Maʻi maʻi Interstitial

ʻO ka maʻi maʻi Interstitial lung (ILD) kahi hui o nā maʻi pūpū kahi e wela ai nā aʻa a laila ʻino hoʻi.

Loaʻa i nā akemāmā nā ʻeke ea liʻiliʻi (alveoli), kahi e komo ai ka oxygen. Hoʻonui kēia mau ʻeke ea me kēlā me kēia hanu.

ʻO nā mea i puni i kēia ʻeke ʻea i kapa ʻia ʻo interstitium. I ka poʻe me ka maʻi pūpū interstitial, paʻakikī a wili paha kēia mea, a ʻaʻole hiki i nā ʻeke lewa ke hoʻonui a nui. ʻO ka hopena, ʻaʻole hiki i ka oxygen ke hōʻea i ke kino.

Hiki i ka ILD ke hana me ka ʻole o kahi kumu i ʻike ʻia. Kāhea ʻia kēia ʻo idiopathic ILD. Idiopathic pulmonary fibrosis (IPF) ka maʻi maʻamau o kēia ʻano.

Aia pū kekahi o nā kumu i ʻike ʻia o ka ILD, me:

• Nā maʻi Autoimmune (kahi e hoʻouka ai ka ʻōnaehana pale i ke kino) e like me lupus, rheumatoid arthritis, sarcoidosis, a me scleroderma.
• Lū mumū ma muli o ka hanu ʻana i kahi mea haole e like me kekahi ʻano o ka lepo, fungus, a mould (hypersensitivity pneumonitis).
• Nā lāʻau (e like me nitrofurantoin, sulfonamides, bleomycin, amiodarone, methotrexate, gula, infliximab, etanercept, a me nā lāʻau chemotherapy).
• Lapaʻau hoʻomālama i ka umauma.
• Ke hana nei a i ʻole asbestos a puni paha, lepo lehu, lepo lepo, a me ka lepo silica (i kapa ʻia ʻo ka maʻi maʻi ʻoihana).

Hiki i ka uahi paka ʻana ke hoʻonui i ka makaʻu o ka hoʻomohala ʻana i kekahi ʻano o ka ILD a e ʻoi aku paha ke koʻikoʻi o ka maʻi.

ʻO ka hanu hanu kahi hōʻailona nui o ILD. Hiki paha iā ʻoe ke hanu wikiwiki a pono paha e hanu hohonu:

• I ka wā mua, ʻaʻole paʻakikī paha ka hanu ʻana a ʻike wale ʻia me ka hoʻoikaika kino, ka piʻi piʻi ʻana i ke alapiʻi, a me nā hana ʻē aʻe.
• I ka hala ʻana o ka manawa, hiki ke hana ʻia me ka hana ʻoi aku ka ikaika e like me ka ʻauʻau ʻana a me ke kapa komo ʻana, a ʻoiai e ʻino ai ka maʻi, ʻoiai me ka ʻai ʻana a me ke kamaʻilio ʻana.

ʻO ka hapanui o ka poʻe me kēia ʻano he ʻūhā maloʻo kekahi. ʻO ka uha maloʻo ʻaʻole ʻoe e kau i luna i kekahi mute a i ʻole ʻauha.

I ka hala ʻana o ka manawa, ka pohō, ka luhi, a me nā ʻeha a me nā ʻeha pū kekahi.

Loaʻa paha i ka poʻe me ka ILD ʻoi aku i mua:

• Hoʻonui ākea a me ka curve o ke kumu o nā manamana lima (clubbing).
• ʻO ka waihoʻoluʻu polū o nā lehelehe, ka ʻili, a i ʻole nā ​​manamanalima ma muli o ke kiʻekiʻe o ke kiʻekiʻe o ka oxygen (cyanosis).
• Nā ʻōuli o nā maʻi ʻē aʻe e like me ka rumitis a i ʻole ka pilikia e ale (scleroderma), e pili pū ana me ILD.

E hana ka mea mālama ola i kahi hoʻokolohua kino. Lohe paha i nā kani nahenahe, haʻalulu ke hoʻolohe i ka pahu me kahi stethoscope.

E hana ʻia paha kēia mau hoʻāʻo:

• ʻO nā hoʻokolohua koko e nānā no nā maʻi autoimmune
• ʻO Bronchoscopy me ka biopsy ʻole a i ʻole
• Pākuʻi x-ray
• ʻO ke kaha kiʻekiʻe CT (HRCT) scan o ka umauma
• Umauma MRI
• ʻEchocardiogram
• Wehe biopsy māmā
• Ke ana o ke kiʻekiʻe o ka oxygen oxygen i ka hoʻomaha a i ʻole ke hana
• Nā kinoea koko
• Nā hoʻāʻo hana pulmonary
• ʻEono mau minuke hele hoʻāʻo (hōʻoia i ka mamao e hiki ai iā ʻoe ke hele wāwae i 6 mau minuke a ehia mau manawa e pono ai ʻoe e kū e hopu i kou hanu)

ʻO ka poʻe i hōʻike nui ʻia i nā kumu i ʻike ʻia o ka maʻi maʻi i ka wahi hana e nānā pinepine ʻia no ka maʻi maʻi. ʻO kēia mau hana e komo pū ana me ka mining ʻana i ka lanahu, ka hoʻohaunaele ʻana o ke one, a me ka hana ʻana ma ka moku.

Pili ka mālama ʻana i ke kumu a me ka lōʻihi o ka maʻi. Kau ʻia nā lāʻau e kāohi i ka ʻōnaehana paleʻoniʻoni a hoʻēmi i ka pehu ʻana i loko o nā akemāha ke loaʻa i kahi maʻi autoimmune ka pilikia.No kekahi poʻe i loaʻa ka IPF, ʻo pirfenidone a me nintedanib kekahi mau lāʻau i hiki ke hoʻohana ʻia e hoʻolohi i ka maʻi. Inā ʻaʻohe mālama kūikawā no ke ʻano, ʻo ka pahuhopu e hoʻonui iā ʻoe i ke ʻoluʻolu a kākoʻo i ka hana māmā:

• Inā ʻoe puhipaka, e nīnau i kāu mea hāʻawi e pili ana pehea e hoʻōki ai i ka puhipaka.
• ʻO ka poʻe me nā pae oxygen haʻahaʻa haʻahaʻa e loaʻa ka oxygen therapy i ko lākou home. E kōkua kahi mea kōkua hanu iā ʻoe e hoʻonohonoho i ka oxygen. Pono nā ʻohana e aʻo i ka mālama pono ʻana i ka oxygen a me ka palekana.

Hiki i ka rehabilitation lung ke hāʻawi i ke kākoʻo, a kōkua iā ʻoe e aʻo:

• Nā ʻano hanu ʻokoʻa
• Pehea e hoʻonohonoho ai i kou home e mālama i ka ikehu
• Pehea e ʻai ai i ka nui o nā calories a me nā meaola
• Pehea e noho ai i ka hana a me ka ikaika

Pono paha kekahi poʻe me ka ILD holomua i kahi transplant lung.

Hiki iā ʻoe ke hoʻomāmā i ke koʻikoʻi o ka maʻi ma ke komo ʻana i kahi hui kākoʻo. ʻO ke kaʻana ʻana me nā poʻe ʻē aʻe i loaʻa nā ʻike a me nā pilikia maʻamau e hiki ke kōkua iā ʻoe e noʻonoʻo ʻole.

ʻO ka manawa o ke ola ʻana a i ʻole ILD e lilo ana i mea ʻino e pili ana i ke kumu a me ke ʻano o ka maʻi i ka manawa i ʻike mua ʻia ai.

Hoʻolālā kekahi poʻe me ka ILD i ka ʻole o ka puʻuwai a me ke kiʻekiʻe o ke koko i nā kīʻaha koko o ko lākou mau māmā.

ʻIke maikaʻi ʻole ka Idiopathic pulmonary fibrosis.

Kāhea i kāu mea hāʻawi inā:

• Ke paʻakikī nei ka hanu o kou hanu, wikiwiki, a ʻoi aku paha ka papaʻu ma mua o mua
• ʻAʻole hiki iā ʻoe ke loaʻa ka hanu hohonu, a i ʻole pono e hilinaʻi i mua ke noho
• Loaʻa pinepine ʻoe i ka ʻeha poʻo
• Hiamoe a huikau paha ʻoe
• He kuni kou
• Ke ʻeha nei ʻoe i nā mākala ʻeleʻele
• Polū kou manamana lima a i ʻole ka ʻili a puni kou mau manamana lima

Diffuse parenchymal lung maʻi; Alveolitis; Idiopathic pulmonary pneumonitis (IPP)

• Pehea e hanu ai inā pōkole ʻoe o ka hanu
• Maʻi maʻi Interstitial lung - makua - hoʻokuʻu
• Ka palekana o oxygen
• ʻO ka huakaʻi me nā pilikia hanu
• Ke hoʻohana nei i ka oxygen ma ka home

• Pāʻālua
• ʻO nā limahana o nā lānahu pneumoconiosis - pae II
• ʻO nā limahana o nā lānahu pneumoconiosis - pae II
• ʻO nā limahana o ka lānahu pneumoconiosis, paʻakikī
• ʻŌnaehana hanu

ʻO Corte TJ, Du Bois RM, Wells AU. Nā maʻi palahalaha hoʻohui. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 65.

ʻO Raghu G, ʻo Martinez FJ. Maʻi maʻi Interstitial I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 86.

Ryu JH, Selman M, Colby TV, King TE. Nā pneumonias interstitial Idiopathic. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 63.