He poto hoki tō manawa? He maremare tonu tōu? Tērā pea he Tracheobronchomalacia (TBM) tēnei?

He uaua ki a koe te manawa i ētahi wā ina piki koe i te arawhata, ina tere ake rānei te hikoi? Kei te whakaaro rānei koe kei te raru te manawa o tāu tamaiti ina whāngai ū koe? Kei te āwangawanga anō hoki koe mō ngā mea pēnei i te maremare tonu, te tangi rerekē rānei e puta mai ana i roto i tō uma? Ahakoa he maha ngā take mō ēnei mea, pēnei i te mate huango, i tēnei rā ka kōrero tātou mō tētahi āhuatanga kāore anō kia rongohia e tātou, engari he mea tino nui. Ko te Tracheobronchomalacia, ko te TBM rānei te whakarapopototanga.

He aha te Tracheobronchomalacia (TBM)?

Ahakoa te āhua roa, te āhua rerekē hoki o tēnei kupu, he tino māmā noa iho tōna tikanga. Ko te Tracheobronchomalacia (TBM) he mate e ngoikore ai ngā pakitara o te trachea me te bronchi, arā, ngā wāhanga matua e rua o tō tātou pūnaha manawa, ka whakawhāiti, ka kati hoki ēnei ngongo ina manawa tātou, inā koa ina manawa tātou, ina maremare rānei.

Whakaarohia ko tō tātou pūwero hau he rite ki te pūwero kirihou e kawe ana i te wai. Mēnā he pakari ngā pakitara o tēnei pūwero, kāore he raruraru ina rere te wai. Engari ki te mea he tino angiangi, he ngoikore hoki ngā pakitara o te pūwero, ka taea te mau te wai ki roto i te pūwero ina tere te rere, tika? Koinei te mea ka tupu i roto i te TBM. Ina ngoikore ngā wāhanga kaha e kiia nei ko te kiriuhi i roto i ngā pakitara o te pūwero hau me te trachea, ka mau, ka āraia ēnei ngongo ina tere te neke haere o te hau ki mua, ki muri. Koinā te wā ka uaua te manawa, ka puta te maremare, ā, ka puta he haruru mai i te uma.

Ka taea tēnei āhuatanga te whānau mai (Congenital TBM) , arā, ka whānau mai he pēpi me tēnei ngoikore. Mō ētahi atu, ka taea te whiwhi (Acquired TBM), arā, ka taea te whanake i te wā e ora ana nā ētahi atu mate, maimoatanga, ētahi atu take o waho rānei.

He aha ngā tohu o te TBM?

Tērā pea ka rerekē ngā tohu nei i runga i te mea kei te whānau mai te mate, kei te whanake rānei i muri mai. Me titiro tātou ki ngā tohu o ngā mea e rua.

He aha i puta ai tēnei āhuatanga TBM?

E ai ki tā tātou i kōrero ai i mua ake nei, ka taea te wehewehe i ngā take mō tēnei mea kia rua ngā wāhanga.

1. Te Mate Pukupuku Tuatahi/Whānau

He maha ngā take ka whānau mai ai tētahi pēpi me tēnei mate:

• TBM Idiopathic: Tērā pea ka whānau mai ētahi pēpi me te ngoikore o te kiriuhi i roto i te trachea, kāore he take e kitea ana.
• Ngā Mowhiti Toto: Ka puta tēnei ina he te hanganga o te oko toto matua o te pēpi (aorta) mai i te ngākau, ā, ka takai ki te trachea i a ia e tipu ana i roto i te kōpū. Ka pēhia te trachea e tēnei oko toto, ka ngoikore ai.
• Ētahi mate ira: Ka taea e ngā āhuatanga onge, tuku iho pērā i te mate Hunter, te mate Hurler, me te mate Ehlers-Danlos te whakaiti i te kiriuhi o te tinana. Ka pā hoki tēnei ki ngā ara manawa.
• Whānautanga wawe: Ko ngā pēpi i whānau i mua i te 37 wiki te pakeke, ka nui ake te mōrearea o te mate pēpi mate huka (TBM) nā te mea kāore anō kia tino whanakehia ō rātou ara manawa.

2. Te mate pāwera e puta ana i te wā e ora ana (Te mate pāwera tuarua/te mate pāwera i whiwhi)

He maha ngā take ka puta ai tēnei āhuatanga i roto i te pakeke.

Me pēhea te tautuhi tika a te tākuta i tēnei mate?

Mena kei a koe, kei tāu tamaiti rānei ēnei tohu, ko te mea pai ko te toro atu ki te tākuta. Ka tirotirohia koe e te tākuta, ka pātai atu ki a koe me tāu tamaiti mō ō tohu. He maha ngā pātai ka pātaihia e rātou ki a koe, pērā i te mea he maha ōu mate makariri, me te mea he mate manawa anō ōu.

I muri i tēnā, he maha ngā whakamātautau ka taea te whakahaere hei whakaū i tēnei mate.

• Ngā Whakamātautau Mahi a ngā Pūkahukahu: Ka whakamātautau tēnei i te pai o te mimiti me te tango a ō pūkahukahu i te hau.
• Pūnaha tirotiro manawa: Koinei te whakamātautau tino nui, tino tika hoki hei whakaū i te TBM. I roto i tēnei, ka whakauruhia he ngongo angiangi, he kāmera kei roto i te waha, i te ihu rānei, hei tirotiro i te roto o te pūhā me ngā pūhā. Ka taea e te tākuta te kite i te nui o te aukati o te pūhā mā te tono atu kia manawa koe ki roto, kia maremare hoki.
• Matawai CT (Matawai Tomography Rorohiko): Ka taea e tēnei te tango pikitia taipitopito o te uma. Ka taea e tēnei te āwhina ki te whakatau mēnā he take kē atu te TBM, mēnā rānei he huringa kei te āhua o te ara manawa.

He aha ngā maimoatanga mō tēnei?

He rerekē ngā kōwhiringa maimoatanga i runga i te nui o te pānga o te TBM ki a koe, ki tāu tamaiti rānei. Ehara i te mea me pokanga te katoa.

1. Ngā rongoā me ngā taputapu tautoko

• Te rongoā mō ngā mate pāwera: Mena he maha ngā mate manawa o tō pēpi, ka hoatu pea he rongoā ki a koe pēnei i ngā paturopi .
• Ngā tikanga whāngai ū: Mena kei te uaua te manawa o tō pēpi i a ia e whāngai ū ana, ma tō tākuta, ma tō nēhi rānei koe e ako ki te whakarerekē i ngā tūranga kia māmā ake ai te manawa.
• Te Whakaora i ngā Pūkahukahu: Kei roto i tēnei ko te whakaako i ngā mahi manawa hei whakahaere i ngā tohumate.
• Ngā mīhini CPAP, BiPAP® rānei: Ka whakamahia hoki ēnei mō te hunga e pāngia ana e te mate moe pōrearea. Ka tukuna e rātou te hau i tētahi pēhanga mā roto i tētahi kopare e uru ana ki runga i te mata, hei āwhina i te pupuri i te ara manawa kia tuwhera, kia kore ai e āraia.
• Ngā Wāhi Patu o Waho: He uaua pea te maremare i te hūpē ina pāngia koe e te TBM. He taputapu tēnei ka mau koe pērā i te kākahu. Ina honoa ki te mīhini, ka tere te wiri, ka wetekina te hūpē i roto i tō uma, ka māmā ake te maremare.
• Nebulizer: He taputapu e huri ai i te rongoā wai hei kohu angiangi ka taea te manawa mā te kopare. Ka taea e tēnei te tuku tika i te rongoā ki ngā pukahukahu.

2. Pokanga

I ētahi wā tino kino, me mahi pokanga pea.

• Te tāurunga o te pūkahukahu me te stent: Ka taea hoki te whakamahi i te tāurunga o te pūkahukahu tātaritanga hei maimoatanga. I roto i tēnei tikanga, ka whakauruhia he ngongo kirihou, he ngongo whakarewa rānei (stent) ki roto i te ara manawa hei pupuri i te aukati kia tuwhera tonu. He wā poto noa iho ēnei.
• Te Tracheobronchoplasty:I roto i tēnei tikanga, ka pokangahia he hanganga rite ki te mata whatu ki waho o te trachea, ā, ka tuia ki tōna wāhi tika. Ka whakarato tēnei mata whatu i te kaha ake ki te trachea, ka whakaiti i tōna tūponotanga ki te hinga.
• Tracheopexy: Ko tēnei pokanga he tuitui i te pakitara ngoikore o muri o te puku manawa ki ngā hononga kaha o te tuaiwi. Mā tēnei ka ārai i te hinganga o te rohe ki roto ina manawa koe.

Nā te mea he pokanga nui ēnei, kei reira ngā mōrearea pērā i te toto nui rawa, te toto totoka, me te mate pāwera o te patunga . Mena ka tūtohutia kia pokanga, ka whakamāramahia e tō tākuta ēnei mea katoa ki a koe.

Me pēhea te noho tahi me te mate TBM?

Mena he TBM tō te tamaiti:

I te pakeketanga o te tamaiti, ka kaha ake te kiriuhi i roto i ngā ara manawa. Nō reira, ka memeha haere pea ngā tohu. Heoi, i te nuinga o te wā, me tirotirohia te tamaiti e te rata me ētahi maimoatanga puta noa i te tamarikitanga. He mea tino nui te tiaki i te tamaiti mai i ngā mate manawa maha.

Mena he mate pukupuku tō te pakeke:

Ko te mate pukupuku roro (TBM) i roto i ngā pakeke he mate mau tonu, ka kino haere i roto i te wā . Ka taea te whakahaere i ngā tohu mā te whakaiti i te taumaha me ētahi atu mate hauora. Ka whai hua pea te pokanga. Heoi, he maha ngā tāngata whai mate pukupuku roro (TBM) he mate kē atu anō hoki ō rātou, pērā i te mate huango me te COPD, nō reira me aroturukihia rātou e te tohunga manawa mō te toenga o ō rātou oranga.

Ka taea te ārai i tēnei āhuatanga?

Kāore he huarahi hei ārai i te mate pēpi whānau. Heoi anō, tera ētahi mea ka taea e koe te mahi hei whakaiti i te mōrearea o te mate pēpi i roto i ngā pakeke.

• Kaua e momi hikareti, kaua hoki e noho tahi me te hunga momi hikareti.
• Mena kei a koe ngā mate pēnei i te huango, te COPD, te GERD rānei, me tango te maimoatanga tika mō aua mate, kia pai ai te whakahaere i te mate.
• Kia mau tonu te taumaha hauora.
• Mena kei te pāngia koe e ngā hau paitini, me whai i ngā tikanga haumaru e tika ana.

Ki te mea he maremare tonu tōu, he uaua rānei ki te manawa, kaua e whakaaro noa he makariri, engari me toro atu ki te tākuta kia tirohia koe. Ko te tere o te tautuhi i te mate, ko te nui ake o ngā tūponotanga ka puta he hua pai mai i te maimoatanga.