Ðe kuxi sia le fu ɖem na wò le wò lãkusiwo ŋua? Mina míasrɔ̃ nu tso Interstitial Lung Disease (ILD) ŋu!

Ðe gbɔgbɔtsixe tsia ƒowò ɣeaɖewoɣia? Alo ɖe kɔdzi ƒuƒu si nɔa anyi ɖaa le ŋuwòa? Alo ɖe nèsena le ɖokuiwò me be yegbɔdzɔ ne èle agbagba dzem? Ðewohĩ esiawo menye ɖeɖiteameŋu ko o. Woateŋu anye nɔnɔme aɖe si ŋu míele nu ƒom tsoe egbea si woyɔna be ``Interstitial Lung Disease`` (``ILD``) ƒe dzesiwo hã. Mègatsi dzi o, míaƒo nu tso esia ŋu bɔbɔe, le mɔ si gɔme nàte ŋu ase nu.

Nukae Nye Interstitial Lung Disease?

Kpuie ko la, interstitial lung disease (ILD) menye dɔléle ɖeka o. Enye dɔlélewo ƒe ƒuƒoƒo. Le nyateƒe me la, ƒomevi siwo wu 200 ye li. Dɔléle siawo nana lãkusi tsɛ siwo le wò lãkusi me ( interstitium ) la vuvu, xɔa abi, eye abi nɔa wo ŋu. Fifia ɖewohĩ èle biabiam be, "Nukae nye dometsotso sia?" Bu eŋu abe alesi míaƒe lãkusiwo nye ʋuʋudedi suesuesuewo ƒe hatsotso aɖe (si woyɔna be alveoli ). Interstitium nye lãkusi tsɛ si le yakotoku siawo kple ʋuka siwo ƒo xlã wo dome. Ne míele gbɔgbɔm la, woxɔa ɔksidzin hedoa go yia ʋua me to yakotoku siawo me. Eyata le ILD me la, lãmenugbagbevi vevi siawo gblẽna, eyata oxygen metoa ŋutilãa me nyuie o.

Wogayɔa `ILD` be `Diffuse Parenchymal Lung Disease (DPLD).` Ke hã, `ILD` ye nye ŋkɔ si wozãna wu.

Nukae dzɔna ɖe ŋutilãa dzi ne `ILD` do?

Ne ILD le ŋuwò la, wò lãkusi ƒe akpa siwo ƒoa oxygen nu ƒu tso wò ʋu me heɖonɛ ɖe wò ŋutilã ƒe akpa mamlɛa la gblẽna. Lãmetsi sia va zua abi (si woyɔna hã be fibrosis ), si wɔnɛ be gbɔgbɔ sesẽna. Àte ŋu axɔ kɔdzidɔ si nɔa anyi ɖaa eye wòƒuna hã. Ðewohĩ ɖeɖi te ŋuwò ɣesiaɣi le esi wò ŋutilã mele oxygen si sɔ xɔm o ta.

Ne nugbegblẽ sia yi edzi le dzidzim ɖe edzi la, ate ŋu ahe kuxi siwo ate ŋu ade ame ƒe agbe afɔku me ɣeaɖewoɣi vɛ. Le kpɔɖeŋu me, lãkusi me dɔlékuiwo kple gbɔgbɔtsixe ƒe dɔmawɔmawɔ nyuie (afisi ŋutilãa mekpɔa oxygen si sɔ gbɔ o alo carbon dioxide sɔ gbɔ ɖe eme).

`ILD` ƒomevi kawoe li?

Abe alesi míegblɔe va yi ene la, `ILD` ƒomevi siwo wu 200 ye li. Wo dometɔ ɖeka si bɔ wue nye `Idiopathic Pulmonary Fibrosis` . Gakpe ɖe eŋu la, `ILD` ateŋu atso nusiwo le míaƒe dɔwɔƒe (dɔwɔƒe ƒe nukpɔkpɔwo) alo kadodoŋusẽ ƒe dɔlélewo hã gbɔ. Kpɔɖeŋu bubu aɖewoe nye:

• Asbestosis ƒe dɔléle
• Silicosis ƒe dɔléle
• Kekeli ƒe Aklãdɔléle
• Aklãdɔ si mebɔ o si le domedome

Vovototo kae le `Interstitial Lung Disease` (ILD) kple `Pulmonary Fibrosis` dome?

Esia nye nusi tɔtɔa ame geɖe. Aklã me lãkusi ƒe dɔléleAklã ƒe Dɔléle (Pulmonary Fibrosis) nye ILD ƒomevi aɖe. Eyae nye be menye ILD-wo katãe nye aklã me lãkusi o. Aklã me fibrosis nye abi ƒe dzɔdzɔ le aklã me. Togbɔ be abi sia nye ILD aɖewo ƒe akpa vevi aɖe hã la, dɔdzẽ ate ŋu anye ILD bubuwo ƒe dzesi vevitɔ.

Amekae le afɔku me wu be wòaxɔ `ILD`?

Ðewohĩ àte ŋu axɔ ILD ne è:

• Ne èxɔ ƒe 70 kple edzivɔ.
• Ne ŋutsue nènye. (Nyɔnuwo hã ate ŋu axɔe, gake ebɔ ɖe ŋutsuwo me wu)
• Ne èno atama alo no atama kpɔ va yi.
• Ne dɔléle aɖewo nɔ ŋuwò kpɔ, le kpɔɖeŋu me, Aklãdɔ, Yɔmekpe, Aklãdɔ, COPD, alo Lãmetsiŋusẽ ƒe Dɔléle.
• Ne ègbɔ nusiwo gblẽa nu le wò lãkusi ŋu le wò dɔ alo nuto si me nèle ta . Kpɔɖeŋuwo: asbestos, silica, aŋɔ, fungi, alo dɔlékuiwo.
• Ne wotsɔ keklẽŋusẽ da dɔ na wò le wò akɔta ƒe akpa aɖe kpɔ la .

Aleke gbegbee `ILD` nye nu vevii?

Esi `ILD` ƒomevi geɖewo li ta la, `ILD` ƒe sesẽme si ame ɖesiaɖe xɔna ateŋu ato vovo. Ðewo ate ŋu anye ame fafa, gake bubuwo ya ate ŋu anye ame veviwo ŋutɔ. Vevietɔ la, nusiwo `ILD` ƒomevi geɖewo gblẽna le lãkusiwo ŋu la nye `siwo womate ŋu atrɔ o`. Esia fia be esesẽna be woadzra lãkusi si gblẽ la ɖo. `ILD` ƒomevi sesẽ aɖewo va gblẽna ɖe edzi le ɣeyiɣi aɖe megbe (`ŋgɔyiyi`).

Nukae nye `ILD` ƒe dzesiwo?

ILD ƒe dzesi siwo bɔ wue nye:

• Yagbɔgbɔ sesẽ (yagbɔgbɔ sesẽ): Esia ate ŋu agblẽ ɖe edzi, vevietɔ le kamedede alo dɔ sesẽ wɔwɔ me.
• Kɔdzi ƒuƒu (kɔdzi si me ʋuʋudedi mele o).
• Sese le eɖokui me be ɖeɖi te ye ŋu ŋutɔ (ɖeɖiteameŋu).
• Akɔta ƒe vevesese alo vevesese.

Ðewohĩ dzesi siawo masesẽ le gɔmedzedzea me o, gake woate ŋu agblẽ ɖe edzi vivivi le ɣleti alo ƒe geɖe megbe. Dzesi bubuwo hã ate ŋu ado mo ɖa, le nusi gbɔ ILD la tso nu.

Nukae nye nusiwo gbɔ `ILD` tsona?

Woate ŋu ama nusiwo gbɔ ILD tsona ɖe hatsotso vevi eve me: nusiwo gbɔ wòtso siwo wokpɔ kple nusiwo gbɔ wòtso si womenya o .

Nusiwo Wonya be Nusiwo Gbɔ Wòtso

Esia fia be ILD dzɔna le dɔléle bubu si le ŋuwò xoxo ta, alo le atike aɖewo siwo nènona, keklẽŋusẽdɔdamɔnu, alo nusiwo gblẽa nu le ame ŋu le nutoa me ta.

Susu vevi siwo wode dzesii dometɔ aɖewo:

• Lãmetsiŋusẽ ƒe Dɔléle: Kpɔɖeŋu aɖewoe nye dɔlélewo abe Rheumatoid Arthritis (RA), Lupus, kple Scleroderma ene.
• Granulomatous Dɔléle: Kpɔɖeŋu aɖee nye sarcoidosis.
• Nu aɖewo gbɔgbɔ: nuwo abe asbestos, silica, atama, kple beryllium ene.
• Inhalant allergy (Hypersensitivity Pneumonitis): Nɔnɔme sia ate ŋu atso nuwo abe aŋɔ, fungi, dɔlékui, xeviwo ƒe fu, alo xeviwo ƒe aɖuɖɔ suesuesuewo gbɔgbɔ me.
• Atike alo atike aɖewo: Le kpɔɖeŋu me, atikewo abe amiodarone, nitrofurantoin, methotrexate, kple keklẽŋusẽdɔdamɔnu ene.

Nusiwo Womenya O (`Nu Siwo Womenya O` alo `Idiopathic`)

Ɣeaɖewoɣi la, ɖɔktawo mete ŋu kpɔa nusi tututu gbɔ ILD tsona o. Esia fia be èxɔ ILD atikewɔwɔ ƒe nɔnɔme bubu aɖeke manɔmee alo naneke si agblẽ nu le ŋuwò o. Míeyɔa esia be aklãdɔ si nye idiopathic interstitial pneumonia . ILD ƒomevi vovovowoe li. ILD ƒomevi si bɔ wu, afisi womate ŋu akpɔ nusi gbɔ wòtso o, enye aklã me dɔléle si nye idiopathic pulmonary fibrosis .

Aleke woawɔ anya ILD? (Dɔléle ƒe dzesi) .

Wò ɖɔkta awɔ ɖe afɔɖeɖe geɖe dzi atsɔ anya ILD. Gbã la, woado wò kpɔ, aɖo to wò lãkusiwo eye woalé ŋku ɖe gbeɖiɖi aɖeke si mebɔ o (abe ʋuʋudedi ene) ŋu hã. Emegbe woabia nyawo abe:

• Wò atikewɔwɔ ŋutinya bliboa kple atikewɔwɔ ƒe nɔnɔme bubu ɖesiaɖe si li fifia.
• Ku ɖe atike siwo zãm nèle fifia alo nèzã va yi ŋu .
• Ðe dɔléle siawo alo kadodoŋusẽdɔléle siawo dometɔ aɖe le wò ƒomea mea ?
• Eɖanye wò dɔ alo modzakaɖeɖewo na nèdo go nusiwo ateŋu ahe `ILD` vɛ o .

Dodokpɔ kawoe wozãna tsɔ dea dzesi `ILD`?

Ne ɖɔktaa susui be ILD la, woate ŋu awɔ dodokpɔ siwo gbɔna:

• Aklã ƒe Dɔwɔwɔ Dodokpɔ (PFT): Zi geɖe la, esiawo nyea gbɔgbɔ dodokpɔ, gake ɣeaɖewoɣi la, woate ŋu anye ʋudodokpɔ alo kamedede dodokpɔ hã. Esiawo léa ŋku ɖe alesi wò lãkusiwo le dɔ wɔm nyuie ŋu.
• Nɔnɔmetatawo Dodokpɔwo: Woɖea akɔta ƒe X-ray alo CT scan si me kɔ nyuie (HRCT) tsɔ léa ŋku ɖe lãkusi ƒe nɔnɔme ŋu. HRCT ate ŋu akpɔ nyatakaka nyui ŋutɔwo tsitotsito.
• Ʋudodokpɔwo: Wodoa ʋu si woɖe tso wò alɔnu kpɔna be nu aɖewo li siwo wonya be nusiwo gbɔ wòtsona (e.g., kadodoŋusẽdɔlélewo) siwo ate ŋu ahe ILD vɛ hã.
• Aɖuɖɔtoemedɔdada:Esia bia be nàtsɔ mɔ̃ tsɛ aɖe si me fotoɖemɔ̃ le (`bronchoscope`) ato wò ŋɔti alo nu me ayi wò lãkusi me be nàdo wò yaƒoƒomɔ̃wo kpɔ. Ɣeaɖewoɣi la, woateŋu axɔ lãmenugbagbeviwo ƒe kpɔɖeŋu (`lavage`) hã tso wò lãkusi me.
• Biopsy: Le go aɖewo me la, woɖea lãkusi sue aɖe tso lãkusi me hedoa eŋu le nusuekpɔmɔ̃ me. Esia ate ŋu akpe ɖe ame ŋu woade dzesi ILD ƒomevi si tututu. Woate ŋu awɔ biopsy la to bronchoscopy dzi alo to amekoko sue aɖe me (surgical lung biopsy).

Nukae nye atikewɔwɔ na `ILD`?

Nublanuitɔe la, atike aɖeke meli si ate ŋu ada `ILD` keŋkeŋ o.

Gake mègana mɔkpɔkpɔ o. Woɖoe be woawɔ atikewɔwɔa be woada nɔnɔme si gbɔ wòtso si he ILD vɛ, akpɔ dzesiwo dzi, eye woana dɔlélea ƒe ŋgɔyiyi nagbɔdzɔ. Wò ɖɔkta ate ŋu aŋlɔ kamedede, ɔksidzin kpeɖeŋutɔ, alo atikewo na wò be wòaɖe abi si le wò lãkusi me dzi akpɔtɔ alo aɖu abi siwo le ŋuwò dzi.

Nukae nye atike kple atike siwo wozãna na `ILD`?

• Corticosteroids: Atikewo abe prednisone ene kpena ɖe ame ŋu wòɖea aɖuɖɔtoewo ƒe vuvu dzi kpɔtɔna.
• Atike Siwo Tsi Tre Ðe Fibrotic Kple Cytotoxic Ŋu: Atike siawo ate ŋu ana abi siwo le lãkusiwo me nagbɔdzɔ. Kpɔɖeŋuwo: Azathioprine, Cyclophosphamide, Pirfenidone, Nintedanib.
• Atike Siwo Wozãna Le Nu Gbagbewo Me: Wozãa atikewo abe Rituximab ene tsɔ daa dɔléle aɖewo siwo dɔlélenutsiŋutete hena vɛ kple nɔnɔme bubu siwo hea ILD vɛ.
• GERD ƒe Atikewɔwɔ: Ne dɔgbo ƒe ʋuʋu ƒe dɔléle (GERD) le ŋuwò la, ate ŋu ana ILD nagado gã ɖe edzi. Eyata woate ŋu ana atike wò be nàtsɔ aɖu dɔgbo me acid dzi.
• Aklã ƒe Gbugbɔgaɖɔɖo: Esia nye kamedede kple hehenana ƒe ɖoɖo tɔxɛ aɖe. Yagbɔgbɔ ƒe kamedede kple kamedede kpena ɖe ŋuwò wòdoa ŋusẽ wò lãkusiwo eye wònana wònɔa bɔbɔe be nàgbɔ ya.
• Oxygen Dɔdamɔnu: Ne oxygen mesɔ gbɔ na wò ʋu alo lãkusiwo o la, wò ɖɔkta ate ŋu aŋlɔ oxygen kpeɖeŋutɔ na wò. Wotoa aɖuɖɔtoe alo motsyɔnu dzi naa esia.
• Aklãdodo: Le amesiwo ŋu ILD sesẽ ŋutɔ gome la, aklã dodo ate ŋu anye mɔnu mamlɛtɔ.

Atikewɔwɔ ƒe nugbegblẽ le ame ŋu

ILD ƒe atike aɖewo (vevietɔ corticosteroids kple atike siwo wua lãmenugbagbeviwo) ate ŋu ana wò dɔlélenutsiŋutete nagbɔdzɔ. Eyata wò ɖɔkta alé ŋku ɖe ŋuwò edziedzi eye wòalé ŋku ɖe kuxi siwo ate ŋu ado mo ɖa ŋu.

Ðe woate ŋu axe mɔ ɖe ILD nua?

Esesẽna be woaxe mɔ ɖe ILD ƒomevi geɖe nu. Gake àte ŋu awɔ nu siwo gbɔna be nàɖe afɔku si le wò ILD xɔxɔ me dzi akpɔtɔ:

• Dzra atikewɔwɔ ƒe nɔnɔme ɖesiaɖe si le ŋuwò xoxo gbɔ (e.g., kadodoŋusẽ ƒe dɔlélewo).
• Ƒo asa na nusiwo gblẽa nu le lãkusi ŋu la gbɔgbɔ.
• Ne èle dɔ wɔm le teƒe siwo asbestos, ga ƒe ke, alo atikewo le la, do yagbɔgbɔmɔ̃ si sɔ (ametakpɔnu si ɖea nu suesuesue siwo le ya me).
• Nusiwo abe gbe, nuku, xeviwo ƒe aɖuɖɔ alo fu, kple dzoxɔxɔ kple fafa ƒe mɔ̃wo ate ŋu ahe nulɔdɔ siwo nɔa anyi didi vɛ. Do yagbɔgbɔmɔ̃ ne èle dɔ wɔm kple nu siawo.
• Ne dɔléle aɖe abe kadodoŋusẽdɔ alo sarcoidosis ene le ŋuwò la, ƒo nu kple wò ɖɔkta tso mɔ siwo dzi nàto axe mɔ ɖe ILD nu ŋu.
• Ne ènoa atama la, ke dzudzɔ godoo. Ne mènoa atama o la, mègadze egɔme o.

Nukae etsɔme ahe vɛ na amesi ŋu `ILD` le?

Ne ILD le ŋuwò la, mia kple wò ɖɔkta miawɔ dɔ aduadu akpɔ alesi woakpɔ wò dɔlélea gbɔe, le nusi gbɔ ILD la tso nu. Le kpɔɖeŋu me, ne wò dɔ alo nulɔdɔ (hypersensitivity pneumonitis) gbɔe wò ILD tso la, ahiã be nàdzudzɔ dɔwɔwɔ kple nusi hea ILD vɛ alo nàwɔ afɔɖeɖe tɔxɛwo.

Togbɔ be atikewo ate ŋu aɖe abi dzi akpɔtɔ hã la, abi siwo dona le lãkusiwo me le ILD ta la nɔa anyi ɖaa. Esia fia be womate ŋu atrɔ nusiwo gblẽ la o. Ne dɔléle aɖe le ŋuwò la, edzikpɔkpɔ nyuie ate ŋu akpe ɖe ŋuwò nàxe mɔ ɖe nu bubu siwo agblẽ nu le ŋuwò nu. Ne ILD le ŋuwò si womate ŋu akpɔ nusi gbɔ wòtso o (idiopathic) la, wò ɖɔkta ada wò dzesiwo eye wòadze agbagba be yeaxe mɔ ɖe nusiwo agblẽ le ŋuwò nu.

Nukae nye kuxi siwo ate ŋu ado tso `ILD` me?

Ne ILD va nu sẽ la, kuxi siwo ate ŋu ade ame ƒe agbe afɔku me ate ŋu ado mo ɖa, abe:

• Aklã me Ʋusɔgbɔdɔ
• Aklã si Mu (Pneumothorax) .
• Aklãdɔlélewo
• Yagbɔgbɔ ƒe Dɔmawɔmawɔ nyuie
• Aklãdɔléle

Nukae nye ame si ŋu `ILD` le ƒe agbenɔƒe?

Nya sia nye nya si ame geɖe biana. Ame si ŋu `ILD` le ƒe agbenɔƒe nɔ te ɖe nusi gbɔ `ILD` la tso kple eƒe sesẽ dzi. Ame aɖewo ateŋu anɔ agbe si sɔ atike aɖeke manɔmee alo atikewɔwɔ suetɔ kekeake ne woƒe `ILD` mesẽ o. Ne wò dɔlélea mele sesẽm ɖe edzi o (si fia be ne `eli ke`) la, nukpɔsusua (`nyagblɔɖi`) nyo vie.

Ke hã, le amesiwo ŋu `ILD` ƒe dɔléle sesẽtɔ kekeake eye wòle gbegblẽm ɖe edzi kabakaba le gome la, agbenɔƒe si woakpɔ mɔ na le dɔlélea didi vɔ megbe ate ŋu anɔ kpuie abe ƒe 3-5 ene. Mègavɔ̃ na akɔntabubu siawo o. Esia to vovo na ame ɖesiaɖe.

Aleke mawɔ akpɔ ɖokuinye dzi ne `ILD` le ŋunye?

Ne wokpɔ ILD le ŋuwò la, mɔ nyuitɔ si dzi nàto akpɔ ɖokuiwò dzie nye be nàwɔ dɔ kple wò ɖɔkta awɔ ɖoɖo aɖe si dzi nàto akpɔ wò dzesiwo gbɔ eye nàxe mɔ ɖe nusiwo agblẽ le ŋuwò nu.

• Da nɔnɔme ɖesiaɖe si ate ŋu anɔ ILD la hem vɛ.
• Dzra nusiwo ate ŋu ana ILD nagblẽ ɖe edzi (e.g., GERD).
• Ne èwɔa dɔ kple nusiwo gblẽa nu le lãkusi ŋu alo nana nulɔdɔ nɔa ame ŋu ɣeyiɣi didi la, ke ele be nàwɔ dedienɔnɔ ŋuti ɖoɖo tɔxɛwo.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Yi ɖɔkta enumake ne dzesi siawo le ŋuwò:

• Gbɔgbɔ sesẽ si le dzidzim ɖe edzi vivivi.
• Yagbɔgbɔ sesẽ le kamedede me.
• Kɔdzi ƒuƒu si nɔa anyi ɖaa.

Zi alesi woda ILD kaba la, zi nenemae emetsonua nyonae.

Nya kawoe wòle be mabia nye ɖɔkta?

Mègaŋlɔ be be yeabia nya siawo ne èkpɔ wò ɖɔkta o:

• Nukatae dɔléle sia dze dzinye?
• Atikewɔwɔmɔnu kawoe le asinye?
• Ðe nɔnɔme sia agagblẽ ɖe edzia?
• Ðe woate ŋu aɖe nusiwo gblẽ le lãkusiwo ŋu dzi akpɔtɔa?
• Tɔtrɔ kawoe mate ŋu awɔ be nye agbenɔnɔ nanyo ɖe edzi?

ILD ƒomevi gbogbo aɖewo li. Wo dometɔ aɖewo mefa o, ɖewo hã metsɔa ɖeke le eme na ame ŋutɔ. Àte ŋu akpɔ akɔntabubu dziŋɔwo le Internet dzi, gake wò ɖɔkta koe ate ŋu agblɔ nusi tututu wò nɔnɔmea nye na wò. Ðo dze kple wò ɖɔkta anukwaretɔe eye nàse nusiwo nèkpɔ mɔ na gɔme nyuie. Mia kple wò ɖɔkta miate ŋu awɔ ɖoɖo ɖe miaƒe dzesiwo ŋu eye mianɔ agbe nyuitɔ kekeake.

Mina míaɖo ŋku nu vevitɔwo dzi (Take-Home Message) .

• `ILD` nye dɔlélewo ƒe ƒuƒoƒo si gblẽa nu le lãkusi ƒe lãkusi tsɛwo ŋu, si wɔnɛ be gbɔgbɔ sesẽna.
• Kɔdzi ƒuƒu, gbɔgbɔ sesẽ, kple ɖeɖiteameŋue nye dzesi vevitɔwo.
• Susu geɖewo ate ŋu anɔ anyi, eye ɣeaɖewoɣi la, womate ŋu ake ɖe susu aɖeke ŋu o.
• Togbɔ be womate ŋu adae bliboe o hã la, atikewɔmɔnu aɖewo li siwo dzi woato aɖu dɔlélea ƒe dzesiwo dzi ahaxe mɔ na dɔlélea be wòagagblẽ ɖe edzi o.
• Ele vevie be nàƒo asa na atamanono, aƒo asa na nusiwo gblẽa nu le ame ŋu la gbɔgbɔ, eye nàɖu atikewɔwɔ me nɔnɔme siwo le ame me dzi.
• Ne dzesiwo le ŋuwò la, mègatsi dzodzodzoe eye nàdi atikewɔlawo ƒe aɖaŋuɖoɖo o. Dɔlélea didi kple edada kaba le vevie ŋutɔ.

Míele mɔ kpɔm be nyatakaka sia aɖe vi na wò. Nɔ lãmesẽ me!

` interstitial lung disease, ILD, lãkusidɔ, gbɔgbɔtsixetsixe, kɔdzi ƒuƒu, aklã me fibrosis, lãkusi ƒe abi, gbɔgbɔtsixe ƒe dzesiwo