Mukukuhu, madziro ari mukati memapapu anomhanya mweya anonzi alveoli anokuvadzwa, zvichiita kuti pakupedzisira aputike. Izvi zvinoita kuti pave nenzvimbo huru yemhepo panzvimbo yenzvimbo duku, zvichiita kuti nzvimbo inoshandiswa pakutsinhana kwemhepo iwedzere kudzikira.
Emphysema chirwere chemapapu chinogara kwenguva refu chinokonzera kushaya mweya. Nekufamba kwenguva, chirwere ichi chinovakuvadza madziro akapfava emapapu anomhanya mweya anonzi alveoli. Mumapapu ane hutano, aya mapapu anozunza uye anozadzwa nemhepo kana uine mweya. Mapapu ane elasticity anobatsira mhepo kubuda kana uchiita kufema. Asi kana mapapu akakuvadzwa ne emphysema, zvinonetsa kufambisa mhepo kubva mumapapu ako. Izvi hazvisi kusiya nzvimbo yemhepo itsva, ine oksijeni yakawanda kupinda mumapapu ako.
Zviratidzo zve emphysema zvinosanganisira dambudziko rekufema, kunyanya kana uchiita mabasa, uye kurira kwemhepo kana uchiita kufema. Kuomarara kwechirwere kunogona kusiyana.
Kusvuta ndicho chikonzero chikuru che emphysema. Kurapa kunogona kubatsira nezviratidzo uye kunogona kudzikisira kuti chirwere ichi chinokura nekukurumidza sei. Asi hachigone kudzorera kukuvara.
Unogona kuva ne emphysema kwemakore mazhinji usati wazivisa chero zviratidzo. Kazhinji anotanga zvishoma nezvishoma anosanganisira: Kushomeka kwemhepo, kunyanya nemabasa emuviri. Iri ndiro chiratidzo chikuru che emphysema. Kuchema, kurira kurira kana kurira kwakaita sehwhistle paunobuda mweya. Kukosora. Kuomarara kwepfupa kana kuremerwa. Kunzwa kuneta kwazvo. Kurasikirwa nehuremu nekukwira kwemabvi izvo zvinogona kuitika sezvo mamiriro acho achiwedzera nekufamba kwenguva. Ungatanga kudzivisa mabasa anokonzera kushomeka kwemhepo, saka zviratidzo hazvibude dambudziko kusvikira zvikukanganisa kuita mabasa ezuva nezuva. Emphysema pakupedzisira inokonzera dambudziko rekufema kunyangwe uri kuzorora. Emphysema imhando imwe ye mhando mbiri dzakajairika dze chirwere chekufema chinonzi chronic obstructive pulmonary disease (COPD). Imwe mhando yakajairika ndeye chronic bronchitis. Mu chronic bronchitis, lining yematubhu anokwevera mweya kumapfupa ako, anonzi bronchial tubes, anokwenya nekukura. Kuchema uku kunoderedza nzvimbo yemhepo yekufamba mukati nekunze kwemapfupa uye kunogadzira mvura yakawandisa inovhara nzira dzemhepo. Emphysema ne chronic bronchitis kazhinji zvinoitika pamwe chete, saka izwi rokuti COPD rinogona kushandiswa. Kunyangwe uine kurapwa kuri kuenderera mberi, ungave une nguva apo zviratidzo zvinova zvakanyanya kwemazuva kana mavhiki. Izvi zvinonzi kuwedzera kwakanyanya (eg-zas-er-bay-shun). Zvinogona kukonzera kukundikana kwemapfupa kana usingawani kurapwa nekukurumidza. Kuwedzera kunogona kukonzerwa nehutachiona hwekufema, kusvibiswa kwemhepo kana zvimwe zvinhu zvinokonzera kuchema. Chero chikonzero chacho, zvakakosha kuwana rubatsiro rwekurapa nekukurumidza kana ukaona kukosora kuri kuwedzera kana mvura yakawandisa, kana kana uine nguva yakaoma yeku fema. Ona nyanzvi yako yekurapa kana uine kushomeka kwemhepo kwausingakwanisi kutsanangura kwemavhiki mazhinji, kunyanya kana kuri kuwedzera kana kuri kukutadzisa kuita mabasa ako ezuva nezuva. Usazvidzora kana kuzviti ndizvo nekuti uri kukwegura kana kuti hauna muviri. Enda ku emergency department muchipatara kana: Uri kunetseka kubata mweya kana kutaura. Miromo yako kana misumari inoshanduka kuva bhuruu kana grey nemabasa emuviri. Vamwe vanoona kuti hausi wakangwara.
Ona chiremba wako kana uine kufema kusinganyanyi kwakagara kwenguva yakareba, kunyanya kana kuri kuwedzera kuipa kana kuri kukutadzisa kuita mabasa ako ezuva nezuva. Usazviregeredza kana kuzviti ndizvo zvinoitika nekuti uri kukwegura kana kuti hausi muviri. Enda kuimba rekuvhuvhuta pachipatara kana kuti:
Emphysema inokonzerwa nekutsakatika kwenguva refu kune zvinhu zvinokonzera kukwenya mumapapu, izvi zvinosanganisira:
Kakawanda, emphysema inokonzerwa nechinja chejini chinopfuudzwa mumhuri. Ichi chinja chejini chinoita kuti pave nehuwandu hushoma hwechirwere chinonzi alpha-1-antitrypsin (AAT). AAT inogadzirwa muchiropa uye inopinda muropa kuti ibatsire kudzivirira mapapu kubva kukuvara kunokonzerwa nekusvuta, utsi nehwemvura. Huwandu hushoma hweAAT, mamiriro anozivikanwa se alpha-1-antitrypsin deficiency, anogona kukonzera kukuvara kwechiropa, zvirwere zvemapapu senge emphysema kana zvose zviri zviviri. NeAAT deficiency, kazhinji kune nhoroondo yemhuri yeemphysema, uye zviratidzo zvinovamba pazera riri duku.
Kukuvadzwa kwemapapu mu emphysema kunoitika zvishoma nezvishoma. Muvanhu vakawanda vane chirwere ichi, zviratidzo zvinovamba mushure memakore makumi mana. Zvinhu zvinoita kuti uve panjodzi yekuwana emphysema zvinosanganisira:
Vanhu vane emphysema vane mukana mukuru wekuwana: Kuderera kweropa mumapapu. Emphysema inogona kukonzera kuderera kweropa mumitsinga inounza ropa kumapapu. Iyi nyaya yakakomba inonzi pulmonary hypertension. Pulmonary hypertension inogona kukonzera divi rekurudyi remwoyo kuti riwedzere uye rioneke, mamiriro anozivikanwa se cor pulmonale. Matambudziko emwoyo mamwe. Nezvikonzero zvisinganzwisisike zvizere, emphysema inogona kuwedzera njodzi yemwoyo, kusanganisira kurwisa kwemwoyo. Nzvimbo huru dzemhepo mumapapu. Nzvimbo huru dzemhepo dzinozivikanwa se bullae dzinoumbwa mumapapu apo masvingo epamukati e alveoli anoparadzwa. Izvi zvinosiya bhegi rimwe guru remhepo panzvimbo yeboka remadiki mazhinji. Aya mabullae anogona kukura zvikuru, kunyange sezhinji sehafu yemapapu. Mabullae anoderedza nzvimbo iripo yemapapu kuti atambe. Uyewo, mabullae makuru anogona kuwedzera njodzi yekudonha kwemapapu. Kuwa kwemapapu. Kuwa kwemapapu kunonzi pneumothorax kunogona kutyisidzira hupenyu muvanhu vane emphysema yakakomba nekuti mapapu avo atokuvadzwa. Izvi hazviwanzoitika asi zvakakomba kana zvikaitika. Kenza yemapapu. Vanhu vane emphysema vane njodzi yakakwira yekuwana kenza yemapapu. Kusvuta kunowedzera njodzi iyi zvakanyanya. Kusagadzikana uye kuora mwoyo. Matambudziko ekufemba anogona kukurambidza kuita mabasa aunofarira. Uye kuva nechirwere chakakomba se emphysema dzimwe nguva kunogona kukonzera kusagadzikana uye kuora mwoyo.
Kuti udzivise emphysema kana kuti zviratidzo zvisawedzere kuipa:
Spirometeri chishandiso chekurapa chinochera huwandu hwemhepo yaunokwanisa kufema mukati nekunze, nenguva yainotora kufema kunze zvizere mushure mekufema kwakadzika.
Kuti uwane kana une emphysema, chiremba wako kana mumwe mushandi wehutano anobvunza nezve nhoroondo yako yekurapa nemhuri, kusvuta, uye kana kazhinji uri pedyo nevamwe vanokonzera kukuvara kwemapapu. Mushandi wehutano wako anoita bvunzo yemuviri inosanganisira kuteerera mapapu ako. Ungave une bvunzo dze mifananidzo, bvunzo dzebasa remapapu nebvunzo dzerabhoritari.
Inonziwo bvunzo dzebasa remapapu, bvunzo dzebasa remapapu dzinoyera huwandu hwemhepo yaunokwanisa kufema mukati nekunze, uye kana mapapu ako achibudisa oksijeni yakakwana muropa rako.
Spirometry ndiyo bvunzo inonyanya kuitwa yekuongorora emphysema. Panguva yespirometry unofema mukati metubhu hombe yakabatana nechishandiso chidiki. Izvi zvinoyera kuti mapapu ako anokwanisa kuchengeta mhepo yakawanda sei uye kuti unokwanisa kubudisa mhepo kubva mumapapu ako nekukurumidza sei. Spirometry inoratidza kuti kuyerera kwemhepo kwakaderedzwa sei.
Bvunzo dzimwe dzinosanganisira kuyera huwandu hwemhepo mumapapu uye simba rekupararira, bvunzo yekufamba kwemaminitsi matanhatu, uye pulse oximetry.
Bvunzo dzebasa remapapu nemifananidzo dzinogona kuratidza kana uine emphysema. Uye dzinogona kushandiswawo kuongorora mamiriro ako nguva nenguva uye kuona kuti kurapwa kuri kushanda zvakanaka sei.
Bvunzo dzeropa hadzishandiswi kuongorora emphysema, asi dzinogona kupa ruzivo rwakawanda nezve mamiriro ako, kuwana chikonzero chezviratidzo zvako kana kubvisa zvimwe zvirwere.
Kurapa kunobva pane zviratidzo zvako zvakakomba sei uye kazhinji sei unonzwa zvirwere. Kurapa kunobudirira kunogona kudzora zviratidzo, kunononotsa kuti chirwere chichinje sei nekukurumidza, kuderedza njodzi yematambudziko nezvirwere, uye kukubatsira kurarama hupenyu hunoshanda zvakanyanya. Danho rinonyanya kukosha mune chero chirongwa chekurapa che emphysema nderekusiya kusvuta zvachose. Kusiya kusvuta kunogona kudzivirira emphysema kuti irege kuipa uye kuita kuti kufema kuome. Taura nachiremba wako nezvemaprogram ekurega kusvuta, zvigadzirwa zvekutsiva nicotine uye mishonga inogona kubatsira. Marudzi akawanda emishonga anoshandiswa kurapa zviratidzo nematambudziko e emphysema. Unogona kutora mishonga yakati wandei nguva dzose uye vamwe sezvinodiwa. Kazhinji mishonga ye emphysema inopiwa uchishandisa inhaler. Iyi mudziyo mudiki, unobatwa nemaoko unounza mushonga zvakananga kumapapu ako paunofema mukati memakore kana poda. Taura nachiremba wako kuti uzive nzira yakarurama yekushandisa inhaler yakanyorwa. Mishonga inogona kusanganisira: - Bronchodilators. Bronchodilators mishonga inowanzo kuuya mu inhalers. Bronchodilators inosunungura tsandanyama dziri kumativi emapapu ako. Izvi zvinogona kubatsira kuderedza kukosora uye kuita kuti kufema kuve nyore. Zvichienderana nekuoma kwe emphysema yako, ungada bronchodilator inoshanda nekukurumidza usati waita mabasa, bronchodilator inoshanda kwenguva refu yaunoshandisa zuva nezuva kana ese ari maviri. - Inhaled steroids. Inhaled corticosteroids inogona kuderedza kuzvimba kwemapapu uye kubatsira kuchengetedza zvirwere kuti zvisazoitika. Migumisiro inogona kusanganisira kuvhunduka, hutachiona hwemukanwa uye kuoma kwezwi. Mishonga iyi inobatsira kana iwe uine kazhinji zvirwere zve emphysema. - Combination inhalers. Inhalers dzakati dzinobatanidza bronchodilators ne inhaled steroids. Kunewo inhalers dzinobatanidza dzinosanganisira rudzi rwakawanda rwe bronchodilator. - Antibiotics. Kana uine hutachiona hwebhakitiriya, sekunge acute bronchitis kana pneumonia, antibiotics inogona kubatsira. - Oral steroids. Kune zvirwere, kosi pfupi, semuenzaniso, kwemazuva mashanu e oral corticosteroids inogona kuchengetedza zviratidzo kuti zvisaipa. Asi kushandiswa kwenguva refu kwemishonga iyi kunogona kuva nemigumisiro yakakomba, sekunge kuwedzera uremu, chirwere cheshuga, osteoporosis, cataracts uye njodzi yakakwira yekutapukirwa. - Pulmonary rehabilitation. Aya maprogram kazhinji anobatanidza dzidzo, kudzidziswa kwemuviri, mazano ekudya uye mazano. Unoshanda nevanachiremba vakasiyana-siyana vanogona kugadzirisa chirongwa chako chekurapa kuti chienderane nezvaunoda. Pulmonary rehabilitation inogona kubatsira kuderedza kufema kwako uye kukubvumira kuti uve ane simba uye kuita maekisesaizi. - Nutrition therapy. Ungabatsirwa nezano pamusoro pekudya nekushanda nemunyanzvi wekudya. Pakutanga kwe emphysema, vanhu vazhinji vanoda kuderedza uremu, nepo vanhu vane emphysema yekupedzisira vanowanzo kuwedzera uremu. - Oxygen therapy. Kana uine emphysema yakakomba ine mazinga e oxygen mashoma eropa, ungada oxygen yakawedzerwa kumba. Unogona kuwana iyi oxygen yakawedzerwa ku mapapu ako kuburikidza nemucheka kana chubhu yepurasitiki ine matipi anoenderana nemuromo wako. Izvi zvinobatanidza kutangi re oxygen. Mauniti akareruka, anotakurika anogona kubatsira vamwe vanhu kufamba zvakanyanya. Oxygen yakawedzerwa inogona kubatsira kufema kwako panguva yekuita zvemuviri uye kukubatsira kurara zvirinani. Vanhu vazhinji vanoshandisa oxygen maawa 24 pazuva, kunyangwe vari kuzorora. Oxygen therapy. Kana uine emphysema yakakomba ine mazinga e oxygen mashoma eropa, ungada oxygen yakawedzerwa kumba. Unogona kuwana iyi oxygen yakawedzerwa ku mapapu ako kuburikidza nemucheka kana chubhu yepurasitiki ine matipi anoenderana nemuromo wako. Izvi zvinobatanidza kutangi re oxygen. Mauniti akareruka, anotakurika anogona kubatsira vamwe vanhu kufamba zvakanyanya. Oxygen yakawedzerwa inogona kubatsira kufema kwako panguva yekuita zvemuviri uye kukubatsira kurara zvirinani. Vanhu vazhinji vanoshandisa oxygen maawa 24 pazuva, kunyangwe vari kuzorora. Kana zvirwere zvikaitika, ungada mishonga yakawedzerwa, senge antibiotics, oral steroids kana ese ari maviri. Ungadawo oxygen yakawedzerwa kana kurapwa muchipatara. Kana zviratidzo zvave nani, chiremba wako anogona kutaura newe nezve matanho ekutora kuti abatsire kumisa zvirwere zvenguva yemberi. Zvichienderana nekuoma kwe emphysema yako, chiremba wako anogona kukurudzira rudzi rumwe kana kupfuura rwemishonga, kusanganisira: - Lung volume reduction surgery. Mukuvhiya uku, chiremba anobvisa zvidimbu zvidiki zvetishu yemapapu yakakuvadzwa kubva kumapapu epamusoro. Izvi zvinoita nzvimbo yakawanda muchipfuva kuitira kuti tishu yemapapu ine hutano inosara igone kuwedzera uye tsandanyama inobatsira mukufema igone kushanda zvirinani. Kune vamwe vanhu, kuvhiya uku kunogona kuita kuti hupenyu hwavo huve nani uye kuvabatsira kurarama kwenguva refu. - Endoscopic lung volume reduction. Inonziwo endobronchial valve surgery, iyi ndiyo nzira isingakuvadzi yakawanda yekurapa vanhu vane emphysema. Valve diki ye endobronchial inoiswa mumapapu. Mhepo inogona kubuda muchikamu chakuvadzwa chemapapu kuburikidza ne valve, asi hapana mhepo itsva inopinda. Izvi zvinoita kuti lobe yemapapu yakakuvadzwa zvakanyanya idzikire kuitira kuti chikamu chine hutano chemapapu chive nenzvimbo yakawanda yekuwedzera uye kushanda. - Bullectomy. Nzvimbo huru dzemhepo dzinoitwa bullae mumapapu apo masvingo epamukati e alveoli anoparadzwa. Izvi zvinosiya bhegi rimwe guru remhepo panzvimbo yeboka remazhinji madiki. Aya mabullae anogona kukura zvikuru uye kukonzera matambudziko ekufema. Mu bullectomy, chiremba anobvisa mabullae kubva mumapapu kuti abvumire kuti mhepo iyerere zvakanyanya. - Lung transplant. Kusimudza mapapu kunogona kuva sarudzo kune vamwe vanhu vanosangana nezvinodiwa. Kuwana mapapu matsva kunogona kuita kuti kufema kuve nyore uye kubvumira hupenyu hunoshanda zvakanyanya. Asi kuvhiya kukuru kunova nemigumisiro yakakomba, sekunge kurambwa kwechikamu. Kuti edze kuchengetedza kurambwa kwechikamu kuti kurege kuitika, zvakakosha kutora mushonga wehupenyu hwose unoderedza immune system. Kune vakuru vane emphysema ine hukama ne AAT deficiency, sarudzo dzekurapa dzinosanganisira dzinoshandiswa kune vanhu vane marudzi akajairika e emphysema. Vamwe vanhu vanogona kurapwa nekutsivawo protein ye AAT isingawanikwe. Izvi zvinogona kumisa kukuvara kwakawanda ku mapapu.
Chiziviso: August ipuratifomu yemashoko ehutano uye mhinduro dzayo haisi zano rekurapa. Gara uchibvunza nyanzvi yezvekurapa ine rezinesi pedyo newe usati waita chero shanduko.
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