Meconium aspiration chirwere

Meconium aspiration syndrome (MAS) inoreva matambudziko ekufema anogona kuve nemwana achangoberekwa kana:

• Iko hakuna zvimwe zvikonzero, uye
• Mwana apfuura meconium (chigaro) muamniotic fluid panguva yekusununguka kana yekusununguka

MAS inogona kuitika kana mwana achifemera mukati (aspirates) ichi chinoyerera mumapapu.

Meconium ndiyo chigaro chekutanga chakapfuudzwa nemucheche achangoberekwa, mwana asati atanga kufura nekugaya mukaka kana fomura.

Mune zvimwe zviitiko, mwana anopfuura meconium achiri mukati mechibereko. Izvi zvinogona kuitika kana vacheche "vaine kushushikana" nekuda kwekuderera kweropa neoksijeni. Izvi zvinowanzo kukonzerwa nematambudziko neiyo placenta kana umbilical tambo.

Kana mwana achinge apfuudza meconium kupinda amniotic fluid yakatenderedza, vanogona kuifemera mumapapu. Izvi zvinogona kuitika:

• Mwana achiri muchibereko
• Panguva yekusununguka
• Pakarepo mushure mekuzvarwa

Meconium inogona zvakare kuvharidzira nzira dzemucheche mushure mekuzvarwa. Zvinogona kukonzera matambudziko ekufema nekuda kwekuzvimba (kuzvimba) mumapapu emwana mushure mekuzvarwa.

Njodzi zvinhu zvinogona kukonzera kushushikana pamwana asati azvarwa zvinosanganisira:

• "Kukwegura" kwepacenta kana nhumbu ikaenda kure kupfuura nguva yakatarwa
• Yakaderedza okisijeni kumucheche achiri muchibereko
• Chirwere cheshuga muna amai vane nhumbu
• Kunetsa kuendesa kana refu basa
• Kuwedzera kweropa muamai vane nhumbu

Vazhinji vacheche vakapfuura meconium kupinda muamniotic fluid havaifeme mumapapu avo panguva yekusununguka nekusununguka. Ivo havakwanisi kuve nezviratidzo kana matambudziko.

Vacheche vanofema mune ino fluid vanogona kuwana zvinotevera:

• Bluish ganda ruvara (cyanosis) mumucheche
• Kushanda nesimba kufema (kufema zvine ruzha, kugunun'una, kushandisa mhasuru dzekufema, kufema nekukurumidza)
• Hapana kufema (kushaya kwekufema, kana kufema)
• Kukamhina pakuzvara

Asati aberekwa, iyo fetal monitor inogona kuratidza kunonoka kurova kwemoyo. Panguva yekusununguka kana pakuzvarwa, meconium inogona kuonekwa mune amniotic fluid uye pamucheche.

Mucheche angangoda rubatsiro nekufema kana kurova kwemoyo achangoberekwa. Vanogona kunge vaine yakaderera Apgar mamaki.

Boka rezvehutano rinoteerera chipfuva chemucheche ne stethoscope. Izvi zvinogona kuratidza kusanzwisisika kwekufema kurira, kunyanya kwakatetepa, kutinhira kurira.

Kuongororwa kweropa reropa kucharatidza:

• Yakaderera (acidic) ropa pH
• Yakaderera oxygen
• Yakawedzera carbon dioxide

X-ray yechipfuva inogona kuratidza nzvimbo dzakapetana kana dzakatsetseka mumapapu emucheche.

Chikwata chakakosha chekuchengetedza chinofanirwa kuve chiripo kana mwana achizvarwa kana zvisaririra zvemeconium zvikawanikwa muamniotic fluid. Izvi zvinoitika mune zvinopfuura gumi muzana zvemimba zvakajairika. Kana mwana ari kushanda uye achichema, hapana kurapwa kunodiwa.

Kana mwana asingashande uye achichema achangopona, timu icha:

• Warm uye chengetedza zvakajairwa tembiricha
• Dry uye kumutsa mwana

Kana mwana asiri kufema kana ane yakaderera kurova kwemoyo:

• Chikwata ichi chinobatsira mwana kufema achishandisa chifukidzo chemeso chakasungirirwa muhomwe iyo inoburitsa musanganiswa weoksijeni kufema mapapu emwana.
• Mucheche anogona kuiswa munzvimbo inochengeterwa vanochengeterwa vana kana chevacheche chevanotarisirwa zvakanyanya kuitira kuti anyatso tariswa.

Mimwe mishonga inogona kusanganisira:

• Mishonga inorwisa mabhakitiriya kurapa hutachiona hunogona kuitika.
• Muchina wekufema (ventilator) kana mwana asingakwanise kuzvifemera ega kana kuda huwandu hwakawanda hweoksijeni yakawedzera.
• Oxygen yekuchengetedza huwandu hweropa zvakajairika.
• Intravenous (IV) kudya kunovaka muviri - chikafu kuburikidza netsinga - kana matambudziko ekufema ari kutadzisa mwana kuti agone kudya nemuromo.
  
• Radiant kudziya kuchengetedza tembiricha yemuviri.
• Surfactant kubatsira mapapu kuchinjanisa oxygen. Izvi zvinongoshandiswa chete mune zvakakomba zviitiko.
• Nitric oxide (inonziwo NO, gasi inhaled) kubatsira kuyerera kweropa uye kuchinjana oksijeni mumapapu. Izvi zvinoshandiswa chete mumatambudziko akaoma.
• ECMO (extracorporeal membrane oxygenation) imhando yemoyo / yemapapu inopfuura. Inogona kushandiswa mumatambudziko akakomba.

Muzviitiko zvakawanda zvemeconium-yakasviba fluid, iwo maonero akanaka uye hapana hurefu-hurefu mhedzisiro.

• Ingangoita hafu yevana vacheche vane meconium-yakasviba fluid ichave nematambudziko ekufema uye ingangoita 5% ndiyo ichave neMAS.
• Vacheche vangangoda rutsigiro rwakawedzerwa nekufema uye chikafu mune dzimwe nguva. Ichi chinodiwa chinowanzoenda mumazuva maviri kusvika mana. Zvisinei, kufema nekukurumidza kunogona kuenderera kwemazuva akati wandei.
• MAS kashoma inotungamira mukukuvara kwemapapu zvachose.

MAS inogona kuonekwa pamwe nedambudziko rakakomba nekuyerera kweropa kuenda nekubva kumapapu. Izvi zvinonzi zvinoramba zvichidzvinyirira pulmonary hypertension yemwana achangozvarwa (PPHN).

Kuti udzivise matambudziko anotungamira kune meconium kuvepo, gara uine hutano panguva yekuzvitakura uye uteedzere rairo yako yemubatsiri wehutano.

Wako mupi achazoda kuve akagadzirira meconium kuvapo pakuzvarwa kana:

• Mvura yako yakatyoka kumba uye mvura yacho yainge yakajeka kana kusvibiswa nechinhu chine greenish kana shava.
• Chero kuyedzwa kunoitwa panguva yaunenge uine pamuviri kunoratidza kuti panogona kunge paine matambudziko aripo
• Fetal yekutarisa inoratidza chero zviratidzo zvekutambudzika kwemucheche.

MAS; Meconium pneumonitis (kuzvimba kwemapapu); Basa - meconium; Dhirivhari - meconium; Kuberekwa - meconium; Kuchengetwa achangoberekwa - meconium

• Meconium

Ahlfeld SK. Matambudziko ekufema. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chap 122.

Crowley MA. Neonatal mweya wekufema. Mune: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff naMartin's Neonatal-Perinatal Mushonga: Zvirwere zveMucheche neMucheche. 11th ed. Philadelphia, PA: Elsevier; 2020: chitsamba 66.

Wyckoff MH, Aziz K, Escobedo MB, uye al. Chikamu 13: Kumutsidzirwa kweNonatal: 2015 American Heart Association nongedzo yekumutsiridza ye cardiopulmonary kumutsidzira uye emergency emergency yemoyo kuchengetwa. Kutenderera. 2015; 132 (18 Suppl 2): ​​S543-S560. PMID: 26473001 pubmed.ncbi.nlm.nih.gov/26473001/.