Bronchiolite

Mu mwijima wawe, inzira nyamukuru z'umwuka, zizwi nka bronchi, zikwirakwira mu nzira nto cyane. Inzira nto cyane z'umwuka, zizwi nka bronchioles, zijyana mu mifuka mito y'umwuka yitwa alveoli.

Bronchiolitis ni indwara ikunze kugaragara mu mwijima mu bana bato n'abana bafite amezi make. Iterwa no kubyimba no gucika intege ndetse no kubura amavuta mu nzira nto z'umwuka mu mwijima. Izi nzira nto z'umwuka zizwi nka bronchioles. Bronchiolitis iterwa hafi ya hose na virusi.

Bronchiolitis itangira ikugaragaraho ibimenyetso bisa cyane n'iby'umwijima usanzwe. Ariko nyuma ikaza kuba mbi, itera inkorora n'ijwi rihanitse rijyana n'umwuka uhembuka, bizwi nko guhumeka nabi. Rimwe na rimwe abana bagira ikibazo cyo guhumeka. Ibimenyetso bya bronchiolitis bishobora kumara ibyumweru 1 kugeza kuri 2 ariko rimwe na rimwe bishobora kumara igihe kirekire.

Abana benshi barakira bafashwe neza mu rugo. Umubare muto w'abana bakeneye kujya mu bitaro.

Mu minsi mike ya mbere, ibimenyetso bya bronchiolite bisa cyane n'iby'umwijima: Kuzana amazuru. Amazuru afunze. Kukohoka. Rimwe na rimwe umuriro muke. Nyuma yaho, umwana wawe ashobora kumara icyumweru cyangwa birenga akora cyane kurusha uko bisanzwe kugira ngo ahume, ibyo bishobora kuba birimo no guhumeka umwuka. Abana bato benshi barwaye bronchiolite bagira kandi indwara y'amatwi yitwa otite ya milieu. Niba ibimenyetso bikomeye, hamagara umuganga wita ku mwana wawe. Ibi ni ingenzi cyane niba umwana wawe afite munsi y'ibyumweru 12 cyangwa afite izindi mpamvu zishobora gutera bronchiolite — urugero, kuba yaravutse imburagihe, cyangwa kugira ikibazo cy'umutima. Shaka ubuvuzi ako kanya niba umwana wawe afite kimwe muri ibi bimenyetso: Afite uruhu, iminwa n'imisumari byera cyangwa byatukura kubera kutagira umwuka uhagije. Arwanira guhumeka kandi ntashobora kuvuga cyangwa kurira. Yangira kunywa bihagije, cyangwa ahumeka vuba cyane ku buryo adashobora kurya cyangwa kunywa. Ahumeka cyane cyane — ku bana bato ibi bishobora kuba byinshi kurusha impumuro 60 ku munota — afite impumuro ngufi kandi zidahagije. Ntabasha guhumeka neza kandi amabere asa n'aho asohotse hanze iyo ahumeka. Akora amajwi y'umwuka iyo ahumeka. Akora amajwi asa n'uguhinda umushyitsi buri gihe ahumeka. Agira intege nke, arushye cyangwa ananiwe cyane.

Niba ibimenyetso bikomeye, hamagara umuvuzi w'umwana wawe. Ibi ni ingenzi cyane cyane niba umwana wawe afite munsi y'ibyumweru 12 cyangwa afite izindi mpamvu zishobora gutera bronchiolite — urugero, kuba yaravutse imburagihe, cyangwa kuba afite ikibazo cy'umutima. Kora ikizamini cya muganga ako kanya niba umwana wawe afite kimwe muri ibi bimenyetso:

• Afite uruhu, iminwa n'imisumari y'ibara ry'ubururu cyangwa icyatsi kubera kutagira umwuka uhagije.
• Arwanira guhumeka kandi ntashobora kuvuga cyangwa kurira.
• Yangira kunywa bihagije, cyangwa ahumeka vuba cyane ku buryo adashobora kurya cyangwa kunywa.
• Ahumeka cyane cyane — mu bana bato ibi bishobora kuba inshuro zirenga 60 ku munota — afite imihumeko migufi kandi mito.
• Ntabasha guhumeka neza kandi ibibuno bigaragara nk'ibikururwa mu gihe ahumeka.
• Akora amajwi y'uruhuri mu gihe ahumeka.
• Akora amajwi asa n'uguhuha buri gihe ahumeka.
• Agaragara afite intege nke, adakomeye cyangwa ananiwe cyane.

Bronchiolite iba iyo virus yanduye bronchioles, ari zo nzira nto z'ubuhumekero mu bihaha. Ubwandu butuma bronchioles ziba zivuye kandi zikababara. Umutobe uteranira muri izi nzira z'ubuhumekero, bituma umwuka udashobora kunyura neza mu bihaha no kuhava.

Bronchiolite iterwa ahanini na respiratory syncytial virus (RSV). RSV ni virus isanzwe, ishobora kwandura buri mwana wese mbere y'imyaka ibiri. Ibihe by'ubwandu bwa RSV bikunze kuba mu mezi akonje y'umwaka ahantu hamwe, cyangwa mu gihe cy'imvura ahandi. Umuntu ashobora kuyirwara inshuro nyinshi. Bronchiolite ishobora kandi guterwa n'izindi virusi, zirimo iziterwa na grippe cyangwa ibicurane bisanzwe.

Virusi ziterwa na bronchiolite byoroshye gukwirakwira. Ushobora kuyandura binyuze mu matonyanga yo mu kirere igihe umuntu arwaye akohose, agasetsa cyangwa aganira. Ushobora kuyandura kandi ukoze ku bintu byakoreshejwe n'abandi — nka za dishi, ibikoresho byo gufungura imiryango, amasahani cyangwa ibikinisho — hanyuma ukakora ku maso, izuru cyangwa akanwa.

Bronchiolite ikunda kwibasira abana bari munsi y'imyaka 2. Abana bafite munsi y'amezi 3 nibo bafite ibyago byinshi byo kwibasirwa na bronchiolite kuko imyanya yabo y'ubuhumekero n'ubushobozi bwabo bwo kurwanya indwara bitaratera. Gake cyane, abantu bakuru bashobora kwibasirwa na bronchiolite.

Izindi mpamvu zongerera ibyago byo kwibasirwa na bronchiolite mu bana bato, harimo:

• Kuvuka imburagihe.
• Kugira ikibazo cy'umutima cyangwa cy'ubuhumekero.
• Kugira ubudahangarwa bw'umubiri buke. Ibi bituma bigorana kurwanya indwara.
• Kwinjira mu mwotsi w'itabi.
• Guhura n'abana benshi, nko mu kigo cyita ku bana.
• Kumara igihe ahantu hahuriye abantu benshi.
• Kugira abavandimwe bajya ku ishuri cyangwa babona serivisi zita ku bana, bagataha bazanye iyo ndwara.

Ingaruka z'uburwayi bukomeye bwa bronchiolite zishobora kuba:

• Umusaruro muke w'umwuka mu mubiri.
• Guhagarika guhumeka, ibi bikunze kugaragara ku bana bavutse imburagihe n'abana bari munsi y'amezi abiri.
• Kudashaka kunywa amazi ahagije. Ibi bishobora gutera kukama, iyo umubiri utakaza amazi menshi.
• Kudashaka guhabwa umwuka uhagije. Ibi bita gucika intege z'ubuhumekero.

Iyo ibi bibaye, umwana wawe ashobora kuba akeneye kujyanwa kwa muganga. Gucika intege bikomeye by'ubuhumekero bishobora gusaba ko umuyoboro ushyirwa mu muyoboro w'ubuhumekero. Ibi bifasha umwana wawe guhumeka kugeza ubwo ubwandu bukikize.

Kubera ko virusi bitera bronchiolite byandura kuva ku muntu ku wundi, imwe mu nzira nziza zo kwirinda kwandura ni ukukaraba intoki kenshi. Ibi ni ingenzi cyane mbere yo gukora ku mwana wawe iyo ufite uburwayi bwa grippe cyangwa izindi ndwara zishobora kwandura. Niba ufite imwe muri izo ndwara, wambare agapfukamunwa.

Niba umwana wawe arwaye bronchiolite, umugumise mu rugo kugeza igihe arwaye arangiye kugira ngo wirinde kuyikwirakwiza ku bandi.

Kugira ngo ufashe mu kwirinda kwandura:

• Kigira uruhare mu guhura n'abantu bafite umuriro cyangwa ibicurane. Niba umwana wawe ari umwana ukiri muto, cyane cyane umwana wavutse imburagihe, banuka abantu bafite ibicurane. Ibi ni ingenzi cyane mu mezi abiri ya mbere y'ubuzima.
• Komesha no guhanagura ubuso. Komeza kandi uhanagure ubuso n'ibintu abantu bakoraho kenshi, nka byuma n'amadirishya. Ibi ni ingenzi cyane niba umuntu wo mu muryango arwaye.
• Karaba intoki kenshi. Karaba intoki zawe n'iz'umwana wawe kenshi. Karaba n'amazi n'isabune byibuze amasegonda 20. Gabanya umuti w'intoki ukoresha inzoga uba ufite igihe uri kure y'urugo. Menya neza ko ufite byibuze 60% ya alcool.
• Fupfura inkorora no guhisha. Fupfura akanwa kawe n'izuru ryawe ukoresheje agatambaro. Joga agatambaro. Hanyuma ukarabe intoki. Niba amazi n'isabune bidahari, koresha umuti w'intoki. Niba udafite agatambaro, korora cyangwa hisha mu kuboko kwawe, atari mu ntoki.
• Koresha ikirahure cyawe bwite. Ntukagire icyo usangira n'abandi, cyane cyane niba hari umuntu wo mu muryango wawe arwaye.
• Konsa, aho bishoboka. Indwara z'ubuhumekero ni nke mu bana bonsa. Muri Amerika, virusi ya respiratory syncytial (RSV) ni yo itera bronchiolite na pneumonia cyane mu bana bari munsi y'umwaka umwe. Hari uburyo bubiri bwo gukingira bushobora gufasha mu kwirinda ko abana bato bakira RSV ikomeye. Zombi zirasuzurwa na American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, n'abandi. Wowe n'abaganga bawe mukwiye kuganira ku buryo bwiza bwo kurinda umwana wawe:
• Umusemburo witwa nirsevimab (Beyfortus). Uyu muti ni urushinge rumwe rutangwa mu kwezi mbere cyangwa mu gihe cy'icyorezo cya RSV. Ni ku bana bavutse n'abafite munsi y'amezi 8 bavutse mu gihe cyangwa binjira mu gihe cyabo cya mbere cya RSV. Muri Amerika, igihe cy'icyorezo cya RSV gisanzwe ari Ugushyingo kugeza muri Werurwe, ariko bihinduka muri Florida, Alaska, Hawaii, Puerto Rico, Guam n'ibindi bice bya Amerika byo mu birwa byo muri Pasifika.
• Nirsevimab ikwiye kandi gutangwa ku bana bafite amezi 8 kugeza ku mezi 19 bafite ibyago byinshi byo kurwara RSV ikomeye mu gihe cyabo cya kabiri cya RSV. Ibintu by'ibyago birimo:

• Abana bafite indwara z'ibihaha zidakira kuva bavutse imburagihe (imburagihe).
• Abana bafite ubudahangarwa bw'umubiri butameze neza.
• Abana bafite cystic fibrosis ikomeye.
• Abana b'Abanyamerika bakomoka mu bwoko bw'Abahinde cyangwa Abanyamerika bakomoka muri Alaska.

• Abana bafite indwara z'ibihaha zidakira kuva bavutse imburagihe (imburagihe).
• Abana bafite ubudahangarwa bw'umubiri butameze neza.
• Abana bafite cystic fibrosis ikomeye.
• Abana b'Abanyamerika bakomoka mu bwoko bw'Abahinde cyangwa Abanyamerika bakomoka muri Alaska.
• Urushinge rw'abagore batwite. FDA yemeje urushinge rwa RSV rwitwa Abrysvo ku bagore batwite kugira ngo birinde RSV mu bana kuva bavutse kugeza ku mezi 6. Urushinge rumwe rwa Abrysvo rushobora gutangwa kuva mu cyumweru cya 32 kugeza mu cyumweru cya 36 cyo gutwita hagati ya Nzeri na Mutarama muri Amerika. Abrysvo ntisuzurwa ku bana cyangwa abana.
• Abana bafite indwara z'ibihaha zidakira kuva bavutse imburagihe (imburagihe).
• Abana bafite ubudahangarwa bw'umubiri butameze neza.
• Abana bafite cystic fibrosis ikomeye.
• Abana b'Abanyamerika bakomoka mu bwoko bw'Abahinde cyangwa Abanyamerika bakomoka muri Alaska. Mu bihe bitoroshye, iyo nirsevimab itaboneka cyangwa umwana adashobora kuyibona, undi muti witwa palivizumab ushobora gutangwa. Ariko palivizumab isaba inshinge za buri kwezi zitangwa mu gihe cy'icyorezo cya RSV, mu gihe nirsevimab ari urushinge rumwe gusa. Palivizumab ntisuzurwa ku bana cyangwa abantu bakuze bafite ubuzima bwiza. Virusi izindi zishobora guteza bronchiolite. Izi zirimo COVID-19 na grippe. Gukingirwa kuri COVID-19 ya buri mwaka na grippe birasuzurwa kuri buri wese ufite imyaka irenga itandatu.

Umuforomokazi wita ku mwana wawe ashobora kumenya indwara ya bronchiolite hakurikijwe ibimenyetso n'uko yumva imyanya y'ubuhumekero y'umwana wawe akoresheje stetoskope.

Ibizamini n'ama rayons X ntabwo bikenewe cyane kugira ngo hamenyekane indwara ya bronchiolite. Ariko umuforomokazi wita ku mwana wawe ashobora kugutegeka gukora ibizamini niba umwana wawe ari mu kaga ko kurwara bronchiolite ikomeye, niba ibimenyetso biri kwiyongera cyangwa niba umuforomokazi atekereza ko hari ikibazo cyindi ndwara.

Ibizamini bishobora gukorwa birimo:

• Radiographie ya thorax. Radiographie ya thorax ishobora kwerekana niba hari ibimenyetso by'indwara y'igipumu.
• Isuzuma rya virusi. Igice cy'amacandwe ava mu mazuru y'umwana wawe gishobora gukoreshwa mu isuzuma rya virusi itera bronchiolite. Ibi bikorwa hakoreshejwe agatambakazi gashyirwa mu mazuru y'umwana.
• Ibizamini by'amaraso. Rimwe na rimwe, ibizamini by'amaraso bishobora gukoreshwa mu kugenzura umubare w'utugingo tw'amaraso yera. Kugwira kw'utugingo tw'amaraso yera ni ikimenyetso cyerekana ko umubiri urwanya ubwandu. Ibizamini by'amaraso bishobora kandi kwerekana niba urugero rw'oxygène mu maraso y'umwana wawe ari hasi.

Umuforomokazi wita ku mwana wawe ashobora kureba ibimenyetso byo gukama, cyane cyane niba umwana wawe yanze kunywa cyangwa kurya cyangwa niba aruka. Ibimenyetso byo gukama birimo akanwa n'uruhu byumye, umunaniro ukabije, no kunyara gato cyangwa kuta nyara na gato.

Bronchiolite isanzwe imara ibyumweru 1 cyangwa 2, ariko rimwe na rimwe ibimenyetso bikaba byaramara igihe kirekire. Abana benshi barwaye bronchiolite bashobora kwitabwaho mu rugo hakoreshejwe uburyo bwo kubahumuriza. Ni ngombwa kuba maso ku bibazo byo guhumeka bikomeza kuba bibi. Urugero, guhangayika buri gihe umwana ahemukira, kutamenya kuvuga cyangwa kurira kubera guhangayika guhumeka, cyangwa gukora amajwi nk'ay'ingurube buri gihe ahemukira. Kubera ko virusi ari zo ziterwa na bronchiolite, antibiyotike - zikoreshwa mu kuvura indwara ziterwa na bagiteri - ntizikora ku virusi. Indwara ziterwa na bagiteri nka pneumonia cyangwa indwara y'amatwi zishobora kubaho hamwe na bronchiolite. Muri iki gihe, umuvuzi w'umwana wawe ashobora guha antibiyotike yo kuvura indwara y'abagiteri. Imiti yitwa bronchodilators ifungura inzira z'ubuhumekero isa ntiyafashije bronchiolite, bityo akenshi ntihawe. Mu bihe bikomeye, umuvuzi w'umwana wawe ashobora kugerageza kuvura albuterol nebulized kugira ngo arebe niba bifasha. Muri iki gihe cyo kuvura, imashini ikora umwotsi mwiza w'imiti umwana wawe ahumeka mu mwijima. Imiti ya corticosteroid yo kunywa no gukubita ku gatuza kugira ngo umusemburo uboneke, uburyo bwo kuvura bwitwa physiotherapy y'igituza, ntabwo byagaragaye ko bifasha bronchiolite kandi ntibyemerwa. Kwitabwaho mu bitaro Umubare muto w'abana ashobora gukenera kuba mu bitaro. Umwana wawe ashobora guhabwa ogisijeni binyuze mu gikoresho cyo mu maso kugira ngo abone ogisijeni ihagije mu maraso. Umwana wawe ashobora kandi guhabwa amazi binyuze mu mutsi kugira ngo yirinde gukama. Mu bihe bikomeye, umuyoboro ushobora kuyoborwa mu muyoboro w'ubuhumekero kugira ngo ufashe guhumeka. Saba gahunda yo kuza kuvuzwa