Uvavanyo lomsebenzi wePulmonary

Uvavanyo lomsebenzi wePulmonary liqela leemvavanyo ezilinganisela ukuphefumla kunye nendlela esebenza kakuhle ngayo imiphunga.

I-Spirometry imilinganiselo yokuhamba komoya. Ngokulinganisa ukuba ungakanani umoya ophuma kuwo, kwaye ukhupha ngokukhawuleza kangakanani, i-spirometry inokuvavanya uluhlu olubanzi lwezifo zemiphunga. Kuvavanyo lwe-spirometry, ngelixa uhleli, uphefumlela kwisithethi somlomo esidityaniswe nesixhobo esibizwa ngokuba yi-spirometer. I-spirometer irekhoda isixa kunye nenqanaba lomoya ophefumla ngaphakathi nangaphandle kwexesha. Xa umile, amanye amanani anokwahluka kancinci.

Kweminye yemilinganiselo yovavanyo, unokuphefumla ngokwesiqhelo nangokuthe cwaka. Olunye uvavanyo lufuna ukunyanzeliswa okanye ukukhupha umoya emva kokuphefumla. Ngamanye amaxesha, uya kucelwa ukuba uphefumle irhasi eyahlukileyo okanye iyeza ukuze ubone ukuba lizitshintsha njani iziphumo zakho.

Imilinganiselo yevolung yemilinganiselo inokwenziwa ngeendlela ezimbini:

• Eyona ndlela ichanekileyo ibizwa ngokuba ngumzimba we-plethysmography. Uhleli kwibhokisi engena moya ecacileyo ekhangeleka ngathi yeyomnxeba. Itekhnoloji ikucela ukuba uphefumle ngaphakathi nangaphandle komlomo. Utshintsho kuxinzelelo ngaphakathi kwebhokisi kunceda ukumisela ivolumu yemiphunga.
• Umthamo wemiphunga unokulinganiswa xa uphefumla i-nitrogen okanye i-helium gas ngetyhubhu kangangexesha elithile. Ukuxinana kwerhasi kwigumbi eliqhotyoshelwe kumbhobho kulinganiswa ukuqikelela ivolumu yemiphunga.

Ukulinganisa amandla okusasazeka, uphefumla igesi engenabungozi, ebizwa ngokuba yi-tracer gas, ixesha elifutshane kakhulu, ihlala iphefumla kube kanye. Ukulinganiswa kwerhasi emoyeni ophefumlela ngaphandle kuyalinganiswa. Umahluko kumthamo wegesi ophefumlelweyo kunye namanyathelo okukhupha indlela eyiyo ehamba ngayo kakuhle ukusuka emiphungeni iye egazini. Olu vavanyo luvumela umboneleli wezempilo ukuba aqikelele ukuba imiphunga ihambisa njani ioksijini evela emoyeni iye kwigazi.

Musa ukutya isidlo esinzima ngaphambi kovavanyo. Musa ukutshaya iiyure ezi-4 ukuya kwezi-6 phambi kovavanyo. Uyakufumana imiyalelo ethile ukuba ufuna ukuyeka ukusebenzisa ii-bronchodilators okanye amanye amayeza omphefumlayo. Kuya kufuneka uphefumle amayeza ngaphambi okanye ngexesha lovavanyo.

Kuba uvavanyo lubandakanya ukuphefumla ngokunyanzelwa kunye nokuphefumla ngokukhawuleza, unokuba nokuphefumla okwexeshana okanye ubenentloko elula. Kananjalo unakho ukukhohlela. Uphefumla ngomlomo oqinileyo kwaye uya kuba neempumlo zempumlo. Ukuba u-claustrophobic, inxenye yovavanyo kwindlwana evaliweyo inokuziva ingonwabanga.

Landela imiyalelo yokusebenzisa umlomo we-spirometer. Itywina elibi xa ujikeleze umlomo kunokubangela iziphumo ezingachanekanga.

Uvavanyo lomsebenzi wePulmonary lwenziwa:

• Ukuchonga iintlobo ezithile zesifo semiphunga, esifana nesifuba, i-bronchitis, kunye ne-emphysema
• Fumana unobangela wokuphefumla okufutshane
• Linganisa ukuba ukubonakaliswa kweekhemikhali emsebenzini kuchaphazela ukusebenza kwemiphunga
• Jonga ukusebenza kwemiphunga ngaphambi kokuba umntu enze utyando
• Vavanya umphumo wamayeza
• Linganisa inkqubela phambili kunyango lwezifo
• Linganisa impendulo kunyango lwe-cardiopulmonary vascular disease

Amaxabiso aqhelekileyo asekwe kubudala bakho, ubude, ubuhlanga, kunye nesini. Iziphumo eziqhelekileyo zichazwe njengepesenti. Ixabiso lihlala lithathwa njengengaqhelekanga ukuba liphantse libe ngaphantsi kwe-80% yexabiso lakho eliqikelelweyo.

Amaxabiso esiqhelo ahluka kancinci kwiilebhu ezahlukeneyo, ngokusekwe kwiindlela ezahlukeneyo zokumisela amaxabiso aqhelekileyo. Thetha nomboneleli wakho malunga nentsingiselo yeziphumo zakho zovavanyo.

Imilinganiselo eyahlukeneyo enokufunyanwa kwingxelo yakho emva kovavanyo lomsebenzi we-pulmonary ibandakanya:

• Ubunzima besisombululo kwi-carbon monoxide (DLCO)
• Umthamo wokugcina ophefumlelweyo (ERV)
• Umthamo obalulekileyo onyanzelekileyo (FVC)
• Ukunyanzelwa kwevolumu yokuphelelwa lixesha kwimizuzwana eyi-1 (FEV1)
• Ukuhamba ngokunyanzelwa kokuphuma kwama-25% ukuya kuma-75% (FEF25-75)
• Umsebenzi wentsalela yokusebenza (FRC)
• Ubuninzi bomoya wokuzithandela (MVV)
• Umthamo wentsalela (RV)
• Ukuhamba okuphezulu kokuphuma (PEF)
• Isantya esibalulekileyo (SVC)
• Umthamo wamaphaphu uwonke (TLC)

Iziphumo ezingaqhelekanga zihlala zithetha ukuba unokuba nesifo sesifuba okanye semiphunga.

Ezinye izifo zemiphunga (ezinjenge-emphysema, i-asthma, i-bronchitis engapheliyo, kunye nosulelo) zinokwenza imiphunga ibe nomoya omninzi kwaye ithathe ixesha elide ukuyikhupha. Ezi zifo zemiphunga zibizwa ngokuba kukuphazamiseka kwemiphunga.

Ezinye izifo zemiphunga zenza imiphunga ibene scarred kwaye incinci ukuze iqulethe umoya omncinci kakhulu kwaye ihlwempuzeke ekuhambiseni ioksijini egazini. Imizekelo yezi ntlobo zezifo ibandakanya:

• Ukutyeba kakhulu
• I-pulmonary fibrosis (ukutyhafa okanye ukuqina kwethishu yemiphunga)
• I-Sarcoidosis kunye ne-scleroderma

Ubuthathaka bemisipha bunokubangela iziphumo zovavanyo ezingaqhelekanga, nokuba imiphunga iqhelekile, oko kukuthi, kuyafana nezifo ezibangela imiphunga emincinci.

Kukho umngcipheko omncinci wokuwa kwemiphunga (pneumothorax) kubantu abanesifo esithile semiphunga. Uvavanyo akufuneki lunikwe umntu oye wahlaselwa sisifo sentliziyo kutshanje, uneentlobo ezithile zesifo sentliziyo, okanye obenomphunga osandul 'ukuwa.

Ii-PFTs; Spirometry; Isipirogram; Uvavanyo lwemiphunga; Umthamo wemiphunga; Imvelaphi

• Spirometry
• Uvavanyo lomdlalo

Igolide WM, Koth LL. Uvavanyo lomsebenzi wePulmonary. Ku: Broaddus VC, Mason RJ, Ernst JD, et al, ii-eds. Incwadi kaMurray kunye neNadel yeyeza lokuphefumla. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 25.

U-Putnam JB. Umlenze, udonga lwesifuba, i-pleura, kunye ne-mediastinum. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango: Isiseko sebhayiloji yoQeqesho lwangoku. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 57.

Iskena PD. Umsebenzi wokuphefumla: iindlela kunye novavanyo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl. 79.