Isishwankathelo

I-Impulse Oscillometry (IOS) yindlela entsha, engangenisi ntsholongwane yokuvavanya ukusebenza kwemiphunga. Ngokungafaniyo ne-spirometry eqhelekileyo, efuna ukunyanzeliswa kokuqhuba umoya kunye nentsebenziswano ebalulekileyo yesigulane, i-IOS ilinganisa ukungasebenzi kakuhle kokuphefumla ngexesha lokuphefumla okuzolileyo. Oku kuyenza ixabiseke kakhulu ukusetyenziswa ebantwaneni, kubantu abadala, nakwizigulane ezingakwaziyo ukwenza i-spirometry ethembekileyo. Eli nqaku liphonononga imigaqo, iiparameter eziphambili, ukusetyenziswa kweklinikhi, iingenelo, kunye nemida ye-IOS kunyango lwanamhlanje lokuphefumla.

Intshayelelo

Uvavanyo lomsebenzi wemiphunga (ii-PFT) lubalulekile ekuxilongeni nasekulawuleni izifo zokuphefumla. I-Spirometry, umgangatho ogqwesileyo, inemida ngenxa yokuxhomekeka kwayo kwimizamo yesigulana kunye nokulungelelaniswa kwayo. I-Impulse Oscillometry (IOS) ivele njengendlela enamandla yokongeza kunye nendlela encedisayo eyoyisa le mingeni ngokufuna ukuphefumla nje kuphela.

Imigaqo ye-Impulse Oscillometry

Inkqubo ye-IOS isebenzisa imiqondiso yoxinzelelo olufutshane nolushukumayo (equlethe uluhlu lwee-frequency eziphantsi neziphezulu, eziqhelekileyo ukusuka kwi-5 ukuya kwi-35 Hz) kwiindlela zomoya zesigulana ngokusebenzisa umlomo. Esi sixhobo silinganisa ngaxeshanye imiqondiso yoxinzelelo kunye nokuhamba komoya okuvela emlonyeni. Ngokusebenzisa umgaqo ofana nomthetho we-Ohm kwi-elektroniki, sibala i-Respiratory Impedance (Z).

Impedance yokuphefumla yenziwe ngezinto ezimbini eziphambili:

Ukuchasana (R): Inxalenye ye-impedance kwisigaba sokuhamba. Ngokuyintloko ibonisa iipropati zokuxhathisa zeendlela zomoya ukuya ekuphumeni komoya. Iifrikhwensi eziphezulu (umz., 20Hz) zingena phakathi, zibonisa ukumelana nomoya ophakathi, ngelixa iifrikhwensi ezisezantsi (umz., 5Hz) zingena nzulu, zibonisa ukumelana nomoya opheleleyo.

Ukusabela (X): Inxalenye ye-impedance ephuma kwisigaba ngokuhamba. Ibonakalisa ukujijeka kwe-elastic kwezicubu zemiphunga kunye nodonga lwesifuba (capacitance) kunye neempawu ze-inertial zomoya kwi-central airways (inertance).

Iiparameters eziphambili kunye nokubaluleka kwazo kweklinikhi

R5: Ukumelana kwi-5 Hz, okumela ukumelana okupheleleyo kokuphefumla.

R20: Ukumelana kwi-20 Hz, okumela ukumelana nomoya ophakathi.

R5 – R20: Umahluko phakathi kwe-R5 kunye ne-R20 luphawu olubonakalayo lokuxhathisa umoya ongaphandle okanye omncinci. Ixabiso elongeziweyo libonisa ukungasebenzi kakuhle komoya okuncinci.

IiFres (Ubuninzi beResonant): Ubuninzi apho i-reactance ingasebenzi khona. Ukwanda kweeFres kubonisa ukwanda kokuvaleka kunye nokuqina kwemiphunga, uphawu lwesifo esincinci somoya.

I-AX (Indawo Yokusabela): Indawo edibeneyo yokusabela ukusuka kwi-5 Hz ukuya kwi-Fres. Ukwanda kwe-AX luphawu olubuthathaka lokuphazamiseka kwendlela yomoya ejikeleze umoya.

Uxinzelelo oluQinisekisiweyo vs. Uxinzelelo oluPheleleyo kuVavanyo loMsebenzi weMiphunga

Zombini iindlela zeForced Oscillation Technique (FOT) kunye ne-Impulse Oscillometry (IOS) azingonakalisiyo ezilinganisa i-respiral impedance ngexesha lokuphefumla okuzolileyo. Umahluko ophambili usekwe kuhlobo lwesignali abayisebenzisayo ukuphazamisa inkqubo yokuphefumla.

1. Indlela yokuQokelela ngokuNgqiniweyo (FOT)

Uphawu:Isebenzisa i-frequency enye, ecocekileyo okanye umxube wee-frequency ezichazwe kwangaphambili (ii-frequency ezininzi) ngaxeshanye. Le signal yi-wave eqhubekayo, ye-sinusoidal.

Uphawu oluPhambili:Lumlinganiselo wesimo esizinzileyo. Ngenxa yokuba ingasebenzisa i-frequency enye, ichanekile kakhulu ekulinganiseni i-impedance kuloo frequency ithile.

2. I-Impulse Oscillometry (IOS)

Uphawu:Isebenzisa amaza oxinzelelo amafutshane kakhulu, afana ne-pulse. I-pulse nganye yi-square wave equlethe uluhlu lwee-frequency ezininzi (ngesiqhelo ukusuka kwi-5Hz ukuya kwi-35Hz).

Uphawu oluPhambili:Lumlinganiselo wexesha elifutshane. Inzuzo enkulu kukuba i-pulse enye inika idatha ye-impedance kuluhlu olubanzi lwee-frequency phantse ngoko nangoko.

Ngamafutshane, nangona zombini ezi ndlela zibalulekile, indlela ye-IOS yokubetha kwentliziyo yenza ukuba ikhawuleze, ibe lula kwizigulane, kwaye isebenze kakuhle ekufumaneni izifo ezincinci zomoya, nto leyo enegalelo ekwamkelweni kwayo ngokubanzi kwezonyango.

Iingenelo ze-IOS

Intsebenziswano Encinci Yezigulane: Ifuna ukuphefumla okuzolileyo nokushukumayo, okwenza kube yinto efanelekileyo kubantwana abancinci, abantu abadala, kunye nezigulane ezigula kakhulu.

Uvavanyo olupheleleyo: Yahlula phakathi kokuvaleka kwendlela yomoya ephakathi neyangaphandle kwaye inika ulwazi malunga nokuthobela imiphunga.

Uvakalelo Oluphezulu kwiSifo Esincinci Somoya: Ingabona izinto ezingaqhelekanga kwindlela yomoya emincinci ngaphambi kwe-spirometry.

Igqibelele kakhulu ekuBek' esweni: Ivumela ukulinganiswa okuphindaphindiweyo nokwexesha elide, iluncedo kuvavanyo lomngeni we-bronchial, uvavanyo lokuphendula kwe-bronchodilator, kunye nokubeka esweni ngexesha lokulala okanye i-anesthesia.

Izicelo zeKlinikhi

I-Pediatric Pulmonology: Isetyenziswa kakhulu, ingakumbi ekuxilongeni nasekujongeni isifo sombefu kubantwana abancinci.

Isifuba somoya: Sibonakaliswa yi-R5 ephezulu kunye nempendulo ebalulekileyo ye-bronchodilator. I-IOS ikwasetyenziselwa ukujonga ukusebenza kakuhle konyango kunye nokufumanisa isifo esingalawulekiyo ngokusebenzisa iiparamitha ezincinci zomoya (R5-R20, AX).

Isifo Esingapheliyo Sokuthinteleka Kwemiphunga (i-COPD): Sibonisa ukumelana okuphezulu kunye nokungasebenzi kakuhle komoya okuncinci (ukwanda kwe-R5-R20, iFres, kunye ne-AX).

Izifo zeMiphunga eziPhakathi (ILD): Ngokuyintloko zichaphazela ukusabela, zibangela i-X5 engalunganga kunye neFres ephezulu, ebonisa ukuncipha kokuhambelana kwemiphunga (imiphunga eqinileyo).

Uvavanyo lwangaphambi kotyando kunye nokubeka iliso ngaphakathi kotyando: Ibonelela ngovavanyo olukhawulezileyo lomsebenzi wemiphunga kwaye inokubhaqa i-bronchospasm ebukhali ngexesha lotyando.

Uvavanyo lwe-Unclaimed Dyspnea: Inceda ukwahlula phakathi kweepatheni ezithintelayo nezithintelayo.

Isiphelo

I-Impulse Oscillometry yindlela ephucukileyo, enobuhlobo nesigulane eye yatshintsha uvavanyo lomsebenzi wemiphunga, ngakumbi kwiindawo apho i-spirometry inzima khona. Ukukwazi kwayo ukubona izifo ezincinci zomoya kunye nokubonelela ngohlalutyo olwahlukileyo lweendlela zomoya kwenza ukuba ibe sisixhobo esibalulekileyo sokuxilongwa kwangoko, i-phenotyping, kunye nolawulo lwexesha elide lweemeko ezahlukeneyo zokuphefumla. Nangona ihambelana endaweni yokuthatha indawo ye-PFTs eqhelekileyo, i-IOS ifumene indima ehlala ihleli nekhulayo kwizixhobo zanamhlanje zokuxilonga ukuphefumla.