Stridor yog lub suab nrov, feem ntau yog lub suab nrov ua los ntawm kev nrawm, muaj dej ntws ntws los ntawm qhov nqaim nqaim ntawm cov hlab cua sab saud. Feem ntau qhov kev tshoov siab, nws yuav luag ib txwm hnov ​​tsis muaj lub tshuab raj. Tam sim no hauv menyuam yaus, nws puas tuaj yeem muaj nyob hauv cov neeg laus? Dab tsi ua rau? Thiab qhov tshwm sim? Yuav kho nws li cas?

Stridor yog ib qho txawv txav, ua tsis taus pa, ntau dua lossis tsawg dua suab nrov nrov tawm los ntawm kev ua pa. Feem ntau, nws nrov txaus kom hnov ​​los ntawm qhov deb. Nov yog cov tsos mob, tsis yog kuaj mob, thiab nrhiav qhov laj thawj yog qhov tseem ceeb heev vim tias stridor feem ntau yog kev kho mob xwm txheej ceev. 

Los ntawm laryngotracheal keeb kwm, stridor yog tshwm sim los ntawm kev nrawm nrawm, muaj dej ntws ntws los ntawm qhov nqaim, lossis ib nrab cuam tshuam, ua pa sab hauv. Nws tuaj yeem yog:

• suab nrov thiab suab paj nruag, ze rau zaj nkauj;
• mob hnyav, xws li hnoos lossis txham;
• qias neeg nrog hom horny, zoo li tus nkhaus.

Stridor tuaj yeem yog:

• kev tshoov siab: nws yog lub suab hnov ​​ntawm kev tshoov siab thaum lub sijhawm kab mob nqaim ntawm txoj kab nruab nrab ntawm txoj hlab ntsws sab saud sab saud (pharynx, epiglottis, larynx, sab hauv thoracic trachea);
• biphasic: thaum muaj teeb meem loj, nws yog biphasic, uas yog hais tam sim no ntawm ob theem ntawm kev ua pa;
• lossis kev tuag: thaum muaj kev cuam tshuam nyob rau hauv cov hlab cua hauv plab, stridor feem ntau yog kev tuag.

Stridor yog qhov tshwm sim tshwm sim hauv cov menyuam yaus ntawm cov kab mob ntawm txoj hlab ua pa. Nws qhov xwm txheej tsis paub nyob hauv cov pej xeem menyuam yaus. Txawm li cas los xij, tau pom ntau zaus hauv cov tub hluas.

Nws yuav tsum raug sau tseg tias txawm hais tias nws tsis tshua muaj tshwm sim ntau, stridor kuj tseem muaj nyob hauv cov neeg laus.

Cov menyuam yaus muaj cov pa me me, nqaim thiab nquag ua pa nrov nrov. Stridor yog tshwm sim los ntawm cov kab mob cuam tshuam nrog lub ntsws thiab lub ntsws. Kev hnoos qeev yog ib yam ntawm cov kab mob ntsws ntsws. Thaum ua pa nrov nrov tau nce ntxiv thaum pw tsaug zog, qhov ua rau hauv oropharynx. Thaum ua pa nrov dua thaum tus menyuam tsaug zog, qhov ua rau hauv lub ntsws lossis lub ntsws.

Hauv cov menyuam yaus, qhov ua rau tshwm sim feem ntau suav nrog ua rau menyuam hauv plab thiab ua rau muaj mob.

Congenital ua rau ntawm stridor hauv cov menyuam

• Laryngomalacia, uas yog hais txog lub suab nrov mos mos: nws yog qhov ua rau muaj menyuam yaus ntau tshaj plaws thiab sawv cev rau 60 txog 70% ntawm cov menyuam uas muaj menyuam tsis taus;
• Kev tuag tes tuag taw ntawm cov suab nrov;
• Stenosis, uas yog hais kom nqaim, congenital subglottis;
• Ib qho tracheomalacia, uas yog hais txog cov mos mos thiab hloov pauv tau;
• Subglottic hemangioma;
• Lub laryngeal lub vev xaib, uas yog hais txog daim nyias nyias txuas ob lub suab hu nkauj vim yog qhov tsis zoo ntawm lub cev;
• Laryngeal diastema, uas yog hais txog qhov ua tsis raug uas ua rau lub suab nrov sib txuas lus nrog txoj hnyuv.

Tau txais qhov ua rau ntawm stridor hauv menyuam yaus 

• Tau txais subglottic stenosis;
• Croup, uas yog mob ntawm cov hlab ntsws thiab cov suab nrov, feem ntau tshwm sim los ntawm kev kis kab mob sib kis;
• Lub cev nqus tau lwm lub cev;
• Mob ntsws laryngitis;
• Epiglottitis, uas yog kis mob ntawm epiglottis los ntawm cov kab mob Haemophilus influenzae hom b (Sib). Feem ntau ua rau stridor hauv menyuam yaus, nws qhov xwm txheej tau poob qis txij li qhia txog kev txhaj tshuaj tiv thaiv Haemophilus influenzae hom B;
• tracheitis, thiab lwm yam.

Feem ntau ua rau cov neeg laus

• Cov qog ntawm lub taub hau thiab caj dab, xws li mob qog noj ntshav, tuaj yeem ua rau stridor yog tias lawv cuam tshuam ib nrab ntawm txoj hlab pa;
• Ib ntus;
• Edema, piv txwv li o, ntawm txoj hlab ua pa sab saud uas tuaj yeem tshwm sim los ntawm kev nthuav tawm;
• Lub suab tsis ua haujlwm, tseem hu ua kev sib txuas lus suab tsis sib xws;
• Kev tuag tes tuag taw ntawm cov suab nrov, tom qab phais lossis tso dej tshwj xeeb: thaum ob lub suab hu nkauj tuag tes tuag taw, qhov chaw nruab nrab ntawm lawv yog nqaim heev thiab txoj kev ua pa tsis txaus;
• Ib qho nqus tau lub cev txawv teb chaws xws li cov khoom noj me me lossis dej me ntsis nqus mus rau hauv lub ntsws ua rau lub suab nrov sib cog lus;
• Epiglottitis;
• Kev ua xua tsis haum.

Qhov ua rau ntawm stridor tseem tuaj yeem raug cais raws li nws lub suab:

• Mob: laryngomalacia lossis tuag tes tuag taw ntawm cov suab nrov;
• Loj: laryngomalacia lossis subglottic pathology;
• Hnov: laryngitis, stenosis lossis subglottic lossis siab tracheal angioma.

Stridor tuaj yeem ua ke nrog kev ua pa lossis cov zaub mov cuam tshuam, nrog rau cov cim ntawm qhov hnyav xws li:

• nyuaj hauv kev noj zaub mov;
• ntu ntawm kev nqus pa thaum pub mis;
• retarded hnyav kev loj hlob;
• dyspnea, uas ua pa nyuaj;
• ntu ntawm kev ua pa nyuaj siab;
• ntu ntawm cyanosis (muaj xim daj ntawm cov tawv nqaij thiab cov hnoos qeev);
• obstructive pw tsaug zog apnea;
• qhov hnyav ntawm cov cim ntawm kev ua pa nyuaj: flapping ntawm tis ntawm lub qhov ntswg, intercostal thiab suprasternal retraction.
  

Ua ntej txhua tus stridor, kev kuaj ENT nrog ua qhov nasofibroscopy yuav tsum tau thov. Kev kuaj ntshav, kuaj CT, thiab MRI tseem ua tiav yog tias xav tias muaj qog.

Stridor ua rau ua tsis taus pa thaum tus neeg so yog qhov xwm txheej kho mob. Kev tshuaj xyuas cov cim tseem ceeb thiab qib kev ua pa nyuaj yog thawj kauj ruam hauv kev tswj hwm. Qee qhov xwm txheej, kev nyab xeeb ntawm cov pa yuav tsum tau ua ntej lossis ua ke nrog kev kuaj mob.

Cov kev kho mob rau stridor sib txawv nyob ntawm qhov ua rau muaj tsos mob.

Nyob rau hauv cov ntaub ntawv ntawm laryngomalacia

Tsis muaj cov txheej txheem ntawm kev mob hnyav, lossis tsis muaj tsos mob tshwm sim, lub sijhawm soj ntsuam tuaj yeem thov, raug rau kev ua raws li kev tiv thaiv kev rov ua dua tshiab (antacids, ua kom cov mis tuab). Kev rov qab taug qab yuav tsum yog ib txwm txhawm rau txhawm rau txhawm rau maj mam rov thim rov qab ntawm cov tsos mob thiab tom qab ntawd lawv ploj mus nyob rau lub sijhawm kwv yees.

Cov tsos mob ntawm laryngomalacia feem ntau me me thiab ploj mus ntawm lawv tus kheej ua ntej hnub nyoog ob xyoos. Txawm li cas los xij, yuav luag 20% ​​ntawm cov neeg mob nrog laryngomalacia muaj cov tsos mob hnyav (mob hnyav stridor, pub zaub mov nyuaj, thiab kev loj hlob qeeb) xav tau kev kho mob nrog kev phais endoscopic (supraglottoplasty).

Thaum muaj qhov nqus tau lub cev txawv teb chaws

Yog tias tus neeg nyob sab nraum tsev kho mob, lwm tus neeg tuaj yeem, yog tias tau kawm, pab lawv tshem tawm lub cev txawv teb chaws los ntawm kev ua Heimlich maneuver.

Yog tias tus neeg nyob hauv tsev kho mob lossis chav kho mob xwm txheej ceev, lub raj tuaj yeem tso los ntawm tus neeg lub qhov ntswg lossis lub qhov ncauj (tracheal intubation) lossis ncaj qha mus rau hauv lub ntsws tom qab kev phais me me (tracheostomy), kom huab cua hla dhau qhov teeb meem thiab tiv thaiv ua pa.

Yog tias edema ntawm txoj hlab ntsws

Nebulized racemic adrenaline thiab dexamethasone tuaj yeem pom zoo rau cov neeg mob uas muaj kev ua pa ntawm lub ntsws.

Yog muaj teeb meem ua pa hnyav

Raws li kev ntsuas ib ntus, kev sib xyaw ntawm helium thiab oxygen (heliox) txhim kho huab cua ncig thiab txo qis stridor hauv cov hlab ntsha loj xws li mob qog noj ntshav tom qab kis kab mob, mob qog noj ntshav thiab mob qog noj ntshav. Heliox tso cai txo qis kev ntws vim yog qhov qis dua ntawm helium piv rau cov pa thiab nitrogen.