Ngaba umntwana wakho wenza isandi esingaqhelekanga xa ephefumla? Masifunde ngeLaryngomalacia!

Ngaba ngamanye amaxesha ukhe uve isandi esiphantsi okanye isandi esiphantsi sokubhomboloza xa umntwana wakho ephefumla? Kuqhelekile ukuba abazali bakhathazeke kancinci xa bebona oku kwiintsana ezisandul’ ukuzalwa. Kodwa uninzi lwexesha, akukho nto imbi kangako . Namhlanje, siza kuthetha ngemeko ebizwa ngokuba yiLaryngomalacia, enokubangela oku, kwaye ixhaphakile phakathi kweentsana.

Yintoni iLaryngomalacia?

Ngamafutshane, iLaryngomalacia bubuthathaka obuncinci kwingxolo yebhokisi yelizwi yomntwana wethu . Oku kwenzeka kuba izicubu ezithambileyo ezingaphezulu kwebhokisi yelizwi zibuthathaka kancinci, kwaye xa umntwana ephefumla, loo zicubu zitsala okwethutyana ziye kwi-windpipe. Cinga ngayo njengebhaluni enomlomo ovulekileyo kancinci, isenza ingxolo njengoko umoya uphuma. Esi sesona sizathu siphambili sokuba iintsana ezisandul’ ukuzalwa zenze ingxolo xa ziphefumla.

Esi sandi sisibiza ngokuba sisandi somlozi ophakamileyo (stridor) . Esi sandi sivakala rhoqo xa umntwana ephefumla. Uninzi lwexesha, esi asiyongxaki. Nangona kunjalo, kwezinye iimeko ezingaqhelekanga nezinzima , sinokubangela ukuba umntwana abe nobunzima bokuphefumla okanye abe neengxaki zokutya.

Ingaba oku kuqhelekile?

Ewe, le meko ibizwa ngokuba yiLaryngomalacia ixhaphake kakhulu kwiintsana ezisandul’ ukuzalwa. Le meko yokuzalwa (Congenital Laryngomalacia) inokubonwa kwiintsana ezingaphezulu kwesiqingatha kwiveki yokuqala yobomi bazo. Kwabanye abantwana, inokuvela phakathi kweeveki ezimbini ukuya kwezine ubudala.

Abantu abadala nabo banokuba ne-laryngomalacia, kodwa ayiqhelekanga. Oogqirha bayibiza ngokuba yi-"acquired laryngomalacia".

Zithini iimpawu?

Iimpawu zeLaryngomalacia zinokuqala kwezincinci ukuya kwezinzima . Uphawu oluphambili sisandi esikhulu, esikhalayo, okanye esikhalayo esenzeka xa umntwana ephefumla. Esi sandi sidla ngokuba sibi kakhulu kwiinyanga zokuqala zobomi kwaye sidla ngokunyamalala ngokupheleleyo xa eneminyaka enye okanye emibini ubudala.

Uninzi lweentsana luyasiva esi sandi sokuphefumla, kodwa asiyongxaki yokuphefumla okanye yokuncancisa . Nangona kunjalo, esi sandi sinokubonakala ngakumbi xa umntwana elele phantsi, elele, ekhala, okanye emva kokuncancisa.

Nangona kunjalo, iintsana ezine-laryngomalacia enzima zinokubonisa iimpawu ezifana nezi:

• I-Apnea (ukuyeka ukuphefumla ixesha elide)
• Ukufuthwa kokutya okanye ulwelo emiphungeni
• Ulusu oluluhlaza okwesibhakabhaka (iCyanosis) (ingakumbi ejikeleze imilebe)
• Ubunzima bokuginya (i-Dysphagia)
• Ubunzima bokutyeba (ukungatyebi nasemva kokusela ubisi)
• Uvakalelwa ngathi intamo okanye isifuba sakho siyatsala xa uphefumla("ukutsala" okanye "ukutsala ngaphakathi")

Ukuba umntwana wakho ubonakalisa naziphi na iimpawu ezinzima ezikhankanywe apha ngasentla, bonana nogqirha wabantwana ngokukhawuleza.

Kutheni oku kusenzeka? Zithini izizathu zeLaryngomalacia?

Iingcali azikayazi ukuba kutheni ezinye iintsana zine-laryngomalacia kanti ezinye azinayo. Kodwa kukho izinto ezimbalwa ezicinga ukuba zinokuba negalelo koku:

• Ukuphazamiseka kwesakhiwo: Ngelixa umntwana ekhula esibelekweni, i-cartilage okanye izihlunu ezijikeleze ibhokisi yelizwi zikhula ngendlela eyahlukileyo okanye kakubi.
• Iingxaki ze-neuromuscular: Le meko inokubangelwa ziingxaki ezithile ezichaphazela imithambo-luvo kunye nemisipha yebhokisi yelizwi.
• Isifo se-Gastroesophageal Reflux Disease (GERD): Ngamafutshane, sisiphumo se-asidi yesisu enyuka iye emqaleni. Ukuba le asidi ifikelela kwibhokisi yelizwi, inokubangela ukudumba kuloo ndawo. Oku kunokwenza ubuthathaka besakhiwo bube mandundu obubangela i-laryngomalacia.

Ngaba kukho iintlobo zeLaryngomalacia?

Oogqirha bahlula i-laryngomalacia kwiintlobo ezintathu eziphambili ngokusekwe kwisizathu sale meko:

• Uhlobo 1: Ukuxinana okanye ukufinyezwa kweenwebu ze-mucous zebhokisi yelizwi.
• Uhlobo 2: Izicubu ezithambileyo kakhulu kwinxalenye ephezulu yebhokisi yelizwi.
• Uhlobo 3: I-Laryngomalacia yenzeka ngenxa yesinye isifo esingaphantsi (umz., i-GERD okanye isifo se-neuromuscular).

Uyibona njani le nto kanye kanye?

Uvavanyo oluphambili olusetyenziselwa ukuxilonga i-laryngomalacia yi -nasopharyngolaryngoscopy (NPL) . Kolu vavanyo, ingcali yendlebe, impumlo, kunye nomqala (ENT specialist) ifaka ityhubhu encinci efakwe ikhamera (endoscope) ngempumlo yomntwana ize iye ezantsi emqaleni ukuze ihlole ibhokisi yelizwi. Olu vavanyo ludla ngokuthatha malunga nemizuzu emibini ukuya kwemihlanu. Ayibuhlungu kakhulu kumntwana.

Yintoni enye oyivavanyayo?

Ukuba umntwana wakho uqinisekisiwe ukuba une-laryngomalacia, ugqirha wakho unokufuna ukwenza olunye uvavanyo ukuze afumanise ukuba ungakanani umonakalo owenziweyo. Olu vavanyo luquka:

• I-Airway fluoroscopy: Oku kusebenzisa i-X-ray kunye nolwelo olukhethekileyo (i-contrast agent) ukuze kubonakale ngokucacileyo iindawo ezichaphazelekayo zomzimba womntwana. Ingasetyenziselwa nokujonga inkqubo yokuginya ('uphando lokuginya').
• Uvavanyo lwe-Impedance:Kufakwa ityhubhu encinci ngempumlo yomntwana ize ingene kwi-esophagus ukuze kulinganiswe ukuba ingakanani na i-asidi yesisu ephumayo kwibhokisi yelizwi. Iintsana ezinesi sivivinyo zihlala zisesibhedlele ubuncinane ubusuku obunye.
• I-Microlaryngoscopy kunye ne-bronchoscopy (ML&B): Oku kusebenzisa ityhubhu ekhanyisiweyo ukuhlola i-trachea/windpipe yomntwana kunye nebhokisi yelizwi ukuze kuchongwe unobangela wesandi sokuphefumla. Oku kwenziwa phantsi kwe-anesthesia eqhelekileyo.
• Ii-X-reyi zentamo okanye zesifuba: Le mifanekiso inokunceda ugqirha abone ukuba kukho naziphi na ezinye iziphene ezakhiweyo ezinokubangela isandi sokuphefumla komntwana.

Iphathwa njani?

Into ebalulekileyo kukuba uninzi lwexesha, iLaryngomalacia iyaphela yodwa kungekapheli unyaka okanye emibini . Ingxolo yokuphefumla iya kuncipha kancinci kancinci. Kwiimeko ezincinci nezincinci, ungazilawula iimpawu ekhaya. Nangona kunjalo, ukuba umntwana wakho uneLaryngomalacia enzima, unokufuna amayeza okanye utyando.

Indlela yokuphatha ekhaya?

Ukuba umntwana wakho uneempawu eziqhelekileyo, ungazijonga ezi zinto ekhaya. Indlela yokulawula i-laryngomalacia inokwahluka kumntwana ngamnye:

• Ukuba umntwana wakho unengxaki yokuginya: Kusenokufuneka utye rhoqo ukuze ubuyisele iikhalori kunye nezondlo ezilahlekileyo. Ungazama nokwenza ifomula ibe nkulu kancinci (ungasebenzisa i-cereal yosana okanye izithambisi ezithengiswa ngaphandle kwekhawuntara). Oku kuya kunceda ukunciphisa inani lokutya okubuyela emqaleni.
• Ukuba umntwana wakho unengxaki yokuphefumla: Ugqirha wakho angakucebisa ukuba ulale umntwana wakho intloko yakhe iphakanyisiwe kancinci. Oku kunokunceda ukuvula indlela yomoya kwaye kwenze ukuphefumla kube lula.

Soloko ubuza ugqirha wakho ngeendlela ezithile zokulawula iimpawu zeLaryngomalacia kumntwana wakho.

Ngaba ikho na indlela yokunyanga ngeyeza?

Ukuba umntwana wakho une-GERD (gastroesophageal reflux disease) kunye ne-laryngomalacia, ugqirha wakho unokukunika amayeza anjenge -proton pump inhibitor (PPI) okanye i-H2 blocker yokuyinyanga. I-GERD inokunyusa ukudumba okunxulunyaniswa ne-laryngomalacia, ngoko ke kubalulekile ukuyilawula.

Ngaba kuza kufuneka utyando?

I-Laryngomalacia ayifuni utyando (supraglottoplasty). Olu tyando lubandakanya ukusika nokususa izicubu ezibuthathaka nezigobileyo ngaphezulu kwebhokisi yelizwi lomntwana. Ugqirha wendlebe, impumlo, nomqala (ENT) wenza olu tyando kwigumbi lotyando, umntwana ephantsi kwe-anesthesia jikelele. Emva kotyando, umntwana uhlala esibhedlele ubusuku bonke ukuze ajongwe.

Kuthatha ixesha elingakanani ukuchacha emva konyango?

Amayeza e-GERD adla ngokunciphisa iimpawu kwiiveki ezimbini, kodwa umntwana wakho unokufuna ukuqhubeka esela amayeza kangangeeveki eziliqela, okanye iinyanga.

Ukuba umntwana wakho utyando lwe-laryngomalacia, usenokuva ukunyuka okuncinci kokuphefumla kwakhe kwiintsuku ezimbalwa zokuqala . Oku kuqhelekile. Oku kungenxa yokudumba okujikeleze iintambo zelizwi emva kotyando. Le ngxolo iya kuncipha kancinci kwaye iya kuthatha malunga neeveki ezimbini ukuba iphile ngokupheleleyo.

Ngaba oku kungathintelwa?

Hayi, akukho ndlela yokuthintela i-laryngomalacia. Nangona kunjalo, unyango lunokunceda iimpawu zomntwana wakho zilawulwe ngcono.

Njengomzali, uhlala ufuna ukukhusela umntwana wakho kuzo zonke iingozi. Kodwa iLaryngomalacia yinto eyenzeka ngokuzenzekelayo ngamanye amaxesha. Oko akuthethi ukuba wenze into engalunganga. Nangona isandi esenziwa ngumntwana wakho xa ephefumla sinokuba sisoyikisa ekuqaleni, asisoloko sifuna unyango.

Ngaba ufanele ukoyika oku?

I-Laryngomalacia, nangona inokwenza ingxolo xa uphefumla, ayisoloko iyingozi . Uninzi lweentsana ziyaphila ngokwazo kule meko, kodwa ezinye iintsana zinokufuna utyando, ingakumbi ukuba zinobunzima bokutyeba okanye zineengxaki ezinkulu zokuphefumla. Ukuba ugqirha wakho ukuxelela ukuba umntwana wakho unale meko, uya kukuchazela into omawuyilindele.

Le meko iza kuhlala ixesha elingakanani?

I-Laryngomalacia idla ngokuba ngcono ngokwayo xa ineminyaka eli-1 okanye eli-2 ubudala. Nangona kunjalo, kufuneka uqaphele iimpawu ezinzulu ngakumbi, ezifana ne-apnea, oku kuthetha ukuyeka ukuphefumla okwethutyana, kunye nokutshintsha kombala oluhlaza okwesibhakabhaka okujikeleze imilebe. Oku kunokukhokelela kwiingxaki ezinkulu.

Ndifanele ndimbone nini ugqirha? / Ndifanele ndiye nini kwigumbi likaxakeka?

Ukuba umntwana wakho ubonisa iimpawu ze-laryngomalacia, ezifana nesandi sokuphefumla, licebo elihle ukwenza idinga nogqirha wakho. Ugqirha angamhlola umntwana wakho, akuthumele kwingcali yendlebe, impumlo, nomqala (ENT) ukuba kuyimfuneko, aze akunike iingcebiso zendlela yokunyamekela umntwana wakho ekhaya.

Ukuba umntwana wakho uqalisa ukuba neempawu ngequbuliso, okanye ukuba umntwana wakho une-GERD (isifo se-gastroesophageal reflux), fowunela ugqirha wakho ngoko nangoko.

Kwimeko enjalo, yiya kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ekufutshane:

• Ukuba umntwana akaphefumli ngaphezu kwemizuzwana eli-10 .
• Ukuba intamo okanye isifuba sakho sibonakala ngathi siyatsala ngaphakathi xa uphefumla.
• Ukuba imilebe ijika ibe luhlaza okwesibhakabhaka .

Yintoni umahluko phakathi kweLaryngomalacia kunye neTracheomalacia?

I-Laryngomalacia kunye ne-tracheomalacia zombini ziimeko ezichaphazela indlela yomoya. I-Laryngomalacia kubuthathaka kwezicubu ezingaphezulu kwebhokisi yelizwi, ngelixa i-tracheomalacia ibuthathaka okanye igobile ye-cartilage engaphantsi kwayo, kumbhobho womoya . I-Tracheomalacia yimeko engaqhelekanga kakhulu kune-laryngomalacia, kwaye idla ngokuba yingozi ngakumbi.

Eminye imibuzo emincinci embalwa...

Ngaba iLaryngomalacia ingabangela ukutyeba?

Akunjalo rhoqo. Enyanisweni, iintsana ezine-laryngomalacia enzima zinokuba nobunzima bokutyeba .

Yintoni eyenza iLaryngomalacia ibe mandundu?

Iimpawu zeLaryngomalacia zinokuba zimbi kancinci xa umntwana wakho elele ngomqolo . Ukuba uqaphela ukuba umntwana wakho unengxaki yokuphefumla ngelixa elele ngomqolo, nceda ubone ugqirha.

Ukongeza, iimpawu zinokuba mandundu ngenxa ye-GERD (isifo se-gastroesophageal reflux), imeko eqhelekileyo phakathi kweentsana ezine-laryngomalacia.

Okokugqibela, izinto ekufuneka uzikhumbule...

Ingxaki ebizwa ngokuba yiLaryngomalacia inokuba yinto exhalabisayo kancinci, ingakumbi ukuba ungumzali omtsha. Isandi esivakalayo nesiphantsi esenziwa ngumntwana wakho xa ephefumla sinokukwenza uxhalabe kwaye sikushiye uzibuza, "Ngaba le yinto enzulu ngakumbi?"

Kodwa khumbula, kwiimeko ezininzi, iLaryngomalacia ayiyongozi. Nangona kunjalo, ukuba unamathandabuzo okanye inkxalabo, kungcono ukubona ugqirha wabantwana womntwana wakho, kwaye ukuba kuyimfuneko, ucele ukuthunyelwa kwingcali yendlebe, impumlo, nomqala (ENT). Ungakhathazeki, oogqirha balapha ukukunceda!

I- Laryngomalacia, i-Laryngomalacia, Ukuphefumla kosana, Ibhokisi yelizwi, iStridor, Ubunzima bokuphefumla, Impilo yosana