Uri Mudiwa weBronchial Thermoplasty?
Waiziva here kuti pane ikozvino isiri yemishonga nzira inowanikwa kana iwe uine chirwere chakasimba chinoramba chichidzivirirwa zvakanaka nekakanyanyisa murwere wegricticosteroids uye kwenguva yakareba-beta-agonists ? Zvechokwadi, Alair Bronchial Thermoplasty System yakakunda 2010 Popular Sayenzi "Best of What's New" Mubayiro muHutano hwekuvandudza kweiyo teknolojia.
Bronchial thermoplasty inoratidzika kunze (kureva varwere vakawanda vanoenda kumusha uye vanovata mumubhedha wavo) nzira inoparadzanisa iyo inoderedza kukwanisa kwemhepo yako yepamhepo kunomira uye yakamanikana paunenge uchitarisana nezvikonzero zvinotungamirira mukurwiswa kwepifma . Bronchial thermoplasty inzira inopa simba rinopisa kumapapu evarwere vane asthma kuitira kuti kuderedza huwandu hwehutendere hwakanaka mumapapu, mishonga inotungamirira kuchirwere chechirwere chechirwere uye zviratidzo zvechirwere . Varwere vanogadziriswa zviri nani zvemafivha avo nokuti mapapu haakwanisi kuwedzera zvakanyanya uye kuita sezvinoita simba rekusimudzira mweya.
IAirir Bronchial Thermoplasty System inoderedza huwandu hwemhepo inosvibisa musumbu nokutungamirira simba rinopisa kumapapu zvakananga. Bronchial thermoplasty inowanzoitwa pasi pedestate sedation nemurwere inowanzoenda kumba pazuva rimwe chete. Chirwere chakakwana zvikamu zvitatu zvakasiyana zvakasiyana-siyana zvinotapira nzvimbo yakasiyana yemapapu.
Panguva ino, kuchengetedzwa nekubudirira kwekudzokorora mishonga hazvizivikanwi.
Zviratidzo zveBronchial Thermoplasty
Maererano neAlair Bronchial Thermoplasty System webhusaiti, inoratidzwa "mukurapa kwechirwere chinoramba chichirwere mumakirini makumi mapfumbamwe nerekare avo vane maitiro asina kukodzera kunyatsogadziriswa nekarticosteroids inoputika uye varati venguva refu vanoita beta."
Chiremba wako anoda kuve nekuziva mu bronchoscopy nzira, asi anodawo kudzidziswa zvakananga mukushandiswa kwebronchial thermoplasty asati agona kushandisa Alair Bronchial Thermoplasty System.
Contraindications ye Bronchial Thermoplasty
Vamwe varwere havakwanisi kurapwa ne bronchial thermoplasty:
- Varwere vane mhando ipi zvayo yezvigadzirwa zvinoshandiswa zvakadai se pacemaker , mukati me defibrillator, kana zvimwe zvigadzirwa zvemagetsi zvinoshandiswa.
- Varwere vane ruzivo rwakanzwisisika kana kushandiswa kwemishonga inoshandiswa panguva yebronchoscopy yakadai sedidocaine, atropine, uye benzodiazepines.
- Varwere vakatobatwa neAirir Bronchial Thermoplasty System. Kudzokorora hakusi kurayirwa zvino sezvo kuchengetedzwa nekubudirira kwekudzokorora mishonga hakuzivikanwi.
Uyezve, mamwe mamiriro ezvinhu angangodaro asinganzwisisiki kwenguva pfupi kune bronchial thermoplasty. Varwere vane zvinotevera havafaniri kuiswa bronchial thermoplasty:
- Zvakanyanya kupemha utachiona.
- Kuwedzera kwechirwere mukati memavhiki maviri ekupedzisira.
- Kuchinja chirwere che systemic corticosteroids ye asthma (kumusoro kana pasi) mumazuva gumi apfuura
- Anozivikanwa coagulopathy kana dambudziko rekubuda ropa
- Varwere vanofanira kurega kutora anticoagulants, antiplatelet agents, aspirin uye NSAIDS vasati vamboita mushure mekutaura nachiremba wavo.
Pakupedzisira, paiva nemamwe marudzi evarwere vezvechirwere vasina kudzidza mune mimwe miedzo yeAlair Bronchial Thermoplasty System uye hazvizivikanwe kana vachizozviratidza zvakafanana kune vamwe varwere. Kana imwe yeiyo inotevera ichokwadi, unofanirwa kukurukura nezvengozi uye zvinobatsira zvebronchial thermoplasty nachiremba wako sezvo iwe ungave uri pangozi yakawanda yezviitiko zvakashata zvingave zvakabatanidzwa nehurumende inonzi bronchial thermoplasty:
- Your post-bronchodilator FEV1 iri pasi pe65% yezvakafanotaurwa.
- Iwe une dzimwe zvirwere zvepapupa zvakadai se emphysema, tambo yezwi, kushandiswa kwemhepo, cystic fibrosis kana kuti kusadzivirirwa kunokanganisa kurara kwepabonde.
- Iwe waifanira kushandisa yako-bronchodilator yako-shomanana kudarika 12 kushuva zuva nezuva mumazuva maviri usati waita bronchial thermoplasty.
- Iwe uri steroid unotarisira uye unoda muromo corticosteroids sezvakaitwa prednisone pane imwe yei 10 milligrams pazuva.
- Iwe une zvimwe zvirwere zvinogona kuwedzera mungozi yezvinetso zvinosanganisira insulini-inokonzerwa nechirwere cheshuga, kushaya chifukidzo, kutadza kudzora maronary artery chirwere, kukanganisa kwakanyanya kana kusingaperi kwetsvina, uye kusachengetedzwa kwehuwandu hwehutano.
- Iwe wakave nekugamuchirwa kwepma iyo inoda chikwata chekuchengetedza zvakanyanya kana intubation mumakore maviri apfuura.
- Iwe wakave nemakore mana kana kupfuura ekuputika kwezvirwere mukati megore rapera.
- Iwe wakave nemakore matatu kana kupfuura ekurapa kwezvirwere zvekuporesa mugore rapera.
- Iwe wakanga uine 4 kana kupfuura yakawanda yemaitiro ekuda inonzi systic, oral steroids mugore rapera.
Bronchial Thermoplasty Results
Chirongwa cheAIR2 chakaratidza kuti varwere vanobatwa ne bronchial thermoplasty vaiva nehuwandu hwehutano hunovandudzwa huripo hunosanganiswa nehutano hwavo:
- Kuvandudzwa kwehupenyu hwehupenyu
- 32% kuderedzwa mukurwiswa kwechirwere
- 84% kuderedza mukana wekutsvaga mumba
- 73% kuderedza muzvipatara
- 66% kuderedza mumazuva akarasika kubva kuchikoro nekushanda
Zvimwe zvidzidzo zveAlair Bronchial Thermoplasty System zvakaratidza kuti hapana kuora kweFiV1 uye yakagadzikana, yakareba kwenguva yakajeka purogiramu. Chipatori chekuongorora uchapupu hunoratidza makore mashanu okuchengeteka pasina pneumothorax, intubation, mechanical ventilation, cardiac arrhythmias, kana kufa nekuda kwechirwere chinonzi bronchial thermoplasty.
Kunyange zvazvo paiva nevamwe kuwedzerwa muzvirwere zvekuporesa nguva pfupi kutevera nzira, pane zvakafanana nezvo munhu aizotarisira kutevera bronchoscopy mune murwere wehma.
Mune pepanhau rekare rekubudiswa, kambani yakataura kuti migumisiro yekudzidza yakanga ichivimbisa sepamusoro-panjodzi, zvakaoma-ku-kutonga asthmatics dzaive nekuvandudza. Nhamba yakawanda yekare yakakurukura kurapwa kuripo kwemakore mashanu uye kuve nekuderedza kukuru kwekuwedzera kwechirwere panguva iyoyo.
> Sources:
> ASTHMATX, Inc. Pamusoro peBronchial Thermoplasty.
> Wechsler M et al. J Allergy Clin Immunol. 2013 Dec; 132 (6): 1295-302.