Pfupiso

Impulse Oscillometry (IOS) inzira itsva, isingakuvadzi yekuongorora mashandiro emapapu. Kusiyana ne spirometry yechinyakare, iyo inoda kumanikidzwa kufema nekushanda pamwe chete nevarwere, IOS inoyera kufema kusina simba panguva yekufema kwakanyarara. Izvi zvinoita kuti ive yakakosha zvikuru kushandiswa muvana, vakwegura, nevarwere vasingakwanise kuita spirometry yakavimbika. Chinyorwa chino chinoongorora misimboti, zviyero zvakakosha, mashandisirwo ekiriniki, zvakanakira, uye zvipingamupinyi zveIOS mukurapa kwekufema kwemazuva ano.

Nhanganyaya

Kuongororwa kwebasa remapapu (PFTs) kwakakosha pakuongorora nekutarisira zvirwere zvekufema. Spirometry, chiyero chegoridhe, ine miganho nekuda kwekuvimba kwayo nekushanda nesimba kwemurwere uye kubatana. Impulse Oscillometry (IOS) yave nzira ine simba uye nzira yekuwedzera inokunda matambudziko aya nekungoda kufema chete.

Nheyo dzeImpulse Oscillometry

Sisitimu yeIOS inoshandisa masaini mapfupi, ane pulsed pressure (ane spectrum yemafrequency akaderera uye akakwira, anowanzova kubva pa5 kusvika ku35 Hz) kumhepo yemurwere kuburikidza ne mouthpiece. Mudziyo uyu unoyera panguva imwe chete masaini ekumanikidzwa uye kuyerera kwemhepo mumuromo. Nekushandisa musimboti wakafanana nemutemo weOhm mumagetsi, unoverenga Respiratory Impedance (Z).

Kufema kwemhepo kunoumbwa nezvinhu zviviri zvikuru:

Kuramba (R): Chikamu che impedance muchikamu nekufamba. Chinonyanya kuratidza hunhu hwe resistance yenzira dzemhepo kuenda kumhepo. Frequency dzakakwirira (semuenzaniso, 20Hz) dzinopinda nepakati, dzichiratidza resistance yepakati pemhepo, nepo frequencies dzakaderera (semuenzaniso, 5Hz) dzichipinda zvakadzika, zvichiratidza resistance yemhepo yese.

Kuita (X): Chikamu che impedance chinobva muchikamu nekuyerera. Chinoratidza kudzokeka kwe elastic kwe mapapu nemadziro echipfuva (capacitance) uye hunhu hwe inertial hwemhepo mu central airways (inertance).

Zvikamu Zvikuru uye Kukosha Kwazvo Kwekiriniki

R5: Kuramba pa5 Hz, zvichimiririra kuramba kwese kwekufema.

R20: Kuramba pa20 Hz, zvichimiririra kuramba kwepakati pemhepo.

R5 – R20: Musiyano uripo pakati peR5 neR20 chiratidzo chekusagona kufamba zvakanaka kwemhepo inoyerera kana kuti kufema kudiki. Kuwedzera kwehuwandu kunoratidza kusashanda zvakanaka kwemhepo inoyerera.

Fres (Resonant Frequency): Kuwanda kwereactance kuri zero. Kuwedzera kweFres kunoratidza kuwedzera kwekuvharika uye kuomarara kwemapapu, chiratidzo chechirwere chidiki chemhepo.

AX (Nzvimbo yeKupindura): Nzvimbo yakabatana yekuchinja kubva pa5 Hz kusvika paFres. Kuwedzera kweAX chiratidzo chekusashanda zvakanaka kwemhepo inofambisa mweya.

Kumanikidzwa Kutenderera vs. Kutenderera Kwemhepo Mukuedzwa Kwebasa reMapapu

Nzira dzeForced Oscillation Technique (FOT) neImpulse Oscillometry (IOS) hadzisi dzekupinda muropa dzinoyera kufema kusina simba panguva yekufema kwakanyarara. Musiyano mukuru uri murudzi rwechiratidzo chavanoshandisa kukanganisa kufema.

1. Maitiro Ekudzikisa Kumanikidzwa (FOT)

Chiratidzo:Inoshandisa frequency imwe chete, yakachena kana musanganiswa wema frequency akatsanangurwa (multi-frequency) panguva imwe chete. Chiratidzo ichi iwaya inoenderera mberi, isina kusimba.

Hunhu Hunokosha:Ichi chiyero che steady-state. Nekuti chinogona kushandisa frequency imwe chete, chakanyatsojeka pakuyera impedance pafrequency iyoyo chaiyo.

2. Impulse Oscillometry (IOS)

Chiratidzo:Inoshandisa mafungu mapfupi, akafanana neanoda kutenderera. Kutenderera kwega kwega iwaya ine sikweya ine mafungu akawanda (kazhinji kubva pa5Hz kusvika pa35Hz).

Hunhu Hunokosha:Kuyera kwenguva pfupi. Chinhu chikuru ndechekuti kurira kwemoyo kamwe chete kunopa data re impedance mumafrequencies akasiyana-siyana panguva imwe chete.

Muchidimbu, kunyange zvazvo nzira dzese dziri mbiri dzichikosha, nzira yeIOS yekurova kwemoyo inoita kuti ikurumidze, ive nyore kuvarwere, uye ishande zvakanaka pakuona chirwere chidiki chemhepo, zvichibatsira kuti ishandiswe zvakanyanya mukurapa.

Mabhenefiti eIOS

Kushanda Pamwe Chete Kwevarwere: Inoda kufema kwakanyarara, kunobva kwaita kuti ive yakakodzera vana vadiki, vakwegura, nevarwere vanorwara zvakanyanya.

Ongororo Yakakwana: Inosiyanisa pakati pekuvharika kwenzira yekufema yepakati neyekunze uye inopa ruzivo nezvekuenderana kwemapapu.

Kunzwa Kwakanyanya Kwezvirwere Zvidiki Zvemhepo: Inogona kuona kusarongeka kwenzira dzekufema diki isati yaongororwa ne spirometry.

Yakanakira Kutarisa: Inobvumira kuyerwa kwenguva refu uye kakawanda, inobatsira pakuyedzwa kwebronchial challenge, bvunzo dzebronchodilator response, uye kutarisa panguva yekurara kana anesthesia.

Maitiro Ekurapa

Pediatric Pulmonology: Inonyanya kushandiswa, kunyanya pakuongorora nekutarisa asthma muvana vadiki.

Asthma: Inoratidzwa neR5 yakakwira uye mhinduro yakakura yebronchodilator. IOS inoshandiswawo kutarisa kushanda kwekurapa uye kuona chirwere chisingadzoreki kuburikidza nematanho madiki ekufema (R5-R20, AX).

Chirwere Chisingaperi Chekuvharira Mapupa (COPD): Chinoratidza kuramba kwakakwira uye kusashanda zvakanaka kwemhepo (R5-R20, Fres, uye AX yakawedzera).

Zvirwere zveMapapu zveInterstitial (ILD): Zvinonyanya kukanganisa reactance, zvichikonzera X5 isina kunaka uye Fres yakakwira, zvichiratidza kudzikira kwekuenderana kwemapapu (mapapu akaomarara).

Kuongororwa kwemapapu asati avhiyiwa uye Kuongororwa kwemukati mekuvhiyiwa: Kunopa kuongororwa nekukurumidza kwekushanda kwemapapu uye kunogona kuona bronchospasm yakanyanya panguva yekuvhiyiwa.

Kuongorora Kushaya Simba Kusinganzwisisike: Kunobatsira kusiyanisa pakati pemaitiro anodzivisa uye anorambidza.

Mhedziso

Impulse Oscillometry inzira yakaoma uye inoshanda nevarwere yakachinja nzira yekuongorora mashandiro emapapu, kunyanya munzvimbo dzine spirometry yakaoma. Kugona kwayo kuona zvirwere zvidiki zvemhepo uye kupa ongororo yakasiyana yemafambiro emhepo kunoita kuti ive chishandiso chakakosha chekuongorora nekukurumidza, phenotyping, uye kubata kwenguva refu zvirwere zvakasiyana-siyana zvekufema. Kunyange zvazvo ichibatsira pane kutsiva PFTs dzechinyakare, IOS yakawana basa rekusingaperi uye riri kukura muzvigadzirwa zvemazuva ano zvekuongorora kufema.