Maererano neHome Initiative for Chronic Obstructive Lung Disease (GOLD), kuongororwa kwechirwere chisingaperi chinokonzera zvirwere (COPD) kunofanirwa kutaridzirwa mune chero murwere ane ucheperesi, kuora kwenguva refu kana kubudiswa kweputum, uye / kana nhoroondo zvekutsvaga kuCOPD zvinhu zvinokonzera njodzi , zvakadai sekusvuta, kusvibiswa kumakumbo emapapu semakemikari, kusvibiswa, kana utsi hwechipiri, kana kuti mazamu / maitiro ekusimudzira.
Zvisinei, kuongororwa kweCOPD kunogona kuoma sezvo kune zviratidzo zvakafanana kune dzimwe zvirwere uye zvinogona kuzviratidza zvakasiyana pane mumwe nomumwe.
Labs uye Miedzo
Kana chiremba wako achishuva kuti une COPD, iye angangodaro akawana nhoroondo yako yehutano yakakwana, kuita chimiro, uye kuedza miedzo yekusimbisa kana kutonga kunze kweCOPD.
Nhoroondo uye Nyama
Kuongorora kwako kunotanga nekutarisa zvakadzama nezvehupenyu hwako. Izvi zvinofanira kusanganisira kuongorora zvinotevera:
- Zvawakaita zvekare uye zvekare zvakakonzera njodzi zvinhu zvakadai sekusvuta, utsi hwechipiri , kusvibiswa kwemweya , uye / kana kushanda basa kune guruva, gasi, uye makemikari.
- Nhoroondo yako yezvechiremba, kunyanya sezvo inotaura nezvemazuva ano ekufema kunetseka semhepo, chirwere chetachiona, sinusitis, uye / kana zvirwere zvokufema panguva yehuduku hwako.
- Pamberi pezvipatara, kunyanya kana vaibatanidzwa nehosha yekufema.
- Kana mumwe munhu ari mumhuri yako akambova neCOPD kana chero imwe chirwere chisingaperi chemapapu.
- Kana iwe uine zvimwe zvirwere zvehutano zviripo, zvakadai sechirwere chemwoyo kana osteoporosis, izvo zvinogona kuwedzera hutano hwekuongororwa kweCOPD.
- Muenzaniso wechiratidzo chako kukura, kusanganisira kana zviratidzo zvako zvatanga uye nguva yakareba sei wakamirira usati watsvaga kurapwa.
- Zvinokonzera zviratidzo zvako muupenyu hwako hwezuva nezuva. Somuenzaniso, kana zviratidzo zvako zvakakonzera kusuwa basa, rega kuita mabasa ako nguva dzose, kana kunzwa uora mwoyo kana kufunganya.
Chiremba wako anofanirwawo kuongorora zvakakwana mumuviri zvinogona kusanganisira:
- Kutora ushuhuro yako, kuputika, kufema neminiti, kupisa, uye ropa.
- Kuteerera mwoyo wako nemapapu ne stethoscope.
- Kuongorora nzeve dzako, mhuno, maziso, uye nehuro nokuda kwezviratidzo zvehutachiona.
- Kuongorora minwe yako nokuda kwezviratidzo zve cyanosis uye clubbing (apo magumo eminwe yako akawedzerwa).
- Kuongorora zviratidzo zvekudzivirira mumakumbo ako, maziso, tsoka, kana zvimwe zvikamu zvemuviri wako.
- Kuongorora mitsipa mumutsipa wako kuti uongorore zvinetso zveCOPD zvakadai seCor pulmonale (kusakwanira kwekakarurama kwemoyo wako).
Spirometry
Kuongororwa kwe spirometry kunofanirwa kuita kliniki kuongororwa kweCOPD uye ndiyo inonyanya kushandisa yekuongorora kuoma kweCOPD. Chirwere che spirometry chinotarisa zvakananga pazvikamu zvina zvinokosha zvepamupa basa, kusanganisira:
- Mhepo yakawanda sei iwe unogona kukumanikidza kutora mushure mekutora kufema kwakadzika (kunozivikanwa sekumanikidzwa simba rinokosha, kana FVC).
- Mhepo yakawanda sei iwe unogona kukwanisa kubvisa mune imwe yechipiri (inozivikanwa sekumanikidzirwa kuporesa ivhu mune imwe yechipiri, kana FEV1 ).
- Iko yehuwandu yemhepo yakasara mumapapu ako mushure mekuzadzwa kwakazara (inozivikanwa sehuwandu hwe FEV1 kusvika FVC ).
- Iro yehuwandu yemhepo mumapapu ako (anozivikanwa sehuwandu wemapapu simba, kana TLC ).
Pamwe chete, zviyero zvina izvi hazvirevi kungova kukuvadza kwakadini pamapapu ako asi nzira dzaunokwanisa kuvandudza mararamiro ako kwenguva refu kana iwe uine COPD. Kupera kwemafunguro emhepo, kana COPD, inosimbiswa apo mhinduro dzekuedza dzinoratidza FEV1 / FVC iri pasi pe 0.70 mushure mekushandisa iwe bronchodilator .
Zvimwe zvePulmonary Functions Tests (PFTs)
Mukuwedzera kune spirometry, pane mamwe maviri emapurmoni anoedza kushanda anokosha kana achiongorora mapapu ekushanda muCOPD: miedzo yekupukisa mapapu uye muviri plethysmography. Iyi miedzo inoyera kuti yakawanda sei kabhoni monoxide mapapu ako anokwanisa kuita uye huwandu hwemhepo mumapapu ako pamatanho akasiyana-siyana ekufema, zvichienderana, kuratidza kuti COPD yako yakanyanya sei.
Complete Blood Count (CBC)
Kunyange kuongororwa kweropa hakugone kuongorora COPD, ropa rakazara kuverenga (CBC) richaona chiremba wako kana une chirwere, uyewo kuratidza, pakati pezvimwe zvinhu, kuti hemoglobin yakawanda sei muropa rako. Hemoglobin ndiyo inonzi iron-ine pigment iri muropa rako iyo inotakura oksijeni kubva mumapapu ako kuenda kune imwe muviri wako wose.
Pulse Oximetry
Pulse oximetry inzira isingaoneki yekuyera kuti matukisi ako ari kugoverwa sei neoksijeni. Shanduro kana sensor inowanzobatanidzwa pamunwe wako, pahuma, earlobe, kana bhulogi yemhino dzako. Pulse oximetry inogona kuenderera mberi kana inopindirana uye chiyero che 95 kubva kuzana kubva muzana chinonzi chakanaka. Kana uri pasi pe92 muzana, chiremba wako angada kuita ropa rinopisa ropa (ABG) kuongorora. Pamwe chete neABGs, kuyera yako oxygen saturation level nenzira yekupisa oximetry inobatsira chiremba wako kuti aongorore kudiwa kwerojeni yehutano.
Ropa Ropa Gases
MuCOPD, uwandu hwemweya waunofema mukati uye huri mumapapu ako hahuna maturo. Arterial blood gases inoyera oxygen uye carbon dioxide muropa rako uye inogadzirisa muviri wako pH uye sodium bicarbonate. I-ABG inokosha pakuumba chirwere cheCOPD uyewo pakugadzirisa kudiwa kwekugadzirisa kubuda kwechidimbu cheyero inodhaka yeyerojeni therapy .
Alpha-1-Antitrypsin Kukwana Kuongorora
Kana iwe uchigara munharaunda ine nzvimbo yakawanda yekupararira kweAl-1-antitrypsin (AAT) inoshaya, World Health Organization (WHO) inokurudzira kuti iwe uedzwe chirwere ichi nekutsvaga ropa. Ichokwadi, WHO inokurudzira kuti ani zvake akaonekwa kuti ane COPD anofanirwa kuongororwa kuti AAT yashayike kamwe.
AAT inoshaya ndeye chimiro chinogona kutungamirira kuCOPD. Kunyangwe uongororwa pane imwe nguva duku (pasi pemakore makumi mana nemashanu) unofanirawo kutarisa vanachiremba kuti mukana wekuti AAT inoshaya ndeye chikonzero chinokonzera COPD yako. Kurapa kweCOPD iyo inokonzerwa nekushayikwa kweAAT yakasiyana nekuraira kwakakwana uye inosanganisira kuwedzera kwekurapa .
Imaging
Chiremba wako anogona kuita zvimwe zviitiko zvekufungidzira uye kubatsira kubvisa kunze kana kuongorora COPD.
Chep X-ray
Bhokisi re-ray-raga roga haritisi kuongororwa kweCOPD. Chiremba wako anogona kuraira mumwe pakutanga, zvisinei, kuti atonge zvimwe zvikonzero zvezviratidzo zvako kana kuti kusimbisa kuvapo kweiyo iripo comorbid chimiro . Bhokisi re x-ray rinogona kushandiswa nguva nenguva mukurapa kwako kwose kuti uone kufambira mberi kwako.
Computerized Tomography (CT) Scan
Kunyange zvazvo CT isinganzwisisiki paunenge uchitarisa COPD, chiremba wako anogona kuraira imwe kana zvaratidza. Semuenzaniso, unogona kuva neTCT scan kana une chirwere chisina kugadzirisa, zviratidzo zvako zvachinja, chiremba wako anokanganisa iwe unogona kuva nekenza yemapapu, kana iwe uri kufungidzirwa mukuvhiyiwa. Apo chifukidzo che X-ray chinoratidza nzvimbo dzakakura dzehuwandu hwemapapu mumapapu, CT inowanzojekesa zvikuru, ichiratidza tsanangudzo yakanaka iyo X-ray yechifu haina. Dzimwe nguva, isati yatanga CT scan, chinhu chinonzi kusiyana chinoshandiswa mukati mako. Izvi zvinobvumira chiremba wako kuti aone kuipa kwemuapapu ako zvakajeka.
Kusiyanisa Kuongorora
Pane hutano hwehutano hunogona kuonekwa nyore nyore neine kuongorora ropa kana kuongorora muviri. Zvimwe hazvisi nyore. Mune zvimwe zviitiko, hakuzovi nekuedzwa kumwe kana nzira inogona kusimbisa kana kusabvisa kuvapo kwechirwere. COPD imwe yezvirwere izvi. Kunyange zvazvo zvirwere zvakasiyana-siyana zvinoputika, zvakadai sa spirometry , zvinogona kusimbisa zviratidzo zvechirwere, ivo chete havagoni kusimbisa kuongororwa.
Nokuda kweizvi, chiremba aizoda kuita izvo zvinonzi kusiyanisa kuongorora . Iyi ndiyo nzira iyo zvimwe zvikonzero zvose zvechirwere zvave zvisingabvumirwi. Chero kana chirongwa chacho chapera, chirwere cheCOPD chinogona kuonekwa sechinyatsojeka.
Kusiyana kwekutsvaga kunokosha kunotsigira COPD nokuti inoramba iine chirwere chisina kunaka. Kunyange zvazvo COPD inowanzobatanidzwa nekusvuta fodya, havasi vose vanoputa vane COPD uye havasi vose vane COPD vari kusvuta.
Uyezve, zviratidzo uye kuratidza kwechirwere zvakasiyana zvikuru. Semuenzaniso, munhu uyo maitiro e spirometry asina kuenzaniswa anogona kuve ane zviratidzo zvakanyanya zveCOPD . Zvimwe, mumwe munhu ane urema hunoratidzika anowanzotarisira zvishoma, kana zvipi, zviratidzo.
Izvi zvinoda kuti vanachiremba vatarise chirwere nenzira yakasiyana. Uye, nokuti hatisati taziva zvizere chinokonzera COPD, vanachiremba vanoda ruzivo rwekuchengeteka kwekusiyana kwekutsvaga kuitira kuti zviratidzo zvakanaka zvigadzirwa.
Izvi zvinonyanya kukosha kune vanhu vakwegura vane chirwere chepfungwa nemapapu chinogona kukonzera kukanganisa kwemhepo. Nokushandura dombo rega rega, vanachiremba vanowanzowana chaiyo (panzvimbo pekufungidzirwa) chinokonzera chirwere chokufema, mamwe acho anogona kurapwa.
Mukati yekusiyana kwekuongororwa, zvimwe zvekutsvaga zvakanyanya kunogona kusanganisira asthma, congestive moyo kusagadzikana, bronchiectasis, chirwere chetachiona, uye kubviswa kwebronchiolitis. Zvichienderana nehutano uye nhoroondo yemunhu mumwe, zvimwe zvinokonzera zvinogona kuongororwawo.
Asthma
Chimwe chezvinyanyozivikanwa zvakasiyana pakuongororwa kweCOPD is asthma . Mune zviitiko zvizhinji, mamiriro maviri aya anenge asingakwanisi kutaurira kuparadzana, izvo zvinogona kuita kuti vatungamiri vasaoma sezvo maitiro ekurapwa akasiyana zvikuru. Chimiro chezvinhu zvehutema chinosanganisira:
- Kazhinji inotangira kutanga kweupenyu (kufananiswa neCOPD, inoitika gare gare muupenyu)
- Zviratidzo zvingasiyana-siyana zuva rega rega, kazhinji zvinopera pakati pekurwa
- Nhoroondo yehutachiwana hwemafi inowanikwa
- Kurwara, rhinitis, kana eczema inowanzovapo
- Kuyerera kwemhepo kunowanzoshandurwa zvakare, kusiyana neCOPD
Kukanganisa Mwoyo Kusakundikana
Kukanganisa mwoyo kusagadzikana (CHF) kunoitika kana mwoyo wako usingakwanise kupompa ropa rakakwana kuburikidza nemuviri kuchengetedza zvinhu zvose zvinowanzoshanda. Izvi zvinokonzera kuchengetedza kwemvura mumapapu ako uye zvimwe zvikamu zvemuviri wako. Zviratidzo zve CHF zvinosanganisira chifuva, kusava nesimba, kuneta, uye kuperevedza kwefema nemabasa. Mamwe maitiro eCF anosanganisira:
- Mapapiro akanaka anonzwika ne stethoscope.
- Chep x-ray inoratidza kunyanyisa kwemvura uye kuwedzera kwemaviri emwoyo.
- Pulmonary function tests inoratidzira kuvharirwa kwepamusoro (kusingapesana nemuganhu wekufema kunoonekwa muCOPD).
Bronchiectasis
Bronchiectasis inorambidza chirwere chemapapu chinogona kuvhiringidza (ikozvino pakuberekwa) kana kukonzerwa nehutano hwemucheche hunosanganisira pneumonia, masheya, furuwenza, kana chirwere chetachiona. Bronchiectasis inogona kuitika yoga kana kuitika-pamwe chete neCOPD. Zviratidzo zvebronchiectasis zvinosanganisira:
- Kubereka zvakawanda zve sputum
- Zvirwere zvekare zvebhakitiriya yemapupa
- Nhokwe dzakakanzwa kuburikidza ne stethoscope
- Bhokisi re x-radhi rinoputika bhanchial tubes uye masvingo akakomberedzwa akakomberedzwa
- Clubbing yeminwe
Tuberculosis
Tuberculosis (TB) chirwere chinopararira chinokonzerwa ne microorganism Mycobacterium tuberculosis . Kunyange zvazvo TB inowanzokonzera mapapu, inogona kupararira kune dzimwe nhengo dzomuviri pamwe chete, kusanganisira uropi, itsvo, mapfupa, uye lymph nodes.
Zviratidzo zveTBP zvinosanganisira kuora muviri, kuneta, kuramba uchikanganiswa, kufema kunetseka, kurwadziwa kwepfupa, uye kuputika kweropa kana ropa. Dzimwe humwe unhu hweTB dzinosanganisira:
- Zvirwere zvese zvinogona kuitika chero ipi zvayo
- Bofu x-rays zvinoratidza nzvimbo dzomumhepo dzakagadzirwa nemvura
- Ropa kana tsvina inoratidza kuti kuvapo kwaMer tuberculosis
- Inowanzoonekwa mukati memharaunda kana kuratidza sechikamu chekumuka
Obliterative Bronchiolitis
Obliterative bronchiolitis iyo isiri yomuviri webronchiolitis inogona kutyisa upenyu. Iko kunoitika apo maduku emhepo mashoma emapapu, anozivikanwa sebronchioles, anoputika uye anoputika, achiita kuti apedze kana kuti apfigire. Mamwe maitiro ezvokuparadza zvinonzi bronchiolitis zvinosanganisira:
- Kazhinji inowanikwa pazera remuduku kune vasiri kusvuta
- Zvinokwanisika nhoroondo ye rheumatoid arthritis kana kuiswa kune zvinotyisa
- CT scan inoratidza nzvimbo dze hypodensity apo mapapu emapapu akacheka
- Kuvhara kwemhepo, sekuenzaniswa neFIV , kunogona kunge kwakaderera se16 muzana
Vadzidzi uye Makira eCOPD
Sechirwere chinopfuurira, COPD inoratidzirwa nezvikamu zvechirwere chinogona kukubatsira kuziva zvaunotarisira panguva iyoyo panguva, kunyange nzvimbo yako isingasarudze kuti uchaita sei nekurapa. Kuti uongorore nzvimbo yako, vanachiremba vachati ku Global Initiative for Chronic Obstructive Lung Disease (GOLD) kuisa maitiro, iyo inoparadzanisa hutachiona hunobuda mumatanho mana akasiyana anotsanangurwa nemuedzo we spirometry.
Bhuku 1: Mwoyo COPD
Negiredhi 1 COPD, une kumira kwekufambisa kwemhepo asi iwe ungangodaro usingazivi. Muzviitiko zvakawanda, pangave pasina zviratidzo zvechirwere kana zviratidzo zvichange zvisinganyanyi kuonekwa kune zvimwe zvinokonzera. Kana iripo, zviratidzo zvinogona kusanganisira chifukidziro chinopfuurira nemuchengetedzo unooneka we sputum (musanganiswa wemaseya uye mucus). Nemhaka yezviratidzo zvishoma-grade, vanhu panguva ino havawanzodi kutsvaga kurapwa.
Bhuku 2: Moderate COPD
Negorosi 2 COPD, kupera kwako kwemhepo kunotanga kuwedzera, uye zviratidzo zveCOPD zvinova pachena. Zviratidzo izvi zvinogona kusanganisira chifukidziro chinopfuurira, kuwedzera kwekugadzirwa kweputi, uye kupererwa kwekufema pane kushandiswa kuduku. Izvi zvinowanzoita danho apo vanhu vazhinji vanotsvaka kurapwa.
Bhuku rechitatu: COPD yakanyanya
Negorosi 3 COPD, kuregererwa uye / kana kudzivirirwa kwemafasiro enyu egungwa kunooneka. Iwe uchaona kuwedzera kwezviratidzo zvakakomba, inozivikanwa seCOPD kuwedzera , uyewo kuwedzerwa nguva uye kuoma kwekukanganiswa. Kwete chete iwe unenge usisina kubvumira zvishoma kubasa rekuita, kuchava nekuneta kukuru uye chipfuva chisina kunaka.
Bhuku 4: COPD Yakanyanya
Negorosi 4 COPD, hutano hwako hwehupenyu husingave hwakakosha zvikuru nezviratidzo zvichibva pakushata kusvika kuhupenyu hunotyisidzira. Dambudziko rekushaya kuputika rakakwirira pakudini chechirwere chechina uye zvinogona kutungamirira kumatambudziko mumoyo mako, kusanganisira chirwere chinouraya chinonzi cor pulmonale .
COPD Groups
GOLD yakauya zvakare nemitungamiri yekuwedzera varwere vane COPD mumapoka akanyorwa A, B, C, kana D. Aya mapoka anotsanangurwa nekuti matambudziko anokonzerwa neCOPD akadai sekuneta, kupererwa kwemhepo, kuti zviratidzo zvakadini zvinopesana newe hupenyu hwezuva nezuva, uye huwandu hutsinye hwawakaita mugore rapera. Kushandisa zvikwereti zvose uye mapoka anogona kubatsira chiremba wako kuuya nechirongwa chakanakisisa chokurapa pane zvaunoda iwe pachako.
Boka A
Iwe wakanga usina hutsinye kana humwe huwandu hukuru hwekuwedzera hwakanga usingadi kuti ugone kupararira, mugore rapfuura. Iwe unononoka kuenzanisa kufema kwekufema, kuneta, uye zvimwe zviratidzo.
Boka B
Iwe wakanga usina kana kana imwe chete yakanyanya kukura iyo isina kudikanwa muchengeti mumakore akapfuura. Iwe unowedzera kupera kwekufema, kuneta, uye zvimwe zviratidzo.
Boka C
Iwe wakanga uine hutsinye humwe hunodiwa hutachipatara kana huviri kana humwe huwandu hwekuwedzera hunogona kana kuti husingave huchida kuti zvipatara mumakore akapfuura. Zviratidzo zveCOPD zvinyoro kuenzanisa.
Boka D
Iwe wakave nekuwedzera kwekuwedzera kwekuchengetwa kwezvipatara kana maviri kana kupfuura kuwedzeredza kana kusina kutarisirwa gore rapfuura. Zviratidzo zveCOPD zvakanyanya kuoma.
> Sources:
> Global Initiative Yezvokudya Zvisingagumi Zvirwere Zvirwere. Purogiramu Yenyika Yose yeKutsvaga, Kutungamirirwa, uye Kudzivirira Kushaya Kurapa Pulmonary Disease: 2018 Report . Yakabudiswa naNovember 20, 2017.
> Mayo Clinic Staff. COPD: Kuziva nekurapa. Mayo Clinic. Yakapedzwa musi waAugust 11, 2017.
> National Heart, Lung, uye Blood Institute. COPD. National Institute of Health. Dhipatimendi reUnited Health Health and Human Services.