Kudzokorora kwechirwere chekutanga

Retinopathy ye prematurity (ROP) ndeyekusajairika kweropa remidziyo kukura muziso reziso. Izvo zvinoitika muvacheche vanozvarwa nekukurumidza (nguva isati yakwana).

Tsinga dzeropa dzetina (kumashure kweziso) dzinotanga kukura ingaita mwedzi mitatu kuva nepamuviri. Muzviitiko zvakawanda, ivo vanogadzirirwa zvizere panguva yekuzvarwa kwese. Maziso anogona kutadza kukura zvakanaka kana mwana akazvarwa achiri mudiki kwazvo. Midziyo yacho inogona kumira kukura kana kukura zvisina kujairika kubva kuziso richienda kumashure kweziso. Nekuti midziyo iyi haina kusimba, inogona kudonha uye inokonzera kubuda ropa muziso.

Mavara matsvuku anogona kukura uye kudhonza iyo retina kusununguka kubva mukati memukati weziso (retinal detachment). Muzviitiko zvakakomba, izvi zvinogona kukonzera kurasikirwa kwemaonero.

Munguva yakapfuura, kushandiswa kweoxygen yakawandisa pakurapa vana vasati vasvika kwakakonzera kuti ngarava dzikure zvisina kujairika. Nzira dziri nani dzave kuwanikwa yekutarisa oxygen. Nekuda kweizvozvo, dambudziko rave kushoma, kunyanya munyika dzakabudirira. Nekudaro, kuchine kusava nechokwadi nezveyero chaiyo yeoksijeni kune vacheche vasati vasvika pazera rakasiyana. Vatsvagiri vari kudzidza zvimwe zvinhu kunze kweoksijeni zvinoita sekukanganisa njodzi yeROP.

Nhasi, njodzi yekuvandudza ROP inoenderana padanho re prematurity. Vacheche vacheche vane mamwe matambudziko ekurapa vari panjodzi huru.

Vanenge vese vacheche vanozvarwa vasati vasvika makumi matatu evhiki kana kuyera isingasviki mapaundi (1500 magiramu kana 1.5 makirogiramu) pakuzvarwa vanoongororwa mamiriro acho. Vamwe vana vane njodzi huru vanorema mapaundi matatu kusvika ku4,5 (1.5 kusvika 2 makirogiramu) kana vanozvarwa mushure memasvondo makumi matatu vanofanira kuongororwa.

Mukuwedzera kune prematurity, zvimwe zvinhu zvine njodzi zvinogona kusanganisira:

• Mhedziso mira mukufema (apnea)
• Chirwere chemoyo
• Yakakwira carbon dioxide (CO2) muropa
• Utachiona
• Yakaderera ropa acidity (pH)
• Yakaderera ropa oxygen
• Kufuridzira kutambudzika
• Inononoka kurova kwemoyo (bradycardia)
• Kuwedzerwa

Chiyero cheROP mune vakawanda vacheche vasati vasvika chakadzika zvakanyanya munyika dzakabudirira mumakumi mashoma emakore apfuura nekuda kwekuchengetwa kuri nani muchipatara chekubereka (NICU). Zvisinei, vamwe vacheche vanozvarwa mangwanani-ngwanani vava kukwanisa kurarama, uye vana vacheche vasati vasvika vari panjodzi yepamusoro yeROP.

Ropa reropa shanduko harigone kuonekwa neziso rakashama. Kuongororwa kweziso nachiremba wemaziso kunodiwa kuratidza matambudziko akadaro.

Pane matanho mashanu eROP:

• Chikamu I: Kune zvinyoro nyoro zvisina kujairika yeropa mudziyo kukura.
• Stage II: Ropa mudziyo kukura kuri zvine mwero zvisina kujairika.
• Chikamu chechitatu: Ropa mudziyo kukura kwakanyanya zvisina kujairika.
• Chikamu chechina IV: Ropa remidzi kukura rinosemesa zvakanyanya uye pane retina isina kudzikama.
• Chikamu V: Kune yakazara retinal detachment.

Mucheche ane ROP anogona zvakare kuverengerwa seane "kuwedzera chirwere" kana iyo isina kujairika mitsipa yeropa ichifananidza mifananidzo inoshandiswa kuongorora mamiriro acho.

Zviratidzo zveROP yakaoma zvinosanganisira:

• Kufambisa kwemaziso kusingaite
• Maziso akayambuka
• Kuona kwakanyanya kuona
• Vachena-vanotarisa vadzidzi (leukocoria)

Vacheche vanozvarwa mavhiki makumi matatu asati asvika, vanorema asingasviki 1,500 gramu (anenge mapaundi matatu kana 1.5 makirogiramu) pakuzvarwa, kana vane njodzi huru kune zvimwe zvikonzero vanofanirwa kunge vaine bvunzo dzemumaziso.

Kazhinji, bvunzo yekutanga inofanira kunge iri mukati memasvondo mana kusvika mapfumbamwe mushure mekuzvarwa, zvinoenderana nezera remwana rekubata.

• Vacheche vanozvarwa pamasvondo makumi maviri nemanomwe kana kuti anowanzozoita bvunzo yavo pamasvondo mana ekuberekwa.
• Vaya vanozvarwa pakutanga kazhinji vanozove nemabvunzo gare gare.

Yotevera-bvunzo bvunzo dzinovakirwa pamhedzisiro yekutanga bvunzo. Vacheche havade imwe bvunzo kana iyo tsinga dzeropa mune ese maviri maitina apedza zvakajairika kukura.

Vabereki vanofanira kuziva kuti ndeapi mabvunzo ezvekutevera anodiwa mwana asati abva kukireshi.

Kurapa kwekutanga kwakaratidzwa kunatsiridza mikana yemwana yekuona chaiko. Kurapa kunofanira kutanga mukati memaawa makumi maviri nemaviri ekubvunzwa kwemaziso.

Vamwe vacheche vane "plus chirwere" vanoda kurapwa nekukurumidza.

• Laser therapy (photocoagulation) inogona kushandiswa kudzivirira zvinetso zveROP yepamusoro.
• Iyo laser inomisa iyo isina kujairika mitsipa yeropa kubva mukukura.
• Mushonga wacho unogona kuitwa mureshi uchishandisa michina inotakurika. Kuti ishande nemazvo, inofanirwa kuitwa pamberi penzvimbo yeta inotanga kuvenga kana kutsauka kubva pane ziso rose.
• Mamwe marapirwo, sekubaya jekiseni rehutachiona rinovharira VEG-F (reropa rekukura chinhu) muziso, zvichiri kuongororwa.

Kuvhiya kunodiwa kana iyo retina ichidonha. Kuvhiya hakuwanzo kuguma nekuona kwakanaka.

Vazhinji vacheche vane zvakanyanya kuona kurasikirwa kwakabatana neROP vane mamwe matambudziko ane chekuita nekuzvarwa kwekutanga. Vachada marapirwo akasiyana siyana.

Vanenge mwana mumwe chete pagumi vacheche vane shanduko dzekutanga vanozoita chirwere chakakomba chemuviri. Yakakomba ROP inogona kutungamira kumatambudziko makuru ekuona kana hupofu. Chinhu chakakosha mumhedzisiro kuona kwekutanga uye kurapwa.

Zvinetso zvinogona kusanganisira kuona kwakanyanya kana kuona.

Nzira yakanakisa yekudzivirira iyi mamiriro kutora matanho ekudzivirira kuberekwa nguva isati yakwana. Kudzivirira mamwe matambudziko e prematurity kunogona zvakare kubatsira kudzivirira ROP.

Retrolental fibroplasia; ROP

Fierson WM; American Academy yePediatrics Chikamu pane Ophthalmology; American Academy yeOphthalmology; American Association yePediatric Ophthalmology uye Strabismus; American Association yeVanozivikanwa Vanachiremba. Kuongorora kuongorora kwevana vasati vasvika kwe retinopathy ye prematurity. Pediatrics. 2018; 142 (6): e20183061. Pediatrics. 2019; 143 (3): 2018-3810. PMID: 30824604 www.ncbi.nlm.nih.gov/pubmed/30824604.

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