Ingabe uvame ukuba nokukhwehlela okugcwele amafinyila? Ngezinye izikhathi ungase ucabange ukuthi umkhuhlane nje ovamile, kodwa uma uqhubeka, kungaba uphawu lwesifo samaphaphu esibizwa ngokuthi i-bronchiectasis. Ungakhathazeki, leli gama lingase lizwakale njengento enkulu, kodwa uma ulazi futhi ulandela imiyalelo kadokotela wakho, lingaphathwa kahle. Ake sixoxe ngakho konke ngamagama alula.
Kalula nje, kuyini i-Bronchiectasis?
Cabanga ngalokhu: sinesimiso samapayipi amancane athwala umoya emaphashini ethu. Lokhu sikubiza ngokuthi imigudu yomoya noma i-bronchi. I-Bronchiectasis yisimo lapho le migudu yomoya yonakala khona futhi ivuleke unomphela, njengebhaluni.
Uma kwenzeka lo monakalo, la mapayipi awakwazi ukususa kahle ulwelwesi oluqukethwe yiwo. Ngokuvamile, amaphaphu omuntu ophilile abamba amagciwane kanye nezinhlayiya zothuli kulwelwesi bese ezikhwehlela. Kodwa kumuntu one-bronchiectasis, ulwelwesi luyanqwabelana emigwaqweni yomoya eyonakele. Amagciwane aqala ukukhula kulolwelwesi oluqongelelekile. Lokhu kuholela ekuthelelekeni okuvamile kanye nomonakalo owengeziwe emaphashini. Ngakho-ke, umzimba uyaqhubeka nokukhwehlela njengoba uzama ukususa lolu lwelwesi oluqongelelekile.
Uyini umehluko phakathi kwe-bronchitis ne-bronchitis?
Abantu abaningi bayawadida la magama amabili ngoba azwakala efana kancane. Izimpawu nazo ziyafana kancane, kanye ne-phlegm kanye nokukhwehlela kokubili. Kodwa kunomehluko omkhulu phakathi kwala magama amabili.
| Isici | I-Bronchiectasis | I-Bronchitis |
|---|---|---|
| Uhlobo lomonakalo | Umonakalo ohlala njalo kanye nokwanda kwemigudu yomoya kwenzeka. | Lokhu ukutheleleka kwesikhashana kwendlela yokuphefumula. Akudali umonakalo ohlala njalo. |
| Ubude besikhathi | Lesi yisimo esingapheli . | Isimo sesikhashana (esibucayi) esivame ukuxazululeka phakathi namasonto ambalwa. |
Ziyini izimpawu ze-bronchiectasis?
Lezi zimpawu aziveli ngendlela efanayo kuwo wonke umuntu. Abanye abantu bangase babe nezimpawu ezincane kakhulu, kanti abanye bangase babe nezimpawu ezinzima. Futhi, kungase kube nezikhathi zokuyekelela, kulandelwe izikhathi "zokwanda" noma ukuqhuma okukhulu.
| Izimpawu ezivamile | |
|---|---|
| Ukukhwehlela okuvamile okune-mucus | Lolu uphawu oluyinhloko. Ngezinye izikhathi kungase kube noketshezi olufana nobomvu oluphuzi noma oluhlaza okotshani. |
| Ubunzima bokuphefumula (i-Dyspnea) | Kunzima ukuphefumula, ikakhulukazi uma ukhathele. |
| Umkhuhlane noma izifo zamaphaphu ezivame ukwenzeka | Ukuminyana kwesifuba kukhula ngokushesha kakhulu kunezinye. |
| Ukushaya umoya (ukushaya ikhwela) lapho uphefumula | Umsindo uzwakala usuka emphinjeni noma esifubeni lapho ukhipha umoya. |
| Ukukhwehlela igazi (i-Hemoptysis) | Kungase kube negazi elincane noma mhlawumbe eliningi liphuma ne-mucus. |
| Ukugoba izinzipho (ukuvuvukala kweminwe kanye nokugoba kwezinzipho) | Uphawu olungavela ngenxa yamazinga aphansi omoya-mpilo isikhathi eside. |
| Izimpawu ezenzeka lapho isifo siba sibi kakhulu (ukubhebhetheka) | |
| Ukukhathala okukhulu (Ukukhathala) | Ukuzizwa ukhathele kakhulu. |
| Umkhuhlane kanye nokubanda | Uphawu lokuthi kukhona ukutheleleka emzimbeni. |
| Ubunzima obandayo bokuphefumula | Ukuphefumula kunzima kakhulu kunokujwayelekile. |
| Ukujuluka ebusuku | Esinye isibonakaliso sokutheleleka. |
Kungani lesi simo senzeka?
I-Bronchiectasis yenzeka "ngomjikelezo omubi." Iqala ngendlela exakile kakhulu. Inezinyathelo ezimbili.
1. Ukuthuka Kokuqala: Okokuqala, isifo esithile, ukutheleleka, noma esinye isizathu silimaza imigudu yomoya emaphashini.
2. Umjikelezo Omubi: Lo monakalo ubangela ukwakheka kwe-mucus esikhundleni sokuthi isuswe kahle. Amabhaktheriya akhula ku-mucus eqongelelekile. Lawa mabhaktheriya abangela ukutheleleka okwengeziwe, anciphise izindonga zamaphaphu, futhi awonakale kakhulu. Lo mjikelezo uyaqhubeka.
Ngezinye izikhathi, cishe ku-40% weziguli, imbangela eqondile yalo monakalo wokuqala ayikwazi ukutholakala.
Izimbangela eziyinhloko ze-bronchiectasis
- I-Cystic Fibrosis: Lesi yisifo esithinta amaphaphu ngenxa yokunqwabelana kwamafinyila emzimbeni.
- Ukutheleleka okukhulu kwamaphaphu: Ukutheleleka okukhulu njenge-pneumonia, ukukhwehlela okukhulu, noma isifo sofuba (TB) ebuntwaneni kungabangela umonakalo ongapheli emaphashini.
- Isimiso somzimba sokuzivikela esibuthakathaka: Izifo ezifana ne-HIV noma ezinye izinkinga zomzimba (njenge-hypogammaglobulinemia) zingabangela ukutheleleka njalo futhi zilimaze amaphaphu.
- Izinkinga Zokuzivikela Emzimbeni:Ezifweni ezifana ne-Rheumatoid Arthritis (RA) noma i-Lupus (SLE), amangqamuzana omzimba angahlasela futhi alimaze amaphaphu.
- Ukuvaleka komoya: Uma isimila, umzimba wangaphandle, noma i-lymph node evuvukele ivimba indlela yokuphefumula, i-mucus ingaqoqana kuleyo ndawo futhi ibangele i-bronchiectasis.
- I-Allergy Bronchopulmonary Aspergillosis (ABPA): Lokhu kuwukusabela kokungezwani komzimba nohlobo lwesikhunta.
- I-Primary Ciliary Dyskinesia: Lesi futhi yisimo sofuzo. I-mucus iyakheka ngoba 'izinwele ezincane' (cilia) ezikhipha i-mucus esweni, esikhulume ngazo ngaphambili, azisebenzi kahle.
Udokotela usithola kanjani lesi sifo?
Uma uya kudokotela, uzolalela ngokucophelela izimpawu zakho kanye nomlando wezokwelapha odlule. Uzobe eselalela isifuba sakho nge-stethoscope bese encoma ukuthi kwenziwe ezinye izivivinyo ezimbalwa.
- Ukuskena kwe-CT esifubeni: Lena yindlela engcono kakhulu yokuxilonga i-bronchiectasis. Kungabona ngokucacile ukuthi izindlela zomoya emaphashini zibanzi yini nokuthi izindonga zijiyile. Nakuba i-X-ray ingenziwa kuqala, ukuskena kwe-CT kuyindlela kuphela yokuqinisekisa ukuxilongwa.
- Ukukhula Kwesikhwehlela: Kuthathwa isampula yesikhwehlela sakho bese kuhlolwa uhlobo lwebhaktheriya ekhula kuso ukuze kutholakale ukuthi ama-antibiotic ayadingeka yini.
- Ukuhlolwa Kokusebenza Kwamaphaphu: Ucelwa ukuthi uphefumulele ngaphakathi nangaphandle emshinini ukuze ukale ukuthi amaphaphu akho asebenza kahle kangakanani.
- Ukuhlolwa kwegazi: Ukuhlolwa kwegazi kusiza ekunqumeni ukuthi kukhona yini ukutheleleka emzimbeni noma ukuthi kunenkinga ngesimiso somzimba sokuzivikela.
- I-Bronchoscopy: Ngezinye izikhathi, udokotela wakho kuzodingeka abheke ngaphakathi kwemigudu yakho yomoya. Lokhu kusebenzisa ithubhu elincane elinekhamera (i-bronchoscope) ukuze abone ukuthi kukhona yini okubhajwe ngaphakathi nokuthi i-mucus injani.
Yiziphi izindlela zokwelapha lokhu?
Into yokuqala okufanele uyikhumbule ukuthi i-bronchiectasis yisimo esingelapheki ngokuphelele , njengoba umonakalo wamaphaphu ungeke ulungiswe. Kodwa-ke, ngokwelashwa okufanele kanye nokushintsha kwendlela yokuphila, abantu abaningi bangakwazi ukulawula izimpawu zabo futhi baphile impilo evamile.
Kunezinhloso ezintathu eziyinhloko zokwelashwa:
1. Ukususa amafinyila aqoqana emaphashini.
2. Ukulawula nokuvimbela ukutheleleka.
3. Ukunciphisa ukuvuvukala emaphashini.
| Indlela yokwelapha | Incazelo |
|---|---|
| Amasu Okususa Imigwaqo Yomoya | |
| Ukuzivocavoca kokuphefumula kanye nokwelashwa ngokomzimba | Udokotela wezokwelapha uzokufundisa amasu okukhwehlela nokuphefumula azokusiza ukuthi ukhiphe amafinyila kalula. Lokhu kungafaka phakathi amasu anjengokushaya isifuba. |
| Imishini yezokwelapha | Amadivayisi amancane afana namadivayisi e-PEP anyakazayo noma ama-vest agqokwa esifubeni angasetshenziswa ukusiza ukukhulula nokukhipha amafinyila. |
| Imithi | |
| Ama-antibiotic | Uma kuvela izifo, zelashwa ngamaphilisi, ama-syrup, noma ezimweni ezimbi kakhulu, imithi ye-intravenous (IV). Ngezinye izikhathi, zingase zinikezwe ngemithamo ephansi isikhathi eside ukuvimbela izifo. |
| Imithi ye-Mucolytic | Lokhu kusiza ekunciphiseni ulwelwesi olujiyile futhi kwenze kube lula ukukhwehlela. Kukhona nemithi ethathwa ngesimo somhwamuko nge-nebulizer. |
| Imithi yokulwa nokuvuvukala | Imithi efana nama-macrolide isiza ekunciphiseni ukuvuvukala emigwaqweni yomoya ngenkathi ilawula ukutheleleka. |
Uma udinga ukubona udokotela
Uma ukhwehlela njalo ngenxa ye-phlegm noma unenkinga yokuphefumula, qiniseka ukuthi ubona udokotela. Uma usuvele utholakale une-bronchiectasis, shayela udokotela wakho ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo:
- Uma unezimpawu zokutheleleka, njengomkhuhlane kanye nokubanda.
- Uma ukuphefumula kuba nzima kakhulu kunokujwayelekile.
- Uma ukhathele kakhulu kunokujwayelekile.
- Uma inani le-mucus oyikhwehlelayo liphezulu kakhulu, umbala we-mucus ushintshile (oluhlaza/ophuzi), noma uma kukhona igazi ku-mucus.
- Uma ulahlekelwa yisifiso sokudla futhi wehlisa isisindo.
Kodwa esimweni esinjengalesi, kufanele uye e-ETU (i-Emergency Treatment Unit) ngokushesha:
- Uma uphuma igazi kakhulu.
- Uma unezinhlungu esifubeni.
- Uma kunzima kakhulu ukuphefumula.
Umlayezo Wokuya Nawe Ekhaya
- I-Bronchiectasis yisimo sesikhathi eside lapho izindlela zokuphefumula emaphashini zilimala unomphela futhi zivuleke.
- Uphawu oluyinhloko ukukhwehlela okuqhubekayo okukhiqiza inani elikhulu lamafinyila.
- Nakuba kungelapheki ngokuphelele, ungakwazi ukulawula izimpawu, uvimbele izifo, futhi uphile impilo enhle.
- Kubaluleke kakhulu ukusebenzisa imithi enikezwe udokotela ngqo nokwenza izivivinyo zokususa amafinyila nsuku zonke.
- Gwema ukubhema ngokuphelele. Gwema ukuphefumula intuthu kanye namagesi alimaza amaphaphu.
- Zivikele ezifweni ngokuthola imijovo edingekayo (isib. i-Flu, i-Pneumococcal) ngesikhathi.
- Uma izimpawu ziba zimbi kakhulu noma kuvela izimpawu zesixwayiso eziphuthumayo, funa iseluleko sezokwelapha ngokushesha.
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