Poniaʻi i nā keiki - loaʻa ke kaiāulu

ʻO ka pulumonia kahi maʻi maʻi maʻi i hoʻokumu ʻia e nā bacteria, nā mea ʻino, a i ʻole nā ​​fungi.

Mālama kēia ʻatikala i ka pulumonia i loaʻa i ke kaiāulu (CAP) i nā keiki. Kū kēia ʻano pneumonia i nā keiki olakino i hele ʻole i ka haukapila a i ʻole kahi wahi mālama olakino ʻē aʻe.

ʻO ka pulumonia e pili ana i ka poʻe i nā wahi olakino, e like me nā haukapila, ke kumu pinepine ʻia e nā g germ i ʻoi aku ka paʻakikī e mālama.

ʻO nā Virus ke kumu pinepine o ka maʻi pneumonia i nā pēpē a me nā keiki.

Nā ala i hiki i kāu keiki ke kiʻi iā CAP me:

• Pāhola a me nā mea hoʻomaʻi e noho ana i ka ihu, nā lawehala, a i ʻole ka waha e pāhola aʻe i nā ake māmā.
• Hiki paha i kāu keiki ke hanu pololei i kekahi o kēia mau mikrob i loko o nā akemāmā.
• Hanu kāu keiki i ka meaʻai, nā wai, a i ʻole ka luaʻi mai ka waha a i kona mau māmā.

ʻO nā kumu pilikia e hoʻonui i ka manawa o ke keiki e loaʻa iā CAP:

• ʻO ka ʻōpio ma mua o 6 mau makahiki o kou mau makahiki
• Hānau mua ʻia
• Nā kīnā hānau, e like me ka pā palai
• Nā pilikia ʻōnaehana hopohopo, e like me ka hopu ʻana a i ʻole ka palsy cerebral
• ʻO ka maʻi puʻuwai a i ʻole lung i ka wā hānau
• Nānaehana pale nawaliwali (hiki i kēia ke hana ma muli o ka mālama ʻana i ka maʻi ʻaʻai a i ʻole nā ​​maʻi e like me HIV / AIDS)
• ʻO ke kahakaha hou a trauma paha

ʻO nā ʻōuli maʻamau o ka niumonia i nā keiki e:

• Hoʻopiha ʻia a ihu paha, ihu poʻo
• Kaha nui
• Fever, he akahai paha a kiʻekiʻe paha, me nā haʻalulu a me ka hou ʻana
• ʻO ka hanu wikiwiki ʻana, me nā puka ihu a me ke kanana ʻana o nā mākala ma waena o nā iwi ʻaoʻao
• ʻUhihi
• ʻĀʻī a ʻeha paha i ka ʻeha o ka umauma e ʻoi aku ka maikaʻi ke hanu nui a i ʻole ka ʻeha
• ʻO ka ikehu haʻahaʻa a me ka malaise (ʻaʻole maikaʻi)
• ʻO ka luaʻi a i ʻole ka lilo o ka makemake

ʻO nā ʻōuli maʻamau i nā keiki me nā maʻi ʻino ʻē aʻe:

• ʻO nā lehelehe polū a me nā manamana lima no ka liʻiliʻi o ka oxygen i loko o ke koko
• Huikau a paʻakikī loa paha e hoʻāla

E hoʻolohe ka mea mālama ola i ka umauma o kāu keiki me kahi stethoscope. E hoʻolohe ka mea hāʻawi i nā crackles a i ʻole nā ​​kani hanu maʻamau. ʻO ke paʻi ʻana ma ka paia o ka umauma (percussion) kōkua i ka mea hāʻawi e hoʻolohe a manaʻo no nā kani maʻamau.

Inā kānalua ʻia ka niumonia, e kauoha paha ka mea hāʻawi i kahi ray x.

Hiki i nā hoʻokolohua ʻē aʻe ke:

• Nā kinoea koko Arterial e ʻike inā lawa ka oxygen e komo ana i ke koko o kāu keiki mai nā ake māmā
• ʻO ka moʻomeheu koko a me ka moʻomeheu sputum e nānā no ka germ i hiki ke kumu i ka maʻi pneumonia
• CBC e nānā i ka helu o ke koko keʻokeʻo
• Chest X-ray a i ʻole CT scan o ka umauma
• ʻO Bronchoscopy - kahi ʻōmole maʻalahi me kahi kāmela i hoʻomālamalama ʻia i ka hopena i lalo i lalo i nā māmā (i nā manawa kakaikahi)
• Ke wehe nei i ka wai mai ka hakahaka ma waena o ka uhi waho o nā akemāmā a me ka paia o ka umauma (i nā manawa maʻamau)

Pono e hoʻoholo ka mea hāʻawi i ka pono o kāu keiki i ka haukapila.

Inā mālama ʻia i ka haukapila, e loaʻa i kāu keiki:

• Fluids, electrolytes, a me nā antibiotic ma o nā uaua a i ʻole ka waha
• ʻOkoʻa oxygen
• Nā hana hanu e kōkua i ka wehe i nā ala nui

E hoʻokomo ʻia paha kāu keiki i ka haukapila inā lākou:

• Loaʻa kekahi pilikia olakino koʻikoʻi, e pili ana i nā pilikia olakino lōʻihi (mau) e like me cystic fibrosis a i ʻole diabetes mellitus
• Loaʻa nā ʻōuli koʻikoʻi
• ʻAʻole hiki ke ʻai a inu paha
• Aia ma lalo o 3 a 6 mau makahiki paha
• Loaʻa i ka pulumonia ma muli o kahi germ
• Ua lawe i nā antibiotic ma ka home, akā ʻaʻole maikaʻi

Inā loaʻa iā CAP kāu keiki e ke koʻohune, e hāʻawi ʻia nā lāʻau ʻaloʻalo. Hāʻawi ʻole ʻia nā antibiotic no ka maʻi pneumonia ma muli o ka maʻi. ʻO kēia no ka mea ʻaʻole pepehi nā antibiotic i nā virus. Hāʻawi ʻia nā lāʻau ʻē aʻe, e like me nā antivirals inā loaʻa ka maʻi flu i kāu keiki.

Hiki ke mālama ʻia nā keiki he nui ma ka home. Inā pēlā, pono paha i kāu keiki e lawe i nā lāʻau e like me nā antibiotic a i ʻole nā ​​antivirals.

Ke hāʻawi nei i nā antibiotic i kāu keiki:

• E ʻike pono ʻaʻole e nalo kāu keiki i nā kau.
• E mālama pono i kāu keiki i nā lāʻau āpau e like me ke kuhikuhi. Mai hoʻōki i ka hāʻawi ʻana i ka lāʻau, ʻoiai ke hoʻomaka ka maikaʻi o kāu keiki.

Mai hāʻawi i kāu keiki i ka maʻi puʻu a i ʻole ka lāʻau anuanu ke ʻole ke kauka i ʻōlelo mai ua maikaʻi. Kōkua ka ʻūmū i ke kino e hemo i ka mucus mai nā akemāmā.

ʻO nā hana mālama home ʻē aʻe:

• No ka lawe ʻana mai i nā mākala mai nā akemāmā, paʻi mālie i ka umauma o kāu keiki i kekahi mau manawa o ka lā. Hiki ke hana i kēia ke moe ana kāu keiki.
• E hānai i kāu keiki i kahi hanu hohonu he 2 a i ʻole 3 mau manawa i kēlā me kēia hola. Kōkua ka hanu hohonu i ka hāhā o kāu keiki.
• E ʻike pono i ka inu wai ʻana o kāu keiki. E noi i kāu mea hāʻawi i ka nui o kāu keiki e inu ai i kēlā me kēia lā.
• E hoʻomaha nui kāu keiki, me ka hoʻopili ʻana i ka lā holoʻokoʻa inā pono.

Hoʻonui ka hapa nui o nā keiki ma 7 a 10 mau lā me ka lapaʻau. ʻO nā keiki i loaʻa nui i ka maʻi pneumonia me nā pilikia e pono ai i ka lāʻau no 2 a 3 mau pule. ʻO nā keiki e makaʻu nei i ka niumonia nui pū kekahi:

• ʻO nā keiki nona ka ʻōnaehana pale ʻole e holo pono
• ʻO nā keiki me ka maʻi puʻuwai a puʻuwai paha

I kekahi mau hihia, hiki i nā pilikia koʻikoʻi ke ulu aʻe, e like me:

• ʻO nā loli hoʻoweliweli i ke ola i nā māmā e pono ai kahi mīkini hanu (ventilator)
• Fluid a puni ka lung, a hiki ke lilo i maʻi
• Nā abscesses o ka lepa
• ʻO bacteria i ke koko (bacteremia)

E kauoha paha ka mea hāʻawi i kahi hona hou. E hōʻoia kēia i ka maopopo o ka māmā o kāu keiki. E hala paha i mau hebedoma no ka hoʻomaʻemaʻe o ka x-ray. E hauʻoli paha kāu keiki no kekahi manawa ma mua o ka maopopo ʻole o nā kukuna.

Kāhea i ka mea hāʻawi inā loaʻa kāu keiki i kēia mau ʻōuli:

• ʻŪhā maikaʻi ʻole
• Hanu paʻakikī (wheezing, grunting, wikiwiki hanu)
• ʻO ka luaʻi
• Loaʻa ka ʻai ʻole
• Fiva a me nā anuanu
• Nā hanu (hanu) nā ʻōuli e ʻoi aku ka maikaʻi
• ʻO ka ʻeha o ka umauma ke ʻoi aku ka maikaʻi ke ʻoka a hanu paha i loko
• Nā hōʻailona o ka niumonia a me kahi ʻōnaehana pale nāwaliwali (e like me HIV a chemotherapy)
• Nā hōʻailona hōʻino ma hope o ka hoʻomaka ʻana e maikaʻi

E aʻo i nā keiki makua e holoi pinepine i ko lākou mau lima:

• Ma mua o ka ʻai ʻana i ka meaʻai
• Ma hope o ka puhi ʻana i ko lākou ihu
• Ma hope o ka hele ʻana i ka lua
• Ma hope o ka pāʻani ʻana me nā hoaaloha
• Ma hope o ka launa ʻana me ka poʻe maʻi

Hiki ke kōkua i nā maʻi koʻokoʻo i ka pale ʻana i kekahi ʻano o ka pneumonia. E mālama pono i kāu keiki i ka lāʻau āpau me:

• Pākuʻi pneumococcal
• Puukū flu
• Pākuʻi Pertussis a me vacc vaccine

Ke ʻōpio loa nā pēpē a hiki i ka pale ʻana, hiki i nā mākua a i ʻole nā ​​mea mālama ke pale iā lākou iho i nā pale pale pale pale pale pale pneumonia.

Bronchopneumonia - keiki; Pulumonia i loaʻa i ke kaiāulu - keiki; CAP - keiki

• Pulumonia

Bradley JS, Byington CL, Shah SS, et al. Hōʻuluʻulu Manaʻo: ka mālama ʻana i ka pulumonia i loaʻa i ke kaiāulu i nā pēpē a me nā keiki i ʻoi aku ma mua o 3 mau makahiki o ka makahiki: nā kulekele hana lapaʻau e ka Pediatric Infectious Diseases Society of America Maʻi maʻi maʻi Dis. 2011; 53 (7): 617-630. PMID: 21890766 pubmed.ncbi.nlm.nih.gov/21890766/.

Kelly MS, Sandora TJ. Pulumonia i loaʻa i ke kaiāulu. 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 428.

ʻO Shah SS, ʻo Bradley JS. Loaʻa i ke kaiāulu Ponia keiki. I: Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ. ʻO Feigin lāua ʻo Cherry's Textbook of Pediatric Infectious Diseases. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 22.