Chibayo chopezeka pagulu mwa akulu

Chibayo ndimapuma (kupuma) momwe muli matenda am'mapapo.

Nkhaniyi ikufotokoza chibayo chopezeka pagulu (CAP). Chibayo chotere chimapezeka mwa anthu omwe sanakhalepo kuchipatala kapena malo ena azachipatala monga malo osungira okalamba kapena malo obwezeretsera anthu. Chibayo chomwe chimakhudza anthu m'malo azachipatala, monga zipatala, chimatchedwa chibayo chomwe chimapezeka kuchipatala (kapena chibayo chokhudzana ndi chisamaliro chaumoyo).

Chibayo ndi matenda wamba omwe amakhudza anthu mamiliyoni ambiri chaka chilichonse ku United States. Majeremusi otchedwa mabakiteriya, mavairasi, ndi bowa angayambitse chibayo. Kwa akulu, mabakiteriya ndi omwe amayambitsa chibayo.

Njira zomwe mungapezere chibayo ndi monga:

• Mabakiteriya ndi mavairasi okhala m'mphuno mwanu, m'mphuno kapena pakamwa atha kufalikira m'mapapu anu.
• Mutha kupumira ena mwa majeremusi awa m'mapapu anu.
• Mumapumira (kukoka) chakudya, zakumwa, kusanza, kapena madzi amkamwa m'mapapu anu (aspiration pneumonia).

Chibayo chimatha kuyambitsidwa ndi mitundu yambiri ya majeremusi.

• Mtundu wofala kwambiri wa mabakiteriya ndi Streptococcus pneumoniae (chibayo).
• Chibayo chodziwika bwino, chomwe nthawi zambiri chimatchedwa chibayo choyenda, chimayambitsidwa ndi mabakiteriya ena.
• Bowa wotchedwa Pneumocystis jiroveci imatha kuyambitsa chibayo mwa anthu omwe chitetezo chamthupi chawo sichikuyenda bwino, makamaka anthu omwe ali ndi kachilombo ka HIV.
• Mavairasi, monga kachilombo ka chimfine, komanso SARS-CoV-2 yaposachedwa kwambiri (yomwe imayambitsa COVID-19), nawonso ndi omwe amayambitsa chibayo.

Zowopsa zomwe zimawonjezera mwayi wanu wopeza chibayo ndi izi:

• Matenda am'mapapo (COPD, bronchiectasis, cystic fibrosis)
• Kusuta ndudu
• Dementia, stroke, kuvulala kwaubongo, kufooka kwa ubongo, kapena zovuta zina zamaubongo
• Vuto la chitetezo cha mthupi (mukamalandira khansa, kapena chifukwa cha HIV / AIDS, kumuika ziwalo, kapena matenda ena)
• Matenda ena akulu, monga matenda amtima, chiwindi, kapena matenda ashuga
• Opaleshoni yaposachedwa kapena zoopsa
• Opaleshoni yochiza khansa yapakamwa, pakhosi, kapena m'khosi

Zizindikiro zofala kwambiri za chibayo ndi izi:

• Kukhosomola (ndi chibayo chimatha kutsokomola ntchofu zobiriwira kapena zachikasu, kapena ntchofu zamagazi)
• Malungo, omwe atha kukhala ofatsa kapena okwera
• Kugwedeza kuzizira
• Kupuma pang'ono (kumatha kuchitika mukangokwera masitepe kapena mukamachita khama)

Zizindikiro zina ndizo:

• Kusokonezeka, makamaka kwa okalamba
• Khungu lotuluka thukuta kwambiri
• Mutu
• Kutaya njala, mphamvu zochepa, ndi kutopa
• Malaise (osamva bwino)
• Kupweteka kapena kubaya pachifuwa komwe kumakulirakulira mukamapuma kwambiri kapena kutsokomola
• Matenda oyera a msomali, kapena leukonychia

Wothandizira zaumoyo amamvetsera chifukwa cha mabala kapena mpweya wosamveka bwino akamamvera pachifuwa ndi stethoscope. Kugogoda pakhoma panu pachifuwa (phokoso) kumathandiza woperekayo kuti amvetsere ndikumva mawu osamveka bwino pachifuwa chanu.

Ngati chibayo chikukayikiridwa, woperekayo akhoza kuyitanitsa x-ray pachifuwa.

Mayesero ena omwe angayitanidwe ndi awa:

• Mitsempha yamagazi yamagazi kuti muwone ngati oxygen yokwanira ikulowa m'magazi anu kuchokera m'mapapu.
• Magazi ndi zikhalidwe za sputum kuyang'ana kachilomboka komwe kangayambitse chibayo.
• CBC kuti muwone kuchuluka kwama cell oyera.
• Kujambula kwa CT pachifuwa.
• Bronchoscopy. Chubu chosinthika chokhala ndi kamera yowala kumapeto chimadutsa m'mapapu anu, munthawi zosankhidwa.
• Thoracentesis. Kuchotsa madzimadzi kuchokera pakatikati pazenera zakunja ndi khoma lachifuwa.
• Nasopharyngeal swab yowunika ma virus ngati fuluwenza ndi SARS-CoV-2.

Wothandizira anu ayenera kusankha kaye ngati mukufuna kukhala mchipatala. Mukalandira chithandizo kuchipatala, mudzalandira:

• Madzi ndi maantibayotiki kudzera m'mitsempha yanu
• Thandizo la oxygen
• Mankhwala opumira (mwina)

Ngati mwapezeka kuti muli ndi chibayo cha bakiteriya, ndikofunikira kuti muyambe kumwa maantibayotiki mutangolandira. Ngati muli ndi chibayo cha virus, simulandila maantibayotiki. Izi ndichifukwa choti maantibayotiki samapha mavairasi. Mutha kulandira mankhwala ena, monga ma antivirals, ngati muli ndi chimfine.

Mutha kuloledwa kupita kuchipatala ngati:

• Khalani ndi vuto lina lalikulu lachipatala
• Khalani ndi zizindikiro zoopsa
• Simulephera kudzisamalira nokha kunyumba, kapena mukulephera kudya kapena kumwa
• Ndioposa 65
• Ndakhala ndikumwa maantibayotiki kunyumba ndipo sakupeza bwino

Anthu ambiri amatha kuchiritsidwa kunyumba. Ngati ndi choncho, omwe akukupatsani akhoza kukuwuzani kuti mumwe mankhwala monga maantibayotiki.

Mukamamwa maantibayotiki:

• Musaphonye mlingo uliwonse. Tengani mankhwalawo mpaka atatha, ngakhale mutayamba kumva bwino.
• Musamamwe mankhwala a chifuwa kapena mankhwala ozizira pokhapokha dokotala atanena kuti zili bwino. Kutsokomola kumathandiza thupi lanu kuchotsa mamina m'mapapu anu.

Kupuma kofunda, konyowa (konyowa) kumathandiza kumasula mamina omwe angakupangitseni kumva kuti mukutsamwa. Zinthu izi zitha kuthandiza:

• Ikani chovala chofunda, chonyowa momasuka pamphuno ndi pakamwa.
• Dzazani chopangira chinyezi ndi madzi ofunda ndikupumira mu nkhungu yotentha.
• Pumirani kangapo kawiri kapena katatu pa ola lililonse. Kupuma kozama kumathandizira kutsegula mapapu anu.
• Dinani pachifuwa panu pang'ono kangapo patsiku mukugona ndi mutu wanu wotsika kuposa chifuwa. Izi zimathandiza kutulutsa ntchofu m'mapapu kuti mutha kutsokomola.

Imwani zakumwa zambiri, bola ngati wothandizira wanu akunena kuti zili bwino.

• Imwani madzi, msuzi, kapena tiyi wofooka
• Imwani makapu osachepera 6 mpaka 10 (1.5 mpaka 2.5 malita) patsiku
• Osamwa mowa

Muzipuma mokwanira mukamapita kunyumba. Ngati mukuvutika kugona usiku, pumulani masana.

Ndi chithandizo, anthu ambiri amasintha mkati mwa masabata awiri. Okalamba kapena odwala kwambiri angafunikire chithandizo chotalikirapo.

Omwe atha kukhala ndi chibayo chovuta kwambiri ndi awa:

• Okalamba okalamba
• Anthu omwe chitetezo cha mthupi chawo sichigwira ntchito bwino
• Anthu omwe ali ndi mavuto ena azachipatala monga matenda ashuga kapena cirrhosis ya chiwindi

M'mikhalidwe yonseyi, chibayo chimatha kubweretsa imfa, ngati chiri chachikulu.

Nthawi zambiri, mavuto akulu akhoza kukhala, kuphatikiza:

• Zosintha zowopsa m'mapapu zomwe zimafunikira makina opumira
• Madzi ozungulira mapapo (pleural effusion)
• Madzi opatsirana mozungulira mapapo (empyema)
• Ziphuphu zotupa

Wopereka wanu atha kuyitanitsa x-ray ina. Izi ndizowonetsetsa kuti mapapu anu ali bwino. Koma zimatha kutenga milungu ingapo kuti x-ray yanu ithe. Mutha kumva bwino x-ray isanathe.

Itanani omwe akukuthandizani ngati muli ndi:

• Chifuwa chomwe chimabweretsa ntchofu zamagazi kapena dzimbiri
• Kupuma (kupuma) zizindikiro zomwe zimakulirakulirabe
• Kupweteka pachifuwa kumawonjezeka mukamatsokomola kapena kupuma
• Kupuma mofulumira kapena kupweteka
• Kutuluka thukuta usiku kapena kuonda kosadziwika
• Kupuma pang'ono, kugwedeza kuzizira, kapena malungo osalekeza
• Zizindikiro za chibayo ndi chitetezo chamthupi chofooka (mwachitsanzo, monga HIV kapena chemotherapy)
• Kukula kwa zizindikilo pambuyo pakusintha koyamba

Mutha kuthandiza kupewa chibayo potsatira njira zotsatirazi.

Sambani m'manja nthawi zambiri, makamaka:

• Musanaphike ndi kudya chakudya
• Mukaphulitsa mphuno yanu
• Atapita kubafa
• Mukasintha matewera a mwana
• Atakumana ndi anthu omwe akudwala

Pewani kukumana ndi anthu omwe akudwala.

Osasuta. Fodya amawononga mapapu anu kuthana ndi matenda.

Katemera angathandize kupewa mitundu ina ya chibayo. Onetsetsani kuti mwalandira katemera otsatirawa:

• Katemera wa chimfine angathandize kupewa chibayo chomwe chimayambitsidwa ndi kachilomboka.
• Katemera wa pneumococcal amachepetsa mwayi wanu wopeza chibayo Streptococcus pneumoniae.

Katemera ndiofunikanso kwambiri kwa okalamba komanso anthu omwe ali ndi matenda ashuga, mphumu, emphysema, HIV, khansa, anthu opatsirana ziwalo, kapena zinthu zina zazitali.

Matenda am'mimba; Chibayo chopezeka pagulu; Kapu

• Bronchiolitis - kumaliseche
• Chimfine ndi chimfine - zomwe mungafunse dokotala wanu - wamkulu
• Chimfine ndi chimfine - zomwe mungafunse dokotala - mwana
• Momwe mungapume mukakhala ndi mpweya wochepa
• Kuteteza kwa oxygen
• Chibayo mwa akulu - kutulutsa
• Chibayo mwa ana - kutulutsa
• Kugwiritsa ntchito mpweya kunyumba
• Kugwiritsa ntchito mpweya kunyumba - zomwe mungafunse dokotala wanu
• Mwana wanu wakhanda akatentha thupi

• Dongosolo kupuma
• Chibayo
• Matenda oyera a msomali

Daly JS, Ellison RT. Chibayo chachikulu. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 67.

Musher DM. Chidule cha chibayo. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 91.

Wunderunk RG. Malangizo othandizira kusamalira chibayo. Clin Chifuwa Med. 2018; 39 (4): 723-731. (Adasankhidwa) PMID: 30390744 adatulidwa.ncbi.nlm.nih.gov/30390744/.