Mamiriro akaipa emhepo pamwe nepamusoro pemuviri inowanzoita kuti dutu rive rakakwana
MuMelbourne, kuAustralia, musi waNovember 21, 2016, pakange pane dutu rakanyarara. Mhepo, mvura inonaya, uye yakakwirira yemapenene inopa vanhu vanodarika 8 500 muchipatara vane chirwere chakasimba chokurwisa. Vanhu vapfumbamwe vakafa.
Vakawanda vevanhu ava avo vakava nekushungurudzwa kwakaipisisa vakanga vasina nhoroondo yemafi uye vaimbova nefivha fever. Chii chakanyatsoitika?
Chirwere chinotsanangurwa
Chirwere chinokanganisa vanhu vanosvika mamiriyoni mazana matatu pasi rose. Nhamba yevanhu vane astmma iri kuwedzera, chiitiko chakange chichibatanidzwa nekupararira kwemaguta. Kuwedzerwa kwenyika yose muhuwandu hwevanhu vane astmma pamwe nepamusoro-soro mari dzinobatanidza chirwere chacho zvakatungamirira kuongororo yakawanda kuongorora nzira dzayo uye kurapa.
Maererano neCDC, pamusoro pevamwe vekuAmerica (vanhu vanosvika mamiriyoni 25) vane asthma. Muna 2008, vanenge 50 kubva muzana veAmerica vane chirwere chekushaya chirwere vaiva nechirwere cheputi-vazhinji vavo vangadai vakadziviswa. Uyezve, muna 2007, chirwere chemafiya chakaguma chichibhadhara maAmerica $ 56 mabhiriyoni mune zvekurapa mari, kurasikirwa nemari, uye vakarasika chikoro mazuva.
Vanhu vane astmma vanowanzouya nezviratidzo panguva yevangwana. Vanenge kaviri vakomana vazhinji vane asthma. Nokuva munhu mukuru, zvisinei, chirwere chinowanikwa zvakafanana pakati pevarume nevakadzi.
Zviratidzo zveAhma zvinosanganisira magetsi, kufema, kukwezva, uye chifu chechisimba.
Asthma is syndrome yakaoma yakaratidzwa neinotevera:
- kuvharidza kwepakati pemhepo
- rudzi rukuru rwekuvhuvhuta kwemhepo
- bronchospasm, kana kuti spasm yemusero unotapira mumasvingo ematavi maduku emugwagwa, iyo inotungamirira kukuderedza kwenguva pfupi.
Chinhu chinonyanya kukonzera kukanganisa kwechirwere chemafi isopy .
Atopy inowanzoita zvirwere zvinokonzera zvirwere zvinokonzerwa nehutachiona asi kwete yea-asthma asiwo yeergic rhinitis uye atopic dermatitis. Nyaya, inokonzera rhinitis inowanzonzi hay fever uye atopic dermatitis i eczema . Vanhu vane ruzivo rwezvemapurisa vakagadzirisa zvirwere zvekudzivirira mafungiro kune zvinowanikwa zvinowanikwa munzvimbo dzakasviba, zvakadai semapenene, chimiro, uye zvimwe zvokudya.
Zvimwe zvinokonzera zvinogona kutungamirira kumhepo yekuvhiringidza uye kuputika kwechirwere. Izvi zvinokonzera zvinosanganisira zvinotevera:
- allergens (semuenzaniso, mapureni)
- utachiona hwehutachiona (semuenzaniso, rhinovirus)
- kurovedza muviri
- kutonhora mhepo
- kuseka
- weather change
- mishonga (semuenzaniso, β-blockers)
- kushandiswa kwebasa
- GERD
- kudya
Chiremba anokwanisa kuongororesa asthma inobva munhoroondo yezvokurapa, kuongororwa kwepanyama, uye spirometry. Spirometry chirwere chokuongororwa chakaitwa muhofisi, iyo inoyera huwandu hwemhepo yaunoshandisa, uwandu hwemhepo yaunotora, uye nguva inokutora iwe kuti uende.
Chirwere chinowanzotarisirwa nechiremba mukuru wekuchengeta. Kurapa kweAphma kunoenderana nezvinodiwa nomunhu uye kunobva pane zvimwe zvinhu, kusanganisira zvinokonzera, mharidzo, nhoroondo, uye kupindura kurapwa.
Heano mavariro ekurapwa kwechirwere:
- kudzivirira kana kuderedza chirwere cheputi
- kudzora zviratidzo
- kubvisa kushanya kune imwe nzvimbo yepamhanho
- kuchengetedza mabasa ehupenyu hwezuva nezuva
- kuderedza usiku-nguva inowedzera (usiku hwemazuva)
- ramba uine maitiro
- kuchengeta zvakanaka mapapu ekushanda
- kuderedza zvakaipa zvakaipa zvemishonga
Vanhu vazhinji vane astmma vanotora mishonga ne inhaler. Inhaled corticosteroids inoshandiswa kwenguva refu yekudzora mweya. Kuchenjerera uye kushandiswa kwepakati pekushandiswa kwenguva refu-β2-agonists kunogona kubatsirawo. Inhaled short-acting β2-agonists se albuterol inogona kushandiswa pakununurwa nekukurumidza.
Mushure mekuedzwa, muromo corticosteroids, albuterol nebulizer kurapwa, nezvimwe zvakadaro zvinogona kushandiswa kurapa kuputika kwechirwere.
Izvo zvakananga zvehutano zvinoenderana nekuoma. Kurwiswa kwehupenyu hunokonzerwa nekupatara kune ICU.
Mheni inonzwika seChirwere cheAphma
Kunyangwe zvazvo Melbourne chirwere chemafi munaNovember 2016 chaiva chakanyanya kuitika, kutinhira kwemhepo kwakaunza zvirwere zvakafanana mumaguta akawanda munyika yose kusanganisira Naples neLondon. Nyaya, nokuti Australia yose iri kumaodzanyemba kweHemisphere uye munzvimbo yeAustralia inotonhora, chitubu chinoitika pakati peSeptember naNovember.
Munguva dzenguva apo pane zvakawanda zvepenene mumhepo, sechitubu, mapurisa emadonzvo anotinhira anogona kutakura iyi mbesa pasi. MuUnited States, zvakananga zvezvenyeredzi nguva zvinowanzoenderana nenharaunda, asi inogona kutanga munaFebruary uye inowedzera kusvika pakutanga kwezhizha. Uyezve, kutonhora kwechando kunogona kukonzera mbeu kuti dzipe maperembudzi mangwanani, uye nguva zhinji mvura yechando inogona kutungamirira kukura kwekukura nokukurumidza uye kuwedzerwa kweganda.
Kazhinji, mapureni haapindi mumhepo yakadzika yemapapu. Zvisinei panguva yemvura yemamiriro emvura, mapepa anokwira mvura uye kuputika nenzira inonzi osmosis. Izvo zvipembenene zvemapenene zvinoshandiswa uye zvinopinda mazinga ezasi emapapu. Mune vanhu vanokonzerwa nemapenene, kubudiswa uku kunogona kukonzera kuputika kwechifu uye dzimwe nguva kufa.
Maminitsi makumi maviri kana makumi matatu emvura yemvura inonyanya kutyisa kune avo vane chirwere chepemeneni uye zvinogona kutungamirira kuhutachiona kurwisa kunyange kune avo vasina kumbobvira vaine imwe uye vane hay fever. Pamusoro pemvura uye mhepo yemheni, zvimwe zvinhu zvakadai semheni (magetsi mumhepo) uye kutonhora zvinogonawo kuita basa mumhepo inokonzerwa neyemhepo inonzi asthma exacerbation. Kunyanya, mishonga yemagetsi inogona kupindira kupera kwemapenene.
Dzimwe nyanzvi dzinonetseka kuti kutinhira kunogona kuva dambudziko rehutano hwevanhu kune avo vane fever fever uye vari pamwe kana vasina vasina mafi. Iko kuwedzera kwepenene iri kuwedzera, uye kuchinja kwemamiriro ekunze kuri kuita kutinhira kwemhepo uye zvimwe zviitiko zvinonaya zvinowanzoonekwa.
Mushure mokuita tsvakurudzo yakawanda, nyanzvi dzinogona kukwanisa kutanga zvirongwa zvekunyevera kuti vaudze avo vane mishonga yepamusoro pamusoro pekugona kwemhepo inokonzerwa nedutu rine simba. Yunivhesiti yeGeorgia vatsvakurudzi vari kutsvaga sarudzo iyi.
Mune chinyorwa chakanzi "Kutinhira Kwakafanana Nezvokurwisana neHurma," D'Amato uye vanyori vanyori vanyore:
Mharidzo yekutora kumusha ndeyokuti varwere vanobatwa nemapenene zvinokonzerwa nemararamiro vanofanira kunge vakangwaririra njodzi yekuve kunze kwekunaya kwemheni munguva yepenene. Nyevero inofanira kupiwa munguva yepenene kusvika kune varwere vane hanya nevarwere.
Kunyanya, inogona kunge iri pfungwa yakanaka kune avo vane mishonga yemapureni yekugara mumba uye vanochengetedza mahwindo akapfigwa panguva yemheni inowanika munguva yemaruva.
> Sources:
> Asthma. Family Practice Notebook. http://www.fpnotebook.com
> Nyota Kuwedzera. Family Practice Notebook. http://www.fpnotebook.com.
> Barnes PJ. Asthma. Muna: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e New York, NY: McGraw-Hill; 2014.
> D'Amato, G, et al. Kutinhira-Kunokonzerwa Nehutachiona hweHurma. The Journal of Allergy and Clinical Immunology. 2017.
> Usmani OS, Barnes PJ. Chirwere chepamuviri: Clinical Presentation and Management. Mu: Grippi MA, Elias JA, Fishman JA, Kotloff RM, Pack Pack AI, Senior RM, Siegel MD. eds. Fishman's Pulmonary Diseases and Disorders, Fifth Edition New York, NY: McGraw-Hill; 2015.