I-Stridor iwumsindo ohefuzelayo, ovame ukuba phezulu okhiqizwa ukugeleza komoya okusheshayo, okunyakazayo engxenyeni ewumngcingo yemigudu yomoya ephezulu. Okuvame ukukhuthaza, cishe njalo kuzwakala ngaphandle kwe-stethoscope. Ikhona ezinganeni, ingaba khona nakubantu abadala? Ziyini izimbangela? Futhi imiphumela? Indlela yokwelapha?

I-Stridor ingumsindo ongajwayelekile, ohefuzela, noma omncane okhanyayo ophuma ngokuphefumula. Imvamisa, inomsindo omkhulu ngokwanele ukuba uzwakale ukude nayo. Lokhu kuyisibonakaliso, hhayi ukuxilongwa, nokuthola izimbangela eziyisisekelo kubaluleke kakhulu njengoba i-stridor imvamisa iyisimo esiphuthumayo sezokwelapha. 

Ngomsuka we-laryngotracheal, i-stridor ibangelwa ukugeleza komoya okusheshayo, okunesiphithiphithi ngomgudu wokuphefumula oncishisiwe, noma ovinjwe kancane. Angaba:

• okusezingeni eliphezulu nomculo, eduze nengoma;
• okunzima, njengokukhala noma ukuhosha;
• ukuhoshoza ngohlobo olunezimpondo, njenge-croak.

I-Stridor ingaba:

• okukhuthazayo: kuzwakala ngokuphefumulelwa ngesikhathi sokuncipha kwe-pathological of the upper a-extra-thoracic airways (pharynx, epiglottis, larynx, extra-thoracic trachea);
• i-biphasic: uma kwenzeka ukuvinjelwa okukhulu, kuyi-biphasic, okusho ukuthi ikhona kuzo zombili izigaba zokuphefumula;
• noma ukuphefumula: lapho kwenzeka ukuvinjelwa okutholakala ezindleleni zomoya ze-intrathoracic, i-stridor ngokuvamile iyaphefumula.

I-Stridor ukubonakaliswa okuvamile ezinganeni zezifo zomgudu wokuphefumula. Isigameko saso asaziwa kubantu jikelele bezingane. Kodwa-ke, imvamisa ephakeme yabonwa kubafana.

Kumele kuqashelwe ukuthi yize kungavamile kakhulu, i-stridor nayo ikhona kubantu abadala.

Izingane zinemigwaqo yomoya emincane, emincane futhi zithambekele ekuphefumuleni okunomsindo. I-Stridor ibangelwa izifo ezibandakanya i-larynx ne-trachea. I-Wheezing ijwayelekile ye-bronchial pathology. Lapho ukuphefumula okunomsindo kwanda ngesikhathi sokulala, imbangela ise-oropharynx. Lapho ukuphefumula kunamandla kakhulu lapho ingane iphapheme, imbangela iku-larynx noma trachea.

Ezinganeni, izimbangela ezivame kakhulu zifaka izimbangela zokuzalwa kanye nezimbangela ezitholakele.

Izimbangela zokuzalwa ze-stridor ezinganeni

• I-Laryngomalacia, okusho ukuthi i-larynx ethambile: iyimbangela evame kakhulu ye-stridor yokuzalwa futhi imele ama-60 kuya kuma-70% ezinkinga zokuzalwa zelaryngeal;
• Ukukhubazeka kwezintambo zezwi;
• I-stenosis, okusho ukuthi i-subglottis encane, yokuzalwa;
• I-tracheomalacia, okungukuthi i-trachea ethambile futhi eguquguqukayo;
• I-hemangioma ye-subglottic;
• I-laryngeal web, okungukuthi ulwelwesi oluxhuma izintambo zombili zezwi ngenxa yokukhubazeka okuzelwe;
• I-diastema ye-laryngeal, okungukuthi ukukhubazeka okwenza i-larynx ixhumane nomgudu wokugaya ukudla.

Izimbangela ezitholiwe ze-stridor ezinganeni 

• Ukutholwa kwe-subglottic stenosis;
• I-Croup, okuwukuvuvukala kwe-trachea nezintambo zezwi, ngokuvamile okubangelwa ukutheleleka ngegciwane elithathelwanayo;
• Umzimba wangaphandle ohogelwe;
• I-laryngitis ekhazimulayo;
• I-Epiglottitis, ukutheleleka kwe-epiglottis okubangelwa amagciwane Uhlobo lwe-Hemophilus influenzae b (Hhawu). Isizathu esivamile se-stridor ezinganeni, ukwenzeka kwayo kwehlile kusukela kwethulwa umgomo wokugomela i-Haemophilus influenzae hlobo B;
• i-tracheitis, njll.

Izimbangela ezivamile kubantu abadala

• Izicubu zekhanda nezentamo, njengomdlavuza we-laryngeal, zingadala i-stridor uma zivimbela kancane imigwaqo yomoya engenhla;
• Ithumba;
• I-Edema, okusho ukuvuvukala, kwendlela ephezulu yokuphefumula engahle ivele ngenxa yokuqothuka;
• Ukungasebenzi kahle kwentambo yezwi, okubizwa nangokuthi i-paradoxical vocal cord movement;
• Ukukhubazeka kwezintambo zezwi, kulandela ukuhlinzwa noma ukufakwa intubation ikakhulukazi: lapho izintambo zombili zezwi zikhubazekile, isikhala esiphakathi kwazo sincane kakhulu futhi nezindlela zomoya azanele;
• Umzimba wangaphandle ohogelwayo ofana nenhlayiya yokudla noma amanzi amancane ahogelwe emaphashini okwenza ukuba umphimbo ungene;
• I-Epiglottitis;
• Ukusabela okweqile.

Izimbangela ze-stridor nazo zingahlukaniswa ngokwethoni yayo:

• Acute: laryngomalacia noma ukukhubazeka kwezintambo zezwi;
• Kunzima: i-laryngomalacia noma i-subglottic pathology;
• I-Hoarseness: i-laryngitis, i-stenosis noma i-subglottic noma i-angioma ephezulu ye-tracheal.

I-Stridor ingaqondana nemiphumela yokuphefumula noma yokudla, ehambisana nezimpawu zokuqina okufana nokuthi:

• ubunzima bokudla;
• iziqephu zokuphelelwa umoya ngesikhathi sokudla;
• ukukhula kancane kwesisindo;
• i-dyspnea, enzima ekuphefumuleni;
• iziqephu zokucindezeleka kokuphefumula;
• iziqephu ze-cyanosis (i-bluish yesikhumba nolwelwesi lwamafinyila);
• i-apnea yokulala evimbelayo;
• ukuqina kwezimpawu zomzabalazo wokuphefumula: ukubhakuzisa amaphiko ekhala, ukuhlehla kwe-intercostal kanye ne-suprasternal.
  

Ngaphambi kwanoma iyiphi i-stridor, ukuhlolwa kwe-ENT okwenza i-nasofibroscopy kufanele kuhlongozwa. I-biopsy, i-CT scan, ne-MRI nayo iyenziwa uma kusolwa isimila.

I-stridor ebangela ukuphefumula okuncane ngenkathi umuntu ephumule kuyisimo esiphuthumayo sezokwelapha. Ukuhlolwa kwezimpawu ezibalulekile nezinga lokucindezeleka kokuphefumula kuyisinyathelo sokuqala ekuphathweni. Kwezinye izimo, ukuvikela imigwaqo yomoya kungadingeka ngaphambi noma ngokuhlangana nokuhlolwa komtholampilo.

Izinketho zokwelashwa kwe-stridor ziyahlukahluka kuye ngokuthi imbangela yophawu.

Uma kwenzeka i-laryngomalacia

Ngaphandle kwenqubo yobucayi, noma uphawu oluhambisanayo, isikhathi sokubheka singahlongozwa, ngokuya ngokuqaliswa kokwelashwa kwe-anti-reflux (ama-antacid, ukujiya kobisi). Ukulandelela kufanele kube njalo ukuze kuqinisekiswe ukuhlehla kancane kancane kwezimpawu bese ziyanyamalala phakathi nesikhathi esilindelekile.

Izimpawu ze-laryngomalacia ngokuvamile zithambile futhi zihamba zodwa ngaphambi kweminyaka emibili. Kodwa-ke, cishe u-20% weziguli ezine-laryngomalacia zinezimpawu ezinzima (i-stridor eqinile, ubunzima bokudla, nokukhubazeka kokukhula) ezidinga ukwelashwa ngokuhlinzwa kwe-endoscopic (supraglottoplasty).

Uma kwenzeka kuba nomzimba wangaphandle ohogelwayo

Uma lo muntu engaphandle kwesibhedlela, omunye umuntu angakwazi, uma eqeqeshiwe, ukumsiza axoshe umzimba wangaphandle ngokwenza i-Heimlich maneuver.

Uma umuntu esesibhedlela noma egumbini labezimo eziphuthumayo, ithubhu lingafakwa ngamakhala omlomo noma ngomlomo (tracheal intubation) noma ngqo ku-trachea ngemuva kwesikhumba esincane sokuhlinzwa (i-tracheostomy), ukuvumela umoya ukuthi udlule kuleso sithiyo futhi uvimbele ukufuthwa.

Uma kwenzeka i-edema yomgudu wokuphefumula

I-adrenaline ne-dexamethasone ene-nebulized ingahle inconywe ezigulini okubandakanyeka kuzo i-airway edema.

Esimeni sokucindezeleka okukhulu kokuphefumula

Njengesilinganiso sesikhashana, ingxube ye-helium ne-oxygen (i-heliox) ithuthukisa ukujikeleza komoya futhi inciphisa i-stridor ezinkingeni ezinkulu zomoya njenge-post-extubation laryngeal edema, i-stridular laryngitis kanye nezimila ze-larynx. I-Heliox ivumela ukunciphisa ukugeleza kokugeleza ngenxa yobuningi obuphansi be-helium uma kuqhathaniswa nomoya-mpilo ne-nitrogen.