He pōkole kou hanu? He ʻū mau kou? He Tracheobronchomalacia paha kēia (TBM)

Ke paʻakikī nei ʻoe i kekahi manawa ke hanu i kou piʻi ʻana i luna o nā alapiʻi a i ʻole e hele wikiwiki iki? A i ʻole ke manaʻo nei ʻoe e pilikia iki ana kāu keiki liʻiliʻi i ka hanu ʻana i kou wā e hānai waiū ai? Ke hopohopo nei hoʻi ʻoe no nā mea e like me ka ʻū mau a i ʻole kahi leo ʻē e puka mai ana mai loko mai o kou umauma? ʻOiai he nui nā kumu no kēia mau mea, e like me ka hānō, i kēia lā e kamaʻilio mākou e pili ana i kahi kūlana i lohe ʻole ʻia e kekahi o mākou, akā hiki ke lilo i mea nui loa. ʻO ia ʻo Tracheobronchomalacia, a i ʻole TBM no ka pōkole.

I ka ʻōlelo maʻalahi, he aha ka Tracheobronchomalacia (TBM)?

ʻOiai paha he huaʻōlelo lōʻihi a ʻano ʻē kēia, he maʻalahi loa kona manaʻo. ʻO Tracheobronchomalacia (TBM) kahi kūlana kahi e nāwaliwali ai nā paia o ka trachea a me ka bronchi, ʻelua mau ʻāpana nui o kā mākou ʻōnaehana hanu, e hoʻoulu ai i kēia mau ʻōmole e ʻūlū a pani i ka wā e hanu ai mākou, ʻoiai ke hanu mākou i waho a i ʻole ke kuʻi ʻana.

E noʻonoʻo i ko kākou ʻōpū hanu e like me ka paipu plastik e lawe ana i ka wai. Inā ikaika nā paia o kēia paipu, ʻaʻohe pilikia ke kahe ka wai. Akā inā lahilahi loa nā paia o ka paipu a nāwaliwali, hiki i ka wai ke paʻa i loko o ka paipu ke kahe wikiwiki, ʻeā? ʻO ia ka mea e hana ʻia ma TBM. Ke nāwaliwali nā ʻāpana ikaika i kapa ʻia he cartilage i loko o nā paia o ka ʻōpū hanu a me ka trachea, paʻa a ālai ʻia kēia mau paipu ke neʻe wikiwiki ka ea i mua a i hope. ʻO ia ka manawa e paʻakikī ai ka hanu ʻana, kū ka ʻū, a puka mai kahi leo mai ka umauma.

Hiki i kēia kūlana ke hānau ʻia (Congenital TBM) , ʻo ia hoʻi, ua hānau ʻia kahi pēpē me kēia nāwaliwali. No kekahi poʻe, hiki ke loaʻa (Acquired TBM), ʻo ia hoʻi, hiki ke ulu i ka wā o ke ola ma muli o nā maʻi ʻē aʻe, nā lāʻau lapaʻau, a i ʻole nā ​​​​kumu o waho ʻē aʻe.

ʻAʻole kēia he maʻi maʻamau e like me ka hānō. ʻO ia ke kumu i kekahi manawa hiki ke hoʻopoina ʻia ka TBM i ka wā e mālama ai i nā mea e like me ke kuni mau a me ka wheezing. Akā inā pololei ka hōʻailona, ​​​​aia nā lāʻau lapaʻau e hiki ke hana.

He aha nā hōʻailona o ka TBM?

Hiki ke ʻokoʻa iki kēia mau hōʻailona ma muli o ke ʻano hānau ʻia a i loaʻa paha. E nānā kākou i nā hōʻailona o nā mea ʻelua ma ke kaʻawale.

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No ke aha lā e kū mai ai kēia kūlana TBM?

E like me kā mākou i ʻōlelo ai ma mua, hiki ke hoʻokaʻawale ʻia nā kumu o kēia ʻano i ʻelua mau ʻāpana.

1. TBM mua/hānau mua

Aia kekahi mau kumu e hiki ai ke hānau ʻia kahi pēpē me kēia maʻi:

• ʻO Idiopathic TBM: Hiki ke hānau ʻia kekahi mau pēpē me ka nāwaliwali o ke cartilage i loko o ka trachea me ke kumu ʻole.
• Nā Apo o ke Alaula: Hana ʻia kēia ke hana hewa ʻia ke aʻa koko nui o ka pēpē (aorta) mai ka puʻuwai a puni ka trachea. Kaomi kēia aʻa koko i ka trachea, e hoʻonāwaliwali ai.
• ʻO kekahi mau maʻi hoʻoilina: ʻO nā kūlana laha ʻole e like me ka Hunter syndrome, Hurler syndrome, a me Ehlers-Danlos syndrome hiki ke hoʻonāwaliwali i ke cartilage o ke kino. Hiki i kēia ke hoʻopilikia i nā alaloa hanu.
• Ka hānau mua ʻana: ʻO nā pēpē i hānau ʻia ma mua o 37 mau pule e ʻoi aku ka nui o ka pilikia o ka TBM no ka mea ʻaʻole i hoʻomohala piha ʻia ko lākou mau ala ea.

2. TBM e kū mai ana i ka wā o ke ola (Secondary/Acquired TBM)

Nui nā kumu e hiki ai ke loaʻa kēia ʻano maʻi i kahi pākeke.

Pehea e ʻike pono ai ke kauka i kēia maʻi?

Inā loaʻa iā ʻoe a i ʻole kāu keiki kēia mau hōʻailona, ​​ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke ʻike i ke kauka. E nānā pono ke kauka iā ʻoe a nīnau iā ʻoe a me kāu keiki e pili ana i kāu mau hōʻailona. E nīnau lākou iā ʻoe i nā nīnau he nui, e like me ke anu pinepine ʻana a inā he mau maʻi hanu ʻē aʻe kāu.

Ma hope o kēlā, hiki ke hana ʻia kekahi mau hoʻokolohua e hōʻoia i kēia maʻi.

• Nā Hoʻāʻo Hana Pulmonary: Hoʻāʻo kēia i ka maikaʻi o ka hiki i kou mau māmā ke lawe i ka ea i loko a i waho.
• Bronchoscopy: ʻO kēia ka hoʻāʻo koʻikoʻi a pololei hoʻi e hōʻoia i ka TBM. Ma kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi i lako me ke kāmela ma o ka waha a i ʻole ka ihu e nānā i loko o ka ʻōpū hanu a me ka bronchi. Hiki i ke kauka ke ʻike i ka nui o ka ālai ʻia o ka ʻōpū hanu ma ke noi ʻana iā ʻoe e hanu i loko a me ka ʻū.
• ʻO ke scan CT (Computed Tomography Scan): Hiki i kēia ke kiʻi i nā kiʻi kikoʻī o ka umauma. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā ua hana ʻia ka TBM e kekahi mea ʻē aʻe a i ʻole he loli i ke ʻano o ke alaea.

He aha nā lāʻau lapaʻau no kēia?

ʻOkoʻa nā koho lapaʻau ma muli o ka nui o ka hopena o ka TBM iā ʻoe a i ʻole kāu keiki. ʻAʻole pono nā kānaka a pau i ke ʻoki ʻana.

1. Nā lāʻau lapaʻau a me nā lako kākoʻo

• Lapaʻau no nā maʻi: Inā loaʻa pinepine i kāu pēpē nā maʻi hanu, hiki ke hāʻawi ʻia iā ʻoe nā lāʻau lapaʻau e like me nā antibiotics .
• Nā ʻano hana hānai waiū: Inā pilikia kāu pēpē i ka hanu ʻana i ka wā e hānai waiū ana, e aʻo aku kāu kauka a kahu maʻi paha iā ʻoe pehea e hoʻololi ai i nā kūlana e maʻalahi ai ka hanu ʻana.
• Hoʻoponopono Hou ʻana i ka Pulmonary: Pili kēia i ke aʻo ʻana i nā hoʻomaʻamaʻa hanu e hoʻokele i nā hōʻailona.
• Nā mīkini CPAP a i ʻole BiPAP®: Hoʻohana ʻia kēia mau mea no ka poʻe i loaʻa i ka apnea hiamoe. Hāʻawi lākou i ka ea ma kahi kaomi ma o kahi pale maka e kūpono ana ma luna o ka maka, e kōkua ana i ka mālama ʻana i ke ala ea e wehe a ʻaʻole e ālai ʻia.
• Nā ʻAʻahu Paʻi Waho: Hiki ke paʻakikī ke kuʻi i ka mucus ke loaʻa iā ʻoe ka TBM. He mea hana kēia āu e ʻaʻahu ai e like me ke kapa. Ke hoʻopili ʻia i kahi mīkini, haʻalulu koke ia, e hoʻokuʻu ana i ka mucus i loko o kou umauma, e maʻalahi ai ke kuʻi.
• Nebulizer: He mea hana e hoʻololi i ka lāʻau lapaʻau wai i loko o ka noe liʻiliʻi e hiki ke hanu ʻia ma o kahi pale maka. Hiki i kēia ke hāʻawi pololei i ka lāʻau lapaʻau i nā māmā.

2. ʻOki kino

I kekahi mau hihia koʻikoʻi, pono paha ke ʻoki kino.

• ʻO ka Bronchoscopy a me ke kau ʻana o ka stent: Hiki ke hoʻohana ʻia kahi bronchoscopy diagnostic ma ke ʻano he lāʻau lapaʻau. Ma kēia kaʻina hana, hoʻokomo ʻia kahi paipu plastik a me ka metala liʻiliʻi (stent) i loko o ke ala ea e mālama i ka wehe ʻana o ka mea i paʻa. He manawa pōkole kēia mau mea.
• ʻO ke kaʻina hana tracheobronchoplasty:Ma kēia kaʻina hana, ua kau ʻia kahi ʻano mesh ma ke ʻoki ʻana ma waho o ka trachea a humuhumu ʻia i kona wahi. Hāʻawi kēia mesh i ka ikaika hou aku i ka trachea, e hōʻemi ana i kona pilikia o ka hiolo ʻana.
• Tracheopexy: ʻO kēia ʻoki kino e pili ana i ka humuhumu ʻana i ka paia hope nāwaliwali o ka ʻōpū makani i nā ligaments ikaika ma ka iwi kuamoʻo. Pale kēia i ka ʻāpana mai ka hiolo ʻana i loko ke hanu ʻoe.

Ma muli o kēia mau ʻoki kino nui, aia nā pilikia e like me ke kahe koko nui ʻana, nā ʻūpā koko, a me ka maʻi ʻeha . Inā ʻōlelo ʻia ke ʻoki kino, e wehewehe pono kāu kauka i kēia mau mea āpau iā ʻoe.

Pehea e ola ai me ka maʻi TBM?

Inā loaʻa i ke keiki ka TBM:

I ka ulu ʻana o ke keiki, e ikaika ana ke cartilage i loko o nā alaloa hanu. No laila, hiki ke emi mālie nā hōʻailona. Eia nō naʻe, i ka hapanui o nā hihia, pono ka nānā ʻana o ke kauka a me kekahi mau lāʻau lapaʻau i ka wā kamaliʻi. He mea nui loa ia e pale i ke keiki mai nā maʻi hanu pinepine.

Inā loaʻa i kahi pākeke ka TBM:

ʻO ka TBM i nā pākeke he maʻi maʻi mau loa ia e hiki ke ʻoi aku ka ʻino i ka hala ʻana o ka manawa . Hiki ke mālama ʻia nā hōʻailona e ka pohō kaumaha a me nā kūlana olakino ʻē aʻe. Hiki ke kūleʻa ke ʻoki kino. Eia nō naʻe, he nui ka poʻe me TBM i loaʻa nā kūlana ʻē aʻe, e like me ka hānō a me ka COPD, no laila pono lākou e nānā ʻia e kahi loea hanu no ke koena o ko lākou ola.

Hiki i ka TBM ke loaʻa ka hopena hoʻoweliweli i ke ola o nā pākeke. ʻO kēia no ka mea ua pili ka TBM ponoʻī me nā maʻi koʻikoʻi ʻē aʻe. E kūkākūkā i nā nīnau a hopohopo paha āu e loaʻa ai me kāu kauka.

Hiki ke pale ʻia kēia kūlana?

ʻAʻohe ala e pale aku ai i ka TBM hānau. Eia nō naʻe, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i ka pilikia o ka TBM i nā pākeke.

• E pale i ka puhipaka a me ka noho ʻana a puni ka poʻe puhipaka.
• Inā loaʻa iā ʻoe nā maʻi e like me ka hānō, COPD, a i ʻole GERD, e lawe i ka lāʻau kūpono no lākou a kaohi maikaʻi i ka maʻi.
• E mālama i ke kaumaha olakino.
• Inā pili kāu hana i ka ʻike ʻana i nā kinoea ʻawahia, e hahai i nā kaʻina hana palekana kūpono.

Inā loaʻa iā ʻoe ka ʻū mau a i ʻole ka paʻakikī o ka hanu ʻana, mai manaʻo wale he anu ia, akā e ʻike pono i ke kauka a e nānā. ʻO ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi, ʻoi aku ka maikaʻi o ka loaʻa ʻana o nā hopena maikaʻi mai ka lāʻau lapaʻau.