Pneumothorax - pēpē

ʻO ka Pothothorax ka hōʻiliʻili o ke ea a i ʻole ke kōkō ma kahi ākea i loko o ka umauma a puni nā māmā. ʻO kēia ke alakaʻi i ka hāʻule o ka hū.

Kūkākūkā kēia ʻatikala i ka pneumothorax i nā pēpē.

Hana ʻia kahi pneumothorax ke hele a hoʻonui ʻia kekahi o nā ʻeke ea liʻiliʻi (alveoli) i loko o ka māmā o kahi pēpē. Hoʻopuka kēia i ka lewa i ka lewa i waena o ka māmā a me ka paia o ka umauma (pleura space).

ʻO ke kumu maʻamau o ka pneumothorax ka maʻi kūpilikiʻi hanu. He kūlana kēia e kū i nā pēpē i hānau mua ʻia (premature).

• ʻAʻohe o nā māmā o ka pēpē i ka mea paheʻe (surfactant) i kōkua iā lākou e hāmama (inflated). No laila, ʻaʻole hiki i nā ʻeke ea liʻiliʻi ke hoʻonui me ka maʻalahi.
• Inā makemake ka pēpē i kahi mīkini hanu (ʻenekini mīkini), keu kaomi ma luna o nā māmā o ka pēpē, mai ka mīkini hiki i kekahi manawa ke haki i nā ʻeke lewa.

ʻO Meconium aspiration Syndrome kekahi kumu o ka pneumothorax i nā keiki hānau hou.

• Ma mua a i ʻole i ka wā o ka hānau ʻana, hanu paha ka pēpē i ka neʻe mua o ka ʻōpū, i kapa ʻia ʻo meconium. Hiki i kēia ke ālai i nā alaloa a hana i nā pilikia hanu.

ʻO nā kumu ʻē aʻe e laʻa me ka pulumonia (maʻi o ka akemāhā) a i ʻole ke kūkulu ʻia o ka ake māmā.

ʻOi aku ka liʻiliʻi, hiki i kahi pēpē olakino ke ulu i kahi leak lewa ke lawe ia i nā hanu mua ma hope o ka hānau ʻana. Kū kēia ma muli o ke kaomi e pono ai e hoʻonui i nā māmā no ka manawa mua. Aia paha he kumu kūlohelohe e alakaʻi ai i kēia pilikia.

ʻAʻole loaʻa nā ʻōpio he nui me nā maʻi pneumothorax. Ke hiki mai nā hōʻailona, ​​hiki iā lākou ke hoʻopili:

• ʻO kaʻili o kaʻili Bluish (cyanosis)
• Hanu wikiwiki
• ʻO ka lapalapa ʻana o nā puka ihu
• Ke namunamu nei me ka hanu ʻana
• Huhū
• Hoʻomaha ʻole
• Hoʻohana o nā mākala o ka umauma a me ka ʻōpū e kōkua i ka hanu ʻana (retractions)

Hiki paha i ka mea mālama ola ke paʻakikī i ka lohe ʻana i nā kani o ka hanu ke hoʻolohe i nā ake māmā o ke pēpē me kahi stethoscope. ʻO ke kani o ka puʻuwai a i ʻole ka lung e like paha me he mea lā e hele mai ana lākou mai kahi ʻokoʻa o ka umauma ma mua o ka maʻamau.

ʻO nā hoʻāʻo no ka pneumothorax me:

• Pākuʻi x-ray
• Kau ʻia ka ʻimi māmā e kūʻē i ka umauma o ka pēpē, a ʻike ʻia ʻo "transillumination" (e hōʻike ʻia nā ʻeke o ka ea ma ke ʻano he mau māmā)

ʻAʻole pono nā pēpē me ka ʻole o nā ʻōuli i ka lāʻau. E nānā ka pūʻulu mālama olakino i ka hanu ʻana o kāu pēpē, ka nui o ka puʻuwai, ka nui o ka oxygen, a me ke kala o ka ʻili. E hāʻawi ʻia ka oxygen hoʻonui inā pono.

Inā loaʻa kāu mau ʻōuli i kāu pēpē, e hoʻokau ka mea hāʻawi i ka nila a i ʻole ka paipu lahilahi i kapa ʻia he catheter i loko o ka umauma o ka pēpē e wehe i ka ea i komo i loko o ka umauma.

Ma muli o ka mālama ʻana e hilinaʻi ʻia i nā pilikia o ke akemā i alakaʻi ʻia i ka pneumothorax, mau paha ia no kekahi mau lā i mau pule.

E hele aku kekahi mau leaka lewa i loko o kekahi mau lā me ka mālama ʻole ʻia. ʻO nā pēpē i hemo ka ea me kahi nila a catheter paha e hana maikaʻi ma hope o ka hoʻomaʻamaʻa inā ʻaʻohe pilikia ʻē aʻe.

Ke kūkulu nei ka ea i ka umauma, hiki iā ia ke pahu i ka puʻuwai i kekahi ʻaoʻao o ka umauma. Kau kēia i ke kaomi ma luna o nā māmā ʻelua i hāʻule ʻole a me ka puʻuwai. Ua kapa ʻia kēia ʻano he pneumothorax tension. He pilikia olakino ia. Hiki ke hoʻololi i ka hana puʻuwai a me ka lung.

ʻIke pinepine ʻia kahi pneumothorax ma hope koke iho o ka hānau ʻana. Kāhea i kāu mea hāʻawi inā loaʻa kāu pēpē i nā ʻōuli o ka pneumothorax.

Pono nā mea hoʻolako i ka mālama mālama nui hānau (NICU) e nānā pono i kāu pēpē no nā hōʻailona o kahi leak o ka ea.

Kahe ka lewa pulmonary; Pneumothorax - neonatal

• Pneumothorax

ʻO Crowley MA. Nā maʻi hanu neonatal. I: Martin RJ, Fanaroff AA, Walsh MC, hua. ʻO Fanaroff lāua ʻo Martin's Neonatal-Perinatal Medicine. 11th hua. Piladelapia, PA: Elsevier Saunders; 2020: chap 66.

ʻO RW māmā, ʻo Lee GL. ʻO Pneumothorax, chylothorax, hemothorax, a me fibrothorax. 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 81.

Winnie GB, Haider SK, Vemana AP, Lossef SV. Pneumothorax. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 439.