Hānō i nā ʻīlio

ʻO ka hānō Bronchial i nā ʻīlio he maʻi maʻi maʻi maʻi o ka ʻōpū hanu, ʻo ka mea pōʻino, ua lilo i mea maʻamau i nā ʻīlio i kēlā me kēia makahiki. Hōʻike ʻia ka hānō i loko o nā ʻīlio e nā ʻāpana o ka hanu ʻana i hui pū ʻia me ka ʻuʻu a/a i ʻole ka hōʻeha ʻana ma muli o ka haʻikiʻi o ke alaloa. ʻO ka mea pōʻino, pinepine ka poʻe nona ka nānā ʻole i nā hōʻailona mua o ka maʻi a hele i ke keʻena me kahi holoholona maʻi maʻi. ʻOiai ke ʻike ʻia i ka wā mua a kuhikuhi i ka lāʻau kūpono, hoʻokō ka hapa nui o nā mea nona ka mālama paʻa i ka maʻi o ka holoholona a mālama i ka maikaʻi o ke ola no nā ʻīlio hoa, a no nā ʻīlio hana a lawelawe - hiki ke hana.

Ma kēia ʻatikala, e nānā mākou i nā kumu, nā hōʻailona, ​​​​ka hōʻoia, ka mālama ʻana a me ka prognosis i nā ʻīlio me ka hānō bronchial.

Nā kumu o ka Asthma

ʻO ka hānō i loko o nā ʻīlio he maʻi maʻi maʻi mau. Nui nā kumu e hiki ai ke alakaʻi i kēia maʻi, akā naʻe, ʻaʻole hiki ke hoʻoholo i kahi kumu kikoʻī.

I kēlā me kēia hihia, inā ua ʻike ʻia kāu pipi me ka hānō, pono ʻoe e hoʻolohe i kēia mau ʻano o ka mālama ʻana i kahi holoholona:

• nā kemika o ka hale (nā mea hoʻomaʻemaʻe papahele, nā mea hoʻomaʻemaʻe ea, nā aerosol like ʻole, nā deodorants);
• pauda holoi, kahi e holoi ai i ka moena moe kahi e moe ai ka ilio, kona mau kapa (a me kou wahi moe, ina e moe ka ilio me oe);
• ʻO ka lepo kahi allergen ikaika;
• uahi mai ka paka;
• nā mea kanu hale pua;
• nā mea haumia ea ʻē aʻe.

Ua manaʻo ʻia hiki ke loaʻa i nā allergies i ka hulu, ka puʻu kapena, ka lauoho mai nā ʻano holoholona ʻē aʻe, a me nā mea ʻē aʻe.

ʻO ka hopena o ka hana a ka allergen, e ulu hou ana ka mumū o nā ala ea. Hoʻopili pinepine ʻia ka mumū me ka hoʻololi ʻana i ka epithelium o nā paia o ka trachea a me ka bronchi. Hoʻonui i ka hana mucus. ʻO ka hopena, ʻo ka hoʻopaʻapaʻa ʻana o ke ea, hoʻonui ʻia ke kūpaʻa ʻana o ka pulmonary, a hoʻemi ʻia ka ea exhaled, a hōʻike ka ʻīlio i nā hōʻailona o ka hānō. ʻO ke kumu o ka hōʻeha ʻana i ka hānō i nā ʻīlio, ʻo ia ka hāʻule ʻole o ka hanu.

Akā, no ke aha e ulu ai ka hānō ma ka pane ʻana i ka hana a kahi allergen wale nō i ka hapa liʻiliʻi o nā ʻīlio, ʻoiai ke koena o nā holoholona, ​​​​nā mea like ʻole, ʻaʻole e hoʻomaka i ka maʻi? ʻAʻohe pane i kēia nīnau. Manaʻo ʻia he mea nui ka genetic factor. ʻAʻole ʻo ka makahiki a me ke kāne ke kumu predisposing. Eia naʻe, ʻoi aku ka nui o nā holoholona ʻōpio e hoʻomohala i nā maʻi hanu, e hoʻonāukiuki i nā hōʻike o ka maʻi bronchial obstructive mua. ʻO ka hapa nui e ʻike ʻia nā hōʻailona ma waena o nā makahiki a me nā ʻīlio senile.

Pono e hoʻomaopopo ʻia ʻo nā kumu pilikia no ka hoʻomohala ʻana o kēia maʻi e pili ana i nā maʻi bacterial hou, inhalation lōʻihi o nā mea hoʻonāukiuki, a me ke kaumaha.

Nā hōʻailona hānō i nā ʻīlio

ʻO ka hōʻailona nui o ka hānō i loko o nā ʻīlio he ʻū i kekahi manawa. ʻO ka maʻi maʻamau ka maloʻo, a ʻo ka luaʻi ma hope o ke kau ʻana kekahi ʻano o ka hānō. ʻO nā hōʻailona ʻē aʻe i loko o nā ʻīlio ke komo pū kekahi:

• lethargy;
• hoʻouka hānō;
• hiamoe;
• ke alo o ka wheezing;
• koi e luaʻi;
• intolerance i ka hana kino;
• Maule paha kekahi mau holoholona.

ʻO nā hōʻike lapaʻau ma luna nei ma muli o ka paʻakikī o ka ea ma muli o ka paʻakikī o nā kumu: hoʻonui i ka hana mucus, mucosal edema a me ka spasm o nā ʻiʻo maʻemaʻe bronchial. Eia kekahi, ʻo ke kumu o ka ʻuhū ʻana paha ʻo ia ka hoʻonāukiuki ʻana o nā ʻāpana ʻōpū hanu ma muli o ka mumū a i ʻole ka spasm. Ma kahi o nā hōʻike nui o ka hānō ponoʻī, ʻo ka maʻi, ma muli o ka nele o ka hāʻawi ʻana i ka oxygen i ke kino, hiki ke alakaʻi i kahi hoʻopiʻi ma ke ʻano o ka maʻi cardiovascular, hiki ke hōʻike ʻia e ka pōkole o ka hanu, tachycardia, cyanosis o ka maʻi. nā mucous membrane a me ka lethargy nui o nā holoholona.

ʻO kahi hiʻohiʻona ʻokoʻa o ka hānō i loko o nā ʻīlio ʻo ia ka mea ʻaʻohe hōʻailona ma ka hoʻomaha. Eia kekahi, i kekahi mau holoholona, ​​ua ʻike ʻia kahi seasonality o ka maʻi.

lapaʻau '

Hiki ke hoʻopiʻi mua ʻia ka hānō i nā ʻīlio e nā ʻano hōʻailona: ʻo ka ʻu ʻana no ka manawa lōʻihi, ʻoiai ʻoi aku ka maikaʻi o ka maikaʻi o ka holoholona, ​​​​a ʻaʻohe piʻi o ka mahana o ke kino. Eia kekahi, hiki i nā mea nona ke hoʻomaopopo i ka lethargy o ka ʻīlio, ka emi ʻana o ka hoʻoikaika kino, ka pōkole o ka hanu, ka uwē ʻana, nā manawa maule, nā maʻi hānō. I ka hoʻomaka ʻana o ka maʻi, hiki i ka mea nāna e mālama pono ke hoʻolohe i ke kīwī kikoʻī o ka paia o ka ʻōpū i ka hopena o ka exhalation a me ka wheezing.

ʻO ka palpation o ka trachea ka mea maʻamau i ka maʻi ʻaʻa, kahi e pili ana me ka piʻi ʻana o ka naʻau o ka trachea.

No ka hana ʻana i kahi hōʻailona kūpono a haʻalele i nā maʻi concomitant (no ka laʻana, hiki i ka hānō ke hele pū me ka bronchitis of bacterial etiology!) Pono e hana i kahi hōʻailona piha, e like me:

• auscultation;
• umauma x-ray;
• nā ho'āʻo koko (ma kēia hihia, ʻo ka hōʻike koko maʻamau ka mea e hōʻike ai);
• echo a me ka electrocardiography;
• bronchoscopy.

Hana ʻia ka ʻike o ka hānō ma hope o ka hoʻokuʻu ʻia ʻana o nā kumu ʻē aʻe o ka cough - pneumonia, parasitic infection, neoplasms in the chest cavity, ke komo ʻana o ke kino haole i loko o ka ʻōnaehana hanu, pathology cardiac.

ʻO ka mea mua, ma ke koho, e hana ke kauka hoʻohanohano He hana koʻikoʻi ia i ka ʻike ʻokoʻa o ka maʻi pulmonary a me ka hōʻole ʻole o ka naʻau. Ma waho aʻe o nā leo ʻano, e helu pono ke kauka i ka puʻuwai puʻuwai - me ka hāʻule ʻole o ka naʻau, e hoʻonui ʻia ka piʻi ʻana o ka puʻuwai (tachycardia), a me ka hānō, ma ke ʻano he maʻamau, e maʻamau ka puʻuwai.

On hōʻike koko maʻamau ʻike pinepine ʻia ka piʻi ʻana o ka nui o nā eosinophils - ma ka hopena e kākau ʻia e pili ana i ka eosinophilia pili a i ʻole. Eia nō naʻe, pono e hoʻomaopopo ʻia aia paha kēia hōʻailona i ka hihia o nā maʻi ʻē aʻe i pili ʻole i kahi kaʻina maʻi, no ka laʻana, me ka helminthic invasion. No laila, i nā hihia āpau o ka ʻike ʻana i ka piʻi ʻana o nā eosinophils i ke koko o kahi holoholona, ​​​​e kuhikuhi pono ke kauka i nā lāʻau antiparasitic. Akā ʻo ka helu maʻamau o nā eosinophils i loko o ke koko ʻaʻole ia e kāpae i ke alo o ka hānō!

Ninaninau X-ray ʻo ka ʻōpū o ka ʻōpū ka mea hana nui i ka ʻike. Pono e hana ʻia nā kukui X i ʻekolu projections e kāpae i nā kiʻi a me nā pathologies huna - ua kiʻi ʻia ka holoholona mai ka ʻaoʻao hema, ma ka ʻaoʻao ʻākau a hana ʻia kahi kuhi pololei. Ma nā x-ray o nā ʻīlio me ka hānō, ʻike paha ke kauka i ka piʻi ʻana o ka māmā māmā, hoʻonui ʻia ke ʻano o ka māmā ma muli o ka hoʻololi ʻana o ka maʻi o ka bronchi, a me ka hoʻoneʻe ʻana a me ka hoʻoneʻe ʻana o ka diaphragm ma muli o ka hoʻonui ʻana o ka māmā ma muli o ke keakea.

Eia kekahi, i kekahi mau hihia, ʻoi aku ka haʻalele ʻana i ke kaʻina tumora, ma kahi o nā x-ray, pono paha e hana. CT - computed tomography - ʻo ia ke kūlana gula no ka haʻalele ʻana i ke alo o nā neoplasms.

No ka hoʻokaʻawale ʻana i ka maʻi maʻi puʻuwai, ʻo ia ke kumu mua o ka ʻā (chronic heart failure) a me ka hoʻopiʻi ʻana mai ka lōʻihi o ka hanu ʻana (ka mea i kapa ʻia ʻo cor pulmonale), pono e hana. uila uila (ECG) a echocardiography (ultrasound of the heart).

ʻO kekahi o nā pae koʻikoʻi o ka diagnostics, ʻo ia hoʻi, ʻaʻole i mālama pinepine ʻia e nā mea nona ka pono e hāʻawi i ka anesthesia holoholona, ​​​​ʻo ia. bronchoscopy me ka holoi ʻana i ka bronchoalveolar e loaʻa ai nā swabs mai ka trachea a me ka bronchi. Pono nā swabs i loaʻa no ka hoʻokolokolo cytological a me ka inoculation microflora me ka hoʻoholo ʻana i ka naʻau antibacterial. Hana ʻia ka Cytology e kāpae i kahi kaʻina maʻi (me ka hānō, e loaʻa ka nui o nā eosinophils) mai nā maʻi bacterial a me nā fungal (e loaʻa ka nui o nā neutrophils). ʻO ka mea pōʻino, pono e hoʻomanaʻo i ka nui o nā eosinophils a / a i ʻole neutrophils hiki ke loaʻa i mua o kahi kaʻina maʻi maʻi. He mea makemake nō hoʻi e hoʻokō i ka helu helu o nā cell bacteria e hoʻokaʻawale i ka contamination o ka microflora maʻamau mai kahi maʻi ʻeha hanu maoli, a me ka hana PCR diagnostics no ke alo o Mycoplasma (Mycoplasma) a me Bordetella (Bordetella bronchiseptica).

Ka mālama ʻana i ka hānō ma nā ʻīlio

Pono ka mālama ʻana i ka hānō i nā ʻīlio i kahi ala holoʻokoʻa. Ma waho aʻe o ke koho ʻana i nā lāʻau lapaʻau kūikawā, pono ʻoe e kāohi i ka maʻemaʻe o ke kaiapuni, ke kaumaha o ka holoholona, ​​​​a me ka hele ʻana o nā hopena ʻaoʻao mai ka lāʻau i kuhikuhi ʻia.

ʻAʻohe mea maʻamau no ka mālama maʻi maʻi, koe wale nō ke koi ʻia ka lāʻau oxygen, nā lāʻau intravenous, a me nā kaʻina hana ʻē aʻe i hiki ʻole i nā mea nona ke hana ma ka home.

Inā loaʻa nā hōʻailona o ke ala ala ea haʻahaʻa ma muli o ka hoʻoikaika kino, pono e kaupalena ʻia. Eia nō naʻe, hiki ke kōkua i ka hoʻoikaika kino inā pono e hoʻomaʻamaʻa i ka hele ʻana o nā mea huna bronchial a hoʻemi i ke kaumaha o ke kino i nā holoholona momona. ʻO ke kānāwai nui, ʻo ia ke kaupalena ʻia ka ukana a hiki ʻole i ka hoʻoikaika kino ke kumu ʻole.

Manaʻo ʻia nā holoholona momona i nā meaʻai haʻahaʻa haʻahaʻa haʻahaʻa, no ka mea, ua hōʻike ʻia ʻo ka nui o ke kaumaha e hoʻopilikia i ke ʻano o ka maʻi. He mea nui i ka poʻe nona ka hoʻomaopopo ʻana he mea nui ka pohō kaumaha o ka mālama ʻana, hoʻonāwaliwali i nā hōʻike o ka maʻi, ʻaʻole i hoʻōla mau ʻia.

ʻO ke kumu o ka mālama lōʻihi he mau lāʻau hormonal (glucocorticoids). Hiki ke hoʻoholo wale ʻia e ke kauka ke ʻano mua o ka lāʻau. I ka emi ʻana o ka paʻakikī o nā hōʻailona, ​​​​e hoʻemi mālie ʻia ka nui a me ka helu o nā kau ma mua o 2-4 mau mahina. I ka hapanui o nā hihia, ʻo ka palena liʻiliʻi o ka mālama mālama pono e kuhikuhi ʻia no ka hoʻohana mau ʻana, akā naʻe, ke koho ʻia nei ke koho ʻana i kēlā me kēia. ʻO ka mea pōʻino, pono e hoʻomanaʻo ʻia ʻo ka hoʻohana lōʻihi ʻana i nā lāʻau lapaʻau hormonal hiki ke alakaʻi i ka ulu ʻana o kekahi mau pilikia. Hiki i nā holoholona predisposed ke hoʻomohala i ka maʻi maʻi mellitus, congestive heart failure, urinary infection, iatrogenic hyperadenocorticism (Cushing's syndrome). Ma kēia mea, pono nā mea maʻi e loaʻa ana i ka hormone therapy i nā hoʻokolohua maʻamau e ke kauka a lawe i nā hoʻokolohua koko (general a me biochemistry) e nānā i ka ulu ʻana o nā hoʻopiʻi.

Hoʻohana ʻia nā lāʻau antibiotic i ka hoʻokaʻawale ʻana o ka microflora mai ka hoʻokuʻu ʻana o ka ʻōpū hanu. ʻO ka papa o ka mālama ʻana he 10-14 mau lā e like me nā hopena o ka moʻomeheu sputum i loaʻa ma muli o ka bronchoscopy, e hoʻoholo ai i ka naʻau o ka microflora. Inā ʻaʻole hiki i ka moʻomeheu antimicrobial susceptibility, koho ʻia nā lāʻau antibiotic ākea me ka bioavailability kiʻekiʻe a me ka liʻiliʻi o ka ʻona (e laʻa, synulox).

Me ka hormonal a me antibacterial therapy, hiki i ke kauka ke kuhikuhi i nā bronchodilators - ʻo ia hoʻi, nā lāʻau lapaʻau e kōkua i ka hoʻonui ʻana i nā alaloa, hoʻomaikaʻi i ka neʻe ʻana o ka diaphragm, a hoʻemi i ke kaomi ʻana i ka pulmonary tract. E like me ke kānāwai, ua kuhikuhi ʻia kēia mau lāʻau i ke ʻano o nā inhalations.

I kekahi mau hihia, ma ke alo o ka ʻūlū lōʻihi, maloʻo, hoʻonāwaliwali, ua kuhikuhi ʻia nā lāʻau antitussive.

Forecast

ʻO ka wānana no ka hānō i hoʻopaʻa ʻia i loko o kahi ʻīlio e pili ana i ke koʻikoʻi o ka maʻi, ke koʻikoʻi o nā hōʻailona, ​​​​ka ʻae ʻia o ka mālama ʻana, ka pane ʻana i nā lāʻau lapaʻau, a me ka hele ʻana o nā comorbidities.

He mea nui i ka mea nona ka hoʻomaopopo ʻana e piʻi mau ana ka hānō bronchial i ka wā lōʻihi a ʻaʻole hiki ke hoʻōla piha ʻia (inā wale nō ke ʻike a hoʻopau ʻia ke kumu o ka maʻi). Hiki ke ho'ēmi i ka pinepine o ka hoʻoukaʻana, akā,ʻaʻole hiki ke hoʻopau loaʻia.

Pono e loiloi ʻia nā ʻīlio i kēlā me kēia 3-6 mahina e ʻike i nā hōʻailona o ka pōʻino i ka manawa kūpono. I ka wā e puka mai ai nā hōʻailona o ka wīwī a i ʻole nā ​​​​hōʻailona ʻē aʻe o ka ʻeha hanu, pono e hoʻopili ka mea nona ke kauka holoholona.

ʻAʻole ka ʻatikala he kāhea e hana!

No ka ʻike kikoʻī hou aku o ka pilikia, manaʻo mākou e hoʻopili i kahi loea.

E nīnau i ke kauka

16 September 2020

Hana hou ʻia: Pepeluali 13, 2021