Epiglottitis

I-Epiglottitis kukudumba kwe-epiglottis. Esi sisicubu esigubungela i-trachea (umbhobho womoya). I-Epiglottitis inokuba sisifo esisongela ubomi.

I-epiglottis sisihlunu esiqinileyo, kodwa esiguqukayo (esibizwa ngokuba yi-cartilage) ngasemva kolwimi. Ivala i-windpipe yakho (i-trachea) xa uginya ukuze ukutya kungangeni kwindlela yakho yomoya. Oku kunceda ukuthintela ukukhohlela okanye ukukrwitsha emva kokuginya.

Kubantwana, i-epiglottitis ihlala ibangelwa yintsholongwane Haemophilus influenzae (H influenzaeUhlobo B. Kubantu abadala, kuhlala kungenxa yezinye iibacteria ezinje I-Strepcoccus pneumoniae, okanye iintsholongwane ezinjenge-herpes simplex virus kunye ne-varicella-zoster.

I-Epiglottitis ngoku ayiqhelekanga kakhulu kuba isitofu sokugonya se-H influenzae B (Hib) sinikwa rhoqo kubo bonke abantwana. Esi sifo sasikhe sibonwe rhoqo kubantwana abaneminyaka emi-2 ukuya kweye-6. Kwiimeko ezinqabileyo, i-epiglottitis inokwenzeka kubantu abadala.

I-Epiglottitis iqala ngomkhuhlane omkhulu kunye nomqala obuhlungu. Ezinye iimpawu zingabandakanya:

• Izandi zokuphefumla ezingaqhelekanga (stridor)
• Ifiva
• Umbala wolusu oluhlaza okwesibhakabhaka (cyanosis)
• Ukutsala amathe
• Ubunzima bokuphefumla (umntu unokufuna ukuhlala nkqo kwaye ancike kancinci phambili ukuze aphefumle)
• Kunzima ukugwinya
• Utshintsho kwilizwi (ukungxola)

Iindlela zomoya zinokuvaleka ngokupheleleyo, ezinokubangela ukubanjwa kwentliziyo kunye nokufa.

I-Epiglottitis inokuba ngxamisekileyo kwezonyango. Funa uncedo lwezonyango kwangoko. Sukusebenzisa nantoni na ukucinezela ulwimi ukuzama ukujonga umqala ekhaya. Ukwenza njalo kunokwenza imeko ibe mandundu.

Umboneleli wezempilo unokuvavanya ibhokisi yelizwi (ingqula) esebenzisa isipili esincinci esibanjwe ngasemva komqala. Okanye ityhubhu yokubukela ebizwa ngokuba yi-laryngoscope inokusetyenziswa. Olu vavanyo lwenziwa ngcono kwigumbi lokusebenza okanye kwindawo efanayo apho iingxaki zokuphefumla ngequbuliso zinokuphathwa ngokulula.

Uvavanyo olunokwenziwa lunokubandakanya:

• Inkcubeko yegazi okanye inkcubeko yomqala
• Gcwalisa ubalo lwegazi (CBC)
• Intamo x-ray

Ukuhlala esibhedlele kuyafuneka, zihlala kwigumbi labagula kakhulu (ICU).

Unyango lubandakanya iindlela zokunceda umntu aphefumle, kubandakanya:

• Ityhubhu yokuphefumla (intubation)
• I-oksijini efumileyo

Olunye unyango lunokubandakanya:

• Antibiotic ukunyanga usulelo
• Amayeza alwa nokudumba, abizwa ngokuba yi-corticosteroids, ukunciphisa ukudumba komqala
• Ulwelo olunikwa ngomthambo (ngo-IV)

I-Epiglottitis inokusongela ubomi. Ngonyango olufanelekileyo, umphumo uhlala ulungile.

Ubunzima bokuphefumla luphawu lokugqibela, kodwa olubalulekileyo. I-Spasm inokubangela ukuba i-airways ivalwe ngequbuliso. Okanye, iindlela zomoya zinokuvalwa ngokupheleleyo. Nokuba zezi meko zinokubangela ukufa.

Isitofu sokugonya se-Hib sikhusela uninzi lwabantwana kwi-epiglottitis.

Iibhaktheriya eziqhelekileyo (H umkhuhlane uhlobo b) ebangela i-epiglottitis isasazeka ngokulula. Ukuba umntu kusapho lwakho uyagula kule bhaktiriya, amanye amalungu osapho kufuneka avavanywe kwaye anyangwe.

Supraglottitis

• Umqala womzimba
• Haemophilus influenzae umzimba

UNayak JL, Weinberg GA. Epiglottitis. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahl. 63.

URodrigues KK, uRoosevelt GE. Ukuphazamiseka kwendlela ephezulu yomoya (croup, epiglottitis, laryngitis, kunye ne-bacterial tracheitis). Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 412.