He aha ka maʻi ʻili o ka mākū? Nā hōʻailona, nā kumu, a me ka mālama

ʻO ka maʻi ʻili o ka mākū (ILD) kahi hui o nā kūlana e hoʻoulu ai i ka mumū a me ka ʻili ma nā ʻeke ea liʻiliʻi a me nā pūnaewele o kou mākū. E noʻonoʻo iā ia e like me kou mākū e hoʻomohala ana i nā ʻāpana mānoanoa, paʻakikī e hana ai i ka oxygen e neʻe mai kou mākū i loko o kou kahe koko.

Hoʻopili kēia kūlana i ka interstitium, ʻo ia ka pūnaewele pūnaewele māmā e hoʻopuni a kākoʻo i nā ʻeke ea o kou mākū. Ke mumū a ʻili paha kēia pūnaewele, ʻaʻole hiki i kou mākū ke hana maikaʻi e like me ka mea e pono ai.

He aha nā hōʻailona o ka maʻi ʻili o ka mākū?

ʻO ka hōʻailona maʻamau loa āu e ʻike mua ai ʻo ka pōkole o ka hanu, ʻoi aku hoʻi i ka wā o nā hana kino e like me ke piʻi ʻana i nā alapiʻi a i ʻole ke hele ʻana i luna. Hana kēia no ka mea e hana nui ana kou mākū e kiʻi i ka oxygen i loko o kou kino.

Eia nā hōʻailona nui e hiki ke hoʻomohala mālie i ka manawa:

• Ka ʻōhū maloʻo mau ʻaʻole e hoʻopuka i ka mucus
• Pōkole o ka hanu i ka wā o ka hoʻoikaika kino a i ʻole nā hana o kēlā me kēia lā
• Luhi a me ka manaʻo luhi maʻamau
• ʻEha umauma a i ʻole ka paʻa
• Nalo o ka makemake a me ka nalowale kaumaha i manaʻo ʻole ʻia
• Clubbing o nā manamana lima (lilo nā manamana lima i ākea a puni i nā ʻōlelo)

Hoʻomohala mālie kēia mau hōʻailona i nā mahina a i ʻole nā makahiki, ʻo ia ke kumu e hoʻohoka ai ka poʻe he nui iā lākou ma ke ʻano he hōʻailona o ka ʻelemakule a i ʻole ka nele o ke ʻano.

He aha nā ʻano o ka maʻi ʻili o ka mākū?

Aia ma mua o 200 mau ʻano like ʻole o nā maʻi ʻili o ka mākū, akā maʻamau lākou i loko o kekahi mau māhele nui. Hiki i ka hoʻomaopopo ʻana i kēia mau ʻano ke kōkua iā ʻoe e hoʻomaopopo i kāu ʻike a me nā koho mālama.

ʻO nā ʻano maʻamau loa e komo pū ana:

• Idiopathic pulmonary fibrosis (IPF) - ʻO ka ʻano maʻamau loa kahi i ʻike ʻole ʻia ai ke kumu kūpono
• Sarcoidosis - Hoʻoulu i ka mumū i nā ʻōnaehana he nui, me ka mākū
• Hypersensitivity pneumonitis - Hoʻoulu ʻia e ka hanu ʻana i kekahi mau ʻāpana a i ʻole nā kemika
• Connective tissue disease-related ILD - Hoʻopili ʻia me nā kūlana e like me ka maʻi ʻili rheumatoid
• Drug-induced ILD - Hoʻoulu ʻia e kekahi mau lāʻau lapaʻau
• Occupational lung disease - Mai ka hōʻike hana i nā mea ʻino

ʻO kekahi mau ʻano ʻoi aku ka liʻiliʻi e komo pū ana me ka lymphangioleiomyomatosis (LAM), ka mea e hoʻopili nui ai i nā wāhine, a me ka Langerhans cell histiocytosis, i hoʻopili pinepine ʻia i ka puhipaka.

He aha nā kumu o ka maʻi ʻili o ka mākū?

He nui nā kumu o ka maʻi ʻili o ka mākū, a i kekahi manawa ʻaʻole hiki i nā kauka ke ʻike i ka mea hoʻoulu kūikawā. Ke ʻike ʻole ʻia ke kumu, ua kapa ʻia ʻo ia he "idiopathic," ʻo ia hoʻi he "kumu ʻike ʻole.

ʻO nā hōʻike ʻāina a me nā hana he mau mea lawehala maʻamau e hiki ke hōʻino i kou pūnaewele mākū i ka manawa:

• Nā fiber asbestos mai nā mea kūkulu hale a i ʻole nā hale kahiko
• Lepo silica mai ka ʻeli ʻana, ka sandblasting, a i ʻole ka ʻoki pōhaku
• Lepo lanahu mai nā hana ʻeli ʻana
• Nā ʻōpala manu a i ʻole nā hulu (maʻi mākū manu)
• Nā hua mold mai nā wahi pulu
• Nā lepo metala mai ka welding a i ʻole ka hana metala

Hiki i kekahi mau lāʻau lapaʻau ke hoʻoulu i ka mumū mākū, me kekahi mau lāʻau chemotherapy, nā lāʻau naʻau, a me nā antibiotics. Hiki i nā kūlana autoimmune e like me ka maʻi ʻili rheumatoid a i ʻole scleroderma ke hoʻoulu i kou ʻōnaehana pale e hoouka i nā pūnaewele mākū olakino.

Hiki i nā kumu genetic ke hoʻolilo i kekahi poʻe i ʻoi aku ka maʻalahi i ka hoʻomohala ʻana i ka ILD, ʻoi aku inā loaʻa i nā lālā ʻohana nā kūlana mākū like. Hoʻonui nui ka puhipaka i kou pilikia a hiki ke hoʻoino i ka maʻi ʻili o ka mākū i loaʻa.

I ka wā e ʻike ai i ke kauka no ka maʻi ʻili o ka mākū?

Pono ʻoe e hoʻokaʻaʻike i kāu kauka inā loaʻa iā ʻoe ka pōkole o ka hanu mau ʻaʻole e hoʻomaikaʻi me ka hoʻomaha, ʻoi aku inā pili ia i kāu mau hana o kēlā me kēia lā. Hiki i ka loiloi mua ke hoʻolilo i kahi ʻokoʻa nui i ka hoʻokele ʻana i kēia kūlana maikaʻi.

E ʻimi i ka mālama lapaʻau koke inā ʻike ʻoe:

• Pōkole o ka hanu e hoʻonui i nā hebedoma a i ʻole nā mahina
• ʻO ka ʻōhū maloʻo e mau ana no nā hebedoma ma mua o kekahi mau hebedoma
• Luhi i ʻike ʻole ʻia e kaupalena i kāu mau hana maʻamau
• ʻEha umauma a i ʻole ka ʻoluʻolu ʻole
• Loli i kou mau kui a i ʻole nā manamana lima

E kāhea no ke kōkua lapaʻau koke inā loaʻa iā ʻoe ka pōkole o ka hanu nui i ka hoʻomaha, ka ʻeha umauma, a i ʻole inā lilo kou mau lehelehe a i ʻole nā manamana lima i uliuli. Hōʻike kēia mau hōʻailona i kou pae oxygen he haʻahaʻa weliweli a pono e hoʻomaopopo koke ʻia.

He aha nā mea pilikia no ka maʻi ʻili o ka mākū?

ʻOiai hiki i nā poʻe he nui me ka maʻi ʻili o ka mākū ke mālama i kahi ola maikaʻi me ka mālama kūpono, hiki i kēia kūlana ke alakaʻi i nā pilikia koʻikoʻi inā waiho ʻole ʻia a i ʻole inā holomua wikiwiki.

ʻO nā pilikia koʻikoʻi loa e komo pū ana:

• Pulmonary hypertension - Ke koko kiʻekiʻe i loko o ka mākū e hoʻoikaika i kou naʻau
• Right heart failure - Ke hiki ʻole i kou naʻau ke hoʻopuka koko maikaʻi i kou mākū
• Respiratory failure - Ke hiki ʻole i kou mākū ke hāʻawi i ka oxygen lawa i kou kino
• Lung cancer - Hoʻonui kekahi mau ʻano o ka ILD i ka pilikia o ka maʻi kanesa
• Blood clots - ʻOi aku ka nui o nā clots i nā kīʻaha koko mākū
• Collapsed lung (pneumothorax) - Ke ea e komo ana i ka wahi a puni kou mākū

ʻO nā pilikia liʻiliʻi akā koʻikoʻi e komo pū ana me nā maʻi nui ma muli o nā pale mākū nāwaliwali a me ka pulmonary embolism. Kūpono ka nānā mau ʻana e kāu hui olakino e hopu i kēia mau pilikia i ka wā mua i ka wā e mālama maikaʻi ʻia ai.

Pehea e pale aku ai i ka maʻi ʻili o ka mākū?

ʻOiai ʻaʻole hiki iā ʻoe ke pale aku i nā ʻano o ka maʻi ʻili o ka mākū, ʻoi aku hoʻi nā mea me nā ʻāpana genetic, hiki iā ʻoe ke hoʻemi nui i kou pilikia ma ka pale ʻana i nā mea hoʻoulu i ʻike ʻia a me ka mālama ʻana i ke olakino maikaʻi.

ʻO nā hana pale maikaʻi loa e kau nui ana i ka pale ʻana i kou mākū mai nā hōʻike ʻino:

• E haʻalele i ka puhipaka a pale i ka ua puhipaka
• E hoʻohana i nā lako pale kūpono ma ka hana inā hōʻike ʻia i ka lepo a i ʻole nā kemika
• E mālama i ka ea maikaʻi i kou home a me ka wahi hana
• E hahai i nā kuhikuhi palekana i ka wā e lawelawe ana i nā mea pilikia
• E hoʻokele i ka maʻi reflux gastroesophageal inā loaʻa iā ʻoe
• E noho hou me nā lāʻau lapaʻau e pale aku i nā maʻi mākū

Inā hana ʻoe i nā hana pilikia kiʻekiʻe e like me ka ʻeli ʻana, ka hana kūkulu, a i ʻole ka hana ʻana, hiki i nā hoʻokolohua hana mākū maʻamau ke kōkua i ka ʻike ʻana i nā loli mua ma mua o ka hoʻomohala ʻana o nā hōʻailona. ʻO ka ʻike mua pinepine e alakaʻi i nā hopena maikaʻi a me nā koho mālama hou aku.

Pehea ka ʻike ʻana i ka maʻi ʻili o ka mākū?

Pono ka ʻike ʻana i ka maʻi ʻili o ka mākū i ka hui ʻana o nā hoʻokolohua no ka mea hiki i nā hōʻailona ke like me nā kūlana mākū ʻē aʻe. E hoʻomaka kāu kauka me ka moʻolelo lapaʻau piha a me ka nānā kino, e hoʻolohe nui ana i kāu mau ʻano hanu a me nā leo mākū.

ʻO ke kaʻina hana ʻike maʻamau e komo pū ana i kekahi mau hoʻokolohua nui:

• Chest X-rays - Hōʻike i ka hoʻolālā mākū maʻamau a me ka ʻili maopopo
• High-resolution CT scan - Hāʻawi i nā kiʻi kikoʻī o ka pūnaewele mākū
• Pulmonary function tests - Ana i ka hana maikaʻi o kou mākū
• Blood tests - E nānā no nā mea hōʻailona autoimmune a me ka mumū
• Bronchoscopy - ʻAe i ka nānā pololei ʻana i nā ala ea
• Lung biopsy - Lawe i nā laʻana pūnaewele liʻiliʻi no ka nānā microscopic

Hiki i kāu kauka ke kauoha i kahi echocardiogram e nānā i ka hana o kou naʻau, ʻoiai hiki i ka maʻi mākū ke hoʻopili i kou naʻau i ka manawa.

He aha ka mālama no ka maʻi ʻili o ka mākū?

Kaukaʻi ka mālama ʻana i ka maʻi ʻili o ka mākū i ka hoʻolohi ʻana i ka holomua o ka maʻi, ka hoʻokele ʻana i nā hōʻailona, a me ka mālama ʻana i kou ola maikaʻi. Kaukaʻi ka ʻano kūikawā i ke ʻano o ka ILD āu i loaʻa ai a pehea ka holomua i ka wā i ʻike ʻia ai.

Hoʻokumu nā lāʻau lapaʻau i ke kumu o ka mālama ʻana no nā ʻano o ka ILD:

• Anti-fibrotic drugs - Hoʻolohi i ka ʻili i ka idiopathic pulmonary fibrosis
• Corticosteroids - Hoʻemi i ka mumū i nā ʻano mumū
• Immunosuppressive drugs - Hoʻokele i ka hōʻino mākū pili i ka autoimmune
• Oxygen therapy - Kūpono e mālama i nā pae oxygen lawa
• Bronchodilators - Wehe i nā ala ea e hoʻomaikaʻi i ka hanu

Hui pū nā papahana hoʻōla mākū i ka hoʻomaʻamaʻa hoʻoikaika kino, nā ʻano hanu, a me ka hoʻonaʻauao e kōkua iā ʻoe e hoʻokele i nā hana o kēlā me kēia lā me ka maikaʻi. Hiki i kēia mau papahana ke hoʻomaikaʻi nui i kou hoʻomanawanui a me kou ola maikaʻi.

No nā hihia holomua, hiki ke noʻonoʻo ʻia ka hoʻololi ʻana i ka mākū inā olakino ʻoe no ka ʻoki kino a hoʻokō i nā kūlana kūikawā. Hiki i kēia koho ke ola ola no nā poʻe me ka maʻi holomua wikiwiki.

Pehea e hoʻokele ai i ka maʻi ʻili o ka mākū ma ka home?

ʻO ka hoʻokele ʻana i ka maʻi ʻili o ka mākū ma ka home e komo pū ana i ka hoʻololi ʻana i ke ola e kākoʻo i kou olakino mākū a me kou olakino maikaʻi. Hiki i nā loli liʻiliʻi i kāu hana o kēlā me kēia lā ke hoʻolilo i kahi ʻokoʻa nui i kou manaʻo.

ʻO nā ʻano hanu a me ka mālama ikehu he kōkua nui loa:

• E hoʻomaʻamaʻa i ka hanu pursed-lip e hoʻomaikaʻi i ka hoʻololi oxygen
• E hoʻohana i nā hana hanu diaphragmatic i kēlā me kēia lā
• E hoʻolālā iā ʻoe iho i nā hana a lawe i nā hoʻomaha pinepine
• E mālama i nā lāʻau lapaʻau hoʻopakele a me nā lako oxygen maʻalahi
• E mālama i ke kūlana maikaʻi e hoʻonui i ka hiki o ka mākū
• E noho wai e mālama i nā mea huna mākū lahilahi

Hiki i nā hoʻololi ʻāina i kou home ke hoʻemi i ka huhū mākū a hoʻomaikaʻi i ka hanu. E mālama i kou wahi noho maikaʻi, e hoʻohana i nā mea hoʻomaʻemaʻe ea inā pono, a pale i nā mea ʻala ikaika a i ʻole nā mea hoʻomaʻemaʻe kemika.

ʻO ka hoʻoikaika kino māmā maʻamau, e like me ka ʻae ʻana o kāu kauka, e kōkua i ka mālama ʻana i ka ikaika o nā ʻiʻo a me ka olakino cardiovascular. Hiki i nā hele pōkole a i ʻole ka hoʻonui ʻana i ka maikaʻi inā hana mau ʻia.

Pehea ʻoe e hoʻomākaukau ai no kāu hālāwai kauka?

ʻO ka hoʻomākaukau ʻana no kāu hālāwai kauka e kōkua i ka hōʻoia ʻana e loaʻa iā ʻoe ka mea nui loa mai kāu kipa a hāʻawi i kāu hui olakino i ka ʻike nui e pili ana i kou kūlana. Hiki i ka hoʻomākaukau maikaʻi ke alakaʻi i nā loiloi pololei a me nā hoʻoholo mālama maikaʻi.

Ma mua o kāu hālāwai, e hōʻiliʻili i ka ʻike nui e pili ana i kāu mau hōʻailona a me ka moʻolelo lapaʻau:

• E kākau i ka wā i hoʻomaka ai nā hōʻailona a pehea lākou i loli ai
• E papa inoa i nā lāʻau lapaʻau, nā mea hoʻohui, a me nā dosages āu e lawe nei
• E hoʻomaopopo i nā hōʻike ʻāina a i ʻole nā hana
• E hoʻomākaukau i nā nīnau e pili ana i kou kūlana a me nā koho mālama
• E lawe mai i nā hopena hoʻokolohua mua a me nā haʻawina kiʻi
• E komo pū me ka moʻolelo ʻohana o nā maʻi mākū a i ʻole nā maʻi autoimmune

E noʻonoʻo e lawe mai i kahi lālā ʻohana a hoaaloha paha e kōkua i ka hoʻomanaʻo ʻana i ka ʻike i kūkākūkā ʻia i ka wā o ka hālāwai. Hiki i ka loaʻa ʻana o kekahi e kōkua nui i ka wā e kūkākūkā ana i nā koho mālama paʻakikī a i ʻole nā hopena hoʻokolohua.

E kākau i kāu mau nīnau nui loa ma mua, ʻoiai he maʻalahi ke poina iā lākou i ka wā o ka hālāwai. Mai kānalua e noi i ka wehewehe inā ʻaʻole maopopo kekahi mea.

He aha ka mea nui e pili ana i ka maʻi ʻili o ka mākū?

Hoʻopili ka maʻi ʻili o ka mākū i kahi hui nui o nā kūlana e hoʻoulu ai i ka mumū mākū a me ka ʻili, akā me ka ʻike pololei a me ka mālama, hiki i nā poʻe he nui ke mālama i kahi ola maikaʻi. He mea nui ka ʻike mua ʻana i nā hōʻailona a me ka mālama lapaʻau koke no nā hopena maikaʻi loa.

ʻOiai hiki i ka ILD ke lilo i kūlana koʻikoʻi, ua hoʻomaikaʻi nā holomua i ka hoʻomaopopo ʻana a me ka mālama ʻana i ka manaʻolana no nā mea maʻi he nui. ʻO ka hana pili me kāu hui olakino, ka hahai ʻana i nā hoʻolālā mālama, a me ka hana ʻana i nā hoʻololi ola kūpono e kōkua iā ʻoe e hoʻokele i ke kūlana maikaʻi.

E hoʻomanaʻo he kūikawā ka ʻike o kēlā me kēia kanaka me ka ILD, a ʻo ka mea e hana ai no kekahi kanaka ʻaʻole paha e hana no kekahi. E noho pili me kāu hui mālama, e nīnau i nā nīnau, a mai kānalua e ʻimi i ke kākoʻo i ka wā e pono ai.

Nā nīnau pinepine e pili ana i ka maʻi ʻili o ka mākū

Q1. He mea make mau anei ka maʻi ʻili o ka mākū?

ʻAʻole, ʻaʻole make mau ka maʻi ʻili o ka mākū. ʻOiai kekahi mau ʻano e like me ka idiopathic pulmonary fibrosis e holomua wikiwiki, nui nā poʻe me ka ILD e ola no nā makahiki me ka mālama a me ka hoʻokele kūpono. Hoʻololi nui ka prognosis ma muli o ke ʻano kūikawā o ka ILD, pehea ka mua o ka ʻike ʻana, a pehea ka maikaʻi o kou pane i ka mālama.

Q2. Hiki ke ho'ōla ʻia ka maʻi ʻili o ka mākū?

I kēia manawa, ʻaʻohe lāʻau lapaʻau no ka hapa nui o nā ʻano o ka maʻi ʻili o ka mākū, akā hiki i nā mālama ke hoʻolohi nui i ka holomua a hoʻomaikaʻi i ka ola maikaʻi. Hiki i kekahi mau ʻano i hoʻoulu ʻia e nā mea hoʻoulu kūikawā ke hoʻomaikaʻi ke wehe ʻia ka hōʻike. ʻO ke kaukaʻi o ka mālama ʻana ma ka hoʻokele ʻana i nā hōʻailona, ​​​​ka hoʻolohi ʻana i ka holomua o ka maʻi, a me ka mālama ʻana i kou hiki ke hana i nā hana o kēlā me kēia lā.

Q3. Pehea ka wikiwiki o ka holomua o ka maʻi ʻili o ka mākū?

Hoʻololi nui ka wikiwiki o ka holomua ma muli o ke ʻano o ka ILD a me nā kumu pilikino. Holomua mālie kekahi mau ʻano i nā makahiki he nui, ʻoiai hiki i kekahi mau mea e like me ka acute interstitial pneumonia ke hoʻonui wikiwiki i nā hebedoma a i ʻole nā mahina. Hoʻomohala maʻamau ka idiopathic pulmonary fibrosis i nā makahiki 2-5, akā hiki i kēia ke hoʻololi nui ma waena o nā kānaka.

Q4. Hiki i ka hoʻoikaika kino ke kōkua me ka maʻi ʻili o ka mākū?

ʻAe, hiki i ka hoʻoikaika kino kūpono ke lilo i mea kōkua nui no nā poʻe me ka maʻi ʻili o ka mākū. Hiki i nā papahana hoʻōla mākū e komo pū ana i ka hoʻoikaika kino e hoʻomaikaʻi i kou hoʻomanawanui, hoʻemi i ka pōkole o ka hanu, a hoʻomaikaʻi i ka ola maikaʻi. Eia naʻe, pono e hoʻopilikino ʻia ka hoʻoikaika kino i kou kūlana kūikawā a nānā ʻia e nā limahana olakino.

Q5. Pono anei wau i ka oxygen therapy no ka maʻi ʻili o ka mākū?

ʻAʻole pono nā mea a pau me ka maʻi ʻili o ka mākū i ka oxygen therapy, akā hiki ke lilo i mea pono i ka holomua o ke kūlana. E nānā kāu kauka i kāu mau pae oxygen ma o nā hoʻokolohua koko a me ka pulse oximetry. Inā hāʻule kou pae oxygen ma lalo o kekahi mau palena, hiki i ka oxygen ke kōkua iā ʻoe e ʻoluʻolu a pale i kou naʻau a me nā ʻōnaehana ʻē aʻe mai ka hōʻino.