I-Emphysema

Ukuphefumula ngakunye kuba umshikashika wezigidi zabantu abaphila ne-emphysema isifo, isimo esibucayi samaphaphu esilimaza kancane kancane amasaka omoya amancane emaphashini. Nakuba lingekho ikhambi lalesi simo esiqhubekayo, ukuqonda nokuphatha okufanele kungasiza abantu abane-emphysema balondoloze izinga lokuphila elingcono. Lesi sihloko sihlola izici ezibalulekile zesifo i-emphysema, kusukela ekuboneni izimpawu eziyisixwayiso zangaphambi kwesikhathi kuye ekuqondeni izinketho zokwelapha ezingasiza ekubambezeleni ukuqhubeka kwaso.

Iyini I-Emphysema?

I-Emphysema yisifo samaphaphu esithuthukayo esishintsha ngokuyisisekelo indlela amaphaphu asebenza ngayo. Iqala lapho amasaka omoya amancane emaphashini (alveoli) ewonakala, okuholela ebunzimeni obukhulu bokuphefumula. Amasaka omoya amancane, anezindonga ezincane emaphashini - uma enempilo, ahlukene futhi ayanwebeka, kodwa isifo se-emphysema siwenza ahlehle futhi ahlangane abe yizikhala ezinkulu, ezingasebenzi kahle.

Lesi sifo sithinta amaphaphu ngezindlela eziningi ezibalulekile:

• Icekela phansi izindonga phakathi kwamasaka omoya, idale izikhala ezinkulu, ezingasebenzi kahle
• Yehlisa ikhono lamaphaphu lokudlulisa umoya-mpilo egazini
• Ivalela umoya omdala emaphashini, ishiye indawo encane yomoya omusha
• Yehlisa indawo yonke yamaphaphu
• Kwenza ukuphefumula kube nzima ngokuhamba kwesikhathi

I-Emphysema noma i-emphysematous lung disease ingenye yezinhlobo eziphambili ze-Chronic Obstructive Pulmonary Disease (COPD), evame ukwenzeka eduze kwe-bronchitis engapheli. Nakuba i-bronchitis engapheli ithinta imigudu yomoya ngokuvuvukala nokukhiqizwa kwamafinyila ngokweqile, i-emphysema iqondise ngokuqondile amasaka omoya. Le nhlanganisela idala izinselelo ezibalulekile zokuphefumula, njenge amaphaphu zilahlekelwa ukunwebeka kwazo kwemvelo nokusebenza kahle ekucubunguleni umoya.

Umonakalo obangelwa yi-emphysematous lung disease unomphela, nakuba ukwelashwa kungasiza ukulawula izimpawu zesifo se-emphysema futhi kubambezele ukuqhubeka kwayo. 

Izigaba ze-Emphysema

Odokotela basebenzisa uhlelo olujwayelekile olubizwa ngeGlobal Initiative for Chronic Obstructive Lung Disease (GOLD) ukuze bahlukanise ukuqhubeka kwe-emphysema kube izigaba ezine ezihlukene:

• Isigaba 1 (Simaphakathi): Ukusebenza kwamaphaphu kuhlala ku-80% noma ngaphezulu uma kuqhathaniswa nabantu abanempilo yobudala kanye nokwakheka okufanayo. 
• Isigaba 2 (Okulingene): Ukusebenza kwamaphaphu kwehla phakathi kuka-50% no-79%. Iningi labantu lifuna usizo lwezempilo kulesi sigaba njengoba libona ukuphelelwa umoya ngesikhathi sokuzivocavoca umzimba.
• Isigaba 3 (Sinzima): Ukusebenza kwamaphaphu kwehla phakathi kuka-30% no-49%. Izinkinga zokuphefumula ziba sobala kakhulu, zithinta imisebenzi yansuku zonke.
• Isigaba 4 (Sinzima Kakhulu): Umsebenzi wamaphaphu wehlela ngaphansi kwama-30%. Iziguli ziba nobunzima obukhulu bokuphefumula futhi zingadinga ukwelashwa komoyampilo.

Izimpawu ze-Emphysema

Izimpawu zokuqala zihlanganisa:

• Ukuphelelwa umoya okuqhubekayo, ikakhulukazi phakathi nomsebenzi womzimba
• Ukukhwehlela njalo noma ukuhefuzela
• Ukwanda kokukhiqizwa kwamafinyila ngombala ophuzi noma oluhlaza
• Ukuqina kwesifuba noma ubuhlungu
• Umsindo womlozi ngenkathi uphefumula
• Ukukhathala nenkinga yokulala

Njengoba isimo siqhubeka, iziguli zingase zithole ukubonakaliswa okunzima kakhulu. Lokhu kubandakanya: 

• Izifo zokuphefumula ezivamile, njengemikhuhlane nomkhuhlane, ezingaba nomthelela omkhulu eqophelweni lempilo yazo 
• Ukulahlekelwa kwesisindo esingachaziwe
• Ubuthakathaka emisipha engezansi
• Ukuvuvukala emaqakaleni nasezinyaweni

Izingozi Ezibangelwa I-Emphysema Disease

Ukuthuthukiswa kwe-emphysema kubangelwa izici ezihlukahlukene ezilimaza izicubu zamaphaphu ngokuhamba kwesikhathi. Ukuqonda lezi zimbangela kusiza ekuvimbeleni kanye namasu okungenelela kusenesikhathi.

Intuthu kagwayi isalokhu iyimbangela ehamba phambili ye-emphysema, kanti ukubhema ugwayi kubala ngaphezu kwengxenye yazo zonke izimo. Amakhemikhali asentuthwini kagwayi enza buthaka izivikeli zemvelo zamaphaphu futhi acekele phansi amasaka omoya, okuholela ekulimaleni unomphela. 

Kunezici ezimbalwa ezibalulekile ezifaka engcupheni ekwakhiweni kwe-emphysema:

• Ukuchayeka Kwemvelo: Ukuxhumana isikhathi eside nezinto ezingcolisa umoya, okuhlanganisa nentuthu yezimboni kanye ne-exhaust yezimoto
• Izingozi Zomsebenzi: Ukuchayeka othulini namakhemikhali ezimayini, ezakhiweni, nasekwenziweni kwezindwangu
• Ukungcola Kwasendlini: Intuthu evela kuphethiloli wokushisisa nokungangeni komoya kahle, ikakhulukazi ezindaweni ezisebenzisa izitofu zokhuni ezisendlini
• Isici sobudala: Izigameko eziningi ezihlobene nogwayi ziba neminyaka ephakathi kuka-40 no-60
• I-Genetic Predisposition: Ukuntuleka kwe-Alpha-1 antitrypsin, isimo esingavamile esizuzwe njengefa, kungabangela i-emphysema ngisho nangaphandle kokuchayeka kwezinye izici eziyingozi.

Izinkinga ze-Emphysema

Izinkinga ezibaluleke kakhulu zihlanganisa:

• Ingozi Yenyumoniya: Abantu abane-emphysema baye banda amathuba okuba sengozini yokuthola izifo zamaphaphu, ikakhulukazi inyumoniya, ngenxa yezindlela zokuvikela amaphaphu ezisengozini.
• Iphaphu Eligoqekile: Amaphakethe omoya amakhulu abizwa ngokuthi i-bullae angakhula emaphashini, okungenzeka aqhume futhi abangele ukuwa kwamaphaphu (pneumothorax)
• Izinkinga Zenhliziyo: Lesi simo singaholela ku-cor pulmonale, lapho uhlangothi lwenhliziyo lwesokudla lukhula futhi lube buthaka ngenxa yokwanda kwengcindezi emithanjeni yamaphaphu.
• Imiphumela Yesistimu: Iziguli zivame ukuba nokuncipha kwesisindo, imisipha ebuthaka, nokuvuvukala emaqakaleni nasezinyaweni

Sifo

Umlando Wezempilo kanye Nokuhlolwa Komtholampilo: Odokotela bahlola umzimba wonke, balalele imisindo yokuphefumula futhi babheke izimpawu ezibonakalayo ezifana nesifuba somgqomo noma izindebe eziluhlaza okwesibhakabhaka. Baphinde babuyekeze umlando wesiguli sezokwelapha kanye nemikhuba yokubhema.

Ukuhlola okubalulekile okuningana kusiza ukuqinisekisa i-emphysema:

• Ukuhlolwa Kokusebenza Kwephaphu (PFTs): Lezi zikala umthamo wamaphaphu, ukugeleza komoya, nokusebenza kahle kokudlulisa umoya-mpilo
• Izikena ze-CT zokulungiswa okuphezulu: Nikeza izithombe ezinemininingwane yokulimala kwezicubu zamaphaphu kanye nesaka lomoya
• I-X-ray yesifuba: Siza ukuhlonza i-emphysema ethuthukisiwe futhi ukhiphe ezinye izimo
• Ukuhlolwa kwe-Arterial Blood Gas: Ibala amazinga omoya-mpilo kanye ne-carbon dioxide egazini
• Isibalo Segazi Esiphelele: Ihlola ukutheleleka futhi iqaphe amazinga abomvu egazi
• I-CT Scans: Zibonakala zibalulekile kakhulu njengoba zikwazi ukubona i-emphysema ekuqaleni kwayo, ngisho nangaphambi kokuba izimpawu zibonakale. 

Ukwelashwa

Izindlela eziyinhloko zokwelashwa kwe-emphysema zihlanganisa:

• Izinhlelo Zokuyeka Ukubhema: Isinyathelo sokuqala esibaluleke kakhulu esingabambezela ukuqhubeka kwesifo
• Ukuphathwa Kwemithi: Ama-bronchodilators kanye ne-corticosteroids (ngomlomo noma ephefumulelwe) ukuthuthukisa ukuphefumula
• Ukuvuselelwa Kwephaphu: Izinhlelo zokuzivocavoca nezemfundo ezihleliwe
• Ukwelashwa Ngeoksijini: I-oxygen eyengeziwe yamakesi athuthukile
• Ukungenelela Kokuhlinzwa: Izinketho ezifana nokuhlinzwa kokunciphisa umthamo wamaphaphu ezimweni ezinzima

Uzoyibona Nini Udokotela

Iziguli kufanele zithinte udokotela wazo uma zithola:

• Ukwanda kobunzima bokuphefumula uma kuqhathaniswa nokujwayelekile
• Izinguquko kumbala wamafinyila ube ophuzi noma oluhlaza
• Ukusetshenziswa njalo kwemithi ebekiwe
• Ukusebenza okuncishisiwe kwemithi yamanje
• Ukwanda kweziqephu zokukhwehlela
• Ukuphazamiseka kokulala ngenxa yezinkinga zokuphefumula
• Ukwehla okungachazeki kumazinga wamandla

Ukwelashwa ngokushesha kuyadingeka uma iziguli ziba:

• Ukuphefumula kanzima okuvimbela ukugibela izitebhisi
• Ukushintsha umbala okuluhlaza okwesibhakabhaka noma okumpunga kwezindebe noma izinzipho
• Ukudideka kwengqondo noma ukunciphisa ukuqapha
• Ukungakwazi ukukhuluma imisho ephelele ngenxa yokuphelelwa umoya

Prevention

Amasu okuvimbela aphumelela kakhulu ahlanganisa:

• Ukuvimbela Ukubhema kanye Nokuyeka:
  • Gwema ukuqala ukubhema
  • Yeka ukubhema ngosizo lochwepheshe
  • Joyina amaqembu osekelo ukuze uthole amanani empumelelo angcono
  • Sebenzisa imishanguzo ebekiwe kanye ne-nicotine replacement therapy
• Ukuvikelwa Kwezemvelo:
  • Gwema ukuchayeka entumeni kagwayi
  • Hlola amakhaya e-radon
  • Gqoka okokuvikela lapho usebenza ngamakhemikhali
  • Nciphisa ukuchayeka ekungcoleni komoya kanye nentuthu yezimboni
• Ukunakekela Impilo:
  • Thola imigomo ejwayelekile yomkhuhlane kanye nenyumoniya
  • Gcina ukuvivinya umzimba njalo
  • Landela iseluleko esifanele sokudla
  • Funa ukwelashwa ngokushesha kwezifo zokuphefumula

Isiphetho

Isayensi yezokwelapha iyaqhubeka nokuthuthuka ekuqondeni nasekwelapheni i-emphysema. Ngamasu okuphatha afanele, ukwesekwa kodokotela, kanye nezinyathelo zokuvimbela, abantu abane-emphysema bangaphila impilo ekhuthele, enempilo kuyilapho begcina izimpawu zabo zilawulwa. Inhlanganisela yokwelashwa, izinguquko zendlela yokuphila, nokuqapha okuvamile kunikeza indlela engcono kakhulu eya phambili kunoma ubani othintwe yilesi simo.

Imibuzo Evame Ukubuzwa

1. Ithinta bani i-emphysema?

I-Emphysema ivamise ukuphatha amadoda aphakathi kweminyaka engama-50 nengama-70. Kodwa-ke, lesi simo singase sikhule kunoma ubani, okuhlanganisa nabesifazane kanye nabantu abadala abasebasha, kunoma ibuphi ubudala (ngaphambi kuka-40). Ababhemayo babhekene nengozi enkulu kakhulu, nakuba abangabhemi bangaphinde bahlakulele lesi sifo ngokuchayeka kwemvelo noma izici zofuzo.

2. Ivame kangakanani i-emphysema?

I-Emphysema ingenye yezifo ezivame kakhulu zamaphaphu. Amazinga aphezulu avela phakathi:

• Abantu abamhlophe okungebona abeSpanishi
• Abesilisa uma kuqhathaniswa nabesifazane
• Abantu abadala abaneminyaka engu-65 nangaphezulu

3. Ingabe amaphaphu angalulama ku-emphysema?

Umonakalo odalwa yi-emphysema unomphela futhi awulungiseki. Nakuba amaphaphu engakwazi ukuphulukiswa ku-emphysema, ukwelashwa okufanele kanye nokuguqulwa kwendlela yokuphila kungasiza:

• Ukuqhubeka kwesifo kancane
• Thuthukisa amandla okuphefumula
• Thuthukisa izinga lempilo
• Yehlisa ukushuba kwezimpawu

4. Iliphi ikhambi elihle lasekhaya le-emphysema?

Amasu amaningana asekelwe ekhaya angasiza ekulawuleni izimpawu ze-emphysema ngempumelelo:

• Ukuzivocavoca okuphefumula njalo
• Ukugcina ukudla okufanele
• Ukuhlala umatasatasa ngaphakathi kwemikhawulo
• Ukuzijwayeza amasu okulawula ukucindezeleka

5. Uyini umehluko phakathi kwe-emphysema ne-COPD?

Emphysema empeleni uhlobo COPD (Izifo Ezingalapheki Ezivimbela Amaphaphu). I-COPD isebenza njengegama lesambulela elihlanganisa kokubili i-emphysema kanye ne-bronchitis engapheli. Nakuba bonke abantu abane-emphysema bane-COPD, akubona bonke abane-COPD abane-emphysema. Izimo zihlanganyela izimbangela kanye nokwelashwa okufanayo kodwa zithinta izingxenye ezahlukene zesakhiwo samaphaphu.

UDkt. TLN Swamy

I-MBBS, MD (Izifo Zokuphefumula)
I-CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad, CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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