Isifinyezo

I-Impulse Oscillometry (IOS) iyindlela entsha, engangenisi umswakama yokuhlola ukusebenza kwamaphaphu. Ngokungafani ne-spirometry evamile, edinga ukuphoqwa kokuphefumula kanye nokubambisana okukhulu kweziguli, i-IOS ilinganisa ukuvimba kokuphefumula ngesikhathi sokuphefumula okuthule. Lokhu kuyenza ibe usizo kakhulu ekusetshenzisweni ezinganeni, asebekhulile, kanye neziguli ezingakwazi ukwenza i-spirometry ethembekile. Lesi sihloko sibuyekeza izimiso, imingcele ebalulekile, ukusetshenziswa kwemitholampilo, izinzuzo, kanye nemikhawulo ye-IOS kwezokwelapha zokuphefumula zanamuhla.

Isingeniso

Ukuhlolwa kokusebenza kwamaphaphu (ama-PFT) kubalulekile ekuxilongeni nasekuphatheni izifo zokuphefumula. I-Spirometry, indinganiso yegolide, inemikhawulo ngenxa yokuncika kwayo emzamweni wesiguli kanye nokuxhumana. I-Impulse Oscillometry (IOS) ivele njengendlela enamandla ehlukile futhi ehambisanayo enqoba lezi zinselele ngokudinga ukuphefumula okungenamsebenzi kuphela.

Izimiso ze-Impulse Oscillometry

Uhlelo lwe-IOS lusebenzisa izimpawu zokucindezela ezimfushane, ezishaywayo (eziqukethe ububanzi bemvamisa ephansi nephezulu, ngokuvamile kusukela ku-5 kuya ku-35 Hz) emigudwini yomoya yesiguli ngokusebenzisa umlomo. Idivayisi ilinganisa ngesikhathi esisodwa izimpawu zokucindezela nokugeleza okuvela emlonyeni. Ngokusebenzisa isimiso esifana nomthetho we-Ohm kuma-elekthronikhi, ibala i-Respiratory Impedance (Z).

Impedance yokuphefumula yakhiwa izingxenye ezimbili eziyinhloko:

Ukumelana (R): Ingxenye ye-impedance esigabeni sokugeleza. Ibonisa ngokuyinhloko izakhiwo zokumelana zezindlela zomoya ekugelezeni komoya. Amaza aphezulu (isb., 20Hz) angena phakathi, ekhombisa ukumelana komoya ophakathi, kuyilapho amaza aphansi (isb., 5Hz) engena ngokujulile, ekhombisa ukumelana okuphelele komoya ophakathi.

Ukusabela (X): Ingxenye ye-impedance ephuma esigabeni sokugeleza. Ibonisa ukugoba okunwebekayo kwezicubu zamaphaphu kanye nodonga lwesifuba (i-capacitance) kanye nezakhiwo ze-inertial zomoya emigwaqweni yomoya ephakathi (inertance).

Amapharamitha Abalulekile Nokubaluleka Kwawo Kwezokwelapha

R5: Ukumelana ku-5 Hz, okumelela ukumelana okuphelele kokuphefumula.

R20: Ukumelana ku-20 Hz, okumelela ukumelana komoya ophakathi.

R5 – R20: Umehluko phakathi kuka-R5 no-R20 uyinkomba ebucayi yokumelana kwemigudu yomoya engaphandle noma encane. Inani elikhuphukile lisikisela ukungasebenzi kahle kwemigudu yomoya encane.

Ama-Fres (Imvamisa Eguquguqukayo): Imvamisa lapho ukusabela ku-zero khona. Ukwanda kwama-Fres kubonisa ukwanda kokuvinjelwa nokuqina kwamaphaphu, uphawu lwesifo esincane somoya.

I-AX (Indawo Yokusabela): Indawo ehlanganisiwe yokusabela kusukela ku-5 Hz kuya ku-Fres. Ukwanda kwe-AX kuwuphawu olubucayi lokuphazamiseka komoya ongaphandle.

Ukujikijela Okuphoqelelwe vs. Ukujikijela Okushukumayo Ekuhlolweni Komsebenzi Wamaphaphu

Zombili izindlela ze-Forced Oscillation Technique (FOT) kanye ne-Impulse Oscillometry (IOS) azivamile ukuhlasela umoya ezilinganisa ukuphefumula ngesikhathi sokuphefumula buthule. Umehluko omkhulu usehlobo lwesignali abayisebenzisayo ukuphazamisa uhlelo lokuphefumula.

1. Indlela Yokujikisa Ephoqelelwe (FOT)

Isignali:Isebenzisa imvamisa eyodwa, emsulwa noma ingxube yamaza achazwe ngaphambilini (amaza amaningi) ngasikhathi sinye. Lesi siginali siyigagasi eliqhubekayo, le-sinusoidal.

Isici Esiyinhloko:Kuyindlela yokulinganisa isimo esizinzile. Ngenxa yokuthi ingasebenzisa imvamisa eyodwa, inembe kakhulu ekulinganiseni i-impedance kuleyo mvamisa ethile.

2. I-Impulse Oscillometry (IOS)

Isignali:Isebenzisa amagagasi okucindezela amafushane kakhulu, afana nokushaya kwenhliziyo. I-pulse ngayinye iyigagasi eliyisikwele eliqukethe ububanzi bemvamisa eminingi (ngokuvamile kusukela ku-5Hz kuya ku-35Hz).

Isici Esiyinhloko:Kuyindlela yokulinganisa yesikhashana. Inzuzo enkulu ukuthi i-pulse eyodwa inikeza idatha ye-impedance kuzo zonke izinhlobo zamaza cishe ngokushesha.

Ngamafuphi, nakuba zombili lezi zindlela ziwusizo, inqubo ye-IOS yokushaya kwenhliziyo yenza kube lula, kube lula esigulini, futhi kube nempumelelo enkulu ekutholeni izifo ezincane zomoya, okufaka isandla ekwamukelweni kwayo kabanzi kwezokwelapha.

Izinzuzo ze-IOS

Ukubambisana Okuncane Kweziguli: Kudinga ukuphefumula okuthule, okunamandla, okwenza kube kuhle ezinganeni ezincane, asebekhulile, kanye neziguli ezigula kakhulu.

Ukuhlolwa Okuphelele: Ihlukanisa phakathi kokuvinjelwa komoya okuphakathi nendawo kanye nokungaphandle futhi inikeza ulwazi mayelana nokuhambisana kwamaphaphu.

Ukuzwela Okuphezulu Kwezifo Ezincane Zomoya: Ingabona ukukhubazeka emigwaqweni emincane yomoya ngaphambi kwe-spirometry.

Kuhle kakhulu ekuqapheni: Ivumela ukulinganisa okuphindaphindiwe nokude, okuwusizo ekuhlolweni kwezinkinga ze-bronchial, ukuhlolwa kwempendulo ye-bronchodilator, kanye nokuqapha ngesikhathi sokulala noma sokubulala izinzwa.

Izicelo Zemitholampilo

I-Pediatric Pulmonology: Uhlelo lokusebenza oluyinhloko, ikakhulukazi ekuxilongeni nasekuqapheni i-asthma ezinganeni ezincane.

I-asthma: Ibonakala ngokuphakama kwe-R5 kanye nokusabela okukhulu kwe-bronchodilator. I-IOS isetshenziselwa futhi ukuqapha ukusebenza kahle kokwelashwa nokuthola isifo esingalawulwa ngemingcele emincane yomoya (R5-R20, AX).

Isifo Sokuvinjelwa Kwamaphaphu Esingamahlalakhona (i-COPD): Sibonisa ukumelana okuphezulu kanye nokungasebenzi kahle komgudu womoya okuphawulekayo (ukwanda kwe-R5-R20, i-Fres, kanye ne-AX).

Izifo Zamaphaphu Ezingaphakathi Kwezitho (ILD): Ngokuyinhloko zithinta ukusabela, okubangela i-X5 engemihle kanye ne-Fres ephezulu, okubonisa ukwehla kokuhambisana kwamaphaphu (amaphaphu aqinile).

Ukuhlolwa Kwangaphambi Kokuhlinzwa kanye Nokuqapha Kwangaphakathi Kokuhlinzwa: Kuhlinzeka ngokuhlolwa okusheshayo kokusebenza kwamaphaphu futhi kungabona i-bronchospasm ebukhali ngesikhathi sokuhlinzwa.

Ukuhlolwa Kokuphazamiseka Kwemizwa Okungachazeki: Kusiza ukuhlukanisa phakathi kwamaphethini okuvimbela kanye nalawo anomkhawulo.

Isiphetho

I-Impulse Oscillometry iyindlela eyinkimbinkimbi, enobungane nesiguli eshintshe kakhulu ukuhlolwa kokusebenza kwamaphaphu, ikakhulukazi ezindaweni lapho i-spirometry iyinselele khona. Ikhono layo lokubona izifo ezincane zomoya kanye nokunikeza ukuhlaziywa okuhlukile kwendlela yomoya okwenza kube ithuluzi elibalulekile lokuxilongwa kwasekuqaleni, ukuhlaziya ama-phenotyping, kanye nokuphathwa kwesikhathi eside kwezinhlobo eziningi zezimo zokuphefumula. Nakuba ihambisana esikhundleni sokufaka esikhundleni sama-PFT avamile, i-IOS ithole indima ehlala njalo nekhulayo ezikhalini zesimanje zokuxilonga ukuphefumula.