Tập thở ở người bị bệnh phổi tắc nghẽn mãn tính

1 ^ Do thuoc hg. di^ng. Dung thutfc

ha dfldng (insulin vd thuoc vien

utfng tdng titft insulin) khdng hdp

I^ cd the dan dtfn tdng dfldng huytft

khi ddi vdo budi sdng. Ly do Id cdc

thutfc ndy cd the gay ra ha dfldng

huytft trong dfim vd kich thich

Cd the titft ra hormon dtfi khang

insulin dd tdng dfldng huye't. Ngfldi

bfinh dang ngii se bi "cu stfc" danh

thflc vdi bieu hifin tim ddp nhanh,

h6i hdp vd huytft dp tang cao. Tuy

nhifin, ntfu thijT dfldng huytft luc ndy

lai thay khdng thtfp. Ngfldi bfinh

nfin cai dtfng h6 hao thflc luc 2- 3

gid khuya (trfldc khi "cu stfc" xay

ra) vd thijf dfldng huytft luc nay,

ntfu ktft qua thtfp tM xdc dinh ha

dfldng huytft trong dem gay ra do

thutfc. Cdn bdo bdc si dtf dilu chinh

lai thutfc thi mdi cd thd chtfm ddt

dfldc tinh hutfng ndy.

Do thudc hg. huyet dp. US'ng

nhilu thud'c ha huye't dp cd the

ddn dtfn huytft ap trong dfim

gidm xud'ng qua mdc, lam phdng

thich cdc hormon dfi'i khdng nhfl

epinephrin vd Cortisol... ddn dfi'n

tdng huyfi't dp vd tang dfl&ng huytft

sdng sdm.

Cach xu( ly tang di^dng huye t

doi butfi sang

- Cdt gidm Iflpng tinh bfit vdo

mdi bda dn theo diing khau phan

ndng Iflgng hdng ngdy.

- Utfng mfit ly rfldu vang nhd

vdi bda dn ttfi hodc trfldc khi di ngu.

Rfldu cd tac dung dc che gan phdng

thich glucose trong dfim nfin han chfi'

dfldc tdng dfldng huye't buoi sang.

- Trdnh fin qud khuya, nfi'u cdn

thi chi nfin dting mpt bda an nhe

trfldc khi di ngu vdi loai thdc an chfla

chat dam hoac beo (cdc loai hat, bd

dfiu phdng, pho mdt, hoac thit).

- Dilu chinh thdi ditfm uong

thud'c trong ngay, vi du metformin

ud'ng budi td'i se cd tdc dfing manh

me dfi'n dfldng huyfi't ddi hcfn so vdi

ud'ng budi trfla hofic sang. Bdi vi,

metformin cd tdc dung dc chtf gan

phdng thich glucose td sfl phan huy

glycogen vdo ban dfim, vi vfiy tranh

tdng dfldng huytft ddi hudi sang sdm.

- Khi cdn dung insulin nen lieu

cao, khdng nen dung mfit lan qud

nhilu vdo budi ttfi md nen chia ra

hai Idn sdng vdi toi. i$£

20

Tap thddngwi bf

binh phoi

Da stf ngfldi tim dtfn thtf

due thtf thao vdi mue

dfch nfing cao sflc khde

han than, dieu nay cdng ddc bifit

quan trpng dtfi vdi n^d i hi benh

man tinh. Dd'i vdi nhflng ngfldi hi

bfinh phtfi tac nghen man tinh,

vific tap luyen dung each cung

cho thay nhilu ldi ich qua nhilu

nghien cdu dflpc bdo cao tren thtf

gidi. Viec tap luyen dung each se

gdp phdn thfim cho hifiu qua dilu

tri cung nhfl phdng ngfla tinh trang

ctfp tinh cua bfinh, chd't Ifldng cude

sd'ng dflgc cai thien hdn.

Thd la nhu cau thitft ytfu cua

stf so'ng va nd xay ra mdt cdch tfl

dpng hang ngay, lien tuc trong

sutft cudc ddi cua ban md ban

khdng he quan tam de'n nd. Nhflng

ngfldi bfinh thfldng dac bifit chii y

hdn de'n each thd cua ho va dilu

chinh nd theo nhu cdu ban thdn.

Mdt cau hdi dat ra: Ban cd bitft

each thd nhfl thtf nao la dung va cd

ich cho sdc khoe cua ban? Chung

ta thfldng cd mot nhdm lan nh6

ve each thd, chang han "hay thd

thdt sdu, ban se cd dflgc nhieu

oxy hgn" hay "thd sdu hdn, tot

hcfn cho sflc khde cua ban"... Cdc

nghien cdu cho thtfy, khi ban thd

qua mdc (thuat ngfl chuyfin mdn

tang thdng khi) se dfla dtfn giam

ndng dd khi carbonic (CO2). Mae

du, C02 Id mfit khi ddc doi vdi cd

the nhflng khi ndng dp eua nd

trong co the giam tha'p lai gdy ra

tac dung bat lpi cho cd the. Don

cd, khi nong dp cua nd gidm thap

gay ra tinh trang co mach khitfn

viec cung cap mdu vd oxy dfi'n co

quan nao, tim, gan, thdn, Idch,

rupt,... suy giam.

Phflcmg phdp ddnh gid thdi gian

tam dflng thd cd kiem sodt (CP:

Control Pause) la mpt phtftmg thdc

don gian va chinh xdc trong vi^c

xdc dinh ban thd cd ttft khfing.

Ban hay ngoi xutfng vd thfl gian

5 - 7 phut. Sau dd, kep gifl mui

c6a ban vdo cutfi giai doan ttid ra

binh thfldng ci^a ban vd ddng vific

thd. Ban bdt ddu dem stf gidy ban

ngflhg thd cho tdi khi cd the Ifin

titfng yfiu cau ban thd lai. Hdy thd

lai binh thfldng nhfl ban da thS

trfldc dd. Mfit dilu rd't quan trpng

khi titfn hdnh ddnh gid: khdng cd

htft k^ sfl n5 Iflc nin thd ndo dflffc

thflc hifin trong qud trinh ddnh

gid. Ntfu b^n thd ttft, thdi gian

tam ddng thd cd kidm sodt thfldng

khodng 40 gifiy. Nd cdng ngdn, b^n

thd cdng khfing ttft.

Ngfldi bi b§nh phdi tdc nghfin

man tfnh thfldng cd tinh trang d

khf CO2 man tinh nhiftig cung cd

nhdng bdo cdo cho thtfy: ngfldi bi

bfinh cd tinh trang tdng thfing

khi qud mdc. Do dd, ngfldi hi bfinh

phdi tdc nghfin mfin tfnh eung cdn

tim cho minh mfit cdch luyfin t^p

thd thtf ndo de ttft cho sflc khde

bdn thfin.

Xin gidi thifiu vdi bdi tfip thd

qua cdc nghifin cdu cho thtfy cd ldi

cho ngfldi hi bfinh phdi tdc nghen

man tinh.

7.2

4^

THU6C&S0C KHOE so 489 (1.12.2013)