Ke paʻakikī nei ʻoe a i ʻole kāu keiki liʻiliʻi ke ale i ka meaʻai? Loaʻa iā ʻoe kahi ʻeha nui o ka puʻu, a he paʻakikī iki paha ka hanu ʻana? No laila, e pili ana kēia i kahi kūlana e pono ai mākou e makaʻala nui i ia mau manawa, hiki ke lilo i mea koʻikoʻi iki, akā hiki ke ho'ōla ʻia inā ʻike ʻia a mālama ʻia i ka wā mua. I kēia lā e kamaʻilio mākou e pili ana i kahi mea i kapa ʻia ʻo 'Retropharyngeal Abscess' .
He aha kēia 'Retropharyngeal Abscess'? I ka ʻōlelo maʻalahi...
I ka ʻōlelo maʻalahi, ʻo ka 'retropharyngeal abscess' he hōʻiliʻili o ka pus i loko o kou puʻu, kokoke i ka paia hope o kou puʻu. I ka pololei, hana ia i ka wā e komo ai kahi maʻi bacteria i loko o nā lymph nodes i loko o kou puʻu. Ua ʻike anei ʻoe he ʻāpana kēia mau lymph nodes o ka ʻōnaehana pale o kou kino? Kōkua lākou i ke kaua ʻana i nā maʻi. No laila, ke loaʻa iā ʻoe kahi maʻi, hiki i kēia mau nodes ke pehu, ʻeha, a i kekahi manawa hiki ke hana ʻia ka pus.
ʻAʻole kēia he ʻeha puʻu wale nō, he maʻi koʻikoʻi ia e pono ai ke kōkua koke ʻia e ke kauka . ʻOiai he mea maʻamau ia i nā keiki ʻōpio, hiki iā ia ke hoʻopilikia i kekahi o nā makahiki āpau.
ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana? ʻO nā kamaliʻi liʻiliʻi?
ʻAe, ʻike pinepine ʻia kēia ʻano i kapa ʻia ʻo 'retropharyngeal abscess' i nā keiki liʻiliʻi ma waena o 2 a me 4 mau makahiki. ʻO ke kumu o kēia, i kēia makahiki, ʻoi aku ka nui o nā lymph nodes i loko o ka puʻu o nā keiki. No laila, ʻoi aku ka maʻalahi o lākou i nā maʻi. I ko kākou ulu ʻana, emi mālie kēia mau lymph nodes. A laila emi ka pilikia o ka loaʻa ʻana o ia mau abscesses.
ʻO kekahi mea, ua ʻōlelo ʻia he ʻoi aku ka maʻamau o kēia maʻi i waena o nā keikikāne ma mua o nā kaikamahine.
Pehea ka maʻamau o ka 'retropharyngeal abscess'? No ke aha e hoʻonui nei?
ʻAʻole kēia he maʻi maʻamau loa. Eia nō naʻe, i nā makahiki he 20 i hala iho nei, ua piʻi iki ka nui o nā hihia i hōʻike ʻia i waena o nā keiki ʻōpio a me nā pākeke. Manaʻo kekahi mau noiʻi e pili ana paha kēia i ka piʻi ʻana o nā hihia o ka tonsillitis , kahi maʻi o nā tonsils ma ka puʻu. ʻO nā tonsils ʻelua mau ʻiʻo i loaʻa ma nā ʻaoʻao ʻelua o ka puʻu.
ʻO kekahi kumu i manaʻo ʻia ʻo ka piʻi ʻana o nā maʻi MRSA , kahi ʻano bacteria i kūʻē i kekahi mau antibiotics.
He aha nā hōʻailona o kēia? Pehea ʻoe e ʻike ai?
ʻO nā hōʻailona maʻamau o kēia ʻano, ʻo ia ka paʻakikī i ka ale ʻana i ka meaʻai a me ka mea inu a me ka ʻeha o ka puʻu . Eia kekahi, aia paha nā hōʻailona ʻē aʻe e like me:
- ʻEha nui ka ʻāʻī: E like me ka ʻāʻī ʻeha.
- Nā nipples pehu: Hiki i nā ʻaoʻao o ka ʻāʻī ke manaʻo e like me nā puʻupuʻu ke hoʻopā ʻia.
- Paʻakikī ka hanu ʻana:Hiki paha iā ʻoe ke hana i kahi walaʻau i ka wā e hanu ana, a hiki paha iā ʻoe ke manaʻo ua pio kou hanu.
- Paʻakikī i ka ʻōlelo ʻana: Hiki ke loli kou leo a hiki paha iā ʻoe ke paʻakikī i ka ʻōlelo ʻana.
- Ke hana nei i kahi walaʻau i ka wā e hanu ana: e like me ke kani ʻana o ka hānō.
- ʻEha poʻo nui.
- ʻĀʻī ʻoʻoleʻa, paʻakikī ke hoʻohuli i ka ʻāʻī.
- Kuke.
- Kuni.
Inā loaʻa i kahi keiki ʻōpio kēia ʻano maʻi, hiki iā lākou ke hoʻomaha loa a huhū . Hiki paha iā lākou ke kahe i ka wai no ka mea ʻaʻole hiki iā lākou ke ale i ka meaʻai. Inā paʻa ke keiki i ko lākou ʻāʻī i kahi kūlana ʻē (me he mea lā e maʻalahi ai ka hanu ʻana), ʻo ia hoʻi, ʻaʻole lākou e loaʻa ana ka ea lawa e hanu ai.
Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, pono ʻoe e ʻike koke i ke kauka . ʻAʻole kēia he kūlana maikaʻi e mālama ʻia ma ka home.
He aha nā pilikia e hiki mai ana inā ʻaʻole mālama ʻia? He mea weliweli anei kēia?
ʻAe, he maʻi koʻikoʻi ka abscess retropharyngeal. ʻO ke kumu nui o kēia, ʻo ia ka wahi o ka abscess. Inā ʻaʻole mālama pono ʻia, hiki i ka abscess ke ulu a ālai i kou ala ea , e paʻakikī loa ai ka hanu ʻana. Eia kekahi, hiki i ka maʻi ke laha i ke kahe koko a me nā ʻōpū kokoke ʻē aʻe, e hoʻoulu ai i nā pilikia e hoʻoweliweli ai i ke ola.
Hiki ke loaʻa nā pilikia e like me kēia:
- Ka ālai ʻana o ke ala ea.
- ʻO ka niumonia aspiration: ʻO ka niumonia i hoʻokumu ʻia e ka hanu ʻana i ka pus a i ʻole nā mea ʻē aʻe i loko o ke ala hanu .
- Ka pehu ʻana a me ka mumū o ka umauma.
- Nā ʻūpā koko i loko o nā aʻa koko nui o ka ʻāʻī (ʻoi aku hoʻi nā aʻa koko jugular).
- Ka laha ʻana o ka maʻi i nā ʻiʻo a me nā ʻōpū a puni, e like me nā māmā.
- ʻO ka Septic shock kahi maʻi i hoʻokumu ʻia e ka laha ʻana o ka maʻi i loko o ke koko.
ʻO ia ke kumu a mākou e ʻōlelo nei, mai lawe māmā i kēia a e ʻimi koke i ka lāʻau lapaʻau.
He aha nā kumu o ka 'retropharyngeal abscess'? He ʻokoʻa anei ia no nā keiki a me nā pākeke?
Hoʻokumu ʻia kēia ʻōpū ke komo kahi maʻi i loko o nā kelepa sebaceous i loko o ka puʻu. A laila, pehu kēlā mau kelepa, pohā mālie, a hōʻiliʻili ka pus, e hana ana i kēia 'ʻōpū'. Eia nō naʻe, ʻokoʻa iki nā kumu o kēia no nā keiki ʻōpio a me nā pākeke.
- Nā kamaliʻi ʻōpio: Hoʻomohala pinepine kēia ʻano i nā keiki ma hope o ka maʻi ʻōpū hanu luna. No ka laʻana, kahi maʻi sinus e ʻoi aku ka ʻino ma hope o ke anu a i ʻole ka maʻi pepeiao. Hoʻolaha kēia maʻi mua i nā tonsils ma ke kua o ka puʻu, e hana ana i kahi abscess.
- E noʻonoʻo ua loaʻa i kāu keiki liʻiliʻi ke anu a me ka ʻeha pepeiao no kekahi mau lā. Inā ʻaʻole mālama pono ʻia ka maʻi, hiki iā ia ke komo hohonu i loko o ka puʻu a hana i kahi mea e like me kēia. No laila he mea nui e mālama i nā keiki liʻiliʻi ʻoiai inā he anu ko lākou.
- Nā Pākeke: ʻO ke kumu nui o kēia i nā pākeke he ʻeha ma ke kua o ka puʻu. Hiki ke loaʻa kēia ʻeha ke paʻa kahi mea e like me ka iwi iʻa a i ʻole ka iwi moa i loko o ka puʻu i ka wā e ʻai ana. A i ʻole hiki ke loaʻa ma ke ʻano he hopena ʻaoʻao o nā mea e like me ka ʻeha ma ke kua o ka puʻu i ka wā o ka hana niho, ka unuhi ʻana i ka niho, ka endoscopy, a i ʻole ka intubation.
Ke kumu ʻia nei kēia e kahi huakino a bacteria paha?
ʻO ka maʻamau, hoʻokumu ʻia kēia maʻi e ka hui pū ʻana o nā bacteria, ʻaʻole hoʻokahi wale nō . ʻO kekahi o nā bacteria e hiki ai ke hana i kahi abscess retropharyngeal:
- ʻO ka Streptococcus pyogenes
- ʻO Staphylococcus aureus (ua komo pū kēia me ke ʻano kū'ē i nā lāʻau lapaʻau i kapa ʻia ʻo MRSA)
- ʻO nā Bacteroides
- ʻO ka Fusobacteria
- ʻO ka Peptostreptococcus
- ʻO Porphyromonas
- ʻO Prevotella
- ʻO Veillonella
- ʻO ka maʻi Haemophilus influenzae
He mea paʻakikī iki kēia, akā he mea nui i nā kauka ke koho i ka lāʻau kūpono.
Pehea e ʻike ai nā kauka i kēia?
Ke ʻike ʻoe i ke kauka, e hoʻolohe pono mua ʻo ia i kāu mau hōʻailona, a laila e hana i kahi hoʻokolokolo kino. E nānā ʻo ia i kou puʻu a me kou ʻāʻī.
Eia kekahi, hiki ke hana ʻia nā hoʻokolohua kiʻi e ʻike pono inā loaʻa kēia 'abscess' a pehea kona nui.
- Eia kekahi laʻana, hiki ke hana ʻia kahi X-ray a i ʻole CT scan . Hiki i kahi CT scan ke hōʻike maopopo loa i ka abscess.
Eia kekahi, hana ʻia nā hoʻāʻo koko .
- E hōʻike ana ka helu koko piha (CBC) i ka piʻi ʻana o ka helu o nā kele koko keʻokeʻo inā he maʻi i loko o ke kino.
- I kekahi manawa, hana ʻia kahi hoʻāʻo moʻomeheu bacteria me ka hoʻohana ʻana i kahi swab i lawe ʻia mai ka puʻu. Hiki i kēia ke kōkua i ka hoʻoholo pono ʻana i ke ʻano o ka bacteria e hoʻoulu ai i ka maʻi.
E kuhikuhi pinepine ʻia ʻoe i kahi loea pepeiao, ihu, a me ka ʻāʻī (loea ENT) no ka ʻike a me ka mālama ʻana.
He aha nā lāʻau lapaʻau no ka 'retropharyngeal abscess'? (Lāʻau lapaʻau)
No ka mea he maʻi koʻikoʻi kēia, mālama pinepine ʻia ia ma ka haukapila . ʻElua mau pahuhopu nui o ka lāʻau lapaʻau: ka kaohi ʻana i ka maʻi a, i kekahi mau hihia, ka hoʻokahe ʻana i ka abscess.
Eia nā lāʻau lapaʻau:
- Nā lāʻau antibiotic:No ke kaua ʻana i ka maʻi, hāʻawi ʻia nā antibiotic ikaika ma o ka intravenous. Hiki i kēia ke lilo i 'antibiotics broad-spectrum', ʻo ia hoʻi, hana lākou i nā ʻano bacteria like ʻole. Inā ʻike ʻia kahi ʻano bacteria kikoʻī i loko o kahi hoʻāʻo moʻomeheu bacteria, hiki ke hāʻawi ʻia kahi antibiotic kikoʻī e mālama ai.
- ʻOki: ʻAʻole pono nā kānaka a pau i ke ʻoki. Eia nō naʻe, inā nui ka ʻōpū a ke ālai nei i kou hanu ʻana, hiki i kāu kauka ke hoʻoholo e hana i ke ʻoki e wehe i ka ʻōpū. I loko o kēia ʻoki, hoʻokomo ʻia kahi ʻōmole hanu e kōkua iā ʻoe e hanu. A laila, ʻoki ʻia ka ʻōpū a hoʻokahe ʻia ka pus i loko.
Ma muli o ka nui o ka ʻūpā ʻana o ka abscess i kou ala ea, hiki ke hāʻawi ʻia iā ʻoe ka oxygen i kou wā e noho ai i ka haukapila. Inā pilikia ʻoe i ka moni ʻana, hiki ke hāʻawi ʻia iā ʻoe ka saline (nā wai IV) e pale aku i ka maloʻo ʻana.
ʻOiai ma hope o ka haʻalele ʻana i ka haukapila, pono ʻoe e hoʻomau i ka lawe ʻana i nā lāʻau antibiotic waha no kekahi mau lā e hōʻoia ai ua ho'ōla loa ʻia ka maʻi a ʻaʻole e hoʻi hou.
He aha nā antibiotics i kuhikuhi pinepine ʻia?
ʻO kekahi o nā antibiotic i hoʻohana ʻia e mālama ai i ka abscess retropharyngeal:
- ʻAmpicillin sulbactam
- ʻO Clindamycin
- ʻO Vancomycin (ʻoi aku hoʻi no nā maʻi e like me MRSA)
- ʻO Linezolid
- ʻAmoxicillin-clavulanate
ʻO kēia nā lāʻau lapaʻau i kuhikuhi ʻia e ke kauka.
He aha kā mākou e hana ai e pale aku iā mākou iho mai kēia kūlana? (Ka pale ʻana)
ʻOiai ʻaʻohe ala e pale loa ai iā ia, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i ka pilikia.
- Inā maʻi kāu keiki, ʻoiai inā loaʻa iā lākou kahi maʻi hanu o luna (e like me ke anu, ʻeha pepeiao, sinusitis), mai hoʻokaʻulua i ka ʻimi ʻana i ka lāʻau lapaʻau . E ʻimi koke i ke kōkua lapaʻau.
- I kou ʻike koke ʻana i nā hōʻailona o kahi abscess retropharyngeal (i loko ou a i ʻole kāu keiki) , e lawe koʻikoʻi iā lākou a e ʻike koke i ke kauka . Hiki i kēia ke kōkua i ka pale ʻana i nā pilikia.
He aha ka mea e hana ai inā loaʻa iā ʻoe kahi 'retropharyngeal abscess'? E ola anei ia?
Me ka mālama kūpono, kiʻekiʻe loa ka nui o ka ho'ōla ʻana. Hiki ke ho'ōla loa ʻia ka maʻi ma ka hāʻawi ʻana i nā lāʻau antibiotic a, inā pono, e hoʻokahe i ka pus.
Eia nō naʻe, he mea kākaʻikahi loa (i hōʻike ʻia ma 1% - 5% o nā hihia) hiki ke hoʻi hou mai kēia cyst. No laila, ma hope o ka ho'ōla ʻana, e makaʻala inā e hoʻi hou mai nā hōʻailona i ʻōlelo ʻia ma luna. Inā ʻike ʻoe i kekahi mea e like me kēia, e ʻike koke i ke kauka.
He mea hoʻoweliweli paha kēia i ke ola? He pilikia anei kēia?
ʻAe, hiki i kēia ke hoʻoweliweli i ke ola inā ʻaʻole mālama pono ʻia. ʻO ia ke kumu e ʻōlelo ai mākou e ʻimi i ka lāʻau lapaʻau i ka wā e hoʻomaka ai nā hōʻailona.
ʻOiaʻiʻo, he pilikia olakino ka 'retropharyngeal abscess'.No ka mea hiki i kēia ke ālai loa i kou puʻu a ʻoki i kāu lako oxygen. Mai kali a hiki i kēlā manawa, e ʻike koke i ke kauka.
Pehea e mālama ai iaʻu iho? (Mālama ponoʻī ma hope o ka lāʻau lapaʻau)
E lawe i nā lāʻau antibiotic a pau i kuhikuhi ʻia e kāu kauka, e like me ke kuhikuhi ʻana, no ka papa holoʻokoʻa . ʻOiai inā ʻoe e manaʻo nei ua ʻoi aku ka maikaʻi, e lawe i ka papa holoʻokoʻa o ka lāʻau. Hiki ke hoʻi hou mai nā abscesses retropharyngeal, no laila ʻo ka lawe pololei ʻana i kāu lāʻau lapaʻau hiki ke hōʻemi i ka pilikia.
He aha ka ʻokoʻa ma waena o kahi 'retropharyngeal abscess' a me kahi 'peritonsillar abscess'?
He mau ʻōpū kēia mau mea ʻelua i hana ʻia i loko o ka puʻu, akā he ʻokoʻa iki nō.
- ʻO ka ʻōpū retropharyngeal: Hoʻomaka kēia ma kahi hohonu kokoke i ka paia hope o ka puʻu.
- ʻO ka ʻōpū Peritonsillar: Hoʻomaka kēia ma kahi kokoke i nā tonsils.
Hoʻokumu ʻia nā mea ʻelua e nā maʻi, a ua like like nā ʻano lapaʻau - ʻo ia hoʻi, ka hāʻawi ʻana i nā antibiotics a, inā pono, ka hoʻokahe ʻana i ka pehu.
ʻO ka mea hope loa, ʻo ka mea nui e hoʻomanaʻo (Leka Lawe-Home)
ʻO ka 'retropharyngeal abscess' he hōʻiliʻili ʻana o ka pus i loko o ka puʻu. ʻAʻole kēia he maʻi maʻamau e hiki ke mālama ʻia ma ka home . Ua manaʻo ʻia he pilikia olakino no ka mea hiki ke ālai i ke ala ea a hoʻolaha i ka maʻi i nā ʻōpū ʻē aʻe.
No laila, inā loaʻa iā ʻoe a i ʻole kāu keiki kēia mau hōʻailona, mai hoʻokaʻulua i ka ʻimi ʻana i ka lāʻau lapaʻau . E ʻimi koke i ke aʻo lapaʻau. ʻO ka wikiwiki o kou hoʻomaka ʻana i nā antibiotics, ʻoi aku ka maikaʻi o kou manawa e hoʻopau ai i ka abscess, e pale ai i nā pilikia koʻikoʻi, a e hoʻōla koke.
ʻO ka ʻōpū Retropharyngeal, ʻO ka ʻōpū Retropharyngeal, ʻōpū puʻu, maʻi puʻu, nā maʻi pediatric, nā pilikia hanu, nā pilikia ale
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