Ingabe unale nkinga ngamaphaphu akho? Ake sifunde nge-Interstitial Lung Disease (ILD)!

Ingabe ngezinye izikhathi uzizwa uphelelwa umoya? Noma ukhwehlela okomile okuqhubekayo? Noma uzizwa uphelelwa amandla uma uzikhandla? Lokhu kungase kungabi ukukhathala nje kuphela. Kungase futhi kube izimpawu zesimo esizokhuluma ngaso namuhla esibizwa ngokuthi "Isifo Samaphaphu Esingaphakathi Kwezinzwa" ("ILD"). Ungakhathazeki, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.

Iyini Isifo Samaphaphu Esingaphakathi Kwezinzwa?

Kalula nje, isifo samaphaphu esiphakathi nendawo (i-ILD) asisona isifo esisodwa. Siyiqembu lezifo. Eqinisweni, kunezinhlobo ezingaphezu kuka-200. Lezi zifo zibangela ukuthi izicubu ezithambile ngaphakathi kwamaphaphu akho ( i-interstitium ) zivuvuke, zilimale, futhi zibe nezibazi. Manje ungase ubuze, "Kuyini lokhu okuphakathi nendawo?" Cabanga ngakho njengoba amaphaphu ethu enziwe ngamabhaluni amancane (abizwa ngokuthi ama-alveoli ). I-interstitium iyizicubu ezithambile phakathi kwalezi zikhwama zomoya kanye nemithambo yegazi ezizungezile. Uma siphefumula, umoya-mpilo uyangeniswa bese ukhishwa egazini ngalezi zikhwama zomoya. Ngakho-ke, ku-ILD, lezi zicubu ezibalulekile ziyalimala, ngakho umoya-mpilo awungeni emzimbeni ngendlela efanele.

I-'ILD' ibizwa nangokuthi 'Isifo Samaphaphu Esisabalalayo Se-Parenchymal (DPLD).' Kodwa-ke, igama elithi 'ILD' yilona elisetshenziswa kakhulu.

Kwenzekani emzimbeni uma kukhula i-'ILD'?

Uma une-ILD, izingxenye zamaphaphu akho eziqoqa umoya-mpilo egazini lakho bese ziwuthumela kuwo wonke umzimba wakho ziyalimala. Lezi zicubu ziba nezibazi (ezibizwa nangokuthi i-fibrosis ), okwenza kube nzima ukuphefumula. Ungase futhi ube nokukhwehlela okungapheli nokomile. Ungase uzizwe ukhathele ngaso sonke isikhathi ngoba umzimba wakho awutholi umoya-mpilo owanele.

Uma lo monakalo uqhubeka nokwanda, ungaholela ezinkingeni ezingaba yingozi empilweni ngezinye izikhathi. Isibonelo, izifo zamaphaphu kanye nokwehluleka kokuphefumula (lapho umzimba ungatholi khona umoya-mpilo owanele noma uthola i-carbon dioxide eningi kakhulu).

Yiziphi izinhlobo ze-'ILD' ezikhona?

Njengoba sishilo ngaphambili, kunezinhlobo ezingaphezu kuka-200 ze-'ILD'. Enye yezinhlobo ezivame kakhulu yi-'Idiopathic Pulmonary Fibrosis' . Ngaphezu kwalokho, i-'ILD' ingabangelwa yizinto ezisendaweni yethu yokusebenza (ukuchayeka emsebenzini) noma izinkinga zezicubu ezixhumeneyo. Ezinye izibonelo yilezi:

• I-Asbestosis
• I-Silicosis
• I-Radiation Pneumonitis
• I-Pneumonia Yangaphakathi Engaqondile

Uyini umehluko phakathi kwe-'Interstitial Lung Disease' (ILD) kanye ne-'Pulmonary Fibrosis'?

Lokhu kuyinto edida abantu abaningi. I-Pulmonary fibrosisI-Pulmonary Fibrosis (i-Pulmonary Fibrosis) uhlobo lwe-ILD. Okusho ukuthi, akuzona zonke i-ILD eziyi-pulmonary fibrosis. I-Pulmonary fibrosis ukwakheka kwezibazi emaphashini. Nakuba lokhu kuzibazi kuyisici esiyinhloko kwezinye i-ILD, ukuvuvukala kungaba yisici esiyinhloko kwezinye i-ILD.

Ubani osengozini enkulu yokuthola i-'ILD'?

Ungase ube namathuba amaningi okuthola i-ILD uma:

• Uma uneminyaka engaphezu kuka-70 ubudala.
• Uma uyindoda. (Abesifazane nabo bangayithola, kodwa ivame kakhulu kwabesilisa)
• Uma ubhema noma uke wabhema esikhathini esidlule.
• Uma uke waba nezifo ezithile ngaphambili, isibonelo, i-Hepatitis C, i-Tuberculosis, i-Pneumonia, i-COPD, noma i-Connective Tissue Disease.
• Uma uphefumula izinto eziyingozi emaphashini akho ngenxa yomsebenzi wakho noma indawo okuyo . Izibonelo: i-asbestos, i-silica, isikhunta, isikhunta, noma amagciwane.
• Uma uke welashwa ngemisebe esifubeni sakho .

Ingakanani i-'ILD'?

Ngenxa yokuthi kunezinhlobo eziningi ze-'ILD', ubukhali be-'ILD' umuntu ngamunye abuthola bungahluka. Ezinye zingase zibe zincane, kodwa ezinye zingaba zimbi kakhulu. Okubalulekile, umonakalo emaphashini obangelwa izinhlobo eziningi ze-'ILD' 'awulungiseki'. Lokhu kusho ukuthi kunzima ukulungisa izicubu ezonakele. Ezinye izinhlobo ezimbi ze-'ILD' ziya ziba zimbi ngokuhamba kwesikhathi ('eziqhubekayo').

Ziyini izimpawu ze-'ILD'?

Izimpawu ezivame kakhulu ze-ILD yilezi:

• Ubunzima bokuphefumula (ukuphelelwa umoya): Lokhu kungaba kubi kakhulu, ikakhulukazi ngesikhathi sokuzivocavoca noma umsebenzi onzima.
• Ukukhwehlela okomile (ukukhwehlela okungenaso isikhwehlela).
• Ukuzizwa ukhathele kakhulu (ukukhathala).
• Ukungakhululeki noma ubuhlungu esifubeni .

Lezi zimpawu zingase zingabi zimbi ekuqaleni, kodwa zingaba zimbi kancane kancane ngemva kwezinyanga noma iminyaka. Izimpawu ezengeziwe zingase zivele, kuye ngokuthi imbangela eyinhloko ye-ILD ibangelwa yini.

Yiziphi izimbangela ze-'ILD'?

Izimbangela ze-ILD zingahlukaniswa ngezigaba ezimbili eziyinhloko: izimbangela ezihlonziwe kanye nezimbangela ezingahlonziwe .

Izimbangela Ezaziwayo

Lokhu kusho ukuthi i-ILD iqala ngenxa yesinye isifo osunaso kakade, noma ngenxa yemithi ethile oyithathayo, ukwelashwa ngemisebe, noma ukuchayeka ezintweni eziyingozi endaweni ezungezile.

Ezinye zezizathu eziyinhloko ezitholakele:

• Isifo Sezicubu Ezixhumeneyo: Izibonelo zifaka phakathi izifo ezifana ne-Rheumatoid Arthritis (RA), i-Lupus, kanye ne-Scleroderma.
• Isifo se-Granulomatous: Isibonelo yi-sarcoidosis.
• Ukuphefumula izinto ezithile: izinto ezifana ne-asbestos, i-silica, ugwayi, kanye ne-beryllium.
• Ukungezwani komzimba okubangelwa ukuphefumula (i-Hypersensitivity Pneumonitis): Lesi simo singabangelwa ukuphefumula izinto ezifana nesikhunta, isikhunta, amabhaktheriya, izimpaphe zezinyoni, noma izinhlayiya ezincane zendle yezinyoni.
• Imithi ethile noma ukwelashwa: Isibonelo, imithi efana ne-amiodarone, i-nitrofurantoin, i-methotrexate, kanye nokwelashwa ngemisebe.

Izimbangela Ezingaziwa (`Izimbangela Ezingaziwa` noma `Idiopathic`)

Ngezinye izikhathi odokotela abakwazi ukuthola imbangela eqondile ye-ILD. Lokhu kusho ukuthi uba ne-ILD ngaphandle kwanoma yisiphi esinye isimo sezokwelapha noma ukuchayeka kunoma yini eyingozi. Lokhu sikubiza ngokuthi i -idiopathic interstitial pneumonia . Kunezinhlobo eziningana ze-ILD. Uhlobo oluvame kakhulu lwe-ILD, lapho kungatholakali khona imbangela, yi -idiopathic pulmonary fibrosis .

Ungayithola kanjani i-ILD? (Ukuxilongwa)

Udokotela wakho uzolandela izinyathelo eziningana zokuxilonga i-ILD. Okokuqala, uzokuhlola, alalele amaphaphu akho futhi ahlole noma yimiphi imisindo engavamile (njengokuqhekeka). Bese bezokubuza imibuzo efana nale:

• Umlando wakho wezokwelapha ophelele kanye nanoma yiziphi ezinye izimo zezokwelapha zamanje.
• Mayelana nemithi oyisebenzisayo njengamanje noma oke wayisebenzisa esikhathini esidlule .
• Ingabe ukhona emndenini wakho onayo noma yiziphi zalezi zifo noma izifo zezicubu ezixhumeneyo?
• Kungakhathaliseki ukuthi umsebenzi wakho noma izinto ozithandayo zikuvezela izinto ezingadala i-'ILD' .

Yiziphi izivivinyo ezisetshenziswa ukuxilonga i-'ILD'?

Uma udokotela esola ukuthi une-ILD, angenza lezi zivivinyo ezilandelayo:

• Ukuhlolwa Kokusebenza Kwamaphaphu (ama-PFT): Lokhu kuvame ukuba ukuhlolwa kokuphefumula, kodwa ngezinye izikhathi kungase kuhlanganise nokuhlolwa kwegazi noma ukuhlolwa kokuzivocavoca. Lokhu kuhlola ukuthi amaphaphu akho asebenza kahle kangakanani.
• Ukuhlolwa Kwezithombe: Kuthathwa i-X-ray yesifuba noma i-CT scan enekhwalithi ephezulu (HRCT) ukuze kubhekwe isimo samaphaphu. I-HRCT ingabona imininingwane emincane kakhulu.
• Ukuhlolwa Kwegazi: Isampula yegazi ethathwe engalweni yakho iyahlolwa ukuze kubonakale ukuthi zikhona yini izimbangela ezaziwayo (isib. izifo zezicubu ezixhumeneyo) ezingase zibangele i-ILD.
• I-Bronchoscopy:Lokhu kuhilela ukudlulisa ithubhu elincane, elifakwe ikhamera (i-'bronchoscope') ngekhala noma emlonyeni wakho liye emaphashini akho ukuze kuhlolwe izindlela zakho zokuphefumula. Ngezinye izikhathi isampula yamaseli ('i-lavage') ingathathwa emaphashini akho.
• Ukuhlolwa kwezicubu: Kwezinye izimo, kuthathwa ingxenye encane yezicubu emaphashini bese ihlolwa ngaphansi kwe-microscope. Lokhu kungasiza ekuboneni uhlobo oluqondile lwe-ILD. Ukuhlolwa kwezicubu kungenziwa nge-bronchoscopy noma ngokuhlinzwa okuncane (ukuhlinzwa kwezicubu zamaphaphu).

Yiziphi izindlela zokwelapha i-'ILD'?

Ngokudabukisayo, akukabikho ukwelashwa okungayelapha ngokuphelele i-'ILD'.

Kodwa ungalilahli ithemba. Ukwelashwa kuhloswe ekwelapheni isimo esiyisisekelo esibangele i-ILD, ukulawula izimpawu, kanye nokunciphisa ukuqhubeka kwesifo. Udokotela wakho angase akunikeze ukwelashwa ngokomzimba, umoya-mpilo owengeziwe, noma imithi yokunciphisa ukuvuvukala emaphashini akho noma ukulawula izibazi.

Yimiphi imithi kanye nokwelashwa okusetshenziselwa i-'ILD'?

• Ama-Corticosteroids: Imithi efana ne-prednisone isiza ekunciphiseni ukuvuvukala emaphashini.
• Imithi Elwa Ne-fibrotic kanye Ne-Cytotoxic: Le mithi inganciphisa izinga lokuqhekeka kwamanxeba emaphashini. Izibonelo: I-Azathioprine, i-Cyclophosphamide, i-Pirfenidone, i-Nintedanib.
• Imithi Yezinto Eziphilayo: Imithi efana neRituximab isetshenziselwa ukwelapha ezinye izifo ezihlasela amasosha omzimba kanye nezinye izimo ezibangela i-ILD.
• Ukwelashwa kwe-GERD: Uma unesifo se-gastroesophageal reflux (GERD), singaba sibi kakhulu i-ILD. Ngakho-ke, unganikezwa imithi yokulawula i-asidi yesisu.
• Ukuvuselelwa Kwemiphunga: Lolu uhlelo olukhethekile lokuzivocavoca kanye nokufundisa. Ukuzivocavoca kokuphefumula kanye nokuzivocavoca umzimba kusiza ukuqinisa amaphaphu akho futhi kwenze kube lula ukuphefumula.
• Ukwelashwa Nge-Oxygen: Uma igazi noma izicubu zakho zingatholi umoya-mpilo owanele, udokotela wakho angase akunikeze umoya-mpilo owengeziwe. Lokhu kunikezwa nge-cannula yamakhala noma i-mask yobuso.
• Ukufakelwa Amaphaphu: Kubantu abane-ILD enzima kakhulu, ukufakelwa amaphaphu kungaba yindlela yokugcina.

Imiphumela emibi yokwelashwa

Ezinye izindlela zokwelapha i-ILD (ikakhulukazi ama-corticosteroids kanye nemithi ebulala amagciwane) zingawenza buthaka amasosha omzimba wakho. Ngakho-ke, udokotela wakho uzokuqapha njalo futhi aqaphele izinkinga ezingaba khona.

Ingabe i-ILD ingavinjelwa?

Kunzima ukuvimbela izinhlobo eziningi ze-ILD. Kodwa-ke, ungenza okulandelayo ukuze unciphise ingozi yakho yokuthola i-ILD:

• Phatha noma yiziphi izimo zezokwelapha osunazo kakade (isib. izifo zezicubu ezixhumeneyo).
• Gwema ukuhogela izinto eziyingozi emaphashini.
• Uma usebenza ezindaweni lapho kukhona khona i-asbestos, uthuli lwensimbi, noma amakhemikhali, gqoka umshini wokuphefumula ofanele (imaski ehlunga izinhlayiya emoyeni).
• Ukungezwani komzimba kwesikhathi eside kungabangelwa izinto ezifana notshani, okusanhlamvu, indle yezinyoni noma izimpaphe, kanye nezinhlelo zokushisa nokupholisa. Gqoka umshini wokuphefumula uma usebenza ngalezi zinto.
• Uma unesifo esifana nesifo sezicubu ezixhumeneyo noma i-sarcoidosis, khuluma nodokotela wakho ngezindlela zokuvimbela i-ILD.
• Uma ubhema, yeka nakanjani. Uma ungabhemi, ungaqali.

Ikusasa liphetheni kumuntu one-'ILD'?

Uma une-ILD, wena nodokotela wakho nizosebenzisana ukuze ninqume ukuthi ningayiphatha kanjani isimo sakho, kuye ngokuthi imbangela ye-ILD iyini. Isibonelo, uma i-ILD yakho ibangelwa umsebenzi wakho noma ukungezwani komzimba (hypersensitivity pneumonitis), kungadingeka uyeke ukusebenza nento ebangela i-ILD noma uthathe izinyathelo zokuphepha ezikhethekile.

Nakuba imithi inganciphisa ukuvuvukala, izibazi ezenzeka emaphashini ngenxa ye-ILD zihlala njalo. Lokhu kusho ukuthi umonakalo awukwazi ukubuyiselwa emuva. Uma unesifo esingaphansi, ukusiphatha kahle kungasiza ekuvimbeleni umonakalo owengeziwe. Uma une-ILD okungatholakali imbangela yayo (idiopathic), udokotela wakho uzokwelapha izimpawu zakho futhi azame ukuvimbela umonakalo owengeziwe.

Yiziphi izinkinga ezingaba khona ze-'ILD'?

Uma i-ILD iba yimbi kakhulu, kungavela izinkinga ezisongela ukuphila, njenge:

• Umfutho wegazi ophezulu wamaphaphu
• Iphaphu Eliwile (i-Pneumothorax)
• Ukutheleleka Kwamaphaphu
• Ukwehluleka Kokuphefumula
• Umdlavuza Wamaphaphu

Ingakanani iminyaka yokuphila yomuntu one-'ILD'?

Lona umbuzo abantu abaningi abawubuzayo. Isikhathi sokuphila somuntu one-'ILD' sincike embangela ye-'ILD' kanye nobunzima bayo. Abanye abantu bangaphila impilo evamile ngaphandle kokwelashwa noma ngokwelashwa okuncane uma i-'ILD' yabo ingekho nzima kakhulu. Uma isifo sakho singabi sibi kakhulu (okungukuthi, uma 'sizinzile'), isimo sengqondo ('isibikezelo') sihle kakhulu.

Kodwa-ke, kulabo abanezinhlobo ze-'ILD' ezimbi kakhulu neziwohloka ngokushesha, isikhathi sokuphila ngemva kokuxilongwa singaba yiminyaka emi-3-5. Ungakhathazeki ngalezi zibalo. Lokhu kuhlukile kumuntu ngamunye.

Ngingazinakekela kanjani uma ngine-'ILD'?

Uma utholakale une-ILD, indlela engcono kakhulu yokuzinakekela ukusebenzisana nodokotela wakho ukuze wakhe uhlelo lokuphatha izimpawu zakho nokuvimbela umonakalo owengeziwe.

• Yelapha noma yiziphi izimo ezingaphansi ezingase zibangele i-ILD.
• Lawula izinto ezingenza i-ILD ibe yimbi kakhulu (isib., i-GERD).
• Uma usebenza ngezinto ezilimaza amaphaphu noma ezibangela ukungezwani komzimba isikhathi eside, udinga ukuthatha izinyathelo zokuphepha ezikhethekile.

Kufanele ngimbone nini udokotela?

Bheka udokotela ngokushesha uma unalezi zimpawu:

• Ubunzima bokuphefumula buyanda kancane kancane.
• Ubunzima bokuphefumula ngesikhathi sokuzivocavoca.
• Ukukhwehlela okomile okuqhubekayo.

Uma i-ILD isheshe yelashwe, umphumela uba ngcono.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungakhohlwa ukubuza le mibuzo uma ubona udokotela wakho:

• Kungani ngithole lesi sifo?
• Yiziphi izindlela zokwelapha enginazo?
• Ingabe lesi simo sizoba sibi kakhulu?
• Ingabe umonakalo emaphashini ungancishiswa?
• Yiziphi izinguquko engingazithatha ukuze ngithuthukise ikhwalithi yempilo yami?

Kunezinhlobo eziningi ze-ILD. Ezinye zincane, ezinye zimbi kakhulu. Ungase ubone izibalo ezesabekayo ku-inthanethi, kodwa udokotela wakho kuphela ongakutshela ngqo ukuthi isimo sakho sinjani. Khuluma ngokwethembeka nodokotela wakho futhi uthole ukuqonda okucacile kwalokho okulindelwe. Ngokubambisana, wena nodokotela wakho ningakha uhlelo lokuphatha izimpawu zakho futhi niphile impilo engcono kakhulu.

Masikhumbule izinto ezibaluleke kakhulu (Umyalezo Wokuya Ekhaya)

• I-'ILD' iyiqembu lezifo ezilimaza izicubu ezithambile zamaphaphu, okwenza kube nzima ukuphefumula.
• Ukukhwehlela okomile, ubunzima bokuphefumula, kanye nokukhathala yizimpawu eziyinhloko.
• Kungaba nezizathu eziningi, futhi ngezinye izikhathi asikho isizathu esingatholakala.
• Nakuba kungekho ukwelashwa okuphelele, kunezindlela zokwelapha zokulawula izimpawu nokuvimbela lesi sifo ukuba singabi sibi kakhulu.
• Kubalulekile ukugwema ukubhema, ukugwema ukuhogela izinto eziyingozi, nokulawula izimo zezempilo eziyisisekelo.
• Uma unezimpawu, ungesabi futhi ufune iseluleko sezokwelapha. Ukuxilongwa nokwelashwa ngokushesha kubaluleke kakhulu.

Sithemba ukuthi lolu lwazi luwusizo. Hlala uphilile!

isifo samaphaphu esingaphakathi kwe - interstitial, i-ILD, isifo samaphaphu, ukucindezeleka kokuphefumula, ukukhwehlela okomile, i-pulmonary fibrosis, izibazi zamaphaphu, izimpawu zokuphefumula