Ke loaʻa nei kēia pilikia me kou mau māmā? E aʻo kākou e pili ana i ka Interstitial Lung Disease (ILD)!

Ke manaʻo nei ʻoe i kekahi manawa ua pōkole kou hanu? A i ʻole he ʻū maloʻo mau kou? A i ʻole ua nāwaliwali ʻoe i kou hoʻoikaika kino ʻana? ʻAʻole paha he luhi wale nō kēia. He mau hōʻailona paha ia o kahi maʻi a mākou e kamaʻilio ai i kēia lā i kapa ʻia ʻo "Interstitial Lung Disease" (``ILD``). Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano e hiki ai iā ʻoe ke hoʻomaopopo.

He aha ka maʻi mama Interstitial?

I ka ʻōlelo maʻalahi, ʻaʻole hoʻokahi maʻi ka maʻi māmā interstitial (ILD). He hui ia o nā maʻi. ʻOiaʻiʻo, aia ma mua o 200 mau ʻano. ʻO kēia mau maʻi ke kumu o ka mumū ʻana o nā ʻiʻo palupalu i loko o kou mau māmā ( ka interstitium ), ʻeha, a ʻeha. I kēia manawa ke nīnau nei paha ʻoe, "He aha kēia interstitium?" E noʻonoʻo e like me ko kākou mau māmā i hana ʻia me kahi puʻu o nā pōpō liʻiliʻi (i kapa ʻia ʻo alveoli ). ʻO ka interstitium ka ʻiʻo palupalu ma waena o kēia mau ʻeke ea a me nā kīʻaha koko e hoʻopuni ana iā lākou. Ke hanu mākou, lawe ʻia ka oxygen a hoʻokuʻu ʻia i loko o ke koko ma o kēia mau ʻeke ea. No laila, ma ILD, ua hōʻino ʻia kēia mau ʻiʻo koʻikoʻi, no laila ʻaʻole hiki i ka oxygen ke hele pono i ke kino.

Ua kapa ʻia ʻo `ILD` ʻo `Diffuse Parenchymal Lung Disease (DPLD).` Eia naʻe, ʻo `ILD` ka inoa i hoʻohana nui ʻia.

He aha ka mea e hana ʻia i ke kino ke ulu aʻe ka `ILD`?

Inā loaʻa iā ʻoe ka ILD, e hōʻino ʻia nā ʻāpana o kou mau māmā e hōʻiliʻili ana i ka oxygen mai kou koko a hoʻouna aku i ke koena o kou kino. Lilo kēia ʻiʻo i ʻeha (i kapa ʻia hoʻi he fibrosis ), e paʻakikī ai ka hanu ʻana. Hiki iā ʻoe ke loaʻa i kahi ʻū mau a maloʻo. Hiki iā ʻoe ke luhi i nā manawa a pau no ka mea ʻaʻole lawa ka oxygen i kou kino.

Inā hoʻomau kēia hōʻino i ka hōʻiliʻili ʻana, hiki iā ia ke alakaʻi i nā pilikia i hiki ke hoʻoweliweli i ke ola. Eia kekahi laʻana, nā maʻi māmā a me ka hāʻule ʻana o ka hanu (kahi i loaʻa ʻole ai i ke kino ka oxygen lawa a loaʻa paha ka nui o ke kalapona ʻokikene).

He aha nā ʻano `ILD` i loaʻa?

E like me kā mākou i ʻōlelo ai ma mua, aia ma mua o 200 mau ʻano o ka `ILD`. ʻO kekahi o nā mea maʻamau ka `Idiopathic Pulmonary Fibrosis` . Eia kekahi, hiki ke hana ʻia ka `ILD` e nā mea i loko o kā mākou wahi hana (nā hōʻike ʻana i ka hana) a i ʻole nā ​​maʻi pili o nā ʻiʻo. ʻO kekahi mau laʻana ʻē aʻe:

• ʻAsbestosis
• ʻO ke silicosis
• ʻO ka Pneumonitis Radiation
• ʻO ka Pneumonia Interstitial Kūikawā ʻole

He aha ka ʻokoʻa ma waena o ka 'Maʻi Maʻi Lung Interstitial' (ILD) a me ka 'Pulmonary Fibrosis'?

He mea kēia e huikau ai nā kānaka he nui. ʻO ka fibrosis pulmonaryʻO ka Pulmonary Fibrosis (Pulmonary Fibrosis) kahi ʻano ILD. ʻO ia hoʻi, ʻaʻole nā ​​​​ILD āpau he fibrosis pulmonary. ʻO ka pulmonary fibrosis ka hoʻokumu ʻia ʻana o nā ʻōpala i loko o nā māmā. ʻOiai ʻo kēia ʻōpala kahi hiʻohiʻona nui o kekahi mau ILD, ʻo ka mumū paha ke ʻano nui o nā ILD ʻē aʻe.

ʻO wai ka mea i pilikia nui i ka loaʻa ʻana o ka `ILD`?

Hiki paha iā ʻoe ke hoʻomohala i ka ILD inā ʻoe:

• Inā ʻoe ma luna o 70 mau makahiki.
• Inā he kāne ʻoe. (Hiki i nā wahine ke loaʻa, akā ʻoi aku ka maʻamau i nā kāne)
• Inā ʻoe e puhipaka a i ʻole ua puhipaka ʻoe ma mua.
• Inā ua loaʻa iā ʻoe kekahi mau maʻi ma mua, e like me ka Hepatitis C, Tuberculosis, Pneumonia, COPD, a i ʻole ka maʻi pili.
• Inā ʻoe e hanu i nā mea e hōʻino ai i kou mau māmā ma muli o kāu hana a i ʻole ke kaiapuni . Nā laʻana: asbestos, silica, molds, fungi, a bacteria paha.
• Inā ua loaʻa iā ʻoe ka lāʻau lapaʻau radiation ma kou umauma .

Pehea ke koʻikoʻi o ka 'ILD'?

No ka mea, he nui nā ʻano o ka `ILD`, hiki ke ʻokoʻa ke koʻikoʻi o ka `ILD` i loaʻa i kēlā me kēia kanaka. Hiki ke akahai kekahi, akā hiki i kekahi ke koʻikoʻi loa. ʻO ka mea nui, ʻo ka hōʻino ʻana i nā māmā i hana ʻia e nā ʻano `ILD` he `hiki ʻole ke hoʻihoʻi ʻia`. ʻO ia hoʻi, he paʻakikī ke hoʻoponopono i nā ʻiʻo i hōʻino ʻia. ʻO kekahi mau ʻano koʻikoʻi o ka `ILD` e ʻoi aku ka ʻino i ka hala ʻana o ka manawa (`progressive`).

He aha nā hōʻailona o ka 'ILD'?

ʻO nā hōʻailona maʻamau o ka ILD:

• Paʻakikī ka hanu ʻana (dyspnea): Hiki i kēia ke lilo i mea ʻino, ʻoiai i ka wā o ka hoʻoikaika kino a i ʻole ka hana ikaika.
• ʻO ke kuʻi maloʻo (he kuʻi me ka ʻole o ka phlegm).
• Manaʻo luhi loa .
• ʻO ka ʻeha a i ʻole ka ʻeha o ka umauma .

ʻAʻole paha e koʻikoʻi kēia mau hōʻailona i ka wā mua, akā hiki iā lākou ke ʻoi aku ka ʻino ma hope o nā mahina a i ʻole nā ​​​​makahiki. Hiki ke ulu aʻe nā hōʻailona ʻē aʻe, ma muli o ke kumu kumu o ka ILD.

He aha nā kumu o ka `ILD`?

Hiki ke hoʻokaʻawale ʻia nā kumu o ILD i ʻelua mau māhele nui: nā kumu i ʻike ʻia a me nā kumu i ʻike ʻole ʻia .

Nā Kumu i ʻIke ʻia

ʻO ke ʻano kēia, ulu ka ILD ma muli o kekahi maʻi ʻē aʻe āu i loaʻa ai, a i ʻole ma muli o kekahi mau lāʻau lapaʻau āu e lawe ai, ka radiation therapy, a i ʻole ka ʻike ʻana i nā mea ʻino i ke kaiapuni.

ʻO kekahi o nā kumu nui i ʻike ʻia:

• ʻO ka maʻi pili o nā ʻiʻo: ʻO nā hiʻohiʻona e pili ana i nā maʻi e like me ka Rheumatoid Arthritis (RA), Lupus, a me Scleroderma.
• Maʻi Granulomatous: ʻO kahi laʻana he sarcoidosis.
• Ke hanu ʻana i kekahi mau mea: nā mea e like me ka asbestos, silica, paka, a me ka beryllium.
• ʻAleʻaleʻa hanu ʻia (Hypersensitivity Pneumonitis): Hiki ke hana ʻia kēia ʻano ma ka hanu ʻana i nā mea e like me ka ʻōpala, ka fungi, ka bacteria, ka hulu manu, a i ʻole nā ​​​​​​ʻāpana liʻiliʻi o ka lepo manu.
• Kekahi mau lāʻau lapaʻau a i ʻole nā ​​​​lāʻau lapaʻau: No ka laʻana, nā lāʻau lapaʻau e like me amiodarone, nitrofurantoin, methotrexate, a me ka radiation therapy.

Nā Kumu i ʻIke ʻole ʻia ('Nā Kumu i ʻIke ʻole ʻia' a i ʻole 'Idiopathic')

I kekahi manawa, ʻaʻole hiki i nā kauka ke loaʻa ke kumu pololei o ka ILD. ʻO ke ʻano kēia e loaʻa iā ʻoe ka ILD me ka ʻole o kekahi kūlana olakino ʻē aʻe a i ʻole ka ʻike ʻana i kekahi mea ʻino. Kāhea mākou i kēia he idiopathic interstitial pneumonia . Aia kekahi mau ʻano ILD. ʻO ke ʻano maʻamau o ka ILD, kahi hiki ʻole ke loaʻa ke kumu, ʻo ia ka idiopathic pulmonary fibrosis .

Pehea e ʻike ai i ka ILD? (Diagnosis)

E hahai ana kāu kauka i kekahi mau ʻanuʻu e ʻike ai i ka ILD. ʻO ka mea mua, e nānā lākou iā ʻoe, e hoʻolohe i kou mau māmā a nānā i nā leo ʻē (e like me nā crackles). A laila e nīnau lākou iā ʻoe i nā nīnau e like me:

• Kou mōʻaukala olakino piha a me nā kūlana olakino ʻē aʻe o kēia manawa.
• E pili ana i nā lāʻau lapaʻau āu e hoʻohana nei a i ʻole i hoʻohana ai ma mua .
• Aia kekahi o kou ʻohana i loaʻa i kekahi o kēia mau maʻi a i ʻole nā ​​maʻi pili i nā ʻiʻo?
• Inā paha e hōʻike ana kāu hana a i ʻole kāu mau hana leʻaleʻa iā ʻoe i nā mea e hiki ai ke hoʻoulu i ka 'ILD' .

He aha nā hoʻokolohua e hoʻohana ʻia no ka ʻike ʻana i ka `ILD`?

Inā kānalua ke kauka i ka ILD, hiki iā lākou ke hana i nā hoʻokolohua aʻe:

• Nā Hoʻāʻo Hana Puʻuwai (PFT): ʻO kēia mau mea he mau hoʻāʻo hanu ʻana, akā i kekahi manawa hiki iā lākou ke komo pū me nā hoʻāʻo koko a i ʻole nā ​​​​hoʻāʻo hoʻoikaika kino. Nānā kēia i ka maikaʻi o ka hana ʻana o kou mau māmā.
• Nā Hoʻāʻo Kiʻi: Lawe ʻia kahi X-ray umauma a i ʻole kahi scan CT hoʻonā kiʻekiʻe (HRCT) e nānā i ke kūlana o nā māmā. Hiki i kahi HRCT ke ʻike i nā kikoʻī liʻiliʻi loa.
• Nā Hoʻāʻo Koko: Hoʻāʻo ʻia kahi hāpana koko i lawe ʻia mai kou lima e ʻike inā he mau kumu i ʻike ʻia (e laʻa me nā maʻi pili) e hiki ai ke hoʻoulu i ka ILD.
• Bronchoscope:ʻO kēia ke komo ʻana i kahi ʻōmole lahilahi i lako me ke kāmela (he `bronchoscope`) ma kou ihu a waha paha i loko o kou mau māmā e nānā i kou mau ala ea. I kekahi manawa hiki ke lawe ʻia kahi laʻana o nā cell (`lavage`) mai kou mau māmā.
• Biopsy: I kekahi mau hihia, lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka māmā a nānā ʻia ma lalo o kahi microscope. Hiki i kēia ke kōkua i ka ʻike ʻana i ke ʻano kikoʻī o ILD. Hiki ke hana ʻia ka biopsy ma o ka bronchoscopy a i ʻole ma o kahi hana liʻiliʻi (surgical lung biopsy).

He aha nā lāʻau lapaʻau no ka `ILD`?

ʻO ka mea kaumaha, ʻaʻohe lāʻau lapaʻau e hiki ke ho'ōla loa i ka 'ILD'.

Akā, mai hoʻopau i ka manaʻolana. ʻO ke kumu o ka lāʻau lapaʻau ka mālama ʻana i ke kūlana kumu i hoʻokumu ai i ka ILD, ka kaohi ʻana i nā hōʻailona, ​​a me ka hoʻolohi ʻana i ka holomua o ka maʻi. Hiki i kāu kauka ke kuhikuhi i ka lāʻau lapaʻau kino, ka oxygen hoʻohui, a i ʻole nā ​​​​lāʻau lapaʻau e hōʻemi i ka pehu ʻana i kou mau māmā a i ʻole ka kaohi ʻana i ka ʻeha.

He aha nā lāʻau lapaʻau a me nā lāʻau lapaʻau i hoʻohana ʻia no ka `ILD`?

• Corticosteroids: ʻO nā lāʻau lapaʻau e like me ka prednisone e kōkua i ka hōʻemi ʻana i ka pehu ʻana i loko o nā māmā.
• Nā Lāʻau Anti-fibrotic a me Cytotoxic: Hiki i kēia mau lāʻau ke hoʻolohi i ka wikiwiki o ka ʻeha ma nā māmā. Nā Laʻana: Azathioprine, Cyclophosphamide, Pirfenidone, Nintedanib.
• Nā Lāʻau Lapaʻau Olaola: Hoʻohana ʻia nā lāʻau lapaʻau e like me Rituximab e mālama i kekahi mau maʻi autoimmune a me nā kūlana ʻē aʻe e hoʻoulu ai i ka ILD.
• Lapaʻau no GERD: Inā loaʻa iā ʻoe ka maʻi reflux gastroesophageal (GERD), hiki iā ia ke hoʻonui i ka ILD. No laila, hiki ke hāʻawi ʻia iā ʻoe ka lāʻau lapaʻau e kāohi i ka waikawa o ka ʻōpū.
• Hoʻōla Hou ʻana i ka Puʻuwai: He papahana hoʻoikaika kino kūikawā kēia a he papahana hoʻonaʻauao. Kōkua nā hoʻomaʻamaʻa hanu a me nā hoʻoikaika kino i ka hoʻoikaika ʻana i kou mau māmā a e maʻalahi ai ka hanu ʻana.
• Lapaʻau Oxygen: Inā ʻaʻole lawa ka oxygen i kou koko a i ʻole nā ​​​​ʻiʻo, hiki i kāu kauka ke kuhikuhi i ka oxygen hou. Hāʻawi ʻia kēia ma o ka cannula ihu a i ʻole kahi pale maka.
• Hoʻoili Mama: No nā poʻe me ka ILD koʻikoʻi loa, hiki i ka hoʻoili mama ke lilo i hopena hope loa.

Nā hopena ʻaoʻao o ka lāʻau lapaʻau

Hiki i kekahi mau lāʻau lapaʻau no ka ILD (ʻoi aku hoʻi nā corticosteroids a me nā lāʻau cytotoxic) ke hoʻonāwaliwali i kāu ʻōnaehana pale. No laila, e nānā mau kāu kauka iā ʻoe a nānā i nā pilikia e hiki mai ana.

Hiki ke pale ʻia ka ILD?

He mea paʻakikī ke pale aku i nā ʻano ILD he nui. Eia nō naʻe, hiki iā ʻoe ke hana i kēia mau mea e hōʻemi ai i kou pilikia o ka loaʻa ʻana o ka ILD:

• E mālama i kekahi mau kūlana olakino āu i loaʻa mua (e laʻa me nā maʻi pili).
• E pale i ka hanu ʻana i nā mea ʻino i nā māmā.
• Inā ʻoe e hana ma nā wahi i loaʻa ai ka asbestos, ka lepo metala, a i ʻole nā ​​​​kemika, e ʻaʻahu i kahi respirator kūpono (kahi pale maka e kānana i nā ʻāpana i ka lewa).
• Hiki ke hana ʻia nā maʻi ʻaleka lōʻihi e nā mea e like me ka mauʻu maloʻo, ka palaoa, nā ʻōpala manu a i ʻole nā ​​hulu manu, a me nā ʻōnaehana hoʻomehana a me ka hoʻoluʻu. E komo i ka respirator i ka wā e hana ana me kēia mau mea.
• Inā loaʻa iā ʻoe kahi maʻi e like me ka maʻi pili pili a i ʻole sarcoidosis, e kamaʻilio me kāu kauka e pili ana i nā ala e pale aku ai i ka ILD.
• Inā ʻoe e puhipaka ana, e hoʻōki loa. Inā ʻaʻole ʻoe e puhipaka ana, mai hoʻomaka.

He aha ka mea e hiki mai ana no kekahi me ka `ILD`?

Inā loaʻa iā ʻoe ka ILD, e hana pū ʻoe a me kāu kauka e hoʻoholo pehea e hoʻokele ai i kou kūlana, ma muli o ke kumu o ka ILD. No ka laʻana, inā ua hana ʻia kāu ILD e kāu hana a i ʻole kahi allergy (hypersensitivity pneumonitis), pono paha ʻoe e hoʻōki i ka hana ʻana me ka mea e hoʻoulu ai i ka ILD a i ʻole e hana i nā hana palekana kūikawā.

ʻOiai hiki i nā lāʻau lapaʻau ke hōʻemi i ka pehu ʻana, ʻo ka ʻeha e kū mai ana i loko o nā māmā ma muli o ka ILD he mau loa ia. ʻO ke ʻano kēia, ʻaʻole hiki ke hoʻohuli ʻia ka pōʻino. Inā loaʻa iā ʻoe kahi maʻi kumu, hiki i ka mālama pono ʻana ke kōkua i ka pale ʻana i ka pōʻino hou aʻe. Inā loaʻa iā ʻoe ka ILD ʻaʻole hiki ke loaʻa ke kumu (idiopathic), e mālama kāu kauka i kāu mau hōʻailona a hoʻāʻo e pale i ka pōʻino hou aʻe.

He aha nā pilikia e hiki mai ana o ka `ILD`?

Inā lilo ka ILD i mea koʻikoʻi, hiki ke loaʻa nā pilikia e hoʻoweliweli ana i ke ola, e like me:

• Ke koko kiʻekiʻe o ka puʻuwai
• ʻO ka Mama Hiolo (Pneumothorax)
• Nā maʻi ʻaʻai māmā
• Ka Holo ʻole o ka Hanu ʻana
• Ka maʻi ʻaʻai māmā

He aha ke ola lōʻihi o kekahi me ka `ILD`?

He nīnau kēia a ka poʻe he nui e nīnau ai. ʻO ke ola o kekahi kanaka me ka `ILD` e pili ana i ke kumu o ka `ILD` a me kona koʻikoʻi. Hiki i kekahi poʻe ke ola maʻamau me ka ʻole o ka lāʻau lapaʻau a i ʻole me ka lāʻau lapaʻau liʻiliʻi inā ʻaʻole koʻikoʻi ko lākou `ILD`. Inā ʻaʻole e ʻoi aku ka ʻino o kou maʻi (ʻo ia hoʻi, inā he `paʻa`), maikaʻi ka nānā ʻana (`prognosis`).

Eia nō naʻe, no ka poʻe me nā ʻano ʻino loa a wikiwiki hoʻi o ka `ILD`, hiki i ka lōʻihi o ke ola ma hope o ka ʻike ʻia ʻana ke pōkole e like me 3-5 mau makahiki. Mai hopohopo i kēia mau helu. He ʻokoʻa kēia no kēlā me kēia kanaka.

Pehea wau e mālama ai iaʻu iho inā loaʻa iaʻu ka 'ILD'?

Inā ua ʻike ʻia ʻoe me ILD, ʻo ke ala maikaʻi loa e mālama ai iā ʻoe iho, ʻo ia ke hana pū me kāu kauka e hoʻomohala i kahi hoʻolālā e hoʻokele i kāu mau hōʻailona a pale i ka hōʻino hou aʻe.

• E mālama i kekahi mau kūlana kumu e hoʻoulu ai i ka ILD.
• E kāohi i nā mea e hiki ke hoʻonui i ka ILD (e like me GERD).
• Inā ʻoe e hana me nā mea e hōʻino ai i nā māmā a i ʻole e hoʻoulu ai i nā maʻi allergies no ka manawa lōʻihi, pono ʻoe e lawe i nā hana palekana kūikawā.

Āhea wau e ʻike ai i ke kauka?

E ʻike koke i ke kauka inā loaʻa iā ʻoe kēia mau hōʻailona:

• Ke piʻi mālie nei ka paʻakikī o ka hanu ʻana.
• Ka paʻakikī o ka hanu ʻana i ka wā hoʻoikaika kino.
• ʻO ka ʻūhū maloʻo mau.

ʻO ka wikiwiki o ka mālama ʻia ʻana o ILD, ʻoi aku ka maikaʻi o ka hopena.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Mai poina e nīnau i kēia mau nīnau ke ʻike ʻoe i kāu kauka:

• No ke aha i loaʻa ai iaʻu kēia maʻi?
• He aha nā koho lapaʻau e loaʻa iaʻu?
• E ʻoi aku ka ʻino o kēia kūlana?
• Hiki ke hoʻēmi ʻia ka hōʻino ʻana i nā māmā?
• He aha nā hoʻololi e hiki iaʻu ke hana e hoʻomaikaʻi ai i koʻu ola maikaʻi?

He nui nā ʻano o ka ILD. He ʻoluʻolu kekahi, a he koʻikoʻi loa kekahi. Hiki paha iā ʻoe ke ʻike i nā helu weliweli ma ka pūnaewele, akā hiki i kāu kauka ke haʻi pololei iā ʻoe i kou kūlana kikoʻī. E kamaʻilio pololei me kāu kauka a loaʻa kahi ʻike maopopo o kāu mau mea i manaʻo ai. I ka hui pū ʻana, hiki iā ʻoe a me kāu kauka ke hoʻomohala i kahi hoʻolālā e hoʻokele i kāu mau hōʻailona a ola i ke ʻano maikaʻi loa o ke ola.

E hoʻomanaʻo kākou i nā mea nui loa (Leka Lawe-Home)

• He hui maʻi ʻo `ILD` e hōʻino ana i nā ʻiʻo palupalu o nā māmā, e paʻakikī ai ka hanu ʻana.
• ʻO ka ʻū maloʻo, ka paʻakikī o ka hanu ʻana, a me ka luhi nā hōʻailona nui.
• He nui nā kumu, a i kekahi manawa ʻaʻole hiki ke loaʻa ke kumu.
• ʻOiai ʻaʻohe lāʻau lapaʻau piha, aia nā lāʻau lapaʻau e kaohi i nā hōʻailona a pale i ka hoʻonui ʻana o ka maʻi.
• He mea nui e pale i ka puhipaka, pale i ka hanu ʻana i nā mea ʻino, a kaohi i nā kūlana olakino ma lalo.
• Inā loaʻa iā ʻoe nā hōʻailona, ​​mai hopohopo a e ʻimi i ke kōkua lapaʻau. He mea nui loa ka ʻike koke ʻana a me ka mālama ʻana.

Lana ko mākou manaʻo he mea pono kēia ʻike nou. E ola kino!

ʻO ka maʻi māmā interstitial, ILD, maʻi māmā, pilikia hanu, ʻū maloʻo, fibrosis pulmonary, ʻeha o ka māmā, nā hōʻailona hanu