Chimiro asthmaticus, kana SA kupfupika, chirwere chakaipa chekushaya chirwere chinowanzotora nguva refu kana kuti kamwe kamwe pakarepo. MuZimbabwe, zviratidzo zvechirwere zvinopfuurira uye kuporesa kunorambidzwa, pasinei nemishonga inoratidzika.
Pakati pehuwandu hwehuwandu hwevanhu, chirwere cheputi chinokanganisa anenge masere kubva muzana zvevanhu vakuru uye 10 muzana yevana. Pakati idzi, zvishanu kusvika kuzana muzana zvine utachiona hwakanyanya hwemafi uye vari pangozi yakakura yehupenyu hwe asthmaticus.
SA inogona kukonzera kukundikana kuputika , kupora kwenguva yakareba, uye kunyange kufa. Icho chinomiririra chirwere chekurapa chinokurumidza chinoda kurapwa nokukurumidza uye kunorwadza. Vose 10% yevanhu vanoona SA vachafa.
Uyewo, chimiro che asthmaticus chinowanikwa zvikuru, zvichiita kuti vanhu vanopfuura 5 000 vafa gore roga roga muUnited States Munhu wose ane kana kuti asina chirwere anofanira kunge achiziva zviratidzo zvinowanzowedzera zviratidzo nezviratidzo.
Panzvimbo yekuita izvi zvinotyisa kunzwa, ramba uchiverenga. Dzidza zvaunogona kuita kuti urege kuva umwe wezviyero izvi.
Zviratidzo
Munguva yekurwiswa kwemaitiro ephma, nzira iyo muviri inowanzoita kuporesa magasi muAlveoli haina kuoma. Izvi zvinokonzera kudzikisa majini oksijeni uye yakakwirira carbon dioxide muropa, iro, mumamiriro ezvinhu akaipisisa, rinogona kukonzera coma uye rufu.
Nyeredzi inobatsirawo kutengesa mweya mumapapu, mamiriro ezvinhu anokonzera kuwedzera kwechisimba mubhokisi. Izvi zvinogona kuita kuti mapapu aparare uye kunyange kusungwa kwemwoyo.
Aina
Kune marudzi maviri eSA:
- Slow-allt attack . Ichi chinowanzozivikanwa chingatora nguva yakareba kuti iparuke uye kazhinji inoguma nekuda kwekushaya kukodzera. Munhu ane rudzi urwu rweSA achasangana nemazuva kana vhiki dzekuwedzera zviratidzo, zvinogadziriswa nenguva dzekununura uye kuguma zviratidzo zvisingagoni kuderedzwa nemishonga mumusha.
- Kamwe kamwe-kamwe kunotanga kurwisa . Munhu ane rudzi urwu rweSA haana kumboona zviratidzo zvinowedzera mumasvondo apfuura, asi anorohwa nekushungurudzika uye kwakanyanya bronchospasm, kufema, kuputika, nekukanganiswa. Izvi zvinowanzosangana nehuwandu hwekugadzirisa zvinhu, zvakadai semapenene, guruva kana zvokudya zvinokonzera.
Kuziva
Izvi zvinotevera zviratidzo uye zviratidzo izvo vanachiremba vanoshandisa kuongorora SA:
- Kusuruvara pakuzorora (Nekudzivirira zvishoma nezvishoma, kufema kwepfupi kunogona kutanga nemabasa chete uye kufambira mberi kwainoitika pazororo.)
- Kusakwanisa kutaura mumitauro kana kusakwanisa kutaura zvachose
- Kuvharidzirwa kwepamusoro pamapfupa ekuzorora (Makuru makumi matatu nemakumi mapfumbamwe neminomwe muminiti inofunganya, asi kunyange mitengo inopfuura 18 mucheche mucheche wechikoro kana munhu mukuru anofanira kukonzera kunetseka uye kuongororwa zvakanyanya.Imari inowanzowedzera kuvana vaduku uye zvakakosha kubvunza yako allergist kana mapapu nyanzvi pamusoro pechiyero chaunofanirwa kuva nehanya nevana vaduku.)
- Kuwedzera kwepulse yepamusoro pakuzorora (guru kupfuura 120 kurova paminiti)
- Kushungurudzika uye kusagadzikana (Kunyange zvazvo, sezvo kurwiswa kunofambira mberi, kurara uye kusuruvara zvinotyisa.)
- Kuderera kwekisijeni muropa (hypoxemia uye then hypoxia )
- Yakapera simba rokufema, sezvakayerwa nepamusoro pekudzivirira kupera (PEF)
Kurapa
Kurapa kwechimiro chechimiro che asthmaticus muimba yekutambudzika kunosanganisira:
- Oxygen ne mask
- Kuyera kwe PEF ne spirometry (mumhepo yakanyanya kuoma, izvi zviyero zvinogona kuva zvakaoma)
- Short acting beta agonists (yakadaro albuterol) kuburikidza ne inhaler kana zvichida kuburikidza nebulibulizer
- Corticosteroid mishonga (yakadai sa prednisone) yakapiwa kana nemuromo kana mukati
- Inhaled medication anticholinergic (yakadai seatrovent)
Mimwe mishonga inogona kushandiswa panguva yechiitiko chakaoma inosanganisira:
- Beta-agonists inorowa pasi peganda (zvakadai seTetbutaline)
- Magnesium sulfate intravenously
- Leukotriene modifiers (yakadai seZafirlukast kana Zileuton) nemuromo
Mechanical ventilation inorapwa (inenge inenge iri) yekupedzisira kushandiswa nekuda kwengozi yekutambudzika kumapapu nezvimwe zvinetso zvakakomba zvinogona kuitika. Anenge makumi mana kubva muzana yekutsvaga mukana yekushanyira hofema kuchaita kuti murwere achida mhepo inoputika. Sekupedzisira modality, extracorporeal membrane oxygenation (ECMO) yakashanda mune vashoma varwere umo chirwere chemahara chinenge chichiuraya kunyange nemagetsi emhepo.
ECMO (extracorporeal membrane oxygenation) inopa imwezve sarudzo yekupedzisira uye yekupedzisira kurapwa kwemaitiro kune avo avo maitiro ose emishonga anosanganisira kupisa kwema mechanical vakakundikana. Iko zvino inofungidzirwa kuti ECMO inofanirwa kuonekwa seyokurapa kwekutanga kune vanhu vane chimiro che asthmaticus nevanoshayiwa gasi kushandiswa (kusava nekudya kwe okisijeni nekupera kwe carbon dioxide) izvo hazvisi kupindura zvakanaka kune kurapa kuripo. ECMO inopa nzira yekudzorera kugadzirisana kwegasi mumuviri nekudzivirira kupisa kwemapapu inobatana nemichina inoputika.
Nhamba yePFF
Kazhinji kuoma kwezviratidzo zvomunhu ane astmma hazvibatanidzi zvakadzama nekuoma kwemapapu ake. Saka, zvinokosha kuti vose asthmatics vaone PEF yavo nguva dzose. Izvi zvinoshandiswa nokushandisa nhamba yepamusoro yemamita , iyo ipurasitiki duku inoputirwa nesimba, iyo inoyera PEF.
Chiyero che PEF chinopa ruzivo pamusoro pemamiriro ekufema, chero kuparara kunobva kumunhu chaiyo (yekutanga) mamiriro ezvinhu, uye chido chekuwedzera mishonga kana kutsvaga kurapwa. Chero munhu chero upi zvake ane chirwere chemafu chinokonzera kupera kwemazana makumi matatu kana kupfuura mu PEF, kunyanya kana kuponeswa kwevanhu vasiri kuve kusina kubudirira, vanofanira kutsvaga kurapwa pasina kushamisika.
Risk Factors
Iwe ungaziva sei kana iwe uri pangozi yekukuvara nekurwiswa kwemafi ? Nechiitiko chisinganzwisisiki asthmaticus, pane, nekunzwisisa, mashomanana ekunyevera zviratidzo. Kana iwe uine rudzi rwemishonga inokonzerwa neizvi, iyo yako inonzi allergen inokurukura kuti kurwisa uku kunogona kuitika sei uye kukurumidza sei.
Nekunonoka kunotangira chimiro che asthmaticus, pane zviratidzo zvekuchenesa zvakasiyana-siyana zvinofanira kukurudzira iwe kuti utane chiremba wako kana kutsvaga kurapwa kwekukurumidza. Izvi zvinosanganisira:
- Kuderera kwe PEF kwe30 muzana kana kupfuura, sezvakataurwa pamusoro apa, kunyange zvazvo yourergist yako inogona kukupa mararamiro akasiyana zvichienderana nehma yako
- Kuwedzera kwekudiwa kwekuponesa kwako
- Usiku hunomuka nokuda kwemafupa ako
- Kuwedzera kukurumidza kufema kunze kwekushandisa kushandiswa kwemishonga yako
- Kana iwe wakashandisa mabhuku maviri kana kupfuura e-short-acting inhaler mumwedzi wapfuura
Kana iwe uine nhoroondo yehutachiona hunokonzerwa nehutachiona, iwe unofanirwa kutsvaga rubatsiro rwekukurumidzira kana ukacherechedza chimwe chezviratidzo zvawaiva nazvo panguva yawakamborwisa.
Shoko Rinobva
Zvakakosha kuti munhu wese ane astmma, uye avo vanodiwa vanotarisira vanhu vane astmma, zivai zvose zvinonyeverwa zviratidzo zvehutachiona hwakanyanya uye kuoma kwechirwere ichi. Pasinei nokufambira mberi mukurapa, kune vanhu vakawanda kwazvo vanofa nehosha iyi gore negore.
Chikamu chechinetso ndechekuti vanhu vazhinji havaoni kuti mishonga inotora sei kumba inowanzova yakasimba, uye izvi zvinogona kupa pfungwa dzenhema yekuchengeteka. Kana munhu ari kuwedzera kushandiswa kwekushandisa kumba, dzimwe nguva zvinogona kunge zvakaoma zvikuru kuwana chirwere chinotungamirirwa mushure mekunge vasvika muimba yepamhanho.
Izvozvo zvakati, kuva nechirwere hachisi chikonzero chekutya. Sezvambotaurwa kare, vanhu vazhinji vane chimiro che asthmaticus vanononoka kutanga zvirwere. Idzi dzipi pamusoro pechiitiko ichi chinofanira kuita inokurudzira avo vane astmma, kunyange avo vane hutema husina simba, kuti vaone chitendero chavo chepamusoro uye vanoonana navanachiremba vavo vane zviratidzo zvingave zvichiri kuwedzera. Kana iwe usingazivi nezvekuita izvi, tumira iwe allergist nhasi uye dzidza kuti ungashanda sei nehma yako.
Sources:
Di Lascio, G., Prifti, E., Messai, E. et al. Extracorporeal Membrane Oxygenation Support for Life-Threatening Acute Status Status Asthmaticus. Perfusion . 2017. 32 (2): 157-163.
Miller, A., Breslin, M., Pineda, L., naJo Fox. Chirongwa cheAsthma Chichiwedzera Kuwirirana Nezviratidzo-Mazano Anotungamirirwa Nevana Vezvechirongwa Nehutano Hwakanaka Asthmaticus muDhipatimendi Emergency. Kuporesa Kuchengetedza . 2015. 60 (12): 1759-64.
Tramm, R., Ilic, D., Davies, A., Pellegrino, V., Romero, L., naC. Hodgson. Extracorporeal Membrane Oxygenation yeCritally Ill Adults. Cochrane Database yekuongorora kwakarongeka . 2015. 1: CD010381.