Emphyema

Kwisifo se-emphysema, izindonga ezingaphakathi zezakhiwo ze-alveoli zomoya emaphaphwini ziyonakala, okubangela ukuthi ekugcineni ziqhekeke. Lokhu kwenza indawo enkulu yomoya esikhundleni sezindawo ezincane, futhi kunciphisa indawo ebonakalayo yokushintshana komoya. I-emphysema yisimo sempilo eside se-lung esibangela ukuphefumula kanzima. Ngokuhamba kwesikhathi, lesi simo siyonakalisa izindonga ezinqunu zezakhiwo zomoya emaphaphwini ebizwa nge-alveoli. Emaphaphwini aphilile, lezi zakhiwo ziyolula futhi zigcwaliswe umoya uma uphefumula. Izakhiwo ezithambile zisiza umoya ukuthi uphume uma uphefumula. Kodwa uma izakhiwo zomoya ziyonakala kwi-emphysema, kunzima ukususa umoya emaphaphwini akho. Lokhu akusishiyeli indawo yomoya omusha, ocebile nge-oksijini, ukuthi ungene emaphaphwini akho. Izimpawu ze-emphysema zihlanganisa ubunzima bokuphumula, ikakhulukazi ngenkathi usebenza, kanye nomoya oshushumbayo uma uphefumula. Ubunzima besimo singahlukahluka. Ukubhema yisona sizathu esiyinhloko se-emphysema. Ukwelashwa kungasiza ngezimpawu futhi kunganciphisa ukuthi lesi simo sibe sibi kangakanani. Kodwa akukwazi ukubuyisela umonakalo.

Ungaba ne-emphysema iminyaka eminingi ngaphandle kokuthi uqaphele noma yiziphi izimpawu. Ngokuvamile ziqala kancane kancane futhi zihlanganisa: Ukuphefumula okufushane, ikakhulukazi ngemisebenzi yomzimba. Lena yiyona nto ebaluleke kakhulu yesimptome se-emphysema. Ukukhwehlela, umsindo wokukhwehlela noma wokukhishwa lapho uphefumula. Ukukhwehlela. Ukuqina noma ukukhulu kwesifuba. Ukuzizwa ukhathele kakhulu. Ukwehla kwesisindo nokuvuvukala kwezinyawo okungase kwenzeke njengoba isimo siqhubeka sibe sibi ngokuhamba kwesikhathi. Ungaqala ukugwema imisebenzi ebangela ukuba uphefumule kancane, ngakho izimpawu azibi yinkinga kuze kube yilapho zikuvimbela ekwenzeni imisebenzi yansuku zonke. Ekugcineni i-emphysema ibangela ubunzima bokuqeda umoya ngisho nalapho ukhululekile. I-emphysema ingenye yezinhlobo ezimbili ezivamile zesifo sokuphefumula esiqhubekayo (COPD). Olunye uhlobo oluvamile yi-bronchitis eqhubekayo. Ku-bronchitis eqhubekayo, ukugqoka kwemiyenge ethatha umoya emaphaphwini akho, okuthiwa yi-bronchial tubes, kuqala futhi kuqina. Le ntshukumo ibeka umkhawulo endaweni yomoya ukuze uhambe ngaphakathi nangaphandle kwamaphaphu futhi yenza i-mucus eyengeziwe evikela izindlela zokuphefumula. I-emphysema ne-bronchitis eqhubekayo ngokuvamile zenzeka ndawonye, ngakho igama elithi COPD lingase lisetshenziswe. Ngisho nokwelashwa okuqhubekayo, ungaba nezimo lapho izimpawu zibe sibi khona izinsuku noma amasonto. Lokhu kubizwa ngokuthi ukwanda okukhulu (eg-zas-er-bay-shun). Kungase kube yimbangela yokwehluleka kwamaphaphu uma ungatholi ukwelashwa okusheshayo. Ukwanda kungase kubangelwe yisifo sokuphefumula, ukungcoliswa komoya noma ezinye izinto ezibangela ukuvuvukala. Kungakhathaliseki ukuthi yini imbangela, kubalulekile ukuthola usizo lwezokwelapha ngokushesha uma uqaphela ukukhwehlela okuqhubekayo noma i-mucus eyengeziwe, noma uma kunzima ukuqeda umoya. Bheka ochwepheshe bakho bezempilo uma ube nokuphefumula okufushane ongakwazi ukuchaza izinyanga eziningi, ikakhulu uma kuya kubi noma uma kukuvimbela ekwenzeni imisebenzi yakho yansuku zonke. Ungakwenqabi noma uzitshele ukuthi kungenxa yokuguga noma ukungabi semthethweni. Hamba e-emergency department esibhedlela uma: Kunzima ukuqeda umoya noma ukukhuluma. Izindebe zakho noma iinzipho zakho zibe luhlaza okwesibhakabhaka noma oluhlaza okumnyama ngemisebenzi yomzimba. Abanye baqaphela ukuthi awuhloniphanga.

Bona udokotela wakho uma uhlushwa ukuphefumula okunzima ongakwazi ukuchaza izinyanga eziningi, ikakhulu uma kubi kakhulu noma uma kukuvimbela ekwenzeni imisebenzi yakho yansuku zonke. Ungakwenqabi noma uthi kungenxa yokuguga noma ukungabi semthethweni. Hamba eSigulwini esiphuthumayo esibhedlela uma:

• Kunzima ukuthatha umoya noma ukukhuluma.
• Izindebe zakho noma iinzipho zakho ziyaba luhlaza okwesibhakabhaka noma oluhlaza okumnyama uma usebenza ngokomzimba.
• Abanye babona ukuthi awunalo uqaphelo oluhle lwengqondo.

I-emphysema ivela ekubeni isikhathi eside kudalwe izinto ezicasulayo emoyeni, okuhlanganisa:

• Ukubhema ugwayi, okuyimbangela evamile kunazo zonke.
• Umoya wezinto ezikhiqizwayo, ikakhulukazi endaweni yokusebenza.
• Imimoya kanye nothuli, ikakhulukazi endaweni yokusebenza.

Ngokwengxenye, i-emphysema ivela ekuguqukeni kwe-jini elidluliselwa emindenini. Leli guquko le-jini liholela emazingeni aphansi we-proteni ebizwa nge-alpha-1-antitrypsin (AAT). I-AAT yenziwa e-liver futhi idluliselwa egazini ukuze isize ekuvikeleni amaphaphu ekubhujisweni okubangelwa ukubhema, umoya wezinto ezikhiqizwayo nothuli. Amazinga aphansi e-AAT, isimo esibizwa ngokuthi ukushoda kwe-alpha-1-antitrypsin, kungaholela ekubhujisweni kwe-liver, izimo zamaphaphu ezinjenge-emphysema noma kokubili. Ngokushoda kwe-AAT, ngokuvamile kube khona umlando womndeni we-emphysema, futhi izimpawu ziqala ebuntwaneni.

Ukuphazamiseka kwamaphaphu emphysema kuqhubeka kancane kancane. Kubantu abaningi abane leli gciwane, izimpawu ziqala ngemva kweminyaka engu-40.

Izinto ezandisa ingozi yakho yokuthuthukisa i-emphysema zifaka:

• Ukubhema. Ukubhema isigarethi noma ukubhema esikhathini esidlule yiyona ingozi enkulu kakhulu ye-emphysema. Kodwa abantu ababhema i-cigars, izikhalazo noma i-marijuana nabo baphazanyiswa. Ingozi yazo zonke izinhlobo zababhemi iyanda ngenani leminyaka yokubhema kanye nenani le-tobacco ebhemiwe.
• Ukuba eduze nomusi wesibili. Umsuzi wesibili yilowo muthi owuphefumula ovela esigarethini, esikhaleni noma esigarethini somuntu. Ukuba eduze nomusi wesibili kukhuphula ingozi yakho ye-emphysema.
• Ukukhishwa emsebenzini ezinthongweni, ezinthongweni noma othulini. Uma uphefumula izinongo noma izinongo ezivela emakhemikhali athile noma uthuli oluvela e-grain, ikotini, emakhazeni noma imikhiqizo yemigodi, cishe uzothuthukisa i-emphysema. Le ngozi iyanda kakhulu uma ubhema futhi.
• Ukukhishwa ukungcoliswa kwangaphakathi nangaphandle. Ukuphefumula izinto ezingcolisayo ezingaphakathi, njengezinongo ezivela ezinthongweni zokufudumeza, kanye nezinto ezingcolisayo ezingaphandle, njenge-smog noma ukukhishwa kwezimoto, kukhuphula ingozi yakho ye-emphysema.
• I-Genetics. Isimo esingavamile esibizwa nge-AAT deficiency sikhuphula ingozi ye-emphysema. Ezinye izinto zofuzo zingenza ababhemi abathile babe nomkhuba wokuthola i-emphysema.

Abantu abane-emphysema banesigameko esikhulu sokukhula: Izinga eliphezulu legesi legazi emathanjeni ephunga. I-emphysema ingabangela ingcindezi ephakeme yegazi emathanjeni athatha igazi liye emaphaphwini. Lesi simo esibucayi sibizwa ngokuthi yi-pulmonary hypertension. I-pulmonary hypertension ingabangela uhlangothi lwesokudla lenhliziyo ukuba lukhule futhi buthakathaka, isimo esibizwa ngokuthi yi-cor pulmonale. Ezinye izinkinga zenhliziyo. Ngezizathu ezingaqondakali ngokugcwele, i-emphysema ingandisa ingozi yesifo senhliziyo, kufaka phakathi ukuhlaselwa yinhliziyo. Amasango amakhulu emoya emaphaphwini. Amasango amakhulu emoya abizwa ngokuthi yi-bullae akha emaphaphwini lapho izindonga zangaphakathi ze-alveoli zibhujiswe. Lokhu kushiya isikhwama esisodwa esikhulu somoya esikhulu kunokubuthana kwabaningi abancani. Le bullae ingaba khulu kakhulu, ngisho nangaphezulu kwengxenye yephunga. I-bullae incipha isikhala esitholakalayo ukuze iphunga likhule. Futhi, i-bullae enkulu ingandisa ingozi yephunga eliwa phansi. Iphunga eliwa phansi. Iphunga eliwa phansi elibizwa ngokuthi yi-pneumothorax lingaba yingozi eyingozi kubantu abane-emphysema ebuhlungu ngoba amaphaphu abo aselimale. Lokhu akuvamile kodwa kubalulekile lapho kwenzeka. Umgogodla wephunga. Abantu abane-emphysema banengozi enkulu yokuthola umgogodla wephunga. Ukubhema kukhuphula le ngozi nakakhulu. Ukukhathazeka nokucindezeleka. Izinkinga zokuphefumula zingakuvimbela ekwenzeni imisebenzi oyithandayo. Futhi ukuba nesimo sezokwelapha esibuhlungu njenge-emphysema ngezinye izikhathi kungabangela ukukhathazeka nokucindezeleka.

Ukuvimbela i-emphysema noma ukuvimbela izimpawu ezingabi zimbi kakhulu:

• Ungabhemi. Xoxa nodokotela wakho mayelana nezinketho zokuyeka ukubhema.
• Gwema ukubhema okusecondhand.
• Gqoka isigqoko esikhethekile noma sebenzisa ezinye izindlela zokuvikela amaphaphu akho uma usebenza nezikhiye zekhemikhali, ukufuma noma uthuli.
• Gwema ukubhema okusecondhand kanye nokungenwa komoya oyingcolile uma kungenzeka.

I-spirometer iyithuluzi lokuxilonga elilinganisa inani lomoya ongalukhefumula ungene uphume kanye nesikhathi esithathayo ukukukhefumula ngokuphelele ngemva kokukhefumula ngokujulile.

Ukuthola ukuthi une-emphysema yini, udokotela wakho noma omunye ochwepheshe wezokunakekelwa kwezempilo ubuza ngomlando wakho wezokwelapha nowomndeni, ukubhema, nokuthi uhlale eduze kwabanye abaphefumuleli bomoya. Ochwepheshe bakho bezempilo benza ukuhlolwa komzimba okuhlanganisa ukulalela amaphaphu akho. Ungase ube nezivivinyo zezithombe, izivivinyo zomsebenzi wamaphaphu kanye nezivivinyo zelebhu.

• Isithombe se-X-ray sesifuba. Lo mvivinyo ungase ubonise ezinye izinguquko zamaphaphu ezingelwe yi-emphysema. Ungase futhi ukhiphe ezinye izimbangela zezimpawu zakho. Kodwa i-X-ray yesifuba ingase ingabonisi izinguquko ngisho noma une-emphysema.
• Ukuhlolwa kwe-computerized tomography (CT). Ukuhlolwa kwe-CT kuhlanganisa izithombe ze-X-ray ezithathwe ngezindlela eziningi ezahlukene ukudala izithombe zezakhiwo ezingaphakathi komzimba. Ukuhlolwa kwe-CT kunikeza imininingwane eminingi kakhulu yezinguquko emaphaphwini akho kunokuhlolwa kwe-X-ray yesifuba. Ukuhlolwa kwe-CT kwamaphaphu akho kungabonisa i-emphysema. Kungasiza futhi ekubeni unqume ukuthi ungase uzuze ekusebenzeni. Ukuhlolwa kwe-CT kungasetshenziswa ukuhlola umdlavuza wamaphaphu futhi.

Kubizwa nangokuthi izivivinyo zomsebenzi wamaphaphu, izivivinyo zomsebenzi wamaphaphu zilinganisa inani lomoya ongalukhefumula ungene uphume, nokuthi amaphaphu akho anikeza oksijini olukhulu kangakanani egazini lakho.

I-Spirometry yivivinyo eliqhelekile kakhulu lokuxilonga i-emphysema. Phakathi ne-spirometry uqhekeza etyubeni elikhulu elixhunyiwe kumshini omncane. Lokhu kuqapha ukuthi amaphaphu akho angagcina kangakanani umoya nokuthi ungaqhekeza kangcono kangakanani umoya emaphaphwini akho. I-Spirometry ibonisa ukuthi umoya omningi uvinjelwe kangakanani.

Ezinye izivivinyo zihlanganisa ukulinganiswa kwamavolumu amaphaphu namandla okuhambisa, ukuhlolwa lokuhamba imizuzu emihlanu, kanye ne-pulse oximetry.

Izivivinyo zomsebenzi wamaphaphu kanye nezivivinyo zezithombe zingabonisa ukuthi une-emphysema yini. Futhi zingasetshenziswa ukuhlola isimo sakho ngokuhamba kwesikhathi nokuthi ukwelashwa kusebenza kahle kangakanani.

Izivivinyo zegazi azisetshenziswa ukuxilonga i-emphysema, kodwa zingase zinikeze ulwazi oluthe xaxa ngesimo sakho, zithole imbangela yezimpawu zakho noma zikhiphe ezinye izimo.

• Uhlalutyo lwegesi legazi le-Arterial. Lo mvivinyo wegazi uqapha ukuthi amaphaphu akho athatha oksijini kangcono kangakanani egazini lakho futhi asuse ikhabhoni dayoksidi.
• Ukuhlolwa kokuntuleka kwe-AAT. Izivivinyo zegazi zingatshela ukuthi une-gene change elidluliselwe emindenini ebangela isimo sokuntuleka kwe-alpha-1-antitrypsin.