Yini i-Methacholine: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Methacholine iyimithi esetshenziselwa ngqo ukuhlolwa kokuphefumula, hhayi ukwelapha noma yisiphi isimo. Kuyinhlanganisela eyenziwe ngamachiza enciphisa okwesikhashana imigudu yakho yomoya ukusiza odokotela ukuthi bathole i-asthma nezinye izinkinga zokuphefumula. Cabanga ngayo njengethuluzi lokuxilonga elisiza ukudalula ukuthi amaphaphu akho azwela kangakanani ezintweni ezithile ezibangela ukucasuka.

Yini i-Methacholine?

I-Methacholine iyikhemikhali eyenziwe ngumuntu elingisa into yemvelo emzimbeni wakho ebizwa nge-acetylcholine. Uma uyihogela ngesikhathi sokuhlolwa kwezokwelapha, ibangela ukuthi imigudu yakho yomoya iqine kancane. Lokhu kusabela okulawulwayo kusiza odokotela ukuthi babone ukuthi amaphaphu akho asabela kanjani ezintweni ezicasulayo.

Lo muthi uza njengempushana exutshwe nesixazululo se-saline futhi iguqulwe ibe yinkungu enhle. Uzohlangana ne-methacholine kuphela ehhovisi likadokotela noma endaweni yasesibhedlela ngesikhathi sokuhlolwa okukhethekile kokuphefumula okubizwa ngokuthi ukuhlolwa kwe-methacholine challenge. Akukaze kunqunywe ukuthi isetshenziswe ekhaya noma ekwelashweni okuqhubekayo.

Isetshenziselwani i-Methacholine?

I-Methacholine isetshenziselwa kuphela ukuxilonga izimo zokuphefumula, ikakhulukazi i-asthma. Lolu hlolojikelele lusiza odokotela ukuthi banqume ukuthi ngabe unokuzwela ngokweqile kwemigudu yomoya, okusho ukuthi imigudu yakho yomoya isabela ngamandla kakhulu ezintweni ezibangela ukucasuka. Lolu lwazi lubalulekile lapho izimpawu zakho zingacacile noma lapho imiphumela yokuhlolwa ejwayelekile yokuphefumula ibuyela kokujwayelekile.

Udokotela wakho angase ancome lolu hlolojikelele uma unezimpawu ezinjengokukhwehlela okungapheli, ukuphefumula kanzima, noma ukuqina kwesifuba kodwa imiphumela yokuhlolwa engacacile. Inselelo ye-methacholine ingasiza futhi ukuhlukanisa phakathi kwe-asthma nezinye izimo ezibangela izimpawu ezifanayo. Ngezinye izikhathi isetshenziselwa ukuqapha ukuthi ukwelashwa kwe-asthma kusebenza kahle kangakanani ngokuhamba kwesikhathi.

Isebenza kanjani i-Methacholine?

IMethacholine isebenza ngokubopha kuma-receptors athile emsipheni wakho womoya obizwa ngokuthi ama-receptors e-muscarinic. Uma inamathisela kula ma-receptors, ibangela ukuthi imisipha ebushelelezi ezungeze imigudu yakho yomoya iqine, okwenza imigudu yomoya ibe mncane. Lokhu kuyisimo sesikhashana nesilawulwayo esivame ukuthatha imizuzu embalwa.

Umuthi uthathwa njenge-ejenti ephakathi nendawo yokucasula i-bronchial. Inamandla ngokwanele ukubangela ukusabela okulinganisekayo emoyeni ozwelayo kodwa ithambile ngokwanele ukuthi isetshenziswe ngokuphepha ekuhlolweni kwezokwelapha. Umphumela uyaguquleka ngokuphelele, futhi imigudu yakho yomoya ibuyela esimweni esijwayelekile lapho umuthi ususuka emzimbeni wakho.

Ngingayithatha kanjani i-Methacholine?

Awuzithatheli wena i-methacholine - ihlale inikezwa ochwepheshe bezokwelapha abaqeqeshiwe ngesikhathi sokuhlolwa okuqondisiwe. Umuthi unikezwa nge-nebulizer, eguqula isixazululo esiwuketshezi sibe inkungu enhle oyiphefumulayo ngomlomo. Uzoqeqeshwa ukuthi uphefumule kancane, ngokujulile ukuze uqinisekise ukuthi umuthi ufika emoyeni wakho ngempumelelo.

Ngaphambi kokuhlolwa, ngokuvamile uzodinga ukugwema imithi ethile nemisebenzi ethile. Ithimba lakho lezempilo lizokunikeza imiyalelo ethile mayelana nokuyeka ama-bronchodilators, ukugwema i-caffeine, nokungazivocavoci ngaphambi kwesikhathi. Ukuhlolwa kuvame ukwenzeka elabhorethri ekhethekile yokusebenza kwamaphaphu lapho imishini ephuthumayo itholakala kalula.

Ngesikhathi senqubo, uzoqala ngokuphefumula ngokujwayelekile, bese uphefumula ukugxila okukhulayo kwe-methacholine. Phakathi kwemithamo ngayinye, ochwepheshe bazokala ukusebenza kwamaphaphu akho ukuze babone ukuthi imigudu yakho yomoya isabela kanjani. Inqubo yonke ivame ukuthatha imizuzu engama-30 kuya kwengama-45.

Kufanele ngiyithathe isikhathi esingakanani i-Methacholine?

I-Methacholine isetshenziswa kanye kuphela ngesikhathi sokuhlolwa okukodwa - akuyona imithi oyithatha ngokuphindaphindiwe noma ngokuhamba kwesikhathi. Ukuvezwa kwangempela ku-methacholine ngesikhathi sokuhlolwa kuthatha imizuzu embalwa nje njengoba uphefumula ngamunye umthamo. Abantu abaningi baqeda lonke uhlolojikelele lwe-methacholine ngaphansi kwehora elilodwa.

Imiphumela ye-methacholine iyaphela ngokushesha, ngokuvamile phakathi kwemizuzu eyi-15 kuya kwengama-30 ngemuva kokuphela kokuhlolwa. Ithimba lakho lezokwelapha lizokuqapha kuze kube yilapho ukuphefumula kwakho kubuyela kokujwayelekile futhi lingakunika i-bronchodilator ukusheshisa ukululama. Ngeke kudingeke uqhubeke nanoma yikuphi ukwelashwa ekhaya okuhlobene ne-methacholine ngokwayo.

Yiziphi Imiphumela Eceleni ye-Methacholine?

Imiphumela ejwayelekile kakhulu ye-methacholine yenzeka ngesikhathi noma ngemuva nje kokuhlolwa futhi ngokuvamile imnene. Lezi zimo zenzeka njengengxenye yendlela yokusebenza kokuhlolwa. Ithimba lakho lezempilo lilungele ukuphatha noma yiziphi izimpawu eziphakamayo.

Nazi izimo ezijwayelekile ongase uzithole ngesikhathi sokuhlolwa kwe-methacholine:

• Ukuqina kwesifuba okuncane noma ukucindezela
• Ukuphefumula okuncane
• Ukukhwehlela okulula
• Ukuvuvukala komphimbo
• Ukuzwa sengathi udinga ukuhlanza umphimbo wakho

Lezi zimpawu zivame ukuxazululwa ngokushesha lapho ukuhlolwa sekuqediwe futhi imigudu yakho yomoya iphumula ibuyele kokujwayelekile.

Izimo ezingathi sína kodwa ezingavamile zingenzeka, yingakho ukuhlolwa kwenziwa kuphela ezikhungweni zezokwelapha ezinemishini ephuthumayo. Lezi zimpendulo ezingavamile zingabandakanya:

• I-bronchospasm enkulu (ukuncipha okukhulu komgudu womoya)
• Ukuphefumula okunzima okungathuthuki ngokushesha
• Ubuhlungu besifuba obungaphezu kokuqina okuncane
• Isiyezi noma ukukhathala
• Ukushaya kwenhliziyo okusheshayo

Ithimba lakho lezokwelapha likuqapha eduze ngaso sonke isikhathi sokuhlolwa futhi lingahlehlisa ngokushesha noma yiziphi izimo ezingathi sína ngemithi ye-bronchodilator.

Ubani Ongafanele Athole I-Methacholine?

Amaqembu amaningi abantu kufanele agweme ukuhlolwa kwe-methacholine ngenxa yobungozi obukhulu. Udokotela wakho uzobukeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokuncoma lolu vivinyo. Ukuphepha kuhlala kuyinto eza kuqala uma kucatshangelwa noma iyiphi inqubo yokuxilonga.

Akufanele ube nokuhlolwa kwe-methacholine challenge uma unezinye zalezi zimo:

• Isifuba esibi esingalawuleki kahle
• Ukuhlaselwa yinhliziyo kwakamuva noma izimo zenhliziyo ezingazinzile
• Umsebenzi wamaphaphu ophansi kakhulu (FEV1 ngaphansi kuka-50% okulinganiselwe)
• Umfutho wegazi ophezulu ongawelwe kahle
• Ukushaywa unhlangothi kwakamuva noma i-aneurysm yobuchopho
• Ukukhulelwa (ukuphepha akukamiswanga)
• Ukunyuka kokuphefumula noma ukugula kwamanje

Udokotela wakho uzophinda aqaphele uma uthatha imithi ethile, ikakhulukazi lezo ezingaphazamisa imiphumela yokuhlolwa noma zikhuphule ingozi yakho yezinkinga.

Amagama Omkhiqizo we-Methacholine

I-Methacholine itholakala ngaphansi kwegama lomkhiqizo elithi Provocholine e-United States. Le yifomula esetshenziswa kakhulu yokuhlolwa kwe-methacholine challenge. Umuthi uza njengempushana engeyona inzalo abahlinzeki bezempilo abayixuba nesixazululo se-saline ngaphambi nje kokuhlolwa kwakho.

Ezinye izikhungo zezokwelapha zingasebenzisa ezinye izindlela zokulungiselela imithi ye-methacholine, kodwa i-Provocholine iyindinganiso ezibhedlela eziningi nakumalabhorethri omsebenzi wamaphaphu. Kungakhathaliseki igama lomkhiqizo, isithako esisebenzayo kanye nenqubo yokuhlolwa kuhlala kufana.

Ezinye izindlela ze-Methacholine

Ngenkathi i-methacholine iyindinganiso yegolide yokuhlolwa kwe-bronchial provocation, odokotela ngezinye izikhathi basebenzisa ama-ejenti ezinselelo ezingezinye ngokuya ngesimo sakho esithile. Lezi ezinye izindlela zingahlinzeka ngolwazi olufanayo lokuxilonga kodwa zisebenza ngezindlela ezihlukene.

Ezinye izivivinyo ze-bronchial challenge udokotela wakho angazicabangela zihlanganisa:

• Ukuhlolwa kokuphefumula kwe-Mannitol (kulinganisa ukuvuvukala komgudu womoya)
• Ukuhlolwa kokuzivocavoca (kusebenzisa umsebenzi womzimba njengembangela)
• Inselelo yomoya obandayo (isebenzisa izinguquko zamazinga okushisa)
• Inselelo ye-Histamine (indlela efana ne-methacholine)
• Inselelo ye-Adenosine (isetshenziswa kwezinye izikhungo ezikhethekile)

Udokotela wakho wamaphaphu uzokhetha ukuhlolwa okufanele kakhulu ngokusekelwe ezimpawini zakho, umlando wakho wezokwelapha, kanye nolwazi oluthile abaludingayo ukuze benze ukuxilongwa okunembile.

Ingabe i-Methacholine ingcono kune-Histamine Challenge?

Kokubili ukuhlolwa kwe-methacholine kanye ne-histamine challenge kuyithuluzi elihle lokuxilonga isifuba, kodwa i-methacholine ivame ukukhethwa ezikhungweni eziningi zezokwelapha. I-Methacholine ivame ukuba eqondile ekutholeni ukuzwela ngokweqile komgudu womoya futhi inemiphumela emincane kunama-histamine. Imiphumela nayo ihambisana kakhulu futhi kulula ukuyiqonda.

I-Histamine ingabangela ezinye izimpawu ezinjengobuhlungu bekhanda, ukubomvu, nokusabela kwesikhumba ngoba ithinta amasistimu ngaphezu kwemigudu yakho yomoya. I-Methacholine iqondiswe kakhulu emiphumeleni yayo, igxile ikakhulukazi emisipheni ebushelelezi emgudwini wakho wokuphefumula. Lokhu kwenza i-methacholine ibe yindlela ephephe kakhulu futhi enethezekile ezigulini eziningi.

Nokho, ezinye izikhungo ezikhethekile zisaqhubeka nokusebenzisa ukuhlolwa kwe-histamine challenge, ikakhulukazi ezindaweni zocwaningo. Kokubili ukuhlolwa kunikeza ulwazi olubalulekile lokuxilonga, futhi udokotela wakho uzokhetha ngokusekelwe kulwazi lwabo kanye nezidingo zakho zezokwelapha.

Imibuzo Evame Ukubuzwa Mayelana ne-Methacholine

Ingabe i-Methacholine iphephile kubantu abanezifo zenhliziyo?

Ukuhlolwa kwe-Methacholine kudinga ukuqapha okukhethekile kubantu abanezimo zenhliziyo. Umuthi ungase ukwazi ukuthinta izinga lenhliziyo nomfutho wegazi, ngakho-ke udokotela wakho wenhliziyo kanye nodokotela wamaphaphu kuzodingeka basebenzisane ukuze banqume ukuthi ukuhlolwa kuphephile yini kuwe. Abantu abanezifo zenhliziyo ezilawulwa kahle, ezinzile bangase babe ngabazongenela ukuhlolwa ngaphansi kokuqapha okucophelelayo.

Uma unomlando wezinkinga zenhliziyo, qiniseka ukuthi utshela udokotela wakho ngaphambi kokuhlela inselelo ye-methacholine. Bangase bafune ukwenza ukuqapha okwengeziwe kwenhliziyo ngesikhathi sokuhlolwa noma bakhethe enye indlela yokuxilonga. Ukuphepha kwakho kuhlala kubaluleke kakhulu kunokwenza ukuhlolwa okuthile.

Kufanele ngenzeni uma ngithatha i-Methacholine eningi ngengozi?

Awukwazi ukuthatha i-methacholine eningi ngengozi ngoba inikezwa kuphela ochwepheshe bezokwelapha abaqeqeshiwe ezindaweni zokunakekelwa kwezempilo ezilawulwayo. Ukuhlolwa kulandela izinqubo eziqinile ezinemithamo ebekwe ngaphambilini elinganiswa ngokucophelela. Uma ngandlela thize uthole okuningi kunokuhlosiwe ngesikhathi sokuhlolwa, ithimba lakho lezokwelapha lizokunikeza ngokushesha imithi ye-bronchodilator ukuze iguqule imiphumela.

Imvelo yokuhlola yakhelwe ngezindlela eziningi zokuphepha ukuvimbela ukweqisa. Uma uzizwa sengathi izimpawu zakho ziba zimbi kunokulindelekile ngesikhathi sokuhlolwa, tshela uchwepheshe wakho ngokushesha. Bangakwazi ukumisa ukuhlolwa futhi banikeze ukwelashwa ngokushesha.

Kufanele ngenzeni uma ngiphuthelwa umthamo we-Methacholine?

Lo mbuzo awusebenzi ku-methacholine ngoba akuyona imithi oyithatha njalo noma ekhaya. I-Methacholine isetshenziswa kanye kuphela ngesikhathi sokuhlolwa kokuxilonga esikhungweni sezokwelapha. Uma uphuthelwa isikhathi sakho sokuqokwa sokuhlolwa kwe-methacholine, vele usihlele kabusha ngolunye usuku lapho ungalandela yonke imiyalelo yokulungiselela.

Qiniseka ukuthi wazisa isikhungo sokuhlola uma udinga ukuhlela kabusha, njengoba silungisa imithi ngqo ngesikhathi sokuqokwa kwakho. Uma uhlela kabusha, kuzodingeka ukuthi ulandele imihlahlandlela efanayo yokulungiselela mayelana nokugwema imithi ethile nemisebenzi ngaphambi kwesikhathi.

Ngingayeka nini ukuthatha i-Methacholine?

Akudingeki uyeke ukuthatha i-methacholine ngoba akuyona imithi eqhubekayo. Ukuchayeka ku-methacholine kuphela ngokushesha nje lapho ukuhlolwa kwakho kokuxilonga kuqediwe. Imiphumela iyaphela ngokwemvelo phakathi nemizuzu engu-15 kuya kwengama-30 ngemuva kokuhlolwa, futhi ukuphefumula kwakho kufanele kubuyele kokujwayelekile.

Udokotela wakho angase akunikeze umuthi we-bronchodilator ngemuva kokuhlolwa ukusiza ukusheshisa ukululama kwakho, kodwa lokhu kuyisinyathelo sokuzivikela nje. Lapho ukuhlolwa sekuphelile, akusekho i-methacholine esesimeni sakho okufanele ukhathazeke ngayo.

Ngingakwazi yini ukuqhuba ngemuva kokuhlolwa kwe-Methacholine Challenge?

Abantu abaningi bangakwazi ukuzishayela ekhaya ngemuva kokuhlolwa kwe-methacholine challenge, kodwa lokhu kuncike ekutheni uzizwa kanjani ngemuva kwalokho. Ukuhlolwa ngokwako ngokuvamile akubangeli ukozela noma kuphazamise ikhono lakho lokushayela ngokuphepha. Kodwa-ke, abanye abantu bangase bazizwe bekhathele noma bephefumula kancane isikhashana ngemuva kokuhlolwa.

Ithimba lakho lezokwelapha lizokuqapha kuze kube yilapho ukuphefumula kwakho kubuyela kokujwayelekile ngaphambi kokukuvumela ukuthi uhambe. Uma uthole noma yimuphi umuthi we-bronchodilator ngemuva kokuhlolwa, ungase uzizwe uthuthumela kancane noma ube nenhliziyo esheshayo isikhashana. Lalela umzimba wakho futhi ungaqhubi uma uzizwa unganamthetho noma ungazizwa kahle nganoma iyiphi indlela.