COPD (kab mob ntsws ua pa ntev) yog kab mob ntsws ntev uas tshwm sim los ntawm kev mob thiab tom qab "cuam tshuam" ntawm txoj hlab pa. Feem ntau nws tshwm sim los ntawm kev sib xyaw ntawm cov mob ntsws ntev thiab mob ntsws. COPD yuav zoo ib yam li lwm yam mob xws li mob plawv tsis ua haujlwm, mob ntsws (mob ntsws), mob hawb pob, thiab mob ntsws sib kis, nrog rau lwm yam. Hmoov zoo, los ntawm kev ua tib zoo ntsuas koj cov tsos mob thiab kuaj mob, koj tus kws kho mob tuaj yeem pab txiav txim siab seb nws puas yog qhov tseeb COPD uas koj muaj.
Cov kauj ruam
Ntu 1 ntawm 3: Ntsuam Xyuas Cov tsos mob
Kauj Ruam 1. Saib rau qhov ua tsis taus pa, tshwj xeeb nrog kev ua haujlwm
Ua pa luv uas ua rau mob hnyav nrog ua haujlwm yog lub cim tseem ceeb ntawm COPD. Txawm li cas los xij, hauv nws tus kheej nws tsis yog kuaj mob, vim muaj lwm yam mob uas yuav tshwm sim zoo ib yam.
- Congestive plawv tsis ua hauj lwm (CHF) kuj tseem ua tsis taus pa (uas ua rau hnyav dua nrog kev ua haujlwm) raws li ib qho ntawm nws cov cim tseem ceeb. Qhov sib txawv nrog CHF tsis zoo li COPD, txawm li cas los xij, yog tias CHF kuj phem dua thaum pw, thiab tej zaum yuav phem dua thaum ib tag hmo. CHF tseem qhia pom cov txiaj ntsig sib txawv hauv kev ntsuas lub ntsws, ntawm lub hauv siab xoo hluav taws xob, thiab nrog rau lwm qhov kev kuaj mob, raws li tau piav qhia hauv Ntu 2 ntawm kab lus no.
- Ua tsis taus pa kuj tseem yuav tsis meej pem nrog mob hawb pob, thiab ob leeg COPD thiab mob hawb pob tuaj yeem muaj qhov "hawb pob". Txawm li cas los xij, mob hawb pob teb tau zoo dua rau kev siv tshuaj, qhia pom cov txiaj ntsig sib txawv ntawm kev kuaj mob, thiab feem ntau cuam tshuam nrog "ntu" cuam tshuam nrog kev ua ncaj qha (xws li kev ua xua, huab cua txias, ua haujlwm, thiab lwm yam)
Kauj Ruam 2. Ntsuas koj qhov hnoos
Lwm qhov ntawm cov tsos mob tshwm sim ntawm tus kab mob COPD yog mob hnoos, ua rau hnoos (feem ntau nqa cov hnoos qeev/hnoos qeev). Txawm li cas los xij, ib zaug ntxiv, hnoos yog tus tsos mob tshwm sim ntau heev, thiab tuaj yeem tshwm sim nyob rau ntau qhov xwm txheej sib txawv.
- Tej zaum hnoos yuav tshwm sim ntawm txoj hlab ntsws ua pa. Qhov no tuaj yeem txawv ntawm COPD los ntawm kev ua npaws thiab lwm yam kev kis mob, nrog rau kuaj cov hnoos qeev kom pom cov kab mob lossis lwm yam kab mob.
- Hnoos yuav tshwm sim hauv qog noj ntshav hauv lub ntsws. Qhov no tuaj yeem sib txawv ntawm COPD los ntawm kev kuaj pom qhov hnyav (pob) ntawm cov txheej txheem kev siv duab (xws li xoo hluav taws xob lossis CT scan), ntxiv rau lwm yam cim qhia tias mob qog noj ntshav xws li tawm hws hmo ntuj thiab/lossis qhov hnyav tsis xav tau. Tus yam ntxwv ntawm mob qog noj ntshav yog hemoptysis, uas yog hnoos ntshav.
Kauj Ruam 3. Saib xyuas lwm yam tsos mob ntawm kev ua pa
Muaj ntau yam ntawm lwm cov tsos mob ua pa uas tuaj yeem koom tes nrog COPD. Cov no suav nrog hawb pob (uas tuaj yeem tshwm sim hauv ob tus kab mob COPD thiab mob hawb pob), muaj kev xav nruj hauv siab, thiab/lossis mob ntsws ntau zaus (koj muaj feem ntau ua rau mob ua pa rov qab yog tias koj muaj COPD). Koj kuj tseem yuav ntsib kev qaug zog txawv txav, thiab/lossis poob qhov hnyav tsis xav tau (qhov no yuav yog qhov cim qhia lig ntawm COPD hnyav.
Kauj Ruam 4. Coj mus rau qhov muaj feem phom sij
Tus naj npawb ib qho txaus ntshai rau COPD yog haus luam yeeb. Yog tias koj muaj keeb kwm haus luam yeeb, thiab/lossis yog tias koj yog neeg haus luam yeeb tam sim no, koj muaj feem yuav muaj tus kab mob COPD ntau ntxiv. Nws nce ntxiv hauv qhov feem ntawm cov luam yeeb (lossis kav dej lossis yeeb tshuaj xas) uas koj tau haus hauv koj lub neej. Lwm yam kev pheej hmoo rau COPD suav nrog:
- Qhov chaw ua haujlwm raug cov tshuaj, cov pa taws, plua plav, thiab/lossis cov pa phem
- Keeb kwm ntawm lwm yam mob hauv lub ntsws, xws li mob hawb pob lossis lwm yam mob ua pa nyuaj
- Hnub nyoog tshaj 35-40 xyoo
- Ib qho teeb meem caj ces hu ua alpha-1-antitrypsin deficiency
- Kev ua pa ntawm txoj hlab pa nce ntxiv rau kev ua xua lossis ua xua ua rau lub cev thiab atopy
- Tub los ntxhais: poj niam zoo li muaj kev pheej hmoo tsim tus kab mob COPD thiab mob ntsws ntau dua li txiv neej
- Antioxidant deficiency: tsis muaj cov tshuaj tiv thaiv kab mob antioxidant, vitamin C, thiab vitamin E tuaj yeem yog qhov muaj feem cuam tshuam rau COPD
Ntu 2 ntawm 3: Siv Kev Tshuaj Ntsuam Xyuas
Kauj Ruam 1. Xaiv rau kev ntsuas lub ntsws ua haujlwm
Lub ntsws ua haujlwm ntsuas ntsuas yam xws li huab cua hauv koj lub ntsws tuaj yeem tuav tau, thiab koj lub zog ua pa li cas. Lawv muaj peev xwm kuaj pom COPD txawm tias ua ntej koj pib qhia pom cov tsos mob tseem ceeb!
- Txawm li cas los xij, kev kuaj lub ntsws ua haujlwm tsuas yog siv rau cov tib neeg uas qhia pom tias muaj kab mob ua pa (xws li muaj peev xwm muaj COPD, ntawm lwm yam).
- Kev ntsuas lub ntsws tseem tuaj yeem siv rau kev soj ntsuam txuas ntxiv ntawm lub ntsws mob xws li COPD, thiab ntsuas qhov ua tau zoo ntawm ntau yam kev xaiv kho mob.
- Kev ntsuas lub ntsws ua haujlwm yuav muab koj piv rau FEV1/FVC, thiab tus lej no yog ib qho ntawm cov txheej txheem kuaj mob tseem ceeb rau COPD thiab mob hawb pob. Hauv COPD, tus lej tsawg dua.
Kauj Ruam 2. Nug koj tus kws kho mob kom xoo hluav taws xob
Xoo hluav taws hauv siab tuaj yeem muaj txiaj ntsig hauv kev txiav txim siab lossis txiav txim siab qhov xwm txheej uas tuaj yeem nthuav qhia zoo ib yam li COPD. Piv txwv li, lub hauv siab xoo hluav taws xob tuaj yeem pab txiav tawm lub plawv tsis ua haujlwm, uas ib txwm pom pom cov cim ntawm lub plawv loj ntawm x-ray. Xoo hluav taws xob hauv siab kuj tseem tuaj yeem siv los nrhiav lwm yam ua rau hnoos lossis ua tsis taus pa, xws li mob ntsws, mob ntsws ntsws, lossis mob ntsws sib quas ntus.
- Thaum kawg, xoo hluav taws xob hauv siab tuaj yeem pom cov tsos mob ntawm tus mob emphysema, uas yog ib qho ntawm qhov cuam tshuam rau COPD. Yog tias pom tus mob emphysema ntawm xoo hluav taws xob, feem ntau koj yuav muaj tus kab mob COPD.
- Cov cim qhia ntawm COPD ntawm CXR suav nrog lub diaphragm tiaj tus, nce lub zog hluav taws xob, thiab lub plawv ntev thiab nqaim.
Kauj Ruam 3. Tau txais CT scan
CT scan tuaj yeem muab cov ncauj lus ntxaws ntxaws ntawm lub ntsws ntau dua li xoo hluav taws xob tuaj yeem ua tau. Nws tuaj yeem piav qhia cov xwm txheej zoo li kab mob hauv lub ntsws, mob ntsws ntsws (ntshav khov hauv lub ntsws), mob ntsws ntsws, mob ntsws, thiab COPD.
Kauj Ruam 4. Tau txais kev ntsuas ntshav ntshav
Qhov kev ntsuas no txiav txim siab qhov ua tau zoo ntawm koj lub ntsws thaum xa cov pa oxygen thiab tshem cov pa roj carbon dioxide. Qhov kev xeem no pab qhia rau koj tus kws kho mob txog qhov mob hnyav ntawm koj tus kab mob COPD, yog tias koj muaj nws tiag, thiab yuav kho qhov kev kho mob li cas (xws li seb koj puas yuav xav tau cov pa ntxiv).
Ntu 3 ntawm 3: Kho COPD
Kauj Ruam 1. Txiav luam yeeb
Kev haus luam yeeb yog tus naj npawb ib qho kev pheej hmoo rau kev txhim kho COPD, thiab tseem yuav ua rau mob hnyav zuj zus ntxiv nrog lub sijhawm. Yog li, ib yam uas zoo tshaj plaws uas koj tuaj yeem ua hauv kev kho mob COPD yog txiav luam yeeb, yog tias koj haus luam yeeb tam sim no. Qhov no yuav txo qhov hnyav ntawm koj cov tsos mob thiab tiv thaiv qhov mob los ntawm kev loj hlob ntxiv nrog rau lub ntsws puas.
- Yog tias koj xav txiav luam yeeb, koj tuaj yeem tham nrog koj tus kws kho mob kom pab thiab txhawb nqa.
- Muaj cov tshuaj nrog rau cov txheej txheem hloov pauv nicotine uas tuaj yeem ua rau nws yooj yim dua - thiab ua rau koj muaj feem yuav ua tiav - thaum nws los txog kev txiav luam yeeb.
- Ua raws li START acronym: S = Teem hnub tawm haujlwm; T = Qhia rau koj cov phooj ywg thiab tsev neeg uas koj tab tom txiav tawm; A = Xav txog qhov nyuaj thiab npaj ua ntej; R = Tshem tawm cov luam yeeb ntawm koj lub tsev, tsheb, thiab tom haujlwm; thiab T = Tham nrog koj Tus Kws Kho Mob thiab qhia nws txog koj cov phiaj xwm.
Kauj Ruam 2. Kho koj cov tsos mob nrog tshuaj
Muaj ntau cov tshuaj uas tuaj yeem pab txo cov tsos mob ntawm COPD thiab txhim kho koj txoj kev ua pa. Qee qhov kev xaiv suav nrog:
- "Bronchodilators" - cov no pab ua kom dav koj txoj hauv kev thiab tuaj yeem txhim kho koj txoj kev ua pa. Ib qho piv txwv ntawm nqus cov tshuaj bronchodilator yog Salbutamol (Ventolin), lossis Atrovent.
- Steroids - koj tuaj yeem siv nqus cov tshuaj steroids kom txo qhov mob hauv koj cov hlab pas, thiab yog li txhawm rau txhim kho kev ua pa. Ib qho piv txwv ntawm kev nqus cov tshuaj steroid yog Fluticasone (Flovent).
- Xyuas kom koj noj koj cov tshuaj raws li koj tus kws kho mob hais.
Kauj Ruam 3. Mus ntsib kws kho mob rau COPD "exacerbations
"Cov tsos mob ntawm tus kab mob COPD zoo li txuas ntxiv ua ntu zus ib hnub dhau ib hnub. Txawm li cas los xij, muaj qee lub sijhawm ob peb hnub uas koj yuav ntsib qhov hu ua" COPD exacerbation. "Qhov no yog thaum koj cov tsos mob ib ntus. Cov tsos mob ntawm tus kab mob COPD hnyav tuaj yeem suav nrog hnoos hnyav dua, ua kom cov hnoos qeev ntau ntxiv, ua pa luv, thiab/lossis ua npaws.
- Kev tswj hwm cov tshuaj tua kab mob yog tias muaj kev kis mob yog qhov ua rau koj mob COPD ntau ntxiv.
- Kev siv tshuaj ntau ntxiv ntawm nqus cov tshuaj bronchodilator thiab nqus cov tshuaj corticosteroid kom tswj tau cov tsos mob zoo dua.
- Cov txheej txheem (tshuaj ntsiav) tshuaj steroid los txo qhov mob yog xav tau.
- Ntxiv cov pa oxygen, thiab cov tshuab los pab ua pa yog xav tau.
- Kev tswj hwm cov tshuaj tiv thaiv tsim nyog (xws li tshuaj tiv thaiv kab mob khaub thuas, thiab lwm yam), yog tias koj tseem tsis tau txhaj tshuaj tiv thaiv kab mob ntxiv, uas tuaj yeem zam tau los ntawm kev txhaj tshuaj tiv thaiv kab mob.
Kauj Ruam 4. Nug txog kev ntxiv oxygen
Yog tias koj cov tsos mob COPD ua rau nws nyuaj rau ua pa ib hnub dhau ib hnub, thiab cuam tshuam nrog koj li haujlwm niaj hnub, koj tuaj yeem xav nug koj tus kws kho mob txog cov pa oxygen ntxiv. Qee tus neeg uas muaj tus kab mob COPD hnyav tau txais txiaj ntsig zoo los ntawm cov pa oxygen ntxiv, thiab nws tuaj yeem ua kom yooj yim ua pa nyuaj.
- Cov pa oxygen ntxiv feem ntau cuam tshuam nrog lub tank oxygen uas koj tuaj yeem log nrog koj.
- Koj feem ntau muaj lub qhov ntswg uas xa cov pa tawm ntawm lub tank mus rau koj lub ntsws.
- Qhov taw qhia rau cov pa ntxiv suav nrog mem tes oximetry tsawg dua 88% ntawm kev cia siab.
Kauj Ruam 5. Xav txog kev phais thiab/lossis hloov lub ntsws ua qhov kawg
Thaum cov tsos mob COPD hnyav heev, muaj ob txoj kev phais uas yuav txiav txim siab kho. Cov no yog:
- Kev phais kom tshem tawm ib feem mob ntawm koj lub ntsws. Yog tias qee thaj chaw ntawm koj lub ntsws tau ua haujlwm yam tsis muaj txiaj ntsig los ntawm koj tus kab mob COPD, cov chaw no tuaj yeem raug phais tshem tawm. Qhov no, nyeg, qhib qhov chaw hauv koj lub hauv siab rau thaj chaw ua haujlwm ntawm koj lub ntsws kom ua haujlwm tau zoo dua - tom qab ntawd lawv muaj chaw ntau ntxiv los nthuav nrog huab cua, thiab koj txoj kev ua pa yooj yim yuav tsum txhim kho ntau.
- Lub ntsws hloov. Qhov no zoo li siv los ua qhov kev xaiv zaum kawg, vim tias ib qho kev hloov pauv hauv lub cev yog txheej txheem tseem ceeb uas muaj kev pheej hmoo loj, thiab koj yuav tsum tau siv tshuaj tiv thaiv kab mob mus ib txhis hauv kev cia siab tias koj lub cev yuav tsis thim qhov kev hloov pauv. Nws tau siv hauv tsawg tus neeg mob COPD. Txawm li cas los xij, rau cov neeg uas mob hnyav heev, nws yuav yog qhov kev xaiv zoo tshaj plaws rau kev kho mob.
