Stridor yana hucewa, yawanci sautin sautin da ake samarwa ta hanzari, kwararar iska mai iska ta cikin kunkuntar sashin hanyoyin iska. Mafi sau da yawa ana yin wahayi, kusan koyaushe ana jin sa ba tare da stethoscope ba. Gabatarwa a cikin yara, shin yana iya kasancewa a cikin manya? Menene sanadin? Kuma sakamakon? Yadda za a bi da shi?

Stridor mahaukaci ne, yana huci, fiye ko noiseasa hayaniyar amo da iska ke fitarwa. Yawancin lokaci, yana da ƙarfi sosai don a ji daga nesa. Wannan alama ce, ba ganewar asali ba, kuma gano musabbabin abubuwan da ke haifar da ita yana da matukar mahimmanci kamar yadda stridor galibi gaggawa ce ta likita. 

Daga asalin laryngotracheal, stridor yana haifar da hanzari, kwararar iska mai kwarara ta cikin kunkuntar, ko kuma wani ɗan toshe, ɓangaren sama na numfashi. Yana iya zama:

• babban kiɗa da kiɗa, kusa da waƙa;
• mai tsanani, kamar tsugunawa ko huci;
• m tare da nau'in jaraba, kamar croak.

Stridor na iya zama:

• Inpiratory: ana iya jin sa a kan wahayi yayin raguwar cututtukan cuta na diamita na manyan hanyoyin iska na sama (pharynx, epiglottis, larynx, trachea extra-thoracic);
• biphasic: idan an sami cikas sosai, to biphasic ne, wato a gabatar a duka matakan numfashi;
• ko ƙarewa: idan akwai toshewar da ke cikin hanyoyin iska na intrathoracic, stridor gabaɗaya yana ƙarewa.

Stridor shine bayyanar yau da kullun a cikin yara na cututtukan cututtukan numfashi. Ba a san abin da ya faru ba a cikin yawan yaran yara. Duk da haka, an lura da yawan mita a cikin samari.

Ya kamata a lura cewa duk da cewa ba a cika samun na kowa ba, amma akwai babba a cikin manya.

Yara suna da ƙananan hanyoyin iska masu kunkuntar kuma sun fi saurin numfashi da hayaniya. Stridor yana faruwa ne ta hanyar cututtukan cututtukan da suka shafi larynx da trachea. Wheezing yana da alaƙa da cututtukan cututtukan huhu. Lokacin da ƙarar numfashi ke ƙaruwa yayin bacci, sanadin yana cikin oropharynx. Lokacin da numfashi ya yi ƙarfi lokacin da yaron ya farka, sanadin yana cikin maƙogwaro ko trachea.

A cikin yara, abubuwan da suka fi yawa sun haɗa da abubuwan haifuwa da abubuwan da aka samo.

Abubuwan da ke haifar da kumburi a cikin yara

• Laryngomalacia, wato larynx mai taushi: shine mafi yawan abin da ke haifar da kumburin ciki kuma yana wakiltar kashi 60 zuwa 70% na cututtukan laryngeal;
• Shanyewar muryoyin sauti;
• Stenosis, wato a takaice, subglottis na haihuwa;
• A tracheomalacia, wato a ce trachea mai taushi da sassauci;
• Hemangioma na subglottic;
• Gidan yanar gizo na makogwaro, wato membrane mai haɗa igiyoyin murya guda biyu saboda lalacewar da aka samu;
• Diastema mai laryngeal, wato wani ɓarna da ke sa maƙogwaron sadarwa tare da tsarin narkewa.

Abubuwan da aka samo na stridor a cikin yara 

• Samun subglottic stenosis;
• Croup, wanda shine kumburin trachea da igiyoyin murya, galibi sanadiyyar kamuwa da cuta mai yaduwa;
• Jiki na waje da aka shaƙa;
• Cututtuka na laryngitis;
• Epiglottitis, wanda shine kamuwa da epiglottis da ƙwayoyin cuta ke haifarwa Haemophilus influenzae irin b (Hib). Dalilin da ke haifar da hauhawa a cikin yara, abin da ya faru ya ragu tun lokacin gabatar da allurar rigakafin cutar Haemophilus irin B;
• tracheitis, da dai sauransu.

Abubuwan da ke faruwa a cikin manya

• Ciwon kan kai da wuya, kamar ciwon daji na makoshi, na iya haifar da taɓarɓarewar ruwa idan sun ɗan toshe hanyoyin iska na sama;
• Ciwon ƙurji;
• Edema, watau kumburi, na babba babba na numfashi wanda zai iya faruwa sakamakon fitar da ruwa;
• Dasfunction na igiyar murya, wanda kuma ake kira motsi paradoxical vocal cord motsi;
• Shanyewar muryoyin muryoyin, bayan tiyata ko intubation musamman: lokacin da muryoyin muryoyin biyu suka shanye, sarari tsakanin su yana da ƙunci sosai kuma hanyoyin iska ba su isa ba;
• Jikin waje da aka shaka kamar guntun abinci ko ɗan ruwa da aka shiga cikin huhu yana haifar da makoshi;
• Epiglottitis;
• Maganin rashin lafiyan.

Hakanan ana iya rarrabe dalilan stridor gwargwadon sautin sa:

• M: laryngomalacia ko inna na muryoyin murya;
• Mai tsanani: laryngomalacia ko subglottic pathology;
• Haushi: laryngitis, stenosis ko subglottic ko babban tracheal angioma.

Stridor na iya dacewa da numfashi ko sakamakon abinci, tare da alamun tsananin kamar:

• wahala a cin abinci;
• aukuwar tashin hankali a lokacin ciyarwa;
• jinkirin nauyin nauyi;
• dyspnea, wanda ke da wahalar numfashi;
• aukuwar tashin hankali na numfashi;
• aukuwar cyanosis (canza launin fata da fata na fata);
• barci barci mai hanawa;
• tsananin alamun gwagwarmayar numfashi: murɗa fikafikan hanci, intercostal da retraction suprasternal.
  

Kafin kowane hanya, yakamata a gabatar da gwajin ENT tare da yin nasofibroscopy. Ana kuma yin biopsy, CT scan, da MRI idan ana zargin ƙari.

Stridor yana haifar da karancin numfashi yayin da mutum yake hutawa gaggawa ce ta likita. Ƙididdigar muhimman alamomi da kuma matakin wahalar numfashi shine matakin farko na gudanarwa. A wasu lokuta, tsare hanyoyin iska na iya zama dole kafin ko a haɗe da gwajin asibiti.

Zaɓuɓɓukan jiyya don stridor sun bambanta dangane da dalilin alamar.

Idan akwai laryngomalacia

Ba tare da ma'aunin mahimmanci ba, ko alamar alaƙa, za a iya ba da shawarar lokacin lura, dangane da aiwatar da maganin anti-reflux (antacids, thickening of the milk). Bin diddigin yakamata ya zama na yau da kullun don tabbatar da raguwar alamun alamun sannu a hankali sannan ɓacewar su cikin lokacin da ake tsammanin.

Alamomin laryngomalacia galibi suna da sauƙi kuma suna tafiya da kansu kafin su cika shekaru biyu. Koyaya, kusan kashi 20% na marasa lafiya tare da laryngomalacia suna da alamomi masu tsanani (matsananciyar wahala, wahalar ciyarwa, da raunin girma) da ke buƙatar magani tare da tiyata na endoscopic (supraglottoplasty).

Idan aka samu gawarwakin waje

Idan mutumin yana waje da asibiti, wani mutum zai iya, idan an horar da shi, ya taimaka musu su fitar da jikin waje ta hanyar aiwatar da aikin Heimlich.

Idan mutumin yana cikin asibiti ko ɗakin gaggawa, ana iya shigar da bututu ta hancin mutum ko bakinsa (intubation tracheal) ko kai tsaye cikin trachea bayan ƙaramin tiyata (tracheostomy), don ba da damar iska ta ratsa cikin cikas kuma ta hana. shaƙewa.

Idan akwai edema na fili na numfashi

Ana iya ba da shawarar tserewar adrenaline da dexamethasone a cikin marasa lafiya waɗanda ke da kumburin iska.

Idan akwai tsananin wahalar numfashi

A matsayin ma'aunin wucin gadi, cakuda helium da iskar oxygen (heliox) yana inganta yanayin iska kuma yana rage hauhawa a cikin manyan lamuran iska kamar ɓarkewar laryngeal edema, stridular laryngitis da kumburin maƙogwaro. Heliox yana ba da damar rage tashin hankali mai gudana saboda ƙarancin helium idan aka kwatanta da oxygen da nitrogen.