambi isifo esingapheliyo sokuvimbela kwamaphaphu (COPD). Kodwa-ke, kunezinhlobonhlobo zezindlela zokwelapha ongazenza kanye nokuziphatha ongazisebenzisa ukuze usize ukunqanda ukuqhubeka - okukusiza ukuthi uphile kahle nalesi simo. Udokotela wakho uzosebenza eduze nawe ukuze enze okomuntu siqu uhlelo lokuzilawula ukumboza ukuphila kwansuku zonke nokuthi yini okufanele uyenze uma uqala ukuzizwa kabi.

Siza ukuyeka ukubhema

Uma unayo COPD nokubhema, ukuyeka kungase kube into eyodwa enkulu kunazo zonke ongayenza ukuze unciphise izimpawu zakho futhi usize ukumisa isimo sakho sibe sibi kakhulu. Cela udokotela wakho womndeni ukuthi akusekele ngalokhu. Bangakwazi ukunikeza:

Imikhiqizo ethatha indawo ye-Nicotine, etholakala ngezindlela ezihlukahlukene njengenhlaka, i-inhaler, i-spray yamakhala, i-skin patch, i-lozenge noma ithebhulethi engaphansi kolimi.
Imithi yokunciphisa izifiso ze-nicotine kanye nezimpawu zokuhoxa
Ukwesekwa kokuziphatha njengokwelulekwa komuntu ngamunye, kweqembu, noma ku-inthanethi.

Labo abasebenzisa inhlanganisela yokwesekwa nemithi banamathuba aphindwe kathathu okuyeka ngempumelelo.

Gonywa

Iba nomkhuhlane waminyaka yonke ukuze uvikeleke kumagciwane akamuva omkhuhlane njalo ebusika. Mancane amathuba okuthi ube nokuqubuka kwe-COPD noma ugule kakhulu futhi udinga ukuya esibhedlela.

Ungaphinda ucele udokotela wakho ukuthi akugomele i-pneumococcal. Lokhu kuzovikela ukutheleleka kwe-pneumococcal, okubangela inyumoniya nezinye izifo. Uzodinga lokhu kanye kuphela, hhayi minyaka yonke.

Uma ungazange ube ne-whooping jab/diphtheria/tetanus jab ngesikhathi usemusha, kuyanconywa ukuthi ube nakho lokho.
Kufanele futhi ube ne- COVID-19 ukugoma ngokushesha lapho lokhu kutholakala endaweni yangakini. Ucwaningo lubonisa ukuthi ingozi yokuhlupheka izimpawu ezinzima nge COVID-19 iphezulu kulabo abaneCOPD.

Ukuvuselelwa kwamaphaphu

Ukuvuselelwa kwamaphaphu (PR) wuhlelo olulodwa lokuzivocavoca, ulwazi, kanye nezeluleko ezikusiza ukuthi uhlale usebenza uma unesimo samaphaphu njengeCOPD esikwenza uphefumule. Iningi lezinhlelo ze-PR lihlala cishe amasonto ayisithupha, lapho uzomenywa khona ukuthi uhambele amaseshini eqembu izikhathi ezimbalwa ngeviki.
I-PR ivamise ukulethwa ithimba lochwepheshe bezempilo - okuhlanganisa ama-physiotherapist, abahlengikazi abangochwepheshe, nama-dietitians - ezindaweni zomphakathi. Cishe ingxenye yeseshini yeqembu ngalinye ichithwa ekugadweni Ukuvivinya. Umqondo uwukuba uphelelwe umoya kancane - uzogadwa ukuze ukwazi ukuzivocavoca ngokuphepha.
Nakuba i-PR ingelona ikhambi le-COPD, inezinzuzo ezifakazelwe ukuthi:

Thuthukisa amandla emisipha, ukuze uphefumule ngokuphumelelayo futhi ungaphefumuli
Ikuvumela ukuthi ufunde izindlela zokubhekana kangcono nomuzwa wokuphelelwa umoya
Khulisa izinga lakho lokufaneleka
Thuthukisa impilo yakho yengqondo
Ikusiza ukuthi ufunde ngokuthi isimo sakho sikuthinta kanjani nokuthi ungasiphatha kanjani kangcono. Izibonelo zezihloko zifaka indlela yokuhogela umoya, ukudla ngendlela enempilo, ukulawula ukukhathazeka kanye nomuzwa ophansi, nokuthi yini okufanele uyenze uma uzizwa ungalungile.

Kunobufakazi bokuthi abantu abazibandakanya ne-PR bangahamba phambili, bazizwe bengcono emisebenzini yabo yansuku zonke, mancane amathuba okuba badinge ukuya esibhedlela, bathuthukise ukuphila kwabo komphakathi futhi ngokuvamile bakwazi ukubuyela emsebenzini.

Lawula noma yiziphi ezinye izinkinga zempilo

Izimo ezivamile ongase ube nazo nge-COPD zihlanganisa izifo zenhliziyo, umdlavuza wamaphaphu, ukukhumuzeka kwamathambo, ukucindezeleka, ukukhathazeka, kanye ne-reflux ye-gastro-esophageal. Zingathinta indlela i-COPD yakho eqhubeka ngayo, ikakhulukazi uma ingaxilongwa futhi ingalashwa.
Udokotela wakho uzokubuza ngalokhu ukuze ukwandise ukwelashwa kwakho konke kanye nempilo evamile.

Imithi

Kunezinhlobo eziningi zemithi esetshenziselwa ukwelapha i-COPD. Bangasiza ukunciphisa izimpawu ze-COPD, unciphise ukuthi kungakanani ukuqubuka kwakho nokuthi kubi kangakanani, uthuthukise ikhono lakho lokuvivinya umzimba, futhi ugcine unempilo ngangokunokwenzeka. I-COPD ithinta wonke umuntu ngendlela ehlukile ngakho udokotela wakho uzosebenzisana nawe ukwenza iphakethe lokwelapha elingcono kakhulu elihambisana nezidingo zakho. Inhloso ukuthuthukisa indlela osabela kahle ngayo ekwelashweni nasekulinganiseni lokho ngokumelene nemiphumela engemihle, ukulawula izimpawu, ukuqubuka, kanye nezindleko ezingenzeka.

Abahogelwayo

I-inhaler iletha umuthi ngokuqondile emigudwini yakho yomoya nasemaphashini njengoba uphefumula. Akuwona wonke ama-inhaler afanayo, ngakho udokotela noma unesi uzokukhombisa ukuthi ulusebenzisa kanjani ucingo lwakho ngendlela efanele. Izindlela zokwelapha eziphefumulelwe ezisetshenziselwa i-COPD zihlanganisa:

Ama-beta-2-agonists asebenza isikhathi esifushane (i-SABA) noma ama-anti-muscarinics asebenza isikhathi esifushane (SAMA)

I-SABA kanye ne-SAMA imvamisa ukukhetha kuqala. Lawa ama-bronchodilator - enza ukuphefumula kube lula ngokuphumuza nokukhulisa imigudu yokuphefumula emincane. Lokho kungakhulula umuzwa ongakhululekile lapho amaphaphu akho egcwele ngokweqile. Usebenzisa lolu hlobo lwe-inhaler noma nini lapho uzizwa uphefumula kuze kube izikhathi ezine ngosuku.

I-beta-2-agonists esebenza isikhathi eside (i-LABA) kanye ne-anti-muscarinics (LAMA) esebenza isikhathi eside

I-LABA ne-LAMA isetshenziswa uma usenezimpawu zansuku zonke naphezu kokusebenzisa i-SABA yakho noma i-SAMA inhaler ngendlela efanele. Imiphumela yabo ye-bronchodilation ihlala isikhathi eside ngakho-ke uzodinga ukuzisebenzisa kanye noma kabili ngosuku.

I-corticosteroid ehogeliwe (ICS)

Uma kunesidingo, i-ICS ingengezwa ku-inhaler yakho ye-bronchodilator esebenza isikhathi eside ukusiza ukunciphisa ukuvuvukala emigwaqweni yakho yomoya. I-ICS ingavimbela cishe ingxenye yesine yokuqubuka komlilo.

Amaphilisi omlomo

Uma izimpawu zakho ze-COPD zingalawulwa kahle ngokwelashwa okuphefumulelwe, udokotela wakho angase ancoma ukuthi wengeze ithebhulethi yomlomo, iphilisi, noma i-capsule. Kuya ngokuthi imuphi umuthi abawuncomayo, kungase kudingeke uwuphuze nsuku zonke, noma lapho nje uhlangabezana nokuqubuka noma ukuthuthukiswa kwezifo zokuphefumula.

Theophylline

Lena i-bronchodilator yomlomo, ngokuvamile ethathwa kabili ngosuku. Imiphumela engemihle ingabandakanya ikhanda elibuhlungu, ukugula (isicanucanu), izinkinga zokulala (ukuqwasha), isilungulela, noma ukushaya kwenhliziyo okubhakuzayo/okungavamile (ukushaya kwenhliziyo). Udokotela wakho uzokuqapha futhi alungise umthamo wakho ukuze ulinganise ukulawulwa kwezimpawu ngokumelene nokunciphisa noma yimiphi imiphumela emibi.

Isidakamizwa se-mucolytic

Ukuphuza umuthi we-mucolytic nsuku zonke kungasiza kwesinye isikhathi uma unokukhwehlela okungapheli. Kwenza iphlegm kube lula ukukhwehlela. I-Carbocysteine i-mucolytic esetshenziswa kakhulu - ithathwa njengethebhulethi noma i-capsule ngokuvamile kathathu noma kane ngosuku. Enye i-mucolytic - ebizwa ngokuthi i-acetylcysteine - iza njengempushana oyixuba namanzi ngaphambi kokuyithatha.

I-Oral steroids

Lokhu kunciphisa ukuvuvukala kwendlela yokuphefumula. Zisetshenziswa kakhulu ezifundweni ezimfushane - cishe izinsuku ezinhlanu - ukwelapha ukuqubuka okukhulu kakhulu. Imiphumela engemihle ingabandakanya ukukhuluphala, ukushintshashintsha kwemizwelo, nokuncipha kwamathambo (i-osteoporosis). Ngakho-ke, uma udinga ukuthatha ama-steroids isikhathi eside udokotela wakho uzogcina umthamo uphansi ngangokunokwenzeka futhi aqaphe noma yimiphi imiphumela emibi ngokucophelela.

Njengengxenye yohlelo lwakho lokuzilawula, udokotela wakho angase akunike isifundo esifushane samaphilisi e-steroid ukuze uwagcine ekhaya uma kwenzeka kuqubuka umlilo.

Nemithi Elwa Namagciwane

Ungase udinge inkambo emfushane yama-antibiotics ukuze welaphe isifo sesifuba kanye/noma ukuqubuka kwe-COPD. Udokotela wakho angase akunike inkambo eyodwa yama-antibiotic okufanele uwagcine ekhaya futhi uwathathe uma uba nezimpawu zokutheleleka kwesifuba.

I-Roflumilast

Lolu wuhlobo olusha lomuthi weCOPD olubizwa nge-phosphodiesterase-4 enzyme inhibitor. Ithathwa njengethebhulethi kanye ngosuku futhi isebenza ukwehlisa ukuvuvukala. Udokotela onguchwepheshe angase anikeze i-roflumilast uma une-COPD enzima futhi usabhekana nokuqubuka okuningana naphezu kokusebenzisa i-LAMA/LABA/ICS i-inhaler ephindwe kathathu. I-Roflumilast inemiphumela emibi kakhulu kunokwelashwa kwe-COPD ehogeliwe, okuhlanganisa isifo sohudo, ukuzizwa ugula, ukuncipha kwesifiso sokudla, ukuncipha, ubuhlungu besisu, izinkinga zokulala, nekhanda elibuhlungu.

Izidakamizwa ze-diuretic

Lezi zisusa amanzi amaningi emzimbeni. Bangakwazi ukukhulula amaqakala avuvukele ezimweni ezinzima ze-COPD.

Ezinye izindlela zokwelapha

I-Nebulizer therapy

Uma i-COPD yakho inzima noma unokuqubuka okubi, umshini obizwa ngokuthi i-nebulizer ungakusiza uphefumule umuthi wakho nge-facemask noma umlomo ukuze usize ukukhulula izimpawu. Uma wena noma umnakekeli wakho niqeqeshelwe ukwenza kanjalo, ungasebenzisa i-nebulizer ekhaya.

Ukwelashwa kwe-oxygen

Uma amazinga omoya-mpilo egazini lakho elokhu ephansi ngokuqhubekayo lokhu kungase kubeke umthwalo owengeziwe enhliziyweni yakho. Unganikezwa imishini ukuze ukwazi ukuthola ukwelashwa komoyampilo ekhaya. Lokhu ngeke kumise noma kunciphise ukuphelelwa umoya, kodwa kunganciphisa izinkinga zenhliziyo ezifana nomfutho wegazi ophakeme wamaphaphu. Uzokwazi ukuphefumula umoya-mpilo kusuka kusifihlabuso noma ishubhu lekhala. Kunezindlela ezahlukahlukene ongasebenzisa ngazo umoya-mpilo wasekhaya:

Ukwelashwa komoyampilo isikhathi eside kuzinzisa amazinga akho komoyampilo amahora ayi-15 noma ngaphezulu
I-Ambulatory oxygen therapy - ebizwa nangokuthi i-oxygen ephathekayo - ikuvumela ukuthi usebenze kakhulu ekhaya noma uma uphuma ngaphandle
I-Palliative oxygen therapy ingasiza ekudambiseni ukuphefumula njengengxenye yokwelapha noma ukuphela kokunakekelwa kwempilo.

Umoya-mpilo uvutha kakhulu futhi akumele ubheme lapho uthola lokhu kwelashwa ngenxa yengozi yomlilo noma ukuqhuma.

Ukuphefumula okungangenisi umoya

I-Non-invasive ventilation (NIV) ingumshini ophathwayo okusiza ukuthi uphefumule. Uphefumula ngemaski yobuso noma yekhala - odokotela ngeke badinge ukufaka ishubhu kuqhoqhoqho (uqhoqhoqho). Imishini ye-NIV ithatha omunye umsebenzi onzima wokuphefumula lapho une-COPD evuthayo futhi udinga ukunakekelwa esibhedlela.

Ukwelashwa kwe-NIV okuphumelelayo kungasebenza phakathi nehora elilodwa noma amabili. Mancane amathuba okuba ube nezinkinga ngenkathi usesibhedlela futhi andisa amathuba akho okukwazi ukubuyela ekhaya ngokushesha.