I-Bronchiolitis ezinganeni: izimpawu, ukuqhubeka, kanye nezici eziyingozi okufanele uzazi

  • I-Bronchiolitis iwukutheleleka ngegciwane kwendlela yokuphefumula engezansi ethinta kakhulu izinsana ezingaphansi kweminyaka emibili ubudala, okunengozi ekhethekile ezinsaneni ezingaphansi kwezinyanga ezintathu kanye nezinsana ezingaphambi kwesikhathi.
  • Kuqala njengomkhuhlane ovamile futhi kungaqhubeka ezinsukwini ezingu-2-3 kube ukucindezeleka kokuphefumula ngokuphefumula okusheshayo, ukuhoxa kwembambo, kanye nomsindo wokuphefumula lapho uphefumula.
  • Ukuba nezingane zakubo ezifunda esikoleni, ukuya esikhungweni sokunakekela izingane, ukuchayeka entuthwini kagwayi, ukukhulelwa ngaphambi kwesikhathi, isifo senhliziyo, kanye nokungancelisi ibele kwandisa ingozi yokuthola i-bronchiolitis kanye nengozi yokuthola izinhlobo ezimbi kakhulu zalesi sifo.
  • Ukwelashwa kusekelwe ekunakekelweni okusekelayo (ukufaka amanzi emzimbeni, ukugeza amathumbu, umoya-mpilo uma kudingeka); ama-bronchodilator, ama-corticosteroids, ama-antibiotic kanye nama-syrup okukhwehlela awakhonjiswa njalo.
Nati GarciaKubuyekezwe ngomhla ka-

Imizuzu ye-14

I-Bronchiolitis ezinganeni

Cishe sonke siyamazi umuntu oye wadinga ukuyisa ingane yakhe esibhedlela ngenxa ye-bronchiolitis. Yini esiyaziyo ngempela ngalesi sifo sokuphefumula, esivame kangaka eminyakeni yokuqala yokuphila? Kubalulekile ukwazi. Kuyini i-bronchiolitis?ukuthi idluliselwa kanjani, yiziphi izici zayo izimpawu, ini izici zobungozi Zingenza ukuvela kwesimo kube kuncane noma kube nzima kakhulu, futhi ngaphezu kwakho konke, lokho esingakwenza ekhaya nalapho kudingeka ukuya ekamelweni lezimo eziphuthumayo.

Ukuqonda lezi zici kusiza imindeni ukuthi thatha isinyathelo ngokusheshaukuqapha kangcono ingane nokugwema izinkinga ezingadingekile, ikakhulukazi ezinganeni ezisengozini enkulu, njengezingane ezizalwa ngaphambi kwesikhathi noma lezo ezinesimo esivele sikhona.

Iyini i-bronchiolitis?

Ingane esanda kuzalwa isengozini yokuthola i-bronchiolitis

I-bronchiolitis enamandla i ukutheleleka okuphefumula lokho kuthinta ingxenye engezansi yohlelo lokuphefumula, okungukuthi, kuyathinta emaphashini kanye nasezindleleni zomoya ezincaneAma-bronchioles. Lezi zakhiwo ezincane zifana "namagatsha" okugcina e-bronchi, lapho umoya udlula khona uye e-alveoli. Uma evuvukala futhi egcwele i-mucus, umoya uyaphuma Ungena futhi uphuma ngobunzima.ukukhiqiza amakhwela noma ukuphefumula okuhlukile.

Esinye sezici ezijwayelekile zale nqubo ukuthi yenzeka ezinganeni izingane ezingaphansi kweminyaka emibili ubudala, kaningi ku izinsana ezingaphansi kwezinyanga eziyisithupha futhi ikakhulukazi phakathi kwezinyanga ezi-3 nezi-6 ubudala. Kulesi sigaba, ama-bronchioles mancane kakhulu, ngakho-ke noma yikuphi ukuvuvukala noma ukwanda kwe-mucus kuvimbela kalula ukudlula komoya.

Izimbangela zokutheleleka yilezi izinhlobo ezahlukene zegciwaneOkuvame kakhulu ukubangela ukutheleleka yi- Igciwane Lokuphefumula Elihambisana Nokuphefumula (RSV)Yiyona ebangela izimo eziningi, ikakhulukazi ngesikhathi sobhubhane. Kodwa akuyona yodwa: igciwane lomkhuhlane, amagciwane e-parainfluenza, i-adenovirus, i-rhinovirus, i-human metapneumovirus, i-coronavirus, nezinye zingadala ne-bronchiolitis noma iziqephu zokuphefumula ezinganeni.

Uma la magciwane ehlasela umgudu wokuphefumula ongezansi, abangela ukuvuvukala kwezindonga ze-bronchiolarUkukhiqizwa kwama-mucus okwenyukayo, futhi ngezinye izikhathi, ama-plug amancane okukhipha. Konke lokhu kubangela ukuvinjelwa okuyingxenye noma okucishe kuphelele yalezi zindlela zokuphefumula ezincane, okuchaza ubunzima bokuphefumula kanye nomsindo lapho uphefumula.

I-bronchiolitis isakazeka kanjani?

Ukutheleleka kwe-bronchiolitis ezinganeni

I-Bronchiolitis iyathelelana kakhulu. Igciwane lidluliselwa kakhulu nge- amaconsi okuphefumula esikukhiphayo uma sikhwehlela, sithimula, noma sikhuluma, kodwa futhi nange ukuthintana noketshezi (ifinyila, amathe) kanye nezindawo ezingcolisiwe, njengezinto zokudlala, amatafula noma izinsimbi zokubiyela.

Igciwane lingena emzimbeni nge- ulwelwesi lwamafinyila ekhaleni, emlonyeni, noma emehlweniUkuthinta nje indawo engcolile ngezandla zakho bese uthinta ubuso bakho kwanele ukuthi igciwane lidluliselwe. Yingakho lisakazeka kalula ezindaweni lapho izingane eziningi zihlangene, njengezikhungo zokunakekela izingane.

Amanye amaphuzu abalulekile mayelana nokuthelelana:

  • Izinsana nezingane ezincane eziya khona enkulisa noma labo abanayo odadewabo nabafowabo nodadewabo abadala abaneminyaka yesikole Banamathuba amaningi okuhlangana negciwane.
  • Igciwane lingasinda amahora amaningana ezindaweniNgakho-ke, amathoyizi ahlanganyelwe ayindlela evamile yokuthelelana.
  • Abantu abadala bangathelelana ngezimpawu ezimbalwa noma bangabi nazo nhlobo, babonisa kuphela isimo esincane se- umkhuhlane omncane kanti enganeni imelela icala elibi le-bronchiolitis.

I-bronchiolitis ithuthuka kanjani?

Ukuthuthukiswa kwe-bronchiolitis ezinganeni

Iningi lezingane liyagula phakathi Izinsuku eziyi-7 nezingama-12 y Bayalulama ngaphandle kwezinkinga ngemva kwalokhonakuba ukukhwehlela kungase kuqhubeke isonto elilodwa. Ezinsukwini ezimbalwa zokuqala, izimpawu zivame ukuqala njenge- ukutheleleka kokuphefumula okuphezuluBese kuthi, ezinsukwini ezimbili noma ezintathu, kuvele izimpawu zokubandakanyeka komgudu womoya ophansi.

Kwezinye izimo ezibucayi kakhulu, umntwana Kuzodingeka ungeniswe esibhedlelaLokhu kwenzeka ikakhulukazi uma kukhona ukucindezeleka okukhulu kokuphefumula, ukungakwazi ukudla, ukugcwala komoya-mpilo okuphansi, noma ukuba khona kwezinto eziyingozi (ukungavuthwa ngaphambi kwesikhathi, isifo senhliziyo, isifo samaphaphu esingamahlalakhona, ukuntuleka kwamasosha omzimba, njll.).

Kulezi zimo ezibucayi kakhulu, lapho izingane zidinga ukulaliswa esibhedlela, kuvamile ukuthi ezinyangeni ngisho neminyaka elandelayo, lapho ingane ithola umkhuhlane, Izimpawu ezibonakalayo zifana neze-bronchiolitis (iziqephu zemisindo yokuphefumula noma yokushaya ikhwela, ukuphefumula okusheshayo, ukukhwehlela okuqhubekayo). Lokhu kubizwa ngokuthi ukuphefumula okuphindaphindiwengezinye izikhathi ezididaniswa ne-asthma yezingane.

Ezinye izifundo zocwaningo zikhombisile nokuthi izingane eziye zahlushwa yi-bronchiolitis ezinyangeni zokuqala zokuphila, ngesikhathi sobuntwana kanye nokuthomba, ziye zahlushwa yi-bronchitis. ingozi eyengeziwe yokuhlaselwa yisifuba somoya Izingane ezingakaze zihlushwe yi-bronchiolitis zisengozini enkulu, ikakhulukazi uma kukhona ezinye izici ezihlobene nazo, njengomlando womndeni we-asthma noma i-allergies.

Ukuphulukiswa kwe-bronchiolitis kuhamba kancaneKuvamile ngemindeni ukuzizwa sengathi ingane yabo "ayilulami" ngoba ukukhwehlela nokukhwehlela kwesifuba kungahlala amasonto amaningana. Kubalulekile ukwazi ukuthi lokhu kululama isikhathi eside kuyinto evamile. kulindeleke ezimweni eziningiuma nje ingane igcina impilo enhle, idla ngendlela eyamukelekayo futhi ingakhombisi zimpawu zokukhathazeka.

Izimpawu ze-bronchiolitis

Izimpawu ze-bronchiolitis ezinganeni

Izimpawu ekuqaleni yilezo zomkhuhlane ovamileIngane inekhala elicijile, ukukhwehlela izinsuku ezimbili noma ezintathu, kanye nomkhuhlane omncane noma umkhuhlane ongadluli ku-39°C. Ingase ithukuthele kancane noma ingabi nesifiso sokudla esiningi, kodwa igcina isimo sayo esihle.

Ngemuva kwalokho kungenzeka ukuthi i- isifo sibonakala simileKuyakhathaza kakhulu ngoba kunikeza umbono wokuthi ingane ngeke ilulame futhi asazi ukuthi sisazokwenzenjani. Noma kungaba kubi kakhuluokuyinto evame kakhulu kusukela ngosuku lwesibili noma lwesithathu ngemva kokuqala komkhuhlane.

Ukuwohloka okuvamile kubonakala ngokuthi:

  • Khulisa ku- isilinganiso sokuphefumula (uphefumula ngokushesha kunokujwayelekile ngokweminyaka yakhe).
  • Ukuphefumula kunzima, ngokucwila kwezimbambo (ukuhoxa), ukunyakaza okukhulu kwesisu kanye nokwanda kwamakhala.
  • Khulisa ku- tos, ngezinye izikhathi ngokushaya okulandelanayo okungabangela ukuhlanza.
  • Ukubukeka kwe- imisindo yokuphefumulaikakhulukazi lapho ukhipha umoya, okuchazwa ngokuthi “amakhwela” noma “amakhwela”.

Ukukhwehlela kuyanda, ingane iyaphefumula ngokushesha futhi ngobunzimaSibona indlela izimbambo zabo ezigqama ngayo, isisu sabo siphakama futhi siwa kakhulu, futhi amakhala abo aqhuma ngayo njalo lapho bephefumula. Ukuphefumula kwabo kungaba nomsindo omkhulu. uhlobo oluthile lomsindo wokukhala luvela lapho uphefumulaKonke lokhu kubonisa ukuthi i-bronchi kanye ne-bronchioles zivinjelwe ukuvuvukala futhi ngenxa yokwanda kwamafinyila okubangelwa yilesi sifo.

Ezinsaneni ezincane kakhulu, ikakhulukazi ezizalwa ngaphambi kwesikhathi, uphawu olubalulekile lungaba zokuphelelwa umoya (ukuyeka ukuphefumula imizuzwana embalwa), ngezinye izikhathi ngaphandle kokuba ubunzima bokuphefumula bubonakale kakhulu. Lezi zigameko zidinga ukuhlolwa kwezokwelapha ngokushesha.

Sekuyisikhathi sokubonana nodokotela wezingane futhi noma iya emnyangweni ophuthumayoKungase kudingeke ukuthi ungeniswe esibhedlela ukuze uqaphe ukuphefumula kwakho, uqinisekise ukuthi umanzi kahle, futhi, uma kudingeka, unikeze umoya-mpilo.

Cishe kuzodingeka uye ku- ukuhlolwa kudokotela wezingane zakho noma egumbini lezimo eziphuthumayo, njengoba kuyalelwe, ukuze kuhlolwe intuthuko yakho. Ngaphezu kokuba nesineke, kubalulekile ukucaca ukuthi yiziphi izimpawu okufanele uziqaphele ekhaya nokuthi yiziphi izindlela zokuzinakekela ezizokusekela kangcono ukululama kwakho.

Izizathu ze-alamu

Intuthu kagwayi kanye nengozi ye-bronchiolitis

Noma yikuphi Ukwanda noma ukuba kubi kwezimpawu kuyimbangela yokwethuka.Ngaphezu kwalokho, kunezimpawu ezithile ezibonisa ukuthi ingane ingase ibe yimbi futhi ezidinga ukubonisana ngokushesha:

  • Ukuphalaza okuphindiwe. Ingane ayikwazi ukugcina uketshezi phansi futhi uma ushintsha inabukeni yomile noma imanzi nje kancane. Lokhu kungakhombisa ukuthi ingane ikhona kuyawohloka.
  • Uma baby Ulele kakhuluKunzima ukuvuka noma ubonakala ekhathele ngendlela engavamile futhi engasabeli.
  • Uma isikhumba sengane siqala zinombala onsomiikakhulukazi eduze kwezindebe noma iminwe. Lokhu kungase kubonise ukuthi umntwana Ayikwazi ukufaka umoya-mpilo egazini ngendlela efanele.
  • Uma uqaphela ukuthi ingane Uphenduka abe nombala okhanyayo futhi ajuluke., ngokubukeka okungekuhle ngokuvamile.
  • Uma ukhathala kakhulu nge-feedings futhi akadli kakhulu, noma enqaba ngokuphindaphindiwe ibele noma ibhodlela.
  • Uma ingane iphefumulela phezulu nangaphezulu: ngokushesha, izimbambo ziyavela kakhulu, isisu siyanyakaza kakhulu, isifuba siyacwila, noma siyeke ukuphefumula imizuzwana.
  • Uma ingane ibingakafiki noma inesifo senhliziyo noma amaphaphu, kufanele uthintane nochwepheshe noma uye egumbini eliphuthumayo uma izimpawu zokuqala yokutheleleka kokuphefumula, noma ngabe kubonakala kuncane.

Emkhakheni wezempilo, okulandelayo kusetshenziswa: i-pulse oximetry Ukugcwala komoya-mpilo kulinganiswa ukuze kuhlolwe ukuthi ingane idinga umoya-mpilo owengeziwe noma ukulaliswa esibhedlela. Njengesiqondiso esijwayelekile, ukugcwala okungaphansi kuka-92% kuvame ukubonisa ukudluliselwa esibhedlela, yize zonke izici zihlala zicatshangelwa ndawonye. ezinye izimpawu zomtholampilo kanye nezici eziyingozi zomntwana.

Izici zengozi ye-bronchiolitis kanye nezinhlobo ezinzima

Izici eziyingozi ze-bronchiolitis

Kunezici ezithile eziyingozi ezingathinta ingane ukuthuthukisa i-bronchiolitis futhi ukuze umdwebo ube okungathi sína kakhulu futhi kudinga ukulaliswa esibhedlelaNgokusho kwezifundo eziningana, ezibaluleke kakhulu yilezi:

  • Ukuthi umntwana unabafowabo nodadewabo abaneminyaka yesikoleikakhulukazi uma behlanganyela ikamelo elilodwa noma bechitha amahora amaningi ndawonye.
  • Usizo lwenkulisa noma ezikoleni zabantwana abancane, lapho ukuxhumana nezinye izingane kanye namagciwane okuphefumula kuvame kakhulu.
  • Ukuthi ivezwa ezindaweni ezinentuthuIkakhulukazi uma abazali babo bebhema noma uma kukhona ukusetshenziswa kukagwayi ekhaya noma emotweni. Ukubhema kuyacasula indlela yokuphefumula futhi kwandisa amathuba okutheleleka ngezifo ezinkulu.
  • Izingane ezizalwa ngaphambi kwesikhathiikakhulukazi uma ukukhulelwa bekungaphansi kwamasonto angu-35 noma uma kukhona i-bronchopulmonary dysplasia noma esinye isifo samaphaphu esingamahlalakhona sosana oluzalwe ngaphambi kwesikhathi.
  • Ukuba nesisindo esiphansi sokuzalwa noma izinkinga zokukhula ezinyangeni ezimbalwa zokuqala, njengoba izinqolobane zomntwana ziphansi.
  • Isifo senhliziyo esizalwa naso esinemiphumela ye-hemodynamic noma ezinye izifo zenhliziyo ezenza umzimba ungabekezeleli kahle ukuntuleka komoya-mpilo.
  • Ama-Immunodeficiencies noma ukwelashwa okwehlisa ukuzivikela, okusiza ukutheleleka okunamandla kakhulu nokuthatha isikhathi eside.
  • izifo ze-neuromuscular ezivimbela ikhono lengane lokukhwehlela nokuhlanza uketshezi lwayo.
  • Ukuchayeka njalo ekungcoleni kanye nezindawo ezingcoliswe kakhulu, ezilimaza futhi zicasule umgudu wokuphefumula.
  • Ungancelisi ibeleKunezifundo eziningana ezinikeza inani lokuvikela ekunceliseni ibele mayelana nengozi yokuba ne-bronchiolitis kanye nokuba yingozi. Ngisho nesikhathi sokuncelisa, kokubili sodwa kanye nesixubile, sihlotshaniswa ne- ukuvela okungcono kokutheleleka kanye nesidingo esincane semali engenayo.

Ngaphezu kwalezi zici, kufanele kucatshangelwe ukuthi izinsana ezingaphansi kwezinyanga eziyisithupha Banengozi ekhethekile yemiphumela eyinkimbinkimbi, noma ngabe bazalwa bephilile futhi sebekhulelwe. Kuzo, amandla okuphefumula aphansi, futhi noma yikuphi ukwanda komsebenzi wokuphefumula kungaholela ekukhathaleni ngokushesha.

Ukwelashwa kwe-bronchiolitis: okufanele ukwenze nokungafanele ukwenze

Ukunakekelwa nokwelashwa kwe-bronchiolitis

Ku-bronchiolitis Ayikho imithi yokwelapha lesi sifo noma esheshisa ukululama.Ukutheleleka kuvela egciwaneni, futhi umzimba udinga isikhathi sokulawula igciwane nokulungisa ukuvuvukala endleleni yokuphefumula. Ngakho-ke, imithi eminingi Azinconywa njalo..

Into ebaluleke kakhulu ukugxila ku- ukunakekelwa okusekelayo:

  • Gcina eyodwa i-hydration eyaneleukunikeza ukuncelisa okuncane, njalo ukuze umntwana angakhathali.
  • Qaphela ukugeza amakhala ngesisombululo se-saline esingokwenyama kanye nokufuthwa okuncane koketshezi, ikakhulukazi ngaphambi kokuncelisa kanye nokulala.
  • Qinisekisa a ukuphefumula kahle kwe-oxygen uma kudingeka, nikeza umoya-mpilo esibhedlela uma ukugcwala kuphansi.

Ngokuphathelene nemithi ethile, izincomo ezivela eziqondisweni eziyinhloko zezokwelapha yilezi:

  1. Ama-bronchodilators
    Azisebenzi ezimweni eziningi ngoba ukuvaleka kubangelwa kakhulu ukuvuvukala kanye ne-mucus eningiakuyona i-bronchospasm njengase-asthma. Kwezinye izimo ezithile, lapho kukhona ukusolakala kokuthi i-asthma noma i-bronchial hyperreactivity Ezinganeni ezindala kancane, zingazanywa futhi zigcinwe kuphela uma kukhona ukuthuthuka okucacile ngemva komthamo wokuhlola.
  2. Ama-Corticoids
    Nakuba ziyimithi enamandla yokulwa nokuvuvukala, angizange ngibonise inzuzo kwi-bronchiolitis ejwayelekile ezinganeni eziphilile. Azinciphisi ukwamukelwa esibhedlela noma zifinyeze isikhathi sokugula, ngakho-ke akufanele zisetshenziswe njalo kwi-bronchiolitis ebukhali.
  3. Ama-antibiotic
    Azinamsebenzi ngoba i-bronchiolitis iyisifo esithathelwanayo. ukutheleleka ngegciwaneZisetshenziswa kuphela uma ukutheleleka kwamagciwane okwengeziwe (i-otitis, i-bacterial pneumonia, njll.), into engavamile futhi okufanele ihlolwe udokotela wezingane.
  4. I-adrenaline efakwe ku-nebulized
    Kungase kunikeze impumuzo yesikhashana kwezinye izimo ezinzima esibhedlela, kodwa akushintshi indlela isifo esiqhubeka ngayo noma kuvimbele izinkinga, ngakho-ke Akukhuthazwa njalo kwi-bronchiolitis engeyona inkimbinkimbi.
  5. Eminye imithi ayinconywa
    Ama-mucolytics, ama-syrup okukhwehlela, ama-decongestant, ama-antihistamine, noma ezinye izindlela zokwelapha abakabonisi ukusebenza kahle futhi kungaba yingozi. Ukwelashwa ngokuphefumula okunokunyakaza noma ukushaya kwenhliziyo nakho akubonisiwe ku-bronchiolitis evamile ebukhali, njengoba kungathuthukisi inkambo yesimo futhi kungabangela imiphumela emibi.

Ukunakekelwa kwasekhaya nokuvimbela

Ukuvimbela nokunakekela i-bronchiolitis

Ezimweni eziningi, i-bronchiolitis iyinkinga enkulu. isifo esizikhawulela ukuthi izingane zihlala ekhaya ziqashwe ngokwanele. Ezinye izindlela ezilula zingathuthukisa kakhulu induduzo yengane futhi zinciphise ingozi yezinkinga:

  • Gcina eyodwa i-hydration efaneleNikeza ibele noma ibhodlela kaningi, kodwa ngobuningi obuncane ukuze umntwana angakhathali kakhulu.
  • Qaphela ukugeza amakhala ngesisombululo sikasawoti bese ukhipha kancane uketshezi oluphumayo, ikakhulukazi ngaphambi kokudla nokulala.
  • Faka umntwana ngaphakathi isikhundla esiqondile kancane uma uvukile futhi uqashwe, ukuze kube lula ukuphefumula nokukhipha amanzi angcolile.
  • Gcina a indawo engenantuthu futhi kuvimbele noma ubani ukuthi angabhemi ekhaya noma emotweni.
  • Faka umoya kahle emakamelweni futhi ugcine izinga lokushisa elihle, ngaphandle kokugqokisa ingane ngokweqile.
  • Gwema, ngangokunokwenzeka, ukusondelana nabantu abanezimpawu zomkhuhlane, ikakhulukazi uma ingane isencane kakhulu noma inezici eziyingozi.

Njengezinyathelo ezijwayelekile zokuvimbela i-bronchiolitis nezinye izifo zokuphefumula, kubalulekile ukugeza izandla njalo Kwabantu abadala nezingane, ukuhlanzwa njalo kwamathoyizi nezindawo, kanye nokunciphisa ukuya esikhungweni sokunakekela izingane ezisengozini enkulu ngezikhathi zokwanda kokujikeleza kwegazi kwamagciwane okuphefumula uma udokotela wezingane eluleka.

Iyatholakala okwamanje ukugonywa ngama-antibodies e-monoclonal ngokumelene ne-RSV Lokhu kuvimbela kwenzelwa izingane ezithile ezisengozini enkulu yezinhlobo ezimbi ze-RSV (izinsana ezingaphambi kwesikhathi, izinsana ezinesifo senhliziyo esibucayi, izinsana ezinesifo samaphaphu esingamahlalakhona, kanye namanye amaqembu achazwe ochwepheshe). Kunikezwa ngezikhathi zokujikeleza kwegazi okuphezulu kwe-RSV futhi kunikezwa umuntu ngamunye yithimba lezingane noma lezingane ezisanda kuzalwa.

Ngolwazi olucacile, ukuqapha kahle izimpawu, kanye nemikhuba emihle yokuvimbela, amacala amaningi e-bronchiolitis ezinsaneni nasezinganeni ezincane angaphathwa ngokuphephile, kuncishiswe ingozi yezinkinga kanye nokulaliswa esibhedlela okungadingekile.


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