ʻO Stridor kahi panting, kani maʻamau kiʻekiʻe i hana ʻia e kahi kahe wikiwiki a huikau o ka lewa ma o kahi ʻāiki o nā alaloa o luna. ʻO ka manawa pinepine inspiratory, ʻaneʻane hiki ke lohe ʻia me ka stethoscope. Aia i loko o nā keiki, hiki i ke ʻano me ka poʻe mākua? He aha nā kumu? A ʻo nā hopena? Pehea e mālama ai?

ʻO Stridor kahi ʻano maʻamau, panting, ʻoi aku a ʻoi paha o ke kani kani i hoʻokuʻu ʻia e ka hanu ʻana. ʻO ka maʻamau, nui ka leo e lohe ʻia mai kahi mamao. He hōʻailona kēia, ʻaʻole kahi hōʻailona, ​​a ʻo ka ʻimi ʻana i nā kumu kumu nui loa ia e like me ka stridor he ulia pōpilikia maʻamau. 

No ka kumu laryngotracheal, kumu ʻia ka stridor e kahi kahe wikiwiki a huikau o ke kahe o ka lewa ma o kahi wahi liʻiliʻi, a i ʻole hapa ʻia, o ke kahawai hanu luna. Hiki iā ia ke:

• mele kiʻekiʻe a me ke mele, kokoke i kahi mele;
• koʻikoʻi, e like me ke ʻū ʻana a i ʻole ke ʻū ʻana;
• hoarse me kahi ʻano horny, e like me ka ʻūlū ʻana.

Hiki i Stridor ke:

• hoʻouluulu: lohe ʻia ia i ka hoʻoulu ʻana i ka manawa o ka hoʻoliʻiliʻi pathological o ke anawaena o nā alaloa keu o ke keu (pharynx, epiglottis, larynx, extra-thoracic trachea);
• biphasic: i ka hanana o ke ākea koʻikoʻi, he biphasic ia, ʻo ia hoʻi i kēia manawa i nā pae ʻelua o ka hanu ʻana;
• a i ʻole expiratory: i ka hanana o kahi ālai ʻia i loko o nā alaloa intrathoracic, expiratory ka stridor.

ʻO Stridor ka hōʻike pinepine i nā keiki o kahi pathology o ka respiratory respiratory. ʻAʻole ʻike ʻia kāna hanana i ka heluna pediatric lehulehu. Eia naʻe, ua ʻike ʻia ke alapine kiʻekiʻe ma nā keikikāne.

Pono e hoʻomaopopo ʻia ʻoiai ʻoi aku ka liʻiliʻi o ka maʻamau, aia kekahi stridor i nā mākua.

Loaʻa nā keiki i nā ala liʻiliʻi a liʻiliʻi a kūpono i ka hanu walaʻau. Hoʻokumu ʻia ʻo Stridor e nā pathologies e pili ana i ka larynx a me ka trachea. ʻO Wheezing kahi ʻano o nā pathology bronchial. Ke hoʻonui ʻia ka hanu walaʻau i ka wā hiamoe, aia ke kumu i ka oropharynx. Ke kani nui ka hanu ke ala ke keiki, aia ke kumu i ka larynx a i ʻole trachea.

I nā keiki, ʻo nā kumu maʻamau e pili ana i nā kumu hānau a me nā kumu i loaʻa.

Nā kumu kūpuna o ke stridor i nā keiki

• ʻO Laryngomalacia, ʻo ia hoʻi kahi larynx palupalu: ʻo ia ke kumu maʻamau o ke alaloa congenital a kū i 60 a 70% o nā anomalies laryngeal congenital;
• Lōlō o nā kaula leo;
• ʻO kahi stenosis, ʻo ia ka mea e hoʻopili ana, subglottis hānau;
• ʻO kahi tracheomalacia, ʻo ia hoʻi he trachea palupalu a maʻalahi hoʻi;
• He hemangioma subglottic;
• ʻO kahi pūnaewele laryngeal, ʻo ia hoʻi kahi membrane e hoʻopili ana i nā kaula leo ʻelua ma muli o kahi hōʻino kūlohelohe;
• ʻO kahi lastngeal diastema, ʻo ia hoʻi kahi malformation e kamaʻilio ai ka larynx me ka digestive tract.

Loaʻa nā kumu o ke stridor i nā keiki 

• Loaʻa ka stenosis subglottic;
• ʻO Croup, ʻo ia ka mumū o ka trachea a me nā kaula leo, i hana pinepine ʻia e ka maʻi maʻi lele;
• He kino haole i hanu ʻia;
• ʻO kahi maʻi laryngitis
• ʻO Epiglottitis, kahi maʻi o ka epiglottis i hoʻokumu ʻia e nā bacteria Haemophilus influenzae ʻano b (Hib). ʻO kahi kumu pinepine o ke stridor i nā keiki, ua hoʻemi ʻia kāna hanana mai ka hoʻokomo ʻana o ka lāʻau lapaʻau iā Haemophilus influenzae type B;
• tracheitis, etc.

Nā kumu maʻamau i nā mākua

• ʻO nā tumors poʻo a me nā ʻāʻī, e like me ka maʻi ʻaʻai laryngeal, hiki ke hana i ke stridor inā keakeʻa hapa lākou i nā alaloa kiʻekiʻe;
• He abscess;
• ʻO Edema, ʻo ia hoʻi ka ʻōhū ʻana, o ka hanu hanu luna i kū i kahi hopena o ka extubation;
• ʻO ke kīnā ʻole o ke kaula mele, i kapa ʻia hoʻi ka neʻe ʻana o ke kaula leo paradoxical;
• Ka palu ʻana o nā kaula leo, ma hope o ke kahakaha ʻana a i ʻole ka intubation kikoʻī: i ka wā e lōlō ai nā kaula leo ʻelua, ʻākiki loa ka manawa ma waena o lākou a lawa ʻole nā ​​alaloa;
• Kahi kino haole i hanu ʻia e like me ka ʻāpana meaʻai a i ʻole kahi wai liʻiliʻi i hoʻopili ʻia i loko o nā akemāmā e hoʻoili ana i ka larynx;
• Epiglottitis;
• Nā hopena āpau.

Hiki ke hoʻokaʻawale ʻia nā kumu o ke stridor e like me kona kani:

• Acute: laryngomalacia a i ʻole ka maʻi lōlō o nā kaula leo;
• Koʻikoʻi: laryngomalacia a i ʻole subglottic pathology;
• Hoarseness: laryngitis, stenosis a i ʻole subglottic a i ʻole kiʻekiʻe tracheal angioma.

Hiki paha i Stridor ke kūlike me ka hanu a me ka hopena o ka meaʻai, me nā ʻōuli o ke koʻikoʻi e like me:

• ka paʻakikī i ka lawe ʻana i ka meaʻai;
• nā ʻāpana o ka hanu i ka wā o ka hānai ʻana;
• ke hoʻohiehie kaumaha ana;
• dyspnea, ʻo ia ka paʻakikī i ka hanu ʻana;
• nā hanana o ka hanu kaumaha;
• nā hanana o ka cyanosis (ka hoʻoliʻiliʻi bluish o ka ʻili a me nā membrane mucous);
• ʻokiʻoki hiamoe hoʻōla;
• ka ikaika o nā hōʻailona o ka paio hanu ʻana: ka lele ʻana o nā ʻeheu o ka ihu, intercostal a me suprasternal retraction.
  

Ma mua o kekahi stridor, pono e noi ʻia kahi hoʻokolokolo ENT me ka hana ʻana i nasofibroscopy. Hana ʻia kahi biopsy, CT scan, a me MRI inā kuhi ʻia kahi tumo.

ʻO Stridor ke kumu o ka hanu ʻana i ka manawa e hoʻomaha ai ke kanaka he pilikia olakino. ʻO ka loiloi i nā hōʻailona koʻikoʻi a me ke kēkelē o ka hanu hanu ka mea mua i ka hoʻokele. I kekahi mau hihia, pono pono ka hoʻopaʻa ʻana i nā alaloa ma mua a i ʻole ka hui pū ʻana me ka hoʻokolohua hoʻokolohua.

ʻOkoʻa nā koho lapaʻau no ka stridor ma muli o ke kumu o ka hōʻailona.

I ka hihia o laryngomalacia

Me ka ʻole o nā pae hoʻohālikelike o ke koʻikoʻi, ʻaʻole hoʻi nā hōʻailona e pili ana, hiki ke noi ʻia kahi wā e nānā ai, ma lalo o ka hoʻokō ʻana o kahi lāʻau anti-reflux (antacids, ka mānoanoa o ka waiū). Pono e mālama i ka ukali i mea e hōʻoia ai i ka lohi o ka hoʻi ʻana o nā ʻōuli a laila ka nalowale ʻana i loko o ka manawa i manaʻo ʻia.

ʻO nā ʻōuli o ka laryngomalacia he akahai a hele aku iā lākou iho ma mua o ka piha ʻana o ʻelua mau makahiki. Eia nō naʻe, ʻaneʻane 20% o nā maʻi me ka laryngomalacia i loaʻa nā ʻōuli koʻikoʻi (stridor koʻikoʻi, nā pilikia hānai, a me ka hoʻoneʻe ulu ʻana) e koi ana i ka lāʻau me ke ʻoki endoscopic (supraglottoplasty).

I ka hanana o kahi kino haole i hanu ʻia

Inā aia ka mea ma waho o kahi haukapila, hiki i kekahi kanaka ke hoʻomaʻamaʻa iā ia ke kipaku aku i ke kino haole ma o ka hana ʻana i ka maneuver Heimlich.

Inā aia ka mea i loko o kahi haukapila a i ʻole kahi keʻena pilikia, e hoʻokomo ʻia kahi paipu ma o ka ihu a waha paha o ke kanaka (tracheal intubation) a i ʻole pololei i loko o ka trachea ma hope o kahi ʻoki ʻoki liʻiliʻi (tracheostomy), e ʻae ai i ka ea i loko o ka mea keʻakeʻa a pale paupauaho.

I ka hihia o edema o ka hanu tract

Hiki ke koi ʻia ka adrenaline a me ka dexamethasone neʻe neʻeneʻe i nā mea maʻi e pili ana i ka edema airway.

Inā loaʻa i ka hanu kaumaha nui

Ma ke ʻano he manawa kuʻuna, hoʻomaikaʻi ka hoʻohuihui o ka helium a me ka oxygen (heliox) i ka holo ʻana o ka ea a hoʻoliʻiliʻi i ka stridor i nā maʻi ākea nui e like me ka edema laryngeal post-extubation, laryngitis stridular a me nā tumors o ka larynx. ʻAe ʻo Heliox i ka hoʻoliʻiliʻi o ke kūpikipiki kahe ma muli o kahi haʻahaʻa o ka helium i hoʻohālikelike ʻia me oxygen a me nitrogen.