Chipatara Chakanakisisa Chiri Pedyo neni Chennaimufananidzo
Goverana Kuburikidza ne:
Kuisirwa mapapu kunongofungwa chete kana chirwere chemapapu chakakomba, chisingarapiki chisisashande zvakanaka chisisashande zvakanaka nemishonga, oxygen therapy uye pulmonary rehabilitation. Kurapa kunoda chirongwa chakarongwa chekuisirwa mapapu, kutarisirwa kwakakosha nguva dzese, kudzora hutachiona, uye kuteverwa kwehupenyu hwese. Ruzivo rwuri pazasi runotsanangura kuti kutarisirwa kwakadaro kunorongwa sei kuApollo Hospitals, Lucknow, kuti maitiro acho anosanganisirei, uye kuti varwere nemhuri muUttar Pradesh vanofanira kutarisira chii chaizvo.
Sei Mhuri Dzichifunga Nezvezvipatara zveApollo Kuti Zvishandiswe Pakuisirwa Mapapu
- Nhaka yeboka kubvira muna 1983: Zvipatara zveApollo zvakavambwa muna 1983 seboka rekutanga rezvipatara zvemakambani muIndia uye nhasi uno zvine zvipatara zvinopfuura makumi manomwe zvine mibhedha inopfuura 10,000, zvichipa mukana wekuwana nzira dzekurapa dzakagadzirwa dzekubvisa nhengo dzemuviri, dzemwoyo nedzekurapa varwere vakaoma dzinoshandiswa mu network yese.
- Ruzivo rwekuisira mbeu muboka rese: Zvipatara zveApollo zvakamboita mabasa ekuisira nhengo dzakasimba anopfuura 25,000 muzvikamu zvayo, kusanganisira kuisira mwoyo nemapapu munzvimbo dzazvo dzakatsaurirwa kuisira mwoyo muChennai neHyderabad, uye nyaya dzakaoma dzekuLucknow dzinogona kukurukurwa uye, pazvinenge zvakakodzera, dzinogona kutaurwa mukati mesangano iri.
- Multidisciplinary team: Kuongororwa kwechirwere chemapapu chakakwira kuApollo Hospitals, Lucknow inosanganisira vanachiremba vemapapu, vanachiremba vemwoyo nevetsinga dzeropa, vanachiremba vekuchengetedza varwere vane hutano, vanachiremba vemwoyo, vanachiremba vetsinga, nyanzvi dzezvirwere zvinotapukira, vanachiremba veanosthesiologists, vanachiremba vephysiotherapists, vanachiremba vezvekudya uye varongi ve transplantation vanoshanda sechikwata chimwe chete, vane makore akati wandei eruzivo rwekurapa rwakabatana.
- Chipatara chinotenderwa neNABH muLucknow: Chipatara cheLucknow chipatara chepamusoro chine hunyanzvi hwakasiyana-siyana chine dzimba dzekuvhiya dzinoshandiswa, nzvimbo dzekutarisira varwere zvakanyanya, rutsigiro rwekuchengetera ropa maawa makumi maviri nemana pazuva, uye mabasa ekurapa varwere vanorwara zvikuru maawa makumi maviri nemana pazuva, mazuva ese.
- Tekinoroji yekuongorora uye yekutsigira: CT ine resolution yepamusoro, CT pulmonary angiography, echocardiography, right heart catheterization kana zvaratidzwa, kushanda kwemapapu ese uye kuyedzwa kwekufamba kwemaminitsi matanhatu, bronchoscopy, rutsigiro rwepamusoro rwekufema, uye rabhoritari ye microbiology yekutarisa hutachiona hwemhando ye transplant-grade.
- Kugadzirisa kwakarongeka usati waisa mwana mudumbu: Kugadziriswa kwemapapu emunhu oga, kugadziriswa kwekudya kunovaka muviri, kurega kusvuta nekusvuta fodya, kuongororwa kwejekiseni uye mazano epfungwa - zvinhu zvinonyanya kupesvedzera kana murwere achigona kushivirira kuvhiyiwa kwekuisirwa nhengo yemuviri zvakachengeteka.
- Nzira dzekutarisira dzemapoka akasiyana-siyana ezera: Nzira dzakasiyana dzekurapa vanhu vakuru, varwere vakwegura vane zvimwe zvirwere zvakasiyana-siyana, uye varwere vevana kana vechidiki vane zvirwere zvakaita se cystic fibrosis kana bronchiectasis, kusanganisira rubatsiro rwevana vanorwara zvakanyanya.
- Kugadziriswazve mushure mekuisirwa mwana uye mushure mekurwara zvakanyanya: Kudzidzira muviri (physiotherapy) kwakarongwa, kudzidziswazve kufema, kushanda nesimba uye mapurogiramu ekudzoka kumabasa, zvakagadzirirwa vanhu vanoda kutangazve mabasa emaoko, basa repapurazi kana kudzidza.
- Kupinda munzvimbo: Chipatara ichi chiri muKanpur Road, Lucknow, inzvimbo inoshanda yekutumira varwere vanobva kuUttar Pradesh nedzimwe nyika dziri pedyo, uye kune nzvimbo dzekubatsira varwere neinishuwarenzi dzepasi rose dziripo.
Ruzivo rwakadzama nezvechirongwa - kusanganisira kana kuisirwa mapapu kwakaitwa kuLucknow unit kana kuti kwakaitwa neimwe nzvimbo yeApollo transplant - runofanira kusimbiswa nedhipatimendi rekubatanidza kuisirwa mapapu panguva yekubhuka.
tsananguro
Kuvhiyiwa kwekuisirwa mapapu inzira inoponesa hupenyu inotsiva mapapu ane chirwere kana akakuvara nemapapu ane hutano kubva kune anopa. KuApollo Hospitals Lucknow, kutarisirwa kwechirwere chemapapu chakakwira kunobva pakuongororwa kwakazara, tekinoroji yepamusoro uye kutarisirwa kwevarwere vane tsitsi. Chikwata chevanachiremba vane hunyanzvi hwepamusoro uye nyanzvi dzekurapa dzinoshanda kuona kuti murwere wega wega anowana kurapwa kwakagadzirirwa zvido zvake zvakasiyana. Nekusimbisa kwakasimba pakupa mazano pachena uye kutevera kwenguva refu, Apollo Hospitals Lucknow ine chinangwa chekuva mubatsiri akavimbika murwendo rwekuenda kuhutano hwakanaka hwemapapu.
Nei Kuisa Mapapu Kwakakosha?
Kuisirwa mapapu kunowanzo dikanwa kune varwere vane zvirwere zvakakomba zvemapapu zvakaita seChronic Obstructive Pulmonary Disease (COPD), pulmonary fibrosis, cystic fibrosis, uye pulmonary BP. Izvi zvinogona kukonzera kutadza kufema zvakanyanya, zvichikanganisa hupenyu hwemunhu zvakanyanya. Kuisirwa mapapu kunogona kudzorera mashandiro emapapu evarwere vazhinji, zvichivabvumira kufema zviri nyore, kuita mabasa ezuva nezuva, uye kuvandudza hutano hwavo hwese.
Kukosha kwekurapa kwekuisirwa mapapu kwakakura. Izvi zvinopa imwe sarudzo kune vanhu vakaneta nedzimwe nzira dzekurapa. Nekutsiva mapfupa akakuvara ne graft ine hutano, varwere vakakodzera vanogona kuona kuvandudzika kuhutano, zvichitungamira kusimba riri nani, kuwedzera kurovedza muviri, uye kunzwa kwetariro patsva. Mhedzisiro inosiyana pakati pevanhu uye haigone kuvimbiswa.
Ngozi dzekunonoka
Kunonoka kuongororwa kwekuisirwa mapapu kunogona kuva nemigumisiro yakakomba. Sezvo zvirwere zvemapapu zvichiwedzera, varwere vanogona kuona zviratidzo zvichiwedzera kuipa, zvinosanganisira kuwedzera kufema, kuneta, uye kudzikira kwekutsungirira maekisesaizi. Kumbomira kuongororwa kunogona kukonzera matambudziko akadai sekukundikana kufema, kugara muchipatara kakawanda, BP yemapapu, kudzikira uremu zvakanyanya, uye, mune dzimwe nguva, kufa.
Uyewo, kana murwere akamirira kwenguva yakareba, mikana yekuti tsandanyama dzipere, kushushikana kweitsvo kana hutachiona zvinoita kuti kuisirwa nhengo yemuviri kusave kwakachengeteka, uye mukana wekuwana nzira unodzikira sezvo mamiriro acho achiipa. KuApollo Hospitals Lucknow, kusimbiswa kuri pakuongororwa nenguva uye kutumira varwere kuchipatara, kuitira kuti varwere vaongororwe vachiri vakasimba kuti vabatsirwe.
Zvakanakira Lung Transplant
- Kuvandudzwa kwebasa remapapu: Kuisirwa murwere zvakanaka kunogona kudzorera simba rake rekufema, zvichibvumira varwere vazhinji kuti vatangezve mabasa avakanga vasiya.
- Kuwedzera masimba esimba: Varwere vanowanzotaura kuti vanoshaya mweya uye vaneta zvishoma mushure mekupora, zvichiita kuti vatore chikamu mumabasa ezuva nezuva uye muhupenyu hwevanhu.
- Hupenyu hwakavandudzwa: Kuvandudzwa kwebasa kunowanzo reva kuzvimiririra kukuru, kurara zviri nani, uye kugona kufamba uye kupedza nguva nemhuri.
- Kubatsirwa kwekupona muvarwere vakasarudzwa: Kufambira mberi mukuita maoparesheni, kuchengetedza nhengo dzemuviri uye kudzvinyirirwa kwemasoja emuviri kwakaita kuti kurarama kwevarwere vakasarudzwa zvakanaka kuve nani. Mhedzisiro yacho inoenderana nechirwere chiripo, zera uye mamwe mashandiro enhengo dzemuviri.
- Mafungiro ezvepfungwa: Kurerukirwa kubva pakushaya mweya nguva dzose uye kushandisa mweya wakakwana kunogona kuderedza kuzvidya mwoyo uye kuora mwoyo, kunyange hazvo vamwe varwere vachida rubatsiro rwekurapwa nguva dzose.
Kugadzirira uye Kudzorera
Kugadzirira Matipi
- Kubvunzurudza: Ronga kubvunzana nechikwata chevarwere vane chirwere chemapapu chakakwira uye vanoisirwa nhengo dzemuviri kuApollo Hospitals Lucknow kuti vaongorore zvakakwana kana vakakodzera kurapwa.
- Ongororo yezvokurapa: Kuongororwa kwakazara - mifananidzo, kuongororwa ropa, kuongororwa kwebasa remapapu, kuongororwa kwemoyo uye kuongororwa kwehutachiona - kuongorora hutano hwemapapu uye hutano hwese.
- Lifestyle modifications: Rega kusvuta fodya yese, kutsenga fodya nedoro zvachose, ramba uchidya zvine mapuroteni akawanda, uye tevera hurongwa hwekurovedza muviri hwakatarwa. Shanduko idzi dzinokanganisa zvikuru mukana wekupinda muchirongwa uye mhedzisiro yacho.
- Support system: Vakai boka rekutsigirana rakavimbika remhuri neshamwari dzinogona kubatsira munguva yekumirira, kuvhiyiwa uye kupora kwenguva refu. Rutsigiro rwepfungwa nerwemabasa rwakakosha.
Mazano Ekudzoreredza
- Kutevera kutarisira: Pinda ongororo dzese dzakarongwa. Kuongororwa nguva dzose, kusanganisira kuongororwa kwebasa remapapu uye bronchoscopy kana zvataurwa, zvinoona kurambwa uye hutachiona nekukurumidza.
- Kuomerera kwemishonga: Inwa mishonga yese sezvakarairwa. Mishonga inoderedza immune system haifanirwe kusiyiwa kana kugadziriswa wega, sezvo izvi zvichigona kurambwa.
- Kudzoreredza muviri: Tora chikamu muchirongwa chekugadzirisa mapapu kuti uvandudze simba, kutsungirira uye kugona kufema zvakanaka.
- Hupenyu hune hutano: Ramba uchidya zvine mwero, uchidya zvekudya zvakachengeteka, uye uchirovedza muviri nguva dzose.
- Ramba uchiziva: Dzidza zviratidzo zvekurambwa uye hutachiona uye nguva yekuenda kunorapwa nekukurumidza.
Nhungamiro Dziripo Dzinotungamira Kusarudzwa uye Kutevera
Sarudzo dziri muchirongwa chemazuva ano chekuisira mwana kubva kune mumwe munhu dzinoenderana nemagwaro akabudiswa pane zvaanoda munhu:
- Gwaro reISHLT 2021 reKubvumirana kweKusarudzwa kweVanoda Kuisirwa Mapapu (International Society for Heart and Lung Transplantation, yakaburitswa muna 2021) ndiyo inonyanya kutaurwa nezvayo. Chinonyanya kukosha kubva pane cha2014 ndechekusiya miganhu yezera rehuwandu uye nzira imwe chete yekugumisa chirwere ichi. ngozi inowedzera Kuongororwa? zvichireva kuti zvinhu zvakawanda zvine njodzi zviri pakati nepakati (semuenzaniso, kukwegura pamwe nekurema kwetsandanyama shoma pamwe nekusashanda zvakanaka kweitsvo) zvinogona kukosha kupfuura chero nhamba imwe chete. Yakavandudzawo gwara pamusoro pekufuta nehuremu hushoma, kushaya simba, chirwere chemwoyo, kuvhiyiwa kwechipfuva uye kugadzirira psychosocial.
- Nhungamiro dzakabatana dzeIndian Chest Society (ICS) neNational College of Chest Physicians (India) pamusoro pekuongororwa uye kurapwa kwechirwere chemapapu chemukati memapapu uye idiopathic pulmonary fibrosis (2020) uye pamusoro peCOPD (nhungamiro dzeIndia, shanduro dzakagadziridzwa) chimiro chekuti murwere anofanira kutumirwa riini kunoongororwa kuisirwa nhengo dzemuviri muIndia, uye kusimbisa kutumirwa riini nekuti varwere vekuIndia vanowanzouya kunonoka.
- Mutemo weKudyara Nhengo dzeMunhu neTishu dzeMuviri (THOTA), 1994, pamwe nekuvandudzwa kwa2011 neMitemo ya2014, inotungamirwa kuburikidza neNOTTO, SOTTO Uttar Pradesh nedunhu, inotungamira mvumo yevanopa rubatsiro, chitupa chekufa kubva muuropi, kunyoreswa kwevanogamuchira, kugoverwa kwemazita ekumirira uye marezenisi echipatara. Chirongwa chega chega chepamutemo chekuisirwa mwana muIndia chinoshanda mukati mehurongwa uhu.
- Gwaro reISHLT/ATS pamusoro pekuramba kushandiswa kwemasoja ekudzivirira chirwere, kusashanda zvakanaka kwemapapu kwenguva refu uye kudzivirira hutachiona inopa ruzivo nezvehurongwa hwekuchengetedza kwenguva refu.
Kutumirwa kunoongororwa kunowanzo kurudzirwa nguva refu murwere asati arwara zvakanyanya - semuenzaniso, mune progressive fibrotic ILD ine kuderera kwebasa remapapu pasinei nekurapwa kwe antifibrotic, mune COPD ine kushata kwekushanda kwemapapu uye kuwedzera kwakawanda, mune cystic fibrosis kana bronchiectasis ine hutachiona hwakakomba hunodzokororwa, kana mune BP yemapapu isingadzorwi pakurapwa kwakakodzera. Chiremba wemapapu anorapa achashandisa izvi zvinodiwa kune munhu wega wega.
Nguva, Nguva Yekumirira uye Chikamu Chekutanga Chekuita
Kusiyana nekuvhiyiwa kwakawanda, kuisirwa mapapu hakugone kurongerwa zuva rakasarudzwa. Kurongeka kwacho kunowanzo kuve:
- Kutumirwa kune mumwe munhu uye kubvunzana kwekutanga: Ongororo yezvinyorwa, mifananidzo, zvinodiwa neokisijeni uye kurapwa kwakaitwa kare.
- Ongororo yepamutemo (inowanzoitwa mavhiki maviri kusvika matanhatu): Basa remapapu, bvunzo yekufamba kwemaminitsi matanhatu, HRCT, echocardiography, kuongororwa kwemoyo, basa reitsvo nechiropa, mhando yeropa nenyama, kubviswa kwemazino neENT, kuongororwa kwegomarara zvinoenderana nezera, kuongororwa kwehepatitis, HIV, TB nezvimwe zvirwere, kuongororwa kwekudya kunovaka muviri uye kuongororwa kwepfungwa.
- Sarudzo yebhodhi remadhipatimendi akasiyana-siyana: Yakanyorwa, yakambomiswa kana paine zvirwere (semuenzaniso, kuwedzera uremu, kudzikira uremu, kunyoreswa kwekurega fodya, kurapwa kwemazino), kana kurayirwa kuti isaisirwe mushonga wekurapa kumwe kwakarongwa.
- Kumirira pane rondedzero: Kunyoresa kuhurumende nerejistri yenyika. Nguva yekumirira muIndia haigone kufungidzirwa uye zvinoenderana neboka reropa, saizi yechipfuva, kunzwa, kukurumidza kwekurapwa uye kuwanikwa kwevanopa. Vamwe varwere vanomirira mavhiki, vamwe mwedzi yakawanda, uye vamwe vanoora nhengo isati yavapo. Izvi zvinofanirwa kukurukurwa zvechokwadi pakutanga.
- Kufona: Kana munhu akakodzera akawanikwa, murwere anofanira kukwanisa kusvika kuchipatara nekukurumidza, achitsanya, aine magwaro akagadzirira. Mapurogiramu mazhinji anokumbira varwere vakanyorwa kuti vatamire pedyo neguta revanoisirwa nhengo dzemuviri.
- Kuvhiya: Kuisirwa mapapu kamwe chete kana maviri pasi peanesthesia, kazhinji kunotora maawa matanhatu kusvika gumi nemaviri, dzimwe nguva ne cardiopulmonary bypass kana rutsigiro rweECMO.
Sarudzo dzeTekiniki neKurapa Zvichienzaniswa
| Pfungwa | Inowanzo tariswa kuti | Zvakanakira zvikuru | Mipimo mikuru |
|---|---|---|---|
| Single lung transplant | Varwere vakwegura vane fibrotic ILD kana emphysema vasina hutachiona | Kuvhiyiwa kwenguva pfupi, mapapu emupi mumwe chete anoshandira vanhu vaviri, zvichideredza njodzi yekuvhiyiwa nekukurumidza | Mapapu anoramba aine chirwere anoramba aripo; kushaya simba kwenguva refu |
| Kuisirwa mapapu maviri (aviri) | Cystic fibrosis, bronchiectasis, chirwere chemapapu chinoputika, BP yemapapu, varwere vazhinji vechidiki | Inobvisa nyama dzese dzine hutachiona; kazhinji inoshanda zvakanaka kwenguva refu uye inorarama | Kuvhiyiwa kwenguva refu uye kune njodzi huru; kunoda mapapu ese ari maviri evanopa rubatsiro |
| Kuisirwa moyo? mapapu | Chirwere chemwoyo chisingarapiki chinokonzereswa nekukuvara kwemapapu, kana kutadza kushanda zvakanaka kwemoyo nemapapu | Inotaura nhengo dzese dziri mbiri mukuvhiya kumwe chete | Hazviwanzoitwa; nhengo shoma; kuomarara kwakanyanya |
| Kuisirwa lobar nekupa mari kune mumwe munhu ari mupenyu | Nyaya dzisingawanzoitiki, dzakasarudzwa nevana kana dzekukurumidzira | Inodzivisa runyorwa rwevanhu vakamirira vakafa | Njodzi kune vanopa zvipo vaviri vane hutano; mvumo yakasimba yepamutemo uye yetsika; haisi kupihwa nguva dzose muIndia |
| ECMO sezambuko | Varwere vari kuramba vachiderera pavanenge vakanyorwa | Inogona kuchengetedza munhu ari muchikwata chemuviri ari mupenyu kusvika nhengo yemuviri yavapo | Zvinodhura, zvinowanzokonzera matambudziko, chete kune varwere vakasarudzwa zvakanaka |
| Kutarisirwa kwepamusoro kwekurapa kusingaisirwe mwana mumwe chete | Varwere vasingakodzeri kuisirwa kana kuti vanoramba kuisirwa | Hapana njodzi yekuvhiyiwa; mishonga inorwisa mafibronchitis, mishonga inobvisa mabronchodilator, okisijeni, kugadziriswa, kubaiwa majekiseni, rutsigiro rwekuderedza kushushikana | Hazvidzore kukuvara kuripo; kudzikira kunowanzoenderera mberi |
| Kuderedzwa kwehuwandu hwemapapu kana bullectomy | Emphysema yakasarudzwa ine anatomy yakakodzera | Zvinogona kuvandudza kutadza kufema zvakanaka; zvinogona kunonotsa kudiwa kwekuisirwa mwana | Inoshanda chete kuboka diki; rubatsiro runogona kuva rwenguva pfupi |
Nzira yekuvhiya inokukodzera zvinoenderana nekuongorora kwako chirwere, chimiro chechipfuva, mamiriro ehutachiona, mashandiro emoyo uye kuwanikwa kwemupi wechirwere. Sarudzo yenzira yekuvhiya inosarudzwa nebhodhi revanoisa murwere, kwete nekuda kwezvinodiwa nemurwere chete.
Maitiro Anoitwa Dzimwe Nguva
- Kunamatira kwenhengo dzemuviri kana kucheneswa kwenhengo dzemuviri uko hutachiona kana kuvhiyiwa kwakakonzera kunamira kwakanyanya.
- Kugadziriswa kweatrial septal defect kana patent foramen ovale kwakawanikwa panguva yekuvhiyiwa.
- Kubatanidzwa kwetsinga dzemwoyo kuburikidza neropa muvanhu vakasarudzwa vane chirwere chemwoyo chakakomba, chisati chambozivikanwa.
- Kuvakazve madziro echifuva kana kuti chipfuva mumamiriro ezvinhu asina kujairika emuviri.
- Kuiswa kweECMO kana cardiopulmonary bypass support panguva yekuisirwa kana mushure mekuisirwa.
- Tracheostomy munguva yekushanda kana kubvisa mwana kubva muchina wekufema kuchitora nguva refu.
Phase-by-Phase Recovery Timeline
| Phase | Nguva yakajairika | Chii chinoitika | Basa remurwere |
|---|---|---|---|
| Kunyatsotarisirwa | Mazuva angangoita matatu kusvika gumi, kana paine matambudziko | Rutsigiro rwemafentilator, madhiri emuchipfuva, kutarisa kwemushonga, kudzvinyirirwa kwemuviri kwemuviri kwakatanga, bronchoscopy yekutanga | Batira pamwe chete nekurovedza muviri kufema uye kufamba-famba kwemakumbo nemaoko nekukurumidza |
| Kugara muwadhi | Varwere vazhinji vanotora mavhiki maviri kusvika mana ekugara muchipatara | Kubvisa tsvina, mishonga yemuromo, tsika yekufamba netsoka, kutarisa hutachiona, kutarisa huwandu hwemishonga | Dzidza mazita emishonga, madosi nenguva; geza maoko uye shandisa masiki |
| Danho rekutanga repamba | Mavhiki 3 kusvika 12 | Kushanya kakawanda kuOPD, kuongororwa ropa, spirometry, kugadziriswa kwemuyero, kuongorora bronchoscopy sekurairwa | Kuongorora tembiricha yemba zuva nezuva; dzivisa kuungana kwevanhu, guruva, nzvimbo dzekuvaka uye utsi |
| rehabilitation phase | Mwedzi 3 kusvika 6 | Kugadziriswa kwemapapu, kuvaka simba uye kutsungirira, kudzokera kubasa rakareruka kwakakurukurwa | Enda kunorapwa nguva dzose; gara uchidya zvine mapuroteni akawanda; usaputa fodya kana doro |
| Stabilization | Mwedzi 6 kusvika 12 | Kushanya kunoderera kana kwakasimba; mishonga yakagadziriswa zvakanaka; kuongorora mapfupa, itsvo, shuga uye BP | Tangazve mabasa ako ezuva nezuva; ramba uchibaya majekiseni sezvakarayirwa |
| Kutevera kwehupenyu hwose | Kupfuura gore rimwe chete | Ongororo yenguva nenguva yekurambwa kwenguva refu, hutachiona, mashandiro eitsvo, chirwere cheshuga, ganda nedzimwe kenza | Usamborega kana kuchinja mishonga inodzvinyirira masoja emuviri; taura zviratidzo zvitsva nekukurumidza |
Kudzokera kuMabasa Akajairika, Basa uye Maitiro Ezuva Nezuva eIndia
Nguva yakatarwa ndeyemunhu mumwe nemumwe, uye zano rachiremba wako rinodarika chero nhungamiro yakajairika.
- Kufamba mumba: inotanga kuchipatara, kazhinji mukati mevhiki yekutanga.
- Kuporeswa kwemapfupa epachipfuva: Kwemavhiki matanhatu kusvika gumi nemaviri, dzivisa kusimudza makirogiramu anopfuura mashoma, kusunda, kudhonza, kana kutakura mutoro pamaoko uku pfupa rechipfuva kana madziro echipfuva achipora.
- Zvimbuzi zvekusvirana uye zverudzi rwechiIndia: Dzivisai kugara muchinyararira uye zvimbuzi zverudzi rwechiIndia mumavhiki ekutanga, sezvo zvichinetsa chipfuva nedumbu uye zvinogona kudonha kana simba rava shoma. Chigaro chekugara kana chigaro chakasimudzwa pamusoro pechimbuzi chiripo, pamwe nebhara rekubatirira, zvinokurudzirwa zvikuru. Kugara muchinyararira kunowanzo dzorerwa chete mushure mekunge simba nekugadzikana zvadzorerwa uye chiremba wezvekuvhiya abvuma.
- Kugara pasi wakapfugama makumbo: Kazhinji zvinogamuchirwa kana zvambova zvakanaka, asi kusimuka kubva pasi usingashandise maoko ndiko kwakaoma; shandisa chigaro chekudya uye kunamata pakutanga.
- Kurara pasi: Kurara pamubhedha wemubhedha kana mubhedha wakasimba kunonyanya kunaka kwemwedzi miviri kusvika mitatu yekutanga, sezvo kusimuka kubva padanho repasi kunoshandisa maoko nechipfuva zvakanyanya. Kurara wakasimudza musoro zvishoma kunobatsira kufema uye kudzoka kwemuviri.
- Kutyaira: usati wagadzikana chipfuva, kurwadziwa kushoma, nguva yekuita chiito yakajairika uye warega kushandisa mishonga inonyaradza - kazhinji kwete usati wasvika mavhiki matanhatu kusvika masere, uye chete mushure mekubvumidzwa nachiremba.
- Basa repadhesiki kana remuhofisi: kazhinji zvinogoneka kwemwedzi mitatu kana kupora kwacho kuri nyore; kutanga nechikamu chenguva.
- Basa remaoko, basa repurazi, kuvaka, basa remandi: Izvi zvinotakura guruva, chakuvhuvhu uye zvinhu zvinorema. Vazhinji vanowana rubatsiro vanoda kuchinjwa kwebasa kana matanho ekudzivirira; kurukurai izvi zvakananga musati madzoka.
- Kurovedza muviri nemitambo: Kufamba-famba, kutasva bhasikoro usingamire uye kuita aerobics zvine mwero zvinokurudzirwa kubva pakudzorerwa mumuviri zvichienda mberi. Mitambo yekuvaraidza isingasanganisi vanhu inogona kuitika mushure memwedzi mitanhatu kusvika pagore kune varwere vakagadzikana. Mitambo yekusangana nevanhu, cricket yemakwikwi uye mitambo yerudzi rwekabaddi inowanzo rambidzwa.
- Misangano yechitendero, michato, matembere, mamelas uye kufamba nechitima chakazara vanhu: Mira kwemwedzi mitatu kusvika mitanhatu yekutanga, wobva waenda chete nemasiki akakwana uye kana nguva yekubaiwa nhomba yapera.
- Mabasa ekicheni nepamba: Dzivisai chulha ine utsi kana kubika pamoto wehuni, zvinonhuwira uye zvinomonera umhutu, kupukuta guruva nekutsvaira musina chifukidziro, uye kubata manyowa, ivhu kana zviyo zvakanyorova nekuda kwenjodzi yefungus spore.
Kudzivirira Mapapu Matsva uye Kudzivirira Matambudziko
- Kurega kusvuta fodya, bidis, hookah, kutsenga fodya uye utsi hwemutsi hunopfungaira hupenyu hwese.
- Kunyatsotevedzera mushonga uchishandisa bhokisi remapiritsi, maalamu uye chati yakanyorwa; usambofa wakagadzirisa madosi kana wapihwa zano nenyanzvi yemishonga kana muvakidzani.
- Kubaiwa nhomba sezvinorayirwa nechikwata chevanoisa nhomba, kusanganisira furuwenza, pneumococcal, COVID-19 uye hepatitis B; majekiseni mhenyu haadzivirirwe mushure mekuisirwa nhomba.
- Kuchengetedzeka kwechikafu: chikafu chinopisa chichangobva kubikwa, mvura yakabikwa kana kusefa, chikafu chisina kubikwa mumugwagwa, mabukira asina kubikwa, mukaka usina kupiswa, michero yakachekwa kubva kuvatengesi kana zvasara zvinodziiswazve kakawanda.
- Dzivisa guruva rekuvaka, nzvimbo dzekugadzirisa, guruva repurazi, huku, njiva, ivhu rekuisira muhari, chakuvhuvhu uye nzvimbo dzekuchengetera zvinhu dzine hunyoro.
- Kuchenesa maoko, kushandisa masiki munzvimbo dzine vanhu vakawanda kana dziri mukati mevanhu, uye kudzivirira kusangana nemunhu ane fivha, kukosora kana chickenpox.
- Kuongororwa kwezviratidzo zvezuva nezuva kumba uye dhayari yezviratidzo - kudonha kwenguva refu mukuverenga kumba kazhinji chiratidzo chekutanga chekurambwa.
- Kuongororwa nekurapa chirwere cheshuga, BP, kusashanda zvakanaka kweitsvo, osteoporosis uye shanduko dzeganda, zvese izvi zvinowanzoonekwa pakuderedza simba remuviri.
- Kudzivirira zuva uye kuongororwa ganda negomarara nguva nenguva, sezvo kudzvinyirirwa kwemasoja emuviri kuchiwedzera njodzi yegomarara.
- Ongororo yemazino kanenge gore rega rega; zivisa chiremba wese nachiremba wemazino kuti uri kugamuchira kuisirwa nhengo usati waita chero nzira kana mushonga mutsva, kusanganisira mishonga yeAyurvedic, homoeopathic kana mishonga yemishonga, iyo inogona kusangana nemishonga inodzvinyirira immune system.
Zvinofanira Kufungwa Nevana, Vachiri Kuyaruka Nevakuru
Vana nevechiri kuyaruka
Kuisirwa mapapu evana muchipatara hazviwanzoitiki muIndia uye zvinowanzoonekwa sechirwere checystic fibrosis, bronchiectasis, BP yakanyanya yemapapu kana mamwe mamiriro emapapu ekuzvarwa nawo. Vana vanoda vanopa vana vakaenzana, izvo zvinotora nguva yakareba, pamwe nekutarisa kukura kwavo, zvirongwa zvechikoro, kuongororwa kwevana vanobayiwa majekiseni uye kudzidziswa kwemhuri kwakarongeka. Vechidiki vanoda kutariswa zvakanyanya pakutevedzera mishonga, sezvo kutadza kushandisa mishonga panguva yekuyaruka kuri chikonzero chinozivikanwa chekurasikirwa negraft; kubatanidza wechidiki zvakananga muzvisarudzo kunobatsira.
Vakuru vakuru
Kubvumirana kweISHLT 2021 kwakabvisa kuderedzwa kwezera zvachose, saka munhu ane makore 65 ekuberekwa akasimba anogona kunge ari nani pane munhu ane makore 55 ekuberekwa asina simba. Chinonyanya kukosha njodzi yekuwedzera: kushanda kweitsvo, chirwere chemwoyo, tsandanyama nekushaya simba, kudya kunovaka muviri, kudzora chirwere cheshuga, kuwanda kwemapfupa uye kugona kubata nguva yekurapwa kwakaoma. Vanhu vakuru vanogamuchira mishonga iyi vanotsungirirawo hutachiona uye migumisiro yemishonga isinganyanyi kukosha, saka kugadzirisa chirwere usati waiswa uye kuronga kwemuchengeti wevarwere zvinonyanya kukosha.
Kutarisira mhuri pamwe chete muIndia
Mhuri dzemuIndia dzinowanzova nevakawanda vanoda kuchengeta varwere, izvo zvine pundutso - asi zvinokonzeresawo kuvhiringidzika pamusoro penguva dzekurapa uye mashoko akasiyana-siyana. Maitiro anoshanda: kusarudza muchengeti wekutanga mumwe chete nemumwe wekubatsira, tumirai vese kumisangano yekudzidzisa kuisirwa nhengo dzemuviri, chengetai chati imwe chete yemishonga pamadziro, uye rambidzai vashanyi mumwedzi mitatu yekutanga. Kutumira murwere kumusha wemumusha une guruva, mhuka, huni dzinobikwa kana mvura isina kuvimbika panguva yekupora kwekutanga kwakanakira kudzivirirwa.
Kana Ukasarudza Kusaisa Chirimwa
Kuramba kana kuwanikwa usina kukodzera kuisirwa mushonga hazvirevi kuti wapera kurapwa. Kuronga kwakazara kwekusaisirwa mushonga kunogona kuvandudza runyararo uye mashandiro emuviri:
- Kurapa nemishonga kwakagadziriswa - mishonga inorwisa mabhakitiriya yeILD inofambira mberi, mushonga unofema weCOPD, mushonga unorapwa neBP yemapapu, mushonga unobvisa mweya wemapapu, mushonga unobvisa mabhakitiriya emudumbu.
- Kurapa neokisijeni kwenguva refu, uye kufefetera kusingapindi mhepo kana zvichidikanwa.
- Kugadziriswa kwemapapu, izvo zvinovandudza daro rekufamba uye kutadza kufema pasina kuisirwa chimwe chinhu.
- Rutsigiro rwezvekudya, kurapwa kwe reflux, kufema kusina kugadzikana muhope uye anemia.
- Kubaiwa nhomba uye kurapwa kwezvirwere nekukurumidza.
- Kurapa kunoderedza kufema, kukosora, kuzvidya mwoyo uye kurara, pamwe nekupa mazano kumurwere nemhuri, uye kukurukura chokwadi nezvezvinodiwa pakurapwa pachine nguva.
Pasina kuisirwa nhengo dzemuviri, zvirwere zvakawanda zvemapapu zviri kukura zvinoramba zvichikura. Chinangwa chechirongwa ichi nderekunyaradzwa, kushanda zvakanaka uye chiremera pane kudzorera chirwere ichi kumashure.
Zvinhu Zvinochinja Mutengo weKudyara Mapapu
Kuisirwa mapapu ndeimwe yenzira dzinonyanya kushandiswa mukurapa dzinoda mari yakawanda, uye hapana nhamba imwe chete ine zvazvinoreva inogona kutaurwa pachine nguva. Kuti uwane fungidziro yakanyorwa, yakanyorwa-nyorwa yenyaya yako, taura nemukuru wezvekusirwa mapapu pamwe nedhipatimendi rekubhadhara kuApollo Hospitals, Lucknow. Zvinhu zvinosanganisira:
| Factor | Nei zvichichinja huwandu hwese |
|---|---|
| Kuisirwa kwemunhu mumwe chete kana kuti maviri | Kuvhiyiwa kwepadivi peviri kunotora nguva yakareba uye kunoshandisa nzira dzakawanda dzekurapa, kuvhiya ropa uye nzvimbo yekurapa varwere vadiki. |
| Kureba kweongororo | Huwandu hwekuongorora, catheterization, bronchoscopy, tissue typing uye bvunzo dzakadzokororwa |
| Mamiriro ekuti mwana atange kuisirwa mwana | Kuvimba nemhepo inofefetedza kana ECMO, hutachiona hunoshanda kana kushaya chikafu chinodiwa usati wavhiyiwa zvinokwira zvakanyanya mitengo |
| Kutora nhengo dzemuviri uye kutakurwa | Kureba kubva kuchipatara chevanopa rubatsiro, mugwagwa kana kuti nendege, uye chikwata chekutakura zvinhu |
| Mazuva eICU neventilator | Chinhu chikuru chinochinja-chinja; zuva rega rega rekutarisira varwere vakaoma rinowedzera zvakanyanya |
| Kushandiswa kweCardiopulmonary bypass kana ECMO | Kushanda nevanofambisa mafuta mudunhu, zvinodyiwa uye vashandi vehunyanzvi mukufambisa mafuta |
| Ropa nezvigadzirwa zveropa | Kudiwa kwekuisirwa ropa kunosiyana zvakanyanya nekubatana uye kubuda ropa |
| Kudzikisa uye kuchengetedza immune system | Sarudzo yevamiririri, kutarisa huwandu hwemishonga uye mutengo wemishonga yehupenyu hwese |
| Matambudziko | Zviitiko zvekurambwa, pneumonia, hutachiona hwefungus, dialysis, tracheostomy, kuvhiyiwazve |
| Chikamu chemakamuri | Kugovana, imba imwe chete kana suite, pamwe nemari yekushandira |
| Kutevera kwakasimba | Kuongororwa kwebronchoscopy, biopsies, CT scans uye bvunzo dzemarabhoritari dzinoitwa kakawanda mugore rekutanga |
| Kutamiswa uye kugara | Pekugara pedyo nechipatara panguva yekunyorwa kwenyaya uye kuteverwa nekukurumidza, pamwe nenguva yemuchengeti asiri kubasa |
| Mishonga yehupenyu hwese | Mari inodzokororwa pamwedzi inoramba iripo nekusingaperi uye inofanira kurongwa bhajeti zvakasiyana |
Inishuwarenzi, Kurapwa Pasina Mari uye Kuronga Mari muIndia
- Simbisa kuti waisa nhengo yemuviri wakafukidzwa nekunyora. Mapoka mazhinji ehutano muIndia anovhara mari yekurapwa kwemugamuchiri uye mari yakatarwa yemupi wechirwere, asi mashoko acho anosiyana. Bvunza kambani yako yeinishuwarenzi kana TPA kuti ikupe humbowo hwakanyorwa hwekuti waisirwa mapapu usati wapinda muchipatara.
- Nguva yekumirira inokosha. Mitemo yakajairika inoshandisa nguva yekutanga yekumirira kwemazuva angangoita makumi matatu kune zvichemo zvechirwere, uye nguva yekumirira chirwere chisati chavapo inowanzova makore maviri kusvika mana zvichienderana nechigadzirwa. Chirwere chemapapu chakanyanya kupararira chinowanzoonekwa sechakavapo kare, saka zuva rekutanga kwemutemo uye kuziviswa zvizere panguva yekutenga zvakakosha.
- Kudzivirirwa kwenjodzi kwakarongwa kana kuchienzaniswa nenjodzi. Kukuvara netsaona kunowanzo kubhadharwa kubva pazuva rekutanga, asi kuisirwa mapapu kunenge kuri kurongwa nekuda kwechirwere, saka nguva yekumirira, miganhu midiki uye kusabatanidzwa kwechirwere chimwe chete zvinoshanda.
- Maitiro ekubhadhara mari pasina mari: Tumira chikumbiro chemvumo yekutanga pamwe chete nemagwaro ekiriniki, mishumo yekuferefeta uye chirongwa chachiremba wezvekuvhiya kuburikidza nedhipatimendi reinishuwarenzi yechipatara nguva isati yakwana usati wapinda muchipatara. Kana paine dambudziko rekufona kubva kuhofisi yenhengo dzemuviri, panogona kunge pasina nguva, saka chengeta magwaro ako pachine nguva uye gadzirira kubhadharwa mari yako.
- Tarisira kubhadhara chikamu. Mari yekurenda imba, mari inobviswa zvichienderana nezvinodiwa, zvinhu zvinoshandiswa, zvinhu zvisiri zvekurapa, mari inoiswa mudumbu kana kuti inoyerera, uye mari shoma inoenderana nezvirwere zvinowanzosiya muripo wekubhadhara pamwe chete. Kumbira kuti muongorore bhiri renguva pfupi panguva yekugara muICU kuitira kuti zvinhu zvisingatarisirwi zvidziviswe.
- Mari yekurapwa kunze kwechipatara uye yemishonga inowanzo bviswa. Mishonga inodzvinyirira immune system yehupenyu hwese, bvunzo dzemurabhoritari uye kushanya kweOPD hazviwanzo kuvharwa pasi pemitemo yekudzivirira kunze kwekunge paine munhu anotyaira OPD.
- Zvirongwa zvehurumende nevashandirwi: Ayushman Bharat PM-JAY, CGHS, ECHS, ESIC, zvirongwa zvehutano zvehurumende uye mapaneru echitima kana ePSU chimwe nechimwe chine mitemo yaro yekupa vanhu vanovhiyiwa uye kuvharwa kwemapakeji ekuisirwa nhengo dzemuviri. Kana chirongwa chakati chichishanda kuLucknow unit pakuita izvi kunofanirwa kusimbiswa nedhipatimendi reinishuwarenzi yechipatara, sezvo runyorwa rwekupa vanhu vanovhiyiwa uye runyorwa rwemapakeji zvichichinja.
- Magwaro ekuchengetedza akagadzirira: kopi yemutemo nekadhi, ID yemushandi kana chirongwa, Aadhaar nePAN, zvese zvipfupiso zvekuburitswa mujeri uye mishumo, tsamba yekutumira, uye munhu wemhuri akasarudzwa kuti awane mvumo.
- Ronga kupfuura kuvhiyiwa. Bhajeti yenguva yekumirira, pekugara, kuongororwa kunodzokororwa, uye mishonga yemwedzi wega wega, kwete kuvhiyiwa chete.
Dudziro dzese dzemitemo, kubatanidzwa kwepakeji uye mitemo yekubhadhara zvakanangana neApollo Hospitals, Lucknow zvinofanirwa kusimbiswa neinishuwarenzi yechipatara uye dhipatimendi rekubhadhara pane kungofungidzira.
Kuronga Kupinda uye Zvekuunza
Documents
- Chitupa chehurumende chine mufananidzo uye humbowo hwekero yemurwere nemutarisiri mukuru; Aadhaar yekukumbira zvikumbiro zvechirongwa.
- Mishonga yese yekare, pfupiso dzekubuda muchipatara, mafirimu eCT neX-ray kana maCD, mishumo yekushanda kwemapapu, echocardiography uye mishumo yebiopsy.
- Kadhi reinishuwarenzi kana gwaro remutemo, ruzivo rweTPA, uye chero nhamba yekutarisa isati yabvumidzwa.
- Rondedzero yemishonga iripo ine madosi chaiwo, kusanganisira mishonga yekufema, oxygen settings, mishonga yemishonga yemishonga uye mishonga inotengeswa kunze kwechitoro chemishonga.
- Runyorwa rweboka reropa uye ruzivo rwekuwedzerwa ropa kana pamuviri kare, izvo zvinokanganisa kuongororwa kwemasoja ekudzivirira chirwere.
Zvako zvinhu
- Zvipfeko zvedonje zvisina kuvhurika pamberi, masiraidhi asingatsvedzeri kana shangu dzine soli yakasimba.
- Zvimbuzi, magirazi maviri ekuwedzera, bhokisi remazino ekugadzira mazino, chinhu chinobatsira kunzwa chine mabhatiri.
- Masiki akakwana zvakanaka emurwere nemushandi, mushonga wekuchenesa maoko.
- Nharembozha, charger, waya refu, uye runyoro rwakanyorwa rwenhamba dzemhuri dzekutaurirana.
- Chero ruzivo rwemushonga weokisijeni wepamba pamwe neCPAP kana BiPAP device kana ukashandisa imwe.
- Chinoyera spirometer chepamba kana chatovepo, uye bhuku rekuverenga nguva yemishonga nekuverenga kwayo.
Pfungwa dzinoshanda
- Chengeta bhegi rakarongwa rakagadzirira nguva dzese kana ranyorwa, sezvo runhare ruchigona kuuya chero nguva.
- Tevedzera mirairo yekutsanya chaiyo kana wadanwa.
- Ronga zvekufambisa pachine nguva, kusanganisira hurongwa hwekufamba husiku uye mota.
- Siya zvishongo nezvinhu zvinokosha kumba.
- Sarudza mushandi mumwe chete kuti agare muchipatara uye mumwe kuti atarisire magwaro uye kufambiswa kwemishonga; kushanya kuICU kunorambidzwa kudzivirira hutachiona.
- Simbisai maawa ekushanda kwechipatara aripo, mutemo wemushandi pamwe nemitemo yekushanyira varwere vari muICU nechipatara panguva yekubhuka, sezvo izvi zvinogona kuchinja.
Zviratidzo Zvenyevero Zvinoda Kuongororwa Nekukurumidza
Bata timu yevanoisira mwana kana kuti svika kudhipatimendi re emergency nekukasika kana ukaona:
- Fivha, kutonhora kana kudikitira, kana kunzwa kusanzwa zvakanaka.
- Kutadza kufema kutsva kana kuri kuwedzera, kana kudzikira kwekuverenga kwespirometry kumba kwako kwakaitika kwemazuva maviri kana anopfuura.
- Kukosora kutsva, manyoka ane ruvara kana kuti ane ropa, kana kurwadziwa pachipfuva.
- Kutsvuka, kuzvimba, kubuda ropa kana kuvhurika kweronda rekuvhiyiwa.
- Kurutsa kana manyoka zvinokudzivirira kuti usarambe uchideredza simba remuviri
Nzwisisa Ruzivo Rwemaitiro
Ichangobva kuwedzerwa
Nyanzvi Dzedu.
Chikwata Chenyu Chekutarisira.
KuApollo Hospitals, vanachiremba vedu vepamusoro-soro vanobatanidza hunyanzvi hwakadzama netsitsi kuti vape rubatsiro rwevarwere rwakanaka uye mhedzisiro.
Pulmonology
Makore manomwe zvichikwira MD (Mushonga wekufema), PDCC (Interventional Pulmonology)
Pulmonology
Makore mashanu zvichikwira MBBS (Menduru yeGoridhe) MD, DM (Pulmonary, Critical Care uye Hope Medicine) DNB (Mushonga), MRCP (UK), EDARM,
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Disclaimer:
Ruzivo rwuri papeji rino rwakagadzirirwa ruzivo rwese uye zvinangwa zvedzidzo chete. Kunyange zvazvo tichiita zvese zvatinogona kuti tive nechokwadi chekuti ruzivo rwacho rwakarurama, rwakavimbika, uye rwunoongororwa nguva nenguva, harufanirwe kuonekwa serunotsiva mazano echiremba, kuongororwa, kana kurapwa kwenyanzvi.
Kukodzera kwekurapwa, pamwe chete nemabhenefiti akwo, njodzi, kugadzirira, kupora, matambudziko angangoitika, uye mhedzisiro inotarisirwa, zvinogona kusiyana kubva pamunhu kusvika pamunhu. Nyanzvi yako yehutano ichaona kana kurongeka kwacho kwakakodzera zvichienderana nemamiriro ako ezvinhu uye nhoroondo yekurapa.
Ndapota bvunza nyanzvi yehutano ine hunyanzvi kuti uwane mazano akakodzera usati waita sarudzo maererano nechero nzira yekurapa.
Kuti uwane rumwe ruzivo nezvekuti zvinyorwa zvedu zvehutano zvinogadzirwa sei, zvinoongororwa, zvinovandudzwa, uye zvinochengetwa sei, ndapota verenga [Mutemo wedu weKunyora].
