Ukukhwehlela

Wake wakuzwa ukukhwehlela kwengane okuzwakala njengokukhonkotha kwemvubu? Lo msindo ohlukile uvame ukubonisa i-croup, evamile isifo sobuntwana ethinta imigudu yomoya engenhla. Ukukhwehlela kungabangela ukukhathazeka kubazali, kodwa ukuqonda izimpawu zakho nezindlela zokwelashwa kungasiza ukuphatha lesi simo ngempumelelo.
Nakuba ukukhwehlela kungase kucindezele, ngokuvamile kuyelapheka ekhaya. Nokho, kwezinye izimo, kungase kudingeke usizo lwezokwelapha. Le bhulogi izohlola izimbangela, izimpawu, nokwelashwa kwe-croup, inikeze abazali ulwazi lokuhlonza nokubhekana nalesi simo ngokuzethemba.

Iyini i-Croup?

I-Croup, noma i-laryngotracheobronchitis, isifo sokuphefumula esithinta ngokuyinhloko izingane ezincane. Lesi simo sibangela ukuvuvukala kwebhokisi lezwi (umphimbo) kanye noqhoqhoqho (uqhoqhoqho), ukuncipha kwendlela yokuphefumula ngezansi kwezintambo zezwi. Ngenxa yalokho, izingane ezine-croup zithola ubunzima bokuphefumula kanye nomsindo onzima, onomsindo lapho ziphefumula. Lesi simo ngokuvamile sibangelwa izifo ezibangelwa amagciwane, nokuvuvukala nokucasuka okudlulela kumashubhu e-bronchial (bronchi) futhi.

Uphawu oluphawulekayo lwe-croup ukukhwehlela okuhlukile okuzwakala kufana ngokuphawulekayo ne-barking seal. Lo msindo oyingqayizivele uvela lapho umoya uphoqeka ephasejini eliwumngcingo, okwenza izintambo zezwi ezivuvukele zinyakaze. Ukwengeza, izingane ezine-croup zivame ukubonisa umsindo wekhwela ophakeme okuthiwa i-stridor lapho ziphefumula.

Izimpawu ze-Croup

I-Croup ngokuvamile iqala ngezimpawu ezifana nomkhuhlane ojwayelekile. Isimo singaba sibi kakhulu emahoreni ayi-12 kuya kwangama-48 alandelayo, kanti ukukhwehlela okukhonkothayo kungase kuqale futhi kuvame ukuba kubi kakhulu ebusuku.

Bangaqaphela ukuthi ingane yabo ihlangabezana:

• Ukuthuthumela
• Fever
• Ukuphefumula okunomsindo noma kanzima
• Umsindo onokhahlo, nomsindo lapho udonsa umoya (i-stridor)
• Rash
• Ububomvu beso (conjunctivitis)
• Izimbali ezivuvukala ze-lymph

Ezimweni ezimaphakathi kuya kwezinzima, izingane zingabonisa:

• Ukuphefumula kanzima
• Ukungahlaliseki noma ukwethuka
• Ukuhlehla (ukumunca isikhumba ezimbanjeni nangaphezulu kwethambo lesifuba)
• I-Cyanosis (isikhumba esiluhlaza okwesibhakabhaka)
• Ukukhala, ukukhwehlela, nokucindezeleka kungandisa izimpawu, kudale umjikelezo wezimo eziya ziba zimbi. 

Nakuba i-croup ngokuvamile ihlala izinsuku ezi-3 kuya kwezi-5, ukuqapha izimpawu eduze kubalulekile. 

Izinkinga zeCroup

I-Croup ngokuyinhloko ibangelwa izifo ezibangelwa amagciwane. Icala elivame kakhulu igciwane le-parainfluenza, kodwa amanye amagciwane afana nomkhuhlane, i-respiratory syncytial virus (RSV), isimungumungwane, kanye ne-adenovirus nawo angabangela i-croup. La magciwane aholela ekuvuvukeni kwemigudu yokuphefumula ephezulu, okwenza ukuphefumula kube nzima ezinganeni.

Izingane ngokuvamile ziwathola la magciwane ngokuhogela amaconsi okuphefumula angenwe yileli gciwane akhwehlelwe noma athimulwe emoyeni. Ukwengeza, izinhlayiya zegciwane zingaphila ezindaweni ezinjengamathoyizi. Kungase kulandele ukutheleleka uma ingane ithinta lezi zindawo ezingcolile bese ithinta ikhala, amehlo, noma umlomo wayo.

Ezimweni ezingavamile, amabhaktheriya angaba nzima ukutheleleka ngegciwane, okwenza kube nzima ukuphefumula. Kodwa-ke, izimbangela zebhaktheriya ze-croup azivamile kakhulu kunezigciwane.

Ukuxilongwa kwe-Croup

Odokotela ngokuvamile baxilonga i-croup ngokusekelwe ezimpawini zengane kanye nokuhlolwa komzimba. Izimpawu ezivame kakhulu ukukhonkotha okuhlukile kanye ne-stridor nomsindo ohlabayo ophezulu lapho uphefumula. Lezi zimpawu ngokuvamile zivumela abazali ukuthi babone i-croup ekhaya.

Ngesikhathi sokuhlolwa kwezokwelapha, udokotela:

• Qaphela indlela yokuphefumula yengane
• Ulalela isifuba esebenzisa i-stethoscope
• Ihlola umphimbo wengane
• Ngezinye izikhathi, odokotela bangase ba-ode ukuhlolwa okwengeziwe ukuze bakhiphe ezinye izifo. Lokhu kungase kuhlanganise:
• Ama-X-ray entanyeni nasesifubeni
• Ukuhlolwa kwelabhulali

Kubalulekile ukuqaphela ukuthi ukuhlola okunjalo akuvamile ukuba kudingekile. Izimo eziningi ze-croup zingatholwa ngokubhekwa nokuhlolwa ngokomzimba kuphela. 

Ukwelashwa kwe-Croup

Ukwelashwa kwe-croup kuncike ekuqineni kwesimo somntwana. 

Nge-croup encane, abazali bangazama okulandelayo:

• Gcina ingane izolile futhi inethezekile
• Sebenzisa umswakama opholile noma uhlale nengane endlini yangasese eshisayo
• Qinisekisa ukuthi i-hydration efanele

Odokotela bangase baphakamise ukuphathwa kwezokwelapha okulandelayo ezimweni ezimaphakathi kuya kwezinzima:

• I-Corticosteroids: Ukunciphisa ukuvuvukala kwendlela yomoya
• I-Nebulised epinephrine: Ukwelashwa okuhogelwe ukunciphisa ngokushesha ukuvuvukala kwendlela yomoya
• Ukwelashwa komoyampilo: Ukwenza ngcono ukuphefumula ezimeni ezinzima
• Odokotela bangase banikeze umthamo owodwa we-dexamethasone yomlomo, ngokuvamile eqala ukusebenza phakathi namahora ayisithupha. Ezinganeni ezingakwazi ukugcina umuthi uphansi, imijovo ye-intravenous noma ye-intramuscular inketho.

Ezimweni ezingavamile, ezinzima, ingane ingase idinge ukulaliswa esibhedlela ukuze iqashwe eduze futhi ikwazi ukushaywa umoya ngemishini. Kodwa-ke, ngokwelashwa ngokushesha nangokufanelekile kwesifo se-croup, izingane eziningi ezine-croup zilulama ngokushesha.

Izingozi ze-Croup

Kunezici eziningana ezandisa amathuba okuba ingane ibe nalesi simo, njenge:

• Iminyaka yobudala: Izingane eziphakathi kwezinyanga ezingu-6 neminyaka emithathu ubudala zibhekene nengozi enkulu kakhulu. Imigudu yabo yokuphefumula emincane ibenza bathambekele kakhulu ekubeni nezimpawu ezinzima. 
• Ubulili: Abafana nezingane ezabelwe abesilisa ekuzalweni (AMAB) banamathuba amaningi okuthuthukisa i-croup uma kuqhathaniswa namantombazane kanye nezingane ezinikezwe abesifazane ngesikhathi sokuzalwa (AFAB).
• Izici ze-anatomical: Ukuncipha kwendlela yokuphefumula, okungenzeka kube khona kusukela ekuzalweni noma okuthuthukiswe kamuva, kungakhuphula ukungenwa yigciwane. Uma ingane ihlangabezana neziqephu eziphindaphindiwe ze-croup, kungase kubonise inkinga yomoya.

Izinkinga zeCroup

Nakuba i-croup ngokuvamile imnene futhi iyazibekela umkhawulo, izinkinga zingenzeka ezimweni ezingavamile. Ngaphansi kuka-5% wezingane ezine-croup zidinga ukulaliswa esibhedlela. 

Izizathu ezivame kakhulu zokulaliswa esibhedlela zihlanganisa:

• Isidingo sokwelashwa komoyampilo ukuze kugcinwe amazinga komoyampilo aphephile
• Ukuphelelwa amanzi kakhulu emanzini okudinga ukwelashwa nge-intravenous fluid
• Izimpawu zesifo se-croup eziqhubekayo naphezu kokwelashwa kokuqala
• Ngezinye izikhathi, ukuphefumula kwengane kungase kukhathale, kudinge ukuqapha okuseduze nokunakekelwa okujulile.

Izinkinga ezingavamile kodwa ezinzima zingabandakanya:

• I-bacterial tracheitis: Ukutheleleka ngebhaktheriya kuqhoqhoqho
• I-pneumonia: Ukutheleleka kwamaphaphu
• I-pulmonary edema: Ukunqwabelana koketshezi emaphashini

Uzoyibona Nini Udokotela

Abazali kufanele bafune usizo lwezempilo oluphuthumayo uma: 

• Uma izimpawu zengane ziba zimbi kakhulu noma ziphikelela
• Umkhuhlane wengane uhlala isikhathi esingaphezu kwezinsuku ezintathu
• Ingane ingaphansi kwamasonto angu-12 futhi inomkhuhlane ongu-38°C (100.4°F) noma ngaphezulu
• Ingane ikhwehlela inganqamuki noma iphefumula njalo enomsindo lapho inganyakazi
• Ukukhwehlela kuthatha izinsuku ezingaphezu kweziyishumi
• Ingane inenkinga yokuphefumula, ukukhuluma, noma ukuphuza
• Uma ingane ibonisa isikhumba esiluhlaza okwesibhakabhaka emlonyeni noma ezinzipho
• Ingane iconsa kakhulu noma ayikwazi ukugwinya
• Uma umntwana ekhwehlela kanzima
• Ingane inomsindo ozwakalayo womlozi ngenkathi iphefumula (i-stridor)
• Uma ingane ibonisa ukuhlehla kwesifuba (isikhumba sidonsa izimbambo nethambo lesifuba)
• Ingane idonsa kanzima ukuphefumula, ukukhuluma, noma ukuphuza
• Izindebe zabo noma ubuso buphenduka bbelu

Amakhambi Asekhaya E-Croup

Abazali bangaphatha izimo ezithambile ze-croup ekhaya ngamakhambi ambalwa asebenzayo, okuhlanganisa:

• Ukugcina umntwana ezolile kubalulekile, njengoba ukukhala nokuyaluza kungase kubhebhethekise izimpawu. Ukunikeza induduzo ngokugona, amathoyizi ayintandokazi, noma imisebenzi epholile kusiza ukunciphisa ukucindezeleka.
• Ukuhlala endlini yokugezela eshisayo noma umswakama opholile kungasiza ukukhulula izintambo zezwi futhi kunciphise ukuvuvukala. 
• Abanye abazali bathola ukuthi ukubeka umntwana emoyeni opholileyo, ngaphandle noma phambi kwefriji evulekile, kuletha impumuzo.
• I-hydration efanele ibalulekile. Uketshezi olufudumele njengobisi noma okukhethwa kukho okupholile njengamanzi nama-popsicle kungathobisa umphimbo futhi kuvimbele ukuphelelwa amanzi emzimbeni. Ezinganeni ezingaphezu kwezinyanga eziyi-12, i-spoonful of honey ingasiza ukudambisa ukukhwehlela.
• Ukubeka ingane endaweni eqondile noma ebheke phambili kancane kungathuthukisa ukuphefumula. Ukwakha 'inqaba yomcamelo' yokulala noma ukubamba ingane iqonde kungase kukududuze.
• Abazali bangasebenzisa imishanguzo ye-over-the-counter yomkhuhlane noma ukungaphatheki kahle, ngokulandela imihlahlandlela yemithamo efanelekile yobudala. Nokho, imithi yokukhwehlela ayinconyelwe izingane ezincane.

Prevention

Abazali bangathatha izinyathelo ezimbalwa zokuvimbela i-croup futhi banciphise ukusabalala kwayo, njenge: 

• Ukugeza izandla njalo ngensipho namanzi okungenani imizuzwana engu-20 kuyisinyathelo esibaluleke kakhulu. 
• Ukugcina izingane zikude nabantu abagulayo nokuzikhuthaza ukuthi zikhwehlele noma zithimule ezindololwaneni nakho kusiza ukunciphisa ukusuleleka.
• Ukugcina indawo enempilo:
  • Hlanza izindawo ezithintwa njalo
  • Geza amathoyizi phakathi kokusetshenziswa ngakunye
  • Lahla izicubu ezisetshenzisiwe ngokushesha
• Ngesikhathi sokuqubuka kwezifo, ukugcinwa kwezingane ekhaya zisuka esikoleni noma ekunakekelweni kwasemini kuyancomeka. Lo mkhuba usiza ukunqanda ukusabalala kwegciwane.
• Ukugoma kudlala indima ebalulekile ekuvimbeleni. Nakuba ungekho umuthi wokugomela ngokuqondile amagciwane e-parainfluenza, ukugcina imigomo yezingane isesikhathini kunikeza isivikelo ezifweni ezithile ezingavamile kodwa eziyingozi zomgwaqo womoya ongenhla. Imithi yokugoma ye-Haemophilus influenzae yohlobo b (Hib) kanye ne-diphtheria ibalulekile kulokhu.

Isiphetho

I-Croup ingaba yisimo esiphathelene nabazali, kodwa ukuqonda izimpawu zayo nezinketho zokwelapha kusiza ukuyilawula ngempumelelo. Ukukhwehlela okuhlabayo okuhlukile, okuvame ukuhambisana nobunzima bokuphefumula, kuyinkomba ecacile ye-croup ezinganeni ezincane. Nakuba abazali bengakwazi ukusingatha izimo eziningi ekhaya ngamakhambi alula njengenkungu epholile kanye ne-hydration efanele, kubalulekile ukuqaphela lapho ukunakekelwa kwezokwelapha kudingekile. Ngokuqashelwa ngokushesha nokunakekelwa okufanele, izingane eziningi zilulama ngokushesha ku-croup, okuvumela imindeni ukuthi ikwazi ukubhekana nalesi sifo esivamile sezingane ngokuzethemba.

FAQ sika

1. Ingabe i-Steam ilungele i-croup?

Nakuba abazali abaningi bakholelwa ukuthi isitimu siyasiza nge-croup, abukho ubufakazi besayensi bokusekela lokhu. Abanye bathola ukuthi ukuhlala nengane yabo endlini yokugezela eshisayo kuthuthukisa ukuphefumula, kodwa ucwaningo aluzange lukufakazele ukusebenza kwayo. Ama-humidifiers apholile avame ukutuswa esikhundleni se-hot vaporisers ukugwema ingozi yokusha.

2. Ingabe i-nebulizer ilungele i-croup?

Ku-croup emaphakathi kuya kokuqina, ukwelashwa kwe-nebulised kungaba yinzuzo. I-epinephrine, elawulwa nge-nebuliser, inciphisa ukuvuvukala kwendlela yokuphefumula ngokushesha, ngokuvamile phakathi nemizuzu eyi-10. 

3. Yini okufanele uyenze nge-croup ebusuku?

Izimpawu ze-croup ngokuvamile ziba zimbi kakhulu ebusuku. Abazali bangasebenzisa isihwamisa-nkungu esipholile ekamelweni lengane noma bayikhiphele ngaphandle ukuze baphefumule umoya wasebusuku opholile, onomswakama. Kutuswa ukuthi uhlale eduze nengane ukuze unikeze usizo ngokushesha uma kuba nobunzima bokuphefumula. Ukugcina umntwana ezolile kubalulekile, njengoba ukukhathazeka kungandisa izimpawu.

4. Uzikhathaza nini nge-croup?

Abazali kufanele bafune usizo lwezokwelapha ngokushesha uma ingane yabo:

• Unenkinga yokuphefumula noma yokukhuluma
• Ibonisa izindebe eziluhlaza okwesibhakabhaka noma izinzipho
• Ine-stridor (ukuphefumula okunomsindo) ngisho nalapho iphumule
• Amaconsi ngokweqile noma alwela ukugwinya
• Uzwa ukukhwehlela okukhulu

5. Imuphi umuthi ongcono kakhulu we-croup?

I-Corticosteroids iphumelela kakhulu ekwelapheni i-croup. Banciphisa ukuvuvukala kwendlela yokuphefumula, ngokuvamile phakathi namahora ayisithupha omthamo wokuqala. Ezimweni ezithambile, umthamo owodwa ungase wanele. Odokotela bangase banikeze imithamo eyengeziwe noma bayihlanganise nezinye izindlela zokwelapha ezifana ne-nebulised epinephrine ezimeni ezinzima kakhulu.

6. Ngabe i-croup iyayeka iminyaka emingaki?

I-Croup ngokuvamile ihlasela izingane eziphakathi kwezinyanga ezingu-6 neminyaka emithathu ubudala. Njengoba izingane zikhula, imigudu yazo yokuphefumula iyavuleka, okubenza bangabi sengozini yokuphefumula ebangelwa yi-croup. Lesi simo asivamile ukwenzeka ezinganeni ezingaphezu kweminyaka eyisithupha ubudala. 

UDkt. Vittal Kumar Kesireddy

MBBS, MD, Uzakwethu ku-Neonatology
I-CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad, CARE Hospitals, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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