Saluran Pernafasan Jadi Sempit

Setiap tahun penyakit sekatan pulmonari kronik (COPD) menyebabkan lebih tiga juta orang maut dan menjadi punca keempat kematian di dunia. Pertubuhan Kesihatan Sedunia (WHO) menyatakan pada 2030, COPD dijangka menjadi penyebab ketiga kematian di seluruh dunia.

Pada 2007, kira-kira 210 juta menghidap COPD. Di Malaysia, kira-kira 4.5 peratus dewasa berumur 30 tahun ke atas menderita penyakit COPD. Malangnya, tiada pemulihan untuk penyakit yang merosakkan tisu paru-paru dan kebanyakan pesakit tidak mengetahui mereka menghidap penyakit itu.

Menurut Pengerusi Yayasan Paru-Paru Malaysia (LFM), Datuk Dr Zainudin Md Zin, penyakit berkaitan masalah paru-paru adalah lazim di seluruh dunia.

“COPD adalah penyakit kronik yang serius menyebabkan pesakit mengalami sesak nafas, batuk dan mengeluarkan kahak yang banyak secara berterusan dan semakin teruk dari semasa ke semasa.

“Faktor yang meningkatkan risiko itu adalah rokok di mana 90 peratus pesakit COPD adalah perokok. Manakala 10 peratus lagi adalah faktor persekitaran seperti pencemaran dan faktor pekerjaan.

“Di Malaysia, berdasarkan statistik laman web Kementerian Kesihatan, penyakit pernafasan salah satu penyebab kemasukan di hospital serta kematian,” katanya ketika ditemui pada majlis World COPD Day di KPJ Damansara, anjuran LFM,baru-baru ini.

Kebanyakan kes COPD terbentuk selepas pendedahan berpanjangan kepada jelaga yang merosakkan paru-paru dan saluran udara, terutama paip, cerut, asap tembakau dan lain-lain, bahkan asap pasif turut menyakitkan paru-paru dan menyebabkan COPD.

Selain mengganggu tidur, pesakit mengalami sesak nafas walaupun hanya melakukan kerja harian seperti berjalan dan mendaki tangga.

Saluran pernafasan perlahan-lahan menjadi sempit dan akhirnya menimbulkan rasa penat kerana setiap nafas ditarik memerlukan paru-paru bekerja kuat.

Pesakit lazimnya dikenal pasti melalui diagnosis dengan mengesan sejarah pesakit, pemeriksaan fizikal, X-ray dan memeriksa fungsi paru-paru.

Menurut Zainudin, COPD boleh dielak jika individu menjalani hidup sihat seperti tidak merokok. Meskipun pelbagai inisiatif dilakukan kerajaan serta pertubuhan bukan kerajaan (NGO) bagi membanteras gejala ini, ia masih kurang mendapat sambutan.

“Langkah pencegahan awal sepatutnya diambil individu atas rasa tanggungjawab dengan tidak merokok. Mungkin pada usia muda tiada masalah, namun memasuki usia emas ia memberi kesan tidak baik, malah membahayakan nyawa,” katanya.

Di Malaysia, dianggarkan 50 peratus lelaki merokok, manakala wanita adalah 20 peratus daripada lebih satu bilion penduduk dunia yang merokok. Walaupun penyakit ini tidak boleh disembuhkan, COPD boleh dirawat secara berkesan.

Walaupun COPD dianggap sebagai penyakit pada usia tua, anggaran menunjukkan 50 peratus penghidap COPD berusia kurang daripada 65 tahun, menyebabkan peningkatan dalam ketidakhadiran di tempat kerja, persaraan awal dan kurang pembabitan dalam tenaga kerja.

Rawatan COPD

Langkah pertama perlu diambil adalah berhenti merokok. Bincang dengan doktor cara terbaik untuk berhenti merokok. Pelbagai cara diperkenalkan bagi mencapai tujuan ini seperti klinik berhenti merokok, rawatan gantian nikotin, ubat-ubatan untuk kurangkan ketagihan merokok dan kaunseling.

Pendedahan kepada asap, gas kimia dan habuk perlu dikurangkan selain mengelak menghidu asap rokok perokok lain (perokok pasif).

Mengambil suntikan vaksin selesema dan kurang bergaul dengan orang ramai ketika musim demam.

Rawat penyakit ini dengan ubat mengikut nasihat doktor boleh mengawal kesannya. Kebanyakan ubat COPD waktu ini adalah ubat sedutan inhaler yang disedut terus ke saluran udara dan mengurangkan kesempitan dan inflamasi saluran udara. Ubat sedut mempunyai kesan sampingan yang kurang berbanding ubat yang dimakan seperti berdebar-debar dan tangan menggeletar.

Pesakit digalakkan menulis nama semua ubat biji dan ubat sedutan untuk rujukan doktor ketika kecemasan. Kalau boleh, simpan ubat dalam kotak ubat mingguan supaya tidak lupa makan ubat.

Eksaserbasi/keterukan COPD. Ini berlaku kerana pesakit COPD mengalami tanda COPD iaitu mudah penat, kahak yang pekat dan berlebihan warna daripada biasa. Keadaan ini selalu terjadi apabila pesakit COPD diserang demam selesema, terdedah pada habuk atau jerebu dan pesakit COPD tidak makan ubat seperti diarah doktor.

Senaman dan rehabilitasi pulmonari sangat penting untuk menguatkan otot pernafasan supaya proses pernafasan menjadi mudah dan mengurangkan simptom sesak nafas di samping menambah stamina pesakit.

Diet. Kebanyakan penghidapnya menjadi kurus dan mengalami keadaan reput tulang osteoporosis. Pesakit COPD memerlukan tenaga 10 kali ganda berbanding individu normal untuk bernafas. Pemakanan seimbang memberi pesakit tenaga untuk menjalankan tugas harian.

Rawatan oksigen. Ia diberi kepada pesakit yang berada di peringkat sangat teruk iaitu pada tahap oksigen dalam darah, kurang 90 peratus. Oksigen boleh diberi dengan beberapa cara seperti tangki oksigen atau ‘oxygen concentrator’. Rawatan ini membolehkan pesakit COPD kronik memperoleh kualiti hidup lebih baik.

Pembedahan. Ia cara terakhir dalam rawatan penyakit COPD, namun bukan cara terbaik kerana risiko pembedahan tinggi. Antara pembedahan dijalankan untuk pesakit COPD adalah bullectomy dan pemindahan paru-paru.

Ubah suai cara hidup. Jika peringkat COPD sangat teruk, anda mungkin tidak berupaya melakukan kerja harian. Oleh itu, anda mungkin memerlukan bantuan mereka yang terdekat.

Beberapa pengubahsuaian perlu dilakukan dalam mengadaptasikan diri kepada keadaan ini seperti:

- Mendapatkan pertolongan ahli keluarga atau kawan untuk tugas penting.

- Simpan semua benda penting di satu tempat berdekatan supaya tidak perlu berjalan jauh.

- Pakai pakaian longgar supaya pernafasan tidak susah.

- Rancang sebelum keluar rumah dan sentiasa memastikan pengambilan ubat sebelum keluar rumah.

- Bawa nombor telefon rumah, anak atau kawan supaya boleh dihubungi ketika kecemasan.

- Anda dinasihatkan supaya tidak keluar rumah dalam keadaan kurang sihat.

- Jika hendak meninggalkan rumah untuk jangkamasa panjang (melawat anak di negeri lain), jangan lupa membawa ubat anda (buku catatan ubat-ubatan atau surat rujukan daripada doktor).

- Pengurusan diri sendiri untuk penyakit ini sangat penting kerana kebanyakan pesakit COPD hanya diperiksa doktor tiga atau empat bulan sekali. Semua pesakit mesti mencatatkan rawatan penyakit mereka, ikut arahan doktor dan jangan lupa temu janji doktor.

Antara tanda umum masalah paru-paru ialah:

- Sukar bernafas.

- Nafas menjadi pendek (tercungap-cungap apabila bernafas).

- Berasa seperti tidak cukup udara.

- Kemampuan untuk bersenam berkurang.

- Batuk yang tidak surut walaupun mengambil pelbagai jenis ubat.

- Batuk berdarah atau berkahak.

- Sakit atau tidak selesa apabila menarik dan menghembuskan nafas.

Kaedah menjaga paru-paru:

- Berhenti merokok.

- Elak menjadi perokok sekunder.

- Elak persekitaran tercemar.

- Kurangkan penggunaan bahan kimia industri atau domestik.

- Jika bekerja dalam industri berkaitan kimia, pakai topeng penutup muka.

- Amalkan pemakanan seimbang dan gaya hidup sihat.

- Kawal penyakit (jika anda menghidap penyakit berkaitan paru-paru).

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