I-Aspergillosis Isiguli Nokusekelwa

Kuhlinzekwe yi-NHS National Aspergillosis Center

I-Hemoptysis

Uma uletha igazi elingaphezu kwesipuni, vakashela ku-A&E ngokushesha.

I-Hemoptysis isho ukukhwehlela igazi eliphuma emaphashini. Kungase kubukeke njengenani elincane lesikhwehlela esinemithende yegazi, noma inani elikhulu lesikhwehlela esinegwebu elibomvu ngokugqamile.

Lolu wuphawu oluvamile phakathi kweziguli ze-CPA, kanye nezinye iziguli ze-ABPA. Kungakhathaza izikhathi ezimbalwa zokuqala ukwenzeka kodwa iziguli eziningi ziye ziqonde ukuthi yini evamile kuzo. Uma noma yini ishintsha enanini noma iphethini ye-haemoptysis yakho (noma uma uba nayo okokuqala ngqa) kufanele utshele udokotela wakho, ngoba kungaba uphawu oluyisixwayiso lokuthi isifo sakho singase siqhubeke.

I-Massive haemoptysis ichazwa ngokuthi yi-600ml (ngaphezulu nje kwepayinti) wegazi phakathi namahora angu-24, noma u-150ml (isigamu sethini le-Coke) phakathi nehora. Nokho, amanani amancane kakhulu angaphazamisa ukuphefumula kwakho. Uma lokhu kwenzeka kufanele ushayele ku-999 ngokushesha.

Uma wopha kakhulu kakhulu ungase unikezwe i-tranexamic acid (Cyclo-F/Cyclokapron), esiza ukumisa ukopha. Kungumqondo omuhle ukugcina iphakheji ukuze ukwazi ukukhombisa abezimo eziphuthumayo ukuthi yini ngempela oyithathile.

Kwesinye isikhathi iziguli zethu zikuthola kunzima ukutshela abezimo eziphuthumayo nakwabanye odokotela ubucayi balesi simo, ikakhulukazi uma zingayijwayele i-aspergillosis. Iziguli amaphaphu azo alinyazwa i-aspergillosis kanye/noma i-bronchiectasis ingawohloka ngokushesha, ngakho-ke kubalulekile ukuqina futhi ugcizelele ukuthi bakuyise esibhedlela.I-NAC ingakunikeza ikhadi lesexwayiso sesikhwama semali elihlanganisa inothi mayelana nalokhu kwabosizo lokuqala.

Uma ungeniswa esibhedlela ngenxa ye-haemoptysis, ungase uthole igazi noma ukufakelwa uketshezi. Ungase udinge i-bronchoscopy ukuze uthole umthombo wokopha noma ufakwe intubathi ukukusiza uphefumule kangcono. Kungase kudingeke ukuthi wenze i-embolization ukuze umise ukopha, okwenziwa ngokufaka ucingo emithanjeni yegazi emathangeni akho. Okokuqala ukuskena kuzobonisa indawo yomthambo olimele, bese kufakwa izinhlayiya ezincane ukuze zakhe ihlule. Ezimweni ezimbalwa kungase kuphakanyiswe ukuhlinzwa noma i-radiotherapy.

Funda kabanzi mayelana ne-hemoptysis:

  •  I-Tranexamic acid ingasiza ekwehliseni umthamo kanye nesikhathi sokopha ku-hemoptysis, ngengozi ephansi yezinkinga. (U-Moen et al (2013))

Kuyathakazelisa ukuthi amaphaphu anegazi elihlukene elibili: imithambo ye-bronchial (ekhonza i-bronchi) kanye ne-pulmonary arteries (ekhonza i-alveoli). I-90% yokopha kwe-hemoptysis ivela emithanjeni ye-bronchial, engaphansi kwengcindezi ephakeme ngenxa yokuthi iphuma ngqo ku-aorta.