Bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) inguva refu (isingagumi) yemapapu mamiriro ayo anokanganisa vacheche vachangozvarwa vanozoiswa pamushini wekufema mushure mekuzvarwa kana kuti vakazvarwa mangwanani (nguva isati yakwana).

BPD inowanikwa mune vacheche vanorwara vacheche vakagamuchira yakakwira mwero weoksijeni kwenguva yakareba. BPD inogona zvakare kuitika kune vacheche vaive pamushini wekufema (ventilator).

BPD inowanzoitika kune vacheche vanozvarwa nekukurumidza (nguva isati yakwana), ane mapapu asina kunyatso kukura pakuzvarwa.

Njodzi zvinhu zvinosanganisira:

• Congenital chirwere chemoyo (dambudziko nemamiriro emoyo uye basa iro riripo pakuzvarwa)
• Prematurity, kazhinji muvacheche vanozvarwa mavhiki makumi matatu nemaviri asati abata
• Yakanyanya kufema kana chirwere chemapapu

Ngozi yeBPD yakaoma yakaderera mumakore apfuura.

Zviratidzo zvinogona kusanganisira chero zvinotevera:

• Ruvara rweganda rebhuruu (cyanosis)
• Kukosora
• Kukurumidza kufema
• Kufema kwekufema

Miedzo inogona kuitwa kubatsira kuongorora BPD inosanganisira:

• Arterial ropa gasi
• Chest CT scan
• Chest x-ray
• Pulse oximetry

MUCHipatara

Vacheche vane matambudziko ekufema vanowanzoiswa pamhepo. Uyu muchina wekufema uyo unotumira kumanikidza kumapapu emwana kuti arambe akafemerwa uye nekuendesa yakawanda oxygen. Sezvo mapapu emwana anokura, kumanikidza neoksijeni zvinodzikiswa zvishoma nezvishoma. Mwana akarumurwa kubva kumuchina wekufema. Mwana anogona kuramba achiwana oxygen nemask kana chubhu yemhino kwevhiki dzinoverengeka kana mwedzi.

Vacheche vane BPD vanowanzo kupihwa nemachubhu akaiswa mudumbu (NG chubhu). Ava vacheche vanoda mamwe macalorie nekuda kwekuedza kwekufema. Kuchengetedza mapapu avo kuti asazadzwe nefluidhi, kudya kwavo kwemvura kunogona kuda kuganhurirwa. Vanogona zvakare kupihwa mishonga (diuretics) inobvisa mvura kubva mumuviri. Mimwe mishonga inogona kusanganisira corticosteroids, bronchodilators, uye surfactant. Surfactant inotsvedza, sipo-senge chinhu mumapapu iyo inobatsira iyo mapapu kuzadza nemweya uye inochengetedza mweya masaga kubva pakuderera.

Vabereki vevacheche ava vanoda kutsigirwa mupfungwa. Izvi zvinodaro nekuti BPD inotora nguva kuti ive nani uye mucheche angangoda kugara muchipatara kwenguva yakareba.

KUMBA

Vacheche vane BPD vangangoda oxygen kurapwa kwevhiki kusvika kumwedzi mushure mekubva muchipatara. Tevedza rairo yemubatsiri wako wehutano kuti uve nechokwadi chekuti mwana wako anowana chikafu chakakwana panguva yekupora. Mwana wako anogona kuda chubhu feedings kana akakosha mafomula.

Zvakakosha kudzivirira mwana wako kuti asabatwe nezvikosoro nezvimwewo hutachiona, senge yekufema syncytial virus (RSV). RSV inogona kukonzera chirwere chakakomba chemapapu, kunyanya mumwana ane BPD.

Nzira yakapusa yekubatsira kudzivirira hutachiona hweRSV kugeza maoko ako kazhinji. Tevera matanho aya:

• Geza maoko ako nemvura inodziya nesipo usati wabata mwana wako. Udza vamwe kugeza maoko, zvakare, usati wabata mwana wako.
• Kumbira vamwe kuti vadzivise kusangana nemwana wako kana vaine dzihwa kana fivha, kana kuvakumbira kupfeka mask.
• Ziva kuti kutsvoda mwana wako kunogona kuparadzira RSV.
• Edza kuchengeta vana vadiki kure nemwana wako. RSV yakajairika pakati pevana vadiki uye inopararira zviri nyore kubva kumwana kuenda kumwana.
• USASVIRA mukati memba yako, mota, kana chero padhuze nemwana wako. Kuratidzwa kweutsi hwefodya kunowedzera njodzi yeRSV chirwere.

Vabereki vevacheche vane BPD vanofanirwa kudzivirira mapoka panguva yekumuka kweRVV. Kuputika kunowanzo kutaurwa nenhau dzemuno enhau.

Mupiki wemwana wako anogona kunyorera mushonga palivizumab (Synagis) kudzivirira hutachiona hweRSV mumwana wako. Tevedza rairo yekuti ungape sei mwana wako mushonga uyu.

Vacheche vane BPD vanova nani zvishoma nekufamba kwenguva. Oxygen therapy inogona kudiwa kwemwedzi yakawanda. Vamwe vacheche vane kukuvara kwemapapu kwenguva refu uye vanoda okisijeni uye rutsigiro rwekufema, senge nemhepo inofema. Vamwe vacheche vane chirwere ichi vanogona kusararama.

Vacheche vane BPD vari panjodzi huru yekudzokororwa kwekupemha hutachiona, senge pneumonia, bronchiolitis, uye RSV inoda kugara muchipatara.

Zvimwe zvinogona kuitika muvacheche vane BPD ndeizvi:

• Matambudziko ekuvandudza
• Kukura kwakashata
• Pulmonary hypertension (kuwedzerwa kweropa mumatsinga emapapu)
• Yenguva refu-refu yemapapu uye yekufema matambudziko senge scarring kana bronchiectasis

Kana mwana wako aine BPD, tarisa chero matambudziko ekufema. Fonera mupi wemwana wako kana iwe ukaona chero zviratidzo zvehutachiona hwekupemha.

Kubatsira kudzivirira BPD:

• Dzivirira kuendesa nguva isati yakwana pazvinogoneka. Kana iwe uri nepamuviri kana kufunga nezve kutora nhumbu, tora rubatsiro rwepamberi yekubatsira kuchengetedza iwe nemwana wako kugwinya.
• Kana mwana wako ari pakutsigira kufema, bvunza iye mupi kuti mwana wako anogona kurumurwa nekukurumidza sei kubva kumhepo inofema.
• Mwana wako anogona kugamuchira surfactant kuti abatsire kuchengeta mapapu akazaruka.

BPD; Chirwere chisingaperi chemapapu - vana; CLD - vana

Kamath-Rayne BD, Jobe AH. Fetal yemapapu kukura uye surfactant. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Sirivha RM, eds. Creasy uye Resnik's Maternal-Fetal Mushonga: Misimboti uye Dzidzira. 8th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 16.

McGrath-Morrow SA, Collaco JM. Bronchopulmonary dysplasia. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 20th ed. Philadelphia, PA: Elsevier; 2020: chitsama 444.

Roosevelt GE. Chiitiko chekufema kwevana: zvirwere zvemapapu. Mune: Masvingo RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts uye Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chits. 169.