Neonatal kufema kunetseka chirwere

Neonatal kufema kunetseka syndrome (RDS) idambudziko rinowanzoonekwa mumwana asati aberekwa. Mamiriro acho anoita kuti zviomere mwana kufema.

Neonatal RDS inoitika muvacheche mapapu avo asati anyatso kukura.

Chirwere ichi chinonyanya kukonzerwa nekushaikwa kwechinhu chinotsvedza mumapapu anonzi surfactant. Chinhu ichi chinobatsira mapapu kuzadza nemweya uye chinochengeta masaga emweya kubva mukukanganisa. Surfactant iripo kana mapapu akwana zvizere.

Neonatal RDS inogona zvakare kuve nekuda kwematambudziko echisikirwo nekukura kwemapapu.

Kazhinji zviitiko zveRDS zvinoitika muvacheche vanozvarwa pasati pavhiki makumi matatu nemakumi matatu nepfumbamwe. Izvo zvakanyanya mwana asati azvarwa, inowedzera mukana weRDS mushure mekuzvarwa. Dambudziko harina kujairika muvacheche vanozvarwa yakazara-nguva (mushure memasvondo makumi matatu nemasere).

Zvimwe zvinhu zvinogona kuwedzera njodzi yeRDS zvinosanganisira:

• Mukoma kana hanzvadzi vaive neRDS
• Chirwere cheshuga muna amai
• Kuendesa Kesarea kana kuiswa kwebasa mwana asati azara-nguva
• Zvinetso nekutakura zvinoderedza kuyerera kweropa kumwana
• Multiple nhumbu (mapatya kana kupfuura)
• Basa rinokurumidza

Kazhinji yenguva, zviratidzo zvinoonekwa mukati memaminitsi ekuberekwa. Nekudaro, ivo vangasaonekwa kwemaawa akati wandei. Zviratidzo zvinogona kusanganisira:

• Ruvara rweBluish rweganda uye mamukisi membranes (cyanosis)
• Mhedziso mira mukufema (apnea)
• Yakaderera weti kubuda
• Nasal flaring
• Kukurumidza kufema
• Kufema zvishoma
• Kupfupika kwemweya uye kugunun'una kurira uchifema
• Kufema kusinganzwisisike kufamba (sekukwevera kumashure kwepfupa mhasuru nekufema)

Iyi miedzo inotevera inoshandiswa kuona mamiriro acho.

• Ropa gasi ongororo - inoratidza yakaderera oxygen uye yakawandisa acid mumuviri mvura.
• Chest x-ray - inoratidza "girazi repasi" kuoneka kumapapu ayo akajairika chirwere. Izvi zvinowanzoitika maawa matanhatu kusvika gumi nemaviri mushure mekuzvarwa.
• Kuedzwa kweLab - kunobatsira kutonga hutachiona sechikonzero chekukanganisa kufema.

Vacheche vanokurumidza kana vane mamwe mamiriro ezvinhu anoita kuti vave panjodzi huru yedambudziko vanofanirwa kurapwa pakuberekwa neboka rezvechiremba rinotarisana nematambudziko ekufema achangozvarwa.

Vacheche vachapihwa oxygen inodziya, ine mwando. Nekudaro, kurapwa uku kunoda kutariswa zvakanyatso kudzivirira migumisiro kubva kune yakawanda oxygen.

Kupa zvakanyanya kumwe kurwara kumucheche anorwara kwakaratidzirwa kuve kunobatsira. Zvisinei, uyo anoshanda nesimba anounzwa akananga munzira yemwana, saka imwe njodzi inobatanidzwa. Kumwe kutsvagurudza kuchiri kuda kuitwa kuti vacheche vapihwe kurapwa uku uye kuti voshandisa marii.

Kubatsirwa kufefetedza nemhepo inofema (muchina wekufema) kunogona kuponesa hupenyu kune vamwe vacheche. Nekudaro, kushandiswa kwemuchina wekufema kunogona kukuvadza nyama yemapapu, saka kurapwa uku kunofanirwa kudzivirirwa kana zvichibvira. Vacheche vangangoda kurapwa uku kana vaine:

• Yakakwira mwero wekabhoni dhayokisaidhi muropa
• Yakaderera ropa oxygen
• Ropa rakaderera pH (acidity)
• Dzokororo inombomira mukufema

Mushonga unonzi kuramba uchifamba zvakanaka mweya (CPAP) unogona kudzivirira kudiwa kwekubatsira kufefetedza kana kushanda mumhepo mune vazhinji vacheche. CPAP inotumira mweya mumhino kuti ubatsire kuchengetedza nzira dzekuvhurika. Inogona kupihwa nemhepo inofema (apo mwana ari kufema zvakazvimiririra) kana nechero CPAP chishandiso.

Vacheche vane RDS vanoda kutarisirwa padyo. Izvi zvinosanganisira:

• Kuva nemamiriro akadzikama
• Kubata zvinyoro
• Kugara pakakodzera tembiricha yemuviri
• Kunyatsogadzirisa mvura uye chikafu
• Kurapa hutachiona ipapo ipapo

Mamiriro acho anowanzo kuwedzera mazuva maviri kana mana mushure mekuzvarwa uye anovandudzika zvishoma mushure meizvozvo. Vamwe vacheche vane chirwere chakakomba chekufema chirwere vanofa. Izvi zvinowanzoitika pakati pezuva 2 ne7.

Matambudziko enguva refu anogona kukura nekuda kwe:

• Okisijeni yakawandisa.
• Kumanikidza kwakanyanya kunoendeswa kumapapu.
• Humwe hwakanyanya hosha kana kusakura. RDS inogona kusanganiswa nekuzvimba kunokonzeresa kukuvara kwemapapu kana kwehuropi.
• Nguva apo uropi kana dzimwe nhengo dzisina kuwana oxygen yakakwana.

Mhepo kana gasi zvinogona kuvaka mukati:

• Iyo nzvimbo yakatenderedza mapapu (pneumothorax)
• Iyo nzvimbo mubhokisi pakati pemapapu maviri (pneumomediastinum)
• Iyo nharaunda iri pakati pemoyo nesaga rakatetepa rakakomberedza moyo (pneumopericardium)

Mimwe mamiriro akasanganisirwa neRDS kana kunyanyisa prematurity inogona kusanganisira:

• Kubuda ropa muuropi (intraventricular hemorrhage yemwana achangozvarwa)
• Kubuda ropa mumapapu (pulmonary hemorrhage; dzimwe nguva inosanganisirwa neanoshandisa surfactant)
• Matambudziko nekukura kwemapapu uye kukura (bronchopulmonary dysplasia)
• Kunonoka kukura kana kuremara kwepfungwa kwakabatana nekukuvara kwehuropi kana kubuda ropa
• Matambudziko nekuvandudza kwemaziso (retinopathy ye prematurity) uye kupofomara

Kazhinji yenguva, dambudziko iri rinokurumidza kubuda mushure mekuzvarwa mwana achiri muchipatara. Kana iwe wakasununguka pamba kana kunze kwenzvimbo yekurapa, tora rubatsiro rwechimbichimbi kana mwana wako aine matambudziko ekufema.

Kutora matanho ekudzivirira kuberekwa nguva isati yakwana kunogona kubatsira kudzivirira neonatal RDS. Kuchengetwa kwakanaka kwepamuviri uye kugara uchiongorora kutanga nekukurumidza apo mukadzi paanoona kuti ane pamuviri kunogona kubatsira kudzivirira kuzvarwa nguva isati yakwana.

Ngozi yeRDS inogona zvakare kudzikiswa nenguva yakakodzera yekuendesa. Iko kunounzwa kuendesa kana kuregedza kunogona kudikanwa. Kuongororwa kwebazi kunogona kuitwa usati wasununguka kuti utarise kugadzirira kwemapapu emwana. Kunze kwekunge pakurapa kuchidikanwa, kuendeswa kana kwekuregedzwa kunofanira kunonoka kusvika kwevhiki dzinosvika makumi matatu nepfumbamwe kana kusvika bvunzo dzichiratidza kuti mapapu emwana akura.

Mishonga inonzi corticosteroids inogona kubatsira kukurumidza kukura kwemapapu mwana asati azvarwa. Ivo vanowanzo kupihwa kuvakadzi vane nhumbu pakati pemasvondo makumi maviri nemana nemakumi matatu nemana ekuzvitakura avo vanoita kunge vangasununguke muvhiki rinotevera. Imwe tsvagurudzo inodikanwa kuti uone kana corticosteroids inogona zvakare kubatsira vana vacheche vari vadiki pane makumi maviri nemana kana anopfuura mavhiki makumi matatu nemana

Dzimwe nguva, zvinokwanisika kupa mimwe mishonga kunonotsa basa uye kuendesa kusvikira mushonga weSteroid uine nguva yekushanda. Uku kurapwa kunogona kudzikisira kuomarara kweRDS. Inogona zvakare kubatsira kudzivirira kumwe kunetseka kwekutanga prematurity. Nekudaro, hazvizobvisa zvachose njodzi.

Hyaline membrane chirwere (HMD); Mucheche kufema kunetseka chirwere; Kufema kushungurudzika chirwere muvacheche; RDS - vacheche

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