Chidule

Impulse Oscillometry (IOS) ndi njira yatsopano, yosavulaza poyesa momwe mapapo amagwirira ntchito. Mosiyana ndi spirometry yachikhalidwe, yomwe imafuna njira zopumira zokakamiza komanso mgwirizano wofunikira kwa odwala, IOS imayesa kulephera kupuma bwino panthawi yopuma mwakachetechete. Izi zimapangitsa kuti ikhale yothandiza kwambiri kwa ana, okalamba, ndi odwala omwe sangathe kuchita spirometry yodalirika. Nkhaniyi ikuwunikanso mfundo, magawo ofunikira, ntchito zachipatala, zabwino, ndi zofooka za IOS mu mankhwala amakono opumira.

Chiyambi

Mayeso a ntchito ya m'mapapo (PFTs) ndi ofunikira pozindikira ndi kusamalira matenda opumira. Spirometry, muyezo wabwino kwambiri, uli ndi zofooka chifukwa chodalira khama la wodwala komanso kugwirizana kwake. Impulse Oscillometry (IOS) yakhala njira ina yamphamvu komanso yothandiza yomwe imathetsa mavutowa pongofuna kupuma pang'ono.

Mfundo za Impulse Oscillometry

Dongosolo la IOS limagwiritsa ntchito zizindikiro zazifupi, zothamanga (zomwe zili ndi ma frequency otsika komanso okwera, nthawi zambiri kuyambira 5 mpaka 35 Hz) ku njira zopumira za wodwalayo kudzera pakamwa. Chipangizochi chimayesa nthawi yomweyo zizindikiro za kuthamanga ndi kuyenda kwa mpweya zomwe zimachokera pakamwa. Pogwiritsa ntchito mfundo yofanana ndi lamulo la Ohm mu zamagetsi, chimawerengera Respiratory Impedance (Z).

Kulephera kupuma kumapangidwa ndi zigawo ziwiri zazikulu:

Kukana (R): Gawo la impedance mu gawo ndi kuyenda. Limawonetsa makamaka mphamvu zotsutsa za njira zoyendetsera mpweya kupita ku mpweya. Ma frequency apamwamba (monga, 20Hz) amalowa pakati, kuwonetsa kukana kwapakati pa mpweya, pomwe ma frequency otsika (monga, 5Hz) amalowa mkati, kuwonetsa kukana kwathunthu kwa mpweya.

Kuyankha (X): Gawo la impedance lomwe limatuluka mu gawo ndi kuyenda. Limawonetsa kubwereranso kosalala kwa minofu ya m'mapapo ndi khoma la pachifuwa (capacitance) ndi mphamvu ya mpweya m'njira yapakati yopumira (inertance).

Magawo Ofunika ndi Kufunika Kwawo Kwachipatala

R5: Kukana pa 5 Hz, kuyimira kukana konse kwa kupuma.

R20: Kukana pa 20 Hz, kuyimira kukana kwapakati pa mpweya.

R5 – R20: Kusiyana pakati pa R5 ndi R20 ndi chizindikiro chodziwikiratu cha kukana kwa mpweya m'mbali mwa thupi kapena pang'ono. Kuwonjezeka kwa mtengo kumasonyeza kuti mpweya sukuyenda bwino kwenikweni.

Ma Fres (Kuchuluka kwa Resonant): Kuchuluka kwa ma reactance ndi zero. Kuwonjezeka kwa ma Fres kumasonyeza kutsekeka ndi kuuma kwa mapapo, chizindikiro cha matenda ang'onoang'ono a mpweya.

AX (Malo Ochitira Zinthu): Malo ophatikizana a reactance kuyambira 5 Hz mpaka Fres. Kuwonjezeka kwa AX ndi chizindikiro chodziwikiratu cha vuto la mpweya wozungulira.

Kukakamizidwa Kugwedezeka vs. Kugwedezeka kwa Impulse mu Kuyesa kwa Ntchito ya Mapapu

Njira zonse ziwiri za Forced Oscillation Technique (FOT) ndi Impulse Oscillometry (IOS) ndi njira zosagwiritsa ntchito mphamvu zomwe zimayesa kulephera kupuma bwino panthawi yopuma chete. Kusiyana kwakukulu kuli mu mtundu wa chizindikiro chomwe amagwiritsa ntchito kusokoneza dongosolo la kupuma.

1. Njira Yokakamiza Yozungulira (FOT)

Chizindikiro:Imagwiritsa ntchito ma frequency amodzi okha, oyera kapena osakaniza ma frequency omwe adakonzedweratu (ma frequency ambiri) nthawi imodzi. Chizindikiro ichi ndi mafunde osalekeza, a sinusoidal.

Khalidwe Lofunika:Ndi muyeso wa steady-state. Chifukwa ingagwiritse ntchito frequency imodzi, ndi yolondola kwambiri poyesa impedance pa frequency imeneyo.

2. Impulse Oscillometry (IOS)

Chizindikiro:Imagwiritsa ntchito mafunde afupiafupi kwambiri, ofanana ndi mafunde a pulse. Mafunde aliwonse a pulse ndi mafunde a sikweya omwe ali ndi ma frequency ambiri (nthawi zambiri kuyambira 5Hz mpaka 35Hz).

Khalidwe Lofunika:Ndi muyeso wochepa. Ubwino waukulu ndi wakuti kugunda kwa mtima kamodzi kokha kumapereka deta ya impedance pa ma frequency osiyanasiyana nthawi yomweyo.

Mwachidule, ngakhale njira zonsezi zili zothandiza, njira ya IOS yogwiritsira ntchito pulsed imapangitsa kuti ikhale yachangu, yosavuta kwa odwala, komanso yothandiza kwambiri pozindikira matenda ang'onoang'ono opuma, zomwe zimapangitsa kuti igwiritsidwe ntchito kwambiri m'chipatala.

Ubwino wa IOS

Mgwirizano Wochepa wa Odwala: Imafuna kupuma pang'onopang'ono komanso koyenda bwino, zomwe zimapangitsa kuti ikhale yoyenera ana aang'ono, okalamba, ndi odwala matenda oopsa.

Kuwunika Konse: Amasiyanitsa pakati pa kutsekeka kwa mpweya wapakati ndi wa m'mphepete mwa mpweya ndipo amapereka chidziwitso chokhudza momwe mapapo amagwirira ntchito.

Kuzindikira Kwambiri Matenda Ang'onoang'ono a Mpweya: Amatha kuzindikira zolakwika m'njira zazing'ono zopumira mpweya asanayambe kugwiritsa ntchito spirometry.

Zabwino Kwambiri pa Kuwunika: Imalola kuyeza mobwerezabwereza komanso kwa nthawi yayitali, yothandiza pa mayeso a bronchial challenge, mayeso a bronchodilator response, komanso kuyang'anira panthawi yogona kapena yogonetsa.

Mapulogalamu azachipatala

Pulmonology ya Ana: Ntchito yaikulu, makamaka pozindikira ndi kuyang'anira mphumu mwa ana aang'ono.

Mphumu: Imadziwika ndi kuchuluka kwa R5 komanso kuchuluka kwa bronchodilator. IOS imagwiritsidwanso ntchito poyang'anira momwe chithandizo chimagwirira ntchito komanso kuzindikira matenda osalamulirika kudzera mu njira zazing'ono zopumira (R5-R20, AX).

Matenda Osatha a M'mapapo Oletsa Kutsekeka (COPD): Amaonetsa kukana kwakukulu komanso kulephera kugwira ntchito bwino kwa mpweya (kuwonjezeka kwa R5-R20, Fres, ndi AX).

Matenda a m'mapapo a Interstitial (ILD): Amakhudza kwambiri reaction, zomwe zimapangitsa kuti X5 ikhale yoipa komanso kuchuluka kwa Fres, zomwe zimasonyeza kuchepa kwa mgwirizano wa mapapo (mapapo olimba).

Kuwunika Asanachite Opaleshoni ndi Kuwunika Pamaso pa Opaleshoni: Kumapereka kuwunika mwachangu momwe mapapo amagwirira ntchito ndipo kumatha kuzindikira bronchospasm yoopsa panthawi ya opaleshoni.

Kuwunika kwa Kulephera Kumvetsa Zinthu: Kumathandiza kusiyanitsa pakati pa njira zolepheretsa ndi zoletsa.

Mapeto

Impulse Oscillometry ndi njira yodziwika bwino komanso yabwino kwa odwala yomwe yasintha kwambiri mayeso a ntchito ya m'mapapo, makamaka m'magulu omwe spirometry ndi yovuta. Kutha kwake kuzindikira matenda ang'onoang'ono a mpweya ndikupereka kusanthula kosiyanasiyana kwa kayendedwe ka mpweya kumapangitsa kuti ikhale chida chofunikira kwambiri pozindikira matenda oyamba, kusintha kwa phenotyping, komanso kuyang'anira matenda osiyanasiyana a kupuma kwa nthawi yayitali. Ngakhale kuti imathandizira m'malo molowa m'malo mwa PFTs wamba, IOS yapeza gawo lokhazikika komanso lokulirakulira mu zida zamakono zowunikira matenda a kupuma.