Ingabe leli gciwane libangela izinkinga emaphashini akho? Ake sifunde ngqo nge (MAC Lung Disease)!

Ingabe ngezinye izikhathi uzizwa ukhathele ngaphandle kwesizathu, noma ukhwehlela isikhathi eside? Nakuba singazinaki kakhulu izinto ezincane kangaka ekuphileni kwethu kwansuku zonke, kungase kube nezizathu okufanele sizikhathazeke ngazo kancane. Namuhla sizokhuluma ngesifo esibangelwa yiqembu elikhethekile lamagciwane angathinta amaphaphu ethu. Lokhu kubizwa ngokuthi i-MAC Lung Disease .

Siyini isifo samaphaphu se-MAC?

Kalula nje, isifo samaphaphu se-MAC siwukutheleleka kwamaphaphu ethu okubangelwa yiqembu lamagciwane abizwa ngokuthi i-Mycobacterium avium complex (MAC) . Empeleni leli gciwane lihlala lisizungezile, othulini, enhlabathini nasemanzini. Ngisho noma la magciwane engena emzimbeni lapho siphefumula noma sigwinya okuthile, abantu abaningi abaguli. Kodwa-ke, kwabanye abantu, ikakhulukazi labo asebenobuthakathaka obuthile emaphashini abo noma labo abanesimiso somzimba esiphansi sokuzivikela, lapho leli gciwane le-MAC lingena endleleni yokuphefumula, ukutheleleka okukhulu kungavela. Lokhu kutheleleka kubangela ubunzima bokuphefumula. Uma kutholakale sekwephuzile, kungaba nzima futhi ukukwelapha. Into ebaluleke kakhulu ukuthi lesi sifo samaphaphu se-MAC akusona isifo esingadluliselwa kusuka kumuntu siye komunye.

Ibukeka kanjani i-MAC bacteria?

Amabhaktheriya e-MAC angamalungu omndeni omkhulu wamabhaktheriya abizwa ngokuthi i-Nontuberculous mycobacteria (NTM) . Kunezinhlobo ezingaba ngu-200 ze-NTM. Amabhaktheriya e-MAC abangela cishe u-80% wokutheleleka kwe-NTM emaphashini emazweni afana ne-United States.

Cabanga ngakho, lokhu kutheleleka kwe-NTM akufani nesifo sofuba (TB) esisaziyo sonke. Isifo sofuba yisifo esisakazeka sisuka komunye umuntu siye komunye futhi singaba sibi ngokushesha. Amagciwane asibangela nawo ahlukile, abizwa ngokuthi `(Mycobacterium tuberculosis)`.

Kunezinhlobo eziningi ezahlukene ze-mycobacteria ngaphakathi kweqembu le-MAC, kodwa ukwelashwa nokuphathwa kwalesi sifo kuyafana kakhulu.

Sivame kangakanani isifo samaphaphu se-MAC?

Kunabantu abangaphezu kuka-86,000 abanezifo ze-NTM e-United States kuphela. Isifo samaphaphu se-MAC yisona esivame kakhulu, esibangela cishe u-80% wezifo ze-NTM. Inani leziguli zamaphaphu ze-NTM belilokhu likhula kancane kancane eminyakeni engamashumi amabili edlule , futhi ochwepheshe bathi lo mkhuba uzoqhubeka.

Yiziphi izinhlobo zokutheleleka kwe-MAC ezikhona?

Ukutheleleka kwe-MAC kungahlukaniswa ngezinhlobo eziningana eziyinhloko:

• Ukutheleleka kwe-MAC yamaphaphu: Lokhu yilabo abathinta ngqo amaphaphu ethu kanye nohlelo lokuphefumula.
• Ukutheleleka kwe-MAC okusabalalisiwe: Lokhu ukutheleleka okusabalala emzimbeni wonke ngegazi. Kuvame ukubonakala kubantu amasosha abo omzimba abuthakathaka kakhulu ngenxa yezimo ezifana ne-AIDS .
• I-lymphadenitis ehlobene ne-MAC:Lokhu kuthinta kakhulu izingane ezinempilo. Ama-lymph node ezindaweni ezifana nentamo ayavuvukala.

Kunezinhlobo ezimbili eziyinhloko zesifo samaphaphu se-MAC...

Kunezinhlobo ezimbili eziyinhloko zesifo samaphaphu se-MAC esizibonayo:

1. I-nodular bronchiectasis: Yilapho ukutheleleka kuvela khona emigudwini emincane yomoya kanye nasezikhwameni zomoya emaphashini, futhi kuvela njengeziqhubu ezincane ku-X-ray yesifuba. Lawa maqhubu angakhula abe makhulu kakhulu. Lokhu kutheleleka kwesikhathi eside kubangela isimo esibizwa ngokuthi i-bronchiectasis . Lokhu kusho ukuthi imigudwini yomoya ivuleka ngokungenakulungiseka, njengepayipi lerabha eliguga futhi linwebeka. Lokhu kwenza kube nzima ukwelapha ukutheleleka futhi kwandisa ingozi yokutheleleka okusha. Lolu hlobo luvame kakhulu kwabesifazane asebekhulile, abancane, abangabhemi. Uma lungelashwa, lungaholela ezimweni ezifana ne-bronchitis kanye ne-pneumonia.

2. Isifo se-Fibrocavitary: Lolu uhlobo olubi kakhulu lwesifo samaphaphu se-MAC. Ludinga ukwelashwa ngokushesha. Uma ukutheleleka kubangela imigodi (izimbobo) ezicutshini zamaphaphu, ukutheleleka kujule kakhulu futhi kungaba nzima ukukwelapha. Lesi simo sivame kakhulu kubantu ababhemayo noma abantu abanezimo ezifana ne-emphysema.

Isifo samaphaphu se-MAC sikhula kanjani?

Sesikhulume kakade ngendlela amabhaktheriya e-MAC atholakala ngayo ngokwemvelo enhlabathini nasemanzini. Uma simba inhlabathi futhi sivuselela uthuli, la mabhaktheriya angakhishwa emoyeni angene emizimbeni yethu lapho siphefumula. Abantu abasebenza emasimini futhi abavame ukuxhumana nenhlabathi bangase bavezwe amabhaktheriya e-MAC kakhulu kunabanye. Futhi, la mabhaktheriya akhona emanzini, futhi angaba khona emanzini esiwasebenzisa ekhaya. I-chlorine, izibulala-magciwane, futhi ngezinye izikhathi ngisho nokushisa amanzi akubulali la mabhaktheriya. Lokhu kungase kuzwakale kuyesabisa kancane, kodwa abantu abaningi abalinyazwa yila mabhaktheriya. Sonke sivezwa amabhaktheriya e-NTM cishe nsuku zonke, kodwa abantu abaningi abatholi ukutheleleka.

Kodwa-ke, kubantu abambalwa abanezici ezithile eziyingozi, amabhaktheriya angahamba aye emaphashini futhi akhule kancane kakhulu, ngezinye izikhathi iminyaka. Lokhu kutheleleka kwamaphaphu e-MAC kubangela ukuvuvukala okuphansi kanye nezinguquko ezingenakuguqulwa emigudwini yomoya, kuze kube yilapho lesi sifo sitholakala futhi selashwa.

Ubani osengozini enkulu yokuthola isifo samaphaphu se-MAC?

Isifo samaphaphu se-MAC singakhula kunoma yimuphi ubudala nakunoma yiluphi ubulili, kodwa abantu abangaphezu kweminyaka engu-65 kanye nabesifazane abaye badlula esikhathini sokunqamuka kokuya esikhathini basengozini enkulu.

Ngaphezu kwalokho, kungenzeka kakhulu ukuthi ube nesifo samaphaphu se-MAC uma:

• Uma ubhema.
• Uma amasosha akho omzimba ebuthakathaka.
• Uma unesifo samaphaphu esinjengalesi:
• (I-Bronchiectasis)(kanye nezimo eziholela ku-bronchiectasis)
• (Isifo samaphaphu esingapheli esivimbayo - i-COPD )
• (I-cystic fibrosis)
• (I-Emphysema)
• Uma uke waba nesifo sofuba (TB) ngaphambilini.

Ziyini izimpawu zesifo samaphaphu se-MAC?

Izimpawu zesifo samaphaphu se-MAC ziyahlukahluka, futhi ngenxa yokuthi aziqondile, ukuxilongwa kungabambezeleka. Abanye abantu bangase babe nezimpawu ezincane kakhulu noma ezingabonakali. Ngezinye izikhathi izimpawu zingase zingahlobene nohlelo lokuphefumula. Uma kuvela izimpawu, ungase ubhekane nalokhu:

• Ukukhwehlela okungapheli (kukhona noma kungekho ukukhwehlela). Cabanga ngomuntu onjengoNilanthi, obelokhu ekhwehlela izinyanga eziningi, futhi ukukhwehlela kuphuma kancane kancane, kodwa ucabanga ukuthi umkhuhlane nje ovamile.
• Ukukhwehlela igazi (i-Hemoptysis) .
• Ukukhathala .
• Umkhuhlane ophansi (ngokuvamile phakathi kwama- degree Celsius angu-37.5 no-37.9 - 99.6 F kuya ku-100.3 F).
• Ukujuluka ebusuku.
• Ukuphelelwa umoya .
• Ukwehla kwesisindo okungachazeki kanye nokulahlekelwa yisifiso sokudla.
• Ubuhlungu besifuba.
• Ukukhathazeka.

Isifo samaphaphu se-MAC sitholakala kanjani ?

Udokotela wakho uzoqala akuhlole bese ebuza ngezimpawu zakho.

Ukuhlolwa okusetshenziselwa ukuxilonga isifo samaphaphu se-MAC kufaka phakathi:

• Ama-X-ray esifubeni ikakhulukazi ama-CT scan. Lokhu kungabona izinguquko emaphashini ezibangelwa ukutheleleka.
• Ukukhula kwe-sputum. Lokhu kuhilela ukuthatha isampula ye-phlegm emaphashini akho bese uyihlola ukuze ubone ukuthi iyawakhulisa yini amabhaktheriya e-MAC. Njengoba sonke sichayeka kuma-bacteria e-MAC nsuku zonke, lokhu kuhlolwa kungenziwa izikhathi eziningana ezinsukwini ezimbalwa ukuqinisekisa ukuthi amabhaktheriya avela emaphashini akho ngempela.
• I-Bronchoscopy. Lokhu kufana ne-colonoscopy, kodwa kwenziwa emaphashini (kusetshenziswa ithuluzi elincane elihlukile). Kwenziwa lapho ukuxilongwa kungenziwa ngokuhlolwa kwe-sputum.

Yiziphi izindlela zokwelapha isifo samaphaphu se-MAC?

Ngenxa yokuthi isifo samaphaphu se-MAC sinzima kakhulu ukwelapha, kuzodingeka ubone uchwepheshe wezifo ezithathelwanayo noma uchwepheshe wamaphaphu. Bobabili laba odokotela banolwazi olukhethekile ekuxilongeni nasekuphatheni izifo.

Ukwelashwa kwesifo samaphaphu se-MAC kuyahlukahluka kuye ngokuthi izimpawu zibucayi kangakanani. Kungafaka:

• Ukulinda okuqaphile:Labo abanezimpawu ezincane futhi abangenazo izinguquko ezibalulekile emaphashini abo lapho behlolwa bangase bangadingi ukwelashwa ngama-antibiotic ekuqaleni. Kodwa-ke, kuzodingeka babonane nodokotela wabo njalo futhi bahlolwe ukuphefumula kanye ne-sputum.
• Ukuhlanza umoya: Leli yiqembu lezindlela zokwelapha ezisiza amaphaphu ukuthi asuse ulwelwesi (kanye namabhaktheriya akulo) emigudwini yomoya enesifo. Livame ukusetshenziselwa i-bronchiectasis. Lihlanganisa izindlela ezahlukene zokwelapha ukuphefumula ezinikezwa nge- nebulizer , kanye nokusetshenziswa kwamadivayisi athile asiza ekususeni ulwelwesi ezingxenyeni ezingezansi zamaphaphu.
• Imithi: Uma ukuhlanza imigudu yakho yomoya kunganele, udokotela wakho angase akunike ama-antibiotic . Isinqumo sokuqala ukwelashwa sizoncika ezintweni eziningana kanye nengxoxo nochwepheshe wakho. Ngezinye izikhathi amabhaktheriya angaba ukumelana nama-antibiotic , okusho ukuthi awakwazi ukubulawa yimithi. Ukuze unciphise le ngozi futhi uwabulale ngokuphelele amabhaktheriya, kungadingeka ukuthi uthathe izinhlobo ezintathu ezahlukene zama-antibiotic esikhathini esiyizinyanga ezingu-12 kuya kwezingu-18. Kubantu abangaphenduli kwamanye ama-antibiotic zingakapheli izinyanga eziyisithupha, i-US Food and Drug Administration (FDA) isanda kuvuma i-antibiotic ephefumulayo.
• Ukuhlinzwa: Akuvamile kakhulu, uma ama-antibiotic engasizi, kungase kudingeke ukuhlinzwa ukuze kususwe ingxenye yephaphu ethelelekile. Ngemva kokuhlinzwa, kuzodingeka uthathe ama-antibiotic isikhathi esifushane ukuze ubulale noma yimaphi amabhaktheriya asele.

Siphila kanjani nesifo samaphaphu se-MAC? (Ukuphathwa)

Lezi zinto zingasiza ekunciphiseni izimpawu zesifo samaphaphu se-MAC:

• Thola izindlela zokususa amafinyila emigudwini yakho yomoya. Lokhu kufaka phakathi ukuthola okungenani imizuzu eyi-150 yokuzilolonga ngamandla aphakathi ngesonto (ikakhulukazi uma ufanelekela ukwelashwa kwamaphaphu ), ukufunda ngamasu esifuba nokuphefumula kuchwepheshe wokuphefumula, ukukhwehlela okulawulwayo, ukuphuma kwamanzi ngendlela ehlelekile (izindlela zokuma ezisiza ukususa amafinyila emaphashini), kanye nokushaya kwesifuba ukuze kukhululeke amafinyila.
• Thola usizo lokuyeka ukubhema , futhi ugweme ukubhema intuthu esetshenziswa abanye kanye nezinye izinto eziyingozi emaphashini akho.
• Goma. Zivikele ezifweni ezengeziwe zokuphefumula ezifana nomkhuhlane, i-pneumonia, kanye ne-COVID-19.
• Gcina isisindo esinempilo ngokudla okunomsoco. Izikhungo eziningi zinezazi zokudla ezingasiza ngokuntuleka kokudla okunempilo okubangelwa izifo ezithathelwanayo njenge-MAC.

Yiziphi izinkinga ezingaba khona zesifo samaphaphu se-MAC?

Ukusebenzisa ama-antibiotic isikhathi esideIngozi yokumelana nama-antibiotic inganda. Futhi, imiphumela emibi yemithi, njengesicanucanu, isifo sohudo, kanye nobuhlungu besisu, ingase ivele. Njengoba i-antibiotic ngayinye inemiphumela yayo ethile emibi, kubalulekile ukukhuluma nodokotela wakho ngayo.

Abantu asebekhulile basengozini yokuthola ukutheleleka ngebhaktheriya okubizwa ngokuthi i-Clostridium difficile (C. diff) uma bethatha ama-antibiotic isikhathi eside. Lokhu kwenzeka ngoba ama-antibiotic abulala amabhaktheriya amahle esiswini asiza ekugayeni ukudla. Ukutheleleka kwe-C. diff kuthinta uhlelo lokugaya ukudla futhi kubangele uhudo olubi nolungapheli. Lokhu kungaba yingozi empilweni.

Isifo samaphaphu esibi se-MAC singakuvimbela ekwenzeni izinto obuzijabulela. Ngenxa yalokho, ungase uzizwe ucindezelekile noma ukhathazekile.

Ngingayinciphisa kanjani ingozi yokuthola isifo samaphaphu se-MAC?

Lezi zinyathelo zinganciphisa ingozi yakho yokuchayeka kumagciwane e-MAC:

• Uma udokotela wakho ecabanga ukuthi umthombo wamagciwane akho e-MAC kungaba ama-hot tub noma ama-sauna, gwema izindawo ezishisayo, ezishisayo, neziphindaphindayo zokujikeleza kwamanzi.
• Vula izinhlelo zokungenisa umoya endlini yokugezela nasekhishini ukuze ususe umusi.
• Setha isifudumezi samanzi ashisayo sendlu yakho okungenani sibe ngama-degree Celsius angu-54.4 (130 Fahrenheit).
• Gqoka imaski yothuli uma usebenza engadini noma ulima ingadi.
• Ngaphambi kokusebenza ngenhlabathi yokumba, fafaza ngamanzi ukuze unciphise uthuli.
• Landela uhlelo lokuhlanza umoya olunamandla.

Ingabe isifo samaphaphu se-MAC singalapheka ngokuphelele?

Uma ukuhlolwa kwe-sputum kukhombisa ukuthi akukho ukutheleleka izinyanga eziyi-12, odokotela bacabanga ukuthi isifo samaphaphu se-MAC seselaphekile. Kodwa-ke, ukutheleleka kungaphinde kuvele. Lokhu kungaba ngenxa yokuchayeka okusha kubhaktheriya noma kumabhaktheriya asele emaphashini, ikakhulukazi uma usenesimo esabangela i-MAC kwasekuqaleni (njengobuthakathaka bamaphaphu).

Udokotela wakho uzokuqapha ukuthi ukutheleleka kuphinde kwavela futhi. Umonakalo emaphashini akho ngenxa yesifo samaphaphu se-MAC awukwazi ukubuyiselwa emuva. Ungase ube nenkinga yokuphefumula ngemva kokwelashwa. Ngakho-ke, kubalulekile ukuba nemigomo ecacile kanye nokulindela ngaphambi kokuqala ukwelashwa.

Izinto okufanele uzibuze udokotela wakho...

Ungase ufune ukubuza udokotela wakho ngezinto ezifana nalezi:

• Ngithole kanjani isifo samaphaphu se-MAC?
• Uhlobo luni lwesifo samaphaphu se-MAC enginaso?
• Ingabe ngidinga ukwelashwa?
• Yiziphi izindlela zokwelapha enginazo?
• Ingabe ukuhlinzwa kulungile kimi? Ziyini izingozi zokuhlinzwa?
• Ingabe kukhona izinto engingazenza ekhaya ukuze ngiphefumule kalula?
• Ngingazigwema kanjani izifo zamaphaphu ze-MAC esikhathini esizayo?

Ingabe lokhu kuyathelelana kusuka komunye umuntu kuya komunye?

Nakuba ungeke ukwazi ukuthola i-MAC komunye umuntu, ngezinye izikhathi lesi simo sithinta amalungu amaningana omndeni ofanayo. Ochwepheshe bakholelwa ukuthi abanye abantu banokuguqulwa kwezakhi zofuzo okubenza babe sengozini enkulu yokutheleleka yi-MAC.

Ingabe isifo samaphaphu se-MAC singaba yingozi?

Kwabanye abantu, isifo samaphaphu se-MAC singaholela ekuhlulekeni kokuphefumula ngisho nokufa. Kodwa lokhu kuvame ukwenzeka isikhathi eside. Cishe umuntu oyedwa kwabane abanesimiso somzimba sokuzivikela esibuthakathaka kanye nesifo samaphaphu se-MAC sohlobo lwe-cavitary bafa zingakapheli iminyaka emihlanu ngemva kokuxilongwa.

Ukuxilongwa kusenesikhathi kanye nokwelashwa kunganciphisa kakhulu izingozi zesikhathi eside.

Iningi labantu aliguli ngenxa yamagciwane e-MAC. Kulabo abagulayo, isifo samaphaphu se-MAC singabangela izinkinga zokuphefumula ezinkulu, ngezinye izikhathi ezisongela ukuphila. Uma ukhwehlela igazi, noma uma ukhwehlela njalo futhi uzizwa ukhathele kakhulu, kufanele nakanjani ubone udokotela. Abantu abanamasosha omzimba abuthakathaka kanye nalabo abanezinye izifo zamaphaphu basengozini enkulu yokuthola isifo samaphaphu se-MAC. Isifo samaphaphu se-MAC singelashwa ngama-antibiotic, kodwa kungadingeka ukuthi uthathe umuthi isikhathi esingaphezu konyaka.

Okokugcina, izinto okufanele uzikhumbule...

Isifo samaphaphu se-MAC yisimo okufanele sikhathazeke ngaso kancane. Kodwa-ke, akukho okufanele sikhathazeke ngaso. Into ebaluleke kakhulu ukubona udokotela ngokushesha okukhulu uma unezimpawu, uthole ukuxilongwa okunembile, bese uthola ukwelashwa okufanele. Uma kunjalo, singaphila impilo evamile ngalesi sifo. Uma uneminye imibuzo mayelana nalokhu, ungangabazi ukubuza udokotela wakho. Hlala uphilile!

Isifo samaphaphu se - MAC, i-Mycobacterium avium complex, ukutheleleka kwe-NTM, ukutheleleka kwamaphaphu, ukukhwehlela okungapheli, izifo zokuphefumula, ukutheleleka ngamagciwane