Casharka 38aad

 Habdhiska Neefsashada iyo Xanuunnada ku dhaca. 

Casharka 38aad

Jilcanka hunguriga cadka (Tracheomalacia).

Waa xaalad ay jilceyso carjawda hunguriga cadka jilicsanaan iyo dabac, taasoo keeneysa in uu hawo mareenka isku dumo xilliga neefshada,  waxay keeneysaa neefsashada oo aadkaata, cod qallafsan oo laga maqlo sambabbada (Wheezing), soo laba noqoshada caabuqa hawo mareenka.

Caadiyan waxa la weynayaa qaabdhiska carjawda hunguriga cadka  ku giraansan, taasoo keeneysa isku dumida hawo mareenka xilliga neefsaarida ama inuu siyaado cadaadiskaas guddaha saableyda. Daciifsanaanta waxay ka dhallataa xaalad lagu dhasho, ama qofka uu xidhnaado hawo cusbooneysiinta( mechanical ventilation), ama hafeef muddo badan ka jirray hawo mareenka(chronic inflammation) ama cadaadis kaga yimaada dibada. Caadiyan  shaqada carjawda hunguri cadka waxay siisaa qofka adkaansho iyo isku dheellitirka marrinka hawadda xilliga neefshada. Sidaan horrey u soo sheegnay haddii carjawda hunguriga cadka dhibaato ay soo gaadho ama ay noqoto mid jilicsan waxay keeneysaa in ay isku dunto marrinka hawadda, gaar ahaan xilliga neef saarida, qufaca ama qofka marka uu ooyayo. Xaddiga isku dumida ama xirranka  marrinka hawadda waxay ku xidhan tahay darnaashaha xanuunka. Isku dunka marrinka hawadda waxa uu yareynaya qulqulka hawadda, isagoo sababaya adkaanshaha hawadda.

 

Waxaa loo qeybiyaa labo qeybood.

1:Qeyb lagu dhasho(Congenital Tracheomalacia).  Midi waxay la xidhiidhaa xilliga ilmaha in aanu si fiican u dhammeystirmin sameysanka carjawda hunguriga cadka.  Waxaa kaloo ay la xidhiidhaa  xaalado qaar  sida in aanu hunguriga si fiican u sameysmin,  taasina waa ay keeni kartaa. Waxaa kaloo keeni kara in hunguriga iyo hunguriga cadka ay si qaldan iskugu xirmaan(tracheoesophageal fistula).

2:Waxaa kaloo keenna xaalad aan lagu dhallan(Acquired Tracheomalacia). Taasoo ka timaado xaaladdo dibada kaga yimaada bukaanka. Sida inuu qofka qaato waqti dheer mishiinka hawo cusbooneysiinta ( endotracheal intubation) taasoo dhaawaceysa carjawda hunguriga cadka.  Qofka oo muddo dheer qaba xanuunka gaaska. Waxaa kaloo keeni kara  jug ama cadaadis xooggan oo fuula hunguriga. Hafeefka muddada dheer soo jiitama( soo laba noqoshada caabuqa habdhiska neefsashada,  iyo hafeefka hunguriga cadka)  waxay keenayaan barar kaasoo burburinaya nud gudeedka carjawda(matrix) hafeefkaasi waxa uu luminayaa qaabdhiska carjawda.

Waxaa kaloo keeni kara qaliinnada qaar sida qaliinka lagu saxo ama hawadda lagu gaarsiiyo samababada,  kaddib marka loo sameeyo ayay xaaladdan isku dunka hawo mareenka keentaa(Post-Tracheostomy), qaalinkaasi waxa uu toos u dhaawacayaa carjawda hunguriga cadka,  taasoo keeneysa isbeddel ku yimaada qaabdhiska. Ugu dambeyn waxay abuureysaa  nabar taasoo cadaadis saareysa hawo mareenka xilliga neefsaarida.

 Calaamadaha. 

1:Neefsasho buuq oo kale ah gaar ahaan xilliga qofka neefta uu soo saarayo. Badanaa waxay  korodhaa xilliga qofka ooynayo, cabsanayo,wax quudanayo, ama uu dhacdiid u jiifanayo.

2:Qufac waqti dheer soo jiitima, kaasoo adag.

3:Neefsashada oo adkaata,  xilliga qofka uu sameynaayo jimicsiga ama uu jirro caabuq.

4:Waxaa la maqlayaa cod qallafsan(Wheezing) mararka qaar waxa lagu qaldaa xanuunka xiiqda(asthma).

5:Caabuq soo laba noqda(Frequent Lung Infections) sida oofwareen, ama hafeefka hunguriga cadka, taasoo ugu wacan xabka oo ka buuxsamaha sambabbada. 

5:Maqaarka iyo dibnaha oo noqda buluug, haddii ay xaaladda bukaanka darran tahay waxa hoos u dhacaya ogsijiinta, taas ugu wacan inuu maqaarka isbeddelo.

6:Liqida oo adkaata( difficult swallowing).

Baadhitaanka. 

1:Hubbinta ( Flexible Bronchoscopy (Gold Standard),  Waa tuubo kaamiro ah laga galinayo qofka, gaar ahaan marrinka hawadda. Waxa lagu arkayaa isku dunka hawo mareenka,  ama inuu xidhan yahay hawo mareenka iyo sababaha keenay. Waana baadhitaanka ugu muhiimsan ee loo isticmaalo.

2:Baadhitaanka kale ee loo isticmaalo

(CT Scan or MRI (Dynamic CT/MRI), waxa uu inna siinayaa baadhitaankan  war bixin dheeraad ah lagu ogaanayo marrinka hawadda, kaasoo innaga caawinaya haddii uu jirro dhaawac ama cadaadis fuulay, ama ay jiraan burooyin meesha cidhiidhyeeyay.

3:Waxaa loo isticmaalayaa baadhitaanka kale gaar ahaan carruurta (Fluoroscopy (Real-time X-ray Video) waxay inna tusinaysaa hunguriga cadka. Haddii aan ilmahaa la galin karin baadhitaanka(bronchoscopy)  loo isticmaalo baadhinkan.

4:Waxaa la hubbinayaa shaqada neefsashada (Pulmonary Function Test), waxa la cabirayaa heerka shaqada samababbada.  Haddii uu jirro xirranka marrinka hawadda.

Daaweynta. 

1. Waxa la siinayaa dawooyinka kala bixiya marrinka hawadda( Bronchodilators). Sida 

Beta-2 Agonists (e.g., Albuterol) dawooyinkan waxay kala bixinayaan ama dabcinayaan murqaha ku meegaaran marrinka hawadda, kuwaasoo keenaya kala baxa laamahunguriga,  si markaasi marrinka hawadda u wanaagsanaato.

 

2. Dawooyinka waxay hoos u dhigayaan soo daynta xabka marrinka hawadda(Anticholinergic Agents), waxa ka mid ah Ipratropium Bromide, dawooyinkan waxay hoos u dhigayaan soo daynta dheecaanka marrinka hawadda, si markaasi marrinka hawadda uga baaqsado ciriirsanka,  waxay innaga caawinaysaa isku dheellitirnaanta marrinka hawadda.

3: Mucolytics: dawooyinkan waxay sarre u qaadayaan nadiifinta xabka, waxay carinayaan difaacaha kiish haweedka, waxa uu yareynayaa isku dhagdhaga xabka darbiyada hunguriga cadka.  Waxay dawooyinkan qummaneynayaan in xabka ay ka nadiifiyaan marrinka hawadda. Kana hortagaan xirranka hawo mareenka.

4:Lidiga dawooyinka hafeefka(Anti-Inflammatory Agents), waxay hoos u dhigayaan  hafeefka iyo bararka marrinka hawadda.  Dawooyinka waxa ka mid ah corticosteroids(inhaled),  waana in laga taxaddaraa dawooyinkan in waqti dheer la qaato.

5:Waxaa loo sameynayaa qaliinno kala duwan hadba ka ay baahida qofka ku jirto(Aortopexy) qaliinkan waxa laga soo riixayaa garka wadnaha, isagoo laga soo fogeynaya marrinka hawadda, isagoo lagu dhajinayo lafta horaadka. Si  markaasi loo yareeyo cadaadiska hunguriga cadka soo fuulaya. Badanaa waxa loo sameeyaa carruurta ay neefsashada ku adag tahay.

6:Tracheopexy. Qaliinkan waxa la isku xidhayaa qeyb ka mid ah hunguriga cadka meesh u dhow, sida lafta horaadada ama  seedah kore ee winiinta(spine), waxay ilaalineysaa hunguriga cadka iyadoo ka hortageysaa isku dunka hawo mareenka.

7:Tracheostomy qaliinkan  waa tubbo la dhigayo hunguriga cadka taas qofka ka caawineysa neefsashada. 

8: Jeermis dilaha ma ahan wax si joogto loo isticmaalayo ilaa haddii uu jirro caabuq.  Waxay ku xidhan tahay baadhitaanka loo sameeyo bukaanka haddii laga helo caabuqa. Haddii caabuqa uu yahay mid dhex dhexaad ah waxa la siinayaa Amoxicillin-Clavulanate, Azithromycin, ama Cefuroxime. Haddii uu darran yahay caabuqa waxa la siinayaa Piperacillin-Tazobactam, ama Vancomycin .

Tixraaca. 

1. "Pediatric Otolaryngology" by Bluestone and Simons – Covers surgical management of congenital tracheomalacia.

2. "Sabiston Textbook of Surgery" (Current Edition) – Discusses surgical options for airway disorders.

3. Mayo Clinic & Cleveland Clinic – Provide guidelines on surgical interventions for airway collapse.

4. Amboss & Medscape – Online medical resources with updated treatment recommendations for tracheomalacia.

5. "Cummings Otolaryngology: Head and Neck Surgery" – Covers surgical techniques, including tracheopexy and tracheostomy.

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