Yintoni uKhohlokhohlo oluNgapheliyo?

Ukhohlokhohlo olungapheliyo lukhohlokhohlo oluzingileyo oluhlala ngaphezulu kweeveki ezisi-8-12/ngaphezu kweenyanga ezi-2 (1;2). Ukhohlokhohlo olungapheliyo ludla ngokubangelwa sisifo esibangelwa yintsholongwane egazini esifana nomkhuhlane okanye sinokunxulunyaniswa neemeko ezifana ne-asthma, sinusitis okanye ithontsi yasemva kweempumlo, kunye ne-gastroesophageal reflux (GERD).  

Xa ukhohlokhohlo lungapheli ngaphandle konyango lwezi meko, luhlelwa njenge “UKhohlokhohlo oluNgapheliyo” (isifinyezo I-RCC).  
Xa kubonakala ngathi akukho nanye imeko esisiseko ichazwa njenge “Ukhohlokhohlo olungapheliyo lwe-idiopathic” (3). Abantu abaninzi abanale meko bathwaxwa yi-hypersensitivity yendlela yomoya ephezulu ukuya kwizinto ezicaphukisayo ezifana nevumba elibi, uthuli, okanye utshintsho kwiqondo lobushushu. Ezinye izinto ezibangela ukhohlokhohlo zisenokuquka ukuthetha okanye ukuhleka. 

Zeziphi iimpawu zoKhohlokhohlo oluNgapheliyo?

Iziphumo ezinokubakho zokuPhila noKhohlokhohlo oluNgapheliyo:

Ukhohlokhohlo olungapheliyo lunokuphazamisa kakhulu umgangatho wobomi babantu. I-Paroxyms (ukulingana) yokhohlokhohlo isenokudinwa emzimbeni, kwaye inokuba mandundu xa ukungakwazi ukulala okukhokelela ekudinweni okukhulu. Ukhohlokhohlo olungapheliyo lunokubangela ukuba abantu baphephe iindibano zikawonke-wonke, okanye izithuthi ezikhokelela ekubeni babe bodwa ekuhlaleni kunye nokudakumba. (4-7)  

Ukukhohlela kakhulu kunokubangela umonakalo emzimbeni kubandakanya ukwaphuka kweembambo, ukungaphumeleli komchamo, kunye ne-syncope (ukuphuma). (7-9)

Indoda ehleli esofeni, ithimla engqinibeni ngelixa iphethe imagi ngesinye isandla. Unxibe ibhatyi yedenim kwaye ubonakala esekhaya.

Lufunyaniswa njani kwaye lulandelelwe njani uKhohlokhohlo oluNgapheliyo?

Ukuxoxa ngeempawu zakho kunye nomboneleli wezempilo kudla ngokuba yeyona ndlela ilungileyo yokufumanisa ukhohlokhohlo olungapheliyo, emva koko nikunye ninokukhangela unobangela walo ngokusebenzisa iimvavanyo ezahlukeneyo. 

  • Uvavanyo loxilongo: 
    • Umfanekiso wemiphunga
      • I-X-reyi okanye i-CT scans inceda ukuxilonga ezinye zezizathu zokukhohlela okungapheliyo 
    • Umsebenzi weLebhu 
      • Ichonga iimpawu zokudumba okanye ukwalana negazi lakho okanye isikhohlela (phlegm) 
    • Iimvavanyo zokusebenza kwemiphunga
      • Chonga ezinye izifo ezifana nesifuba, okanye COPD 
      • Olona vavanyo luxhaphakileyo yi-spirometry, edla ngokusetyenziswa ukuxilonga i-COPD kunye ne-asthma, kodwa unokuthunyelwa kuvavanyo lomthamo wemiphunga okanye uvavanyo lwamandla okusasaza.
    • Iimvavanyo usebenzisa umda (umbhobho)
      Kwiimeko apho ugqirha wakho engakwazi ukufumanisa unobangela wokukhohlela kwakho, banokuyalela iimvavanyo ezikhethekileyo zomda onje irhinoscopy kwaye ibronchoscopy.

      Oku kuya kubandakanya ukufaka ityhubhu encinci ngokukhanya kunye ne-lens empumlweni okanye emlonyeni. I-biopsy inokuthatyathwa kwezi ndawo ukujonga izinto ezingaqhelekanga.
      • I-Rhinoscopy ibandakanya ukusebenzisa i-rhinoscope ukujonga izono, iipaseji zempumlo, kunye nomoya ophezulu.
      • I-bronchoscopy isebenzisa i-bronchoscope ukujonga iindlela zomoya kunye nemiphunga. 
    • Uvavanyo lwe-allergies yolusu
      • Inokukunceda ukuchonga izinto ezikubangela ukukhohlela
  • Ukujonga ukhohlokhohlo ukulandelela ukhohlokhohlo olungapheliyo 
    • Izixhobo kunye / okanye usetyenziso oluphuhliswe njengezixhobo ezinokukunceda, umnakekeli wakho kunye nomboneleli wezempilo ukulawula ukukhohlela kwakho kwaye uqonde unyango olungcono kuwe. Ngokubeka iliso kutshintsho lokukhohlela rhoqo kunye nomgangatho, unyango lunokulungelelaniswa ukuze lufanele iimfuno zakho. (21;22)

Loluphi Unyango oluFumanekayo lokuLawula uKhohlokhohlo oluNgapheliyo?

  • Unyango lonyango
    • Ukunyanga unobangela (ukuba uyaziwa) kuya kuphucula okanye kuphelise ukukhohlela okungapheliyo: “unyango”
    • Akukho mayeza avunyiweyo okhohlokhohlo olungapheliyo olunxulumene noonobangela abangaziwayo (ukhohlokhohlo lwe-idiopathic). 
    • Umboneleli wakho wezempilo unokucebisa ngokucinezela ukhohlokhohlo ngaphandle kwekhawuntara, kodwa azikhuthazwa ngokhohlokhohlo olungapheliyo njengoko kukho ubungqina obuncinane bokuba ziyasebenza.
    • Ii-opiates: Unyango lwangoku lokhohlokhohlo olungapheliyo lubandakanya ii-opiates ezifana ne-codeine, i-morphine, kunye ne-diamorphine. I-opiates kufuneka ithathwe kuphela xa ichazwe ngugqirha wakho kunye nedosi efanelekileyo, njengoko kuyalelwe.
    • I-Gefapixant: Umchasi we-P2X3 we-receptor osebenza ngokuzibophelela kwii-receptors ezikhoyo kwi-lining of sensory nerve fibers kwi-airways kunye nokunciphisa ukusebenza kwazo. Ivunyiwe okwangoku eJapan, eSwitzerland, kunye neManyano yaseYurophu kunyango lwabantu abadala abanokhohlokhohlo olungapheliyo okanye olungachazwanga. Ngeli xesha, akuvunywanga e-US, kodwa uphando luyaqhubeka ukuxhasa ukuhlaziywa yi-US Food and Drug Administration (FDA). (24)
  • UbuChwephesha bokuCoca indlela yomoya kunye nezixhobo zinceda ukukhupha i-mucus okanye i-phlegm 
  • Unyango lwasekhaya kunokubandakanya ukusela amanzi aneleyo kunye nokuhlala unamanzi ngokwaneleyo, ukusebenzisa izifudumezi zomoya ukhohlokhohlo olomileyo, i-mint lozenges, okanye iti enobusi enokuthi yenze lula iimpawu. (24)
  • Yehlisa imingcipheko yakho: ukunciphisa ukuba sesichengeni sakho kumsi, ungcoliseko, kunye nomsi oyityhefu. Thetha nomboneleli wakho wezempilo malunga nokuyeka ukutshaya okanye ukujoyina iqela lenkxaso.

Ngubani oNyanga uKhohlokhohlo oluNgapheliyo?

Uninzi lwabantu abanokhohlokhohlo olungapheliyo bafunyaniswa ngumboneleli wezempilo wosapho, ugqirha wabantwana (abantwana) okanye ugqirha jikelele kwindawo abahlala kuyo. Abo bane-co-morbidities baphathwa ziingcali: i-pulmonologists, i-allergists, kunye / okanye i-gastroenterologists.

Zeziphi izizathu okanye imiba yoMngcipheko woKhohlokhohlo oluNgapheliyo?

Zininzi izinto ezinokuba ngunobangela wokhohlokhohlo olungapheliyo, kuquka iimeko zonyango ezingapheliyo ezidla ngokubizwa ngokuba zi-co-morbidities ezifana ne-asthma, i-gastroesophageal reflux (13), ukwaliwa okanye ukuthontsiza ngeempumlo (14). Xa unobangela ungaziwa, ukhohlokhohlo olungapheliyo lubizwa ngokuba yi-idiopathic. Unyango luxhomekeke kuhlobo lokhohlokhohlo olungapheliyo onalo.

Imiba yomngcipheko woKhohlokhohlo oluNgapheliyo:

Le mingcipheko inokulawulwa ngokuphepha ukuba sesichengeni

  • ukutshaya
    • Abantu abatshaya ubuncinane i-100 yecuba ebomini babo banomngcipheko ophindwe kabini okanye kathathu wokukhohlela okungapheliyo xa kuthelekiswa nabantu abangatshayiyo. (17).
  • Ukusetyenziswa kwamayeza abizwa ngokuba yi-ACE inhibitors
    • Iziyobisi ezisetyenziselwa ukunyanga uxinzelelo lwegazi oluphezulu. Ukuba unokhohlokhohlo olungapheliyo kwaye uthathe eli yeza, umboneleli wakho wezempilo unokukumisela elinye iyeza. 
  • Okusingqongileyo/Izingcolisi zomoya 
    • Abantu abatshayayo (ukuhlala okanye ukuchitha ixesha nabantu abatshayayo) (18).
    • Ukuhlala okanye ukusebenza kwiindawo ezithile kunokubangela ukuchanabeka ngakumbi kwizinto zangaphandle okanye amasuntswana aphuma emoyeni, kunye neekhemikhali eziyityhefu. (19;20).

Yintoni uKhohlokhohlo oluNgapheliyo kwihlabathi jikelele?

Ukhohlokhohlo olungapheliyo ngumba wehlabathi jikelele. Uphononongo olutshanje lubonisa ukuba luxilongo oluqhelekileyo kwimimandla ethile (i-Australia, ingxelo ye-NZ> i-20% yeziganeko ngelixa i-North America kunye neYurophu ibala i-10-15% yabemi) kunye neengxelo ezincinci e-Asia, eLatin America nase-Africe. Izizathu zolu mahluko azicacanga. Isenokuba ngenxa yokungaxelwanga ngokwaneleyo okanye izigulana ezifunyaniswe zinezinye iimeko ezifana nombefu, okanye ukwaliwa. 

Nangona kunjalo, nangona imimandla eyahlukeneyo ichaza ukhohlokhohlo olungapheliyo ngokwahlukileyo, ubudlelwane phakathi kwengingqi kunye nokhohlokhohlo olungapheliyo lubonakala lungaguquguquki kwizifundo ezininzi. Kusenokwenzeka ukuba kukho iimeko zokusingqongileyo okanye zemfuza ezibaphembelelayo. (10; 11; 12)

"Ukufumana ulwazi oluthe kratya malunga nefuthe lehlabathi lokukhohlela okungapheliyo cofa apha: "I-epidemiology yehlabathi yokukhohlela okungapheliyo kubantu abadala" 

Ngaba lukhona uPhando ngoNyango lwexesha elizayo loKhohlokhohlo oluNgapheliyo?

  • Kukho amayeza amatsha amaninzi kulingo lwezonyango lokhohlokhohlo olungapheliyo.
  • I-GAAPP ijolise ekuncedeni ukuxhasa uphando oluya kufumana unyango olukhuselekileyo lokhohlokhohlo lwe-idiopathic (oonobangela abangaziwayo, okukwabizwa ngokuba lukhohlokhohlo lwe-refractory xa lungaphenduli kunyango.
  • Ukufumana ulingo lwezonyango lokugaya abasebenzi kwindawo yakho, unokukhangela irejistri yolingo klinikhi.gov usebenzisa igama elithi “Ukhohlokhohlo oluNgapheliyo” okanye “Ukhohlokhohlo oluNganyangekiyo”, ukongeza indawo okuyo (ilizwe) kwaye ukhethe “Ukuqesha kwaye awukaqeshwanga izifundo”  

Ucaphulo

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Umxholo uhlaziywe lilungu le-GAAPP Clinical and Scientific Advisory Panel