Casharka 33aad

 Habdhiska Neefsashada iyo Xanuunnada ku dhaca. 

Casharka 33aad

Hafeefka laamahunguriga yaryar(bronchiolitis)

Waa hambaabuqa ku dhaca habdhiska neefsashada qeybta hoose, kaasoo saameeya ilmaha bil dhalladka ah iyo carruurta waa wayn, waxa uu yeelayaa hafeef iyo barar, iyo xirran ku yimaada marrinnada hawada kuwooda yar(laamo hunguriga cadka), badanaa waxa keenna cudur dhalliye (respiratory syncytial) waana midka ugu caansan keenna. 

Hafeefka laamahunguriga sidaan horrey u soo qeexnay waa caabuqa ku dhaca marrinnada yaryar ee hawomareenka (bronchioles). Waxa ugu badan ee keena waa fayraska Respiratory Syncytial Virus (RSV), laakiin fayrasyo kale sida Influenza iyo Parainfluenza ayaa sidoo kale sababi kara. Cabuqa wuxuu ka bilaabmaa markii fayrasku uu galo jirka iyada uu ka soo galayo sanka ama afka, kaddibna waxa uu gaarayaa sambabada, halkaas oo uu ku weeraro unugyada ku meegaaran laamo hungurigacadka. Unugyadaas waxa soo gaaraya dhaawac,  taasoo keeneysa falcellinnada difaaca jirka, iyadoo unugyada dhiigga cad cad ay u huleelayaan meesha uu dulinka  soo galay, taasoo keeneysa barar, xirrinka marrinnada hawadda.

 Hafeefka waxa uu keenayaa in marrinada hawada cidhiidhyoodaan, taasoo neefsashada ka dhigeysa mid adag. Waxaa aad loo soo saarayaa xab, xabkaasi waxa uu xidhayaa marrinnada hawo mareenka.  Hafeefka iyo xabka waxay ciriirinayaan awoodda samababada si loo kala beddelo ogsijiin iyo kaarboon laba ogsaydhka, taasoo keeneysa ogsijiinta heerka dhiigga in ay hoos u dhacdo.Si kastaba ha ahaatee, marka uu jirku ka adkaado fayraska, hafeefka wuu yaraadaa, xabkana waa uu idlaadaa, laanhungurida waxay ku noqonayaan si doodii hore.Si kastaba ha ahaatee, heerka xanuunka wuxuu ku xirnaan karaa da'da ilmaha iyo xaaladaha caafimaad ee hore, sida haddii ilmaha uu yahay mid aad u da'yar ama uu leeyahay dhibaatooyin caafimaad oo kale.

Hafeefka laamahunguriga waa caabuq ku dhaca sambabada, gaar ahaan carruurta yaryar ee ka yar laba sanno. Caabuqan badanaa waxaa keena fayruska loo yaqaan Respiratory Syncytial Virus (RSV), inkasta oo fayrusyo kale sida hargabka (flu), rhinovirus, iyo parainfluenza ay sidoo kale sababi karaan.Caabuqu wuxuu ka soo galaa sanka iyo afka, kadibna wuxuu ku faafaa marinnada hawada ee yaryar ee sambabada (bronchioles). Tani waxay keentaa barar iyo caabuq ku dhaca marinnadaas. Marinnada hawadu waxay ka buuxsamaan xab(mucus) iyo unugyo dhintay oo ka dhashay caabuqa, kuwaas oo xannibaya socodka hawada.

Xannibaaddan awgeed, hawada si dhib leh ayay uga soo gashaa ugana baxdaa sambabada. Tani waxay keentaa in hawadu ku xayirmato sambabada (overinflation), mararka qaarna qaybo ka mid ah sambabada ay isku dumaan ayaa iman karta (atelectasis). Ilmaha ayaa la kulmi kara neefsashada oo ku adkaata iyo heerka ogsajiinta dhiigga oo hooseeya sababtoo ah sambabadu si fiican uma shaqeyn karaan si ay ogsajiin ugu gudbiyaan dhiigga. Sababta oo ah ilmaha yaryar marinnadooda hawadu aad bay u yar yihiin, xaaladdan waxay si degdeg ah u noqon kartaa mid halis ah.

Calaamadaha Guud

1.Qufac joogto ah.

2. Neefsashada oo dhib ku noqota (Respiratory Distress):

3:Neefsashada oo aad u dhakhsaha badan (Tachypnea).

4:Caloosha iyo feeraha oo xoog u dhaqaaqaya marka ilmaha neefsanayo (Subcostal retractions).

5:Cod qallafsan oo laga maqlo sambabbada (Wheezing).

6. Qandho (Fever): Heer-kulka oo kordha.

7. Sanka isku caburma (Nasal Congestion): Sanka oo ciriiri noqda ama duuf badan yeesha.

8. Daal iyo Tamaryari (Fatigue): Ilmaha oo daalan ama hurdo badan.

9. Cunista oo yaraata (Poor Feeding): Ilmaha oo dhibsada ama diida cunto ama nuugista naaska.

Calaamadaha Halista Ah

1. Midabka maqaarka oo buluug isu beddela (Cyanosis): Ogsijiin yaraanta awgeed.

2.  Neef-qabad daran.

(Severe Dyspnea): 

3. Ilmo aan deggenayn (Restlessness): Ilmaha oo ka cabanaya raaxo-darro joogto ah.

4. Isbeddel maskaxeed: Ilmaha oo aan firfircooneyn, ama dhaq-dhaqaaq yar.

Baadhitaanka. 

1:Chest X-ray:  waxa laga baadhayaa haddii ay jirto wax caaalamad muujineyso oofwareen(pneumonia).

2:Blood tests: hubbinta dhiigga, waxa la hubinayaa heerka dhiigga unugyada cad, ayaa la xisaabinayaa, haddii ay kacsan yihiin waxay muujineysaa inuu jirro caabuq.

4:Viral testing. Ilmaha waxa laga qaadayaa muunad xab ah laga soo qadaya sanka hubbintaasi waxa lagu ogaanayaa fayruska keenna xanuunkan(swab ).

Daaweynta. 

1. Oxygen Therapy: waxa la siinayaa ogsijiin  si markaasi loo siyaadiyo ribanaanta ogsijiinta kiish haweedka,  si markaasi ogsijiinka gaaraya nuddaha u wanaagsanaado.

 

2:Hydration and Nutrition: waxa loo sameynayaa nafaqeyn haddii aanu afka waxba ka qaadaneyn,  ama haddii ay xaaladda bukaanka darran tahay waxa la siinayaa hoore xiddideed(IV FLUIDS), si markaasi la iskugu dheellitiro,  loogana hortago fuuq baxa.

3: Bronchodilators (albuterol ama nebulized epinephrine): waxay dabcinayaan murqaha hawo mareenka, si loo yareeyo isk caabinta hawo mareenka,  si  loo wanaajiyo qulqulka hawada.

4:Antipyretics ( acetaminophen, ibuprofen): waxa loo siinayaa si markaasi loo xakameeyo qandhada. Waxay xidhayaan faldajiyaha prostaglandin si markaasi loo yareeyo qandhada.

5:Antiviral Therapy: waxa la siinayaa lidiga dawooyinka fayruska,  iyadoo xidhaya  sameysanka borotiinka iyo taranka. Waxa ka mid ah:Ribavirin:

References:

1. Amboss: Management guidelines for bronchiolitis.

2. Medscape: Clinical approach to bronchiolitis in infants.

3. National Institute for Health and Care Excellence (NICE): Guideline NG9 on bronchiolitis in children.

4. American Academy of Pediatrics (AAP): Clinical Practice Guidelines for bronchiolitis.

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