Kupisa kunopesana sezvo mapapu ako ari kushoma
Kuguma-chiitiko chronic obstructive chirwere cheplm (COPD) chinoreva kuva mumatanho ekupedzisira echirwere. Izvi zvinoreva kuti munhu ane uwandu hwekufema kwakanyanya kunyange kana achizorora uye ari pangozi yakakura yezvipembenene zvepapu uye kusaputsika kwekuputika. Vanhu vazhinji vanoshamwaridzana neshoko rokuti "kuguma-gadziriro" nekufa kwekufa kana guva kuremara kunotungamirira kurufu.
Asi izvi hazvisi nguva dzose.
Tsanangudzo
Nenzira, "kuguma-gadziriro" inoreva "chikamu chekupedzisira munguva yezvirwere zvinopfuurira." Vamwe vanhu vanofunga kuti izwi iri rinoshandiswa kune murwere apo vanopa utano hwehutano vanonzwa kuti vakaita zvose zvavanokwanisa kuita mushonga kune murwere. Asi pane kazhinji nguva dzose chimwe chinhu chinopa vashandi vanogona kurapa varwere vane chirwere chisingaperi chisingabvumirwe chepodemoni ( COPD ). Zvinogona kungoreva kuti zvinangwa zvekutarisira zvakashanduka, kubva pakurapa chirwere kupa kupa nyaradzo.
Maererano ne Global Initiative for Obstructive Lung Disease (GOLD), kune zvikamu zvina zveCOPD :
- Nhanho I: Mucheche COPD. Mhemberero inotanga kumira asi iwe unogona kusazviona.
- Nhanho II: Yakawandisa COPD. Zviratidzo zvinopfuurira, nekufema kwekufema kunowedzera pakuedza.
- Danho III: Yakanyanya COPD. Kupfupika kwefema kunowedzera kuipa uye kuwedzera kweCOPD kwakajairika.
- Nhanho IV: COPD Yakanyanya. Unhu hwehupenyu hwakakosha. Kuwedzera kweCOPD kunogona kuisa upenyu pangozi.
Chikamu chimwe nechimwe chinotsanangurwa maererano ne spirometry chiyero cheFiV1 (iyo yakawanda yemhepo yakafuridzirwa mumutsara wokutanga mushure mekudzora mweya). Mugumo-gadziriro COPD inhanho IV kana kuti yakanyanya zvikuru COPD.
Nepo vamwe vari munharaunda iyi vane chirwere chakakomba, pane vamwe vasina. Iboka ripi raunowira naro rine chokuita nezvinhu zvakasiyana-siyana zvinokonzera kutarisira kweupenyu hweCOPD kusanganisira fodya yako, nhamba yako yedyspnea (kukurumidza kufema), hutano hwehutano, uye chikafu chekudya.
Vamwe vanhu muchitambo chechina vanogona kukwanisa kuita zvakanaka chaizvo nezvishoma zvishoma. Kune rumwe rutivi, panewo vanhu vakawanda pane iri danho avo vanorwara zvikuru.
Kurapa
Kunyange zvazvo kupindira kwekuvhiya kungava sarudzo (somuenzaniso, bullectomy, mapapu ekuderedza kupera kwepamusoro, kana kupemwa kwemapapu), zvichida kungobatsira chete nhamba duku yevarwere veCOPD.
Kune vamwe, sezvo kuoma kwechirwere chavo kuchiwedzera, chinangwa chekurapa chinotanga kuchinja kubva pakuwedzera hupenyu hunoita kuti pave nehanya nekutarisira kubvisa zviratidzo zveCOPD .
Nezvo, kana uri kutarisana nechiratidzo chekupedzisira kweCOPD, chiremba wako anogona kupa mishonga inotevera:
- Bronchodilators: Zvose zvenguva pfupi uye zvinoita kwenguva refu zvinonzi bronchodilators zvinokurudzirwa kana kukurumidza kufema mukati memabasa nguva dzose hakubvumiri nevanoshandisa bhatinaratidzi venguva pfupi chete.
- Opiates: Morphine, kunyanya, inogona kuchinja zvakanyanya kufema. Zvisinei, dzimwe dzidzo dzinoratidza kuti dzinogona kuva nemigumisiro yakakomba uye kuti inobatsira chete nhamba yakasarudzwa yevarwere.
- Inhaled glucocorticoids: Izvozvo zvinogona kutarisirwa kune varwere vane FEV1 pasi pe50 muzana yehuwandu hunofanirwa uye nhoroondo yekudzokororwa kwakawanda kweCOPD .
- Supplemental oksijeni: Oxygen inoderedza kusuruvara kunokonzerwa nebasa uye inovandudza kurovedza muviri kushivirira kune varwere vane uwandu hwemhepo yakadzika.
- Noninvasive positive pressure ventilation (NIPPV): Nzira dzisina kuvharwa dzisina kupisa dzinogona kuderedza carbon dioxide kuchengetedza nekuvandudza kupfupika kwemhepo mune vamwe varwere, asi haisi nguva dzose inokurudzirwa.
- Kuvandudzwa kwepulmonary: Izvi zvakaratidza kuti zvinobatsira varwere veCOPD pamatanho ose echirwere chacho.
- Kupa mazano ekurovedza muviri: Izvi zvingave zvinoratidzirwa nokuti kusadya kwezvokudya zvinovaka muviri ndeyekunyanya kunetseka mumagumo ekupedzisira eCOPD uye kunowedzera dambudziko rekufa.
- Kugutsikana kwepfungwa nehutano: Izvi ndizvo zvinokosha pakurapa nokuti varwere vazhinji havasi kurondedzera nyaya yekupedzisira-yehupenyu nevanachiremba.
- Mishonga inobatanidza: Relaxation uye maitiro ekuratidzira, kurapa kurapa, uye mimhanzi inorapwa nemitambo inorarama, CD, kana redhiyo inogona kubatsira kugadzirisa zviratidzo sekupererwa kwemhepo.
End-of-Life Issues
Kana iwe uchitenda kuti rufu rwemudiwa runosvika nekuda kweCOPD, inguva yekubata nekutarisira matambudziko ekupedzisira-ehupenyu. Zvisinei, izvi zvinogona kunge zvakaoma zvakaoma nekuda kwechimiro chinokanganisa chechirwere chinopisa chirwere chepemmonic.
Kuomesa nyaya, kutsvakurudza kwakaratidza kuti pasinei nekubatana kweCOPD nekuremara kwakakomba nekufa kusati kwasvika, varwere veCOPD vachiri kugamuchira kusagadzikana kuguma-kwe-hupenyu hwekutarisira. Nokuda kwezvikonzero izvi, iwe nemhuri yako ungada kufungidzira kubhadhara rubatsiro rwekuchengetedzwa kwekutarisira kukutungamirira munguva ino.
Chiratidzo chekushanda ndechimwe chezvinhu zvakakosha zvekuguma kwehupenyu nekuda kwekuti zviratidzo zveCOPD zvinowanzowedzera mumazuva ekupedzisira-kunyanya, dyspnea uye kuora , kurwadziwa, kuzvidya mwoyo uye kuora mwoyo, kuvhiringidzika, anorexia, uye cachexia .
Pasi pose, kuguma kwoupenyu hwemunhu kunogona kuva nguva yekufungisisa zvakadzama kune vose varwere nemhuri. Inogonawo kuva nguva yekusuwa kukuru. Yeuka kuti zviratidzo zvisiri nyore zvakadai sekubata ruoko rwomudiwa wako uye kuvapo zvinogona kukupa kunyaradza kukuru.
Kudzokorora End-Stage COPD
Kana chirwere chacho chisati chichifambira mberi, kune mararamiro akawanda emararamiro ayo munhu anogona kuisa mararamiro ehupenyu kuti ave nehutano hwakanaka .
- Rega Kusvuta: Kusvuta kusvuta kunoramba kuri imwe chete inonyanya kukosha, nzira inobatsira yekudzivirira nekubata COPD. Kana chinangwa chako kuti uchinzwe zviri nani, kunonoka kufambira mberi kwechirwere, uye kurarama kwenguva yakareba, saka iwe unofanirwa kutaurira kusvuta fodya kamwe chete.
- Kudzidzira: Kunze kwokusiya kusvuta, kana iwe uchizoita mararamiro ehupenyu humwe mushure mekuonekwa kweCOPD iyo ichave yakakosha zvikuru muupenyu hwako, chimbofunga chirongwa chezuva nezuva.
- Idya Utano: Ikudya kwakanaka kunofanirwa kuva nheyo yaunotangira rwendo rwako mushure mekunyatsoongorora chirwere cheCOPD, kana kuti kana wakamboonekwa kwemakore uye uchida kuchinja mararamiro akanaka kuti akubatsire kunzwa uri nani. Icho chikamu chinokosha chepurogiramu yehutano hwehutano uye inopa avo vane COPD simba rinokosha ravanoda kufema nekurwisa utachiona.
- Ramba Wakanaka: Mumwe munhu akambotaura kuti hupenyu ndeyegumi muzana zvinoitika kwauri uye 90 muzana zvaunoita pamusoro payo. Kuramba uine humwe hwakanaka mukati mehutano husingaperi hutachiwana hwakaoma, asi hazvibviri. Izvo zvose pamusoro pekuvandudza dzimwe nzira itsva dzekutarisana dzichaenderana nemararamiro ako.
Shoko Rinobva
Kunzwisisa kuguma-shanduka COPD uye zvaunogona kuita kuti uzvidzivirire pakuenda ikoko unotanga nekutora nguva yakareba, kuzvitarisa pachako uri muchioni uye uchizvibvunza mubvunzo umwechete: "Ndiri kukoshesa here?" Munhu uyo anotarisa kumashure kwauri achavimba kuti anonyemwerera shure uye anopindura, "hongu."
Sources:
> Ambrosino N, Gherardi M, Carpenè N. End-Stage Chronic Obstructive Pulmonary Disease. Pneumonol Alergol Pol. 2009; 77 (2): 173-9.
> Vestbo J, Hurd SS, Agustí AG, et al. Global Strategic for diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine . 2013; 187 (4): 347-365. doi: 10.1164 / rccm.201204-0596pp.