COPD matenda: zimayambitsa, zizindikiro, matenda ndi mankhwala. Matenda obstructive matenda m'mapapo mwanga

COPD (matenda osachiritsika a matenda oopsa) ndi matenda omwe amaphatikizidwa ndi kutupa mu njira yopuma. Zifukwa zikhoza kukhala zochitika zachilengedwe ndi zina zambiri, kuphatikizapo kusuta. Matendawa amachitidwa patsogolo, zomwe zimapangitsa kuchepa kwa ntchito ya kupuma. Patapita nthawi, izi zimapangitsa kuti munthu asapume bwinobwino.

Kawirikawiri matendawa amachitika ali ndi zaka 40 kapena kupitirira. Nthaŵi zina, odwala omwe ali ndi COPD amapita kuchipatala ali aang'ono. Monga lamulo, izi zimachokera ku chibadwa cha chibadwa. Komanso, chiopsezo cha kudwala kwa omwe amasuta kwambiri.

Gulu la ngozi

Kuzindikira kwa COPD kwa amuna akuluakulu ku Russia kumawonetsedwa mu magawo atatu alionse, adadutsa mzere mu zaka 70. Ziwerengero zimatilola kunena molimba mtima kuti izi zikugwirizana ndi kusuta fodya. Komanso pali mgwirizano womveka bwino ndi njira ya moyo, yomwe ndi malo ogwira ntchito: mwayi wa kukula kwa matenda ndipamwamba pamene munthu amagwira ntchito zoopsa komanso ali ndi pfumbi. Kukhudzidwa ndi kukhala m'mizinda ya mafakitale: apa peresenti ya odwala ndi yapamwamba kusiyana ndi malo okhala ndi chilengedwe choyera.

Zowonjezeka kwambiri ndi COPD kwa okalamba, koma chifukwa cha chibadwa, mukhoza kudwala ali wamng'ono. Izi zimachokera ku chidziwitso cha mbadwo wa mawonekedwe ogwirizana ndi thupi. Palinso maphunziro a zachipatala omwe amatilola kufotokoza kugwirizana pakati pa matenda ndi chiyambi cha mwanayo, popeza pakadali pano palibe chokwanira chokwanira m'thupi, chifukwa chiwalo cha ziwalo sichikhoza kukonzekera bwino pa kubadwa.

Ndipo asayansi amati chiyani?

COPD, zomwe zimayambitsa matenda, njira ya chithandizo - zonsezi zakhala zikukopa madokotala. Pofuna kupeza zinthu zokwanira zofufuza, deta inasonkhanitsidwa, pamene matenda adaphunziridwa kumidzi ndi kumidzi. Chidziwitsocho chinasonkhanitsidwa ndi madokotala achi Russia.

Zinali zotheka kuvumbulutsa kuti ngati ndi funso la anthu omwe amakhala m'midzi, mudziwu, pano mu COPD njira yovuta imakhala yosavuta, komabe matendawa amamuzunza kwambiri. Kawirikawiri, anthu a m'mudzimo ankaona endobronchitis ndi kutaya kwa magazi kapena atrophy ya tiyi. Pali zovuta ndi matenda ena opweteka.

Ananenedwa kuti chifukwa chachikulu ndicho maphunziro apansi a chithandizo chamankhwala m'madera akumidzi. Kuwonjezera pamenepo, n'zosatheka kupanga spirometry m'midzi kumene amuna osuta fodya a zaka 40 ndi kupitirira amawafuna.

Ndi angati omwe amadziwa COPD - ndi chiyani? Kodi amachizidwa bwanji? Kodi chikuchitika chiani? Muzinthu zambiri, chifukwa chosoŵa chidziwitso, kuchepa kwa chidziwitso, chifukwa cha mantha a imfa, odwala amadandaula. Chimodzimodzinso ndi izi ndi midzi, ndi kumidzi. Kusokonezeka maganizo kumayanjananso ndi hypoxia, yomwe imakhudza dongosolo la mantha la wodwalayo.

Kodi matendawa amachokera kuti?

Kuzindikira kwa COPD ndipo masiku athu ndi ovuta, chifukwa sizidziwika chifukwa chake matendawa amayamba. Komabe, zinali zotheka kuzindikira zinthu zingapo zomwe zimayambitsa matendawa. Mfundo zofunika:

• Kusuta;
• Mavuto osagwira ntchito;
• Nyengo;
• Kutengera;
• Khwangwala yayitali;
• Matenda opatsirana;
• Genetics.

Pazifukwa zambiri

Kupewa koyenera kwa COPD kumapitabe patsogolo, koma anthu omwe akufuna kukhalabe ndi thanzi labwino, ayenera kulingalira momwe izi kapena zifukwa zina zimakhudzidwira thupi la munthu, zomwe zimachititsa kuti matendawa asokonezeke. Atazindikira ngozi yawo ndikuchotsa zinthu zovulaza, mukhoza kuchepetsa matendawa.

Chinthu choyamba chomwe chiyenera kutchulidwa chokhudzana ndi COPD ndi, ndithudi, kusuta. Zomwe zimakhudza zowawa zonse. Tsopano, mankhwala akunena mosakayika kuti kusuta ndiko chinthu chofunikira kwambiri pa chitukuko cha matenda. Matendawa amachititsa kuti nicotine ndi zigawo zina zili mu utsi wa fodya.

Muzinthu zambiri, mawonekedwe a matendawa pamene kusuta kumagwirizanitsidwa ndi amene amachititsa matenda pamene akugwira ntchito yovulaza, kuyambira pano munthu amapuma mpweya wodzaza ndi tinthu tating'onoting'ono. Mukamagwira ntchito mufumbi, mu alkali ndi steam, nthawi zonse kupuma mankhwala, sizingatheke kuti mapapu akhale wathanzi. Ziwerengero zimasonyeza kuti matenda a COPD amapezeka kawirikawiri m'migodi ndi anthu ogwira ntchito ndi chitsulo: ogaya, oyang'anira, metallurgists. Komanso, matendawa amakhudza ogulitsa welders ndi antchito ogulitsa mapepala, ogwira ntchito zaulimi. Mavuto onsewa akugwirizanitsidwa ndi zida za fumbi.

Zowonjezereka zina zimakhudzana ndi chithandizo chokwanira cha mankhwala: ena alibe madokotala oyenerera, ena amayesa kupewa kafukufuku wamankhwala nthawi zonse.

Zizindikiro

Matenda a COPD - ndi chiyani? Kodi amachizidwa bwanji? Kodi angakayikire bwanji? Tsatanetsatane (kuphatikizapo kuchepetsa matendawa - matenda osokoneza bongo) mpaka lero sichimanena zambiri kwa ambiri. Ngakhale kuti kufalikira kwakukulu kwa anthu ambiri, anthu sakudziwa ngakhale kuti moyo wawo umakhala wotani. Kodi mungayang'ane bwanji ngati mukufuna kupereka matenda a mapulusa ndikuganiza kuti ikhoza kukhala COPD? Kumbukirani kuti zizindikiro zotsatirazi ndizoyamba:

• Kuthyoka, mcofu mucosa (kawirikawiri m'mawa);
• Dyspnoea, poyamba akuwuka panthawi ya masewera olimbitsa thupi, ali ndi nthawi yopuma.

Ngati kuwonjezeka kumachitika panthawi ya COPD, ndiye kuti chifukwa chake ndi matenda, omwe amakhudza:

• Dyspnea (kuwonjezera);
• Mphungu (imakhala purulent, imatulutsidwa muwindo waukulu).

Matendawa akayamba, ngati matenda obwera chifukwa cha matenda obwera m'mimba amapezeka, zizindikirozo ndi izi:

• Kulephera kwa mtima;
• Ululu mu mtima;
• Zola zachitsulo ndi milomo zimakhala ndi bluish tinge;
• Mafupa amachira;
• Mitundu imachepa;
• Zolemba zazing'ono;
• Misomali amasintha mawonekedwe, khalani convex.

Kuzindikira kwa COPD: magawo

Zimavomerezedwa kusiyanitsa magawo angapo.

Kuyamba kwa matenda ndi zero. Amadziwika ndi kupanga mateti ambirimbiri, munthuyo amatsokomola nthawi zonse. Ntchito ya mapapo pamsinkhu uwu wa kukula kwa matendawa ikupitirirabe.

Gawo loyamba ndi nthawi ya chitukuko cha matendawa, kumene wodwalayo amakopera. Maungulo nthawi zambiri amapanga sputum ambiri. Pomwe mukuphunzira za kupuma, ndizotheka kuzindikira choletsedwa pang'ono.

Ngati matenda omwe ali pakati-aakuluwa amapezeka, amadziwika ndi zizindikiro za kuchipatala (tawonedwa kale), akuwonetseredwa panthawi ya masewera olimbitsa thupi.

Kupezeka kwa COPD, siteji yachitatu, kumatanthauza kuti kulephera kupuma kumakhala koopsa. Ndi mtundu uwu wa matenda, chomwe chimatchedwa "pulmonary mtima" chikuwonekera. Mawonetseredwe owonekera a matenda: kuchepetsa kutuluka kwa mpweya panthawi yopuma, dyspnea ndi kawirikawiri ndi yamphamvu. Nthawi zina, zimakhala zolepheretsa kugwiritsidwa ntchito, zomwe zimakhala zovuta kwambiri. Izi ndi zoopsa pamoyo wa munthu.

Kudziwa sikophweka

Ndipotu, matenda a COPD amaikidwa ndi mtundu woyamba wa matendawa mobwerezabwereza kuposa momwe amachitira. Izi ndi chifukwa chakuti zizindikiro sizitchulidwa. Kumayambiriro kumeneku, matenda amatha kuyenda mobisa. Chithunzi chachipatala chikhoza kuwonedwa pamene chikhalidwe chimafika polemera kwambiri, ndipo munthuyo amatembenukira kwa dokotala, akudandaula za phlegm ndi chifuwa.

Kumayambiriro koyambirira pamakhala zochitika zambiri nthawi zambiri pamene munthu akukhomerera kuchuluka kwa sputum. Popeza izi zimachitika mobwerezabwereza, nthawi zambiri anthu samadandaula ndipo samapita kwa dokotala nthawi yake. Dokotala amadza pambuyo pake, pamene chitukukochi chikuyambitsa chifuwa chachikulu.

Zinthuzo ndi zovuta

Ngati matendawa atengedwa ndi njira zothandizira, siziri nthawi zonse, mwachitsanzo, chithandizo chamakono cha COPD chomwe chimasonyeza zotsatira zabwino. Kawirikawiri vutoli ndi chifukwa cha matenda a chipani chachitatu.

Ngati pali matenda ena, ngakhale kupumula, munthu amakhala ndi mpweya wochepa. Pali kusintha kwa chikhalidwe cha madokotala: malowa amayamba kukhala opulupudza. Pali njira ziwiri zothetsera matenda:

• Chowombera;
• Emphysematous.

Pachiyambi choyamba, mfuti imamasulidwa mochuluka kwambiri ndipo nthawi zonse imatsokomola. Milandu yoledzeretsa kawirikawiri, bronchi imayambidwa ndi kutupa kwa purulent, khungu la khungu limatha. Kuwonongedwa kumakula kwambiri. Mphumpha ya emphysema ya mtundu uwu wa matenda imakhala yofooka.

Pogwiritsa ntchito mankhwalawa, dyspnoea imapuma kupuma, ndiko kuti, ndi kovuta kutulutsa. Emphysema yapamwamba imakhala yaikulu. Khungu limapeza mthunzi wa pinkish wa imvi. Maonekedwe a chifuwa amasintha: amawoneka ngati mbiya. Ngati matendawa atenga njirayi, ndipo ngati mankhwala oyenerera adasankhidwa kwa COPD, wodwalayo akhoza kukhala ndi zaka zambiri.

Kupita patsogolo kwa matendawa

Ndi chitukuko cha COPD monga zovuta zikuwonekera:

• Chibayo;
• Kuperewera kwa kupuma, kawirikawiri mu mawonekedwe ovuta.

Zomwe sizinkachitika kawirikawiri:

• Pneumothorax;
• Kulephera kwa mtima;
• Pneumosclerosis.

Pazirombo zoopsa, matenda a pulmona amatha kuwoneka:

• Mtima;
• Kuthamanga kwa magazi.

Kukhazikika ndi kusakhazikika kwa COPD

Matendawa akhoza kukhala amodzi mwa mawonekedwe awiri: okhazikika kapena ovuta. Pokhala ndi mitundu yosiyana ya chitukuko, palibe kusintha kwa thupi komwe kungapezeke pakuwona kusintha kwa kusintha kwa masabata ndi miyezi. Mutha kuona chithunzi chodziwika bwino ngati mumayang'anitsitsa wodwalayo nthawi yosachepera chaka chimodzi.

Koma kupweteka kwa tsiku lonse kapena awiri kuwonetsa kale kuwonongeka kwakukulu mu boma. Ngati zovuta zoterozo zikuchitika kawiri pachaka kapena kuposa, zimatengedwa kuti ndi zofunika kwambiri ndipo zingayambitse wodwala kuchipatala. Chiwerengero cha kuchulukitsa kumakhudza kwambiri khalidwe la moyo ndi nthawi yake.

Panthawi yapadera, odwala omwe kale anavutika ndi mphumu yowonongeka amapatsidwa. Pa nthawi yomweyi amalankhula za "matenda a mtanda". Ziphuphu za thupi la wodwala wotere satha kudya kuchuluka kwa mpweya umene umafunika kuti uzigwira bwino ntchito, zomwe zimachepetsa mphamvu ya thupi kuti ikhale yogwirizana. Mu 2011, matenda amtundu uwu adayimilira kupanga kalasi yapadera, koma pakuchita madokotala ena adagwiritsabe ntchito dongosolo lakale lero.

Kodi adokotala amadziŵa bwanji matendawa?

Mukapita kuchipatala, wodwalayo adzayenera kuphunzira zofufuza kuti apeze COPD kapena kupeza chifukwa china cha matenda. Zowonongeka zikuphatikizapo:

• Kufufuza kaŵirikaŵiri;
• Mzimu;
• Kuyesedwa kupyolera mu bronchodilator, kuphatikizapo kuphulika kwa COPD, isanayambe ndi pambuyo pake kufufuza kwapadera kwa kupuma kwachitidwa, kuyang'ana kusintha kwa zizindikiro;
• X-rays, kuphatikizapo - tomography, ngati nkhaniyo siyikudziwika (izi zimakulolani kuti muwone momwe kusintha kwakukulu kumakhalira).

Ndikofunika kukonzekera zitsanzo zamatenda pofuna kufufuza zinsinsi. Izi zimakulolani kulingalira za kuchuluka kwa kutupa ndi mtundu wanji wa khalidwe. Ngati kuli kovuta kwa COPD, ndiye mfuti angaganizire za tizilombo toyambitsa matenda zomwe zimayambitsa matenda, ndipo ndi antibayotiki yanji yomwe ingagwiritsidwe ntchito motsutsana nayo.

Bodipletizmografiya imachitika, pamene mpweya wakunja umayesedwa . Izi zimakulolani kufotokozera za mapupa, mphamvu, komanso magawo angapo omwe sangathe kuwerengedwa ndi zojambula.

Onetsetsani kuti mutenge magazi kuti muwone bwinobwino. Izi zimatithandiza kuzindikira hemoglobin, erythrocytes, zomwe timagwirizana nazo za kuchepa kwa oxygen. Ngati kuli kovuta, ndiye kuti kufotokozera kwakukulu kumapereka chidziwitso pa kutupa. Fufuzani chiwerengero cha leukocyte ndi ESR.

Magazi amafufuzidwanso chifukwa cha mafuta. Zimenezi zimatithandiza kudziwa kuti oxygen ndi yotani, komanso carbon dioxide. Mukhoza kudziwa bwinobwino ngati magazi ali okhutira mokwanira ndi mpweya.

Maphunziro ofunikira ndi ECG, ECHO-CG, ultrasound, pamene dokotala amalandira chidziwitso cholondola chokhudza mtima, komanso amadziwa kuponderezedwa kwa mitsempha ya pulmonary.

Potsirizira pake, fibrobronchoscopy ikuchitika. Ichi ndi mtundu wa phunziro, pomwe mkhalidwe wa mucosa mkati mwa bronchi umatchulidwa. Madokotala, pogwiritsira ntchito mankhwala osokoneza bongo, amapeza zitsanzo zamagulu zomwe zimakulolani kuti muyang'ane mapangidwe a makina a mucosa. Ngati matendawa sakudziwika bwino, teknolojiyi ndi yofunika kwambiri pofotokozera, chifukwa imalola kuti pasakhale matenda ena omwe ali ndi zizindikiro zofanana.

Malingana ndi zenizeni za mlanduwo, kuyendera kwina kwa pulmonologist kukhoza kulamulidwa kuti afotokoze mkhalidwe wa zamoyo.

Timachiza popanda mankhwala

Kuchiza kwa COPD sikophweka, kufuna njira yowonjezera. Choyamba, tidzakambirana zapadera zomwe ndizovomerezeka ku matendawa.

Madokotala amalangiza:

• Kusiyiratu kusuta;
• Kulingalira bwino, kuphatikizapo zakudya zopangidwa ndi mapuloteni;
• Sinthani katundu, musamangoganizira;
• Pezani kulemera kwa muyezo, ngati muli ndi mapaundi owonjezera;
• Nthawi zonse yendani pang'onopang'ono;
• Kupita kukasambira;
• Yesetsani kuchita kupuma.

Ndipo ngati mankhwala osokoneza bongo?

Inde, popanda mankhwala opangira mankhwala kwa COPD, nayenso, sangathe kuchita. Choyamba, yang'anireni katemera motsutsana ndi chimfine ndi pneumococcus. Ndibwino kuti katemera mu October-pakati pa mwezi wa November, ngati kuchepetsa kuchepa kwachitika, zikutheka kuti mwakhala mukulankhulana ndi mabakiteriya, mavairasi, ndi jekeseni sangapereke chitetezo cha mthupi.

Amagwiritsanso ntchito mankhwalawa, cholinga chachikulu chake ndichokulitsa bronchi ndi kuwasunga mu chikhalidwe chachilendo. Pachifukwachi, amatha kulimbana ndi zochepa zomwe zimapangitsa kuti pakhale nthiti. Mankhwala otsatirawa ndi othandiza apa:

• Theophyllines;
• Agon-2 agonists;
• M-holinolitiki.

Mankhwala omwe adatchulidwawa adagawidwa m'magulu awiri:

• Kutenga nthawi yaitali;
• Zochita zochepa.

Yoyamba imakhala ndi bronchi mudziko labwino kwa maola 24, gulu lachiwiri limakhala maola 4-6.

Mankhwala afupipafupi ali oyenera pachigawo choyamba, komanso m'tsogolomu, ngati kufunika kanthawi kochepa, ndiye kuti zizindikiro zikuwoneka kuti ziyenera kuchotsedwa mwamsanga. Koma ngati mankhwalawa sapereka zotsatira zokwanira, gwiritsani ntchito mankhwala osokoneza bongo.

Komanso, mankhwala osokoneza bongo sangathe kunyalanyazidwa, chifukwa amaletsa njira zolakwika mu mtengo wa bronchial. Koma sangagwiritsidwe ntchito kunja kwa madokotala. Ndikofunika kwambiri kuti dokotala aziyang'anira mankhwala opatsirana mankhwala.

Thandizo lalikulu si chifukwa cha mantha

Ndi COPD, mahomoni a glucocorticosteroid amalembedwa. Monga lamulo, mwa mawonekedwe a inhalations. Koma mu mawonekedwe a mapiritsi, mankhwala oterowo amakhala abwino panthawi ya kuchulukitsidwa. Maphunzirowa amatenga iwo, ngati matendawa ndi oopsa, amayamba kufika kumapeto. Kafukufuku amasonyeza kuti odwala amaopa kugwiritsa ntchito njira ngati dokotala akuwayamikira. Izi zikugwirizana ndi nkhawa za zotsatira.

Kumbukirani kukumbukira kuti zotsatira zina zimayambitsidwa ndi mahomoni omwe amatengedwa mu mapiritsi kapena jekeseni. Pankhani iyi, osati nthawi zonse:

• Osteoporosis;
• Kuthamanga kwa magazi;
• Matenda a shuga.

Ngati mankhwala akutumikira mu mawonekedwe a inhalations ndi zotsatira zawo zidzakhala bata chifukwa mlingo wochepa wa chinthu yogwira mu thupi. Izi mawonekedwe ntchito kwanuko, kumachita makamaka mtengo bronchial, ndipo kuti amathandiza kupewa ambiri mavuto.

Kuiwala kuti matenda amagwirizana ndi kutupa aakulu, kutanthauza mankhwala ogwira kokha maphunziro yaitali. Kuwona ngati zotsatira ndi mankhwala osankhidwa, ayenera kuti atenge kwa miyezi itatu, kenako yerekezerani zotsatira.

Inhalation formulations angayambitse zotsatira otsatirawa mbali:

• candidiasis;
• kusasa mawu.

Popewa izi, muyenera muzimutsuka pakamwa panu nthawi iliyonse Kulandira kutanthauza.

Kodi china chimene chingakuthandizeni?

Pamene COPD amagwira ntchito antioxidant formulations munali zovuta za mavitamini A, C ndi E. Chabwino kutsimikiziridwa wothandizila mucolytic chifukwa iwo woonda ndi ntchofu opangidwa ndi mucous ndi kuthandiza chifuwa chake. Zothandiza mpweya mankhwala ndi zochitika aakulu - yokumba magawanidwe a dongosolo m'mapapo mwanga. Pa exacerbation la matenda akhoza kutenga mankhwala, koma kuyang'aniridwa ndi dokotala.

madalitso ambiri anabweretsa zoletsa kusankha phosphodiesterase - 4. mankhwala enieni ndithu kuti saloledwa kuphatikiza zina mwa njira ntchito pa matenda a COPD.

Ngati matenda kumayambika ndi chilema chibadwa, ndiye anaganiza amachita mankhwala m'malo. Pakuti ichi ntchito alpha-1-antitrypsin, ndilo chifukwa kobadwa nako sanakhaleko mwa thupi mokwanira.

opaleshoni

Nthawi zina, madokotala amalangiza kutembenukira kwa mipata opaleshoni chithandizo. Choncho dokotala anachotsa zinthu zowonongeka m'mapapo, ndipo nthawi makamaka zovuta m'mapapo kupatsidwa zina.

zodzitetezera

ankachita COPD kupewa ndi chiyani? Kodi pali ogwira njira za momwe angapewere matendawa? mankhwala amakono limanena kuti kuteteza matenda ndi zotheka, koma ichi, ayenera kusamalira thanzi lawo ndi kuchitira nokha moyenera.

Chinthu choyamba kusiya kusuta, komanso zokhuza kuthekera kupeza kuthetsa zinthu zoipa.

Ngati nthendayo wapezeka, kupitirira yake mochedwa pogwiritsa ntchito miyeso sekondale njira. The asonyeza umboni:

• Katemera kumathandiza imfa ya fuluwenza, pneumococcus;
• madyedwe zonse mankhwala. Kumbukirani kuti matenda ndi aakulu, choncho ndi mankhwala pang'ono sizitanthauza phindu lenileni;
• kuwunika zolimbitsa thupi. Izi zimathandiza kuti kuphunzitsa minofu ya dongosolo kupuma. Ndi yaitali kuyenda ndi kusambira, ntchito njira zokambirana kupuma;
• odwala. Iwo ayenera kukhala wokhoza ntchito molondola, monga ntchito pachithunzichi zikubweretsa kusowa zotsatira za mankhwala amenewa. Kawirikawiri, dokotala kufotokoza kwa wodwala momwe ntchito mankhwala kuti anali aluso.