THEufuba imvamisa i-a isifo esingelapheki okudinga ukwelashwa okuvamile, ngisho naphakathi kokuhlaselwa. I izidakamizwa ukulawula isifuba somoya akunikezeli ikhambi eliqinisekile. Benza ukuphefumula kube lula ngokukhulisa ukuvuleka kwe-bronchi (bronchodilation) nokunciphisa ukuvuvukala. Iningi labo liyabanjwa inhalation, okubavumela ukuthi benze ngokushesha, ngemiphumela embalwa engenzeka. Udokotela futhi uzama ukunikeza umthamo omncane wemithi yokulawula izimpawu ngokubekezeleleka okungcono kakhulu kokwelashwa.

Nokho naphezu kokuphumelela kokwelashwa, abantu abayisi-6 kwabayishumi abanesifuba somoya bayehluleka ukulawula impilo yabo izimpawu. Izimbangela eziyinhloko ukungaqondi kahle kwesifo, ukwesaba Okuqhamuka uma udla imishanguzo nokukhohlwa imithi. Nokho, imiphumela engemihle yemithi yokwelapha ethathwe ngokuhogela mincane uma iqhathaniswa nezingozi ezihlobene nokuhlasela kwesifuba somoya okunzima nokuvamile.

• Ama-aerosol amamitha. Kumelwe unyakazise i-aerosol kahle futhi uyibambe iqonde. Ngemva kokukhipha umoya kancane kancane emaphashini, phefumula kancane futhi ujule kakhulu ngomlomo wakho, ucuphe i-aerosol phakathi nomzuzwana wokuqala wokuphefumula. Kufanele ubambe umoya wakho imizuzwana emi-5 kuya kweyi-10, bese uphefumula kancane.
• Izihogela eziyimpuphu eyomile (isb: i-Turbuhaler®). Lezi zinhlelo zilula ukuzisebenzisa ngoba azidingi ukukhuthazwa nokucupha. Kufanele uhogele umoya ngamandla futhi ngokushesha ngangokunokwenzeka, uvimbele ukuphefumula kwakho imizuzwana eyi-10 bese ukhipha umoya ngaphandle kwe-inhaler.
• Amakamelo okuphefumula. Zisetshenziswa nge-inhaler yomthamo wemitha ezinganeni ezingaphansi kweminyaka eyi-8 nabadala. Ezinganeni ezincane, i-inhalation yenziwa nge-mask yobuso, okufanele igcinwe ebusweni okungenani ukuphefumula oku-6 okuzolile.

Abantu abanesifuba somoya baya ngokuya becelwa ukuthi baqaphe isimo sabo sokuphefumula. Ngokwesibonelo, abantu abane i-asthma enamandla, angakwazi ukukala ukugeleza kwawo okuphezulu kokuphelelwa umoya ekhaya (ukugeleza okuphezulu) ukuze balungise ukwelashwa kwabo ngokwemiphumela. Ukuqeqeshwa kumele ngabe kwathathwa ngaphambili.

izidakamizwa

Kunezigaba ezi-2 ze izidakamizwa ukulawula izimpawu zesifuba somoya. Owokuqala, wabizwa izinkinga noma imithi yokuhlenga, kufanele ithathwe uma kunezimpawu. Banesenzo sokusiza ngokushesha, kodwa ungathulisi ukuvuvukala kwe-bronchi.

Ezinye izidakamizwa yilezi ukulawula noma ukwelashwa kwangemuva. Kufanele ziphuzwe nsuku zonke, ngisho nalapho kungabikho ukuphazamiseka kokuphefumula ngokushesha nje lapho isifuba somoya sesilinganiselwe futhi siphikelela. Benza ukuthi kwenzeke ukunciphisa ukuvuvukala kwe-bronchi nokubeka isikhala sokuhlaselwa. Uma kungaphuzwanga njalo, imvamisa kanye nokuqina kokuhlaselwa kuyanda, kanjalo nesidingo somuthi wokuhlenga.

Ukwelashwa kwenhlekelele (noma yokuhlenga).

Imithi ye-Crisis kubhekiselwa kuyo ngamagama ahlukene, okuhlanganisa ama-bronchodilators osebenza ngokushesha noma beta2 agonists umdlalo omfushane. Asetshenziselwa kuphela ukukhulula izimpawu zokuhlasela (ukukhwehlela, ukucinana kwesifuba, ukushaywa umoya kanye nokuphelelwa umoya) noma ngaphambi kokuzivocavoca ngesifuba somoya lapho uzikhandla. Uma unesifuba somoya esithambile, esiphakathi, ukwelashwa kokuquleka kungase kube ukuphela komuthi odingekayo.

Lezi zidakamizwa zihlanganisa salbutamol ((Ventoline®, Ventilastin®, Airomir®, Apo-Salvent®, Novo Salmol®) noma i-terbutaline (Bricanyl®). Zithathwa ngokuhogela bese zinweba imigudu yomoya ngokushesha okukhulu, imizuzu engu-1 ukuya kwemi-3. Kunemiphumela engemihle embalwa uma isetshenziswa ngezikhathi ezithile, kodwa ngemithamo ephezulu ingabangela ukundindizela, ukwethuka kanye nokushaya kwenhliziyo okusheshayo. Uma uzwa isidingo sokuyithatha kaningi (imvamisa izikhathi ezingaphezu kwezi-3 ngesonto), kusho ukuthi isifuba somoya asilawuleki ngokwanele. Khona-ke kuyadingeka ukuthi usebenzise izidakamizwa zangemuva ukwelapha ukuvuvukala.

Ipratropium bromide inhalation (akuvamile). Kuyi-anticholinergic evimbela ukusebenza kwekhemikhali ebangela ukuthi imisipha emigwaqweni yomoya ifinyele. Isebenza kancane kune-beta2 agonists ehogeliwe, kwesinye isikhathi isetshenziswa ezimeni zokungabekezelelani kubo. Kuthatha ihora elingu-1 kuye kwayi-2 ngomphumela omkhulu.

Izidakamizwa njengendlela yokwelapha eyisisekelo (yokulawula).

Ngokungafani nemithi yokuquleka noma imithi yokuhlenga, imithi ye-DMARD (control) ayiziqedi ngokushesha izimpawu. Zisebenza kancane futhi zisebenza kahle esikhathini eside ekunciphiseni ukuvuvukala kanye nemvamisa yokubamba. Yingakho kubalulekile ukuwathatha nsuku zonke.

Ama-Corticosteroids. I-Corticosteroids inciphisa ukuvuvukala kwemigudu yomoya futhi ngenxa yalokho ukukhiqizwa kwamafinyila. Ngokuvamile zithathwa ngemithamo emincane njengokuhogela (isifutho), nsuku zonke (isibonelo, i-Alvesco® ne-Pulmicort®). Udokotela ubeka umthamo ophansi kakhulu osebenza ngempumelelo ngangokunokwenzeka. Angabuye athathwe njengamaphilisi ku-asthma enzima isikhathi esifushane sezinsuku ezimbalwa (isibonelo: i-prednisolone, i-methylpredinosolone). Kungakhathaliseki ukuthi athathwe ngokuhogela umoya noma ngamaphilisi, asebenza ngendlela efanayo, kodwa ukuhogela kuvumela imithamo ephansi kakhulu, isenzo sendawo kakhudlwana ngakho-ke imiphumela emibi embalwa. Lesi sigaba sezidakamizwa sisebenza kahle kakhulu ekulawuleni isifuba somoya. Umphumela wabo uzwakala ngemva kwezinsuku ezimbalwa zokusetshenziswa.

Ukusabela okubi

Ithathwe ngokuhogela umoya nangemithamo emaphakathi, ama-corticosteroids ibe nemiphumela emibi embalwa, noma ithathwe isikhathi eside. Ukuhosha nokuhosha noma ukubonakala kwe umguet (noma i-candidiasis, ebangelwa imvubelo eyenza amabala amhlophe olimini) yimiphumela emibi evame kakhulu. Ngakho-ke, kufanele ugeze umlomo wakho ngemva kokuhogela umthamo ngamunye. Amaphilisi e-Corticosteroid anemiphumela engathandeki yesikhathi eside enamandla (ukuqina kwamathambo, ukwanda kwengozi yokuba nesifo samehlo, njll.). Zigcinelwe izimo zesifuba somoya esibi kakhulu, ezihambisana nezinye izindlela zokwelapha.

Ama-bronchodilator asebenza isikhathi eside. Lokhu kunqunywa ngokuhlangene lapho i-corticosteroids ehogeliwe iyodwa inganele ukulawula izimpawu zesifuba somoya. I beta2 agonists ukusebenza isikhathi eside kubangela i-bronchodilation amahora angu-12. Ukusebenza kwabo kungashesha emizuzwini emi-3 kuye kwemi-5 njenge- i-formoterol® (ex Foradil®, Asmelor®) noma kancane ngemva kwemizuzu engu-15 njenge i-salmeterol (Serevent®). Zisetshenziswa ngokuhlanganiswa ne-corticosteroid. Kunama-inhalers ahlanganisa izinhlobo ezimbili zezidakamizwa njenge-Seretide® (fluticasome/salmeterol). Inhlanganisela ne-formoterol (i-Symbicort®, i-Innovair® ne-Flutiform®) ingasetshenziswa futhi njengemithi yokuhlenga, nakuba iphinde isebenze ekuvuvukeni esikhathini eside.

Izidakamizwa ze-Antileukotrienes. Uma zithathwa ngomlomo, zinciphisa ukuvuvukala okubangelwa ama-leukotrienes, izinto ezibangela impendulo yokuvuvukala.E-France, i-antileukotrienes iyatholakala: i-montelukast (Singulair®). E-Canada, kukhona ne-lezafirlukast (Accolate®). Zingasetshenziswa zodwa noma zihlanganiswe ne-corticosteroids ehogeliwe. Aboniswa ukuze avimbele isifuba somoya ekuzilolongeni, kusifuba somoya esithambile, kubantu abasifuba sabo singalawulwa yi-corticosteroids ehogeliwe kuphela, nalabo abasebenzisa kabi isifutho sabo.

Theophylline. Iyona endala kakhulu kuma-bronchodilator (isb: Theostat®). Akuvamile ukusetshenziswa namuhla, ngoba umthamo ophumelelayo ngaphandle kwemiphumela emibi kunzima ukuyithola. Inganqunywa njengethebhulethi okufanele ithathwe kanye nesidlo sakusihlwa kubantu abanobunzima bokuthatha izifutho.

I-Anti-immunoglobulin E. Leli klasi lezidakamizwa kuhloswe ngalo ukwelapha isifuba somoya esibi kakhulu kubantu abakunzima ukulawula isifuba sabo ngezinye izindlela zokwelapha. I-Omalizumab (Xolair®) ukuphela komuthi kuleli klasi otholakala ngo-2015. Unikezwa njengemijovo engaphansi kwesikhumba kanye noma kabili ngenyanga.

Umbono kadokotela, uDkt Annabel Kerjan we-pulmonologist:

Uma umuntu enesifuba somoya, akufanele avume ukuba nezimpawu engenzanga lutho. Akufanele, isibonelo, ubekezelele ukuphefumula, ukukhwehlela okuncane, ukuphefumula kanzima ebusuku. Lesi sifo akufanele sivunyelwe ukuba siguquke, ngoba uma sikhathala ngaphandle kokusiphatha, ngoba singakwazi ukwehlisa i-bronchi ngokuhamba kwesikhathi, okuholela ekulimazeni okungapheli kwezimpawu, futhi ezimweni ezimbi kakhulu izifo zesibili kanye nokulaliswa esibhedlela. Kungcono ukuthola nodokotela wakho ukwelashwa okusebenzayo okungenani.

Lokhu kubaluleke kakhulu kubazali bezingane ezinesifuba somoya. Bavame ukungabaza ukunikeza izingane zabo imithi futhi lokhu kuyaqondakala. Kodwa kulokhu, banephutha. Lezi zingane kufanele zinikezwe ithuba lokuthuthukisa kahle imali yazo yokuphefumula ukuze itholakale lapho sezikhulile. Futhi-ke, ingane enezimpawu zesifuba somoya esingalashwanga ilala kahle, inobunzima kwezemidlalo futhi ikhula kancane kahle. Nakuba ngokwelashwa, uzizwa engcono futhi ulondolozela i-bronchi yakhe esikhathini esizayo.