Ingabe nawe uphelelwa umoya? Ingabe ukhwehlela njalo? Lokhu kungaba yi-Tracheobronchomalacia (TBM)

Ingabe ngezinye izikhathi ukuthola kunzima ukuphefumula uma ukhuphuka izitebhisi noma ngisho uhamba ngokushesha? Noma uzizwa sengathi ingane yakho encane inenkinga yokuphefumula uma uncelisa? Ingabe ukhathazekile ngezinto ezifana nokukhwehlela okuqhubekayo noma umsindo ongajwayelekile ophuma esifubeni sakho? Nakuba kunezimbangela eziningi zalezi zinto, njenge-asthma, namuhla sizokhuluma ngesimo okungekho noyedwa kithi oke wezwa ngaso kakhulu, kodwa esingaba sibaluleke kakhulu. Leso yi-Tracheobronchomalacia, noma i-TBM ngamafuphi.

Kalula nje, iyini i-Tracheobronchomalacia (TBM)?

Nakuba lokhu kungase kubonakale njengegama elide nelingavamile, incazelo yalo ilula kakhulu. I-Tracheobronchomalacia (TBM) yisimo lapho izindonga ze -trachea kanye ne-bronchi, izingxenye ezimbili eziyinhloko zesimiso sethu sokuphefumula, ziba buthakathaka, okubangela ukuthi la mapayipi anciphe futhi avaleke lapho siphefumula, ikakhulukazi lapho sikhipha umoya noma sikhwehlela.

Cabanga ukuthi ipayipi lethu lomoya lifana nepayipi lepulasitiki elithwala amanzi. Uma izindonga zaleli payipi ziqinile, akukho nkinga lapho amanzi egeleza khona. Kodwa uma izindonga zepayipi zincane kakhulu futhi zibuthakathaka, amanzi angabhajwa epayipini uma egeleza ngokushesha, akunjalo? Yilokho okwenzekayo ku-TBM. Lapho izingxenye eziqinile ezibizwa ngokuthi i-cartilage ezindongeni zepayipi lomoya kanye ne-trachea ziba buthaka, la mapayipi ayabhajwa futhi avalwe lapho umoya uhamba uye emuva naphambili ngokushesha. Yilapho kuba nzima ukuphefumula, kuvela ukukhwehlela, futhi kuzwakale umsindo esifubeni.

Lesi simo singaba yisifo sokuzalwa (i-Congenital TBM) , okusho ukuthi umntwana uzalwa enalobu buthakathaka. Kwabanye, singatholakala (i-Acquired TBM), okusho ukuthi singakhula ngesikhathi sokuphila ngenxa yezinye izifo, ukwelashwa, noma ezinye izimbangela zangaphandle.

Ziyini izimpawu ze-TBM?

Lezi zimpawu zingase zihluke kancane kuye ngokuthi isimo sikhona yini ekuzalweni noma sivela kamuva. Ake sibheke izimpawu zazo zombili ngokwehlukana.

Kungani lesi simo se-TBM senzeka?

Njengoba sixoxile ngaphambili, izizathu zalokhu zingahlukaniswa ngezigaba ezimbili.

1. I-TBM Eyinhloko/Ezalwa Nayo

Kunezizathu eziningana zokuthi kungani umntwana angazalwa enalesi simo:

• I-TBM Engavamile: Ezinye izingane zingase zizalwe zine-cartilage ebuthakathaka ku-trachea ngaphandle kwesizathu esibonakalayo.
• Amasongo Emithambo: Lokhu kwenzeka lapho umthambo wegazi oyinhloko wengane (i-aorta) ovela enhliziyweni wakheka ngendlela engafanele futhi ugoqa i-trachea njengoba ikhula esibelethweni. Lo mthambo wegazi ucindezela i-trachea, okwenza ibe buthaka.
• Ezinye izifo zofuzo: Izimo ezingavamile, ezizuzwe njenge-Hunter syndrome, i-Hurler syndrome, kanye ne-Ehlers-Danlos syndrome zinganciphisa uqwanga lomzimba. Lokhu kungathinta nemigudu yomoya.
• Ukuzalwa ngaphambi kwesikhathi: Izingane ezizalwa ngaphambi kwamasonto angu-37 zingase zibe sengozini enkulu yokuthola i-TBM ngoba izindlela zazo zokuphefumula azikakhuli ngokugcwele.

2. I-TBM eyenzeka ngesikhathi sokuphila (i-TBM yesibili/etholakale)

Kunezizathu eziningi zokuthi kungani lesi simo singenzeka kumuntu omdala.

Udokotela usithola kanjani lesi sifo ngqo?

Uma wena noma ingane yakho ninalezi zimpawu, into engcono kakhulu ongayenza ukubona udokotela. Udokotela uzokuxilonga kahle bese ebuza wena nengane yakho ngezimpawu zenu. Bazokubuza imibuzo eminingi, njengokuthi uvame yini ukuthola umkhuhlane nokuthi unezinye izifo zokuphefumula.

Ngemva kwalokho, kungenziwa izivivinyo eziningana ukuqinisekisa lesi sifo.

• Ukuhlolwa Kokusebenza Kwamaphaphu: Lokhu kuhlola ukuthi amaphaphu akho angawuthatha kahle kangakanani umoya ongenayo nophumayo.
• I-Bronchoscopy: Lolu ukuhlolwa okubaluleke kakhulu nokunembayo ukuqinisekisa i-TBM. Kulokhu, kufakwa ipayipi elincane, elifakwe ikhamera ngomlomo noma ekhaleni ukuze kuhlolwe ingaphakathi lomphimbo kanye ne-bronchi. Udokotela angabona ukuthi umphimbo uvalwe kangakanani ngokukucela ukuthi uphefumule futhi ukhwehlele.
• I-CT scan (I-Computed Tomography Scan): Lokhu kungathatha izithombe ezinemininingwane zesifuba. Lokhu kungasiza ekunqumeni ukuthi i-TBM ibangelwa yini okunye noma kukhona ushintsho esimweni sendlela yokuphefumula.

Yiziphi izindlela zokwelapha lokhu?

Izinketho zokwelapha ziyahlukahluka kuye ngokuthi i-TBM ikuthinte kangakanani wena noma ingane yakho. Akuwona wonke umuntu ozodinga ukuhlinzwa.

1. Imithi kanye nemishini yokusekela

• Ukwelashwa kwezifo: Uma ingane yakho inezifo zokuphefumula ezivame ukwenzeka, unganikezwa imithi efana nama-antibiotic .
• Amasu okuncelisa: Uma ingane yakho inenkinga yokuphefumula ngesikhathi incelisa, udokotela wakho noma umhlengikazi uzokufundisa ukuthi ungashintsha kanjani izikhundla ukuze kube lula ukuphefumula.
• Ukuvuselelwa Kwemiphunga: Lokhu kuhilela ukufundisa izivivinyo zokuphefumula ukuze kulawulwe izimpawu.
• Imishini ye-CPAP noma ye-BiPAP®: Le mishini isetshenziselwa nabantu abane-sleep apnea. Ikhipha umoya ngengcindezi ethile ngemaski efanela ubuso, okusiza ukugcina indlela yokuphefumula ivulekile futhi ingavimbeki.
• Ama-Percussion Vests angaphandle: Kungaba nzima ukukhwehlela ama-mucus uma une-TBM. Lena idivayisi oyigqoka njengengubo. Uma ixhunywe emshinini, iyadlidliza ngokushesha, ikhulule ama-mucus esifubeni sakho, okwenza kube lula ukukhwehlela.
• I-Nebulizer: Idivayisi eguqula umuthi owuketshezi ube yinkungu encane engaphefumulwa ngemaski. Lokhu kungaletha umuthi ngqo emaphashini.

2. Ukuhlinzwa

Kwezinye izimo ezinzima kakhulu, kungase kudingeke ukuhlinzwa.

• I-Bronchoscopy kanye nokubekwa kwe-stent: I-bronchoscopy yokuxilonga ingasetshenziswa futhi njengokwelashwa. Kule nqubo, kufakwa ipayipi elincane lepulasitiki noma lensimbi (i-stent) endleleni yokuphefumula ukuze kugcinwe ukuvaleka kuvulekile. Lokhu kuvame ukuba okwesikhashana.
• Ukuhlinzwa kwe-Tracheobronchoplasty:Kule nqubo, isakhiwo esifana ne-mesh sifakwa ngokuhlinzwa ngaphandle kwe-trachea bese sithungwa endaweni yaso. Le mesh inikeza amandla engeziwe ku-trachea, kunciphisa ingozi yokuwa kwayo.
• I-Tracheopexy: Lokhu kuhlinzwa kuhilela ukuthunga udonga olubuthaka lwangemuva lomphimbo womoya kuma-ligaments aqinile emgogodleni. Lokhu kuvimbela indawo ukuthi ingawi ngaphakathi uma uphefumula.

Ngenxa yokuthi lokhu kuyizinqubo zokuhlinzwa ezinkulu, kunezingozi ezifana nokopha ngokweqile, amahlule egazi, kanye nokutheleleka kwamanxeba . Uma kunconywa ukuhlinzwa, udokotela wakho uzokuchazela konke lokhu ngokugcwele.

Ungaphila kanjani nesifo se-TBM?

Uma ingane ine-TBM:

Njengoba ingane ikhula, uqwanga emigudwini yomoya luyaqina. Ngakho-ke, izimpawu zingase zinciphe kancane kancane. Kodwa-ke, ezimweni eziningi, kudingeka ukubhekwa kwezokwelapha kanye nokwelashwa okuthile ebuntwaneni bonke. Kubaluleke kakhulu ukuvikela ingane ezifweni zokuphefumula ezivame ukwenzeka.

Uma umuntu omdala ene-TBM:

I-TBM kubantu abadala imvamisa iyisimo esingamahlalakhona esingaba sibi kakhulu ngokuhamba kwesikhathi . Izimpawu zingalawulwa ngokunciphisa isisindo kanye nezinye izimo zezokwelapha. Ukuhlinzwa kungasebenza kahle. Kodwa-ke, abantu abaningi abane-TBM banezinye izimo, njenge-asthma kanye ne-COPD, ngakho-ke badinga ukubhekwa uchwepheshe wokuphefumula impilo yabo yonke.

Ingabe lesi simo singavinjelwa?

Ayikho indlela yokuvimbela i-TBM yokuzalwa. Kodwa-ke, kunezinto ezithile ongazenza ukuze unciphise ingozi ye-TBM kubantu abadala.

• Gwema ukubhema nokuba seduze nabantu ababhemayo.
• Uma unezimo ezifana ne-asthma, i-COPD, noma i-GERD, thatha ukwelashwa okufanele futhi ulawule lesi sifo kahle.
• Gcina isisindo esinempilo.
• Uma umsebenzi wakho uhilela ukuchayeka kumagesi anobuthi, landela izinqubo zokuphepha ezifanele.

Uma ukhwehlela njalo noma uphefumula kanzima, ungacabangi nje ukuthi umkhuhlane, kodwa qiniseka ukuthi ubonana nodokotela bese uhlolwa. Uma lesi sifo sisheshe sitholakale, amathuba okuthola imiphumela emihle ekwelashweni ayanda.